Towards Attention Monitoring of Older Adults with Cognitive Impairment During Interaction with an Embodied Conversational Agent

International audienceEmbodied conversational agents (ECAs) are virtual characters using verbal and non-verbal communication for Human-machine interaction. The aim of our research is to create an ECA-based user interface for assistive technologies targeting older adults with cog-nitive impairment. Our design methodology is a co-design living lab approach, collecting design guidelines through questionnaires, focus groups and user trials. In this paper, we report on the results of the first phase of this iterative design process. We developed Louise, a semi-automatic ECA prototype that aims to compensate, through attention monitoring , for a user's attentional disorders by performing autonomous prompting, i.e., calling the user to regain his or her attention in case he or she got distracted. We evaluated the performance of Louise with a group of experts in assistive technologies and collected their feedback. Louise's simple attention estimator is more than 80% accurate. The system got quite positive reviews from users

Pump requirements for betatron-generated femtosecond X-ray laser at saturation from inner-shell transitions

International audienceWe study pump requirements to produce femtosecond X-ray laser pulses at saturation from inner-shell transitions in the amplified spontaneous emission regime. Since laser-based betatron radiation is considered as the pumping source, we first study the impact of the driving laser power on its intensity. Then we investigate the amplification behavior of the K-a transition of nitrogen at 3.2 nm (395 eV) from radiative transfer calculations coupled with kinetics modeling of the ion population densities. We show that the saturation regime may be experimentally achieved by using PW-class laser-accelerated electron bunches. Finally, we show that this X-ray laser scheme can be extended to heavier atoms and we calculate pump requirements to reach saturation at 1.5 nm (849 eV) from the K-a transition of neon. © Springer-Verlag 2012

Reduction of Time on the Ground Related to Real-Time Video Detection of Falls in Memory Care Facilities: Observational Study

Background Lying on the floor for a long period of time has been described as a critical determinant of prognosis following a fall. In addition to fall-related injuries due to the trauma itself, prolonged immobilization on the floor results in a wide range of comorbidities and may double the risk of death in elderly. Thus, reducing the length of Time On the Ground (TOG) in fallers seems crucial in vulnerable individuals with cognitive disorders who cannot get up independently. Objective This study aimed to examine the effect of a new technology called SafelyYou Guardian (SYG) on early post-fall care including reduction of Time Until staff Assistance (TUA) and TOG. Methods SYG uses continuous video monitoring, artificial intelligence, secure networks, and customized computer applications to detect and notify caregivers about falls in real time while providing immediate access to video footage of falls. The present observational study was conducted in 6 California memory care facilities where SYG was installed in bedrooms of consenting residents and families. Fall events were video recorded over 10 months. During the baseline installation period (November 2017 to December 2017), SYG video captures of falls were not provided on a regular basis to facility staff review. During a second period (January 2018 to April 2018), video captures were delivered to facility staff on a regular weekly basis. During the third period (May 2018 to August 2018), real-time notification (RTN) of any fall was provided to facility staff. Two digital markers (TUA, TOG) were automatically measured and compared between the baseline period (first 2 months) and the RTN period (last 4 months). The total number of falls including those happening outside of the bedroom (such as common areas and bathrooms) was separately reported by facility staff. Results A total of 436 falls were recorded in 66 participants suffering from Alzheimer disease or related dementias (mean age 87 years; minimum 65, maximum 104 years). Over 80% of the falls happened in bedrooms, with two-thirds occurring overnight (8 PM to 8 AM). While only 8.1% (22/272) of falls were scored as moderate or severe, fallers were not able to stand up alone in 97.6% (247/253) of the cases. Reductions of 28.3 (CI 19.6-37.1) minutes in TUA and 29.6 (CI 20.3-38.9) minutes in TOG were observed between the baseline and RTN periods. The proportion of fallers with TOG &gt;1 hour fell from 31% (8/26; baseline) to zero events (RTN period). During the RTN period, 76.6% (108/141) of fallers received human staff assistance in less than 10 minutes, and 55.3% (78/141) of them spent less than 10 minutes on the ground. Conclusions SYG technology is capable of reducing TOG and TUA while efficiently covering the area (bedroom) and time zone (nighttime) that are at highest risk. After 6 months of SYG monitoring, TOG was reduced by a factor of 3. The drastic reduction of TOG is likely to decrease secondary comorbid complications, improve post-fall prognosis, and reduce health care costs. </jats:sec

Reduction of Time on the Ground Related to Real-Time Video Detection of Falls in Memory Care Facilities: Observational Study.

BackgroundLying on the floor for a long period of time has been described as a critical determinant of prognosis following a fall. In addition to fall-related injuries due to the trauma itself, prolonged immobilization on the floor results in a wide range of comorbidities and may double the risk of death in elderly. Thus, reducing the length of Time On the Ground (TOG) in fallers seems crucial in vulnerable individuals with cognitive disorders who cannot get up independently.ObjectiveThis study aimed to examine the effect of a new technology called SafelyYou Guardian (SYG) on early post-fall care including reduction of Time Until staff Assistance (TUA) and TOG.MethodsSYG uses continuous video monitoring, artificial intelligence, secure networks, and customized computer applications to detect and notify caregivers about falls in real time while providing immediate access to video footage of falls. The present observational study was conducted in 6 California memory care facilities where SYG was installed in bedrooms of consenting residents and families. Fall events were video recorded over 10 months. During the baseline installation period (November 2017 to December 2017), SYG video captures of falls were not provided on a regular basis to facility staff review. During a second period (January 2018 to April 2018), video captures were delivered to facility staff on a regular weekly basis. During the third period (May 2018 to August 2018), real-time notification (RTN) of any fall was provided to facility staff. Two digital markers (TUA, TOG) were automatically measured and compared between the baseline period (first 2 months) and the RTN period (last 4 months). The total number of falls including those happening outside of the bedroom (such as common areas and bathrooms) was separately reported by facility staff.ResultsA total of 436 falls were recorded in 66 participants suffering from Alzheimer disease or related dementias (mean age 87 years; minimum 65, maximum 104 years). Over 80% of the falls happened in bedrooms, with two-thirds occurring overnight (8 PM to 8 AM). While only 8.1% (22/272) of falls were scored as moderate or severe, fallers were not able to stand up alone in 97.6% (247/253) of the cases. Reductions of 28.3 (CI 19.6-37.1) minutes in TUA and 29.6 (CI 20.3-38.9) minutes in TOG were observed between the baseline and RTN periods. The proportion of fallers with TOG &gt;1 hour fell from 31% (8/26; baseline) to zero events (RTN period). During the RTN period, 76.6% (108/141) of fallers received human staff assistance in less than 10 minutes, and 55.3% (78/141) of them spent less than 10 minutes on the ground.ConclusionsSYG technology is capable of reducing TOG and TUA while efficiently covering the area (bedroom) and time zone (nighttime) that are at highest risk. After 6 months of SYG monitoring, TOG was reduced by a factor of 3. The drastic reduction of TOG is likely to decrease secondary comorbid complications, improve post-fall prognosis, and reduce health care costs

X-ray amplification in Ne-like silver - gain determination and time-resolved beam divergence measurement

International audienc

Objeção de consciência, aborto e religiosidade: práticas e comportamentos dos profissionais de saúde em Lisboa Conscience objection, abortion and religiosity: practices and behaviors of the health professionals in Lisbon, Portugal

Neste artigo, discuto a presença da dimensão religiosa na biomedicina1 que se manifesta nos discursos, nas práticas e nos comportamentos desses profissionais em Lisboa quando o assunto refere-se ao aborto. Ao mesmo tempo, observo que tal religiosidade não se configura homogeneamente entre os sujeitos, pois muitos ao se declararem objetores de consciência utilizam esse protocolo como poder simbólico,2 afetando as mulheres em seus direitos reprodutivos. Foram realizadas 12 entrevistas semi-estruturadas durante o doutorado-sanduíche com profissionais de saúde que trabalhavam em diferentes instituições hospitalares nesse país.<br>In this article I discuss the presence of the religious dimension in the biomedical area manifested in the discourses, practices and behaviors of these professionals in Lisbon, Portugal, when the issue is abortion. At the same time I observe that such religiosity does not configure itself homogeneously among the subjects, because many, claiming to be conscience objectors, use this protocol as symbolic power affecting women in their reproductive rights. Twelve semi-structured interviews were made during the sandwich doctorate with health professionals who work in different hospitals in Portugal

Femtosecond Soft X-Ray Laser by Temporal Ionization Gating

International audienc

Extended, continuous measures of functional status in community dwelling persons with Alzheimer's and related dementia: Infrastructure, performance, tradeoffs, preliminary data, and promise.

BackgroundThe past decades have seen phenomenal growth in the availability of inexpensive and powerful personal computing devices. Efforts to leverage these devices to improve health care outcomes promise to remake many aspects of healthcare delivery, but remain in their infancy.New methodWe describe the development of a mobile health platform designed for daily measures of functional status in ambulatory, community dwelling subjects, including those who have Alzheimer's disease or related neurodegenerative disorders. Using Smartwatches and Smartphones we measure subject overall activity and outdoor location (to derive their lifespace). These clinically-relevant measures allow us to track a subject's functional status in their natural environment over prolonged periods of time without repeated visits to healthcare providers. Functional status metrics are integrated with medical information and caregiver reports, which are used by a caregiving team to guide referrals for physician/APRN/NP care. COMPARISON: with Existing Methods We describe the design tradeoffs involved in all aspects of our current system architecture, focusing on decisions with significant impact on system cost, performance, scalability, and user-adherence.ResultsWe provide real-world data from current subject enrollees demonstrating system accuracy and reliability.ConclusionsWe document real-world feasibility in a group of men and women with dementia that Smartwatches/Smartphones can provide long-term, relevant clinical data regarding individual functional status. We describe the underlying considerations of this system so that interested organizations can adapt and scale our approach to their needs. Finally, we provide a potential agenda to guide development of future systems