End-user Testing Research Articles

ParaVerse: co-design of a parachute rehearsal and training virtual-reality enhanced simulator for the Australian Defence Force: combining a generative co-design framework and an agile approach to development

While co-design methods are crucial for developing digital educational interventions that are user-centred, contextually relevant, inclusive, and effective in meeting the diverse needs of learners and educators, little attention has been paid to the potential value of co-design processes for digital application development in the Defence context. This research gauged the efficacy of combining a generative co-design framework making use of agile and iterative co-design principles in an applied research and development project. The project produced an immersive virtual reality based digital solution in collaboration with the Australian Defence Force Special Operations Command (SOCOMD) Army. Specifically, the ParaVerse project sought to develop a solution considering the advanced Tactics, Techniques and Procedures (TTPs) relevant to special operations soldiers for advanced parachute training. A Defence advisory group consisting of a series of subject matter experts was formulated to consult with the research and development team over the course of the co-design process. End-user testing with 35 SOCOMD personnel demonstrated the value of the ParaVerse application for SOCOMD personnel, speaking to the success of the leveraged generative co-design model. End-users rated ParaVerse as having greater capacity to influence education and training practices for SOCOMD and Defence generally in comparison to a pre-existing virtual parachute simulator. ParaVerse was also rated higher for satisfaction and useability and was associated with fewer instances of motion sickness. The Generative Co-Design Framework leveraged for this research provides one roadmap on how to integrate end-users in innovation design, particularly for projects working across the nexus of Defence and academia.

On Development of a SIM-Based Prototype for Enhancing the Usability of Mobile Value-Added Services

The advent of Mobile Value-Added Services (VAS) has witnessed widespread adoption in developing regions, notably within East Africa. This surge is attributed to advancements in information and communication technology, 3G/4G proliferation, growth of mobile internet accessibility, and rising smartphone penetration. Despite this progress, a significant segment of the population continues to rely on basic phones. Studies have shown that the text-based applications used on these types of mobile phones still pose significant obstacles in delivering a user-friendly VAS experience. This paper explores the potential for improving the usability of mobile value-added services on basic phones. We employed an action research approach, utilizing quantitative and qualitative data collection methods. Questionnaires gathered feedback on end-user testing, while in-depth interviews with five industry experts provided insights into potential solutions. This multi-faceted approach ensures a comprehensive understanding of user feedback and expert insights, culminating in the design of an intuitive SIM-based user interface prototype. This highly customised prototype prioritises services and functionalities simplify the user experience through improved navigability and accessibility. The effectiveness of this prototype was quantitatively analysed using descriptive statistics, focusing on ease of use, efficiency, effectiveness, and user satisfaction. With an average ease of use score of 85.8%, a geometric mean time on task of 29.43 seconds, and a user satisfaction score of 79.5%, the prototype demonstrates impressive functionality and garners acclaim for improved navigation and information discovery from users and experts. Further, comparative analysis from expert interviews reveald a more nuanced understanding of technology preferences for basic phone usability, contrary to previous studies. Building upon these demonstrably positive results, the paper concludes by advocating for user interface standardisation and recommending user-generated content for a more inclusive VAS ecosystem.

Heuristic evaluation and end-user testing of a machine learning-based lower-limb exercise training system for management of knee pain in individuals aged 55 years or over

ObjectiveUsing machine learning techniques, we have developed an interactive exercise training system to assist individuals aged 55 years or over with knee pain to perform lower-limb exercises to improve their knee health. The system has three features: video-based exercise demonstrations, real-time feedback on exercise movements, and tracking of exercise performance and progress. The current study aimed to evaluate the design of the computer prototype of the system, and determine its usability and end users’ intention to use it (i.e., acceptance of it). MethodsHeuristic evaluation and end-user testing of the computer-based prototype system were conducted. Three human factors practitioners identified the design deficiencies, with reference to 64 design principles. In addition, 10 individuals with knee pain were recruited to use the prototype system to complete five tasks in the study laboratory. We recorded and examined the task success rate, number of requests for assistance, difficulties encountered during tasks, and perceptions of usability and acceptance. ResultsFour design deficiencies were identified, regarding recognition and recovery of errors, navigation, auditory perception, and help documentation. Most participants had difficulty in calibrating the camera and performing exercises. However, in general, the prototype system was perceived as usable and acceptable. ConclusionsThe use of heuristic evaluation and end-user testing revealed the capacity to systematically detect design deficiencies in interactive self-help systems, allowing for effective system adjustments. Moreover, our system shows potential for individuals managing knee pain, but conducting iterative usability testing is necessary to identify additional improvements. Furthermore, several design propositions have been submitted.

Development of Multimedia-Based Learning Media for Multimedia Courses

This research is research into the development of learning media which aims to produce learning media for Multimedia courses which is expected to help lecturers in the teaching and learning process. This research is research into developing the Multimedia Development Life Cycle (MDLC). In this method there are 6 (six) stages, namely: (1) Concept, (2) Design, (3) Obtaining Content Material, (4) Assembly, (5), Testing, (6) Distribution. In this testing phase, there are four testing forms: Developer Tests, Media Experts, Material Experts, and End -End-user tests. The research obtained good results, and from these results, the research concluded that the application of multimedia learning media.

3D printing traceability in healthcare using 3Diamond software

Background3D printing is one of the fastest-growing technologies in medicine, but it is essential to have a system for 3D printing documentation that is accessible for not only clinical engineers and surgeons, but also quality managers and data-privacy officers in hospitals. Dedicated software such as product lifecycle management (PLM) software could enable comprehensive management and traceability of all data relevant to 3D printing tasks in a hospital and would highly beneficial. Therefore, customizable software called 3Diamond was developed for 3D printing in medicine. MethodsThe software development process involved several stages, including setting specifications based on end-user requirements, design, implementation, and testing. In order to ensure the software's long-term success and smooth operation, critical phases were also considered, such as deployment and maintenance. ResultsThe developed software provides immediate and complete traceability of all preparations and controls, as well as management of reports, orders, stock, and post-operative follow-up of tasks related to 3D printing in a hospital. Based on user requirements, software testing is provided automatically with each release. The software was implemented in a natural clinical environment with a developed 3D printing center. ConclusionAlthough 3D printing has potential for innovation in the medical profession, it is nevertheless subject to regulations. Even though there are exemptions for patient-specific products, the effects of their local legal implementations related to 3D printing cannot be fully overseen. To this end, 3Diamond provides a robust system for 3D printing documentation that is accessible to different personnel in hospitals.

Co-design of the Spinal Cord Injury Health Maintenance Tool to Support Self-Management: A Mixed-Methods Approach.

There is a lack of consumer-friendly tools to empower and support people living with spinal cord injury (SCI) to self-manage complex health needs in community. This article describes the co-design process of the new SCI Health Maintenance Tool (SCI-HMT). Co-design of the SCI-HMT using a mixed-methods approach included a rapid review, e-Delphi surveys with range of multidisciplinary health care professionals (n = 62), interviews of participants with SCI (n = 18) and general practitioners (n = 4), focus groups (n = 3 with 7, 4, and 4 participants with SCI, respectively), design workshops with stakeholders (n = 11, 8), and end-user testing (n = 41). The SCI-HMT (healthmaintenancetool.com) was developed based on participatory research with data synthesis from multiple sources. Five priority health maintenance issues for bladder, bowel, skin, pain, and autonomic dysreflexia were originally covered. Best practice recommendations, red flag conditions, referrals, and clinical pathways were agreed on through an e-Delphi technique. Qualitative analysis identified six broad key concepts for self-management, including early symptom recognition, role of SCI peers, knowledge sharing with primary care, general practitioners as gatekeepers, and shared decision-making and highlighted a need to place much stronger emphasis on mental health and well-being. Design workshops and end-user testing provided key insights about user experience, functionality, and content for the SCI-HMT. The co-design process engaging end users, including people with SCI and general practitioners, enabled a shared understanding of the problem and identification of important needs and how to meet them. Informed by this process, the SCI-HMT is a freely accessible resource supporting SCI self-management, shared decision-making, and early problem identification.

The development of a web-based infographic for the introduction of palm industry to young learners

Exposure to the palm industry begins in the early stages of secondary school, highlighted through the agricultural sector topic in the geography subject syllabus. However, the information provided about the palm industry is insufficient to give young learners adequate exposure. Consequently, Generation Z lacks knowledge and remains unaware that the palm industry significantly contributes to the national economy. This paper aims to explain the process of developing an infographic website to expose the palm industry to young learners. The topics are traditionally presented using textbooks, but it is essential to incorporate information delivery methods in line with technological developments and interactive aspects to cater to today's Generation Z. An infographic website has been developed to introduce the palm industry to the younger generation, serving as a platform for information delivery and exposure. The website development process follows the Agile model, encompassing planning, analysis, design and development, testing, and deployment phases. Based on end-user testing involving 81 high school students who completed questionnaires, the three usability test criteria yielded an average score of 4.82 for web usability, 4.72 for information quality, and 4.82 for interface quality. The results of the students' feedback were positive, indicating that the infographic offered more detailed information, and the use of animation and posters provided a clearer depiction of palm industry-related information. In conclusion, an infographic website introducing the palm industry to the younger generation proves to be a suitable alternative for their initial exposure, garnering positive responses from this target group.

Helping patient educators meet health literacy needs: End-user testing and iterative development of an innovative health literacy editing tool.

The Sydney Health Literacy Lab (SHeLL) Editor is an online text-editing tool that provides real-time assessment and feedback on written health information (assesses grade reading score, complex language, passive voice). This study aimed to explore how the design could be further enhanced to help health information providers interpret and act on automated feedback. The prototype was iteratively refined across four rounds of user-testing with health services staff (N=20). Participants took part in online interviews and a brief follow-up survey using validated usability scales (System Usability Scale, Technology Acceptance Model). After each round, Yardley's (2021) optimisation criteria guided which changes would be implemented. Participants rated the Editor as having adequate usability (M=82.8 out of 100, SD=13.5). Most modifications sought to reduce information overload (e.g. simplifying instructions for new users) or make feedback motivating and actionable (e.g. using frequent incremental feedback to highlight changes to the text altered assessment scores). terative user-testing was critical to balancing academic values and the practical needs of the Editor's target users. The final version emphasises actionable real-time feedback and not just assessment. The Editor is a new tool that will help health information providers apply health literacy principles to written text.

Media Learning-Based Multimedia for Eye Studying Multimedia

Study This is a study development media learning That aims To produce media learning eye studying Multimedia Which is expected can help in the process of Study teaching. Research This is a study development of the Multimedia Development Life Cycle (MDLC). In the method, 6 (six) stages are (1) Concept, (2) design, (3) Obtaining Content Material, (4) Assembly, (5), Testing, and (6) Distribution. On stage In this testing or testing phase, there are four forms of testing, namely Developer Tests, Expert Media, Expert Material, and End-user Tests. From study obtained good results, and from these results, the research drew conclusions that media applications learning multimedia.

Outcomes of End-User Testing of a Care Coordination Mobile App With Families of Children With Special Health Care Needs: Simulation Study.

Care for children with special health care needs relies on a network of providers who work to address the medical, behavioral, developmental, educational, social, and economic needs of the child and their family. Family-directed, manually created visual depictions of care team composition (ie, care mapping) and detailed note-taking curated by caregivers (eg, care binders) have been shown to enhance care coordination for families of these children, but they are difficult to implement in clinical settings owing to a lack of integration with electronic health records and limited visibility of family-generated insights for care providers. Caremap is an electronic health record-integrated digital personal health record mobile app designed to integrate the benefits of care mapping and care binders. Currently, there is sparse literature describing end-user participation in the co-design of digital health tools. In this paper, we describe a project that evaluated the usability and proof of concept of the Caremap app through end-user simulation. This study aimed to conduct proof-of-concept testing of the Caremap app to coordinate care for children with special health care needs and explore early end-user engagement in simulation testing. The specific aims included engaging end users in app co-design via app simulation, evaluating the usability of the app using validated measures, and exploring user perspectives on how to make further improvements to the app. Caregivers of children with special health care needs were recruited to participate in a simulation exercise using Caremap to coordinate care for a simulated case of a child with complex medical and behavioral needs. Participants completed a postsimulation questionnaire adapted from 2 validated surveys: the Pediatric Integrated Care Survey (PICS) and the user version of the Mobile Application Rating Scale (uMARS). A key informant interview was also conducted with a liaison to Spanish-speaking families regarding app accessibility for non-English-speaking users. A Caremap simulation was successfully developed in partnership with families of children with special health care needs. Overall, 38 families recruited from 19 different US states participated in the simulation exercise and completed the survey. The average rating for the survey adapted from the PICS was 4.1 (SD 0.82) out of 5, and the average rating for the adapted uMARS survey was 4 (SD 0.83) out of 5. The highest-rated app feature was the ability to track progress toward short-term, patient- and family-defined care goals. Internet-based simulation successfully facilitated end-user engagement and feedback for a digital health care coordination app for families of children with special health care needs. The families who completed simulation with Caremap rated it highly across several domains related to care coordination. The simulation study results elucidated key areas for improvement that translated into actionable next steps in app development.

Developing and validating a novel staff questionnaire to identify barriers and enablers to nutrition and mealtime care on hospital wards.

Improving hospital nutrition and mealtime care is complex and often requires multifaceted interventions and implementation strategies to change how staff, wards and systems operate. This study aimed to develop and validate a staff questionnaire to identify multilevel barriers and enablers to optimal nutrition and mealtime care on hospital wards, to inform and evaluate local quality improvement. Literature review, multidisciplinary focus groups and end-user testing informed questionnaire development and establishment of content and face validity. To determine the construct validity, the questionnaire was administered to ward staff working in five wards across two facilities (acute hospital, rehabilitation unit). Exploratory factor analysis was used to estimate the number of factors and to guide decisions about whether to retain or reject individual items. Scale reliability was assessed using Cronbach's alpha. The questionnaire was completed by 138 staff, with most respondents being nurses (57%) and working in the acute care facility (76%). Exploratory factor analysis supported construct validity of four of the original seven subscales. The final questionnaire consisted of 17 items and 4 sub sub-scales related to (1) Personal Staff Role; (2) Food Service; (3) Organisational Support, and (4) Family Involvement; each sub-scale demonstrated good reliability with Cronbach's alpha values all >0.70. This novel and brief questionnaire shows good reliability and preliminary evidence of construct validity in this small sample. It provides a potentially useful instrument to identify barriers and enablers to nutrition and mealtime care from the staff perspective and inform where improvement efforts should be focused.

Codevelopment and usability testing of Patient Engagement 101: a Patient-Oriented Research Curriculum in Child Health e-learning module for health care professionals, researchers and trainees.

Background:Patient and family engagement is thought to improve the quality and relevance of child health research. We developed and evaluated the usability of Patient Engagement 101, an e-learning module designed to strengthen the patient-oriented research readiness of health care professionals, researchers, trainees and other stakeholders.Methods:The development of Patient Engagement 101 was co-led by a parent and a researcher and overseen by a diverse multistake-holder steering committee. The module was refined and evaluated using a mixed-methods usability testing approach with 2 iterative cycles of semistructured interviews, observations and questionnaires. We collected module feedback by way of semistructured interviews, the validated System Usability Scale, and satisfaction, knowledge and confidence questionnaires. Thematic coding of transcripts and field notes, informed by team discussions, guided the module revisions.Results:Thirty end-users completed usability testing (15 per cycle). In each cycle, we modified the module with respect to its content, learner experience, learner-centred design and aesthetic design. Participants were highly satisfied, and System Usability Scale scores indicated the module had the best imaginable usability. Substantial increases in the participants’ knowledge test scores and the confidence to engage in patient-oriented research, but not self-rated knowledge, were observed after module completion.Interpretation:Codevelopment with patients and caregivers, and refinement through comprehensive end-user testing, resulted in a training resource with exceptional usability that improved knowledge and confidence to engage in patient-oriented research in child health. Patient Engagement 101 is openly available online, and the methods used to develop and evaluate it may facilitate the creation and evaluation of similar capacity-building resources.

Clinical validation of deep learning algorithms for radiotherapy targeting of non-small-cell lung cancer: an observational study

Artificial intelligence (AI) and deep learning have shown great potential in streamlining clinical tasks. However, most studies remain confined to in silico validation in small internal cohorts, without external validation or data on real-world clinical utility. We developed a strategy for the clinical validation of deep learning models for segmenting primary non-small-cell lung cancer (NSCLC) tumours and involved lymph nodes in CT images, which is a time-intensive step in radiation treatment planning, with large variability among experts. In this observational study, CT images and segmentations were collected from eight internal and external sources from the USA, the Netherlands, Canada, and China, with patients from the Maastro and Harvard-RT1 datasets used for model discovery (segmented by a single expert). Validation consisted of interobserver and intraobserver benchmarking, primary validation, functional validation, and end-user testing on the following datasets: multi-delineation, Harvard-RT1, Harvard-RT2, RTOG-0617, NSCLC-radiogenomics, Lung-PET-CT-Dx, RIDER, and thorax phantom. Primary validation consisted of stepwise testing on increasingly external datasets using measures of overlap including volumetric dice (VD) and surface dice (SD). Functional validation explored dosimetric effect, model failure modes, test-retest stability, and accuracy. End-user testing with eight experts assessed automated segmentations in a simulated clinical setting. We included 2208 patients imaged between 2001 and 2015, with 787 patients used for model discovery and 1421 for model validation, including 28 patients for end-user testing. Models showed an improvement over the interobserver benchmark (multi-delineation dataset; VD 0·91 [IQR 0·83-0·92], p=0·0062; SD 0·86 [0·71-0·91], p=0·0005), and were within the intraobserver benchmark. For primary validation, AI performance on internal Harvard-RT1 data (segmented by the same expert who segmented the discovery data) was VD 0·83 (IQR 0·76-0·88) and SD 0·79 (0·68-0·88), within the interobserver benchmark. Performance on internal Harvard-RT2 data segmented by other experts was VD 0·70 (0·56-0·80) and SD 0·50 (0·34-0·71). Performance on RTOG-0617 clinical trial data was VD 0·71 (0·60-0·81) and SD 0·47 (0·35-0·59), with similar results on diagnostic radiology datasets NSCLC-radiogenomics and Lung-PET-CT-Dx. Despite these geometric overlap results, models yielded target volumes with equivalent radiation dose coverage to those of experts. We also found non-significant differences between de novo expert and AI-assisted segmentations. AI assistance led to a 65% reduction in segmentation time (5·4 min; p<0·0001) and a 32% reduction in interobserver variability (SD; p=0·013). We present a clinical validation strategy for AI models. We found that in silico geometric segmentation metrics might not correlate with clinical utility of the models. Experts' segmentation style and preference might affect model performance. US National Institutes of Health and EU European Research Council.

Light-initiated chemiluminescent assay of 17β-estradiol metrological traceability system established by manufacturer according to ISO17511:2020 and basic performance evaluation performed by clinical end-users.

BackgroundIn order to ensure the accuracy of the product, we established 1st model of metrological traceability hierarchy for light‐initiated chemiluminescent assay (LICA) of 17β‐estradiol (E2) at the manufacturer, based on International Organization for Standardization (ISO) 17511:2020. Moreover, we verified/validated the basic performance (such as matrix effect and long‐term stability of end‐user IVD MD calibrator, precision, linearity interval, accuracy/ trueness, and detection capability) at the clinical end‐user.MethodsHuman serum samples were used in this study. E2 was detected by mass spectrometry (MS) and LICA. The metrological traceability of LICA for E2 was established according to ISO 17511: 2020 standards, and pools of human samples were used as the m.3. secondary calibrator. Precision was validated according to Clinical and Laboratory Standards Institute (CLSI) EP05‐A3. The linear interval was verified according to CLSI EP06‐ED2. Comparison of accuracy and trueness of E2 with MS and Roche according to CLSI EP09‐A3. The detection capability was validated according to EP17‐A2. Matrix effect and long‐term stability evaluation of end‐user IVD MD calibrator were carried out according to CLSI EP14‐A2, EP25‐A. Statistical software was used for data analyses.ResultsThe use of pools of human samples and fine adjusting calibrators ensured the accuracy of end‐user test results. The metrological traceability of LICA for E2 was established. It showed excellent precision, meeting the requirements of allowable imprecision (7.5%). The allowable deviation from linearity (ADL) of 5% was allowed to show a good linear interval (12.52–4167.25 pg/ml). The accuracy/ trueness was verified, and relative deviation in the medical decision level met the performance specification of 10.03% compared with MS or Roche. The validated limit of blank, limit of detection, and limit of quantitation of E2 were 4.95 pg/ml, 8.93 pg/ml, and 9.88 pg/ml, respectively (the allowed imprecision is 20.00%). The interference rate of E2 ranged from −5.5% to 6.6%.ConclusionLICA showed high sensitivity, high specificity, excellent precision, wide linearity interval, IVD MD calibrator has long‐term stability, and no matrix effect. The metrological traceability of E2 established by using pools of human samples as M.3. can deliver accuracy to the end‐user IVD MD and show good consistency with MS and Roche.

The Impact of Health Literacy-Sensitive Design and Heart Age in a Cardiovascular Disease Prevention Decision Aid: Randomized Controlled Trial and End-User Testing.

BackgroundShared decision-making is an essential principle for the prevention of cardiovascular disease (CVD), where asymptomatic people consider lifelong medication and lifestyle changes.ObjectiveThis study aims to develop and evaluate the first literacy-sensitive CVD prevention decision aid (DA) developed for people with low health literacy, and investigate the impact of literacy-sensitive design and heart age.MethodsWe developed a standard DA based on international standards. The standard DA was based on our existing general practitioner DA. The literacy-sensitive DA included simple language, supporting images, white space, and a lifestyle action plan. The control DA used Heart Foundation materials. A randomized trial included 859 people aged 45-74 years using a 3 (DA: standard, literacy-sensitive, control) ×2 (heart age: heart age + percentage risk, percentage risk only) factorial design, with outcomes including prevention intentions and behaviors, gist and verbatim knowledge of risk, credibility, emotional response, and decisional conflict. We iteratively improved the literacy-sensitive version based on end-user testing interviews with 20 people with varying health literacy levels.ResultsImmediately after the intervention (n=859), there were no differences in any outcome among the DA groups. The heart age group was less likely to have a positive emotional response, perceived the message as less credible, and had higher gist and verbatim knowledge of heart age risk but not percentage risk. After 4 weeks (n=596), the DA group had better gist knowledge of percentage risk than the control group. The literacy-sensitive DA group had higher fruit consumption, and the standard DA group had better verbatim knowledge of percentage risk. Verbatim knowledge was higher for heart age than for percentage risk among those who received both.ConclusionsThe literacy-sensitive DA resulted in increased knowledge of CVD risk and increased fruit consumption in participants with varying health literacy levels and CVD risk results. Adding heart age did not increase lifestyle change intentions or behavior but did affect psychological outcomes, consistent with previous findings. This tool will be integrated with additional resources to improve other lifestyle outcomes.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12620000806965; https://tinyurl.com/226yhk8a

A WeChat-Based Rehabilitation Platform for Children and Adolescents with Congenital Heart Disease to Promote Cardiac FITness (HeartFIT): Protocol for a Mixed-Methods Strategy from Evidence-Based Design to Pilot Study.

Progress in medical and surgical care has tremendously improved the survival rates of children with congenital heart disease (CHD). However, reduced aerobic capacity and health-related issues remain a threaten to quality survival and prevention of related complications among children and adolescents with CHD. This research program aims to develop and evaluate a WeChat-based health platform (HeartFIT) to facilitate cardiac rehabilitation and promote physical fitness for this rapidly expanding young population. The study protocol describes the use of an iterative process of using a mixed-methods strategy to develop, refine, and pilot test the proposed HeartFIT platform. A sequential problem-solving process comprising four iterative phases with ongoing end-user input will be implemented. In phase 1, relevant literature was systematically reviewed (completed) and then child-parent dyads will be interviewed to understand the broad context and the requirements and considerations of the target population toward the WeChat-based rehabilitation platform. In phase 2, key features and priority functionalities for the platform will be ideated and refined, and a digital interactive prototype will be created. In phase 3, heuristic evaluation and three rounds of end-user testing will be conducted to ensure further refinement and usability of the prototype. In phase 4, a prospective pilot study will be performed to investigate the feasibility, acceptability, and preliminary efficacy of the developed platform over a 12-week intervention period. If HeartFIT intervention is feasible, acceptable, and demonstrates promising efficacy, an adequately powered randomized controlled trial (future work) will be deployed to test the real-world effectiveness of the intervention.

User-Centered Back-Support Exoskeleton: Design and Prototyping

Exhausting manual labor is still predominant in the industrial context. It typically consists in manipulating heavy parts or working in nonergonomic conditions. The resulting work-related musculoskeletal disorders are a major problem to tackle. The most-affected body section is the lumbar spine. Recently, exoskeletons have been identified as a possible non-invasive solution to reduce the impact of low-back pain. State-of-the-art prototypes have been optimized to: follow unconstrained human kinematics, (partially) relieve the load on assisted joints, and allow anthropometric adaptation. Yet, this technology still has limited adoption. Manufacturing optimization may address the following limitations: bulky/heavy resulting designs, complex assembly and maintenance, high manufacturing costs, long procedures for adaptation and wearing, and psychological effects (e.g., cognitive load and usability). In this contribution, the aforementioned issues are tackled improving a previous low-back exoskeleton prototype. In particular, kinematic analysis, Finite-Element-Method, and topological optimization have been combined to obtain a lightweight prototype, testing different materials (Nylon, carbon-fiber reinforced PC/ABS, etc.).We applied both Design for Assembly and Design for Manufacturability. The resulting exoskeleton prototype is described in the paper, ready for end-user field tests

User-centered development and performance assessment of a modular full-body exoskeleton (AXO-SUIT)

This paper presents the design and preliminary performance assessment of a full-body assistive exoskeleton (AXO-SUIT) for older adults. AXO-SUIT is a system that consists of separate lower-body and upper-body modular exoskeletons, which can be combined to form a full-body system to provide flexible physical assistance as needed. The full-body exoskeleton comprises 27 degrees of freedom (dof), of which 17 are passive and 10 active. It can assist people in walking, standing, carrying and handling tasks. A user-centered design approach was adopted throughout the development of the exoskeleton. This paper describes the design process of AXO-SUIT, involving a review of user needs, a kinematic and kinetic motion study, and innovative system design. Tests with the developed systems were conducted on selected end-user subjects, covering both performance evaluations at different levels and useability testing. End-user testing results show the effectiveness of the exoskeleton in providing flexible physical assistance.

Application of Anti-Stigma Design Heuristics for Usability Inspection.

User interface evaluation has become important in developing usable health care technologies. Although usability engineering methods have been applied in the design and evaluation of health care software, available heuristics focus on task-work aspects and do not address stigma associated with many health conditions. We used a previous set of heuristics and propose a new set of anti-stigma heuristics to evaluate stigmatization in health care websites. The extended set of heuristics were concurrently applied in a heuristic evaluation and a cognitive walkthrough to evaluate an endometriosis and sexual pain website. The walkthrough involved 5 tasks that required 21 actions to execute. Twenty-six usability problems were identified and recommendations for re-design were made to the design team before end-user testing. The anti-stigma heuristics received worse ratings than the traditional heuristics, resulting in several design changes that might otherwise have been missed. Thus, the new anti-stigma heuristics were a valuable contribution.

Development and Evaluation of a Cognitive Training Application for Children with Learning Difficulties- A Design-Based Approach

The studies targeting cognitive training via computerized applications focused on suggesting varied types of Working Memory's (WM) tasks rather than offering those tasks in a user-friendly way or suggesting practical guidelines targeting the end-user. Therefore, the purpose of the current study is to adopt the design based-research method (DBR) to design, develop, and evaluate a cognitive training application in the light of a set of proposed guidelines. This developed application is targeting children with LDs at primary schools. The current study focused on end-user testing by evaluating the children's perceived experience during and after engagement in the application. The results showed that most of the children (86.5%) perceived a good experience with the application as well as their verbal and no-verbal WM performance improved significantly after the training period. A set of theoretical and practical implications derived from the study was embedded for future research.