Digital bother and burden in older age: a transnational LEGO® Serious Play® exploration

Bother and burden are terms associated with older persons in the management of a range of health conditions. As healthcare becomes more digitalized, older persons are encouraged to use digital health and wellbeing technologies to manage their own self-care. To date, however, there has been little examination of how bother, as distinct from burden, with such technologies may impact engagement with digital self-management of personal health and wellbeing. Using the LEGO® Serious Play® method, the concepts of bother and burden are examined with older persons in Ireland and Belgium. Findings have implications for the successful implementation of digital health technology solutions intended for use by older citizens as well as the use of the LEGO® Serious Play® method in living lab context

Exploring Patterns of Engagement with Digital Health Technologies Amongst Older Adults Living with Multimorbidity

Multiple chronic conditions (multimorbidity) are becoming more prevalent amongst ageing populations. Digital health technologies have the potential to assist in the self-management of multimorbidity, supporting monitoring of symptom and well-being parameters, improving a person’s awareness of their health and well-being, supporting a better understanding of the disease(s), encouraging health behaviour change and ultimately resulting in improved health outcomes. However, little research has explored the long-term engagement of older adults with such digital interventions. The aim of this PhD project was to analyse how 60 older adults (average age=74 ± 6.4 [65-92 years]) with multimorbidity (two or more of the conditions diabetes, heart failure, heart disease, chronic obstructive pulmonary disorder (COPD)) engaged with digital symptom and well-being monitoring when using the ProACT digital health platform over a period of approximately 12 months. For the purposes of this thesis, only 56 participants' data records were used in the data analysis phase, as four participants had no data records in the dataset. The ProACT platform consisted of a suite of digital devices (for example a blood pressure monitor, blood glucometer, pulse oximeter, weight scales, and activity and sleep tracker) and the ProACT CareApp which participants used to view their data, self-report on other areas of health and well-being not measurable by a digital device (such as breathlessness, mood), set goals and receive education. Three studies were carried out on the resulting quantitative dataset. In the first study, data analysis focused on user retention, frequency of monitoring, intervals in monitoring and patterns of daily engagement. During the second study, principal component analysis and clustering analysis were used to group participants based on their levels of engagement, and the data analysis focused on characteristics such as age, gender and chronic health conditions, engagement outcomes and symptom outcomes of the different clusters that were discovered. In the final study, the weekly submission times for each parameter were used to obtain an engagement score (ES) and this score was compared with the Mobile Device Proficiency Score (MDPS), a measure of an older adult’s technical proficiency with mobile devices. Both cluster analysis and multiple regression were used in this study to explore whether participants’ engagement with digital health technology was related to their mobile device proficiency. The findings from the studies show that the overall engagement with the ProACT digital health platform was high, with more than 80% of participants using the technology devices for over 200 days. The submission frequency for different symptom parameters (e.g. blood glucose, blood pressure, etc.) was between three and four times per week which was higher than that of self-report (2.24) and weight (2.84). Submissions of activity (6.12) and sleep (5.67) were more frequent. The majority of interactions happened in the morning time. The most common time of submission for symptom parameters was 10 am, whereas 8 am was the most common time for weight measurements. In addition, three clusters were identified: the typical user group (n = 24), the least engaged user group (n = 13), and the highly engaged user group (n = 17) in the second stage of analysis. The findings indicate that gender and the types of chronic conditions do not influence engagement. Whether the same device was used to submit different health and/or well-being parameters; the number of manual operations required to take a reading; and the daily routine of the participants were the three primary factors influencing engagement. Findings also indicate that higher levels of engagement may improve the participants’ outcomes (e.g., reduce symptom exacerbation, and increase physical activity). Finally, results from the third study indicate that engagement with digital health technology has a weak correlation with mobile device proficiency in older adults. Despite participants having low to modest technical proficiency, the majority engaged with the platform for the duration of the trial. The findings highlight the patterns of engagement of older adults with complex chronic diseases with a digital home-based self-management platform and demonstrate the potential of a digital health platform, such as ProACT, to empower older adults with multimorbidity to engage in digital self-management. Based on the findings, a series of recommendations for researchers, designers and developers of digital health technologies are provided. For example, engagement might be enhanced by delivering reminders in the mornings and reducing the number of manual operations required to use monitoring devices. The outcomes of this PhD also have possible implications spanning digital inclusion policies, health outcomes, health systems, cost-effectiveness, and health policy. For example, through the use of digital health technologies, older adults might potentially have better health outcomes, which could ultimately reduce healthcare costs for both patients and healthcare systems

A NEED FOR PIED PIPERS?: MAKING CONNECTIONS IN A COMMUNITY ARTS SONG-MAKING PROJECT

Music and musicking are powerful contributors to a sense and awareness of place. A community music project in 2021 focused on the small town of Dunleer on the east coast of Ireland. Overshadowed by the larger towns of Dundalk and Drogheda to the north and south respectively, Dunleer has a rich history and many opportunities for the local community to engage in the arts. However, despite much talent, the groups and individuals involved are largely disconnected from and sometimes unaware of each other. This paper considers how a participatory, arts-based virtual project that sought to encourage collaboration through artistic endeavour highlighted the potential for greater collaboration between stakeholders to achieve increased participation in the arts and the local community. Drawing on the author’s perspective as an artist and lead facilitator, it details the process and critiques the role of various stakeholders in the project, incorporating an autoethnographic approach that focuses on the role of third-party facilitators in community music initiatives

Let’s put up a stage: Experiencing Speyfest, a Celtic Music Festival in Scotland

In July 2022, the music festival Speyfest celebrated its 25th event, returning after two years without a festival due to the COVID-19 pandemic and only weeks after the death of festival founder, Sir James Alexander MBE (1955–2022). Utilising ethnographic fieldwork and incorporating interdisciplinary approaches from ethnomusicology, geography and tourism studies, this chapter critically examines the festival from the perspective of researchers who were performers and workshop facilitators at the festival. Recognising Alexander’s initial desire to develop an event whereby local musicians experience and perform with professional artists, we reflect on the expression of culture, authenticity, and meaning with particular consideration for the conceptualisation of ‘Celtic’ music as a musical and commercial term. We critique how the event has changed the ecosystem of traditional music around Fochabers, particularly in terms of the resilience of local music community. Central to the study is a consideration of the Fochabers Fiddlers, an ensemble founded by Alexander in 1980 that, for the festival, not only include locally based members but also members who have left the area but return to perform with the group at the festival. This chapter demonstrates how community festivals and events impact on both place-making and the development of a community of musical practice

Review: Becoming an Irish Traditional Musician: Learning and Embodying Musical Culture by Jessica Cawley

Revie

Assessing environmental distribution and stakeholder awareness of microplastics: A case study in Dundalk Bay

Microplastics have fast become a pollutant of ubiquitous nature in the environment, documented in pristine and remote regions worldwide and recently in humans. While studies on microplastics in marine environments are more established, comparatively understudied is the freshwater environment, with freshwater research generally focusing on larger rivers. Further to this, little work has been completed understanding the social aspect of microplastics despite it being an anthropogenically-caused pollutant. Additionally, the majority of studies completed on assessing microplastic presence are one dimensional in nature focusing on one environmental compartment, however, microplastics released into the environment can interact with numerous biota and travel between terrestrial, freshwater and marine systems. In light of these factors the research in this thesis therefore presents a holistic approach to microplastic pollution in Dundalk Bay and its associated freshwater inputs, while examining stakeholders in Irish fishing relationship with plastic. An important nursery for all commercial fish species in the Irish Sea, sustaining both a productive cockle and razor clam fishery and serving as a vital overwintering refuge for thousands of seabirds, the ecological and economic benefits of a healthy ecosystem here are numerous. In spite of these factors Dundalk Bay has until now been unstudied in terms of microplastics pollution and while its shallow nature with many freshwater inputs lend to a productive environment these factors may contribute to the accumulation of microplastics here and it being a hotspot for this pollutant. The results of this study indicate that microplastics are polluting the marine environment and associated freshwater environment of Dundalk Bay. Microplastics primarily fibrous in nature were documented in surface water, sediment and G. duebeni examined in freshwater rivers as well as in marine intertidal sediments and inhabitants of this shallow marine environment. Those surveyed within the Irish fishing community were aware of microplastic pollution pertaining to aquatic environments moreso than the terrestrial and noticed litter frequently and in large quantities when taking part in fishing activities but were also likely to remove it from the environment highlighting the role that fishers can have in reducing secondary microplastic pollution in more remote environments. The ubiquitous presence of microplastics in environs studied in this thesis highlight the need for mitigation with regards to this pollutant entering the environment

Happy to Zoom: a New Frontier in Online Delivery of Day-care for Older People During COVID-19

From early in the COVID-19 pandemic, community day-care centres sought to find ways to deliver services remotely using digital tools, but older people are often presumed resistant to using digital technologies. This study sought to examine the delivery of community day-care services at the beginning of the COVID-19 pandemic and to identify the willingness of older service users to participate in day-care activities remotely while in-person services were unavailable. Community day-care services are essential to ensuring social participation and overall wellbeing for many older people who remain living at home. On March 16th, 2020, like many other services, community day-care in Ireland was paused to reduce Coronavirus transmission among this at-risk cohort. This paper presents quantitative findings from a survey, conducted in September 2020 by a community day-care service in a large town in Ireland, examining pre-COVID-19 service engagement and willingness of day-care members (n=81) to participate in online delivery of social activities. Descriptive analysis of responses, using SPSS software, shows older people were willing to use digital interventions to engage with day-care activities, where access to devices was assured and if support was provided to help them overcome technology-related challenges. Differences between groups of day-care service users were identified. Findings from this research suggest opportunities exist to increase engagement with day-care services through remotely delivered activities both during and after the COVID-19 pandemic

Spaces on the Stave: Documenting the Musical Lives of Transgender People in Ireland

'Spaces on the Stave: Documenting the Musical Lives of Transgender People in Ireland' is a study situated in the domain of cultural musicology, establishing socio-historical context in alignment with a mapping of the musical lives of transgender people in Ireland. Identifying and interviewing transgender music-makers resulted in the collation of primary data for this research, combined with a nationwide survey that maps transgender music fandom. This data was analysed in order to develop a cultural historical perspective on the impact that gender identity has had on music-making and consumption for transgender people in Ireland. This research project engages with three research methods: archival research, online survey, and the semi-structured interview. Archival research reveals traces of a history of transgender people in Ireland from the 1970s onwards with documentation of transgender experiences, community frameworks and music consumption. The survey investigates the role of music in participants' lives, transgender musical icons within Ireland and internationally and music venues, scenes and communities in Ireland. 230 transgender people from all over Ireland responded to the survey and shared their experiences as a means of supporting this research project centred on their lives and music. The series of interviews conducted with four transgender music-makers based in Ireland provide insight into career development, status in venues, spaces and scenes, and perspectives on a lineage of transgender music-makers. This thesis serves as a documented chronology of transgender musical experiences in Ireland dating from the 1970s to the present

Review: Lea Hagmann (2022), Celtic Music and Dance in Cornwall: Cornu-Copia (London: Routledge), 238 pp., £130, ISBN: 978-0-367-69141-7

Review of Lea Hagmann (2022), Celtic Music and Dance in Cornwall: Cornu-Copia (London: Routledge)

Classification of Frailty among Community Dwelling Older Adults Using Parameters of Physical Activity Obtained Independently and Unsupervised

The global population is ageing at an unprecedented rate, with the percentage of those aged over 65 years expected to double and those aged over 80 years expected to treble by the year 2050. With ageing comes biological and physiological changes that affect functional capacity. Frailty is a potentially avoidable, reversible biopsychosocial condition associated with biological but not chronological age, affecting a quarter of all community-dwelling older adults. Frailty results in disability, increased dependency and institutionalisation. Screening for frailty could help reduce its prevalence and mitigate the adverse outcomes however, traditional screening tools are time-consuming to perform, require clinician input and by their subjective nature are flawed. The use of wearable sensors has been proposed as a means of screening for frailty and parameters of mobility and physical activity have been identified as being associated with frailty. The goal of this thesis was to examine if community-dwelling older adults could capture parameters of mobility and physical activity independently in their own home and if these parameters could discriminate between frail and non-frail status. This work provides evidence that a single parameter of mobility and physical activity obtained from a single body-worn sensor correlates with frailty. It also provides evidence that community-dwelling older adults can independently capture parameters of mobility and physical activity, unsupervised in their own home using a consumer-grade wearable device, and that these data can predict pre-frailty and frailty with acceptable accuracy. Thresholds for parameters of physical activity predictive of frailty have been identified. The results of this thesis will guide future work to focus community-dwelling older adults on the importance of frailty screening and guide the development of a user-friendly device or sensor system suitable for use by older adults for continuous data collection relevant to frailty