a critical review

The availability of wearable devices (WDs) to collect biometric information and their use during activities of daily living is significantly increasing in the general population. These small electronic devices, which record fitness and health-related outcomes, have been broadly utilized in industries such as medicine, healthcare, and fitness. Since they are simple to use and progressively cheaper, they have also been used for numerous research purposes. However, despite their increasing popularity, most of these WDs do not accurately measure the proclaimed outcomes. In fact, research is equivocal about whether they are valid and reliable methods to specifically evaluate physical activity and health-related outcomes in older adults, since they are mostly designed and produced considering younger subjects? physical and mental characteristics. Additionally, their constant evolution through continuous upgrades and redesigned versions, suggests the need for constant up-to-date reviews and research. Accordingly, this article aims to scrutinize the state-of-the-art scientific evidence about the usefulness of WDs, specifically on older adults, to monitor physical activity and health-related outcomes. This critical review not only aims to inform older consumers but also aid researchers in study design when selecting physical activity and healthcare monitoring devices for elderly people.DB19-D819-F720 | Carlos Eduardo da Silva TeixeiraN/

Smart homes for the elderly of rural Oklahoma: A strategy for ethical implementation

Smart homes, telemedicine, and robots are often proposed as solutions to the upcoming problem of providing care to millions of older adults. The number of elderly in need of care has risen substantially, the number of available caretakers has not kept pace with demand, and this disparity will only increase as the Baby Boomer generation ages. The care of the elderly, which results in dependency on their part, conflicts with the strong individualism of American society, sometimes causing difficulties between the patient and caretaker(s) when making care decisions. Thus, many ethical concerns have been voiced about smart home technology, from privacy issues to fears of isolation (Fritz, 2015). These concerns vary based on the cultural background of the elderly user, with upper-middle class users feeling more comfortable with the technology (Fritz, 2015). Rural users, who are most in need of the technology due to having fewer nearby healthcare providers, and dementia users, who are in need of the technology to help manage their illness during the early stages while living at home, are the ones who tend to distrust the technology the most (Fritz, 2015). Smart home implementation for the elderly has progressed rapidly in recent years, but research has fallen behind in the sense of connecting theory and practice (Berridge, 2018). As a way to address this, the author proposes a study with researchers in the Dept. of Telemedicine at the OSU Medical School in Tulsa of the rural elderly in Oklahoma, since Oklahoma has approved insurance reimbursement for telemedicine, that would be expanded to include assistive technologies for smart homes in order to try to develop a participatory model for the ethical diffusion of this technology on a mass level

An IoT based Virtual Coaching System (VSC) for Assisting Activities of Daily Life

Nowadays aging of the population is becoming one of the main concerns of theworld. It is estimated that the number of people aged over 65 will increase from 461million to 2 billion in 2050. This substantial increment in the elderly population willhave significant consequences in the social and health care system. Therefore, in thecontext of Ambient Intelligence (AmI), the Ambient Assisted Living (AAL) has beenemerging as a new research area to address problems related to the aging of the population. AAL technologies based on embedded devices have demonstrated to be effectivein alleviating the social- and health-care issues related to the continuous growing of theaverage age of the population. Many smart applications, devices and systems have beendeveloped to monitor the health status of elderly, substitute them in the accomplishment of activities of the daily life (especially in presence of some impairment or disability),alert their caregivers in case of necessity and help them in recognizing risky situations.Such assistive technologies basically rely on the communication and interaction be-tween body sensors, smart environments and smart devices. However, in such contextless effort has been spent in designing smart solutions for empowering and supportingthe self-efficacy of people with neurodegenerative diseases and elderly in general. Thisthesis fills in the gap by presenting a low-cost, non intrusive, and ubiquitous VirtualCoaching System (VCS) to support people in the acquisition of new behaviors (e.g.,taking pills, drinking water, finding the right key, avoiding motor blocks) necessary tocope with needs derived from a change in their health status and a degradation of theircognitive capabilities as they age. VCS is based on the concept of extended mind intro-duced by Clark and Chalmers in 1998. They proposed the idea that objects within theenvironment function as a part of the mind. In my revisiting of the concept of extendedmind, the VCS is composed of a set of smart objects that exploit the Internet of Things(IoT) technology and machine learning-based algorithms, in order to identify the needsof the users and react accordingly. In particular, the system exploits smart tags to trans-form objects commonly used by people (e.g., pillbox, bottle of water, keys) into smartobjects, it monitors their usage according to their needs, and it incrementally guidesthem in the acquisition of new behaviors related to their needs. To implement VCS, thisthesis explores different research directions and challenges. First of all, it addresses thedefinition of a ubiquitous, non-invasive and low-cost indoor monitoring architecture byexploiting the IoT paradigm. Secondly, it deals with the necessity of developing solu-tions for implementing coaching actions and consequently monitoring human activitiesby analyzing the interaction between people and smart objects. Finally, it focuses on the design of low-cost localization systems for indoor environment, since knowing theposition of a person provides VCS with essential information to acquire information onperformed activities and to prevent risky situations. In the end, the outcomes of theseresearch directions have been integrated into a healthcare application scenario to imple-ment a wearable system that prevents freezing of gait in people affected by Parkinson\u2019sDisease

An analytical comparison of datasets of Real-World and simulated falls intended for the evaluation of wearable fall alerting systems

Automatic fall detection is one of the most promising applications of wearables in the field of mobile health. The characterization of the effectiveness of wearable fall detectors is hampered by the inherent difficulty of testing these devices with real-world falls. In fact, practically all the proposals in the literature assess the detection algorithms with ‘scripted’ falls that are simulated in a controlled laboratory environment by a group of volunteers (normally young and healthy participants). Aiming at appraising the adequacy of this method, this work systematically compares the statistical characteristics of the acceleration signals from two databases with real falls and those computed from the simulated falls provided by 18 well-known repositories commonly employed by the related works. The results show noteworthy differences between the dynamics of emulated and real-life falls, which undermines the testing procedures followed to date and forces to rethink the strategies for evaluating wearable fall detectors.Funding for open access charge: Universidad de Málaga / CBUA. This research was funded by FEDER Funds (under grant UMA18-FEDERJA-022), Andalusian Regional Government (-Junta de Andalucía- grant PAIDI P18-RT-1652) and Universidad de Málaga, Campus de Excelencia Internacional Andalucia Tech

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

Design and Validation of a Wearable, Continuous, and Non-Invasive Hydration Monitor that uses Ultrasonic Pulses to Detect Changes in Tissue Hydration Status

Chronic dehydration is an endemic problem for many population groups. Current methods of monitoring hydration status are invasive, time consuming, cannot be performed while exercising, and require lab resources. A proposed solution is a wearable, continuous, and non-invasive device that uses harm-free ultrasonic pulses to detect changes in tissue hydration status over time. Customer and engineering requirements were defined and used to guide the design process. Literature reviews were performed to identify essential information on dehydration, assess current methods, discover state of the art devices, and describe ultrasonic theory. Market research was performed to identify athletes as the target population group. An adjustable elastic nylon bicep band prototype was manufactured and the integration of more advanced components was proposed. The theoretical signal processing method used to detect hydration status was validated through initial tests with a prototype electrical system composed of a Teensy 3.1 board, two 18 kHz piezoceramic disc elements, and an Arduino/LabVIEW interface. Tests with aluminum, rubber, and sponge materials were performed to compare the signal response to propagation through materials with different acoustic properties and water contents. Finally, tests performed with dehydrated bovine muscle tissue revealed a statistically significant difference between hydrated and dehydrated tissue, a promising indication for future device refinement

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

Independent Aging with the Help of Smart Technology:Investigating the Acceptance of Ambient Assisted Living Technologies

Who takes care of our older adults? According to the European Union, smart technologies that support independent living and active aging, introduced as ‘Ambient Assisted Living’ (AAL), are the future for our aging population. Promises of AAL include saving long-term care costs, improving the quality of care, unburdening family caregivers, and increasing the older adults’ independence and overall quality of life. While the policy enthusiasm for AAL technology is high, it is unclear if the potential users of AAL are willing to embrace AAL technologies in their daily lives. This dissertation addressed this issue by focusing on the perspective of older adults and their caregivers. Using a combination of qualitative and quantitative approaches, we developed a comprehensive and theoretically grounded understanding of how and why users perceive AAL technologies in a certain way. Important factors that drive or hinder the acceptance were identified. These insights resulted in a model of AAL acceptance that was validated in a representative sample (n = 1296) of the Dutch older adult population. This dissertation contributes to a more user-driven approach in AAL research and development and has important implications for researchers, developers and policy makers alike. We hope that our results will guide future research efforts, design and policy directions in the AAL field

The Effect of Font Type and Font Size on the Legibility in Smart Watch Usage of the Elderly People

학위논문 (석사)-- 서울대학교 대학원 : 공과대학 산업공학과, 2018. 8. 윤명환.전 세계적으로 늘어나고 있는 고령 인구에 따라, 고령자의 건강 관리에 대한 요구와 비용 또한 늘어날 것으로 예상되고 있다. 그에 따라 고령자의 건강 상태를 연속적이고 경제적으로 모니터링할 수 있는 웨어러블 디바이스를 이용한 건강 관리 모니터링 시스템에 대한 연구가 활발하게 이루어지고 있다. 스마트 워치는 고령자의 건강 관리 모니터링 시스템에 적용되기에 적합한 웨어러블 디바이스 중 하나이다. 그러나 스마트 워치의 작은 디스플레이로 인한 낮은 가독성은 문제점으로 지적되고 있다. 가독성은 제품의 사용성 요인 중에 하나이며, 고령자의 기기 수용도에 영향을 미칠 수 있기 때문에, 제품의 가독성을 향상시키는 것은 매우 중요한 문제이다. 그러나 고령자를 대상으로 한 스마트 워치의 가독성 연구는 미비한 실정이다. 따라서, 본 연구에서는 고령자를 대상으로 소형 디스플레이에서 중요한 가독성 영향 요인으로 꼽히는 글자체와 글자 크기가 스마트 워치의 가독성에 미치는 영향을 알아보고자 하였다. 글자체의 경우 고딕체와 명조체를 대상으로 하였으며, 글자 크기의 경우 9 point, 10 point, 11 point, 12 point를 대상으로 하였다. 그 후 결과를 반응 시간, 오류 횟수, 주관적 만족도로 나누어 분석하였다. 실험 결과, 글자체에 따른 반응 시간, 오류 횟수, 주관적 만족도에 통계적으로 유의미한 차이는 나타나지 않았다. 그러나 종합 만족도에서는 명조체보다 고딕체가 더 높은 만족도를 보였다. 따라서 선호도가 중요한 인터페이스의 경우 고딕체를 사용할 것을 권장한다. 이와 달리 각 글자체에서 글자 크기의 변화에 따른 가독성의 차이는 다르게 나타났다. 고딕체의 경우 반응 시간의 차이는 없었지만 오류 횟수에서 10 point와 11 point가 9 point와 12 point보다 더 좋은 결과를 보였으며, 주관적 만족도에서도 정확도와 편안함에서 11 point까지는 글자 크기가 커질수록 만족도가 높아지다가 12 point에서는 더 낮아지는 경향을 보였다. 명조체의 경우, 반응 시간에서 9 point와 10 point보다 11 point와 12 point가 더 좋은 결과를 보였으며, 오류 횟수에서는 차이가 나타나지 않았다. 또한, 통계적으로 차이는 없었지만, 주관적 만족도에서도 정확도와 편안함에서 모두 글자 크기가 커질수록 만족도가 높아지는 경향을 보였다. 따라서, 고딕체를 사용할 경우에는 11 point, 명조체를 사용할 경우에는 12 point 사용을 권장한다. 본 연구는 고령자의 스마트 워치 사용에 있어 글자체와 글자 크기에 대한 가독성 지침을 제시하고자 하였다. 이는 고령자의 스마트 워치 사용에서 사용성을 높일 것으로 기대되며, 이로 인해 고령자의 스마트 워치 기기에 대한 수용도 또한 높일 수 있을 것으로 기대된다. 주요어 : 고령자, 스마트 워치, 가독성, 글자체, 글자 크기제 1 장 서론 1 1.1 연구 배경 및 목적 1 1.2 논문의 구성 3 제 2 장 배경 이론 5 2.1 고령자 5 2.1.1 고령자와 고령 사회 5 2.1.2 고령자의 특성 5 2.2 스마트 워치(Smart Watch) 7 2.2.1 스마트 워치의 정의와 기능 7 2.2.2 고령자와 스마트 워치 8 2.3 가독성 10 2.3.1 가독성의 정의 10 2.3.2 가독성에 영향을 미치는 요인 12 2.3.3 서체 14 2.3.4 가독성 측정 방법 16 2.3.5 고령자에 관한 가독성 연구 18 2.3.6 스마트 워치에 관한 가독성 연구 20 제 3 장 연구 방법 23 3.1 피실험자 23 3.2 실험 장비 23 3.3 실험 자극 25 3.4 독립 변인 26 3.5 종속 변인 26 3.6 실험 절차 27 3.7 실험 환경 28 제 4 장 실험 결과 30 4.1 연구 가설 30 4.2 반응 시간 31 4.2.1 정규성 검정 32 4.2.2 분산의 동질성 검정 33 4.2.3 분산 분석 33 4.3 오류 횟수 38 4.3.1 정규성 검정 39 4.3.2 Mann-Whitney U 검정 40 4.3.3 Kruskall-Wallis 검정 41 4.4 주관적 만족도 47 4.4.1 정확도 정규성 검정 47 4.4.2 정확도 Mann-Whitney U 검정 48 4.4.3 정확도 Kruskall-Wallis 검정 50 4.4.4 편안함 정규성 검정 55 4.4.5 편안함 Mann-Whitney U 검정 56 4.4.6 편안함 Kruskall-Wallis 검정 57 4.4.7 종합 만족도 62 제 5 장 논의 64 제 6 장 결론 67 6.1 결론 67 6.2 연구의 한계 68 6.3 향후 연구 과제 및 연구 의의 70 참고문헌 71 Abstract 82Maste

A Critical Review of Consumer Wearables, Mobile Applications, and Equipment for Providing Biofeedback, Monitoring Stress, and Sleep in Physically Active Populations

The commercial market for technologies to monitor and improve personal health and sports performance is ever expanding. A wide range of smart watches, bands, garments, and patches with embedded sensors, small portable devices and mobile applications now exist to record and provide users with feedback on many different physical performance variables. These variables include cardiorespiratory function, movement patterns, sweat analysis, tissue oxygenation, sleep, emotional state, and changes in cognitive function following concussion. In this review, we have summarized the features and evaluated the characteristics of a cross-section of technologies for health and sports performance according to what the technology is claimed to do, whether it has been validated and is reliable, and if it is suitable for general consumer use. Consumers who are choosing new technology should consider whether it (1) produces desirable (or non-desirable) outcomes, (2) has been developed based on real-world need, and (3) has been tested and proven effective in applied studies in different settings. Among the technologies included in this review, more than half have not been validated through independent research. Only 5% of the technologies have been formally validated. Around 10% of technologies have been developed for and used in research. The value of such technologies for consumer use is debatable, however, because they may require extra time to set up and interpret the data they produce. Looking to the future, the rapidly expanding market of health and sports performance technology has much to offer consumers. To create a competitive advantage, companies producing health and performance technologies should consult with consumers to identify real-world need, and invest in research to prove the effectiveness of their products. To get the best value, consumers should carefully select such products, not only based on their personal needs, but also according to the strength of supporting evidence and effectiveness of the products