10 research outputs found

    Keep Your Eyes above the Ball: Investigation of Virtual Reality (VR) Assistive Gaming for Age-Related Macular Degeneration (AMD) Visual Training

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    Humans are beyond all visual beings since most of the outside information is gathered through the visual system. When the aging process starts, visual functional damages become more and more common and the risk of developing visual impairment is higher. Age-related macular degeneration (AMD) is one of the main afflictions that leads to severe damage to the optical system due to the aging process. The ones affected lose the ability to use the central part of vision, essential for accurate visual information processing. Even if less accurate, peripheral vision remains unaffected, hence medical experts have developed training procedures to train patients to use peripheral vision instead to navigate their environment and continue their daily lives. This type of training is called eccentric viewing. However, there are several shortcomings in current approaches, such as not being engaging or individualizable enough nor cost and time-effective. The main scope of this dissertation was to find out if more engaging and individualizable methods can be used for peripheral training of AMD patients. The current work used virtual reality (VR) gaming to deliver AMD training; the first time such an approach was used for eccentric viewing training. In combination with eye-tracking, real-time individualized assistance was also achieved. Thanks to an integrated eye-tracker in the headset, concentric gaze-contingent stimuli were used to redirect the eyes toward an eccentric location. The concentric feature allowed participants to choose freely and individually their peripheral focus point. One study investigated the feasibility a VR system for individualized visual training of ophthalmic patients, two studies investigated two types of peripheral stimuli (three spatial cues and two optical distortions) and the last study was a case study looking into the feasibility of such an approach for a patient with late AMD. Changes in gaze directionality were observed in all the last three studies for one specific spatial cue, a concentric ring. In accordance with the literature, the gaze was directed spontaneously toward the most effective peripheral position. The last study additionally proved gaming feasible for future testing of the elderly AMD population. The current work opened the road to more individualized and engaging interventions for eccentric viewing training for late AMD

    Meshfree Approximation Methods For Free-form Optical Surfaces With Applications To Head-worn Displays

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    Compact and lightweight optical designs achieving acceptable image quality, field of view, eye clearance, eyebox size, operating across the visible spectrum, are the key to the success of next generation head-worn displays. The first part of this thesis reports on the design, fabrication, and analysis of off-axis magnifier designs. The first design is catadioptric and consists of two elements. The lens utilizes a diffractive optical element and the mirror has a free-form surface described with an x-y polynomial. A comparison of color correction between doublets and single layer diffractive optical elements in an eyepiece as a function of eye clearance is provided to justify the use of a diffractive optical element. The dual-element design has an 8 mm diameter eyebox, 15 mm eye clearance, 20 degree diagonal full field, and is designed to operate across the visible spectrum between 450-650 nm. 20% MTF at the Nyquist frequency with less than 3% distortion has been achieved in the dual-element head-worn display. An ideal solution for a head-worn display would be a single free-form surface mirror design. A single surface mirror does not have dispersion; therefore, color correction is not required. A single surface mirror can be made see-through by machining the appropriate surface shape on the opposite side to form a zero power shell. The second design consists of a single off-axis free-form mirror described with an x-y polynomial, which achieves a 3 mm diameter exit pupil, 15 mm eye relief, and a 24 degree diagonal full field of view. The second design achieves 10% MTF at the Nyquist frequency set by the pixel spacing of the VGA microdisplay with less than 3% distortion. Both designs have been fabricated using diamond turning techniques. Finally, this thesis addresses the question of what is the optimal surface shape for a single mirror constrained in an off-axis magnifier configuration with multiple fields? Typical optical surfaces implemented in raytrace codes today are functions mapping two dimensional vectors to real numbers. The majority of optical designs to-date have relied on conic sections and polynomials as the functions of choice. The choice of conic sections is justified since conic sections are stigmatic surfaces under certain imaging geometries. The choice of polynomials from the point of view of surface description can be challenged. A polynomial surface description may link a designer s understanding of the wavefront aberrations and the surface description. The limitations of using multivariate polynomials are described by a theorem due to Mairhuber and Curtis from approximation theory. This thesis proposes and applies radial basis functions to represent free-form optical surfaces as an alternative to multivariate polynomials. We compare the polynomial descriptions to radial basis functions using the MTF criteria. The benefits of using radial basis functions for surface description are summarized in the context of specific head-worn displays. The benefits include, for example, the performance increase measured by the MTF, or the ability to increase the field of view or pupil size. Even though Zernike polynomials are a complete and orthogonal set of basis over the unit circle and they can be orthogonalized for rectangular or hexagonal pupils using Gram-Schmidt, taking practical considerations into account, such as optimization time and the maximum number of variables available in current raytrace codes, for the specific case of the single off-axis magnifier with a 3 mm pupil, 15 mm eye relief, 24 degree diagonal full field of view, we found the Gaussian radial basis functions to yield a 20% gain in the average MTF at 17 field points compared to a Zernike (using 66 terms) and an x-y polynomial up to and including 10th order. The linear combination of radial basis function representation is not limited to circular apertures. Visualization tools such as field map plots provided by nodal aberration theory have been applied during the analysis of the off-axis systems discussed in this thesis. Full-field displays are used to establish node locations within the field of view for the dual-element head-worn display. The judicious separation of the nodes along the x-direction in the field of view results in well-behaved MTF plots. This is in contrast to an expectation of achieving better performance through restoring symmetry via collapsing the nodes to yield field-quadratic astigmatism

    The development of viewing strategies in patients with macular disease.

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    Background: This thesis describes the results of the first longitudinal study of visual behaviour in patients with newly developed macular disease (MD). The study is of a natural history, case series design. Methods: Twenty patients with age-related macular disease and five with juvenile forms of MD were recruited. All patients had developed scotomas in their second affected eye within the previous two weeks. Patients were assessed five times over the next twelve months. In addition to clinical tests, fixation behaviour was assessed using a scanning laser ophthalmoscope, eye movements were measured using an infra-red eyetracker and reading speed was recorded. Multivariate statistical techniques were applied to determine which factors limit reading speed and which variables lead to a change in reading speed. Results: All 25 patients developed a preferred retinal locus (PRL) within six months. Sixteen patients made an adaptation whereby they were unaware of using the PRL. By the end of the study, fifteen patients (60%) repeatedly made eye movements which displayed the characteristics of non-foveating saccades. Saccade efficiency reached normal levels in eight patients (32%). Over the course of the study, reading speed improved in four patients (16%), deteriorated in 7 patients (28%) and remained constant in the remaining 14 patients. Changes in reading speed were due to changes in fixation stability, non-awareness of using the PRL and developing a strategy of repeatedly using the same number of PRLs. The likelihood of a change in reading speed could not be predicted by disease type, visual acuity or scotoma size. Conclusions: It was not possible to predict which patients' reading speed will change from the measures used in this study. The conclusions of this thesis have implications for the counselling of patients with macular disease and the development of training programs for patients with this common, debilitating condition

    Motivation Modelling and Computation for Personalised Learning of People with Dyslexia

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    The increasing development of e-learning systems in recent decades has benefited ubiquitous computing and education by providing freedom of choice to satisfy various needs and preferences about learning places and paces. Automatic recognition of learners’ states is necessary for personalised services or intervention to be provided in e-learning environments. In current literature, assessment of learners’ motivation for personalised learning based on the motivational states is lacking. An effective learning environment needs to address learners’ motivational needs, particularly, for those with dyslexia. Dyslexia or other learning difficulties can cause young people not to engage fully with the education system or to drop out due to complex reasons: in addition to the learning difficulties related to reading, writing or spelling, psychological difficulties are more likely to be ignored such as lower academic self-worth and lack of learning motivation caused by the unavoidable learning difficulties. Associated with both cognitive processes and emotional states, motivation is a multi-facet concept that consequences in the continued intention to use an e-learning system and thus a better chance of learning effectiveness and success. It consists of factors from intrinsic motivation driven by learners’ inner feeling of interest or challenges and those from extrinsic motivation associated with external reward or compliments. These factors represent learners’ various motivational needs; thus, understanding this requires a multidisciplinary approach. Combining different perspectives of knowledge on psychological theories and technology acceptance models with the empirical findings from a qualitative study with dyslexic students conducted in the present research project, motivation modelling for people with dyslexia using a hybrid approach is the main focus of this thesis. Specifically, in addition to the contribution to the qualitative conceptual motivation model and ontology-based computational model that formally expresses the motivational factors affecting users’ continued intention to use e-learning systems, this thesis also conceives a quantitative approach to motivation modelling. A multi-item motivation questionnaire is designed and employed in a quantitative study with dyslexic students, and structural equation modelling techniques are used to quantify the influences of the motivational factors on continued use intention and their interrelationships in the model. In addition to the traditional approach to motivation computation that relies on learners’ self-reported data, this thesis also employs dynamic sensor data and develops classification models using logistic regression for real-time assessment of motivational states. The rule-based reasoning mechanism for personalising motivational strategies and a framework of motivationally personalised e-learning systems are introduced to apply the research findings to e-learning systems in real-world scenarios. The motivation model, sensor-based computation and rule-based personalisation have been applied to a practical scenario with an essential part incorporated in the prototype of a gaze-based learning application that can output personalised motivational strategies during the learning process according to the real-time assessment of learners’ motivational states based on both the eye-tracking data in addition to users’ self-reported data. Evaluation results have indicated the advantage of the application implemented compared to the traditional one without incorporating the present research findings for monitoring learners’ motivation states with gaze data and generating personalised feedback. In summary, the present research project has: 1) developed a conceptual motivation model for students with dyslexia defining the motivational factors that influence their continued intention to use e-learning systems based on both a qualitative empirical study and prior research and theories; 2) developed an ontology-based motivation model in which user profiles, factors in the motivation model and personalisation options are structured as a hierarchy of classes; 3) designed a multi-item questionnaire, conducted a quantitative empirical study, used structural equation modelling to further explore and confirm the quantified impacts of motivational factors on continued use intention and the quantified relationships between the factors; 4) conducted an experiment to exploit sensors for motivation computation, and developed classification models for real-time assessment of the motivational states pertaining to each factor in the motivation model based on empirical sensor data including eye gaze data and EEG data; 5) proposed a sensor-based motivation assessment system architecture with emphasis on the use of ontologies for a computational representation of the sensor features used for motivation assessment in addition to the representation of the motivation model, and described the semantic rule-based personalisation of motivational strategies; 6) proposed a framework of motivationally personalised e-learning systems based on the present research, with the prototype of a gaze-based learning application designed, implemented and evaluated to guide future work

    The Augmented Learner : The pivotal role of multimedia enhanced learning within a foresight-based learning model designed to accelerate the delivery of higher levels of learner creativity

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    The central theme for this dissertation lies at the intersection of multisensory technology enhanced learning, the field of foresight and transformative pedagogy and their role in helping to develop greater learner creativity. These skills will be key to meeting the needs of the projected growing role of the creative class within the emerging global workforce structure and the projected growth in R&D and the advancement of human-machine resource management. Over the past two decades, we have traversed from the Industrial Age through the Information Age into what we now call postnormal times, manifested partly in Industry 4.0. It is widely considered that the present education system in countries with developed economies is not optimised for delivering the much-needed creative skills, which are prominent amongst the critical 21st C skills required by the creative class, (also known as creatives), which will be increasingly dominant in terms of near future employability. Consequently, there will be a potential shortfall of creatives unless this issue is rapidly addressed. To ensure that the creative skills I aimed to enhance were relevant and aligned with emerging demands of the changing landscape, I deconstructed the critical dimensions, context, and concept of creativity in postnormal times as well as undertaking in-depth research on the potential future workscape and the future of education and learning, applying a comprehensive foresight approach to the latter using a 2030-2040 horizon. Based upon the outcomes of these studies I designed an experimental integrative learning system that I have applied, researched, and evolved over the past 4 years with over 150 students at PhD and master’s level. The system is aimed at generating higher levels of creative engagement and development through a focus on increased immersion and creativity-inducing approaches. The system, which I call the Living Learning System, is based upon eight integrated elements, supported by course development pillars aimed at optimizing learner future skill competencies and levels of creativity for which I apply severalevaluation techniques and metrics. Accordingly, as the central hypothesis of this dissertation, I argue that by integrating the critical elements of the Living Learning System, such as emerging multisensory technology enhanced learning coupled with optimised transformative and experiential learning approaches, framed within the field of foresight, with its futures focus and decentralised thinking approaches, students increase their ability to be creative. This increased ability is based on the student attaining a richer level of personal ambience through deeper immersion generated through higher incidence of self-direction, constructivism-based blended pedagogy, futures literacy, and a balance of decentralised and systems-based thinking, as well as cognitive and social platforms aimed at optimizing learner creative achievement. This dissertation demonstrates how the application of the combined elements of the Living Learning System, with its futures focus and its ensuing transdisciplinary curricula and courses, can provide a clear path towards significantly increased learner creativity. The findings of the quantitative, questionnaire-based research set out in detail in Chapter 9, together with the performance and creativity evaluation models applied against the selected case studies of student projects substantiate the validity of the hypothesis that the application of the Living Learning System with its futures focus leads to increased creativity in line with the needs of the postnormal era.publishedVersio

    Proceedings of the 1st European conference on disability, virtual reality and associated technologies (ECDVRAT 1996)

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    The proceedings of the conferenc

    A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

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    Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

    Training Needs and Development of Online AT Training for Healthcare Professionals in UK and France

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    Background: Assistive Technology (AT) solutions for people with disabilities has become part of mainstream care provision. Despite advantages of AT on offer, abandonment and non-compliance are challenges for healthcare professionals (HCPs), introducing this technology to clients. Studies of abandonment reveal that 1/3 of all devices provided to service users end up stored unused. Key need is training to make informed decisions about AT tailored to individual needs and circumstances. In an online survey undertaken by the ADAPT project, HPCs identified AT training needs and barriers. Currently, a programme is being developed aimed at introducing AT concepts and enhancing practices to a wide range of HCPs. Method: Survey questions explored gaps, availability, qualifications and barriers to AT training in England and France. A series of consultation meetings with ADAPT partners took place. An advisory group consisting of longstanding AT users and their formal/informal carers and HCPs (occupational therapist, speech and language therapist, psychologist and biomedical engineer) contributed to the discussions on survey findings, development and evaluation of AT training for HCPs, key content areas and means of delivery. Key results: HCPs had no AT specific qualifications (UK 94.6%; FR 81.3%) nor in-service AT training (UK 65.1%; FR 66.4%). They either did not know of AT courses (UK 63.3%) or knew that none existed (FR 72.5%). Barriers to AT training were mainly local training (UK 62.7%, FR 50%) and funding (UK 62.7%, FR 55.7%). Some training priorities were clearer for French HCPs – overall knowledge of AT devices (82.1%, UK 45.8%), customization of AT (65.3%, UK 30.1%), assessing patient holistically (53.4%, UK 25.3%), educating patient/carers (56.5%, UK 28.3%) (p < 0.001). Variances may be due to differing country-specific HCP education approach. A third of both groups highlighted also abandonment, client follow-up, powered wheelchair training and prescribing AT. To bridge gaps in knowledge and identified training needs of HCPs, the online interactive training programme starts by introducing foundations of AT, including definitions, types/uses of AT, legislation/policies and AT in practice. More specialist units build and expand on specific areas, e.g. AT for mobility, communication, assessment and evidence-based practice. The biopsychosocial model of Health and World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework underpin development of content. ICF shifts focus from disability to health and functioning, in line with a social model of rehabilitation. E-learning comprises existing videos, AT textbook material and bespoke animated presentations. Selfassessment and evaluation of training are embedded and learners receive certificate of completion. Training was piloted to a group of HCPs trainees and postregistration HCPs who commented on relevance of AT content, clarity, accessibility of presentation, and usefulness. Users found training very useful, especially legislation/policies and AT literature. Conclusion: Overall, survey results suggest that both UK and French HCPs’ training on AT solutions is limited and highly variable. There is need for crosschannel AT professional competencies, availability of work-based training and funding support. Development of online, interactive training aims to increase professional confidence and competence in this area as well as the evidence base for AT

    A Literature Review of the Challenges Encountered in the Adoption of Assistive Technology (AT) and Training of Healthcare Professionals

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    Background: Long-term disabilities often result in loss of autonomy and social interaction. Accordingly, there is a demand for Assistive Technology (AT) devices to enable individuals to live independently for as long as possible. However, many people experience difficulties in obtaining and using AT. This paper presents findings from a narrative literature review undertaken as part of the development of AT training for healthcare professionals, one of the work areas of the ADAPT project (Assistive Devices for Empowering Disabled People through Robotic Technologies), funded by EU INTERREG France (Channel) England. The results of the review informed the design of a survey of healthcare professionals regarding their views and experiences of AT and the development of AT training. Method: The review sought to understand challenges encountered in the adoption and use of AT as well as how training of healthcare professionals in AT takes place. A narrative approach was adopted as the most appropriate way to synthesise published literature on this topic and describe its current state-of-art. Narrative reviews are considered an important educational tool in continuing professional development. An initial search was conducted via databases in the UK and France, including CINAHL, Academic Search Index, Social Sciences Citation Index, BDSP (Base de données en Santé Publique), Documentation EHESP/MSSH (Ecole des Hautes Etudes en Santé Publique/Maison des Sciences Sociales et Handicap), Cairn, Google Scholar and Pubmed. Inclusion criteria for the review included: covering issues relating to AT provision and training, English or French language, and published from 1990 onwards. Application of these criteria elicited 79 sources, including journal papers (48), reports (11), online sources (11), books (6) and conference papers (3). Sources were thematically analysed to draw out key themes. Key results: The majority of papers were from USA and Canada (27), then UK (20) and France (19). Others were from Europe (7), Australia (3), country unknown (2), and one joint UK/France publication. The main source of literature was journal papers (48), of which the most common types were practice reports (18), evaluation surveys (10) and qualitative studies (9). The review uncovered a number of key challenges related to the adoption of devices, including: difficulty defining AT across disciplines, lack of knowledge of healthcare professionals and users, obtrusiveness and stigmatisation AT users can experience when using devices, and shortfalls in communication amongst professional groups and between professionals and users. These issues can lead to abandonment of AT devices. Furthermore, substantial barriers to healthcare professionals exist, including inconsistent provision and quality of training, lack of evaluation of training, lack of resources and funding, shortage of qualified professionals to teach, and the increasingly rapid development of the technologies. Conclusion: Support, training and education for prescribers, distributors, users, and their carers is vital in the adoption and use of AT. Evidence indicates a need for comprehensive education in the AT field, as well as ongoing assessment, updates and evaluation which is embedded in programmes
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