Assessment of ambient assisted living systems for patients with mild cognitive impairment

According to the World Health Organization, about 50 million people worldwide suffer from dementia. Ten million new cases added every year. Mild Cognitive Impairment (MCI) affects more than 15% of the population aged 65. Technological solutions, such as smart home technology with ubiquitous computing devices, 24/7 telemedical observation and support can alleviate the growing problem and lower pressure on the healthcare system. This approach is also preferable for homecare patients in distant and rural areas. MCI patients are mostly home-based. Ambient Assisted Living (AAL) systems provide tools for automatic registration of vital signs and other medically and socially important information. AAL system for MCI patients is a logical answer to the problem. At the same time, many of the proposed AAL systems are proprietary, technically complicated and have a high price tag for implementation and service. Also, some proposed technical solutions not entirely reflect the opinion of healthcare stakeholders. The current study was proposed as a way to bridge the possible differences in the positions. An online anonymous questionnaire for healthcare professionals was created to prove or disprove the number of interconnected hypotheses about the necessity and feasibility of AAL system for MCI patients. The main focus was made on the hypotheses: "There is necessity of AAL systems for the healthcare" and "AAL systems are capable of providing assistance for patients with Mild Cognitive Impairment". The questionnaire was presented to more than three hundred potential respondents. Around a hundred and twenty agreed to fill it, and sixty completed the whole questionnaire. Results were analyzed to produce some directions guideline for future technical applications of AAL systems for MCI patients and future research. Descriptive statistics show support for the implementation of general AAL and variants for MCI patients. Comparative analysis of ordinal data for specific groups of respondents is done with help of non-parametric tests. Mann–Whitney–Wilcoxon test and Kruskal-Wallis test are applied. Table questions results are analyzed with chisquare for frequency tables. Group analysis demonstrated relative positive uniformity in of responses in the support of AAL of MCI patients.Segundo a Organização Mundial da Saúde, cerca de 50 milhões de pessoas em todo o mundo sofrem de demência. Dez milhões de novos casos adicionados a cada ano. O comprometimento cognitivo leve (MCI) afeta mais de 15% da população com 65 anos. Soluções tecnológicas, como tecnologia de casa inteligente com dispositivos de computação onipresentes, observação e suporte telemédico 24 horas por dia, 7 dias por semana, podem aliviar o problema crescente e diminuir a pressão sobre o sistema de saúde. Essa abordagem também é preferível para pacientes de cuidados domiciliares em áreas distantes e rurais. Os pacientes com CCL são, em sua maioria, domiciliares. Os sistemas Ambient Assisted Living (AAL) fornecem ferramentas para registro automático de sinais vitais e outras informações médicas e socialmente importantes. O sistema AAL para pacientes com MCI é uma resposta lógica para o problema. Ao mesmo tempo, muitos dos sistemas AAL propostos são proprietários, tecnicamente complicados e têm um alto preço para implementação e serviço. Além disso, algumas soluções técnicas propostas não refletem inteiramente a opinião das partes interessadas na área da saúde. O presente estudo foi proposto como forma de colmatar as possíveis diferenças nas posições. Um questionário anônimo online para profissionais de saúde foi criado para comprovar ou refutar o número de hipóteses interligadas sobre a necessidade e viabilidade do sistema AAL para pacientes com CCL. O foco principal foi feito nas hipóteses: "Há necessidade de sistemas de AAL para a saúde" e "Os sistemas de AAL são capazes de prestar assistência a pacientes com Comprometimento Cognitivo Leve". O questionário foi apresentado a mais de trezentos respondentes potenciais. Cerca de cento e vinte concordaram em preenchê-lo e sessenta preencheram todo o questionário. Os resultados foram analisados para produzir algumas diretrizes para futuras aplicações técnicas de sistemas AAL para pacientes com MCI e pesquisas futuras. Estatísticas descritivas mostram suporte para a implementação de AAL geral e variantes para pacientes com CCL. A análise comparativa de dados ordinais para grupos específicos de respondentes é feita com a ajuda de testes não paramétricos. Aplicam-se os testes de Mann-Whitney-Wilcoxon e Kruskal-Wallis. Os resultados das questões da tabela são analisados com qui-quadrado para tabelas de frequência. A análise do grupo demonstrou relativa uniformidade positiva nas respostas no suporte de AAL de pacientes com CCL.Selon l'Organisation mondiale de la santé, environ 50 millions de personnes dans le monde souffrent de démence. Dix millions de nouveaux cas ajoutés chaque année. Les troubles cognitifs légers (MCI) touchent plus de 15 % de la population âgée de 65 ans. Les solutions technologiques, telles que la technologie de la maison intelligente avec des appareils informatiques omniprésents, l'observation et le soutien télémédicaux 24 heures sur 24, 7 jours sur 7, peuvent atténuer le problème croissant et réduire la pression sur le système de santé. Cette approche est également préférable pour les patients en soins à domicile dans les régions éloignées et rurales. Les patients MCI sont pour la plupart à domicile. Les systèmes Ambient Assisted Living (AAL) fournissent des outils pour l'enregistrement automatique des signes vitaux et d'autres informations importantes sur le plan médical et social. Le système AAL pour les patients MCI est une réponse logique au problème. Dans le même temps, bon nombre des systèmes AAL proposés sont propriétaires, techniquement compliqués et ont un prix élevé pour la mise en oeuvre et le service. De plus, certaines solutions techniques proposées ne reflètent pas entièrement l'opinion des acteurs de santé. L'étude actuelle a été proposée comme un moyen de combler les différences possible dans les positions. Un questionnaire anonyme en ligne destiné aux professionnels de la santé a été créé pour prouver ou réfuter le nombre d'hypothèses interconnectées sur la nécessité et la faisabilité du système AAL pour les patients MCI. L'accent a été mis principalement sur les hypothèses: "Il existe une nécessité de systèmes AAL pour les soins de santé" et "Les systèmes AAL sont capables de fournir une assistance aux patients atteints de troubles cognitifs légers". Le questionnaire a été présenté à plus de trois cents répondants potentiels. Environ cent vingt ont accepté de le remplir, et soixante ont rempli tout le questionnaire. Les résultats ont été analysés pour produire des lignes directrices pour les futures applications techniques des systèmes AAL pour les patients MCI et l'avenir de la recherche. Les statistiques descriptives montrent un soutien à la mise en oeuvre de l'AAL général et des variantes pour les patients MCI. L'analyse comparative des données ordinales pour des groupes spécifiques de répondants est effectuée à l'aide de tests non paramétriques. Le test de Mann-Whitney-Wilcoxon et le test de Kruskal-Wallis sont appliqués. Les résultats des questions de tableau sont analysés avec le chi carré pour les tableaux de fréquence. L'analyse de groupe a démontré une uniformité positive relative dans les réponses à l'appui de l'AAL des patients MCI

Is the timed-up and go test feasible in mobile devices? A systematic review

The number of older adults is increasing worldwide, and it is expected that by 2050 over 2 billion individuals will be more than 60 years old. Older adults are exposed to numerous pathological problems such as Parkinson’s disease, amyotrophic lateral sclerosis, post-stroke, and orthopedic disturbances. Several physiotherapy methods that involve measurement of movements, such as the Timed-Up and Go test, can be done to support efficient and effective evaluation of pathological symptoms and promotion of health and well-being. In this systematic review, the authors aim to determine how the inertial sensors embedded in mobile devices are employed for the measurement of the different parameters involved in the Timed-Up and Go test. The main contribution of this paper consists of the identification of the different studies that utilize the sensors available in mobile devices for the measurement of the results of the Timed-Up and Go test. The results show that mobile devices embedded motion sensors can be used for these types of studies and the most commonly used sensors are the magnetometer, accelerometer, and gyroscope available in off-the-shelf smartphones. The features analyzed in this paper are categorized as quantitative, quantitative + statistic, dynamic balance, gait properties, state transitions, and raw statistics. These features utilize the accelerometer and gyroscope sensors and facilitate recognition of daily activities, accidents such as falling, some diseases, as well as the measurement of the subject's performance during the test execution.info:eu-repo/semantics/publishedVersio

A Review of Artificial Intelligence and Robotics in Transformed Health Ecosystems

Health care is shifting toward become proactive according to the concept of P5 medicine – a predictive, personalized, preventive, participatory and precision discipline. This patient-centered care heavily leverages the latest technologies of artificial intelligence (AI) and robotics that support diagnosis, decision making and treatment. In this paper, we present the role of AI and robotic systems in this evolution, including example use cases. We categorize systems along multiple dimensions such as the type of system, the degree of autonomy, the care setting where the systems are applied, and the application area. These technologies have already achieved notable results in the prediction of sepsis or cardiovascular risk, the monitoring of vital parameters in intensive care units, or in the form of home care robots. Still, while much research is conducted around AI and robotics in health care, adoption in real world care settings is still limited. To remove adoption barriers, we need to address issues such as safety, security, privacy and ethical principles; detect and eliminate bias that could result in harmful or unfair clinical decisions; and build trust in and societal acceptance of AI

Machine learning methods for detecting urinary tract infection and analysing daily living activities in people with dementia

Dementia is a neurological and cognitive condition that affects millions of people around the world. At any given time in the United Kingdom, 1 in 4 hospital beds are occupied by a person with dementia, while about 22% of these hospital admissions are due to preventable causes. In this paper we discuss using Internet of Things (IoT) technologies and in-home sensory devices in combination with machine learning techniques to monitor health and well-being of people with dementia. This will allow us to provide more effective and preventative care and reduce preventable hospital admissions. One of the unique aspects of this work is combining environmental data with physiological data collected via low cost in-home sensory devices to extract actionable information regarding the health and well-being of people with dementia in their own home environment. We have worked with clinicians to design our machine learning algorithms where we focused on developing solutions for real-world settings. In our solutions, we avoid generating too many alerts/alarms to prevent increasing the monitoring and support workload. We have designed an algorithm to detect Urinary Tract Infections (UTI) which is one of the top five reasons of hospital admissions for people with dementia (around 9% of hospital admissions for people with dementia in the UK). To develop the UTI detection algorithm, we have used a Non-negative Matrix Factorisation (NMF) technique to extract latent factors from raw observation and use them for clustering and identifying the possible UTI cases. In addition, we have designed an algorithm for detecting changes in activity patterns to identify early symptoms of cognitive decline or health decline in order to provide personalised and preventative care services. For this purpose, we have used an Isolation Forest (iForest) technique to create a holistic view of the daily activity patterns. This paper describes the algorithms and discusses the evaluation of the work using a large set of real-world data collected from a trial with people with dementia and their caregivers

Geospatial analysis of mental health in Switzerland: Impact of environmental factors on suicide risk

This quantitative statistical work deals with the relationship between environmental factors and suicide in Switzerland. Suicide is a serious public health problem and is associated with high economic costs for society. According to the WHO, one person in the world takes own life every 35 seconds. Despite its fatal consequences, suicide is still a taboo subject in society. The suicide rate in Switzerland has been declining since 2000, but it is still too high. Most suicides occur in spring and summer. Certain groups of people have a higher risk of taking their own lives. These include men, foreigners, the divorced, the widowed and the elderly. There are also differences between urban and rural areas and between different language regions. More people take their own lives in the countryside than in the city. The suicide rate is also lowest in the Italian-speaking part of Switzerland. Socio-cultural characteristics contribute to this pattern. The results of this work show that environmental factors have a direct influence of more than 2% on the suicide rate, but socio-economic position and urbanity together contribute more than 10% to the suicide rate. The environmental variable that contributes most to the suicide rate is air pollution, followed by temperature. For now, the impact is relatively small, but the predictive model shows that suicide rates will be higher in the future due to climate change. After comparing the adjusted with the unadjusted values as LISA clusters and Local Moran's I, there are no large differences between the observed suicide rates and the residuals. Only three regions show differences in residuals and observed suicide numbers pattern. Environmental factors, together with SSEP and land type, explain 15.45% of suicide rates. The rest is influenced by other factors that will not examined in this study. There are crucial factors that influence suicide rates which are due to lifestyle habits as well as psychological and sociological characteristics. Environmental factors are therefore not the main cause of suicide

Ambient assisted living systems for older people with Alzheimer’s

The older people population in the world is increasing as a result of advances in technology, public health, nutrition and medicine. People aged sixty or over were more than 11.5% of the global population in 2012. By 2050, this percentage is expected to be doubled to two billion and around thirty-three countries will have more than ten million people aged sixty or more each. With increasing population age around the word, medical and everyday support for the older people, especially those who live with Alzheimer’s who can't be trusted for consistence interaction with their environment, attract the attention of scientists and health care providers. Existing provisions are often deemed inadequate; e.g.; current UK housing services for the older people are inadequate for an aging population both in terms of quality and quantity. Many older people prefer to spend their remaining life in their home environment; over 40% of the older people have concerns about having to move into a care home when they become old and nearly 70% of them worry about losing their independence or becoming dependent on others. There is, therefore, a growing interest in the design and implementation of smart and intelligent Ambient Assisted Living (AAL) systems that can provide everyday support to enable the older people to live independently in their homes. Moreover, such systems will reduce the cost of health care that governments have to tackle in providing assistance for this category of citizens. It also relieves relatives from continuous and often tedious supervision of these people around the clock, so that their life and commitments are not severely affected. Hence, recognition, categorization, and decision-making for such peoples’ everyday life activities is very important to the design of proper and effective intelligent support systems that are able to provide the necessary help for them in the right manner and time. Consequently, the collection of monitoring data for such people around the clock to record their vital signs, environmental conditions, health condition, and activities is the entry level to design such systems. This study aims to capture everyday activities using ambient sensory II information and proposes an intelligent decision support system for older people living with Alzheimer’s through conducting field study research in the Kingdom of Saudi Arabia within their homes and health care centres. The study considers the older people, who live with Alzheimer’s in Kingdom of Saudi Arabia. Since Alzheimer’s is a special form of dementia that can be supported in early stages with the ambient assistive systems. Further, the results of the field study can also be generalized to societies, which are interested in the mental and cognitive behaviour of older people. This generalization is related to the existence of common similarities in their daily life. Moreover, the approach is a generalized approach. Hence it can also be utilized on a new society which is conducting the same field study. This study initially presents a real-life observation process to identify the most common activities for these patients’ group. Then, a survey analysis is carried out to identify the daily life activities based on the observation. The survey analysis is accomplished using a U-test (Mann-Whitney). According to the analysis, it has been found that these people have fourteen common activities. However, three of these activities such as sleeping, walking (standing) and sitting cover about 72% of overall activities. Therefore, this study focuses on the recognition of these three common activities to demonstrate the effectiveness of the research. The activity recognition is carried out using a common image processing technique, called Phase-Correlation and Log-Polar (PCLP) transformation. According to results, the techniques predicted human activities of about 43.7%. However, this ratio is low to utilise for further analysis. Therefore, an Artificial Neural Network (ANN)- based PCLP model is developed to increase the accuracy of activity recognition. The enhanced PCLP transformation method can predict nearly 80% of the evaluated activities. Moreover, this study also presents a decision support system for Alzheimer’s people, which will provide these people with a safe environment. The decision support system utilises an extended sensory-based system, including a vision sensor, vital signs sensor and environmental sensor with expert rules. The proposed system was implemented on an older people patient with 87.2% accuracy

Pathways to climate adapted and healthy low income housing

AbstractThis report presents the findings from the “Pathways to Climate Adapted and Healthy Low Income Housing” project undertaken by the CSIRO Climate Adaptation Flagship in partnership with two organisations responsible for providing social housing in Australia.The project was based on the premise that interactions between people, housing, and neighbourhood are dynamic and best viewed as a complex, dynamic social-ecological system. Using social housing as a case study, the objectives of the project were to:Model vulnerability of housing and tenants to selected climate change impacts;Identify/evaluate engineering, behavioural and institutional adaptation options;Scope co-benefits of climate adaptation for human health and well-being; andDevelop house typologies and climate analogues for national generalisations.This project was developed with the rationale that a multi-level focus on the cross-scale interactions between housing, residents, neighbourhood, and regional climate was vital for understanding the nature of climate change vulnerability and options for adaptation. The climate change hazards that were explored were increasing temperatures and more frequent and severe heatwaves in the context of heat-related health risks to housing occupants, and changes in radiation, humidity, and wind, in relation to material durability and service life of housing components and the implications for maintenance.Please cite as:Barnett G, Beaty RM, Chen D, McFallan S, Meyers J, Nguyen M, Ren Z, Spinks A, and Wang, X 2013 Pathways to climate adapted and healthy low income housing, National Climate Change Adaptation Research Facility, Gold Coast, pp. 110.This report presents the findings from the \u27Pathways to Climate Adapted and Healthy Low Income Housing\u27 project undertaken by the CSIRO Climate Adaptation Flagship in partnership with two organisations responsible for providing social housing in Australia.The project was based on the premise that interactions between people, housing, and neighbourhood are dynamic and best viewed as a complex, dynamic social-ecological system. Using social housing as a case study, the objectives of the project were to:Model vulnerability of housing and tenants to selected climate change impacts;Identify/evaluate engineering, behavioural and institutional adaptation options;Scope co-benefits of climate adaptation for human health and well-being; andDevelop house typologies and climate analogues for national generalisations.This project was developed with the rationale that a multi-level focus on the cross-scale interactions between housing, residents, neighbourhood, and regional climate was vital for understanding the nature of climate change vulnerability and options for adaptation. The climate change hazards that were explored were increasing temperatures and more frequent and severe heatwaves in the context of heat-related health risks to housing occupants, and changes in radiation, humidity, and wind, in relation to material durability and service life of housing components and the implications for maintenance

Ambient assisted living systems for older people with Alzheimer’s

The older people population in the world is increasing as a result of advances in technology, public health, nutrition and medicine. People aged sixty or over were more than 11.5% of the global population in 2012. By 2050, this percentage is expected to be doubled to two billion and around thirty-three countries will have more than ten million people aged sixty or more each. With increasing population age around the word, medical and everyday support for the older people, especially those who live with Alzheimer’s who can't be trusted for consistence interaction with their environment, attract the attention of scientists and health care providers. Existing provisions are often deemed inadequate; e.g.; current UK housing services for the older people are inadequate for an aging population both in terms of quality and quantity. Many older people prefer to spend their remaining life in their home environment; over 40% of the older people have concerns about having to move into a care home when they become old and nearly 70% of them worry about losing their independence or becoming dependent on others. There is, therefore, a growing interest in the design and implementation of smart and intelligent Ambient Assisted Living (AAL) systems that can provide everyday support to enable the older people to live independently in their homes. Moreover, such systems will reduce the cost of health care that governments have to tackle in providing assistance for this category of citizens. It also relieves relatives from continuous and often tedious supervision of these people around the clock, so that their life and commitments are not severely affected. Hence, recognition, categorization, and decision-making for such peoples’ everyday life activities is very important to the design of proper and effective intelligent support systems that are able to provide the necessary help for them in the right manner and time. Consequently, the collection of monitoring data for such people around the clock to record their vital signs, environmental conditions, health condition, and activities is the entry level to design such systems. This study aims to capture everyday activities using ambient sensory II information and proposes an intelligent decision support system for older people living with Alzheimer’s through conducting field study research in the Kingdom of Saudi Arabia within their homes and health care centres. The study considers the older people, who live with Alzheimer’s in Kingdom of Saudi Arabia. Since Alzheimer’s is a special form of dementia that can be supported in early stages with the ambient assistive systems. Further, the results of the field study can also be generalized to societies, which are interested in the mental and cognitive behaviour of older people. This generalization is related to the existence of common similarities in their daily life. Moreover, the approach is a generalized approach. Hence it can also be utilized on a new society which is conducting the same field study. This study initially presents a real-life observation process to identify the most common activities for these patients’ group. Then, a survey analysis is carried out to identify the daily life activities based on the observation. The survey analysis is accomplished using a U-test (Mann-Whitney). According to the analysis, it has been found that these people have fourteen common activities. However, three of these activities such as sleeping, walking (standing) and sitting cover about 72% of overall activities. Therefore, this study focuses on the recognition of these three common activities to demonstrate the effectiveness of the research. The activity recognition is carried out using a common image processing technique, called Phase-Correlation and Log-Polar (PCLP) transformation. According to results, the techniques predicted human activities of about 43.7%. However, this ratio is low to utilise for further analysis. Therefore, an Artificial Neural Network (ANN)- based PCLP model is developed to increase the accuracy of activity recognition. The enhanced PCLP transformation method can predict nearly 80% of the evaluated activities. Moreover, this study also presents a decision support system for Alzheimer’s people, which will provide these people with a safe environment. The decision support system utilises an extended sensory-based system, including a vision sensor, vital signs sensor and environmental sensor with expert rules. The proposed system was implemented on an older people patient with 87.2% accuracy