A Review of 25 Years of CSCW Research in Healthcare: Contributions, Challenges and Future Agendas

CSCW as a field has been concerned since its early days with healthcare, studying how healthcare work is collaboratively and practically achieved and designing systems to support that work. Reviewing literature from the CSCW Journal and related conferences where CSCW work is published, we reflect on the contributions that have emerged from this work. The analysis illustrates a rich range of concepts and findings towards understanding the work of healthcare but the work on the larger policy level is lacking. We argue that this presents a number of challenges for CSCW research moving forward: in having a greater impact on larger-scale health IT projects; broadening the scope of settings and perspectives that are studied; and reflecting on the relevance of the traditional methods in this field - namely workplace studies - to meet these challenges.     

A demonstration of level-anchored ratio scaling for prediction of grip strength

Level-anchored ratio scaling, such as the Borg CR10 scale^® and the Borg CR100 scale^®, uses verbal anchors in congruence with numbers to give ratio data together with natural levels of intensity. This presupposes that the anchors possess natural positions in the subjective dynamic range and also “numerical” inter-relations. In an experiment, subjects had to produce a force of handgrip corresponding to their conception of “Strong”, followed by a “Maximal” performance. By using the previously found relationship between “Strong” and “Maximal” of 1:2 together with knowledge of the exponent in the power S-R-function (R = c × Sⁿ) for grip strength, n = 1.8, predictions of individual maximal performances were obtained. The predicted values correlated 0.76 with, and deviated only 3% (ns) from, actual maximal performances of grip strength. This result –as previously also found for aerobic capacity–gives a strong support for the use of verbal anchors, so common in category scaling, also in “ratio scaling” and that the Borg CR-scales fulfill the requirements for ratio scales. For estimation of muscular strength, such as grip strength, this present study points to the value of using submaximal determinations as a compliment to maximal performances (e.g., to obtain measures of functional capacity). The results also support the increasingly common use of the CR-methodology in other ergonomic settings concerning suitable design of tools and equipment.     

Software Assumptions Lead to Preventable Errors

Undocumented assumptions are often the cause of serious software system failure. Thus, to reduce such failures, developers must become better at discovering and documenting their assumptions. In this article, we focus on common categories of assumptions in software, discuss methods for recognizing when developers are making them, and recommend techniques for documenting them.     

Between Elderly Parents and Grandchildren—Geographic Proximity and Trends in Four-Generation Families

In an ageing society, families may have an important role in the caretaking and well-being of the elderly. Demographic changes have an impact on the size and structure of families; one aspect is how intergenerational support is distributed when there is a need for support to both older and younger generations at the same time. Another vital aspect of the provision of care for the elderly is geographic proximity. This study is oriented towards the potential “both-end carers” i.e. persons who have grandchildren in potential need of care while still having living ageing parents. The incidence of having grandchildren and having living parents at age 55 and the proximity between generations is described using Swedish register data. The results show that the share of 55-year-olds who are grandparents decreased dramatically from 70% to 35% between 1990 and 2005. As expected, more 55-year-olds have living parents—a proportion that increased from 37% to 47% during this period. As a result of delayed childbearing among the children of these cohorts, the likelihood of belonging to a four-generation family among 55-year-olds has not increased, despite increased longevity. Furthermore, most individuals live within daily reach of their kin and no evidence was found of a trend of increasing geographic distances between generations.     

Non-positive autoimmune responses against CYP2E1 in refrigeration mechanics exposed to halogenated hydrocarbons

The aim of the study was to determine if occupational exposure to hydrofluorocarbons (HFC) and hydrochlorofluorocarbons (HCFC) generates autoimmune responses against CYP2E1. HFCs and HCFCs have replaced the chlorofluorocarbons (CFC) in e.g. refrigeration installations and air-conditioning systems. During the substitution period, refrigeration mechanics reported symptoms like asthma, influenza-like reactions, and joint troubles. These symptoms resemble those of chronic inflammatory diseases with an autoimmune component. Since exposure to structurally similar chemicals, e.g. halothane, has previously been associated with autoimmune responses and diseases, autoimmunity among the refrigeration mechanics might hypothetically explain the reported inflammatory symptoms. Serum from 44 Swedish men, occupationally exposed to halogenated hydrocarbons, was screened for antibodies against CYP2E1 with enzyme-linked immunosorbent assay. Thirty of the workers had asthma, joint problems or influenza-like symptoms whereas 14 of them had no such symptoms. They were all selected from a cohort of 280 refrigeration mechanics. Unexposed, healthy, Swedish men (n=35) constituted control group. The study was approved by the Ethics Committee at Karolinska Institutet. No increase in autoantibodies against CYP2E1 was detected among the occupationally exposed workers as compared to the unexposed controls. Further, there was no difference in antibody titer between the exposed workers with symptoms and the exposed, asymtomatic workers or the unexposed controls. The present study does not completely exclude a connection between exposure and effect but makes the relation less likely at these exposure levels.     

Prof. Dr.-Ing. Dr. h. c. Franz Kollmann Zum 65. Geburtstag

Ohne Zusammenfassung     

Verification of cardiac tissue electrophysiology simulators using an N-version benchmark

Ongoing developments in cardiac modelling have resulted, in particular, in the development of advanced and increasingly complex computational frameworks for simulating cardiac tissue electrophysiology. The goal of these simulations is often to represent the detailed physiology and pathologies of the heart using codes that exploit the computational potential of high-performance computing architectures. These developments have rapidly progressed the simulation capacity of cardiac virtual physiological human style models; however, they have also made it increasingly challenging to verify that a given code provides a faithful representation of the purported governing equations and corresponding solution techniques. This study provides the first cardiac tissue electrophysiology simulation benchmark to allow these codes to be verified. The benchmark was successfully evaluated on 11 simulation platforms to generate a consensus gold-standard converged solution. The benchmark definition in combination with the gold-standard solution can now be used to verify new simulation codes and numerical methods in the future.     

Production and Characterization of Peptide Antibodies to the C-Terminal of Frameshifted Calreticulin Associated with Myeloproliferative Diseases

Myeloproliferative Neoplasms (MPNs) constitute a group of rare blood cancers that are characterized by mutations in bone marrow stem cells leading to the overproduction of erythrocytes, leukocytes, and thrombocytes. Mutations in calreticulin (CRT) genes may initiate MPNs, causing a novel variable polybasic stretch terminating in a common C-terminal sequence in the frameshifted CRT (CRTfs) proteins. Peptide antibodies to the mutated C-terminal are important reagents for research in the molecular mechanisms of MPNs and for the development of new diagnostic assays and therapies. In this study, eight peptide antibodies targeting the C-terminal of CRTfs were produced and characterised by modified enzyme-linked immunosorbent assays using resin-bound peptides. The antibodies reacted to two epitopes: CREACLQGWTE for SSI-HYB 385-01, 385-02, 385-03, 385-04, 385-07, 385-08, and 385-09 and CLQGWT for SSI-HYB 385-06. For the majority of antibodies, the residues Cys¹, Trp⁹, and Glu¹¹ were essential for reactivity. SSI-HYB 385-06, with the highest affinity, recognised recombinant CRTfs produced in yeast and the MARIMO cell line expressing CRTfs when examined in Western immunoblotting. Moreover, SSI-HYB 385-06 occasionally reacted to CRTfs from MPN patients when analysed by flow cytometry. The characterized antibodies may be used to understand the role of CRTfs in the pathogenesis of MPNs and to design and develop new diagnostic assays and therapeutic targets.     

Laboratory examination of anisotropy in the foliation plane of metamorphic rocks

Mechanical testing and ultrasonic measurements were used to establish the properties of metamorphic rocks in different directions of the foliation plane. Tests were undertaken on 42 mm diameter specimens cored at right angles to the foliation of gneissic rocks from southwest Sweden. Ultrasonic and tensile testing was carried out in three diametral directions and the data for each direction were compared. Coefficients, failure load anisotropy and velocity anisotropy were obtained. An anisotropy coefficient of 3% was detected by ultrasonic measurements, while the Brazilian tests indicated 15%. The study has shown that an anisotropy coefficient of the foliation plane is present, albeit small. Electronic Publication