Smart First Aid Kit

E-patients, Footfalls and Heartbeats

Preface This is a documentation of my work for INDN312. The client for this project is Footfalls & Heartbeats, a recent NZ startup company that produces Intelligent Fabric. The aim of this project is to create a brand and identity for the client company.

This documentation follows the entire process of the project from initial research & analysis right through to Final presentation

of the Product. Along this deign journey I have discovered how materiality, object, interface and numerous other factors impact to such a large degree on how a company is perceived.

Indeed a logo and slogan is important to a companies image but a companies identity itself is made up by so much more. This is an exploration of that discovery.

Part I: Research & Analysis

Richard Clarkson 3 0 0 1 6 0 2 2 0

Intro: Goals.

Methods used: Cultural Probe Visual & Physical collages Personal Design Diary “Design is basic to all human activities – the placing and patterning of an act towards a desired goal constitutes a design process” (Papanek, 1973) –one footfall and one heartbeat at a time.

(Footfalls & HeartBeats)

I begin this booklet of my findings with the above quote as I feel it is central to not only this design project but also design as a whole.

Victor Papanek emphasizes that design acts towards a desired goal, and so it is the identification and development of this goal where I begin my research.

What is the goal of the Footfalls & Heartbeats, the collaborative company whose technology and

identity I am exploring? What is the goal of the technology itself? What are my goals as a designer for this company?

Throughout this booklet I hope to address these and other questions, as I come to define what goals this project has, it will give my clarity and direction in the next phase of design.

John Thackara identifies that in the design world we must first define where we are and where we want to go before we even start thinking about how to get there. (Thackara, 2005)

pter 01: “Where We Are” – an Exploration of Footfalls & Heartbeats Technology

F

ootfalls and Heartbeats is a recent start-up company founded

by Karen Bender & Simon McMaster with the aim of designing and manufacturing functional, comfortable, nonobtrusive, ‘smart’ textile technology.

This technology currently has the ability to measure a user’s perspiration levels, respiration rate and heart rate through a complex woven sensory system worn on the body in the form of an item of clothing or jewelry.

Through a bottom up design and research process Simon has been able to create this system so that it is discrete, comfortable and most importantly, in terms of competitive advantage over existing products on the market, it is washable.

1 Footfalls & Heartbeats advances in technology of wearable sensors.

Through constant research and development into Nano technology and other avenues Footfalls and Heartbeats expect their technology to also be able to measure the user’s heart rate to quality of Electrocardiography (ECG), limb and muscle movement, bio electrical signals from muscles and changes in hormones/emotions. They also aim to have the garment solar powered, act as a capacitor to hold its charge and also to transmit data wirelessly directly to the user’s smartphone or other such device.

Existing substitutes for this technology include a halter monitor system, lab testing with electrodes and a chest strap. All of these objects and systems are in some way a restriction, either to the user or to the validity of the data, they also have been known to cause damage to human tissue, are uncomfortable to wear and require an additional objects than normally worn.

2 Descriptive Wordcloud of Footfalls & Heartbeats technology.

“Who We Are” – Exploration of business branding and identity in general & applied to Footfalls & Heartbeats.

T

he name Footfalls & Heartbeats has two meanings, first the literal and subjective – being the steps you may be taking and the reading of your heartbeats as you take them. The second is ideological and objective – comparing the technology and company to the human heart, providing the lifeblood (data) to the user and society, this objective aspect involves ideals such as Beauty, Humanity and Harmony.

Through choosing to be based in New Zealand Footfalls & Heartbeats hope to immerse themselves into New Zealand culture in order to adopt characteristics and values they find desirable. These characteristic goals are already beginning to form the image and personality of the company and include:

-equitable actions, responsibility and transparency -accountability at all levels -adaptability to new changes -co-operation and interconnection -courage, curiosity and thrill seeker mentality -adventurous and sustainable outlook

3 The fresh outdoors and New Zealand based Ideals of Footfalls & Heartbeats

give the company a strong foundation from which to grow.

-balance of work and play and of personal and professional -a protected incubation and strong foundation leading to positive risks & growth -associations with NZ Wool industry, including Icebreakertm Brand

“Where do We Want to Go” – Exploration of initial scopes

I

“By merging the intimacy of clothing with the empowerment of technology, electricfoxy garments strive to enhance our lives and offer a much richer language for self-expression.” (Darmour, 2010)

began looking into possible directions for applications of this technology by identifying key scopes; medical, sport, research and leisure. I then branched out from these key scopes into smaller and more specific directions, these branches in turn created more branches and began to interconnect with other areas. Some of the avenues I looked at were: - Fire fighters - Sea Divers - Facebook Users - Furniture - Gaming Controls - Bio mimicry - Visual Feedback art - And even creating

superhuman abilities.

As I continued my research I began to become increasingly interested in how this technology might be adaptable to social networking sites such as Facebook and Google +, looking at projects by Jennifer Darmour [aka electricfoxy] in particular her project Ping A social networking garment:

It was in this phase of research that I began to focus on the idea of empowerment and discovered the term ‘e-patient.’

4 Image Cloud of research ideas

5 Ping A social networking garment / Wearable technology

The term ‘e-patient,’ believed to be coined by Dr. Tom Ferguson, is a patient who is “Equipped, Engaged, Empowered and Enabled.” (deBronkart, Meet e-Patient Dave, 2011) They are people using the internet as a tool to gather information – recent data on health information shows that 66% of all US adults have looked online for health related information at some point (Fox, 2008) (Gupta & Udupa, 2011) – and also to find other e-patients who can help deliver trustworthy information.

I use the word trustworthy on somewhat a case by case basis as information must still be filtered by the patient and compared to

a primary source of information from a medical professional but generally patients know what other patients want to know. “I want to note especially the importance of the resource that is most often under-utilised in our information systems – the patient�

Charles Safran, 2004, Senior Doctor. (deBronkart, Meet e-Patient Dave, 2011) The e-patient movement takes advantage of this under-utilised resource creating a platforms where patients can share and find real information on symptoms, diagnosis, treatments, side effects, risks, second opinions, methods to communicate with healthcare providers and countless other element of an illness that a patient should be well informed on. (Fox, 2008) Currently e-patients are spread across many different websites and forum platforms and I propose a system that allows Footfalls & Heartbeats technology to bring e-patients together on a single platform and in time become an integral part of being an e-patient.

6 Exploring the links between e-patient, comfort and social architecture / Group Contextual Map by Richard Clarkson, Tui Harrington and David Hardgraves

Exploration of refined scope – E-patient Mentality, Data and Social Capital. e-patient population.

E-patient Mentality

Throughout my research into e-patients I have come across people with inspiring stories to tell, important advice to give and a life changing experiences they want to share. It is this sharing and wanting to share that drives the e-patient movement and begins to create a social support network. (deBronkart, Meet e-Patient Dave, 2011) The system operates through people wanting to give information without asking anything in return, no momentary compensation and no expectation of recognition or attribution. When combined with the desire to take control of their situation this is what the e-patient mentality is all about.

“I began tweeting and then blogging under the name DCPatient and found this fabulous cadre of E-patients. For the first time I felt, “These are my people. This is the language I’ve been searching for to describe the power and potential of personal patient advocacy.”

My passion and energy were renewed and taken to an entirely new level.” (Cryer, 2010)

A

s we begin to comprehensively explore what it is to be an e-patient, we must first identify the difference between Healthcare, being day to day healthy living vs. Medical care, when a more serious accident, disease or illness requires attention from a medical professional. (deBronkart, Meet e-Patient Dave, 2011) The distinction of the two is important as it shows the two avenues Footfalls & Heartbeats can accommodate to, both being vital to what makes up the

DATA “...gimmie my dam data because you people can’t be trusted to keep it clean.” (Regina Holiday,2010) What is the goal of the technology?

I believe it is the collection of 7 Medical Care vs. Social Networks / Contextual Map with inlaid objects

data. A theory that aligns perfectly with creator of the World Wide Web Tim Berners-Lee’s theory – that the next evolution of the internet is ‘Raw Data.’ (BernersLee, 2009) What better avenue to begin this next step than with the e-patient movement? Through arming e-patients with the tools and systems to collect, store and share their own raw data we can move medical mountains.

All of these projects and initiatives will help form the new e-patient network model, the forming of which is the next step later on in this project. To the popular e-patient slogan, “It’s your illness, it’s your body, it’s your life!” I now also add that: “It’s your DATA!”

“a main obstacle to developing good personal health software is that developers need real clinical data for test purposes.” (deBronkart, The Green Button idea, 2011)

The power of social networking is evident in today’s society, organizations like twitter, Facebook, and Google, as well as physical networks such as family, friends and community groups, are now being recognized as what has come to be known as ‘Social Capital.’ This can be defined as:

There are already proposals of methods for sharing data such as the Greenbutton idea, where people can ‘donate’ their data to websites and research projects they choose, through a secure and private online data bank. (deBronkart, The Green Button idea, 2011) There are also initiatives in place exploring how Data can be transformed into visualisations and interfaces.

(Sonin, 2011)

Social Capital

8 Social Networks are a form of Social Capital / from top left clockwise: Google+, Twitter, Tumblr and Facebook.

“networks, together with shared norms, values and understandings, that facilitate cooperation within or among groups.” (Thackara, 2005) Health trends show that the population is aging faster than current technology and

infrastructure can maintain and with the baby boomer generation reaching retirement age there is an inevitability of an approaching Health Crunch. Governments are only now beginning to realise the power of Social Capital as a powerful, but difficult to measure, economic factor that could aid in the diversion of this Crunch, and Governments worldwide are becoming more and more interested in the e-patient movement. If individuals can take more responsibility for their own healthcare and rely less on government funded services the government can temporality reduce its Healthcare Budget and put it towards funding of ‘patientcentered’ medicine programs that would have the capacity to accommodate for the approaching Crunch. (Thackara, 2005) One such system currently operating is an Israel based company known as Shahal Medical Services, serving 40,000 subscribers using a ‘Transtelephonic’ system – information sent over telephone wires, managed by a central operations center [registered nurses] and mobile intensive care

units [qualified physicians and paramedics]. Each subscriber is given a ‘cardiobeeper’ made by Meridian Medical Technologies Inc. that transmits the wearer’s heartbeat on either a 3 or 12 lead ECG to the central operations center. (Roth, et al., 2000) I propose that Footfalls & Heartbeats technology be integrated into a system that follows the Shahal model and incorporates a support system that aligns to the e-patient movement.

9 Image Logo of the Shahal Medical Services in Israel operates on a system suitable as a model the new e-patient network.

My direction:

How: Using Footfalls & Heartbeats technology to give patients and everyday people the tools and the system in which they can become empowered e-patients. This will be explored further in the design process of this project.

Combination of Industrial Design, Service Design and Organisational/Change Design to produce an object or series of objects as well as an interaction and a system, with the aim of that system then becoming a culture.

Why: Improve Healthcare and Medical Care in general, Reduce preventable Hospital Deaths, Improve Healthcare and Medical Care experience for patient, create a croudsource of useful information and data between different groups i.e. public, neighbourhood, nationality and especially between family both alive and deceased, allow patient to be active but safe/monitored.

Who: Patients and everyday people, also applications for future integration of sporting persons.

What: Patients ----> E-patients When: Technology currently in Licencing process, establishment of Company Brand and Identity beginning July 2011, Product prototyped by October 2011.

Technological research and improvements on-going.

Where: Initially Wellington, then New Zealand, then developed countries, then world wide integration.

10 The Four Orders of Design / INDN312 Class map of ideas.

E-patient Email Probe: Emails similar to the one bellow sent to; Dave debBronkart (e-patient spokesperson), Juhan Sonin (Designer of Health Visuals for data), Center for Controlled Health Board representative and Ministry of Health New Zealand representative.

Email Conversation between Dave debBronkart and myself: From To Date Subject

Richard Clarkson clarkson.richard.nz@gmail.com dave@epatientdave.com 25 July 2011 19:50 Research - Clarkson

Hi Dave, First may I say I am a big believer in your recent work of encouraging empowerment for patients and especially enjoyed your TED talk.

I am a final year Industrial Designer at Victoria University of Wellington in New Zealand and we have been given a project brief collaborating with a manufacture of "smart textiles," these textiles can be made into garments that have the potential to monitor the following: heart-rate, respiration rate, perspiration rate, limb movement, muscle activity and more and more things as the technology continues to advance. The benefit of this system is that it can be an non obtrusive garment and can produce real time and wireless data for both the client and an off-location observer, e.g. a nurse or doctor.

We are in the research phase of this project and are identifying potential directions for this technology. I am very interested in creating a system to align with the "e-patient movement" enabling the user access to their own data as well as having the potential to share and compare it with others in a 'patient based medical network'. I feel that such a system could be practical method of utilising the vast resource that is the patient.

Having you as a resource will give my research an extremely credible foundation on which to grow from and so I ask that you kindly answer the following questions: 1. In your experience what are the main benefits of having a network in which you can communicate with other patients?

2. How did you first find out about the e-patient network?

3. In your view where do you see the Health system in 20 years? i.e would a hospital function in the same way as is does now or would it operate in an entirely different manner?

4. Do you think there is potential for the system (or something similar) to the one I have outlined above?

5. Would you personally use such a garment? why/why not?

6. Would you be concerned about who had access to the data?

7. What sort of branding or Identity would you imagine a company to have that was producing these 'smart garments'? and finally 8. If this garment could be anything worn on the body - from a singlet to shoes to a piece of jewellery - what do you imagine it as?

I will reference you accordingly of course. Thank you in advance for your time and hope to hear from you in the coming days. If you have any recommendations of people I should talk to this would also be greatly appreciated. If you have any questions about me or this project please do not hesitate to ask.

Best wishes and regards, Richard Clarkson.

From To Date Subject

e-Patient Dave deBronkart dave@epatientdave.com Richard Clarkson clarkson.richard.nz@gmail.com 25 July 2011 19:54 Re: Research - Clarkson

Hi Richard - forgive my harried brain, but have we met yet? I’m catching up at 4 a.m. with weeks of backlogged email since the TED video went live, and I’ve lost all track of who’s what and where.

Forgive me.

For the same reason, I find I’m completely unable to offer feedback to the many ideas people are sending me. A quick skim of yours says it sounds like a wonderful idea, if it could be made comfortable and commercially viable. Have you bounced it off people like the Center for Connected Health?

Sorry I can’t offer more - just too flooded. I just tonight found two speaking invitations that have been sitting unanswered for a week or more!

12 Dave deBronkart / E-patient dave

E-patient Health Forum Probe: I wanted to simulate what a patient’s first move might be in becoming an e-patient, so as part of my research I myself became an e-patient for a short time. I joined a website called Healthboard.com, the first health forum that came up when I googled, “health forum.” Then I created my first post in a ‘create new discussion’ topic and asked people, “to answer what was their favorite e-patient network blog? What did they find helpful/

unhelpful? And to share some of their e-patient experiences.

The result was the email below and my account being banned from Website. Although my e-patient experience was brief it did make me learn to take more care in the research questions I ask and how I ask them, and I will apply this experience to my next forum Probe in the next phase of research.

From adminmod@healthboards.com To Richard Clarkson Date 27 July 2011 23:15 Subject Re: Research Mailed by healthboards.com Nothing may be posted or acquired VIA this website may be used or reproduced for articles or projects of any kind.

Professional, business, or school survey project or research use is not allowed.

Thank you for your cooperation.

-Administrator www.healthboards.com 13 Healthboard Website Homepage / Screenshot

Research Conclusions: The e-patient medical Network I propose is one based on psychological positive peer pressure to achieve goals, empowerment, fear reduction, emotional support and the sharing of useful and trustworthy information and Raw Data.

Just as the internet is used as a tool by e-patients I propose that Footfalls & Heartbeats technology can and must become an integral part of being an e-patient, as it is only through the technology of Footfalls & Heartbeats that such a system can operate.

I began this booklet by questioning the goals of different aspects of this project and

have introduced, discussed and proposed answers to all but one “what are my own goals as the designer?”

To answer this I have created the following personal design brief:

Use Footfalls & Heartbeats Technology to design a product and/or system of products that will allow and encourage patients – from critical patients to everyday people – to become E-patients. This product and/or system of products must adhere to the values of E-patients and Footfalls & Heartbeats and must have the aim of creating a culture that leads to an improved healthcare system worldwide.

Part II: Scenario Diagraming &Concept Generation

Part III: Refinement & Final Design Prototyping

Intro: Goals.

Methods used: Prototyping Aesthetic Prototyping Affordance Diagraming Maya Principal application Interface Development

From the concpeting phase of the last project I began to carry through the wooden aesthetic.

This comes about for more than one reason. The first is the psychological connections we have with the materiality of wood. As a substance it carries with it connotations of nature, warmth and individuality. It is these qualities that I feel perfectly suit the values of Footfalls & Heartbeats. It is in this way that the materiality of a product can begin to reflect its identity for both that of the product and that of the company

The next reason for my choice of wood, is the physical characteristics of wood. I have used New Zealand Native Rimu. Rimu along with many other hardwoods actually have an antibacterial characteristic, similar to that of bamboo.

(Entis, 2007). The advantages of this antibacterial quality are applicable in both the casing and instruments of medical goods.

The final reason for my choice in wood is sustainablity. Designers are increasingly aware and interested in what happens to a product post use. Although here I have used a New Zealand Native wood that is less sustainable than say Pine, it is a big step away from the masses of plastics that are currently predominantly used. We can regrow the wood we use and in doing so effectively reduce the goods carbon footprint.

Natural - Value - Antibacterial - Sustainable Identity through Materiality

Similar to other stages in this project, we joined into groups to expand our collective knowledge. The aim of this particular group work was a discussion and reflection of the Affordance and Maya Principals.

Maya was conceived by Ramond Lowery and is defined by him as being “the most advanced yet acceptable�. (Blum, 2004) We developed this and created a scale between Acceptance and

Advanced as the two extremes.

We then placed our concepts onto this scale and justified that placement through Affordance.

Which We defined as the justification of an object or idea as indicated by its characteristics and values. This placement on the scale proved useful in comparing our concepts both with each other and with the reality of its possible production, a very usefull indicator of progress.

Ground-breaking - Curious - Inventive - Progressive Identity through Technology and Innovation

Simon and Karen of Footfalls & Heartbeats give a demonstration of the fabric’s qualities and capabilities

13 (Precedent work by Yohan Sonin - see image appendix)

14

15

From the beginning of this project as my focus became E-patients and the medical online network. I realized that the interface of this product would be critical to its success.

As a foundation for my interface

I adopted a precedent in the form of Yohan Sonin, and used his work as a foundation from which to develop my own. I did in fact email Yohan to get his point of view of the e-patient topic but my email went unanswered.

The interface I have modeled is a culmination of all the characteristics and values behind each of the other components of this product. It could be said that this interface ties the aesthetics of all the other components together. It contains ideas

of nature, sterility, forward thinking and community. I have kept the actual function of the application as intuitive and free flowing as possible, in this way the client can access layers of information without the felling of being overwhelmed by it.

The Flagship product. My intention for this product is not necessarily mass production.

For me and for footfalls and heartbeats this products contains a stronger set of values and beliefs than a truly functional product can contain. It is for this reason this particular version of this product becomes the flagship. This is the attention grabber, the conversation starter, and the conceptual

idea. Once Footfalls and Heartbeats has the attention of the design and consumer world the company would release a commercialized version. This would be more functional, more mass producible and less extravagant. It is in many ways a reduced version, still containing the essence of the product and values it carries but in a more user friendly dosage and with a more realistic aesthetic.

Antique - Inquisitive - Elaborate - Conceptual Identity through Flagship Product

The Smart bandage and Smart Bandage Clip use the FITT logo (Functional Intelligent Textile Technology) rather than the standard Footfalls & Heartbeats Logo to differentiate between the type of service the different products carry. For instance the bandage fabric and clip are the physical components that record and process the data. It is only once all of these components are combined in the entire package that the unit qualifies for the Footfalls & Heartbeats title i.e. the full service. This distinction is important in terms of marketing both the Footfalls & Heartbeats brand and the FITT brand. In doing things this way I have differentiated the two while

allowing them to come together as a harmonious unit, much is the mentality of the e-patient.

Everyone is individual and together we can help each other by combining our individuality.

The bandage fabric itself can be cut at any of the indicator points and can also be washed in any standard washing machine preferably on a delicate setting.

The wood detail ties the whole product together and creates a continuity throughout the different components, providing another visual cue to the values of Footfalls & Heartbeats and E-patients.

The Smart Plaster is a sterile two-step modular plaster.

Similar to the Smart Bandage this unit is broken down into two parts. The actual plaster which lasts two weeks and in then disposed of made from the Footfalls & Heartbeats special knit fabric is held to the body using a conductive soft silicon rubber glue used in many medical applications today. The other component to the Smart Plaster is the electronic and data processing module. This is kept as clean and sterile as possible using a cleaver two stage cover.

The electronic Module is simply placed over the indicator on the fabric where it meets the two contacts. The upper tab is removed and the electric

module is sealed in place . The combined unit is then attached to the body where needed and the monitoring begins. The unit can be synced at any time by attaching the Magsafe USB. This sycing would normally be done at the end of the plasters 2 week cycle, but can be done intermittently on the body if the client needs real-time data for one reason or another. At the end of the 2 week cycle the fabric is removed and either recycled or disposed of and the electronic module is fully synced and recharged to its 2 week capacity. The fabric plasters come in packs of 3 and the kit comes with 2 electronic modules for multi positioned body area networking.

The Scenario I chose to represent my product is a developed version of my conceptual process. Using the Smart First Aid Kit the user is able to utilise see vast potential of the e-patient network and

perform self triage. Through the products ability to measure the swelling and inflammation of his ankle in real time the user is able to compare his results with others on the e-patient network to define how bad his injury is.

Final Conclusions & Evaluation: Over the course of this project I have come to realize how a company’s identity is formed.

It comes from many things, materiality, product, values, mentality, actions, logo, colour, interface, use, management, philosophy and people. Industrial design impacts all of these factors in one way or another.

I hold in very high regard the values of Footfalls & Heartbeats

and greatly appreciate the help they have given throughout this project. I also admirer the strong will power of the E-patient Network. I ended the research phase of this project by introducing a personalized project brief and I finish this documentation with a final statement of the success of my product in light of that brief and the elements specified within it -->

“I have used Footfalls & Heartbeats Technology to design a product that allows and encourages patients – from critical patients to everyday people – to become E-patients. This product adheres to the values of both E-patients and Footfalls & Heartbeats and has a future plan for creating a culture that leads to an improved healthcare system worldwide.”

Blum, M. (2004). Raymond Loewy: Designs for a Consumer Culture (review). Technology and Culture, 45(4), 854-855.

Cryer, D. (2010, May 22). Donna Cryer’s “I am an e-patient” story: e-patient advocate to the FDA. Retrieved July 31, 2011, from e-patients.net: http://e-patients.net/archives/2010/05/donna-cryers-i-am-an-epatient-story-e-patient-advocate-to-the-fda.html Darmour, J. (2010). Ping A social networking garment. Retrieved July 30, 2011, from electricfoxy: http:// www.electricfoxy.com/ping/ deBronkart, D. (2011, April 2). Meet e-Patient Dave [Video File]. Maastricht: TEDx Retrieved from http:// www.ted.com/talks/dave_debronkart_meet_e_patient_dave.html. deBronkart, D. (2011, July 21). The Green Button idea: support app development with a “Donate My Data” button. Retrieved August 1, 2011, from e-patients.net: http://e-patients.net/archives/2011/07/the-greenbutton-idea-support-app-development-with-a-donate-my-data-button.html Entis, P. (2007). Food safety: old habits, new perspectives. Boston: Wiley-Blackwell.

Fox, S. (2008). The Engaged E-patient Population. [http://www.pewinternet.org/Reports/2008/TheEngaged-Epatient-Population.aspx]: Pew Internet & American Life Project.

Gupta, P., & Udupa, A. (2011). Social Media Marketing by Pharmaceutical Industry: Perception and Attitudes of Key Stakeholders. Business and Economics Journal , Volume 2011 (BEJ-20), 1-8.

Papanek, V. (1973). Design for the real world : human ecology and social change. New York: Bantam Books.

Roth, A., Laniado, S., Malov , N., Carthy , Z., Golovner, M., Naveh, R., et al. (2000). Potential reduction of costs and hospital emergency department visits resulting from prehospital transtelephonic triage—the shahal experience in israel. Clinical Cardiology , 23 (4), 271–276.

Sonin, J. (2011, April 26). Hacking Health: Designing for and Understanding My Health. Vol. 3 . Journal of Participatory Medicine Retrieved from [http://www.jopm.org/perspective/narratives/2011/04/26/hackinghealth-designing-for-and-understanding-my-health/].

Thackara, J. (2005). In the bubble : Designing in a complex world. Cambridge, Mass.: MIT Press.

Image Appendix

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Image by Richard Clarkson, Tui Harrington and David Hardgraves 7.

Image by Richard Clarkson 8.

From top left clockwise:

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Image by INDN312 11.

Close up of Image by INDN312 12. http://epatientdave.com/about-dave/ 13. http://www.healthboards.com/ 14. http://www.flickr.com/photos/juhansonin/393271975/in/set-72157610925772960 15. http://www.flickr.com/photos/juhansonin/5590865513/in/set-72157610925772960/ 16. http://www.flickr.com/photos/juhansonin/4863961488/in/set-72157610925772960/

Thanks to: Simon and Karen from Footfalls & Heartbeats Tutors and Lecturer of INDN312 2011 Victoria University of Wellington Dave deBronkart Ancal Pharmacy Global Fabrics Yohan Sonin