Irene Zaragozá

The Intelligent e-Therapy System: A New Paradigm for Telepsychology and Cybertherapy.

ABSTRACT One of the main drawbacks of computer-assisted psychology tools developed up to now is related to the real time customisation and adaptation of the content to each patient depending on his/her activity. In this paper we propose a new approach for mental e-health treatments named Intelligent e-Therapy (eIT) with capabilities for ambient intelligence and ubiquitous computing. From a technical point of view, an eIT system is based on four fundamental axes: ambient intelligence for capturing physiological, psychological and contextual information of the patient; persuasive computing for changing/reinforcing behaviours; ubiquitous computing for using the system at any place, and at any time; and multiple technological platforms support.

Improving Childhood Obesity Treatment Using New Technologies: The ETIOBE System

Childhood obesity is an increasing public health problem in western culture. Sedentary lifestyles and an “obesogenic environment” are the main influences on children leading to an increase in obesity. The objective of this paper is to describe an e-health platform for the treatment and prevention of childhood obesity called ETIOBE. This e-health platform is an e-therapy system for the treatment of obesity, aimed at improving treatment adherence and promoting the mechanisms of self-control in patients, to obtain weight loss maintenance and to prevent relapse by establishing healthy lifestyle habits. ETIOBE is composed of three different applications, the Clinician Support System (CSS), the Home Support System (HSS) and the Mobile Support System (MSS). The use of new Information and Communication (ICT) technologies can help clinicians to improve the effectiveness of weight loss treatments, especially in the case of children, and to achieve designated treatment goals.

An optical see-through augmented reality system for the treatment of phobia to small animals

This paper presents an optical see-through (OST) Augmented Reality (AR) system for the treatment of phobia to small animals. Our group has already presented two AR systems for this treatment. The first system was a video see-through (VST) AR system. The second one was a markerless AR system. And now, we present a third version using an OST approach. To check whether the OST AR system is more or less effective than the OST AR system, we have carried out an experiment comparing both systems. In this paper we focus on the anxiety level of participants during the experiment. Results show that both systems provoke anxiety in participants even if they do not have fear to cockroaches/spiders. OST AR system provokes slightly more anxiety than the VST AR system.

Ubiquitous monitoring and assessment of childhood obesity

Childhood obesity is a significant health problem in current societies that is increasing at an alarming way among population of all ages. To date, studies on the effectiveness of treatments for childhood obesity in the medium and long term suggest a moderate effect on weight loss and maintenance, which has led to suggestions that early interventions have a preventive nature on adult obesity. The long-term recovery of the weight lost is often associated with a lack of adherence to recommendations for changing life habits. Then, obesity becomes a chronic problem, difficult to approach, and the main difficulty lies in promoting and ensuring adherence to a change in lifestyle. A system known as ETIOBE has been developed to improve the treatment adherence, to promote the mechanisms of self-control in patients and to prevent relapses. An important part of the ETIOBE system is the ubiquitous monitoring platform since it enables the clinician to obtain relevant information from patients (contextual, physiological and psychological), which enables treatment customization and adaptation, depending on the patient’s evolution. The aim of this paper is to describe the monitoring platform which is intended to establish a sensor network whose focus is the obese children under clinical treatment, and the various elements that compose it: electronic PDA records to establish diet habits, HAS: home ambulatory system (data integration of biomedical devices; blood pressure to study hypertension; pulse oximeter to detect Sleep Disorders; and electronic t-shirt to detect physical activity). This paper presents the first validations of the electronic PDA records and the electronic t-shirt. These validations suggest that the monitoring platform can help to achieve the goals previously mentioned, by offering constant support and increasing motivation to change.

Shared virtual environment (SVE): a framework for developing social games

The communication channels are changing. More and more, face to face communication is being replaced by computer mediated communication. Using mediated communication, the non-verbal communication cues that are available in face to face communication are not. PASION is a European project where mediated communication is augmented. In this paper we present the Shared Virtual Environment (SVE), the framework to be used for the development of two types of applications (social gaming and collaborative work) where augmentation will be studied. The first version of SVE has been used for the development of the first version of a pervasive game for treasure hunting, Bluenet.

PDA self-register system for eating disorders: a study on acceptability and satisfaction.

Self-monitoring techniques, such as the use of dietary registers, are considered to be central to cognitive-behavioral treatment of Eating Disorders (ED). This information allows the clinician to identify the triggers of the behaviors associated to ED as purges and/or binges, and the associated thoughts and emotions, helping to carry out a more accurate assessment. Traditionally these registers are made with paper and pencil mode, where the patient has to register every eating and the emotions/thoughts associated; but this system has some problems, as low portability, low adherence or methodological difficulties. The use of PDA for self-registers can help to solve these problems. The aim of this study is to study the levels of acceptability and satisfaction with PDAs self-register system specifically designed for assessment and treatment of ED. Samples of 30 subjects diagnosed with ED are receiving a PDA with software specifically designed for recording type and amount of food, emotions before and after eating and other behaviors. The participants are completing self-register daily during a week, and afterwards answer an acceptance and satisfaction questionnaire. This work is in progress at the moment. It is expected that the PDA system will show high levels of acceptance and satisfaction.

Ontologies for Intelligent e-Therapy: Application to Obesity

In this paper we propose a new approach for mental e-health treatments named intelligent e-therapy (e-it) with capabilities for ambient intelligence and ubiquitous computing. The proposed e-it system supposes an evolution of cybertherapy and telepsychology tools used up to now. The e-it system is based in a knowledge base that includes all the knowledge related to the disorder and its treatment. We introduce the use of ontologies as the best option for the design of this knowledge base. We also present a fist e-it system for obesity treatment called etiobe.

Improving pain treatment with a smartphone app: study protocol for a randomized controlled trial

BackgroundChronic pain has become a major health problem across the world, especially in older adults. Unfortunately, the effectiveness of medical interventions is modest. Some have argued that assessment strategies should be improved if the impact of medical interventions is to be improved. Ecological momentary assessment using smartphones is now considered the gold standard in monitoring in health settings, including chronic pain. However, to the best of our knowledge, there is no randomized controlled trial to show that telemonitoring using a smartphone app can indeed improve the effectiveness of medical treatments in adults with chronic pain. The goal of this study will be to explore the effects of using a smartphone app for telemonitoring adults with chronic pain.MethodsThe study will be a randomized controlled trial with three groups: treatment as usual (TAU), TAU+app, and TAU+app+alarms. All groups will receive the adequate treatment for their pain, which will be prescribed the first day of study according to clinical guidelines. Assessment in the TAU group will be the usual at the Pain Clinic, that is, a paper-and-pencil evaluation at the onset of treatment (beginning of study) and at follow up (end of study, 30 days later). The other two groups (TAU+app and TAU+app+alarms) will be assessed daily using Pain Monitor, a smartphone app developed by our multidisciplinary team. Telemonitoring will only be made in the TAU+app+alarms group. For this group, physicians at the Pain Clinic may decide to adjust pain treatment in response to alarms. Telemonitoring is not the usual practice at the Pain Clinic and will not occur in the other two groups (TAU and TAU+app), so no changes in treatment are expected in these groups after the first appointment. The total sample size will be 150, with 50 patients in each group. The assessment protocol will be the same in all groups and will include pain intensity and side effects of the medication (primary outcomes), together with several pain-related variables like pain interference, activity level, use of rescue medication, pain catastrophizing, and pain acceptance, among others.DiscussionWe believe that the present trial has important clinical implications. We think that telemonitoring using ecological momentary assessment is crucial to improve current interventions for pain. The armamentarium of available treatments for pain is large, so physicians can turn to different treatments or dosages in the presence of an undesired event. The use of the app for telemonitoring can allow for this rapid detection of unwanted events, thus improving patient safety (i.e., withdrawal of treatment causing side effects) and augmenting treatment effectiveness (i.e., changing an ineffective treatment or dosage). In a time when smartphones are a mainstream technology, we should take advantage of them in the promotion of health care.Trial registrationClinicalTrials.gov, NCT03247725. Registered on 25 July 2017.

Teaching digital literacy skills to the elderly using a social network with linear navigation: A case study in a rural area

Abstract Information and Communication Technologies (ICTs) have considerably increased the information and communication channels, favoring the emergence of new models for social relations, such as social networks. However, for elderly users whose learning has traditionally been based on linear models of information such as textbooks, unfamiliarity with Internet can be a barrier. Moreover, elderly people living in rural communities face a lack of telecommunication infrastructures, which increases their difficulties in accessing ICTs. The aim of this study is to test a social network consisting of multiple applications with linear navigation as a digital literacy method for the elderly in rural areas. A sample of 46 participants between 60–76 years old with heterogeneous previous experience with ICTs participated in the study. They performed eight standardized sessions in an Elderly Leisure Center. Results showed differences in perceived usefulness between users with high and low ICT experience. After eight training sessions, the majority of the participants were able to independently use all the system applications, and positive results were obtained on the variables measured, i.e., learnability, sense of control over the system, ability to use the system, orientation, efficiency, accessible design, perceived ease, perceived usefulness, and intention to use. The participants with previous experience with other ICT methods preferred the linear navigation method because they thought it was easier than other ICTs. The results showed interaction differences when touch screens were used. Qualitative results showed that one of the most frequent emotions at the beginning of the ICT sessions was “fear” (related to breaking the computer or to making fools of themselves), but the continued use of the system improved the users’ perceptions of their own capacity to handle ICTs and their interest in ICTs in general. The main contribution of this work consists of exploring the usefulness of linear navigation and social network systems in the context of digital literacy for elderly users in rural areas.

A user-friendly tool for detecting the stress level in a person's daily life

Mental health care represents over a third of the cost of health care to all EU nations and, in USA, it is estimated to be around the 2.5% of the gross national product. Depression and Stress related disorders are the most common mental illnesses. The European project OPTIMI will develop tools to make predictions through the early identification on the onset of the disease. In this paper, we present a user-friendly application developed in the OPTIMI project to detect the stress level in a persons daily life. The results of a first usability study of this application are also presented.