Resilience by design: A participatory approach to designing an interactive digital application for promoting children's resilience

The promotion of resilience (the capacity of an individual or community to bounce back and recover from adversity) has become an important area of public health. In recent years it has expanded into the digital domain, and many online applications have been developed to promote children's resilience. In this study, it is argued that the majority of existing applications are limited because they take a didactic approach, and conceive of interaction as providing navigational choices. Because they simply provide information about resilience or replicate offline, scenario-based strategies, the understanding of resilience they provide is confined to a few, predetermined factors. In this study I propose a new, experiential approach to promoting resilience digitally. I define resilience as an emergent, situated and context-specific phenomenon. Using a Participatory Design model in combination with a salutogenic (strength-based) health methodology, this project has involved approximately 50 children as co-designers and co-researchers over two years. The children have contributed to the design of a new set of interactive resilience tools, which facilitate resilience promotion through dialogic and experiential learning. The major outcomes of this study include a new methodology for developing digital resilience tools, a new set of tools that have been developed and evaluated in collaboration with children and a set of design principles to guide future development. Beyond these initial and tangible outcomes, this study has also established that the benefits of introducing Participatory Design into a health promoting model rests primarily in the change of the role of children from "users" of technology and education to co-designers, where they assume a leadership role in both designing the tools and in directing their resilience learning.

Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management : Baseline findings and six-month outcomes

Background: Effective self-management of diabetes is essential for the reduction of diabetes-related complications, as global rates of diabetes escalate. Methods: Randomised controlled trial. Adults with type 2 diabetes (n = 120), with HbA1c greater than or equal to 7.5 %, were randomly allocated (4 × 4 block randomised block design) to receive an automated, interactive telephone-delivered management intervention or usual routine care. Baseline sociodemographic, behavioural and medical history data were collected by self-administered questionnaires and biological data were obtained during hospital appointments. Health-related quality of life (HRQL) was measured using the SF-36. Results: The mean age of participants was 57.4 (SD 8.3), 63 % of whom were male. There were no differences in demographic, socioeconomic and behavioural variables between the study arms at baseline. Over the six-month period from baseline, participants receiving the Australian TLC (Telephone-Linked Care) Diabetes program showed a 0.8 % decrease in geometric mean HbA1c from 8.7 % to 7.9 %, compared with a 0.2 % HbA1c reduction (8.9 % to 8.7 %) in the usual care arm (p = 0.002). There was also a significant improvement in mental HRQL, with a mean increase of 1.9 in the intervention arm, while the usual care arm decreased by 0.8 (p = 0.007). No significant improvements in physical HRQL were observed. Conclusions: These analyses indicate the efficacy of the Australian TLC Diabetes program with clinically significant post-intervention improvements in both glycaemic control and mental HRQL. These observed improvements, if supported and maintained by an ongoing program such as this, could significantly reduce diabetes-related complications in the longer term. Given the accessibility and feasibility of this kind of program, it has strong potential for providing effective, ongoing support to many individuals with diabetes in the future.

Telephone support to rural and remote patients with heart failure : the Chronic Heart failure Assessment by Telephone (CHAT) study

Background Heart failure (HF) remains a condition with high morbidity and mortality. We tested a telephone support strategy to reduce major events in rural and remote Australians with HF, who have limited healthcare access. Telephone support comprised an interactive telecommunication software tool (TeleWatch) with follow-up by trained cardiac nurses. Methods Patients with a general practice (GP) diagnosis of HF were randomised to usual care (UC) or UC and telephone support intervention (UC+I) using a cluster design involving 143 GPs throughout Australia. Patients were followed for 12 months. The primary end-point was the Packer clinical composite score. Secondary end-points included hospitalisation for any cause, death or hospitalisation, as well as HF hospitalisation. Results Four hundred and five patients were randomised into CHAT. Patients were well matched at baseline for key demographic variables. The primary end-point of the Packer Score was not different between the two groups (P=0.98), although more patients improved with UC+I. There were fewer patients hospitalised for any cause (74 versus 114, adjusted HR 0.67 [95% CI 0.50-0.89], p=0.006) and who died or were hospitalised (89 versus 124, adjusted HR 0.70 [95% CI 0.53 – 0.92], p=0.011), in the UC+I vs UC group. HF hospitalisations were reduced with UC+I (23 versus 35, adjusted HR 0.81 [95% CI 0.44 – 1.38]), although this was not significant (p=0.43). There were 16 deaths in the UC group and 17 in the UC+I group (p=0.43). Conclusions Although no difference was observed in the primary end-point of CHAT (Packer composite score), UC+I significantly reduced the number of HF patients hospitalised amongst a rural and remote cohort. These data suggest that telephone support may be an efficacious approach to improve clinical outcomes in rural and remote HF patients.

Exploration and reflection in interactive art : glass pond

Glass Pond is an interactive artwork designed to engender exploration and reflection through an intuitive, tangible interface and a simulation agent. It is being developed using iterative methods. A study has been conducted with the aim of illuminating user experience, interface, design, and performance issues.The paper describes the study methodology and process of data analysis including coding schemes for cognitive states and movements. Analysis reveals that exploration and reflection occurred as well as composing behaviours (unexpected). Results also show that participants interacted to varying degrees. Design discussion includes the artwork's (novel) interface and configuration.

Emergence in interactive art

This thesis is concerned with creating and evaluating interactive art systems that facilitate emergent participant experiences. For the purposes of this research, interactive art is the computer based arts involving physical participation from the audience, while emergence is when a new form or concept appears that was not directly implied by the context from which it arose. This emergent ‘whole’ is more than a simple sum of its parts. The research aims to develop understanding of the nature of emergent experiences that might arise during participant interaction with interactive art systems. It also aims to understand the design issues surrounding the creation of these systems. The approach used is Practice-based, integrating practice, evaluation and theoretical research. Practice used methods from Reflection-in-action and Iterative design to create two interactive art systems: Glass Pond and +-now. Creation of +-now resulted in a novel method for instantiating emergent shapes. Both art works were also evaluated in exploratory studies. In addition, a main study with 30 participants was conducted on participant interaction with +-now. These sessions were video recorded and participants were interviewed about their experience. Recordings were transcribed and analysed using Grounded theory methods. Emergent participant experiences were identified and classified using a taxonomy of emergence in interactive art. This taxonomy draws on theoretical research. The outcomes of this Practice-based research are summarised as follows. Two interactive art systems, where the second work clearly facilitates emergent interaction, were created. Their creation involved the development of a novel method for instantiating emergent shapes and it informed aesthetic and design issues surrounding interactive art systems for emergence. A taxonomy of emergence in interactive art was also created. Other outcomes are the evaluation findings about participant experiences, including different types of emergence experienced and the coding schemes produced during data analysis.

An interactive and adaptive building layer : strategies for allowing people to become advanced building-users

This paper reports outcomes of a pilot study to develop a conceptual framework to allow people to retrofit a building-layer to gain better control of their own built- environments. The study was initiated by the realisation that discussions surrounding the improvement of building performances tend to be about top-down technological solutions rather than to help and encourage bottom-up involvement of building-users. While users are the ultimate beneficiaries and their feedback is always appreciated, their direct involvements in managing buildings would often be regarded as obstruction or distraction. This is largely because casual interventions by uninformed building-users tend to disrupt the system. Some earlier researches showed however that direct and active participation of users could improve the building performance if appropriate training and/or systems were introduced. We also speculate this in long run would also make the built environment more sustainable. With this in mind, we looked for opportunities to retrofit our own office with an interactive layer to study how we could introduce ad-hoc systems for building-users. The aim of this paper is to describe our vision and initial attempts followed by discussion.

Development and testing of an iPad application for teaching self-management to heart failure patients. (Nursing/Allied Health Professional Investigator Award)- Abstract

Purpose: Heart failure (HF) is the leading cause of hospitalization and significant burden to the health care system in Australia. To reduce hospitalizations, multidisciplinary approaches and enhance self-management programs have been strongly advocated for HF patients globally. HF patients who can effectively manage their symptoms and adhere to complex medicine regimes will experience fewer hospitalizations. Research indicates that information technologies (IT) have a significant role in providing support to promote patients' self-management skills. The iPad utilizes user-friendly interfaces and to date an application for HF patient education has not been developed. This project aimed to develop the HF iPad teaching application in the way that would be engaging, interactive and simple to follow and usable for patients' carers and health care workers within both the hospital and community setting. Methods: The design for the development and evaluation of the application consisted of two action research cycles. Each cycle included 3 phases of testing and feedback from three groups comprising IT team, HF experts and patients. All patient education materials of the application were derived from national and international evidence based practice guidelines and patient self-care recommendations. Results: The iPad application has animated anatomy and physiology that simply and clearly teaches the concepts of the normal heart and the heart in failure. Patient Avatars throughout the application can be changed to reflect the sex and culture of the patient. There is voice-over presenting a script developed by the heart failure expert panel. Additional engagement processes included points of interaction throughout the application with touch screen responses and the ability of the patient to enter their weight and this data is secured and transferred to the clinic nurse and/or research data set. The application has been used independently, for instance, at home or using headphones in a clinic waiting room or most commonly to aid a nurse-led HF consultation. Conclusion: This project utilized iPad as an educational tool to standardize HF education from nurses who are not always heart failure specialists. Furthermore, study is currently ongoing to evaluate of the effectiveness of this tool on patient outcomes and to develop several specifically designed cultural adaptations [Hispanic (USA), Aboriginal (Australia), and Maori (New Zealand)].

Interactive conference voting

We describe and analyze opinion polling results from interactive voting procedures undertaken before and after presentations during the Outcome Measures in Rheumatoid Arthritis Clinical Trials Conference (OMERACT II) in Ottawa, Canada, June 30-July 2, 1994. The scoring procedure was a matched voting design; when a participant used the same keypad at the beginning and end of voting, change within a participant could be estimated. Participants, experienced in the rheumatic diseases included clinicians, researchers, methodologists, regulators, and representatives of the pharmaceutical industry. Patients under consideration were those with any rheumatic diseases. Questions were constructed to evaluate the change in voting behavior expected from the content of the presentation. Statistically significant and substantively important changes were evident in most questions.

Positive experiences for participants in suicide bereavement groups : a grounded theory model of elements that contribute to the process of adjusting to the loss

Grounded Theory was used to examine the experiences of 13 participants who had attended psycho-educational support groups for those bereaved by suicide. Results demonstrated core and central categories which fit well with group therapeutic factors developed by Yalom (1995) and emphasised the importance of universality, imparting information and instilling hope, catharsis and self-disclosure, and broader meaning making processes surrounding acceptance or adjustment. Participants were commonly engaged in a lengthy process of oscillating between loss oriented and restoration focused reappraisals. The functional experience of the group comprised feeling normal within the group, providing a sense of permission to feel and to express emotions and thoughts and to bestow meaning. Structural variables of information and guidance and different perspectives on the suicide and bereavement were gained from other participants, the facilitators, group content and process. Personal changes, including in relationships and in their sense of self, assisted participants to develop an altered and more positive personal narrative.

Self-directed student work groups using blended learning

This paper provides a description of an innovative teaching approach designed to facilitate student work groups using a blended learning approach that incorporates both traditional face-to-face teaching methods and an online student work group facility. The teaching approach is designed to accommodate a large introductory human resource management subject positioned within an undergraduate business degree.

Student or scholar? Transforming identities through a research writing group

This article explores the role a writing group played in influencing the scholarly identities of a group of doctoral students by fostering their writing expertise. While the interest in writing groups usually centres on their potential to support doctoral students to publish, few studies have been conducted and written by the students themselves. Using a situated learning perspective on identity, we explore the connection that emerged between our perceptions of ourselves as developing expertise as scholarly writers and the function of the writing group as a dynamic space for transforming our identities. Findings show that our writing group served as a flexible and interactive Community of Practice (CoP) that shaped critical and durable shifts in identity amongst members.

An integrated educational model for continuing nurse education

Aim This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Background Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. Methods A quasi experimental pre test, post test non–equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. Findings The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. Conclusion The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

A known-groups evaluation of the Response Bias Scale in a neuropsychological setting

We evaluated the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) Response Bias Scale (RBS). Archival data from 83 individuals who were referred for neuropsychological assessment with no formal diagnosis (n = 10), following a known or suspected traumatic brain injury (n = 36), with a psychiatric diagnosis (n = 20), or with a history of both trauma and a psychiatric condition (n = 17) were retrieved. The criteria for malingered neurocognitive dysfunction (MNCD) were applied, and two groups of participants were formed: poor effort (n = 15) and genuine responders (n = 68). Consistent with previous studies, the difference in scores between groups was greatest for the RBS (d = 2.44), followed by two established MMPI-2 validity scales, F (d = 0.25) and K (d = 0.23), and strong significant correlations were found between RBS and F (rs = .48) and RBS and K (r = −.41). When MNCD group membership was predicted using logistic regression, the RBS failed to add incrementally to F. In a separate regression to predict group membership, K added significantly to the RBS. Receiver-operating curve analysis revealed a nonsignificant area under the curve statistic, and at the ideal cutoff in this sample of >12, specificity was moderate (.79), sensitivity was low (.47), and positive and negative predictive power values at a 13% base rate were .25 and .91, respectively. Although the results of this study require replication because of a number of limitations, this study has made an important first attempt to report RBS classification accuracy statistics for predicting poor effort at a range of base rates.

The role of the internet and digital technologies in the struggle for recognition of the forgotten Australians

Our contemporary public sphere has seen the 'emergence of new political rituals, which are concerned with the stains of the past, with self disclosure, and with ways of remembering once taboo and traumatic events' (Misztal, 2005). A recent case of this phenomenon occurred in Australia in 2009 with the apology to the 'Forgotten Australians': a group who suffered abuse and neglect after being removed from their parents – either in Australia or in the UK - and placed in Church and State run institutions in Australia between 1930 and 1970. This campaign for recognition by a profoundly marginalized group coincides with the decade in which the opportunities of Web 2.0 were seen to be diffusing throughout different social groups, and were considered a tool for social inclusion. This paper examines the case of the Forgotten Australians as an opportunity to investigate the role of the internet in cultural trauma and public apology. As such, it adds to recent scholarship on the role of digital web based technologies in commemoration and memorials (Arthur, 2009; Haskins, 2007; Cohen and Willis, 2004), and on digital storytelling in the context of trauma (Klaebe, 2011) by locating their role in a broader and emerging domain of social responsibility and political action (Alexander, 2004).

Learning hierarchical prototypes of motion time series for interactive systems

Abstract. For interactive systems, recognition, reproduction, and generalization of observed motion data are crucial for successful interaction. In this paper, we present a novel method for analysis of motion data that we refer to as K-OMM-trees. K-OMM-trees combine Ordered Means Models (OMMs) a model-based machine learning approach for time series with an hierarchical analysis technique for very large data sets, the K-tree algorithm. The proposed K-OMM-trees enable unsupervised prototype extraction of motion time series data with hierarchical data representation. After introducing the algorithmic details, we apply the proposed method to a gesture data set that includes substantial inter-class variations. Results from our studies show that K-OMM-trees are able to substantially increase the recognition performance and to learn an inherent data hierarchy with meaningful gesture abstractions.