ABSTRACT
BACKGROUND: Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. OBJECTIVE: This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. METHODS: We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. RESULTS: We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. CONCLUSIONS: These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
ABSTRACT
The Toll-like receptor 4 (TLR4) has a wide spectrum of bacteria recognition receptors that may be involved in the signaling of the immune responses in the prostate. A few association studies have assessed the relationship between the risk of prostate cancer (PC) and the polymorphism in the TLR4 gene in European-ancestry populations. To evaluate the association of TLR4 polymorphisms and the risk for PC in Korean men, we genotyped five single-nucleotide polymorphisms (SNPs) of the TRL4 gene (rs11536858, rs1927914, 1927911, rs11536891, and rs11536897) by PCR-restriction fragment length polymorphism from unrelated 157 PC patients and 143 age-matched controls. The rs1927911 SNP increased the risk of PC (adjusted odds ratio ORadj=2.73, 95% CI=1.54-4.87 for the TC genotype; ORadj=6.68, 95% CI=3.27-13.66 for the CC genotype). The GG genotype of the rs11536858 SNP also carried increased risk (ORadj=2.296, 95% CI=1.07-4.93). There was no statistically significant correlation between any of the SNPs of TRL4 and such PC prognostic factors as Gleason grade, initial prostate-specific antigen level, or tumor stage. In conclusion, inherited differences in the TLR4 gene influence the risk of PC in Korean men.
