Augmented Reality in Healthcare - Interactive Media Institute · the Interactive Media Institute,...

Issue 1 / 2012

Augmented Reality in Healthcare

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T h e O f f i c i a l V o i c e o f i A C T o R

ISSN 2031 - 278

COVER STORY:

FEATURES:Interactive Augmented Reality ExposureTreatment

p 16

Augmented Reality Handhelds andMobile Devices

p 23

Visual Augmentation for the Blindp 24

ASK THE EXPERT:Ashfaq Ishaq

p 31

COUNTRY FOCUS:The Netherlands

p 40

Visually Realistic - Comfortable - Easy to UseDurable - Reusable - Tactilely Realistic

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• Cricothyrotomy Skills Trainer • Needle Decompression Skills Trainer • Bleeding Wound Skills Trainer • Amputation Skills Trainer • Burn Wound Skills Trainer • Odor Wound Skills Trainer

Merging latest special effects technology with medical and material sciences research to replace live tissue and training.

Physiologically based research and development program focused on providing enhanced training capabilities for medical professionals to include:

• Basic Life Support • Patient Assessment • Hemorrhage Control • Fracture Management • Shock Prevention & Treatment

Cricothyrotomy Skills Trainer

Needle Decompression Skills Trainer

Bleeding Wound Skills Trainer

Visually Realistic - Comfortable - Easy to Use

Severe Amputation Skills Trainer

Severe Amputation Odor Simulation Wound Kit

Simulated Burn Wound Package

Visually Realistic - Comfortable - Easy to UseVisually Realistic - Comfortable - Easy to Use

FOR MORE INFORMATION, CONTACT:Mark D. Wiederhold, M.D., Ph.D. FACP

The Virtual Reality Medical Center858.642.0267 [email protected]

www.vrphobia.com

1

Letter from the Secretary General and Editor-in-ChiefProfessor Dr. Brenda K. Wiederhold

Dear Reader,

Augmented reality (AR) allows interactivity of bothVirtual Reality and real-world elements. Some userswear special glasses that allow them to see the worldas it is, as well as computer-generated objects thatappear as display supplements to the real-world el-ements, as in the augmented optics or endoscopesin AR-assisted surgery. Other users may be in a spe-cially designed room featuring image projectionson objects, as in a factory in which assembly in-structions are superimposed on component parts.Still others may use GPS-tracked smartphones withcameras as the input device, such as to take virtu-al tours of buildings, with information about officespace for rent in them available in real time as theperson arrives at that location.

But with so much information coming at us thesedays, what is the real benefit of AR? If texting whiledriving is such a distrac-tion that it is banned inmany U.S. states, willdrivers using AR systemsdesigned to improvesafety experience dis-tractions that will causethe accidents they aredesigned to prevent? Oris AR better used for en-tertainment, as shop-pers use a smartphone app of a virtual pop-up storein different locations to “try on” different outfitsand post them to Facebook?

While AR applications were developed as early asthe 1960s, the cost of systems and the expertiseneeded to use them has limited their adoption inthe past. Now, thanks to the ubiquitous smartphone,developers have a low cost of entry for this type ofAR. Thanks to social networking, crowd-sourced con-

tent posted to “the cloud” creates large databasesthat developers can call upon to populate the fieldsin their applications. And thanks to the pervasive-ness of computing in modern life, smartphone usershave come to expect the ability to move about inthe real world and simultaneously view an informa-tion overlay that seamlessly integrates data from anumber of sources.

Among the first applications to show benefit werethose in medicine. A recent review concluded that,“After two decades of research on medical AR thebasic concepts seem to be well understood and theenabling technologies are now enough advancedto meet the basic requirements for a number ofmedical applications … A perfect medical AR userinterface would be integrated in such a way thatthe user would not feel its existence, while takingfull advantage of additional in situ information itprovides … The AR window and video-see-through

HMD systems still need hardware and software im-provement in order to satisfy the requirements ofoperating physicians … medical AR will be one ofits first killer applications, saving lives of many fu-ture patients.”

While medical uses of AR may set the highest barfor development, related uses are coming online.For example, for medical training, for which VR haslong been used, the advantage of AR over VR sys-

“While AR applications were developed as early as the 1960s, thecost of systems and the expertise needed to use them has limitedtheir adoption in the past. Now, thanks to the ubiquitous smart-phone, developers have a low cost of entry for this type of AR.”

“While medical uses of AR may set the highest bar fordevelopment, related uses are coming online. For ex-ample, for medical training, for which VR has longbeen used, the advantage of AR over VR systems isthat they offer realistic haptic feedback while provid-ing objective assessment of skill.”

tems is that they offer realistic haptic feedbackwhile providing objective assessment of skill.

In addition to helping adult learners such asphysicians, AR may also be used to help childrento learn. A recent study used AR in combination

with three types of physical exercise to enhancenon-memorized learning, and showed that phys-ical exercise did not detract from ability to com-plete cognitive tasks. In addition, the authors ofa review of AR-assisted learning concluded, “Thestudents we work with are already using their cellphones seamlessly to communicate and share in-formation with their peers throughout the day.The findings from this study emphasize how en-gaged students become simply by using similartools to learn.”

AR may also be used for different types of ther-apy. “TheraMem is a novel system which com-bines Augmented Reality, a simple computergame, and spatial-visual decoupling of the user’shands for use in post-stroke rehabilitation. Thesystem is considered to be mature and usable inthe early stages of stroke recovery.” Another sys-tem still in development uses AR to help patientsconquer fear of spiders and cockroaches, using acamera to put the patient in a real location andrealistic sounds such as a spray can of insecticideor a squishing sound when a pest is killed.

Tracking an individual’s whereabouts opens thedoor for many uses of AR. For example, a muse-um education system uses a markerless pose es-timation algorithm to guide a tourist to super-impose a displayed AR painting, with informationthat enhances the tourist’s understanding of the

creative process, on the cor-responding real-world paint-ing. In the homes of peoplewho have set up a homecomputer network, a programfor the Android platformcould track the WiFi signal ofan individual’s smartphoneto determine her location inthe home. Outdoor trackingis more of a challenge, sinceGPS does not have the preci-

sion and refresh rate required, but researchersare working on methods such as multi-sensor fu-sion that integrates inertial and vision trackingto meet those requirements. A combination ofboth indoor and outdoor AR tracking with coor-dinated alerts could help return wanderingAlzheimer’s patients safely to their homes.

So it seems that while entertainment is one pos-sible use, AR is certainly not limited to that do-main, but can help us stay healthy and improveoutcomes when we need surgery. And what aboutthat question about distraction while driving?Even that is being addressed: New tracking algo-rithms that help car systems estimate the headpose of a driver will enable systems to infer thedriver’s focus of attention, triggering alerts andsaving lives.

Letter from the Secretary General (continued from page 1)

“A recent review concluded that, “… A perfectmedical AR user interface would be integrat-ed in such a way that the user would not feelits existence, while taking full advantage ofadditional in situ information it provides …medical AR will be one of its first killer appli-cations, saving lives of many future patients.”

Create your own reality!Brenda Wiederhold

2

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Professor Mark D. Wiederhold, M.D.,Ph.D., FACPVirtual Reality Medical CenterUSA

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C&R Editorial BoardGENERAL INFORMATION

CyberTherapy & Rehabilitation MagazineISSN: 2031-278GTIN-13 (EAN): 9771784993017

CyberTherapy & Rehabilitation Magazine is published quar-terly by the Virtual Reality Medical Institute (VRMI), 30 ClosChapelle aux Champs, Bte. 3030, 1200 Brussels, Belgium andthe Interactive Media Institute, 9565 Waples Street, Suite 200,San Diego, CA 92121, U.S.A. The magazine explores the usesof advanced technologies for therapy, training, education,prevention, and rehabilitation. Areas of interest include,but are not limited to, psychiatry, psychology, physicalmedicine and rehabilitation, neurology, occupational ther-apy, physical therapy, cognitive rehabilitation, neuroreha-bilitation, oncology, obesity, eating disorders, and autism,among many others.

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LETTER FROM THE EDITOR-IN-CHIEFB.K. Wiederhold p 1

COVER STORYOverview on Augmented RealityM.D. Wiederhold, B.K. Wiederhold p 10

FEATURESInteractive Augmented Reality ExposureTreatmentA. Dünser p 16

Manipulative Augmented Virtuality�forModulating Human Perception and ActionA. Pusch, F. Steinicke p 20

Augmented Reality Handhelds and MobileDevicesA. Ines p 23

Visual Augmentation for the BlindP. Degenaar p 24

PRODUCT COMPARISON CHARTAugmented Reality p 26

Clinical Skills Learning With Touch Technology M.J. Cox, J.P. San Diego, B. Quinn p 28

ASK THE EXPERTA. Ishaq p 31

FROM WHERE WE SITH. Kaufmann p 35

ACROSS THE PONDB.D. Wassom p 36

FURTHER AFIELDL. Kong p 37

COUNTRY FOCUSThe NetherlandsC. Loranger p 40

TABLE OF CONTENTS

7

Manipulative AugmentedVirtuality

Mixed reality display and tracking technologieshave begun to spread into the mass marketand have a great potential to be applied to var-ious healthcare applications. Research hasshown promising leads in the potential of ap-plying manipulative augmented virtuality forindividuals who have trouble walking . Thesedevelopments could lead to enormous poten-tial for rehabilitation, diagnosis and treatmentof various disorders.

Augmented Reality for ExposureTherapy

By overlaying virtual content on the realworld, Augmented Reality has great potentialfor exposure treatment. By interacting with arepresentation of a specific stimulus, such asspiders, the therapist is easily able to controlthe level of exposure experienced by thepatient, leading to reduced levels of anxiety.The virtual stimulus not only appears to bemoving in the real world, but also reacts andadapts to the a client’s presence and actions,making therapy even more effective.

International Association of CyberPsychology, Training & Rehabilitation (iACToR)

Conference Participation Report

8

At the 19th Annual Medicine Meets VirtualReality Conference (MMVR19) held on Feb-ruary 9-11, 2012 in Newport Beach, Califor-nia more than 300 participants from 20countries presented and assessed ground-breaking developments in simulation, mod-eling, imaging, robotics and other emergingtools for patient care and medical educa-tion. Conference organizer Aligned Manage-ment Associates, Inc. (AMA) have organizedthe 3-day conference since 1992 to focus onimproved precision, efficiency, and outcomesin patient care, practitioner training, andpublic health. This year, AMA invited physi-cians, surgeons and other medical profes-sionals interested in emerging tools for di-agnosis and therapy to attend and presenttheir research.

In addition, included in MMVR19’s scientif-ic program was an opportunity for attendeesto discuss their Virtual Reality (VR) modali-ties in medicine, mental health, rehabilita-tion, robotics, engineering, biomedicine andeducation. Many mental health providersmet to share their efforts using VR and ad-vanced technological approaches in clinicaland research settings.

Members of INTERSTRESS (Interreality in theManagement and Treatment of Stress-Relat-ed Disorders) and the International Associa-tion of CyberPsychology, Training & Rehabil-itation (iACToR), as well as board membersfrom C&R and the Journal of CyberTherapy& Rehabilitation, were in attendance duringconference proceedings, and enriched themeeting with their contributions and pre-sentations on their current lines of research.

A notable presentation was given during thePhysical & Mental Health Application sym-posium which included a presentation fromiACToR’s President Giuseppe Riva on “TheEffects of a Mobile Stress Management Pro-

tocol on Nurses Working withCancer Patients: A ControlledStudy.” Regarding his presenta-tion, Riva said, “Oncology nurs-es face extraordinary stresses thatmay lead to emotional exhaus-tion, a feeling of emotional dis-tance from patient and burnout.This presentation … [demon-strates] a significant improve-ment in affective change interms of anxiety trait reductionand coping skills acquisition atthe end of the protocol.”

A spokesperson from AMA, Inc.remarked at the conclusion of theconference, “Our thanks to every-one who participated inMMVR19/NextMed! The confer-ence was definitely a success. We receivednumerous compliments on the program, itsrelevance, focus, and engaging diversity. Weextend particular gratitude to all who sharedtheir research to make the program valuable.”

For more information on Allied Manage-ment Associates, Inc. or on future MedicineMeets Virtual Reality Conferences please vis-it http://www.amainc.com/

4

Medicine Meets Virtual Reality (MMVR) 19 February 9-11, 2012

Newport Beach, California

Figures: Attendees at the con-ference were able to interactwith a wide range of exhibits.

International Association of CyberPsychology, Training & Rehabilitation (iACToR)

Conference Participation Report

Augmented Reality, in some ways seemingly bigger-than-life, combines digi-tal information with a view of the real world in a way that best suits the userto augment the view of their surroundings. Used by pilots in the militaryand investigated by researchers since the 1990s, it is now becoming morewidely used and explored in the medical arena.

10

Augmented Reality:What is it and How is it EnhancingHealthcare Today?

By Mark D. Wiederhold & Brenda K. Wiederhold

While Virtual Reality (VR) has been a moreestablished field of research for sometime, Augmented Reality (AR) is a slight-ly newer field of research whose popular-ity, rate of use, and applicability to vari-ous uses has literally exploded with theincreased usage of smartphones aroundthe world. While readers are likely famil-iar with the term “apps” – applicationsdownloaded to enhance the usability ofa smartphone – the interpretation of ARmay not be so clear cut. Questions in-clude: What is AR? What does it encom-pass? And what are its applications?

What is Augmented Reality?

While VR aims to immerse the user in apurely virtual world, AR attempts to bringvirtual elements to the real world. It is bestdescribed as an “AR Continuum” in whichthe real and virtual environments areplaced at opposite ends with AR and aug-mented virtuality (AV) towards the middle.

AR can be defined as “the art of super-imposing of computer generated contentover a live view of the world” accordingto Dan Sung, a Pocket Lint blogger whowrites on the subject. The viewer’s real-

time view of either the real, surroundingenvironment or streaming video is fusedwith digital information. The paramountadvantage of AR over VR is that it createsan altered or augmented reality withoutlosing the benefits of the physical setting– touch, smell, hearing, taste, and visualcontact with other people.

How does it Work?

Combining real and digital elements canbe done in one of three ways: using aHead-Mounted Display (HMD), placing

the visual information close in front ofthe user’s point of view; using handhelddevices, most commonly smartphonesand tablets; and computer-generatedoverlay that is placed directly on real ob-jects using projects or devices known asSpatial Displays. Each method has distinctadvantages and disadvantages.

While HMDs have been thoroughly re-searched and developed, leave the user’shands free and the entire visual field isaugmented, the hardware can be distract-ing, bulky, and expensive. Handhelds are

COVER STORY

T h e O f f i c i a l V o i c e o f t h e I n t e r n a t i o n a l A s s o c i a t i o n o f C y b e r P s y c h o l o g y , T r a i n i n g & R e h a b i l i t a t i o n

“Although enhanced visualization is mostcommonly brought to mind when discussingAR, it is important to remember AR can hypo-thetically be used to enhance any of the sens-es, for example, with haptics feedback to alterthe sense of touch. Still, the field of augment-ed vision is currently experiencing the mostgrowth and potential for applications in vari-ous fields.”

convenient, cheap and commonly carriedby the majority of users, yet require theuser to give up the use of a hand and thefield of view is limited and framed. View-ing Spatial Displays means more than oneuser is exposed to the same picture andparticipants don’t need to hold or wear any-thing, but the projections only work withspecifically designed environments andagain, set-up costs and specialized hard-ware can be costly and daunting.

Although enhanced visualization is mostcommonly brought to mind when dis-cussing AR, it is important to rememberAR can hypothetically be used to enhanceany of the senses, for example, with hap-tics feedback to alter the sense of touch.Still, the field of augmented vision is cur-

rently experiencing the most growth andpotential for applications in various fields.

Augmented Reality In Medicine

Austrian mathematician Steinhaus first de-scribed an augmented system to visualizea piece of metal embedded within tissuein 1938 when medical practitioners beganenvisioning ways in which real-time x-rayvision would make it possible to visualizepatient data within the same space as thepatient. In 1968 Ivan Sutherland describedthe first HMD and in the ‘90s research intomedical applications of AR began inearnest.

Essentially, the clinical applications of ARin medicine are made up of two types ofsystems. As Dr. Andreas Pusch states, “Onthe one hand, there are systems in whichsynthetic multimodal head-up information

is overlaid on tracked real objects (e.g., pa-tient history and rehabilitation progressdata, or specific information attached tocertain body parts) while on the otherhand, others permit direct guidance andtraining of surgeons and therapists bymeans of interactive co-located real-timesimulations (e.g., visuo-haptic remote nav-igation of inspection or surgery equipment,annotations of regions to operate on, 2-D/3-D visualizations of hidden organs andstructures).” For an in-depth look at Pusch’sfull article, see page 20.

Graphics can be overlaid on patients’ bod-ies to identify organ placement, internaltissues, veins and arteries, and aid in theplacement of stents and catheters, for ex-ample. The widespread use of smartphones

has made the devices an informal tool inthe clinic; practitioners can now positionan iPhone over an ankle joint to readilyview internal angles of bones and ligamentsusing a specialized app.

Not all applications of AR in medicine areaimed at care providers; the growth in appshas made smartphone users able to easilyand cheaply educate themselves on med-ical topics and terminology.

Early in its development, researchers sawthe potential for this technology to supple-ment healthcare. In order to be a widelyused tool, however, it needs to be “scalable,”that is, deliverable within the constraintsthat exist outside the lab. This is wheresmart phones are quickly bridging the gap.Quick Response (QR) codes and Near FieldCommunication (NFC) are two similar waysof allowing smart phones to interact with

the real world. Like bar codes but able tocontain much more information, QR codesare made up of black modules in a squarepattern on a white background which canbe printed on posters, newspaper adver-tisements, tickets, etc.

Pointing a camera phone enabled with ascanning app at a QR code can bring upmany different kinds of data includingcoupons, videos, and Websites that openin the phone’s browser. NFC, on the otherhand, lets smart phones and similar devicesestablish radio communication with eachother by touching them together or mere-ly bringing them close to each other. Com-munication can also be designated be-tween an NFC device and an unpoweredNFC chip, called a “tag.” Contactless pay-ment systems (“virtual wallets”) have at-tracted the most interest in the area ofNFC. However, most smart phones are notyet NFC enabled.

Limitations

While it is doubtless that AR enhances theworld of medical research and treatment,there is still room for vast improvements.Ideally, AR will be seamlessly integrated intothe real world – free of distractions and al-most imperceptible to the user.

Still, a concern voiced by medical expertsis that this focus on technology may drawattention away from important cues thatare present in the natural environment,leading to an over reliance on enhanced vi-sualization and actually increasing the num-bers of errors occurring during surgicalplanning and treatment.

Advantages and Future Research

While the growth of VR in the medical are-na has been stunted due to the high costsof equipment, as well as clunky, cumber-some HMDs, one of the appeals of AR, par-ticularly when coupled with a smartphone,is the ease-of-use, low cost and immediateaccessibility to the needed software. Theseadvantages will further speed its inceptioninto everyday clinical practices.

Before VR and AR see widespread use forhealthcare management, though, certain

11

COVER STORY


“A concern voiced by medical experts is that thisfocus on technology may draw attention awayfrom important cues that are present in the nat-ural environment, leading to an over relianceon enhanced visualization and actually increas-ing the numbers of errors occurring during sur-gical planning and treatment.”

FEATURES

legal and regulatory issues will need to beaddressed. Privacy of medical informationis probably the biggest concern of poten-tial end users. Telemedicine raises ques-tions about how to regulate medical treat-ment across state boundaries, includinglicensure and malpractice issues. Despite these issues, the benefits of VRand AR for healthcare management haveenormous potential, including improvedtraining, better access to services, and in-creased cost-effectiveness and accuracy inperforming certain procedures. Healthcareorganizations and providers will requireproof of these improvements before adopt-ing these technologies. But, ultimately, thecontinual improvement of VR and AR tech-

nology will pave the way for its permanentintegration into surgery, healthcare deliv-ery, and medical education.

AR technology is still a young field withlimitless room to grow and incorporate en-hancements. As it improves and becomesmore widely adopted, the clinical applica-tions will continue to multiply.

While AR has not yet broken through tobe used in everyday technology, the new-ly released Google Glasses are paving theway for mass adoption and implementa-tion of AR. The product is creating wavesin the scientific community and publicconsumer base alike. Looking to the future

of AR, one thing is sure: the world of med-icine will never be the same.

[ ]Mark D. Wiederhold, M.D.,Ph.D., FACPVirtual Reality Medical CenterSan Diego, [email protected]

Brenda K. Wiederhold, Ph.D.,MBA, BCIAVirtual Reality Medical InstituteBrussels, [email protected]

www.vrphobia.eu

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among scientists, engineers, physicians, therapists,

educators, and students. Its outcome is tangibleprogress in clinical care, provider training, and

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Next February’s conference will feature a special half-

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Decades’ Accomplishments and Future Directions,”organized by Professors Brenda Wiederhold, Mark

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Researchers are invited to participate in NextMed /

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Augmented Reality (AR), a technology thatoverlays virtual content on the real world,has great potential for exposure treatmentand in some cases may be more efficientand cost effective than Virtual Reality (VR).An environment that combines real andvirtual elements seems to be especiallysuitable for such treatment because it en-ables displaying virtual fear stimuli in thereal world.

Another benefit of using an AR system inexposure treatment is that it allows pa-tients to use their own body to interactwith the stimuli. However, this type of in-teractivity has so far not been fully imple-mented in AR-based exposure therapy sys-tems. Still, studies have found that thesesystems are capable of inducing high lev-els of anxiety which is a necessary prereq-uisite for such a system to be effective.Considering that a virtual stimulus couldnot just move in the real word but alsoreact and adapt to the client’s presenceor actions (e.g., gestures) might make iteven more effective for therapy.

We are developing an advanced interac-tive AR exposure therapy system that pro-vides a high quality experimental test-bed

and allows us to study the potential of us-ing non-disruptive and interactive AR asa tool for exposure therapy. The noveltyof our system lies in better integratingthe real environment and the user intothe system, using user actions/behavioras a control input to the system and cre-ating a naturalistic environment. Our de-velopment is guided by the following as-pects:

• Stable low cost hardware setup with offthe shelf components

• Natural environment: Creation of a lessdisruptive and more “life-like” environ-ment with using advanced tracking tech-nology

• Environment recognition: Having virtu-al stimuli interact with the real environ-

ment and the client’s actions to furtherenhance interactivity and realism

Our first system integrated most of theseaspects. This system allowed users to seeand interact with virtual stimuli in a nat-uralistic environment. Using planar Nat-ural Feature Tracking allowed us to dis-play virtual stimuli on any sufficientlytextured surface of the environment with-out the need for additional visual mark-ers or tags. Interaction was supportedthrough hand interaction above this sur-face, using a vision-based hand trackingalgorithm and a basic gesture recognitiontechnique.

However, the vision-based approach fortracking the user’s hand had some limi-tations. Therefore, we integrated the Mi-crosoft Kinect into our AR system. The

16

Augmented RealityExposure Treatment

Interactive

“We are creating a new type of highly interactive augmentedreality-based exposure therapy system to treat specific phobias.Extending on previous work, we focus on creating a visuallynaturalistic therapy context. We aim at developing a very life-like system that allows patients to interact with virtual stimuli.”

FEATURES


By Andreas Dünser

Using this information, we can make the virtualstimuli ‘react’ to the real environment and thereforecreate an even more realistic therapy environment.A virtual spider now can walk up, around, or behindreal objects, and better react to user actions.”

“

setup in Figure 1 shows a basic setup us-ing the Kinect’s camera image for track-

ing. However, the system can also be set-up using an additional Head MountedDisplay with attached camera providinga more immersive direct view to the pa-tient.

Using the depth information provided bythe Kinect enables us to get better andmore accurate hand tracking results. Fur-thermore, we get a more accurate mod-

el of the user’senvironment. Us-ing this informa-tion we can makethe virtual stim-uli “react” to thereal environmentand therefore cre-ate an even morerealistic therapy

environment. A virtual spider can nowwalk up, around, or behind real objects,and better react to user actions. For ex-ample (depending on the therapy stage

and goals), a virtual fear stimulus canshow approaching behavior to a patient’shand, avoidance behavior, react to move-ments, be (partially) occluded by the pa-tient, or even sit on the patient’s handsand follow their movements (see Figure2). These elements create a more immer-sive and believable experience for the pa-tient.

Future evaluation studies will focus oninvestigating the benefits of creating amore realistic AR-based exposure treat-ment environment and the effectivenessof such advanced interactivity.

17

[ ]Andreas Dünser, Ph.D.The HIT Lab NZUniversity of CanterburyNew Zealand

[email protected]

FEATURES

o f C y b e r P s y c h o l o g y , T r a i n i n g & R e h a b i l i t a t i o n

Figure 1: AR system setup with the Kinect.

Figure 2: Different ways of interactingwith virtual spiders.

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Mixed Reality (MR) display and track-ing technologies, as well as associat-ed interaction techniques, evolved rap-idly. Recently, they have begun tospread into the mass market and nowenable a variety of promising health-care applications, some of which arealready being applied in medical prac-tice.

The current streams in healthcare canbe summarized as follows:

On the one hand, there are systems inwhich synthetic multimodal head-upinformation is overlaid on tracked realobjects (e.g., patient history and reha-bilitation progress data, or specific in-formation attached to certain bodyparts) while others permit direct guid-ance and training of surgeons and ther-apists by means of interactive co-locat-ed real-time simulations (e.g.,visuo-haptic remote navigation of in-spection or surgery equipment, anno-tations of regions to operate on, 2-D/3-D visualizations of hidden organs and

structures). In the context of mentaland motor disorder treatment, patientsare presented with highly controllableMR stimuli (e.g., protocols for cogni-tive and sensorimotor function assess-ment, [self-]perceptual illusions, andphobic or otherwise mentally or emo-tionally stressing situations) whose re-

20

Manipulative AugmentedVirtuality� for ModulatingHuman Perception and Action“Recently, Mixed Reality display and tracking technologies havebegun to spread into the mass market and now enable a variety ofpromising healthcare applications ... Our research focuses on staticand dynamic manipulations of a user's perception and action dur-ing body and limb movement, locomotion, as well as during interac-tion with multimodal virtual and augmented real environments.”

FEATURES

T h e O f f i c i a l V o i c e o f t h e I n t e r n a t i o n a l A s s o c i a t i o n

By Andreas Pusch &Frank Steinicke

Figure 1a: Hand shift during virtualforce field interaction produces

active haptic illusion.

Figure 1b: Visual object penetrationprevention conveying realistic virtualshape cues.

sponses are monitored and evaluated.

Our research focuses on static and dy-namic manipulations of a user's per-ception and action during body andlimb movement, locomotion, as wellas during interaction with multimodalvirtual and augmented real environ-ments. Within Milgram's reality-virtu-ality continuum, it is "Augmented Vir-tuality" (AV) that fits our methodologybest, because we bring the real to thevirtual rather than the other wayaround (the latter being called Aug-mented Reality, AR). That is, we seekto transfer the user's body to the vir-tual world – and there gain full con-

trol over its multimodal manifestation.

In 2011, we have presented a systemthat is capable of introducing visuo-proprioceptive conflicts at the handand lower arm levels in a very flexibleway. Video of a user's limbs is first cap-tured using stereo cameras built intoa head-mounted display (HMD) andthen embedded into a purely virtualworld.

This self-representation can be shift-ed in 3-D and, though not reported sofar, be scaled in place and shaded dif-ferently while interacting with virtualobjects or avatars. As shown in Figures1, the system proved useful for self-per-ception studies and the evocation ofhaptic illusions. But it can do more:Unconscious hand movement guid-ance and error correction in people

with limited manual abilities; enablestudies on static and dynamic multi-sensory conflict processing in healthy

and neurologically im-paired subjects; offer aframework for the in-vestigation and treat-ment of phobic behav-ior involving a subject’sown hands (e.g., Chirap-tophobia, Ablutomaniaand -phobia); simulatedynamic prism glasses;and develop better ac-cessible or assistive userinterfaces (UI). A moresophisticated system of-fering full control overall parameters of the

perceived “self ” is what we are nowabout to conceive.

Manipulative AV approaches can alsobe applied during locomotion. Inhealthy people, while walking in thereal world, sensory information fromthe vestibular, proprioceptive and vi-sual systems, as well as efferent copysignals, produce consistent multisen-sory cues. But various impairmentsranging from lower level perceptual tocognitive, can make it very difficult tomaintain orientation and explore theworld by walking naturally . It has beendemonstrated that users tend to un-wittingly compensate for small percep-tual inconsistencies. For instance, ma-nipulations applied to the view in anAV environment cause users to un-knowingly compensate by reposition-ing and/or reorienting themselves.

Since 2008, we have performed a se-ries of experiments in which we ana-lyzed how much users can be guidedon a different path in the real worldin comparison to the perceived pathcovered in the AV environment. In thiscontext (see Figure 2) we found thatan AV self-representation of the user,that is, a visual high-fidelity video-based blending, further improves thesense of presence during walking.Hence, Redirected Walking techniquesprovide an enormous potential for thediagnosis and treatment/rehabilitationof disorders affecting, for instance, theacquisition and maintenance of spa-tial maps, the production of locomo-tor commands, actual walking, and abroad diversity of related everyday cog-nitive activities.

In conclusion, we believe that the prin-ciples of MR have the potential to sus-tainably stimulate fruitful multidisci-plinary research and to contribute toan even faster growth of innovative,future-oriented healthcare applica-tions. We look forward to being a partof this endeavor.

21

“There are systems in which syn-thetic multimodal head-up infor-mation is overlaid on tracked realobjects,while others permit directguidance and training of surgeonsand therapists by means of inter-active co-located real-time sim-ulations.”

FEATURES


[ ]Andreas Pusch, Ph.D.Frank Steinicke, Ph.D.Immersive Media GroupJulius-Maximilians-Universität WürzburgGermany

[email protected]

Figure 2: Fully immersive pit environment for conducting phobia experiments(left); Realistic self-representation brought to the pit environment (right).

As of July 2011, 35% of mobile users ownsmartphones and it is widely accepted thatall mobile users will own smartphones bythe end of this decade. Many healthcarecompanies seek to provide their servicesto patients and healthcare professionalsalike by means of creating smartphoneapplications (apps) that are both user- andwallet-friendly. The young mobile health(mHealth) market raked in $718 millionin 2011 solely from profit on smartphoneapps, over a sevenfold increase from the$100 million profit in 2010.

Many sophisticated apps are penetratingthe mHealth market as companies be-gin to incorporate Augmented Reality(AR) technology into their services. ARimplements technology to analyze oursensory perceptions and is considered a“mixed” or “mediated” reality becausethe technology adds virtual overlays inreal time. AR is comprised of three basicelements – a computer processor, cam-era and display – and it is for this reasonthat smartphones serve as an ideal can-didate for the distribution of handheld,AR medical services.

Prior to the addition of smartphonemedical apps, quick response (QR)

codes served as the backbone of themHealth market. QR codes are a typeof data matrix barcode that can be readwith a cell phone camera to access in-formation about the object it is affixedto. Among other uses, QR codes may beplaced on medication labels to providepharmacy and physician contact infor-mation and identify specific drug reac-tions; on food and drink packages topresent interactive calorie counters; andon medical devices/monitors to offerhow-to information in text, audio andvideo form.

To incorporate AR technology into thispremise, the software developers at Grav-ity Jack have invented quick augmentedreality (QAR). QAR allows virtual informa-tion to directly overlay a data matrix bar-

code through the use of browsAR, Grav-ity Jack’s unique QAR-code reader app,instead of having to view the informa-tion through a Web browser. Althoughcurrent uses are limited to personalizedQAR codes displaying Facebook and busi-ness profiles, there is great promise fortheir technology to penetrate themHealth market to promote patient ed-ucation.

Many medical AR smartphone apps de-signed by healthcare professionals havebeen marketed to assist fellow colleagues

by providing supplemental tools specif-ic to their line of work. WG Healthcaredeveloped the Hallux Angles iPhone appto aid in the pre-operative radiographicplanning process used by foot surgeons.

23

FEATURES

Augmented RealityHandhelds and Mobile Devices

By Allison Ines

“Many healthcare companies seek to provide their services topatients and healthcare professionals alike by means of creatingsmartphone applications that are both user- and wallet-friendly.The young mobile health market raked in $718 million in 2011solely from profit on smartphone apps, over a sevenfold increasefrom the $100 million profit in 2010.”

“Another important concern is the potential over-reliance on the AR system itself: important cuesfrom the environment might be missed, provingto be hazardous to the user. Preventative meas-ures must be made, such as guidelines in thedevelopment and use of AR handheld apps.”

FEATURES AR Handhelds and Mobile Devices

By aligning the iPhone with forefootbones pictured on an x-ray film (usingthe camera and on-screen guides), thebuilt-in goniometer and accelerometerscan measure specific angles – the Dis-tal Metatarsal Articular Angle, Inter-Pha-langeal Angle and Hallux Valgus Angle –and record measurements for patientsdirectly on their phone for future refer-ence.

A similar program is the CobbMeter appdeveloped by Dr. Fredric P. Jacquot forspinal care professionals. The CobbMe-ter is designed to measure the Cobb an-gle, kyphosis angle and the sacral slopeon vertical spine radiographs using inte-grated position sensors, and claims to ac-curately measure within one-tenth of adegree, making it more precise than thetools used in everyday practice.

A number of healthcare AR smartphoneapps are geared specifically towards pa-tients. The AED4.EU app, created by theRadboud University Nijmegen MedicalCentre and only available in the Nether-lands, allows patients to locate the near-est automated external defibrillator (AED)registered in their independent database

using Layar, an AR browser for smart-phones that overlays information onmaps using built-in GPS. By turning onthe camera, lifting the phone and facinga street, icons pointing to the nearestAED will pop up on the device in realtime. There are currently more than20,000 AEDs registered and the generalpublic is encouraged to register theirAEDs online (www.aed4.eu) in order topotentially save lives of those who suf-fer from cardiac arrest. MediaspreeLLC’siBlemish app for iPhones uses advanced“complexion matrix” image effects andhigh-resolution camera optics to scanand reveal skin damage on the face, fromblemishes and blackheads to sun dam-age and abscesses, which could poten-tially lead to early detection of precan-cerous cells.

The incorporation of AR into mobilephones is still relatively new and has itslimitations. Current GPS technology onsmartphones is only accurate within ninemeters and doesn’t work well indoors.Developments in the technology are alsoaddressing issues such as system tempo-ral delays and inaccurate depth percep-tion. Another important concern is the

potential overreliance on the AR systemitself: important cues from the environ-ment might be missed, proving to be haz-ardous to the user. Preventative meas-ures must be made, such as guidelinesin the development and use of AR hand-held apps.

The mHealth market already containscountless smartphone apps that are ben-eficial to and easily accessible for boththe patient and the professional. Withcontinued research on the dynamics ofAR on handhelds and the production ofnew and upgraded smartphones, com-panies will be able to present newportable and innovative medical servic-es that can potentially make the smart-phone-acclimated public more proactiveand responsible with their health.

Human beings have six dominant senses –vision, hearing, touch, taste, smell, andvestibular balance. Of these, vision is perhapsour most important. The loss of vision canbe devastating, but not entirely disabling, es-pecially in the young. The brain is sufficient-ly adaptable to re-route other functions, suchthat visual loss coincides with significantlyimproved hearing, touch and associatedmemory. Therefore, the visually impaired canaugment their reality via sensory substitu-

24

Visual Augmentationfor the Blind“Perhaps the most exciting work in the field is withthe new optogenetic method. Instead of implanti-ng electrodes, it is now possible to genetically re-engineer the remaining cells of the eye to be lightsensitive. Specially adapted Virtual Reality headsetscan then transmit high intensity pulses of light toreturn vision.”

By Patrick Degenaar


[ ]Allison InesInteractive Media InstituteSan Diego, California

[email protected]

tion. In rare cases, individuals (blindfrom birth) are even able to develop anauditory visual system through echolo-cation – making small clicking noisesand detecting their 3-D environment bytiming how long it takes for the echo toreturn.

Techniques to enhance sensory substi-tution, through for example walkingsticks, have been around for some time.Now in the 21st century, blind comput-er users regularly use a screenreaderprogram called JAWS, which convertsthe screen information to sound. Suchusers can navigate using auditory infor-mation streams which are unintelligi-ble to the normally sighted. Day to daymobility can now be enhanced via anecholocating walking stick – the ultra-cane, which gives vibrating feedbackabout objects three to five meters away.There are even attempts to use a cam-era and processing engine to convertthe visual world into auditory or gusta-tional signals. And yet, the overwhelm-ing desire of the majority of the visual-ly impaired is to return to at least somevisual function rather than sensory sub-stitution.

Electrical stimulation of the visual sys-tem has been attempted for almost acentury. The first experiments on live

humans date to 1929, but subsequentprogress has been slow. The most im-pressive results to date have been by aGerman company, Retina AG, whose lowresolution implant has allowed individ-uals to be able to read large, high con-trast characters.

Perhaps the most exciting work in thefield is with the new optogeneticmethod. Instead of implanting elec-trodes, it is now possible to genetically

re-engineer the re-maining cells ofthe eye to be lightsensitive. Speciallyadapted Virtual Re-ality headsets canthen transmit highintensity pulses oflight to return vi-sion. This is the ba-sis of the EuropeanOptoNeuro proj-ect. What is partic-ularly exciting isthat resolution isno longer limitedby the curvature ofthe eye and degra-dation of implant-ed electrodes. Ad-ditionally, withoutthe need for ex-pensive surgerythe cost of suchsystems can be re-duced significantlyfrom hundreds of thousands to thou-sands.

We must, however, accept that in theearly phases, perfect vision will not bereturned. As such, the prosthesis needsto interpret the world and send only themost useful information. By cartooniz-

ing thescene, lessi m p o r t a n ttextures aresuppressedto give bettercontrast tothe more im-portant fea-

tures (e.g., body shapes). A particularlyintriguing question is whether the usersof such visual systems will want to lim-it themselves entirely to the visualrange. In Song of the Machine, my teamat Newcastle in conjunction with Super-flux conceptually explore the possibili-ties of the future – where users canview the world in the infrared and ultra-violet as well as the visible. This can becombined with assistive technologiessuch as navigation and face recognition,

so that the total package – mixing aug-mented visual return with supplement-ed sensory substitution – will allow theblind to lead normal lives.

Full human trials of such optogeneticretinal prosthesis are a few years awaypending safety trials and will in the firstinstance only help those suffering fromthe Retinitis Pigmentosa disease. Trialsfor those blinded by other conditionswill be further down the line. Assistivetechnologies are however already here.The touchscreen smartphones are nowbecoming surprisingly popular amongstthe visually impaired because previouskeypads are being replaced with vibrat-ing and auditory feedback. As such, GPSbased navigational apps are alreadychanging lives.

FEATURES


25

[ ]Patrick Degenaar, Ph.D.School of Electrical and ElectronicEngineeringNewcastle UniversityUnited Kingdom

[email protected]

Figures 1: Human vision is limited to between wavelengthsof 400 and 700nm. If we return vision to the blind, sceneswill be interpreted through the medium of silicon technolo-gy. The user may then find it more useful to augmenthis/her information stream by viewing the world as a car-toon, or in ultraviolet or infrared.

“ ... the total package, mixing augment-ed visual return with supplemented sen-sory substitution, will allow the blind tolead normal lives.”

26

PRODUCT

Hallux Angles

iBlemish

CobbMeter

www.aed4.eu

The Computer As-

sisted Medical Di-

agnosis and Sur-

gery System

Dankam

Virtual Retinal

Display

myGames

Essential Reality

P5 Data Glove

DESCRIPTION

radiographic measurement aid utilizing Augmented Reality for assisting in the

pre-operational radiographic planning process with an intention to supplement

conventional techniques for those practicing forefoot surgeries; also able to record

measurements for either foot which are individually stored along with the patient

ID, date and time

used with a handheld device or smartphone, utilizes high resolution camera optics

and an advanced “complexion matrix” imaging system to detect skin damage in-

cluding age spots, wrinkles and sun damage which could potentially lead to earli-

er detection of precancerous cells not yet visible to the naked eye

medical tool application designed for spinal care professionals to be used with smart-

phone; measures Cobb angle, kyphoses angle and sacral slope on vertical spine ra-

diographs to effectively monitor degenerative and deformitic conditions as well as

spinal fractures

mobile smartphone app allows patients to locate the nearest automated ex-

ternal defibrillator (AED) registered in their independent database using Layar,

an AR browser for smartphones that overlays information on maps using built-

in GPS

prototype consisting of an ultrasound and HMD, visual cues are displayed in the HMD

and projected over the patient’s body while voice controls guide the user through

procedures; designed to allow astronauts in orbit the ability to diagnose and treat

medical complications without depending on ground personnel

app applies filters to assist color blind users in determining colors, or differences in

colors, that would otherwise be invisible; currently optimized system for the most

common form of color vision deficiency

prototype creates images viewed directly on the retina by scanning low pow-

er lasers into the eye in a raster pattern; ideal for improving the human-com-

puter interface during surgery where doctors traditionally rely on screens for

AR guidance

VR games created for patients with upper limb motor disorders that combine both

real and virtual objects to promote movement necessary for regaining motor abili-

ties and improve activities of daily living; can be played at home for convenience,

and level of difficulty can be modified to best suit an individual’s abilities and

progress

Input device designed to capture data on finger-bend and relative hand-position

to enable intuitive interaction with 3-D environments, includes tactile feedback;

potential applications in rehabilitation using haptic feedback

MANUFACTURER

App Store

App Store

ALTAVI sarl

Radboud Uni-

versity Nijmegen

Medical Centre

European Space

Agency

Dan Kaminsky

Holdings, LLC

Human Interface

Technology Lab

Myomo and the

University of Ul-

ster

Essential Reality

Product Comparison Chart:Augmented Reality

PRODUCT COMPARISON

RESEARCHERS:

Rasheda Farid & Allison InesEditorial Department, C&R Magazine

www.vrphobia.eu, [email protected]

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Previous studies have shown that a rangeof manipulative clinical skills can be prac-ticed through the use of haptics (sense oftouch), such as tooth drilling, needle inser-tion, bone surgery, and instrumentationfor gum diseases. Presently there is littleevidence of what actual impact haptic de-vices might have on students' learning, onthe curriculum and on institutions’ adop-tion and integration of such technologies.

The hapTEL project, based at King’s Col-lege London Dental Institute, was set upin July 2007, and is funded by the UK’s Eco-nomic and Social Research Council andthe Engineering and Physical Sciences Re-search Council, to develop, evaluate andintegrate the use of haptics in dental edu-cation and investigate its impact on teach-ing and learning. The hapTEL team, whichhas won many awards for dental educa-tion and technological innovation, includesdentists, e-learning professionals and ed-ucational researchers at King’s College Lon-don, cyberneticists from Reading Univer-sity and engineers from Birmingham CityUniversity.

The Development of the System

The technical development involved cre-ating a realistic virtual mouth using MRI/CTscans of the human jaw combined withclinical expert feedback. The touch inputdevice is based on that used in the gam-ing industry. A real dental drill connectedto the device enables students to operateon the virtual mouth, feeling the difference

between drilling hard healthy and softerdecayed tooth tissues. Operated by a footpedal, as in a regular dental chair, the stu-dents learn how much pressure needs tobe applied in preparing a cavity. In orderto see the virtual mouth in 3-D, shutterglasses are worn and students’ head move-ments are tracked by a camera to givethem a real world experience of examin-ing the mouth from different angles. Thescreen display shows the learning activi-ties from selecting the patient case, tochoosing the correct instruments and as-sessing clinical performance.

Fourteen identical workstationswere produced and located inthe clinical skills lab (CSL) atKing's College London. Figure1 shows the hapTEL worksta-tion being used by a student.

Identifying the CurriculumUse and Measuring the

Curriculum Impact

In order to know if the systemcould be integrated successful-ly in the curriculum, the teamfirstly reviewed the traditionalcourse to identify where hap-tics might most appropriatelybe used. Students worked inpairs, one as the “dentist” andthe other as the “nurse.” ThehapTEL system recorded com-puter logs of the interactionsand the procedures performed.

During traditional simulation students firstlearn to prepare small carious cavities ad-vancing to more complex preparations.

Measuring the Impact on Students’ Learning

Previous studies on haptics have only re-ported limited measurements of the im-pact on students’ learning. The projecttherefore conducted two years of large-scale student trials with one-third of the144 Year 1 students using the hapTEL de-vices and the other two-thirds learning inthe traditional laboratory. Figure 2 shows

“The hapTEL project [was designed] to develop, evaluate and integrate theuse of haptics in Dental Education and investigate its impact on teachingand learning ... The research showed that an advantage of the hapTEL sys-tem is the instant analysis, review and repetition.”

28


FEATURES

Clinical Skills Learning withTouch Technology

By Margaret J. Cox, Jonathan P. San Diego & Barry Quinn

Figure 1: hapTEL Dental Workstation.

the trials’ arrange-ments.

Feedback from thefirst year trials en-abled the system tobe improved for thesecond year. For eachyear cohort a series ofpre- and post-testswere developed andused to measure thestudents’ psychomo-tor skills, what theyhad learned, and theirattitudes towards us-ing the system andwhether there wereany differences be-tween the groups’learning outcomes.

Project Outcomes

The project has obtained many useful out-comes from this large study.

The first difficulty students encounter islearning to hold the instruments correct-ly and ergonomically positioning the pa-tient. Further, they often use too muchpressure for too long with the concomitantremoval of too much dental tissue. ThehapTEL system allowed them to gothrough this process repeatedly withoutdestroying plastic or natural extracted teethwhich are in short supply. The studentswere able to learn clinical skills to expedi-tiously prepare carious virtual teeth andtransfer these skills into the real clinical en-vironment. The student and tutor couldalso play back a video to examine the tech-nique and to see how much decayed ver-sus healthy tooth they had removed.

Comments included, “The device hastaught the students to become more self-critical and that skill is just as importantas the manipulation."

"When you first come into dentistry every-thing is very alien to you, the way you posi-tion your hand, the tiny movements that youneed to perform procedures. These are dif-ficult to achieve. The hapTEL system allowsyou to repeat a task over and over again, it

gets ingrained into your muscle memory, andimproves your manual dexterity."

The results of the large-scale tests showedno statistical difference between thegroups; hapTEL trained students performedequally as well as traditionally trained.

Cost Savings using the hapTEL System

Traditional training is performed on a man-nequin with plastic teeth. The researchshowed that an advantage of the hapTELsystem is the instant analysis, review andrepetition. One hapTEL device costs ap-proximately £10,000, compared with the£30,000- £40,000 price for a traditional sim-ulator with the added cost of using multi-ple plastic teeth. Multilayered anatomicalplastic teeth cost approximately £16 each.

Future Developments

This study has shown that the hapTEL sys-tem can provide equally effective trainingas the traditional system with the addition-al advantages of costing less and providingdocumented individualized feedback toevery student. The same hapTEL systemcould be used for dental hygienists, med-ical and nurse education on a wide varietyof procedures from suturing to injections.Further technological developments would

provide the opportunity to broaden its ap-plication to other fields and contexts. Forexample, patient rehabilitation after strokeis possible, improving motor skills withfeedback and monitoring of progress.

At the moment, the hapTEL system is stillbeing developed, but additional function-ality will make it a marketable product thatcould be made available to other health-care institutes for tutor-led or independ-ent study.

Acknowledgements: hapTEL™ is part ofthe Technology-Enhanced Learning Pro-gramme (TEL) funded by the United King-dom, Economic and Social Research Coun-cil (ESRC) and the Engineering and PhysicalSciences Research Council (EPSRC) AwardNumber: RES-139-25-0387 (http://www.hap-tel.kcl.ac.uk).

29


FEATURES

[ ]Margaret J. Cox OBE, FKCJonathan P. San Diego Barry QuinnThe Dental Institute, King’s College LondonUnited Kingdom

[email protected]

Figure 2: The educational evaluation settings for the traditional and hapTEL lab activities.

Ask the Expert:Ashfaq M. Ishaq

Brenda K. Wiederhold: Tell us about yourbackground and experience

Ashfaq M. Ishaq: I started my career atthe World Bank headquarters in Wash-ington DC conducting economic re-search on entrepreneurship and smallindustry development in 1980. Thebank’s research department had ac-quired an IBM System 360 at that timewhich opened possibilities for econo-metric analysis of primary data whichwe had collected. I coauthored a bookwhich was published by the Oxford Uni-versity Press in 1987 and by that time Ihad joined the economics faculty at theGeorge Washington University. Soonthereafter I wanted to leverage my eco-nomic development and teaching expe-riences into advisory services. So Iopened a project development compa-ny in Washington which eventually be-came successful by the mid-1990s. I hadto close this business in 2001 to devoteall my time and energy to the Interna-tional Child Art Foundation (ICAF).

BKW: What inspired you to found the In-ternational Child Foundation?

AMI: I was always interested in creativ-ity and my research on entrepreneur-ship deepened this passion. It frustrat-

ed me that economics dealt withproductivity alone and not creativity. Iwas asking myself why innately creativechildren grow up to become bureau-crats. E. Paul Torrance, who is consid-ered the father of creativity, document-ed the “4th-grade slump” in thecreativity of children through his longi-tudinal and cross-cultural studies. Some-thing happens to us at that age, be itconformity or being educated out of ourcreativity. How to help children over-come their creativity slump? The least

cost and more effective approach is toemploy the arts. But there was no na-tional art organization for American chil-dren, nor an international arts organi-zation for the world’s children. The ICAFhad to fill this vacuum.

BKW: Tell us more about the backgroundof the International Child Foundation,and the aims of the organization.

AMI: Running the ICAF posed a big chal-lenge as neither I nor my wife had non-profit experience. I knew that at leastinitially we had to invest our own funds,which is what we did. Right after incor-porating the ICAF we launched an inter-national art competition for children age8 to 12 to address the “4th-grade slump.”In September 1998 the ICAF hosted the

31

Executive ChairmanInternational Child Art Foundation

&

“The power of the arts to foster creativity anddevelop empathy is overlooked. Since creativityand empathy are preconditions for a just, pros-

perous, and nonviolent world, we should allchampion global art programs.”

“We are also developing a virtual creativityplayground (VCP) because if a child's creativi-ty is not encouraged, it could be lost forever.”

INTERVIEW

first-ever national children’s art festival,held on the National Mall in Washing-ton DC.

The problem with creativity is that it ismorally neutral. "The greatest work of

art imaginable for the whole cosmos”is how a German avant-garde compos-er Karlheinz Stockhausen described the9/11 terrorist attacks on the UnitedStates. Creativity alone cannot do thejob. We need empathy as well. Creativ-ity and empathy together are necessaryand sufficient conditions to build abrighter future for all.

Neurobiologists inform us that ourbrains are hardwired for both creativi-ty and empathy. The 4-th grade slumpand the selfish gene play against ourbetter instincts. It just so happens thatthe arts can be employed for the devel-opment of creativity and empathy. Thisis what the ICAF does.

BKW: Could you tell us about your cur-rent research?

AMI: Do children through their art of-fer insights into our creative purposeand potential? Can we, former children,learn from the new generation? Whatis this learning?

BKW: Do you think the public shouldbe more aware of the issues your organ-ization aim to promote?

AMI: People do not appreciate children’s

imagination and art and hence it haszero market value. Consequently, thepower of the arts to foster creativity anddevelop empathy is overlooked. Sincecreativity and empathy are precondi-tions for a just, prosperous, and nonvi-

olent world, we should all championglobal art programs.

BKW: What are the best achievementsyou have experienced since foundingthe organisation?

AMI: The ICAF is today a world leaderin children’s art. Next year we launchthe 5th Arts Olympiad (2013-2016). Weexpect that about two million 8 to 12year olds worldwide will participate inand benefit from their Arts Olympiadexperience. This innovative art andsport program inspires them to em-brace the Artist-Athlete Ideal! of thecreative mind and healthy body—menssana in corpore sano. Although theICAF receives little financial support, itswork is essential and its achievementsincredible.

It has been especially important tobreak with history and bring children'svoices to major conferences where wehave organized children's panels. Insti-tuting the "World Children's Award" isanother achievement. Introducing achild's imagination to the adults is whatwe do every day. We continue to con-vince contemporary art museums todedicate at least one room to art by chil-dren.

BKW: Could you explain what the WorldChildren’s Festival is about?

AMI: The festival honors the ArtsOlympiad winners from U.S. states andparticipating countries. In 1999 we pro-duced the first World Children’s Festi-val and ever-since the festival is heldquadrennially as Olympics of children’simagination and co-creation. Child per-formers and musicians from aroundthe world apply to showcase their tal-ents. Architects, engineers, scientists,technologists, writers, Olympians andother professionals come to Washing-ton at their own expense to host work-shops and activities for the children,who arrange their own workshops aswell.

This educational festival has grown intoa global showcase for STEAMS Educa-tion! which integrates Arts and Sportwith STEM disciplines (science, tech-nology, engineering and mathematics)for children’s holistic development.The 5th World Children’s Festival willbe held in Washington in 2015. It isfree and open to the public, so you aremost welcome.

BKW: How has technology impactedyour work?

AMI: When we started in 1997 all com-munications were by snail mail, whichwas very costly and time consuming.Today, about 80 percent of our work isonline. The ICAF was one of first civilsector organizations to publish a website in early 1998. We added digitalart as a category to the Arts Olympiadin 2004. At the 1st World Children's Fes-tival in 1999, very few teachers and par-ents had E-mails. At the 4th World Chil-dren's Festival in 2011, nearly all thechildren had E-mail addresses. The cur-rent issue of ChildArt magazine is onGames & Online Experience. We are alsodeveloping a virtual creativity play-ground (VCP) because if a child's cre-ativity is not encouraged, it could belost forever.

32

ASK THE EXPERT Ashfaq M. Ishaq

“Neurobiologists inform us that our brainsare hardwired for both creativity andempathy. The 4th grade slump and theself ish gene play against our betterinstincts. It just so happens that the artscan be employed for the development ofcreativity and empathy.”

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35

FROM WHERE WE SIT:Augmented Reality for an Active Ageing European Society

Augmented Reali-ty (AR) per defini-tion combines thereal and the virtu-al and is interac-tive in real-time.In addition, virtu-al and real objectsare registered in3-D space to pin-point their posi-

tions for precise overlays. AR has been inthe news a lot in recent years, mainly be-cause of AR Apps on smartphones. ARhas a lot more to offer though.

Hardware setups are versatile and rangefrom mobile devices to immersive labinstallations. Just as versatile are the ap-plication areas ranging from industrialuses (automotive, manufacturing, etc.),training and education, modeling (archi-tectural planning), design, visualization(scientific, medical, information), enter-tainment and more recently, the widen-ing spectrum of possibilities in the med-ical domain, rehabilitation and therapy.

The most visible area of research in ARin recent years has been localization.Tracking the positions of persons and ob-jects in 3-D as accurately as possible inindoor and outdoor environments is thechallenge here. Vision-based solutions,in combination with additional availablesensors, deliver the best and most prom-ising results these days.

In Europe we have a strong researchcommunity working on AR in a widerange of application areas. In order topursue interesting and promising newapplication ideas, especially in the med-ical domain which is one of our priori-ties, funding is always critical. In mostEuropean countries we rely mainly onthree sources of funding: (1) National ba-sic and applied research funding institu-tions, (2) the European Union Framework

Programme and (3) industry. Due to theeconomic situation, the national fund-ing programs are about to be cut.

However, faced with an ageing Europeansociety and with hardly a country exemptfrom problems financing pensions andhealthcare, the European Commissionseems to be taking a different route byinvesting in research and driving inno-vation forward.

In the current Framework Programme 7(FP7), the European Union is fundinghealth research in the amount of ¤ 6.1billion. Within FP7, the “ICT Challenge5: Information and CommunicationTechnologies for Health, Ageing Well, In-clusion and Governance” has a budgetof ¤ 258 million. This sum for health re-search will be topped in the years 2014-2020 in HORIZON 2020, the new namefor the upcoming framework program.There will also be funding opportunitiesfor cooperations with neighboring, in-dustrialized and emerging economies.In HORIZON 2020, ¤ 9.07 billion are re-served for “Health, demographic change,and well-being.” This brings interestingopportunities for the AR community.

FP7 and HORIZON cover many topics theAR/VR community is currently workingon. As an example, I would like to men-tion an FP7 project on virtual rehabilita-tion in which we participated. The PLAY-MANCER FP7 ICT Project focused ondeveloping serious games for cognitivebehavioral therapy – specifically for pa-tients with eating disorders and patho-logical gambling – and on serious gamesfor the rehabilitation of chronic backpain patients.

Rehabilitation for chronic pain follows amultidisciplinary approach, which de-spite the effort, often lacks long termsuccess. Patients fail to translate skillslearned in therapy to everyday life. In or-der to encourage continuous trainingand ensure impact at a wider scale whenit comes to “Active Ageing,” technology

can and should be used to motivate peo-ple to exercise at home.

As an alternative home motion capturesystem, the low cost Microsoft Kinect wascompared to our eight-camera precisemotion capture system. The purpose ofthis comparison within the project wasthat recorded movement data could pro-vide medical experts with useful infor-mation regarding patients’ home train-ing such as duration, intensity andcorrectness.

Overall, the Kinect works surprisinglywell. It correctly captured some of theexercises used within our serious game.It cannot measure all required parame-ters (e.g., head rotations cannot be de-tected) and lacks accuracy required forothers (e.g., velocities of hand/arm move-ment). For clinical evaluation such a de-vice cannot be recommended due tolarge errors. However, for health relatedhome use, a Kinect-like depth cameracan be used as a full body input devicefor serious games and other rehab orhealth programs that do not need super-vision.

To reach the general public, using mo-bile technologies for healthcare purpos-es seems to have the broadest impact.MIT’s CATRA and EyeNETRA projects areperfect examples. AR is predestined tocontribute in these areas as well. Regard-ing mobile and upcoming technologiesfor elderly people, excellent usabilitymust be of utmost importance. We willsee a variety of new approaches andhealth technologies emerging until theend of this decade. With the excellentfunding opportunities on the horizon,we should take our chances to developand spread successful medical applica-tions based on virtual, augmented andmixed reality.

For more information on the mentionedprojects visit:

By Hannes Kaufman

Continued on page 37

Social media haveforever altered theway that humansin general, andNorth Americansin particular, re-late to each other.By supplying uswith new tools toshape our ownreputations and

personas, the same media have changedthe way we represent and understandourselves, as well.

Now we find ourselves on the cusp of anew digital revolution — the moment atwhich “augmented reality” (AR) technol-ogy will liberate electronic data from two-dimensional screens and infuse our phys-ical surroundings with digital content.There is every reason to expect that thisdevelopment will further “augment” ourperceptions of each other and ourselves.

It is already a given that most NorthAmericans use Facebook, Twitter, or someother venue for online expression. Thesesites tie information that we choose toreveal about ourselves together with con-tent such as photos, messages, or sharedlocations — that our acquaintances havedecided to associate with us.

We all realize on some level that the re-sulting pastiche of information is not en-tirely within our control, and that it cansometimes create unwanted perceptionsof us. But there is at least some comfortin knowing that the whole exchange takesplace “out there,” in a virtual place thatis less tangible and somehow less “real”because it is accessible only through thescreen of a desktop computer or mobiledevice.

AR, however, promises to tear down thewalls between our digital and physicallives. No longer will individuals in our

digital social networks need to “look usup” online to discover what is revealedabout us there. Rather, they will merelyneed to quite literally “look up” at usthrough an AR-equipped mobile device— most likely one embedded in the eye-wear on their faces. They will see virtu-al information about us displayed as if itis floating in mid-air over our physical

selves. By merely waving a hand, a per-son standing in front of us might accessour Facebook profiles or recent activities,or use a search engine to discover any-thing the Internet may have to say aboutus.

For the first time, we will interact witheach other’s physical and digital personassimultaneously. The comforting chasmbetween our multiple personas will dis-appear, to the disconcertion of many.

The effect is likely to be particularly pro-nounced for Americans, who have longchampioned the public’s collective rightto share and access information online.Even those individuals who are comfort-able with the knowledge that sensitive,personal information about them is avail-

able “out there” somewhere are likely togain a new appreciation for the Europeanview of privacy when that data is aggre-gated and made to appear as if it is float-ing over their heads as they walk downthe street.

Experiences like these sound tantalizing-ly novel in the context of fiction, where

they have been explored for decades.Now that our digital and physical reali-ties are actually beginning to blend, how-ever, society as a whole will need to de-velop new norms to minimize theresulting feelings of awkwardness and in-trusion. The adjustments that social me-dia required of us are likely to seem triteby comparison.

36

“The effect is likely to be particularly pronouncedfor Americans, who have long championed thepublic’s collective right to share and access infor-mation online. Even those individuals who arecomfortable with the knowledge that sensitive,personal information about them is available‘out there’ somewhere are likely to gain a newappreciation for the European view of privacywhen that data is aggregated and made toappear as if it is floating over their heads as theywalk down the street.”

[ ]Brian D. Wassom, J.D.Honigman Miller Schwartz andCohn, LLPBloomfield Hills, Michigan

[email protected]...

ACROSS THE POND:Augmenting Perceptions of Society and Self

By Brian D. Wassom

HORIZON 2020 – A Short Overview(http://www.ostina.org/content/view/6153/1567/)

International Funding in HORIZON 2020(http://ec.europa.eu/research/hori-zon2020/pdf/press/fact_sheet_on_inter-na t iona l_p a r t i c ip a t ion_ in_hor i -zon_2020.pdf )

HORIZON 2020 - Health, demographic

change and well-being (http://www.nhscon-fed.org/NationalAndInternational/NHSEu-ropeanOffice/Innovation_EU_funding/Pages/Horizon2020.aspx)

Schönauer C., Pintaric T., Kaufmann H.,Jansen-Kosterink S., VollenbroekM.Chronic Pain Rehabilitation with aSerious Game using Multimodal InputIn Proceedings of Virtual Rehabilitation2011, Zurich, June 2011.

CATRA (http://web.media.mit.edu/~pam-plona/CATRA/)

EyeNetra (http://eyenetra.com/)

[ ]Hannes Kaufmann, Ph.D.Vienna University of TechnologyAustria

[email protected]

Although Aug-mented Reality(AR) is not a newterm in the VirtualReality field, recent-ly to consumers,this technology hasbeen popping outof nowhere and at-tacking with force.Marketers are now

keen on knowing more and getting in-volved. In China, there are increasinglymore and more agencies exploring AR in-novation.

Augmented Reality has come to life withthe flexible publishing platforms and pow-erful camera-equipped devices. Vendors areanxious to learn the next new way to con-nect with consumers. They are striving toget involved and see how AR can be appliedto their products successfully. The currentface of AR seems to only be the tip of theiceberg and will only be a matter of timebefore it reaches a tipping point, becomingindispensable in consumers’ lives.

Like the rest of world, China is innovatingand accepting AR into their mobile tech-nology swiftly. In May 2011, Senscapelaunched China’s first indigenous AR plat-form, which is currently compatible withAndroid and iOS. The platform is intendedto be a universal API for developers to buildAR objects, which users can then accessthrough the Senscape App. The upcomingapplications of the Senscape platform will

be expanded to include applications in e-commerce, branding, tourist informationand interactive game plays.

The project’s developers have mentionedmany possible applications for the soft-ware: branding and e-commerce functions,interactive games with GPS, virtual touristinformation booths, and educational tuto-rials. Similarly, AiSIDE is an alliance of soft-ware developers that support using AR foriOS and Android development and licens-es technology from the German-based ARcompany, Metaio. Along with the gradual-ly established AR platforms, more and moreAR applications have started to penetrateinto people’s everyday life.

Volkswagen China is a frontier at this are-na. Volkswagen recently demonstrated thepower of AR by launching its first AR-basedmarketing campaign in China. They fea-tured a pull-out steering wheel in their com-pany’s magazine advertisements. Readerscould enter into an AR “race” via the com-pany web site and compete to win prizes.Notably, of the 50,000 people who partic-ipated in the virtual race, nearly 7% signedup to take an actual test-drive of a Volkswa-gen vehicle. Advertisers are finding newways to utilize AR and tie it back to old-fashioned methods of marketing to in-crease their effectiveness and sales.

Another AR app from Volkswagen is “Elec-tric Café” which educates and inspires peo-ple in China about the energy efficiency ofthe Volkswagen Golf electric car. Users ofthe app are able to scan everyday householditems, such as a refrigerator or toaster, andan AR experience would be created around

that appliance, showcasing just how far youcould drive a Volkswagen Golf on the samepower it takes to run that appliance.

Tencent recently launched an AR mobileChinese translator, “Intelligent Eye.” Sim-ply by aiming the camera at text in needof translation. Tencent’s product offersMandarin learners a free, valuable toolthat can translate English, French and Ger-man into Chinese and vice versa. Tencentplans to add othe features like AR land-mark tagging, and logo recognition in thenear future.

Although current efforts are still in theirinfancy and it will take time to see howthe technology rolls out, this is an excit-ing advancement. The implications andconsumer involvement are far too inter-esting for it to simply come and go. Plus,the number of users of computers andsmartphones are massive in China. Thepotential for AR technology in marketing,the social sector, entertainment andhealthcare is huge and most organizationshave yet to investigate this digital phe-nomenon. The technology is so new andrevolutionary from the consumer point ofview. I am really excited to see AR becomemainstream in China. – it should happensoon!

FURTHER AFIELD: A Taste of AR in China

By Lingjun Kong

[ ]Lingjun Kong, PMPVirtual Reality Medical CenterSan Diego, California

[email protected]

37

“Alongside countries like Italy, Spain and Germany, theNetherlands are at the forefront in Europe for imple-menting new technologies in order to refine our compre-hension of different mental illnesses and to improve thequality of various treatments. Since the Netherlands is awealthy region, investment in the academic field is gen-erally sufficient and promotes the development of high-standard research facilities.”

[ ]C&R in the Netherlands

he standard of living of theDutch population is amongst thehighest in the world. Indeed, theNetherlands’ human develop-

ment index (a measure of three basic di-mensions of human development: educa-tion, health and income) is considered tobe very high and the country is rankedthird out of 187 countries with compara-ble data. It is also interesting to note thatDutch people are not only known for theirprosperity and well-being, but also for theirsatisfaction with life. In fact, according tosurveys, the Dutch population is one ofthe happiest in the world, with almost 90%of people reporting themselves satisfiedin their everyday life.

Furthermore, the Netherlands are distinctfor their people’s progressive ideas aboutvarious social issues. For example, legisla-tion and regulation about controversialsubjects such as prostitution, use of mar-ijuana and euthanasia are definitely avant-garde.

Mental Health in the Netherlands

Many epidemiology studies have beenconducted in the Netherlands in the pastdecades and they have greatly contributedto our understanding of psychopatholo-gy. Thus, the portrait of the mental healthsituation in the Dutch population is be-coming well defined and government’shealth and social policies seem to be im-proving accordingly.

According to the Netherlands MentalHealth Survey and Incidence Study-2(NEMESIS-2), 18% of adults aged 18-64 inthe general population had suffered froma mental health condition in the past year.This percentage rises to 43% for the pres-ence of a mental disorder at some pointin their lifetime. More specifically, accord-ing to the Netherlands Study of Depres-sion and Anxiety (NESDA), approximatelyone out of three individuals in the Nether-lands will be affected by depression oranxiety disorders at some time during

their lives. Amongst all mental health dis-orders, depression contributes to the high-est strain on health services. Similarly, suf-ferers of depression are also most likelyto require and use medication.

Statistics also show that Dutch inhabitantswith a lower level of education, lower in-come and those without paid employmenthave greater chances of developing a men-tal health disorder. Fortunately, since 2008,the mental healthcare services developeda program in which people can benefitfrom a whole year of free services. Moreprecisely, the first year of mental healthservices is entirely covered by the generalhealthcare insurance policy.

Moreover, Internet-based psychotherapyis now recognized by Dutch regulatoryhealth bodies as a valid alternative to reg-ular therapy and is even reimbursedthrough public health insurance. Such so-cial policies reveal the government’s gen-uine interest regarding mental health is-

T

> COUNTRY FOCUS


40

AUTHORS:

Claudie LorangerFreelance ContributorC&R Magazine

[email protected]

41

> COUNTRY FOCUS

sues and testify to their sincere will of offer-ing cutting edge services to their popula-tion.

Research Facilities in Netherlands

Alongside countries like Italy, Spain and Ger-many, the Netherlands are at the forefrontin Europe for implementing new technolo-gies in order to refine our comprehensionof different mental illnesses and to improvethe quality of various treatments. Since theNetherlands is a wealthy region, investmentin the academic field is generally sufficientand promotes the development of high-stan-dard research facilities. For instance, two im-portant research teams – University of Am-sterdam and Delft University of Technology– use head-mounted displays in their proj-ects related to the field of cyberpsychology.

Research Areas and Topics

Exergaming (a combination of active videogaming and exercise), Virtual Reality (VR) ex-

posure therapy for anxiety disorders, levelof presence and therapy outcome, interapy(Internet-based psychotherapy), and virtualenvironments to study paranoia and psy-chosis are important fields of research thatare highlighted by Dutch researchers. Theimprovements in the field of cyberpsychol-ogy are hastening developments in thesetopics of interest.

Dutch Projects in the Spotlight

Recently, two important research projectshave been completed at the University ofAmsterdam under the supervision of pro-fessor Paul M. G. Emmelkamp, clinical psy-chologist. The aim of the first controlled tri-al study was to compare VR exposuretherapy (VRET) with in vivo exposure in thetreatment of panic disorder with agorapho-bia (PDA). Results have shown similar effectsfor the two treatment modalities. Dr. Em-melkamp says, “Such work is of great inter-est because there is a clear need for con-trolled clinical studies regarding the

treatment of more complex and prevalentanxiety disorders like PDA, social anxiety,posttraumatic stress or obsessive-compul-sive disorder.”

The second research project’s goal was tomeasure the effect of Internet-based psy-chotherapy (INTERAPY) on subjects affect-ed by Posttraumatic Stress Disorder, burnout,depression, eating disorders and panic dis-order.

The results gathered from nine controlledtrials showed that patients’ improvementsin the Internet-based psychotherapy condi-tion were comparable to those of the sub-jects who received classical (face-to-face)cognitive behavioral therapy. In a subsequentseries of 1,500 regular patients, Internet-based CBT was found to be equally effectiveas the treatments in the randomized con-trolled trials.

Moreover, according to Dr. Emmelkamp, “Pa-tients’ reaction to the online psychotherapy


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10.8

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was positive and they seemed to be high-ly satisfied at the end of the treatment.”In summary, a decade of online therapyresearch has provided compelling sup-port for the efficacy and effectiveness ofInternet-based cognitive behavioral treat-ment. In the Netherlands, the implemen-

tation and dissemination of such tech-nology has begun and is supported byreputable healthcare professionals.

Another interesting project in ICT re-search will soon take place at the Univer-sity of Amsterdam. This innovative studywill combine Internet-based psychother-apy with VRET, two methods that haveshown promising results as mentionedearlier. This new treatment for social pho-bia will include exposure sessions toavatars that could be completed online.Of course, if effective, “this project is agreat demonstration of the potential ofinformation technologies in the treat-ment of mental disorders,” says Dr. Em-melkamp.

Dr. Willem-Paul Brinkman with the In-teractive Intelligence Group at Delft Uni-versity of Technology has also dedicat-ed his time towards pioneering worksimplementing VR techniques for men-tal healthcare. “The group’s researchmission is to create synergy between

humans and technology by understand-ing, shaping and using fundamentals ofintelligence and interaction,” he explains.“Our research finds applications in mul-tiple contexts, such as healthcare, well-being, entertainment, safety and secu-rity.”

Drs. Emmelkamp and Brinkman recent-ly partnered to work on a project “Com-puter support for anxiety disorder treat-ment at home” (CATCH) project fundedby the Netherlands Organisation for Sci-entific Research (NWO). “We developeda VR exposure therapy system specifical-ly designed to expose patients with so-cial phobia to various social situations,”says Dr. Brinkman. “Patients can engagein free speech dialogue with virtualavatars, which the therapist can controlfor specific phobic stressors.” The effec-

tiveness of the treatment is currently be-ing evaluated in an extensive RCT.

Looking to the future role of advancedtechnologies in healthcare, Dr. Brinkmansays, “Considering demographic changesin the western world and rising nationalhealthcare costs, patient self-manage-ment systems will become more impor-tant. In this context, the use of eCoach-es seems an important element inpatient empowerment and a way to re-duce face-to-face consultation with careproviders.”

The Future of ICT Researchin the Netherlands

Even with promising results in research,the implementation of new technologiesin the treatment of mental illnesses inthe Netherlands still faces major chal-lenges and obstacles. Indeed, one of themost important difficulties is the trans-fer of knowledge from the academic com-munity to common clinical practice. The

use of new technologies has presentedmany advantages and is associated withgreat satisfaction in service users, butsome practitioners show resistance tochange because it makes them feelsomewhat obsolete. In other words, someclinicians may fear being replaced bycomputers.

Another important issue related to theimplementation of new equipment likeHMDs is the lack of training on how touse VRET and appropriate technical sup-port. In order to efficiently use such tech-nology, clinicians may need help in caseof deficiencies of the equipment or forinstallation. According to Dr. Emmelkamp,one of the solutions might be to “createcentral locations where practitioners coulduse the equipment and demand techni-cal support when needed.”

Finally, since people around the world arebecoming more and more familiar withnew technologies, another challenge inICT research will be to keep up with theproducts offered by the competitive in-dustry. For example, the graphic qualityof video games improves continuouslyso the virtual environments created inthe future will have to meet the same ex-pectations or otherwise they will seemoutdated.

Nevertheless, the support for these tech-nologies is leading to exciting develop-ments in the treatment of mental healthdisorders. The Netherlands will undoubt-edly use these advancements to contin-ue offering cutting-edge care for its pop-ulation.

42

> COUNTRY FOCUS

Sources:

Personal communication with PaulM.G. Emmelkamp, Ph.D., Willem-PaulBrinkman, Ph.D., World Health Or-ganization, Organisation for Econom-ic Co-operation and Development,Trimbos Institute, and NetherlandsStudy of Depression and Anxiety.

“Internet-based psychotherapy is now recognizedby Dutch regulatory health bodies as a valid alter-native to regular therapy”.

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www.vrphobia.eu I [email protected]

The Official Conference of the International Association of CyberPsychology, Training & Rehabilitation (iACToR)

CYBER17 will bring together researchers, clinicians, funders and policymakers to share and discusstrends in healthcare and technology. CYBER17 continues to seek input from a wider segment of the sci-entific community, and is interested in attracting experts in clinical therapy and rehabilitation, cognitivesciences, social sciences, and computer sciences dedicated to shaping the future of health & well-being.

Key focus areas will include:

1. The Impact of Technologies as Tools: technology's use in train-ing, therapy, rehabilitation, and education to improve the qualityand availability of healthcare.

2. The Influence of New Technologies: technology's influence onbehavior and society (e.g., positive technology for well-being,healthy ageing, and inclusion).

3. The Imprint of Social Networking: the exploration of social net-working tools on individual behavior and societal relations.

4. New Technologies/New Terms: studying the psychologicalaspects of new areas influenced by technology (e.g., cyberfashion,cyberadvertising, cyberstalking).

For more information please visit http://www.interactivemediainstitute.com/conferences.html

or e-mail [email protected]

2012 CALL FOR PAPERSSUBMISSION/REGISTRATION

DEADLINES:

Abstract Deadline Submission: March 1, 2012

Notification of Acceptance/Rejection ofAbstract: April 1, 2012

Full Paper/Presenter RequirementsDeadline: June 1, 2012

Early Registration Deadline:July 1, 2012

Augmented Reality in Healthcare - Interactive Media Institute · the Interactive Media Institute,...

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