Modeling an ambient agent to support depression relapse prevention

One of the challenges for the patients with a history of unipolar depression is to stay healthy throughout their lifetime.In principle, with more prior onset cases, it escalates the risk of the patients to fall into a relapse.In this paper, an ambient agent based model to support patients from relapse is presented. Theories and related works in depression relapse prevention provide a foundation for the formalization of the temporal properties to describe the model.This model was analyzed under several scenarios using simulation and automated verification

A model for continuous monitoring of patients with major depression in short and long term periods

The final publication is available at IOS Press through http://dx.doi.org/10.3233/THC-161289BACKGROUND AND OBJECTIVE: Major depressive disorder causes more human suffering than any other disease affecting humankind. It has a high prevalence and it is predicted that it will be among the three leading causes of disease burden by 2030. The prevalence of depression, all of its social and personal costs, and its recurrent characteristics, put heavy constraints on the ability of the public healthcare system to provide sufficient support for patients with depression. In this research, a model for continuous monitoring and tracking of depression in both short-term and long-term periods is presented. This model is based on a new qualitative reasoning approach. METHOD: This paper describes the patient assessment unit of a major depression monitoring system that has three modules: a patient progress module, based on a qualitative reasoning model; an analysis module, based on expert knowledge and a rules-based system; and the communication module. These modules base their reasoning mainly on data of the patient's mood and life events that are obtained from the patient's responses to specific questionnaires (PHQ-9, M.I.N.I. and Brugha). The patient assessment unit provides synthetic and useful information for both patients and physicians, keeps them informed of the progress of patients, and alerts them in the case of necessity. RESULTS: A set of hypothetical patients has been defined based on clinically possible cases in order to perform a complete scenario evaluation. The results that have been verified by psychiatrists suggest the utility of the platform. CONCLUSION: The proposed major depression monitoring system takes advantage of current technologies and facilitates more frequent follow-up of the progress of patients during their home stay after being diagnosed with depression by a psychiatrist.Peer ReviewedPostprint (author's final draft

A theoretical and practical approach to a persuasive agent model for change behaviour in oral care and hygiene

There is an increased use of the persuasive agent in behaviour change interventions due to the agent‘s features of sociable, reactive, autonomy, and proactive. However, many interventions have been unsuccessful, particularly in the domain of oral care. The psychological reactance has been identified as one of the major reasons for these unsuccessful behaviour change interventions. This study proposes a formal persuasive agent model that leads to psychological reactance reduction in order to achieve an improved behaviour change intervention in oral care and hygiene. Agent-based simulation methodology is adopted for the development of the proposed model. Evaluation of the model was conducted in two phases that include verification and validation. The verification process involves simulation trace and stability analysis. On the other hand, the validation was carried out using user-centred approach by developing an agent-based application based on belief-desire-intention architecture. This study contributes an agent model which is made up of interrelated cognitive and behavioural factors. Furthermore, the simulation traces provide some insights on the interactions among the identified factors in order to comprehend their roles in behaviour change intervention. The simulation result showed that as time increases, the psychological reactance decreases towards zero. Similarly, the model validation result showed that the percentage of respondents‘ who experienced psychological reactance towards behaviour change in oral care and hygiene was reduced from 100 percent to 3 percent. The contribution made in this thesis would enable agent application and behaviour change intervention designers to make scientific reasoning and predictions. Likewise, it provides a guideline for software designers on the development of agent-based applications that may not have psychological reactance

Wearable feedback systems for rehabilitation

In this paper we describe LiveNet, a flexible wearable platform intended for long-term ambulatory health monitoring with real-time data streaming and context classification. Based on the MIT Wearable Computing Group's distributed mobile system architecture, LiveNet is a stable, accessible system that combines inexpensive, commodity hardware; a flexible sensor/peripheral interconnection bus; and a powerful, light-weight distributed sensing, classification, and inter-process communications software architecture to facilitate the development of distributed real-time multi-modal and context-aware applications. LiveNet is able to continuously monitor a wide range of physiological signals together with the user's activity and context, to develop a personalized, data-rich health profile of a user over time. We demonstrate the power and functionality of this platform by describing a number of health monitoring applications using the LiveNet system in a variety of clinical studies that are underway. Initial evaluations of these pilot experiments demonstrate the potential of using the LiveNet system for real-world applications in rehabilitation medicine

Adherence to Pharmacological Smoking Cessation Treatment among Weight-Concerned Women

The concern about weight gain that usually accompanies smoking cessation is a substantial impediment to quitting for many women. Given that sustained-released (SR) bupropion is associated with decreased post-cessation weight gain (Jorenby et al., 1999), this pharmacological agent may be particularly effective in improving quit rates among weight-concerned women. Despite the increasing utilization of smoking cessation medications, such as bupropion, relatively little is known about adherence to these regimens. This study examined the rates, predictors, and sequalae of medication adherence among weight-concerned women participating in a 90-day smoking cessation program. In addition to receiving group behavior therapy, participants were randomized to receive either SR bupropion or placebo. Medication adherence was measured over time with electronic pill cap monitors, smoking cessation was measured by self-report and verified with carbon monoxide readings, and several psychosocial variables were assessed with self-report questionnaires. With 112 participants (91% Caucasian; mean age = 43, SD = 10 years), descriptive statistics were computed to summarize medication adherence, and linear and logistic regression analyses were used to predict medication adherence and prolonged smoking abstinence through the end of treatment, respectively. Overall medication adherence was less than optimal throughout the 90-day study period and adherence rates decreased during each successive 30-day period. Depending on the type of summary index, results indicated that medication adherence ranged from 26% to 73% over the 90-day period. Conscientiousness, openness to experience, social support and medication outcome expectancies measured at Week 6 were positively associated with 90-day medication adherence. Independent of medication status, medication adherence predicted increased likelihood of maintaining prolonged smoking abstinence. Follow-up cross-lagged panel design analyses indicated that medication adherence significantly predicted subsequent point-prevalence abstinence. Moreover, openness to experience and Week 6 social support predicted increased likelihood of maintaining prolonged smoking abstinence, and post-hoc analyses indicated that medication adherence mediated the associations between openness to experience and prolonged abstinence, and between Week 6 social support and prolonged abstinence. These results suggest that interventions designed either to modify psychosocial variables associated with medication adherence or to match treatments with individual differences may enhance adherence and possibly improve smoking cessation rates among weight-concerned women

Modeling technological change on telecenter effectiveness

Technological change (TC) is the overall process of continuous invention, innovation and diffusion of technology that aims at improving the quality of technical performance. Without TC, there would be no business growth and development particularly in a telecenter. A telecenter is public environments that people develop essential digital skills to access information and communications technologies to create, learn and achieve their specific needs. The major goal of a telecenter is to bridge the digital gap between the urban and the rural areas, and provide digital support services to the neighbouring community. Telecenter effective usage is a major issue of telecenter sustainability because it has been found that there a lack of usage. Hence, this study focused on identifying TC factors that contribute significantly to telecenter effectiveness. The first objective of the study was to identify the contributing factors of TC. The second objective was to construct a computational model based on selected factors obtained from objective 1. The third objective was to evaluate the effectiveness of the model. The research was conducted using the computational model approach through three phases: abstraction, formlization, and evaluation. The results showed that the computational model was able to show the effect of the selected TC on telecenter effectiveness in different types of scenarios. The usage of telecenter can be more effective by considering the TC factors that are appropriate

Positive Recovery

Addiction is a chronic, progressive, and self-perpetuating disease that profoundly diminishes individual, family, and community well-being. Every year in the U.S., drugs (including alcohol and tobacco) are responsible for 25% of hospital admissions, 25% of deaths, and hundreds of billions of dollars in lost productivity, healthcare costs, and criminal justice costs. Addiction adversely impacts every arena of life ranging from hedonistic pursuits, occupational success, familial and other supportive relationships, to a sense of meaning, physical health, and overall fulfillment of individual potential. Addiction is amenable to treatment, but our medical-model approach to addiction is merely effective for initiating abstinence and reducing symptoms. Interrupting addiction in the short term breaks its self-perpetuation and restores individual free will, but it does not build “recovery.” Recovery is a rich and full lifestyle that makes abstinence sustainable because it is accompanied by a rewarding and meaningful life. The medical model has limitations and offers myriad opportunities for improvement, as relapse rates during and soon after treatment remain high. Insights from positive psychology can increase the efficacy and effectiveness of addiction treatment by nurturing recovery. The Positive Recovery construct and curriculum applies positive psychology insights to help recovering addicts establish lifelong skills to pursue happier, more meaningful lives so that addiction is less tempting and relapse is less likely. This capstone discusses the rationale and evidence for an addiction curriculum that integrates existing effective approaches with interventions that enhance wellbeing through positive emotions, engagement, relationships, meaning, and achievement

Verification analysis of an agent based model in behaviour change process

This paper describes the verification analysis for agent formal model of behaviour change process. The verification analysis was based on two widely used approaches in agent formal evaluation namely mathematical and automated analysis. The mathematical analysis made use of stability equilibria point while the automated, made use of Temporal Trace Language (TTL). The results obtained verify the formal model validity

Stepped Care for Smoking Cessation: A Cost-Effectiveness Analysis and Simulation of Future Outcomes

It has been well established that smoking is the leading avoidable cause of premature morbidity and mortality in the United States and abroad. Smoking is attributable to over 400,000 annual deaths, and $193 billion in healthcare costs and lost productivity. Despite the apparent dangers and tremendous costs of tobacco use and dependence, smokers find difficulty quitting. Recently, stepped care has been proposed as a viable intensive approach for achieving long-term cessation. This research sought to evaluate cost-effectiveness of stepped care in a diverse population of smokers and analyze future health outcomes of smoking cessation. Cost-effectiveness analysis was conducted from an institutional perspective alongside an NIH-funded multi-site study, “Long-term Smoking Cessation Using Prescription Step Care” (STEP), which compared stepped care to a repeat care intervention. The outcome of interest was incremental cost per quit achieved by stepped care. Secondly, long-term cost-effectiveness of successful smoking cessation was analyzed using a societal perspective. A microsimulation model was developed to predict changes in morbidity and mortality over the lifetime for four smoking-related diseases (ischemic heart disease, cerebrovascular disease, lung cancer, and emphysema) due to successful cessation. Here, the outcome of interest was incremental cost per quality-adjusted life year due to successful cessation. Lastly, sensitivity analyses were conducted to gauge robustness of estimates. In the STEP study, costs for stepped versus repeat care were$875.09 and $422.26, respectively. Point-prevalence abstinence was validated among 20.5$49,025 and $48,956, respectively; QALYS gained were 8.62 and 8.6, for the aforementioned analyses. Successful cessation yielded incremental cost-effectiveness of$3,450 per QALY. In sensitivity analysis, incremental cost-effectiveness varied from cost-saving to $13,700 per QALY. Stepped care was not cost-effective relative to repeat intervention. Quitting at the UTHSC site and among ethnic minorities was low, despite better rates of participation. Higher depression scores may have attributed to these results. Success of repeat care in STEP affirms findings of two recent studies. However, long-term cessation did prove highly cost-effective. Smoking cessation interventions continue to be extremely cost-effective and provide sizable returns on investment to employers and payers alike; enhanced coverage of smoking cessation treatments and programs will likely increase quit attempts and ultimately, cessation

A formal model for analyzing manager’s performance during stress

Managers who are exposed to stress have the risk of taking insufficient decisions, which will affect their performance levels. The affect could be either positive or negative, depending on the individual’s perception on stress. Many inadequate conventional studies have been conducted for analyzing the complicated relationship of stress and performance. Hence this study introduces a formal model supports managers’ performance during stress. This model can be encapsulated within an intelligent agent or robots that can be used to support managers. The methodology was used to explore human cognitive processes during stress consisted of four phases: identification of local and non-local properties, conceptualization of the model of these properties, formalization, and evaluation. Deferential equations have been used in formalizing the properties. The developed model has been simulated by applying it to different scenarios. Mathematical analysis has been used for the evaluation of the model. Results showed that the formal model was able to show the effects of different levels of stress on managers’ performance