What is Sensemaking in the Context of External Radiotherapy Treatment Planning?

The external beam radiotherapy (RT) is one of the medical treatments against cancer, which is changing rapidly in these years as a result of technological advancements. Despite the expected benefits of integrating new technologies, often it results in increased cognitive workload for the user. This paper describes the (a) current clinical context of external radiotherapy from the perspective of defining tumorous volumes; (b) the concepts of problem solving, decision making and sensemaking; and (c) the main cognitive processes while defining tumorous volumes in the frame of user-system-environment interaction.Design EngineeringIndustrial Design Engineerin

Innovating health care: Key characteristics of human-centered design

Human-centered design is about understanding human needs and how design can respond to these needs. With its systemic humane approach and creativity, human-centered design can play an essential role in dealing with today's care challenges. 'Design' refers to both the process of designing and the outcome of that process, which includes physical products, services, procedures, strategies and policies. In this article, we address the three key characteristics of human-centered design, focusing on its implementation in health care: (1) developing an understanding of people and their needs; (2) engaging stakeholders from early on and throughout the design process; (3) adopting a systems approach by systematically addressing interactions between the micro-, meso- and macro-levels of sociotechnical care systems, and the transition from individual interests to collective interests. Applied Ergonomics and DesignHuman-Centered Desig

Zitten: Wat weet je stoel daar nu van? Een veldstudie naar zithoudingen en zittijd tijdens kantoorwerk

Dit artikel is geschreven op basis van onderzoek gericht op het meten van zitgedrag van kantoorwerkers en het evalueren van twee typen interventies om zithoudingen te verbeteren (Netten, 2011). Daarna is praktijkdata van het zitgedrag vergeleken met de richtlijnen voor zittijden uit Ryan et al. (2011).Industrial DesignIndustrial Design Engineerin

Self-assessment in laparoscopic surgical skills training: Is it reliable?

Background: The concept of self-assessment has been widely acclaimed for its role in the professional development cycle and self-regulation. In the field of medical education, self-assessment has been most used to evaluate the cognitive knowledge of students. The complexity of training and evaluation in laparoscopic surgery has previously acted as a barrier in determining the benefits self-assessment has to offer in comparison with other fields of medical education. Methods: Thirty-five surgical residents who attended the 2-day Laparoscopic Surgical Skills Grade 1 Level 1 curriculum were invited to participate from The Netherlands, India and Romania. The competency assessment tool (CAT) for laparoscopic cholecystectomy was used for self- and expert-assessment and the resulting distributions assessed. Results: A comparison between the expert- and self-assessed aggregates of scores from the CAT agreed with previous studies. Uniquely to this study, the aggregates of individual sub-categories—‘use of instruments’; ‘tissue handling’; and errors ‘within the component tasks’ and the ‘end product’ from both self- and expert-assessments—were investigated. There was strong positive correlation (rs > 0.5; p < 0.001) between the expert- and self-assessment in all categories with only the ‘tissue handling’ having a weaker correlation (rs = 0.3; p = 0.04). The distribution of the mean of the differences between self-assessment and expert-assessment suggested no significant difference between the scores of experts and the residents in all categories except the ‘end product’ evaluation where the difference was significant (W = 119, p = 0.03). Conclusion: Self-assessment using the CAT form gives results that are consistently not different from expert-assessment when assessing one’s proficiency in surgical skills. Areas where there was less agreement could be explained by variations in the level of training and understanding of the assessment criteria.Applied Ergonomics and DesignIndustrial Desig

Pressure sensitivity for head, face and neck in relation to soft tissue

Pressure sensitivity research on the head, face, and neck is critical to develop ways to reduce discomfort caused by pressure in head-related products. The aim of this paper is to provide information for designers to be able to reduce the pressure discomfort by studying the relation between pressure sensitivity and soft tissue in the head, face and neck. We collected pressure discomfort threshold (PDT) and pressure pain threshold (PPT) from 119 landmarks (unilateral) for 36 Chinese subjects. Moreover, soft tissue thickness data on the head, face and neck regions of 50 Chinese people was obtained through CT scanning while tissue deformation data under the PDT and PPT states was obtained from literature. The results of the three-elements correlation analysis revealed that soft tissue thickness is positively correlated with deformation but not an important factor in pressure sensitivity. Our high-precision pressure sensitivity maps confirm earlier findings of more rough pressure sensitivity studies, while also revealing additional fine scale sensitivity differences. Finally, based on the findings, a high-precision "recommended map” of the optimal stress-bearing area of the head, face and neck was generated.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Human-Centered DesignApplied Ergonomics and Desig

Digital Patient Experience: Umbrella Systematic Review

Background: The adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx). Objective: This study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health. Methods: We performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories. Results: The search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx-related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations. Conclusions: We propose the following definition for digital PEx: "Digital patient experience is the sum of all interactions affected by a patient's behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health." In this study, we constructed a design and evaluation framework that contains 4 phases-define design, define evaluation, design ideation, and design evaluation-and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx-related research.Applied Ergonomics and DesignHuman-Centered Desig

Design-Relevant Factors Affecting the Patient Experience in Digital Health: Preliminary Results of an Umbrella Systematic Review

Since Covid-19, digital health interventions (DHIs) have been embraced as never before. The pandemic led to many new challenges, including the patient experience in digital health care delivery. In this literature study, we identified and synthesized factors that impact patient experience in digital health (dPEx), and reviewed the methods and strategies relevant to its design and implementation. We conducted an umbrella review including 15 reviews representing 543 studies. Four themes were identified that describe design-relevant factors that impact dPEx: individual context, content, technical issues, and design features. We propose a preliminary framework to explain the relationship between each factor and support user-centered design efforts. Further research is needed to identify which factors have the most impact.Applied Ergonomics and DesignHuman-Centered Desig

DINED Mannequin

Designing products that closely interact with the human body can be quite challenging. Think for example about wearables like helmets, (Virtual Reality-) goggles, masks, garments, sports braces, or shoes. We are all unique individuals and this requires designers to carefully consider the great variety of human body shapes and come up with smart ways of accommodating this variety in such products through the use of sizing systems, adjustable parts, or flexible materials.We introduce ‘Mannequin’, a new tool for the DINED- platform. Through this tool, we want to make 3D anthropometry accessible for engineers, designers, and ergonomists by providing an intuitive interface for exploring 3D body shape variation and creating 3D design manikins. In the open data spirit of DINED, Mannequin can be freely used for both research and commercial purposes.Applied Ergonomics and DesignHuman-Centered Desig

Identify Finger Rotation Angles With ArUco Markers and Action Cameras

Measuring the motions of human hand joints is often a challenge due to the high number of degrees-of-freedom. In this study, we proposed a hand tracking system utilizing action cameras and ArUco markers to continuously measure the rotation angles of hand joints during motion. Three methods were developed to estimate the joint rotation angles. The pos-based method transforms marker positions to a reference coordinate system and extracts a hand skeleton to identify the rotation angles. Similarly, the orient-x-based method calculates the rotation angles from the transformed x-orientations of the detected markers in the reference coordinate system. In contrast, the orient-mat-based method first identifies the rotation angles in each camera coordinate system using the detected orientations and then synthesizes the results regarding each joint. Experiment results indicated that the repeatability errors with one camera regarding different marker sizes were around 2.64–27.56 deg and 0.60–2.36 deg using the marker positions and orientations, respectively. With multiple cameras employed, the joint rotation angles measured by using the three methods were compared with that measured by a goniometer. Comparison results indicated that the results of using the orient-mat-based method are more stable and efficient and can describe more types of movements. The effectiveness of this method was further verified by capturing hand movements of several participants. Therefore, it is recommended for measuring joint rotation angles in practical setups.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Emerging MaterialsHuman-Centered DesignApplied Ergonomics and Desig

Comparing the Active, Functional, and Passive Range of Motion of Finger Joints Using Dynamic Measurement

Studies on finger kinematics, especially the range of motion (RoM) measurements, are essential to understand the use of finger joints and the pathology of related disease. Limited literatures compared the active RoM (A-RoM) of finger joints with either their functional RoM (F-RoM) or passive RoM (p-RoM) using different measuring protocols and tools. This study aims to provide an overall comparison including all three types of RoMs. We measured A-RoM, F-RoM, and P-RoM, using a dynamic measurement system. Our goal is to investigate the relationships among the three RoMs by comparing their extreme rotation angles. The results suggested that P-RoM was the largest motion range, and F-RoM can exceed their A-RoM. The F-RoM of distal-interphalangeal joints may rotated 8–20° more than their A-RoM, mainly during precise and power manipulations. Besides to A-RoM, knowledge of F-RoM and P-RoM are also important for a comprehensive understanding for clinical practice, and thus, to support the optimization and evaluation of treatment devices for finger joint, such as implant replacement.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Human-Centered DesignApplied Ergonomics and Desig