A protected discharge facility for the elderly: design and validation of a working proof-of-concept

With the increasing share of elderly population worldwide, the need for assistive technologies to support clinicians in monitoring their health conditions is becoming more and more relevant. As a quantitative tool, geriatricians recently proposed the notion of frail elderly, which rapidly became a key element of clinical practices for the estimation of well-being in aging population. The evaluation of frailty is commonly based on self-reported outcomes and occasional physicians evaluations, and may therefore contain biased results. Another important aspect in the elderly population is hospitalization as a risk factor for patient\u2019s well being and public costs. Hospitalization is the main cause of functional decline, especially in older adults. The reduction of hospitalization time may allow an improvement of elderly health conditions and a reduction of hospital costs. Furthermore, a gradual transition from a hospital environment to a home-like one, can contribute to the weaning of the patient from a condition of hospitalization to a condition of discharge to his home. The advent of new technologies allows for the design and implementation of smart environments to monitor elderly health status and activities, fulfilling all the requirements of health and safety of the patients. From these starting points, in this thesis I present data-driven methodologies to automatically evaluate one of the main aspects contributing to the frailty estimation, i.e., the motility of the subject. First I will describe a model of protected discharge facility, realized in collaboration and within the E.O. Ospedali Galliera (Genoa, Italy), where patients can be monitored by a system of sensors while physicians and nurses have the opportunity to monitor them remotely. This sensorised facility is being developed to assist elderly users after they have been dismissed from the hospital and before they are ready to go back home, with the perspective of coaching them towards a healthy lifestyle. The facility is equipped with a variety of sensors (vision, depth, ambient and wearable sensors and medical devices), but in my thesis I primarily focus on RGB-D sensors and present visual computing tools to automatically estimate motility features. I provide an extensive system assessment I carried out onthree different experimental sessions with help of young as well as healthy aging volunteers. The results I present are in agreement with the assessment manually performed by physicians, showing the potential capability of my approach to complement current protocols of evaluation

A Sensing Platform to Monitor Sleep Efficiency

Sleep plays a fundamental role in the human life. Sleep research is mainly focused on the understanding of the sleep patterns, stages and duration. An accurate sleep monitoring can detect early signs of sleep deprivation and insomnia consequentially implementing mechanisms for preventing and overcoming these problems. Recently, sleep monitoring has been achieved using wearable technologies, able to analyse also the body movements, but old people can encounter some difficulties in using and maintaining these devices. In this paper, we propose an unobtrusive sensing platform able to analyze body movements, infer sleep duration and awakenings occurred along the night, and evaluating the sleep efficiency index. To prove the feasibility of the suggested method we did a pilot trial in which several healthy users have been involved. The sensors were installed within the bed and, on each day, each user was administered with the Groningen Sleep Quality Scale questionnaire to evaluate the user’s perceived sleep quality. Finally, we show potential correlation between a perceived evaluation with an objective index as the sleep efficiency.</p

State of the art of audio- and video based solutions for AAL

Working Group 3. Audio- and Video-based AAL ApplicationsIt is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living (AAL) technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters (e.g., heart rate, respiratory rate). Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals (e.g., speech recordings). Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary 4 debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely (i) lifelogging and self-monitoring, (ii) remote monitoring of vital signs, (iii) emotional state recognition, (iv) food intake monitoring, activity and behaviour recognition, (v) activity and personal assistance, (vi) gesture recognition, (vii) fall detection and prevention, (viii) mobility assessment and frailty recognition, and (ix) cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed.publishedVersio

Unobtrusive Health Monitoring in Private Spaces: The Smart Home

With the advances in sensor technology, big data, and artificial intelligence, unobtrusive in-home health monitoring has been a research focus for decades. Following up our research on smart vehicles, within the framework of unobtrusive health monitoring in private spaces, this work attempts to provide a guide to current sensor technology for unobtrusive in-home monitoring by a literature review of the state of the art and to answer, in particular, the questions: (1) What types of sensors can be used for unobtrusive in-home health data acquisition? (2) Where should the sensors be placed? (3) What data can be monitored in a smart home? (4) How can the obtained data support the monitoring functions? We conducted a retrospective literature review and summarized the state-of-the-art research on leveraging sensor technology for unobtrusive in-home health monitoring. For structured analysis, we developed a four-category terminology (location, unobtrusive sensor, data, and monitoring functions). We acquired 912 unique articles from four relevant databases (ACM Digital Lib, IEEE Xplore, PubMed, and Scopus) and screened them for relevance, resulting in n=55 papers analyzed in a structured manner using the terminology. The results delivered 25 types of sensors (motion sensor, contact sensor, pressure sensor, electrical current sensor, etc.) that can be deployed within rooms, static facilities, or electric appliances in an ambient way. While behavioral data (e.g., presence (n=38), time spent on activities (n=18)) can be acquired effortlessly, physiological parameters (e.g., heart rate, respiratory rate) are measurable on a limited scale (n=5). Behavioral data contribute to functional monitoring. Emergency monitoring can be built up on behavioral and environmental data. Acquired physiological parameters allow reasonable monitoring of physiological functions to a limited extent. Environmental data and behavioral data also detect safety and security abnormalities. Social interaction monitoring relies mainly on direct monitoring of tools of communication (smartphone; computer). In summary, convincing proof of a clear effect of these monitoring functions on clinical outcome with a large sample size and long-term monitoring is still lacking

A synergistic wearable health monitoring system using cellular network technology

Thesis (M.S.) University of Alaska Fairbanks, 2017This thesis presents a synergistic approach to healthcare applications by integrating a wearable health monitoring system into a smart home system. By exploiting synergy within each system and between these two systems, this thesis shows that the efficiency of the health care can be increased while providing the added advantage of utmost user-friendly environment. Initially, a wearable health monitoring prototype system was developed for vital sign data collection and processing. The developed system used biosensor integration to distinguish amongst multiple physical activities and to compare the variations in physiological conditions according to physical activity of the user. Afterward, system learning techniques were established for accomplishing the scalability of the health monitoring system. The resulting system is able to monitor different users without the need for explicitly changing the thresholds for the individual user. The health monitoring was further improved through integration with the smart home system to exploit synergy between various physiological sensors and to reduce false alarms generated by the system. A cellular communication interface was developed for transmitting the collected data to a remote caregiver and also to store the time-stamped data on the online web server. A web interface was developed to allow monitoring user's health and activity data, along with their surrounding environment

Measuring frailty and detecting falls for elderly home care using depth camera

International audienceThis work concerns the development of low-cost am- bient systems for helping elderly to stay at home. Depth cameras allow a real-time analysis of the dis- placement of the person. We show that it is possible to recognize the activity of the person and to measure gait parameters from the analysis of simple features extracted from depth images. Activity recognition is based on Hidden Markov Models and performs fall detection. When a person is walking, the analysis of the trajectory of her centre of mass allows to mea- sure gait parameters that can then be used for frailty evaluation. We show that the proposed models are robust enough for activity classification, and that gait parameters measurement is accurate. We believe that such a system could be installed in the home of the elderly, while respecting privacy, since it relies on a local processing of depth images. Our system would be able to provide daily information on the person’s activity, the evolution of her gait parameters, and her habits, information that is useful for securing her and evaluating her frailty

Development of a simulation tool for measurements and analysis of simulated and real data to identify ADLs and behavioral trends through statistics techniques and ML algorithms

openCon una popolazione di anziani in crescita, il numero di soggetti a rischio di patologia è in rapido aumento. Molti gruppi di ricerca stanno studiando soluzioni pervasive per monitorare continuamente e discretamente i soggetti fragili nelle loro case, riducendo i costi sanitari e supportando la diagnosi medica. Comportamenti anomali durante l'esecuzione di attività di vita quotidiana (ADL) o variazioni sulle tendenze comportamentali sono di grande importanza.With a growing population of elderly people, the number of subjects at risk of pathology is rapidly increasing. Many research groups are studying pervasive solutions to continuously and unobtrusively monitor fragile subjects in their homes, reducing health-care costs and supporting the medical diagnosis. Anomalous behaviors while performing activities of daily living (ADLs) or variations on behavioral trends are of great importance. To measure ADLs a significant number of parameters need to be considering affecting the measurement such as sensors and environment characteristics or sensors disposition. To face the impossibility to study in the real context the best configuration of sensors able to minimize costs and maximize accuracy, simulation tools are being developed as powerful means. This thesis presents several contributions on this topic. In the following research work, a study of a measurement chain aimed to measure ADLs and represented by PIRs sensors and ML algorithm is conducted and a simulation tool in form of Web Application has been developed to generate datasets and to simulate how the measurement chain reacts varying the configuration of the sensors. Starting from eWare project results, the simulation tool has been thought to provide support for technicians, developers and installers being able to speed up analysis and monitoring times, to allow rapid identification of changes in behavioral trends, to guarantee system performance monitoring and to study the best configuration of the sensors network for a given environment. The UNIVPM Home Care Web App offers the chance to create ad hoc datasets related to ADLs and to conduct analysis thanks to statistical algorithms applied on data. To measure ADLs, machine learning algorithms have been implemented in the tool. Five different tasks have been identified. To test the validity of the developed instrument six case studies divided into two categories have been considered. To the first category belong those studies related to: 1) discover the best configuration of the sensors keeping environmental characteristics and user behavior as constants; 2) define the most performant ML algorithms. The second category aims to proof the stability of the algorithm implemented and its collapse condition by varying user habits. Noise perturbation on data has been applied to all case studies. Results show the validity of the generated datasets. By maximizing the sensors network is it possible to minimize the ML error to 0.8%. Due to cost is a key factor in this scenario, the fourth case studied considered has shown that minimizing the configuration of the sensors it is possible to reduce drastically the cost with a more than reasonable value for the ML error around 11.8%. Results in ADLs measurement can be considered more than satisfactory.INGEGNERIA INDUSTRIALEopenPirozzi, Michel

Fusion of Unobtrusive Sensing Solutions for Home-Based Activity Recognition and Classification using Data Mining Models and Methods

This paper proposes the fusion of Unobtrusive Sensing Solutions (USSs) for human Activity Recognition and Classification (ARC) in home environments. It also considers the use of data mining models and methods for cluster-based analysis of datasets obtained from the USSs. The ability to recognise and classify activities performed in home environments can help monitor health parameters in vulnerable individuals. This study addresses five principal concerns in ARC: (i) users’ privacy, (ii) wearability, (iii) data acquisition in a home environment, (iv) actual recognition of activities, and (v) classification of activities from single to multiple users. Timestamp information from contact sensors mounted at strategic locations in a kitchen environment helped obtain the time, location, and activity of 10 participants during the experiments. A total of 11,980 thermal blobs gleaned from privacy-friendly USSs such as ceiling and lateral thermal sensors were fused using data mining models and methods. Experimental results demonstrated cluster-based activity recognition, classification, and fusion of the datasets with an average regression coefficient of 0.95 for tested features and clusters. In addition, a pooled Mean accuracy of 96.5% was obtained using classification-by-clustering and statistical methods for models such as Neural Network, Support Vector Machine, K-Nearest Neighbour, and Stochastic Gradient Descent on Evaluation Test

A smart home environment to support safety and risk monitoring for the elderly living independently

The elderly prefer to live independently despite vulnerability to age-related challenges. Constant monitoring is required in cases where the elderly are living alone. The home environment can be a dangerous environment for the elderly living independently due to adverse events that can occur at any time. The potential risks for the elderly living independently can be categorised as injury in the home, home environmental risks and inactivity due to unconsciousness. The main research objective was to develop a Smart Home Environment (SHE) that can support risk and safety monitoring for the elderly living independently. An unobtrusive and low cost SHE solution that uses a Raspberry Pi 3 model B, a Microsoft Kinect Sensor and an Aeotec 4-in-1 Multisensor was implemented. The Aeotec Multisensor was used to measure temperature, motion, lighting, and humidity in the home. Data from the multisensor was collected using OpenHAB as the Smart Home Operating System. The information was processed using the Raspberry Pi 3 and push notifications were sent when risk situations were detected. An experimental evaluation was conducted to determine the accuracy with which the prototype SHE detected abnormal events. Evaluation scripts were each evaluated five times. The results show that the prototype has an average accuracy, sensitivity and specificity of 94%, 96.92% and 88.93% respectively. The sensitivity shows that the chance of the prototype missing a risk situation is 3.08%, and the specificity shows that the chance of incorrectly classifying a non-risk situation is 11.07%. The prototype does not require any interaction on the part of the elderly. Relatives and caregivers can remotely monitor the elderly person living independently via the mobile application or a web portal. The total cost of the equipment used was below R3000