Mark Cypher

Background: The consideration of health-related quality of life (HRQL) is a hallmark of best practice in HIV care. Information technology offers an opportunity to more closely engage patients with chronic HIV infection in their long-term management and support a focus on HRQL. However, the implementation of patient-reported outcome (PRO) measures, such as HRQL in routine care, is challenged by the need to synthesize data generated by questionnaires, the complexity of collecting data between patient visits, and the integration of results into clinical decision-making processes. Objective: Our aim is to design and pilot-test a multimedia software platform to overcome these challenges and provide a vehicle to increase focus on HRQL issues in HIV management. Methods: A multidisciplinary team in France and Australia conducted the study with 120 patients and 16 doctors contributing to the design and development of the software. We used agile development principles, user-centered design, and qualitative research methods to develop and pilot the software platform. We developed a prototype application to determine the acceptability of the software and piloted the final version with 41 Australian and 19 French residents using 2 validated electronic questionnaires, the Depression, Anxiety and Stress Scale-21 Items, and the Patient Reported Outcomes Quality of Life-HIV. Results: Testing of the prototype demonstrated that patients wanted an application that was intuitive and without excessive instruction, so it felt effortless to use, as well as secure and discreet. Clinicians wanted the PRO data synthesized, presented clearly and succinctly, and clinically actionable. Safety concerns for patients and clinicians included confidentiality, and the potential for breakdown in communication if insufficient user training was not provided. The final product, piloted with patients from both countries, showed that most respondents found the application easy to use and comprehend. The usability testing survey administered found that older Australians had reduced scores for understanding the visual interface (P=.004) and finding the buttons organized (P=.02). Three-fourths of the respondents were concerned with confidentiality (P=.007), and this result was more prevalent in participants with higher anxiety and stress scores (P=.01), as measured by the Depression, Anxiety and Stress Scale-21 Items. These statistical associations were not observed in 15 French patients who completed the same questionnaire. Conclusions: Digital applications in health care should be safe and fit for purpose. Our software was acceptable to patients and shows potential to overcome some barriers to the implementation of PROs in routine care. The design of the clinicians’ interface presents a solution to the problem of voluminous data, both synthesizing and providing a snapshot of longitudinal data. The next stage is to conduct a randomized controlled trial to determine whether patients experience increased satisfaction with care and whether doctors perceive that they deliver better clinical care without compromising efficiency.

This paper argues for an approach to mediation in digital arts practice that focuses on how change and difference emerge in the art-making process. Using Karen Barad’s agential realist conception of intra-action, this paper describes how the form and expression of digital art practice is co-constituted, yet contingently differentiated by the mediations of a whole host of entangled (f)actors. The case study that follows shows how these actors become more or less determinate and come to embody a particular set of concepts that become meaningful through digital art practice.

Practice-based visual art research is a field that inadvertently recognises the role of non-human actors in the creative process. Generally, the relation is described in terms of the artist's skilful manipulation of objects and materials and the symbolic interpretation of these actions. This paper uses an actor-network approach to argue for a reconsideration of non-human actors as vital collaborators and explores how such relations disrupt assumptions of artistic control. I conclude with a description of how intention, motivation and knowledge are generated in these crucial relations.

The evolution of interactivity in the visual arts as beholden to the notion of the participant is well known. The participant provides a neat and historical narrative for the precursors of what we call interactive art. However, the focus on the singular participant, much like a deterministic focus on the technology, merely exacerbates many age-old technology and user binaries. This paper presents an alternative narrative that charts Systems art and cybernetics theory as precursors to a version of interactivity that attempts to move beyond such binaries. The hope is to move the focus away from singular, more taxonomic narratives that illustrate the quantitative value of inputs and outputs, so that we can begin to describe the greater co-dependencies in systems that afford the actual interaction.

Rather than follow the machinations of a singular artist in the production and exhibition of an interactive artwork, this paper uses an actor-network approach to collectively hold to account a whole host of actors that liter¬ally make a difference in the production of an interactive artwork, Biophilia (2004-2007). My main argument is that in order for any action to take place both humans and non-humans must on some level collectively work together, or, in actor-network terms translate one another. However, such new relations are predicated and indeed just as dependent on and what these new actors are willing to give up as it is to do with what they can offer. Needless to say that when the negotiations are momentarily over, actors give up individual goals and compel others to collectively form new definitions, new intentions and new goals with each interaction. In other words, the ‘work’ represents neither the beginning nor the end of a par-ticular event, but is described more as a continually shifting and cumulative series of distributed actions.

Critical Masses is a multidisciplinary pilot project that aims to graphically represent and mediate the histories, spaces and narratives concerning former nuclear installations within central Australia. These include the abandoned British atomic test sites at Emu Field and Maralinga, the Intercontinental Ballistic Missile (ICBM)/Intermediate Range Ballistic Missile (IRBM) rocket launchers at Woomera, and the decommissioned US National Security Agency early warning satellite base at Nurrungar. Significantly, each of these Cold War sites are situated in either hazardous, remote, secure and/or culturally sensitive areas and require sophisticated analysis and negotiation in order to best render their complexity for both online access and on-site tourism. In association with the Maralinga-Pilling Trust and traditional indigenous landowners a multi-tiered approach (re)creating these locations is being modelled across platforms for diverse audiences. Digital materials are being authored and designed for stand-alone DVD, online interactive sites and archives, an immersive/simulated space for interpretation centres, and augmented/enhanced reality interfaces via GPS and mobile/handheld devices used in situ at key sites.