Extreme mediation: Observing mental and physical health in everyday life

The excessive use of smartphones resulting in extreme mediation has been identified to result in psychological problems including anxiety, depression, and an overall neural change that is impacting people of all ages on many levels. An exploratory study using Experience Sampling Method (ESM) concluded a significant increase in positive mood, conscious awareness of the surrounding environment, and an increased number of participants self-reporting physical activity lasting 15 minutes on days without smartphone use. Results suggest the need to avoid increased use of noninvasive technology such as smartphones resulting in deterioration of mental and physical health

Think-aloud evaluation of mobile information technology for older adults with chronic heart failure

poster abstractChronic heart failure (CHF) is a complex disease that often requires continuous medical attention.CHF is globally prevalent, especially among older adults. With more healthcare taking place in homes, controlling and managing the symptoms and progression of CHF depends critically on self-care behaviors such as medication taking and nutrition management by elderly patients. Based on Human Factors analysis of data gathered from interviews, surveys and in-home observations, our team designed Engage, a mobile, health information technology (HIT) tool customized for use by older adults with CHF. Engage is primarily envisioned to provide support for self-care and includes functionality designed and evaluated such as the: (1) logging daily values; (2) setting and monitoring daily self-management goals related to food intake and physical activities; (3) learning more information on self-care topics such as nutrition; and (4) visualizing collected information. Our team conducted an initial exploratory evaluation of Engage used think-aloud testing (in a controlled lab setting) with 5 older patients with CHF. Evaluation sessions involved patients using Engage’s functionalities based on hypothetical scenarios. Patients completed tasks guided by scripted instructions with each evaluation session being video recorded to capture user expectations and Engage’s usability. Results revealed design recommendations that will be tested in subsequent iterations of Engage. Our initial evaluation also pointed to the patients’ perceived benefits and barriers in using Engage over a 30-day period

Mediating ICU patient situation-awareness with visual and tactile notifications

Indiana University-Purdue University Indianapolis (IUPUI)Healthcare providers in hospital intensive care units (ICUs) maintain patient situation awareness by following task management and communication practices. They create and manipulate several paper-based and digital information sources, with the overall aim to constantly inform themselves and their colleagues of dynamically evolving patient conditions. However, when increased communication means that healthcare providers potentially interrupt each other, enhanced patient-situation awareness comes at a price. Prior research discusses both the use of technology to support increased communication and its unintended consequence of (wanted and unwanted) notification interruptions. Using qualitative research techniques, I investigated work practices that enhance the patient-situation awareness of physicians, fellows, residents, nurses, students, and pharmacists in a medical ICU. I used the Locales Framework to understand the observed task management and communication work practices. In this study, paper notes were observed to act as transitional artifacts that are later digitized to organize and coordinate tasks, goals, and patient-centric information at a team and organizational level. Non digital information is often not immediately digitized, and only select information is communicated between certain ICU team members through synchronous mechanisms such as face-to-face or telephone conversations. Thus, although ICU providers are exceptionally skilled at working together to improve a critically ill patient’s condition, the use of paper-based artifacts and synchronous communication mechanisms induces several interruptions while contextually situating a clinical team for patient care. In this dissertation, I also designed and evaluated a mobile health technology tool, known as PANI (Patient-centered Notes and Information Manager), guided by the Locales framework and the participatory involvement of ICU healthcare providers as co designers. PANI-supported task management induces minimal interruptions by: (1) rapidly generating, managing, and sharing clinical notes and action-items among clinicians and (2) supporting the collaboration and communication needs of clinicians through a novel visual and tactile notification system. The long-term contribution of this research suggests guidelines for designing mobile health technology interventions that enhance ICU patient situation-awareness and reduce unwanted interruptions to clinical workflow

Human factors analysis, design, and evaluation of Engage, a consumer health IT application for geriatric heart failure self-care

Human factors and ergonomics (HFE) and related approaches can be used to enhance research and development of consumer-facing health IT systems, including technologies supporting the needs of people with chronic disease. We describe a multiphase HFE study of health IT supporting self-care of chronic heart failure by older adults. The study was based on HFE frameworks of "patient work" and incorporated the three broad phases of user-centered design: study or analysis; design; and evaluation. In the study phase, data from observations, interviews, surveys, and other methods were analyzed to identify gaps in and requirements for supporting heart failure self-care. The design phase applied findings from the study phase throughout an iterative process, culminating in the design of the Engage application, a product intended for continuous use over 30 days to stimulate self-care engagement, behavior, and knowledge. During the evaluation phase, we identified a variety of usability issues through expert heuristic evaluation and laboratory-based usability testing. We discuss the implications of our findings regarding heart failure self-care in older adults and the methodological challenges of rapid translational field research and development in this domain

Uncanny valley and motor empathy

poster abstractThe uncanny valley phenomenon (Mori, 1970/2012) is the tendency to perceive as eerie human-looking characters with nonhuman features. It has been repeatedly claimed that falling into the uncanny valley can lead to a loss of empathy for a character (Hodgins, Jörg, O’Sullivan, Park, & Mahler, 2010). Empathy is the tendency to orient one’s responses to the situation of another instead of one’s own (de Vignemont & Singer, 2006). Empathy has been shown to be a combination of dissociable neurocognitive processes broadly grouped as cognitive, emotional, and motor empathy (Blair, 2005). It takes on such forms as perspective taking, sympathy, nonconscious mimicry, and the synchronizing of facial expressions, postures, and movements. To determine whether the uncanny valley suppresses motor empathy, operationalized as movement synchronization, a pilot study was undertaken by 25 participants. The study required participants to perform an action while viewing videos of a human character or its silhouette performing the same action. The frequency of actions performed by participants fell within their individual frequency and that of the character regardless of whether the participants were asked to coordinate or not coordinate their movement with the character. No significant difference in performance was noticed between the human character and its silhouette for all the conditions. Participants were observed to adjust their individual frequency in a similar manner for both the human character and its silhouette. Future studies with systematic variation in the human realism of the character’s features (e.g., skin texture or eye size) and its type of movement (biological vs. mechanical) can help ascertain the extent to which the uncanny valley phenomenon suppresses motor empathy

Supporting Information Management in ICU Rounding

Team rounds on patients in the hospital's intensive care unit (ICU) results in the generation of several paper-based and digital notes. Paper-based notes, although short-lived, act as translational artifacts that help organize and coordinate patient information and care. Maintaining double records of paper and digital notes can introduce several awareness and coordination problems such as contextually situating clinicians as to a patient's on-going care. Based on the design requirements derived from our fieldwork, we propose a new technology, PANI (Patient-centered Notes and Information Manager). PANI is a clinical tool that integrates the use of a mobile application, paper-based artifacts, and a wearable device (such as FitBit) in one system to support the management of notes and action-items that are generated throughout a typical ICU clinical shift. In this paper, we present the functional design of PANI and our preliminary findings of a participatory study that included 15 clinician participants

Smartphone Dependency and Consciousness: Observing Flow in the Everyday Life

poster abstractBackground: Excessive use of technology has led to neural change that is impacting people of all ages on many levels, of which children and adolescents are the most vulnerable [1]. These effects are cognitive [2], emotional [3], social [4], and also relate to their conscious awareness of the world around them [5]. Studies confirm a range of psychiatric disorders that have been correlated with excessive use of computer games and Internet use, including: ADHD, weakening of cognitive focus and shallower thinking skills, reduction of creativity and problem solving skills, a lowered ability to filter out extraneous information, adverse effects upon psychosocial development, hyperactivity and behavioral problems, feelings of isolation, depression, anxiety and restlessness, and an inability to form meaningful and long-lasting relationships, leading to abnormal or anti-sociopsychology [6,7,8]. Moreover, studies using MRI technology show the effects of brain activation patterns on middle age adults that use online searching, suggesting sensitivity of brain neural circuits and the “potential for negative brain and behavioral effects, including impaired attention and addiction” [9, p. 124]. These are examples of the neurological changes as a result of extreme mediation during increased use of non-invasive technologies such as interactive games and the Internet. Problem: In addition to the aforementioned technologies, an increased dependence on mobile technology (e.g., smartphones) has created an even greater neuro-psychological and neuro-social effect on users [10,11,12,13,14,15]. The focus of our research addresses the effects of smartphone use and its potential for altering human consciousness in everyday life. We define consciousness as the inner state of being and intrinsic governing structures of human awareness. Chalmers refers to it as self-inwardness, self-awareness, and attention, voluntary control, knowledge, introspection, reportability, and awakeness [16]. For centuries, human artifacts of cultural mediation, such as tools for work, have evolved from clubs to hammers to machines of the industrial age. Electronic tools/technologies, however, have never become so indistinguishably interwoven and prevailingly rooted within the development of our consciousness. Specifically, smartphones have become psychological tools that extend the conscious mind in the way we distribute thoughts, memories, exchange information and ideas, and fortify our personal relationships [17]. Aim: The aim of our research is to probe a segment of a very complex and broad area of consciousness research. While psychologists propose possible reasons for smartphone addiction owing to its ability to alter mood and trigger enjoyable feelings, it is not fully known if repetition of use is correlated to flow [18,19] and other areas of development. Hence, the aim of this study is to identify smartphone dependency and its relationship to consciousness and the experience of flow and mood in everyday life. Research questions include: Does smartphone use create dependency and in what way is flow a factor? Does smartphone use alter human consciousness? Method: Participants included 24 graduate students. Three data collection methods include: (1) The Experience Sampling Method (ESM) to observe levels of flow and reported measures of activity and conscious awareness. Participants logged subjective experience seven times per day throughout three consecutive days for two weeks of days with and without cell phone use. (2) Face-to-face interviews, self-reporting personal experience during the six-day study, and (3) Post-test demographic questionnaire. Results: Initial results from method one show a significant increase in flow strength (Z = 13.94, p < .001), consciousness (Z = 12.65, p < .001) and positive mood (Z = 11.32, p < .001) between the days students used and did not use their smartphones respectively. Participants showed increased consciousness on second day (without cell use) as compared with the first and third days. Broader Implications: Vygotsky [20] argued that consciousness results when humans perpetually construct their sociocultural environment by engaging in activity. In the analysis of the social mind, he suggested that through the use of tools during activity the natural psychological functions of the mind are re-structured and distributed. Technologies such as smartphones are engendering a new kind of psychological tool that is radically transforming consciousness. For this reason, we hold that a symbiosis between human life and artificial life is causing an evolving sociocultural mind: a form of cyborg consciousness [21]. While this study is still in progress, early results show that human consciousness and our deeply subjective experiences of everyday life can be impacted by the technologies we use

Symbiont Consciousness: Sociocultural Embodied Augmentation of Humanity

The psychology of consciousness as explained by Vygotsky is the ability of one to focus on the inner state of being. Vygotsky’s proposition of external tools redistributing mental and external processes into internalized acts lacks the concept of embodied mediational tools existing in the current world as computational artifacts extending or augmenting human capabilities. This paper proposes sociocultural embodied augmentation theory (SEAT) as a means to explain the impact of augmenting technologies on Vygotsky’s original notion of “psychological tool,” therefore initiating an inevitable transformation of the sociocultural mind. Hence, a new social mind is posited as an evolving symbiosis between human life and artificial life that extends consciousness: a symbiont consciousness

The human likeness of computer-generated characters predicts altercentric intrusion during a counting task (Alternative title: An uncanny valley of visual perspective taking: A study of the effects of character human likeness and eeriness on altercentric intrusion during a counting task)

poster abstractAbstract: Perceivers lose empathy for synthetic human characters when the characters' nonhuman features elicit an eerie feeling. This phenomenon, termed the uncanny valley, may specifically diminish the likelihood of understanding these characters' perspective. Such perspective taking should rely on a more fundamental ability to infer a character's visual perspective merely by looking at the character. Based on this assumption, a dot-counting task was undertaken by 268 undergraduate students in which they either took or ignored the apparent field of vision of computer-drawn characters with varying human likeness. It was predicted that for characters that appear more humanlike, task trials with a similar visual perspective between participant and character would predict shorter response times and higher accuracy, whereas task trials with dissimilar visual perspectives would predict longer response times and lower accuracy. Although these predictions were supported, trials with dissimilar visual perspectives also yielded longer response times when they included certain photorealistic inanimate objects (e.g., a chair). Future studies will ascertain whether such perspective taking ability is similarly affected when the synthetic human characters are more photorealistic

Evaluation of Renoprotective Effects of Ethanolic Extract of Morinda citrifolia L. in a Murine Model of Gentamicin-induced Nephrotoxicity

AIM: The present study was undertaken to evaluate noni fruit juice for its protective effects on gentamicin-induced nephrotoxicity in rats. METHODS:Wistar albino rats of either sex, weighing 150-200g were divided into 4 groups; normal saline, gentamicin 80 mg/kg, i.p.,i for 8 days, noni fruit juice 5 and 10 mg/kg, p.o., for 8 days, noni fruit juice 3 days prior and concurrently with gentamicin for 5 days. Blood urea, serum creatinine, serum uric acid and blood urea nitrogen analyses and microscopic examination of kidney were performed after the treatment. RESULTS: Gentamicin treatment caused nephrotoxicity as evidenced by marked elevation in blood urea and serum creatinine. Serum urea, serum uric acid, serum creatinine and blood urea nitrogen were increased with gentamicin compared to saline-treated animals (162.33 ± 9.92mg/dl, 3.13 ± 0.12 mg/dl, 6.85 ± 0.35 mg/dl and 75.86 ± 4.64 mg/dl respectively).Co-administration of noni fruit juice with gentamicin decreased the rise in in these parameters in a dose dependent manner. Study of renal morphology by light microscope showed epithelial loss with intense granular degeneration involving \u3e50% renal cortex in gentamicin treated rats, whereas in noni fruit juice plus gentamicin treated rat revealed insignificant changes in tubular epithelium. CONCLUSION: To conclude, our data suggest that supplementation of noni fruit juice may be useful in reducing gentamicin nephrotoxicity in rats