Advances in computer technology have hastened the development and dissemination of a wide range of electronic media into the workplace and educational settings. Electronic media offer many advantages, including quicker access to information and easier information sharing among professions. However, electronic reading media have still not been well integrated into these settings, especially for non-routine cognitive tasks like active reading. Conflicting results from different measures (e.g., performance, preference) have been reported regarding their efficacy. Despite the fact that there are no significant performance differences between reading from paper and reading from electronic media, people still show a preference for reading from paper and resist changes in the workplace, which often results in the abandonment of electronic reading media. Therefore, in order to maximize the potential benefits from electronic reading media, researchers and designers need more valid ways to assess the effectiveness of electronic reading media than relying on existing methods using outcome-based measures of reading. Although the act of reading is primarily a cognitive process, there are relatively few comprehensive empirical reports on how the use of different reading media impacts cognitive processes like reading strategies. Moreover, researchers have rarely considered generational differences, even though generation-specific reading practices could significantly affect readers' current reading practices using different media. Therefore, the overall objective of this research was to develop and evaluate a new method to test the effectiveness of reading medium in terms of supporting design and evaluation. Specifically, this research examined how reading strategies can be used as a process measure. The research consisted of three parts: (1) investigating readers' use of reading strategies using different types of media, (2) identifying the relationship between readers' use of reading strategies and their performance and subjective response, and (3) identifying the relationship between readers' use of reading strategies and cognitive load. Resultant findings are expected to improve how we measure the effectiveness of electronic reading media. First, readers' use of reading strategies for different types of media was examined and associated generational differences were investigated. A laboratory experiment was conducted in which three generations of participants (Baby Boomers, Generation X, and Generation Y) were asked to perform an active reading task (a simulated work-related reading task) with three types of media (paper, computer, and iPad). Readers' uses of reading strategies were identified from task observation and Retrospective Think Aloud (RTA) sessions. Quantitative analyses revealed significant differences in readers' use of reading strategies, and which depended on both the type of media and individual attributes (generation). Detailed qualitative analyses were conducted to help explain the underlying reasons for these differences in the use of reading strategies. Second, based on the identified reading strategies, the relationships between readers' use of reading strategies and their performance and subjective responses were examined. Such outcome measures have traditionally been used to assess the efficacy of different reading media. However, previous studies have generated conflicting results and did not clearly demonstrate the underlying aspects that influence readers' performance and subjective responses. The results of this study showed a clear association between readers' use of reading strategies and their performance and subjective responses. Accordingly, it was revealed that participants who used the reading strategies they developed in their formative period exhibited higher subjective responses. Third, again based on the identified reading strategies, the association between readers' use of reading strategies and cognitive load was examined. Reading from electronic media has been regarded as requiring more cognitive resources than reading from paper. However, it has not been well understood precisely which aspects of reading from different media actually influence cognitive load in terms of cognitive and metacognitive perspectives. The results reported herein showed an association between reading strategies and cognitive load. Therefore, this study revealed that the use of reading strategies was critical to their cognitive load. Overall, this research demonstrated how reading strategies could be used as process measures to assess the effectiveness of specific media for active reading activities. The way in which people interact with a text (readers' use of reading strategies) was affected by the medium, as well as by generation-specific reading practices. The extent to which reading strategies can explain reading differences was confirmed, by investigating the associations between readers' use of reading strategies and other measures. These findings can contribute to the design of reading media and help to determine the most suitable reading media for active reading activities (e.g., work-related reading activities). In addition, the findings also support the importance of culturally situated experience for non-routine cognitive activities and the use of an integrated approach that takes into account both cognitive and cultural aspects in designing human-computer interaction for non-routine cognitive activities. / Ph. D.

There is substantial evidence regarding the positive influences of natural elements on patients' health outcomes. However, the research has tended to focus on green elements rather than blue elements. While sky and water are significant elements in what humans perceive as 'nature' and both offer considerable value in terms of restorative effects in various built environments, research on their role in healthcare facilities has been limited. Therefore, this PhD thesis aims to address this knowledge gap by introducing new research directions that focus on the influences of exposure to natural blue elements in healthcare settings. This research study draws inspiration from Iranian traditional architecture, which has a rich history of incorporating natural elements, particularly sky and water, into built environments. This was followed by investigating current healthcare settings to identify feasible forms of exposure to blue elements in such environments. Due to various reasons, medical imaging environments were chosen as the study setting. These settings are typically windowless and lack exposure to natural elements. However, despite limited evidence, alternative methods of exposure to natural elements, particularly blue elements, have been adopted in these environments. Therefore, this study investigated the influences of exposure to blue elements on patients in medical imaging environments and explored how the built environment can enhance the positive effects of such exposure in these settings. A mixed methods research approach, integrating both qualitative and quantitative data, was employed across two phases to address the main questions of this thesis. The initial phase, crucial for informing the subsequent phase, focused on gathering insights from architects regarding the implementation of blue elements and their potential influences on patients. The insights gained in this phase were then utilized to design the second phase – a patients' experiment conducted through virtual reality from November 2022 to March 2023 at Städtisches Klinikum Dresden, Germany. The results show that certain design strategies including all aspects of blue elements, such as water sound, water motion, water reflection, the light in the sky, clouds and the presence of birds in flight, have the potential to evoke specific positive subjective and physiological responses in medical imaging settings. Furthermore, the results indicate that the motion of blue elements can attract the attention of patients more strongly and emerged as a significant factor in triggering positive reactions. This underscores the crucial significance of incorporating blue elements in motion into design strategies for medical imaging environments. Additionally, by considering individual preferences regarding the amount and placement of blue elements, built environments can enhance the positive influences of blue elements on patients in medical imaging environments. Based on these results, evidence-based guidelines were established for integrating natural blue elements in healthcare settings, with a specific focus on PET/CT scan rooms of medical imaging environments. These guidelines target architects, medical professionals, and other stakeholders engaged in the planning process, facilitating collaboration and communication among them. In general, this PhD thesis provides insights into the studied phenomenon and offers new results, contributing to filling the knowledge gap in this field of research.