P5 eHealth: An Agenda for the Health Technologies of the Future

This open access volume focuses on the development of a P5 eHealth, or better, a methodological resource for developing the health technologies of the future, based on patients’ personal characteristics and needs as the fundamental guidelines for design. It provides practical guidelines and evidence based examples on how to design, implement, use and elevate new technologies for healthcare to support the management of incurable, chronic conditions. The volume further discusses the criticalities of eHealth, why it is difficult to employ eHealth from an organizational point of view or why patients do not always accept the technology, and how eHealth interventions can be improved in the future. By dealing with the state-of-the-art in eHealth technologies, this volume is of great interest to researchers in the field of physical and mental healthcare, psychologists, stakeholders and policymakers as well as technology developers working in the healthcare sector

Design revolutions: IASDR 2019 Conference Proceedings. Volume 4: Learning, Technology, Thinking

In September 2019 Manchester School of Art at Manchester Metropolitan University was honoured to host the bi-annual conference of the International Association of Societies of Design Research (IASDR) under the unifying theme of DESIGN REVOLUTIONS. This was the first time the conference had been held in the UK. Through key research themes across nine conference tracks – Change, Learning, Living, Making, People, Technology, Thinking, Value and Voices – the conference opened up compelling, meaningful and radical dialogue of the role of design in addressing societal and organisational challenges. This Volume 4 includes papers from Learning, Technology and Thinking tracks of the conference

Gratitude in Healthcare an interdisciplinary inquiry

The expression and reception of gratitude is a significant dimension of interpersonal communication in care-giving relationships. Although there is a growing body of evidence that practising gratitude has health and wellbeing benefits for the giver and receiver, gratitude as a social emotion made in interaction has received comparatively little research attention. To address this gap, this thesis draws on a portfolio of qualitative methods to explore the ways in which gratitude is constituted in care provision in personal, professional, and public discourse. This research is informed by a discursive psychology approach in which gratitude is analysed, not as a morally virtuous character trait, but as a purposeful, performative social action that is mutually co-constructed in interaction.I investigate gratitude through studies that approach it on a meta, meso, macro, and micro level. Key intellectual traditions that underpin research literature on gratitude in healthcare are explored through a metanarrative review. Six underlying metanarratives were identified: social capital; gifts; care ethics; benefits of gratitude; staff wellbeing; and gratitude as an indicator of quality of care. At the meso (institutional) level, a narrative analysis of an archive of letters between patients treated for tuberculosis and hospital almoners positions gratitude as participating in a Maussian gift-exchange ritual in which communal ties are created and consolidated.At the macro (societal) level, a discursive analysis of tweets of gratitude to the National Health Service at the outset of the Covid-19 pandemic shows that attitudes to gratitude were dynamic in response to events, with growing unease about deflecting attention from risk reduction for those working in the health and social care sectors. A follow-up analysis of the clap-for-carers movement implicates gratitude in embodied, symbolic, and imagined performances in debates about care justice. At the micro (interpersonal) level, an analysis of gratitude encounters broadcast in the BBC documentary series, Hospital, uses pragmatics and conversation analysis to argue that gratitude is an emotion made in talk, with the uptake of gratitude opportunities influencing the course of conversational sequencing. The findings challenge the oftenmade distinction between task-oriented and relational conversation in healthcare.Moral economics are paradigmatic in the philosophical conceptualisation of gratitude. My research shows that, although balance-sheet reciprocity characterised the institutional culture of the voluntary hospital, it is hardly ever a feature ofinterpersonal gratitude encounters. Instead, gratitude is accomplished as shared moments of humanity through negotiated encounters infused with affect. Gratitude should never be instrumentalised as compensating for unsafe, inadequatelyrenumerated work. Neither should its potential to enhance healthcare encounters be underestimated. Attention to gratitude can participate in culture change by affirming modes of acting, emoting, relating, expressing, and connecting that intersect with care justice.This thesis speaks to gratitude as a culturally salient indicator of what people express as worthy of appreciation. It calls for these expressions to be more closely attended to, not only as useful feedback that can inform change, but also because gratitude is a resource on which we can draw to enhance and enrich healthcare as a communal, collaborative, cooperative endeavour

Inferring Complex Activities for Context-aware Systems within Smart Environments

The rising ageing population worldwide and the prevalence of age-related conditions such as physical fragility, mental impairments and chronic diseases have significantly impacted the quality of life and caused a shortage of health and care services. Over-stretched healthcare providers are leading to a paradigm shift in public healthcare provisioning. Thus, Ambient Assisted Living (AAL) using Smart Homes (SH) technologies has been rigorously investigated to help address the aforementioned problems. Human Activity Recognition (HAR) is a critical component in AAL systems which enables applications such as just-in-time assistance, behaviour analysis, anomalies detection and emergency notifications. This thesis is aimed at investigating challenges faced in accurately recognising Activities of Daily Living (ADLs) performed by single or multiple inhabitants within smart environments. Specifically, this thesis explores five complementary research challenges in HAR. The first study contributes to knowledge by developing a semantic-enabled data segmentation approach with user-preferences. The second study takes the segmented set of sensor data to investigate and recognise human ADLs at multi-granular action level; coarse- and fine-grained action level. At the coarse-grained actions level, semantic relationships between the sensor, object and ADLs are deduced, whereas, at fine-grained action level, object usage at the satisfactory threshold with the evidence fused from multimodal sensor data is leveraged to verify the intended actions. Moreover, due to imprecise/vague interpretations of multimodal sensors and data fusion challenges, fuzzy set theory and fuzzy web ontology language (fuzzy-OWL) are leveraged. The third study focuses on incorporating uncertainties caused in HAR due to factors such as technological failure, object malfunction, and human errors. Hence, existing studies uncertainty theories and approaches are analysed and based on the findings, probabilistic ontology (PR-OWL) based HAR approach is proposed. The fourth study extends the first three studies to distinguish activities conducted by more than one inhabitant in a shared smart environment with the use of discriminative sensor-based techniques and time-series pattern analysis. The final study investigates in a suitable system architecture with a real-time smart environment tailored to AAL system and proposes microservices architecture with sensor-based off-the-shelf and bespoke sensing methods. The initial semantic-enabled data segmentation study was evaluated with 100% and 97.8% accuracy to segment sensor events under single and mixed activities scenarios. However, the average classification time taken to segment each sensor events have suffered from 3971ms and 62183ms for single and mixed activities scenarios, respectively. The second study to detect fine-grained-level user actions was evaluated with 30 and 153 fuzzy rules to detect two fine-grained movements with a pre-collected dataset from the real-time smart environment. The result of the second study indicate good average accuracy of 83.33% and 100% but with the high average duration of 24648ms and 105318ms, and posing further challenges for the scalability of fusion rule creations. The third study was evaluated by incorporating PR-OWL ontology with ADL ontologies and Semantic-Sensor-Network (SSN) ontology to define four types of uncertainties presented in the kitchen-based activity. The fourth study illustrated a case study to extended single-user AR to multi-user AR by combining RFID tags and fingerprint sensors discriminative sensors to identify and associate user actions with the aid of time-series analysis. The last study responds to the computations and performance requirements for the four studies by analysing and proposing microservices-based system architecture for AAL system. A future research investigation towards adopting fog/edge computing paradigms from cloud computing is discussed for higher availability, reduced network traffic/energy, cost, and creating a decentralised system. As a result of the five studies, this thesis develops a knowledge-driven framework to estimate and recognise multi-user activities at fine-grained level user actions. This framework integrates three complementary ontologies to conceptualise factual, fuzzy and uncertainties in the environment/ADLs, time-series analysis and discriminative sensing environment. Moreover, a distributed software architecture, multimodal sensor-based hardware prototypes, and other supportive utility tools such as simulator and synthetic ADL data generator for the experimentation were developed to support the evaluation of the proposed approaches. The distributed system is platform-independent and currently supported by an Android mobile application and web-browser based client interfaces for retrieving information such as live sensor events and HAR results

Data and the city – accessibility and openness. a cybersalon paper on open data

This paper showcases examples of bottom–up open data and smart city applications and identifies lessons for future such efforts. Examples include Changify, a neighbourhood-based platform for residents, businesses, and companies; Open Sensors, which provides APIs to help businesses, startups, and individuals develop applications for the Internet of Things; and Cybersalon’s Hackney Treasures. a location-based mobile app that uses Wikipedia entries geolocated in Hackney borough to map notable local residents. Other experiments with sensors and open data by Cybersalon members include Ilze Black and Nanda Khaorapapong's The Breather, a "breathing" balloon that uses high-end, sophisticated sensors to make air quality visible; and James Moulding's AirPublic, which measures pollution levels. Based on Cybersalon's experience to date, getting data to the people is difficult, circuitous, and slow, requiring an intricate process of leadership, public relations, and perseverance. Although there are myriad tools and initiatives, there is no one solution for the actual transfer of that data

Molecular biomarkers in head and neck cancer: Evaluation of biomarkers in prognostication and radiotherapy response prediction

Radiotherapy plays an integral part in the treatment of head and neck squamous cell carcinoma (HNSCC). Despite rigorous investigation spanning several decades, no molecular biomarkers are currently available for the prediction of radiotherapy response of an individual HNSCC tumour. Several radioresistance mechanisms have been acknowledged, including p53 alterations, hypoxia, and cancer stem cells. In this thesis, the overall purpose, role, and interpretation of molecular biomarkers in the context of HNSCC is discussed, and the clinical problem-field is emphasized. Putative radioresistance related molecular biomarkers were selected for investigation in HNSCC cell lines and patient materials. For clinical investigation, all HNSCC patients treated in the tertiary referral centre of Turku University Hospital during 2005-2010 were retrospectively collected. Clinical patient data was gathered, patient tumour samples were collected and processed into a tissue microarray. Immunohistochemistry and in situ hybridization were used for detection of biomarker expression and their relation to patient survival was analysed in multivariable survival models. Copy number alterations of stemness associated cancerous inhibitor of protein phosphatase 2A (CIP2A) were demonstrated in HNSCC cell lines and the presence of copy number alterations was found to be associated with a poor prognosis in HNSCC patients. Putative radioresistance biomarkers were investigated in several HNSCC cell lines after construction of a cell microarray. Stem cell marker OCT4 was revealed to be significantly associated with intrinsic radioresistance. The representativeness of the clinical tissue microarray was carefully confirmed using a novel population validation method. Using immunohistochemical stains, putative prognostic biomarkers were shown to perform poorly in the population-validated tissue microarray (PV-TMA). Finally, using the PV-TMA, OCT4 was found to predict for poor radiotherapy response and improved chemoradiotherapy response. In conclusion, using HNSCC cell line microarray and highly representative PVTMA patient material, OCT4 was established as a stratification biomarker between radiotherapy and cisplatin-based chemoradiotherapy.Molekulaariset biomarkkerit pään ja kaulan alueen syövässä Sädehoidolla on keskeinen rooli pään ja kaulan alueen levyepiteelisyöpien hoidossa. Vuosikymmenten tutkimuksesta huolimatta yksittäisen pään ja kaulan alueen levyepiteelisyövän sädehoitovastetta ennustavaa molekulaarista biomarkkeria ei ole käytettävissä. Nykyisin tunnetaan lukuisia huonoa sädeherkkyyttä selittäviä mekanismeja kuten p53-geenin mutaatiot, kasvaimen hypoksiset olosuhteet ja syöpäkantasolut. Tässä työssä tarkastellaan molekulaarisen biomarkkerin tehtävää, tarkoitusta ja tulkintaa pään ja kaulan alueen levyepiteelisyövän yhteydessä korostaen kliinistä ongelmakenttää. Sädeherkkyyteen liitettyjä biomarkkeriehdokkaita tutkittiin pään ja kaulan levyepiteelisyöpäsolulinjoja ja potilasaineistoja hyödyntäen. Kliinisenä tutkimuksena kerättiin kaikki vuosina 2005–2010 Turun yliopistollisessa keskussairaalassa hoidetut pään ja kaulan alueen levyepiteelisyöpäpotilaat käsittävä aineisto. Potilasnäytteet kerättiin ja niistä valmistettiin kudosmikrosiru. Biomarkkerien ilmentymistä tutkittiin immunohistokemiallisilla menetelmillä ja in situ hybridisaatiolla ja niiden yhteyttä potilaiden ennusteeseen selvitettiin monimuuttujaisilla ennustemalleilla. CIP2A-proteiinin kopiolukumuutoksia todettiin pään ja kaulan alueen levyepiteelisyöpäsolulinjoissa, ja kopiolukumuutosten havaittiin olevan yhteydessä pään ja kaulan levyepiteelisyöpäpotilaiden heikentyneeseen ennusteeseen. Pään ja kaulan alueen levyepiteelisyöpäsolulinjoista kootussa solumikrosiruaineistossa havaittiin kantasolutekijä OCT4:n olevan merkitsevästi yhteydessä solujen sädeherkkyyteen. Kliinisen kudosmikrosiruaineiston todettiin olevan edustava. Biomarkkeriehdokkaat suoriutuivat huonosti potilaiden ennusteen määrittämisestä, mutta OCT4 ennusti levyepiteelikasvaimen huonoa sädehoitovastetta, mutta hyvää ennustetta sisplatiinipohjaisen kemosädehoidon jälkeen. Tutkimuksessa todettiin pään ja kaulan levyepiteelisoluja ja edustavaksi havaittua väestövarmennettua kudosmikrosiruaineistoa hyödyntäen, että OCT4 soveltuu sädehoidon ja sisplatiinipohjaisen kemosädehoidon valintaa ohjaavaksi biomarkkeriksi

Redesenho da interface de utilizador da aplicação móvel Us'Em

Mestrado em Comunicação MultimédiaThe research presented here aims to design a feasible and adequate mobile application (app) user interface. This mobile app is part of Us'em system, designed to promote self-rehabilitation after stroke. The system is based on wearable, mobile and tracking sensors-based technology. The app works as a feedback tool, communicating Us’em system users about the frequency of their upper limb moves and about their recovery process. The mobile app aims increasing patient’s motivation in using their arm-hand through the day and improving their rehabilitation through self-training at home with continuous feedback. The design of its user interface is of great relevance, because it determines if post stoke patients can use Us’em system. The empirical part begins with interviews, questionnaires and observation of post stroke patients and physical therapists from Portugal and the Netherlands. It provides a better understanding of post stroke rehabilitation process and stroke victims’ characteristics and requirements regarding rehabilitation and mobile devices interaction. The gathered information contributed to the development of a prototype that materializes the defined Us’em app. The prototyping process ran through iterative cycles of design, implementation and evaluation to ascertain the adequacy of Us’em app user interface. The final prototype is the final product of this research project and it was evaluated through usability tests with post stroke patients from both countries aforementioned. Tests to the final prototype show it may be difficult to design a unique solution for all the users due to the wide range of their requirements. However, the core requirements of Us'em mobile app is simplicity: the number of user interface elements, the amount of information and the complexity of iteractions and functionalities of this app should be the lowest as possible. The research also allows to conclude that the user interface designed meets most of user’s requirements and it has a significant impact on the motivation of post stroke patients in moving their impaired arm-hand autonomously.O trabalho de investigação aqui apresentado objetiva o desenvolvimento de uma viável e adequada interface de utilizador de uma aplicação móvel (app). Esta app é um dos componentes do sistema Us’em, desenvolvido para promover a auto reabilitação após acidentes vasculares cerebrais (AVC). O sistema é baseado em tecnologia vestível, móvel e de monitorização através de sensores. A app funciona como uma ferramenta de feedback, informando os utilizadores do sistema Us’em sobre a frequência dos movimentos dos seus membros superiores e sobre o seu processo de recuperação. A app objetiva aumentar a motivação dos pacientes em usar o seu braço ou mão debilitado ao longo do dia e, assim, promover a sua reabilitação através do treino autónomo em casa com feedback contínuo. O desenvolvimento da interface de utilizador é de grande relevância, pois determina se pacientes vítimas de AVC conseguem utilizar o sistema Us’em. O estudo empírico parte da realização de entrevistas, questionários e observação de pacientes vítimas de AVC e fisioterapeutas Portugueses e Holandeses. Este estudo permite uma melhor compreensão do processo de reabilitação e das características e requisitos de vítimas de AVC no que respeita à reabilitação e à interação com dispositivos móveis. A informação recolhida contribuiu para o desenvolvimento de um protótipo que concretizasse a app Us’em definida. O processo de prototipagem ocorreu ao longo de ciclos iterativos de desenvolvimento, implementação e teste de forma a verificar a adequação da interface de utilizador da app Us’em. O protótipo final é o produto final deste projeto de investigação e foi testado através de testes de usabilidade com pacientes vítimas de AVC de ambos os países referidos anteriormente. Os testes ao protótipo final revelam que poderá ser difícil desenvolver uma solução única para todos os utilizadores devido ao conjunto vasto dos seus requisitos. No entanto, o requisito chave da app Us’em é simplicidade: o número de elementos da interface de utilizador, a quantidade de informação e a complexidade das interações e funcionalidades da app deve ser o mais reduzido possível. Esta investigação também permite concluir que a interface de utilizador desenvolvida satisfaz a maior parte dos requisitos dos utilizadores e tem um impacto significativo na motivação de pacientes vítimas de AVC em movimentar o seu braço ou mão desabilitada de forma autónoma

AI as a Material for Design

From Netflix recommendations to Amazon Echos sitting proudly on kitchen countertops, artificial intelligence (AI) has been inserted into the mundane settings of our everyday lives. These ‘smart’ devices and services have given rise to the collection of data and processing within everyday objects, accumulating new challenges, particularly in legibility, agency, and negotiability of interactions. The emerging field of Human Data Interaction (HDI) recognises that these challenges go on to influence security, privacy, and accessibility protocols, while also encompassing socio-technical implications. Furthermore, these objects challenge designers’ traditional conventions of neutral interactions, which only work as instructed. However, these smart objects go beyond typical human-object relationships functioning in new and unexpected ways, creeping in function, and existing within independent and interdependent assemblages of human and non-human actants—demanding alternative considerations and design practice. This thesis aims to question the traditional practice of considering and designing for AI technology by arguing for a post-anthropocentric perspective of things with agency, by adopting the philosophical approach of Object Orientated Ontology with design research. This research ultimately presents and builds (a currently) unorthodox design approach of Human-AI Kinship that contests the design orthodoxies of human-centred design. Conclusively, this research seeks to bring into being AI as a material for design and justify through the case study of AI legibility. A More than Human Centered Design approach is established through a transdisciplinary and iterative Research through Design methodology, resulting in the design of AI iconography that attempts to communicate and signify AI’s ontology to human users. This thesis is concluded by testing the legibility of the icons themselves and discussing philosophy as an asset for design research

D-STEM: a Design led approach to STEM innovation

Advances in the Science, Technology, Engineering and Maths (STEM) disciplines offer opportunities for designers to propose and make products with advanced, enhanced and engineered properties and functionalities. In turn, these advanced characteristics are becoming increasingly necessary as resources become ever more strained through 21st century demands, such as ageing populations, connected communities, depleting raw materials, waste management and energy supply. We need to make things that are smarter, make our lives easier, better and simpler. The products of tomorrow need to do more with less. It is recognised that STEM subjects need Design to translate and realise their full value to the economy and that Design’s role is greater than being a creator of objects. The issue is how to maximize the potential for exploiting opportunities offered by STEM developments and how best to enable designers to strengthen their position within the innovation ecosystem as active agents of change. As a society, we need designers able to navigate emerging developments from the STEM community to a level that enables understanding and knowledge of the new material properties, the skill set to facilitate absorption into the design ‘toolbox’ and the agility to identify, manage, contextualise and influence innovation opportunities emerging from STEM developments. This paper proposes the blueprint for a new design led approach to STEM innovation that begins to redefine studio culture for the 21st Century