Big Data and the Internet of Things

Advances in sensing and computing capabilities are making it possible to embed increasing computing power in small devices. This has enabled the sensing devices not just to passively capture data at very high resolution but also to take sophisticated actions in response. Combined with advances in communication, this is resulting in an ecosystem of highly interconnected devices referred to as the Internet of Things - IoT. In conjunction, the advances in machine learning have allowed building models on this ever increasing amounts of data. Consequently, devices all the way from heavy assets such as aircraft engines to wearables such as health monitors can all now not only generate massive amounts of data but can draw back on aggregate analytics to "improve" their performance over time. Big data analytics has been identified as a key enabler for the IoT. In this chapter, we discuss various avenues of the IoT where big data analytics either is already making a significant impact or is on the cusp of doing so. We also discuss social implications and areas of concern.Comment: 33 pages. draft of upcoming book chapter in Japkowicz and Stefanowski (eds.) Big Data Analysis: New algorithms for a new society, Springer Series on Studies in Big Data, to appea

Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED).

BackgroundRecurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease. In addition, community health workers (CHWs) have played an integral role in reducing health disparities; however, their effectiveness in reducing vascular risk among stroke survivors remains unknown. Our objectives are to develop, test, and assess the economic value of a CCM-based intervention using an Advanced Practice Clinician (APC)-CHW team to improve risk factor control after stroke in an under-resourced, racially/ethnically diverse population.Methods/designIn this single-blind randomized controlled trial, 516 adults (≥40 years) with an ischemic stroke, transient ischemic attack or intracerebral hemorrhage within the prior 90 days are being enrolled at five sites within the Los Angeles County safety-net setting and randomized 1:1 to intervention vs usual care. Participants are excluded if they do not speak English, Spanish, Cantonese, Mandarin, or Korean or if they are unable to consent. The intervention includes a minimum of three clinic visits in the healthcare setting, three home visits, and Chronic Disease Self-Management Program group workshops in community venues. The primary outcome is blood pressure (BP) control (systolic BP <130 mmHg) at 1 year. Secondary outcomes include: (1) mean change in systolic BP; (2) control of other vascular risk factors including lipids and hemoglobin A1c, (3) inflammation (C reactive protein [CRP]), (4) medication adherence, (5) lifestyle factors (smoking, diet, and physical activity), (6) estimated relative reduction in risk for recurrent stroke or myocardial infarction (MI), and (7) cost-effectiveness of the intervention versus usual care.DiscussionIf this multi-component interdisciplinary intervention is shown to be effective in improving risk factor control after stroke, it may serve as a model that can be used internationally to reduce race/ethnic and socioeconomic disparities in stroke in resource-constrained settings.Trial registrationClinicalTrials.gov Identifier NCT01763203

Smart Moves Bright Bodies: A Rural Adaptation to Combat Obesity among African-American Teenagers in Wilcox and Lowndes Counties, Alabama

Obesity is a significant problem in the United States; however, it is a burgeoning epidemic among youth in the United States. As of 2016, Alabama is the second-most obese state in the nation1 and 16% of Alabama adolescents are obese2. While obesity is a significant problem across all ethnic groups, minorities bear a disproportionate burden in Alabama: one in five African-American adolescents is obese2. This disproportionate burden is demonstrated in two Alabama counties: Wilcox and Lowndes. Both counties are predominately African-American and rank in the bottom ten counties, statewide, for overall health outcomes9,14. Nearly 50% of residents in both counties are obese9,14 compared to the national average of 36.5%1. Several health indicators have been identified as possible contributors to the obesity epidemic in these counties: food insecurity, unemployment rates, poverty, poor dietary practices and physical inactivity. To mitigate the obesity prevalence among African-American teenagers in these counties, the Alabama Department of Public Health will implement the Smart Moves Bright Bodies program. Smart Moves Bright Bodies is a weight management program designed for obese and overweight adolescents. The program includes three components: physical activity, nutrition education, and behavior modification. The program is also designed to strengthen the family unit as parents and students are encouraged to identify healthier coping strategies and to prepare meals with healthier ingredients. Various partners such as the YMCA and local grocery stores will also help with reinforcement of sessions. The aim of the program is to help teenagers maintain a healthy weight while encouraging uptake of healthier lifestyle behaviors

Design, Implementation and Evaluation of a Game-Based Intervention Targeting Latino Children for Improving Obesity Outcomes

This paper presents the design, implementation and evaluation of a hybrid clinic plus home based intervention targeting Latino children to improve obesity outcomes. The intervention applies motivational game based learning and behavior change theories during design. Latino American children are the main target group for this study as they have significantly high obesity rates due to socio-economic conditions and lack of awareness. There have been several interventions that have targeted game based strategies in the clinic to promote health outcomes and some have even targeted obesity problems, however to our knowledge this is the first effort that adds an inhome component to the clinical intervention. We discuss in detail the challenges faced while designing and implementing this hybrid clinical trial. Finally, we present the evaluation results from a randomized clinical trial that recruited 101 children

Comparative effectiveness trial comparing MyPlate to calorie counting for mostly low-income Latino primary care patients of a federally qualified community health center: study design, baseline characteristics.

BackgroundPrimary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation.MethodsA comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation.AnalysisBaseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression.ResultsTwo thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m2; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality.ConclusionsThe two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality.Trial registrationNCT02514889 , posted on 8/4/2015

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

Coronary Heart Disease Prevention with a Focus on Diet Modifications in Female College Students at a Local Community College

In the United States, cardiovascular disease is the number one cause of death in women. The most common and deadly form of cardiovascular disease is coronary heart disease (CHD). Many coronary heart preventive education awareness programs focus on the adult women population (40 years old \u3e). By that time, many previous lifestyle choices such as poor dietary choices have contributed to the development of risk factors for developing CHD. Young college women (18-24 years old) have the ability to implement healthy diet choices, which in turn will help to decrease their risk for CHD development. Sinclair Community College is located in the city of Dayton, Ohio. Many that live in the city of Dayton are classified at greater risk for developing CHD due to race and economic status. This project focuses on evidence-based research studies on dietary strategies to help female college students minimize their risk factors for developing CHD and to encourage self-efficacy. A literature review was conducted with a focus on creating an evidenced-based approach to implement health promotion in those at risk for the development of coronary heart disease at Sinclair Community College. From the numerous findings in the literature, recommendations were made and categorized by level of evidence; strong, moderate, and weak recommendations. From those recommendations, five summarized recommendations were made. The information was compiled and disseminated to Sinclair faculty who assisted with this project