Digest of Papers. First International Symposium on Wearable Computers
This paper reports on an experiment investigating the functionality and usability of novel input ... more This paper reports on an experiment investigating the functionality and usability of novel input devices on a wearable computer, for text entry tasks. Over a three week period, twelve subjects used three different input devices to create and save short textual messages. The virtual keyboard, forearm keyboard, and Kordic keypad input devices were assessed as to their eficiency and usability for simple text entry tasks. Results collected included the textual data created by the subjects, the duration of activities, the survey data and observations made by supervisors. The results indicated that the forearm keyboard is the best performer for accurate and efJicient text entry while other devices m q benefit from more work on designing specialist CUls for the wearable computer.
2006 10th IEEE International Symposium on Wearable Computers, 2006
This paper presents the results of two experiments comparing four commercially available pointing... more This paper presents the results of two experiments comparing four commercially available pointing devices performing drag and drop tasks for use with wearable computers. The pointing devices evaluated consist of a Trackball, Touchpad, Gyroscopic mouse and Twiddler2 mouse. The studies involved 24 participants performing drag and drop tasks with the pointing devices while wearing a wearable computer on their back
The first paper in this series explored the general philosophy of evidence-based practice for son... more The first paper in this series explored the general philosophy of evidence-based practice for sonographers. Aims: This paper focuses on a specific type of research question that is of most relevance to the practice of sonography, the diagnostic accuracy study. As users of the medical literature, it is important that sonographers are able to accurately read and critically review diagnostic accuracy studies.
Background: There is evidence that consistent sitting for prolonged periods is associated with up... more Background: There is evidence that consistent sitting for prolonged periods is associated with upper quadrant musculoskeletal pain (UQMP). It is unclear whether postural alignment is a significant risk factor. Objective and design: The aim of the prospective study (2010 -2011) was to ascertain if threedimensional sitting postural angles, measured in a real-life school computer classroom setting, predict seated-related UQMP. Method: Asymptomatic Grade 10 high-school students, aged 15 -17 years, undertaking Computer Application Technology, were eligible to participate. Using the 3D Posture Analysis Tool, sitting posture was measured while students used desk-top computers. Posture was reported as five upper quadrant angles (Head flexion, Neck flexion; Craniocervical angle, Trunk flexion and Head lateral bending). The Computer Usage Questionnaire measured seated-related UQMP and hours of computer use. The Beck Depression Inventory and the Multidimensional Anxiety Scale for Children assessed psychosocial factors. Sitting posture, computer use and psychosocial factors were measured at baseline. UQMP was measured at six months and one-year follow-up. Results: 211, 190 and 153 students participated at baseline, six months and one-year follow-up respectively. 34.2% students complained of seated-related UQMP during the follow-up period. Increased head flexion (HF) predicted seated-related UQMP developing over time for a small group of students with pain scores greater than the 90 th pain percentile, adjusted for age, gender, BMI, computer use and psychosocial factors (p=0.003). The pain score increased 0.22 points per 1° increase in HF.
A common knee injury mechanism sustained during basketball is landing badly from a jump. Landing ... more A common knee injury mechanism sustained during basketball is landing badly from a jump. Landing is a complex task and requires good coordination, dynamic muscle control and flexibility. For adolescents whose coordination and motor control has not fully matured, landing badly from a jump can present a significant risk for injury. There is currently limited biomechanical information regarding the lower limb kinetics of adolescents when jumping, specifically regarding jump kinematics comparing injured with uninjured adolescents. This study reports on an investigation of biomechanical differences in landing patterns of uninjured and injured adolescent basketball players. A matched case-control study design was employed. Twenty-two basketball players aged 14-16 years participated in the study: eleven previously knee-injured and eleven uninjured players matched with cases for age, gender, weight, height and years of play, and playing for the same club. Six high-speed, three-dimensional V...
Correct upright posture is considered to be a measure of good musculoskeletal health. Little is k... more Correct upright posture is considered to be a measure of good musculoskeletal health. Little is known about the usual variability of children's upright standing posture. The aim of this study was to assess differences between repeated measures of upright posture in a group of primary school children. Sagittal plane photographs of usual, relaxed upright standing posture of 38 boys and girls aged 5-12 years were taken twice within an hour. Reflective markers were placed over the canthus, tragus, C7 spinous process, greater trochanter and lateral malleolus. Digitising software was used to calculate the x,y plane coordinates, from which five postural angles were calculated (trunk, neck, gaze, head on neck, lower limb). Height, weight, motor control estimates (as measured by the Brace Tests) and presence of recent pain were recorded for each child, and the association between the first test measure of posture angles and these factors was assessed using linear regression and ANOVA mod...
A unique management system was developed to enhance the quality of allied health care for the eld... more A unique management system was developed to enhance the quality of allied health care for the elderly. The management system is a multipronged framework of processes and outcomes, which address key stakeholder needs, and is based on best scientific evidence. Use of the management system provides efficiencies for funding bodies in data collection and monitoring service quality. It also confirms the professional integrity of the allied health service provider and underscores the importance of client-therapist partnership in determining appropriate health outcomes. Further testing is required to assess the relationship between use of the allied health management system and better quality service provision, cost containment, and consistently good client health outcomes.
The aim of this study was to establish intra-and interobserver repeatability in the direct linear... more The aim of this study was to establish intra-and interobserver repeatability in the direct linear measurement of knee structures displayed using three-dimensional (3-D) reconstructed computer imaging. Methods To test inter-observer repeatability, using a commercially available image reconstruction software package, seven observers were asked to record measurements for each of 30 individual structural features identified from a previously generated series of MR-based 3-D computer reconstructions of a single, complete, ovine knee. To test intra-observer repeatability, a single observer was asked to record measurements of the same 30 features on three separate occasions. Results Statistical analysis of the collected data suggests a high degree of repeat measurement agreement both within (P ¼ 0:76) and between observers (P ¼ 0:87). The findings of this study suggest that defined linear measurements can be generated from 3-D MR images created using the new reconstructive system, by imaging technologists, with a high degree of both intra-and inter-observer
Sustainable implementation of new workforce redesign initiatives requires strategies that minimiz... more Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scopeof-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes.
BackgroundPerformance evaluation raises several challenges to allied health practitioners and the... more BackgroundPerformance evaluation raises several challenges to allied health practitioners and there is no agreed approach to measuring or monitoring allied health service performance. The aim of this review was to examine the literature on performance evaluation in healthcare to assist in the establishment of a framework that can guide the measurement and evaluation of allied health clinical service performance. This review determined the core elements of a performance evaluation system, tools for evaluating performance, and barriers to the implementation of performance evaluation.MethodsA systematic review of the literature was undertaken. Five electronic databases were used to search for relevant articles: MEDLINE, Embase, CINAHL, PsychInfo, and Academic Search Premier. Articles which focussed on any allied health performance evaluation or those which examined performance in health care in general were considered in the review. Content analysis was used to synthesise the findings ...
Background Functional decline (FD) is a largely preventable feature of aging, characterized as gr... more Background Functional decline (FD) is a largely preventable feature of aging, characterized as gradual erosion of functional autonomy. This reduces an older person’s capacity for safe, independent community living. The healthcare needs of an unprecedented aging population places pressure on health systems to develop innovative approaches to ensuring older people live healthy and independent lives for as long as possible. TRIIFL aims to demonstrate that: Incipient FD in older people can be identified using a simple telephone-screening process within four weeks of discharge from an emergency department presentation for a minor health event; and Early engagement into a person-centered individualized intervention arrests or reduces the rate of FD over the next 12 months. Methods/Design A randomized controlled trial (RCT) nested within a 13-month longitudinal cohort study. The RCT (conducted over 12 months) tests the effectiveness of a novel, early, home-based, personalized program (comp...
Evidence-based practice involves the application of the best available evidence, often from resea... more Evidence-based practice involves the application of the best available evidence, often from research findings, into the clinical setting to ensure best practice. This paper discusses some of the issues faced by allied health therapists when attempting to integrate research evidence into their ...
We investigated the effects of placement of a TouchPad input device on a user's body for the cont... more We investigated the effects of placement of a TouchPad input device on a user's body for the control of a wearable computer. This study involved 25 subjects performing selection tasks with a TouchPad mouse while wearing a wearable computer on their back and using a head-mounted display. Each subject performed the tasks in 27 different combinations of four postures (sitting, kneeling, standing and prone) and seven different placements of the TouchPad mouse on the subject's body (forearm, thigh by 2, torso by 2, and upper arm by 2). We measured the time and error rate to complete the selection of a circular target. The results for the effects due to posture showed that there were similar time effects for sitting, standing and kneeling. When examining the effects resulting from mouse position, the front of the thigh was shown to be the best position of the mouse. When the posturing and mouse position conditions were combined, the results indicated that the thigh front mouse position would be most appropriate for sitting, kneeling and standing postures, and the forearm mouse position would be best for the prone position.
Aim: To investigate the repeatability of a short stress test of coughing and jumping (the expande... more Aim: To investigate the repeatability of a short stress test of coughing and jumping (the expanded Paper Towel Test (PTT)) to quantify urine loss in stress incontinent adult women. Materials and Methods: In the laboratory, the reliability of two methods of measuring the size of the wet area, produced by a typical volume of water titrated onto paper towel was investigated and some absorbency properties of the brand of towel used were quanti¢ed. Thirty one women performed a provocative coughing and jumping test on consecutive days using a ''perineal pad'' of paper towel. The repeatability coe⁄cient was calculated. Results: The provocative test was repeatable to within 2.8 ml of urine loss, but with the exclusion of one anomalous result, the repeatability improved to lie within 1 ml. The coe⁄cient of variation (CV) for the between-method di¡erences (computer scanning and graph paper) was 1.27%. A volume of 1 ml of water produced a wet area of 25.7 cm 2 . The range of measurable areas corresponded to volumes of 0.005 ^8 ml. Standardization of method is required because the size of the wet area di¡ered by manufacturer of paper towel (P < 0.01, two products compared) and with time elapsed since titration (P < 0.01). Conclusions: The ''expanded PTT'' is a simple tool for quanti¢cation of urine loss (0.005 ^8 ml) in women to 72 years with stress incontinence. With a suggested modi¢cation, it should prove reliable for detection of between-visit di¡erences of 1 ml. The reliability of the test is dependent upon the use of standard protocol and paper towel with known volume ^area ratio. To improve clinical diagnosis, it can also be used with any brand of paper towel to con¢rm the sign of stress incontinence on exertion. Neurourol. Urodynam. 23:649 ^655, 2004.
This study describes the prevalence of adolescent ankle and knee injuries from participation in r... more This study describes the prevalence of adolescent ankle and knee injuries from participation in recreational and sporting activities. Data were collected over a one-week retrospective time frame from 3,538 subjects aged 11-12 years and 15-16 years from the Adelaide metropolitan region.Young people reported participating in 142 recreational activities and, overall, one injury was reported by every fourth subject and in every third activity. Knee and ankle injuries were the most prevalent, reflecting approximately 13 and 14 per cent respectively overall. The most commonly reported activities which had large numbers of knee and/or ankle injuries were investigated in this paper. There were significant differences in risk of ankle and knee injury within age and gender strata for different activities, although similar mechanisms and types of injury were found for both knees and ankles. Strategies to prevent adolescent lower limb sporting and recreational injury are discussed.
Digest of Papers. First International Symposium on Wearable Computers
This paper reports on an experiment investigating the functionality and usability of novel input ... more This paper reports on an experiment investigating the functionality and usability of novel input devices on a wearable computer, for text entry tasks. Over a three week period, twelve subjects used three different input devices to create and save short textual messages. The virtual keyboard, forearm keyboard, and Kordic keypad input devices were assessed as to their eficiency and usability for simple text entry tasks. Results collected included the textual data created by the subjects, the duration of activities, the survey data and observations made by supervisors. The results indicated that the forearm keyboard is the best performer for accurate and efJicient text entry while other devices m q benefit from more work on designing specialist CUls for the wearable computer.
2006 10th IEEE International Symposium on Wearable Computers, 2006
This paper presents the results of two experiments comparing four commercially available pointing... more This paper presents the results of two experiments comparing four commercially available pointing devices performing drag and drop tasks for use with wearable computers. The pointing devices evaluated consist of a Trackball, Touchpad, Gyroscopic mouse and Twiddler2 mouse. The studies involved 24 participants performing drag and drop tasks with the pointing devices while wearing a wearable computer on their back
The first paper in this series explored the general philosophy of evidence-based practice for son... more The first paper in this series explored the general philosophy of evidence-based practice for sonographers. Aims: This paper focuses on a specific type of research question that is of most relevance to the practice of sonography, the diagnostic accuracy study. As users of the medical literature, it is important that sonographers are able to accurately read and critically review diagnostic accuracy studies.
Background: There is evidence that consistent sitting for prolonged periods is associated with up... more Background: There is evidence that consistent sitting for prolonged periods is associated with upper quadrant musculoskeletal pain (UQMP). It is unclear whether postural alignment is a significant risk factor. Objective and design: The aim of the prospective study (2010 -2011) was to ascertain if threedimensional sitting postural angles, measured in a real-life school computer classroom setting, predict seated-related UQMP. Method: Asymptomatic Grade 10 high-school students, aged 15 -17 years, undertaking Computer Application Technology, were eligible to participate. Using the 3D Posture Analysis Tool, sitting posture was measured while students used desk-top computers. Posture was reported as five upper quadrant angles (Head flexion, Neck flexion; Craniocervical angle, Trunk flexion and Head lateral bending). The Computer Usage Questionnaire measured seated-related UQMP and hours of computer use. The Beck Depression Inventory and the Multidimensional Anxiety Scale for Children assessed psychosocial factors. Sitting posture, computer use and psychosocial factors were measured at baseline. UQMP was measured at six months and one-year follow-up. Results: 211, 190 and 153 students participated at baseline, six months and one-year follow-up respectively. 34.2% students complained of seated-related UQMP during the follow-up period. Increased head flexion (HF) predicted seated-related UQMP developing over time for a small group of students with pain scores greater than the 90 th pain percentile, adjusted for age, gender, BMI, computer use and psychosocial factors (p=0.003). The pain score increased 0.22 points per 1° increase in HF.
A common knee injury mechanism sustained during basketball is landing badly from a jump. Landing ... more A common knee injury mechanism sustained during basketball is landing badly from a jump. Landing is a complex task and requires good coordination, dynamic muscle control and flexibility. For adolescents whose coordination and motor control has not fully matured, landing badly from a jump can present a significant risk for injury. There is currently limited biomechanical information regarding the lower limb kinetics of adolescents when jumping, specifically regarding jump kinematics comparing injured with uninjured adolescents. This study reports on an investigation of biomechanical differences in landing patterns of uninjured and injured adolescent basketball players. A matched case-control study design was employed. Twenty-two basketball players aged 14-16 years participated in the study: eleven previously knee-injured and eleven uninjured players matched with cases for age, gender, weight, height and years of play, and playing for the same club. Six high-speed, three-dimensional V...
Correct upright posture is considered to be a measure of good musculoskeletal health. Little is k... more Correct upright posture is considered to be a measure of good musculoskeletal health. Little is known about the usual variability of children's upright standing posture. The aim of this study was to assess differences between repeated measures of upright posture in a group of primary school children. Sagittal plane photographs of usual, relaxed upright standing posture of 38 boys and girls aged 5-12 years were taken twice within an hour. Reflective markers were placed over the canthus, tragus, C7 spinous process, greater trochanter and lateral malleolus. Digitising software was used to calculate the x,y plane coordinates, from which five postural angles were calculated (trunk, neck, gaze, head on neck, lower limb). Height, weight, motor control estimates (as measured by the Brace Tests) and presence of recent pain were recorded for each child, and the association between the first test measure of posture angles and these factors was assessed using linear regression and ANOVA mod...
A unique management system was developed to enhance the quality of allied health care for the eld... more A unique management system was developed to enhance the quality of allied health care for the elderly. The management system is a multipronged framework of processes and outcomes, which address key stakeholder needs, and is based on best scientific evidence. Use of the management system provides efficiencies for funding bodies in data collection and monitoring service quality. It also confirms the professional integrity of the allied health service provider and underscores the importance of client-therapist partnership in determining appropriate health outcomes. Further testing is required to assess the relationship between use of the allied health management system and better quality service provision, cost containment, and consistently good client health outcomes.
The aim of this study was to establish intra-and interobserver repeatability in the direct linear... more The aim of this study was to establish intra-and interobserver repeatability in the direct linear measurement of knee structures displayed using three-dimensional (3-D) reconstructed computer imaging. Methods To test inter-observer repeatability, using a commercially available image reconstruction software package, seven observers were asked to record measurements for each of 30 individual structural features identified from a previously generated series of MR-based 3-D computer reconstructions of a single, complete, ovine knee. To test intra-observer repeatability, a single observer was asked to record measurements of the same 30 features on three separate occasions. Results Statistical analysis of the collected data suggests a high degree of repeat measurement agreement both within (P ¼ 0:76) and between observers (P ¼ 0:87). The findings of this study suggest that defined linear measurements can be generated from 3-D MR images created using the new reconstructive system, by imaging technologists, with a high degree of both intra-and inter-observer
Sustainable implementation of new workforce redesign initiatives requires strategies that minimiz... more Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scopeof-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes.
BackgroundPerformance evaluation raises several challenges to allied health practitioners and the... more BackgroundPerformance evaluation raises several challenges to allied health practitioners and there is no agreed approach to measuring or monitoring allied health service performance. The aim of this review was to examine the literature on performance evaluation in healthcare to assist in the establishment of a framework that can guide the measurement and evaluation of allied health clinical service performance. This review determined the core elements of a performance evaluation system, tools for evaluating performance, and barriers to the implementation of performance evaluation.MethodsA systematic review of the literature was undertaken. Five electronic databases were used to search for relevant articles: MEDLINE, Embase, CINAHL, PsychInfo, and Academic Search Premier. Articles which focussed on any allied health performance evaluation or those which examined performance in health care in general were considered in the review. Content analysis was used to synthesise the findings ...
Background Functional decline (FD) is a largely preventable feature of aging, characterized as gr... more Background Functional decline (FD) is a largely preventable feature of aging, characterized as gradual erosion of functional autonomy. This reduces an older person’s capacity for safe, independent community living. The healthcare needs of an unprecedented aging population places pressure on health systems to develop innovative approaches to ensuring older people live healthy and independent lives for as long as possible. TRIIFL aims to demonstrate that: Incipient FD in older people can be identified using a simple telephone-screening process within four weeks of discharge from an emergency department presentation for a minor health event; and Early engagement into a person-centered individualized intervention arrests or reduces the rate of FD over the next 12 months. Methods/Design A randomized controlled trial (RCT) nested within a 13-month longitudinal cohort study. The RCT (conducted over 12 months) tests the effectiveness of a novel, early, home-based, personalized program (comp...
Evidence-based practice involves the application of the best available evidence, often from resea... more Evidence-based practice involves the application of the best available evidence, often from research findings, into the clinical setting to ensure best practice. This paper discusses some of the issues faced by allied health therapists when attempting to integrate research evidence into their ...
We investigated the effects of placement of a TouchPad input device on a user's body for the cont... more We investigated the effects of placement of a TouchPad input device on a user's body for the control of a wearable computer. This study involved 25 subjects performing selection tasks with a TouchPad mouse while wearing a wearable computer on their back and using a head-mounted display. Each subject performed the tasks in 27 different combinations of four postures (sitting, kneeling, standing and prone) and seven different placements of the TouchPad mouse on the subject's body (forearm, thigh by 2, torso by 2, and upper arm by 2). We measured the time and error rate to complete the selection of a circular target. The results for the effects due to posture showed that there were similar time effects for sitting, standing and kneeling. When examining the effects resulting from mouse position, the front of the thigh was shown to be the best position of the mouse. When the posturing and mouse position conditions were combined, the results indicated that the thigh front mouse position would be most appropriate for sitting, kneeling and standing postures, and the forearm mouse position would be best for the prone position.
Aim: To investigate the repeatability of a short stress test of coughing and jumping (the expande... more Aim: To investigate the repeatability of a short stress test of coughing and jumping (the expanded Paper Towel Test (PTT)) to quantify urine loss in stress incontinent adult women. Materials and Methods: In the laboratory, the reliability of two methods of measuring the size of the wet area, produced by a typical volume of water titrated onto paper towel was investigated and some absorbency properties of the brand of towel used were quanti¢ed. Thirty one women performed a provocative coughing and jumping test on consecutive days using a ''perineal pad'' of paper towel. The repeatability coe⁄cient was calculated. Results: The provocative test was repeatable to within 2.8 ml of urine loss, but with the exclusion of one anomalous result, the repeatability improved to lie within 1 ml. The coe⁄cient of variation (CV) for the between-method di¡erences (computer scanning and graph paper) was 1.27%. A volume of 1 ml of water produced a wet area of 25.7 cm 2 . The range of measurable areas corresponded to volumes of 0.005 ^8 ml. Standardization of method is required because the size of the wet area di¡ered by manufacturer of paper towel (P < 0.01, two products compared) and with time elapsed since titration (P < 0.01). Conclusions: The ''expanded PTT'' is a simple tool for quanti¢cation of urine loss (0.005 ^8 ml) in women to 72 years with stress incontinence. With a suggested modi¢cation, it should prove reliable for detection of between-visit di¡erences of 1 ml. The reliability of the test is dependent upon the use of standard protocol and paper towel with known volume ^area ratio. To improve clinical diagnosis, it can also be used with any brand of paper towel to con¢rm the sign of stress incontinence on exertion. Neurourol. Urodynam. 23:649 ^655, 2004.
This study describes the prevalence of adolescent ankle and knee injuries from participation in r... more This study describes the prevalence of adolescent ankle and knee injuries from participation in recreational and sporting activities. Data were collected over a one-week retrospective time frame from 3,538 subjects aged 11-12 years and 15-16 years from the Adelaide metropolitan region.Young people reported participating in 142 recreational activities and, overall, one injury was reported by every fourth subject and in every third activity. Knee and ankle injuries were the most prevalent, reflecting approximately 13 and 14 per cent respectively overall. The most commonly reported activities which had large numbers of knee and/or ankle injuries were investigated in this paper. There were significant differences in risk of ankle and knee injury within age and gender strata for different activities, although similar mechanisms and types of injury were found for both knees and ankles. Strategies to prevent adolescent lower limb sporting and recreational injury are discussed.
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Papers by Karen Grimmer