Anticipating intended users - Prospective sensemaking in technology development

How do developers and designers of a new technology make sense of intended users? The critical groundwork for user-centred technology development begins not by involving actual users' exposure to the technological artefact but much earlier, with designers' and developers' vision of future users. Thus, anticipating intended users is critical to technology uptake. We conceptualise the anticipation of intended users as a form of prospective sensemaking in technology development. Employing a narrative analytical approach and drawing on four key communities in the development of Grid computing, we reconstruct how each community anticipated the intended Grid user. Based on our findings, we conceptualise user anticipation in Terms of two key dimensions, namely the intended possibility to inscribe user needs into the technological artefact as well as the intended scope of the application domain. In turn, these dimensions allow us to develop an initial typology of intended user concepts that in turn might provide a key building block towards a generic typology of intended users.

A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures

Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well as highlighting the differences between bone and soft tissue punctures. An overall average error of 4.23 mm and 3.07 mm for bone and soft tissue punctures, respectively, demonstrated the feasibility of using this system for such interventions. The proposed system workflow was shown to be effective in separating the preparation from the sterile phase, as well as in keeping the system manageable by a single operator. Among the distinct sources of error, the user error based on the system accuracy (defined as the distance from the planned target to the actual needle tip) appeared to be the most significant. Bone punctures showed higher user error, whereas soft tissue punctures showed higher tissue deformation error.

An Instrument Design for Space-Based Optical Observation of Space Debris

Currently, observations of space debris are primarily performed with ground-based sensors. These sensors have a detection limit at some centimetres diameter for objects in Low Earth Orbit (LEO) and at about two decimetres diameter for objects in Geostationary Orbit (GEO). The few space-based debris observations stem mainly from in-situ measurements and from the analysis of returned spacecraft surfaces. Both provide information about mostly sub-millimetre-sized debris particles. As a consequence the population of centimetre- and millimetre-sized debris objects remains poorly understood. The development, validation and improvement of debris reference models drive the need for measurements covering the whole diameter range. In 2003 the European Space Agency (ESA) initiated a study entitled “Space-Based Optical Observation of Space Debris”. The first tasks of the study were to define user requirements and to develop an observation strategy for a space-based instrument capable of observing uncatalogued millimetre-sized debris objects. Only passive optical observations were considered, focussing on mission concepts for the LEO, and GEO regions respectively. Starting from the requirements and the observation strategy, an instrument system architecture and an associated operations concept have been elaborated. The instrument system architecture covers the telescope, camera and onboard processing electronics. The proposed telescope is a folded Schmidt design, characterised by a 20 cm aperture and a large field of view of 6°. The camera design is based on the use of either a frame-transfer charge coupled device (CCD), or on a cooled hybrid sensor with fast read-out. A four megapixel sensor is foreseen. For the onboard processing, a scalable architecture has been selected. Performance simulations have been executed for the system as designed, focussing on the orbit determination of observed debris particles, and on the analysis of the object detection algorithms. In this paper we present some of the main results of the study. A short overview of the user requirements and observation strategy is given. The architectural design of the instrument is discussed, and the main tradeoffs are outlined. An insight into the results of the performance simulations is provided.

Bone-anchored Hearing Aids: correlation between pure-tone thresholds and outcome in three user groups

OBJECTIVE: To investigate correlations between preoperative hearing thresholds and postoperative aided thresholds and speech understanding of users of Bone-anchored Hearing Aids (BAHA). Such correlations may be useful to estimate the postoperative outcome with BAHA from preoperative data. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS:: Ninety-two adult unilaterally implanted BAHA users in 3 groups: (A) 24 subjects with a unilateral conductive hearing loss, (B) 38 subjects with a bilateral conductive hearing loss, and (C) 30 subjects with single-sided deafness. INTERVENTIONS: Preoperative air-conduction and bone-conduction thresholds and 3-month postoperative aided and unaided sound-field thresholds as well as speech understanding using German 2-digit numbers and monosyllabic words were measured and analyzed. MAIN OUTCOME MEASURES: Correlation between preoperative air-conduction and bone-conduction thresholds of the better and of the poorer ear and postoperative aided thresholds as well as correlations between gain in sound-field threshold and gain in speech understanding. RESULTS: Aided postoperative sound-field thresholds correlate best with BC threshold of the better ear (correlation coefficients, r2 = 0.237 to 0.419, p = 0.0006 to 0.0064, depending on the group of subjects). Improvements in sound-field threshold correspond to improvements in speech understanding. CONCLUSION: When estimating expected postoperative aided sound-field thresholds of BAHA users from preoperative hearing thresholds, the BC threshold of the better ear should be used. For the patient groups considered, speech understanding in quiet can be estimated from the improvement in sound-field thresholds.

Three-year cost analysis of function-centred versus pain-centred inpatient rehabilitation in patients with chronic non-specific low back pain

OBJECTIVE: To compare costs of function- and pain-centred inpatient treatment in patients with chronic low back pain over 3 years of follow-up. DESIGN: Cost analysis of a randomized controlled trial. PATIENTS: A total of 174 patients with chronic low back pain were randomized to function- or pain-centred inpatient treatment. METHODS: Data on direct and indirect costs were gathered by questionnaires sent to patients, health insurance providers, employers, and the Swiss Disability Insurance Company. RESULTS: There was a non-significant difference in total medical costs after 3 years' follow-up. Total costs were 77,305 Euros in the function-centred inpatient treatment group and 83,085 Euros in the pain-centred inpatient treatment group. Likewise, indirect costs after 3 years from lost work days were non-significantly lower in the function-centred in-patient treatment group (6354 Euros; 95% confidence interval -20,892, 8392) and direct medical costs were non-significantly higher in the function-centred inpatient treatment group (574 Euros; 95% confidence interval -862, 2011). CONCLUSION: The total costs of function-centred and pain-centred inpatient treatment were similar over the whole 3-year follow-up.