bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-Motion: Mobility and Wellbeing in Later Life
Authors: Bevan Mark  , Petrie Helen  , Cambridge Howard  , Cinderby Steve  , Croucher Karen  , Swallow David  , Gilroy Rose  , Attuyer Katia
Published: February 2025

In considering the role of place in supporting positive well-being choices for all, including older people, there has been an almost exclusive focus on issues of design in the public realm. Emerging findings from the Co-Motion project suggest that the experience of being out and about can be also facilitated or profoundly damaged by the attitudes and behaviours of fellow public realm users.
Challenges and Successes in the Application of Universal Access Principles in the Development of Bus Rapid Transport Sytems in South Africa
Authors: Thompson Phillip
Published: February 2025

The National Department of Transport started a programme to upgrade public transport systems throughout South Africa in 2008, which included the upgrading of transport systems for host cities of the 2010 World Cup. This was the first time there was a clear commitment to produce universally accessible public transport systems in South Africa. The requirement to achieve universal access was reinforced by National Treasuries stipulation, that universal access was a precondition for the approval of all funding for these projects. In the absence of any specific legislation in the transport sector to address universal access and the South African National Building Regulations and the associated deemed to satisfy code, South African National Standard (SANS) 10400 Part S: “Facilities for Persons with Disabilities”, providing the only associated standards, there has been a need to revisit traffic engineering codes. This has created an opportunity to look at the functionality and safety of commuters, especially those who have functional limitations, at traffic intersections and midblock pedestrian crossings, especially as the commuters have to access predominately median located Bus Rapid Transport (BRT) trunk stations. Included in the specific areas of focus that impact on the issues of pedestrian safety, has been the application and functionality of tactile wayfinding and warning surfaces and other support systems for commuters with functional sight limitations and the integration of the systems with other infrastructure and the safety of all commuter. In addition to the issues of functionality, this paper will address the influence of misdirected foreign expertise that set the initial BRT Systems on a high floor vehicle modality, which has created operational challenges that have seriously compromised functional universal access. This presentation will highlight these challenges, opportunities and solutions, the procedural complexities, as well as the inherent resistance by traffic engineers to new functional modalities, in the cites of Johannesburg, Cape Town, George, as well as the proposed BRT Systems in EThekwini and Ekurhuleni, through the paradigm of Universal Design.
Deregulation of the Building Code and the Norwegian Approach to Regulation of Accessibility in the Built Environment
Authors: Lyngstad Pål
Published: February 2025

Deregulation is on the political agenda in the European countries. The Norwegian building code related to universal design and accessibility is challenged. To meet this, the Norwegian Building Authority have chosen to examine established truths and are basing their revised code on scientific research and field tests. But will this knowledge-based deregulation comply within the framework of the anti-discrimination act and, and if not: who suffers and to what extent?
Defects of the Urea Cycle
Authors: Lichter-Konecki Uta
Published: February 2025

The elimination of waste nitrogen as urea is a final and central step of amino acid catabolism. It is accomplished by one of the most essential pathways of terrestrial animals, the urea cycle. This chapter describes the basic function of the 5 catalytic enzymes, the two transporters, and the cofactor synthesizing enzyme that comprise the urea cycle as well as the consequences of their deficiencies and ways to treat them. The chapter then elaborates on related disorders of metabolism that may either cause hyperammonemia or elevation of an amino acid that is key to urea cycle function.
How to Reach Evidence-Based Usability Evaluation Methods
Authors: Marcilly Romaric  , Peute Linda
Published: February 2025

This paper discusses how and why to build evidence-based knowledge on usability evaluation methods. At each step of building evidence, requisites and difficulties to achieve it are highlighted. Specifically, the paper presents how usability evaluation studies should be designed to allow capitalizing evidence. Reciprocally, it presents how evidence-based usability knowledge will help improve usability practice. Finally, it underlines that evaluation and evidence participate in a virtuous circle that will help improve scientific knowledge and evaluation practice.
Design and Development of a Web-Based Self-Monitoring System to Support Wellness Coaching
Authors: Zarei Reza  , Kuo Alex
Published: February 2025

We analyzed, designed and deployed a web-based, self-monitoring system to support wellness coaching. A wellness coach can plan for clients' exercise and diet through the system and is able to monitor the changes in body dimensions and body composition that the client reports. The system can also visualize the client's data in form of graphs for both the client and the coach. Both parties can also communicate through the messaging feature embedded in the application. A reminder system is also incorporated into the system and sends reminder messages to the clients when their reporting is due. The web-based self-monitoring application uses Oracle 11g XE as the backend database and Application Express 4.2 as user interface development tool. The system allowed users to access, update and modify data through web browser anytime, anywhere, and on any device.
Considering the Language of Computerized Order Entry Systems
Authors: Diemert Simon  , Weber Jens  , Price Morgan
Published: February 2025

Computerized Provider Order Entry (CPOE) systems have been shown to introduce new problems into clinical environments. Given the communication intensive nature of these systems considering the language(s) of communication can provide insight into their function and subsequent problems. The current (as November 2015) CPOE literature was reviewed using the language concepts of syntax, semantics, and pragmatics as a lens. In total, 202 articles were considered, of these only 46 received a full review. 145 results related to language concepts were extracted from these articles. These were categorized into five categories: syntax, semantics, system-pragmatics, syntax-pragmatics, and semantic-pragmatics. In total key themes were synthesized. The themes identified can be used to direct further research in the area of CPOE systems. It was found that current literature heavily favors pragmatics concerns of language at the expense of considering underlying factors (syntax and semantics). The results support the use of language as a means of analyzing interactions between actors in communication intensive systems.
Querying EHRs with a Semantic and Entity-Oriented Query Language
Authors: Lelong Romain  , Soualmia Lina  , Dahamna Badisse  , Griffon Nicolas  , Darmoni Stéfan J.
Published: February 2025

While the digitization of medical documents has greatly expanded during the past decade, health information retrieval has become a great challenge to address many issues in medical research. Information retrieval in electronic health records (EHR) should also reduce the difficult tasks of manual information retrieval from records in paper format or computer. The aim of this article was to present the features of a semantic search engine implemented in EHRs. A flexible, scalable and entity-oriented query language tool is proposed. The program is designed to retrieve and visualize data which can support any Conceptual Data Model. The search engine deals with structured and unstructured data, for a sole patient from a caregiver perspective, and for a number of patients (e.g. epidemiology). Several types of queries on a test database containing 2,000 anonymized patients EHRs (i.e. approximately 200,000 records) were tested. These queries were able to accurately treat symbolic, textual, numerical and chronological data.
Feasibility of Representing a Danish Microbiology Model Using FHIR
Authors: Andersen Mie Vestergaard  , Kristensen Ida Hvass  , Larsen Malene Møller  , Pedersen Claus Hougaard  , Gøeg Kirstine Rosenbeck  , Pape-Haugaard Louise B.
Published: February 2025

Achieving interoperability in health is a challenge and requires standardization. The newly developed HL7 standard: Fast Healthcare Interoperability Resources (FHIR) promises both flexibility and interoperability. This study investigates the feasibility of expressing a Danish microbiology message model content in FHIR to explore whether complex in-use legacy models can be migrated and what challenges this may pose. The Danish microbiology message model (the DMM) is used as a case to illustrate challenges and opportunities accosted with applying the FHIR standard. Mapping of content from DMM to FHIR was done as close as possible to the DMM to minimize migration costs except when the structure of the content did not fit into FHIR. From the DMM a total of 183 elements were mapped to FHIR. 75 (40.9%) elements were modeled as existing FHIR elements and 96 (52.5%) elements were modeled as extensions and 12 (6.6%) elements were deemed unnecessary because of build-in FHIR characteristics. In this study, it was possible to represent the content of a Danish message model using HL7 FHIR.
Multivariate and Longitudinal Health System Indicators
Authors: Powell Guido Antonio  , Luo Yu T.  , Verma Aman  , Stephens David A.  , Buckeridge David L.
Published: February 2025

Within population health information systems, indicators are commonly presented as independent, cross-sectional measures, neglecting the multivariate, longitudinal nature of disease progression, health care use, and profiles of performance. We use administrative claims data of Montreal, Canada to identify patterns across indicators and over time in chronic obstructive pulmonary disease patients. We first cluster regions based on four health service indicators. Our second approach discovers individual-level trajectories based on a hidden Markov model using the same four indicators. Both approaches offer additional insights by facilitating the discovery and interpretation of indicators, such as a dual interpretation of low use of general practitioner services. These approaches to the analysis and visualization of health indicators can provide a foundation for information displays that will help decision makers identify areas of concern, predict future disease burden, and implement appropriate policies.
Business Rules to Improve Secondary Data Use of Electronic Healthcare Systems
Authors: Blaisure Jonathan  , Ceusters Werner
Published: February 2025

The ‘fit for purpose’ paradigm used for data quality assessment in electronic healthcare record (EHR) systems is not so fit when assessed in the light of secondary data use. An analysis of the difficulties encountered in trying to use existing EHR data for cohort identification for prospective clinical trials and retrograde data analytics, revealed the root causes to fall in three categories: (1) issues in workflow and data registration, (2) preventable inadequacies in software configuration and personalization and (3) software development issues on the side of the vendor. By reviewing secondary data use requirements and formulating value adding business rules, development and data collection practices can be steered towards greater value in secondary data consumption.
Preventing Unintended Disclosure of Personally Identifiable Data Following Anonymisation
Authors: Smith Chris
Published: February 2025

Errors and anomalies during the capture and processing of health data have the potential to place personally identifiable values into attributes of a dataset that are expected to contain non-identifiable values. Anonymisation focuses on those attributes that have been judged to enable identification of individuals. Attributes that are judged to contain non-identifiable values are not considered, but may be included in datasets that are shared by organisations. Consequently, organisations are at risk of sharing datasets that unintendedly disclose personally identifiable values through these attributes. This would have ethical and legal implications for organisations and privacy implications for individuals whose personally identifiable values are disclosed. In this paper, we formulate the problem of unintended disclosure following anonymisation, describe the necessary steps to address this problem, and discuss some key challenges to applying these steps in practice.
SNOMED CT as Reference Terminology in the Danish National Home Care Documentation Standard
Authors: Gøeg Kirstine Rosenbeck  , Elberg Pia Britt  , Højen Anne Randorff  , Eskildsen Ulla Lund
Published: February 2025

In Danish home care, multiple professions deliver services to citizens. FSIII is a national home care documentation standard, where one of the goals is to share documentation to improve coordination between these professional groups and avoid double documentation. The aim of this study was to develop a SNOMED-CT based navigation hierarchy to ensure that professions could preserve their documentation practice, to help avoid double documentation, and to ensure that the technical implementation did not require sophisticated semantic tools. The method involved mapping of non-SNOMED-CT content to SNOMED CT, visualization of merged graphs, identification of reference concepts, relating reference concepts to the documentation models of each profession, and representation of the navigation hierarchy in a reference set. The navigation hierarchy ensures that citizen conditions appear in a relevant context, regardless of which profession entered the data. Our approach paves the way for incremental standardization projects, where an implementation artefact, such as the navigation hierarchy, highlights the semantic features of SNOMED CT that can be used to reach specific business goals; in this case, sharing data across professional groups.
Computable Information Governance Contracts
Authors: Cunningham James  , Leeming Gary  , Ainsworth John
Published: February 2025

The risks of relinquishing control of electronic healthcare data for re-use in research are mitigated by the use of data sharing agreements and information governance procedures. These exist as legal, or quasi-legal, textual documents exchanged between data owners. Their existence outside of the digital realm leads to a situation where breaches of an agreement can only be detected and acted on post-hoc. We introduce the design of a system of computable contracts, specified formally, that can enforce the rules of data sharing agreements within the bounds of electronic health care systems.
A Case Study on Sepsis Using PubMed and Deep Learning for Ontology Learning
Authors: Arguello Casteleiro Mercedes  , Maseda Fernandez Diego  , Demetriou George  , Read Warren  , Fernandez Prieto Maria Jesus  , Des Diz Julio  , Nenadic Goran  , Keane John  , Stevens Robert
Published: February 2025

We investigate the application of distributional semantics models for facilitating unsupervised extraction of biomedical terms from unannotated corpora. Term extraction is used as the first step of an ontology learning process that aims to (semi-)automatic annotation of biomedical concepts and relations from more than 300K PubMed titles and abstracts. We experimented with both traditional distributional semantics methods such as Latent Semantic Analysis (LSA) and Latent Dirichlet Allocation (LDA) as well as the neural language models CBOW and Skip-gram from Deep Learning. The evaluation conducted concentrates on sepsis, a major life-threatening condition, and shows that Deep Learning models outperform LSA and LDA with much higher precision.
Using the MRC Framework for Complex Interventions to Develop Clinical Decision Support: A Case Study
Authors: Dowding Dawn  , Lichtner Valentina  , Closs S. José
Published: February 2025

The Medical Research Council (MRC) framework for complex interventions provides useful guidance to assist with the development and evaluation of health technology interventions such as decision support. In this paper we briefly summarise a project that focused on designing a decision support intervention to assist with the recognition, assessment and management of pain in patients with dementia in an acute hospital setting. We reflect on our experience of using the MRC framework to guide our study design, and highlight the importance of considering decision support interventions as complex interventions.
Evidence for Busines Intelligence in Health Care: A Literature Review
Authors: Loewen Liz  , Roudsari Abdul
Published: February 2025

This paper outlines a systematic literature review undertaken to establish current evidence regarding the impact of Business Intelligence (BI) on health system decision making and organizational performance. The review also examined BI implementation factors contributing to these constructs. Following the systematic review, inductive content analysis was used to categorize themes within the eight articles identified. This study demonstrated there is little evidence based literature focused on BI impact on organizational decision making and performance within health care. There was evidence found that BI does improve decision making. Implementation success was found to be dependent on several factors, many of which relate to broader organizational culture and readiness.
The Importance of Gene-Drug-Drug-Interactions in Pharmacogenomics Decision Support: An Analysis Based on Austrian Claims Data
Authors: Blagec Kathrin  , Kuch Wolfgang  , Samwald Matthias
Published: February 2025

While pharmacogenomic testing combined with clinical decision support has the potential to increase the safety and efficacy of medical treatments, the intake of multiple prescription drugs can – if not sufficiently addressed by decision support solutions – impair the effectiveness of such interventions by modulating the capacity of precisely those enzymes whose function pharmacogenomic tests try to predict. We quantified the potential extent of such drug-mediated mismatches between genotype-derived phenotypes and real phenotypes, commonly called “phenoconversion”, by screening claims data from 1,587,829 Austrian health insurance holders of the years 2006 and 2007 for concomitant prescriptions of drugs that can be dosed based on pharmacogenomics, and drugs that modulate enzyme activity. In total, 232,398 such prescription overlaps were detected, of which more than half (54.6%) could be attributed to co-prescriptions of moderate or strong modulators. Our results indicate that prescription drug-mediated phenoconversion is not uncommon, and should therefore be adequately reflected in decision support solutions by integrating algorithms to detect potential gene-drug-drug interactions.
A Two-Layer Method for Sedentary Behaviors Classification Using Smartphone and Bluetooth Beacons
Authors: Cerón Jesús D.  , López Diego M.  , Hofmann Christian
Published: February 2025

Background: Among the factors that outline the health of populations, person's lifestyle is the more important one. This work focuses on the caracterization and prevention of sedentary lifestyles. A sedentary behavior is defined as “any waking behavior characterized by an energy expenditure of 1.5 METs (Metabolic Equivalent) or less while in a sitting or reclining posture”.
The Guiding Role of a Paradigm in Informatics Education and Research
Authors: Saranto Kaija  , Kinnunen Ulla-Mari  , Kivekäs Eija  , Huusko Juhamatti  , Kuusisto-Niemi Sirpa
Published: February 2025

This study presents the current status of a paradigm used in informatics education and research in the health and human services fields. The aim is to synthesize the research focuses of students' theses and evaluate the current situation. The paradigm models informatics research. The research focus, questions and applied research methods were coded for 144 Master's degree theses. Based on the results, the theses could easily be coded for the paradigm concepts and research focuses. The most often used concept was data, which was connected to steering and organizing information management in work processes.
Actions to Empower Digital Competences in Healthcare Workforce: A Qualitative Approach
Authors: Konstantinidis Stathis Th.  , Li Sisi  , Traver Vicente  , Zary Nabil  , Bamidis Panagiotis D.
Published: February 2025

While healthcare systems are taking advantage of the ICT to improve healthcare services, healthcare workforce needs additional competencies in order to continue the provision of the best achievable care. In this paper emphasis is given to an active research effort taken during the MEI2015 Conference. Based on hands-on group-work, participants identified the actions needed to boost the acquisition of IT competences by healthcare workforce and collaboratively indicated the most important actions. The leading priority actions were integration of IT into Curriculum, continuous IT/eHealth training at the work place, raising awareness of IT competences, participatory decisions for actions, match healthcare applications to users' own context, inclusion of professionals in the development of eHealth projects. Interestingly, the proposed actions coupling the outcomes of another study following a different methodology, but also support the cooperation opportunities on IT skills for healthcare workforce. The latter formed a set of recommendations which were proposed within the CAMEI coordination and support action of EC-FP7.
Evaluation of an Integrated Health Information System (HIS) in a Public Hospital in Cyprus: A Pilot Study
Authors: Stylianides Antonis  , Mantas John  , Roupa Zoe  , Yamasaki Edna N.
Published: February 2025

Health information systems can improve the quality of services in healthcare. Evaluation of health information systems in hospitals is a very complex process, and it is more effective when different aspects are considered. The present work aims to develop an evaluation framework of an integrated HIS in order to improve the quality of healthcare services provided in Cyprus. Qualitative and quantitative methods were used, that measured three aspects of the system: technology, human factor and organization. Preliminary results showed that while participants seem to agree with the potential benefits of the integrated HIS, safety of data within the HIS is seen as a problem. Qualitatively, the study pointed to 3 factors that might improve the current integrated HIS: increasing interdisciplinary cooperation, training of staff, and upgrading the infrastructure. Further studies will provide a comprehensive picture for Cyprus, so that appropriate measures can be proposed and put in action.
The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement
Authors: Brach Cindy
Published: February 2025

A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the U.S. National Academies of Sciences, Engineering, Medicine Roundtable on Health Literacy defined ten attributes of health literate health care organizations.
Engaging Patients in Decision-Making and Behavior Change to Promote Prevention
Authors: Krist Alex H.  , Tong Sebastian T.  , Aycock Rebecca A.  , Longo Daniel R.
Published: February 2025

Effectively engaging patients in their care is essential to improve health outcomes, improve satisfaction with the care experience, reduce costs, and even benefit the clinician experience. This chapter will address the topic of patient engagement directly and review the relationships between health literacy and patient engagement. While there are many ways to define patient and family engagement, this chapter will consider engagement as “patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system – direct care, organizational design and governance, and policy making – to improve health and health care [1].” We will specifically focus on the patient engagement and health literacy needs for three scenarios (1) decision-making, (2) health behavior change, and (3) chronic disease management; we will include the theoretical underpinnings of engagement, the systems required to better support patient engagement, how social determinants of health influence patient engagement, and practical examples to demonstrate approaches to better engage patients in their health and wellbeing. We will close by describing the future of patient engagement, which extends beyond the traditional domains of decision-making and self-care to describe how patient engagement can influence the design of the healthcare delivery system; local, state, and national health policies; and future research relevant to the needs and experiences of patients.
Social Media: A Path to Health Literacy
Authors: Roberts Michelle  , Callahan Lizz  , O'Leary Catina
Published: February 2025

Social media – websites and other online tools called social networks – serve as a tool to connect people and organizations around topics of common interest. Social media platforms offer tremendous opportunity to engage quickly and sometimes in depth with many and diverse stakeholders as people have the ability to communicate back-and-forth from anywhere in the world. As increasing numbers of people receive their news and health information online, it is important to ensure content delivered through online resources is accessible to diverse target audiences. This chapter discusses a mid-sized health literacy nonprofit organizations' social media philosophy and tactics during the past 10 years, as both social media and health literacy strategies evolved continuously. The integration of social media in health literacy program content depends on the use with best evidence health literacy strategies, such as the use of plain language techniques. Strategy and technical considerations for the implementation and integration of social media within a health literate health communications model are discussed.
A Comparison of Danish and Canadian Consumer Medication Information
Authors: Monkman Helen  , Nøhr Christian  , Kushniruk Andre W.
Published: February 2025

Many people around the world use prescription medications. Consumers often require information about their medications to support taking them safely and effectively. One source of such information is Consumer Medication Information (CMI). Canadians typically receive printed CMI when a new prescription is filled whereas Danes have the online resource min.medicin.dk. This study compared the content and design of Danish and Canadian CMI. Danish CMI satisfied seven of the 11 content utility criteria (developed in previous work) identified as supporting the safe and effective medication use. However, Danish CMI provided a more information about how frequently possible side effects occur and multimedia (e.g., images, videos) directions for some medications. This study examined some of the similarities and differences between how Canadians and Danes are informed about medications. However, further research is required to determine what content and methods of delivery are most beneficial in supporting safe and effective medication use.
Potential of Decision Support in Preventing Pressure Ulcers in Hospitals
Authors: Wang Ju  , Gong Yang
Published: February 2025

The development of hospital-acquired pressure ulcers signals low quality of care. Despite the established guidelines and best practices on pressure ulcer prevention, the incidence of pressure ulcers in hospital remains high. To meet the challenges of consistently translating best practices into effective clinical practices and promote effective teamwork communication and interprofessional collaboration, we consider the failure of consistent care delivery as loss of information and reveal the opportunities of informatics methods to reinforce information delivery, evidenced by typical cases. We, then, explain and summarize information-related issues existing at the initial assessment upon hospital admission, routine treatments, and team communication. Clinical decision support methods are promising in addressing these issues by optimizing care plans, improving adherence to best practices, reinforcing effective team communication, and customizing event report feedback.
Moving Past Exploration and Adoption: Considering Priorities for Implementing Mobile Learning by Nurses
Authors: Mather Carey  , Cummings Elizabeth
Published: February 2025

Successful implementation of mobile technology for informal learning and continuing professional development within healthcare settings cannot be achieved or sustained, until end-users recognise that the benefits of using this innovation, outweigh the issues of non-use. At a systems level there is a need for standards, guidelines and codes of conduct to support deployment of mobile technology at an individual level. The aim of this research was to explore findings of a previous focus group study to elucidate priorities for action, provide evidence and focus impetus for advocating progression of the installation of standards and guidelines at an organisation level. The study confirms nurse supervisors' preparedness and readiness to employ mobile learning at point of care. However, successful implementation requires organisations engaging with, and embracing the evolving digital landscape, and supporting this new andragogy. Organisational level commitment will promote contemporary nursing practice, support the best clinical outcomes for patients, and provide educational support for nurses. Nurse leaders and professional bodies must drive and guide development of robust standards, guidelines, and codes of conduct to prioritise mobile learning as a component of digital professionalism within healthcare organisations.
Designing Situated Learning Experiences: Interdisciplinary Collaboration for Design Education in Healthcare
Authors: Reay Stephen  , Collier Guy
Published: February 2025

This paper describes how the DHW Lab facilitates third mission activities, as well as advancing undergraduate pedagogy and post-graduate research. It suggests there are challenges and opportunities involved in creating a hybrid of two very different organizations, that need to be addressed to advance transdisciplinary education in the ‘transformative university’.
Roles and Responsibilities of Parents and Therapists in a Kindergarten Treatment Centre
Authors: Spierts Nadine
Published: February 2025

The aim of the study is 1) to gather insights into the current procedure used to coordinate/determine the roles and responsibilities between parents and therapists from a Kindergarten Treatment centre in The Netherlands with respect to the treatment and support of the children and 2) to examine parents and professionals experience in this procedure.
Remote Care Technology: A Systematic Overview
Authors: Queirós Alexandra  , Alvarelhão Joaquim  , Cerqueira Margarida  , Silva Anabela G.  , Santos Milton  , Rocha Nelson Pacheco
Published: February 2025

The present study was based on a systematic review of reviews and meta-analyses and aimed to identify technologies being used to provide home monitoring to support older adults with chronic diseases and to promote their empowerment, as well as to identify how these technologies impact health related outcomes.
E-Inclusion: Social Inclusion of Young Adults with Intellectual Disabilities – A Participatory Design
Authors: Louw Julia S.
Published: February 2025

By examining the role of digital tools and social media, this paper discusses an innovative prospective research study to enhance social inclusion of young adults with intellectual disabilities (ID). The paper begins with an overview of how individuals with disabilities have historically been excluded from society based on limited access and minimal opportunities afforded to them. Next, the paper presents the caveats that may hinder the improvement of social inclusion of young adults with ID and the oversights when developing digital technologies. Details about a prospective intervention research study are described that include a mobile application and a social media component. Finally, implications for research and practice are highlighted to emphasize the fundamental call for an insightful deliberation of these caveats that needs to be addressed in the design of a research study of this nature.
“Sliders” Android Game – Improving Logical Skills of People with Disabilities
Authors: Guzsvinecz Tibor  , Koszegi-Vigh David  , Szucs Veronika  , Sik Lanyi Cecilia
Published: February 2025

Logic is part of our everyday life. However, there are some cases where people have difficulties using deductive reasoning. The aim of this work is to help people with mild intellectual disability or learning disability to learn the basis of logical thinking. We developed an application on Android operating system to improve logical thinking.
An Innovative Speech-Based User Interface for Smarthomes and IoT Solutions to Help People with Speech and Motor Disabilities
Authors: Malavasi Massimiliano  , Turri Enrico  , Atria Jose Joaquin  , Christensen Heidi  , Marxer Ricard  , Desideri Lorenzo  , Coy Andre  , Tamburini Fabio  , Green Phil
Published: February 2025

A better use of the increasing functional capabilities of home automation systems and Internet of Things (IoT) devices to support the needs of users with disability, is the subject of a research project currently conducted by Area Ausili (Assistive Technology Area), a department of Polo Tecnologico Regionale Corte Roncati of the Local Health Trust of Bologna (Italy), in collaboration with AIAS Ausilioteca Assistive Technology (AT) Team. The main aim of the project is to develop experimental low cost systems for environmental control through simplified and accessible user interfaces. Many of the activities are focused on automatic speech recognition and are developed in the framework of the CloudCAST project. In this paper we report on the first technical achievements of the project and discuss future possible developments and applications within and outside CloudCAST.
Cloud-Based Speech Technology for Assistive Technology Applications (CloudCAST)
Authors: Cunningham Stuart  , Green Phil  , Christensen Heidi  , Atria José Joaquín  , Coy André  , Malavasi Massimiliano  , Desideri Lorenzo  , Rudzicz Frank
Published: February 2025

The CloudCAST platform provides a series of speech recognition services that can be integrated into assistive technology applications. The platform and the services provided by the public API are described. Several exemplar applications have been developed to demonstrate the platform to potential developers and users.
Analysis of an Individual's Language to Improve Efficiency of an AAC System
Authors: Wade Will  , Koester Heidi  , McNeilly Samantha
Published: February 2025

The paper discusses the collection and analysis of a three-month language sample from an adult using a low-tech augmentative and alternative communication (AAC) system transcribed to analyse the frequency of words and letters to make suggestions for more efficiency.
Robots for Elderly Care: Their Level of Social Interactions and the Targeted End User
Authors: Bedaf Sandra  , de Witte Luc
Published: February 2025

Robots for older adults have a lot of potential. In order to create an overview of the developments in this area a systematic review of robots for older adults living independently was conducted. Robots were categorized based on their market readiness, the type of provided support (i.e., physical, non-physical, non-specified), and the activity domain they claim to support. Additionally, the commercially available robots are places in a proposed framework to help to distinguish the different types of robots and their focus. During the presentation an updated version of the state of the art will be presented.
Citizen and Stakeholder Perspectives About Approaches to Enhance Equitable Access to Assistive Technologies for Older Adults
Authors: Mattison Cristina A.  , Waddell Kerry  , Wang Rosalie H.  , Wilson Michael G.
Published: February 2025

Assistive technologies play an important role in promoting healthy aging, independent living and aging-in-place, yet many experience unmet needs. This project reports on three citizen panels and a stakeholder dialogue convened in Canada to spark action towards enhancing equitable access to assistive technologies for older adults.
Mobile App Selection Tool (MAST) for Post-Secondary Students with Disabilities
Authors: Chmiliar Linda
Published: February 2025

This paper discusses research examining the use of a Mobile Apps Selection Tool (MAST) designed to facilitate the use of the iPad by post-secondary students with disabilities. MAST is a public website that was developed to support students to become independent in their use of the iPad to meet their learning needs.
Accapto, a Generic Design and Development Toolkit for Accessible Mobile Apps
Authors: Krainz Elmar  , Miesenberger Klaus
Published: February 2025

Smartphones show potential to improve and support the daily lives of people with disabilities. User experience of mobile apps is generally good, but rather unsatisfying for people with disabilities relying on accessibility support. Developers often are not aware of and do not respect this user group. We propose a system supporting developers in early stages of app development. The Accapto toolkit allows modelling accessible smartphone interaction during the design phase. Based on this interaction model the prototype of the resulting app is generated. Predefined accessibility features based on standards and expert knowledge are automatically integrated to enhance accessibility.
Designing Web-Apps for All: How Do We Include Those with Cognitive Disabilities?
Authors: James Abi  , Draffan E.A.  , Wald Mike
Published: February 2025

Accessibility guidance for the development of web-apps for users with cognitive disabilities is sorely lacking despite the availability of extensive web content accessibility standards. This paper examines additional requirements suggested by specialists in the field, in order to further aid developers looking to create accessible interactive web experiences for all.
Comparing Accessibility Auditing Methods for Ebooks: Crowdsourced, Functionality-Led Versus Web Content Methodologies
Authors: James Abi  , Draffan E.A.  , Wald Mike
Published: February 2025

This paper presents a gap analysis between crowdsourced functional accessibility evaluations of ebooks conducted by non-experts and the technical accessibility standards employed by developers. It also illustrates how combining these approaches can provide more appropriate information for a wider group of users with print impairments.
Development of National Guidelines for the Ground Rules to Lending Assistive Technology Devices in Finland
Authors: Kanto-Ronkanen Anne  , Hupli Markku  , Nyfors Hanna
Published: February 2025

Central Hospital Districts (CHD) in Finland provide most of the Assistive Technology Device Services (ATDS). ATDSs have been developing their work and unifying their practices regionally. Each of these 20 CHDs have their own guidelines for the ground rules for lending assistive technology devices. These ground rules include principles of ATD Services and lending rules for different device groups classified by ISO 9999 standard. There has been a growing pressure to unify the practices of ATDS nationally, because of a growing need for devices and economy. A project to unify National Guidelines was set up in spring 2016. There were four different review rounds among CHD ATD services and patient organizations. The Ground Rules will be published in 2017.
ICT and UD: Preliminary Study for Recommendations to Design Accessible University Courses
Authors: Pagliara Silvio Marcello  , Sánchez Utgé Marta  , De Anna Lucia
Published: February 2025

Starting from the Universal Design in the educational context principles, the experiences gained during the FIRB project “Net@ccessibility” and the high-education courses for teachers' specialization on special education, this research will focus on preliminary studies in order to define the recommendations for designing accessible university courses.
Machine Learning Models of Post-Intubation Hypoxia During General Anesthesia
Authors: Sippl Philipp  , Ganslandt Thomas  , Prokosch Hans-Ulrich  , Muenster Tino  , Toddenroth Dennis
Published: February 2025

Fine-meshed perioperative measurements are offering enormous potential for automatically investigating clinical complications during general anesthesia. In this study, we employed multiple machine learning methods to model perioperative hypoxia and compare their respective capabilities. After exporting and visualizing 620 series of perioperative vital signs, we had ten anesthesiologists annotate the subjective presence and severity of temporary post-intubation oxygen desaturation. We then applied specific clustering and prediction methods on the acquired annotations, and evaluated their performance in comparison to the inter-rater agreement between experts. When reproducing the expert annotations, the sensitivity and specificity of multi-layer neural networks substantially outperformed clustering and simpler threshold-based methods. The achieved performance of our best automated hypoxia models thereby approximately equaled the observed agreement between different medical experts. Furthermore, we deployed our classification methods for processing unlabeled inputs to estimate the incidence of hypoxic episodes in another sizeable patient cohort, which attests to the feasibility of using the approach on a larger scale. We interpret that our machine learning models could be instrumental for computerized observational studies of the clinical determinants of post-intubation oxygen deficiency. Future research might also investigate potential benefits of more advanced preprocessing approaches such as automated feature learning.
IT Infrastructure for Biomedical Research in North-West Germany
Authors: Seeger Insa  , Zeleke Atinkut  , Freitag Michael  , Röhrig Rainer
Published: February 2025

The efficient use of routine data for biomedical research presupposes an IT infrastructure designed for health care facilities. The objective of this study was to analyse which IT infrastructure is used in hospitals and by general practitioners' (GP) practices in the region Oldenburg-Bremen and to examine how well this supports research projects. To this end, IT managers and GPs were interviewed. The usage of hospital information systems (HIS) and data warehouse systems (DWS) in hospitals is of major importance for the study. Over 90 % use DWS for administration, 42 % for clinical research. None of the hospitals implemented consent for the use of routine data for research. Only a third of the GPs have participated in studies. The GPs' offices based EHR systems in use offer virtually no support for research projects. The study results demonstrate that technical and organisational measures are required for the further usage of routine data in the region.
Developing and Evaluating Collaborative Online-Based Instructional Designs in Health Information Management
Authors: Ammenwerth Elske  , Hackl Werner O.  , Felderer Michael  , Hoerbst Alexander
Published: February 2025

The number of students enrolled in online courses is increasing steadily. Distance education offers many advantages, but also has inherent challenges. Successful distance education needs a thoughtfully designed instructional strategy where students are supported to actively create knowledge. We present the design and evaluation of three online-based courses in health informatics. The courses were based on a collaborative instructional strategy. The evaluation comprised workload analysis, student evaluation, student interviews and student reflections. Students expressed high satisfaction with online learning, despite a high workload, and high perceived learning outcomes. Using the Community of Inquiry framework as reference, we found very high levels of teaching presence, social presence and cognitive presence. Summarizing, we found that the chosen instructional strategy supported student-centered, collaborative learning. We conclude by presenting lesson learned for online-based instructional design.
Implementing a Data Management Platform for Longitudinal Health Research
Authors: Weiß Jan-Patrick  , Hübner Ursula  , Rauch Jens  , Hüsers Jens  , Teuteberg Frank  , Esdar Moritz  , Liebe Jan-David
Published: February 2025

Health IT adoption research is rooted in Rogers' Diffusion of Innovation theory, which is based on longitudinal analyses. However, many studies in this field use cross-sectional designs. The aim of this study therefore was to design and implement a system to (i) consolidate survey data sets originating from different years (ii) integrate additional secondary data and (iii) query and statistically analyse these longitudinal data. Our system design comprises a 5-tier-architecture that embraces tiers for data capture, data representation, logics, presentation and integration. In order to historicize data properly and to separate data storage from data analytics a data vault schema was implemented. This approach allows the flexible integration of heterogeneous data sets and the selection of comparable items. Data analysis is prepared by compiling data in data marts and performed by R and related tools. IT Report Healthcare data from 2011, 2013 and 2017 could be loaded, analysed and combined with secondary longitudinal data.
Regional Monitoring of Cervical Cancer
Authors: Crisan-Vida Mihaela  , Lupse Oana Sorina  , Stoicu-Tivadar Lacramioara  , Salvari Daniela  , Catanet Radu  , Bernad Elena
Published: February 2025

Cervical cancer is one of the most important causes of death in women in fertile age in Romania. In order to discover high-risk situations in the first stages of the disease it is important to enhance prevention actions, and ICT, respectively cloud computing and Big Data currently support such activities. The national screening program uses an information system that based on data from different medical units gives feedback related to the women healthcare status and provides statistics and reports. In order to ensure the continuity of care it is updated with HL7 CDA support and cloud computing. The current paper presents the solution and several results.
Development and Evaluation of a Blood Glucose Management System for Reducing the Delay in Measurement
Authors: Kei Teramoto  , Tsuyoshi Okura  , Rie Koshitani  , Murata Takahiro  , Yuko Yorifuji  , Erika Hotta  , Yusuke Endo  , Masaru Ueki  , Hiroshi Kondoh
Published: February 2025

The purpose of this study was to develop and evaluate the blood glucose management (BGM) system, which supports the scheduling of blood glucose measurements for medical staff. This system enables medical staff to continually confirm the instructions of the physicians by measuring blood glucose levels using a smart device (iPod). This paper describes the difference in the delay of the measurement between the BGM system and the non-BGM system. For the iPod device in the BGM system, the desktop device, and the laptop device, the frequencies of a delay under 30 minutes were 94%, 67%, and 80%, respectively (Ryan-test, P < 0.01), and that over 30 minutes were 6%, 33%, and 20%, respectively (Ryan-test, P < 0.01). We concluded that the BGM system reduced the delay in blood glucose measurements and led to an optimization of the time of measurement.