The role of immersion and narrative in mediated presence: the virtual hospital experience

Feasibility of virtual reality and machine learning to assess personality traits in an organizational environment

Introduction

Personality plays a crucial role in shaping an individual's interactions with the world. The Big Five personality traits are widely used frameworks that help describe people's psychological behaviours. These traits predict how individuals behave within an organizational setting.

Methods

In this article, we introduce a virtual reality (VR) strategy for relatively scoring an individual's personality to evaluate the feasibility of predicting personality traits from implicit measures captured from users interacting in VR simulations of different organizational situations. Specifically, eye-tracking and decision-making patterns were used to classify individuals according to their level in each of the Big Five dimensions using statistical machine learning (ML) methods. The virtual environment was designed using an evidence-centered design approach.

Results

The dimensions were assessed using NEO-FFI inventory. A random forest ML model provided 83% accuracy in predicting agreeableness. A k-nearest neighbour ML model provided 75%, 75%, and 77% accuracy in predicting openness, neuroticism, and conscientiousness, respectively. A support vector machine model provided 85% accuracy for predicting extraversion. These analyses indicated that the dimensions could be differentiated by eye-gaze patterns and behaviours during immersive VR.

Discussion

Eye-tracking measures contributed more significantly to this differentiation than the behavioural metrics. Currently, we have obtained promising results with our group of participants, but to ensure the robustness and generalizability of our findings, it is imperative to replicate the study with a considerably larger sample. This study demonstrates the potential of VR and ML to recognize personality traits.

Interactive virtual reality training to improve socio-emotional functioning in adolescents with developmental language disorders: A feasibility study

Methods to effectively improve socio-emotional functioning by adolescents with developmental language disorders (DLD) are scarce. Current methods to improve socio-emotional functioning in adolescents with other neurobiological disorders seem less suitable, as these methods are highly language based. This study therefore examined the feasibility of the virtual reality (VR) training for socio-emotional skills: 'InterAction'. The aims of the present study were to (1) examine whether interactive VR is a feasible training method for adolescents with DLD; (2) investigate adolescents' appreciation of the VR training; (3) examine whether the virtual reality training facilitates the participants' sense of presence during social practice situations in an interactive digital world; and (4) explore whether adolescents socio-emotional skills improved during the six-session training. A sample of nine adolescents (13-16 years) with DLD reported on their presence in VR contexts and their appreciation toward the VR training. They also completed weekly self-reports on their socio-emotional functioning. Results indicated that 'InterAction' was a feasible method to practice socio-emotional functioning with adolescents with DLD. Adolescents highly appreciated the VR training. In addition, adolescents rated the sense of presence as high in the VR training. The individual trajectories showed that improvements in the trained skills varied both between and within participants. The results were also not uniform between the specific skills trained. The findings suggest that interactive virtual reality training may be a promising tool for improving socio-emotional functioning in adolescents with DLD. Future studies should examine the positive indications of this study in a larger sample.

Oxidative stress responses of virtual reality use in refugee children undergoing elective surgery: A randomized controlled trial

BACKGROUND

With the Virtual Reality (VR) technique, 3D movies can be made for refugee children for pre-operative stress. The study aims to reveal the oxidative responses of the VR technique in pre-operative anxiety in elective surgery in children aged 5-12 years.

METHODS

The Study was designed according to the CONSORT checklist with a randomized controlled parallel design. The whole sample (n = 23), VR experimental group (n = 12), and control group (n = 11) were determined according to the total count method prospectively in 6 months. Oxidative stress parameters (Cortisol, Malondialdehyde, Nitric oxide, Glutathione) were measured in blood samples from the first hospitalization (beginning) and before the intervention (pre-operative) in the experimental and control groups.

FINDINGS

MDA, NO, and cortisol levels (p < 0.05), which indicate the stress level, are high in all groups. In pre-operative measurements, oxidative parameters were lower in the VR experimental group than in the control group. At the same time, the anti-stress antioxidant factor Glutathione was higher in the VR experimental group in pre-operative measurements.

DISCUSSION

The application of 3D film as a VR technique reduces stress parameters in pre-operative stress, and its antioxidant system activating effect has been determined.

APPLICATION TO PRACTICE

It can be applied to refugee child groups for pre-operative stress by shooting 3D movies in different languages.

Does sleep promote adaptation to acute stress: An experimental study

Objectives

Evidence of the impact of chronic stress on sleep is abundant, yet experimental sleep studies with a focus on acute stress are scarce and the results are mixed. Our study aimed to fill this gap by experimentally investigating the effects of pre-sleep social stress on sleep dynamics during the subsequent night, as measured with polysomnography (PSG).

Methods

Thirty-four healthy individuals (65% females, Mage = 25.76 years SD = 3.35) underwent a stress-inducing (SC) or neutral control condition (CC) in virtual reality (VR). We used overnight EEG measurements to analyze the basic sleep parameters and power spectral density (PSD) across the sleep cycles, and measured heart rate and its variability (HRV), skin electrodermal activity (EDA), and salivary cortisol to capture physiological arousal during the VR task and the pre-sleep period.

Results

Following acute stress (SC), the amount of slow-wave sleep (SWS) was higher and N2 sleep lower relative to CC, specifically in the first sleep cycle. In SC, PSD was elevated in the beta-low (16-24 Hz) and beta-high (25-35 Hz) frequency ranges during both stages N2 and SWS over the entire night.

Conclusions

Sleep promoted adaptation to acute social stress by a longer duration of SWS in the subsequent sleep period, especially in early sleep. A similar homeostatic effect towards restorative sleep is well-evidenced in animal model stress studies but has not been previously reported in experimental human studies. Whether the high-frequency PSD activity during stages N2 and SWS also serves in the resolution of transient stress, remains open.

The development of aesthetic experience through virtual and augmented reality

Emerging technological innovations offer the potential for experiential engagement through virtual scenarios, yet the viability of this approach for educational purposes remains significantly underexplored. This study aims to assess the feasibility of Augmented Reality (AR) and Virtual Reality (VR) technologies in providing users with aesthetic experiences when visiting digital exhibitions. A total of 190 students participated in this investigation. The control group visited traditional exhibits at the Palace Museum in Beijing. This group underwent a survey to evaluate their acquired aesthetic experience. In contrast, the experimental group, comprising 96 students, engaged with VR/AR scenarios at the Palace Museum in Beijing. Accordingly, students in the experimental group were also surveyed to evaluate both their aesthetic experiences and, additionally, their user experiences. The survey results unveiled significant distinctions in aesthetic experiences between students in the control and experimental groups. Moreover, there were notable correlations between individual variables related to user and aesthetic experiences within the experimental group. Furthermore, the study revealed disparities in both user and aesthetic experiences among male and female students. The findings have implications for aesthetic education teachers and officials in the context of developing sound strategies for providing aesthetic experiences to their students. This information is also of interest to employees of museums, exhibitions, and other cultural facilities, who are interested in holding or hold digital exhibitions.

The Effects of Nature-Based Travel in Virtual Reality: The Role of Spatial Presence and Narrative Engagement

The benefits of nature tourism, or nature-based travel, are plentiful. For example, participation in nature tours has positively impacted environmental attitudes and behaviors. Unfortunately, while psychologically beneficial, nature-based tourism can hurt the environment through a myriad of factors. Therefore, we must continue to explore ways to make the benefits of nature-based travel more sustainable and impactful. Research suggests that nature-based travel in virtual reality (VR) may impart numerous travel benefits, such as improving conservational behavior and interconnectedness with nature. While these early findings are promising, questions remain regarding the theoretical mechanisms underlying the effects of nature-based VR travel. Therefore, this study explores how VR may provide an avenue to make nature tourism more environmentally friendly while simultaneously making people more environmentally connected and conscious. Furthermore, a theoretical framework is posited that combines concepts from the spatial presence and narrative persuasion literature to help explain the effects. To accomplish these goals, an experiment was conducted using a two-condition (VR travel vs. TV control) between-subjects factorial design with random assignment. The participants were 66 college students from a large Midwestern University in the United States. Results indicated that there wasn't a statistically significant difference between the VR travel condition and the television (TV) control condition regarding the environmental outcome variables. However, while the nature-based VR travel experience did not appear to influence the environmental outcome variables directly, it did indirectly affect them through the mediating roles of spatial presence and narrative engagement.

Use and Acceptance of Digital Communication Technology by Older Adults for Social Connectedness During the COVID-19 Pandemic: Mixed Methods Study

BACKGROUND

Older adults are at higher risk for health issues, including mental health problems. This was especially apparent during the COVID-19 pandemic, where older adults were simultaneously more vulnerable to the disease and the mental health concerns created by social distancing. Subsequently, the use of digital communication technology (DCT) became a critical option for maintaining social connectedness in older adults. Prior to the pandemic, the low uptake and use of technology by older adults was an established problem, known as the digital divide. However, not much is known about how this may have changed as a result of the pandemic.

OBJECTIVE

This study aims to explore how older adults maintained social connectedness through DCT during the pandemic and to understand factors influencing the use and acceptance of DCT.

METHODS

A mixed methods explorative field study was set up, involving surveys and interviews of 25 community-dwelling older adults (65-88 years old) living in the United Kingdom. The surveys included the internet acceptance questionnaire (based on the Technology Acceptance Model [TAM]); COVID-19 dysfunctional anxiety was captured using the COVID-19 Anxiety Scale (CAS). Background information (demographics, use of technology) was gathered before conducting semistructured interviews. We hypothesized that CAS would affect constructs of TAM and that predictive constructs of TAM would have remained valid during the pandemic. We also posited that there would be unidentified themes outside TAM that impacted the acceptance and use of DCT. We used the quantitative data to guide the semistructured interviews, which were then analyzed through thematic analysis to identify additional themes.

RESULTS

Correlational analysis showed that CAS influences all constructs of TAM. We also saw that the predictive constructs of TAM, especially the perceived ease of use (PEU) and perceived usefulness (PU), remained valid during the pandemic. Common acceptance-influencing themes were encountered in both quantitative and qualitative analyses, with 3 matching the known constructs of TAM (PU, PEU, and behavioral intention). We identified 2 additional themes affecting acceptance, namely influence of the pandemic (situational context) and privacy and security concerns. DCT use (especially email and videoconferencing use) increased during the pandemic, but the results related to social networking sites were mixed.

CONCLUSIONS

The COVID-19 pandemic impacted technology acceptance and use by older adults, encouraging their use of certain DCT apps (email and videoconferencing apps, such as WhatsApp). These apps helped insulate them from adverse effects (social isolation and loneliness). Other social networking apps, however, exerted a negative influence, increasing anxiety and a general feeling of negativity. Future studies should maximize older adult agency related to design, privacy, security, and user requirements for development. We also recommend that when studying DCT acceptance for older adults, our additional identified themes should be considered alongside the existing TAM constructs.

A High-Density EEG Study Investigating the Neural Correlates of Continuity Editing Theory in VR Films

This paper presents a cognitive psychology experiment to explore the differences between 2D and virtual reality (VR) film editing techniques. We recruited sixteen volunteers to view a range of different display modes and edit types of experimental material. An electroencephalogram (EEG) was recorded simultaneously while the participants watched. Subjective results showed that the VR mode reflects higher load scores, particularly in the effort dimension. Different editing types have no effect on subjective immersion scores. The VR mode elicited stronger EEG energy, with differences concentrated in the occipital, parietal, and central regions. On the basis of this, visual evoked potential (VEP) analyses were conducted, and the results indicated that VR mode triggered greater spatial attention, while editing in 2D mode induced stronger semantic updating and active understanding. Furthermore, we found that while the effect of different edit types in both display modes is similar, cross-axis editing triggered greater cognitive violations than continuity editing, which could serve as scientific theoretical support for the development of future VR film editing techniques.

Investigating the human chemical communication of positive emotions using a virtual reality-based mood induction

Humans can communicate their emotions to others via volatile emissions from their bodies. Although there is now solid evidence for human chemical communication of fear, stress and anxiety, investigations of positive emotions remain scarce. In a recent study, we found that women's heart rate and performance in creativity tasks were modulated by body odors of men sampled while they were in a positive vs. neutral mood. However, inducing positive emotions in laboratory settings remains challenging. Therefore, an important step to further investigate the human chemical communication of positive emotions is to develop new methods to induce positive moods. Here, we present a new mood induction procedure (MIP) based on virtual reality (VR), that we assumed to be more powerful than videos (used in our previous study) to induce positive emotions. We hypothesized that, consequently, given the more intense emotions created, this VR-based MIP would induce larger differences between the receivers' responses to the positive body odor versus a neutral control body odor, than the Video-based MIP. The results confirmed the higher efficacy of VR to induce positive emotions compared with videos. More specifically, VR had more repeatable effects between individuals. Although positive body odors had similar effects to those found in the previous video study, especially faster problem solving, these effects did not reach statistical significance. These outcomes are discussed as a function of the specificities of VR and of other methodological parameters, that may have prevented the observation of such subtle effects and that should be understood more in-depth for future studies on human chemical communication.

The influence of music liking on episodic memory for rich spatiotemporal contexts

It is thought that the presence of music influences episodic memory encoding. However, no studies have isolated the influence of music liking - the hedonic value listeners attribute to a musical stimulus - from that of the core affect induced by the presence of that music. In an online survey, participants rated musical excerpts in terms of how much they liked them, as well as in terms of felt valence, felt arousal and familiarity. These ratings were then used to inform the stimuli presented in an online episodic memory task which, across different scenarios, involved dragging cued objects to cued locations and then recalling details of what was moved, where they were moved to and the order of movements made. Our results showed an influence of liking and music-reward sensitivity on memory for what was moved, as well as a detrimental effect of arousing musical stimuli on memory for un-cued scenario details. Taken together, our study showcases the importance of episodic memory paradigms that involve rich spatiotemporal contexts and provides insights into how different aspects of episodic memory may be influenced by the presence of music.

Feeling Virtually Present Makes Me Happier: The Influence of Immersion, Sense of Presence, and Video Contents on Positive Emotion Induction

Immersive technologies, such as Virtual Reality (VR), have great potential for enhancing users' emotions and wellbeing. However, how immersion, Virtual Environment contents, and sense of presence (SoP) influence emotional responses remains to be clarified to efficiently foster positive emotions. Consequently, a total of 26 participants (16 women, 10 men, 22.73 ± 2.69 years old) were exposed to 360-degree videos of natural and social contents on both a highly immersive Head-Mounted Display and a low immersive computer screen. Subjective emotional responses and SoP were assessed after each video using self-reports, while a wearable wristband collected continuously electrodermal activity and heart rate to record physiological emotional responses. Findings supported the added value of immersion, as more positive emotions and greater subjective arousal were reported after viewing the videos in the highly immersive setting, regardless of the video contents. In addition to usually employed natural contents, the findings also provide initial evidence for the effectiveness of social contents in eliciting positive emotions. Finally, structural equation models shed light on the indirect effect of immersion, through spatial and spatial SoP on subjective arousal. Overall, these are encouraging results about the effectiveness of VR for fostering positive emotions. Future studies should further investigate the influence of user characteristics on VR experiences to foster efficiently positive emotions among a broad range of potential users.

Virtual Reality for Awe and Imagination

Empirical research has explored the potential of the emotion of awe to shape creativity, while theoretical work has sought to understand the link between this emotion and transformation in terms of imagining new possible worlds. This branch of study relies on the transformative potential of virtual reality (VR) to examine and invite cognitive and emotional components of transformative experiences (TEs) within the interdisciplinary model of Transformative Experience Design (TED) and the Appraisal-Tendency Framework (ATF). TED suggests using the epistemic and emotional affordances of interactive technologies, such as VR, to invite TEs. The ATF can provide insight into the nature of these affordances and their relationship. This line of research draws on empirical evidence of the awe-creativity link to broaden the discourse and consider the potential impact of this emotion on core beliefs about the world. The combination of VR with these theoretical and design-oriented approaches may enable a new generation of potentially transformative experiences that remind people that they can aspire to more and inspire them to work toward imagining and creating a new possible world.

Using interpretative phenomenological analysis to gain a qualitative understanding of presence in virtual reality

Quantitative methods have thus far been the predominant methodological stance of virtual presence research, leaving much to be desired in terms of qualitative understanding. Yet, virtual experiences are a highly personal engagement, unique to each individual, and their presence in virtual reality can be viewed in terms of its experiential individuality. This aspect of the virtual experience is overlooked by conventional quantitative methods, which clusters ratings or scores to form group deductions. Therefore, to address the qualitative gap in the literature and provide an appropriate examination of virtual experiences from the perspective of the individual, an Interpretative Phenomenological Approach was undertaken. This alternate methodology sought to reveal which aspects of virtual experiences users identify as enabling feelings of presence. Examination of common themes among accounts of individuals were performed, to investigate the generation of feelings of presence in virtual reality. Online recruitment provided six interviewees who participated in online semi-structured interviews, prior to Interpretive Phenomenological Analysis. Three superordinate themes were identified: visual satisfaction, freedom of interaction and suspension of real life. Expectance, realism and prevention of disbelief are among the sub-themes identified that contributed to the interviewee's highly present experiences. The identified themes demonstrated the greatest influences of enabling a deeper sense of presence, in turn enhancing their experiences within virtual reality. In acknowledging these mitigating influences, it is hoped this may enable future virtual systems to build upon the research provided and produce consistently high-presence experiences. Consequently, this can aid educational, therapeutic and entertainment applications of virtual reality.

From Virtual Reality to Regenerative Virtual Therapy: Some Insights from a Systematic Review Exploring Inner Body Perception in Anorexia and Bulimia Nervosa

Despite advances in our understanding of the behavioral and molecular factors that underlie the onset and maintenance of Eating Disorders (EDs), it is still necessary to optimize treatment strategies and establish their efficacy. In this context, over the past 25 years, Virtual Reality (VR) has provided creative treatments for a variety of ED symptoms, including body dissatisfaction, craving, and negative emotions. Recently, different researchers suggested that EDs may reflect a broader impairment in multisensory body integration, and a particular VR technique-VR body swapping-has been used to repair it, but with limited clinical results. In this paper, we use the results of a systematic review employing PRISMA guidelines that explore inner body perception in EDs (21 studies included), with the ultimate goal to analyze the features of multisensory impairment associated with this clinical condition and provide possible solutions. Deficits in interoception, proprioception, and vestibular signals were observed across Anorexia and Bulimia Nervosa, suggesting that: (a) alteration of inner body perception might be a crucial feature of EDs, even if further research is needed and; (b) VR, to be effective with these patients, has to simulate/modify both the external and the internal body. Following this outcome, we introduce a new therapeutic approach-Regenerative Virtual Therapy-that integrates VR with different technologies and clinical strategies to regenerate a faulty bodily experience by stimulating the multisensory brain mechanisms and promoting self-regenerative processes within the brain itself.

A Comparative Study on the Temporal Effects of 2D and VR Emotional Arousal

Previous research comparing traditional two-dimensional (2D) and virtual reality with stereoscopic vision (VR-3D) stimulations revealed that VR-3D resulted in higher levels of immersion. However, the effects of these two visual modes on emotional stimulus processing have not been thoroughly investigated, and the underlying neural processing mechanisms remain unclear. Thus, this paper introduced a cognitive psychological experiment that was conducted to investigate how these two visual modes influence emotional processing. To reduce fatigue, participants (n = 16) were randomly assigned to watch a series of 2D and VR-3D short emotional videos for two days. During their participation, electroencephalograms (EEG) were recorded simultaneously. The results showed that even in the absence of sound, visual stimuli in the VR environment significantly increased emotional arousal, especially in the frontal region, parietal region, temporal region, and occipital region. On this basis, visual evoked potential (VEP) analysis was performed. VR stimulation compared to 2D led to a larger P1 component amplitude, while VEP analysis based on the time course of the late event-related potential component revealed that, after 1200 ms, the differences across visual modes became stable and significant. Furthermore, the results also confirmed that VEP in the early stages is more sensitive to emotions and presumably there are corresponding emotion regulation mechanisms in the late stages.

Use Virtual Reality to Enhance Intercultural Sensitivity: A Randomised Parallel Longitudinal Study

Prior studies suggest that emotional empathy is one of the components of intercultural sensitivity - the affective dimension under the concept of intercultural communication competence. Based on existing theories and findings, this paper reports a randomised parallel longitudinal study investigating the use of virtual reality (VR) exposure to enhance intercultural sensitivity. A total of 80 participants (36 females and 44 males) joined the study and were included in the data analysis. The participants were randomly assigned to the VR group, the video group, and the control group. Their intercultural sensitivity was measured three times: one week before the exposure ($T_{1}$), right after the exposure ($T_{2}$), and three weeks after the exposure ($T_{3}$). The results suggested that (1) the intercultural sensitivity of the VR group was significantly enhanced in both within-subject comparisons and between-subject comparisons, (2) there were no significant differences in intercultural sensitivity between the VR group and the video group at $T_{2}$, but the VR group retained the enhancement better at $T_{3}$, and (3) the sense of presence and emotional empathy well predicted the change in intercultural sensitivity of the VR group. The results, together with the participants' feedback and comments, provide new insights into the practice of using VR for intercultural sensitivity training and encourage future research on exploring the contributing factors of the results.

Mitigating negative emotions through virtual reality and embodiment

Oncological treatments are responsible for many of the physical changes (aesthetic and functional) associated with cancer. Because of this, cancer patients are at high risk of developing mental health problems. The aim of this study is to propose an innovative Virtual Reality (VR) training that uses a somatic technique (i.e., embodiment) to create a bridge with the bodily dimension of cancer. After undergoing a psycho-educational procedure, a combination of exposure, out-of-body experience, and body swapping will gradually train the patient to cope with cancer-related difficulties, increasing stress tolerance, and patient empowerment. The most engaging step of this advanced form of Stress Inoculation Training is the body swapping experience, which will guide the patient in embodying a resilient cancer patient who is facing similar difficulties. Through the VR ability to simulate the human brain functioning, and the potential of embodiment to hook to the somatic dimension of illness, we expect that once the concepts endured through the patient’s experience of resilience are triggered, the patient will be more prone to implement functional coping strategies in real life, reaching empowerment and adjusting to the post-treatment difficulties. When the scenarios are built and the training tested, our intervention could be used to support patients with different oncological diseases and who are treated in different cancer hospitals, as well as patients with other non-oncological problems (e.g., social anxiety). Future research should focus on using our paradigm for other clinical populations, and supporting cancer patients in coping with different distressing situations.

Effectiveness of Using Virtual Reality-Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials

Background

In recent years, efforts have been made to implement virtual reality (VR) to support the delivery of poststroke upper extremity motor rehabilitation exercises. Therefore, it is important to review and analyze the existing research evidence of its effectiveness.

Objective

Through a systematic review and meta-analysis of randomized controlled trials, this study examined the effectiveness of using VR-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke.

Methods

This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The CINAHL Plus, MEDLINE, Web of Science, Embase, and Cochrane Library databases were searched on December 31, 2021. Changes in outcomes related to impairments in upper extremity functions and structures, activity limitations, and participation restrictions in life situations from baseline to after intervention, after intervention to follow-up assessment, and baseline to follow-up assessment were examined. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup analyses were performed to determine whether the differences in treatment outcomes depended on age, stroke recovery stage, VR program type, therapy delivery format, similarities in intervention duration between study groups, intervention duration in VR groups, and trial length.

Results

A total of 42 publications representing 43 trials (aggregated sample size=1893) were analyzed. Compared with the control groups that used either conventional therapy or no therapy, the intervention groups that used VR to support exercise therapy showed significant improvements in upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity; SMD 0.45, 95% CI 0.21-0.68; P<.001), range of motion (goniometer; SMD 1.01, 95% CI 0.50-1.52; P<.001), muscle strength (Manual Muscle Testing; SMD 0.79, 95% CI 0.28-1.30; P=.002), and independence in day-to-day activities (Functional Independence Measure; SMD 0.23, 95% CI 0.06-0.40; P=.01, and modified Rankin Scale; SMD 0.57, 95% CI 0.01-1.12; P=.046). Significant subgroup differences were observed in hand dexterity (Box and Block Test), spasticity (Ashworth Scale or modified Ashworth Scale), arm and hand motor ability (Wolf Motor Function Test and Manual Function Test), hand motor ability (Jebsen Hand Function Test), and quality of life (Stroke Impact Scale). There was no evidence that the benefits of VR-supported exercise therapy were maintained after the intervention ended.

Conclusions

VR-supported upper extremity exercise therapy can be effective in improving motor rehabilitation results. Our review showed that of the 12 rehabilitation outcomes examined during the course of VR-based therapy, significant improvements were detected in 2 (upper extremity motor function and range of motion), and both significant and nonsignificant improvements were observed in another 2 (muscle strength and independence in day-to-day activities), depending on the measurement tools or methods used.

Trial Registration

PROSPERO CRD42021256826; https://tinyurl.com/2uarftbh

Deep-Breathing Biofeedback Trainability in a Virtual-Reality Action Game: A Single-Case Design Study With Police Trainers

It is widely recognized that police performance may be hindered by psychophysiological state changes during acute stress. To address the need for awareness and control of these physiological changes, police academies in many countries have implemented Heart-Rate Variability (HRV) biofeedback training. Despite these trainings now being widely delivered in classroom setups, they typically lack the arousing action context needed for successful transfer to the operational field, where officers must apply learned skills, particularly when stress levels rise. The study presented here aimed to address this gap by training physiological control skills in an arousing decision-making context. We developed a Virtual-Reality (VR) breathing-based biofeedback training in which police officers perform deep and slow diaphragmatic breathing in an engaging game-like action context. This VR game consisted of a selective shoot/don’t shoot game designed to assess response inhibition, an impaired capacity in high arousal situations. Biofeedback was provided based on adherence to a slow breathing pace: the slower and deeper the breathing, the less constrained peripheral vision became, facilitating accurate responses to the in-game demands. A total of nine male police trainers completed 10 sessions over a 4-week period as part of a single-case experimental ABAB study-design (i.e., alternating sessions with and without biofeedback). Results showed that eight out of nine participants showed improved breathing control in action, with a positive effect on breathing-induced low frequency HRV, while also improving their in-game behavioral performance. Critically, the breathing-based skill learning transferred to subsequent sessions in which biofeedback was not presented. Importantly, all participants remained highly engaged throughout the training. Altogether, our study showed that our VR environment can be used to train breathing regulation in an arousing and active decision-making context.

Influence of Virtual Experience Immersion, Product Control, and Stimulation on Advertising Effects

With advances in communication technologies, virtual reality (VR) has become increasing popular. This study investigated the influence of virtual experiences on advertising effects. A 2 (virtual experience immersion: high vs. low) × 2 (virtual experience product control: high vs. low) × 2 (virtual experience product stimulation: high vs. low) between-subjects design was conducted. The results revealed that compared with the low-immersion virtual experience, the high-immersion virtual experience produced better advertisement attitudes. Furthermore, virtual experiences with high product control generated better advertisement attitudes when compared with virtual experiences with low product control. The two-way interactions between virtual experience product stimulation and immersion and between virtual experience product stimulation and virtual experience product control induced better brand attitude and purchase intention. In addition, telepresence and perceived enjoyment mediated the relationship between virtual experience and advertisement attitudes.

Immersive 360° videos in health and social care education: a scoping review

BACKGROUND

Research on the pedagogical use of immersive 360° videos is a rapidly expanding area within health and social care education. Despite this interest, there is a paucity of empirical data on its application.

METHOD

A scoping review methodology framework was used to search for relevant articles published between 1970 and July 2021. Six databases were used to identify studies using immersive 360° videos for training and education purposes within health and social care: PubMed, Ovid Medline, Psych Info, Psych Articles, Cochrane Database and Embase. Research questions included: Is there any evidence that immersive 360° videos increase learning outcomes and motivation to learn in health and social care education? What are the key pedagogical concepts and theories that inform this area of research? What are the limitations of using immersive 360° videos within health and social education? The four dimensions contained within Keller's ARCS model (attention, relevance, confidence and satisfaction) frame the results section.

RESULTS

Fourteen studies met our inclusion criteria. Learning outcomes confirm that immersive 360° videos as a pedagogical tool: increases attention, has relevance in skill enhancement, confidence in usability and user satisfaction. In particular, immersive 360° videos has a positive effect on the user's emotional response to the learning climate, which has a significant effect on users' motivation to learn. There was a notable lack of pedagogical theory within the studies retrieved and a general lack of clarity on learning outcomes.

CONCLUSION

Studies examining the effectiveness of such interventions remains weak due to smaller sample sizes, lack of randomised control trials, and a gap in reporting intervention qualities and outcomes. Nevertheless, 360° immersive video is a viable alternative to VR and regular video, it is cost-effective, and although more robust research is necessary, learning outcomes are promising.

FUTURE DIRECTIONS

Future research would do well to focus on interactivity and application of pedagogical theory within immersive 360° videos experiences. We argue that more and higher quality research studies, beyond the scope of medical education, are needed to explore the acceptability and effective implementation of this technology.

A High-Density EEG Study Investigating VR Film Editing and Cognitive Event Segmentation Theory

This paper introduces a cognitive psychological experiment that was conducted to analyze how traditional film editing methods and the application of cognitive event segmentation theory perform in virtual reality (VR). Thirty volunteers were recruited and asked to watch a series of short VR videos designed in three dimensions: time, action (characters), and space. Electroencephalograms (EEG) were recorded simultaneously during their participation. Subjective results show that any of the editing methods used would lead to an increased load and reduced immersion. Furthermore, the cognition of event segmentation theory also plays an instructive role in VR editing, with differences mainly focusing on frontal, parietal, and central regions. On this basis, visual evoked potential (VEP) analysis was performed, and the standardized low-resolution brain electromagnetic tomography algorithm (sLORETA) traceability method was used to analyze the data. The results of the VEP analysis suggest that shearing usually elicits a late event-related potential component, while the sources of VEP are mainly the frontal and parietal lobes. The insights derived from this work can be used as guidance for VR content creation, allowing VR image editing to reveal greater richness and unique beauty.

Embodiment in Virtual Reality Intensifies Emotional Responses to Virtual Stimuli

Modulating emotional responses to virtual stimuli is a fundamental goal of many immersive interactive applications. In this study, we leverage the illusion of illusory embodiment and show that owning a virtual body provides means to modulate emotional responses. In a single-factor repeated-measures experiment, we manipulated the degree of illusory embodiment and assessed the emotional responses to virtual stimuli. We presented emotional stimuli in the same environment as the virtual body. Participants experienced higher arousal, dominance, and more intense valence in the high embodiment condition compared to the low embodiment condition. The illusion of embodiment thus intensifies the emotional processing of the virtual environment. This result suggests that artificial bodies can increase the effectiveness of immersive applications psychotherapy, entertainment, computer-mediated social interactions, or health applications.

Emotional arousal in 2D versus 3D virtual reality environments

Previous studies have suggested that virtual reality (VR) can elicit emotions in different visual modes using 2D or 3D headsets. However, the effects on emotional arousal by using these two visual modes have not been comprehensively investigated, and the underlying neural mechanisms are not yet clear. This paper presents a cognitive psychological experiment that was conducted to analyze how these two visual modes impact emotional arousal. Forty volunteers were recruited and were randomly assigned to two groups. They were asked to watch a series of positive, neutral and negative short VR videos in 2D and 3D. Multichannel electroencephalograms (EEG) and skin conductance responses (SCR) were recorded simultaneously during their participation. The results indicated that emotional stimulation was more intense in the 3D environment due to the improved perception of the environment; greater emotional arousal was generated; and higher beta (21-30 Hz) EEG power was identified in 3D than in 2D. We also found that both hemispheres were involved in stereo vision processing and that brain lateralization existed in the processing.

Effect of a Virtual Reality-Based Restorative Environment on the Emotional and Cognitive Recovery of Individuals with Mild-to-Moderate Anxiety and Depression

In this study, restorative environment theory and virtual reality (VR) technology were combined to build different 3D dynamic VR interactive scenes. We discuss the effects of a VR restorative environment on the emotional and cognitive recovery of individuals with mild-to-moderate anxiety and depression. First, we built a VR restorative garden scene, divided into four areas: forest, lawn, horticultural planting, and water features. The scene was verified to have a good recovery effect in 26 participants. Then, 195 participants with mild-to-moderate anxiety and depression were selected as experimental subjects. Through psychological testing and EMG (Electromyography) and EEG (Electroencephalography) data feedback, we further explored the differences in the sense of presence in VR restorative scenes and their effect on individual emotional and cognitive recovery. The results showed that (1) both the restorative environment images and the VR scenes had a healing effect (the reduction in negative emotions and the recovery of positive emotions and cognition), with no difference in the subjective feeling of recovery among the different scenes, but the recovery score of the VR urban environment was higher than that of the natural environment (differing from the results in real environments); (2) a high sense of presence can be experienced in different VR scenes, and interactive activities in VR scenes can provide a great presence experience; (3) the recovery effects of VR restorative environment on emotion and self-efficacy are realized through the presence of VR scenes; (4) a VR restorative environment is helpful for the emotional improvement and cognitive recovery of individuals with mild-to-moderate anxiety and depression. VR urban scenes also have good recovery effects. In terms of cognitive recovery, self-efficacy improved significantly. In addition, from the perspective of EEG indicators, the VR restorative scene experience activated the prefrontal lobe, which is conducive to cognitive recovery in individuals with mild-to-moderate anxiety and depression. In terms of emotional improvement, negative emotions were significantly reduced in the different VR scene groups. In conclusion, we further explored ways to help individuals with mild-to-moderate anxiety and depression, in order to promote the development and application of mental health.

Methodological and institutional considerations for the use of 360-degree video and pet animals in human subject research: An experimental case study from the United States

Head-mounted virtual-reality headsets and virtual-reality content have experienced large technological advances and rapid proliferation over the last years. These immersive technologies bear great potential for the facilitation of the study of human decision-making and behavior in safe, perceptually realistic virtual environments. Best practices and guidelines for the effective and efficient use of 360-degree video in experimental research is also evolving. In this paper, we summarize our research group's experiences with a sizable experimental case study on virtual-reality technology, 360-degree video, pet animals, and human participants. Specifically, we discuss the institutional, methodological, and technological challenges encountered during the implementation of our 18-month-long research project on human emotional response to short-duration 360-degree videos of human-pet interactions. Our objective in this paper is to contribute to the growing body of research on 360-degree video and to lower barriers related to the conceptualization and practice of research at the intersection of virtual-reality experiences, 360-degree video, live animals, and human behavior. Practical suggestions for human-subject researchers interested in utilizing virtual-reality technology, 360-degree videos, and pet animals as a part of their research are discussed.

Presence, flow, and narrative absorption: an interdisciplinary theoretical exploration with a new spatiotemporal integrated model based on predictive processing

Presence, flow, narrative absorption, immersion, transportation, and similar subjective phenomena are studied in many different disciplines, mostly in relation to mediated experiences (books, film, VR, games). Moreover, since real, virtual, or fictional agents are often involved, concepts like identification and state empathy are often linked to engaging media use. Based on a scoping review that identified similarities in the wording of various questionnaire items conceived to measure different phenomena, we categorize items into the most relevant psychological aspects and use this categorization to propose an interdisciplinary systematization. Then, based on a framework of embodied predictive processing, we present a new cognitive model of presence-related phenomena for mediated and non-mediated experiences, integrating spatial and temporal aspects and also considering the role of fiction and media design. Key processes described within the model are: selective attention, enactment of intentions, and interoception. We claim that presence is the state of perceived successful agency of an embodied mind able to correctly enact its predictions. The difference between real-life and simulated experiences ("book problem," "paradox of fiction") lays in the different precision weighting of exteroceptive and interoceptive signals.

Prolonged, High-Fidelity Simulation for Study of Patient Care in Resource-Limited Medical Contexts and for Technology Comparative Effectiveness Testing

Most high-fidelity medical simulation is of limited duration, used for education and training, and rarely intended to study medical technology. U.S. caregivers working in prehospital, resource-limited settings may need to manage patients for extended periods (hours to days). This "prolonged casualty care" occurs during military, wilderness, humanitarian, disaster, and space medicine. We sought to develop a standardized simulation model that accurately reflects prolonged casualty care in order to study caregiver decision-making and performance, training requirements, and technology use in prolonged casualty care.

DESIGN

Model development.

SETTING

High-fidelity simulation laboratory.

SUBJECTS

None.

INTERVENTIONS

We interviewed subject matter experts to identify relevant prolonged casualty care medical challenges and selected two casualty types to further develop our model: a large thermal burn model and a severe hypoxia model. We met with a multidisciplinary group of experts in prolonged casualty care, nursing, and critical care to describe how these problems could evolve over time and how to contextualize the problems with a background story and clinical environment with expected resource availability. Following initial scenario drafting, we tested the models with expert clinicians. After multiple tests, we selected the hypoxia model for refinement and testing with inexperienced providers. We tested and refined this model until two research teams could proctor the scenario consistently despite subject performance variability.

MEASUREMENTS AND MAIN RESULTS

We developed a 6-8-hour simulation model that represented a 14-hour scenario. This model of pneumonia evolved from presentation to severe hypoxia necessitating advanced interventions including airway, breathing, and shock management. The model included: context description, caregiver orientation scripts, hourly progressive physiology tracks corresponding to caregiver interventions, intervention/procedure-specific physiology tracks, intervention checklists, equipment lists, prestudy checklists, photographs of setups, procedure, telementor, and role player scripts, business rules, and data collection methods.

CONCLUSIONS

This is the first standardized, high-fidelity simulation model of prolonged casualty care described in the literature. It may be used to assess caregiver performance and patient outcomes resulting from that performance during a complex, 14-hour prolonged casualty care scenario. Because it is standardized, the model may be used to compare differences in the impact of new technologies upon caregiver performance and simulated patient outcomes..

Virtual Reality (VR) Applications in Cardiology: A Review

Virtual reality (VR) has applications in cardiology to create enhancement, thereby improving the quality of associated planning, treatment and surgery. The need is to study different applications of this technology in the field of cardiology. We have studied research papers on VR and its applications in cardiology through a detailed bibliometric analysis. The study identified five significant steps for proper implementation of this technology in cardiology. Some challenges are to be undertaken by using this technology, and they can provide some benefits; thus, authors contemplate extensive research and development. This study also identifies 10 major VR technology applications in cardiology and provided a brief description. This innovative technology helps a heart surgeon to perform complex heart surgery effectively. Thus, VR applications have the potential for improving decision-making, which helps save human life. VR plays a significant role in the development of a surgical procedure. This technology undertakes 3D heart model information in full colour, which helps to analyze the overall heart vane, blockage and blood flow. With the help of this digital technology, a surgeon can improve the accuracy of heart surgery, and he can simulate the surgery. A surgeon can undertake surgery in a virtual environment on a virtual patient. The unique purpose of this technology is to practice pre-operatively on the specific circumstance. A cardiologist can also check the proper status of inner and outer heart wall layer. Thus, by using this 3D information, the surgeon can now interact with heart data/information without any physical touch. This technology opens a new opportunity to improve the heart surgery and development in cardiovascular treatment to improve patient outcome.

Psychosocial Effects and Use of Communication Technologies during Home Confinement in the First Wave of the COVID-19 Pandemic in Italy and The Netherlands

(1) Background: The COVID-19 pandemic forced people from all around the globe to strongly modify their daily routines, putting a significant strain on the social aspects of daily lives. While the first wave of the pandemic was a very challenging time in all countries, it is still uncertain whether various lockdown intensities and infection rates differed regarding their psychosocial impact. This work therefore aimed to investigate (i) the psychosocial effects of home confinement in two European countries that underwent different lockdown intensities: Italy and the Netherlands and (ii) the role of communication technology in relation to feelings of loneliness. (2) Methods: A cross-sectional online survey inquiring about different psychosocial variables and the use of and satisfaction towards communication technology was circulated among the general public during the first wave of the COVID-19 pandemic. In total, 629 participants (66% female, 68% from the Netherlands) answered each question twice, referring to "before" and "during" the pandemic. (3) Results: We found significant negative effects of COVID-19 home confinement on depressive feelings (p < 0.001, %∆ = +54%), loneliness (p < 0.001, %∆ = +37.3%), life satisfaction (p < 0.001, %∆ = -19.8%) and mental wellbeing (p < 0.001, %∆ = -10.6%) which were accompanied with a significantly increased need for psychosocial support (p < 0.001, %∆ = +17.3%). However, the magnitude of psychosocial impact did not significantly differ between residents undergoing a more intense (Italy) versus a less intense (Netherlands) lockdown, although the decrease in social participation was found to be significantly different for both countries (z = -7.714, p < 0.001). Furthermore, our findings demonstrate that the increase in loneliness was associated with the adoption of new digital communication tools (r = 0.21, p < 0.001), and significantly higher for individuals who started to adopt at least one new digital communication tool during confinement than for those who did not (z = -4.252, p < 0.001). (4) Conclusions: This study highlights that, although COVID-19 home confinement significantly impacted psychosocial wellbeing during the first wave of the pandemic, this impact did not differ based on lockdown intensity. Recognizing the increasing adoption of digital communication technology in an attempt to reduce lockdown loneliness, future studies should investigate what is needed from the technology to achieve this effect.

Digi-Do: a digital information tool to support patients with breast cancer before, during, and after start of radiotherapy treatment: an RCT study protocol

BACKGROUND

Radiation Therapy (RT) is a common treatment after breast cancer surgery and a complex process using high energy X-rays to eradicate cancer cells, important in reducing the risk of local recurrence. The high-tech environment and unfamiliar nature of RT can affect the patient's experience of the treatment. Misconceptions or lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time is often quite long. The primary aim of this study will be to evaluate whether a digital information tool with VR-technology and preparatory information can decrease distress as well as enhance the self-efficacy and health literacy of patients affected by breast cancer before, during, and after RT. A secondary aim will be to explore whether the digital information tool increase patient flow while maintaining or increasing the quality of care.

METHOD

The study is a prospective and longitudinal RCT study with an Action Research participatory design approach including mixed-methods data collection, i.e., standardised instruments, qualitative interviews (face-to-face and telephone) with a phenomenological hermeneutical approach, diaries, observations, and time measurements, and scheduled to take place from autumn 2020 to spring 2022. The intervention group (n = 80), will receive standard care and information (oral and written) and the digital information tool; and the control group (n = 80), will receive standard care and information (oral and written). Study recruitment and randomisation will be completed at two centres in the west of Sweden.

DISCUSSION

Research in this area is scarce and, to our knowledge, only few previous studies examine VR as a tool for increasing preparedness for patients with breast cancer about to undergo RT that also includes follow-ups six months after completed treatment. The participatory approach and design will safeguard the possibilities to capture the patient perspective throughout the development process, and the RCT design supports high research quality. Digitalisation brings new possibilities to provide safe, person-centred information that also displays a realistic picture of RT treatment and its contexts. The planned study will generate generalisable knowledge of relevance in similar health care contexts.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04394325. Registered May 19, 2020. Prospectively registered.

The Study of Walking, Walkability and Wellbeing in Immersive Virtual Environments

Recent approaches in the research on walkable environments and wellbeing go beyond correlational analysis to consider the specific characteristics of individuals and their interaction with the immediate environment. Accordingly, a need has been accentuated for new human-centered methods to improve our understanding of the mechanisms underlying environmental effects on walking and consequently on wellbeing. Immersive virtual environments (IVEs) were suggested as a potential method that can advance this type of research as they offer a unique combination between controlled experimental environments that allow drawing causal conclusions and a high level of environmental realism that supports ecological validity. The current study pilot tested a walking simulator with additional sensor technologies, including biosensors, eye tracking and gait sensors. Results found IVEs to facilitate extremely high tempo-spatial-resolution measurement of physical walking parameters (e.g., speed, number of gaits) along with walking experience and wellbeing (e.g., electrodermal activity, heartrate). This level of resolution is useful in linking specific environmental stimuli to the psychophysiological and behavioral reactions, which cannot be obtained in real-world and self-report research designs. A set of guidelines for implementing IVE technology for research is suggested in order to standardize its use and allow new researchers to engage with this emerging field of research.

Virtual reality distraction for acute pain in children

BACKGROUND

Virtual reality (VR) computer technology creates a simulated environment, perceived as comparable to the real world, with which users can actively interact. The effectiveness of VR distraction on acute pain intensity in children is uncertain.

OBJECTIVES

To assess the effectiveness and adverse effects of virtual reality (VR) distraction interventions for children (0 to 18 years) with acute pain in any healthcare setting.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and four trial registries to October 2019. We also searched reference lists of eligible studies, handsearched relevant journals and contacted study authors.

SELECTION CRITERIA

Randomised controlled trials (RCTs), including cross-over and cluster-RCTs, comparing VR distraction to no distraction, non-VR distraction or other VR distraction.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methodological processes. Two reviewers assessed risk of bias and extracted data independently. The primary outcome was acute pain intensity (during procedure, and up to one hour post-procedure). Secondary outcomes were adverse effects, child satisfaction with VR, pain-related distress, parent anxiety, rescue analgesia and cost. We used GRADE and created 'Summary of findings' tables.

MAIN RESULTS

We included 17 RCTs (1008 participants aged four to 18 years) undergoing various procedures in healthcare settings. We did not pool data because the heterogeneity in population (i.e. diverse ages and developmental stages of children and their different perceptions and reactions to pain) and variations in procedural conditions (e.g. phlebotomy, burn wound dressings, physical therapy sessions), and consequent level of pain experienced, made statistical pooling of data impossible. We narratively describe results. We judged most studies to be at unclear risk of selection bias, high risk of performance and detection bias, and high risk of bias for small sample sizes. Across all comparisons and outcomes, we downgraded the certainty of evidence to low or very low due to serious study limitations and serious or very serious indirectness. We also downgraded some of the evidence for very serious imprecision. 1: VR distraction versus no distraction Acute pain intensity: during procedure Self-report: one study (42 participants) found no beneficial effect of non-immersive VR (very low-certainty evidence). Observer-report: no data. Behavioural measurements (observer-report): two studies, 62 participants; low-certainty evidence. One study (n = 42) found no beneficial effect of non-immersive VR. One study (n = 20) found a beneficial effect favouring immersive VR. Acute pain intensity: post-procedure Self-report: 10 studies, 461 participants; very low-certainty evidence. Four studies (n = 95) found no beneficial effect of immersive and semi-immersive or non-immersive VR. Five studies (n = 357) found a beneficial effect favouring immersive VR. Another study (n = 9) reported less pain in the VR group. Observer-report: two studies (216 participants; low-certainty evidence) found a beneficial effect of immersive VR, as reported by primary caregiver/parents or nurses. One study (n = 80) found a beneficial effect of immersive VR, as reported by researchers. Behavioural measurements (observer-report): one study (42 participants) found no beneficial effect of non-immersive VR (very low-certainty evidence). Adverse effects: five studies, 154 participants; very low-certainty evidence. Three studies (n = 53) reported no adverse effects. Two studies (n = 101) reported mild adverse effects (e.g. nausea) in the VR group. 2: VR distraction versus other non-VR distraction Acute pain intensity: during procedure Self-report, observer-report and behavioural measurements (observer-report): two studies, 106 participants: Self-report: one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) found no evidence of a difference in mean pain change scores (very low-certainty evidence). Observer-report: one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) found no evidence of a difference in mean pain change scores (low-certainty evidence). Behavioural measurements (observer-report): one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) reported a difference in mean pain change scores with fewer pain behaviours in VR group (low-certainty evidence). Acute pain intensity: post-procedure Self-report: eight studies, 575 participants; very low-certainty evidence. Two studies (n = 146) found a beneficial effect favouring immersive VR. Two studies (n = 252) reported a between-group difference favouring immersive VR. One study (n = 59) found no beneficial effect of immersive VR versus television and Child Life non-VR distraction. One study (n = 18) found no beneficial effect of semi-immersive VR. Two studies (n = 100) reported no between-group difference. Observer-report: three studies, 187 participants; low-certainty evidence. One study (n = 81) found a beneficial effect favouring immersive VR for parent, nurse and researcher reports. One study (n = 65) found a beneficial effect favouring immersive VR for caregiver reports. Another study (n = 41) reported no evidence of a difference in mean pain change scores. Behavioural measurements (observer-report): two studies, 106 participants; low-certainty evidence. One study (n = 65) found a beneficial effect favouring immersive VR. Another study (n = 41) reported no evidence of a difference in mean pain change scores. Adverse effects: six studies, 429 participants; very low-certainty evidence. Three studies (n = 229) found no evidence of a difference between groups. Two studies (n = 141) reported no adverse effects in VR group. One study (n = 59) reported no beneficial effect in reducing estimated cyber-sickness before and after VR immersion. 3: VR distraction versus other VR distraction We did not identify any studies for this comparison.

AUTHORS' CONCLUSIONS

We found low-certainty and very low-certainty evidence of the effectiveness of VR distraction compared to no distraction or other non-VR distraction in reducing acute pain intensity in children in any healthcare setting. This level of uncertainty makes it difficult to interpret the benefits or lack of benefits of VR distraction for acute pain in children. Most of the review primary outcomes were assessed by only two or three small studies. We found limited data for adverse effects and other secondary outcomes. Future well-designed, large, high-quality trials may have an important impact on our confidence in the results.

Electroencephalography Data-Driven Lighting System to Improve Sleep Quality in Intensive Care Unit Patients: A Case Study

Sleep disturbance and deprivation are major factors in delayed recovery, which can affect both the physical and emotional well-being of patients. Patients hospitalized in the Intensive Care Unit (ICU) are especially vulnerable to sleep deprivation due to light-induced disturbances. A desirable lighting intervention in the ICU would minimize light-induced disturbances while simultaneously providing feedback for the staff on when to perform patient care activities that require high intensity lighting. To this end, we performed a first phase testing for a biometrics-integrated lighting system that serves a dual function of sleep initiation and maintenance to improve the patient's quality of sleep. Preliminary findings are presented as a case study to assess the feasibility of scaling up the experimental model. While findings point to additional testing being necessary to determine whether the lighting system will be effective, the experiment detailed in this report establishes a starting paradigm upon which to base further investigation.Clinical Relevance- A biometrics-integrated lighting system that can improve sleep quality of the patient will not only reduce cost of care for the patients, but also increase the level of satisfaction for both patients and the hospital staff.

Integrated jerk as an indicator of affinity for artificial agent kinematics: laptop and virtual reality experiments involving index finger motion during two-digit grasping

Uncanny valley research has shown that human likeness is an important consideration when designing artificial agents. It has separately been shown that artificial agents exhibiting human-like kinematics can elicit positive perceptual responses. However the kinematic characteristics underlying that perception have not been elucidated. This paper proposes kinematic jerk amplitude as a candidate metric for kinematic human likeness, and aims to determine whether a perceptual optimum exists over a range of jerk values. We created minimum-jerk two-digit grasp kinematics in a prosthetic hand model, then added different amplitudes of temporally smooth noise to yield a variety of animations involving different total jerk levels, ranging from maximally smooth to highly jerky. Subjects indicated their perceptual affinity for these animations by simultaneously viewing two different animations side-by-side, first using a laptop, then separately within a virtual reality (VR) environment. Results suggest that (a) subjects generally preferred smoother kinematics, (b) subjects exhibited a small preference for rougher-than minimum jerk kinematics in the laptop experiment, and that (c) the preference for rougher-than minimum-jerk kinematics was amplified in the VR experiment. These results suggest that non-maximally smooth kinematics may be perceptually optimal in robots and other artificial agents.

Using immersive virtual reality to modify body image

We tested the efficacy of a training programme, delivered in virtual reality (VR), to modify the perceptual boundary between what participants classify as a fat versus a thin body. Three cohorts of 20 female volunteers with high body image concerns were recruited to two intervention groups and one control group. All participants completed a 4-day training programme in VR where they categorised a series of 3D models as either thin or fat; one intervention group was presented with the stimuli briefly, while the other group had no time limits imposed. Both intervention groups were given inflationary feedback to shift their categorisations of the stimulus models towards higher BMIs. Our results show that, compared to controls, both intervention groups shifted their categorical boundaries between Day 1 and follow-up on Day 14. Unlimited stimulus presentation times were associated with a larger training effect. Furthermore, both intervention groups experienced statistically significant reductions in their concerns about their own body shape, weight and eating habits. However, only in the group with longer stimulus presentation times were these reductions consistent with a clinically meaningful effect. These findings suggest that manipulating categorical perception in VR might provide a complementary addition to existing treatments for eating disorders.

Virtual Reality Nature Experiences Involving Wolves on YouTube: Presence, Emotions, and Attitudes in Immersive and Nonimmersive Settings

As some nature experiences, such as viewing wild animals, may be difficult to implement in science education, immersive virtual reality (VR) technologies have become a promising tool in education. However, there is limited knowledge regarding the effectiveness of nature experiences in VR. In this study, 50 German university students (M = 23.76 years, SD = 3.73 years) from diverse disciplines were randomly assigned to an immersive (head-mounted display; Oculus Quest) or a nonimmersive setting (external computer screen; desktop computer) and individually watched two 360° videos from the social media site YouTube about wolves in their natural habitat. Besides measuring participants’ attitudes towards wolves, we investigated their feeling of presence in the virtual environments with the Spatial Presence Experience Scale (SPES) and the retrospective emotions of interest, joy, and fear with the Differential Affect Scale (M-DAS). The immersive head-mounted display induced higher levels of presence and interest compared to the nonimmersive external computer screen. While higher interest in the screen setting was associated with more positive attitudes towards wolves, such a correlation could not be found in the head-mounted display setting. Thus, our study found that immersive technology could induce interest in a nature experience related to the tested socio-scientific issue, even among people who did not already hold positive attitudes toward the issue. Overall, our findings suggest that 360° videos using immersive technology provide nature experiences with positive affective learning outcomes, even though the study focused on nature experiences in VR and was not an educational experience per se. As we were unable to assess the role of novelty of VR experiences, the application of VR technologies and its effects in larger teaching and learning settings needs to be evaluated in further studies.

Using 360-Degree Video as a Research Stimulus in Digital Health Studies: Lessons Learned

Due to the accessibility of omnidirectional cameras to record 360-degree videos and the technology to view the videos via mobile phones and other devices, 360-degree videos are being used more frequently to place people in different contexts and convey health-related information. Increasingly, 360-degree videos are being employed in health marketing because they have the potential to enhance health-related attitudes and behaviors. As a case study on how this technology may be used for health-related information and its effect on health care providers, we created a 360-degree video that portrays the experience of a migraine sufferer to be used as a stimulus in an online study. We describe the challenges and lessons learned in designing and implementing a 360-degree video as part of an online experiment focused on inducing empathy among clinicians for understanding patient experience. Given the rapid change in digital technology, future research can use this knowledge to design and implement 360-degree video studies more effectively.

Understanding Social Cognition Using Virtual Reality: Are We still Nibbling around the Edges?

Virtual Reality (VR) has a variety of applications in various fields of study, including social work and human performance training. Useful information regarding the neurobiological underpinnings of social cognition (SC) has been obtained from the use of VR. This was mainly achieved by substituting the use of simple and static stimuli (that lack many of the potentially important aspects of real-world activities and social interactions) with fully interactive, three-dimensional computerized models of social situations that can be fully controlled by the experimenter, and can simulate a real-world setting as recently pointed out by Parsons et al. (Virtual Reality for Research in Social Neuroscience. Brain Sciences, 2017). As a consequence, the cognitive training in the field of SC and, broadly, social neuroscience, has greatly benefited from the use of VR. However, specific issues concerning the VR neurophysiological underpinnings remain to be clarified, as well as the social and cultural consequences of VR technologies focusing on the processing of social information and the consequences arising from the understanding of self and others. Notwithstanding, it is important to remark that VR-based social neuroscience scenarios can reliably enhance the affective experience and social interactions, whether added to or coupled with traditional cognitive behavioural therapy.

Virtual skills training: the role of presence and agency

Virtual reality (VR) simulations provide increased feelings of presence and agency that could allow increased skill improvement during VR training. Direct relationships between active agency in VR and skill improvement have previously not been investigated. This study examined the relationship between (a) presence and agency, and (b) presence and skills improvement, via active and passive VR simulations and through measuring real-world golf-putting skill. Participants (n = 23) completed baseline putting skill assessment before using an Oculus Rift VR head-mounted display to complete active (putting with a virtual golf club) and passive (watching a game of golf) VR simulations. Measures of presence and agency were administered after each simulation, followed by a final putting skill assessment. The active simulation induced higher feelings of general presence and agency. However, no relationship was identified between presence and either agency or skill improvement. No skill improvement was evident in either the active or passive simulations, potentially due to the short training period applied, as well as a lack of realism in the VR simulations inhibiting a transfer of skills to a real environment. These findings reinforce previous literature that shows active VR to increase feelings of presence and agency. This study generates a number of fruitful research questions about the relationship between presence and skills training.

Real vs. immersive-virtual emotional experience: Analysis of psycho-physiological patterns in a free exploration of an art museum

Virtual reality is a powerful tool in human behaviour research. However, few studies compare its capacity to evoke the same emotional responses as in real scenarios. This study investigates psycho-physiological patterns evoked during the free exploration of an art museum and the museum virtualized through a 3D immersive virtual environment (IVE). An exploratory study involving 60 participants was performed, recording electroencephalographic and electrocardiographic signals using wearable devices. The real vs. virtual psychological comparison was performed using self-assessment emotional response tests, whereas the physiological comparison was performed through Support Vector Machine algorithms, endowed with an effective feature selection procedure for a set of state-of-the-art metrics quantifying cardiovascular and brain linear and nonlinear dynamics. We included an initial calibration phase, using standardized 2D and 360° emotional stimuli, to increase the accuracy of the model. The self-assessments of the physical and virtual museum support the use of IVEs in emotion research. The 2-class (high/low) system accuracy was 71.52% and 77.08% along the arousal and valence dimension, respectively, in the physical museum, and 75.00% and 71.08% in the virtual museum. The previously presented 360° stimuli contributed to increasing the accuracy in the virtual museum. Also, the real vs. virtual classifier accuracy was 95.27%, using only EEG mean phase coherency features, which demonstrates the high involvement of brain synchronization in emotional virtual reality processes. These findings provide an important contribution at a methodological level and to scientific knowledge, which will effectively guide future emotion elicitation and recognition systems using virtual reality.

Present in Body or Just in Mind: Differences in Social Presence and Emotion Regulation in Live vs. Virtual Singing Experiences

Over the past two decades, many musical experiences have become mediated by digital technology, including the distribution of music online, the generation of new content and participation in virtual musical experiences. However, whether virtual musical experiences lead to different experiences of social presence or differential use of emotion regulation strategies (ERSs) compared to live musical experiences remains un-researched. We compared the experiences of 1,158 singers in a virtual choir (VC) with the experiences of 1,158 singers from a live choir using propensity score matching based on a range of demographic, social and musical factors. Participants in VCs reported a slightly greater feeling of social presence than participants in live choirs [t(1157) = -19.85, p < 0.002]. They also made less use of overall ERSs [t(1157) = 3.10, p = 0.002], avoidance strategies [t(1157) = 4.51, p < 0.001], and approach strategies [t(1157) = 3.34, p < 0.001]. However, they made greater use of self-development strategies [t(1157) = -3.11, p = 0.002]. Social presence was associated with greater use of all ERSs. This study showed that although a sense of social presence in a choir is not reduced by engagement in VCs compared to live choirs, there is a lowered use of ERSs when engaging in VCs. However, as the difference in use of ERSs is relatively modest, virtual musical experiences may still have a role to play in supporting those who cannot engage in live experiences such as people who are socially isolated.