Asynchronous Remote Medical Consultation for Ghana

Computer-mediated communication systems can be used to bridge the gap between doctors in underserved regions with local shortages of medical expertise and medical specialists worldwide. To this end, we describe the design of a prototype remote consultation system intended to provide the social, institutional and infrastructural context for sustained, self-organizing growth of a globally-distributed Ghanaian medical community. The design is grounded in an iterative design process that included two rounds of extended design fieldwork throughout Ghana and draws on three key design principles (social networks as a framework on which to build incentives within a self-organizing network; optional and incremental integration with existing referral mechanisms; and a weakly-connected, distributed architecture that allows for a highly interactive, responsive system despite failures in connectivity). We discuss initial experiences from an ongoing trial deployment in southern Ghana.Comment: 10 page

Human computer interaction for international development: past present and future

Recent years have seen a burgeoning interest in research into the use of information and communication technologies (ICTs) in the context of developing regions, particularly into how such ICTs might be appropriately designed to meet the unique user and infrastructural requirements that we encounter in these cross-cultural environments. This emerging field, known to some as HCI4D, is the product of a diverse set of origins. As such, it can often be difficult to navigate prior work, and/or to piece together a broad picture of what the field looks like as a whole. In this paper, we aim to contextualize HCI4D—to give it some historical background, to review its existing literature spanning a number of research traditions, to discuss some of its key issues arising from the work done so far, and to suggest some major research objectives for the future

Implementation of Telemedicine Services in Lower-Middle Income Countries: Lessons for the Philippines

Regardless of the promising potential of telemedicine to address healthcare problems, especially in lower-middle income countries, its success rate has been unsatisfactory and many telemedicine services fail to sustain their implementation shortly after initial funding or after a pilot phase. Therefore, it is important to document existing models of telemedicine implementation in these countries, to identify commonalities and extract experiences that would be useful for implementers, policy makers and future researchers. This review seeks to review and describe the experience of Low and Middle Income Countries (LMICs) in implementing telemedicine services. Evidence extracted from the included studies were analysed through a narrative synthesis which suggests a multi-sectoral approach for implementing telemedicine. It highlights the importance of education, financing options, policy, technology, governance, and partnership, in the wider picture of a sustainable telemedicine implementation among developing countries such as the Philippines. Moreover, the literature reveals both top-down and bottom-up approach for successful telemedicine implementation. These approaches include strengthening the local health workers and integrating telemedicine into the health system. Studies included in this review have been helpful, but there is an obvious lack of studies with high level of evidence that can yield generalisable, thus findings must be inferred with prudence. Even so, this review described and summarised the data which allowed description of factors and lessons in the implementation of telemedicine in LMICs

e-ESAS: Evolution of a Participatory Design-based Solution for Breast Cancer (BC) Patients in Rural Bangladesh

Healthcare facility is scarce for rural women in the developing world. The situation is worse for patients who are suffering from diseases that require long-term feedback-oriented monitoring such as breast cancer. Lack of motivation to go to the health centers on patients’ side due to sociocultural barriers, financial restrictions and transportation hazards results in inadequate data for proper assessment. Fortunately, mobile phones have penetrated the masses even in rural communities of the developing countries. In this scenario, a mobile phone-based remote symptom monitoring system (RSMS) with inspirational videos can serve the purpose of both patients and doctors. Here, we present the findings of our field study conducted on 39 breast cancer patients in rural Bangladesh. Based on the results of extensive field studies, we have categorized the challenges faced by patients in different phases of the treatment process. As a solution, we have designed, developed and deployed e-ESAS—the first mobile-based RSMS in rural context. Along with the detail need assessment of such a system, we describe the evolution of e-ESAS and the deployment results. We have included the unique and useful design lessons that we learned as e-ESAS evolved through participatory design process. The findings show how e-ESAS addresses several challenges faced by patients and doctors and positively impact their lives

The Use of Mobile Phones for Development in Africa: Top-Down-Meets-Bottom-Up Partnering

The African continent currently boasts the highest mobile telephony growth rates in the world, bringing new communications possibilities to millions of people. The potential for mobile phones to reach a large and growing base of users across the continent, and to be used for development-related purposes, is becoming widely recognized, evidenced by the growing number of development-oriented projects, applications, and programs that specifically make use of mobiles. Pent-up demand and limited resources have led to innovative usage and services being developed at the grassroots level. Yet much remains to be done by governments in order to support further growth of telecommunications markets and services, while the private sector, non-profits, and academics all have an important role to play in the development process as well. The phenomenon of top-down-meeting-bottom-up partnerships that are springing up across the continent offers the potential for cultivating the necessary feedback loops between various actors involved in the development process, in order to create relevant applications that meet real needs

A New Medium for Remote Music Tuition

It is common to learn to play an orchestral musical instrument through regular one-to-one lessons with an experienced musician as a tutor. Students may work with the same tutor for many years, meeting regularly to receive real-time, iterative feedback on their performance. However, musicians travel regularly to audition, teach and perform and this can sometimes make it difficult to maintain regular contact. In addition, an experienced tutor for a specific instrument or musical style may not be available locally. General instrumental tuition may not be available at all in geographically distributed communities. One solution is to use technology such as videoconference to facilitate a remote lesson; however, this fundamentally changes the teaching interaction. For example, as a result of the change in communication medium, the availability of non-verbal cues and perception of relative spatiality is reduced. We describe a study using video-ethnography, qualitative video analysis and conversation analysis to make a fine-grained examination of student–tutor interaction during five co-present and one video-mediated woodwind lesson. Our findings are used to propose an alternative technological solution – an interactive digital score. Rather than the face-to-face configuration enforced by videoconference, interacting through a shared digital score, augmented by visual representation of the social cues found to be commonly used in co-present lessons, will better support naturalistic student–tutor interaction during the remote lesson experience. Our findings may also be applicable to other fields where knowledge and practice of a physical skill sometimes need to be taught remotely, such as surgery or dentistry

Translation in Conversation

This article started with an invitation from the editors to share reflections on translations and, in particular, how academic scholarship gets rearticulated across a variety of audiences. The editors asked us to experiment with new formats for conversation such as passing thoughts back and forth, eliciting responses and explorations. The following text comes from one such experiment inform: an asynchronous exchange that spanned many months and 10 time zones

Professional Implications of Using Online Social Networking Systems By Persons Who Are Blind

The online social networking (OSN) phenomenon has grown dramatically over the past decade, with websites such as Facebook and Twitter becoming household names. Although a lot of literature exists on online social networking systems, little exists on these systems\u27 practical impact on the offline world, beyond cyberspace. Similarly, little attention has been given to the use of these systems by persons who are blind or have other disabilities. This research attempts to redress this situation by exploring the relationship between the usage of OSN systems and professional achievement for persons who are blind

MOBILE BASED SYMPTOM MANAGEMENT FOR PALLIATIVE CARE

The goal of palliative care is to improve the quality of life of terminally ill patients through the management of pain and other symptoms. Though the term `palliative care\u27 is well known in the developed world, it is relatively a new term in the developing world. According to WHO, each year 4.8 million people suffering from severe pain caused by cancer, fail to receive treatment due to lack of resources and other barriers. In this thesis we have elaborated on the challenges faced by the rural breast cancer (BC) patients of Bangladesh and a solution for their palliative care treatment. Although breast cancer is commonly thought of as a disease of the developed world, the WHO statistics show that 69% of all BC deaths occur in developing countries. Unlike western countries where 89% of the women have a survival rate of more than 5 years, most BC patients in Bangladesh die because the majority of cases are diagnosed in late stages. These patients need palliative care which is almost absent in rural Bangladesh. These issues show the desperate need of a low cost palliative care system solution for the terminally ill patients of the developing world. Based on detailed field studies, we have developed and deployed a mobile based remote symptom monitoring and management system named e-ESAS. Design of e-ESAS has evolved through continuous feedback from both the patients and doctors. e-ESAS is being used by 10 breast cancer patients to submit symptom values from their home for the last 10 months (Nov\u2711- Sep \u2712). Our results show how e-ESAS with motivational videos not only helped the patients to have a `dignified\u27 life but also helped the doctors to achieve the goals of palliative care. Also the analyzed results are shown in 4 categories to appropriately measure the contribution of e-ESAS in improving the QoL. This thesis also focuses on developing a mobile based pain intensity detection tool which is a first step in replacing the manual paper based scale for measuring pain. The tool also might play a big role in assessing the pain level of verbally impaired patients