Usability of an adaptive computer assistant that improves self-care and health literacy of older adults.

OBJECTIVES: We developed an adaptive computer assistant for the supervision of diabetics' self-care, to support limiting illness and need for acute treatment, and improve health literacy. This assistant monitors self-care activities logged in the patient's electronic diary. Accordingly, it provides context-aware feedback. The objective was to evaluate whether older adults in general can make use of the computer assistant and to compare an adaptive computer assistant with a fixed one, concerning its usability and contribution to health literacy. METHODS: We conducted a laboratory experiment in the Georgia Tech Aware Home wherein 28 older adults participated in a usability evaluation of the computer assistant, while engaged in scenarios reflecting normal and health-critical situations. We evaluated the assistant on effectiveness, efficiency, satisfaction, and educational value. Finally, we studied the moderating effects of the subjects' personal characteristics. RESULTS: Logging self-care tasks and receiving feedback from the computer assistant enhanced the subjects' knowledge of diabetes. The adaptive assistant was more effective in dealing with normal and health-critical situations, and, generally, it led to more time efficiency. Subjects' personal characteristics had substantial effects on the effectiveness and efficiency of the two computer assistants. CONCLUSIONS: Older adults were able to use the adaptive computer assistant. In addition, it had a positive effect on the development of health literacy. The assistant has the potential to support older diabetics' self care while maintaining quality of life.

Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia.

The aim of the present study was to evaluate the effectiveness of low-budget virtual reality (VR) exposure versus exposure in vivo in a between-group design in 33 patients suffering from acrophobia. The virtual environments used in treatment were exactly copied from the real environments used in the exposure in vivo program. VR exposure was found to be as effective as exposure in vivo on anxiety and avoidance as measured with the Acrophobia Questionnaire (AQ), the Attitude Towards Heights Questionnaire (ATHQ) and the Behavioral Avoidance Test (BAT). Results were maintained up to six months follow-up. The present study shows that VR exposure can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. Further studies into the effectiveness of VR exposure are recommended in other clinical groups as agoraphobics and social phobics and studies in which VR exposure is compared with more emerging virtual worlds as presented in CAVE-type systems.

Research on presence in virtual reality: a survey.

Virtual Reality (VR) is starting to be used in psychological therapy around the world. However, a thorough understanding of the reason why VR is effective and what effect it has on the human psyche is still missing. Most research on this subject is related to the concept of presence. This paper gives an up-to-date overview of research in this diverse field. It starts with the most prevailing definitions and theories on presence, most of which attribute special roles for the mental process of attention and for mental models of the virtual space. A review of the phenomena thought to be effected by presence shows that there is still a strong need for research on this subject because little conclusive evidence exists regarding the relationship between presence and phenoma such as emotional responses to virtual stimuli. An investigation shows there has been substantial research for developing methods for measuring presence and research regarding factors that contribute to presence. Knowledge of these contributing factors can play a vital role in development of new VR applications, but key knowledge elements in this area are still missing.

Virtual reality treatment in acrophobia: a comparison with exposure in vivo.

The aim of the present study was to evaluate the effectiveness of low-budget virtual reality exposure versus exposure in vivo in a within-group design in 10 individuals suffering from acrophobia. Virtual reality exposure was found to be at least as effective as exposure in vivo on anxiety and avoidance as measured with the Acrophobia Questionnaire (AQ), and even more effective on the Attitude towards Heights Questionnaire (AHQ). The present study shows that virtual reality exposure can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. Further studies are recommended, in which virtual reality exposure is compared with in vivo exposure in a between-group design, thus enabling investigation of the long-term effects of virtual reality treatment.

Effects of azetidine-2-carboxylic acid on treatments of hepatoma cells with single or fractionated X-ray irradiations and on thermal radiosensitization in normal and thermotolerant cells.

The amino acid analog azetidine-2-carboxylic acid (azetidine) is a potent sensitizer to both hyperthermia and ionizing radiation. Incubation of H35 hepatoma cells with 2.5 mM azetidine before or after treatments with X-rays causes a time- and sequence-dependent enhancement of cell killing. Exposure of cells to 1-1.5 mM azetidine for 96 h in combination with repeated doses of 3 Gy X-rays at 24 h intervals causes an enhanced reduction of the surviving cell population due to both radiosensitization and an additional growth inhibition. Azetidine does not prevent the induction of thermotolerance after a heat shock. This thermotolerance proportionally reduces thermal radiosensitization but does not seem to affect azetidine radiosensitization. It is suggested that thermal radiosensitization and azetidine radiosensitization operate by different mechanisms.

Is heat shock protein re-induction during tolerance related to the stressor-specific induction of heat shock proteins?

The existence of stressor-specific induction programs of heat shock proteins (hsps) leads us to analyze the possible occurrence of a stressor-specific tolerance induced by either heat shock, arsenite, or cadmium. As a measure of this tolerance re-induction of hsps was studied. In this paper, we tested whether the refractory state is either valid for each specific hsp (implying independent regulation of every member of the heat shock protein family) or extends from small subsets of the hsp-family to even larger groups of proteins (indicating a more common denominator in their regulation). (re-)induction of hsps does not seem to be regulated at the level of each individual hsp since differences in induced synthesis of hsps between two stressor conditions are not supplemented systematically upon the sequential application of the two stressors. The most notable example in this respect is hsp60. A pretreatment with cadmium, which hardly induces synthesis of this hsp, does induce a tolerance to (re)-induction by heat shock, which normally induces hsp60. This suggests the existence of a more common denominator regulating the coordinate expression of at least some hsps. From our data we conclude that the degree, but not the pattern, of hsp re-induction is influenced by the type of stressor used in the pretreatment. The pattern of hsps induced by a secondary applied stressor still shows most of its stressor-specificity and seems to be independent of any pretreatment. The possible implications of stressor-specificity are discussed.

Separation of translationally active mRNAs by reversed-phase ion-pair high-performance liquid chromatography.

An ion-pair high-performance liquid chromatographic method on C4 columns was developed for the separation of mRNAs. The addition of methylmercuric hydroxide markedly influenced the separation according to length of these molecules. A method is given to recover minute amounts of translatable mRNA from the organic phase. The resolution of mRNAs improved with increasing pore size of the column support.

Short-term exposure to cadmium modifies phosphorylation of gill proteins in the sea mussel.

1. Sea mussels were exposed to cadmium for short periods of time. The excised gills were incubated with radioactive orthophosphate. The gill proteins were separated by 1- and 2-dimensional gel electrophoresis and the phosphorylation state of the proteins was determined by image analysis of autoradiographs. 2. 1-Dimensional gel electrophoresis revealed that exposure of the animals to cadmium stimulated phosphorylation of the gill proteins in a cadmium concentration-dependent manner. 3. 2-Dimensional gel electrophoresis showed that cadmium differentially affected the phosphorylation of various proteins. Major alterations were observed in the basic, high mol. wt proteins and in the acidic, low mol. wt polypeptides.

Synthesis of stress proteins under normal and heat shock conditions in gill tissue of sea mussels (Mytilus edulis) after chronic exposure to cadmium.

1. Sea mussels were exposed to 16.5 micrograms Cd/1 under semi-field conditions for almost one year. The isolated gills were incubated with 35S-methionine or -cysteine. 2. Chronic exposure to cadmium neither altered the rate of amino acid incorporation nor induced expression of heat shock proteins in the gills. 3. Heat shock imposed after chronic exposure to cadmium resulted in an increased synthesis of heat shock proteins, especially those of high molecular weight. 4. Synthesis of cadmium-binding, low molecular weight proteins was observed at any point of the exposure time. Their cadmium-binding capacity and rate of synthesis, after the initial increase, remained unchanged throughout the exposure.

The puromycin reaction mediated by yeast ribosomes in high salt.

The extend of the reaction between puromycin and yeast peptidyl-tRNA prelabeled in vitro was determined by measuring the distribution of trichloroacetic acid precipitable material in isokinetic sucrose gradients in the presence of 0.5 M KCl.Thus it was found that increasing amounts of puromycin remove increasing amounts of peptidyl-tRNA from the 80S position in the gradient. The extend of the reaction, however, was independent of pretreatment of the ribosomes with inhibitors of the translocation indicating that peptidyl-tRNA at the donor and at the acceptor site of the ribosomes are equally accessible to puromycin at 0.5 M KCl.The exposure of both ribosomal binding sites to puromycin in high salt is accompanied by an enhanced reactivity of puromycin towards peptidyl-tRNA. The ED50 determined by measuring the inhibition by puromycin of the poly-U dependent phenylalanine incorporation drops from 5×10(-5) M below 250 mM KCl to 5×10(-6) M at 300 mM and higher concentrations of KCl.