Getting it Right: Lessons Learned in Applying a Critical Artefact Approach

“Critical artefacts”, the products of critical design (Dunne 1999), prompt reflection rather than satisfy obvious user needs. The author is developing an instrumental use of critical artefacts as part of a human-centred design process. Earlier work showed the effectiveness of this approach in allowing stakeholders to engage with novel product ideas. This paper describes a project, Living Rooms, developing the approach with a broader group of stakeholders and devising the critical artefacts with other designers. Although providing insights into the design context (Bowen & Chamberlain 2008), this application of the approach was less productive than in earlier projects and suggested factors that could affect its efficacy. Implications for future applications of the approach are noted: the type of contexts it is appropriate for; the characteristics of effective stakeholder participants and the need to educate them in the context and enable them to think imaginatively. Von Hippel’s ‘lead users’ (1986, 1988) could provide a framework for selecting stakeholders likely to engage effectively with critical artefacts. The second part of the paper summarises lead user theory and discusses how the two characteristics of lead users, motivation and capability (Luthje & Herstatt 2004), tend to make them suitable participants for the critical artefact approach. A second project, Digital Mementos, is described – in particular how lead-user-based selection and the above implications have been applied. The paper concludes by reviewing the progress in developing generalisable methods exploiting the critical artefact approach, noting the need to position the approach within wider design activity and points toward future work relating it to the entire product design process. Keywords: Critical Design; Human-Centred Design; Innovation; Design Methodology</p

Service innovation for living well with type 1 Diabetes

The UK’s NHS must evolve to embrace the co-production of health outcomes and patient-centred care to shift from the reductive treatment of illness to a holistic promotion of wellness. We are developing a methodology for service innovation building on this. Designing innovative services for young people with type 1 diabetes surfaced different views of wellness from health professionals, young people and their parents. Our challenge has been to value each perspective in what we have designed. Deploying artefacts enabled constructive dialogue with our participants, so how might interactive artefacts challenge views of wellness

Different views : including others in participatory health service innovation

We describe our experiences employing experience-based design (EBD) to improve an outpatients health service in the UK and discuss the impacts of incorporating the voices of those not directly using or working within the service. We suggest that such new perspectives, experiences and expertise may enable the development of service innovations outside patients’ and staffs’ conceptual space of problems/solutions, but can affect the ownership and agency within the change project. To conclude, we propose a balance between accomplishing change and creating the self-belief to achieve it

Use of quantitative ultrasound scans of the calcaneus to diagnose osteoporosis in patients with rheumatoid arthritis

Background: Patients with rheumatoid arthritis are recognized as being at risk for osteoporosis as a result of the disease process as well as the medication used to treat it. This study was conducted to consider the use of calcaneal scanning with quantitative ultrasound—contact ultrasound bone analysis (CUBA)—to diagnose osteoporosis in patients with rheumatoid arthritis.Methods: Forty-six patients (11 men and 35 women) with established rheumatoid arthritis underwent dual-energy x-ray absorptiometry (DEXA) of the nondominant wrist andCUBA of the nondominant heel. Sensitivity, specificity, and positive and negative predictive values were used to determine the correlation between osteoporosis as diagnosedby the CUBA heel scan compared with the DEXA wrist scan given that DEXA is widely seen as the gold standard for the diagnosis of osteoporosis.Results: The CUBA heel scan revealed a sensitivity of 90% and a specificity of 44% for a diagnosis of osteoporosis compared with DEXA. The positive predictive value of theCUBA scan was 31%, and the negative predictive value was 94%. Therefore, if normal bone density is found using CUBA, there is 94% certainty this is correct. However, if osteoporosis is diagnosed using CUBA, there is only 31% certainty this is correct. In such instances a secondary scan using a different method (eg, DEXA) would be required. Future work should consider the effect of minor alterations to the equipment or scanning protocol, because this may improve diagnosis.Conclusions: The CUBA unit could be used as a primary screening device. Given the cost and accessibility issues associated with DEXA, quantitative ultrasound may have arole in screening for osteoporosis in the primary-care setting to determine the most appropriate routes of referral for patients requiring further investigations. <br/

Participatory healthcare service design and innovation

This paper describes the use of Experience Based Design (EBD), a participatory methodology for healthcare service design, to improve the outpatient service for older people at Sheffield Teaching Hospitals. The challenges in moving from stories to designing improvements, co-designing for wicked problems, and the effects of participants' limited scopes of action are discussed. It concludes by proposing that such problems are common to participatory service design in large institutions and recommends that future versions of EBD incorporate more tools to promote divergent thinking

Aspects of the population biology of the cyst nematode parasites of oilseed rape

Investigation of the host-parasite relationship between oilseed rape, Heterodera cruciferae and H. schachtii has shown that the rate of hatching, development and reproduction is strongly influenced by temperature, two possible generations occurring on an autumn-sown crop. H.schachtii preferred warmer temperatures, hatched and reproduced more than H. cruciferae. Comparisons between newly-formed eggs in cysts and egg sacs showed that their different hatching responses were related to their physiology; cyst-bound eggs hatched poorly whereas juveniles hatched readily from egg sacs and facilitated the early establishment of a second generation. Multiplication of both species varied greatly between cultivars and differences in hatching and multiplication were attributed to the effects of plant growth and intrinsic differences between cultivars. Plant age influenced the hatching activity of root diffusates and nematode development. Multiplication rates of single and mixed species populations declined with increaSing initial population density indicating that intraspecific competition and root damage limited population growth. Nematodes multiplied synergistically in concomitant infestations suggesting that interspecific competition was less important. In a damage assessment test, root and shoot growth of nematodeinfested plants was reduced and the increased accumulation of calcium in their shoots indicated that they used water less efficiently than uninfested plants. These effects were density-dependent and H.schachtii was more damaging than H.cruciferae. Tolerance to nematode attack was attributed to good root establishment. The rate of decline of H.cruciferae populations varied with time, soil depth and between populations; low soil moisture and temperature favouring nematode survival. The role of weeds as ~maintainer hosts' of H.cruciferae was assessed but considered negligible. Nematode population dynamics were simulated using a computer model. Population densities fluctuated considerably under typical crop rotations but large populations had generally declined to less damaging levels before a host was cropped again. It was indicated that a long run of non-hosts or nematicide use would achieve better control of H.schachtii than H.cruciferae

Using popular culture to enable health service co-design with young people

This paper reports on participatory service design with young people with type 1 diabetes – a long-term condition that can impact their emotional wellbeing and where poor self-care often leads to negative health consequences. The paper describes a project working with young people with type 1 diabetes to design innovative health services. The project consisted of eight creative workshops, in which we used popular cultural references as a means to create enjoyable activities and encourage the young people to engage with design. These cultural references can be understood as creating design language games that allowed the young people to understand and participate in the activities required at each stage of the design process. However, not all popular culture references worked equally well and this paper explores the reasons for this