57 research outputs found
Investigating the feasibility and acceptability of the HOLOBalance system compared with standard care in older adults at risk for falls: study protocol for an assessor blinded pilot randomised controlled study
INTRODUCTION: Approximately one in three of all older adults fall each year, with wide ranging physical, psychosocial and healthcare-related consequences. Exercise-based interventions are the cornerstone for falls prevention programmes, yet these are not consistently provided, do not routinely address all components of the balance system and are often not well attended. The HOLOBalance system provides an evidence-based balance training programme delivered to patients in their home environment using a novel technological approach including an augmented reality virtual physiotherapist, exergames and a remote monitoring system. The aims of this proof-of-concept study are to (1) determine the safety, acceptability and feasibility of providing HOLOBalance to community dwelling older adults at risk for falls and (2) provide data to support sample size estimates for a future trial. METHODS: A single (assessor) blinded pilot randomised controlled proof of concept study. 120 participants will be randomised to receive an 8-week home exercise programme consisting of either: (1) HOLOBalance or (2) The OTAGO Home Exercise Programme. Participants will be required to complete their exercise programme independently under the supervision of a physiotherapist. Participants will have weekly telephone contact with their physiotherapist, and will receive home visits at weeks 0, 3 and 6. Outcome measures of safety, acceptability and feasibility, clinical measures of balance function, disability, balance confidence and cognitive function will be assessed before and immediately after the 8 week intervention. Acceptability and feasibility will be explored using descriptive statistics, and trends for effectiveness will be explored using general linear model analysis of variance. ETHICS AND DISSEMINATION: This study has received institutional ethical approvals in Germany (reference: 265/19), Greece (reference: 9769/24-6-2019) and the UK (reference: 19/LO/1908). Findings from this study will be submitted for peer-reviewed publications. TRIAL REGISTRATION NUMBER: NCT04053829. PROTOCOL VERSION: V.2, 20 January 2020
Nitrogen nutrition optimization in organic greenhouse tomato through the use of legume plants as green manure or intercrops
Empowering Community Dwelling Older Citizens to Improve Their Balance with a Novel Technology Platform
The prevalence of balance deficits increases as the population is ageing. Such deficits are associated with the increased incidence of falls which in turn is linked with substantial limited functionality and morbidity. Vestibular rehabilitation therapy (VRT) as a component of the treatment has been shown to be effective in reducing symptoms and improving balance. HOLOBALANCE is an intervention based on a novel technology platform for providing VRT unsupervised, at home which means that motivating citizens to be compliant and promoting empowerment are the cornerstones for its wide adoption. Here we present how citizens empowerment is being addressed in HOLOBALANCE
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MFN status and the choice of tariff regime
The gradualist approach to trade liberalization views the uniform tariffs implied by MFN status as an important step on the path to free trade. We investigate whether a regime of uniform tariffs will be preferable to discriminatory tariffs when countries engage in non-cooperative interaction in multilateral trade. The analysis includes product differentiation and asymmetric costs. We show that with the cost asymmetry the countries will disagree on the choice of tariff regime. When the choice of import tariffs and export subsidies is made sequentially the uniform tariff regime may not be sustainable, because of an incentive to deviate to a discriminatory regime. Hence, an international body is needed to ensure compliance with tariff agreement
A Dynamic Bayesian Network Approach to Behavioral Modelling of Elderly People during a Home-based Augmented Reality Balance Physiotherapy Programme
In this study, we propose a dynamic Bayesian network (DBN)-based approach to behavioral modelling of community dwelling older adults at risk for falls during the daily sessions of a hologram-enabled vestibular rehabilitation therapy programme. The component of human behavior being modelled is the level of frustration experienced by the user at each exercise, as it is assessed by the NASA Task Load Index. Herein, we present the topology of the DBN and test its inference performance on real-patient data.Clinical Relevance- Precise behavioral modelling will provide an indicator for tailoring the rehabilitation programme to each individual's personal psychological needs
Analysis of the sentiments of the participants in a clinical study to evaluate a balance rehabilitation intervention delivered by a Virtual Coach
Multiple studies for balance rehabilitation interventions have been accomplished aiming to demonstrate that sensory interventions and cognitive functionality are crucial for postural control and improvement of the quality of patient's daily life. However, none of the existing studies is filling the lack of expert physiotherapists availability. A pilot randomized study was conducted to assess the acceptability of the HOLOBalance telerehabilitation system. HOLOBalance is an interactive AR rehabilitation system which encompasses multi-sensory training program to enhance balance and cognitive coaching, for older adults at falls risk. In this work, we present a sentiment analysis of the patients participating in this study using the VADER methodology to evaluate and quantify their attitude towards the HOLOBalance system. Our results highlight the importance of findings positive polarity towards the AR interaction, which is based on the use of a holographic virtual physiotherapist. The compound score of 0.185 indicates the valuable positive feedback gained from the user experience
Designing a mHealth clinical decision support system for Parkinson's disease: a theoretically grounded user needs approach.
BACKGROUND: Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson's disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty. METHODS: A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson's disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians' (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians' (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both. RESULTS: Study 1 indicated that system development should move away from the traditional silos of 'motor' and 'non-motor' symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients' overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient's condition from the patient's self-report and the wearable devices. CONCLUSIONS: Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment
Achieving adherence in home-based rehabilitation with novel human machine interactions that stimulate community-dwelling older adults
Balance disorders are expressed with main symptoms of vertigo, dizziness instability and disorientation. Most of them are caused by inner ear pathologies, but neurological, medical and psychological factors are also responsible. Balance disorders overwhelmingly affect daily activities and cause psychological and emotional hardship. They are also the main cause of falls which are a global epidemic. Home based balance rehabilitation is an effective approach for alleviating symptoms and for improving balance and self-confidence. However, the adherence in such programs is usually low with lack of motivation and disease related issues being the most influential factors. Holobalance adopts the Capability, Opportunity and Motivation (COM) and Behaviour (B) model to identify the sources of the behaviour that should be targeted for intervention and proposes specific Information Technology components that provide the identified interventions to the users in order to achieve the target behavioural change, which in this case is adherence to home base rehabilitation
Enantiopure Dinaphtho[2,3-b:2,3-f]thieno[3,2-b]thiophenes: Reaching High Magnetoresistance Effect in OFETs
Chiral molecules are known to behave as spin filters due to the chiral induced spin selectivity (CISS) effect. Chirality can be implemented in molecular semiconductors in order to study the role of the CISS effect in charge transport and to find new materials for spintronic applications. In this study, the design and synthesis of a new class of enantiopure chiral organic semiconductors based on the well-known dinaphtho[2,3-b:2,3-f]thieno[3,2-b]thiophene (DNTT) core functionalized with chiral alkyl side chains is presented. When introduced in an organic field-effect transistor (OFET) with magnetic contacts, the two enantiomers, (R)-DNTT and (S)-DNTT, show an opposite behavior with respect to the relative direction of the magnetization of the contacts, oriented by an external magnetic field. Each enantiomer displays an unexpectedly high magnetoresistance over one preferred orientation of the spin current injected from the magnetic contacts. The result is the first reported OFET in which the current can be switched on and off upon inversion of the direction of the applied external magnetic field. This work contributes to the general understanding of the CISS effect and opens new avenues for the introduction of organic materials in spintronic devices
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