Background: Uncorrected-refractive-error (URE) is the leading cause of global visionimpairment (VI); 122.5 million people are estimated VI from URE. NETRA is a $30USD clip-on application for smartphones.

Purpose: To validate the NETRA as an alternative to subjective refraction for potential use in resource-poor countries.

Methods: NETRA uses a pinhole mask attached to a smartphone displaying a spatially resolved pattern to the subject. Refractive error is estimated by the patient subjectively aligning patterns by a touchscreen interface on the smartphone. NETRA was compared to subjective refraction in 34 eyes.

Results: The mean Subjective Spherical Equivalent (SSE) was -0.65D (std 2.79, 95%CI ±0.97) Two-sided T-test showed that mean SSE is not statistically significantly different (two sided t-test; t=1.6742 p=0.1036, 95% CI±0.29) from the mean NETRA Spherical Equivalent (NSE) .  Mean difference of Spherical Equivalents (NSE – SSE) was 0.24D (Std 0.84, 95%CI ±0.29). And NETRA produced a mean VA improvement of 0.44LogMAR (Std 0.52, 95%CI±0.18), or four Snellen lines.

Conclusion:In settings where access to a trained refractionist is not possible, NETRA has the potential to estimate refractive error closely enough to render an individual no longer VI from URE. NETRA is potentially a cost-effective tool in meeting the VISION2020 goals to eradicate avoidable blindness and warrants further testing in resource-poor settings.

Purpose: To examine scientific evidence on the effectiveness of mobile phone technology in Diabetes Mellitus (DM) care management.

Methods: A systematic review was conducted through literature searches from three electronic databases and was restricted to English-language articles published between January 2002 and March 2012. Studies that used mobile phone intervention and reported changes in diet, physical activity, and blood glucose and /or glycosylated hemoglobin (HbA1c) levels were retrieved. A meta-analysis was conducted for studies with HbA1c measures.

Results: More than 50 articles were screened. Of them, 15 met the review criteria. Of the 15, study sample sizes ranged from 12 to 130 participants aged 8 to 70 years old. Duration of intervention ranged from 1 to 12 months. Overall, significant improvements were observed in blood glucose and/or HbA1c concentration, adherence to medication, healthy lifestyle, and self-efficacy. Twelve of 15 trials, which had serum HbA1c measures, showed an average 0.39% (95%CI: -0.067, -0.721) HbA1c reduction from studies with pre- to post-tests (p=0.018).

Conclusion: Findings from the study provide the evidence that health reminders, disease monitoring and management, and education through mobile phone technology may significantly help improve glycaemic control patients with DM.

Background: Many adolescent mothers experience significant challenges in regulating emotions due to adverse life experiences, which can place adolescent mothers and their children at risk for poor developmental outcomes.  Ambulatory monitoring of stress that also provides immediate feedback using wearable biosensors has the potential to enhance clinician-delivered parenting interventions and help young mothers develop emotion regulatory skills.

Methods: We conducted a pilot study to assess the acceptability, ease of use, and preliminary efficacy of a wearable biosensor, the iCalm sensor band, among a sample of four mothers, ages 15-18 years.  Mothers wore the biosensor for a period of 24-36 hours while engaging in normal, daily tasks (e.g. caring for their child, attending school).  Both quantitative electrodermal activity (EDA) data (via the iCalm sensor band) and qualitative data (via individual semi-structured interviews) were collected.

Results: The adolescent mothers were able to comfortably use and wear the iCalm sensor band.  EDA data were collected and corresponded with stressful daily life events described by the mothers during qualitative interviews.

Conclusion: The iCalm biosensor is acceptable to use among high-risk adolescent mothers and appears to help mothers with the development of emotion regulatory skills.

Background: The successful integration of mobile information technology (IT) and existing health information technology (HIT) requires a critical evaluation of factors that may impede implementation and end-user perceptions of new technology.

Purpose: Using a mixed-method approach researchers interviewed and issued questionnaires to a family medicine faculty and residents to ascertain: 1) usability of iPad features and functions in a practice setting, and 2) perceptions of barriers to and support for implementation of HIT in a clinical setting.

Methods: Two faculty physicians and one resident were interviewed to discuss the HIT infrastructure for the clinical site, as well as attitudes and preferences about iPad usability. Qualitative data was transcribed and analyzed. Resident and faculty physicians (n=42) from a family medicine residency completed an American Medical Association survey on HIT readiness. Descriptive and non-parametric statistics were tabulated.

Results: Both interview and survey participants reported individual readiness for HIT adoption, while listing environmental barriers. Interview participants also described physical and software features of the iPad they would find useful in practice. Survey respondents reported clinical staff readiness as a strength for adoption of HIT.

Conclusion: Participants reported readiness to integrate HIT into clinical practice and have a clear idea of useful device features. HIT adoption may be hampered by environmental factors, and future research should focus in this area.

Background: Eye screening programs have been effective in reducing the burden of eye diseases in the developing world.  Most use paper recording systems which are prone to misplacement and are inefficient for auditing purposes.  Digital data collection via mobile devices may prove more efficient, but reliable strategies information sharing between devices in rural settings remain an issue. This paper examines the speed and range of use of Mobile Tethering technology to synchronize data across devices, and hence the suitability of such devices in the eye screening setting.

Methods: The data synchronization feature of eyePatients software for iPhone and iPad was tested using an Apple iPhone 4 as the central router, with Mobile Tethering activated. Apple iPad 2 devices were connected to the wireless local area networks (WiFi) generated by the iPhone 4. The linear range of data synchronization and the effect of corners and barriers on synchronization were tested.

Results: Synchronization was rapid, taking between 1.0-1.5 seconds to complete when linear distance was within 30 meters.  Beyond 34 meters considerable slowing was noted and no successful connections were able to be established beyond 40 meters. A single corner had no statistically significant effect on the maximum range of a single tether connection, but two corners or a door barrier had a small but statistically significant reduction on range.

Conclusion: Mobile Tethering provides a reliable and fast connection between multiple devices that can be used for the synchronization of large amounts of data required for eye screening purposes.