Charting Complex Changes: Application of the eHealth Implementation Toolkit (e-HIT) in the Delivering Assisted Living Lifestyles at Scale (dallas) Programme

The 'dallas' (Delivering Assisted Living Lifestyles at Scale) programme is a UK-wide digital healthcare initiative that has been designed to support independent living, enhance preventative care, and improve lifestyles by harnessing the potential of e-health technologies and digital services. This short paper presents a brief update on one strand of the University of Glasgow evaluation of the dallas programme. We have used the e-Health Implementation Toolkit (e-HIT) to investigate processes involved in the implementation of e-health tools and digital services being developed and deployed across the dallas communities and to assess 'distance travelled' by communities from baseline to midpoint of a three year programme. Qualitative data analysis was guided by the Normalisation Process Theory (NPT) and Framework Analysis. The e-HIT scores indicated that the dallas communities had underestimated the amount of work involved in implementing at scale. Qualitative data analysis showed that communities have successfully navigated barriers in order to make significant progress in strategic areas, including the development of new models of partnership working resulting in brand recognition and agile service design. The dallas communities are now sharing lessons learned and generating new professional knowledge, skills and understanding across several key strategic areas required for operationalising the implementation of e-health technologies and digital services at scale. The new knowledge being generated through the dallas programme will contribute to the ongoing transformation of digitally enabled healthcare based on more personalised flexible models of provision which resonates with the current e-health policy environment

Evaluation of a mobile phone-based, advanced symptom management system (ASyMS©) in the management of chemotherapy-related toxicity

Objectives: To evaluate the impact of a mobile phone-based, remote monitoring, advanced symptom management system (ASyMS©) on the incidence, severity and distress of six chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand-foot syndrome and diarrhoea) in patients with lung, breast or colorectal cancer. Design: A two group (intervention and control) by five time points (baseline, pre-cycle 2, pre-cycle 3, pre-cycle 4 and pre-cycle 5) randomised controlled trial. Setting: Seven clinical sites in the UK; five specialist cancer centres and two local district hospitals. Participants: One hundred and twelve people with breast, lung or colorectal cancer receiving outpatient chemotherapy. Interventions: A mobile phone-based, remote monitoring, advanced symptom management system (ASyMS©). Main outcome measures: Chemotherapy-related morbidity of six common chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand-foot syndrome and diarrhoea). Results: There were significantly higher reports of fatigue in the control group compared to the intervention group (odds ratio∈=∈2.29, 95%CI∈=∈1.04 to 5.05, P∈=∈0.040) and reports of hand-foot syndrome were on average lower in the control group (odds ratio control/intervention∈=∈0.39, 95%CI∈=∈0.17 to 0.92, P∈=∈0.031). Conclusion: The study demonstrates that ASyMS © can support the management of symptoms in patients with lung, breast and colorectal cancer receiving chemotherapy

An Atlas of FUSE Sight Lines Toward the Magellanic Clouds

We present an atlas of 57 Large Magellanic Cloud (LMC) and 37 Small Magellanic Cloud (SMC) observations obtained with the Far Ultraviolet Spectroscopic Explorer (FUSE) satellite. The atlas highlights twelve interstellar absorption line transitions at a resolution of ~15 km/s. These transitions cover a broad range of temperatures, ionization states, and abundances. The species included are OVI, which probes hot (T~3x10^5 K) ionized gas; CIII and FeIII, which probe warm (T~10^4 K) ionized gas; SiII, PII, CII, FeII, and OI, warm neutral gas; and six different molecular hydrogen transitions, which trace cold (T<=500 K) gas. We include Schmidt Halpha CCD images of the region surrounding each sight line showing the morphology of warm ionized gas in the vicinity, along with continuum images near each FUSE aperture position. Finally, we present several initial scientific results derived from this dataset on the interstellar medium of the Magellanic Clouds and Galactic halo.Comment: 29 pages, 6 figures. Complete Atlas of 94 additional images (~800kB each) is available at http://fuse.pha.jhu.edu/~danforth/atlas Accepted to the ApJS March 200

Robot deployment in long-term care: a case study of a mobile robot in physical therapy

Background. Healthcare systems in industrialised countries are challenged to provide care for a growing number of older adults. Information technology holds the promise of facilitating this process by providing support for care staff, and improving wellbeing of older adults through a variety of support systems. Goal. Little is known about the challenges that arise from the deployment of technology in care settings; yet, the integration of technology into care is one of the core determinants of successful support. In this paper, we discuss challenges and opportunities associated with technology integration in care using the example of a mobile robot to support physical therapy among older adults with cognitive impairment in the European project STRANDS. Results and discussion. We report on technical challenges along with perspectives of physical therapists, and provide an overview of lessons learned which we hope will help inform the work of researchers and practitioners wishing to integrate robotic aids in the caregiving process

Reminders that make sense: designing multimodal notifications for the home

This paper argues that reminders or notifications delivered in the home (such as appointments or when to take medication) should be available in multiple modalities (visual, auditory, tactile and olfactory) in order to increase the usability and acceptability of electronic home reminder systems. Briefly reviewing the context of the home as an interaction space this paper introduces some of the issues that can be addressed by exploiting multimodality. The paper goes on to present an overview of the different modalities available for electronic reminder delivery and finally gives an overview of the guidelines for multimodal reminder design emerging from the first year of the MultiMemoHome Project

User-centred multimodal reminders for assistive living

While there has been a lot of research on the usability of reminders and alarms in the work context, the home has been somewhat neglected despite the importance of reminder systems for telecare and assistive living systems. We conducted a comprehensive mixed-methods study into the requirements for useable and acceptable reminders in the home. The study consisted of a questionnaire (N=379), 6 focus groups, and 7 home tour interviews. Our results highlight the need for highly flexible and contextualized multimodal and multi-device reminder solutions that build on existing successful strategies for remembering in and around the home. We suggest that developers of home care reminder systems should design for diversity, context, priorities, autonomy, shared spaces, and optimal care. Author Keywords Multimodal interfaces, personalisation, reminder systems, assisted living, telecare. focus groups, home tours, survey

User-centred design of technologies to support Care at home

This chapter argues that user centred design and evaluation of home care technologies is fundamental for their success. Designing technologies that work and that are acceptable to users is a significant challenge. Including users in the process of design and development increases the likelihood for products that result in good usability and positive user experiences. This in turn should lead to increased uptake and success of assisted living technologies in the homes of users. This chapter provides a brief overview of user centred design methods and presents several examples of how these have been used in the MATCH project in the design of technologies to support care at home. We also present some emerging guidelines for the design of home care technologies

Designing multimodal reminders for the home: pairing content with presentation

Reminder systems are a specific range of technologies for care at home that can deliver notifications or reminders (such as 'take your medication') to assist with daily living. How to best deliver these reminders is an interesting research challenge. Today's technologies have the potential to deliver the notifications in a range of output modalities. The delivery methods can be selected both by the system (depending on what devices are available in the home) and on the users' needs, capabilities and preferences. This paper describes a user-centred approach to the design of multimodal output for reminders in the home. In a focus group study (N=15), this paper explores how six output modalities could be used to present reminders in a home setting. The results demonstrate user requirements that can be incorporated into the early phases of the design of a multimodal reminder system