A comparison of specialist rehabilitation and care assistant support with specialist rehabilitation alone and usual care for people with Parkinson's living in the community: study protocol for a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Parkinson's Disease is a degenerative neurological condition that causes movement problems and other distressing symptoms. People with Parkinson's disease gradually lose their independence and strain is placed on family members. A multidisciplinary approach to rehabilitation for people with Parkinson's is recommended but has not been widely researched. Studies are needed that investigate cost-effective community-based service delivery models to reduce disability and dependency and admission to long term care, and improve quality of life.</p> <p>Methods</p> <p>A pragmatic three parallel group randomised controlled trial involving people with Parkinson's Disease and live-in carers (family friends or paid carers), and comparing: management by a specialist multidisciplinary team for six weeks, according to a care plan agreed between the professionals and the patient and carer (Group A); multidisciplinary team management and additional support for four months from a trained care assistant (Group B); usual care, no coordinated team care planning or ongoing support (Group C). Follow up will be for six months to determine the impact and relative cost-effectiveness of the two interventions, compared to usual care. The primary outcomes are disability (patients) and strain (carers). Secondary outcomes include patient mobility, falls, speech, pain, self efficacy, health and social care use; carer general health; patient and carer social functioning, psychological wellbeing, health related quality of life. Semi structured interviews will be undertaken with providers (team members, care assistants), service commissioners, and patients and carers in groups A and B, to gain feedback about the acceptability of the interventions. A cost - effectiveness evaluation is embedded in the trial.</p> <p>Discussion</p> <p>The trial investigates components of recent national policy recommendations for people with long term conditions, and Parkinson's Disease in particular, and will provide guidance to inform local service planning and commissioning.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN44577970">ISRCTN44577970</a></p

Building Rapport with a 3D Conversational Agent

While embodied conversational agents improve a user\u27s experience with a system, systems meant for repeated use may need agents that build a relationship with the user. Anita is a low-cost 3D agent capable of talking, displaying emotions, gesturing, and postural mimicry, all of which may increase the rapport between agent and user. Motion capture and pressure sensors were used to create an agent capable of realistic, responsive motions. © 2011 Springer-Verlag

The Evolutionary Significance of Affect in Groups: Communication and Group Bonding

Recent theorizing and research has attempted to explicate the functions of moods and emotions within small groups. In this paper, we examine these areas and suggest that affect in groups, as well as specific mechanisms to regulate and maintain certain affective states in groups, have had important roles in promoting group survival over evolutionary history. Specifically, we suggest that affect in groups serves a coordination function, which can take one of two forms. First, affect in groups quickly provides information about the environment and group structure to other group members, thus coordinating group activity via a communication function. Second, shared affect in groups coordinates group activity through fostering group bonds and group loyalty. These two functions of affect in groups are closely related and mutually reinforcing. Current research and directions for future research within an evolutionary perspective are also discussed