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Fast development of computer and information technology enables realization and application of new methods and systems that were not feasible in the past century. One example of such development is the area of virtual reality (VR), virtual surgery (VS), virtual endoscopy (VE), computer assisted surgery (CAS), 3D-CAS, robotic/telerobotic surgery, and Tele-3D-CAS. The real visual, auditory, and tactile cues are replaced by computer-generated sensory cues, therefore giving the user a sense of presence in a virtual world. CAS and VR have found many applications in the field of medicine. Advances in high performance computing, graphics, and networking, together with new human-machine interfaces form a technological basis for VR/3D-CAS/Tele-3D-CAS applications. Related fields and terminology such as augmented reality, full and partial immersion, wearable computers, telepresence, and telemedicine will be introduced in the paper. The aims of the paper are to present VR, 3D-CAS, and Tele-3D-CAS technology, to provide an overview of some mentioned research activities, information and research resources. An overview of the current research activities in the field of medicine of the 21st century includes: education, surgical planning and simulation, visualization, telemedicine/telesurgery, computer-aided surgery, human-machine interfaces, and rehabilitation and therapy. [ABSTRACT FROM AUTHOR]

Controlled studies by groups throughout the world have proven the efficacy of virtual reality (VR) exposure for “mental rehabilitation,” including treatment of Specific Phobias (SP), Social Phobia (SoP), and Panic Disorder with Agoraphobia (PDA). In addition, many are now showing the power of adding VR to protocols to treat individuals with Posttraumatic Stress Disorder (PTSD) as well as to prevent PTSD by “inoculating” individuals against stressful situations they may encounter (Stress Inoculation Training). Others have shown how VR can be added to protocols for those needing “physical rehabilitation” to improve patient compliance and outcomes. In addition, studies have shown the addition of physiological monitoring and feedback to the VR protocol can have added benefit, both in terms of short term effectiveness and in terms of lowering recidivism in the long term. VR allows stimuli to be presented in a systematic, controlled fashion, and physiology provides objective evidence of when the stimuli are eliciting appropriate responses in the patient or trainee. This enables treatment and training to be individualized, focusing in on those specific parts of the experience which cause the individual the most difficulty. By combining such measures as subjective ratings, physiological data, personality type, and self-report questionnaire scores, with expert clinical observations; it is possible to further refine and improve clinical and research-based protocols. Decades after the first simulators were used to train fighter pilots, advanced technologies and simulations are now impacting military medicine. This paper highlights illustrative studies to introduce the reader to this area. [ABSTRACT FROM AUTHOR]

Several studies using VR exposure therapy for PTSD have been conducted to date, with promising results. The need for better accuracy of the patient's arousal assessment requires aggregation of various measures of arousal, including physiological ones, which may increase the mental burden on the therapist. Assessment of the patient's arousal, automated by the computer, may therefore be useful. As the therapist also needs to manipulate user interface to introduce appropriate trigger stimuli in the virtual environment, automated adaptation of VR scenarios in response to the patient's level of arousal may alleviate this task. This paper describes the architecture of the software that performs appropriate automation according to the rules of graded exposure therapy, and discusses issues for successful implementation of such software. [ABSTRACT FROM AUTHOR]

Post Traumatic Stress Disorder is reported to be caused by traumatic events that are outside the range of usual human experiences including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) exposure treatment has been used in previous treatments of PTSD patients with reports of positive outcomes. The aim of the current paper is to specify the rationale, design and development of a Virtual Iraq PTSD VR application that has been created from the virtual assets that were initially developed for a combat tactical training simulation, which then served as the inspiration for the X-Box game entitled Full Spectrum Warrior. [ABSTRACT FROM AUTHOR]

This paper describes the result of a discussion in a working group and a plenary discussion at the NATO Advanced Research Workshop on Novel approaches to the diagnosis and treatment of posttraumatic stress disorder. Several technological challenges are presented with regard to the basic functions of a VRET system. Most challenges are demand-driven and are focused on better ways to support the therapist, for better and more efficient treatment. Tele-care is one of the most promising but difficult challenges. The results give directions for both fundamental and practical research. [ABSTRACT FROM AUTHOR]

We believe that this Advanced Research Workshop has given participants an opportunity to foster essential international collaborative research on the diagnosis and treatment of posttraumatic stress disorder, a common and disabling consequence of war, terrorism, and natural disasters. As a result, it represents an important piece in efforts to help soldiers and civilians of NATO and partner nations in the face of future international conflicts. This publication contains the full papers corresponding to the relevant presentations provided at the workshop. This text is organized so as to provide a coherent picture of the work and thoughts of participants in the ARW, rather than necessarily following the exact order of the presentations as they were provided in Cavtat, although this summary conveys to the reader the manner in which presentations and working groups were conducted. Appropriate financial support was vital for the successful organization and implementation of the workshop. Grateful acknowledgments for generosity go to the primary sponsor, the NATO Security through Science Programme, as well as to a number of Croatian donors, who recognized the importance of this event. As a token of our appreciation, the logos of all sponsors are included here. The workshop was organized and this accompanying publication was assembled by joint dedication and efforts from the members of Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, and University of Zagreb, Faculty of Electrical Engineering and Computing (FEEC), Croatia. Professor Michael Roy of USUHS, the NATO-country program co-director and organizing co-director, conceived the overall design of the workshop, and with the assistance of his research assistant Patricia Kraus, wrote and submitted an application to NATO. Dr. Roy selected and invited the majority of the speakers and participants, and he and Ms. Kraus edited each of the chapters incorporated in this publication. Professor Kresimir Cosic, the organizing co-director and a member of FEEC, coordinated financial aspects of the ARW, solicited additional funding from Croatian donors, invited representatives of the Government of Croatia, and promoted the workshop within international politico-military circles. He coordinated coverage of the workshop with Croatian Radiotelevision, and organized meals as well as a boat trip to Dubrovnik for participants. Professor Dragica Kozaric Kovacic, the partner-country program co-director and a member of University Hospital Dubrava in Zagreb, Croatia, extended invitations to several international speakers, further improving the quality of the workshop. Assistant Professor Miroslav Slamic, a member of FEEC, handled accreditations, the purchase of consumable supplies, and designed such items as the workshop poster, program cover, and the appearance of compact disks (CDs) of presentations and pictures for participants. He was also the workshop photographer. Sinisa Popovic, a member of FEEC, was the “glue” that held together the planning and smooth running of the workshop, coordinating travel, lodging and meal arrangements, precise estimation of expenses, assembling of workshop materials, and other arrangements with the conference site. Marko Cosic designed the gala dinner menu and coupons, and assisted Mr. Popovic with local arrangements and assembling of workshop materials, handled some on-site financial matters, etc. Workshop CDs were made possible through the joint efforts of Miroslav Slamic, Sinisa Popovic, Marko Cosic, and Patricia Kraus. Dr. Roy also gratefully acknowledges the many hours of assistance Ms. Kraus provided in reviewing the manuscripts for this text. [ABSTRACT FROM AUTHOR]