Painting the ideal home: using art to express visions of technologically supported independent living for older people in North East England

This paper describes the investigation of the development of future technological products to support older people in everyday living through the agency of a community art group. Recent research has identified a number of challenges facing designers seeking to use traditional participatory design approaches to gather technology requirements data from older people. Here, a project is described that sought to get a group of older people to think creatively about their needs and desires for technological support through the medium of paint. The artistic expression technique described in this article allowed the identification of issues that had also been found by previous research that used a range of different techniques. This indicates that the approach shows promise, as it allows information to be gathered in an environment that is comfortable and familiar using methods already known by the participants and which they find enjoyable. It provides a complement (or possible alternative) to standard protocols and has the potential benefit of extracting even richer information as the primary task for participants is enjoyable in its own right and is not associated with an interrogative process. Furthermore, it is argued that some of the key risks of traditional approaches are lessened or removed by the naturalistic setting of this approach

Implications of abnormal abdominal wall computed tomographic angiography findings on postmastectomy free flap breast reconstruction.

BACKGROUND: Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan. METHODS: We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected. RESULTS: Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were "miscellaneous." In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, and significant bone metastases. Another patient had no suitable vessels for a free flap and the surgical plan converted to a pedicled transverse rectus abdominis musculocutaneous flap. The remaining incidental findings had no impact on the surgical plan or appropriateness of FFBR. More than one in 10 of those with abnormal findings went on to have further imaging before their operation. CONCLUSIONS: CTA in FFBR can have a wider impact than facilitating surgical planning and reducing operative times. Incidental findings can influence the surgical plan, and in some instances, avoid doomed-to-fail and unsafe surgery. It is therefore important that these scans are reported by an experienced radiologist

Protocol for a multicentre randomised feasibility trial evaluating early Surgery Alone In LOw Rectal cancer (SAILOR)

Introduction There are 11,500 rectal cancers diagnosed annually in the UK. Although surgery remains the primary treatment there is evidence that preoperative radiotherapy (RT) improves local recurrence rates. High quality surgery in rectal cancer is equally important in minimising local recurrence. Advances in magnetic resonance imaging (MRI)-guided prediction of resection margin status and improvements in abdominoperineal excision of the rectum (APER) technique supports a reassessment of the contribution of preoperative RT. A more selective approach to RT may be appropriate given the associated toxicity. Methods and analysis This trial will explore the feasibility of a definitive trial evaluating the omission of RT in resectable low rectal cancer requiring APER. It will test the feasibility of randomising patients to i) standard care (neoadjuvant long course radiotherapy +/- chemotherapy and APER, or ii) APER surgery alone for cT2/T3ab N0/1 low rectal cancer with clear predicted resection margins on MRI. Radiotherapy schedule will be 45Gy over 5 weeks as current standard, with restaging and surgery after 8-12 weeks. Recruitment will be for 24 months with a minimum 12 month follow up. Objectives include testing the ability to recruit, consent and retain patients, to quantify the number of patients eligible for a definitive trial and to test feasibility of outcomes measures. These include locoregional recurrence rates, distance to circumferential resection margin, toxicity and surgical complications including perineal wound healing, quality of life and economic analysis. The quality of MRI staging, radiotherapy delivery and surgical specimen quality will be closely monitored. Ethics and dissemination The trial is approved by the regional ethics committee and Health Research Authority (HRA) or equivalent. Written informed consent will be obtained. Serious adverse events will be reported to Swansea Trials Unit (STU), the ethics committee and trial sites. Trial results will be submitted for peer review publication and to trial participants. Strengths and limitations of this study • A unique interventional study specific to low rectal cancer • Will explore the contribution of the modern abdominoperineal excision operation to cancer outcomes • Strict quality assurance processes for imaging, radiotherapy, surgery and pathology • Will establish if a future trial minimising radiotherapy use in low rectal cancer is feasible • Study is limited by short follow up perio

Applying a User-centred Approach to Interactive Visualization Design

Analysing users in their context of work and finding out how and why they use different information resources is essential to provide interactive visualisation systems that match their goals and needs. Designers should actively involve the intended users throughout the whole process. This chapter presents a user-centered approach for the design of interactive visualisation systems. We describe three phases of the iterative visualisation design process: the early envisioning phase, the global specification hase, and the detailed specification phase. The whole design cycle is repeated until some criterion of success is reached. We discuss different techniques for the analysis of users, their tasks and domain. Subsequently, the design of prototypes and evaluation methods in visualisation practice are presented. Finally, we discuss the practical challenges in design and evaluation of collaborative visualisation environments. Our own case studies and those of others are used throughout the whole chapter to illustrate various approaches

Designing for Experiences in Blended Reality Environments for People with Dementia

Blended Reality environments have the potential to provide scalable solutions that are affordable, adaptable and easily deployable to support people with dementia. Use of these technologies is associated with experience of presence which is an experience with technologically mediated perceptions that generates a feeling of being there and the illusion of non-mediation. Our study examines what constitutes an experience of presence for people with dementia when they interact with MRTs. An observational study with ten participants (MoCA = 18 to 23, Age = 63 to 88 years) played a game of Tangram on Osmo. Six of these participants also played Young Conker on HoloLens. The experiences of the participants in the digital space, the physical space, and their attention crossover between the two spaces were coded in Noldus Observer XT 14.1. The study found four main themes that have an impact on the experience of presence in PwD – correspondences, effortless access to physical and digital content, awareness of reality and emergence. Correspondences between physical and digital spaces require PwD to have constant information about the state and nature of physical and digital content. The transitions between physical and digital should be seamless. PwD demonstrated positive experiences with Osmo, an augmented Virtuality technology while their experience with HoloLens, augmented reality technology was negative. The factors impacting experience of presence were prominent in Osmo while they were mostly absent in HoloLens throughout the game play. The outcomes of this study have resulted in a set of recommendations and guidelines for designers to design correspondences for experience of presence. We are currently working on developing prototypes using these guidelines for evaluations with PwD.AGE-WEL

Two Plant Bacteria, S. meliloti and Ca. Liberibacter asiaticus, Share Functional znuABC Homologues That Encode for a High Affinity Zinc Uptake System

The Znu system, encoded for by znuABC, can be found in multiple genera of bacteria and has been shown to be responsible for the import of zinc under low zinc conditions. Although this high-affinity uptake system is known to be important for both growth and/or pathogenesis in bacteria, it has not been functionally characterized in a plant-associated bacterium. A single homologue of this system has been identified in the plant endosymbiont, Sinorhizobium meliloti, while two homologous systems were found in the destructive citrus pathogen, Candidatus Liberibacter asiaticus. To understand the role of these protein homologues, a complementation assay was devised allowing the individual genes that comprise the system to be assayed independently for their ability to reinstate a partially-inactivated Znu system. Results from the assays have demonstrated that although all of the genes from S. meliloti were able to restore activity, only one of the two Ca. Liberibacter asiaticus encoded gene clusters contained genes that were able to functionally complement the system. Additional analysis of the gene clusters reveals that distinct modes of regulation may also exist between the Ca. Liberibacter asiaticus and S. meliloti import systems despite the intracellular-plant niche common to both of these bacteria