Designing technology to promote mental health and wellbeing

PhD ThesisMental health and wellbeing are fundamental to our quality of life, enabling us to be resilient against everyday stresses, work productively, to have fulfilling relationships, and experience life as meaningful. While HCI research has recently begun to address important challenges in the treatment of mental illness, approaches to promote and protect mental wellbeing, as positive emotional, psychological and social health, have received far less attention. Besides, the design space for technology innovation for people with severe mental health problems and as hospital inpatients is largely under-explored. The research presented in this thesis investigates how technology can promote the mental health and wellbeing of a group of women, living in the medium secure services of a forensic hospital in the UK. These women present a difficult to treat group due to the complexity of their mental health problems, extremely challenging behaviours, and a mild-tomoderate Learning Disability. Following an Experience-centred Design (ECD) approach in this context, the thesis describes how I worked collaboratively with hospital staff to gain a rich understanding of the women, their treatment regime, and constraints of their secure care; my approach to sensitively engaging this vulnerable group of women into a co-creative process to personalise their technology, and to carefully build up a relationship with them; and how the design of the technology builds upon qualities of creativity, physicality and personal significance for promoting engagement in mental health and wellbeing enhancing activities. In response to the design context I introduce the concept of the Spheres of Wellbeing, a set of three artefacts designed to collectively offer opportunities for engagements that are stimulating, enjoyable and personally meaningful; contribute to the formation of a positive sense of self; assist in tolerating emotional distress; and help familiarise the women with therapeutic concepts of mindfulness. Furthermore, in presenting the findings of a real-world deployment and evaluative study of the Spheres, this thesis contributes to current discourse in HCI on how empathy can be enabled with vulnerable populations, and provides rich insights into the complexities and challenges of conducting design-led research within hospital settings.Microsoft Research through its PhD Scholarship Programme and was partly been funded by the RCUK Digital Economy Hub on Social Inclusion through the Digital Economy (SiDE)

Quantitative detection of _Potato virus Y_ in potato plants and aphids - Discussion of diverse applications in potato research

Every year potato growers worldwide complain about severe yield losses caused by _Potato virus Y_ (PVY). Therefore, PVY along with _Potato leafroll virus_ belongs to the most important potato viruses. There are three main strains of PVY: PVY^O^, PVY^N^ and PVY^C^. However, also recombinant forms exist such as PVY^N^Wilga and PVY^NTN^, both of which increase in importance due to their potential to displace the non-recombinant strains at a high percentage. They appear also in mixed infections. In recent years PCR and qPCR assays were developed to differentiate PVY isolates. In order to identify PVY isolates by PCR often large amplicons have to be generated which requires the input of expensive enzymes. On the other hand, qPCR assays until now do not allow the differentiation between PVY^N^Wilga and PVY^NTN^. 

For the discrimination between PVY^O^/PVY^N^Wilga and PVY^N^/PVY^NTN^ a qPCR assay was developed, which allows the differentiation and highly efficient quantification of both strains and recombinants, respectively. For this purpose dual-labeled hydrolysis probes tagged with different fluorophores were designed. The assay is suitable for many different applications, for example safety research on genetically modified (GM) potato plants. The goal of this research is to determine whether genetic modification causes changes in resistance to viruses. Two different GM cultivars were examined for signs of altered resistance to an infection with PVY in comparison to their near-isogenic lines and three reference cultivars. Reference cultivars are included to determine the baselines for resistance and thus to be able to decide if the changes could represent a biological risk. The plants to be investigated were mechanically inoculated with PVY^N^Wilga or PVY^NTN^ and analyzed by means of the developed assay after two weeks. The results of the experiment indicate that the differences in virus titer between the reference cultivars are higher than between the GM potatoes and their isogenic lines. Therefore, in our experiments the GM potato plants showed no alteration in PVY resistance to neither one of the tested strains.

Since _Myzus persicae_ is one of the most important vectors transmitting PVY, the developed assay will also be applied to the quantification of PVY particles in aphids. The displacement of PVY^O^ and PVY^N^ by PVY^N^Wilga and PVY^NTN^ may be due to a difference in efficiency of transmission by _M. persicae_. Therefore, the objective is to test whether more virus particles of the recombinant forms in comparison to the non-recombinant strains PVY^O^ and PVY^N^ bind in the stylets of _M. persicae_. 

A third possible application of the developed assay may be of interest in potato breeding. The exact quantification of PVY particles in plants allows the classification of resistance in potato plants. It is possible to estimate whether a resistance is extreme or not. Extreme resistance is characterized by the absence or presence of very low amounts of virus particles in plants several days after inoculation. When testing the plants for PVY infection by ELISA, often unspecific reactions occur which makes it difficult to differentiate between plants weakly infected and plants very weakly infected. An exact quantification of the PVY titer gives more certainty for the determination of the resistance type.

In conclusion, the developed assay is an efficient and low-cost method that allows the differentiation and quantification of PVY^O^/PVY^N^Wilga on the one hand and PVY^N^/PVY^NTN^ on the other hand with high throughput. The method can be utilized for a wide range of applications in potato research.
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Enabling self, intimacy and a sense of home in dementia

Design and digital technologies to support a sense of self and human relationships for people living with dementia are both urgently needed. We present an enquiry into design for dementia facilitated by a public art commission for an adult mental health unit in a hospital in the UK. The interactive art piece was informed by the notion of personhood in dementia that foregrounds the person's social being and interpersonal relationships as sites where self is maintained and constructed. How clients, clients' family members and staff used the piece is reported and insights related to the notions of home, intimacy, possessions and self are presented. The art piece served as window on both dementia and the institution leading to a number of insights and implications for design

On becoming a counselor: challenges and opportunities to support interpersonal skills training

Well-developed interpersonal skills are crucial for all social interactions. However, understanding how interpersonal skills are taught or learned, and how technology can play a part in this, is yet an under-researched area in CSCW and HCI research. To start addressing this gap, our research explores the learning processes of counselling students, for whom developing interpersonal skills forms a fundamental part of their university education. We followed an iterative process to gain an in-depth understanding of a specific counselling program in the UK, combining interviews and low-fidelity technology prompts. Overall, 26 participants comprising tutors, students and expert counsellors took part. Our findings first provide insights into the highly collaborative and social learning process of the students. We highlight the complexity of interpersonal reflection as a crucial process for developing counselling skills, and identify the challenges to learning that students face. Second, we build on this understanding to draw out empirically grounded design considerations around opportunities for technology innovation in this setting

On becoming a counselor: challenges and opportunities to support interpersonal skills training

Well-developed interpersonal skills are crucial for all social interactions. However, understanding how interpersonal skills are taught or learned, and how technology can play a part in this, is yet an under-researched area in CSCW and HCI research. To start addressing this gap, our research explores the learning processes of counselling students, for whom developing interpersonal skills forms a fundamental part of their university education. We followed an iterative process to gain an in-depth understanding of a specific counselling program in the UK, combining interviews and low-fidelity technology prompts. Overall, 26 participants comprising tutors, students and expert counsellors took part. Our findings first provide insights into the highly collaborative and social learning process of the students. We highlight the complexity of interpersonal reflection as a crucial process for developing counselling skills, and identify the challenges to learning that students face. Second, we build on this understanding to draw out empirically grounded design considerations around opportunities for technology innovation in this setting

Syrian Refugees and Digital Health in Lebanon

There are currently over 1.1 million Syrian refugees in need of healthcare services from an already overstretched Lebanese healthcare system. Access to antenatal care (ANC) services presents a particular challenge. We conducted focus groups with 59 refugees in rural Lebanon to identify contextual and cultural factors that can inform the design of digital technologies to support refugee ANC. Previously identified high utilization of smartphones by the refugee population offers a particular opportunity for using digital technology to support access to ANC as well as health advocacy. Our findings revealed a number of considerations that should be taken into account in the design of refugee ANC technologies, including: refugee health beliefs and experiences, literacy levels, refugee perceptions of negative attitudes of healthcare providers, and hierarchal and familial structures

Inclusive education technologies: emerging opportunities for people with visual impairments

Technology has become central to many activities of learning, ranging from its use in classroom education to work training, mastering a new hobby, or acquiring new skills of living. While digitally-enhanced learning tools can provide valuable access to information and personalised support, people with specific accessibility needs, such as low or no vision, can often be excluded from their use. This requires technology developers to build more inclusive designs and to offer learning experiences that can be shared by people with mixed-visual abilities. There is also scope to integrate DIY approaches and provide specialised teachers with the ability to design their own low cost educational tools, adapted to pedagogical objectives and to the variety of visual and cognitive abilities of their students. For researchers, this invites new challenges of how to best support technology adoption and its evaluation in often complex educational settings. This workshop seeks to bring together researchers and practitioners interested in accessibility and education to share best practices and lessons learnt for technology in this space; and to jointly discuss and develop future directions for the next generation design of inclusive and effective education technologies

Clinically abnormal case with paternally derived partial trisomy 8p23.3 to 8p12 including maternal isodisomy of 8p23.3: a case report

<p>Abstract</p> <p>Background</p> <p>Because of low copy repeats (LCRs) and common inversion polymorphisms, the human chromosome 8p is prone to a number of recurrent rearrangements. Each of these rearrangements is associated with several phenotypic features. We report on a patient with various clinical malformations and developmental delay in connection with an inverted duplication event, involving chromosome 8p.</p> <p>Methods</p> <p>Chromosome analysis, multicolor banding analysis (MCB), extensive fluorescence in situ hybridization (FISH) analysis and microsatellite analysis were performed.</p> <p>Results</p> <p>The karyotype was characterized in detail by multicolor banding (MCB), subtelomeric and centromere-near probes as 46,XY,dup(8)(pter->p23.3::p12->p23.3::p23.3->qter). Additionally, microsatellite analysis revealed the paternal origin of the duplication and gave hints for a mitotic recombination involving about 6 MB in 8p23.3.</p> <p>Conclusion</p> <p>A comprehensive analysis of the derivative chromosome 8 suggested a previously unreported mechanism of formation, which included an early mitotic aberration leading to maternal isodisomy, followed by an inverted duplication of the 8p12p23.3 region.</p

Developing technology to enhance learning interpersonal skills in counsellor education

The integration of new technologies into counsellor education has progressed slowly. We present mPath ; an online system designed to support iterative, multi-levelled and deep reflection on practice in skills training sessions. We propose the integration of new technologies to counsellor education as an area with scope for future research and development