Using design to mobilise knowledge from health research into practice

£8 billion pounds/year is spent on health related research and there is a responsibility to demonstrate a return on investment (Walshe & Davies 2013). Yet currently the translation of health services research knowledge into everyday practice remains a challenge (World Health Organisation, 2006). This challenge is known as the second knowledge translation gap (T2) or ‘campus to clinic’ gap (Greenhalgh & Wieringa 2011). Knowledge is defined by Aristotle in three distinct forms: episteme (facts), techne (skills) and phronesis (practical wisdom). In the context of health services research ‘knowledge’ is often interchangeable with ‘evidence’ and is defined as ‘research evidence’, ‘clinical experience’, ‘patient experience’ and ‘information about the local context’ (Rycroft-Malone et al. 2004). ‘Translation’ has many broad interpretations, with the process element being described as ‘transfer’, ‘exchange’, ‘brokering’, ‘utilisation’, ‘implementation’ and most recently ‘mobilisation’. This gap has given rise to a focused scientific field of study specifically exploring implementation, and resulted in models of factors affecting the implementation of research knowledge into everyday practice. In this research, the author started from the position that implementation is not a science but a practice; a practice that shares many similar traits with design practice. And therefore design practice can offer suggestions as to how to improve implementation of health research knowledge into practice. A review of concepts underpinning participatory design and design practice was conducted and compared to the consolidated framework complied by Damschroder et al (2009). This created two distinct descriptions that were overlaid. This paper presents these and the similarities and differences between the two are discussed to present an argument for the use of design practice to support the implementation of health services research knowledge into everyday practice.</p

Understanding the roll-on-pilfer-proof process

There is a requirement (within the food packaging industry) for a greater analytical knowledge and more scientific understanding of the ROPP capping process and of the interaction of caps (closures) with the threaded part of the glass container (finish). Threads used within the industry have largely developed empirically from metal thread profiles. An improved understanding is needed so that problems associated with that process can be better understood and solved. Such problems can be manifest in damaged closures, ‘spinners’ and closures that are just too difficult to open. The term ‘spinners’ is used for closures that do not break the pilfer band (a tamper evident safety feature) when twisted. The same term is also used to describe closures that have been turned the wrong way (i.e. clockwise) on opening, stripping the thread whilst not breaking the pilfer band. To combat this problem it is desirable to produce a closure system that has a high torque when twisted in the wrong direction (known as the over torque) whilst maintaining good seal integrity and a low torque for correct opening procedure. A successful feasibility study was carried out to investigate the appropriateness of using finite element techniques to investigate closure systems and gain the required understanding to improve these systems. The follow on project utilised these finite element techniques and experimental testing using a single-head capping machine. The Project focuses on the industry standard glass thread finish called the GF305 that utilises an extra deep, aluminium ROPP closure. The results of this work so far are presented here

Is green a grey area? Sustainability and inclusivity; the ageing population and recycling

There are growing pressures (political, legislative and environmental) to increase material recovery through recycling. There are two basic recycling schemes in the UK; kerbside and bring-site schemes. With current kerbside schemes, when a householder becomes unable, through age, illness or disability, to physically move their waste containers (bins,boxes or bags) onto the pavement for collection, the refuse collection service provider will enter the property premises, take the containers out to the refuse collection vehicle (RCV), empty them before returning them to the starting point. Obviously, with bring sites, people travel to the site and place the recycling in the banks themselves. With an ageing population, increasing numbers of older people are requiring specialist recycling services. These are likely to become more time consuming and costly as household numbers increase. Bring sites have obvious limitations for older people with their limited mobility and reduce strength. To date little or no previous research has been undertaken about barriers to recycling for older people and the implications to waste management providers of an ageing population. This paper describes initial work beginning to assess this problem within Lab4Living at Sheffield Hallam University (SHU).In this positioning paper, we examine literature regarding barriers to recycling and relationships with age. We outline a hypothetical scenario for the impact of the ageing population on future material recovery rates in the UK, present the initial results of a survey and we describe the potential role that design can play to eliminate these barriers and our activities within this area in our project; ‘The Grey Areas of Green Design’

Scribe: A Clustering Approach To Semantic Information Retrieval

Information retrieval is the process of fulfilling a user?s need for information by locating items in a data collection that are similar to a complex query that is often posed in natural language. Latent Semantic Indexing (LSI) was the predominant technique employed at the National Institute of Standards and Technology?s Text Retrieval Conference for many years until limitations of its scalability to large data sets were discovered. This thesis describes SCRIBE, a modification of LSI with improved scalability. SCRIBE clusters its semantic index into discrete volumes described by high-dimensional extensions to computer graphics data structures. SCRIBE?s clustering strategy limits the number of items that must be searched and provides for sub-linear time complexity in the number of documents. Experimental results with a large, natural language document collection demonstrate that SCRIBE achieves retrieval accuracy similar to LSI but requires 1/10 the time

Inclusive design: making packaging easier to open for all

Social equality demands a shift in attitude, away from treating older people and people with disabilities as special cases requiring special design solutions, and towards enabling them to have equal access to any product or service through a more inclusive approach to the design of buildings, public spaces and, more recently, products and services. This is not just important for social equality but also for business growth through new products and services and through creating wider potential markets. Consumer packaging is a field in which many people, including young able bodied people, often struggle in relation to openability. Until now, the main thrust of inclusive design in the consumer packaging field has been driven by art and design disciplines, focusing on the shape and ergonomics of the packaging or cognitive solutions in order to make them easier to open. This approach does not always work first time and a time consuming, materially expensive trial and error process often ensues. This paper outlines all the arguments for inclusive design, stressing the importance for both consumers and business. This paper also outlines an engineering design approach for inclusive design that uses real human factors as design limits, resulting in packaging that will be easily opened by all it’s end users without the expensive trial and error approach that has been used up to this point in time. The example of the Roll-On-Pilfer-Proof (ROPP) closure system is used in this paper

The 'inclusive engineering' approach: an optimum diameter for ease of opening

Social equality demands a shift in attitude, away from treating older people and people with disabilities as special cases requiring special design solutions, and towards enabling them to have equal access to any product or service through a more inclusive approach to the design of buildings, public spaces and, more recently, products and services. This is not just important for social equality but also for business growth through new products and services and through creating wider potential markets. It is a sad fact of life that as people get older there is a massive decline in their strength and dexterity. Due to the fact that we handle and manipulate so many things throughout our life time, from the tiniest and most dexterous of tasks to heavy manual labour, this decline is very noticeable in our hands. In nearly all the actions that we use our hands for there is some form of grip used in order to hold onto an object before manipulating it. The natural decrease in strength combined with debilitating illness such as arthritis, means that hand grip strength or finger grip strength are very seriously affected. This has a knock on affect of making it much harder to twist things or pinch and pull things. Therefore there is often a measured decrease in torque strength with age caused not so much by a decrease in wrist strength but more often than not by a decrease in grip strength. Consumer packaging is a field in which many people, including young able bodied people, often struggle in relation to openability. Yet it is present in even the most mundane and neccessary of every day tasks such as eating, cleaning teeth, even drinking. Human interation with consumer packaging requires a wide range of hand dexterity and strength and a variety of differing hand actions. This paper looks at just one such set of actions; that used to open bottles and jars. It outlines all the arguments for inclusive design, stressing the importance for both consumers and business. This paper also outlines an engineering design approach for inclusive design that uses real human factors as design limits, resulting in packaging that will be easily opened by all it’s end users without the expensive trial and error approach that has been used up to this point in time. This paper examines the affect of grip strength on the required trorque to open closures and concludes that there is an optimum diameter for ease of opening that will decrease the required strength to open such closures

Assisted Services - Physical support or psychological blow?

Work by Yoxall (2010) and Light (2010) showed that the relationship between artefacts and their use is complex; often beyond mere functional and physical use to a wider psychosocial context. Lack of understanding of this psychosocial aspect of product or service use immediately compromises the product or services design and future success. Further, in attempting to alleviate one issue through improved design we may create others. There is then an inherent complexity in the provision of design solutions that could be specific for each design. That the design process is complex and is involved in attempting to provide answers to 'wicked' problems (Rittel and Weber, 1973) is well understood. However, little work has been undertaken investigating the relationship between design solutions (either artefacts or services) and their effect on wellbeing. To that end the authors have undertaken a number of case studies outlining the complexity of design solutions, the unintended consequences and the effects on wellbeing of the individuals studied. Further the authors attempt to develop enhanced design processes to understand the complexity of the design solutions proposed and improve their effectiveness. The development of this understanding has required an interdisciplinary approach and has been a significant factor in arriving at the recognition of the importance of these psychosocial attachments. Hence this work examines these case studies in detail and examines the benefits and issues of interdisciplinary research activity

The Aston Medication Adherence Study:mapping the adherence patterns of an inner-city population

Background: The Aston Medication Adherence Study was designed to examine non-adherence to prescribed medicines within an inner-city population using general practice (GP) prescribing data. Objective: To examine non-adherence patterns to prescribed oralmedications within three chronic disease states and to compare differences in adherence levels between various patient groups to assist the routine identification of low adherence amongst patients within the Heart of Birmingham teaching Primary Care Trust (HoBtPCT). Setting: Patients within the area covered by HoBtPCT (England) prescribed medication for dyslipidaemia, type-2 diabetes and hypothyroidism, between 2000 and 2010 inclusively. HoBtPCT's population was disproportionately young,with seventy per cent of residents fromBlack and Minority Ethnic groups. Method: Systematic computational analysis of all medication issue data from 76 GP surgeries dichotomised patients into two groups (adherent and non-adherent) for each pharmacotherapeutic agent within the treatment groups. Dichotomised groupings were further analysed by recorded patient demographics to identify predictors of lower adherence levels. Results were compared to an analysis of a self-reportmeasure of adherence [using the Modified Morisky Scal