Longitudinal Diary Data: Six Months Real-world Implementation of Affordable Companion Robots for Older People in Supported Living

Companion robots have potential for improving wellbeing within aged care, however literature focuses on shorter-term studies often using relatively expensive platforms, raising concerns around novelty effects and economic viability. Here, we report ecologically valid diary data from two supported living facilities for older people with dementia or learning difficulties. Both sites implemented Joy for All robot animals and maintained diaries for six months. Entries were analysed using thematic analysis. We found robot use increased over the six months, changing from short, structured sessions to mainly permanent availability. Thus previously reported concerns on novelty were not warranted. Both sites reported positive outcomes including reminiscence, improved communication and potential wellbeing benefits (reduced agitation/anxiety). Incidences of negative response included devices described as ‘creepy.’ Devices appeared sufficiently robust for prolonged daily use with multiple users. Overall, we provide insight into real-world implementation of affordable companion robots, and longitudinal development of use

Ethical perceptions towards real-world use of companion robots with older people and people with dementia: Survey opinions among younger adults

Background: Use of companion robots may reduce older people’s depression, loneliness and agitation. This benefit has to be contrasted against possible ethical concerns raised by philosophers in the field around issues such as deceit, infantilisation, reduced human contact and accountability. Research directly assessing prevalence of such concerns among relevant stakeholders, however, remains limited, even though their views clearly have relevance in the debate. For example, any discrepancies between ethicists and stakeholders might in itself be a relevant ethical consideration while concerns perceived by stakeholders might identify immediate barriers to successful implementation. Methods: We surveyed 67 younger adults after they had live interactions with companion robot pets while attending an exhibition on intimacy, including the context of intimacy for older people. We asked about their perceptions of ethical issues. Participants generally had older family members, some with dementia. Results: Most participants (40/67, 60%) reported having no ethical concerns towards companion robot use when surveyed with an open question. Twenty (30%) had some concern, the most common being reduced human contact (10%), followed by deception (6%). However, when choosing from a list, the issue perceived as most concerning was equality of access to devices based on socioeconomic factors (m=4.72 on a scale 1-7), exceeding more commonly hypothesized issues such as infantilising (m=3.45), and deception (m=3.44). The lowest-scoring issues were potential for injury or harm (m=2.38) and privacy concerns (m=2.17). Over half (39/67 (58%)) would have bought a device for an older relative. Cost was a common reason for choosing not to purchase a device. Conclusions: Although a relatively small study we demonstrated discrepancies between ethical concerns raised in the philosophical literature and those likely to make the decision to buy a companion robot. Such discrepancies, between philosophers and ‘end-users’ in care of older people, and in methods of ascertainment, are worthy of further empirical research and discussion. Our participants were more concerned about economic issues and equality of access, an important consideration for those involved with care of older people. On the other hand the concerns proposed by ethicists seem unlikely to be a barrier to use of companion robots

The northern sector of the last British ice sheet : maximum extent and demise

Strongly divided opinion has led to competing, apparently contradictory, views on the timing, extent, flow configuration and decay mechanism of the last British Ice Sheet. We review the existing literature and reconcile some of these differences using remarkable new sea-bed imagery. This bathymetric data provides unprecedented empirical evidence of confluence and subsequent separation of the last British and Fennoscandian Ice Sheets. Critically, it also allows a viable pattern of ice-sheet disintegration to be proposed for the first time. Covering the continental shelf around the northern United Kingdom, extensive echosounder data reveals striking geomorphic evidence – in the form of tunnel valleys and moraines – relating to the former British and Fennoscandian Ice Sheets. The pattern of tunnel valleys in the northern North Sea Basin and the presence of large moraines on the West Shetland Shelf, coupled with stratigraphic evidence from the Witch Ground Basin, all suggest that at its maximum extent a grounded ice sheet flowed from SE to NW across the northern North Sea Basin, terminating at the continental-shelf edge. The zone of confluence between the British and much larger Fennoscandian Ice Sheets was probably across the northern Orkney Islands, with fast-flowing ice in the Fair Isle Channel focusing sediment delivery to the Rona and Foula Wedges. This period of maximum confluent glaciation (c. 30–25 ka BP) was followed by a remarkable period of large-scale ice-sheet re-organisation. We present evidence suggesting that as sea level rose, a large marine embayment opened in the northern North Sea Basin, as far south as the Witch Ground Basin, forcing the two ice sheets to decouple rapidly along a north–south axis east of Shetland. As a result, both ice sheets rapidly adjusted to new quasi-stable margin positions forming a second distinct set of moraines (c. 24–18 ka BP). The lobate overprinted morphology of these moraines on the mid-shelf west of Orkney and Shetland indicates that the re-organisation of the British Ice Sheet was extremely dynamic — probably dominated by a series of internally forced readvances. Critically, much of the ice in the low-lying North Sea Basin may have disintegrated catastrophically as decoupling progressed in response to rising sea levels. Final-stage deglaciation was marked by near-shore ice streaming and increasing topographic control on ice-flow direction. Punctuated retreat of the British Ice Sheet continued until c. 16 ka BP when, following the North Atlantic iceberg-discharge event (Heinrich-1), ice was situated at the present-day coastline in NW Scotlan

Microbial contamination and efficacy of disinfection procedures of companion robots in care homes

Background Paro and other robot animals can improve wellbeing for older adults and people with dementia, through reducing depression, agitation and medication use. However, nursing and care staff we contacted expressed infection control concerns. Little related research has been published. We assessed (i) how microbiologically contaminated robot animals become during use by older people within a care home and (ii) efficacy of a cleaning procedure. Methods This study had two stages. In stage one we assessed microbial load on eight robot animals after interaction with four care home residents, and again following cleaning by a researcher. Robot animals provided a range of shell-types, including fur, soft plastic, and solid plastic. Stage two involved a similar process with two robot animals, but a care staff member conducted cleaning. The cleaning process involved spraying with anti-bacterial product, brushing fur-type shells, followed by vigorous top-to-tail cleaning with anti-bacterial wipes on all shell types. Two samples were taken from each of eight robots in stage one and two robots in stage two (20 samples total). Samples were collected using contact plate stamping and evaluated using aerobic colony count and identification (gram stain, colony morphology, coagulase agglutination). Colony counts were measured by colony forming units per square centimetre (CFU/cm2). Results Most robots acquired microbial loads well above an acceptable threshold of 2.5 CFU/cm2 following use. The bacteria identified were micrococcus species, coagulase negative staphylococcus, diptheriods, aerobic spore bearers, and staphylococcus aureus, all of which carry risk for human health. For all devices the CFU/cm2 reduced to well within accepted limits following cleaning by both researcher and care staff member. Conclusions Companion robots will acquire significant levels of bacteria during normal use. The simple cleaning procedure detailed in this study reduced microbial load to acceptable levels in controlled experiments. Further work is needed in the field and to check the impact on the transmission of viruses

Gay Men\u27s Health Crisis: An Ecological Approach

The limited early response to the AIDS epidemic deepened existing prejudices against marginalized groups. Healthcare, government assistance, and social services were denied, insufficient, or inaccessible. The Gay Men\u27s Health Crisis (GMHC) formed in NYC in the 1980s as a volunteer-oriented community response to ameliorate social and medical conditions that clients with AIDS faced. Through Bronfenbrenner\u27s Ecological model, GMHC\u27s monthly archives made for the affected community from 1986 to 1988 were qualitatively analyzed to understand the factors that contributed to the client\u27s experiences with GMHC and AIDS. These included client reports, minutes from team leader meetings, board meeting notes, and newsletters. The major themes found in the archival data include relationships between GMHC and government, relationships between members and clients, public perceptions of AIDS, and changes in the organizational structure of staff.https://orb.binghamton.edu/research_days_posters_spring2020/1060/thumbnail.jp

Companion robots for older people: importance of user-centred design demonstrated through observations and focus groups comparing preferences of older people and roboticists in South West England.

Companion robots for older people: importance of usercentred design demonstrated through observations and focus groups comparing preferences of older people and roboticists in South West England. BMJ Open 2019;9:e032468. doi:10.1136/ bmjopen-2019-032468 ► Prepublication history and additional material for this paper are available online. To view these files, please visit the journal online (http://dx.doi. org/10.1136/bmjopen-2019- 032468). Received 25 June 2019 Revised 05 September 2019 Accepted 09 September 2019 For numbered affiliations see end of article. Correspondence to Hannah Louise Bradwell; hannah.bradwell@plymouth. ac.uk Original research © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Abstract Objective Companion robots, such as Paro, may reduce agitation and depression for older people with dementia. However, contradictory research outcomes suggest robot design is not always optimal. While many researchers suggest user-centred design is important, there is little evidence on the difference this might make. Here, we aimed to assess its importance by comparing companion robot design perceptions between older people (end users) and roboticists (developers). Design Older people and roboticists interacted with eight companion robots or alternatives at two separate events in groups of two to four people. Interactions were recorded, participants’ comments and observations were transcribed, and content was analysed. Subsequently, each group participated in focus groups on perceptions of companion robot design. Discussions were recorded and transcribed, and content was analysed. Participants and settings Seventeen older people (5 male, 12 female, ages 60–99) at a supported living retirement complex, and 18 roboticists (10 male, 8 female, ages 24–37) at a research centre away-day. Results We found significant differences in design preferences between older people and roboticists. Older people desired soft, furry, interactive animals that were familiar and realistic, while unfamiliar forms were perceived as infantilising. By contrast, most roboticists eschewed familiar and realistic designs, thinking unfamiliar forms better suited older people. Older people also expressed desire for features not seen as important by developers. A large difference was seen in attitude towards ability to talk: 12/17 (71%) older people but only 2/18 (11%) roboticists requested speech. Older people responded positively towards life-simulation features, eye contact, robot personalisation and obeying commands, features undervalued by roboticists. These differences were reflected in preferred device, with ‘Joy for All’ cat chosen most often by older people, while roboticists most often chose Paro. Conclusion The observed misalignment of opinion between end users and developers on desirable design features of companion robots demonstrates the need for user-centred design during development

Development and Demonstration of a Wireless Ultraviolet Sensing Network for Dose Monitoring and Operator Safety in Room Disinfection Applications

The use of mobile ultraviolet-C (UV-C) disinfection devices for the decontamination of surfaces in hospitals and other settings has increased dramatically in recent years. The efficacy of these devices relies on the UV-C dose they deliver to surfaces. This dose is dependent on the room layout, the shadowing, the position of the UV-C source, lamp degradation, humidity and other factors, making it challenging to estimate. Furthermore, since UV-C exposure is regulated, personnel in the room must not be exposed to UV-C doses beyond occupational limits. We proposed a systematic method to monitor the UV-C dose administered to surfaces during a robotic disinfection procedure. This was achieved using a distributed network of wireless UV-C sensors that provide real-time measurements to a robotic platform and operator. These sensors were validated for their linearity and cosine response. To ensure operators could safely remain in the area, a wearable sensor was incorporated to monitor the UV-C exposure of an operator, and it provided an audible warning upon exposure and, if necessary, ceased the UV-C emission from the robot. Enhanced disinfection procedures could then be conducted as items in the room could be rearranged during the procedure to maximise the UV-C fluence delivered to otherwise inaccessible surfaces while allowing UVC disinfection to occur in parallel with traditional cleaning. The system was tested for the terminal disinfection of a hospital ward. During the procedure, the robot was manually positioned in the room by the operator repeatedly, who then used feedback from the sensors to ensure the desired UV-C dose was achieved while also conducting other cleaning tasks. An analysis verified the practicality of this disinfection methodology while highlighting factors which could affect its adoption.</jats:p

Exploring the effect of implementing affordable socially assistive pet robots in eight care homes before and during the COVID-19 pandemic: a stratified cluster randomised controlled trial and mixed-method study.

File replaced (incorrect version) on 14/9/2022 by KT (LDS).Abstract Background Robot pets may assist towards challenges of supporting an aging population with growing dementia prevalence. Prior work focused on impacts of robot seal Paro on older adult wellbeing, but recent studies suggest good acceptability and implementation feasibility of more affordable devices (Joy for All (JfA) cats and dogs), yet effectiveness research was limited. Methods We conducted an eight-month, stratified, cluster randomised controlled trial, in eight care homes in Cornwall, UK. Over four months, four care homes each received two JfA devices (one cat and dog), and four homes received care as usual (intervention and control group). Psychometrics were collected pre and post intervention, to compare change from baseline to follow-up in the intervention vs control group. In the final four months, all eight care homes had devices, but only qualitative data was collected, due to Covid-19 and reduced capacity. The primary outcome was neuropsychiatric symptoms (Neuropsychiatric Inventory – Nursing Home version (NPI)). Care provider burden was a secondary outcome (occupational disruptiveness NPI subscale), alongside the Challenging Behaviour scale, Holden Communication scale, Campaign to End Loneliness questionnaire and medication use. Qualitative data was collected through care staff observation calendars and end-of-study interviews to understand use, experience and impact. We also collected demographic data and assessed dementia severity. In total, 253 residents had robot interaction opportunities, and 83 were consented for direct data collection. This trial was pre-registered on Clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT04168463), and is reported following the CONSORT 2010 statement: extension to cluster randomised trials. Results There was a significant difference in total change from baseline to follow-up for NPI (p=.000) and occupational disruptiveness (p=.031) scores between the intervention and control group. Neuropsychiatric symptoms increased in the control group, while decreasing in the intervention group. No significant difference was seen for communication issues or challenging behaviour. On NPI sub-domains, there was a significant difference from baseline to follow-up for delusions (p=.034), depression (p=.010), anxiety (p=.001), elation (p=.023) and apathy (p=.009), all of which decreased in the intervention group and increased slightly in the control group. The summative impact results suggested most residents who interacted with robots received a positive impact (85%, 46/54). Those who interacted had significantly higher dementia severity scores (p=.001) than those who did not interact. The qualitative results suggested good adoption and acceptability, suitability for subjectively lonely individuals, lack of novelty effect through sustained use and demonstrated ‘reasons for use’ of robots were entertainment, anxiety and agitation. Conclusion Affordable robot pets hold potential in improving wellbeing for care home residents and people with dementia, including reduced neuropsychiatric symptoms and occupational disruptiveness. This work suggests no novelty effect, and contributes towards understanding robot pet suitability, finding interactions were more common among residents with more moderate/severe dementia and potentially those subjectively lonely

User-Centered Design of Companion Robot Pets Involving Care Home Resident-Robot Interactions and Focus Groups With Residents, Staff, and Family: Qualitative Study

Background: Globally, pressure is increasing on health and social care resources due to the aging population and growing prevalence of dementia. Companion robots, such as Paro, demonstrate strong potential for helping reduce this pressure through reported benefits including reduced agitation, depression, loneliness, care provider burden, and medication use. However, we previously identified that user-centered design of robot pets is both essential and understudied. We observed that commonly used robot pets are poorly matched to end-user requirements, and that end users and developers of robot pets differ significantly in their perception of appropriate design. This may explain some of the contradictory outcome research and variance in results for robot pets, such as Paro. Objective: In response to the literature gap, we aimed to provide user-centered insights into the design of robot pets from key stakeholders to inform future robot development and the choice of robots for real-world implementation and research. We focused on understanding user requirements. Methods: We conducted a qualitative study with 65 participants from 5 care homes (26 care home residents, 29 staff members. and 10 family members). Care home residents formed groups of between 3 and 4 individuals and experienced free interactions with a range of 8 companion robots and toys, including Paro and more affordable alternatives. The robots provided had a range of esthetics, shell types, interactivity levels, and designs for comparison. Care staff and family members observed the interactions. All participants then engaged in focus groups within their stakeholder category to discuss preferences and user requirements in companion robot design. Both free interactions and focus groups were video and audio recorded, transcribed, and subjected to thematic analysis. Results: Care home residents, family members, and staff were open and accepting of the use of companion robot pets, with the majority suggesting that they would keep a device for themselves or the residents. The most preferred device was the Joy for All cat, followed by the Joy for All dog. In discussions, the preferred design features included familiar animal embodiment (domestic pet), soft fur, interactivity, big appealing eyes, simulated breathing, and movements. Unfamiliar devices were more often seen as toy-like and suitable for children, producing some negative responses. Conclusions: This work provides important and user-centered insights into future robot designs for care home residents by means of a comprehensive comparison with key stakeholders. This work strongly supports the use of familiar embodiment in future robot pet designs, with domestic cat and dog morphologies appearing most acceptable. The results have implications for future robot designs and the selection of robot pets for both research and real-world implementations

User-defined challenges and desiderata for robotics and autonomous systems in health and social care settings

We report the needs and challenges identified by health and social care professionals and service users for robotics and autonomous systems that are of importance to researchers and policymakers. To this end, we held eight workshops in different locations across Cornwall (UK) in which we raised awareness of the applications and opportunities of assistive robots. The 223 participants could interact physically with four robots, watched a multimedia presentation including video and use-case scenarios and then took part in 33 focus groups. Content analysis was carried out based on summaries written by facilitators during the focus groups. The focus groups produced 163 challenges that may have digital solutions including 78 suitable for robotic assistive technology, in three main areas: maintaining independence at home, social isolation, and rurality. Although further research is needed with technology and its implementation, this study shows that health and social care professionals, patients, carers, and students are willing to consider using robotics and autonomous systems in health and social care settings