Implications for the design of a digital stethoscope for anaesthetic preadmission consultations

Background This research addresses the development of a digital stethoscope for use with a telehealth communications network to allow doctors to examine patients remotely (a digital telehealth stethoscope). A telehealth stethoscope would allow remote auscultation of patients who do not live near a major hospital. Travelling from remote areas to major hospitals is expensive for patients and a telehealth stethoscope could result in significant cost savings. Using a stethoscope requires great skill. To design a telehealth stethoscope that meets doctors’ expectations, the use of existing stethoscopes in clinical contexts must be examined. Method Observations were conducted of 30 anaesthetic preadmission consultations. The observations were video- taped. Interaction between doctor, patient and non-human elements in the consultation were “coded” to transform the video into data. The data were analysed to reveal essential aspects of the interactions. Results The analysis has shown that the doctor controls the interaction during auscultation. The conduct of auscultation draws heavily on the doctor’s tacit knowledge, allowing the doctor to treat the acoustic stethoscope as infrastructure – that is, the stethoscope sinks into the background and becomes completely transparent in use. Conclusion Two important, and related, implications for the design of a telehealth stethoscope have arisen from this research. First, as a telehealth stethoscope will be a shared device, doctors will not be able to make use of their existing expertise in using their own stethoscopes. Very simply, a telehealth stethoscope will sound different to a doctor’s own stethoscope. Second, the collaborative interaction required to use a telehealth stethoscope will have to be invented and refined. A telehealth stethoscope will need to be carefully designed to address these issues and result in successful use. This research challenges the concept of a telehealth stethoscope by raising questions about the ease and confidence with which doctors could use such a device.

Equity and research design

This chapter recognizes that research is a cultural invention and explains why. It discusses what equity, research and research design mean, and suggests that the concept of equity is enriched considerably when ideas from Indigenous, critical and politically committed research traditions are involved in research design. When research design and the processes of research are guided by principles of equity, several issues warrant investigation. These include power relations, deficit models of research, homogeneity and reflexivity. Research design that is informed by principles of equity is explicit in its political purpose of seeking socially just outcomes for the short and long term.

The impact of red light cameras on safety in Arizona

Red light cameras (RLCs) have been used in a number of US cities to yield a demonstrable reduction in red light violations; however, evaluating their impact on safety (crashes) has been relatively more difficult. Accurately estimating the safety impacts of RLCs is challenging for several reasons. First, many safety related factors are uncontrolled and/or confounded during the periods of observation. Second, “spillover” effects caused by drivers reacting to non-RLC equipped intersections and approaches can make the selection of comparison sites difficult. Third, sites selected for RLC installation may not be selected randomly, and as a result may suffer from the regression to the mean bias. Finally, crash severity and resulting costs need to be considered in order to fully understand the safety impacts of RLCs. Recognizing these challenges, a study was conducted to estimate the safety impacts of RLCs on traffic crashes at signalized intersections in the cities of Phoenix and Scottsdale, Arizona. Twenty-four RLC equipped intersections in both cities are examined in detail and conclusions are drawn. Four different evaluation methodologies were employed to cope with the technical challenges described in this paper and to assess the sensitivity of results based on analytical assumptions. The evaluation results indicated that both Phoenix and Scottsdale are operating cost-effective installations of RLCs: however, the variability in RLC effectiveness within jurisdictions is larger in Phoenix. Consistent with findings in other regions, angle and left-turn crashes are reduced in general, while rear-end crashes tend to increase as a result of RLCs.

Women are people too : the problem of designing for gender

Cultural theory breaks with Modern analysis by rejecting traditional notions of race, gender, class and sexuality. In doing so, alternative frameworks such as Post-Feminism emerge which are useful for thinking about culture, technology and what our interactions with it mean. From a Post-Feminist perspective it can be seen how in our multi-cultural, post-industrial, digitized world, there is space to move beyond traditional ways of dividing up society such as ‘male’ and ‘female’. We are then free to re-construct our identity in light of a rich diversity of individually relevant experiences. Therefore, in order to get a better understanding of the highly nuanced cultural interactions that characterize our use of technology, this paper argues against using the inherently stereotyped lens of gender and allowing a new set of user needs to emerge.

A CFD study of Hong Kong refuge floor design : floor height effect

Since 1996, ther provision of a refuge floor has been a mandatory feature for all new tall buildings in Hong Kong. These floors are designed to provide for building occupants a fire safe environment that is also free from smoke. However, the desired cross ventilation on these floors to achieve the removal of smoke, assumed by the Building Codes of Hong Kong, is still being questioned so that a further scientific study of the wind-induced ventilation of a refuge fllor is needed. This paper presents an investigation into this issue. The developed computational technique used in this paper was adopted to study the wind-induced natural ventilation on a refuge floor. The aim of the investigation was to establish whether a refuge floor with a cetnral core and having cross ventilation produced by only two open opposite external side walls on the refuge floor would provide the required protection in all situations taking into account behaviour of wind due to different floor heights, wall boundary conditions and turbulence intensity profiles. The results revealed that natural ventilation can be increased by increasng the floor heigh provided the wind angle to the building is less than 90 degrees. The effectiveness of the solution was greatly reduced when the wind was blowing at 90 degrees to the refuge floor opening.

Passenger flow and station facilities modelling for metro station layout design

This paper presents the simulation model development of passenger flow in a metro station. The model allows studies of passenger flow in stations with different layouts and facilities, thus providing valuable information, such as passenger flow and density of passenger at critical locations and passenger-handling facilities within a station, to the operators. The adoption of the concept of Petri nets in the simulation model is discussed. Examples are provided to demonstrate its application to passenger flow analysis, train scheduling and the testing of alternative station layouts.

HCI & sustainable food culture : a design framework for engagement

The current food practices around the world raises concerns for food insecurity in the future. Urban / suburban / and peri-urban environments are particularly problematic in their segregation from rural areas where the natural food sources are grown and harvested. Soaring urban population growth only deteriorates the lack of understanding in and access to fresh produce for the people who live, work, and play in the city. This paper explores the role of Human-Computer Interaction (HCI) design in encouraging individual users to participate in creating sustainable food cultures in urban environments. The paper takes a disciplinary perspective of urban informatics and presents five core constituents of the HCI design framework to encourage sustainable food culture in the city via ubiquitous technologies: the perspective of transdisciplinarity; the domains of interest of people, place, and technology; and the perspective of design.

Advancing design for sustainable food cultures

Our paper, “HCI & Sustainable Food Culture: A Design Framework for Engagement,” presented at the 2010 NordiCHI conference, introduced a design framework for understanding engagement between people and sustainable food cultures (Choi and Blevis, 2010). Our goal for this chapter “Advancing Design for Sustainable Food Cultures” is to expand our notion of this design framework and the programme of research it implies. This chapter presents the three elements of design framework for sustainability: (i) engagement across disciplines; (ii) engagement with and amongst users/non-users and; (iii) engagement for sustained usability. The uses a corresponding sample of photographic records of experiences that reflect three key issues in the current sustainable food domain: respectively, (i) context of food cultures, (ii) farmers’ markets, and (iii) producing food.

Using a design led disruptive innovation approach to develop new services : practising innovation in times of discontinuity

Organisations face increasing competition from new firms in emerging markets and their past superior products may no longer provide competitive advantage in markets based on different cost and value differentials. A shift in design practices from product solutions to health services which are accessible and affordable by all is required. This paper explores a design led approach to innovation to assist medical device companies develop new services and experiences and reshape their notions of the nature, development and deployment of health care services. This approach uses design tools and methodologies that are grounded in the authentic understandings of stakeholder experiences, to assist an organisation create a vision of likely future health care scenarios. Through this process, organisations can explore the complexities in the delivery of future health care services in new and emerging markets allowing them to tailor product and service solutions which focus on being accessible and affordable by all. The industry based case study for the design of health services in carried out in emerging economies. The contribution of this work in advancing research into design innovation and future research directions are also presented.

James Street market, Brisbane : a subtropical retail case study

Climate change mitigation is driving demand for energy-efficient and environmentally conscious commercial buildings in Australia. In the Australian subtropics, high rainfall, warm weather and humidity present unique challenges and opportunities for the architects tasked with designing eco-sensitive projects. The case of the James Street Market in Brisbane’s Fortitude Valley shows that climate-responsive design is an effective approach for reducing the environmental impact of commercial developments. The James Street Market combines climate-responsiveness, environmentally sensitive design strategies and smart planning to create a more sustainable retail precinct. This paper details the design strategies featured in the James Street Market, the project that kicked off a renaissance in climate-responsive commercial building design in Brisbane.

The comparison of international and local sustainable assessment tools of landscape design for housing estate developments : case of Bangkok Metropolitan Region, Thailand

Various countries have been introducing sustainable assessment tools for real estate design to produce integrated sustainability components not just for the building, but also the landscape component of the development. This paper aims to present the comparison between international and local assessment tools of landscape design for housing estate developments in Bangkok Metropolitan Region (BMR), Thailand. The methodologies used are to review, then compare and identify discrepancy indicators among the tools. This paper will examine four international tools; LEED for Neighbourhood Development (LEED – ND) of United State of America (USA), EnviroDevelopment standards of Australia, Residential Landscape Sustainability of United Kingdom (UK) and Green Mark for Infrastructure of Singapore; and three BMR’s existing tools; Land Subdivision Act B.E. 2543, Environmental Impact Assessment Monitoring Awards (EIA-MA) and Thai’s Rating for Energy and Environmental Sustainability of New construction and major renovation (TREES-NC). The findings show that there are twenty two elements of three categories which are neighbourhood design, community management, and environmental condition. Moreover, only one element in neighbourhood designs different between the international and local tools. The sustainable assessment tools have existed in BMR but they are not complete in only one assessment tool. Thus, the development of new comprehensive assessment tool will be necessary in BMR; however, it should meet the specific environment and climate condition for housing estate development at BMR.

Intrinsically photosensitive melanopsin retinal ganglion cell contributions to the pupillary light reflex and circadian rhythm

Recently discovered intrinsically photosensitive melanopsin retinal ganglion cells contribute to the maintenance of pupil diameter, recovery and post-illumination components of the pupillary light reflex and provide the primary environmental light input to the suprachiasmatic nucleus for photoentrainment of the circadian rhythm. This review summarises recent progress in understanding intrinsically photosensitive ganglion cell histology and physiological properties in the context of their contribution to the pupillary and circadian functions and introduces a clinical framework for using the pupillary light reflex to evaluate inner retinal (intrinsically photosensitive melanopsin ganglion cell) and outer retinal (rod and cone photoreceptor) function in the detection of retinal eye disease.

"I'm a designer, get me out of tech class!" : closing the gap between design and technology education

The following paper explores the use of collaborative pedagogical approaches to advance foundational architectural design education, by linking design process to sustainable technology principles. After a brief discussion on architectural design education, the mentioned collaborative approach is described. This approach facilitates students’ exchange of knowledge between two courses, despite no explicit/assessable requirement to do so. The result for the students is deeper learning and a design process that is enriched through collaboration with sustainable technology. The success of this approach has been measured through questionnaires, evaluation surveys, and a comparative assessment of students common to both courses. The paper focuses on the challenges and innovations in connecting architectural design and technology education, where students are encouraged to implement lessons learnt, thereby closing the gap that these courses have traditionally represented.

Navigating technological contexts and experience design in music education

For some time we have jokingly referred to our network jamming research with jam2jam as ‘Switched on Orff’ (Brown, Sorensen and Dillon 2002; Dillon 2003; Dillon 2006; Dillon 2006; Brown and Dillon 2007). The connection with electronic music and Wendy Carlos’ classic work ‘Switched on Bach’ was obvious; we were using electronic music in schools and with children. The deeper connection with Orff however was about recognising that electronic music and instruments could have cultural values and knowledge embedded in their design and practice in same way as what has come to be known as the Orff method (Orff and Keetman 1958-66). However whilst the Orff method focuses upon Western art music perceptual framework electronic instruments have the potential to have more fluid musical environments and even to move to interdisciplinary study by including visual media. Whilst the Orff method focused on making sense of Western art music through experience electronic environments potentially can make sense of the world of multi media that pervades our lives.