Context-aware support for cardiac health monitoring using federated machine learning

Context-awareness provides a platform for healthcare professionals to assess the health status of patients in their care using multiple relevant parameters such as heart rate, electrocardiogram (ECG) signals and activity data. It involves the use of digital technologies to monitor the health condition of a patient in an intelligent environment. Feedback gathered from relevant professionals at earlier stages of the project indicates that physical activity recognition is an essential part of cardiac condition monitoring. However, the traditional machine learning method f developing a model for activity recognition suffers two significant challenges; model overfitting and privacy infringements. This research proposes an intelligent and privacy-oriented context-aware decision support system for cardiac health monitoring using the physiological and the activity data of the patient. The system makes use of a federated machine learning approach to develop a model for physical activity recognition. Experimental analysis shows that the federated approach has advantages over the centralized approach in terms of model generalization whilst maintaining the privacy of the user

ADAPT: Approach to Develop context-Aware solutions for Personalised asthma managemenT

People with asthma have heterogeneous triggers and symptoms, which they need to be aware of in order to implement the strategies to manage their condition. Context-aware reasoning has the potential to provide the personalisation that is required to address the heterogeneity of asthma by helping people to define the information that is relevant considering the characteristics of their condition and delivering services based on this information. This research work proposes the Approach to Develop context-Aware solutions for Personalised asthma managemenT (ADAPT), whose aim is to facilitate the creation of solutions allowing the required customisation to address the heterogeneity of asthma. ADAPT is the result of the constant interaction with people affected by asthma throughout the research project, which was possible to achieve thanks to the collaboration formed with the Centre for Applied Research of Asthma UK. ADAPT context dimensions facilitate the development of preventive and reactive features that can be configured depending on the characteristics of the person with asthma. The approach also provides support to people not knowing their triggers through case-based reasoning and includes virtual assistant as a complementing technology supporting asthma management. ADAPT is validated by people with asthma, carers and experts in respiratory conditions, who evaluated a mobile application that was built based on the approach

From trauma debriefing to trauma support: a South African experience of responding to individuals and communities in the aftermath of traumatising events

This paper documents the approach and experience of Traumaclinic, a Cape Town based organisation offering a trauma support service. The controversy over single session debriefing interventions is examined and it is concluded that interventions that invite intense emotional expression should not be offered indiscriminately or forced on those who do not want them. When they do occur, they need to be carefully managed and take place over several sessions. A review of contemporary approaches to intervention following trauma highlights their comprehensive and flexible nature and the inclusion of multiple components that are introduced in a manner responsive to the needs of the situation. This is the basis of the current model used by Traumaclinic. The principles of that model are summarised and examples given of the application of the approach to specific cases

Context-aware system for cardiac condition monitoring and management: a survey

Health monitoring assists physicians in the decision-making process, which in turn, improves quality of life. As technology advances, the usage and applications of context-aware systems continue to spread across different areas in patient monitoring and disease management. It provides a platform for healthcare professionals to assess the health status of patients in their care using multiple relevant parameters. In this survey, we consider context-aware systems proposed by researchers for health monitoring and management. More specifically, we investigate different technologies and techniques used for cardiac condition monitoring and management. This paper also propose "mCardiac", an enhanced context-aware decision support system for cardiac condition monitoring and management during rehabilitation

Context-aware approach for cardiac rehabilitation monitoring

As technology advances, the usage and applications of context-aware systems continue to spread across different areas in patient monitoring and disease management. It provides a platform for healthcare professionals to assess the health status of patients in their care using multiple relevant parameters. Existing technologies for cardiac patient monitoring are generally based on the physiological information, mostly the heart rate or Electrocardiogram(ECG) Signals. Other important factors such as physical activities and time of the day are usually ignored. We propose a context-aware solution for cardiac rehabilitation monitoring using multiple vital signs from the physiological and activity data of the patient. This research considers the activity of the patient alongside the time of the activity to facilitate physicians decision-making process. We provide a personalised physical activity recognition processing by generating a personalised model for each user. A prototype is presented to illustrate our proposed approach

A Human-in-The-Loop context-aware system allowing the application of case-based reasoning for asthma management

Determining the asthma health status of a person is a relevant task in the application of context-awareness and case-based reasoning for asthma management. As there are no devices that can track the asthma health status of a person constantly, it is necessary to use a Human-in-The-Loop (HiTL) approach for creating a solution able to associate their health status with context-related data. This research work proposes a system that implements the Asthma Control Questionnaire (ACQ) for determining the asthma health status of a person. The system links this health status to context-related data the person is exposed and creates the cases to be used by the CBR component of the system. The system is then evaluated by users from a usability perspective through the Health IT Usability Evaluation Model (Health-ITUEM)

Training on prevention of violence against women in the medical curriculum at the University of Ibadan, Nigeria

Objectives. To determine the knowledge and skills of final-year medical students in managing victims of violence against women (VAW), and to describe the extent to which VAW is included in the undergraduate curriculum of the College of Medicine, University of Ibadan.Method. A mixed-method study design was used that collected qualitative data through a review of curriculum documents and interviews of departmental heads (or their representatives) of 6 departments in the college. A semi-structured, self-administered questionnaire was used to collect quantitative data from 109 final-year students.Results. The response rate was 85.1% and respondents’ mean age was 25.2±3.1 years. Physical, sexual, psychological and economic abuse was found by 73.8%, 72.6%, 54.8% and 44.0% respectively, of the students. Most students (77.4%) felt it was part of their duty to ask patients about abuse. Students with previous training about violence were more likely to be knowledgeable (odds ratio (OR) 1.64; 95% confidence interval (CI) 0.61 - 4.42) and skilled (OR 1.27; 95% CI 0.53 - 3.05). Men had better knowledge and skills than women. VAW was not included as a topic in the curriculum.Conclusion. Most students were willing to ask patients about abuse but lacked the fundamental knowledge and skills to do so. Faculty at the college agreed to review the curriculum to improve students’ knowledge and management skills regarding VAW

Context-aware solutions for asthma condition management: a survey

The evolution of information technology has allowed the development of ubiquitous, user-centred, and context-aware solutions. This article considers existing context-aware systems supporting asthma management with the aim of describing their main benefits and opportunities for improvement. To achieve this, the main concepts related to asthma and context awareness are explained before describing and analysing the existing context-aware systems aiding asthma. The survey shows that the concept of personalisation is the key when developing context-aware solutions supporting asthma management because of the high level of heterogeneity of this condition. Hence, the benefits and challenges of context-aware systems supporting asthma management are strongly linked to contextual Just-In-Time information of internal and external factors related to a person and the heterogeneity it represents

Ambulatory blood pressure monitoring - comparison with office blood pressure in patients on antihypertensive therapy in private practice

Introduction. Available data on the use of 24-hour ambulatory blood pressure recordings in private practice are limited. For this purpose we studied 39 consecutive hypertensive patients on treatment in a private practice.Method. Office blood pressure, 24-hour ambulatory blood pressure, daytime ambulatory blood pressure and M-mode echocardiography were undertaken in 39 consecutive hypertensive patients (21 men, 18 women) on treatment.Results. Mean 24-hour ambulatory blood pressure and mean daytime ambulatory blood pressure were lower than office blood pressure, similar to findings seen in academic settings. A blood pressure load of more than 50% was seen in 12 out of 39 patients (31 %). Left ventricular hypertrophy, assessed by means of Framingham criteria, was seen in 33% of patients. A white-coat effect was seen in 15.4% of patients.Conclusions. A large proportion (33%) of patients on treatment for hypertension had left ventricular hypertrophy, despite normal electrocardiograms. Ambulatory blood pressure measurements identified a blood pressure load of more than 50% in 31 % of patients on treatment for hypertension

Symmetry breaking in MAST plasma turbulence due to toroidal flow shear

The flow shear associated with the differential toroidal rotation of tokamak plasmas breaks an underlying symmetry of the turbulent fluctuations imposed by the up-down symmetry of the magnetic equilibrium. Using experimental Beam-Emission-Spectroscopy (BES) measurements and gyrokinetic simulations, this symmetry breaking in ion-scale turbulence in MAST is shown to manifest itself as a tilt of the spatial correlation function and a finite skew in the distribution of the fluctuating density field. The tilt is a statistical expression of the "shearing" of the turbulent structures by the mean flow. The skewness of the distribution is related to the emergence of long-lived density structures in sheared, near-marginal plasma turbulence. The extent to which these effects are pronounced is argued (with the aid of the simulations) to depend on the distance from the nonlinear stability threshold. Away from the threshold, the symmetry is effectively restored