We evaluated the effects of a nutrition education program using HyperMirror, a video-mediated communication system, on the acquisition of appropriate food and dietary choice skills among Japanese and Thai schoolchildren, and the applicability of HyperMirror for a nutrition education program. HyperMirror uses composite video images and mirrored self-images to make geographically remote individuals feel as if they are in the same room.

The nutrition program, assessed using a pre-post study design, was conducted in 2006 (wherein the target was food choices based on food groups) and 2007 (wherein the target was planning a well-balanced breakfast). Periodic newsletters were distributed between the yearly sessions to ensure knowledge retention. Subjects were students (aged 9-10 years in 2006) from urban areas of Japan (n=70) and Thailand (n=21) who participated in both the lectures in 2006 and 2007.

The study environment was evaluated after every year’s distance lecture.

We also assessed program impact in terms of changes in nutritional knowledge, attitudes and behaviors towards appropriate food and dietary choice. The following behavioral objectives were assessed; (1) making appropriate diet choices, (2) understanding and being interested in foreign dietary/food cultures, and (3) being concerned about their own nutrition after three weeks of distance learning in 2007.

The mean study environment scores were high overall for both sessions (3.8 for Japanese students, 4.4 for Thai), and changes in nutritional knowledge, attitudes, and behaviors were observed. Over 50% of Japanese and Thai students agreed on behavioral objective (1), while agreement rates for behavioral objectives (2) and (3) were greater among Thai than among Japanese students, partly because the periodical newsletters helped maintain students’ learning interest and retention. Our study showed that a distance-learning nutritional education program using HyperMirror effectively induced behavioral channges and improved knowledge of food culture. We also confirmed HyperMirror’s applicability to such programs.

Purpose: It is well documented that amyotrophic lateral sclerosis (ALS) patients experience significant suffering upon loss of motor function; however, there has been extremely little study of how such patients face their disease and cope with it. The life-line method is a useful non-verbal, visual interview method for retrospectively assessing life experience over time. Further, longitudinal research is required to improve validity and deepen understanding of subjects. The purpose of the current study is to use elucidate psychological changes over time and related factors in ALS patients under Tracheostomy, Invasive Positive Pressure Ventilation (TPPV).

Methods: Questionnaires were sent 3 years following the previous survey to 22 ALS patients using TPPV selected in a manner to ensure varied background factors. These questionnaires were followed by semi-structured interviews at their residences or other locations based on questionnaire answers.

Results:The psychological status of all subjects deteriorated after onset, but subsequent patterns diverged into main patterns: steady improvement following the initial deterioration, first signs of recovery while still in the “worsened or stagnated” state, initial recovery followed by a second deterioration, and a persistent “worsened or stagnated” state. The following qualitative factor domains affected psychological status for 3 years in both positive and negative ways: lifestyle factors (the most influential), personal relationships, disease coping, physical impairment and symptoms, roles, experience, and economic factors. These seven domains were divided into 12 positive or negative factors each, some of which were in opposition to each other. Analysis revealed different factors operating on each of the main psychological status patterns. The recovery of psychological status was spurred by adequate medical or nursing services, maintaining sources of enjoyment or meaning, and ascribing positive meaning to disease and cognitive coping; the initial recovery was spurred by support from other people; the recovery was impeded by worsening physical impairment and symptoms, and inadequate medical or nursing services; the initial recovery was impeded by inadequate medical or nursing services, and anxiety about caregiving burden on family.

Conclusions: It is inevitable that ALS patients using TPPV will experience psychological fluctuations. Given this fact, aiding in the task of coping and re-constructing their lives consists of mitigating factors which impede psychological recovery, and enhancing factors which promote recovery.