Great Expectations of Integrated Care : an Investigation of Assumptions Regarding the Impacts of Integrated Care for Frail Elderly People on Formal and Informal Caregivers

Frail elderly people are increasingly being cared for in their own homes by both formal and informal caregivers. Integrated care models are therefore being developed to better coordinate formal and informal care for frail elderly people in communities. However, much remains unclear regarding the impacts of integrated care delivery on formal and informal caregivers. The aim of this dissertation was therefore to investigate the three main assumptions regarding the benefits of integrated care on formal and informal caregivers, i.e., that integrated care for the frail elderly (1) safeguards informal caregivers against the negative impacts of caregiving; (2) improves the work processes and experiences of formal caregivers; and (3) improves the interaction between formal and informal care over time. These assumptions were investigated in the real-life setting of an integrated care intervention for community-dwelling frail elderly people in the Walcheren region of the Netherlands. This intervention, the ‘Walcheren Integrated Care Model’ (WICM), consisted of the following evidence-based elements: a single entry-point, proactive frailty screening, comprehensive needs assessments, case management, multidisciplinary team meetings, protocols and treatment plans, a shared information and communication system, task specialization and tasks delegation, and the creation of a geriatric care network with a formal steering group. The results show that integrated care for the frail elderly can be expected to safeguard informal caregivers against some negative impacts of caregiving, but also that improvements for formal caregivers and formal-informal care interaction should not be readily expected. It is concluded that, as yet, most expectations regarding the benefits of integrated care for formal and informal caregivers remain unjustified

A VNF modeling approach for verification purposes

Network Function Virtualization (NFV) architectures are emerging to increase networks flexibility. However, this renewed scenario poses new challenges, because virtualized networks, need to be carefully verified before being actually deployed in production environments in order to preserve network coherency (e.g., absence of forwarding loops, preservation of security on network traffic, etc.). Nowadays, model checking tools, SAT solvers, and Theorem Provers are available for formal verification of such properties in virtualized networks. Unfortunately, most of those verification tools accept input descriptions written in specification languages that are difficult to use for people not experienced in formal methods. Also, in order to enable the use of formal verification tools in real scenarios, vendors of Virtual Network Functions (VNFs) should provide abstract mathematical models of their functions, coded in the specific input languages of the verification tools. This process is error-prone, time-consuming, and often outside the VNF developers’ expertise. This paper presents a framework that we designed for automatically extracting verification models starting from a Java-based representation of a given VNF. It comprises a Java library of classes to define VNFs in a more developer-friendly way, and a tool to translate VNF definitions into formal verification models of different verification tools

Relational Approach to Knowledge Engineering for POMDP-based Assistance Systems as a Translation of a Psychological Model

Assistive systems for persons with cognitive disabilities (e.g. dementia) are difficult to build due to the wide range of different approaches people can take to accomplishing the same task, and the significant uncertainties that arise from both the unpredictability of client's behaviours and from noise in sensor readings. Partially observable Markov decision process (POMDP) models have been used successfully as the reasoning engine behind such assistive systems for small multi-step tasks such as hand washing. POMDP models are a powerful, yet flexible framework for modelling assistance that can deal with uncertainty and utility. Unfortunately, POMDPs usually require a very labour intensive, manual procedure for their definition and construction. Our previous work has described a knowledge driven method for automatically generating POMDP activity recognition and context sensitive prompting systems for complex tasks. We call the resulting POMDP a SNAP (SyNdetic Assistance Process). The spreadsheet-like result of the analysis does not correspond to the POMDP model directly and the translation to a formal POMDP representation is required. To date, this translation had to be performed manually by a trained POMDP expert. In this paper, we formalise and automate this translation process using a probabilistic relational model (PRM) encoded in a relational database. We demonstrate the method by eliciting three assistance tasks from non-experts. We validate the resulting POMDP models using case-based simulations to show that they are reasonable for the domains. We also show a complete case study of a designer specifying one database, including an evaluation in a real-life experiment with a human actor

A new approach for operating powered wheelchairs by people with severe impairments

This paper discusses the introduction of mechanisms to adapt commercial powered wheelchairs in order to facilitate its driving by people with severe impairments. Several models of operation are proposed and the most promising, at the moment, called legacy adapted mode, is detailed. A part of the formal operation model is presented. The model is then used in the STAGE simulator, not only for its valuation, but also to tune operational parameters that will be specific of each patient and to train the patients without a real wheelchair

Prediction without Preclusion: Recourse Verification with Reachable Sets

Machine learning models are often used to decide who will receive a loan, a job interview, or a public benefit. Standard techniques to build these models use features about people but overlook their actionability. In turn, models can assign predictions that are fixed, meaning that consumers who are denied loans, interviews, or benefits may be permanently locked out from access to credit, employment, or assistance. In this work, we introduce a formal testing procedure to flag models that assign fixed predictions that we call recourse verification. We develop machinery to reliably determine if a given model can provide recourse to its decision subjects from a set of user-specified actionability constraints. We demonstrate how our tools can ensure recourse and adversarial robustness in real-world datasets and use them to study the infeasibility of recourse in real-world lending datasets. Our results highlight how models can inadvertently assign fixed predictions that permanently bar access, and we provide tools to design algorithms that account for actionability when developing models

Assistive VR Gym: Interactions with Real People to Improve Virtual Assistive Robots

Versatile robotic caregivers could benefit millions of people worldwide, including older adults and people with disabilities. Recent work has explored how robotic caregivers can learn to interact with people through physics simulations, yet transferring what has been learned to real robots remains challenging. Virtual reality (VR) has the potential to help bridge the gap between simulations and the real world. We present Assistive VR Gym (AVR Gym), which enables real people to interact with virtual assistive robots. We also provide evidence that AVR Gym can help researchers improve the performance of simulation-trained assistive robots with real people. Prior to AVR Gym, we trained robot control policies (Original Policies) solely in simulation for four robotic caregiving tasks (robot-assisted feeding, drinking, itch scratching, and bed bathing) with two simulated robots (PR2 from Willow Garage and Jaco from Kinova). With AVR Gym, we developed Revised Policies based on insights gained from testing the Original policies with real people. Through a formal study with eight participants in AVR Gym, we found that the Original policies performed poorly, the Revised policies performed significantly better, and that improvements to the biomechanical models used to train the Revised policies resulted in simulated people that better match real participants. Notably, participants significantly disagreed that the Original policies were successful at assistance, but significantly agreed that the Revised policies were successful at assistance. Overall, our results suggest that VR can be used to improve the performance of simulation-trained control policies with real people without putting people at risk, thereby serving as a valuable stepping stone to real robotic assistance.Comment: IEEE International Conference on Robot and Human Interactive Communication (RO-MAN 2020), 8 pages, 8 figures, 2 table

Conformance Analysis of Organizational Models in a new Enterprise Modeling Framework using Algebraic Graph Transformation - Extended Version

Organizational models play a key role in today's enterprise modeling. These models often show up as partial models produced by people with different conceptual understandings in a usually decentralized organization, where they are modeled in a distributed and non-synchronized fashion. For this reason, there is a first major need to organize partial organizational models within a suitable modeling framework, and there is a second major need to check their mutual conformance. This builds the basis to integrate the partial organizational models later on into one holistic model of the organization. Moreover, the partial models can be used for model checking certain security, risk, and compliance constraints. In order to satisfy the two major needs, this paper presents two mutually aligned contributions. The first one is a new enterprise modeling framework the EM-Cube. The second contribution is a new approach for checking conformance of models that are developed based on the suggested formal modeling technique associated with the proposed framework. In addition to that, we evaluate our potential solution against concrete requirements derived from a real-world scenario coming out of the finance industry

Production of Inflected Novel Words in Older Adults With and Without Dementia

While cognitive changes in aging and neurodegenerative disease have been widely studied, language changes in these populations are less well understood. Inflecting novel words in a language with complex inflectional paradigms provides a good opportunity to observe how language processes change in normal and abnormal aging. Studies of language acquisition suggest that children inflect novel words based on their phonological similarity to real words they already know. It is unclear whether speakers continue to use the same strategy when encountering novel words throughout the lifespan or whether adult speakers apply symbolic rules. We administered a simple speech elicitation task involving Finnish‐conforming pseudo‐words and real Finnish words to healthy older adults, individuals with mild cognitive impairment, and individuals with Alzheimer's disease (AD) to investigate inflectional choices in these groups and how linguistic variables and disease severity predict inflection patterns. Phonological resemblance of novel words to both a regular and an irregular inflectional type, as well as bigram frequency of the novel words, significantly influenced participants' inflectional choices for novel words among the healthy elderly group and people with AD. The results support theories of inflection by phonological analogy (single‐route models) and contradict theories advocating for formal symbolic rules (dual‐route models).While cognitive changes in aging and neurodegenerative disease have been widely studied, language changes in these populations are less well understood. Inflecting novel words in a language with complex inflectional paradigms provides a good opportunity to observe how language processes change in normal and abnormal aging. Studies of language acquisition suggest that children inflect novel words based on their phonological similarity to real words they already know. It is unclear whether speakers continue to use the same strategy when encountering novel words throughout the lifespan or whether adult speakers apply symbolic rules. We administered a simple speech elicitation task involving Finnish-conforming pseudo-words and real Finnish words to healthy older adults, individuals with mild cognitive impairment, and individuals with Alzheimer’s disease (AD) to investigate inflectional choices in these groups and how linguistic variables and disease severity predict inflection patterns. Phonological resemblance of novel words to both a regular and an irregular inflectional type, as well as bigram frequency of the novel words, significantly influenced participants’ inflectional choices for novel words among the healthy elderly group and people with AD. The results support theories of inflection by phonological analogy (single-route models) and contradict theories advocating for formal symbolic rules (dual-route models).Peer reviewe

Model Pengembangan Pedagang Kaki Lima (PKL) Kuliner di Kota Singkawang

Even though small businesses are informal, they should always be fostered and facilitated in order to develop these businesses to be more independent in the future. Not to mention, the role of small businesses are very real, especially in employment and to alleviate poverty in Indonesia. There are several important aspects that have not been paid attention for the success of culinary street vendors, for instances organizational, financial, infrastructure, sanitation, environmental and marketing aspects. The main aim of this paper is to examine these aspects that affect the culinary street vendors which is the based on the development model of culinary street vendors that is going to be built in Singkawang city. The methodology used in this paper is descriptive research by combining quantitative and qualitative data analysis. The findings of this study show that street vendors culinary have role in developing local economy and empowering local people because they are able to employ the labors that cannot be employed in the formal sector. The developed models of street vendors culinary that is going to be implemented in Singkawang are dispersed and concentrated models. Keywords: PKL Kuliner, Penataan, Sektor Informa