Designing an adaptive salutogenic care environment

Humans are profoundly affected by the surroundings which they inhabit. Environmental psychologists have produced numerous credible theories describing optimal human environments, based on the concept of congruence or “fit” (1, 2). Lack of person/environment fit can lead to stress-related illness and lack of psychosocial well-being (3). Conversely, appropriately designed environments can promote wellness (4) or “salutogenesis” (5). Increasingly, research in the area of Evidence-Based Design, largely concentrated in the area of healthcare architecture, has tended to bear out these theories (6). Patients and long-term care residents, because of injury, illness or physical/ cognitive impairment, are less likely to be able to intervene to modify their immediate environment, unless this is designed specifically to facilitate their particular needs. In the context of care settings, detailed design of personal space therefore takes on enormous significance. MyRoom conceptualises a personalisable room, utilising sensoring and networked computing to enable the environment to respond directly and continuously to the occupant. Bio-signals collected and relayed to the system will actuate application(s) intended to positively influence user well-being. Drawing on the evidence base in relation to therapeutic design interventions (7), real-time changes in ambient lighting, colour, image, etc. respond continuously to the user’s physiological state, optimising congruence. Based on research evidence, consideration is also given to development of an application which uses natural images (8). It is envisaged that actuation will require machine-learning based on interpretation of data gathered by sensors; sensoring arrangements may vary depending on context and end-user. Such interventions aim to reduce inappropriate stress/ provide stimulation, supporting both instrumental and cognitive tasks

When technology cares for people with dementia:A critical review using neuropsychological rehabilitation as a conceptual framework

Clinicians and researchers have become increasingly interested in the potential of technology in assisting persons with dementia (PwD). However, several issues have emerged in relation to how studies have conceptualized who the main technology user is (PwD/carer), how technology is used (as compensatory, environment modification, monitoring or retraining tool), why it is used (i.e., what impairments and/or disabilities are supported) and what variables have been considered as relevant to support engagement with technology. In this review we adopted a Neuropsychological Rehabilitation perspective to analyse 253 studies reporting on technological solutions for PwD. We analysed purposes/uses, supported impairments and disabilities and how engagement was considered. Findings showed that the most frequent purposes of technology use were compensation and monitoring, supporting orientation, sequencing complex actions and memory impairments in a wide range of activities. The few studies that addressed the issue of engagement with technology considered how the ease of use, social appropriateness, level of personalization, dynamic adaptation and carers' mediation allowed technology to adapt to PWD's and carers' preferences and performance. Conceptual and methodological tools emerged as outcomes of the analytical process, representing an important contribution to understanding the role of technologies to increase PwD's wellbeing and orient future research.University of Huddersfield, under grants URF301-01 and URF506-01

Smart home applications for cognitive health of older adults

Capítulo 6The lifespan of older people is growing together with their proportion in the population Growth in the older population. This leads to an increasing need for support services for older adults who will inevitably experience a significant decrease in their cognitive capabilities and mental health conditions. Cognitive function, including memory, attention, sleeping, problem-solving activities, or speed processing, are playing a crucial role in everyone’s independent daily life. Technologies can help maintain their independence and improve quality of life, reducing the care costs. In this regards, smart home applications (SMAs) offer a solution to the complex needs of older adults and their families, monitoring physiological and functional issues, as well as aiding in emergency detection and response. This chapter provides an overview of current applications reported in the scientific literature, identifies the frameworks proposed for designing these types of applications, and defines evidence based recommendations for designing SMAs for cognitive health of older adults

A conceptual approach to enhance the well-being of elderly people

The number of elderly people living alone is increasing. Consequently, a lot of research works have been addressing this issue in order to propose solutions that can enhance the quality of life of elderly people. Most of them have been concerned in dealing with objective issues such as forgetfulness or detecting falls. In this paper, we propose a conceptual approach of a system that intends to enhance the daily sense of user’s well-being. For that, our proposal consists in a system that works as a social network and a smartwatch application that works unobtrusively and collects the user’s physiological data. In addition, we debate how important features such as to detect user’s affective states and to potentiate user’s memory could be implemented. Our study shows that there are still some important limitations which affect the success of applications built in the context of elderly care and which are mostly related with accuracy and usability of this kind of system. However, we believe that with our approach we will be able to address some of those limitations and define a system that can enhance the well-being of elderly people and improve their cognitive capabilities.The work presented in this paper has been developed under the EUREKA - ITEA3 Project PHE (PHE-16040), and by National Funds through FCT (Fundação para a Ciência e a Tecnologia) under the projects UID/EEA/00760/2019 and UID/CEC/00319/2019 and by NORTE-01-0247-FEDER-033275 (AIRDOC - “Aplicação móvel Inteligente para suporte individualizado e monitorização da função e sons Respiratórios de Doentes Obstrutivos Crónicos ”) by NORTE 2020 (Programa Operacional Regional do Norte)

Recreating living experiences from past memories through virtual worlds for people with dementia

This paper describes a study aimed to understand the use of 3D virtual world (VW) technology to support life engagement for people with dementia in long-term care. Three versions of VW prototypes (reminiscence room, virtual tour and gardening) utilising gestured-base interaction were developed iteratively. These prototypes were tested with older residents (80+) with dementia in care homes and their caregivers. Data collection was based on observations of how the residents and care staff interacted collaboratively with the VW. We discussed in depth the use of VWs in stimulating past memories and how this technology could help enhance their sense of self through various means. We also highlighted key approaches in designing VWs to sustain attention, create ludic experiences and facilitate interaction for older people with dementia

Is movement better? Comparing sedentary and motion-based game controls for older adults

Providing cognitive and physical stimulation for older adults is critical for their well-being. Video games offer the opportunity of engaging seniors, and research has shown a variety of positive effects of motion-based video games for older adults. However, little is known about the suitability of motion-based game controls for older adults and how their use is affected by age-related changes. In this paper, we present a study evaluating sedentary and motion-based game controls with a focus on differences between younger and older adults. Our results show that older adults can apply motion-based game controls efficiently, and that they enjoy motion-based interaction. We present design implications based on our study, and demonstrate how our findings can be applied both to motion-based game design and to general interaction design for older adults. Copyright held by authors

From Wearable Sensors to Smart Implants – Towards Pervasive and Personalised Healthcare

<p>Objective: This article discusses the evolution of pervasive healthcare from its inception for activity recognition using wearable sensors to the future of sensing implant deployment and data processing. Methods: We provide an overview of some of the past milestones and recent developments, categorised into different generations of pervasive sensing applications for health monitoring. This is followed by a review on recent technological advances that have allowed unobtrusive continuous sensing combined with diverse technologies to reshape the clinical workflow for both acute and chronic disease management. We discuss the opportunities of pervasive health monitoring through data linkages with other health informatics systems including the mining of health records, clinical trial databases, multi-omics data integration and social media. Conclusion: Technical advances have supported the evolution of the pervasive health paradigm towards preventative, predictive, personalised and participatory medicine. Significance: The sensing technologies discussed in this paper and their future evolution will play a key role in realising the goal of sustainable healthcare systems.</p> <p> </p

Toolkits for the Development of Hybrid Games: from Tangible Tabletops to Interactive Spaces

Durante los últimos años, los dispositivos tabletop han sido considerados el entorno ideal para los juegos híbridos, los cuales combinan técnicas de juego tradicional, como el uso de objetos físicos para interactuar con el juego de una forma natural, con las nuevas posibilidades que los tabletops ofrecen de aumentar el espacio de juego con imágenes digitales y audio.Sin embargo, los juegos híbridos no se restringen simplemente a tabletops, pudiéndose jugar también en entornos más amplios en los que convergen otros paradigmas de interacción. Por esta razón, el uso de juegos híbridos en Espacios Interactivos está ganando fuerza, pero el número y heterogeneidad de dispositivos y estilos de interacción que se encuentran en estos entornos hace que el diseño y prototipado de juegos sea una tarea difícil. Por lo tanto, el gran reto se encuentra en ofrecer a diseñadores y desarrolladores herramientas apropiadas para la creación de estas aplicaciones.En esta línea de trabajo, el grupo Affective Lab lanzó el proyecto JUGUEMOS (TIN2015-67149-C3-1R), un proyecto nacional centrado en el desarrollo de juegos híbridos en entornos interactivos. Esta Tesis Doctoral se enmarca en este proyecto.El primer paso de la realización de esta tesis fue establecer los dos objetivos principales (Capítulo 1):1) El primer objetivo que se estableció fue profundizar en el uso de tabletops tangibles en terapia con niños con necesidades especiales. Durante los últimos años el grupo Affective Lab había visto la potencialidad de los tabletops tangibles para el trabajo con niños pequeños, pero todavía era necesario llevar a cabo más experiencias y evaluaciones en el ámbito terapéutico, así como explorar si otros grupos de usuarios (adultos con problemas cognitivos) podían beneficiarse de las características de los tabletops.2) El segundo objetivo consistió en diseñar e implementar un toolkit para el desarrollo de juegos híbridos para espacios interactivos. Se decidió que el toolkit estuviera dirigido a desarrolladores para facilitar su trabajo a la hora de crear este tipo de aplicaciones.Una vez establecidos los objetivos, se realizó un estado del arte a su vez dividido en dos partes (Capítulo 2):1) Se realizó una categorización de juegos híbridos para entender y extraer sus principales características, así como los principales retos que surgen al desarrollar este tipo de juegos. También se estudiaron toolkits cuyo objetivo era el desarrollo de juegos híbridos.2) Se estudiaron juegos híbridos desarrollados para niños con necesidades especiales y adultos con problemas cognitivos que hacían uso de la Interacción Tangible y tabletops, así como toolkits dirigidos a terapeutas o educadores para ayudarles en la creación de actividades para sus pacientes.Para llevar a cabo las experiencias y evaluaciones relacionadas con el primer objetivo, se hizo uso del tabletop tangible NIKVision, desarrollado previamente por el grupo Affective Lab, y el toolkit KitVision, una herramienta dirigida a profesionales sin conocimientos de programación para la creación de actividades tangibles y que fue desarrollado durante el Proyecto Final de Carrera de la autora. En el Capítulo 3 de esta Tesis se comenta brevemente el tabletop NIKVision y la arquitectura de KitVision, se describen las evaluaciones que se llevaron a cabo con terapeutas con el objetivo de mejorar y probar la utilidad del toolkit, y se explica una experiencia de un año durante la cual una terapeuta ocupacional de ASAPME, una asociaciónque trabaja con adultos con problemas cognitivos, estuvo usando el tabletop y el toolkit sin supervisión.En el Capítulo 4 se describen diferentes experiencias con KitVision que se llevaron a cabo:- Gracias a una colaboración con la Residencia Romareda, NIKVision y KitVision fueron instalados provisionalmente en la residencia y, tras una evaluación inicial, se desarrollaron tres nuevas actividades para los usuarios de la residencia.- Gracias a la colaboración con ENMOvimienTO y con uno de los centros de Atención Temprana del Instituto Aragonés de Servicios Sociales (IASS), ambos enfocados a trabajar con niños con problemas de aprendizaje, se pudieron realizar evaluaciones que nos permitieron mejorar KitVision y crear nuevas actividades específicamente diseñadas para ellos.- Finalmente, gracias a una colaboración con Atenciona, pudimos evaluar actividades con niños con Trastorno por Déficit de Atención e Hiperactividad (TDAH) y extraer una serie de directrices para diseñar actividades para este tipo de niños. También pudimos llevar a cabo una experiencia de Diseño Participativo con estos niños.El completo desarrollo del toolkit JUGUEMOS, para la creación de juegos híbridos en espacios interactivos, se explica en el Capítulo 5. En este apartado primero se describe el Espacio Interactivo JUGUEMOS que sirvió de base para desarrollar el toolkit. Después se explican con detalle las decisiones de diseño que se tomaron, el modelo de abstracción que se usó para diseñar los juegos, y la arquitectura del toolkit. También se detallan las distintas fases de implementación que se llevaron a cabo, basadas en los tres retos que se extrajeron en el estado del arte: (1) integrar diferentes dispositivos, (2) gestionar salidas gráficas diversas y (3) facilitar la codificación del juego. Finalmente, se presentan dos prototipos de juegos que se desarrollaron durante las dos estancias de investigación que la autora realizó.Finalmente, en el Capítulo 6 se describen los tres casos de uso que se realizaron para tener una primera valoración de la usabilidad del toolkit JUGUEMOS: (1) una evaluación con estudiantes de Máster en la que se implementó un juego completamente funcional para el Espacio Interactivo JUGUEMOS, (2) un juego que fue completamente desarrollado usando el toolkit JUGUEMOS una vez que éste se acabó de implementar, (3) una experiencia que involucró a dos grupos multidisciplinares compuestos por diseñadores y desarrolladores, en la que tuvieron que colaborar para diseñar e implementar dos prototipos de juegos híbridos para el espacio interactivo.<br /

Exploring how persons with dementia and care partners collaboratively appropriate information and communication technologies

Persons with dementia and their care partners have been found to adapt their own technological arrangements using commercially-available information and communication technologies (ICTs). Yet, little is known about these processes of technology appropriation and how care practices are impacted. Adopting a relational perspective of care, we longitudinally examined how four family care networks appropriated a new commercial ICT service into their existing technological arrangements and care practices. Cross-case analysis interpreted collaborative appropriation to encompass two interrelated processes of creating and adapting technological practices and negotiating and augmenting care relationships. Four driving forces were also proposed: motivating meanings that actors ascribe to the technology and its use; the learnability of the technology and actors’ resourcefulness; the establishment of responsive and cooperative care practices; and the qualities of empathy and shared power in care relationships. The importance of technological literacy, learning, meaning-making, and the nature and quality of care relationships are discussed. Future work is urged to employ longitudinal and naturalistic approaches, and focus design efforts on promoting synergistic care relationships and care practices