Embodied creativity: a process continuum from artistic creation to creative participation

This thesis breaks new ground by attending to two contemporary developments in art and science. In art, computer-mediated interactive artworks comprise creative engagement between collaborating practitioners and a creatively participating audience, erasing all notions of a dividing line between them. The procedural character of this type of communicative real-time interaction replaces the concept of a finished artwork with a ‘field of artistic communication’. In science, the field of creativity research investigates creative thought as mental operations that combine and reorganise extant knowledge structures. A recent paradigm shift in cognition research acknowledges that cognition is embodied. Neither embodiment in cognition nor the ‘field of artistic communication’ in interactive art have been assimilated by creativity research. This thesis takes an interdisciplinary approach to examine the embodied cognitive processes in a ‘field of artistic communication’ using a media artwork called Sim-Suite as a case study research strategy. This interactive installation, created and exhibited in an authentic real-world context, engages three people to play on wobble-boards. The thesis argues that creative processes related to Sim-Suite operate within a continuum, encompassing collaborative artistic creation and cooperative creative participation. This continuum is investigated via mixed methods, conducting studies with qualitative and quantitative analysis. These are interpreted through a theoretical lens of embodied cognition principles, the 4E approaches. The results obtained demonstrate that embodied cognitive processes in Sim-Suite’s ‘field of artistic communication’ function on a continuum. We give an account of the creative process continuum relating our findings to the ‘embedded-extended-enactive lens’, empirical studies in embodied cognition and creativity research. Within this context a number of topics and sub-themes are identified. We discuss embodied communication, aspects of agency, forms of coordination, levels of evaluative processes and empathetic foundation. The thesis makes conceptual, empirical and methodological contributions to creativity research

Design revolutions: IASDR 2019 Conference Proceedings. Volume 3: People

In September 2019 Manchester School of Art at Manchester Metropolitan University was honoured to host the bi-annual conference of the International Association of Societies of Design Research (IASDR) under the unifying theme of DESIGN REVOLUTIONS. This was the first time the conference had been held in the UK. Through key research themes across nine conference tracks – Change, Learning, Living, Making, People, Technology, Thinking, Value and Voices – the conference opened up compelling, meaningful and radical dialogue of the role of design in addressing societal and organisational challenges. This Volume 3 includes papers from People track of the conference

Elimination of doubt : methods for a predictive design to direct and optimize the flow of visitors

Ympäristömme globaalistuu ja monimutkaistuu kaiken aikaa. Prosessi näkyy muun muassa kansainvälisen liikenteen solmukohdissa. Esimerkiksi lentokentät ovat kyseisiä eri kulttuurien keskinäisen vuorovaikutuksen kohtia. Eri kulttuureista tulevien ihmisten pitää osata orientoitua vieraassa ja usein sekavassa ympäristössä. Jotta toiminta olisi sujuvaa näissä solmukohdissa, on suunnistamiseen tarvittavan tiedon oltava nopeasti omaksuttavaa ja ymmärrettävää. Monet muotoilijat ja suunnittelijat ajattelevat, että opastejärjestelmät ovat reduktionistisia ja mekanistisia syy-seuraus systeemejä. On kuitenkin ilmeistä, että kansainvälisesti harmonisoimattomien piktogrammien kyky välittää informaatiota on epäonnistunutta. Nykyiset kognitiotieteen havainnot osoittavat, että visuaalisen havaitsemisen ja tilallisen orientaation aikaisemmat mallit ovat vain osittain toimivia. Siispä oli syytä kysyä ”onko mahdollista tuottaa ennakoiva malli jonka avulla voi kehittää, toteuttaa ja varmistaa suunnitteluratkaisuja, jotka ohjaavat ja optimoivat vierailijoiden virtaa laajoissa julkisissa tiloissa.“ Tutkimuksen keskiössä on tästä syystä tilallisessa orientoitumisessa tapahtuva kulttuurinen merkityksellistäminen ja paikkatietoisuuden lisääminen (situation awareness). Juuri tuo yksilöllinen merkityksen tuottaminen voi tarkoittaa laajaa kirjoa erilaisia tulkintoja. Paikkatietoisuuden syntymisen erilaiset mahdollisuudet yhdessä erilaisten menetelmien kanssa voivat tuottaa ratkaisuja suunnitteluprosessiin. Suunnitteluprosessissa voidaan ottaa huomioon myös havaintopsykologisia näkökulmia. Kaiken kaikkiaan tämä johtaa systeemis-holistiseen ja käyttäjäkeskeiseen ajatteluun julkisten tilojen opastejärjestelmien suunnittelun kehityksessä. Esitän myös käytännöllisen ratkaisun opastejärjestelmien suunnitteluun ja arviointiin tarkastelemalla olemassa olevien järjestelmien rakennetta ja parametreja sekä niiden kehitystyötä. Työ sisältää yhteensä yhdeksän tapaustarkastelua. Tutkimusmenetelminä käytin laadullista havainnointia ja kvantitatiivista analyysiä. Havainnoin ja tulkitsin etnisiä tottumuksia ja henkilökohtaisia näkemyksiä. Tekemäni kyselyjen perusteella näyttää siltä, että konstruoimaani mallia voitaisiin käyttää kehittämisen ja todentamisen välineenä.The rapid development of international traffic characterizes our increasingly globalized and ever more complex world. Nodal points (for example, airports) have formed where people from various cultural backgrounds and with differing levels of educational attainment need to reorient themselves in a unfamiliar and often confusing environment. A key condition to ensure everything works smoothly in such an international junction is the extremely fast reception and processing of information by everyone involved. The dominant school of thought among many designers and planners of guidance and routing systems is still a reductionist and mechanistic one (cause - effect). It has become apparent that the use of non-internationally harmonized pictograms as information carriers has failed completely. Recent findings in the field of cognitive science demonstrate convincingly that previous models of visual perception and spatial orientation can only highlight partial aspects. For these aspects, the question has arisen: “Is there a possibility to evolve a predictive system to develop, implement and verify design solutions to direct and optimize the flow of visitors in large public spaces?” Therefore, the moment of semiosis of the orientation seekers moved into the focus of the investigation. This moment of meaning-making, which is perceived by every individual differently, spans the entire spectrum of the perception of the designated item (the optical characteristic of the character substrate) between manifold interpretation or absolute certainty. The various viewing options of “situational awareness” with the help of various methodologies provide solutions for the design process. Taking the aspects of perceptual psychology into account leads to the development of a systemic/holistic and user-centred design of orientation systems in public spaces. Identifying and consulting the predictive parameters in a systematic process could show a practicable solution for the planning and evaluation of guidance and routing systems. In various national and international case studies, the process reliability and processing quality of this solution were demonstrated. Involving mixed research methodologies of qualitative observation and quantitative analysis, it was possible to develop a workable model. Through observation and interpretation, ethnic habits and personal views were taken into account to develop the methods. The use of questionnaires or surveys created statistics to prove or disprove the hypothetical model. The capacity of the presented model and the operationalization of the research demonstrated an effective method for overcoming barriers of age, language and culture. The publication satisfies, therefore, the criteria of the academic quality of a practice-based Ph.D

The design and evaluation of targeted patient-centred health information to improve knowledge and behavioural outcomes in tuberculosis patients with limited literacy

South Africa carries a significant TB burden as evidenced in the 2013 statistics which report 450 000 new active TB cases and 890 000 TB-related mortalities. For successful treatment outcomes, 90% adherence is necessary, but many patients prematurely discontinue treatment due to poor knowledge and understanding of their complex TB medicines. Patient education is pivotal in improving knowledge, health literacy and behavioural outcomes such as health information seeking, self-efficacy and adherence. In the under-resourced South African healthcare system, time and capacity to adequately counsel patients are limited. The value of written medicine information (WMI) to supplement the verbal information provided by healthcare professionals (HCPs) has been widely investigated but minimal South African research is available. Current WMI distributed in South Africa is mainly generated by pharmaceutical manufacturers and is complex, incomprehensible and undesirable to patients. TB-related WMI focuses mainly on the disease, with little information relating to TB medicines and their use. The overall aim of this project was to improve patient knowledge about their TB medicines through the use of a simple illustrated patient information leaflet (PIL). Objectives to achieve this aim included: investigation of the medicine information seeking behaviour (MISB) of long term patients attending public health sector facilities; the development and validation of a medicine literacy test (MLT) to identify patients with limited health literacy requiring additional support and counselling; the development and evaluation of a patient-centred illustrated PIL for first-line TB treatment; the assessment of self-efficacy and adherence using modified versions of the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES) and Morisky 8-item Medicine Adherence Scale (MMAS-8), respectively, and the investigation of the impact of the PIL on patient knowledge and these health-related behaviours. Six focus group discussions (FGDs) conducted in 34 isiXhosa-speaking patients with limited formal education taking long-term treatment explored themes related to information needs, information-seeking practices and awareness of and ability to utilize information sources. Codes were analysed and potential themes and subthemes were identified and refined. The findings of this study reflected a passive, disempowered patient due to both patient-related and systemic healthcare factors. Poor awareness of information sources, lack of health-related knowledge, stigma and lack of awareness of the importance of appropriate medicine-related knowledge contributed to a lack of information-seeking practice. Patients neither asked questions nor were encouraged to do so. All expressed an unmet need for information and a desire for receiving relevant, appropriate, written medicine-related information. Feedback from this phase of the study was used to inform the development of the targeted patientcentred PIL. A double-sided A4 PIL containing information about TB medicines was designed giving careful consideration to content, format and layout features. Twenty five pictograms were designed through a rigorous, iterative design process and were included in the PIL that was evaluated in a randomised control trial (RCT) conducted amongst 120 TB patients attending a high burden TB clinic in South Africa. Interviews were conducted in either isiXhosa or Afrikaans via a trained interpreter. Patients were randomly allocated to either a control (standard care) or an experimental group (standard care plus brief counselling using the PIL). Two interviews were conducted using a prepared questionnaire; one at baseline followed by a 4-week follow-up. Baseline data included demographics, medicine literacy test, health information sources, knowledge of TB medicines, self-reported adherence and self-efficacy. Data collected at the 4-week follow-up interview included TB knowledge, self-reported adherence, self-efficacy, opinion of TB medicine information and interpretation of pictograms. Data were analysed using t-test, correlations, chi-square and ANOVA tests at a 0.05 level of significance. The PIL was successful in improving patient knowledge of the disease, TB medicine-taking, side effects, drug-resistant TB and HIV and TB co-infection. At baseline, there was no significant difference in the overall mean percentage knowledge score between the control and experimental groups (p=0.074). At follow-up, the percentage knowledge score for the experimental group increased significantly from 59.0% to 84.6% (p<0.001) and showed a significantly higher score than the control group (p<0.001), displaying evidence of the impact of the PIL as a counselling tool on patient knowledge. The PIL generated a highly positive response in the experimental group who indicated that they had referred to the leaflet over the last month and that it had played an important role in improving their TB medicine-related knowledge. This was reflected in the experimental group knowledge score of greater than 80% for almost three quarters of the patients whereas only 14% in the control group achieved this score. Patients appreciated the inclusion of pictograms and strongly felt that they helped them to recall and understand the textual PIL content. The study found that patients want side effect information and, interestingly, did not perceive the presentation of side effects in pictorial form to constitute a risk factor for nonadherence. Use of the illustrated PIL (experimental group) resulted in a significant improvement in patient self-efficacy (p=0.002), but showed no effect on self-reported adherence (p=0.563). Neither self-efficacy nor adherence was influenced by gender, age or education. An education effect on knowledge was only observed in the control group at baseline. The newly developed MLT was shown to be a valid and reliable tool and a moderate, positive and significant correlation was noted between the MLT score and baseline TB medicine-related knowledge in both the control and experimental groups. As there is a paucity of studies investigating the influence of take-home written leaflets on TB medicine knowledge and on patient behaviour, this study represents a significant knowledge contribution. It is the first study to report the development and evaluation of a patient-centred PIL to address the dearth of available TB medicine information. The use of targeted user-friendly, illustrated information leaflets can be a valuable counselling aid to improve patient knowledge and self-efficacy, particularly among patients with limited literacy. However, careful consideration of the design and content, with input from the endusers at all stages of the process, will optimise its effectiveness. The proposed framework for the development and implementation of patient-centred health and medicines information in a developing country context presented in this thesis could be used as a theoretical basis for informing the development of effective information materials targeting other disease states. Local patients taking TB medicines identified nurses, WMI and media as their current sources of information but they expressed a strong desire to know more about their treatment. Targeted public health interventions that focus on medicine-taking information and behaviours and encourage patients to adopt a more active, questioning role in health consultations could improve health literacy and empower patients in their medicine-taking practices.Thesis (PhD) -- Faculty of Pharmacy, Pharmacy, 201

A developmental model of number representation

We delineate a developmental model of number representations. Notably, developmental dyscalculia (DD) is rarely associated with an all-or-none deficit in numerosity processing as would be expected if assuming abstract number representations. Finally, we suggest that the "generalist genes” view might be a plausible - though thus far speculative - explanatory framework for our model of how number representations develo