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BackgroundPeople living with cancer face numerous psychosocial challenges, including cancer-related fatigue, fear of recurrence, and depression. There is a lack of digital interventions tailored to the needs of people living with all types of cancer. We developed a 6-week, digital, peer-delivered, self-management program: iHOPE (Help to Overcome Problems Effectively; where ‘i’ indicates the digital version of the program). The program is underpinned by positive psychology and cognitive behavioral therapy to meet these psychosocial challenges. ObjectiveThis study aimed to assess the feasibility of the iHOPE program among people living with cancer. Program adherence and satisfaction along with changes in psychological distress and positive well-being were measured. MethodsA pre-post, acceptability, and feasibility design was used. People living with cancer (N=114) were recruited via a national cancer charity in the United Kingdom and were given access to the iHOPE program. Demographic and other participant characteristics were recorded. Participants completed digital measures at baseline and the end of the 6-week program for depression, anxiety, cancer-related fatigue, cancer worry or fear of cancer recurrence, positive mental well-being, hope, gratitude, and health status. The website’s system recorded data on the usage of the program. Satisfaction with the program was also measured. ResultsA total of 114 participants completed the baseline questionnaires. Of these, 70 people (61.4%) participated in all 6 sessions. The mean number of sessions undertaken was 5.0 (SD 1.5). Moreover, 44.7% (51/114) of participants completed at least three sessions and end-of-program outcome measures. A total of 59 participants completed the satisfaction questionnaire, where ≥90% (54/58) of participants reported that the program was easy to navigate and was well managed by the peer facilitators, and that they found the social networking tools useful. Preliminary efficacy testing among the 51 participants who completed baseline and postprogram outcome measures showed that postprogram scores decreased for depression, anxiety, cancer-related fatigue, and fear of recurrence (all P

Augmented reality (AR) has the potential to support individuals with special needs and to enable their development of daily living skills. This meta-analysis study examined the effect of AR on functional skills acquisition across individuals affected by different disabilities. Group design studies based on a random-effects model alongside the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used in this study. A total of 119 individuals with different types of disabilities (including intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, Down Syndrome, hearing disability, and visual disability) were obtained from seven studies. The overall effect size of AR across the seven studies was significant. The results showed that AR can be effective and helpful for individuals with disabilities to help them make daily decisions and guide their actions in society. The implications for practice and research as well as the possible areas that require further investigation are discussed.

There are currently a wide range of Higher Education Industrial Design courses available in the UK. In the present era, a wider breadth of narrative has developed within the subject, and as a result the content of industrial design educational offerings varies considerably. The paper assesses the industry view of Industrial Design as a discipline from the perspective of those employing university graduates. These views illustrate a change in the discipline, and this is considered in respect to current education practice. The choice of entry courses for the student wishing to embark on a career in the subject has also widened. It is argued that at present, the access to courses offers a haphazard informational stream to the potential applicant. An approach to developing an online facility to enable potential students to apply for the right course is discussed. It is suggested that a consistent and comparable platform of guidance is needed by which potential students can identify and match the course offering against their aptitudes and aspirations. A framework for such a system is proposed. Given that course choice will ultimately define the nature of their career opportunities it is argued that this would be a useful and productive asset.

Evidence suggests that much of the digital technology available and provided to older adults to enable self-management of long-term conditions is under-utilised. This research focuses on three conditions prevalent amongst older adults: diabetes, dementia and chronic kidney disease and explores the individual enablers and barriers to the use of digital self-management technology. The paper reports findings from a series of three systematic reviews of qualitative research (qualitative evidence syntheses). These reviews informed the design of a Delphi study. The first round of the Delphi involving 15 expert interviews is reported. The findings highlight common themes across the three conditions: how technology is used; barriers to use; assessing individual needs when selecting technology; support requirements; multi-functional self-management technologies; trust, privacy and data sharing; achieving accessible and aspirational design. Some emerging recommendations have been suggested to guide the design, and provision of technology to older adults. These will extended and refined through subsequent rounds of the Delphi method. [ABSTRACT FROM AUTHOR]

This paper provides an overview of the usability engineering process and relevant standards informing the development of medical devices, together with adaptations to accommodate situations such as global pandemics where use of traditional face-to-face methods is restricted. To highlight some of those adaptations, a case study of a project developing a novel electronic rehabilitation device is referenced, which commenced in November 2020 amidst the COVID-19 pandemic. The Sheffield Adaptive Patterned Electrical Stimulation (SHAPES) project, led by Sheffield Teaching Hospitals NHS Foundation Trust (STH), aimed to design, manufacture and trial an intervention for use to treat upper arm spasticity after stroke. Presented is an outline and discussion of the challenges experienced in developing the SHAPES health technology intended for at-home use by stroke survivors and in implementing usability engineering approaches. Also highlighted, are the benefits that arose, which can offer easier involvement of vulnerable users and add flexibility in the ways that user feedback is sought. Challenges included: restricted travel; access to usual prototyping facilities; social distancing; infection prevention and control; availability of components; and changing work pressures and demands. Whereas benefits include: less travel; less time commitment; and greater scope for participants with restricted mobility to participate in the process. The paper advocates a more flexible approach to usability engineering and outlines the onward path for development and trialling of the SHAPES technology. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) has the potential to support individuals with special needs and to enable their development of daily living skills. This meta-analysis study examined the effect of AR on functional skills acquisition across individuals affected by different disabilities. Group design studies based on a random-effects model alongside the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used in this study. A total of 119 individuals with different types of disabilities (including intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, Down syndrome, hearing disability, and visual disability) were obtained from seven studies. The overall effect size of AR across the seven studies was significant. The results showed that AR can be effective and helpful for individuals with disabilities to help them make daily decisions and guide their actions in society. The implications for practice and research as well as the possible areas that require further investigation are discussed. [ABSTRACT FROM AUTHOR]

Tram drivers operate a master controller to control the acceleration and braking of the tram. Operation should ensure passenger comfort and safety through smooth tram motion and the avoidance of jerkiness that may cause passengers to fall in the carriage. This work investigates current driver practices and strategies for tram driving in normal operations through interviews and the capacity of a new haptic master controller to support drivers in achieving smooth and safe tram journeys. A haptic feedback algorithm based on viscosity was implemented on the master controller to provide drivers with feedback on the rate at which they were accelerating and braking the tram. This aspect was tested in a virtual tram within a simulated inner city virtual reality environment. Results indicate that the haptic master controller and coupled viscosity feedback algorithm did not increase smoothness of driving during the simulated experiences. Despite this, the drivers indicated a preference for the provision of further haptic information to support driving tasks and the overall journey safety and smoothness. Practitioner Summary: This research comprises two studies. The first investigates strategies currently used by drivers to operate a tram smoothly in order to elicit design requirements for a haptic tram master controller. The second study evaluates the impact of a novel haptic master controller on journey smoothness within a virtual environment. [ABSTRACT FROM AUTHOR]

Background: Each year in England, almost 10,000 parents are informed of their child's positive newborn bloodspot screening (NBS) results. This occurs approximately 2 to 8 weeks after birth depending on the condition. Communication of positive NBS results is a subtle and skillful task, demanding thought, preparation, and evidence to minimize potentially harmful negative sequelae. Evidence of variability in the content and the way the result is currently communicated has the potential to lead to increased parental anxiety and distress. Objective: This study focused on the development of co-designed interventions to improve the experiences of parents receiving positive NBS results for their children and enhance communication between health care professionals and parents. Methods: An experience-based co-design approach was used to explore experiences and co-design solutions with 17 health professionals employed in 3 National Health Service Trusts in England and 21 parents (13/21, 62% mothers and 8/21, 38% fathers) of 14 children recruited from the same 3 National Health Service Trusts. Experiences with existing services were gathered via semistructured interviews with health professionals. Filmed narrative interviews with parents were developed into a composite film. The co-design process identified priorities for improving communication of positive NBS results through separate parent and health professional feedback events followed by joint feedback events. In total, 4 interventions were then co-designed between the participants through a web-based platform. Results: Parents and health professionals provided positive feedback regarding the process of gathering experiences and identifying priorities. Themes identified from the parent interviews included impact of initial communication, parental reactions, attending the first clinic appointment, impact of health professionals' communication strategies and skills, impact of diagnosis on family and friends, improvements to the communication of positive NBS results, and parents' views on NBS. Themes identified from the health professional interviews included communication between health professionals, process of communicating with the family, parent- and family-centered care, and availability of resources and challenges to effective communication. In response to these themes, 4 interventions were co-designed: changes to the NBS card; standardized laboratory proformas; standardized communication checklists; and an email or letter for providing reliable, up-to-date, condition-specific information for parents following the communication of positive NBS results. Conclusions: Parents and health professionals were able to successfully work together to identify priorities and develop co-designed interventions to improve communication of positive NBS results to parents. The resulting co-designed interventions address communication at different stages of the communication pathway to improve the experiences of parents receiving positive NBS results for their children. [ABSTRACT FROM AUTHOR]

Background: Daytime urinary incontinence (UI) is common in childhood and often persists into adolescence. UI in adolescence is associated with a range of adverse outcomes, including depressive symptoms, peer victimization, poor self-image, and problems with peer relationships. The first-line conservative treatment for UI is bladder training (standard urotherapy) that aims to establish a regular fluid intake and a timed schedule for toilet visits. The success of bladder training is strongly dependent on good concordance, which can be challenging for young people. Objective: This paper aims to describe the development of a smartphone app (URApp) that aims to improve concordance with bladder training in young people aged 11 to 19 years. Methods: URApp was designed by using participatory co-design methods and was guided by the person-based approach to intervention design. The core app functions were based on clinical guidance and included setting a daily drinking goal that records fluid intake and toilet visits, setting reminders to drink fluids and go to the toilet, and recording progress toward drinking goals. The development of URApp comprised the following four stages: a review of current smartphone apps for UI, participatory co-design workshops with young people with UI for gathering user requirements and developing wireframes, the development of a URApp prototype, and the user testing of the prototype through qualitative interviews with 23 young people with UI or urgency aged 10 to 19 years and 8 clinicians. The app functions and additional functionalities for supporting concordance and behavior change were iteratively optimized throughout the app development process. Results: Young people who tested URApp judged it to be a helpful way of supporting their concordance with a timed schedule for toilet visits and drinking. They reported high levels of acceptability and engagement. Preliminary findings indicated that some young people experienced improvements in their bladder symptoms, including a reduction in UI. Clinicians reported that URApp was clinically appropriate and aligned with the best practice guidelines for bladder training. URApp was deemed age appropriate, with all clinicians reporting that they would use it within their own clinics. Clinicians felt URApp would be of particular benefit to patients whose symptoms were not improving or those who were not engaging with their treatment plans. Conclusions: The next stage is to evaluate URApp in a range of settings, including pediatric continence clinics, primary care, and schools. This research is needed to test whether URApp is an effective (and cost-effective) solution for improving concordance with bladder training, reducing bladder symptoms, and improving the quality of life. [ABSTRACT FROM AUTHOR]

With an ageing population there is a growing need for technology that enables older adults to live independently for longer. The EU Horizon2020 funded MATUROLIFE project is focused on developing solutions that embed smart textiles to support well-being and independence in older adults. The study described here aimed to explore and initiate development of 'smart' footwear embedding assistive technology. A qualitative research strategy was employed including interviews with 37 older adults and co-creation activities with 56 older adults. Participants were recruited from eight European countries (Belgium, France, Germany, Italy, Poland, Spain, Turkey, and United Kingdom). The results detail the specific needs that older adults have in relation to footwear based on the daily activities they take part in. Participants shared their footwear fashion preferences, as well as their priorities for assistive functionality. A set-of co-created priorities and concept ideas are presented that consider how footwear might enable independent ageing. [ABSTRACT FROM AUTHOR]

There is a growing body of literature regarding living labs, which are seen as an effective way to develop and evaluate research for novel products and services with the actual end users. With growth in the living labs model, there is an increasing need for guidelines to steer and support the set-up and maintenance of initiatives, and to facilitate relationships and engagement with stakeholders and users in this context. This study seeks to address this need, in part, by exploring the needs, expectations, and motivations that older adults have in relation to research participation in an emerging living lab. This work is part of a wider research project to develop an integrated framework to guide emerging living labs. Eight semi-structured interviews were undertaken with six residents and two family members from two residential settings for older adults that were collaborating to establish a living lab environment. A concept-driven coding frame supported the coding and analysis of the interview transcripts. The results provide insights in relation to participant motivation to take part in research, and they identify some issues of concern for participants, both residents and family members, related to living lab initiatives. As a first step in developing a successful living lab culture of collaborative research, this study has demonstrated that open discussion with residents and their families should continue to guide processes and research design as the emerging living lab initiative continues. [ABSTRACT FROM AUTHOR]

There is an increasing drive in health care for creativity and innovation to tackle key health challenges, improve quality and access, and reduce harm and costs. Human-centered design (HCD) is a potential approach to achieving organizational innovation. However, research suggests the nursing workforce feels unsupported to take the risks needed for innovation, and leaders may not understand the conditions required to fully support them. The aim of this study was to identify enabling conditions that support frontline nurses in their attempts to behave as champions of innovation and change. An HCD workshop was undertaken with 125 nurses employed in clinical practice at Kaiser Permanente. The workshop included empathy mapping and semistructured questions that probed participant experiences with innovation and change. The data were collated and thematic analysis undertaken through a Grounded Theory approach. The data were analyzed to identify key enabling conditions. Seven enablers emerged: personal need for a solution; challenges that have meaningful purpose; clarity of goal and control of resources; active experimentation; experiences indicating progress; positive encouragement and confidence; and provision of psychological safety. These enablers were then translated into pragmatic guidelines for leaders on how the tools of HCD may be leveraged for innovation and change in health care. [ABSTRACT FROM AUTHOR]

Background:The European Disability Strategy (2010–2020) seeks to significantly raise the proportion of people with disabilities working in the open labour market. The ERGO WORK project is a collaboration of academic and industrial partners in six European countries, focused on understanding and tackling barriers to workplace inclusion for workers with disabilities. Methods:This study sought to explore the perceptions and needs of stakeholders in terms of workplace adaptation to the needs of employees with disabilities. An exploratory online survey was completed by 480 participants across six countries. Results:The analysis suggests that workplaces could be further improved to meet the needs of employees with considerable scope for training within companies to raise awareness about employees’ needs, employers’ obligations and workplace adaptation. Conclusions:This snapshot suggests there is still a gap between intent and reality in workplace inclusion and further strategies are needed to improve the opportunities for employees with disabilities. The paper argues that ergonomics may have a key role to play in tackling these challenges and adapting the workplace environment and job design to suit the needs of individual employees.Implications for rehabilitationThis study suggests there is considerable scope for workplace adaptation and improvements to meet the needs of employees with disabilities.Employers need and want further specialist practitioner guidance to facilitate workplace inclusion and support adaptation to individual needs.Organisations would benefit from training to raise awareness about potential solutions and approaches that would support more widespread employment of people with disabilities. [ABSTRACT FROM PUBLISHER]

Despite reported benefits of creative methodologies for the design and development of electronic Assisted Living Technologies (eALT), there exists a divide between design and health research, leaving health researchers wishing to pursue creative methods uninformed with regards choice of appropriate methods. This paper describes interim and emerging results from a systematic review which aimed to explore the value of creative methodologies for the design and development of eALT which may form part of the solution to the challenges of the ageing population. [ABSTRACT FROM AUTHOR]

User-context optimises smartphone interface-design. Neglect of usercontext during development, delays or prevents marginalised-consumer benefit. Working with People with Learning Disability (PWLD) to develop interfaces refined by communication-need will improve User-Experience (UX). In research, a Participant Information Sheet (PIS) discloses planned study-activity. This paper explains co-creation of a PIS based on communication-need of PWLD. [ABSTRACT FROM AUTHOR]

Background: With further expansion of the number of conditions for which newborn screening can be undertaken, it is timely to consider the impact of positive screening results and the confirmatory testing period on the families involved. This study was undertaken as part of a larger programme of work to evaluate the Expanded Newborn Screening (ENBS) programme in the United Kingdom (UK). It was aimed to determine the views and experiences of healthcare professionals (HCPs) and parents on communication and interaction during the period of confirmatory testing following a positive screening result.Methods: Semi-structured interviews were undertaken with parents of children who had received a positive ENBS result and HCPs who had been involved with the diagnosis and support of parents. Ten parents and 11 healthcare professionals took part in the in-depth interviews. Questions considered the journey from the positive screening result through confirmatory testing to a confirmed diagnosis and the communication and interaction between the parents and HCPs that they had been experienced. Key themes were identified through thematic analysis.Results: The results point to a number of elements within the path through confirmatory testing that are difficult for parents and could be further developed to improve the experience. These include the way in which the results are communicated to parents, rapid turnaround of results, offering a consistent approach, exploring interventions to support family relationships and reviewing the workload and scheduling implications for healthcare professionals.Conclusions: As technology enables newborn screening of a larger number of conditions, there is an increasing need to consider and mediate the potentially negative effects on families. The findings from this study point to a number of elements within the path through confirmatory testing that are difficult for parents and could be further developed to benefit the family experience. [ABSTRACT FROM AUTHOR]

Purpose: The WheelSense project aims to develop a system for assessing the stability and performance of wheelchairs through a user-centred design process. This study sought to capture user needs and define the specification for the system.Method: A mixed methods approach was adopted. An online survey was completed by 98 participants working in wheelchair provision. The results were built upon through 10 semi-structured interviews and one focus group (n = 5) with professionals working in wheelchair provision in three NHS Trusts in the UK.Results: The results provided a picture of the current UK practice in stability testing. Issues with the reliability and usefulness of the existing methods used to assess the stability and performance of wheelchairs were highlighted. Requirements for a new system were ascertained. These included improved accuracy of tipping angles, features to support record keeping, improved client/carer education support and ability to model or predict client–wheelchair system performance in different configurations. Conclusions: The paper concludes that there is a need for improved tools to determine the stability of the client–wheelchair system and support the prescription process, to ensure client safety and optimum equipment performance. A list of requirements has been produced to guide the future development of WheelSense.Implications for RehabilitationThe results of this survey and interview-based study present a picture of wheelchair stability testing practices in the UK, and highlight the need for new, more informative methods for guiding wheelchair prescription.The requirements for the design of a new system, or further development of existing tools to support the stability testing and prescription of wheelchairs have been established. [ABSTRACT FROM PUBLISHER]

There is increasing recognition of the importance of user-centred design and testing in the healthcare technology domain. Challenges associated with user and stakeholder involvement in designing solutions for healthcare are recognized in the literature and need to be addressed to facilitate the development of new technology that is usable and acceptable to the end-user. The Devices for Dignity Health Technology Cooperative (D4D) has been involved in a range of technology development projects with an underpinning approach of addressing unmet needs through user involvement. This paper provides practical examples of some of the challenges that occur at different stages during a user-centred design process including ethical approval processes; stakeholder and user recruitment and involvement; eliciting needs from users regarding sensitive and personal issues; and interdisciplinary working. The paper will describe some of the strategies that have been employed by D4D to overcome these challenges and facilitate technology development. [ABSTRACT FROM PUBLISHER]

There are currently a wide range of Higher Education Industrial Design courses available in the UK. In the present era, a wider breadth of narrative has developed within the subject, and as a result the content of industrial design educational offerings varies considerably. The paper assesses the industry view of Industrial Design as a discipline from the perspective of those employing university graduates. These views illustrate a change in the discipline, and this is considered in respect to current education practice. The choice of entry courses for the student wishing to embark on a career in the subject has also widened. It is argued that at present, the access to courses offers a haphazard informational stream to the potential applicant. An approach to developing an online facility to enable potential students to apply for the right course is discussed. It is suggested that a consistent and comparable platform of guidance is needed by which potential students can identify and match the course offering against their aptitudes and aspirations. A framework for such a system is proposed. Given that course choice will ultimately define the nature of their career opportunities it is argued that this would be a useful and productive asset. [ABSTRACT FROM AUTHOR]

Wheelchair users experience many situations that affect the stability and associated performance of their wheelchair. Stability is affected by user characteristics and abilities, environmental features and conditions, and wheelchair modification and accessories. Wheelchair prescribers need effective tools and methods to provide quantitative evaluation and prediction of the behavior of the user-wheelchair system in a variety of static and dynamic situations. Such information is very important to guide efficient management of associated risks and adjust chairs accordingly. This project involves a user-centered approach for design and evaluation of a load cell based wheelchair stability assessment system (Wheel-SAS). Here, the current methods for assessing stability are described, and their shortcomings explained. The user-centered design approach being applied to the development of the associated Wheel-SAS hardware and software is described. Future work including semi-structured interviews and an online survey with wheelchair prescribers and associated healthcare professionals for deriving user requirements and a design specification for a load cell system for measuring dynamic wheelchair stability are detailed. [ABSTRACT FROM AUTHOR]

Surgical skills are traditionally assessed through subjective evaluation with experienced surgeons observing and rating trainee activity. However, this process can be expensive, particularly in terms of the time required of expert surgeons. Subjective assessment may also suffer from problems of intersubject variation in the application of evaluation criteria. Computer-based training, in particular systems combining virtual reality interfaces with haptic displays, offers a means of providing both automated and objective assessment of performance. In this paper we propose that, prior to the development of such systems, there is a need to determine measures that can adequately differentiate levels of performance. The paper therefore discusses the evaluation of surgical technique using objective metrics. Two main questions are addressed. How can surgical technique be assessed? What metrics prove useful in defining and modifying surgical skills and techniques? [ABSTRACT FROM AUTHOR]