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Multimodal Interaction in Collaborative Design of a Healthcare Space: A Social Semiotic Approach. 医疗空间协同设计中的多模式交互:一种社会符号学方法。
Pub Date : 2024-11-29 DOI: 10.3233/SHTI240931
Christine Räisänen, Dilek U Duman, Mikael Viklund Tallgren, Johanna Eriksson

In professional interactive practices, space, time, human bodies, and material objects as well as written and oral language are dynamically implicated in a multimodal co-construction of meaning. A healthcare space - an operating room - is a typical example of such a social-semiotic, multimodal arrangement of communication modes which impacts the practices that are played out therein. Therefore, in designing healthcare spaces, it is important to allow for proactive inclusion and engagement of the categories of professionals who carry out their daily work in these spaces. Today, such involvement can be facilitated through mediation tools and simulation in Collaborative Virtual Environments (CVE). However, how collaboration unfolds and manifests at the micro-level of collaborative design interaction remains under-researched. The aim of this discussion paper is to introduce a social-semiotic approach to the analysis of multimodal collaborative design. We show how combinations of modes can trigger transformational shifts in levels of interaction.

在专业的互动实践中,空间、时间、人体、物质对象以及书面和口头语言都动态地牵连在意义的多模态共构中。医疗保健空间——手术室——是这种社会符号学、多模式的通信模式安排的典型例子,它影响了在其中进行的实践。因此,在设计医疗保健空间时,重要的是要允许在这些空间中开展日常工作的各类专业人员的积极参与和参与。今天,这种参与可以通过协作虚拟环境(CVE)中的中介工具和模拟来促进。然而,协作是如何在协同设计交互的微观层面展开和表现的,目前还没有得到充分的研究。本文的目的是介绍一种社会符号学方法来分析多模态协同设计。我们展示了模式的组合如何触发交互水平的转型转变。
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引用次数: 0
Understanding Healthcare Design Transformations. Insights from the Swedish Experience. 理解医疗保健设计转换。瑞典经验的启示。
Pub Date : 2024-11-29 DOI: 10.3233/SHTI240947
Laura Sacchetti, Göran Lindahl

In Europe, most countries are facing common healthcare challenges that lead to a need for innovation, effectiveness and efficiency in the healthcare systems. This is often addressed through actions and intentions including enhanced primary and integrated care. However, these developments seem to be progressing slowly and non-uniformly, nor is there knowledge exchange, and the full implications of these changes on healthcare design are still unfolding. The research presented investigates what are the current trends in healthcare systems and the effects on design transformations, focusing on the Swedish experience. In Sweden, a reform known as "Nära Vård" [Close Care], aims to "reconstruct" the core of the healthcare service around primary care. It strives to bring care "closer" to people and communities concerning access to both care and the facilities where it is delivered. The objective of this paper is to understand what can be learnt from the Swedish experience; the research presented aims at investigating the effects of the Close Care reform on primary care facilities design. The study was conducted from April to July 2023, and it consisted of: i) desk research and literature review; ii) data collection through 12 interviews with experts; iii) data analysis through qualitative content analysis; iv) study visits to local care facilities. From the interviews, 10 factors for change and 9 challenges emerged. Moreover, it appears that the organisational structure of the Swedish healthcare system caters for regional and individual projects' interpretations of how to bring care "closer" to the patients; this variation allows for a broader understanding of the advantages and drawbacks of each organisational model and design, and it reinforces the idea that there is no "one-size-fits-all" for close care. This diversity points to a need for a project evaluation program of the ongoing experiences, aimed at assessing the performance and effectiveness of each approach.

在欧洲,大多数国家都面临着共同的医疗保健挑战,这导致了对医疗保健系统创新、有效性和效率的需求。这通常是通过行动和意图来解决的,包括加强初级保健和综合保健。然而,这些发展似乎进展缓慢且不一致,也没有知识交流,这些变化对医疗保健设计的全面影响仍在展开。研究提出了调查什么是当前的趋势,在医疗保健系统和设计变革的影响,重点是瑞典的经验。在瑞典,一项名为“Nära v rd”(密切护理)的改革旨在围绕初级保健“重建”医疗服务的核心。它努力使保健“更接近”人民和社区,使他们能够获得保健和提供保健的设施。本文的目的是了解可以从瑞典的经验中学到什么;本研究旨在探讨近距离照护改革对初级照护设施设计的影响。该研究于2023年4月至7月进行,包括:1)案头研究和文献综述;Ii)通过12次专家访谈收集数据;Iii)通过定性内容分析进行数据分析;Iv)对当地护理机构的考察访问。从访谈中,我们发现了10个改变的因素和9个挑战。此外,瑞典医疗保健系统的组织结构似乎迎合了区域和个人项目对如何使护理“更接近”患者的解释;这种变化允许更广泛地理解每种组织模型和设计的优点和缺点,并且它强化了没有“一刀切”的想法。这种多样性表明需要对正在进行的经验进行项目评估,旨在评估每种方法的性能和有效性。
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引用次数: 0
Service Thinking in Architectural Design for Dementia in the Finnish Context. 芬兰背景下痴呆症建筑设计中的服务思维
Pub Date : 2024-11-29 DOI: 10.3233/SHTI240970
Natalia Vladykina, Laura Arpiainen

Dementia is a globally growing problem, which is putting pressure on public services, including those in Nordic countries, to offer care to everyone in need. Contemporary approaches to dementia care are evolving from institutional and medical solutions to more human-centred, community-based, and emotion-oriented, which positively impacts the well-being of persons with dementia. Principles of ageing-in-place and the benefits of living at home are strongly emphasised in research. Although cognitive health and memories are associated with the physical environment and architecture and design can play a powerful role in supporting independent living, public system in Finland remains traditional, focused on providing institutional care. Architecture drives the care system and acts as a barrier to delivering ageing-in-place rather than a resource. The architectural and service models for serving seniors with dementia require transformation. This article proposes applying the emerging concept of service architecture to the design of environments for ageing-in-place and transforming care systems with a user-centred systemic approach to spaces, community, and service design. It explores opportunities for co-creation with users with dementia and other stakeholders and describes a new system of services linked with new spatial programming. The architectural solution is a network of spaces, including those for living, care, and connection. Its elements and their design were defined through case studies conducted in Finnish municipalities involved in research. New spatial and service programming, designed with the service architecture concept, has the potential to change the paradigm, transform systems of care, and enable seniors experiencing memory decline to remain in their homes.

痴呆症是一个日益严重的全球性问题,这给包括北欧国家在内的公共服务部门带来了压力,要求它们向所有有需要的人提供护理。当代痴呆症护理方法正在从机构和医疗解决方案演变为更加以人为本、以社区为基础和以情感为导向,从而对痴呆症患者的福祉产生积极影响。居家养老的原则和在家生活的好处在研究中得到了强烈的强调。尽管认知健康和记忆与自然环境有关,建筑和设计可以在支持独立生活方面发挥强大的作用,但芬兰的公共系统仍然是传统的,专注于提供机构护理。建筑驱动着护理系统,并成为提供就地老龄化的障碍,而不是资源。为老年痴呆症患者服务的建筑和服务模式需要转型。本文建议将新兴的服务架构概念应用于就地老龄化环境的设计,并通过以用户为中心的空间、社区和服务设计系统方法来改造护理系统。它探索了与痴呆症患者和其他利益相关者共同创造的机会,并描述了与新空间规划相关的新服务系统。建筑解决方案是一个空间网络,包括生活、护理和连接空间。其要素及其设计是通过在参与研究的芬兰城市进行的案例研究确定的。新的空间和服务规划,以服务架构的概念设计,有可能改变范式,转变护理系统,并使经历记忆衰退的老年人留在家中。
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引用次数: 0
The Human Body in Architectural Theory and Practice. 建筑理论与实践中的人体。
Pub Date : 2024-11-29 DOI: 10.3233/SHTI240935
René Sørensen Overby, Emil Søbjerg Falster

This article deals with representation of the human body in architecture. The human body as a statically balanced symmetrical figure is an antique, time-bound representation of the body and it is important to challenge that image in a modern and more nuanced understanding of being human. To identify some of architecture's reproductions of the human body, we make some historical cuts and exemplify representations of the body in architectural theory. First, we briefly describe the origin of Homo Bene Figuratus (Vitruvius introducing the doctrine of the well-formed body) and the image of the body characterised by geometric proportioning. We then exemplify similar renderings of Reference Man which followed the Vitruvian Man right up to the present. Le Corbusier's "Le Modulor" follows the same path, in a modernist worldview, helped along by Ernst Neufertt's ideas on theory of proportion, first stated in 1936, which standardisation have remained unchanged as essential reference. As a critical response to bodily reductive perceptions in architectural theory, we go beyond Reference Man and seek a broader in-sight into the understanding of human diversity and varieties of bodily abilities. Seen through a Universal Design perspective, a view of the human body as absolute geometric figure inscribed in fixed coordinates has difficulty representing ideas of human beings as a diverse group of bodies. This view also has difficulty representing the idea of the human body as changing through a lifetime. A fixed standard can overlook the human being as diverse in bodies and abilities and even come to leave out significant aspects of design such as health, social wellbeing, and sensory qualities of architecture. In our discussion, we go into more detail about the significance of representations of the ideal human body for the design of architecture and suggest what consequences it may have for architectural practice.

这篇文章讨论的是建筑中人体的表现。人体作为一个静态平衡的对称图形是一种古老的、有时间限制的身体表现形式,在现代和更细致的人类理解中挑战这种形象是很重要的。为了识别一些建筑对人体的复制,我们做了一些历史的切割,并举例说明建筑理论中身体的表现。首先,我们简要地描述了“人本人”的起源(维特鲁威引入了形状良好的身体学说)和以几何比例为特征的身体形象。然后,我们举例说明了类似的参考人的渲染,它遵循了维特鲁威人直到现在。勒·柯布西耶的“Le Modulor”遵循同样的道路,在现代主义世界观中,Ernst Neufertt的比例理论思想帮助下,于1936年首次提出,标准化作为基本参考保持不变。作为对建筑理论中身体还原感知的批判性回应,我们超越了参考人,寻求更广泛的视角来理解人类的多样性和身体能力的多样性。从通用设计的角度来看,人体作为固定坐标上的绝对几何图形的观点很难代表人类作为不同身体群体的想法。这种观点也难以表达人的身体在一生中会发生变化的观点。一个固定的标准可能会忽视人类在身体和能力上的多样性,甚至会忽略设计的重要方面,如健康、社会福利和建筑的感官质量。在我们的讨论中,我们更详细地探讨了理想人体表现对建筑设计的重要性,并提出了它对建筑实践可能产生的影响。
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引用次数: 0
Exploring the Determinants of Age-Friendly Neighbourhoods Among Seniors Residing in a Low-Income Urban Community in Singapore: A Participatory Study. 新加坡低收入城市社区老年人友好社区的决定因素:一项参与性研究。
Pub Date : 2024-11-29 DOI: 10.3233/SHTI240969
Chao Min Tan, Alyssa Marion Jia-Min Chua, Lian Leng Low, Jowy Yi Hoong Seah, Sungwon Yoon

The growing interest regarding the role of the living environment in healthy ageing highlights the need to investigate place-related urban features contributing to health and socio-emotional wellbeing. This study aimed to use a participatory methodology to explore the determinants of an age-friendly neighbourhood built environment that promotes or limits healthy ageing in place among seniors residing in a low-income urban community in Singapore. The study utilised photovoice and semi-structured interviews with 25 community-dwelling seniors aged 65 and above, residing in government-built public housing. Analysis of the photographs and interviews was guided by the World Health Organisation (WHO) Global Age-friendly Cities Framework to assess the age-friendliness of places. Our findings generally corresponded to the WHO framework, and our analysis identified a total of 8 facilitators and 4 barriers affecting the neighbourhood age-friendliness. A safe and pleasant outdoor environment that is connected to essential services, amenities and transport to key destinations encourages higher activity in seniors and enables them to fulfil their daily living needs. However, the lack of wheelchair accessible features in some areas deterred the mobility of seniors in the neighbourhood. Interestingly, there was also a high level of civic participation in the form of senior volunteerism observed among the participants as they took ownership to continuously improve the liveability of their neighbourhood. Additionally, there is a sufficient range of aged care services in their neighbourhood available to support seniors to age in their homes and community. The determinants that emerged from our findings are important for guiding future national policies and initiatives to improve the living environment that supports healthy ageing in place.

人们对生活环境在健康老龄化中的作用越来越感兴趣,这凸显了调查与地方相关的城市特征对健康和社会情感福祉的贡献的必要性。本研究旨在采用参与式方法探讨老年人友好型社区建筑环境的决定因素,该环境促进或限制居住在新加坡低收入城市社区的老年人的健康老龄化。是次研究以影像语音及半结构化访谈的方式,访问了25位居住在政府兴建公共房屋的65岁及以上长者。世界卫生组织(世卫组织)的《全球高龄友好城市框架》指导了对照片和访谈的分析,以评估各地的高龄友好程度。我们的研究结果大体上符合世卫组织的框架,我们的分析确定了总共8个促进因素和4个影响社区年龄友好性的障碍。一个安全、舒适的户外环境,与基本服务、设施和通往主要目的地的交通相连接,鼓励老年人更多地活动,使他们能够满足日常生活需求。然而,一些地区缺乏轮椅无障碍设施,阻碍了社区老年人的行动。有趣的是,在参与者中还观察到老年人志愿服务形式的高水平公民参与,因为他们承担了不断改善其社区宜居性的责任。此外,在他们的社区有足够的老年护理服务,以支持老年人在他们的家庭和社区养老。从我们的研究结果中得出的决定因素对于指导未来的国家政策和举措,以改善支持健康老龄化的生活环境具有重要意义。
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引用次数: 0
Shaping the Typology of Modern Finnish Psychiatric Hospitals: Analyzing Design Briefs of Two Case Studies. 塑造现代芬兰精神病院的类型:分析两个案例的设计摘要。
Pub Date : 2024-11-29 DOI: 10.3233/SHTI240932
Natalia Batrakova

The article aims to study the concepts, themes, and ideas behind the new typology of modern Finnish psychiatric hospitals by analyzing two recently built cases. Several new psychiatric hospitals were built in different regions of Finland in the last decade. They are built on the campuses of somatic central hospitals, they combine outpatient, inpatient, and day wards for many different age groups. They have public functions that serve the whole campus or the surrounding area. The vast gardens of previous facilities were replaced by balconies, enclosed yards, and roof terraces. In the absence of national guidelines on design, the new typology was formed, shaped by cooperation between the hospital administration, hospital staff, and the architects. The article analyzes the design briefs of two similar through inductive content analysis to derive the main themes mentioned in these documents. Then, it is analyzed how the themes were reflected in the final design of the buildings, highlighting the commonalities and differences of the two projects. Some of the most common themes were safety, functionality, centralization, cooperation, proximity, flexibility, renewing psychiatric care, isolation, changing patient demographics, family, privacy, stigma, therapeutic spaces, outdoor spaces, and working environment. They are reflected in the building design being more concerned with security, in more dense and compact floorplans, and in design solutions that make it possible to quickly adapt in crisis situations. The Case B, designed just few years later than Case A, is noticeably more focused on the security aspect. The article also provides an insight into how the typology of hospitals was influenced by societal and legislative changes as well as changes in psychiatric care.

本文旨在通过分析最近建立的两个案例,研究现代芬兰精神病院新类型背后的概念、主题和思想。在过去十年中,芬兰不同地区新建了几家精神病院。它们建在躯体中心医院的校园里,它们为许多不同年龄组的人提供门诊、住院和日间病房。它们具有服务于整个校园或周边地区的公共功能。以前设施的巨大花园被阳台、封闭的院子和屋顶露台所取代。在缺乏国家设计指导方针的情况下,医院管理部门、医院工作人员和建筑师之间的合作形成了新的类型。本文通过归纳性的内容分析,对两份类似的设计简报进行分析,得出这两份文件中提到的主要主题。然后分析这些主题是如何在建筑的最终设计中体现出来的,突出两个项目的共同点和不同点。一些最常见的主题是安全,功能,集中,合作,接近,灵活性,更新精神病学护理,隔离,改变患者人口统计,家庭,隐私,耻辱,治疗空间,户外空间和工作环境。它们反映在建筑设计中,更关注安全性,更密集和紧凑的平面图,以及设计解决方案,使其能够快速适应危机情况。案例B的设计只比案例A晚几年,显然更侧重于安全方面。文章还提供了一个深入了解医院的类型是如何受到社会和立法的变化以及精神病学护理的变化的影响。
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引用次数: 0
Automatic Segmentation of Multicellular Tumour Spheroids Images During Growing. 在生长过程中自动分割多细胞肿瘤球体图像
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241098
Alessandra Introvaia, Sara Muccio, Andrea Bezze, Clara Mattu, Gabriella Balestra

Image segmentation is an important topic in medical image processing. Multicellular tumour spheroids (MTS) are currently one of the most widely employed in vitro model for pre-clinical drug screening in cancer research. Assessing their growing requires the segmentation of images acquired at several time points. This paper presents the preliminary results of an approach for the automatic segmentation of multicellular tumour spheroids. The obtained segmentation accuracy is reasonable demonstrating that the approach proved adequate.

图像分割是医学图像处理中的一个重要课题。多细胞肿瘤球(MTS)是目前癌症研究中用于临床前药物筛选最广泛的体外模型之一。评估其生长情况需要对多个时间点获取的图像进行分割。本文介绍了一种自动分割多细胞肿瘤球的方法的初步结果。所获得的分割精度相当高,证明该方法是可行的。
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引用次数: 0
Visualising Paths for Exploratory Search in the Health IT Ontology. 医疗信息技术本体论中探索性搜索路径的可视化。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241075
Konrad Höffner, Hannes Raphael Brunsch, Franziska Jahn, Alfred Winter

Due to a lack of systematisation and unbiased information, finding the optimal combination of software products for health information systems is a challenging endeavour. We present a novel approach to visually explore the domain of application systems and software products for health care along the paths of the Health IT ontology (HITO). We present an algorithm and implementation in a web application that is freely available at the HITO website and licensed under the open source MIT licence. In comparison to other approaches of path-based exploration of knowledge graphs, the novelty of our approach is the use of path finding on the ontology level and combining this both with the instances of the classes along the chosen path as well as search filters to limit the search space. Our approach can be adapted to other domains where users with complex information needs interact with ontologies and knowledge graphs and can be supported by generative artificial intelligence in the future.

由于缺乏系统化和无偏见的信息,寻找医疗信息系统软件产品的最佳组合是一项具有挑战性的工作。我们提出了一种新颖的方法,沿着医疗信息技术本体(HITO)的路径,以可视化的方式探索医疗领域的应用系统和软件产品。我们在一个网络应用程序中介绍了一种算法和实现方法,该网络应用程序可在 HITO 网站上免费获取,并根据开源 MIT 许可授权。与其他基于路径的知识图谱探索方法相比,我们的方法的新颖之处在于使用本体层面的路径查找,并将其与所选路沿线的类实例以及搜索过滤器相结合,以限制搜索空间。我们的方法可适用于具有复杂信息需求的用户与本体和知识图谱交互的其他领域,并可在未来得到生成式人工智能的支持。
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引用次数: 0
The Creation of Intensional Medication Lists Using the NHS Dictionary of Medicines and Devices. 使用英国国家医疗服务系统(NHS)的《药品与器械词典》创建内部用药清单。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241097
Gavin Jamie, Rachel Byford, Rashmi Wimalaratna, Simon de Lusignan

The identification of medications prescribed to patients in routinely collected health records is an important part of the identification of cohorts for surveillance and research. Preparations available for prescription can change frequently and this presents challenges to the maintenance of extensional or "flat lists" of medications, particularly in ongoing studies such as disease surveillance. The NHS publishes a Dictionary of Medicines and Devices weekly, listing almost all the medications available in the UK as an extension to the UK edition of SNOMED CT. We developed a method of creating intensional specifications of medications using specified active ingredients and the form of the medication. The specifications can be expressed using the SNOMED CT Expression Constraint Language, and can be used to form a library which may be used across multiple projects. We have developed intensional definitions of medication groups for all drugs likely to be used in primary care. We have shown that these can be shared as FHIR valuesets using the NHS Terminology Server. Here we show examples of expressions about medications used for neuropathic pain. We have created expressions which improve the specificity of the extraction by filtering on the form and number of ingredients.

在常规收集的健康记录中确定患者的处方药是确定监测和研究队列的重要部分。可用于处方的制剂可能会经常变化,这就给维护扩展或 "统一列表 "药物带来了挑战,尤其是在疾病监测等持续性研究中。英国国家医疗服务系统(NHS)每周都会出版一本《药品和器械词典》,其中列出了英国几乎所有的药物,作为 SNOMED CT 英国版的扩展。我们开发了一种方法,使用指定的有效成分和药物形式创建药物的内涵规范。这些规范可以使用 SNOMED CT 表达约束语言表达,并可用于形成一个可在多个项目中使用的库。我们已经为初级医疗中可能使用的所有药物开发出了药物组的内在定义。我们已经证明,这些定义可以作为 FHIR 值集使用 NHS 术语服务器进行共享。在此,我们展示了有关神经性疼痛用药的表达式示例。我们创建了表达式,通过过滤成分的形式和数量来提高提取的特异性。
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引用次数: 0
Using Deep Learning to Suggest Treatment for Proximal Humerus Fractures. 利用深度学习为肱骨近端骨折提供治疗建议
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241080
Mohammadreza Azarpira, Ihssen Belhadj, Mohammed Khodja

Proximal humeral fractures are among the most common fractures seen in emergency departments. Accurately diagnosing and selecting the most appropriate treatment for these fractures can be challenging, and consultation with a senior orthopedic surgeon can be time-consuming for both the patient and the emergency unit. We developed a machine learning model for predicting the type of treatment based on injury radiographic images. The model distinguishes between nonoperative and operative treatment options, achieving an accuracy of 86% and an interobserver reliability (kappa) of 0.722 for test-dataset, which is more than the interobserver agreement between shoulder surgeons. This model has the potential to serve as a therapeutic decision support system for the practitioners in the emergency departments to expedite treatment decisions and to reduce patients' waiting time.

肱骨近端骨折是急诊科最常见的骨折之一。对这些骨折进行准确诊断并选择最合适的治疗方法具有挑战性,而向资深骨科医生咨询对患者和急诊科来说都非常耗时。我们开发了一种机器学习模型,用于根据损伤放射影像预测治疗类型。该模型可区分非手术和手术治疗方案,准确率达 86%,测试数据集的观察者间可靠性(kappa)为 0.722,高于肩部外科医生之间的观察者间一致性。该模型有望成为急诊科医生的治疗决策支持系统,加快治疗决策的制定,减少患者的等待时间。
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引用次数: 0
期刊
Studies in health technology and informatics
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