Discovering the typing behaviour of Parkinson's patients using topic models

Sensing health-related behaviours in an unobtrusive, ubiquitous and cost-effective manner carries significant benefits to healthcare and patient management. In this paper, we focus on detecting typing behaviour that is characteristic of patients suffering from Parkinson’s disease. We consider typing data obtained from subjects with and without Parkinson’s, and we present a framework based on topic models that determines the differing behaviours between these two groups based on the key hold time. By learning a topic model on each group separately and measuring the dissimilarity between topic distributions, we are able to identify particular topics that emerge in Parkinson’s patients and have low probability for the control group, demonstrating a clear shift in terms of key stroke duration. Our results further support the utilisation of key stroke logs for the early onset detection of Parkinson’s disease, while the method presented is straightforwardly generalisable to similar applications

Quality of life and palliative care need in multiple system atrophy and progressive supranuclear palsy : a pilot study using quantitative and qualitative methods

MD ThesisBackground Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP) are atypical Parkinsonian disorders which are rapidly progressive. The impact that Parkinsonian disorders has on quality of life (QoL) is increasingly understood, though less work has been done in MSA and PSP compared to Parkinson’s disease. The role of Palliative Care in enhancing QoL is beginning to be translated into clinical practice though fewer studies have been done in MSA and PSP compared with Parkinson’s disease. Methods A cross-sectional study of 23 MSA patients and 24 PSP patients was carried out, assessing aspects of QoL, depression, palliative symptoms and clinical milestones such as dysarthria. Carers for each disease type were assessed in terms of carer strain and QoL. A range of QoL measures including subjective, disease-specific and general QoL scores were taken with the aim of achieving a holistic impression of QoL and symptom burden. A subset of participants were selected for interviews to obtain personal perspectives of living with these conditions. The interviews were evaluated using thematic analysis, to gain a still fuller, richer picture of the implications of these diseases on QoL for patients and carers. The use of both quantitative and qualitative methods was intended to complement each other, with the recognition that QoL is a complex and subjective concept and cannot be encompassed using a single type of assessment. Results Using multiple linear regression, QoL was predicted for by depression and palliative need in MSA and PSP, with severity having an influence in PSP only. Carer mental well-being and patient depression influenced different aspects of carer QoL. Issues with legs was the highest-rated symptom in both groups and there was no significant difference in palliative need between MSA and PSP. Subjective QoL using the SEIQoL-DW score produced diverse domains which people felt influenced their QoL. The most commonly nominated were ‘family’ and ‘partner’; some domains in common were discussed in interviews. ii The overarching themes in interviews were connection to others, transitions (including adjustment) and seeking support, from peers, palliative care services and sourcing expertise for these rare conditions. Conclusion MSA and PSP have a profound effect on QoL, seen using a range of QoL scores. Depression and symptoms frequently managed in palliative care, predict for patient disease-specific QoL, though severity seems to have a greater impact on QoL in PSP compared with MSA. Carer QoL is impacted by patient depression and by carers’ own mental well-being. This work emphasises that QoL in progressive neurological disorders is heterogeneous and individual. Patients and their carers would likely benefit from an individualised, palliative approach supporting patients through the course of their disease, maximising QoL to enhance the experience of living with a progressive disease

Affective Medicine: a review of Affective Computing efforts in Medical Informatics

Background: Affective computing (AC) is concerned with emotional interactions performed with and through computers. It is defined as “computing that relates to, arises from, or deliberately influences emotions”. AC enables investigation and understanding of the relation between human emotions and health as well as application of assistive and useful technologies in the medical domain. Objectives: 1) To review the general state of the art in AC and its applications in medicine, and 2) to establish synergies between the research communities of AC and medical informatics. Methods: Aspects related to the human affective state as a determinant of the human health are discussed, coupled with an illustration of significant AC research and related literature output. Moreover, affective communication channels are described and their range of application fields is explored through illustrative examples. Results: The presented conferences, European research projects and research publications illustrate the recent increase of interest in the AC area by the medical community. Tele-home healthcare, AmI, ubiquitous monitoring, e-learning and virtual communities with emotionally expressive characters for elderly or impaired people are few areas where the potential of AC has been realized and applications have emerged. Conclusions: A number of gaps can potentially be overcome through the synergy of AC and medical informatics. The application of AC technologies parallels the advancement of the existing state of the art and the introduction of new methods. The amount of work and projects reviewed in this paper witness an ambitious and optimistic synergetic future of the affective medicine field

Smart Wearable Device for Reduction of Parkinson’s Disease Hand-Tremor

Parkinson\u27s disease is a neurodegenerative disorder that affects over 10 million people worldwide (Health Unlocked, 2017). People diagnosed with Parkinson\u27s Disease can experience tremors, muscular rigidity and slowness of movement. Tremor is the most common symptom and external agents like stress and anxiety can make it worse, which may cause complications to complete simple day-to-day tasks. Therefore Bio Protech proposes the development of a smart wearable device for reduction of the hand-tremors based on medical evidence that by applying vibration to the wrist may result in a reduction of the involuntary tremor. The device imitates the shape of a wristwatch and the vibration is supplied by motors placed around the wrist. The users will be given the possibility to regulate the frequency according to their needs using a mobile application connected via Bluetooth

The expert patient: an exploration of self-management in long term conditions

Chronic disease is the major challenge facing global health care. In tandem there has been the emergence of active and informed patients in western society, with the contemporary patient increasingly involved in decisions about their treatment and care. However, while it is acknowledged that the vast majority of chronic disease management is via self-care and effective self-management has a potentially significant effect on reducing resource demand, there has been comparatively little research on the concept of the expert self-managing patient within chronic disease. The aims of this study were therefore to: " Investigate how patient expertise is viewed, interpreted, defined and experienced by patients and clinicians. " Understand how patient expertise is promoted and enabled through the self-management process. " Discover how patient expertise is enhanced or impeded by other mechanisms. Adopting a grounded theory approach underpinned by critical realism, the study commenced with three focus groups with patients and seven focus groups conducted with nurses and physiotherapists. Using the emergent themes as a starting point for constant comparative analysis, concurrent data collection via semi-structured interviews and observation was conducted. This included interviews with twenty two patients, twelve clinicians including doctors, nurses and physiotherapists and two Expert Patients Programme lay tutors. Observation was undertaken with ten consultant and nurse-led clinics, a six week Expert Patients Programme and an eight week Back Fitness Course. A storyline is described that illustrates the journey of the expert patient and the thesis explores the barriers and enablers on this journey. A typology of the expert patient is developed in which it is shown that expert patients fall into four quadrants with overt acceptors as the idealized patient within medical consultations. The findings suggest that many expert patients learned characteristics of being succinct and non-emotional when communicating with clinicians, but at the cost of not being able to articulate the emotional consequences of living with chronic disease. Variance from this idealized type leads to conflict which is explored through theories of the medical division of labour. It is concluded that the typology of the expert patient should be widely discussed and acknowledged as a framework for professional and lay practice. In particular, there should be explicit recognition of the emotional needs of people with chronic illness. Recommendations for policy and practice are generated that include acknowledgement of the expert patient beyond the medically idealised type. It is suggested that within the Expert Patients Programme there should be a move away from the current rigid content and delivery style and a greater focus on the subjective experience of chronic illness. Lay tutors would benefit from developing skills to support the psychological needs of participants. Furthermore, it is suggested that the behaviours and working environment that characterised nurse specialists should be used as a template for good practice to enable clinicians to meet the needs of expert patients. Finally, recommendations are made for inter-professional education. It is suggested that the skills of a variety of expert patients beyond the idealized overt-acceptor type are utilised in order to expose clinicians to a fuller range of patient narratives surrounding the experience of chronic disease

Expression profiling of drug response-from genes to pathways

Understanding individual response to a drug—what determines its efficacy and tolerability—is the major bottleneck in current drug development and clinical trials. Intracellular response and metabolism, for example through cytochrome P- 450 enzymes, may either enhance or decrease the effect of different drugs, dependent on the genetic variant. Microarrays offer the potential to screen the genetic composition of the individual patient. However, experiments are “noisy” and must be accompanied by solid and robust data analysis. Furthermore, recent research aims at the combination of highthroughput data with methods of mathematical modeling, enabling problem-oriented assistance in the drug discovery process. This article will discuss state-of-the-art DNA array technology platforms and the basic elements of data analysis and bioinformatics research in drug discovery. Enhancing single-gene analysis, we will present a new method for interpreting gene expression changes in the context of entire pathways. Furthermore, we will introduce the concept of systems biology as a new paradigm for drug development and highlight our recent research—the development of a modeling and simulation platform for biomedical applications. We discuss the potentials of systems biology for modeling the drug response of the individual patient