Developing a systems and informatics based approach to lifestyle monitoring within eHealth:part I - technology and data management

Lifestyle monitoring forms a subset of telecare in which data derived from sensors located in the home is used to identify variations in behaviour which are indicative of a change in care needs. Key to this is the performance of the sensors themselves and the way in which the information from multiple sources is integrated within the decision making process. The paper therefore considers the functions of the key sensors currently deployed and places their operation within the context of a proposed multi-level system structure which takes due cognisance of the requisite informatics framework

Attitudes to telecare among older people, professional care workers and informal carers: a preventative strategy or crisis management?

This paper reports findings from an attitudinal survey towards telecare that emerged from twenty-two focus groups comprising ninety-two older people, fifty-five professional stakeholders and thirty-nine carers. These were convened in three different regions of England as a precursor to telecare service development. The results from this study suggest that informants’ views were shaped by prior knowledge of conventional health and social care delivery in their locality and the implication is that expectations and requirements in respect of telecare services in general are likely to be informed by wider perceptions about the extent to which community care should operate as a preventative strategy or as a mechanism for crisis management

N<i>e</i>XOS – the design, development and evaluation of a rehabilitation system for the lower limbs

Recent years have seen the development of a number of automated and semi-automated systems to support for physiotherapy and rehabilitation. These deploy a range of technologies from highly complex purpose built systems to approaches based around the use of industrial robots operating either individually or in combination for applications ranging from stroke to mobility enhancement. The NeXOS project set out to investigate an approach to the rehabilitation of the lower limbs in a way which brought together expertise in engineering design and mechatronics with specilists in rehabilitation and physiotherapy. The resulting system has resulted in a prototype of a system which is capable in operating in a number of modes from fully independent to providing direct support to a physiotherapist during manipulation of the limb. Designed around a low cost approach for an implementation ultimately capable of use in a patients home using web-baased strategies for communication with their support team, the prototype NeXOS system has validated the adoption of an integrated approach to its development. The paper considers this design and development process and provides the results from the initial tests with physiotherapists to establish the operational basis for clinical implementation

The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12-month period: the Whole Systems Demonstrator cluster randomised trial

Background: home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care. Design: a study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC). Methods: participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873). Results: analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time). Conclusions: TC potentially contributes to the amelioration in the decline in users’ mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive U

Detecting human Activities Based on a multimodal sensor data set using a bidirectional long short-term memory model: a case study

Human falls are one of the leading causes of fatal unintentional injuries worldwide. Falls result in a direct financial cost to health systems, and indirectly, to society’s productivity. Unsurprisingly, human fall detection and prevention is a major focus of health research. In this chapter, we present and evaluate several bidirectional long short-term memory (Bi-LSTM) models using a data set provided by the Challenge UP competition. The main goal of this study is to detect 12 human daily activities (six daily human activities, five falls, and one post-fall activity) derived from multi-modal data sources - wearable sensors, ambient sensors, and vision devices. Our proposed Bi-LSTM model leverages data from accelerometer and gyroscope sensors located at the ankle, right pocket, belt, and neck of the subject. We utilize a grid search technique to evaluate variations of the Bi-LSTM model and identify a configuration that presents the best results. The best Bi-LSTM model achieved good results for precision and f1-score, 43.30% and 38.50%, respectivel

Home Telehealth Uptake and Continued Use Among Heart Failure and Chronic Obstructive Pulmonary Disease Patients: a Systematic Review

Background Home telehealth has the potential to benefit heart failure (HF) and chronic obstructive pulmonary disease (COPD) patients, however large-scale deployment is yet to be achieved. Purpose The aim of this review was to assess levels of uptake of home telehealth by patients with HF and COPD and the factors that determine whether patients do or do not accept and continue to use telehealth. Methods This research performs a narrative synthesis of the results from included studies. Results Thirty-seven studies met the inclusion criteria. Studies that reported rates of refusal and/or withdrawal found that almost one third of patients who were offered telehealth refused and one fifth of participants who did accept later abandoned telehealth. Seven barriers to, and nine facilitators of, home telehealth use were identified. Conclusions Research reports need to provide more details regarding telehealth refusal and abandonment, in order to understand the reasons why patients decide not to use telehealth

Assessment of personal care and medical robots from older adults' perspective

Demographic reports indicate that population of older adults is growing significantly over the world and in particular in developed nations. Consequently, there are a noticeable number of demands for certain services such as health-care systems and assistive medical robots and devices. In today's world, different types of robots play substantial roles specifically in medical sector to facilitate human life, especially older adults. Assistive medical robots and devices are created in various designs to fulfill specific needs of older adults. Though medical robots are utilized widely by senior citizens, it is dramatic to find out into what extent assistive robots satisfy their needs and expectations. This paper reviews various assessments of assistive medical robots from older adults' perspectives with the purpose of identifying senior citizen's needs, expectations, and preferences. On the other hand, these kinds of assessments inform robot designers, developers, and programmers to come up with robots fulfilling elderly's needs while improving their life quality

Innovations to reduce demand and crowding in emergency care; a review study

Emergency Department demand continues to rise in almost all high-income countries, including those with universal coverage and a strong primary care network. Many of these countries have been experimenting with innovative methods to stem demand for acute care, while at the same time providing much needed services that can prevent Emergency Department attendance and later hospital admissions. A large proportion of patients comprise of those with minor illnesses that could potentially be seen by a health care provider in a primary care setting. The increasing number of visits to Emergency Departments not only causes delay in urgent care provision but also increases the overall cost. In the UK, the National Health Service (NHS) has made a number of efforts to strengthen primary healthcare services to increase accessibility to healthcare as well as address patients¿ needs by introducing new urgent care services. In this review, we describe efforts that have been ongoing in the UK and France for over a decade as well as specific programs to target the rising needs of emergency care in both England and France. Like many such programs, there have been successes, failures and unintended consequences. Thus, the urgent care system of other high-income countries can learn from these experiments