The dynamics of sibling relationships with a down syndrome child

Siblings of special needs child are often seen as neglected children, especially when the special needs child needs more attention from their parents. This study aimed to find out the dynamics of sibling relationships with a down syndrome child. A phenomenological qualitative approach with data analysis of Interpretative Phenomenological Analysis (IPA) was chosen as the research method due to its suitability with the purpose of this study. The data were collected using in-depth semi-structured interviews on two biological older sisters (24 and 20 years old) of a boy with down syndrome (12 years old). The selection of subjects used a purposive sampling technique, which was based on the specified criteria. Three main themes were found in this study, namely (1) the functions of parents’ role, (2) acceptance towards a sibling with Down syndrome, and (3) sibling relationship. The results showed that the parents’ role in introducing the Down syndrome from the beginning helped the subjects accepted their sibling’s special needs. The subjects’ acceptance was expressed through their actions in supporting their younger sibling to become independent. Each subject also showed a sense of care in their own ways. Sibling relationships with a Down syndrome child were indicated by the existence of warmth, conflict, rivalry, role, engagement, stress, concern, and coping mechanisms

The dynamics of sibling relationships with a down syndrome child

Siblings of special needs child are often seen as neglected children, especially when the special needs child needs more attention from their parents. This study aimed to find out the dynamics of sibling relationships with a down syndrome child. A phenomenological qualitative approach with data analysis of Interpretative Phenomenological Analysis (IPA) was chosen as the research method due to its suitability with the purpose of this study. The data were collected using in-depth semi-structured interviews on two biological older sisters (24 and 20 years old) of a boy with down syndrome (12 years old). The selection of subjects used a purposive sampling technique, which was based on the specified criteria. Three main themes were found in this study, namely (1) the functions of parents‟ role, (2) acceptance towards a sibling with Down syndrome, and (3) sibling relationship. The results showed that the parents‟ role in introducing the Down syndrome from the beginning helped the subjects accepted their sibling‟s special needs. The subjects‟ acceptance was expressed through their actions in supporting their younger sibling to become independent. Each subject also showed a sense of care in their own ways. Sibling relationships with a Down syndrome child were indicated by the existence of warmth, conflict, rivalry, role, engagement, stress, concern, and coping mechanisms

Two-stage motion artefact reduction algorithm for electrocardiogram using weighted adaptive noise cancelling and recursive Hampel filter

The presence of motion artefacts in ECG signals can cause misleading interpretation of cardiovascular status. Recently, reducing the motion artefact from ECG signal has gained the interest of many researchers. Due to the overlapping nature of the motion artefact with the ECG signal, it is difficult to reduce motion artefact without distorting the original ECG signal. However, the application of an adaptive noise canceler has shown that it is effective in reducing motion artefacts if the appropriate noise reference that is correlated with the noise in the ECG signal is available. Unfortunately, the noise reference is not always correlated with motion artefact. Consequently, filtering with such a noise reference may lead to contaminating the ECG signal. In this paper, a two-stage filtering motion artefact reduction algorithm is proposed. In the algorithm, two methods are proposed, each of which works in one stage. The weighted adaptive noise filtering method (WAF) is proposed for the first stage. The acceleration derivative is used as motion artefact reference and the Pearson correlation coefficient between acceleration and ECG signal is used as a weighting factor. In the second stage, a recursive Hampel filter-based estimation method (RHFBE) is proposed for estimating the ECG signal segments, based on the spatial correlation of the ECG segment component that is obtained from successive ECG signals. Real-World dataset is used to evaluate the effectiveness of the proposed methods compared to the conventional adaptive filter. The results show a promising enhancement in terms of reducing motion artefacts from the ECG signals recorded by a cost-effective single lead ECG sensor during several activities of different subjects

Development and Usability Evaluation of an mHealth Application for Symptom Self-Management in Underserved Persons Living with HIV

Effective symptom management is essential to decrease symptom severity and improve health-related quality of life for persons living with HIV (PLWH). A mobile health (mHealth) application (app) has the potential to be an effective delivery mode of an existing paper-based symptom management manual with self-management strategies for underserved PLWH. The quality of the mHealth app requires a thorough understanding of the needs of the intended end-users and ensuring the app’s usability. The purpose of this study was to translate paper-based health information into an mHealth app for symptom self-management in underserved PLWH, entitled mVIP (mobile Video Information Provider), and assess its usability. To achieve this goal, usability was evaluated rigorously throughout the development process of mVIP. Based on a stratified view of health information technology (IT) usability evaluation framework, usability evaluation was sequentially conducted with the following three levels: 1) user-task, 2) user-task-system, and 3) user-task-system-environment. At level 1 (user-task), we applied a user-centered design method to guide the information architecture of mVIP. Using a reverse in-person card sorting technique, symptoms and self-management strategies from a paper-based HIV/AIDS symptom management manual were ranked. The rank order of the 13 symptoms and 151 self-management strategies determined the order of appearance to end-users of the mVIP app, with higher-ranked symptoms and strategies appearing first. Based on the findings, we developed a prototype of mVIP as following: 1) once users log in, they are guided by an avatar through a series of 13 symptom questions ascertaining the nature and severity of their symptoms, and 2) the avatar recommends three self-management strategies for each symptom reported. At level 2 (user-task-system), we conducted a usability evaluation of the mVIP prototype in a laboratory setting through end-user usability testing and heuristic evaluation. In end-user usability testing, we used an eye-tracking and retrospective think-aloud method to examine task performance by 20 PLWH. For the heuristic evaluation, five usability experts in informatics assessed the user interface. In the two usability evaluations conducted in a laboratory setting, we found strong user acceptance of the mVIP prototype while identifying a number of usability issues with this prototype. Based on the recommendations from the end-users and heuristic evaluators, we iteratively refined the app’s content, functionality, and interface. We then inserted videos of the finalized symptom self-management strategies into the refined mVIP prototype. At level 3 (user-task-system-environment), the usability of the refined mVIP prototype was evaluated in a real-world setting. Through 10 in-depth interviews and four focus groups conducted at the conclusion of a three-month randomized controlled trial, we explored in-depth understandings of users’ experiences, perceptions, and satisfaction of mVIP use. Findings from the study showed that first, mVIP is useful for HIV-related symptom self-management and has the potential for being used as a communication tool with healthcare providers; and second, mVIP is easy to use to monitor symptom experience over time. At the same time, participants suggested mVIP be more sensitively tailored based on years from initial diagnosis of HIV, an individuals’ age, and conditions. The overall user satisfaction with the mVIP prototype was high, which reflects strong user acceptance of mVIP. Integral to the findings from the three-level usability evaluation, we assessed the quality of the mVIP prototype in use and found the prototype was highly accepted by PLWH with high user satisfaction. This study will add to the body of literature on translation of evidence-based health information into an mHealth app and its usability assessment, which highlights the importance of the use of mobile technology for PLWH, specifically racial and ethnic minorities and those from low-socioeconomic groups who have limited health literacy and low level of education