Background: Atrial fibrillation (AF) confers high risk of stroke, but often goes undiagnosed due to difficulties in its diagnosis. AF detection is important in post-stroke populations for secondary prevention and smartwatches have emerged as a promising modality for detecting AF, but little is known about their use in older adults who have experienced a stroke. Methods: This dissertation uses data from the Pulsewatch study, a two-phased trial assessing accuracy, usability, and adherence of smartwatch-based AF detection among older patients after stroke. Analyses performed include: descriptive statistics, linear and logistic regressions, qualitative and mixed-methods analyses, mixed effects modeling, and group-based trajectory modeling. Results: The Pulsewatch system was 91% accurate in detecting AF compared to a clinical gold-standard. Participants found the system easy to use, but indicated that streamlining the smartwatch’s functionalities to focus on passive cardiac monitoring is crucial. Improving battery life to allow for longer wear time would alleviate anxiety in some participants. Participants with previous experience using cardiac rhythm monitors rated the system lower on usability, but overwhelmingly preferred it to previous monitors due to the watch’s comfort, appearance, and convenience. Watch wear decreased over time, and we observed three distinct patterns of decline. No individual-level characteristics were associated with usability or adherence to watch wear. Conclusions: Smartwatches are promising for AF detection in older adults after stroke, though while they offer high accuracy and usability, adherence to wear is low. Strategies to encourage extended watch wear are necessary to realize the potential of smartwatches as a viable cardiac monitoring modality.

Smartwatches are becoming more and more independent from smartphones, with thousands of applications available to smartwatch users. Some businesses already included smartwatches in their marketing initiatives, and it is only a matter of time until advertisers expand to the smartwatch users´ screens. Smartwatches have been called the most personal devices ever and therefore consumer attitudes are a crucial aspect in the adoption of location-based advertisements. This study investigated smartwatch users´ attitudes towards location-based advertising on smartwatches along with the factors that influence these attitudes by employing a research through design approach. Through semi-structured interviews, focus groups and prototypes of pull and push location-based advertisements on smartwatches, it was possible to discover how smartwatch users perceive location-based advertisements on smartwatches. The result of this study is that smartwatch users are open to receive location-based advertisements on their smartwatches, however their attitudes will be affected by the following factors: relevancy, personalization, informativeness, privacy concerns, context (location, frequency, timing), perceived ease of use and attitude towards advertising in general. Factors such as timing and frequency do not apply to pull location-based advertisements. Relevance is the most important factor and includes the element of control, meaning that smartwatch users can provide feedback on the specific advertisement on their smartwatch. The prototypes that were developed based on smartwatch users´ input provide four ready concepts of how location-based advertisements on smartwatches could look like.

Power management is an important part when developing a smartwatch to meet user expectations of battery lifetime and functionality. To develop a good power management structure, measurements of the device is crucial to understand the behavior and power consumption of hardware and software. In this thesis, measurements have been made to hardware connected to the PineTime smartwatch to get knowledge of its behavior and power consumption. A structure for hardware and software was developed to enable the possibility to debug, flash, and perform measurements. The purpose of the measurements is to find possible areas of improvement that have the potential to lower the overall power consumption of the device. From the measurements, the st7789V display driver and the hardware design was detected to have a high power consumption. Bluetooth was also found to have an odd behavior in terms of power consumption. From these findings, suggestions on how to lower the power consumption are presented.

Dissertation-Publikation.

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With 5G around the corner and an overall increase in a faster and more stable internet connection, the future of Internet of Things (IoT) looks bright. There is a steady increase in the development of IoT devices, such as the smartwatch, and a high increase in usage of IoT, both by organizations and private citizens. Organizational managing of a smartwatch falls under the “Bring your own device” (BYOD) policy which allows employees to do work on their private devices. It appears to be a lack of knowledge in organizations on how to manage IoT devices both regarding policies and technical IT security. There has been an increase in malware attacks against IoT devices, and compromised smartwatches could be used to gain unauthorized access to organizations’ networks. The smartwatch is a common and powerful IoT device and will be used as an example in this thesis which purpose is to examine how organizations’ perceive and manage IoT devices, focusing on the smartwatch in order to gain insight regarding whether IoT devices such as the smartwatch is an area of concern within organizations. To understand the smartwatch, understanding IoT first will be important. The literature review delves into both IoT and smartwatch functionality and security. It looks at the BYOD policy and technical IT security solutions regarding the smartwatch. The review pointed to there being IT security issues with smartwatches and that implementing a BYOD policy increases productivity but increases the risk of malware attacks from and against the allowed devices. To fulfill the thesis purpose, qualitative interviews with high ranking IT security personnel at tech organizations were performed, thematized, and analyzed. The most prominent results are discussed; if the smartwatch is a threat and possible technical solutions for prevention, the organizations customer businesses IT security level, and BYOD policy. The results from the thesis showed that the organizations had a high awareness of the smartwatch and the IT security risks brought with it. They all had BYOD policies to restrict/limit access for the smartwatch’s access to their internal networks and a set of technical solutions to prevent breaches in the IT infrastructure and to detect if there had been a breach. The informants claimed that their organizations’ awareness regarding the smartwatch and the concerning IT security was higher than many of their customer businesses, which makes for an interesting subject for future research. How can these organizations reach the same level of awareness? / Med 5G runt hörnet och en generell ökning av både snabbare och stabilare internet så ser framtiden för Internet of Things (IoT) ljus ut. Det pågår en stadig ökning i utvecklingen av IoT-enheter såsom smartklockan, samtidigt som en användandet av IoT ökar både på företag och hos privatpersoner. En verksamhets hantering av smartklockan hamnar under policyn ”Bring your own device” (BYOD) vilket tillåter anställda att använda sina privata enheter i jobbrelaterat syfte. Det verkar finnas en kunskapsbrist hos verksamheter avseende hur man hanterar IoT-enheter, både gällande policy och teknisk IT-säkerhet. Det har skett en ökning av malware attacker (skadlig kod) mot IoT-enheter och en kompromissad smartklocka kan potentiellt användas för att få otillbörlig åtkomst till en verksamhets nätverk. Smartklockan är en vanlig och kraftfull IoT-enhet och kommer att användas som exempel i den här uppsatsen. Syftet med uppsatsen är att undersöka hur verksamheter uppfattar och hanterar IoT-enheter med fokus på smartklockan, för att ta reda på om IoT-enheter såsom smartklockan är ett område som verksamheter arbetar med. För att förstå smartklockan så är det viktigt att först förstå IoT. I litteraturstudien redogörs både IoT och smartklockors funktionalitet samt säkerhetsaspekter. Vidare beskrivs även BYOD policy och tekniska IT-säkerhetslösningar gällande smartklockan. Litteraturstudien pekade på att det existerar IT-säkerhetsproblem med smartklockan och att implementera en BYOD policy kan öka verksamhetens produktivitet men även öka riskerna med malware attacker, både mot och från de tillåtna enheterna. För att uppfylla uppsatsens syfte utfördes kvalitativa intervjuer med högt uppsatt IT-säkerhetspersonal på IT-orienterade verksamheter, som sedan tematiserades och analyserades. De mest relevanta resultaten diskuteras, avseende smartklockan som ett hot och de relaterade tekniska lösningarna, verksamheternas kundföretags IT-säkerhetsnivå och BYOD policyn. De empiriska resultaten från uppsatsen visade att verksamheterna som intervjuades hade en hög medvetenhet relaterat till smartklockan och de IT-säkerhetsproblem som den kan medföra. Alla verksamheterna hade en BYOD policy för att begränsa/förbjuda smartklockans åtkomst till deras interna nätverk, samt ett par tekniska lösningar för att förebygga intrång i deras IT-infrastruktur och för att upptäcka om ett intrång redan skett. Informanterna påstod att deras verksamheters medvetenhet kring smartklockan och den relaterade IT-säkerheten var högre kontra flera av deras kundföretags, vilket är ett relevant ämne för framtida forskning. Hur kan dessa verksamheter nå upp till samma nivå av medvetenhet?

Den här studien undersöker hur och om det med hjälp av Benyons PACT-analys samt Gong ochTarasewichs 15 olika designprinciper, speciellt utformade till mobiler, kan utföra en hel processfrån konceptualisering och idé till en slutgiltig interaktiv app-prototyp som i den här studienkommer att benämnas som Skalman. Målgruppen och de tilltänkta användarna för Skalman ärpersoner med minnessvårigheter, till exempel personer diagnostiserade med Alzheimers. Syftetmed användandet av Skalman är att få fram ett hjälpmedel för målgruppen för att underlätta ochorganisera vardagen när minnet inte räcker till. PACT-analysen bygger på att användarna sätts ifokus för att hitta deras behov för ett hjälpmedel samt att en analysering av fyra olika områden,People, Activities, Context och Technologies görs. Därför kommer grunden av datainsamlingenför detta in från tre olika kvalitativa gruppintervjuer. De två första gruppintervjuernainkluderade två personer i varje grupp, en person med minnessvårigheter samt en anhörig tilldenna. Den sista gruppintervjun gjordes med Alzheimers Sverige för att samla in ytterligareinformation för att öka förståelsen för sjukdomen och dess svårigheter. Resultatet från PACTanalysenanvändes för att kunna bygga upp Skalmanprototypen tillsammans med de 15 olikadesignprinciperna. En LO-FI prototyp testades på respondenterna i gruppintervjuerna för attkunna utvärdera och kunna förbättra prototypen till det slutgiltiga resultatet i form av eninteraktiv HI-FI prototyp av Skalman. / The prototype for people with memory impairmentsThis study aims to examine how and if it is possible to use Benyons PACT-analysis togetherwith Gong and Tarasewichs 15 design principles, to make the process from an idea into a finalinteractive prototype. The prototype is named Skalman. This study focuses on people withmemory impairments, specifically those people diagnosed with Alzheimer’s disease. The aimwith the PACT-analysis was to analyse the target group through four different subjects, People,Activities, Context and Technologies and to use that to find the needs for Skalman that in theend will help the users to manage and organize their daily lives. Three group interviews weremade to collect data from the selected target group for the PACT-analysis. Two groupinterviews included a person with memory impairments/Alzheimer’s disease and one relative ofthis person to help and support throughout the interview. Thereafter an interview was made withthe chancellors of Alzheimer’s Sweden to gather additional information and to increase theunderstanding of the disease and its difficulties. The result of the analysis was then used,together with the design principles to develop a LO-FI prototype and was then tested on thetarget group in order to evaluate the prototype and to improve it to the final result of a HI-FIprototype of Skalman.

The Apple Watch is capable of recording single-lead electrocardiograms (ECGs). To incorporate such devices in routine medical care, the reliability of such devices to obtain precordial leads needs to be validated. The purpose of this study was to assess the feasibility and reliability of a smartwatch (SW) to obtain precordial leads compared to standard ECGs. We included 100 participants (62 male, aged 62.8 ± 13.1 years) with sinus rhythm and recorded a standard 12-lead ECG and the precordial leads with the Apple Watch. The ECGs were quantitively compared. A total of 98 patients were able to record precordial leads without assistance. A strong correlation was observed between the amplitude of the standard and SW-ECGs’ waves, in terms of P waves, QRS-complexes, and T waves (all p-values < 0.01). A significant correlation was observed between the two methods regarding the duration of the ECG waves (all p-values < 0.01). Assessment of polarity showed a significant and a strong concordance between the ECGs’ waves in all six leads (91–100%, all p-values < 0.001). In conclusion, 98% of patients were able to record precordial leads using a SW without assistance. The SW is feasible and reliable for obtaining valid precordial-lead ECG recordings as a validated alternative to a standard ECG.

Some of the recently released smartwatch products feature a single-lead electrocardiogram (ECG) recording capability. The reliability of obtaining 3-lead ECG with smartwatches is yet to be confirmed in a large study. This study aimed to assess the feasibility and reliability of smartwatch to obtain 3-lead ECG recordings, the classical Einthoven ECG leads I-III compared to standard ECG. To record lead I, the watch was worn on the left wrist and the right index finger was placed on the digital crown for 30 s. For lead II, the watch was placed on the lower abdomen and the right index finger was placed on the digital crown for 30 s. For lead III, the same process was repeated with the left index finger. Spearman correlation and Bland-Altman tests were used for data analysis. A total of 300 smartwatch ECG tracings were successfully obtained. ECG waves’ characteristics of all three leads obtained from the smartwatch had a similar duration, amplitude, and polarity compared to standard ECG. The results of this study suggested that the examined smartwatch (Apple Watch Series 4) could obtain 3-lead ECG tracings, including Einthoven leads I, II, and III by placing the smartwatch on the described positions.

An important field of research now is how smartwatches are being adopted and used in variouscultural situations. The adoption of smartwatches among Pakistani consumers is the subject ofthis study, with an emphasis on understanding the behavioral intents and usage patternsinfluenced by cultural customs and lifestyle preferences. Semi-structured interviews and qualitative questionnaires were employed in the study's qualitative research approach to extract insights from a diverse group of individuals. The research utilized qualitative methods, gathering in-depth and nuanced information from Pakistani users through semi-structured interviews and qualitative questionnaires. The data was subjected to thematic analysis, which revealed recurrent themes that provide insights into the variables impacting the adoption and sustained use ofsmartwatches.Five main themes emerged from the participants after thematic analysis. It was revealed that smartwatches were helpful in encouraging better lifestyles because they could beused as health-monitoring devices to actively control their fitness-impacting lifestyles. Users were able to smoothly incorporate technology into their fashion choices thanks to smartwatches, which wereseen as extensions of personal style. Participants praised the ease of managing tasks and notifications straight from the wrist, which facilitated effective time management. Withfeatureslike stresstracking and relaxation activities, smartwatches act as instruments for reducingstress.Participants praised smartwatches for helping them stay connected and organized whileretaining a professional demeanor. The findings were interpreted using a comprehensiveframework basedon the Affordance theory. The themes that were found reflected the perceived benefits that smartwatches are thought to provide, directing users towards activities based on thefunctionality they perceive. By illuminating the complex relationships between perceived affordances and behavioral intentions, this framework improved our knowledge of how cultural practices and lifestyle preferences interact with the adoption of technology. The results highlightthe mutually beneficial interaction between technology, culture, and personal goals whilehighlighting the roleof perceived affordances in influencing users' intents and actions. These observations offer invaluable advice for designers, academics, and stakeholders looking toimprove user experiences across various cultural contexts as smartwatches continue to reshape personal interactions with technology.