Palliative home-based technology from a practitioner's perspective: benefits and disadvantages

This critical review paper explores the concept of palliative home-based technology from a practitioner's perspective. The aim of the critical review was to scope information available from published and unpublished research on the current state of palliative home-based technology, practitioner-focused perspectives, patient-focused perspectives, quality of life, and the implications for clinical practice. Published and unpublished studies were included. An example of one UK patient-centered home-based technology is explored as an exemplar. The evidence suggests that despite the challenges, there are numerous examples of good practice in relation to palliative home-based technology. Improvements in technology mean that telehealth has much to offer people being cared for at home with palliative needs. However, some of the evaluative evidence is limited, and further rigor is needed when evaluating future technology-based solutions innovations

What is the scope to test a smoking cessation intervention aimed at young people admitted to hospital?

Background: Young adults are reluctant to use evidence-based smoking cessation interventions. Subsequently, they are less successful at giving up smoking compared to older adults. This highlights the need for innovative strategies to engage young people in smoking cessation. A novel intervention using photoageing technology has been shown to be an effective trigger for smoking cessation. Aims: To conduct a pilot study deploying photoageing care technology to trigger smoking cessation attempts in young adults admitted to hospital. Method: A randomised controlled trial was designed. Thirty participants were recruited from a regional hospital in Melbourne, Australia. Participants were allocated to the intervention and control groups on alternate weeks. All participants received brief smoking cessation advice. The intervention group was digitally aged using the APRIL Face Aging Software. The primary outcomes were measured at six weeks’ post-intervention and included number of quit attempts, nicotine dependence, and progression through the stages of change model. Results: At six weeks’ post-intervention, there was no difference in quit attempts between the two groups (Mann-Whitney U=111 and p=0.484). There was also no difference in nicotine dependence (Mann-Whitney U=106 and p=0.403) or stage of change (2=1.71 and p=0.634) between the groups. Conclusion: Hospitalisation is associated with a number of barriers, which prevent the implementation of photoageing technology in this setting. Of these barriers, participant recruitment and retention pose the greatest challenge. Due to these considerations, it was not possible to demonstrate an effect size with any confidence

Opening the Black Box: Explaining the Process of Basing a Health Recommender System on the I-Change Behavioral Change Model

Recommender systems are gaining traction in healthcare because they can tailor recommendations based on users' feedback concerning their appreciation of previous health-related messages. However, recommender systems are often not grounded in behavioral change theories, which may further increase the effectiveness of their recommendations. This paper's objective is to describe principles for designing and developing a health recommender system grounded in the I-Change behavioral change model that shall be implemented through a mobile app for a smoking cessation support clinical trial. We built upon an existing smoking cessation health recommender system that delivered motivational messages through a mobile app. A group of experts assessed how the system may be improved to address the behavioral change determinants of the I-Change behavioral change model. The resulting system features a hybrid recommender algorithm for computer tailoring smoking cessation messages. A total of 331 different motivational messages were designed using 10 health communication methods. The algorithm was designed to match 58 message characteristics to each user pro le by following the principles of the I-Change model and maintaining the bene ts of the recommender system algorithms. The mobile app resulted in a streamlined version that aimed to improve the user experience, and this system's design bridges the gap between health recommender systems and the use of behavioral change theories. This article presents a novel approach integrating recommender system technology, health behavior technology, and computer-tailored technology. Future researchers will be able to build upon the principles applied in this case study.European Union's Horizon 2020 Research and Innovation Programme under Grant 68112

Motivations, Classification and Model Trial of Conversational Agents for Insurance Companies

Advances in artificial intelligence have renewed interest in conversational agents. So-called chatbots have reached maturity for industrial applications. German insurance companies are interested in improving their customer service and digitizing their business processes. In this work we investigate the potential use of conversational agents in insurance companies by determining which classes of agents are of interest to insurance companies, finding relevant use cases and requirements, and developing a prototype for an exemplary insurance scenario. Based on this approach, we derive key findings for conversational agent implementation in insurance companies.Comment: 12 pages, 6 figure, accepted for presentation at The International Conference on Agents and Artificial Intelligence 2019 (ICAART 2019

A novel approach to reduce sedentary behaviour in care home residents: the GET READY study utilising service-learning and co-creation

The GET READY study aimed to integrate service-learning methodology into University degrees by offering students individual service opportunities with residential care homes, to co-create the best suited intervention to reduce the sedentary behaviour (SB) of residents throughout the day, with researchers, end-users, care staff, family members and policymakers. Eight workshops with care home residents and four workshops with care staff, relatives and policymakers, led by undergraduate students, were audiotaped, transcribed verbatim and analysed with inductive thematic analysis to understand views and preferences for sustainable strategies to reduce SB and increase movement of residents. Perspectives about SB and movement in care homes highlighted four subthemes. Assets for decreasing SB included three subthemes, and suggestions and strategies encapsulated four subthemes. There is a need to include end-users in decision making, and involve care staff and relatives in enhancing strategies to reduce SB among residents if we want sustainable changes in behaviour. A change in the culture at a policymaker and care staff's level could provide opportunities to open care homes to the community with regular activities outside the care home premises, and offer household chores and opportunities to give residents a role in maintaining their home environment

Virtual Clinical Trials: One Step Forward, Two Steps Back

Virtual clinical trials have entered the medical research landscape. Today’s clinical trials recruit subjects online, obtain informed consent online, send treatments such as medications or devices to the subjects’ homes, and require subjects to record their responses online. Virtual clinical trials could be a way to democratize clinical research and circumvent geographical limitations by allowing access to clinical research for people who live far from traditional medical research centers. But virtual clinical trials also depart dramatically from traditional medical research studies in ways that can harm individuals and the public at large. This article addresses the issues presented by virtual clinical trials with regard to: (1) recruitment methods; (2) informed consent; (3) confidentiality; (4) potential risks to the subjects; and (5) the safety and efficacy of treatments that are approved

Evaluation of TRANSFoRm Mobile eHealth Solution for Remote Patient Monitoring during Clinical Trials

Today, in the digital age, the mobile devices are more and more used to aid people in the struggle to improve or maintain their health. In this paper, the mobile eHealth solution for remote patient monitoring during clinical trials is presented, together with the outcomes of quantitative and qualitative performance evaluation. The evaluation is a third step to improve the quality of the application after earlier Good Clinical Practice certification and validation with the participation of 10 patients and three general practitioners. This time, the focus was on the usability which was evaluated by the seventeen participants divided into three age groups (18-28, 29-50, and 50+). The results, from recorded sessions and the eye tracking, show that there is no difference in performance between the first group and the second group, while for the third group the performance was worse, however, it was still good enough to complete task within reasonable time.Comment: 16 pages, 8 Figures, Results of EU FP7 TRANSFoRm projec