A Review into eHealth Services and Therapies: Potential for Virtual Therapeutic Communities - Supporting People with Severe Personality Disorder

eHealth has expanded hugely over the last fifteen years and continues to evolve, providing greater benefits for patients, health care professionals and providers alike. The technologies that support these systems have become increasingly more sophisticated and have progressed significantly from standard databases, used for patient records, to highly advanced Virtual Reality (VR) systems for the treatment of complex mental health illnesses. The scope of this paper is to initially explore e-Health, particularly in relation to technologies supporting the treatment and management of wellbeing in mental health. It then provides a case study of how technology in e-Health can lend itself to an application that could support and maintain the wellbeing of people with a severe mental illness. The case study uses Borderline Personality Disorder as an example, but could be applicable in many other areas, including depression, anxiety, addiction and PTSD. This type of application demonstrates how e-Health can empower the individuals using it but also potentially reducing the impact upon health care providers and services.Comment: Book chapte

Bridging scales in cancer progression: Mapping genotype to phenotype using neural networks

In this review we summarize our recent efforts in trying to understand the role of heterogeneity in cancer progression by using neural networks to characterise different aspects of the mapping from a cancer cells genotype and environment to its phenotype. Our central premise is that cancer is an evolving system subject to mutation and selection, and the primary conduit for these processes to occur is the cancer cell whose behaviour is regulated on multiple biological scales. The selection pressure is mainly driven by the microenvironment that the tumour is growing in and this acts directly upon the cell phenotype. In turn, the phenotype is driven by the intracellular pathways that are regulated by the genotype. Integrating all of these processes is a massive undertaking and requires bridging many biological scales (i.e. genotype, pathway, phenotype and environment) that we will only scratch the surface of in this review. We will focus on models that use neural networks as a means of connecting these different biological scales, since they allow us to easily create heterogeneity for selection to act upon and importantly this heterogeneity can be implemented at different biological scales. More specifically, we consider three different neural networks that bridge different aspects of these scales and the dialogue with the micro-environment, (i) the impact of the micro-environment on evolutionary dynamics, (ii) the mapping from genotype to phenotype under drug-induced perturbations and (iii) pathway activity in both normal and cancer cells under different micro-environmental conditions

Reinforced Feedback in Virtual Environment for Plantar Flexor Poststroke Spasticity Reduction and Gait Function Improvement

Background. Ankle spasticity is a frequent phenomenon that limits functionality in poststroke patients. Objectives. Our aim was to determine if there was decreased spasticity in the ankle plantar flex (PF) muscles in the plegic lower extremity (LE) and improvement of gait function in stroke patients after traditional rehabilitation (TR) in combination with virtual reality with reinforced feedback, which is termed "reinforced feedback virtual environment" (RFVE). Methods. The evaluation, before and after treatment, of 10 hemiparetic patients was performed using the Modified Ashworth Scale (MAS), Functional Ambulatory Category (FAC), and Functional Independence Measure (FIM). The intervention consisted of 1 hour/day of TR plus 1 hour/day of RFVE (5 days/week for 3 weeks; 15 sessions in total). Results. The MAS and FAC reached statistical significance (P<0.05). The changes in the FIM did not reach statistical significance (P=0.066). The analysis between the ischemic and haemorrhagic patients showed significant differences in favour of the haemorrhagic group in the FIM scale. A significant correlation between the FAC and the months after the stroke was established (P=-0.711). Indeed, patients who most increased their score on the FAC at the end of treatment were those who started the treatment earliest after stroke. Conclusions. The combined treatment of TR and RFVE showed encouraging results regarding the reduction of spasticity and improvement of gait function. An early commencement of the treatment seems to be ideal, and future research should increase the sample size and assessment tools

JENTIL: responsive clothing that promotes an ‘holistic approach to fashion as a new vehicle to treat psychological conditions’

This paper explores an ongoing interdisciplinary research project at the cutting edge of sensory, aroma and medical work, which seeks to change the experience of fragrance to a more intimate communication of identity, by employing emerging technologies with the ancient art of perfumery. The project illustrates .holistic' clothing called the JENTIL® Collection, following on from the Author’s SmartSecondSkin' PhD research, which describes a new movement in functional, emotional clothing that incorporates scent. The project investigates the emergent interface between the arts and biomedical sciences, around new emerging technologies and science platforms, and their applications in the domain of health and well-being. The JENTIL® Collection focuses on the development of .gentle., responsive clothing that changes with emotion, since the garments are designed for psychological end benefit to reduce stress. This is achieved by studying the mind and advancing knowledge and understanding of how known well-being fragrances embedded in holistic Fashion, could impact on mental health. This paper aims to combine applied theories about human well-being, with multisensory design, in order to create experimental strategies to improve self and social confidence for individuals suffering from depressive illnesses. The range of methodologies employed extends beyond the realm of fashion and textile techniques, to areas such as neuroscience, psychiatry, human sensory systems and affective states, and the increase in popularity of complementary therapies. In this paper the known affective potential of the sense of smell is discussed, by introducing Aroma-Chology as a tool that is worn as an emotional support system to create a personal scent bubble. around the body, with the capacity to regulate mood, physiological and psychological state and improve self-confidence in social situations. The clothing formulates a healing platform around the wearer, by creating novel olfactory experiences in textiles that are not as passive as current microencapsulated capsule systems generally are

Public understanding of science and common sense: Social representations of the human microbiome among the expert and non-expert public

The aim of this investigation is to examine the structure and the content of different social groups’ representations of the human microbiome. We employed a non-probabilistic sample comprising two groups of participants. The first group (n = 244) included university students. The second group included lay people (n = 355). We chose a mixed-method approach. The data obtained were processed using IRaMuTeQ software. The results allow us to identify the anchoring and objectification processes activated by the two different groups of interviewees. The results could be useful to those in charge of implementing campaigns aimed at promoting health literac

Fostering collaborative research for rare genetic disease: The example of Niemann-Pick type C disease

Rare disease represents one of the most significant issues facing the medical community and health care providers worldwide, yet the majority of these disorders never emerge from their obscurity, drawing little attention from the medical community or the pharmaceutical industry. The challenge therefore is how best to mobilize rare disease stakeholders to enhance basic, translational and clinical research to advance understanding of pathogenesis and accelerate therapy development. Here we describe a rare, fatal brain disorder known as Niemann-Pick type C (NPC) and an innovative research collaborative known as Support of Accelerated Research for NPC (SOAR-NPC) which illustrates one pathway through which knowledge of a rare disease and its possible treatments are being successfully advanced. Use of the “SOAR” mechanism, we believe, offers a blueprint for similar advancement for many other rare disorders

The shape of things to come: visions for the future of Aboriginal and Torres Strait Islander health research

This paper presents the results of a project that considered how research might best contribute to Aboriginal and Torres Strait Islander health and wellbeing in the year 2030. Executive summary In late 2012, the Lowitja Institute embarked on a project using ‘futures thinking’ to consider how research might best contribute to Aboriginal and Torres Strait Islander health and wellbeing in the year 2030. The project was motivated by a desire to ‘get ahead of the game’: to anticipate and prepare for the potential research demands of the future. In particular, there was a desire to ‘close the gap’ between the point at which important research needs are identified by policy makers or service providers, and when research findings can be delivered. To think about the research needs of the future, it was necessary to first imagine what life might be like in 2030. What might Australia be like then, and the world? And what might the lives of Aboriginal and Torres Strait Islander people be? Workshops were held around the country to consider issues and trends visible in the current landscape, and how these might play out to influence life in 2030. A range of possible scenarios emerged, clustering around two divergent futures: an inclusive, vibrant Australia in which Aboriginal and Torres Strait Islander cultures are valued and embraced as central to the Australian identity; or an Australia in which economic and/or spiritual poverty drive a rejection of diversity and increase the divide between rich and poor. Participants then grappled with the question: If this (or that) scenario occurs, then what will be needed from research? By thinking about the range of possible scenarios for life in 2030, what capabilities are required to deliver the research that will be needed to address emerging issues and create a healthy future? The inspirational and empowering answer—perhaps not surprisingly—was not simply a list of research topics. Instead, participants articulated a strong and widely shared desire for a profoundly different system of research. A vision emerged of a research system in which research and practice are closely interwoven and which would enable greater integration of health services, policy and research. Such a system would be responsive to changing research demands, but also to changing social, economic, technological and knowledge landscapes. Specific research capabilities were also identified. An urgent necessity to actively address the social determinants of health was articulated in every workshop, along with a growing sense that the health and health research sectors may need to play a facilitating role, inviting other sectors—such as education, justice, local government—to collaborate and maximise the impact of their collective efforts to bring about change. A need for more evidence and evaluation around early childhood development programs (social as well as physical development) was seen as a priority for the immediate future. The Aboriginal and Torres Strait Islander health and health research sectors have played a pioneering role in the reform of research in Australia. The strength of vision articulated by participants in this project, and the desire to see that vision become a reality, suggests the sector will succeed in its drive toward a vision of a more effective research system

Protocol for an HTA report: Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic modelling

This article is made available through the Brunel Open Access Publishing Fund. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/Introduction: Long-term medical conditions (LTCs) cause reduced health-related quality of life and considerable health service expenditure. Writing therapy has potential to improve physical and mental health in people with LTCs, but its effectiveness is not established. This project aims to establish the clinical and cost-effectiveness of therapeutic writing in LTCs by systematic review and economic evaluation, and to evaluate context and mechanisms by which it might work, through realist synthesis. Methods: Included are any comparative study of therapeutic writing compared with no writing, waiting list, attention control or placebo writing in patients with any diagnosed LTCs that report at least one of the following: relevant clinical outcomes; quality of life; health service use; psychological, behavioural or social functioning; adherence or adverse events. Searches will be conducted in the main medical databases including MEDLINE, EMBASE, PsycINFO, The Cochrane Library and Science Citation Index. For the realist review, further purposive and iterative searches through snowballing techniques will be undertaken. Inclusions, data extraction and quality assessment will be in duplicate with disagreements resolved through discussion. Quality assessment will include using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data synthesis will be narrative and tabular with meta-analysis where appropriate. De novo economic modelling will be attempted in one clinical area if sufficient evidence is available and performed according to the National Institute for Health and Care Excellence (NICE) reference case.National Institute for Health Research Health Technology Assessment (NIHR HTA) Programm