Buildings and users with visual impairment::uncovering factors for accessibility using BIT-Kit

In this paper, we report on the experiences of visually impaired users in navigating buildings. We focus on an investigation of the way-finding experiences by 10 participants with varying levels of visual ability, as they undertook a way-finding task in an unfamiliar public building. Through applying the BIT-Kit framework in this preliminary user study, we were able to uncover 54 enabling and disabling interactions within the case study building. While this building adhered to building legislation, our findings identified a number of accessibility problems including, issues associated with using doors, hazards caused by building finishes, and difficulty in knowing what to do in the case of an emergency evacuation. This user study has demonstrated a disparity between design guidance and the accessibility needs of building users. It has uncovered evidence to enable architects to begin to design for the real needs of users who have a range of visual impairment. Furthermore, it has instigated discussion of how BIT-Kit's evidence could be incorporated into digital modelling tools currently used in architectural practice

Detecting Simulated Memory Impairment After Closed Head Injury: Validation of the Word Completion Memory Test (WCMT).

Simulation is the intentional production or exaggeration of psychological symptoms (cognitive and/or emotional) in an effort to obtain secondary gain (e.g., avoiding work, obtaining financial compensation). While most current simulation measures can successfully identify obvious attempts at faking cognitive deficits (e.g., memory impairment), they have been much less successful at identifying more sophisticated simulators. The Word Completion Memory Test (WCMT) is the first measure specifically developed to detect more sophisticated attempts at feigning memory impairment. Unlike other simulation detection measures, a sophisticated coaching methodology was used in developing the WCMT. An initial validity study suggested the WCMT is a valid and effective measure of simulation; however, additional data are needed before widespread use of the instrument is appropriate. The primary purpose of the present study was to provide additional validity and reliability information about the WCMT. A total of 71 participants were recruited for this study: 15 undergraduates instructed to perform their best, 15 community volunteers instructed to perform their best, 15 undergraduates instructed to fake memory impairment, 15 community volunteers instructed to fake memory impairment, and 11 memory-disordered patients instructed to perform their best. Undergraduate and community participants were administered five tests of neuropsychological functioning and five tests of simulation (including the WCMT) to explore the convergent and discriminant validity of the WCMT. Two weeks later, these participants completed all 10 measures a second time to examine test-retest reliabilities. Memory-disordered patients were administered the WCMT and two of the same simulation measures administered to undergraduate and community participants during the course of a comprehensive neuropsychological evaluation. Due to time constraints, memory-disordered patients were not administered the other seven measures that were administered to undergraduate and community participants. Results revealed that the WCMT successfully discriminated simulators from nonsimulators with an overall classification accuracy of 97%. When entered into discriminant function analyses, the WCMT consistently entered into the equations first, accounting for 70% of the variance. In addition, the WCMT demonstrated good convergent and discriminant validity, and 2-week test-retest reliabilities ranged from .86 to .94. In conclusion, the WCMT appears to be a valid and reliable measure of simulated memory impairment

Intelligent computational techniques and virtual environment for understanding cerebral visual impairment patients

Cerebral Visual Impairment (CVI) is a medical area that concerns the study of the effect of brain damages on the visual field (VF). People with CVI are not able to construct a perfect 3-Dimensional view of what they see through their eyes in their brain. Therefore, they have difficulties in their mobility and behaviours that others find hard to understand due to their visual impairment. A branch of Artificial Intelligence (AI) is the simulation of behaviour by building computational models that help to explain how people solve problems or why they behave in a certain way. This project describes a novel intelligent system that simulates the navigation problems faced by people with CVI. This will help relatives, friends, and ophthalmologists of CVI patients understand more about their difficulties in navigating their everyday environment. The navigation simulation system is implemented using the Unity3D game engine. Virtual scenes of different living environments are also created using the Unity modelling software. The vision of the avatar in the virtual environment is implemented using a camera provided by the 3D game engine. Given a visual field chart of a CVI patient with visual impairment, the system automatically creates a filter (mask) that mimics a visual defect and places it in front of the visual field of the avatar. The filters are created by extracting, classifying and converting the symbols of the defected areas in the visual field chart to numerical values and then converted to textures to mask the vision. Each numeric value represents a level of transparency and opacity according to the severity of the visual defect in that region. The filters represent the vision masks. Unity3D supports physical properties to facilitate the representation of the VF defects into a form of structures of rays. The length of each ray depends on the VF defect s numeric value. Such that, the greater values (means a greater percentage of opacity) represented by short rays in length. While the smaller values (means a greater percentage of transparency) represented by longer rays. The lengths of all rays are representing the vision map (how far the patient can see). Algorithms for navigation based on the generated rays have been developed to enable the avatar to move around in given virtual environments. The avatar depends on the generated vision map and will exhibit different behaviours to simulate the navigation problem of real patients. The avatar s behaviour of navigation differs from patient to another according to their different defects. An experiment of navigating virtual environments (scenes) using the HTC Oculus Vive Headset was conducted using different scenarios. The scenarios are designed to use different VF defects within different scenes. The experiment simulates the patient s navigation in virtual environments with static objects (rooms) and in virtual environments with moving objects. The behaviours of the experiment participants actions (avoid/bump) match the avatar s using the same scenario. This project has created a system that enables the CVI patient s parents and relatives to aid the understanding what the CVI patient encounter. Besides, it aids the specialists and educators to take into account all the difficulties that the patients experience. Then, is to design and develop appropriate educational programs that can help each individual patient

RRH Library Newsletter, November 2012

Newsletter sections include: Hospital Wayfinding Signage; Library New

Malingering of cognitive symptoms.

Volume 1 is divided into 3 parts as follows: Part 1 (Review Paper) discusses the admissibility of psychometric evidence of cognitive malingering in UK criminal law courts. The paper opens with a historical account of psychologists as expert witnesses, highlighting significant advances relevant to malingering. This sets the context for a discussion about current developments in policy and specifically the creation of a UK standard for the admissibility of scientific evidence. The penultimate section outlines the statistical and methodological issues which challenge the development of empirical cognitive measures of malingering. The paper closes with a discussion of future directions for research and practice in presenting psychological evidence in court. Part 2 (Empirical Paper) reports on a study testing the utility of a battery of measures to identify simulating malingerers from healthy controls and psychiatric inpatients. The battery of measures were chosen for their different approaches to detecting malingerers. An additional qualitative interview was given to the simulating malingerers to investigate the strategies they used to fake the tests. The performance of the test battery was compared to a pre-existing screening tool for malingering. The results were discussed with reference to implications for research and practice. Part 3 (Critical Appraisal) reflects on the process of undertaking the research. It discusses the generalisability of the findings when using a simulating malingering design, the utility of measuring reaction time to detect malingering, difficulties in the recruitment of inpatients, the array of choices in selecting the test battery and the clinical applications of the research

Qualitative scoring of the Rey 15-Item Memory Test in a forensic population

Several studies have examined the ability of the Rey 15-Item Memory Test (MFIT) to identify malingering of memory problems among a variety of psychiatric and neurologically impaired populations. The consensus has been that the quantitative scoring method is overly sensitive to genuine memory impairment and lacks sensitivity to simulated amnesia. However, a reexamination of these studies and available data indicates the MFIT is both valid and effective at identifying actual malingerers among civil litigants, and a number of these studies were limited through inappropriate inclusion of severely impaired patients and research designs of questionable validity. Also, the performance of a group for whom malingering of memory complaints is a relevant issue (criminal defendants) has been overlooked. The present study expands upon previous investigations by comparing the MFIT performance of a known group of forensic malingerers to a group of non-malingering pretrial criminal defendants and non-malingering post-trial forensic inpatients, and by examining the utility of a qualitative scoring approach hypothesized to enhance the MFIT’s detection ability. Using the quantitative method, a low sensitivity of 47.7% was obtained for malingerers. Minimal improvement was found when qualitative scoring was incorporated (56.8%), although confidence in correct identification was increased with very low total scores (\u3c5) and failure to recall at least 3 of the first 6 items. While the quantitative method yielded high specificity for non-malingering post-trial patients (86.7%), this was not the case for the more clinically relevant non-malingering pretrial patients (56.2%). However, specificity was increased for both non-malingering groups through the addition of qualitative scoring. Although both the quantitative and combined quantitative and qualitative scoring methods were found to be accurate at identifying criminal forensic malingerers, neither was found to be more accurate than base rate prediction alone. It is concluded that the lack of effectiveness can be attributed to 1) decreased sensitivity to less blatant forms of malingering, and 2) the adverse impact of lower intelligence and psychiatric symptoms affecting the ability to attend and organize cognitive processes on the MFIT recall for actual patients

A Novel Joint Brain Network Analysis Using Longitudinal Alzheimer's Disease Data.

There is well-documented evidence of brain network differences between individuals with Alzheimer's disease (AD) and healthy controls (HC). To date, imaging studies investigating brain networks in these populations have typically been cross-sectional, and the reproducibility of such findings is somewhat unclear. In a novel study, we use the longitudinal ADNI data on the whole brain to jointly compute the brain network at baseline and one-year using a state of the art approach that pools information across both time points to yield distinct visit-specific networks for the AD and HC cohorts, resulting in more accurate inferences. We perform a multiscale comparison of the AD and HC networks in terms of global network metrics as well as at the more granular level of resting state networks defined under a whole brain parcellation. Our analysis illustrates a decrease in small-worldedness in the AD group at both the time points and also identifies more local network features and hub nodes that are disrupted due to the progression of AD. We also obtain high reproducibility of the HC network across visits. On the other hand, a separate estimation of the networks at each visit using standard graphical approaches reveals fewer meaningful differences and lower reproducibility

Cognitive and bodily selves: how do they interact following brain lesion?

Dualism has long distinguished between the mental and the body experiences. Probing the structure and organisation of the self traditionally calls for a distinction between these two sides of the self coin. It is far beyond the scope of this chapter to address these philosophical issues, and our starting point will be the simple distinction between reflective processes involved in the elaboration of body image, self awareness and self-recognition (i.e. ‘the self’) and the sensori-motor dialogues involved in action control, reactions and automatisms (i.e. ‘the body’ schema). This oversimplification does not take into account the complex interactions taking place between these two levels of description, but our initial aim will be to distinguish between them, before addressing the question of their interactions. Cognitive and sensori-motor processes have frequently been distinguished (review: Rossetti and Revonsuo 2000), and it may be proposed that a similar dissociation can be put forward, a priori, between a central representation of self and a bodily representation corresponding to body schema (Figure 1)

Malingered cognitive symptoms in severe mental illness.

Part I of this thesis comprises a review paper which will contextualise the empirical paper that forms Part II of the thesis. Section A of the literature review offers the reader an introduction to the often-misunderstood phenomenon of malingering. Although avoided by psychologists perhaps due to its seeming incompatibility with the establishment of a therapeutic alliance (Rogers, 1997), the case for the importance of research into improving malingering detection methods is presented. The reader is then orientated to the contemporary understanding of malingering as an elected means of adaptation to circumstance, and this adaptational perspective is used to elaborate on what and how individuals might malinger. Whilst thinking about malingering might be interesting of itself, the aim of any malingering research must be to improve upon the accuracy of classification and detection methods. Section B of the review paper provides the reader with a summary of the development of methodologies and strategies used in the clinical assessment of malingering. This is presented with reference to the theoretical account of the malingering construct elucidated in Section A. Detection methods used in malingered mental illness and malingered cognitive impairment are presented independently, and the distinct domains in which these assessments tend to focus is emphasised. Specifically, individuals suspected of malingering mental illness are assessed predominantly in the psychiatric (not cognitive) domain, and although corroborative evidence of malingering on cognitive tests is routinely sought in order to augment classification accuracy, no cognitive tests have been developed specifically to assess malingered mental illness. This constitutes a gap in the research literature since feigning on tests of cognition among persons malingering mental illness has been repeatedly evidenced (e.g. Boone et al., 2002). Advances in the literature on malingered cognitive impairment (in the context of traumatic brain-injury) are presented and considered then, in the context of developing bespoke cognitive instruments for the assessment of malingered cognitive symptoms in the context of mental illness. Part II of this thesis constitutes the empirical study that was designed and executed in the aim of investigating the utility and validity of a test battery designed to assess malingered cognitive symptoms in severe mental illness. A three-group "fully controlled" simulation study is described, in which psychiatric inpatients, simulating malingerers and healthy controls (total n = 105), were administered a multi-method malingered cognitive symptoms test battery, comprising interview- and performance-based tasks. Established malingering tests were also administered in order that simulated malingering could be externally validated, and also so that classification according to the cognitive battery, could be compared with that according to 'gold standard' instruments. Tests of true ability and pathology were administered in order to explore the potential confound of true mental illness with malingering measures, and also so that the true symptom status of simulating malingerers could be quantified. Results demonstrate a high degree of precision of discrimination between simulating malingerers and their genuine counterparts on the basis of composite scores on the cognitive symptoms battery. Results also show that composite scores on the cognitive symptoms battery are not correlated with true pathology in genuine patients, estimated IQ and level of educational attainment. Part in of this thesis constitutes the critical review section in which qualitative information pertaining to the execution processes of the study is discussed. This information pertains mainly to the engagement of acutely mentally ill patients in this research, and also includes personal reflections on conducting a study entailing simulation

Using the WAIS-IV to Detect Malingering

This study used subtests of the WAIS-IV to detect evidence of malingering. Developing reliable tests for malingering could significantly reduce costs paid to malingering individuals. A within-group known-group design was used. There were 3 known-group conditions. The first group (G1) was instructed to take the tests honestly. The second group (G2) was asked to fake a cognitive disability while taking the tests. The third group (G3) took the tests while undergoing the cold-pressor method (hand immersed in cold water) of inducing pain. Analysis of variance was performed. That analysis appeared to have significant differences; post hock Bonferroni testing was done. The G2 scores were significantly different from the G1 and G3 scores. Dependent variables were participants\u27 group scores on Digit-Span and Block-Design subtests of the WAIS- IV. Independent variables were the testing conditions: honest, malingering or laboratory-induced pain. Outcome variables were the score differences within known-group conditions. The outcome variable score differences in this study supported Digit-Span and Block-Design as tests of mental malingering. Positive social change comes through adding an additional Test of Mental Malingering (TOMM) used to aid in detection of those trying to fake cognitive difficulties based on pain symptoms, reducing the associated costs to members of society paying higher costs for healthcare, and for government paying unnecessary compensation benefits to those who are malingering who do not deserve it