INFLUENCE OF PERSUASIVE REMINDERS AND VIRTUAL REHEARSAL ON INFORMATION SYSTEMS FOR SLEEP DEPRIVATION

Appropriate amount and good quality of sleep are essential for mental and general well-being. Sleep deprivation and other chronic sleep disorders could lead to negative consequences for health, poor quality of life and reduced competence. An individual’s quality of life could be unsettled because of several reasons, sleep deprivation is one of them. Information systems (IS) and human-computer interaction (HCI) researchers have paid considerable attention to promote healthy behaviors however sleep deprivation as a problem domain has received relatively little attention. In this paper, we present qualitative findings from a field study that examined potential influence of persuasive reminders and virtual rehearsal on the effectiveness of a Behavior Change Support System (BCSS). Tyyne is a BCSS developed for people suffering from sleep deprivation. The content of virtual rehearsal modules were drawn from Acceptance and Commitment Therapy. Participants were recruited through newspaper advertisements. After screening at the university clinic, eligible participants (n = 86) were randomized into an Intervention group and a Control (wait-list) group. For data collection, we employed pre and post study structured questionnaires. Upon completion of the study, 41 participants volunteered to complete post study questionnaires. The findings reveal that a moderate number of participants (60.5%) improved their sleeping habits, a significantly high number of participants (79.1%) approved the BCSS, a staggering high number (93.0%) of the participants agreed that learning new skills through web-based BCSS is a good idea, and a substantial number of participants (72.1%) believed that persuasive reminders help people in task completion and compliance. Even though only about one third of participants (37.2%) reported that after using the BCSS they could better manage their sleep disorders, we suggest that the findings are encouraging. Given that treating sleep deprivation requires much longer periods of time than the intervention’s duration (in our case it was 6 weeks), improvement with one third of the participants is nevertheless a promising result. On the whole, persuasive reminders and virtual rehearsal as software features have a significant potential to enhance overall effectiveness of information systems for chronic sleep disorders

Treating Depression with a Behavior Change Support System without Face-to-Face Therapy

In this paper, we present results from a randomized controlled trial (RCT) that examined the impact of persuasive reminders and virtual rehearsal on the effectiveness of a behavior-change support system (BCSS). We developed the Web-based BCSS to support people with mild to moderate depression without face-to-face therapy. We randomized eligible participants into two groups. Both groups rehearsed the target behavior virtually; however, only the first intervention group received email-based reminders. We applied a mixed-methods approach for the analysis. We collected data with semi-structured self-reported questionnaires and post-study interviews. Results indicate that the severity of depression was noticeably decreased and participants’ self-confidence to manage depressive thoughts was generally improved. The influence of persuasive reminders on task completion was less than we anticipated, while the participants felt that virtual rehearsal was an effective technique for learning new behaviors. We discuss possible reasons for the results at the end of the paper

Does a Mindfulness-, Acceptance-, and Value-Based Intervention for Burnout Have Long-Term Effects on Different Levels of Subjective Well-Being?

This study investigated whether beneficial intervention effects on burnout and mindfulness skills diffuse and facilitate the long-term development of different levels of subjective well-being: experiential (perceived stress), eudaimonic (psychological and social well-being), and evaluative (life satisfaction). Participants were Finnish employees with notable burnout (n = 105, 80% women). The study utilized individual profiles of burnout and mindfulness skills identified in a previous study (Kinnunen, Puolakanaho, Tolvanen, Mäkikangas, & Lappalainen, 2019). The profiles were based on levels and changes in burnout and mindfulness skills during an 8-week intervention and 4-month follow-up. In the present study, the same profiles were compared using a χ2 test for changes in the different levels of subjective well-being over 12 months. Although most profiles showed benefits in experiential subjective well-being, achieving a significant increase in eudaimonic or evaluative levels at the 12-month study period required a considerable decrease in burnout and increase in mindfulness skills during the preceding 6 months. Those who initially benefited the most from the intervention, that is, showed a decrease in burnout and increase in mindfulness skills, also showed the most favorable development in all 3 levels of subjective well-being during the 12-month study period. The differences in well-being between those who initially benefited from the intervention and those who did not seemed unlikely to diminish over time. It is thus important to monitor intervention effects on each level of subjective well-being to identify participants who are likely to need additional support to achieve long-term changes in well-being in all levels.peerReviewe

Usage and Dose Response of a Mobile Acceptance and Commitment Therapy App : Secondary Analysis of the Intervention Arm of a Randomized Controlled Trial

Background: Mobile phone apps offer a promising medium to deliver psychological interventions. A mobile app based on Acceptance and Commitment Therapy (ACT) was developed and studied in a randomized controlled trial (RCT). Objective: To study usage metrics of a mobile ACT intervention and dose-response relationship between usage and improvement in psychological flexibility. Methods: An RCT was conducted to investigate the effectiveness of different lifestyle interventions for overweight people with psychological stress. This paper presents a secondary analysis of the group that received an 8-week mobile ACT intervention. Most of the analyzed 74 participants were female (n=64, 86%). Their median age was 49.6 (interquartile range, IQR 45.4-55.3) years and their mean level of psychological flexibility, measured with the Acceptance and Action Questionnaire II, was 20.4 (95% confidence interval 18.3-22.5). Several usage metrics describing the intensity of use, usage of content, and ways of use were calculated. Linear regression analyses were performed to study the dose-response relationship between usage and the change in psychological flexibility and to identify the usage metrics with strongest association with improvement. Binary logistic regression analyses were further used to assess the role of usage metrics between those who showed improvement in psychological flexibility and those who did not. In addition, associations between usage and baseline participant characteristics were studied. Results: The median number of usage sessions was 21 (IQR 11.8-35), the number of usage days was 15 (IQR 9.0-24), and the number of usage weeks was 7.0 (IQR 4.0-8.0). The participants used the mobile app for a median duration of 4.7 (IQR 3.2-7.2) hours and performed a median of 63 (IQR 46-98) exercises. There was a dose-response relationship between usage and the change in psychological flexibility. The strongest associations with psychological flexibility (results adjusted with gender, age, and baseline psychological variables) were found for lower usage of Self as context related exercises (B=0.22, P=.001) and higher intensity of use, described by the number of usage sessions (B=-0.10, P=.01), usage days (B=-0.17, P=.008), and usage weeks (B=-0.73, P=.02), the number of exercises performed (B=-0.02, P=.03), and the total duration of use (B=-0.30, P=.04). Also, higher usage of Acceptance related exercises (B=-0.18, P=.04) was associated with improvement. Active usage was associated with female gender, older age, and not owning a smart mobile phone before the study. Conclusions: The results indicated that active usage of a mobile ACT intervention was associated with improved psychological flexibility. Usage metrics describing intensity of use as well as two metrics related to the usage of content were found to be most strongly associated with improvement.Peer reviewe

Factors Anticipating Adolescents' Adherence and Dropout in an Online ACT Intervention During the COVID-19 Pandemic

This study examined factors anticipating adolescents’ (N=232) adherence and dropout in an online Acceptance and Commitment Therapy (ACT) intervention targeted at promoting well-being during the COVID-19 pandemic. First, results showed that adolescents with high academic achievement and educational expectations were more likely to participate in the induction meeting and start the program. Second, adolescents in the human supported model fulfilled the adherence criterion more often than adolescents supported by the virtual coach only. Finally, while male participants were less likely to participate in the study, the participants who started the online program were likely to adhere to it regardless of gender.Peer reviewe

A randomized controlled trial protocol for persistent physical symptoms associated with indoor environment or chronic fatigue : Effectiveness of video-based functional case conceptualization and web-program for improving quality of life

Introduction: Persistent physical symptoms (PPS) refer to symptoms that cannot be fully explained by structural bodily pathology or by environmental factors. Their impact on daily functioning varies from mild to severe disability. So far, evidence-based treatments for PPS have resulted in only small to moderate effects. Treatment protocols with a stronger orientation toward personalized approaches are needed to improve the efficacy and applicability of treatment. In this study, we aim to assess the effect of an online individual case conceptualization with web-based program for PPS. This study is conducted among two focus groups: patients with indoor air-related symptoms and patients with chronic fatigue syndrome.Methods and analyses: Using a randomized controlled design (RCT) with two parallel groups in a 1:1 ratio, we will compare individual video-based case conceptualization with a web-based program based on Acceptance and Commitment Therapy (ACT), combined with treatment as usual, with treatment as usual only. The web-based program consists of ten modules, each lasting 1 week and including training. The planned sample size is 124 eligible patients without attrition. The primary outcome will be the health-related quality of life as measured by the 15D questionnaire. The secondary outcome measures will include questionnaires on psychiatric and physical symptoms, illness perceptions, psychological flexibility, and work ability. We will also use national registers to obtain information on the use of healthcare and social benefits to complete patient-reported outcomes. Data collection began in August 2020 and will continue until 2023.Discussion: This trial will provide information on the effects and usefulness of an online administrated individual case conceptualization and an ACT-based web-program on PPS.Ethics and dissemination: The Ethics Committee of the Hospital District of Helsinki and Uusimaa, Finland, has granted approval for the study. The results will be published in peer-reviewed journals.Peer reviewe

Endotoxin levels and contribution factors of endotoxins in resident, school, and office environments - A review

As endotoxin exposure has known effects on human health, it is important to know the generally existing levels of endotoxins as well as their contributing factors. This work reviews current knowledge on the endotoxin loads in settled floor dust, concentrations of endotoxins in indoor air, and different environmental factors potentially affecting endotoxin levels. The literature review consists of peer-reviewed manuscripts located using Google and PubMed, with search terms based on individual words and combinations. References from relevant articles have also been searched. Analysis of the data showed that in residential, school, and office environments, the mean endotoxin loads in settled floor dust varied between 660 and 107,000 EU/m(2), 2180 and 48,000 EU/m(2), and 2700 and 12,890 EU/m(2), respectively. Correspondingly, the mean endotoxin concentrations in indoor air varied between 0.04 and 1610 EU/m(3) in residences, and 0.07 and 9.30 EU/m(3) in schools and offices. There is strong scientific evidence indicating that age of houses (or housing unit year category), cleaning, farm or rural living, flooring materials (the presence of carpets), number of occupants, the presence of dogs or cats indoors, and relative humidity affect endotoxin loads in settled floor dust. The presence of pets (especially dogs) was extremely strongly associated with endotoxin concentrations in indoor air. However, as reviewed articles show inconsistency, additional studies on these and other possible predicting factors are needed. (C) 2016 Elsevier Ltd. All rights reserved.Peer reviewe

Evidence for a role of MRCK in mediating HeLa cell elongation induced by the C1 domain ligand HMI-1a3

Diacylglycerol (DAG) is a central mediator of signaling pathways that regulate cell proliferation, survival and apoptosis. Therefore, C1 domain, the DAG binding site within protein kinase C (PKC) and other DAG effector proteins, is considered a potential cancer drug target. Derivatives of 5-(hydroxymethyl)isophthalic acid are a novel group of C1 domain ligands with antiproliferative and differentiation-inducing effects. Our previous work showed that these isophthalate derivatives exhibit antiproliferative and elongation-inducing effects in HeLa human cervical cancer cells. In this study we further characterized the effects of bis(3-trifluoromethylbenzyl) 5-(hydroxymethyl)isophthalate (HMI-1a3) on HeLa cell proliferation and morphology. HMI-1a3-induced cell elongation was accompanied with loss of focal adhesions and actin stress fibers, and exposure to HMI-1a3 induced a prominent relocation of cofilin-1 into the nucleus regardless of cell phenotype. The antiproliferative and morphological responses to HMI-1a3 were not modified by coexposure to pharmacological inhibition or activation of PKC, or by RNAi knock-down of specific PKC isoforms, suggesting that the effects of HMI-1a3 were not mediated by PKC. Genome-wide gene expression microarray and gene set enrichment analysis suggested that, among others, HMI-1a3 induces changes in small GTPase-mediated signaling pathways. Our experiments revealed that the isophthalates bind also to the C1 domains of β2-chimaerin, protein kinase D (PKD) and myotonic dystrophy kinase-related Cdc42-binding kinase (MRCK), which are potential mediators of small GTPase signaling and cytoskeletal reorganization. Pharmacological inhibition of MRCK, but not that of PKD attenuated HMI-1a3-induced cell elongation, suggesting that MRCK participates in mediating the effects of HMI-1a3 on HeLa cell morphology.Peer reviewe

Psychological flexibility mediates change in intuitive eating regulation in acceptance and commitment therapy interventions

Objective: Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches. The study investigates whether psychological flexibility, mindfulness skills and sense of coherence mediated the interventions' effect on intuitive eating and weight. Design: Secondary analysis of a randomized control trial. Mediation analysis compared two ACT interventions - face-to-face (in a group) and mobile (individually) - with a control group using a latent difference score model. Settings: Data were collected in three Finnish towns. Subjects: The participants were overweight or obese (n 219), reporting symptoms of perceived stress. Results: The effect of the interventions on participants' (i) BMI, (ii) intuitive eating and its subscales, (iii) eating for physical rather than emotional reasons and (iv) reliance on internal hunger and satiety cues was mediated by changes in weight-related psychological flexibility in both ACT groups. Conclusions: These findings suggest that ACT interventions aiming for lifestyle changes mediate the intervention effects through the enhanced ability to continue with valued activities even when confronted with negative emotions and thoughts related to weight.Peer reviewe

Plasma lipid profile associates with the improvement of psychological well-being in individuals with perceived stress symptoms

Psychological stress is a suggested risk factor of metabolic disorders, but molecular mediators are not well understood. We investigated the association between the metabolic profiles of fasting plasma and the improvement of psychological well-being using non-targeted liquid chromatography-mass spectrometry (LC-MS) platform. The metabolic profiles of volunteers participating in the face-to-face intervention group (n = 60) in a randomised lifestyle intervention were compared to ones of controls (n = 64) between baseline and 36-week follow-up. Despite modest differences in metabolic profile between groups, we found associations between phosphatidylcholines (PCs) and several parameters indicating stress, adiposity, relaxation, and recovery. The relief of heart-rate-variability-based stress had positive, while improved indices of recovery and relaxation in the intervention group had an inverse association with the reduction of e.g. lysophosphatidylcholines (LPC). Interleukin-1 receptor antagonist and adiposity correlated positively with the suppressed PCs and negatively with the elevated plasmalogens PC(P-18:0/22:6) and PC(P-18:0/20:4). Also, we found changes in an unknown class of lipids over time regardless of the intervention groups, which also correlated with physiological and psychological markers of stress. The associations between lipid changes with some markers of psychological wellbeing and body composition may suggest the involvement of these lipids in the shared mechanisms between psychological and metabolic health.Peer reviewe