Longitudinal diary data: Six months real-world implementation of affordable companion robots for older people in supported living

Companion robots have potential for improving wellbeing within aged care, however literature focuses on shorter-term studies often using relatively expensive platforms, raising concerns around novelty effects and economic viability. Here, we report ecologically valid diary data from two supported living facilities for older people with dementia or learning difficulties. Both sites implemented Joy for All robot animals and maintained diaries for six months. Entries were analysed using thematic analysis. We found robot use increased over the six months, changing from short, structured sessions to mainly permanent availability. Thus previously reported concerns on novelty were not warranted. Both sites reported positive outcomes including reminiscence, improved communication and potential wellbeing benefits (reduced agitation/anxiety). Incidences of negative responses included devices described as 'creepy.' Devices appeared sufficiently robust for prolonged daily use with multiple users. Overall, we provide insight into real-world implementation of affordable companion robots, and longitudinal development of use

Ethical perceptions towards real-world use of companion robots with older people and people with dementia: survey opinions among younger adults

Contains fulltext : 221334.pdf (publisher's version ) (Open Access)Background: Use of companion robots may reduce older people's depression, loneliness and agitation. This benefit has to be contrasted against possible ethical concerns raised by philosophers in the field around issues such as deceit, infantilisation, reduced human contact and accountability. Research directly assessing prevalence of such concerns among relevant stakeholders, however, remains limited, even though their views clearly have relevance in the debate. For example, any discrepancies between ethicists and stakeholders might in itself be a relevant ethical consideration while concerns perceived by stakeholders might identify immediate barriers to successful implementation. Methods: We surveyed 67 younger adults after they had live interactions with companion robot pets while attending an exhibition on intimacy, including the context of intimacy for older people. We asked about their perceptions of ethical issues. Participants generally had older family members, some with dementia. Results: Most participants (40/67, 60%) reported having no ethical concerns towards companion robot use when surveyed with an open question. Twenty (30%) had some concern, the most common being reduced human contact (10%), followed by deception (6%). However, when choosing from a list, the issue perceived as most concerning was equality of access to devices based on socioeconomic factors (m = 4.72 on a scale 1-7), exceeding more commonly hypothesized issues such as infantilising (m = 3.45), and deception (m = 3.44). The lowest-scoring issues were potential for injury or harm (m = 2.38) and privacy concerns (m = 2.17). Over half (39/67 (58%)) would have bought a device for an older relative. Cost was a common reason for choosing not to purchase a device. Conclusions: Although a relatively small study, we demonstrated discrepancies between ethical concerns raised in the philosophical literature and those likely to make the decision to buy a companion robot. Such discrepancies, between philosophers and ‘end-users’ in care of older people, and in methods of ascertainment, are worthy of further empirical research and discussion. Our participants were more concerned about economic issues and equality of access, an important consideration for those involved with care of older people. On the other hand the concerns proposed by ethicists seem unlikely to be a barrier to use of companion robots.10 p

Implementing Affordable Socially Assistive Pet Robots in Care Homes Before and During the COVID-19 Pandemic: Stratified Cluster Randomized Controlled Trial and Mixed Methods Study.

BACKGROUND: Robot pets may assist in the challenges of supporting an aging population with growing dementia prevalence. Prior work has focused on the impacts of the robot seal Paro on older adult well-being, but recent studies have suggested the good acceptability and implementation feasibility of more affordable devices (Joy for All [JfA] cats and dogs). OBJECTIVE: We aimed to address the limited effectiveness research on JfA devices. METHODS: We conducted an 8-month, stratified, cluster randomized controlled trial in 8 care homes in Cornwall, United Kingdom. Over 4 months, 4 care homes each received 2 JfA devices (1 cat and 1 dog; intervention group), and 4 homes received care as usual (control group). Psychometrics were collected before and after the intervention to compare the change from baseline to follow-up between the groups. In the final 4 months, all 8 care homes received devices, but only qualitative data were collected owing to COVID-19 and reduced capacity. The primary outcome was neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI] Nursing Home version). Care provider burden was a secondary outcome (occupational disruptiveness NPI subscale), alongside the Challenging Behavior scale, the Holden communication scale, the Campaign to End Loneliness questionnaire, and medication use. Qualitative data were collected through care staff observation calendars and end-of-study interviews to understand use, experience, and impact. We also collected demographic data and assessed dementia severity. In total, 253 residents had robot interaction opportunities, and 83 were consented for direct data collection. RESULTS: There was a significant difference in the total change from baseline to follow-up between the intervention and control groups for NPI (P<.001) and occupational disruptiveness (P=.03). Neuropsychiatric symptoms increased in the control group and decreased in the intervention group. No significant difference was seen for communication issues or challenging behavior. For NPI subdomains, there were significant differences from baseline to follow-up in delusions (P=.03), depression (P=.01), anxiety (P=.001), elation (P=.02), and apathy (P=.009), all of which decreased in the intervention group and increased slightly in the control group. The summative impact results suggested that most residents (46/54, 85%) who interacted with robots experienced a positive impact. Those who interacted had significantly higher dementia severity scores (P=.001). The qualitative results suggested good adoption, acceptability, and suitability for subjectively lonely individuals and lack of a novelty effect through sustained use, and demonstrated that the reasons for use were entertainment, anxiety, and agitation. CONCLUSIONS: Affordable robot pets hold potential for improving the well-being of care home residents and people with dementia, including reducing neuropsychiatric symptoms and occupational disruptiveness. This work suggests no novelty effect and contributes toward understanding robot pet suitability. Moreover, interactions were more common among residents with more moderate/severe dementia and those subjectively lonely. TRIAL REGISTRATION: ClinicalTrials.gov NCT04168463; https://www.clinicaltrials.gov/ct2/show/NCT0416846

Microbial contamination and efficacy of disinfection procedures of companion robots in care homes

Contains fulltext : 221797.pdf (publisher's version ) (Open Access)Background: Paro and other robot animals can improve wellbeing for older adults and people with dementia, through reducing depression, agitation and medication use. However, nursing and care staff we contacted expressed infection control concerns. Little related research has been published. We assessed (i) how microbiologically contaminated robot animals become during use by older people within a care home and (ii) efficacy of a cleaning procedure. Methods: This study had two stages. In stage one we assessed microbial load on eight robot animals after interaction with four care home residents, and again following cleaning by a researcher. Robot animals provided a range of shell-types, including fur, soft plastic, and solid plastic. Stage two involved a similar process with two robot animals, but a care staff member conducted cleaning. The cleaning process involved spraying with anti-bacterial product, brushing fur-type shells, followed by vigorous top-to-tail cleaning with anti-bacterial wipes on all shell types. Two samples were taken from each of eight robots in stage one and two robots in stage two (20 samples total). Samples were collected using contact plate stamping and evaluated using aerobic colony count and identification (gram stain, colony morphology, coagulase agglutination). Colony counts were measured by colony forming units per square centimetre (CFU/cm2). Results: Most robots acquired microbial loads well above an acceptable threshold of 2.5 CFU/cm2 following use. The bacteria identified were micrococcus species, coagulase negative staphylococcus, diptheriods, aerobic spore bearers, and staphylococcus aureus, all of which carry risk for human health. For all devices the CFU/cm2 reduced to well within accepted limits following cleaning by both researcher and care staff member. Conclusions: Companion robots will acquire significant levels of bacteria during normal use. The simple cleaning procedure detailed in this study reduced microbial load to acceptable levels in controlled experiments. Further work is needed in the field and to check the impact on the transmission of viruses.17 p

The geomorphology of Svínafellsjökull and Virkisjökull-Falljökull glacier forelands, southeast Iceland

A detailed, 1:10,500-scale, surficial geology and glacial geomorphology map of Svínafellsjökull and Virkisjökull-Falljökull glacier forelands in southeast Iceland depicts the landsystem imprint of Holocene glacier fluctuations, volcanogenic outburst floods and recent (post-1990) climate-induced rapid ice-front retreat. The map is based on field survey data in combination with 2012 airborne LiDAR data, 2009–2012 terrestrial LiDAR data and 2007 colour aerial photography. The base digital elevation model (DEM) is compiled from an ice-cap wide airborne LiDAR dataset. The mapped glacial landforms are dominated by sequences of recessional moraines laid down in the mid-Holocene, the Little Ice Age, and the last ∼100 years; the state of landform preservation generally decreasing with age. Interspersed with glaciofluvial sedimentation associated with typical ice-marginal retreat sequences is key geomorphological evidence of high-magnitude volcanogenic outburst floods (jökulhlaups) associated with the eruptions of Öraefajökull in 1362 and 1727 CE. Ice-front retreat has accelerated since c.2005 leaving a rapidly evolving buried-ice landscape in front of Virkisjökull-Falljökull – including an ice-cored esker, a large ice-floored (supraglacial) lake, and numerous actively forming kettle holes and ice caverns. This map could act as a ‘reference frame’ for geomorphologists studying the temporal evolution of glacial landform-sediment assemblages undergoing rapid change

Morphology of socially assistive robots for health and social care: A reflection on 24 months of research with anthropomorphic, zoomorphic and mechanomorphic devices

Contains fulltext : 236633.pdf (Publisher’s version ) (Closed access)This paper reflects on four studies completed over the last 24 months, with social robots including Pepper, Paro, Joy for All cats and dogs, Miro, Pleo, Padbot and cheaper toys, including i) focus groups and interviews on suitable robot pet design, ii) surveys on ethical perceptions of robot pets, and iii) recorded interactions between stakeholders and a range of social robots. In total, up to 371 participants' views were included across the analysed studies. Data was reviewed and mined for relevance to the use and impact of morphology types for social robots in health and social care. Results suggested biomorphic design was preferable over mechanomorphic, and speech and life-simulation features (such as breathing) were well received. Anthropomorphism demonstrated some limitations in evoking fear and task-expectations that were absent for zoomorphic designs. The combination of familiar, zoomorphic appearance with animacy, life-simulation and speech capabilities thus appeared to be an area of research for future robots developed for health and social care.2021 30th IEEE International Conference on Robot & Human Interactive Communication (RO-MAN) (Vancouver, Canada, 8-12 Aug. 2021

Serum free light chain measurement aids the diagnosis of myeloma in patients with severe renal failure

<p>Abstract</p> <p>Background</p> <p>Monoclonal free light chains (FLCs) frequently cause rapidly progressive renal failure in patients with multiple myeloma. Immunoassays which provide quantitative measurement of FLCs in serum, have now been adopted into screening algorithms for multiple myeloma and other lymphoproliferative disorders. The assays indicate monoclonal FLC production by the presence of an abnormal κ to λ FLC ratio (reference range 0.26–1.65). Previous work, however, has demonstrated that in patients with renal failure the FLC ratio can be increased above normal with no other evidence of monoclonal proteins suggesting that in this population the range should be extended (reference range 0.37–3.1). This study evaluated the diagnostic sensitivity and specificity of the immunoassays in patients with severe renal failure.</p> <p>Methods</p> <p>Sera from 142 patients with new dialysis-dependent renal failure were assessed by serum protein electrophoresis (SPE), FLC immunoassays and immunofixation electrophoresis. The sensitivity and specificity of the FLC ratio's published reference range was compared with the modified renal reference range for identifying patients with multiple myeloma; by receiver operating characteristic curve analysis.</p> <p>Results</p> <p>Forty one patients had a clinical diagnosis of multiple myeloma; all of these patients had abnormal serum FLC ratios. The modified FLC ratio range increased the specificity of the assays (from 93% to 99%), with no loss of sensitivity. Monoclonal FLCs were identified in the urine from 23 of 24 patients assessed.</p> <p>Conclusion</p> <p>Measurement of serum FLC concentrations and calculation of the serum κ/λ ratio is a convenient, sensitive and specific method for identifying monoclonal FLC production in patients with multiple myeloma and acute renal failure. Rapid diagnosis in these patients will allow early initiation of disease specific treatment, such as chemotherapy plus or minus therapies for direct removal of FLCs.</p

Automated characterisation of glaciomarine sediments using X-ray computed laminography

This study investigates the potential of a new high-resolution, non-destructive, X-ray imaging technique for the Quaternary Sciences – computed laminography (CL). Greyscale properties are systematically extracted from digital X-radiographic CL images of cored glaciomarine sediments to analyse and characterise sediments at pixel-scale resolution (< 0.1 mm). We show how this can be achieved manually, and also with an easy-to-use, automated statistical tool which we have devised specifically for use in glaciomarine sediments. This Sediment Characteristics tool, in the form of a plugin for the freely available FIJI/ImageJ programme, extracts mean or median X-ray grey values (GV) – a proxy for sediment density; and associated standard deviation (SD) – a proxy for sediment heterogeneity – at sub-mm resolution, across the width of sediment core CL images. We demonstrate how these properties (GV and SD) can be directly used to characterise sediment properties and in particular to quantify the abundance of gravel clasts, or ice-rafted debris, in cored glaciomarine sediments. The tool’s effectiveness is compared with other, more traditional, X-radiographic methods for counting ice-rafted gravel clasts in glaciomarine sediment. We propose that the CL output and Sediment Characteristics tool also have the potential to quantitatively analyse other 3-dimensional structures, such as cyclic lamination (varve) geometry; deformation structures; bioturbation and void space (porosity). Finally, we present the raw code, allowing open-access, transparency and reproducibility in other formats

Detection of oligoclonal IgG kappa and IgG lambda bands in cerebrospinal fluid and serum with Hevylite™ antibodies. comparison with the free light chain oligoclonal pattern

<p>Abstract</p> <p>Background</p> <p>Oligoclonal IgG bands in cerebrospinal fluid that are absent in serum indicate intrathecal IgG synthesis and are a sensitive marker of CNS inflammatory diseases, in particular multiple sclerosis. It may be of interest to determine whether these bands are predominantly IgGκ or IgGλ.</p> <p>Methods</p> <p>We have used Hevylite™ antibodies and developed a technique for detection of oligoclonal IgGκ and IgGλ bands by means of isoelectric focusing followed by immunoblotting. The same technique was used for oligoclonal free κ and free λ detection. Among several techniques tested, affinity immunoblotting appears to be the most sensitive; it can detect less than 1 ng of IgGκ or IgGλ paraprotein. We compared oligoclonal IgG profiles with those of oligoclonal IgGκ and IgGλ. There was good agreement concerning the presence or absence of intrathecal synthesis. We observed the ratios between oligoclonal IgGκ and IgGλ bands, and they did not always match the ratios between free κ and free λ bands. We were also able to detect antigen-specific CSF-restricted oligoclonal IgGκ and IgGλ bands in neuroborreliosis. It remains to be determined subsequently by a clinically-oriented prospective study, whether predominant IgGκ/IgGλ or free κ/free λ can be observed more frequently in particular diseases with oligoclonal IgG synthesis.</p> <p>Discussion</p> <p>Very sensitive detection of oligoclonal IgGκ and IgGλ bands in cerebrospinal fluid with Hevylite antibodies is feasible; detection of antigen-specific IgGκ or IgGλ is possible as well. In particular situations, e.g. when difficulties arise in distinguishing between oligoclonal and monoclonal pattern, the test may be of considerable clinical value.</p