Improving personalized elderly care: an approach using cognitive agents to better assist elderly people

Tesis por compendio de publicaciones[ES]El envejecimiento de la población a nivel global es una constante cada vez más presente en el día a día y las consecuencias derivadas de este problema son cada vez más impactantes para el correcto funcionamiento y estructuración de la sociedad. En este contexto, hablamos de consecuencias a nivel de crecimiento económico, estilos de vida (y jubilación), relaciones familiares, recursos disponibles por el gobierno a la franja etaria más anciana e inevitablemente la prevalencia de enfermedades crónicas. Es ante esta realidad que surge la necesidad de desarrollo y promoción de estrategias eficaces en el acompañamiento, prevención y estímulo al envejecimiento activo y saludable de la población para garantizar que las personas ancianas continúen teniendo un papel relevante en la sociedad en lugar de someterse al aislamiento y fácil deterioro de las capacidades físicas, cognitivas, emocionales y sociales. De esta forma, tiene todo el sentido aprovechar todos los desarrollos tecnológicos verificados en los últimos años, principalmente en lo que se refiere a avances en las áreas de dispositivos móviles, inteligencia artificial y sistemas de monitoreo y crear soluciones capaces de brindar apoyo diariamente al recopilar datos e indicadores del estado de salud y, en respuesta, proporcionar diversas acciones personalizadas que motiven la adopción de mejores hábitos de salud y medios para lograr este envejecimiento activo y saludable. El desafío consiste en motivar a esta población a conciliar su día a día con el interés y la voluntad de utilizar aplicaciones y sistemas que brinden este apoyo personalizado. Algunas de las abordajes recientemente explorados en la literatura con este objetivo y que han alcanzado resultados prometedores se basan en la utilización de técnicas de gamificación e incentivo al cumplimiento de desafíos a nivel de salud (como si la persona estuviera jugando un juego) y la utilización de interacciones personalizadas con objetos (ya sean físicos como robots o virtuales como avatares) capaces de brindar feedback más personal, creando así una conexión más cercana entre ambas entidades. El trabajo aquí presentado combina estas ideas y resulta en un enfoque inteligente para la promoción del bienestar de la población anciana a través de un sistema de cuidados de salud personalizado. Este sistema incorpora diversas técnicas de gamificación para la promoción de mejores hábitos y comportamientos, y la utilización de un asistente virtual cognitivo capaz de entender las necesidades e intereses del usuario para posibilitar un feedback e interacción personalizados con el fin de ayudar y motivar al cumplimiento de los diferentes desafíos y objetivos que se identifiquen. El enfoque propuesto fue validado a través de un estudio con 12 usuarios ancianos y se lograron resultados significativos en términos de usabilidad, aceptación y efectos de salud. Específicamente, los resultados obtenidos permiten respaldar la importancia y el efecto positivo de combinar técnicas de gamificación e interacción con un asistente virtual cognitivo que traduzca el progreso del estado de salud del usuario, ya que se lograron mejoras significativas en los resultados de salud después de la intervención. Además, los resultados de usabilidad obtenidos mediante la cumplimentación de un cuestionario de usabilidad confirmaron la buena adhesión a el enfoque presentado. Estos resultados validan la hipótesis de la investigación estudiada en el desarrollo de esta disertación

A conceptual approach to enhance the well-being of elderly people

The number of elderly people living alone is increasing. Consequently, a lot of research works have been addressing this issue in order to propose solutions that can enhance the quality of life of elderly people. Most of them have been concerned in dealing with objective issues such as forgetfulness or detecting falls. In this paper, we propose a conceptual approach of a system that intends to enhance the daily sense of user’s well-being. For that, our proposal consists in a system that works as a social network and a smartwatch application that works unobtrusively and collects the user’s physiological data. In addition, we debate how important features such as to detect user’s affective states and to potentiate user’s memory could be implemented. Our study shows that there are still some important limitations which affect the success of applications built in the context of elderly care and which are mostly related with accuracy and usability of this kind of system. However, we believe that with our approach we will be able to address some of those limitations and define a system that can enhance the well-being of elderly people and improve their cognitive capabilities.The work presented in this paper has been developed under the EUREKA - ITEA3 Project PHE (PHE-16040), and by National Funds through FCT (Fundação para a Ciência e a Tecnologia) under the projects UID/EEA/00760/2019 and UID/CEC/00319/2019 and by NORTE-01-0247-FEDER-033275 (AIRDOC - “Aplicação móvel Inteligente para suporte individualizado e monitorização da função e sons Respiratórios de Doentes Obstrutivos Crónicos ”) by NORTE 2020 (Programa Operacional Regional do Norte)

Smart textiles for improved quality of life and cognitive assessment

Smart textiles can be used as innovative solutions to amuse, meaningfully engage, comfort, entertain, stimulate, and to overall improve the quality of life for people living in care homes with dementia or its precursor mild cognitive impairment (MCI). This concept paper presents a smart textile prototype to both entertain and monitor/assess the behavior of the relevant clients. The prototype includes physical computing components for music playing and simple interaction, but additionally games and data logging systems, to determine baselines of activity and interaction. Using microelectronics, light-emitting diodes (LEDs) and capacitive touch sensors woven into a fabric, the study demonstrates the kinds of augmentations possible over the normal manipulation of the traditional non-smart activity apron by incorporating light and sound effects as feedback when patients interact with different regions of the textile. A data logging system will record the patient’s behavioral patterns. This would include the location, frequency, and time of the patient’s activities within the different textile areas. The textile will be placed across the laps of the resident, which they then play with, permitting the development of a behavioral profile through the gamification of cognitive tests. This concept paper outlines the development of a prototype sensor system and highlights the challenges related to its use in a care home setting. The research implements a wide range of functionality through a novel architecture involving loosely coupling and concentrating artifacts on the top layer and technology on the bottom layer. Components in a loosely coupled system can be replaced with alternative implementations that provide the same services, and so this gives the solution the best flexibility. The literature shows that existing architectures that are strongly coupled result in difficulties modeling different individuals without incurring significant costs. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Game-Based Learning, Gamification in Education and Serious Games

The aim of this book is to present and discuss new advances in serious games to show how they could enhance the effectiveness and outreach of education, advertising, social awareness, health, policies, etc. We present their use in structured learning activities, not only with a focus on game-based learning, but also on the use of game elements and game design techniques to gamify the learning process. The published contributions really demonstrate the wide scope of application of game-based approaches in terms of purpose, target groups, technologies and domains and one aspect they have in common is that they provide evidence of how effective serious games, game-based learning and gamification can be

A study of learner experience design and learning efficacy of mobile microlearning in journalism education

With the increasing number of mobile technologies, people rely on smartphones to connect with the world and obtain news and information. The emergent use of mobile technologies changes the way journalists produce and disseminate news. It is important for journalism educators to know how to support journalists' digital skills development, particularly digital skills of mobile technologies, and understand which new forms of learning are suitable and feasible for those learners in the journalism sector. Previous research has shown that mobile microlearning (MML) can be a promising learning approach for specific learning needs. Mobile microlearning basically means learning no more than five minutes of lessons that are distributed on the smartphone. However, there is only a little evidence on the design and effects of MML in the context of journalism education research. Hence, this dissertation aims to examine whether MML can be a useful approach to facilitate mobile journalists' digital skills learning with smartphones. Adapting a sociotechnical-pedagogical learner experience framework with a usercentered design process, a four-phase formative research cycle was conducted in this dissertation: Phase 1, a systematic literature review of mobile microlearning (Study 1), Phase 2, a needs assessment for an understanding of mobile journalists' learning needs and requirements (Study 2), Phase 3, an iterative design and development of a mobile microcourse and studying its usability and user experience (Study 3), and Phase 4, an examination of the learning efficacy (i.e., effectiveness, efficiency, and appeal) and learner experience of the developed mobile microcourse (Study 4). A mixed-method data collection and analysis approach was applied throughout this dissertation. The results in this research provided evidence-based findings and indicated that MML is a feasible and effective approach to support mobile journalists' just-in-time learning when the MML designs follow four sequential design principles: (a) an aha moment to help with the learners connecting their previous experiences to the importance of current learning topics, (b) interactive content, (c) short exercises, and (d) instant automated feedback. Lastly, the dissertation discussed the results and addressed insights and implications of the MML design to improve learner experience and learning efficacy.Includes bibliographical references

The Use of digital games to enhance the physical exercise activity of the elderly : a case of Finland

According to the World Health Organization (WHO), population ageing is a global phenomenon, which brings both challenges and opportunities for society. The current longer expected lifespan can create opportunities for the elderly to contribute in many ways to their families and communities. However, it greatly depends on their quality of life, which is affected by many factors, including physical and functional health, social well-being, and cognitive abilities. The WHO (2012) states that physical health is one of the indicators for the elderly’s quality of life, and it declines with increasing age. Participation in regular physical exercises can help the elderly improve their physical and mental health, and this has been aided by the use of modern technologies to promote the elderly’s physical and functional health. Of these latest technologies, digital games have shown promise to improve and enhance the elderly’s physical activities through fun and engaging gameplay. The literature highlights that some commercial games in the market (e.g. Microsoft Kinect- Sports and Nintendo Wii Sports games) have the potential to improve the elderly’s physical health such as gait, balance, and fall prevention. However, researchers argue that these commercial games are not designed specifically for the elderly and their physical exercise activities. They state that most commercial games are not user-friendly for the elderly whose functional and physical abilities are limited due to their advanced years. The literature points out that more studies need to be undertaken to understand the usability and usefulness of digital games for physical exercise activities so that game designers can create elderly-friendly digital games in the future. In Finland, the government has been focusing on promoting healthy ageing and increasing home care services for the elderly. In recent years, Finnish researchers have used digital games to promote older Finns’ healthy and active ageing. The existing literature, whilst showing the potential of digital games for elderly Finns’ physical health, also acknowledges further research is needed particularly in the context of Finland. Thus, in this study, we aimed at investigating digital games to specifically assess their applications for older Finns’ physical activities, focusing on the quality of users’ experiences, and their reported ease of use and perceived usefulness. We used the mixed methods approach, which applies both qualitative and quantitative research methods. The study design included four stages: requirements gathering, analysis and design, prototyping, and evaluation. Firstly, we conducted pre-studies to elicit users’ requirements. This was followed by the analysis of the resulting data to identify trends and patterns, which fuelled ideas in the brainstorming game design and development phases. The final product was a digital game-based physical exercise called the Skiing Game. We then evaluated the Skiing Game in Finland with 21 elderly Finns (M=7, F=14, Average Age =76). By using questionnaires, observation, and interviews, we investigated user experiences, focusing on the game’s usability, and usefulness for enhancing the physical activity and wellbeing of the elderly. We also conducted a comparative test of the Skiing Game in Japan with 24 elderly Japanese participants (M=12, F=12, Average Age = 72) to further understand non-Finnish elderly users’ experiences. The findings from the usability study of the Skiing Game in Finland demonstrated that elderly Finns had a positive experience in the gameplay, and their motivation was noticeably high. It also confirmed that elderly Finns have a genuine interest in digital game-based exercises and strong intentions to play digital games as a form of physical exercise in the future. Although prior to the study most of them had negative views and misconceptions about digital games, after the gameplay their attitudes were decidedly positive. They acknowledged that whilst playing digital games could be an alternative way of exercising for them their use would primarily be when they don’t have access to their usual non-digital physical exercise. The Japanese usability of the Skiing Game showed that the elderly Japanese people also had positive user experiences in playing digital games, and also intend to use them in the future. Similarly, after playing the game they reported that their attitudes towards digital games become positive, and indicated playing digital games could be an alternative way of exercising. Although the comparison of the two studies suggests that the elderly Finns had relatively more positive experiences whilst playing the Skiing Game, compared to their Japanese counterparts, in general, both groups had a positive experience in the gameplay and showed interest in digital games as an alternative exercise. Based on the usability lessons learned from these two studies, recommendations for practitioners and designers regarding improvements in game design and development are made in this report. Implementing these modifications into future designs and further development of digital games for the elderly will improve their commercial viability and user uptake. The findings from this study can provide valuable insights, particularly for Finnish policymakers and healthcare practitioners who are keen to introduce digital games into the aged-care sector in Finland. The studies have also provided valuable insights into the optimal methods for introducing Finnish digital games to international markets, in particular, digital games tailored specifically for the physical exercise needs and motivations of the elderly. By taking into consideration the limitations of the study, we provide our future studies and further improvements of the game to be conducted

Accessibility of Health Data Representations for Older Adults: Challenges and Opportunities for Design

Health data of consumer off-the-shelf wearable devices is often conveyed to users through visual data representations and analyses. However, this is not always accessible to people with disabilities or older people due to low vision, cognitive impairments or literacy issues. Due to trade-offs between aesthetics predominance or information overload, real-time user feedback may not be conveyed easily from sensor devices through visual cues like graphs and texts. These difficulties may hinder critical data understanding. Additional auditory and tactile feedback can also provide immediate and accessible cues from these wearable devices, but it is necessary to understand existing data representation limitations initially. To avoid higher cognitive and visual overload, auditory and haptic cues can be designed to complement, replace or reinforce visual cues. In this paper, we outline the challenges in existing data representation and the necessary evidence to enhance the accessibility of health information from personal sensing devices used to monitor health parameters such as blood pressure, sleep, activity, heart rate and more. By creating innovative and inclusive user feedback, users will likely want to engage and interact with new devices and their own data

Reducing and removing barriers to spatial audio : applications of capital as a critical framework to promote inclusion in spatial audio : a thesis submitted to Massey University in partial fulfilment of the requirements for the degree of Doctorate of Philosophy in Music at Massey University, Wellington, New Zealand

The research within this thesis aims to address the question of whether barriers of capital to the field of spatial audio can be reduced or removed. Spatial audio is the musical utilization of space, where spatialization is the salient feature of the musical work. As a field, it primarily exists within academic and art institutions. Because of this, there are numerous barriers that prohibit people from engaging with the field. These barriers include significant technical requirements, the need for education, the expense of large spatial audio systems, amongst others. These barriers mean that those who are excluded have little to no pathway to engage with the field. This thesis explores the barriers in spatial audio through the lens of capital. Viewed as one’s level of resource, a lack of economic, social, symbolic, cultural, and physical capital can exclude many from engaging with spatial audio. The research within this thesis identifies barriers of capital that exist within the field through qualitative and quantitative survey analysis as well as literature review. The identified barriers are then addressed through practice-led and practice-based research with the creation of new spatial audio works and compositional strategies, alongside user surveys to ascertain the efficacy of the research

Empowering vulnerable people with serious games and gamification

Although many people will associate games with entertainment and leisure, games can also aim more serious purposes, such as training or education. Games with such goals are called serious games. In addition, gamification means that a (serious) task is enhanced with game elements. Examples of serious games and gamification can be seen in many aspects of daily life. Loyalty programs of stores, educational games in schools, fitness wearables and their gamified applications, rehabilitation games, and so on. In this dissertation, the focus is on a specific domain in which serious games and gamification can create societal benefit, namely by using them to empower vulnerable target groups. In the first part of this dissertation, a literature review is performed to understand the domain of serious games and gamification for vulnerable target groups. Based on this review, research gaps can be identified. Moreover, the review resulted in a taxonomy that is used throughout the dissertation to classify different games and applications. In the following parts of the dissertation, projects addressing two different target groups and in total three vulnerabilities are discussed. The first target group is older adults, who are vulnerable in different ways. In this dissertation, safety risks for doorstep scams and health risks through malnutrition are addressed. The first vulnerability is addressed by a serious game using interactive scenarios of doorstep scams. A diet tracking system that was used to support participants in a diet trial addressed the latter vulnerability. The second target group is young adults, which is an age group with a vulnerable mental well-being. The last part of this dissertation aims to study how gamification can be used to enhance self-compassion among young adults via an online 6-weeks training program, to increase their resilience in the face of mental well-being difficulties. Artificial Intelligence (AI) technologies can be used to personalize and adapt the experience of a game to users. Tone of voice analysis was used to influence the progression in scenarios of the serious game about doorstep scams, and it gave players the possibility to assess the assertiveness of their voice. Machine learning algorithms were used to create personalized meal recommendations that can be used to improve the user experience of the diet tracking system for older adults. These algorithms base their recommendations on information about the historical intake of users to suggest meals and to additional items during meal editing. This makes the process of registering a meal less time-consuming. Sentiment analysis is used to adapt responses of the system in an exercise from the self-compassion training program. In addition, a topic detection algorithm was designed to assign one topic from a predefined set of topics to a note by a user of the training program. With this information, users can choose different types of situations to use in the exercises: frequently or rarely discussed topics. Aside from those techniques, knowledge representation is used in all projects, which is important for serious games/gamified applications since they are often based on expert and/or domain knowledge. This dissertation contributes to understanding the domain of serious games and gamification to empower vulnerable groups. The work also contributes to the research on the development of applications within that domain. On top of that, it contributes to understanding how AI techniques can be used to offer (personalized) features that enrich serious games or gamified applications. Finally, for each of the project centered parts, the results that are found in those parts contribute to the research in those specific fields