An Interactive Tablecloth for Facilitating Discussion in a Culturally Diverse Group

Group discussions are a useful tool in a number of environments: from working towards a common goal in a business setting, to gathering feedback on an exhibit in a museum for example. One issue in such sessions is that some group members can talk more loudly and confidently than others, making some group members change their mind or keep quiet, this can result in interesting differences of opinion being lost. In this paper we present a tool for facilitating such group discussions. The tool is an interactive tablecloth that is controlled with tangible interfaces, and provides a method for each group member’s voice to be heard prior to discussion, thus preserving the diversity of responses. When tested after an immersive theatre performance, the tool effectively allowed each group member to answer questions individually prior to beginning group discussion. This also allowed the facilitator to effectively coordinate the discussion in an efficient manner

In the dark – designing navigation for a haptic theatre experience

We describe the ongoing work of a collaborative theatre project, in which blind and sighted members of an interdisciplinary team are working on the creation of an immersive and accessible theatre experience. The theatre experience is set in pitch dark, and uses audio and haptic ubiquitous technologies to guide both blind and sighted members of the audience. During two sessions which explored the use of enactive navigation in the dark space, participants were able to locate areas of interest within the dark, using enactive explorative navigation, and some participants described this as a ‘dense’ experience

Control and Being Controlled: Exploring the use of Technology in an Immersive Theatre Performance

Immersive theatre is a growing trend within theatre entertainment: audience members can now wander around performances and choose how the story unfolds in front of them. Technology can be used to create novel, multi-modal experiences for audiences in these performances; but when the rules of such an experience are ill-defined, how do users react to this technology? We present an evaluation of 25 performances of an immersive, in the dark performance. Issues of control can arise in situations where technology becomes an important part of such a performance. Participants take and relinquish control in three key areas: navigation, exploration and attention during the performance, and this affects their perception of both technology and the piece itself. We discuss how technology can play a positive role in immersive theatre and other cultural settings, yet its use must be carefully choreographed to ensure the audience experience matches the intended goal

First validation of the Haptic Sandwich: a shape changing handheld haptic navigation aid

This paper presents the Haptic Sandwich, a handheld robotic device that designed to provide pedestrian navigation instructions through a novel shape changing modality. The device resembles a cube with an articulated upper half that is able to rotate and translate (extend) relative to the bottom half, which is grounded in the user’s hand when the device is held. The poses assumed by the device simultaneously correspond to heading and proximity to a navigational target. The Haptic Sandwich provides an alternative to screen and/or audio based pedestrian navigation technologies for both visually impaired and sighted users. Unlike other robotic or haptic navigational solutions, the haptic sandwich is discrete in terms of form and sensory stimulus. Due to the novel and unexplored nature of shape changing interfaces, two user studies were undertaken to validate the concept and device. In the first experiment, stationary participants attempted to identify poses assumed by the device, which was hidden from view. In the second experiment, participants attempted to locate a sequence of invisible navigational targets while walking with the device. Of 1080 pose presentations to 10 individuals in experiment one, 80% were correctly identified and 17.5% had the minimal possible error. Multi-DOF errors accounted for only 1.1% of all answers. The role of simultaneous or independent actuator motion on final shape perception was tested with no significant performance difference. The rotation and extension DOF had significantly different perception accuracy. In the second experiment, participants demonstrated good navigational ability with the device after minimal training and were able to locate all presented targets. Mean motion efficiency of the participants was between 32%-56%. Participants made use of both DOF

Testing a Shape-Changing Haptic Navigation Device With Vision-Impaired and Sighted Audiences in an Immersive Theater Setting

Flatland was an immersive “in-the-wild” experimental theater and technology project, undertaken with the goal of developing systems that could assist “real-world” pedestrian navigation for both vision-impaired (VI) and sighted individuals, while also exploring inclusive and equivalent cultural experiences for VI and sighted audiences. A novel shape-changing handheld haptic navigation device, the “Animotus,” was developed. The device has the ability to modify its form in the user's grasp to communicate heading and proximity to navigational targets. Flatland provided a unique opportunity to comparatively study the use of novel navigation devices with a large group of individuals (79 sighted, 15 VI) who were primarily attending a theater production rather than an experimental study. In this paper, we present our findings on comparing the navigation performance (measured in terms of efficiency, average pace, and time facing targets) and opinions of VI and sighted users of the Animotus as they negotiated the 112 m2 production environment. Differences in navigation performance were nonsignificant across VI and sighted individuals and a similar range of opinions on device function and engagement spanned both groups. We believe more structured device familiarization, particularly for VI users, could improve performance and incorrect technology expectations (such as obstacle avoidance capability), which influenced overall opinion. This paper is intended to aid the development of future inclusive technologies and cultural experiences

Haptic Reassurance in the Pitch Black for an Immersive Theatre Experience

An immersive theatre experience was designed to raise awareness and question perceptions of ‘blindness’, through enabling both sighted and blind members to experience a similar reality. A multimodal experience was created, comprising ambient sounds and narratives – heard through headphones – and an assortment of themed tactile objects, intended to be felt. In addition, audience members were each provided with a novel haptic device that was designed to enhance their discovery of a pitch-black space. An in the wild study of the cultural experience showed how blind and sighted audience members had different ‘felt’ experiences, but that neither was a lesser one. Furthermore, the haptic device was found to encourage enactive exploration and provide reassurance of the environment for both sighted and blind people, rather than acting simply as a navigation guide. We discuss the potential of using haptic feedback to create cultural experiences for both blind and sighted people; rethinking current utilitarian framing of it as assistive technology

Subjective experience and meaning of delusions in psychosis : a systematic review and qualitative evidence synthesis

BACKGROUND: Delusions are a common transdiagnostic feature of psychotic disorders, and their treatment remains suboptimal. Despite the pressing need to better understand the nature, meaning, and course of these symptoms, research into the lived experience of delusional phenomena in psychosis is scarce. Thus, we aimed to explore the lived experience and subjective apprehension of delusions in help-seeking individuals with psychosis, regardless of diagnosis and thematic content of the delusion. METHODS: In our systematic review and qualitative evidence synthesis, we searched MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science for qualitative studies published in English from database inception, with the last search on Sept 9, 2021. Grey literature search and hand-searching of relevant journals were also done. Studies were eligible if they provided an analysis of lived experience of delusions or predelusional phenomena presented from the perspective of individuals (age 14-65 years) who had developed a clinical high-risk stage of psychosis, or a diagnosable affective or non-affective psychotic disorder (as clinically defined, self-reported, or assessed within the primary study). Studies with only a subset of relevant participants were eligible only if data for the population of interest were reported separately. Studies that did not discriminate between the experience of delusion and other positive symptoms (eg, hallucinations) were included only if data for delusions were reported separately or could be extracted. First-person accounts (and author interpretations) discussing changes in the sense of self, lived world, and meaning in relation to delusions were extracted and synthesised using a novel thematic synthesis approach informed by a critical realist stance and a phenomenological theoretical framework. Analytic themes were developed into a new overarching framework for understanding the emergence of delusional phenomena. The study was registered with PROSPERO, CRD42020222104. FINDINGS: Of the 3265 records screened, 2115 were identified after duplicate removal. Of these, 1982 were excluded after title and abstract screening and 106 after full-text eligibility assessment. Of the 27 studies entering quality assessment, 24 eligible studies were included in the qualitative evidence synthesis, representing the perspectives of 373 help-seeking individuals with lived experience of delusions in the context of psychosis. Gender was reported as male (n=210), female (n=110), transgender (n=1), or not reported (n=52). Only 13 studies reported ethnicity, with White being predominant. The age of most participants ranged from 15 to 65 years. We found no eligible studies investigating subclinical or predelusional experiences in at-risk mental state populations through qualitative methods. Most studies were undertaken in western, educated, industrialised, rich, and democratic (WEIRD) societies, and most included participants had received or self-reported a diagnosis within the schizophrenia spectrum. Studies differed in relation to whether they focused on one kind or theme of delusion or delusional phenomena more generally as a unified category. Three superordinate themes relating to experiential changes and meanings in delusion were identified: (1) a radical rearrangement of the lived world dominated by intense emotions; (2) doubting, losing, and finding oneself again within delusional realities; and (3) searching for meaning, belonging, and coherence beyond mere dysfunction. Based on the review findings and thematic synthesis, we propose the Emergence Model of Delusion to advance understanding of delusional phenomena in psychosis. INTERPRETATION: Delusions are best understood as strongly individualised and inherently complex phenomena emerging from a dynamic interplay between interdependent subpersonal, personal, interpersonal, and sociocultural processes. Integrative approaches to research on delusion, which consider their potential adaptiveness and favour explanatory pluralism, might be advantageous. Effective clinical care for individuals with psychosis might need adapting to match more closely, and take account of, the subjective experience and meaning of delusions as they are lived through, which might also help redress power imbalances and enduring epistemic injustices in mental health. FUNDING: Priestley Scholars, Wellcome Trust

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention