The use of a wearable camera to explore daily functioning of older adults living with persistent pain: Methodological reflections and recommendations

Background: Persistent pain is prevalent within the ageing population and impacts daily functioning. Measuring daily functioning using conventional measures is problematic and novel technologies offer an alternative way of observing these behaviours. Methods: This study aimed to consider the use of a wearable camera as a method of exploring a range of day-to-day patterns of functioning of older adults living with persistent pain. This study followed a mixed methods design. A purposive sample of 13 older adults (65±) with persistent pain (pain >3 months) took part in this study. Two younger adults (<65) with persistent pain and two older adults with no pain also participated. Individuals used a wearable camera (Microsoft SenseCam) for seven days Results: The wearable camera recorded the frequency of body position, movement, and activities of daily living. The wearable camera also presented contextual data of location, social interactions, use of assistive devices, and behavioural adaptations and was used to inform other methods of data collection. Conclusions: The wearable camera allowed insight into patterns and experiences of daily functioning that would not have otherwise been captured. However, not all aspects of functioning were recorded using the wearable camera, including the relationship between functioning and persistent pain

Experiences of using a wearable camera to record activity, participation and health-related behaviours: Qualitative reflections of using the Sensecam

Objective: Upcoming technology is changing the way that we are able to collect data looking into activity, social participation and health behaviours. Wearable cameras are one form of technology that allows us to automatically record a collection of passive images, building a visual diary of the user’s day. Whilst acknowledging the usefulness of wearable cameras in research, it is also important to understand individuals’ experiences whilst using them. The aim of this study was to explore the acceptance, experience and usability of a wearable camera (Microsoft_ Sensecam) to record the day-to-day activity and social participation of older people. Methods: A total of 18 older adults, who had worn the wearable camera for seven days, took part in semi-structured interviews. Results: Four themes emerged from the findings: ‘Intrusiveness’; ‘Importance of others’; ‘Remembering the wearable camera’; and ‘Ease of use’. Conclusions: Individuals’ expectations and experiences of using the wearable camera differed considerably. Participants believed that the wearable camera would be intrusive, difficult to use and would evoke public reaction; however, these worries were not borne out in experience. Individuals typically forgot about the presence of the wearable camera during use, remembering it only sporadically. One drawback to its use is that some participants were cautious of using the camera when around others, which impacted the amount of time the camera was worn, and, therefore, the nature of the data recorded. Design issues of the Sensecam were also a problem for the older adults in the study and affected their interaction with the technology

Acceptability of novel lifelogging technology to determine context of sedentary behaviour in older adults

<strong>Objective:</strong> Lifelogging, using body worn sensors (activity monitors and time lapse photography) has the potential to shed light on the context of sedentary behaviour. The objectives of this study were to examine the acceptability, to older adults, of using lifelogging technology and indicate its usefulness for understanding behaviour.<strong> </strong><strong>Method:</strong> 6 older adults (4 males, mean age: 68yrs) wore the equipment (ActivPAL^TM and Vicon Revue^TM/SenseCam^TM) for 7 consecutive days during free-living activity. The older adults’ perception of the lifelogging technology was assessed through semi-structured interviews, including a brief questionnaire (Likert scale), and reference to the researcher&#39;s diary. <strong>Results:</strong> Older adults in this study found the equipment acceptable to wear and it did not interfere with privacy, safety or create reactivity, but they reported problems with the actual technical functioning of the camera. <strong>Conclusion:</strong> This combination of sensors has good potential to provide lifelogging information on the context of sedentary behaviour

The assessment of pain in older people: UK National Guidelines

We are facing a huge increase in the older population over the next 30 years. This brings an anticipated increase in the prevalence of chronic pain and with this comes the challenge of assessment of pain in many varied settings. Our first iteration of this document was published in 2007. But there has been a proliferation of literature and research since then, so we have developed a new set of guidelines. Different patterns and sites of pain were seen in men and women. Age differences suggest that pain prevalence increased with age up to 85 years and then decreased. The available studies on barriers and attitudes to pain management point towards an adherence to bio-medically orientated beliefs about pain, concern amongst clinicians in relation to activity recommendations, and a negative orientation in general towards patients with chronic painful conditions. A multidisciplinary approach to the assessment and treatment of pain is essential, but the assessment is a complex process which is hampered by many communication issues, including cognitive ability and socio-cultural factors. Such issues are part of the UK ageing population. Structured pain education should be implemented that provides all health professionals (whether professionally or non-professionally trained) with standardised education and training in the assessment and management of pain according to level of experience. Although subjective, patient self-report is the most valid and reliable indicator of pain and it may be necessary to ask questions about pain in different ways in order to elicit a response. A number of valid and reliable self-report measures are available and can be used even when moderate dementia exists. The Numerical Rating Scale or verbal descriptors can be used with people who have mild to moderate cognitive impairment. For people with severe cognitive impairment Pain in Advanced Dementia (PAINAD) and Doloplus-2 are recommended. PAINAD and Doloplus-2 scales continue to show positive results in terms of reliability and validity. There has been no recent evaluation of the Abbey pain scale although it is widely used throughout the UK. There is a need for more research into pain assessment using the collaborative role of the multidisciplinary team in all care settings. Self-report questionnaires of function are limited in their ability to capture the fluctuations in capacity and ability. The concentration on items of relevance to the population of interest means that issues of personal relevance can be obscured. Strong associations were seen between pain and depressed mood with each being a risk factor for the other. Additionally, loneliness and social isolation were associated with an increased risk of pain. Clinicians should be cognisant that social isolation and or depressive signs and symptoms may be indicators of pre-existing pain or a predictor of future pain onset. There are a number of evidence based guidelines on pain assessment in older people with or without cognitive impairment from around the world, including Australia and Europe

IAPMA 2011: 2nd Workshop on information access to personal media archives

Towards e-Memories: challenges of capturing, summarising, presenting, understanding, using, and retrieving relevant information from heterogeneous data contained in personal media archives. Welcome to IAPMA 2011, the second international workshop on "Information Access for Personal Media Archives". It is now possible to archive much of our life experiences in digital form using a variety of sources, e.g. blogs written, tweets made, social network status updates, photographs taken, videos seen, music heard, physiological monitoring, locations visited and environmentally sensed data of those places, details of people met, etc. Information can be captured from a myriad of personal information devices including desktop computers, PDAs, digital cameras, video and audio recorders, and various sensors, including GPS, Bluetooth, and biometric devices

A cross-sectional study exploring levels of physical activity and motivators and barriers towards physical activity in haemodialysis patients to inform intervention development

Purpose. To describe physical activity (PA) levels and motivators and barriers to PA among haemodialysis patients and to identify an appropriate approach to increasing their PA. Methods. A cross sectional mixed methods study conducted in a tertiary and satellite haemodialysis unit. 101 participants aged 18 years and over, receiving regular haemodialysis for at least four months, were recruited. Patients with recent hospital admission or acute cardiac event were excluded. Participants completed health status (EQ-5D-3L™) and activity (Human Activity Profile) questionnaires. A subgroup were invited to wear accelerometers and wearable cameras to measure PA levels and capture PA episodes, to inform subsequent semi-structured interviews on motivators and barriers. Semi-structured interviews were analysed using the Framework Method informed by constructs of the Health Belief Model. Results. 98/101 completed the study (66 male, 32 female). For 68/98 participants, adjusted activity scores from the Human Activity Profile indicated ‘impaired’ levels of Physical Activity; for 67/98 participants, the EQ-5D-3L indicated problems with mobility. Semi-structured interviews identified general (fear of falls, pain) and disease specific barriers (fatigue) to PA. Motivators included tailored exercise programmes and educational support from health care professionals. Conclusions. Participants indicated a need for co-development with healthcare professionals of differentiated, targeted exercise interventions

Case studies in therapeutic SenseCam use aimed at identity maintenance in early stage dementia

In the absence of a medical cure for memory loss new technologies specialised in pervasive imaging are being incorporated into interventions for dementia. The practice of lifelogging is a digital capture of life experiences typically through mobile devices such as SenseCam. The lightweight wearable digital camera passively captures about 3,000 images a day. Lifelogging results in personal, recent prompts, potentially encouraging sharing of personal memories. This research investigated the incorporation of lifelogging technology into a therapeutic approach aimed to support people with dementia by using the Case Study method, an exploratory and descriptive approach. The case study is a method of empirical inquiry that enables investigation of phenomenon within its real life context. SenseCam therapy aimed to stimulate the cognition of a person with dementia, with support of their personal identity as its primary goal. SenseCam images were used as cues to meaningful discussions about the person’s recent memories. The images enabled a construction of a particular version of the participants’ identities mainly based in their recent past. On the contrary participants seemed to valorise their identity of their distant past. The SenseCam identity also contained uncensored details from participants’ lives as revealed by review of SenseCam images. The exposing nature of SenseCam images posed risks to the users’ privacy and showed the potential ethical risks of using lifelogging technology with people with dementia. There is limited literature on the practical recommendations on how to use lifelogging devices and how they affect people with dementia. The results from this research indicate that a number of factors should be considered when using lifelogging technology with people with dementia. Firstly the contextual factors of people with dementia including the level of cognitive impairment, existing coping mechanisms and the interaction patterns with the carer need to be considered. Secondly the technology should be used within a therapeutic framework and tailored to suit the individual needs of both people with dementia and their carers. Lastly intimate and unexpected details from the participant’s life should be discussed in an ethical and sensitive manner. Implications of not working within these boundaries show clear potential for undermining the human rights and potentially the wellbeing of people with dementia