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1.
PLoS One ; 19(5): e0293164, 2024.
Article En | MEDLINE | ID: mdl-38758835

Unmyelinated C-Tactile (CT) fibres are activated by caress-like touch, eliciting a pleasant feeling that decreases for static and faster stroking. Previous studies documented this effect also for vicarious touch, hypothesising simulation mechanisms driving the perception and appreciation of observed interpersonal touch. Notably, less is known about appreciation of vicarious execution of touch, that is as referred to the one giving gentle touch. To address this issue, 53 healthy participants were asked to view and rate a series of videoclips displaying an individual being touched by another on hairy (i.e., hand dorsum) or glabrous (i.e., palm) skin sites, with touch being delivered at CT-optimal (5 cm/s) or non-CT optimal velocities (0 cm/s or 30 cm/s). Following the observation of each clip, participants were asked to rate self-referred desirability and model-referred pleasantness of vicarious touch for both executer (toucher-referred) and receiver (touchee-referred). Consistent with the CT fibres properties, for both self-referred desirability and model-referred pleasantness judgements of vicarious touch execution and reception, participants provided higher ratings for vicarious touch delivered at CT-optimal than other velocities, and when observed CT-optimal touch was delivered to the hand-dorsum compared to the palm. However, higher ratings were attributed to vicarious reception compared to execution of CT-optimal touch. Notably, individual differences in interoceptive trusting and attitude to interpersonal touch were positively correlated with, respectively, toucher- and touchee-related overall appraisal ratings of touch. These findings suggest that the appreciation of both toucher- and touchee-referred vicarious touch is specifically attuned to CT-optimal touch, even though they might rely on different neurocognitive mechanisms to understand affective information conveyed by interpersonal tactile interactions.


Touch Perception , Touch , Humans , Male , Female , Adult , Touch/physiology , Touch Perception/physiology , Young Adult , Interpersonal Relations
2.
Sci Rep ; 14(1): 11296, 2024 05 17.
Article En | MEDLINE | ID: mdl-38760391

The body and the self change markedly during adolescence, but how does bodily self-consciousness, the pre-reflexive experience of being a bodily subject, change? We addressed this issue by studying embodiment towards virtual avatars in 70 girls aged 10-17 years. We manipulated the synchrony between participants' and avatars' touch or movement, as well as the avatar visual shape or size relative to each participant's body. A weaker avatar's embodiment in case of mismatch between the body seen in virtual reality and the real body is indicative of a more robust bodily self-consciousness. In both the visuo-tactile and the visuo-motor experiments, asynchrony decreased ownership feeling to the same extent for all participants, while the effect of asynchrony on agency feeling increased with age. In the visuo-tactile experiment, incongruence in visual appearance did not affect agency feeling but impacted ownership, especially in older teenage girls. These findings highlight the higher malleability of bodily self-consciousness at the beginning of adolescence and suggest some independence between body ownership and agency.


Body Image , Self Concept , Humans , Adolescent , Female , Child , Body Image/psychology , Consciousness/physiology , Virtual Reality , Touch Perception/physiology , Touch/physiology , Visual Perception/physiology
3.
J Acoust Soc Am ; 155(5): 3101-3117, 2024 May 01.
Article En | MEDLINE | ID: mdl-38722101

Cochlear implant (CI) users often report being unsatisfied by music listening through their hearing device. Vibrotactile stimulation could help alleviate those challenges. Previous research has shown that musical stimuli was given higher preference ratings by normal-hearing listeners when concurrent vibrotactile stimulation was congruent in intensity and timing with the corresponding auditory signal compared to incongruent. However, it is not known whether this is also the case for CI users. Therefore, in this experiment, we presented 18 CI users and 24 normal-hearing listeners with five melodies and five different audio-to-tactile maps. Each map varied the congruence between the audio and tactile signals related to intensity, fundamental frequency, and timing. Participants were asked to rate the maps from zero to 100, based on preference. It was shown that almost all normal-hearing listeners, as well as a subset of the CI users, preferred tactile stimulation, which was congruent with the audio in intensity and timing. However, many CI users had no difference in preference between timing aligned and timing unaligned stimuli. The results provide evidence that vibrotactile music enjoyment enhancement could be a solution for some CI users; however, more research is needed to understand which CI users can benefit from it most.


Acoustic Stimulation , Auditory Perception , Cochlear Implants , Music , Humans , Female , Male , Adult , Middle Aged , Aged , Auditory Perception/physiology , Young Adult , Patient Preference , Cochlear Implantation/instrumentation , Touch Perception/physiology , Vibration , Touch
4.
Science ; 384(6696): 660-665, 2024 May 10.
Article En | MEDLINE | ID: mdl-38723082

Rapid processing of tactile information is essential to human haptic exploration and dexterous object manipulation. Conventional electronic skins generate frames of tactile signals upon interaction with objects. Unfortunately, they are generally ill-suited for efficient coding of temporal information and rapid feature extraction. In this work, we report a neuromorphic tactile system that uses spike timing, especially the first-spike timing, to code dynamic tactile information about touch and grasp. This strategy enables the system to seamlessly code highly dynamic information with millisecond temporal resolution on par with the biological nervous system, yielding dynamic extraction of tactile features. Upon interaction with objects, the system rapidly classifies them in the initial phase of touch and grasp, thus paving the way to fast tactile feedback desired for neuro-robotics and neuro-prosthetics.


Touch , Humans , Touch/physiology , Touch Perception , Hand Strength , Biomimetics , Action Potentials
5.
Science ; 384(6696): 624-625, 2024 May 10.
Article En | MEDLINE | ID: mdl-38723096

An artificial tactile system mimicking human touch enables effective object recognition.


Touch , Humans , Biomimetics , Touch Perception
6.
Int J Qual Stud Health Well-being ; 19(1): 2348891, 2024 Dec.
Article En | MEDLINE | ID: mdl-38723246

PURPOSE: This article describes intensive care nurses` experiences of using communicative caring touch as stroking the patient`s cheek or holding his hand. Our research question: "What do intensive care nurses communicate through caring touch?" METHODS: In this qualitative hermeneutically based study data from two intensive care units at Norwegian hospitals are analysed. Eight specialist nurses shared experiences through individual, semi-structured interviews. RESULTS: The main theme, Communicating safety and presence has four sub-themes: Amplified presence, Communicating security, trust and care, Creating and confirming relationships and Communicating openness to a deeper conversation. Communicative caring touch is offered from the nurse due to the patient`s needs. Caring touch communicates person-centred care, invites to relationship while respecting the patient's dignity as a fellow human being. Caring touch conveys a human initiative in the highly technology environment. CONCLUSION: Caring touch is the silent way to communicate care, hope, strength and humanity to critical sick patients. This article provides evidence for a common, but poorly described phenomenon in intensive care nursing.


Communication , Critical Care Nursing , Empathy , Intensive Care Units , Nurse-Patient Relations , Qualitative Research , Touch , Humans , Norway , Female , Male , Adult , Attitude of Health Personnel , Nursing Staff, Hospital/psychology , Patient-Centered Care , Middle Aged , Trust
7.
Sci Rep ; 14(1): 10164, 2024 05 03.
Article En | MEDLINE | ID: mdl-38702338

Orientation processing is one of the most fundamental functions in both visual and somatosensory perception. Converging findings suggest that orientation processing in both modalities is closely linked: somatosensory neurons share a similar orientation organisation as visual neurons, and the visual cortex has been found to be heavily involved in tactile orientation perception. Hence, we hypothesized that somatosensation would exhibit a similar orientation adaptation effect, and this adaptation effect would be transferable between the two modalities, considering the above-mentioned connection. The tilt aftereffect (TAE) is a demonstration of orientation adaptation and is used widely in behavioural experiments to investigate orientation mechanisms in vision. By testing the classic TAE paradigm in both tactile and crossmodal orientation tasks between vision and touch, we were able to show that tactile perception of orientation shows a very robust TAE, similar to its visual counterpart. We further show that orientation adaptation in touch transfers to produce a TAE when tested in vision, but not vice versa. Additionally, when examining the test sequence following adaptation for serial effects, we observed another asymmetry between the two conditions where the visual test sequence displayed a repulsive intramodal serial dependence effect while the tactile test sequence exhibited an attractive serial dependence. These findings provide concrete evidence that vision and touch engage a similar orientation processing mechanism. However, the asymmetry in the crossmodal transfer of TAE and serial dependence points to a non-reciprocal connection between the two modalities, providing further insights into the underlying processing mechanism.


Adaptation, Physiological , Touch Perception , Visual Perception , Humans , Male , Female , Adult , Touch Perception/physiology , Visual Perception/physiology , Young Adult , Orientation/physiology , Touch/physiology , Orientation, Spatial/physiology , Vision, Ocular/physiology , Visual Cortex/physiology
8.
Commun Biol ; 7(1): 522, 2024 May 03.
Article En | MEDLINE | ID: mdl-38702520

An organism's ability to accurately anticipate the sensations caused by its own actions is crucial for a wide range of behavioral, perceptual, and cognitive functions. Notably, the sensorimotor expectations produced when touching one's own body attenuate such sensations, making them feel weaker and less ticklish and rendering them easily distinguishable from potentially harmful touches of external origin. How the brain learns and keeps these action-related sensory expectations updated is unclear. Here we employ psychophysics and functional magnetic resonance imaging to pinpoint the behavioral and neural substrates of dynamic recalibration of expected temporal delays in self-touch. Our psychophysical results reveal that self-touches are less attenuated after systematic exposure to delayed self-generated touches, while responses in the contralateral somatosensory cortex that normally distinguish between delayed and nondelayed self-generated touches become indistinguishable. During the exposure, the ipsilateral anterior cerebellum shows increased activity, supporting its proposed role in recalibrating sensorimotor predictions. Moreover, responses in the cingulate areas gradually increase, suggesting that as delay adaptation progresses, the nondelayed self-touches trigger activity related to cognitive conflict. Together, our results show that sensorimotor predictions in the simplest act of touching one's own body are upheld by a sophisticated and flexible neural mechanism that maintains them accurate in time.


Cerebellum , Magnetic Resonance Imaging , Somatosensory Cortex , Humans , Somatosensory Cortex/physiology , Male , Cerebellum/physiology , Cerebellum/diagnostic imaging , Female , Adult , Young Adult , Touch Perception/physiology , Touch/physiology
9.
ACS Appl Mater Interfaces ; 16(19): 25404-25414, 2024 May 15.
Article En | MEDLINE | ID: mdl-38692284

Liquid crystal elastomers (LCEs), as a classical two-way shape-memory material, are good candidates for developing artificial muscles that mimic the contraction, expansion, or rotational behavior of natural muscles. However, biomimicry is currently focused more on the actuation functions of natural muscles dominated by muscle fibers, whereas the tactile sensing functions that are dominated by neuronal receptors and synapses have not been well captured. Very few studies have reported the sensing concept for LCEs, but the signals were still donated by macroscopic actuation, that is, variations in angle or length. Herein, we develop a conductive porous LCE (CPLCE) using a solvent (dimethyl sulfoxide (DMSO))-templated photo-cross-linking strategy, followed by carbon nanotube (CNT) incorporation. The CPLCE has excellent reversible contraction/elongation behavior in a manner similar to the actuation functions of skeletal muscles. Moreover, the CPLCE shows excellent pressure-sensing performance by providing real-time electrical signals and is capable of microtouch sensing, which is very similar to natural tactile sensing. Furthermore, macroscopic actuation and tactile sensation can be integrated into a single system. Proof-of-concept studies reveal that the CPLCE-based artificial muscle is sensitive to external touch while maintaining its excellent actuation performance. The CPLCE with tactile sensation beyond reversible actuation is expected to benefit the development of versatile artificial muscles and intelligent robots.


Elastomers , Liquid Crystals , Nanotubes, Carbon , Liquid Crystals/chemistry , Elastomers/chemistry , Nanotubes, Carbon/chemistry , Porosity , Solvents/chemistry , Touch/physiology , Artificial Organs , Muscle, Skeletal/physiology , Muscle, Skeletal/chemistry , Humans
10.
Sci Rep ; 14(1): 11697, 2024 05 22.
Article En | MEDLINE | ID: mdl-38777816

Allogrooming is a widespread, pervasive activity among non-human primates. Besides its hygienic function, it is thought to be instrumental in maintaining social bonds and establishing hierarchical structures within groups. However, the question arises as to whether the physiological and social benefits derived from social touch stem directly from body stimulation, or whether other mechanisms come into play. We address this question by analyzing an elaborate social behavior that we observed in two adult male macaques. This behavior demonstrates the existence of a persistent motivation to interact through a form of simulated grooming, as the animals were housed in adjacent enclosures separated by a glass panel preventing direct tactile contact. We find that such virtual grooming produces similar physiological sensations and social effects as allogrooming. We suggest that this behavior engages affective and reward brain circuits to the same extent as real social touch, and that this is probably achieved through high level processes similar to those involved in bodily illusions or synaesthetic phenomena previously described in humans. This observation reveals the unsuspected capacity of non-human primates to invent alternative, quasi-symbolic strategies to obtain effects similar to those provided by direct bodily interaction, which are so important for maintaining social bonds.


Grooming , Social Behavior , Animals , Male , Grooming/physiology , Behavior, Animal/physiology , Touch/physiology , Macaca , Psychophysiology
11.
Proc Natl Acad Sci U S A ; 121(22): e2404007121, 2024 May 28.
Article En | MEDLINE | ID: mdl-38768347

Sensations of heat and touch produced by receptors in the skin are of essential importance for perceptions of the physical environment, with a particularly powerful role in interpersonal interactions. Advances in technologies for replicating these sensations in a programmable manner have the potential not only to enhance virtual/augmented reality environments but they also hold promise in medical applications for individuals with amputations or impaired sensory function. Engineering challenges are in achieving interfaces with precise spatial resolution, power-efficient operation, wide dynamic range, and fast temporal responses in both thermal and in physical modulation, with forms that can extend over large regions of the body. This paper introduces a wireless, skin-compatible interface for thermo-haptic modulation designed to address some of these challenges, with the ability to deliver programmable patterns of enhanced vibrational displacement and high-speed thermal stimulation. Experimental and computational investigations quantify the thermal and mechanical efficiency of a vertically stacked design layout in the thermo-haptic stimulators that also supports real-time, closed-loop control mechanisms. The platform is effective in conveying thermal and physical information through the skin, as demonstrated in the control of robotic prosthetics and in interactions with pressure/temperature-sensitive touch displays.


Touch , Virtual Reality , Wireless Technology , Humans , Wireless Technology/instrumentation , Touch/physiology , Skin , Robotics/instrumentation , Robotics/methods
12.
PLoS One ; 19(5): e0300128, 2024.
Article En | MEDLINE | ID: mdl-38758733

Interpersonal touch plays a crucial role in human communication, development, and wellness. Mediated interpersonal touch (MIT), a technology to distance or virtually simulated interpersonal touch, has received significant attention to counteract the negative consequences of touch deprivation. Studies investigating the effectiveness of MIT have primarily focused on self-reporting or behavioral correlates. It is largely unknown how MIT affects neural processes such as interbrain functional connectivity during human interactions. Given how users exchange haptic information simultaneously during interpersonal touch, interbrain functional connectivity provides a more ecologically valid way of studying the neural correlates associated with MIT. In this study, a palm squeeze task is designed to examine interbrain synchrony associated with MIT using EEG-based hyperscanning methodology. The phase locking value (PLV) index is used to measure interbrain synchrony. Results demonstrate that MIT elicits a significant increase in alpha interbrain synchronization between participants' brains. Especially, there was a significant difference in the alpha PLV indices between no MIT and MIT conditions in the early stage (130-470 ms) of the interaction period (t-test, p < 0.05). Given the role that alpha interbrain synchrony plays during social interaction, a significant increase in PLV index during MIT interaction seems to indicate an effect of social coordination. The findings and limitations of this study are further discussed, and perspectives on future research are provided.


Brain , Electroencephalography , Interpersonal Relations , Touch , Humans , Brain/physiology , Male , Female , Young Adult , Touch/physiology , Adult , Alpha Rhythm/physiology , Touch Perception/physiology , Social Interaction
13.
J Neuroeng Rehabil ; 21(1): 79, 2024 May 16.
Article En | MEDLINE | ID: mdl-38750521

A large proportion of stroke survivors suffer from sensory loss, negatively impacting their independence, quality of life, and neurorehabilitation prognosis. Despite the high prevalence of somatosensory impairments, our understanding of somatosensory interventions such as sensory electrical stimulation (SES) in neurorehabilitation is limited. We aimed to study the effectiveness of SES combined with a sensory discrimination task in a well-controlled virtual environment in healthy participants, setting a foundation for its potential application in stroke rehabilitation. We employed electroencephalography (EEG) to gain a better understanding of the underlying neural mechanisms and dynamics associated with sensory training and SES. We conducted a single-session experiment with 26 healthy participants who explored a set of three visually identical virtual textures-haptically rendered by a robotic device and that differed in their spatial period-while physically guided by the robot to identify the odd texture. The experiment consisted of three phases: pre-intervention, intervention, and post-intervention. Half the participants received subthreshold whole-hand SES during the intervention, while the other half received sham stimulation. We evaluated changes in task performance-assessed by the probability of correct responses-before and after intervention and between groups. We also evaluated differences in the exploration behavior, e.g., scanning speed. EEG was employed to examine the effects of the intervention on brain activity, particularly in the alpha frequency band (8-13 Hz) associated with sensory processing. We found that participants in the SES group improved their task performance after intervention and their scanning speed during and after intervention, while the sham group did not improve their task performance. However, the differences in task performance improvements between groups only approached significance. Furthermore, we found that alpha power was sensitive to the effects of SES; participants in the stimulation group exhibited enhanced brain signals associated with improved touch sensitivity likely due to the effects of SES on the central nervous system, while the increase in alpha power for the sham group was less pronounced. Our findings suggest that SES enhances texture discrimination after training and has a positive effect on sensory-related brain areas. Further research involving brain-injured patients is needed to confirm the potential benefit of our solution in neurorehabilitation.


Electroencephalography , Humans , Male , Female , Adult , Touch Perception/physiology , Neurological Rehabilitation/methods , Electric Stimulation/methods , Young Adult , Touch/physiology , Stroke Rehabilitation/methods
14.
Sensors (Basel) ; 24(9)2024 May 06.
Article En | MEDLINE | ID: mdl-38733054

The problem of supporting visually impaired and blind people in meaningful interactions with objects is often neglected. To address this issue, we adapted a tactile belt for enhanced spatial navigation into a bracelet worn on the wrist that allows visually impaired people to grasp target objects. Participants' performance in locating and grasping target items when guided using the bracelet, which provides direction commands via vibrotactile signals, was compared to their performance when receiving auditory instructions. While participants were faster with the auditory commands, they also performed well with the bracelet, encouraging future development of this system and similar systems.


Hand Strength , Touch , Visually Impaired Persons , Humans , Male , Touch/physiology , Female , Hand Strength/physiology , Adult , Blindness/physiopathology , Blindness/rehabilitation , Movement/physiology , Middle Aged
15.
Dev Psychobiol ; 66(5): e22486, 2024 Jul.
Article En | MEDLINE | ID: mdl-38739111

Maternal deprivation, as a result of the artificial rearing (AR) paradigm, disturbs electrophysiological and histological characteristics of the peripheral sensory sural (SU) nerve of infant and adult male rats. Such changes are prevented by providing tactile or social stimulation during isolation. AR also affects the female rat's brain and behavior; however, it is unknown whether this early adverse experience also alters their SU nerve development or if tactile stimulation might prevent these possible developmental effects. To assess these possibilities, the electrophysiological and histological characteristics of the SU nerve from adult diestrus AR female rats that: (i) received no tactile stimulation (AR group), (ii) received tactile stimulation in the anogenital and body area (AR-Tactile group), or (iii) were mother reared (MR group) were determined. We found that the amplitude, but not the area, of the evoked compound action potential response in SU nerves of AR rats was lower than those of SU nerves of MR female rats. Tactile stimulation prevented these effects. Additionally, we found a reduction in the outer diameter and myelin thickness of axons, as well as a large proportion of axons with low myelin thickness in nerves of AR rats compared to the nerves of the MR and AR-Tactile groups of rats; however, tactile stimulation only partially prevented these effects. Our data indicate that maternal deprivation disturbs the development of sensory SU nerves in female rats, whereas tactile stimulation partially prevents the changes generated by AR. Considering that our previous studies have shown more severe effects of AR on male SU nerve development, we suggest that sex-associated factors may be involved in these processes.


Maternal Deprivation , Sural Nerve , Touch , Animals , Female , Rats , Sural Nerve/physiology , Touch/physiology , Physical Stimulation , Rats, Wistar , Axons/physiology , Action Potentials/physiology , Myelin Sheath/physiology
16.
Sci Rep ; 14(1): 11766, 2024 05 23.
Article En | MEDLINE | ID: mdl-38783038

Human tactile memory allows us to remember and retrieve the multitude of somatosensory experiences we undergo in everyday life. An unsolved question is how tactile memory mechanisms change with increasing age. We here use the ability to remember fine-grained tactile patterns passively presented to the fingertip to investigate age-related changes in tactile memory performance. In experiment 1, we varied the degree of similarity between one learned and several new tactile patterns to test on age-related changes in the "uniqueness" of a stored tactile memory trace. In experiment 2, we varied the degree of stimulus completeness of both known and new tactile patterns to test on age-related changes in the weighting between known and novel tactile information. Results reveal that older adults show only weak impairments in both precision and bias of tactile memories, however, they show specific deficits in reaching peak performance > 85% in both experiments. In addition, both younger and older adults show a pattern completion bias for touch, indicating a higher weighting of known compared to new information. These results allow us to develop new models on how younger and older adults store and recall tactile experiences of the past, and how this influences their everyday behavior.


Touch , Humans , Aged , Male , Female , Adult , Young Adult , Touch/physiology , Middle Aged , Touch Perception/physiology , Aging/physiology , Memory/physiology , Memory Disorders/physiopathology , Aged, 80 and over
17.
Behav Processes ; 218: 105041, 2024 May.
Article En | MEDLINE | ID: mdl-38692460

A previous study demonstrated that rodents on an inclined square platform traveled straight vertically or horizontally and avoided diagonal travel. Through behavior they aligned their head with the horizontal plane, acquiring similar bilateral vestibular cues - a basic requirement for spatial orientation and a salient feature of animals in motion. This behavior had previously been shown to be conspicuous in Tristram's jirds. Here, therefore jirds were challenged by testing their travel behavior on a circular arena inclined at 0°-75°. Our hypothesis was that if, as typical to rodents, the jirds would follow the curved arena wall, they would need to display a compensating mechanism to enable traveling in such a path shape, which involves a tilted frontal head axis and unbalanced bilateral vestibular cues. We found that with the increase in inclination, the jirds remained more in the lower section of the arena (geotaxis). When tested on the steep inclinations, however, their travel away from the arena wall was strictly straight up or down, in contrast to the curved paths that followed the circular arena wall. We suggest that traveling along a circular path while maintaining contact with the wall (thigmotaxis), provided tactile information that compensated for the unbalanced bilateral vestibular cues present when traveling along such curved inclined paths. In the latter case, the frontal plane of the head was in a diagonal posture in relation to gravity, a posture that was avoided when traveling away from the wall.


Cues , Orientation, Spatial , Vestibule, Labyrinth , Animals , Vestibule, Labyrinth/physiology , Orientation, Spatial/physiology , Male , Touch/physiology , Posture/physiology , Touch Perception/physiology
18.
J Oleo Sci ; 73(5): 801-811, 2024.
Article En | MEDLINE | ID: mdl-38692901

Hair shape affects the frictional properties and tactile sensation of hair. In this study, we evaluated the friction associated with the rubbing of straight, curly, or wavy hair by a contact probe equipped in a sinusoidal motion friction evaluation system. This system provides dynamic information such as the velocity dependence and hysteresis of the frictional force. In the case of hair fibers fixed at 1 mm intervals on a glass plate, a stable friction pattern was observed, in which the friction coefficient was almost constant during the dynamic friction process. The friction coefficients in the inward direction toward the hair root for straight, curly, and wavy hair were 0.47 ± 0.04, 0.51 ± 0.02, and 0.54 ± 0.04, respectively. As wavy hair is thick and has a larger true contact area with the contact probe, the friction coefficient was larger. When the finger model rubbed the straight or curly hair bundle in the inward direction, an oscillation pattern was observed, with the friction coefficient fluctuating at 20 ms intervals and the kinetic friction coefficient evaluated at 0.67 and 0.64, respectively. For the surface of straight hair, containing densely arranged cuticles, a large oscillation was observed in the direction against the cuticles. Meanwhile, no oscillation phenomenon was observed in wavy hair, which is characterized by a smooth cuticle and complex hair flow. Because wavy hair, which is frizzy, has fewer points of contact between hairs, impeding the occurrence of cooperative fluctuations in the frictional force.


Friction , Hair , Hair/physiology , Humans , Touch/physiology
19.
JAMA Netw Open ; 7(4): e245091, 2024 Apr 01.
Article En | MEDLINE | ID: mdl-38573634

Importance: Differences in patient use of health information technologies by race can adversely impact equitable access to health care services. While this digital divide is well documented, there is limited evidence of how health care systems have used interventions to narrow the gap. Objective: To compare differences in the effectiveness of patient training and portal functionality interventions implemented to increase portal use among racial groups. Design, Setting, and Participants: This secondary analysis used data from a randomized clinical trial conducted from December 15, 2016, to August 31, 2019. Data were from a single health care system and included 6 noncancer hospitals. Participants were patients who were at least 18 years of age, identified English as their preferred language, were not involuntarily confined or detained, and agreed to be provided a tablet to access the inpatient portal during their stay. Data were analyzed from September 1, 2022, to October 31, 2023. Interventions: A 2 × 2 factorial design was used to compare the inpatient portal training intervention (touch, in-person [high] vs built-in video tutorial [low]) and the portal functionality intervention (technology, full functionality [full] vs a limited subset of functions [lite]). Main Outcomes and Measures: Primary outcomes were inpatient portal use, measured by frequency and comprehensiveness of use, and use of specific portal functions. A logistic regression model was used to test the association of the estimators with the comprehensiveness use measure. Outcomes are reported as incidence rate ratios (IRRs) for the frequency outcomes or odds ratios (ORs) for the comprehensiveness outcomes with corresponding 95% CIs. Results: Of 2892 participants, 550 (19.0%) were Black individuals, 2221 (76.8%) were White individuals, and 121 (4.2%) were categorized as other race (including African, American Indian or Alaska Native, Asian or Asian American, multiple races or ethnicities, and unknown race or ethnicity). Black participants had a significantly lower frequency (IRR, 0.80 [95% CI, 0.72-0.89]) of inpatient portal use compared with White participants. Interaction effects were not observed between technology, touch, and race. Among participants who received the full technology intervention, Black participants had lower odds of being comprehensive users (OR, 0.76 [95% CI, 0.62-0.91), but interaction effects were not observed between touch and race. Conclusions and Relevance: In this study, providing in-person training or robust portal functionality did not narrow the divide between Black participants and White participants with respect to their inpatient portal use. Health systems looking to narrow the digital divide may need to consider intentional interventions that address underlying issues contributing to this inequity. Trial Registration: ClinicalTrials.gov Identifier: NCT02943109.


Patient Portals , Racial Groups , Humans , Inpatients , Touch , Patient Education as Topic
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