Studies in health technology and informatics最新文献

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.