'Wet' care homes for older people with refractory alcohol problems: a qualitative study

Background This study describes a registered care home in England and a registered nursing home in Norway which provide permanent care for alcohol-dependent older people who are unable or unwilling to stop drinking and cannot maintain an adequate standard of self-care and/or live independently. Prior to admission, most residents have been living unsafely in their own home or were homeless. They have high levels of contact with health, social and criminal justice services and complex needs as a result of mental illness, poor physical health and physical disabilities. Most have lost contact with their families. The aim is to stabilise drinking, physical and mental health and improve quality of life. The homes are based on a harm reduction philosophy, that is, they focus on strategies to reduce harm from high-risk alcohol use, rather than insisting on abstinence. Residents can drink as much alcohol as they want on the premises but staff encourage them to drink less and in a less harmful way (e.g. spreading drinking throughout the day and having ‘dry’ days). Method We carried out interviews and focus groups with staff and residents, observed verbal exchanges, experiences and routines in communal areas, took field notes during staff rounds and analysed documents such as care plans for individual residents. Key findings • Most residents’ drinking, physical and mental health stabilises and their use of health, social and criminal justice services reduces following admission. • This is achieved by encouraging less harmful drinking, providing on-site health care, assistance with medication and self-care and provision of nutritious meals and social activities. • Wet care homes are viewed by some residents as a safe refuge which has improved their quality of life. • Other residents are frustrated by a lack of personal autonomy. • Suitable outcomes include improved hygiene and nutrition, increased self-esteem, better compliance with healthcare, healthier living which is not entirely alcohol focused and more hope for the future. • Homes should have processes in place to collect quantitative measures which provide clear evidence of impact.        

Improved multi-user interaction in a smart environment through a preference-based conflict resolution virtual assistant

In this work we will examine and develop a system that can assist people in Activities of Daily Life (ADL). This study focuses on resolving conflicts for the requests from different users’ profiles, for instance - elderly, adult and young. The objective of the system is to present a dialogue manager which is able to detect multi-user semantic conflict and to resolve the conflict for improved dialogue informing about its decisions using a system interface Avatar. The system is also able to prioritize requests that occurred among the services of multiple home appliances, as well as to deal with conflicting entities involving a single device. We investigated whether the multi-user context awareness by a Virtual Assistant adds value to the Smart Home concept in recognizing multi-user conflicts dynamically. This work has proposed a preference based method for resolving conflict and evaluated the developed system in a smart home environmen

Improved multi-user interaction in a smart environment through a preference-based conflict resolution virtual assistant

In this work we will examine and develop a system that can assist people in Activities of Daily Life (ADL). This study focuses on resolving conflicts for the requests from different users’ profiles, for instance - elderly, adult and young. The objective of the system is to present a dialogue manager which is able to detect multi-user semantic conflict and to resolve the conflict for improved dialogue informing about its decisions using a system interface Avatar. The system is also able to prioritize requests that occurred among the services of multiple home appliances, as well as to deal with conflicting entities involving a single device. We investigated whether the multi-user context awareness by a Virtual Assistant adds value to the Smart Home concept in recognizing multi-user conflicts dynamically. This work has proposed a preference based method for resolving conflict and evaluated the developed system in a smart home environmen

Designing the Health-related Internet of Things: Ethical Principles and Guidelines

The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may be rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols

The Construction of a Community Long-term Care Model for Home-based Elderly Individuals

With rapidly aging populations, family care functions can become weakened, and community health services often lack unified standards. A standardized and professional community home-based long-term care model (CHLCM) for the elderly is urgently needed in many regions of China and in other countries. Here, we explored the indicators of the need for a CHLCM among elderly individuals, and we constructed a CHLCM. We created and distributed a questionnaire regarding the requirement of long-term care services, based on a literature review. The two-rounds Delphi method was used, involving 20 experts who were randomly selected from among the medical universities, community health service centers, and nursing homes in Nanning, Guangxi, China. The experts’ enthusiasm rates in the questionnaire’s two rounds were 95% and 100%, respectively. The authentic coefficient of the experts’ consulting was 0.857, and that of the experts’ academic level was 0.835; the judgement coefficient was 0.880 and the familiar coefficient was 0.855. The CHLCM includes service content and an evaluation. The coordination coefficients for the two primary, eight secondary, and 29 tertiary indicators were 0.200, 0.386, and 0.184, respectively (p<0.05). The experts’ enthusiasm and authority were high. The coordination of the experts’ agreement was sufficient, and the analysis results were reliable. The CHLCM includes 29 items that provide a foundation and references for the formulation of concrete indicators and subsequent research

An Indoor Navigation System Using a Sensor Fusion Scheme on Android Platform

With the development of wireless communication networks, smart phones have become a necessity for people’s daily lives, and they meet not only the needs of basic functions for users such as sending a message or making a phone call, but also the users’ demands for entertainment, surfing the Internet and socializing. Navigation functions have been commonly utilized, however the navigation function is often based on GPS (Global Positioning System) in outdoor environments, whereas a number of applications need to navigate indoors. This paper presents a system to achieve high accurate indoor navigation based on Android platform. To do this, we design a sensor fusion scheme for our system. We divide the system into three main modules: distance measurement module, orientation detection module and position update module. We use an efficient way to estimate the stride length and use step sensor to count steps in distance measurement module. For orientation detection module, in order to get the optimal result of orientation, we then introduce Kalman filter to de-noise the data collected from different sensors. In the last module, we combine the data from the previous modules and calculate the current location. Results of experiments show that our system works well and has high accuracy in indoor situations

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&nbsp;years) with an ischemic stroke, transient ischemic attack or intracerebral hemorrhage within the prior 90&nbsp;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 &lt;130&nbsp;mmHg) at 1&nbsp;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

Spartan Daily, March 6, 2003

Volume 120, Issue 30https://scholarworks.sjsu.edu/spartandaily/9826/thumbnail.jp