Making robots matter in dementia care: Conceptualising the triadic interaction between caregiver, resident and robot animal.

While previous research studies have focused on either caregivers' or residents' perception and use of social robots, this article offers an empirical and theoretical examination of joint activities in triadic human-robot interaction. The symptomatology of dementia creates an asymmetrical relation wherein the impetus to employ a robot often originates from the caregiver. Drawing on field work and video recorded interactions in dementia care homes, the article investigates how caregivers draw on embodied resources to involve residents and robot animals in interaction. The analysis demonstrates how caregivers promote commitment and encounter resistance with residents. We draw on the theory of sociomaterial interactionism to study situated interaction between bodies in a meaning-generating process. By re-conceptualising the theoretical notions of manipulation and recruitment, the article offers an approach for studying orientations that distinguish between reciprocity of agential objects. We show that caregivers usually distinguish between interactions with people and machines by anticipating a specific response from the robots (manipulation), while they invite participation in a broader sense from residents (recruitment). Social friction arises, however, if caregivers act upon the residents as embodied objects in manipulative ways.

Robotic misinformation in dementia care: emotions as sense-making resources in residents' encounters with robot animals.

Robot animals, designed to mimic living beings, pose ethical challenges in the context of caring for vulnerable patients, specifically concerning deception. This paper explores how emotions become a resource for dealing with the misinformative nature of robot animals in dementia care homes. Based on observations of encounters between residents, care workers, and robot animals, the study shows how persons with dementia approach the ambiguous robots as either living beings, material artifacts, or something in-between. Grounded in interactionist theory, the research demonstrates that emotions serve as tools in the sense-making process, occurring through interactions with the material object and in collaboration with care workers. The appreciation of social robots does not solely hinge on them being perceived as real or fake animals; persons with dementia may find amusement in "fake" animals and express fear of "real" ones. This observation leads us to argue that there is a gap between guidelines addressing misinformation and robots and the specific context in which the technology is in use. In situations where small talk and play are essential activities, care workers often prioritize responsiveness to residents rather than making sure that the robot's nature is transparent. In these situations, residents' emotional expressions serve not only as crucial resources for their own sense-making but also as valuable indicators for care workers to comprehend how to navigate care situations.

Racemic Ketamine as an Alternative to Electroconvulsive Therapy for Unipolar Depression: A Randomized, Open-Label, Non-Inferiority Trial (KetECT).

BACKGROUND: Ketamine has emerged as a fast-acting and powerful antidepressant, but no head to head trial has been performed, Here, ketamine is compared with electroconvulsive therapy (ECT), the most effective therapy for depression. METHODS: Hospitalized patients with unipolar depression were randomized (1:1) to thrice-weekly racemic ketamine (0.5 mg/kg) infusions or ECT in a parallel, open-label, non-inferiority study. The primary outcome was remission (Montgomery Åsberg Depression Rating Scale score ≤10). Secondary outcomes included adverse events (AEs), time to remission, and relapse. Treatment sessions (maximum of 12) were administered until remission or maximal effect was achieved. Remitters were followed for 12 months after the final treatment session. RESULTS: In total 186 inpatients were included and received treatment. Among patients receiving ECT, 63% remitted compared with 46% receiving ketamine infusions (P = .026; difference 95% CI 2%, 30%). Both ketamine and ECT required a median of 6 treatment sessions to induce remission. Distinct AEs were associated with each treatment. Serious and long-lasting AEs, including cases of persisting amnesia, were more common with ECT, while treatment-emergent AEs led to more dropouts in the ketamine group. Among remitters, 70% and 63%, with 57 and 61 median days in remission, relapsed within 12 months in the ketamine and ECT groups, respectively (P = .52). CONCLUSION: Remission and cumulative symptom reduction following multiple racemic ketamine infusions in severely ill patients (age 18-85 years) in an authentic clinical setting suggest that ketamine, despite being inferior to ECT, can be a safe and valuable tool in treating unipolar depression.