Progress in ambient assisted systems for independent living by the elderly

One of the challenges of the ageing population in many countries is the efficient delivery of health and care services, which is further complicated by the increase in neurological conditions among the elderly due to rising life expectancy. Personal care of the elderly is of concern to their relatives, in case they are alone in their homes and unforeseen circumstances occur, affecting their wellbeing. The alternative; i.e. care in nursing homes or hospitals is costly and increases further if specialized care is mobilized to patients’ place of residence. Enabling technologies for independent living by the elderly such as the ambient assisted living systems (AALS) are seen as essential to enhancing care in a cost-effective manner. In light of significant advances in telecommunication, computing and sensor miniaturization, as well as the ubiquity of mobile and connected devices embodying the concept of the Internet of Things (IoT), end-to-end solutions for ambient assisted living have become a reality. The premise of such applications is the continuous and most often real-time monitoring of the environment and occupant behavior using an event-driven intelligent system, thereby providing a facility for monitoring and assessment, and triggering assistance as and when needed. As a growing area of research, it is essential to investigate the approaches for developing AALS in literature to identify current practices and directions for future research. This paper is, therefore, aimed at a comprehensive and critical review of the frameworks and sensor systems used in various ambient assisted living systems, as well as their objectives and relationships with care and clinical systems. Findings from our work suggest that most frameworks focused on activity monitoring for assessing immediate risks while the opportunities for integrating environmental factors for analytics and decision-making, in particular for the long-term care were often overlooked. The potential for wearable devices and sensors, as well as distributed storage and access (e.g. cloud) are yet to be fully appreciated. There is a distinct lack of strong supporting clinical evidence from the implemented technologies. Socio-cultural aspects such as divergence among groups, acceptability and usability of AALS were also overlooked. Future systems need to look into the issues of privacy and cyber security

Exploring occupational irritant hand dermatitis amongst healthcare workers in NHS Grampian.

Occupational irritant hand dermatitis (OIHD) is emerging as an important risk caused by or made worse by work. OIHD can cause significant and long-term health issues, and can impact on an individual's employment. Healthcare workers (HCWs) are amongst the occupations with the highest incidence rates of OIHD. The principle aim of this thesis was to explore OIHD amongst HCWs in NHS Grampian. In order to provide a broad overview of the subject matter, the thesis used a three-study approach to explore, appraise and assess OIHD amongst HCWs. The three studies made a stand-alone contribution in an effort to: i) understand the prevalence and incidence of OIHD on a local and national level, by conducting a retrospective review of the available databases; ii) identify, appraise and synthesise the best available evidence on the effectiveness of interventions to prevent OIHD, by conducting a systematic review of the world-wide literature; iii) collect information on the distribution and determinants of OIHD in a sample of NHS Grampian HCWs, by analysing and discussing their views, experiences and perceptions. The key findings of Study I suggested that the period prevalence of OIHD amongst HCWs in NHS Grampian on a local level increased annually (2010: 1.11%, 2011: 1.34%, 2012: 2.65%, 2013: 1.45%, 2014: 2.40%, 2015: 3.35%) between 2010 and 2015, amongst the commonly accepted high-risk occupational groups. The systematic review from Study II identified a lack of studies that had evaluated the effectiveness of interventions for the primary prevention of OIHD. Meanwhile, Study III found that skin health and care for NHS Grampian HCWs is a significant part of their day-to-day job. Skin health and care at work is a multifaceted subject, consisting of facilitators and inhibitors that can affect the management, treatment and prevention of OIHD. The findings of this thesis contributed to the body of research and knowledge, by identifying and exploring gaps in the literature. It is advised that an educational, evidence-based intervention should be developed in order to prevent OIHD in HCWs within NHS Grampian; this would be in-keeping with the current drivers for creating holistically healthier workplaces

Policing Domestic Violence: Influences that Shape the Development of Response Behaviour

Police officer responses to incidents of domestic violence have received widespread criticism in recent years, but the focus of most studies on this topic has been on the experiences of victims and the work of police units established specifically to deal with domestic violence. As a consequence, the responses of front-line officers have received less attention. In particular, the ways in which they perceive and respond to domestic violence as they develop their careers within the police service are almost entirely unresearched. With this in mind, the aim of this research was precisely to map the shifts and changes (if any) in police officers' reactions and responses to domestic violence incidents during their first three years in service. Where previous researchers have examined officers' response to domestic violence in one temporal dimension and others have considered issues of acculturation and socialisation, the uniqueness of this research is in the way in which it has synthesised both these elements in the production of a more complex longitudinal study. Thus the research is informed by the experiences and perceptions of seven officers from their first day as a member of a Constabulary, through to their completion of three years' service. Observation of their probationer training and of the officers on duty, the design and completion of semi-structured interviews and the use of hypothetical scenarios comprise the primary research tools, with additional insights being gained through semi-structured interviews with the officers' tutor constables. The rich and deep insights that emerged from the fieldwork were made possible because of the development and maintenance of a relationship with a small number of officers over the period of three years. My status as a full-time employee of the Constabulary benefited me enormously in this regard. Through the development of this work, I have drawn from a variety of methodological and theoretical approaches but have been mostly persuaded by theories focused on aspects of feminism and symbolic interactionism. Using theories of power and gender in the context of domestic violence and applying these to observations made of the masculine organisational sub-culture of the police service, enables a picture to emerge of officers' explicit and implicit absorption of sub-cultural values, how they learn from their own experiences, how they learn to deal with domestic violence incidents from peers and colleagues, and influences of the training orientation and content. More specifically, I argue that as an organisation, the police service (through its staff) does little to extend officers' understanding of domestic violence either theoretically or actually. There was (and continued to be) a clear lack of recognition by the study's participants of the gendered power relations inherent in most incidents of domestic violence. The study considered the content and form of probationer domestic violence training in this regard and concludes by drawing attention to the importance of officers' tacit knowledge, or in other words, their understanding of domestic violence as a result of their societal socialisation. Crucially, the primary manifestation of this 'lack' of understanding was in officers' confusion over their precise (police) role when confronted with what they perceived to be domestic 'disputes' as opposed to domestic 'violence', where the latter were more easily recognised as requiring a law-and-order response, but where the former were considered as much less straightforward to deal with. Consequently, in most circumstances, officers tended to rely on their personal experiences and understandings as human beings rather than police officers, to guide their response. A contributory factor to the lack of clarity were the many parallels between the gendered power dynamic to be found in situations of domestic violence and the form and content of banter and behaviour in the workplace. The research is not simply an end in itself in terms of answering a particular set of research questions relating to police responses to domestic violence, but could also act as a vehicle for change

THE IMPACT OF GOVERNMENT-LINKED INVESTMENT COMPANIES IN MALAYSIA ON THE PERFORMANCE AND EARNINGS-MANAGEMENT OF THEIR PORTFOLIO COMPANIES

Research into the impact of government ownership on the financial performance and earnings-management of listed companies typically makes the assumption that the government is a monolithic entity and fails to consider that government ownership rights are usually administered by different types of government organisations. This thesis comprises two empirical studies to investigate whether the existence of different government investment organizations in Malaysia (called government-linked investment companies or GLICs,) which have differing objectives and control structures, also have different results in terms of performance and earnings-management. The portfolio companies that GLICs manage are known as government-linked companies (GLCs). The first empirical project explores the impact of GLC ownership structure (relating to the different group of GLCs, GLICs ownership concentration in GLCs, the existence of golden-share provisions and the presence of senior civil servants and of politicians on the boards of directors of GLCs) in terms of corporate performance as measured by accounting and market data. Using panel data of GLCs listed on the Main Board of Bursa Malaysia between 2004 and 2008, we provide evidence that in Malaysia the impact of government ownership on the financial performance of government-controlled listed companies varies depending on the type of organization managing the government’s ownership stakes. In the second empirical project, we investigate the impact of ownership structure (ownership types, blockholders and managerial ownership) on earnings-management practices of listed companies on the Main Board of Bursa Malaysia. This involved 2696 firm-year observations between 2004 and 2008. We provide evidence that firms in our sample indeed managed their reported earnings upward; firms controlled by private blockholders engage in earnings-management practices at a higher magnitude than GLCs controlled by government blockholders. Between the GLCs, we found no evidence of the impact of different GLICs had on GLCs earnings-management practices. This research is of interest to policy makers such as government, GLICs or regulators. In addition, the findings from both empirical projects are of potential interest to portfolio investment companies and minority or foreign investors who might either benefit from the presence of blockholders or might be exploited by their power to pursue self-interested objectives rather than shareholders’ value

Looking for harm in healthcare : can Patient Safety Leadership Walk Rounds help to detect and prevent harm in NHS hospitals? A case study of NHS Tayside

Today, in 21st century healthcare at least 10% of hospitalised patients are subjected to some degree of unintended harm as a result of the treatment they receive. Despite the growing patient safety agenda there is little empirical evidence to demonstrate that patient safety is improving. Patient Safety Leadership Walk Rounds (PSLWR) were introduced to the UK, in March 2005, as a component of the Safer Patients Initiative (SPI), the first dedicated, hospital wide programme to reduce harm in hospital care. PSLWR are designed, to create a dedicated ‘conversation’ about patient safety, between frontline staff, middle level managers and senior executives. This thesis, explored the use of PSLWR, as a proactive mechanism to engage staff in patient safety discussion and detect patient harm within a Scottish healthcare system- NHS Tayside. From May 2005 to June 2006, PSLWR were held on a weekly basis within the hospital departments. A purposive sample, (n=38) of PSLWR discussions were analysed to determine: staff engagement in the process, patient safety issues disclosed; recognition of unsafe systems (latent conditions) and actions agreed for improvement. As a follow-up, 42 semi-structured interviews were undertaken to determine staff perceptions of the PSLWR system. A wide range of clinical and non-clinical staff took part (n=218) including medical staff, staff in training, porters and cleaners, nurses, ward assistants and pharmacists. Participants shared new information, not formally recorded within the hospital incident system. From the participants perspectives, PSLWR, were non threatening; were easy to take part in; demonstrated a team commitment, from the Board to the ward for patient safety and action was taken quickly as a result of the ‘conversations’. Although detecting all patient harm remains a challenge, this study demonstrates PSLWR can be a useful tool in the patient safety arsenal for NHS healthcare organisations

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

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

Homicide Investigations in an Age of Austerity

Stories about homicides dominate the news and the number of fictional depictions of police investigations into them seem to multiple each year. However, we know little about what a real-life, routine homicide investigation entails. Academic inquiry into the topic is dominated by quantitative studies which attempt to identify what factors influence whether a case is cleared, but many of these are restricted to an assessment of the impact of situational factors, or case characteristics. A number of recently published qualitative studies have delved deeper into the topic, exploring through interviews with detectives, the impact of organizational factors such as staffing and workload, areas that are difficult to accurately conceptualize into a statistical model. This thesis adds to the qualitative literature by exploring the impact that government introduced austerity measures had on the ability of homicide detectives in London to solve murders. Twenty-one, in-depth interviews were completed with serving homicide detectives which explored their views on austerity and its impact on how homicide investigations were completed. The themes that emerged centered around factors that were within organizational control with officers believing that decisions made by senior leaders have more of an impact on their ability to do their job effectively than any government introduced austerity measures