Immersive Sessions Research Articles

P032 THE IMPACT OF NATURE IMMERSION THERAPY ON BLOOD PRESSURE IN HYPERTENSIVE SUBJECTS: A PILOT STUDY

Background and Objective: Conscious nature immersion therapy, termed “Vitamin N”, has shown promise in reducing blood pressure levels in individuals with or without hypertension. This pilot study aims to assess the effect of nature immersion on blood pressure specifically in hypertensive subjects. Methods: A convenience sample of stable hypertensive individuals participated in a standardized 3-hour nature immersion session. Systolic and diastolic blood pressure levels were recorded before the intervention (Phase I), after 30 minutes of the intervention (Phase II), and 48 hours post-intervention (Phase III). Statistical analysis employed a one-way non-parametric ANOVA, Kruskal-Wallis test, and Dunn's post hoc test, with a bilateral significance level of 95%. A criterion of at least 3 mmHg reduction in blood pressure was set for clinical significance. Results Eighteen participants, comprising 12 women (64.67%) and 6 men (33.33%), with a mean age of 60±9.04 years and 61±6.88 years, respectively, were included. Six individuals had a medical history of Diabetes Mellitus Type 2, and one had a history of coronary heart disease. Significant differences in median systolic (MSP) and diastolic pressures (MDP) were observed across the three phases (p<0.05). Notably, Phase II and Phase III showed consistent reductions in blood pressure compared to Phase I, exceeding the established 3 mmHg reduction criterion. Conclusions: Conscious nature immersion therapy (“Vitamin N”) exhibited a significant effect in lowering both systolic and diastolic blood pressure levels among hypertensive individuals. These findings suggest the potential of nature immersion as a non-pharmacological intervention for managing hypertension.

P037 IMPROVING WELLBEING AND MENTAL HEALTH IN HYPERTENSIVE PATIENTS: A PILOT STUDY ON NATURE IMMERSION THERAPY

Background and Objective: Nature immersion therapy, also known as “Vitamin N,” has demonstrated a significant impact on enhancing well-being and mental health indicators. This pilot study aims to investigate the effects of Vitamin N treatment on the well-being, mental health, and affect scores of hypertensive patients undergoing medical treatment. Methods: A convenience sample of stable hypertensive individuals participated in a standardized 3-hour nature immersion session. Participants completed pre- and post-treatment assessments using the World Health Organization-Five Well-Being Index (WHO-5), Positive and Negative Affect Schedule (PANAS), and Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Paired samples analysis, including the Wilcoxon signed-rank test, was employed to assess changes in scores, along with effect size calculations. Results: The study comprised 18 participants, including 12 females (64.67%) and 6 males (33.33%), with 6 having a history of diabetes. Following conscious nature immersion therapy, a significant improvement was observed in the scores of the well-being scale, WHO-5, WEMWBS, and PANAS positive affect scale (p < 0.05). Conclusions: Conscious immersion therapy in nature yielded notable improvements in well-being assessment scales and increased positive affect scores (PANAS), suggesting potential benefits for enhancing well-being in patients with arterial hypertension.

Ensemble Methods to Optimize Automated Text Classification in Avatar Therapy

Background: Psychotherapeutic approaches such as Avatar Therapy (AT) are novel therapeutic attempts to help patients diagnosed with treatment-resistant schizophrenia. Qualitative analyses of immersive sessions of AT have been undertaken to enhance and refine the existing interventions taking place in this therapy. To account for the time-consuming and costly nature and potential misclassification biases, prior implementation of a Linear Support Vector Classifier provided helpful insight. Single model implementation for text classification is often limited, especially for datasets containing imbalanced data. The main objective of this study is to evaluate the change in accuracy of automated text classification machine learning algorithms when using an ensemble approach for immersive session verbatims of AT. Methods: An ensemble model, comprising five machine learning algorithms, was implemented to conduct text classification for avatar and patient interactions. The models included in this study are: Multinomial Naïve Bayes, Linear Support Vector Classifier, Multi-layer perceptron classifier, XGBClassifier and the K-Nearest-Neighbor model. Accuracy, precision, recall and f1-score were compared for the individual classifiers and the ensemble model. Results: The ensemble model performed better than its individual counterparts for accuracy. Conclusion: Using an ensemble methodological approach, this methodology might be employed in future research to provide insight into the interactions being categorized and the therapeutical outcome of patients based on their experience with AT with optimal precision.

Enhancing Predictive Power: Integrating a Linear Support Vector Classifier with Logistic Regression for Patient Outcome Prognosis in Virtual Reality Therapy for Treatment-Resistant Schizophrenia.

(1) Background: Approximately 30% of schizophrenia patients are known to be treatment-resistant. For these cases, more personalized approaches must be developed. Virtual reality therapeutic approaches such as avatar therapy (AT) are currently undergoing investigations to address these patients' needs. To further tailor the therapeutic trajectory of patients presenting with this complex presentation of schizophrenia, quantitative insight about the therapeutic process is warranted. The aim of the study is to combine a classification model with a regression model with the aim of predicting the therapeutic outcomes of patients based on the interactions taking place during their first immersive session of virtual reality therapy. (2) Methods: A combination of a Linear Support Vector Classifier and logistic regression was conducted over a dataset comprising 162 verbatims of the immersive sessions of 18 patients who previously underwent AT. As a testing dataset, 17 participants, unknown to the dataset, had their first immersive session presented to the combinatory model to predict their clinical outcome. (3) Results: The model accurately predicted the clinical outcome for 15 out of the 17 participants. Classification of the therapeutic interactions achieved an accuracy of 63%. (4) Conclusion: To our knowledge, this is the first attempt to predict the outcome of psychotherapy patients based on the content of their interactions with their therapist. These results are important as they open the door to personalization of psychotherapy based on quantitative information about the interactions taking place during AT.

Mapping the pathways to health sciences librarianship: reflections and future implications from an immersion session

Objective: Many health sciences librarians enter the profession without specific health sciences training. Some LIS programs have health sciences courses or tracks, but health sciences training within an LIS program is only one path to entering health sciences librarianship. To develop a map of pathways into health sciences librarianship, an immersion session at the Medical Library Association conference in 2022 asked health sciences librarians to share how they entered the profession. Methods: The immersion session was structured in three parts: facilitator introductions, small group discussions, and a whole group summary discussion. Guided by questions from the facilitators, small groups discussed what pathways currently exist, how to promote existing pathways, what new pathways should be created, and how to develop and promote pathways that make the profession more equitable, diverse, and inclusive. Results: Through in-the-moment thematic analysis of the small group discussions, the following emerged as key pathways: library school education; internships and practica; the Library and Information Science (LIS) pipeline; on-the-job training; mentoring; self-teaching/hands-on learning; and continuing education. Themes of equity, diversity, and inclusion arose throughout the session, especially in the concluding whole group discussion. Conclusion: Small group discussions in a conference immersion session showed the value of community building in a profession that has multiple pathways for entrance, highlighting the importance of unearthing hidden knowledge about avenues for exploring and enhancing career pathways. The article seeks to address barriers to entry into the profession and adds to the literature on strengthening the field of health sciences librarianship.

Comparing the Performance of Machine Learning Algorithms in the Automatic Classification of Psychotherapeutic Interactions in Avatar Therapy

(1) Background: Avatar Therapy (AT) is currently being studied to help patients suffering from treatment-resistant schizophrenia. Facilitating annotations of immersive verbatims in AT by using classification algorithms could be an interesting avenue to reduce the time and cost of conducting such analysis and adding objective quantitative data in the classification of the different interactions taking place during the therapy. The aim of this study is to compare the performance of machine learning algorithms in the automatic annotation of immersive session verbatims of AT. (2) Methods: Five machine learning algorithms were implemented over a dataset as per the Scikit-Learn library: Support vector classifier, Linear support vector classifier, Multinomial Naïve Bayes, Decision Tree, and Multi-layer perceptron classifier. The dataset consisted of the 27 different types of interactions taking place in AT for the Avatar and the patient for 35 patients who underwent eight immersive sessions as part of their treatment in AT. (3) Results: The Linear SVC performed best over the dataset as compared with the other algorithms with the highest accuracy score, recall score, and F1-Score. The regular SVC performed best for precision. (4) Conclusions: This study presented an objective method for classifying textual interactions based on immersive session verbatims and gave a first comparison of multiple machine learning algorithms on AT.

Exploration of the role of emotional expression of treatment-resistant schizophrenia patients having followed virtual reality therapy: a content analysis

BackgroundEmotional responses are an important component of psychotherapeutic processes. Avatar therapy (AT) is a virtual reality-based therapy currently being developed and studied for patients suffering from treatment resistant schizophrenia. Considering the importance of identifying emotions in therapeutical processes and their impact on the therapeutic outcome, an exploration of such emotions is needed.MethodsThe aim of this study is to identify the underlying emotions at the core of the patient-Avatar interaction during AT by content analysis of immersive sessions transcripts and audio recordings. A content analysis of AT transcripts and audio recordings using iterative categorization was conducted for 16 patients suffering from TRS who underwent AT between 2017 and 2022 (128 transcripts and 128 audio recordings). An iterative categorization technique was conducted to identify the different emotions expressed by the patient and the Avatar during the immersive sessions.ResultsThe following emotions were identified in this study: Anger, Contempt/ Disgust, Fear, Sadness, Shame/ Embarrassment, Interest, Surprise, Joy and Neutral. Patients expressed mostly neutral, joy and anger emotions whereas the Avatar expressed predominantly interest, disgust/contempt, and neutral emotions.ConclusionsThis study portrays a first qualitative insight on the emotions that are expressed in AT and serves as a steppingstone for further investigation in the role of emotions in the therapeutic outcomes of AT.

Bodily contrast experiences in cultivating character for care.

Since 2008, in Flanders, we organize immersion sessions in a simulated context with the aim of stimulating student nurses and health professionals to learn virtuous caring. In this contribution, we first outline the purpose of this experiential learning: the cultivation of moral character. We come to the core of what we mean by moral character for care. We refer to Joan Tronto and Stan van Hooft to claim that caring is central to all aspects of nursing practice and is the basis of its moral quality. We also stipulate that caring involves the integration of action with emotions, motivations, and knowledge. Second, we briefly explain how the immersion sessions in the care ethics lab take place and, in particular, reflect on what it yields in terms of experiences for the participants who take on the role of simulant patients in this experiential learning process. We focus on the significant role contrast experiences play in these experiences. Especially the negative contrast experiences do not wear off easily; care professionals remember even long after the immersion session and continue to carry them with them as a "corporeal built-in alarm." Third, we discuss the role of contrast experiences in cultivating moral character for care. In particular, we explore the role of the body in the kind of knowing it cultivates and, by extension, its role in cultivating virtuous caring. By referring to specific philosophical ideas of Gabriël Marcel, Hans Jonas and Emmanuel Levinas, we try to understand how contrast experiences bring about an integration of virtuous action into knowledge, motivation, and emotion. We conclude that we need more space for contrast experiences in cultivating moral character. More attention should be paid to the role of the body in this learning process.

Unsupervised Machine Learning Driven Analysis of Verbatims of Treatment-Resistant Schizophrenia Patients Having Followed Avatar Therapy.

(1) Background: The therapeutic mechanisms underlying psychotherapeutic interventions for individuals with treatment-resistant schizophrenia are mostly unknown. One of these treatment techniques is avatar therapy (AT), in which the patient engages in immersive sessions while interacting with an avatar representing their primary persistent auditory verbal hallucination. The aim of this study was to conduct an unsupervised machine-learning analysis of verbatims of treatment-resistant schizophrenia patients that have followed AT. The second aim of the study was to compare the data clusters obtained from the unsupervised machine-learning analysis with previously conducted qualitative analysis. (2) Methods: A k-means algorithm was performed over the immersive-session verbatims of 18 patients suffering from treatment-resistant schizophrenia who followed AT to cluster interactions of the avatar and the patient. Data were pre-processed using vectorization and data reduction. (3): Results: Three clusters of interactions were identified for the avatar's interactions whereas four clusters were identified for the patient's interactions. (4) Conclusion: This study was the first attempt to conduct unsupervised machine learning on AT and provided a quantitative insight into the inner interactions that take place during immersive sessions. The use of unsupervised machine learning could yield a better understanding of the type of interactions that take place in AT and their clinical implications.

Avatar Intervention for Cannabis Use Disorder in Individuals with Severe Mental Disorders: A Pilot Study.

Cannabis use disorder (CUD) is a complex issue, even more so when it is comorbid with a severe mental disorder (SMD). Available interventions are at best slightly effective, and their effects are not maintained over time. Therefore, the integration of virtual reality (VR) may increase efficacy; however, it has not yet been investigated in the treatment of CUD. A novel approach, avatar intervention for CUD, uses existing therapeutic techniques from other recommended therapies (e.g., cognitive behavioral methods, motivational interviewing) and allows participants to practice them in real-time. During immersive sessions, participants are invited to interact with an avatar representing a significant person related to their drug use. This pilot clinical trial aimed to evaluate the short-term efficacity of avatar intervention for CUD on 19 participants with a dual diagnosis of SMD and CUD. Results showed a significant moderate reduction in the quantity of cannabis use (Cohen's d = 0.611, p = 0.004), which was confirmed via urinary quantification of cannabis use. Overall, this unique intervention shows promising results. Longer-term results, as well as comparison with classical interventions in a larger sample, are warranted through a future single-blind randomized controlled trial.

Psycho-Emotional Well-Being in Caregivers of People with Acquired Brain Injury: An Exploratory Study on the Human Immersion Model during the Omicron Wave.

The purpose of this study was to investigate the effects of a "human immersion model" (HIM) in improving psychological well-being in caregivers of patients with acquired brain injury (ABI) during the Omicron wave in Italy. Fifteen subjects affected by ABI, who attended our intensive neurorehabilitation unit from January to March 2022 and their caregivers were submitted to the HIM. This novel approach consisted of "real" long-lasting meetings between the patients and their careers in a hospital setting (1-72 h meeting per week for 8 weeks). Each ABI caregiver was assessed through the administration of a short psychometric battery before starting the first immersion session with their family member and at the end of the HIM. We found significant changes in the caregivers' scores analyzed for anxiety, as per SAS (p < 0.0007, d = 1.02), burden and stress (ZBI-22; p < 0.001, d = 0.65), and emotive intelligence (TEIQue-SF; p < 0.0007, d = 0.82). Our data suggest that the HIM may be useful to promote ABI caregivers' psycho-emotional well-being in the context of critical periods such as the COVID-19 pandemic.

Dyadic Interactions of Treatment-Resistant Schizophrenia Patients Having Followed Virtual Reality Therapy: A Content Analysis

(1) Background: Very little is known about the inner therapeutic processes of psychotherapy interventions for patients suffering from treatment-resistant schizophrenia. Avatar therapy (AT) is one such modalities in which the patient is undergoing immersive sessions in which they interact with an Avatar representing their main persistent auditory verbal hallucination. The aim of this study is to identify the most prevalent dyadic interactions between the patient and the Avatar in AT for patient's suffering from TRS. (2) Methods: A content analysis of 256 verbatims originating from 32 patients who completed AT between 2017 and 2022 at the Institut universitaire en santé mentale de Montréal was conducted to identify dyadic interactions between the patients and their Avatar. (3) Results: Five key dyads were identified to occur on average more than 10 times for each participant during the immersive sessions across their AT: (Avatar: Reinforcement, Patient: Self-affirmation), (Avatar: Provocation, Patient: Self-affirmation), (Avatar: Coping mechanisms, Patient: Prevention), (Patient: Self-affirmation, Avatar: Reinforcement), and (Patient: Self-appraisal, Avatar: Reinforcement). (4) Conclusion: These dyads offer a first qualitative insight to the interpersonal dynamics and patient-avatar relationships taking place during AT. Future studies on the implication of such dyadic interactions with the therapeutic outcome of AT should be conducted considering the importance of dyadic relationships in psychotherapy.

Heart Rate Variability Parameters to Evaluate Autonomic Functions in Healthy Young Subjects during Short-Term “Dry” Immersion

There is a gap in the current knowledge on the immediate mechanisms of cardiovascular regulation in human subjects within short-term exposure to modeled microgravity using “dry” immersion. Aim. The purpose of the study was to evaluate cardiovascular responses in young healthy subjects during a 45 min session with the help of linear and nonlinear heart rate variability and hemodynamics parameters. The research voluntarily enrolled 33 subjects (18 men, 15 women) aged 19–23 years old. Results. The study showed that systolic and diastolic blood pressure was quite stable, some time-domain parameters of heart rate variability (SDNN, RMSSD, pNN50, etc.) and the frequency-domain (TP, HF, LF, but not VLF) have significantly increased within a 45 min “dry” immersion session. Of the non-linear parameters of heart rate variability, only ApEn significantly decreased during the “dry” immersion session. Conclusion. Our results suggest that a short-term 45 min DI session provokes in young healthy subjects neurogenic autonomic reaction based on the baroreceptor reflex. This provides stable hemodynamics in these subjects along the “dry” immersion session.

Avatar Intervention for cannabis use disorder in patients with psychotic and mood disorders

IntroductionCannabis use disorder (CUD) is a complex issue, even more so when it is comorbid with a psychotic disorder or a mood disorder. Indeed, this population seems more vulnerable to this substance since the incidence of developing CUD is five to six times higher. Psychotherapies have only shown a modest short-term effect that is not maintained in the long term. The emergence of the use of virtual reality (VR) in psychiatry could be the tool that will make it possible to overcome this lack of efficiency. Indeed, VR has shown its considerable potential in a variety of psychiatric conditions. However, this modality has not been investigated for treatment for CUD. The Avatar intervention for substance use disorder allows the creation of an avatar and voice transformation that represents a significant person in relation to the patient’s substance use and is interpreted by the therapist. During the immersive sessions, patients are invited to work with their avatars on self-affirmation and refusal techniques, the management of negative emotions, stress and cravings, conflict resolution, self-esteem and motivation for change.ObjectivesThe purpose of this pilot project is to collect preliminary data on a new intervention.MethodsFor the realization of this research project, we intend to recruit 40 participants, aged 18 and over, with a diagnosis of a CUD of at least moderate intensity, with a regular cannabis use and who also has a psychotic and/or mood disorder. The intervention consists of 8 weekly one-hour long sessions. Clinical research interviews were conducted and after therapy, and follow-ups occured at 3, 6 and 12 months. These evaluations will allow us to analyze the quantity of consumption, the severity of CUD measured with the cannabis use problem identification test (CUPIT), as well as objectively the concentration of THC thanks to samples. urinary tests which are carried out at the first and last intervention session as well as at the 3-month follow-up. Also, the psychotic symptoms and the quality of life will be evaluated.ResultsIn November 2022, 32 participants had been recruited of which 17 participants had completed the Avatar intervention. Preliminary results from this sample show that a decrease of moderate effect size for amount of cannabis consumed was observed, as well as on severity of the cannabis use problem after the intervention. The quantity of cannabis consumed and the severity of the problem was also significantly reduced at follow-up Quality of life tends to increase and disease symptoms decreased significantly at 3 and 6 month follow-up.ConclusionsTo our knowledge, this intervention is a first in the world to target CUD in this particular population while using innovative technology The Avatar intervention under study in this project presents itself as a new avenue for cannabis use disorders.Disclosure of InterestNone Declared

Creation of an International Interprofessional Simulation-enhanced Mechanical Ventilation Course.

BackgroundEvidence shows poor adherence to strategies for reducing morbidity and mortality in intensive care unit (ICU) patients receiving mechanical ventilation globally. Best practice management relies on training all members of the interprofessional ICU team, each with complementary roles in patient management.ObjectivesTo develop and evaluate a novel two-phase, train-the-trainer, interprofessional and multicultural “Best Practice Management of the Ventilated ICU Patient” multimodality, simulation-enhanced curriculum for Thai education leaders in critical care.MethodsIn phase 1 (Oregon Health and Science University cohort), two groups of nine ICU nurses and one critical care physician representing experts in critical care and education from a large hospital system in Thailand participated in a weeklong, immersive course consisting of didactic, simulation, and in situ immersive sessions focused on best practice management of mechanically ventilated ICU patients, as well as training in our educational techniques. Outcomes were assessed with pre- and postcourse knowledge assessments and overall course evaluation. In phase 2 (Thai cohort), participants from phase 1 returned to Thailand and implemented a lower fidelity curriculum in two hospitals, using the same pre- and posttest knowledge assessment in 41 participants, before the onset of the coronavirus disease (COVID-19) 6 pandemic.ResultsIn the Oregon Health and Science University cohort, the mean pretest knowledge score was 58.4 ± 13.2%, with a mean improvement to 82.5 ± 11.6% after completion of the course (P , 0.05). The greatest improvements were seen in respiratory physiology and advanced/disease-specific concepts, which demonstrated absolute improvements of 30.4% and 30.6%, respectively (P < 0.05). Participants had a high degree of satisfaction, with 90% rating the course as “excellent” and .90% reporting that the course “greatly improved” their understanding of best practices and comfort in managing mechanical ventilation. The Thai cohort had a mean baseline score of 45.4 ± 15.0% and a mean improvement to 70.3 ± 19.1% after training (P < 0.05). This cohort also saw the greatest improvement in respiratory physiology and advanced/disease-specific concepts, with 26.2% and 26.3% absolute improvements, respectively (P < 0.05).ConclusionA novel, two-phase, interprofessional, multicultural, simulation-enhanced train-the-trainer curriculum was feasible and effective in improving education in best practice management of mechanically ventilated patients and may be a useful model for improving the care of ICU patients across the world.

Welcome to stay-at-home travel and virtual attention restoration

The present investigation takes a qualitative approach to explore Airbnb's Online Experience as a new virtual tourism initiative through the lens of attention restoration theory. Data were collected from tourist reviews at Airbnb's platform with an emphasis on touring services such as sightseeing and cultural immersion sessions. Our findings first point to a multitude of virtual tour experiences germane to deep immersion, authenticity, nostalgia, hedonism, past-present resonance, novelty, learning, social interaction, and escape. These stay-at-home virtual restorative experiences were infused by Airbnb's state-of-the-art platform with features such as a super host, storytelling, personalization, virtual connection, stay-at-home indulgence, and technology enablement, which ultimately transcend home as the center stage for virtual attention restoration under the COVID-19 new normal.

Transforming the once-a-day pill for HIV prevention from medicine to empowering self-care using human-centred design in Zimbabwe

ObjectiveFor adolescent girls and young women (AGYW) in sub-Saharan Africa, oral tenofovir‐based pre‐exposure prophylaxis (commonly referred to as PrEP) provides a user-controlled HIV prevention method, critical to addressing their HIV...

196 Plugged in Sim-Vr 360 Simulation with Headsets: How Does it Work?

Simulation is a technique employed to produce an experience without going through a real event We had used 360 videos for remote simulation and debrief for over 3 years but as face-to-face sessions started to reoccur, we wondered whether we could use these videos to engage learners using VR headsets for short immersive sessions with a targeted debrief.We used unscripted 360-degree scenarios of Paediatric emergency simulations, loaded onto Occulus-Go VR headsets. Between November 2020 and May 2020, we ran sessions for the paediatric and obstetric teams in North Devon district hospital, where groups of up to five learners watched a scenario, followed by a debrief led by a facilitator. We explored its acceptability, immersion and whether the debrief enriched the session through collecting feedback.We engaged 50 participants over 14 sessions. The majority of sessions occurred on night shifts. Twenty-nine staff including doctors, midwives, healthcare assistants and nurses gave feedback. All participants enjoyed the experience and wanted to do it again: 90% felt immersed and 97% enjoyed the debrief. A small minority found the experience strange and one had to stop watching because of motion sickness.Virtual sim with headsets is time-efficient, requires no bedspace and was engaging enough to be requested during out of hours shifts. Feedback proved it to be immersive, safe and enjoyable. It is cost-effective (not needing large numbers of staff or expensive manikins) and the experience reproducible. It was accessible for those who had previously been scared of simulation as they did not feel ‘judged’ and therefore may be a valuable adjunct to engaging those who have not in the past. Debrief was vital and allowed active discussion of learners’ own experiences as well as an exploration of the medicine prompted by being immersed in the scenario. Virtual simulation using headsets and 360 videos gives learners an experience without going through the real event and we feel that it is a valuable tool for engaging teams in simulation education. Through this project have established standards that could help others engage in projects such as this.

Dynamics of Perception Distortions of Human Body Physical Dimensions in Virtual Reality

Controlling characters in a virtual reality (VR) environment can lead to the interiorization of their body dimensions by the recipients. The possible preservation of these distortions in their psyche will indicate a high degree of psychological impact of a VR on a person and the potential danger of developing depersonalization of the recipients and their dependence on such stimulation. The study of the stability of these distortions is necessary in the context of ensuring the safety of the impact of VR environments on the human psyche. The main focus of the study is on the perception distortions of human body dimensions, as they are sensed by people immersed in a VR environment, and their dynamics depending on the number of immersions. The impact of the virtual reality environment was simulated using the Freedom Locomotion VR application. One virtual reality immersion session took 15 minutes. To obtain psychometric indicators of the subjects perception of their own body dimensions, the technique Measurements according to M. Feldenkrais was used. All the participants (N = 45, three experimental groups) underwent a mandatory preliminary measurement using this technique (several hours before exposure) and a final measurement (one day after the last exposure). At the same time, the results of preliminary measurements were taken as indicators of the subjects habitual perception of their own body dimensions and were considered in each data processing as a comparison group. Free movement in a VR environment leads to distortions in the subjects perception of their own body dimensions. In all the experimental groups, there was a tendency to exaggerate body dimensions immediately after immersions, which indicates the qualitative similarity of these distortions. The effect of repetitive immersion in a VR environment on the perception of body dimensions is that it increases awareness in perceiving body parts that are least active at the time of immersion. Controlling an anthropomorphic character in a VR leads to an increase in the subjective significance of the recipients own body perception and an increased concentration of attention on the parameters least involved in immersion. The results of the study show that an increased level of awareness in perceiving their own bodies is characteristic of the subjects who have experience of repetitive immersions in a VR environment in the guise of an anthropomorphic character. Controlling a bodily projection in a VR headset does not cause its long-term interiorization, but has a positive effect on the formation of personal corporeality.

Passive Heat Therapy Reduces Aortic and Carotid Artery Stiffness and Intima‐Media Thickness in Middle‐Aged and Older Adults

Aging is accompanied by stiffening of the large elastic arteries and adverse arterial remodeling, which increase risk for cardiovascular diseases (CVD). Passive heat therapy—chronic use of hot baths and saunas—is associated with lower CVD risk. However, it is unknown if a heat therapy intervention affects arterial stiffness and structure in middle-aged and older (MA/O) adults without overt clinical disorders. Purpose To determine if passive heat therapy, via hot water immersion, in healthy MA/O adults: 1) reduces arterial stiffness, as measured by carotid-femoral pulse wave velocity (c-f PWV; i.e., aortic stiffness) and common carotid artery (CCA) and superficial femoral artery (SFA) β-stiffness index; and 2) alters arterial structure, as measured by CCA and SFA intima-media thickness (IMT) and vessel diameter. Methods 23 healthy, minimally active MA/O men and postmenopausal women (57-79 years) were randomized to participate in 30, 60-minute sessions (3-4x/week over 8-10 weeks) of either hot water immersion (40.5°C, N=12, 5M/7F, 68±2 years) or thermoneutral water immersion (36°C, “sham”, N=11, 4M/7F, 66±2 years). Ultrasound- and tonometry-based measures of arterial stiffness and structure were measured at baseline and 24-72 hours after the final water immersion session. Data are mean ± SEM; P-values were determined by 2-way mixed-design ANOVA with Tukey's post-hoc tests. Results In the large elastic arteries (i.e., the arteries that stiffen with aging), heat therapy reduced c-f PWV from 8.7±0.6 to 8.0±0.7 m/s (p=0.03) and CCA β-stiffness index from 10.6±1.6 to 7.8±0.8 (p=0.02); however, heat therapy did not change SFA β-stiffness index (15.0±1.6 vs. 14.6±1.6, p=0.99), a more muscular artery. Heat therapy also improved selective measures of arterial structure. In the CCA, heat therapy decreased IMT from 0.70±0.01 to 0.66±0.02 mm (p<0.01) without affecting diameter (7.4±0.2 vs. 7.2±0.2 mm, p=0.90). Conversely, in the SFA, heat therapy did not alter IMT (0.56±0.02 vs. 0.57±0.02 mm, p>0.99), but tended to increase diameter from 7.6±0.2 to 7.9±0.3 mm (p=0.06), which likely occurred due to repeated increases in vascular shear stress to the lower body during hot water immersion sessions. No changes were observed in any outcome in sham subjects (c-f PWV: 8.5±0.5 vs. 8.4±0.4 m/s, p=0.85; CCA β-stiffness index: 10.0±2.2 vs. 9.9±2.6, p=0.96; CCA IMT: 0.70±0.02 vs. 0.70±0.02 mm, p=0.92; SFA β-stiffness index: 15.2±2.1 vs. 16.0±2.9, p=0.93; CCA diameter: 7.5±0.1 vs. 7.4±0.1 mm, p=0.42; SFA IMT: 0.57±0.03 vs. 0.56 ±0.03 mm, p=0.85; SFA diameter: 7.8±0.4 vs. 7.9±0.3 mm, p=0.98). Conclusion Heat therapy subjects demonstrated clinically relevant reductions in aortic and carotid artery stiffness, and in CCA IMT, all of which are independent predictors of future CVD risk. As such, heat therapy may be a promising lifestyle-based intervention for improving arterial health and thereby reducing CVD risk in MA/O adults.