Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Strategic Intelligence Monitor on Personal Health Systems (SIMPHS): Report on Typology/Segmentation of the PHS Market

This market segmentation reports for Personal Health Systems (PHS) describes the methodological background and illustrates the principles of classification and typology regarding different fragments forming this market. It discusses different aspects of the market for PHS and highlights challenges towards a stringent and clear-cut typology or defining market segmentation. Based on these findings a preliminary hybrid typology and indications and insights are created in order to be used in the continuation of the SIMPHS project. It concludes with an annex containing examples and cases studies.JRC.DDG.J.4-Information Societ

De concentv amisso qvaerendo: An investigation into the relative benefits of three different types of ambient music on the observed agitated behaviour and quality of life of dementia sufferers in residential aged care facilities

There is an increasing body of research evidence to support the use of music as a therapeutic modality in reducing the agitated behaviour frequently associated with late-stage dementia. Although much of this evidence suggests that music interventions are most effective when they are “individualized”, this type of intervention is often difficult to implement in large, busy, aged care facilities where residents may be located together in communal areas during the day. The challenge therefore is to try and identify a particular musical genre which, when played as “ambient” or “background” music, demonstrates a consistent capacity to reduce agitated behaviour in late-stage dementia across resident populations in multiple facilities. This study was designed to test the comparative utility of three different types of background music identified in the existing research literature as being of possible benefit in this context. These three types of music were: gentle classical music, familiar music and baroque music. Using a sample of 65 older people with late-stage dementia living in a total of eight residential aged care facilities, this quasi-experimental study used quantitative measures to assess a specific range of agitated behaviours over a one week intervention period. The specific agitated behaviours were documented using the Scale for the Observation of Agitation in Persons with Dementia (SOAP-D) scale (Hurley, Volicer, Camberg, Ashley, Woods, Odenheimer, Ooi, McIntyre, & Mahoney, 1999). In addition, the Quality of Life in Alzheimer’s Disease (QoL-AD) tool (Logsdon, 1999) was used to collect collateral information from family members or experienced care staff at each of the participating facilities about whether they perceived that the playing of music exerted any influence on the quality of life of participants. Participants were randomly assigned to one of five experimental subgroups of equal size. Participants in three of the five groups received exposure to audio recordings of music. Participants in one of the two remaining sub-groups were exposed to a non-musical intervention (audio recordings of storybooks) at the same time of day as the participants in the three music groups. Data relating to behaviour and perceived quality of life were recorded in the same manner for this group. The final group of participants acted as the control group for the study. Quantitative data were collected in the same manner for this group: however, they were exposed to no intervention. In addition, a series of structured interviews was undertaken with experienced care providers at each of the participating residential aged care facilities. The purpose of this procedure was to determine whether the experiences and subjective opinions of staff regarding the utility of music as an intervention to settle agitated behaviour in late-stage dementia and improve quality of life were consistent with the observational data recorded using the SOAP-D scale in conjunction with the proxy-rated QoL-AD scale. Results of the study indicated that overall levels of agitated behaviour were less within the three groups exposed to music compared with the nonmusic intervention group and the control. However, perceived quality of life was not measurably improved in any of the three music intervention groups. This study supports the continued use of music as a therapeutic intervention in the management of maladaptive behaviour associated with late-stage dementia, although the results do not support the preferential use of any of the three selected music forms

Implementation of a computer-assisted method in teaching the Nyunga Nyunga Mbira

The study focuses on implementing computer-assisted instruction (CAI) as a method in teaching the nyunga nyunga mbira, to first-time music students at university. The research was undertaken at Midlands State University (MSU) in the Department of Music and Musicology I worked in the above department at MSU. I adopted the learner-centred and constructivist approach in my teaching. The study observed the cognitive load theory in multimedia, which calls for learning experiences commensurate to the mental capacities of students. Over- or under-loading students results in unfulfilled needs in teaching and learning. I enabled students’ involvement to give room to discovery learning. Through action research I aimed to find the efficacy of computer-assisted method, in teaching the mbira instrument. I chose 16 students (5 females and 11 males), on the basis of convenience and availability as music students. The 16 students covered 4 hours every week for two semesters, giving a total time of 128 hours of instruction and practice. The students were exposed to 10 nyunga nyunga mbira tunes. The method provided guidance to the playing of the instrument via the colour code (black, green and red) and audio playback. The method used a software based tuning guide for performers to tune their instruments. The method however requires adequate resources in basic computer skills, staff notation, rhythm and pitch prior to teaching. The study reveals that students need adequate materials and apt work (cognitive load theory) to avoid over and under loading them. Also playback enables students to gradually gain confidence as they learnt to play the tunes, the volume and tempo are adjustable to suit the needs of students. I discovered that the instructor should analyse and study each tune carefully so that complex tunes are taught at a later time after students have gained confidence in using the method. It was noted that materials for teaching should be sequenced from simple to complex to enable skills acquisition. All the students managed to play the 10 tunes at their own paces as their performance was above average. It is concluded that CAI requires sufficient guidance to reduce on instructor’s personal involvement. The method requires enough resources in terms skills of instructors, and purchase of requirements, in computers and notation software. It is practically feasible to apply CAI as a method in the tuition of the nyunga nyunga mbira. I recommend the use of the colour code instead of numbers as aide to sight-reading. Complex tunes require more time hence their introduction should be delayed. Basic knowledge in computers and music theory are critical for students to play mbira using CAI. The size of class should range 15-20 and a number more than 20 should be divided into two groups for adequate management of resources. I recommend that research be done with other mbira types played at universities.Art History, Visual Arts and Musicolog

Secured and Smart Electronic voting system

Now a days various displays are  becoming available for implementing a new kind of human computer interaction (HCI) method. Among them, touch  panel  displays  have  been used in wide variety of applications and are proven to be a useful interface infrastructure. We exemplify our approach through the design and development of secured & smart ectronic voting system. As the Supreme Court recently ordered to include the “Reject” option, so that the voter can reject if he is not interested in any party. This touch screen  based electronic voting system provides confirmation after selecting a party from the list. A beep sound will be generated when the voter presses the confirmation so that the vote will be casted successfully to a right party. This type of electronic voting systems allow easy confirmation and casting of vote without any assistance. This system also provides security by entering the voter ID whether it is correct or not. We also conducted a preliminary evaluation to verify the effectiveness of the system

City Rhythm

Rhythm is fundamental to life. Rhythm can be perceived in the movement of the sun, the moon and the stars. Rhythm makes our hearts tick and defines our breath, in and out. And even the smallest particle in a microbe is part of rhythmic movements. Rhythm in activities is important for culture, for religion, and for sports, schools and hospitals for example. Yet in social situations, social analyses and in social policymaking, rhythm is not considered as a space of analyses or a space of design. City Rhythm explores the potential of using rhythm analyses in the physical world and related data domain for enhancing social safety in neighbourhoods in the Netherlands. Rhythm in the physical world happens both in space as well as in time. Rhythm in data can connect to location (instead of persons), thus circumventing the issue of privacy. However, because the data addresses specific times and places, nonetheless the data still addresses significant social issues. Founded in the social sciences, humanities, arts and computer science, the interdisciplinary research team also includes civil servants of six cities in the Netherlands who have engaged throughout the research. With the help of students, nine case studies are carried out. Building upon methodologies from the social sciences and architecture, it is found that in seven cases rhythm analyses identified new design solution spaces. As a result, a methodology for doing rhythm analyses in the physical world is developed. More theoretical and artistic explorations are carried out. These enable the bridging of experience and insight from rhythm analyses to the data world. The interdisciplinary research team formulates the basic concept and terminology for the City Rhythm Data Model (CRDM). This consists of beats, base and street rhythms. Beats are defined by the state of specific area at a specific moment in time, As an example of a state, a street might have lots of cars, few cars, or no cars at all. Street rhythms show significant transitions over time for the specific area. The base rhythm of an area is defined by comparison to other areas. These derived rhythms are like a musical meter. In this specific context, individual street rhythms develop. Street rhythms represent a variation around a few specific themes. The City Rhythm Data Model (CRDM), based on mixtures of hidden Markov models, is built and run with open and linked data from the Central Bureau for Statistics (CBS) of the Netherlands. Areas can be represented using sizes in different datasets. City Rhythm worked with areas of 500 by 500 meters. The choice of datasets is defined by mapping upon the YUTPA framework which indicates trade-offs for trust. In the validation session of the City Rhythm Data Model it is concluded that the general experience of social safety of specific areas is reflected in CRDM base rhythms. For being able to understand which specific data constitute a beat (or “state”) and for understanding specific street rhythms, further research is necessary. In conclusion to the one year exploratory study, City Rhythm indicates that rhythm analyses, in the physical world as well as in the related data domain, offer a potential new approach for policymaking

City Rhythm

Rhythm is fundamental to life. Rhythm can be perceived in the movement of the sun, the moon and the stars. Rhythm makes our hearts tick and defines our breath, in and out. And even the smallest particle in a microbe is part of rhythmic movements. Rhythm in activities is important for culture, for religion, and for sports, schools and hospitals for example. Yet in social situations, social analyses and in social policymaking, rhythm is not considered as a space of analyses or a space of design. City Rhythm explores the potential of using rhythm analyses in the physical world and related data domain for enhancing social safety in neighbourhoods in the Netherlands. Rhythm in the physical world happens both in space as well as in time. Rhythm in data can connect to location (instead of persons), thus circumventing the issue of privacy. However, because the data addresses specific times and places, nonetheless the data still addresses significant social issues. Founded in the social sciences, humanities, arts and computer science, the interdisciplinary research team also includes civil servants of six cities in the Netherlands who have engaged throughout the research. With the help of students, nine case studies are carried out. Building upon methodologies from the social sciences and architecture, it is found that in seven cases rhythm analyses identified new design solution spaces. As a result, a methodology for doing rhythm analyses in the physical world is developed. More theoretical and artistic explorations are carried out. These enable the bridging of experience and insight from rhythm analyses to the data world. The interdisciplinary research team formulates the basic concept and terminology for the City Rhythm Data Model (CRDM). This consists of beats, base and street rhythms. Beats are defined by the state of specific area at a specific moment in time, As an example of a state, a street might have lots of cars, few cars, or no cars at all. Street rhythms show significant transitions over time for the specific area. The base rhythm of an area is defined by comparison to other areas. These derived rhythms are like a musical meter. In this specific context, individual street rhythms develop. Street rhythms represent a variation around a few specific themes. The City Rhythm Data Model (CRDM), based on mixtures of hidden Markov models, is built and run with open and linked data from the Central Bureau for Statistics (CBS) of the Netherlands. Areas can be represented using sizes in different datasets. City Rhythm worked with areas of 500 by 500 meters. The choice of datasets is defined by mapping upon the YUTPA framework which indicates trade-offs for trust. In the validation session of the City Rhythm Data Model it is concluded that the general experience of social safety of specific areas is reflected in CRDM base rhythms. For being able to understand which specific data constitute a beat (or “state”) and for understanding specific street rhythms, further research is necessary. In conclusion to the one year exploratory study, City Rhythm indicates that rhythm analyses, in the physical world as well as in the related data domain, offer a potential new approach for policymaking

Conception d'un clavier musical pour entraîner les fonctions motrices et cognitives dans la maladie d'Alzheimer

La maladie d’Alzheimer (MA) est la cause la plus fréquente de démence chez les personnes âgées. Un traitement n’a pas encore été trouvé, mais des études montrent que la combinaison de thérapies pharmacologiques et non pharmacologiques (TNP) peut ralentir la progression des symptômes de la maladie. Parmi les TNP, la thérapie musicale active ou musicothérapie active (TMA) a été largement utilisée. Cependant, cette approche requiert une supervision constante pour que la thérapie soit exécutée correctement. L’utilisation de technologies adaptées aux besoins des personnes avec MA pourrait alors leur permettre de participer de manière autonome aux sessions de TMA. Ce mémoire de maîtrise s’organise autour de deux articles scientifiques. Le premier est une recension des écrits au sujet de la TMA utilisée en MA. Le deuxième article présente la démarche de co-conception d’un prototype du dispositif de clavier musical surdimensionné capable de guider les utilisateurs atteints de MA (stade léger) à travers des sessions de TMA qui comprennent des activités musicales,cognitives et motrices. Des études complémentaires devront évaluer les effets de l’utilisation de ce dispositif musical sur les différents symptômes de la MA. Cependant, le matériau présenté dans le premier article de la thèse (recension des écrits) et les données en lien avec le deuxième article (co-conception), tels que les témoignages des participants au stage léger de la MA et les prototypes créés, indiquent que l’utilisation de ce clavier peut potentiellement atténuer les symptômes associés à la MA et ainsi améliorer la qualité de la vie de cette population.Alzheimer’s disease (AD) is the most common cause of dementia in the elderly. A cure has not yet been found, but studies show that the combination of pharmacological and non-pharmacological therapies (NPT) can slow down the progression of the symptoms of the disease. Among the NPT, active music therapy (AMT) has been widely used to help relieve the symptoms of dementia. However,most AMT require constant supervision or guidance so that the person with AD can participate in the therapy session and perform it correctly. The use of technologies specifically designed to meet the needs of this population could allow them to autonomously participate in AMT sessions.This master’s thesis is organized into two articles, the first is a literature review regarding the application of AMT in AD. The second article presents the co-design process of an oversized musical keyboard that can guide users with mild AD through AMT sessions that integrate musical, cognitive and motor tasks. Further studies should evaluate the effects of using this device on different symptoms of Alzheimer’s disease. However, the results presented in the first article of the thesis and the observations from the interactions between the participants (with mild AD) and the prototypes provided during the co-design process indicate that the use of this keyboard has the potential to alleviate symptoms related to AD and, thus, improve the quality of life

On the move and working alone: a study of Newfoundland and Labrador home care workers

Home care workers provide paraprofessional services to adults who require additional support to live within their homes. This manuscript dissertation examines Newfoundland and Labrador home care workers' employment-related geographical mobility (mobility to, from, and as part of work) and its consequences for these workers. Guided by insights from feminist political economy, it uses a mixed-methods approach comprising semi-structured interviews, a review of government policies, online collective agreements, census data, and an internet search for the term 'Newfoundland Ladies.' Chapter Two (manuscript #1) documents the dominant patterns of work-related mobility of two groups of home care workers, unionized workers in St. John's, Newfoundland who engage in daily local commutes (to one or more clients daily) and Southwest Newfoundland workers who commute up to thirteen hours for extended periods to work in Nova Scotia to provide live-in care. It examines the drivers and the multiscalar everyday rhythms of these two groups of home care workers and documents ways these mobilities influence the working conditions, the occupational health and safety risks, and the types of precarity associated with each. Chapter Three (manuscript #2) examines how the rhythms of place influence and are influenced by Southwest Newfoundland interprovincial E-RGM rhythms, examines the power relations found in these workers' everyday lives, and highlights mobile place-making. Chapter Four (manuscript #3) explores the complex commuting patterns of unionized home care workers and the corresponding work-related health and safety risks and reviews if the government and home care agency policies and collective agreements mitigate or exacerbate these risks. The dissertation contributes to the home care work and mobility literatures in three ways. First, it brings to the home care literature a mobility lens and offers recommendations to reduce related occupational health and safety risks. Second, it adds to the intersectional rhythmanalysis literature by comparing the rhythms of two forms of employment-related geographical mobility, argues that the rhythms of place are critical in understanding related rhythms, and combines elements of place ballet with intersectional rhythmanalysis to reveal mobile place-making processes. Third, it adds to the mobility literature by comparing interprovincial home care workers to workers engaged in daily local commutes and the accompanying rhythms, working conditions, and health and safety risks

Understanding the role of contrasting urban contexts in healthy aging: an international cohort study using wearable sensor devices (the CURHA study protocol).

BACKGROUND: Given the challenges of aging populations, calls have been issued for more sustainable urban re-development and implementation of local solutions to address global environmental and healthy aging issues. However, few studies have considered older adults' daily mobility to better understand how local built and social environments may contribute to healthy aging. Meanwhile, wearable sensors and interactive map-based applications offer novel means for gathering information on people's mobility, levels of physical activity, or social network structure. Combining such data with classical questionnaires on well-being, physical activity, perceived environments and qualitative assessment of experience of places opens new opportunities to assess the complex interplay between individuals and environments. In line with current gaps and novel analytical capabilities, this research proposes an international research agenda to collect and analyse detailed data on daily mobility, social networks and health outcomes among older adults using interactive web-based questionnaires and wearable sensors. METHODS/DESIGN: Our study resorts to a battery of innovative data collection methods including use of a novel multisensor device for collection of location and physical activity, interactive map-based questionnaires on regular destinations and social networks, and qualitative assessment of experience of places. This rich data will allow advanced quantitative and qualitative analyses in the aim to disentangle the complex people-environment interactions linking urban local contexts to healthy aging, with a focus on active living, social networks and participation, and well-being. DISCUSSION: This project will generate evidence about what characteristics of urban environments relate to active mobility, social participation, and well-being, three important dimensions of healthy aging. It also sets the basis for an international research agenda on built environment and healthy aging based on a shared and comprehensive data collection protocol