Evaluating the 'lessons learned' in transitioning a digital health technology for dementia from lab to care home

The introduction of technologies and devices to support wellbeing in dementia are often evaluated using sensing technologies in a rather tech-heavy approach. The information presented by these devices is efficiently generated and typically low maintenance but this does not come without certain caveats.By nature, sensing of any type is a probing modality. Hence the information is inquisitory and personal in one form or another. The assurance that this information is collected, managed and shared in the correct manner is essential in ensuring its acceptability. Therefore it seems apparent that careful design of the system architecture and research protocols are key to achieving these objectives. However, as with any research study there are unforeseen circumstances that emerge when operating technology within a new site, presenting new challenges while seemingly at the pinnacle of a study protocol. This can be a head-scratcher for researchers and case-specific issues can demand thinking outside the box. This study considers the specific case of a lighting technology to support the synchronisation of the circadian rhythm for people living with dementia. This represents an interesting case since the amount of research conducted in this area is scarce making standard guidelines for implementation essentially non-existent. As such, this research dissects the following themes from technical, ethical, logistical and coordination issues often present when implementing a new technology in a care home. 1) Technical: The issues of networking and gateway communications are discussed alongside the question of data. How do we ensure it is of the required quality? Is it consistently transferred and stored? How does it remain secure?2) Ethical: The ethical process for implementing technology in care homes is addressed, while considering the perspective of people living with dementia. The question of medical device status is outlined alongside the discussion of consent.3) Logistical/planning: A review of site survey checklists, materials and structural composition of the built environment is evaluated, alongside an insight into the adherence to site-specific requirements.4) Coordination: Implementing a research protocol requires aligning the needs of the residents and care staff in an approach that best suits them in their daily routines, therefore the coordination and communication involved in this process is also outlined.To conclude, an informal evaluation of the entire system and study design is conducted between researchers and the care home manager. The study therefore closes with an approach to revising future designs for larger scale deployments and recommendations for a step-by-step process for designing trials from the lab to care home environment.<br/

The impact of age, gender and severity of overactive bladder wet on quality of life, productivity, treatment patterns and satisfaction

Objective: The objective of this article is to determine the impact of idiopathic overactive bladder wet (OAB wet) severity, age and gender on health-related quality of life (HRQoL), productivity, treatment patterns and treatment satisfaction. Materials and methods: A prospective, cross-sectional online survey of adults in the United Kingdom was performed to screen for self-reported symptoms of OAB wet. Respondents completed the King’s Health Questionnaire or the Incontinence Quality of Life, as well as the Euroqol 5D, and the Work Productivity and Activity Impairment Specific Health Problem questionnaire, and questions pertaining to distress, treatment and treatment satisfaction. Results: A total of 249 of 1126 respondents (22.1%) met the criteria for OAB wet. Respondents with moderate/severe OAB wet and all women experienced significantly worse HRQoL and work productivity than those with mild symptoms and all men, respectively. Among all OAB wet responders, 62.7% were receiving treatment for their condition, predominantly pads (40.2%); only 1.6% were receiving specialised treatment. Nearly one-half (44.6%) were somewhat or completely dissatisfied with their current treatment. Conclusion: In individuals with OAB wet, severity and gender negatively impact HRQoL and work productivity. A substantial proportion of OAB wet individuals were untreated, and low treatment satisfaction was reported in those receiving treatment. Treatment was generally conservative

A tailored Internet of Things lighting solution to support circadian rhythms and wellbeing for people living with dementia

Light is a requirement for setting and maintaining the body’s circadian rhythm, however our knowledge of the spectral content, timing and duration of lighting exposure for the indoors is not well defined. For people living with dementia, this knowledge gap is important to address since they experience more heavily disrupted circadian rhythms, which can heighten symptoms of sundowning, agitation, low mood and poor sleep quality. This paper focuses on the required design aspects for a dynamic lighting and sensing device tailored towards supporting the wellbeing of people living with dementia. The authors discuss the current understanding of lighting for health, identify the gaps to be addressed and propose the design and research protocol for an indoor lighting and sensing solution. The device is currently deployed within a care home and analysis of results is forthcoming

Reciprocity and sensitivity kernels for sea level fingerprints

Reciprocity theorems are established for the elastic sea level fingerprint problem including rotational feedbacks. In their simplest form, these results show that the sea level change at a location x due to melting a unit point mass of ice at x' is equal to the sea level change at x' due to melting a unit point mass of ice at x. This identity holds irrespective of the shoreline geometry or of lateral variations in elastic Earth structure. Using the reciprocity theorems, sensitivity kernels for sea level and related observables with respect to the ice load can be readily derived. It is notable that calculation of the sensitivity kernels is possible using standard fingerprint codes, though for some types of observable a slight generalisation to the fingerprint problem must be considered. These results are of use within coastal hazard assessment and have a range of potential applications within studies of modern-day sea level change.Comment: Paper submitted to Geophysical Journal Internationa

Importance of native language in a population-based health survey among ethnic Chinese in Australia

Objective: To assess the impacts of survey languages on participation and representativeness of the study subjects in a health survey in a Chinese community in Australia

Detection of Airborne Biological Particles in Indoor Air Using a Real-Time Advanced Morphological Parameter UV-LIF Spectrometer and Gradient Boosting Ensemble Decision Tree Classifiers

We present results from a study evaluating the utility of supervised machine learning to classify single particle ultraviolet laser-induced fluorescence (UV-LIF) signatures to investigate airborne primary biological aerosol particle (PBAP) concentrations in a busy, multifunctional building using a Multiparameter Bioaerosol Spectrometer. First we introduce and demonstrate a gradient boosting ensemble decision tree algorithm’s ability to accurately classify laboratory generated PBAP samples into broad taxonomic classes with a high level of accuracy. We then develop a framework to appraise the classification accuracy and performance using the Hellinger distance metric to compare product parameter probability density function similarity; this framework showed that key training classes were sufficiently different in terms of particle fluorescence and morphology to facilitate classification. We also demonstrate the utility of including advanced morphological parameters to minimise inter-class conflation and improve classification confidence, where relying on the fluorescent spectra alone would likely result in misattribution. Finally, we apply these methods to ambient data collected within a large multi-functional building where ambient bacterial- and fungal-like classes were identified to display trends corresponding to human activity; fungal-like classes displayed a consistent diurnal trend with a maximum at midday and hourly peaks correlating to movements within the building; bacteria-like aerosol displayed complex, episodic events during opening hours. All PBAP classes fell to low baseline concentrations when the building was unoccupied overnight and at weekendsPeer reviewe

Airborne Bacterial and Eukaryotic Community Structure across the United Kingdom Revealed by High-Throughput Sequencing

Primary biological aerosols often include allergenic and pathogenic microorganisms posing potential risks to human health. Moreover, there are airborne plant and animal pathogens that may have ecological and economic impact. In this study, we used high-throughput sequencing techniques (Illumina, MiSeq) targeting the 16S rRNA genes of bacteria and the 18S rRNA genes of eukaryotes, to characterize airborne primary biological aerosols. We used a filtration system on the UK Facility for Airborne Atmospheric Measurements (FAAM) research aircraft to sample a range of primary biological aerosols across southern England overflying surface measurement sites from Chilbolton to Weybourne. We identified 30 to 60 bacterial operational taxonomic units (OTUs) and 108 to 224 eukaryotic OTUs per sample. Moreover, 16S rRNA gene sequencing identified significant numbers of genera that have not been found in atmospheric samples previously or only been described in limited number of atmospheric field studies, which are rather old or published in local journals. This includes the genera Gordonia, Lautropia, and Psychroglaciecola. Some of the bacterial genera found in this study include potential human pathogens, for example, Gordonia, Sphingomonas, Chryseobacterium, Morganella, Fusobacterium, and Streptococcus. 18S rRNA gene sequencing showed Cladosporium to be the major genus in all of the samples, which is a well-known allergen and often found in the atmosphere. There were also genetic signatures of potentially allergenic taxa; for example, Pleosporales, Phoma, and Brassicales. Although there was no significant clustering of bacterial and eukaryotic communities depending on the sampling location, we found meteorological factors explaining significant variations in the community composition. The findings in this study support the application of DNA-based sequencing technologies for atmospheric science studies in combination with complementary spectroscopic and microscopic techniques for improved identification of primary biological aerosols

Migrant sexual health help-seeking and experiences of stigmatization and discrimination in Perth, Western Australia: exploring barriers and enablers

Increasing HIV notifications amongst migrant and mobile populations to Australia is a significant public health issue. Generalizations about migrant health needs and delayed or deterred help-seeking behaviors can result from disregarding the variation between and within cultures including factors, such as drivers for migration and country of birth. This study explored barriers and enablers to accessing sexual health services, including experiences of stigma and discrimination, within a purposive sample of sub-Saharan African, Southeast Asian, and East Asian migrants. A qualitative design was employed using key informant interviews and focus group discussions. A total of 45 people with ages ranging from 18 to 50 years, participated in focus group discussions. Common barriers and enablers to help seeking behaviors were sociocultural and religious influence, financial constraints, and knowledge dissemination to reduce stigma. Additionally, common experiences of stigma and discrimination were related to employment and the social and self-isolation of people living with HIV. Overcoming barriers to accessing sexual health services, imparting sexual health knowledge, recognizing variations within cultures, and a reduction in stigma and discrimination will simultaneously accelerate help-seeking and result in better sexual health outcomes in migrant populations