Design and technical evaluation of an enhanced location-awareness service enabler for spatial disorientation management of elderly with mild cognitive impairment

The progressive ageing of population has turned the mild cognitive impairment (MCI) into a prevalent disease suffered by elderly. Consequently, the spatial disorientation has become a significant problem for older people and their caregivers. The ambient-assisted living applications are offering location-based services for empowering elderly to go outside and encouraging a greater independence. Therefore, this paper describes the design and technical evaluation of a location-awareness service enabler aimed at supporting and managing probable wandering situations of a person with MCI. Through the presence capabilities of the IP multimedia subsystem (IMS) architecture, the service will alert patient's contacts if a hazardous situation is detected depending on his location. Furthermore, information about the older person's security areas has been included in the user profile managed by IMS. In doing so, the service enabler introduced contribute to “context-awareness” paradigm allowing the adaptation and personalization of services depending on user's context and specific conditions or preferences

A data-globe and immersive virtual reality environment for upper limb rehabilitation after spinal cord injury

While a number of virtual data-gloves have been used in stroke, there is little evidence about their use in spinal cord injury (SCI). A pilot clinical experience with nine SCI subjects was performed comparing two groups: one carried out a virtual rehabilitation training based on the use of a data glove, CyberTouch combined with traditional rehabilitation, during 30 minutes a day twice a week along two weeks; while the other made only conventional rehabilitation. Furthermore, two functional indexes were developed in order to assess the patient’s performance of the sessions: normalized trajectory lengths and repeatability. While differences between groups were not statistically significant, the data-glove group seemed to obtain better results in the muscle balance and functional parameters, and in the dexterity, coordination and fine grip tests. Related to the indexes that we implemented, normalized trajectory lengths and repeatability, every patient showed an improvement in at least one of the indexes, either along Y-axis trajectory or Z-axis trajectory. This study might be a step in investigating new ways of treatments and objective measures in order to obtain more accurate data about the patient’s evolution, allowing the clinicians to develop rehabilitation treatments, adapted to the abilities and needs of the patients

Designing P4 healthcare interventions for managing cognitive decline and dementia : where are we at?

This paper presents a systematic literature review aimed at assessing how well current technology-based interventions that focus on dementia and other cognitive impairments align with the principles of the P4 vision for healthcare: Predictive, Preventive, Personalised and Participative. A search of the SCOPUS database yielded 887 articles, of which 48 were ultimately selected for analysis. Looking at whether and how each intervention implements each ‘P’-principle, our results suggest a partial and non-systemic embrace of the P4 vision. Reasoning on possible explanations for this state-of-the-art, we propose that our findings represent an opportunity for the engineering design community to engage with P4-based healthcare delivery models through the development of design frameworks, new indicators for assessing the success of such healthcare delivery models, as well as tools and methods

What are the common areas of risk and their characteristics found in intermediate care from an occupational therapy perspective? A scoping review

Engaging with risk is a certain and unavoidable part of occupational therapy. Intermediate care services are mostly accessed by older people with complex needs, yet little is known in the literature about the extent, type and nature of risk involved in these services. Method: A scoping review was systematically conducted to map the common areas of risk (risk domains) from an occupational therapy perspective. Thematic analysis was conducted in order to identify the risk characteristics related to the literature reviewed. Results: Twenty-five journal articles were identified and arranged into ten risk domains: falls, discharge, practice errors, activities of daily living, pressure care, frailty management, patient handling, loneliness, nutritional care, and language barriers. Three risk characteristics were identified 1) Risk awareness and identifying risk, 2) Decision-making under risk 3) Improving safety. Conclusion: Occupational therapists play a diverse role in mitigating risk for older people which is not fully explored beyond addressing deficits in functional ability and hazardous environments. The process of how risk is controlled, reconciled with occupation and how positive risk-taking is facilitated are implicit and not directly addressed within the literature reviewed. The findings reveal gaps in knowledge and provide a foundation for further research

Intelligent assistive technology devices for persons with dementia : a scoping review

Assistive technology with context-aware computing and artificial intelligence capabilities can be applied to address cognitive and communication impairments experienced by persons with dementia (PwD). This research aims to provide an overview of current literature regarding characteristics of intelligent assistive technology devices (IATDs) for cognitive and communicative impairments of PwD as well as of the areas of impairment addressed by the IATDS. A multi-faceted systematic search strategy involving three electronic database platforms, two electronic databases and three electronic journals yielded records produced over the past decade. Predefined criteria were applied for inclusion and data extraction. Data was thematically analysed and synthesised. This review demonstrates that the bulk of research involving IATDs over the past decade has focused on cognitive impairments of PwD and has not yet evolved past the conceptual or prototype stages of development. A summary of commercially available IATDs for PwD is provided at the end of this review. This research concluded that IATDs for PwD primarily focus on social robots, especially PARO, and that they address cognitive impairments of attention and affect, as well as social-pragmatic communicative impairments. Few IATDs address the linguistic impairments experienced by PwD. Future research should involve collaboration between computer engineering and health practitioners to address the identified gaps and to contribute to evidence-based decision making for PwD.Mini Dissertation (MAAC)--University of Pretoria, 2019.Centre for Augmentative and Alternative Communication (CAAC)MAACUnrestricte

The case for investment in technology to manage the global costs of dementia

Worldwide growth in the number of people living with dementia will continue over the coming decades and is already putting pressure on health and care systems, both formal and informal, and on costs, both public and private. One response could be to make greater use of digital and other technologies to try to improve outcomes and contain costs. We were commissioned to examine the economic case for accelerated investment in technology that could, over time, deliver savings on the overall cost of care for people with dementia. Our short study included a rapid review of international evidence on effectiveness and cost-effectiveness of technology, consideration of the conditions for its successful adoption, and liaison with people from industry, government, academic, third sector and other sectors, and people with dementia and carers. We used modelling analyses to examine the economic case, using the UK as context. We then discussed the roles that state investment or action could play, perhaps to accelerate use of technology so as to deliver both wellbeing and economic benefits