A Framework for Designing Inclusive Online Communities The Role of Inclusive Design for Salutogenesis in Chronic Disease Online Communities

Online health communities are often designed for clinical purposes. The user needs within a chronic care community such as cancer are as diverse and complex as their symptom and treatment for latent and long-term effects. While these communities provide the functional needs such as synchronous and asynchronous communication features, they often fail to deliver a functional design that is inclusive of all user needs. The ability to inclusively design online health communities is critical to the overall goal of user satisfaction and in turn the salutogenesis of the participants. The proactive approach to health and wellness can be supported and influenced through online communities however; to ensure the broadest reach is possible to these communities they must be designed to be inclusive. This paper will define a tool by which online health communities can be designed and evaluated for access and participation while ensuring the wide range of human diversity. The Framework for Inclusive Design of Online Communities [FIDOC] will propose the key elements that are necessary to support the notion of well-being in these chronic care communities. FIDOC addresses the process by which designers can iteratively work to achieve inclusion when designing online health communities and offers recommendations for future research

Remote self-testing for sexually transmitted infections, within online care pathways: how could this intervention deliver public health benefit? Formative research using chlamydia as an exemplar

Sexually transmitted infections (STIs) remain a public health challenge in England, despite free, confidential testing/treatment services. The eSTI² Research Consortium is developing a diagnostic self-test for STIs, to be deployed within online care-pathways. Should this intervention lead to increased STI detection and prompt effective treatment, it could reduce transmission and morbidity. Through a scoping review and three studies I explored its potential to benefit public health, thus informing the intervention’s ongoing development. The review (2013) found diverse uses of internet/electronic communications in STI care-pathways, but little research was transferable to remote self-testing or management. Current internet-use for sexual health may predict use of the proposed intervention, so I estimated its prevalence, and identified associated factors, using British probability survey data (2010-12). Among sexually-experienced 16-44-year-olds (n=8926), internet-use for STI testing/treatment was rare (<0.5%), but available services were limited. 4.5% women and 4.6% men reported internet-use for information/support with their sex-lives, elevated among the better-educated and some STI risk-groups including young people. In qualitative interviews, 25 young people at risk of STI expressed enthusiasm for a (hypothetical) STI self-test within online care-pathways. Findings informed colleagues’ development of eSTI²’s Online Chlamydia Pathway (OCP). For people requiring chlamydia treatment, this included: online automated medical assessment, a helpline, and community pharmacy treatment collection or facilitated clinic access. I undertook and thematically-analysed 40 qualitative interviews with OCP users, within pilot studies. Participants valued the rapid, convenient and discreet treatment access, increased control over their healthcare, and optional professional support by telephone, enabled by the OCP. Offline parts of the pathway (pharmacy/clinic attendance) risked compromising its perceived advantages, and require further development. Recommendations derived from an iteratively-developed understanding of this complex intervention’s use and appeal, can enhance its potential to enable STI detection and treatment, promptly, effectively and acceptably. Future evaluation must consider impacts on health inequalities

Disabling Menstrual Barriers: Investigating and addressing the barriers to menstrual hygiene management that young people with disabilities face in the Kavre district, Nepal

BACKGROUND: People with disabilities face inequalities in many areas of life, so are likely to experience poor menstrual hygiene management (MHM). Evidence or interventions to support MHM for this population is lacking. STUDY AIM: To develop an MHM behaviour change intervention for young people with disabilities in Nepal and assess its feasibility. METHODS: The Behaviour Centred Design’s five steps were used to develop the MHM intervention. Assess: systematic review of MHM requirements of people with disabilities and coping strategies. Build: analysis of Nepal’s MHM and water, sanitation and hygiene policies, and a qualitative study exploring MHM behaviours of young people with disabilities in the Kavre district. Create: The “Bishesta” campaign - an MHM behaviour change package for young people with intellectual impairments (hereto referred to as ‘young people’) and their carers. Deliver: Implementation of the Bishesta campaign to 10 young people and carers in Kavre. Evaluate: a feasibility study of the campaign. KEY FINDINGS: The systematic review highlighted limited evidence about the barriers to MHM that people with disabilities and their carers face. People with intellectual impairments experienced the most negative outcomes, but only one MHM intervention was identified for this population. Within Nepal, disability was insufficiently addressed across policy, guidance and implementation. The qualitative study supported the findings of the systematic review, so people with intellectual impairments and their carers were targeted in the Bishesta campaign. The campaign was delivered through three group training modules and household visits; ‘period packs’ containing storage bags, a bin and MHM visual stories were distributed. The campaign was delivered with fidelity, and all target behaviours improved. CONCLUSION: People with disabilities in Nepal, particularly those with intellectual impairments, have large unmet MHM needs. The Bishesta campaign could support MHM for this group but requires efficacy testing before scaling up

Perfect moments: British advertising during the 1990s - an assessment of determinants

The aim of this thesis is to consider how advertisers and their clients in the 1990s conceptualised social and technological change. In particular, I address how advertisers deduced and represented new characteristics in their customers. By reflecting on changes in the content of adverts, I take a symptomatic approach in considering how new conceptualisations were incorporated into new and broader ad styles. To do this, in Chapter 1, the Literature Review, I identify my central approach and key issues against existing literature in the field. Given that this study is essentially an industry-oriented analysis of advertising, which not been attempted this way before, I consider the relevance of existing industrial and academic-centred critical models for this study. Chapter 2 then maps out the key changes in advertising in the 1990s from previous decades. It considers what prompted the ad industries to change their perspectives and how advertisers restructured their operations in an attempt to re-imagine their consumers. In Chapter 3 benchmarks of the key changes are examined in more detail. Three campaigns are examined to explore how promotional strategies negotiated (perceived) changes in consumers. The campaigns for Britvic Tango (1992), Daewoo cars (1995) and Tesco Clubcard (1997) were chosen because they are symptomatic of key moments during the 1990s in which the way advertising targeted consumers was re-addressed. In the final part of this chapter I consider how shifting methods of advertising during the 1990s registers in the 'bigger picture' of twentieth century communication. Following the case studies, the next two chapters review two key issues for advertising during the 1990s. Chapter 4 considers how advertisers changed their tone of address. Here issues such as national/personal representation and 'boutiques of history' are considered. Most notably, changes in youth mood is considered against advertising's own strategies for coping with change. Chapter 5 then considers changes in modes of address, and in particular the impact of digital technology on advertising's means of communication. Unlike the previous chapter, which demonstrates how advertising negotiated change, this section shows how the existing agency system was forced to change. Before 1990 an attitude perSisted in the ad industry that changes to the way agencies communicated and did business was (to a large extent) determined by advertisers themselves. This was not the case in 1990s. This study maps out how change was negotiated in a climate of cultural fragmentation and digitised communication

The role of data supported decision-making technology in respiratory care

Millions of people across the world are affected by Chronic Obstructive Pulmonary Disease (COPD). It is one of the most prevalent chronic health conditions in the world. As a life-long condition that effects breathing, it has a huge physical and mental impact on peoples’ lives every single day. COPD is characterised by periods of respiratory exacerbations which, if are not managed swiftly, can result in hospitalisation for emergency care. However, effective self-management and support can help people with COPD to avoid the distress of requiring emergency care, while supporting their quality of life and independence. In addition to the difficulties that COPD introduces to a plethora of people, it also presents a huge challenge for healthcare services around the world. In the UK, COPD generates a high number of hospital admissions annually, with many of these for emergency care. In this highly demanding and time-pressured context, healthcare professionals are required to make timely and evidence-based decisions to effectively care for patients. This is the challenging reality for all healthcare professionals that collaborate in the ongoing management and support involved for COPD care. Data supported decision-making (DSDM) technology holds potential to support the ongoing care of people with COPD, through connecting them and their healthcare professionals with pertinent data that can inform decision-making around care. Examples of such technologies include patient health monitoring apps that share data with healthcare professionals for personalised care planning, and clinical dashboards that interlink data from different sources to support decision-making about patient treatment. However, there is currently limited research working in partnership with people with COPD and respiratory healthcare professionals to truly understand how these technologies might support care in its real-world context. Specifically, there are three key gaps in knowledge which this thesis addresses. First, there is a need to understand how DSDM technologies can be designed to support healthcare professionals to provide COPD care, while considering the challenges of implementing technology into healthcare systems. Furthering this, there is a need to understand how technology could support the self-management of COPD, considering it is progressive and highly debilitating in nature. Finally, there is a need to understand how technology could support the ongoing care collaboration between healthcare professionals and patients through sharing patient-generated data about COPD symptoms. Each of these three areas are important in developing an understanding about how technology could support the real-world context of COPD care. To advance our knowledge in this space, I conducted three novel pieces of research working with people with COPD and healthcare professionals to understand how DSDM technologies could support everyday challenges related to COPD care. First, I worked with 11 healthcare professionals to co-design a DSDM dashboard by exploring their decision-making needs around COPD care. Then I conducted exploratory research involving 171 people with chronic respiratory conditions to understand how technology may support their self-care. Finally, I conducted a small exploratory case study with eight participants to understand the patient experience of self-monitoring their respiratory symptoms and the healthcare professionals’ experience of receiving this data remotely. The thesis concludes with a synthesis of the key novel findings across the three research studies, providing overarching opportunities and nodes of caution when designing and deploying DSDM technologies in this space. This discussion draws attention to the ways that perceptions of data ‘trustworthiness’ affects how DSDM technologies are used for decision-making, the tensions that occur when technology does not align with the local context of care, the need for self-management technology to support the personal and evolving condition journey of COPD, and how we may consider designing patient facing technologies to better accommodate potential reactive self-care pattern

Empathic design : emerging design research methodologies

A new relationship between product designers and the users of products is emerging. It is now being realised that users have complex supra-functional needs, which include the emotional, spiritual, social, tribal aspects of the relationship between particular products and the user/consumer'. Users seek more than mere functionality. In order to meet these needs designers need to actively develop research methodologies that are specifically aimed at collecting design relevant data which includes the often difficult to grasp elements of the supra-functional. The comfort zone for many designers involves designing products for themselves (or people like themselves) when intuition and insight can be closely matched. In modern, international markets and with increasingly demanding consumers, such approaches are inadequate. However, it is possible for designers to become directly immersed in researching users' needs and experiences rather than rely on third party research which, whilst potentially valuable, does not enable the same intimacy and potential for growth of experience for the designer. This approach is termed empathic design research. It seeks to broaden designers' 'comfort zone' by expanding the number of people they can empathise with, broadening their 'empathic horizon'. This thesis presents a body of published work by the author that explores the position of design research in relation to the changing role of Industrial/Product designers. The thesis consists of an introductory paper that pulls together the various strands in the published work. Following this a set of ten journal papers, one refereed conference paper and three book chapters is presented. The work as a whole defines a number of research approaches that designers can employ to elicit and understand users' suprafunctional needs. The papers establish the evolving context of product design and the growing interest in User-centred Design in its various forms. They examine research approaches that extend beyond user observation, involvement and draw the designer into a more empathic contact with users to illuminate functional and supra-functional requirements. Designers must learn to 'get under the skin' of the user; to develop empathy with users from population groups very different from their own in terms of culture, age and ability. This empathic intimacy can result in data generation and insight with this evaluation becoming an integral part of the designing process. The changing role of the product designer, as well as the nature of the design research process, frames the argument for adopting an empathic design research model. Finally, the author explores the implications of this important paradigm shift for design education.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Lectures on the Law and Labor-Management Relations

The 1950 Summer Institute on International and Comparative Law recognized the great importance, all over the world, of the problems of labor-management relations and the accelerating pace of development of labor law. The Institute sought, through the techniques of lecture, comment, and panel discussion, to provide a basis for an informed appraisal of some of the most challenging questions in this area. For the most part the program dealt with the problems arising in the attempt in the United States and in other countries to develop and apply legal standards to labor-management relations. Underlying the legal framework, however, are major questions of socio-economic policy which necessarily confront the legislator, judge, and lawyer. In recognition of this fact, the program included discussions of significant historical and economic aspects of unionism and collective bargaining.https://repository.law.umich.edu/summer_institute/1001/thumbnail.jp

Challenges for engineering students working with authentic complex problems

Engineers are important participants in solving societal, environmental and technical problems. However, due to an increasing complexity in relation to these problems new interdisciplinary competences are needed in engineering. Instead of students working with monodisciplinary problems, a situation where students work with authentic complex problems in interdisciplinary teams together with a company may scaffold development of new competences. The question is: What are the challenges for students structuring the work on authentic interdisciplinary problems? This study explores a three-day event where 7 students from Aalborg University (AAU) from four different faculties and one student from University College North Denmark (UCN), (6th-10th semester), worked in two groups at a large Danish company, solving authentic complex problems. The event was structured as a Hackathon where the students for three days worked with problem identification, problem analysis and finalizing with a pitch competition presenting their findings. During the event the students had workshops to support the work and they had the opportunity to use employees from the company as facilitators. It was an extracurricular activity during the summer holiday season. The methodology used for data collection was qualitative both in terms of observations and participants’ reflection reports. The students were observed during the whole event. Findings from this part of a larger study indicated, that students experience inability to transfer and transform project competences from their previous disciplinary experiences to an interdisciplinary setting