Technical Development and Clinical Evaluation of Intelligent Continence Management System at Nursing Home

International audienceUrinary incontinence and diaper use is common among elderly people with dementia staying at nursing homes. Delays in timely diaper change will cause personal, social and economic ramifications to those elderly as well as to the carers who provide nursing care. In order to alleviate these daily care issues, an intelligent continence management system leveraging on sensors, pervasive sensor network, ambient intelligence and reminders is designed and developed. Clinical trial is conducted with multiple elderly people with dementia at a nursing home to evaluate the applicability and usefulness of the developed system. The analysis of trial outcomes and usability studies proves that this will be a feasible and effective approach to tackle the problems faced in managing incontinence effectively at nursing home

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Heavens of March, 1936

International audienceWe discuss an integrated approach towards building systems for monitoring and assisting people with mild dementia in their homes. Our approach differs from existing approaches in three ways. First we improve context acquisition and understanding with the concept of micro-context that takes us beyond existing notions of location and temporal context; second, we incorporate plasticity concept into the human computer interface, in order to provide a natural interaction way and accommodative interface to the user; third we target robust and reliable systems that are easy to scale and deploy in diverse end-user settings, through the use of formal model building tools to specify and verify systems at key stages from requirements generation all the way to deployment and user statistics gathering. In order to address real-life end user requirements we are working closely with geriatric doctors and their staff, so as to get inputs as to precise challenges in caring for mild dementia patients, and how systems targeted at holistic, personalized assistance and care-giving can be built with a view towards scaled up deployment in diverse settings. The main contribution of this paper is an approach for system building that incorporates activity monitoring, user interface plasticity and scenario verification targeting people with cognitive decline in regards to a Singapore initiative called A-Star Home 2015 Phase II. We expect our work to lead to a methodology for systematic development of monitoring and assistive systems for cognitive interventions for mild dementia patients at home. Although the integrated framework is still not completely realized, the three areas mentioned above have each yielded significant results on their own, and these are mentioned in the pape

The Healthy Ageing Questionnaire Index: Validation in the Singapore Longitudinal Ageing Study

10.1159/000533635Gerontology691

Growing and gaining through caring for a loved one with dementia

10.1177/1471301209103269Dementia82245-26

Implementation and effectiveness of a multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres

10.1038/s41598-021-83408-5Scientific Reports111378