Author: Brenda Wiederhold

What Are the True Costs of Regulation

What Are the True Costs of Regulation?

 

Many researchers and clinicians working in cybertherapy create their own businesses, which allow them to protect their intellectual property. In the United States, small businesses create the majority of jobs but bear proportionally more of the cost burden of implementing laws and regulations than do larger companies. This is true primarily because larger companies enjoy economies of scale. However, estimates of the true costs of regulation vary widely.

A new study* found that companies with fewer than 20 employees pay 42% more per employee than companies with between 20 and 499 employees, and 36% more than companies with 500 or more employees. For small businesses, the average cost per employee was $10,585 compared to $7,454 for medium-sized and $7,755 for large businesses.

According to the study, environmental regulations cost 364% more in small versus large companies, and tax compliance
is 206% higher. Occupational safety and health and homeland security are other top cost drivers.

The researchers calculated that some types of industry pay more than others. For example, small manufacturers (such as small manufacturers of medical devices) pay 110% more for compliance than medium-sized manufacturers and 125% more than large manufacturers. Small health-care firms (such as cybertherapy clinics) pay 45% more than medium firms and 28% more than large firms.

The authors say the total cost of regulation is $1.75 trillion, and note that businesses must close shop, reallocate activity, absorb the cost, or pass on the costs to customers. They estimate the per-household cost of federal regulation and taxes at $37,962.

The report notes, ‘‘If federal regulations place a differentially large cost on small business, this potentially causes inefficiencies in the structure of American enterprises and the relocation of production facilities to less regulated countries, and adversely affects the international competitiveness of domestically produced American products and services.’’

Some say that the above numbers are inflated and the study methodology is questionable, pointing to the annual report of the Office of Management and Budget (OMB) on the costs and benefits of regulation for a truer picture of the cost of regulation.

The OMB report notes that ‘‘The estimated annual benefits of major Federal regulations reviewed by OMB from October 1, 1999, to September 30, 2009, for which agencies estimated and monetized both benefits and costs, are in the aggregate between $128 billion and $616 billion, while the estimated annual costs are in the aggregate between $43 billion and $55 billion,’’ and that ‘‘Most rules have net benefits, but some rules have net costs.’’

Regardless of which of these estimates is closer to the true cost of regulation, the truth is that many regulatory costs are fixed: they are the same whether a company has 20 employees or 20,000. And the 89% of U.S. companies that have fewer than 20 employees produce a significant number of innovations. As President Obama has said, ‘‘Small businesses are the heart of the American economy.’’

In fall 2010, President Obama signed the Small Business Jobs Act, designed to help small businesses have easier access to credit and to provide more tax breaks. While a worthy effort, it does nothing to stem the tide of ever more regulation coming out of Washington.

Regulation per se is neither good nor bad. Rather, regulation in which the benefit outweighs the cost is good; regulation in which the cost outweighs the benefit is bad. Not all benefits can be quantified, which further complicates the picture.

It is time to start a serious dialog about the true cost of regulation, one that uses methodologically sound benefit–cost ratios as a starting point. I encourage readers to become involved in commenting on proposed regulations, so that only those regulations that pass the benefit–cost test are implemented. It is important to do so: the very future of innovation in health technology is at stake.

                                                                                                                                                                                                         Brenda K. Wiederhold

                                                                                                                                                                                                                      Editor-in-Chief

2010 Winter Editorial

Journal of CyberTherapy & Rehabilitation

Winter 2010, Volume 3, Issue 4

 

  EDITORIAL

Let me take this opportunity to welcome readers to the Winter 2010 issue of the Journal of CyberTherapy & Re- habilitation (JCR). Our peer-reviewed academic journal continues to promote and explore advanced technologies for therapy, training, education, prevention and rehabil- itation. With the end of 2010 drawing to a close, we take this time to reflect on the advancement and recognition JCR has received. We have seen our exposure grow, partly as a result of newly acquired indexing with Scopus and Embase, Cabell’s, Gale, EBSCO and PsycINFO. JCR continues to reach an ever-expanding number of readers around the globe, both as subscribers and at var- ious academic conferences.

In the first article of this issue, Cho and Lee describe the creation and implementation of a virtual optokinetic stimulation program to treat pseudoneglect in healthy individuals. Results and whether the program might be applicable in a clinical setting are addressed as well.

In the second paper, Valtchanov and Ellard explore physiological and affective responses to immersion in Virtual Reality (VR) to determine which environments, natural versus urban, have the most soothing effects on stress.

Next, Lister, Piercey, and Joordens discuss the effective- ness of VR to treat fear of public speaking and expound on future areas of application.

The following paper by Kündiger et al. addresses an online counseling system to treat eating disorders, and how it can complement more traditional methods of treatment and therapy. Level of acceptance for patients is discussed and ways in which to make the program more effective and user-friendly.

An interesting study by Wiederhold, Gavshon, and Wiederhold explores the combination of psychodynamic psychotherapy and VR. Often VR is used in combination with cognitive behavioral therapy, but its use with other types of therapy have found success as well.

A final paper by Santos-Ruiz et al. explores whether the Trier Social Stress Test can be integrated with VR environments to effectively measure levels of stress and anx- iety.

I would like to send a sincere thanks to contributing au- thors for their inspiring work and dedication to this field of research. I also want to thank JCR’s Associate Editors – Professors Botella, Bouchard, Gamberini and Riva for their continued leadership and hard work, as well as or internationally renowned Editorial Board for their contributions. Our board continues to grow, representing diverse disciplines, countries, and areas of expertise.

We continue to strive to provide readers with engaging, informative material, as well as extra supplements, including the newly added continuing education quizzes and book reviews. As always, we welcome your input and suggestions on ways to strengthen JCR’s scientific rigor and visibility. As well as input and recommendations, we welcome new submissions from scholars, researchers, and academics, instructions for which can be found in the back of the journal.

We look forward to providing our readers with cutting-edge studies and information in the upcoming year, and thank you for your continued support.

 

 

Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

2010 Fall Editorial

Journal of CyberTherapy & Rehabilitation

Fall 2010, Volume 3, Issue 3

 

 EDITORIAL

We are pleased to bring the Fall 2010 issue of the Journal of CyberTherapy & Rehabilitation (JCR) to our expand- ing audience around the world. Our quarterly published peer-reviewed academic journal explores the uses of ad- vanced technologies for therapy, training, education, prevention and rehabilitation. JCR continues to actively focus on the rapidly expanding worldwide trend of applying groundbreaking technology towards the field of healthcare.

To educate our readers on new advancements in fields such as robotics, adaptive displays, E-health, virtual re- ality (VR) and non-invasive physiological monitoring as they are applied to diverse disciplines in healthcare, we present comprehensive articles submitted by preeminent scholars in the field. This issue includes topics such as the creation of a virtual aquatic world to aid in education and using night vision during operations to possibly allow greater VR immersion for patients while in surgery.

In the first article of this issue, Wrzesien presents a pilot evaluation of a virtual interactive learning system aiming to teach children about the Mediterranean Sea and relevant ecological issues. The author also considers ways to improve the software after receiving preliminary feed- back.

Next, King, Delfabbro and Griffiths show the reader how cognitive-behavioral therapy might be employed to treat addicts of video games and discuss preliminary treatment techniques for such an addiction.

Thirdly, Rodrigues, Sauzéon, Wallet and N’Kaoua present a study comparing subjects’ spatial performance on a pedestrian route based on the type of learning environment, real or virtual, the exploration mode used during the learning phase and the type of spatial test administered at retrieval. Through this study the authors hope to further

In the fourth article Cowan et al. discuss a serious game for the purpose of teaching orthopedic surgery residents a total knee arthroplasty procedure using a problem based learning approach. The study assessed user per- ceptions of the game’s ease of use and potential for learning and engagement.

In the following article, Stadie et al. examine the differences in efficacy of reconstructing a 3-D arrangement of objects presented as a real model, a magnetic resonance image (MRI) or a VR model. The findings were then ap- plied to real life scenarios aiming to optimize the visual basis for anatomy training and surgery planning.

In the sixth article, Mosso et al. present results of surgeries performed on rabbits using night vision goggles and list ways in which this could benefit patients in the future, such as allowing for greater immersion and distrac- tion during operations using VR in a dark room.

Lastly, Tse and Ho address the management of chronic pain in the elderly population, focusing on a non-pharmacological method known as multisensory stimulation therapy.

While continuing to provide our readers with the latest scholarly studies presented in an informative and engag- ing medium, we will continue to offer the newly added Continuing Education quiz (see page 337 for more details) each issue. In addition, we will now be bringing the readers book reviews, the first of which appears in this issue on page 334, discussing “Interface Fantasy: A Lacanian Cyborg Ontology” by André Nusselder.

Although JCR has been receiving international attention from peers, international institutions and international conferences for some time, we are excited to inform readers that JCR is also continuing to become more widely known and recognized by the scientific commu- nity, as evidenced by the fact that it is now indexed with PsycINFO, Elsevier, Cabell’s, Gale and EBSCO. This recognition will further our cause to inform the wider community about ways in which healthcare can benefit from the applications of advanced technologies.

I would like to take this opportunity to sincerely thank the contributing authors for their inspiring work and ded- ication to this field of research. I also want to as always thank JCR’s Associate Editors – Professors Botella, Bouchard, Gamberini and Riva for their leadership and hard work, as well as or internationally renowned Edi- torial Board for their contributions. Thank you also to our outside reviewers for taking the time to ensure the rigorous nature of the articles.

As always, we welcome your submissions, comments, and thoughts on innovation.

Lastly, I would like to recognize what a huge success our 15th CyberPsychology & CyberTherapy Conference, held in Seoul, Korea in June, was. As you know, JCR is one of the two official journals of the International Association of CyberPsychology, Training & Rehabilitation (iACToR). The annual international conference series agreed, in 2009, to become the official conference of iACToR. So, along with CyberPsychology, Behavior, & Social Networking Journal (CPB&SN), CyberTherapy & Rehabilitation (C&R) Magazine, and JCR, we cele- brate our Combined Communications Platform. We are very excited for next year’s conference to be held June 20-22 in Gatineau, Canada.

We look forward to the future growth of our cause and thank you, our readers and subscribers, for your continued support.

 

 

Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

2010 Summer Editorial

Journal of CyberTherapy & Rehabilitation

Summer 2010, Volume 3, Issue 2

 

 EDITORIAL

Welcome to the Summer 2010 issue of the Journal of Cy- berTherapy & Rehabilitation (JCR). As you know, JCR is one of the two official journals of the International As- sociation of CyberPsychology, Training & Rehabilitation (iACToR). Now in its 15th year, the annual international CyberPsychology & CyberTherapy Conference (CT15) agreed, in 2009, to become the official conference of iACToR. So, along with CyberPsychology, Behavior, & Social Networking Journal (CPB&SN), CyberTherapy & Rehabilitation (C&R) Magazine, and JCR, we cele- brate our Combined Communications Platform. The journals, conference, magazine, and association combine into one powerful platform to address previous informa- tion deficits in the utilization of advanced technologies in healthcare. We will strive to speak with a united voice to inform and educate about the uses of technologies in healthcare, as well as how technologies are impacting behavior and society.

This year we are proud to be holding CT in Asia for the first time. Organized by the Interactive Media Institute (IMI), a 501c3 nonprofit organization, in cooperation with Hanyang University, CT15 is being held June 13- 15, 2010 in Seoul, Korea. This venue speaks to the con- tinued growth and collaboration, not just amongst Europe and America, but also amongst researchers and scholars worldwide. This year’s conference theme is two fold: First, CT15 will explore technologies as enabling tools. This will include the uses of advanced technolo- gies such as virtual reality simulations, videogames, tele- health, video-conferencing, the internet, robotics, brain computer interfaces, wearable computing, non-invasive physiological monitoring devices, in diagnosis, assess- ment, and prevention of mental and physical disorders. In addition, we will look at interactive media in training, education, rehabilitation, and therapeutic interventions. Second, CT15 will explore the impact of new technolo- gies. CT15 will investigate how new technologies are in- fluencing behavior and society through cyberadvertising, cyberfashion, and cyberstalking, to name a few.

I would like to take this opportunity to thank all those who are helping to make this year’s conference possible
through their tireless energy and drive – the Co-Orga- nizer and Conference Co-Chair Professor Sun Kim; this year’s Scientific Chairs, Professors Stéphane Bouchard, José Gutiérrez Maldonado and Giuseppe Riva; Tutorial Chairs, Professor Luciano Gamberini and Alessandra Gorini; Exhibit Chair and Conference Organizer, Profes- sor Jang-Han Lee; Cyberarium Chair Professor Hunter Hoffman; and Technical Chairs Professors Mariano Al- cañiz and Evangelos Bekiaris. Many thanks also to the Scientific Committee, made up of prominent researchers from around the world, and the Local Advisory Commit- tee in Seoul, as well as all of the presenters and attendees. Finally, my gratitude to James Cullen and Jang-Han Lee for overseeing the Conference Coordination, and to the teams at Hanyang University, Interactive Media Institute, Virtual Reality Medical Center, and Virtual Realty Med- ical Institute for their time and contributions to all facets of the conference.

To our sponsors, who continue to support our vision and help make it a reality, a warm and heartfelt thank you – Bionet, Defense Advanced Research Projects Agency/ Defense Science Office (DARPA/DSO), the European Commission, DGINFSO, Hanyang University, Institute of Aging Society Silver & u-Health Research Center, the Interactive Media Institute, Istituto Auxologico Italiano, Mary Ann Liebert, Inc. Publishers, National Institute on Drug Abuse, National Institutes of Health, OsteoSys, Université du Québec en Outaouais, the Virtual Reality Medical Center, and the Virtual Reality Medical Insti- tute.

As integral parts of our Combined Communications Plat- form, the CT Conference series will continue to work to- gether with iACToR, JCR, and C&R to educate industry, academia, and government officials on the explosive growth of advanced technologies for therapy, training, education, prevention and rehabilitation.

As in previous conferences, this year’s conference will be hosting an interactive exhibit area, the Cyberarium, which allows conference attendees and members of the press to try new technologies firsthand. To recognize outstanding achievements by students, new researchers, as well as lifetime achievement to a senior researcher, we will also be hosting awards during the conference and announcing the 2010-2011 iACToR officers during the General Assembly. Pre-conference workshops will high- light psychotherapeutic applications, brain computer in- terface devices, rehabilitation for seasoned researchers, and an introduction to VR will be given for those newer in the field.

As we approach CT15 with excitement, we begin too to look toward next year’s conference, CyberPsychology &
CyberTherapy 16, to be held in Gatineau, Canada on June 20-22, 2011. Thank you again for your commitment to the evolution of healthcare!

 

 

Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

2010 Spring Editorial

Journal of CyberTherapy & Rehabilitation

Spring 2010, Volume 3, Issue 1

 

EDITORIAL

Welcome, readers and researchers, to the Spring 2010 issue of the Journal of CyberTherapy & Rehabilitation (JCR). Our peer-reviewed quarterly academic journal continues to explore and support the uses of advanced technologies for therapy, training, education, preven- tion and rehabilitation. JCR is unique in the fact that it focuses on the rapidly expanding worldwide trend of applying ground-breaking technology towards the field of healthcare, with an emphasis on the fields of psychi- atry, psychology, physical medicine and rehabilitation, neurorehabilitation, oncology, obesity, eating disorders and autism.

With a growing international base of readers and sup- porters driven by a similar goal of advancing the use of technology in the healthcare sector, JCR has re- ceived positive attention from peers, international in- stitutions and international conferences. To keep readers abreast of new developments, within this issue of JCR we present comprehensive articles submitted by preeminent scholars in the field, featuring such top- ics as combining physical activity with learning in an augmented reality setting, including the sense of ol- faction more commonly in VR, and how communica- tion is used in virtual worlds like Second Life.

In the first article Voorhees et al. study the relationship between attitude and adherence to treatment in adoles- cents with sub-threshold depression in order to improve public health strategies to prevent depressive disorders.

Next, Baus and Bouchard address the sense of olfaction and ways in which it can further and enrich VR any ad- vocate the growth of the field while discussing possible applications in virtual environments.

In an attempt to merge learning and physical activity in the classroom, Hsiao next looks at using augmented re- ality and VR applications to provide more effective teaching methods and increase retention, while provid- ing much-needed exercise to the younger population at the same time.

In the fourth article, Alquda et al. use Virtual Humans to look at how race and sex can affect how people interpret others’ pain, pain coping skills, related mood, and other factors.

Lastly, Park discusses the use of Second Life as an ex- ample of how activities in virtual worlds might be used as a communication environment to better understand each other, with an emphasis in this study on gender.

As well as continuing to provide our readers with the latest studies presented in an informative and engaging medium, we will be offering one Continuing Education quiz per issue as a further added service to our sub- scribers and others interested in supporting their educa- tion. For more information, see page 95.

I would like to sincerely thank the contributing authors for their inspiring work and dedication to this field of research. I also want to thank JCR’s Associate Editors – Professor Botella, Professor Bouchard, Professor Gamberini and Professor Riva for their leadership and hard work, as well as or internationally renowned Edi- torial Board for their contributions. I would also like to take this opportunity to welcome new Board members – Linda A. Jackson of Michigan State University, Julian Dooley of Edith Cowan University, Wijnand IJsselsteijn from the Eindhoven University of Technology, Joshua Fogel from the University of New York, and XiaoXiang Zheng of Zhejiang University – whose diverse back- ground and placement around the globe will bring added richness to our board. We encourage readers and sub- scribers to contact us with ideas and we welcome sub- missions. Your input continues to enrich our publication.

With the start of a new year, new possibilities abound and we will continue to promote the growth of the di- verse field of advanced technologies for healthcare in Europe and worldwide. We are happy to count you as a part of this movement and thank you for your continued support.

 

 

Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

PTSD Threatens Global Economies

Recent news reports reveal the tip of an iceberg that is threatening to sink the ship of state in countries worldwide— the iceberg known as posttraumatic stress disorder (PTSD). PTSD increasingly threatens to swamp health systems and social support systems, even as some of these budgets are cut for lack of funds as a result of the global economic crisis. The human toll is even more devastating.

  • On May 12, 2009, the Associated Press (AP) reported that a 44-year-old U.S. sergeant, nearing the end of his third tour in Iraq, was so angry at the Army he opened fire in the combat-stress clinic in Baghdad, killing five people.
  • On May 22, 2009, AP related the story of a 24-year-old ex-soldier on trial in Kentucky for raping a 14-year-old Iraqi girl and murdering her parents and sister while on duty in Iraq. The jury cannot agree whether or not to sentence him to death.

It is probable we will see more headlines like these in the next 6 months because the U.S. Army will not be able to give soldiers adequate time at home between tours of duty until the end of 2010. Since 2001, the U.S. has deployed nearly 1 million soldiers to Iraq and Afghanistan, and more than 300,000 of them have served multiple tours. About 20% of these soldiers return with psychological damage, most commonly PTSD and depression. At least half of PTSD sufferers smoke, and others become dependent on alcohol or prescription drugs. PTSD increases risk of cardiovascular disease, and multiple traumas have a deleterious effect on many aspects of physical health. Overall, the U.S. Army’s suicide rate reached an all-time high in 2008. For those who survive, lifetime benefits for a U.S. service member permanently disabled because of PTSD may top $1 million. Finally, the most recent estimate of the annual cost of anxiety disorders in the United States, with PTSD ranking highest in terms of per-person health care expenditures, was $42.3 billion in mental and physical health services alone.

In Europe, about 41 million people have anxiety disorders, and PTSD may occur in up to 37% of those exposed to trauma such as combat, sexual and physical assault, being held hostage or imprisoned, terrorism, torture, natural and manmade disasters, accidents, and receiving a diagnosis of a life-threatening illness.

Because PTSD has such varied symptoms, a combination of treatments is often necessary. Anxiety-reducing medications, antidepressants, support from friends and family, and cognitive-behavioral therapy (CBT) involving exposure can help with recovery. However, these types of traditional therapies do not have acceptable recovery rates. Front-line antidepressant medications for the disorder—such as selective serotonin reuptake inhibitors—rarely yield better than a 40% reduction in symptoms. Traditional psychotherapy fares only slightly better, with only 44% of all those entering treatment classified as improved at the end of the treatment period.

Fortunately, we live in a time when advances in medical technology abound. A recent Google search of ‘‘PTSD technology issues 2009’’ revealed that two of the five top links addressed the value of virtual reality (VR) therapy for PTSD.

A panel of experts has published a consensus opinion that exposure therapy is the most appropriate therapy for PTSD. Prior to the availability of VR therapy applications, the existing standard of care for PTSD was imaginal exposure therapy in which patients ‘‘relive’’ the traumatic event in a graded and repeated process. Exposure therapy is based on emotional processing theory (EPT). Applying EPT to PTSD, fear memories are stored as a ‘‘fear structure’’ and include psychological and physiological information about stimuli, meaning, and responses. Once accessed and emotionally engaged, the structure is open to modification through CBT, and over time, treatment will result in extinction of the fear response.

Although exposure therapy has been shown to be effective, one hallmark of PTSD is avoiding reminders of the trauma. Because of this, many patients are unable or unwilling to visualize the traumatic event during imaginal therapy. In studies that address treatment nonresponders, failure to engage emotionally or visualize well enough to elicit an emotional response are cited as most predictive of nonresponse to treatment, since the fear structure is not accessed during therapy and is therefore not open to change.

This is where VR can step in to enhance treatment. In recent years, VR has been shown to improve treatment efficacy for PTSD in survivors of many types of trauma, including motor vehicle accidents, war, earthquake, and terrorism such as the 9=11 World Trade Center attacks. By being placed in an environment where a trauma has occurred (in war veterans, it could be a virtual combat setting; in armed conflict survivors, a virtual countryside under attack), and then slowly experiencing that situation in a controlled way, patients may begin to habituate to the PTSD symptoms and come to reappraise the instigating situation. This allows emotional processing to occur and may free PTSD sufferers from their intrusive memories and disturbing symptoms. Unlike in vivo therapy, which takes the patient into real-world scenarios (which is not practical or even possible with war veterans), VR permits the patient to interact with anxiety-inducing scenarios in the safety and confidentiality of the therapy room. Early results indicate response rates as high as 80% with VR exposure therapy.

In Europe and America, decision makers are beginning to focus attention on technology solutions to this problem. A NATO-supported advanced research workshop, Wounds of War: Addressing Posttraumatic Stress Disorder (PTSD) in Peacekeeping and Combat Troops, organized by the Interactive Media Institute and also supported by the U.S. Army’s Military Operational Medicine Research Program, brought together experts from 14 countries in October 2009 in St. Kanzian, Klopeiner See, Su¨dka¨rnten, Austria.

The American Recovery and Reinvestment Act (ARRA) of 2009 provides the U.S. Department of Veterans Affairs (VA) with $1.4 billion, most of which is to be spent on facilities upgrades, health information technology, and other programs designed to create jobs. The U.S. Department of Defense will receive $7.4 billion under ARRA, most of which will be used in a similar fashion. ARRA requires an unprecedented level of accountability and transparency, so world citizens can track the projects completed with these funds. At this, just one third of ARRA funds have been released.

If one of the aims of ARRA funding is, as DoD states, to ‘‘care for U.S. Service members and their families,’’ surely some of these funds can be directed to large-scale research studies designed to prove the efficacy and cost effectiveness of VR therapy for current and former service members with PTSD. While a growing number of Veterans Administration facilities are using VR therapy in controlled studies that allow veterans to receive this most effective treatment, only when governments consider it a priority to mainstream such therapy can we avoid our ships of state becoming the next Titanic.

Editor-in-Chief Brenda K. Wiederhold
 

2009 Winter Editorial

Journal of CyberTherapy & Rehabilitation

Winter 2009, Volume 2, Issue 4

 

EDITORIAL

Welcome to the Winter 2009 issue of the Journal of Cy- berTherapy & Rehabilitation (JCR). We are pleased to bring this special issue of our publication to readers, critics and researchers around the world. Our peer-re- viewed academic journal explores the uses of advanced technologies for therapy, training, education, prevention and rehabilitation. JCR is a quarterly published aca- demic journal, unique in the fact that it focuses on the rapidly expanding worldwide trend of applying ground- breaking technology towards the field of healthcare. Psychiatry, psychology, physical medicine and rehabil- itation, neurorehabilitation, oncology, obesity, eating disorders and autism continue to be main areas of inter- est studied by JCR.

Since our inaugural issue, JCR has received interna- tional attention from peers, international institutions and international conferences. A common thirst for new knowledge and application of cutting-edge technolo- gies to better the lives of others brings this diverse group of people towards a similar goal. Advanced tech- nologies, such as robotics, adaptive displays, E-health, virtual reality (VR) and non-invasive physiological monitoring are now applied to many diverse fields of healthcare. As this body of research is added to, pa- tients, doctors and therapists can look towards a hopeful future and new ways to treat mental and physical dis- orders. Within this issue of JCR, we present compre- hensive review articles submitted by preeminent scholars in the field. The content is diverse, featuring such topics as VR immersions, the effects of video game playing and even online forums to treat sufferers of disease.

This special issue of JCR includes three full papers, as well as all presented abstracts, written by presenters from the “Beyond Brain Machine Interface: Motor, Cognitive and Virtual” pre-conference workshop, held September 2, 2009 in Minneapolis, Minnesota. The conference, co-organized by the Army Research Office, IEEE EMBS and the Interactive Media Institute, edu- cated attendees on more efficient and intuitive ways of achieving system control than manual manipulation and allowed for discourse among academics, members of the scientific community, biomedical device engineers and the clinician user community. Scientists from five different countries and ten diverse institutions gathered to discuss these technologies and developments in their fields of research, and gave formal presentations on their papers.

In this issue’s first article Cai, Milcent and Franco ex- plore the human-machine visual digest system by fo- cusing on the relationship between gaze and object. They describe ways to better utilize network bandwidth and in turn, minimize the resulting media footprint by combining human vision and machine vision.

Next, Scherer et al. discuss brain-computer interface re- search using EEG and ECoG-based paradigms that are presented to the reader, along with ways to improve in- formation transfer rates. Different BCI projects are dis- cussed, such as an anatomically correct testbed for a human hand model.

In the following article, Raspelli et al. conduct further research on the Multiple Errands Test, applying virtual reality to assess executive functions in patients suffer- ing from Parkinson’s disease and stroke.

In the fourth manuscript, Pallavicini et al. report find- ings on a study to treat sufferers of Generalized Anxiety Disorder using biofeedback, virtual reality and mobile phones. The use of mobile phones allowed patients to continue treatment in an outpatient setting and ad- dresses the classic problem associated with VR ther- apy–the lack of mobility for the treatment system.

Gras, Hummer and Hine, in the fifth manuscript, com- pare the reliability and validity of the Nintendo Wii Fit to the widely used NeuroCom EquiTest, to measure bal- ance and help rehabilitate patients.

Lastly, Cantelmi and Talli explain the psychological and psychopathological risks associated with overuse of the Internet, including the problems associated with defining a relevant syndrome, possible diagnostic cri- teria and possible therapies for treatment.

This issue of JCR will continue to explore the ways in which healthcare, in Europe and worldwide, can benefit from the applications of technology. I would like to sin- cerely thank the contributing authors for their inspiring work and dedication to this field of research. I also want to thank JCR’s Associate Editors – Professor Botella, Professor Bouchard, Professor Gamberini and Professor Riva for their leadership and hard work, as well as our internationally renowned Editorial Board for their contributions. We encourage readers and subscribers to con- tact us with ideas and manuscripts. Your input continues to enrich our publication. Looking to 2010, we are op- timistic as this diverse field continues to grow and at- tract those wishing to learn more and those already supporting and implementing new technologies. With only more room to grow, we will continue to bring you news of further developments in the upcoming year.

 

Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

2009 Fall Guest Editorial

Journal of CyberTherapy & Rehabilitation

Fall 2009, Volume 2, Issue 3

 

GUEST EDITORIAL

In this special issue of the Journal of CyberTherapy and Reha- bilitation, you will find several papers that were  selected from the more than one hundred submissions received by the Scien- tific Committee for the International Symposium on Neurore- habilitation.

Seeing the need to strengthen the collaboration between tech- nical and health related disciplines, the International Sympo- sium on Neurorehabilitation: from Basics to Future was held in Valencia, Spain on October 15-16, 2009. The main purpose of the Symposium was to bring together engineers, researchers and health care professionals to share ideas and experiences with the aim of creating a “common language” that will help to increase the efficacy of the neurorehabilitation process and to improve the quality of life of patients. World-renowned re- searchers in cognitive and motor rehabilitation, virtual reality, telerehabilitation, brain-machine interfaces, patient assessment, behavioral science, neuroplasticity, neuroimaging, neurophar- macology and rehabilitation robotics updated participants on the current state of their respective research areas during the Symposium. Similarly, more than 350 delegates from around the world participated in this event and provided examples of their current work.

In the coming years, the incidence of diseases and afflictions with a neurological origin will increase to–what some have ven- tured to call–epidemic proportions. Among the main reasons be- hind this “coming epidemic” is the shift that the world’s population will experience, according to several forecasts, to- wards an increasingly older population as a result of improve- ments in medicine and standards of living. According to the United Nations, more than 20 percent of the world’s population will be over 60 years old by the year 2050, more than doubling the current size of this population segment. This shift towards an older population will not be limited to the developed world; most of the developing world will experience a similar popula- tion shift in the coming decades. Unfortunately, an aging popu- lation increases exponentially the risk of suffering from afflictions affecting the central nervous system, which could lead to a lower quality of life for these individuals, or even death. Among these afflictions one can find multiple sclerosis, Parkin- son’s disease, Alzheimer’s disease, stroke, among many others. Recent advances in neurorehabilitation, the specialized and interdisciplinary treatment of individuals suffering from neu- rological afflictions, can prove to be extremely important to ameliorate the suffering experienced by these individuals and to help them to return to a normal life. At the same time, we are seeing the increasing importance of technology in our everyday lives. As a result, technology is also playing an im- portant role in the improvement of neurorehabilitation, and we feel that its importance will only increase over time. Ap- plying technology to the neurorehabilitation process can not only assist us in obtaining more precise diagnostics and in improving the flow of information between health care pro- fessionals but it can also help us to develop more effective and efficient rehabilitation-specific clinical pathways. Simi- larly, the increasing bandwidth capacity of our telecommuni- cation networks could bring hope to individuals that do not have access to rehabilitation facilities by making possible the implementation of telerehabilitation-based treatments. Fur- thermore, the increasing importance of assistive technology and orthetics also shows how technology can have a great im- pact on the quality of life of our patients long after the reha- bilitation process has finalized.

In this symposium, several sessions have been centered in virtual rehabilitation and related fields. Virtual Rehabilita- tion is a recent scientific and technological area that inves- tigates the use of interactive graphics technologies and telecommunications to provide rehabilitation and clinical services in a more effective and efficient way. It is a multi- disciplinary field that combines technologies such as virtual reality, augmented reality, bioelectronics, medical imaging, ambient intelligence, natural man-machine interfaces, all aimed at achieving better therapies for patients and more sustainable services health.

At this moment, we are experiencing the emergence of an infor- mation society increasingly based on the production and ex- change of information. New information and computer technologies (ICT’s) are having an impact in the field of rehabil- itation of motor and cognitive functions. Over the past twenty years this progress in technology has provided clinicians with new opportunities for evaluation and treatment of cognitive dis- orders, which were not available with traditional methods. Sev- eral tools have been created in order to evaluate and train the cognitive impairment that is associated with acquired or devel- opmental cerebral damage including memory, spatial knowledge representation and planning abilities and executive function.

With virtual rehabilitation we are developing engaging virtual worlds in which patients interact while rehabilitating, envi- ronments that are capable of recognizing the patient and pro- vide the necessary services even at home, miniaturized and low-cost tracking and monitoring systems used to enable pa- tients to continue rehabilitation at home thus saving costs to health services and improving both the quality of care, intel- ligent TV screens that recognize the patient’s movements and through virtual agents are leading him in the exercises, or robotic systems that assist the patient in their exercises in both the clinic and at home. In coming years, we will attend to a revolution in this field through the combined efforts of clini- cians and technology, which we intend to make closer ties in scientific events like the International Symposium on Neu- rorehabilitation. We hope that you enjoy these papers and that you will join us in the next edition of the International Sym- posium on Neurorehabilitation to be held in 2011.

 

 

Mariano Alcañiz, Ph.D.,
Director Institute LabHuman
and Javier Chirivella, Ph.D.,
Director Servicio Daño Cerebral/NISA

“Medical Marker” Inaugural Class Introduced

Another highlight of the EDC’s Schwartz Awards Luncheon was unveiling of bioOrlando’s new “Medical Marker” program, which is designed to build awareness of the growing presence of biotech and life science companies in our region.

Ray Gilley, EDC President & CEO, described the program as a way to recognize the growing number of leaders in scientific research and medical technology, as well as companies who have contributed substantially to the evolution of such technologies in Central Florida. “On an ongoing basis, Medical Markers will be presented to life science and biotech organizations throughout the four county region,” explained Gilley.

A design for the marker, the work of talented local artist Dralene “Red” Hughes, was unveiled. Hughes submitted her concept as part of a design competition promoted by United Arts. The artist explains her design concept (above) as follows: “An abstract figure formed from checks and balances reaches for a goal, represented by the bright star. The figure is stepping forward and up, with the upper extension pointing to the Orlando area on a Florida map.”

Florida Senator Lee Constantine, a tireless community advocate who introduced the bill that put the UCF College of Medicine into Statute, then introduced the inaugural class of Medical Marker recipients. As Constantine explained, this founding group represents the pioneers of our region’s medical and life science industry. “These are the organizations and industries that blazed the trail and ensured that Metro Orlando would be well-positioned as a true contender for the life science industry,” he said.

bioOrlando’s inaugural class of Medical Marker recipients includes:

  • Florida Hospital, est. 1908
  • Orlando Health, est. 1918
  • Florida’s Blood Centers, est. 1942
  • South Lake Hospital, est. 1947; home to National Training Center
  • Health Central, est. 1952
  • Tavistock Group / Lake Nona
  • VaxDesign
  • CuraScript
  • .decimal
  • CORD:USE
  • Emergency Medicine Learning & Resource Center
  • Virtual Reality Medical Center

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