Understanding Iconography: a method to allow rich picture interpretation to improve.

Information Systems for complex situations often fail to adequately deliver quality and suitability. One reason for this failure is an inability to identify comprehensive user requirements. Seldom do all stakeholders, especially those "invisible‟ or "back room‟ system users, have a voice when systems are designed. If this is a global problem then it may impact on both the public and private sectors in terms of their ability to perform, produce and stay competitive. To improve upon this, system designers use rich pictures as a diagrammatic means of identifying differing world views with the aim of creating shared understanding of the organisation. Rich pictures have predominantly been used as freeform, unstructured tools with no commonly agreed syntax. This research has collated, analysed and documented a substantial collection of rich pictures into a single dataset. Attention has been focussed on three main research areas; how the rich picture is facilitated, how the rich picture is constructed and how to interpret the resultant pictures. This research highlights the importance of the rich picture tool and argues the value of adding levels of structure, in certain cases. It is shown that there are considerable benefits for both the interpreter and the creator by providing a pre-drawing session, a common key of symbols and a framework for icon understanding. In conclusion, it is suggested that there is some evidence that a framework which aims to support the process of the rich picture and aid interpretation is valuable.

Understanding nurses’ decision-making when managing weaning from mechanical ventilation: a study of novice and experienced critical care nurses in Scotland and Greece.

Aim and objectives To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Background Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well-described. Design A descriptive ethnographic study exploring critical care nurses' decision-making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Methods Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Results Scottish and Greek critical care nurses acquired patient-centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision-making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Conclusions Nurses used patient-centred information to make a judgment about the patients' ability to wean. Decision-making strategies that involve categorisation of patient-centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Relevance to clinical practice Advanced clinical reasoning skills and accurate detection of cues in respiratory assessment by critical care nurses will ensure optimum patient management in weaning mechanical ventilation

Understanding bystanders’ willingness to Intervene in traditional and cyberbullying scenarios.

Bullying incidents in traditional and online settings are a cause for concern to many parties. The goal of the current study was to explore the extent to which a bystander would intervene in a bullying incident and the degree to which this behavior is influenced by group size (the number of other witnesses), the setting (traditional or cyberbullying), and gender of the victim. Using an online survey method, participants were presented with eight bullying scenarios, each of which involved verbal bullying of a victim. Participants (N = 82) were asked to report how likely they would be to intervene in each of these scenarios. Results showed that female victims were more likely to be helped than male victims. Furthermore, female participants were more willing to intervene than the male participants in the cyberbullying scenarios. Altruism was a positive predictor of participants’ willingness to intervene. The present findings suggest that certain gender differences in helping behavior may depend on the context in which bullying is observed (traditional or cyberbullying).