Investigation of Needle Characteristics Using an Animal Model for Improved Outcomes in Anterior Chamber Paracentesis.

Background/Aims: The current standard of care to perform an anterior chamber paracentesis involves the use of a multipurpose market needle and syringe. The use of standard needles for this purpose may result in injury to the patient due to increased force with insertion and increased globe displacement during the procedure. This research investigates the current market needle characteristics and the impact of each needle characteristic on force. Methods: Several comparative trials were conducted to evaluate the needles. Needle characteristics of interest were gauge, primary bevel angle, number of bevels in the lancet, and needle hub geometry. Measurements of corneal insertion forces were made using a synthetic thermoplastic polyurethane medium, and bovine and porcine models. Needle safety was investigated with corneal abrasion experiments. Results: Reduced insertion force was observed with lower lancet primary angle. There was no difference based on the number of bevels in the lancet. Rounded hub geometry had minimal distribution to the corneal epithelium. Conclusions: Needle characteristics impact the force needed for needle insertion into the tissue. Since higher force can lead to increased risk and less efficiency during the procedure, reducing this force may improve the outcomes of the procedure. Needle entry can be reduced by designing an improved needle that includes a lower gauge and reduced primary angle of the lancet.

Review of assistive devices for the prevention of pressure ulcers: an engineering perspective.

PURPOSE: Pressure ulcers (PUs) are prevalent among immobile bed or wheelchair-reliant individuals who experience prolonged sedentary positions. Pressure relief and frequent repositioning of body posture help to mitigate complications associated with PUs. Adherence with regular repositioning is difficult to maintain due to nursing labour shortages or constraints of in-home caregivers. Manual repositioning, transferring, and lifting of immobile patients are physically demanding tasks for caregivers. This review aimed to explore and categorize these devices, discuss the significant technical challenges that need addressing, and identify potential design opportunities. MATERIALS AND METHODS: In this review, a literature search was conducted using PubMED, Science Direct, Google Scholar and IEEE Xplore databases including studies from 1995 until Feb 2023 with keywords such as pressure ulcer, assistive device, pressure relief, repositioning, transfer, etc. Both commercial and research-level devices were included in the search. RESULTS: 142 devices or technologies were identified and classified into four main categories that were further subcategorized. Within each category, the devices were investigated in terms of their mechanical design, actuation methods, control strategies, sensing technologies, and level of autonomy. Limitations of current technologies are design complexity, lack of patient comfort, and a lack of autonomy requiring caregivers frequent intervention. CONCLUSIONS: Several devices have been developed to help with prevention and mitigation of PUs. There remain challenges that hinder the widespread accessibility and use of current technologies. Advancements in assistive technologies for pressure ulcer mitigation could lie at the intersection of robotics, sensors, perception, user-centered design, and autonomous systems.IMPLICATIONS FOR REHABILITATIONFuture advancements in assistive technologies for pressure ulcer mitigation could lie at the intersection of robotics, sensors, perception, user-centered design, and autonomous systems.Most existing technologies for prevention of pressure ulcers are focused on the mechanical advantage rather than user's needs and preferences. Future designers, engineers, and product developers must be educated to conduct user needs studies concurrently with the development of technology to design the devices based on the user's needs to ensure a balanced design outcome.

Real-Time Monitoring of Post-Surgical and Post-Traumatic Eye Injuries Using Multilayered Electrical Biosensor Chip.

Lack of current techniques for the early monitoring of bleb leaks and other post-traumatic or post-surgical ocular injury has posed an unmet clinical need for the development of new techniques. Present evaluation techniques use either subjective or nonquantitative approaches. At present, there are no FDA approved ocular devices that can directly measure ascorbic acid (AA) concentration levels for both tear film (TF) and aqueous humor (AH) at point-of-care (POC) level. Toward this aim, we present a novel POC quantitative assay, called the ocular biosensor device, which can be used to evaluate the integrity of the anterior surface of the eye by measuring the concentration of AA in TF and AH. Herein, we utilize a novel scientific engineering approach for the development of a disposable paper based POC ocular biosensor strip. A grafted poly(styrene)-block-poly(acrylic acid) (PS-b-PAA) and graphene platelet composite with contour based µ-electrodes design (CBµE) exhibit a highly sensitive platform to perform electrochemical immunosensing technique to study clinical samples that have small volumes like tear fluid. Samples used in this study were collected clinically from subjects undergoing therapeutic anterior chamber paracentesis. The proposed biosensor reports the level of AA concentration on an electronic screen, making the results easy to read, efficient, and reliable.

Shared language:Towards more effective communication.

The ability to communicate to others and express ourselves is a basic human need. As we develop our understanding of the world, based on our upbringing, education and so on, our perspective and the way we communicate can differ from those around us. Engaging and interacting with others is a critical part of healthy living. It is the responsibility of the individual to ensure that they are understood in the way they intended.Shared language refers to people developing understanding amongst themselves based on language (e.g. spoken, text) to help them communicate more effectively. The key to understanding language is to first notice and be mindful of your language. Developing a shared language is an ongoing process that requires intention and time, which results in better understanding.Shared language is critical to collaboration, and collaboration is critical to business and education. With whom and how many people do you connect? Your 'shared language' makes a difference in the world. So, how do we successfully do this? This paper shares several strategies.Your sphere of influence will carry forward what and how you are communicating. Developing and nurturing a shared language is an essential element to enhance communication and collaboration whether it is simply between partners or across the larger community of business and customers. Constant awareness and education is required to maintain the shared language. We are living in an increasingly smaller global community. Business is built on relationships. If you invest in developing shared language, your relationships and your business will thrive.

Empathic design: Research strategies.

This paper explores the role of empathy within new product development from the perspective of human-centred design. The authors have developed a range of empathic design tools and strategies that help to identify authentic human needs.For products and services to be effective, they need to satisfy both functional and emotional needs of individuals. In addition, the individual user needs to feel that the product and/or service has been designed 'just for them', otherwise they may misuse, underuse or abandon the product/service. This becomes critical with a product such as a Zimmer frame (walker), when it fails to resonate with the patient due to any stigma the patient may perceive, and thus remains unused.When training young designers to consider the wider community (people unlike themselves) during the design process, it has proven extremely valuable to take them outside their comfort zones, by seeking to develop empathy with the end user for whom they are designing. Empathic modelling offers designers the opportunity to develop greater insight and understanding, in order to support more effective design outcomes. Sensitising designers to the different ways that individuals complete daily tasks has helped to diminish the gap between themselves and others (e.g. people with disabilities).The authors intend for this paper to resonate with health care providers. Human-centred design can help to refocus the designer, by placing the individual end user's needs at the heart of their decision-making.

Innovating alongside designers.

Building alliances with industrial designers offers health innovators a unique pathway to create new modes to serve their patients. Cross-pollination of ideas from the earliest stages of development in interdisciplinary research and development teams including major stakeholders and designers can lead to more meaningful and impactful innovations.A shift in future healthcare from cure to prevention will rely more heavily upon the individual. The home environment will house consumer medical devices that will carry out basic monitoring of the individual. While technologies are currently being developed to support this trend, there is a gulf that exists between the often-complex interfaces required by the highly specific functionality of products and the emotional needs of the target user. If a target user 'feels' a product was designed 'just for them' they are more likely to develop an emotional bond with that product. This manifests itself in the user engaging and interacting with the product. If a product, regardless of its high functionality, does not resonate with the user, this tends to result in product underuse, misuse and possible abandonment. When those products are related to a course of medical rehabilitation or treatment, these results could be translated to 'more compliant' and 'less compliant' and ultimately can impact upon how a person heals.Industrial designers focus on ensuring that both the functional and emotional needs of mainstream users as well as technical-expert-users are met. Design research provides the opportunity to bridge the gap between the functional requirements and the less tangible unmet needs of the user by exploring authentic human behaviour.This paper presents case studies of collaborative, interdisciplinary teams employing human-centred design and empathic research strategies (incorporating shared language, collaboration, ethnography, empathy and empathic modelling) to create real solutions that are responding to real needs of real users.The future is interdisciplinary. The future is bright.

Good vibrations: do electrical therapeutic massagers work?

Health, leisure and beauty activities are increasing in popularity, with a particular emphasis on self-help and alternative health practices. One product type that has increased sales with this expansion is the hand-held electric massager. These are products that use vibration as a means of alleviating muscular strains and pains, as well as promoting relaxation. Paradoxically, these products are extremely popular as gifts, but are soon discarded. A multi-disciplinary research team was commissioned by a British manufacturer of electrical consumer products to investigate user attitudes and perceptions of existing massagers, to identify areas of user dissatisfaction. The manufacturer was also concerned about a possible stigma attached to these products because of an association with sex aids. This paper provides an account of the perceptions of both consumers and therapists regarding the use of these products. Identifying the differences between the perceptions of consumers and therapists should help provide a basis for effective integration of user needs, manufacturer requirements, designers' skills and sound therapeutic practice. The results provide insight to support the development of more effective hand-held massagers.

Visual product evaluation: exploring users' emotional relationships with products.

This paper discusses an industrial designer's approach to eliciting user perceptions and emotional responses to products through visual evaluation and stimuli. Whilst the authors accept that product functionality is crucial for product success, the appearance, use of materials, shape and form provide the most immediate product data for the user. Less tangible issues such as emotional bonding of users with products, cultural perceptions and social value systems, provide valuable insights for the product developer to help expand knowledge and understanding of the users' need beyond the functional. This paper presents product personality profiling as a new technique for design researchers/designers, and discusses it alongside other emerging approaches such as mood boards and visual product evaluation. The authors have used these techniques during focus group sessions with users to elicit individuals' needs and aspirations towards products. Such a user-centred approach is fundamental to applied ergonomics. Experiences, benefits, and limitations of these techniques are outlined as well as the opportunities for further development.