Camila Shirota

Marketing scholarship increasingly emphasises social relevance through direct engagement with complex human problems, contested service systems and, increasingly, vulnerable consumer populations an...

Background: Co-design is an increasingly prominent method for achieving disability-inclusive research. Co-design draws attention to the value of involving people with lived experience of disability in shaping research questions, methods, and outcomes, making it an ideal vehicle for inclusion. Yet, the rise in popularity of co-design in disability research has created challenges. Inconsistent definitions, misaligned practices, and inadequate reporting have undermined both the rigour of the method and its potential to generate meaningful and impactful outcomes. Discussion: In this commentary, we argue that safeguarding the future of disability inclusive co-design requires a systemic shift towards accountability and transparency. We propose four urgent recommendations to enhance and maintain the integrity and impact of co-design: 1. Establish a shared language that distinguishes levels of participation, clarifies epistemic assumptions, and articulates underlying values. This is critical to ensure that co-design claims accurately reflect the nature of involvement. 2. Build capacity and capability for researchers and people with lived experience of disability. This includes in facilitation skills, ethical engagement, inclusive communication, and navigating power dynamics, to avoid tokenism and collaborate more effectively. 3. Develop a co-design-specific reporting framework to make relational, procedural, and decision-making processes more transparent. 4. Mandate better reporting of co-design practices by funders, journal editors, and institutions to ensure accountability and reportable rigour of co-design research with people with disability. Conclusion: Ultimately, co-design can either be a powerful tool for inclusive research or a hollow promise that perpetuates the exclusion it seeks to remedy. Adopting these recommendations for language, capacity, and standard, mandated reporting are essential steps for safeguarding the integrity of the method. It will also support more accountable, authentic, and impactful research that truly reflects the voices, priorities, and lived experiences of collaborators with disability.

Adjusting to life following an acquired brain injury (ABI) is challenging particularly navigating the timepoint of transitioning from hospital-to-home. Digital technology has been proposed to mitigate broader transitional issues, however whilst still in its infancy more research is recommended within the ABI population. It is important to understand individual experiences in healthcare design. This study aims to identify for people with ABI [1] their unique problems experienced when transitioning hospital-to-home, and [2] how they believe digital technological solutions could solve these issues. Interpretive description guided the review of experiences of four participants with ABI from a larger participatory action research project, where co-design workshops explored digital technological solutions supporting the transition home from inpatient ABI rehabilitation. Comparative analysis was used to analyse the data and develop themes. Six themes emerged including "being told I was ready is different to being ready," "home is a different planet," digital technology can "help connect me to the real word" and "ensure everyone is on the same page." Participants' desire to use tailored digital technology as a transition home strategy highlighted opportunities to manage expectations, and focus on unique preparation needs of participants, rather than organisational discharge goals.

An assistive technology ecosystem requires co-ordinated collaboration between policy, products, provision processes, and personnel. A needs assessment was conducted of the assistive technology sector in Queensland to examine these components from the perspective of all key stakeholders. Materials and Methods: This paper reports the findings of the expressed needs of the assistive technology sector as experienced by the AT advisors and suppliers. A sequential mixed methods design supported completion of a quantitative online survey (n = 29) followed by qualitative exploration with assistive technology advisors (n = 9) and suppliers (n = 6). There was an identified need to address the processes that led to delays or unfavourable outcomes for AT. Despite reporting confidence in the quality of services delivered, the advisors were worried about reduced access to expert consultation and a need to better build capacity and capability in the sector. Access to AT for hire or trial was problematic with conflicting tensions identified by the advisors and suppliers. However, both worried about the impact on the agency of the AT recipient in the process. There are opportunities to enhance the personnel, provision, and policy aspects of the assistive technology ecosystem in Queensland. Pressure points are: workforce capacity and capability to meet the growing need; finding ways to support the trial of assistive technology required to ensure appropriate recommendations for assistive technology that is fit for purpose; and improving information from the bodies that manage funding to reduce the waste in the provision process.

Purpose: Assistive technology (AT) can significantly enhance the daily lives of people with disabilities if matched appropriately to the individual and their context. Gaps remain in the AT sector in terms of provision and uptake. Consequently, this study examined current experiences and needs regarding AT provision throughout Queensland from AT users' perspectives. Materials and Methods: Convenience and snowball sampling recruited participants for this exploratory sequential mixed methods study. Descriptive statistics summarized online survey responses (n = 41) and thematic analysis was completed to analyze qualitative interview data (n = 20). Results: Survey results revealed that whilst all participants used AT, 68% had unmet AT needs. Satisfaction with AT reduced as AT users proceeded through the AT pathway. Three themes were identified from the interviews: (1) Expertise and collaboration are required: "One size doesn't fit all, and one solution doesn't fit all problems," (2) Process rejections and delays: "You're really left high and dry," and (3) Many factors impact the AT experience. Conclusions: Findings indicate that although AT users had clear ideas of their AT needs and goals, they were often unable to access desired AT due to systemic barriers. Any attempts to overcome barriers for AT provision will need to be multi-level and there is a clear need to enhance current AT trial approaches.

Both demand and need for assistive technology (AT) are growing worldwide. However, ensuring an optimal fit between the person and AT is complex. With health professionals often being the "gatekeeper" to AT, it is imperative to understand their experiences of AT. This study was positioned within a sociotechnical space known as "HabITec", which aims to bring together potential AT users with health professionals and technology developers to enhance the technology-person fit. The current paper reports on health professionals' experiences of the HabITec Lab (THL), the physical manifestation of HabITec that was piloted in a tertiary hospital for 12-months. The study used a qualitative descriptive approach to explore the experiences of nine health professionals who referred patients to the lab. Four major themes were identified together with suggestions for the future of THL and HabITec. The themes focused on 1) Balancing service and independence; 2) Capitalising on possibilities and connections; 3) Negotiating multiple mismatches; and 4) Fitting it all together in a coherent service. It was clear that health professionals who referred patients to THL identified a range of benefits associated with it, but barriers to its effectiveness were identified and concerns were raised over health professionals becoming too reliant on the lab. For THL to be sustainably implemented, it appears that a policy-level shift is needed to enable its appropriate resourcing.

To understand and combat the challenges in taking up and implementing technology in rehabilitation settings, the HabITec Lab, a clinical service focused on technology, was piloted for 12-months within a tertiary hospital. This article reports on its preliminary impacts as a clinical service and on clients, including the types of assistive technology (AT) in demand. Referral and administrative data from 25 individuals who attended the HabITec Lab were collated and analysed using descriptive statistics. For those who attended more than once (n = 12), goal attainment was assessed using the Modified Goal Attainment Measure (MGAM). Post-intervention semi-structured interviews were completed with participants to understand their experience at the HabITec Lab. Interviews were analysed using thematic analysis. Most attendees (92%) were undergoing inpatient rehabilitation following a spinal cord injury (SCI). The majority (73%) of goals related to improving entertainment and connection. All participants who completed the MGAM showed improved goal attainment following their HabITec Lab attendance. Qualitative data highlighted appreciation for the service and suggestions for its future. This study revealed a high level of demand for support to use AT amongst individuals with SCI, particularly consumer-grade smart devices that could assist communication. This finding may have been influenced by the impacts of the COVID-19 pandemic and frequent lockdowns during this period. This study indicated that the HabITec Lab was able to address important goals for attendees, but also illuminate a new future and trigger enthusiasm about future goals. Attendance was liberating, but resourcing barriers were frustrating.

Inertial measurement units (IMUs) are increasingly used to estimate movement quality and quantity to the infer the nature of motor behavior. The current literature contains several attempts to estimate movement smoothness using data from IMUs, many of which assume that the translational and rotational kinematics measured by IMUs can be directly used with the smoothness measures spectral arc length (SPARC) and log dimensionless jerk (LDLJ-V). However, there has been no investigation of the validity of these approaches. In this paper, we systematically evaluate the use of these measures on the kinematics measured by IMUs. We show that: (a) SPARC and LDLJ-V are valid measures of smoothness only when used with velocity; (b) SPARC and LDLJ-V applied on translational velocity reconstructed from IMU is highly error prone due to drift caused by integration of reconstruction errors; (c) SPARC can be applied directly on rotational velocities measured by a gyroscope, but LDLJ-V can be error prone. For discrete translational movements, we propose a modified version of the LDLJ-V measure, which can be applied to acceleration data (LDLJ-A). We evaluate the performance of these measures using simulated and experimental data. We demonstrate that the accuracy of LDLJ-A depends on the time profile of IMU orientation reconstruction error. Finally, we provide recommendations for how to appropriately apply these measures in practice under different scenarios, and highlight various factors to be aware of when performing smoothness analysis using IMU data.

Powered lower limb exoskeletons are a viable solution for people with a spinal cord injury to regain mobility for their daily activities. However, the commonly employed rigid actuation and pre-programmed trajectories increase the risk of falling in case of collisions with external objects. Compliant actuation may reduce forces during collisions, thus protecting hardware and user. However, experimental data of collisions specific to lower limb exoskeletons are not available. In this work, we investigated how a variable stiffness actuator at the knee joint influences collision forces transmitted to the user via the exoskeleton. In a test bench experiment, we compared three configurations of an exoskeleton leg with a variable stiffness knee actuator in (i) compliant or (ii) stiff configurations, and with (iii) a rigid actuator. The peak torque observed at the pelvis was reduced from 260.2 Nm to 116.2 Nm as stiffness decreased. In addition, the mechanical impulse was reduced by a factor of three. These results indicate that compliance in the knee joint of an exoskeleton can be favorable in case of collision and should be considered when designing powered lower limb exoskeletons. Overall, this could decrease the effort necessary to maintain balance after a collision and improved collision handling in exoskeletons could result in safer use and benefit their usefulness in daily life.

A bstract: There is an increasing trend in using inertial measurement units (IMUs) to estimate movement quality and quantity, and infer the nature of motor behavior. The current literature contains several attempts to estimate movement smoothness using data from IMUs, most of which assume that the translational and rotational kinematics measured by IMUs can be directly used with existing smoothness measures - spectral arc length (SPARC) and log dimensionless jerk (LDLJ-V). However, there has been no investigation of the validity of these approaches. In this paper, we systematically evaluate the appropriateness of the using these measures on the kinematics measured by an IMU. We show that: (a) current measures (SPARC and LDLJ-V) are inappropriate for translational movements; and (b) SPARC and LDLJ-V can be used rotational kinematics measured by an IMU. For discrete translational movements, we propose a modified version of the LDLJ-V measure, which can be applied to acceleration data (LDLJ-A), while roughly maintaining the properties of the original measure. However, accuracy of LDLJ-A depends on the IMU orientation estimation error. We evaluate the performance of these measures using simulated and experimental data. We then provide recommendations for how to appropriately apply these measures in practice, and the various factors to be aware of when performing smoothness analysis using IMU data.