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

Stress Reduction Using Bilateral Stimulation in Virtual Reality

The goal of this research is to integrate Virtual Reality (VR) with the bilateral stimulation used in EMDR as a tool to relieve stress. We created a 15 minutes relaxation training program for adults in a virtual, relaxing environment in form of a walk in the woods. The target platform for the tool is HTC Vive, however it can be easily ported to other VR platforms. An integral part of this tool is a set of sensors, which serves as physiological measures to evaluate the effectiveness of such system. What is more, the system integrate visual (passing sphere), auditory (surround sound) and tactile signals (vibration of controllers). A pilot treatment programme, incorporating the above mentioned VR system, was carried out. Experimental group consisting of 28 healthy adult volunteers (office workers), participated in three different sessions of relaxation training. Before starting, baseline features such as subjectively perceived stress, mood, heart rate, galvanic skin response and muscle response were registered. The monitoring of physiological indicators is continued during the training session and one minute after its completion. Before and after the session, volunteers were asked to re-fill questionnaires regarding the current stress level and mood. The obtained results were analyzed in terms of variability over time: before, during and after the session

MITIGATING PUBLIC SPEAKING ANXIETY USING VIRTUAL REALITY AND POPULATION-SPECIFIC MODELS

In the education and workplace landscape of the 21st century, it is often said that a person is only as valuable as the ideas s/he has and can share. Public speaking skills are essential to help people effectively exchange ideas, persuade, inform their audiences as well as make a tangible impact. They also plays a vital role in one’s academic and professional success. However, research shows that public speaking anxiety (PSA) ranks as a top social phobia among many people and tends to be aggravated in minorities, first generation students, and non-native speakers. This research aims at mitigating this anxiety by utilizing physiological (cardiovascular activity, electrodermal activity etc.) and acoustic (pitch, intonation, etc.) indices captured from wearable devices and virtual reality (VR) interfaces to quantify and predict PSA. This work also examines the significance of individual-specific factors, such as general trait anxiety and personality metrics, as well as contextual factors, such as age, gender, highest education, and native language, receny of public speaking in moderating the association between bio-behavioural (physiological and acoustic) indices and PSA. The individual-specific information is used to develop population-specific machine learning models of PSA. Results of this research highlight the importance of including such factors for detecting PSA with the proposed population-based PSA models yielding Spearman’s correlation of 0.55 n(p < 0.05) between the actual and predicted state-based scores. This work further analyzes whether systematic exposure to public speaking tasks in a VR environment can help alleviate PSA. Results indicate that systematic exposure to public speaking in VR can alleviate PSA in terms of both self-reported (p < 0.05) and physiological (p < 0.05) indices. Findings of this study will enable researchers to better understand antedecedents and causes of PSA as well as lay the foundation toward developing adaptive behavioural interventions for social communication disorders using systematic exposure (e.g., through VR stimuli), relaxation feedback, and cognitive restructuring

Human Health Engineering Volume II

In this Special Issue on “Human Health Engineering Volume II”, we invited submissions exploring recent contributions to the field of human health engineering, i.e., technology for monitoring the physical or mental health status of individuals in a variety of applications. Contributions could focus on sensors, wearable hardware, algorithms, or integrated monitoring systems. We organized the different papers according to their contributions to the main parts of the monitoring and control engineering scheme applied to human health applications, namely papers focusing on measuring/sensing physiological variables, papers highlighting health-monitoring applications, and examples of control and process management applications for human health. In comparison to biomedical engineering, we envision that the field of human health engineering will also cover applications for healthy humans (e.g., sports, sleep, and stress), and thus not only contribute to the development of technology for curing patients or supporting chronically ill people, but also to more general disease prevention and optimization of human well-being

Interreality for the management and training of psychological stress: study protocol for a randomized controlled trial

Background. Psychological stress occurs when an individual perceives that environmental demands tax or exceed his or her adaptive capacity. Its association with severe health and emotional diseases, points out the necessity to find new efficient strategies to treat it. Moreover, psychological stress is a very personal problem and requires training focused on the specific needs of individuals. To overcome the above limitations, the INTERSTRESS project suggests the adoption of a new paradigm for e-health - Interreality - that integrates contextualized assessment and treatment within a hybrid environment, bridging the physical and the virtual worlds. According to this premise, the aim of this study is to investigate the advantages of using advanced technologies, in combination with cognitive behavioral therapy (CBT), based on a protocol for reducing psychological stress. Methods/Design. The study is designed as a randomized controlled trial. It includes three groups of approximately 50 subjects each who suffer from psychological stress: (1) the experimental group, (2) the control group, (3) the waiting list group. Participants included in the experimental group will receive a treatment based on cognitive behavioral techniques combined with virtual reality, biofeedback and mobile phone, while the control group will receive traditional stress management CBT-based training, without the use of new technologies. The wait-list group will be reassessed and compared with the two other groups five weeks after the initial evaluation. After the reassessment, the wait-list patients will randomly receive one of the two other treatments. Psychometric and physiological outcomes will serve as quantitative dependent variables, while subjective reports of participants will be used as the qualitative dependent variable. Discussion. What we would like to show with the present trial is that bridging virtual experiences, used to learn coping skills and emotional regulation, with real experiences using advanced technologies (virtual reality, advanced sensors and smartphones) is a feasible way to address actual limitations of existing protocols for psychological stress

Being There: Understanding the Feeling of Presence in a Synthetic Environment and its Potential for Clinical Change

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Biofeedback in the prophylactic treatment of medication overuse headache: a pilot randomized controlled trial

Abstract Background: Medication overuse headache (MOH) is a major clinical concern and a common health risk. Recent literature stressed the need to manage chronic headache by using integrated biobehavioral approaches. Few studies evaluated how biofeedback can be useful in MOH. The aim of the study is to evaluate in a randomized, controlled, single-blind trial the effects of biofeedback associated with traditional pharmacological therapy in the prophylactic treatment of MOH. Method: Twenty-seven subjects were randomized to frontal electromyographic (EMG) biofeedback associated with prophylactic pharmacological therapy (Bfb Group) or to pharmacological treatment alone (Control Group). The primary outcome was to evaluate the number of patients that return episodic after treatment. Secondly we evaluate the effects of frontal EMG BFB on frequency of headache and analgesic intake. Changes in coping strategies and in EMG frontalis tension were also evaluated. ANOVA was performed on all the variables of interest. Results: Our results indicate that at the end of treatment the number of patients that returned episodic in the Bfb group was significantly higher than in the Control group. Patients in the Bfb group differed from the Control group in headache frequency, amount of drug intake and active coping with pain. These outcomes were confirmed also after 4 months of follow-up. No significant effects were observed in EMG recordings. Conclusions: Biofeedback added to traditional pharmacological therapy in the treatment of MOH is a promising approach for reducing headache frequency and analgesic intake. Modification of coping cognitions in the Bfb group, as an adjunct mechanism of self-regulation, needs more evaluations to understand the role of biofeedback in changing maladaptive psychophysiological responses

Immersive horizons: navigating ethical terrain and practical boundaries in the use of virtual reality for cancer symptom management – a comprehensive narrative review

Cancer is a significant healthcare problem. However, advancements in diagnostic procedures and therapeutic modalities have led to a decline in cancer mortality rates by 1% annually in most countries. Cancer patients often experience symptoms such as pain, cancer-related fatigue, anxiety, and lymphedema. To counter these side effects, there have been tremendous efforts. One such effort is the use of virtual reality (VR) technology, which is an interactive technology. VR has played a significant role in managing disorders such as phobias and anxiety disorders, and support for patients with cognitive and physical rehabilitation, acute and chronic pain management, and emotional support in different settings such as during hospitalizations. Our team conducted an extensive search for electronic literature on virtual reality in various databases, such as Medline, PubMed, Google Scholar, and Psych INFO, up to July 2023. We used keywords like "virtual reality," "cancer care," "depression," "cognition," "pain," "telemedicine," "rehabilitation care," "physical therapy," "radiotherapy," "telerehabilitation," "avatar," "video games," and "visual aid" as our search criteria. VR interventions for cancer patients include exposure therapy, psycho-education, and relaxation techniques, which have been shown to reduce symptoms significantly. VR distraction can also mitigate pain during medical procedures. Studies suggest that VR holds promise in rehabilitation and oncologic treatment, as it can improve function metrics, range of motion, and motivation for treatment. The review scrutinizes the use of digital information and virtual reality technology to alleviate cancer-related distress by providing remote care.