In-home monitoring of older adults with vision impairment: exploring patients', caregivers' and professionals' views

Objective
To develop a conceptual framework for the design of an in-home monitoring system (IMS) based on the requirements of older adults with vision impairment (VI), informal caregivers and eye-care rehabilitation professionals.

Materials and Methods
Concept mapping, a mixed-methods statistical research tool, was used in the construction of the framework. Overall, 40 participants brainstormed or sorted and rated 83 statements concerning an IMS for older adults with VI. Multidimensional scaling and hierarchical cluster analysis were employed to construct the framework. A questionnaire yielded further insights into the views of a wider sample of older adults with VI (n=78) and caregivers (n=25) regarding IMS.

Results
Concept mapping revealed a nine-cluster model of IMS-related aspects including affordability, awareness of system capabilities, simplicity of installation, operation and maintenance, system integrity and reliability, fall detection and safe movement, user customization, user preferences regarding information delivery, and safety alerts for patients and caregivers. From the questionnaire, independence, safety and fall detection were the most commonly reported reasons for older adults and caregivers to accept an IMS. Concerns included cost, privacy, security of the information obtained through monitoring, system accuracy, and ease of use.

Discussion
Older adults with VI, caregivers and professionals are receptive to in-home monitoring, mainly for fall detection and safety monitoring, but have concerns that must be addressed when developing an IMS.

Conclusion
Our study provides a novel conceptual framework for the design of an IMS that will be maximally acceptable and beneficial to our ageing and vision-impaired population.

Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review

Background
use of virtual reality and commercial gaming systems (VR/gaming) at home by older adults is receiving attention as a means of enabling physical activity.

Objective
to summarise evidence for the effectiveness and feasibility of VR/gaming system utilisation by older adults at home for enabling physical activity to improve impairments, activity limitations or participation.

Methods
a systematic review searching 12 electronic databases from 1 January 2000–10 July 2012 using key search terms. Two independent reviewers screened yield articles using pre-determined selection criteria, extracted data using customised forms and applied the Cochrane Collaboration Risk of Bias Tool and the Downs and Black Checklist to rate study quality.

Results
fourteen studies investigating the effects of VR/gaming system use by healthy older adults and people with neurological conditions on activity limitations, body functions and physical impairments and cognitive and emotional well-being met the selection criteria. Study quality ratings were low and, therefore, evidence was not strong enough to conclude that interventions were effective. Feasibility was inconsistently reported in studies. Where feasibility was discussed, strong retention (≥70%) and adherence (≥64%) was reported. Initial assistance to use the technologies, and the need for monitoring exertion, aggravation of musculoskeletal symptoms and falls risk were reported.

Conclusions
existing evidence to support the feasibility and effectiveness VR/gaming systems use by older adults at home to enable physical activity to address impairments, activity limitations and participation is weak with a high risk of bias. The findings of this review may inform future, more rigorous research.

Where the home in valley meets the damp dirty prison : a human rights perspective on therapeutic jurisprudence and the rule of forensic psychologists in correctional settings

The roles of forensic psychologists in coerced environments such as corrections include that of treatment provider (for the offender) and that of organizational consultant (for the community). This dual role raises ethical issues between offender rights and community rights; an imbalance results in the violation of human rights. A timely reminder of a slippery ethical slope that can arise is the failure of the American Psychological Association to manage this balance regarding interrogation and torture of detainees under the Bush administration. To establish a “bright-line position” regarding ethical practice, forensic psychologists need to be cognizant of international human rights law. In this endeavor, international covenants and a universal ethical code ought to guide practice, although seemingly unresolveable conflicts between the law and ethics codes may arise. A solution to this problem is to devise an ethical framework that is based on enforceable universally shared human values regarding dignity and rights. To this end, the legal theory of therapeutic jurisprudence can assist psychologists to understand the law, the legal system, and their role in applying the law therapeutically to support offender dignity, freedom, and well-being. In this way, a moral stance is taken and the forensic role of treatment provider and/or organizational consultant is not expected to trump the prescriptions and the proscriptions of the law.

Development of a new versatile computer controlled electrochemical/ESR data acquisition system

A new versatile computer controlled electrochemlcal/ESR data acquisition system has been developed for the Investigation of short-lived radicals with life-times of 20 milliseconds and greater, Different computer programs have been developed to monitor the decay of radicals; over hours or minutes, seconds or milliseconds. Signal averaging and Fourier smoothing is employed in order to improve the signal to noise ratio. Two microcomputers are used to control the system, one home-made computer containing the M6800 chip which controls the magnetic field, and an IBM PC XT which controls the electrochemistry and the data acquisition. The computer programs are written in Fortran and C, and call machine language subroutines, The system functions by having the radical generated by an electrochemical pulse: after or during the pulse the ESR data are collected. Decaying radicals which have half-lives of seconds or greater have their spectra collected in the magnetic field domain, which can be swept as fast as 200 Gauss per second. The decay of the radicals in the millisecond region is monitored by time-resolved ESR: a technique in which data is collected in both the time domain and in the magnetic field domain. Previously, time-resolved ESR has been used (without field modulation) to investigate ultra-short-lived species with life-times in the region of only a few microseconds. The application of the data acquisition system to chemical systems is illustrated. This is the first time a computer controlled system whereby the radical is generated by electrochemical means and subsequently the ESR data collected, has been developed.

The ultimate sustainable home

The introduction of assembly line techniques to vehicle manufacturing by Henry Ford in the early 1900s dramatically reduced production costs, improved quality and made cars affordable to all. As a consequence people’s lives, cities and society were transformed.
Many attempts have been made to apply vehicle mass production techniques to domestic housing manufacturing, but the success has been limited largely due to underdeveloped manufacturing processes, incomplete integration of building services and limited consideration of environmental performance.
This paper describes an approach that promises to revolutionize the building market in Australia by providing architect designed attractive high quality comfortable modular housing system that incorporates state-of-the-art services and controls. Costs, GHG emissions and material wastage are all substantially less than timber framed housing construction commonly used in Australia.

Solar lanterns or solar home lighting systems – community preferences in East Timor

Access to electrification in rural areas of East Timor is extremely limited with as few as 5% of rural households connected to electricity. The government of East Timor intends to increase rural access to electricity significantly in the coming decade. The introduction of small PV systems is envisaged for many households in the most remote areas. Several agencies have piloted the introduction of small solar home systems (SHS) and solar lanterns. In the Railaco sub-district of East Timor, some 1000 households have experience of using either SHS and/or solar lanterns and are in a unique position to indicate a preference regarding these forms of PV lighting technology. This paper reports on a survey of 76 households in Railaco investigating experience with PV lighting systems. Results of the survey indicate a strong preference by users for SHS rather than lanterns. The preference for SHS arose from a range of factors including: a perception of better light quality; ability to illuminate the whole house; reduced risk of damage to the PV equipment; and longer duration of nightly operation. The research indicates that where a single PV lighting system is provided, users are likely to prefer SHS to solar lanterns.

An embedded suggestive interface for making home videos

This paper describes a novel suggestive interface embedded in a smart camera prototype aimed at aiding home movie makers. We focus on the problem of generating shot capture suggestions suitable to the user's filming context, intended audience and style, and formulate a novel aesthetic measure by which to judge proposed suggestions. Tight coupling between media and software allows the aesthetic measure to be sensitive to previous footage captures, including those taken without the system's prompting, in a manner allowing flexible, end-to-end migration of the authoring task from user to machine. An approximate method is used to find timely, near-optimal solutions to the aesthetic measure. Qualitative evaluation in the form of a user study shows it to be a promising approach to the flexible home movie authoring context.

Spatial activity recognition in a smart home environment using a chemotactic model

Spatial activity recognition is challenging due to the amount of noise incorporated during video tracking in everyday environments. We address the spatial recognition problem with a biologically-inspired chemotactic model that is capable of handling noisy data. The model is based on bacterial chemotaxis, a process that allows bacteria to change motile behaviour in relation to environmental gradients. Through adoption of chemotactic principles, we propose the chemotactic model and evaluate its performance in a smart house environment. The model exhibits greater than 99% recognition performance with a diverse six class dataset and outperforms the Hidden Markov Model (HMM). The approach also maintains high accuracy (90-99%) with small training sets of one to five sequences. Importantly, unlike other low-level spatial activity recognition models, we show that the chemotactic model is capable of recognising simple interwoven activities.

Situated event bootstrapping and capture guidance for automated home movie authoring

This paper describes a novel interactive media authoring framework, MediaTE, that enables amateurs to create videos of higher narrative or aesthetic quality with a completely mobile lifecycle. A novel event bootstrapping dialog is used to derive shot suggestions that yield both targetted footage and annotation enabling an automatic Computational Media Aesthetics-aware editing phase, the manual performance of which is typically a barrier to the amateur. This facilitates a move away from requiring a prior-conception of the events or locale being filmed, in the form of a template, to at-capture bootstrapping of this information. Metadata gathered as part of the critical path of media creation also has implications for the longevity and reuse of captured media assets. Results of an evaluation performed on both the usability and delivered media aspects of the system are discussed, which highlight the tenability of the proposed framework and the quality of the produced media.

Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

Background The high incidence of falls associated with Parkinson’s disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated.
Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined.
Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD.

How many seabirds do we need to track to define home-range area?

In recent years, marine predator and seabird tracking studies have become ever more popular. However, they are often conducted without first considering how many individuals should be tracked and for how long they should be tracked in order to make reliable predictions of a population's home-range area. Home-range area analysis of two seabird-tracking data sets was used to define the area of active use (where birds spent 100% of their time) and the core foraging area (where birds spent 50% of their time). Analysis was conducted on the first foraging trip undertaken by the birds and then the first two, three and four foraging trips combined. Appropriate asymptotic models were applied to the data, and the calculated home-range areas were plotted as a function of an increasing number of individuals and trips included in the sample. Data were extrapolated from these models to predict the area of active use and the core foraging area of the colonies sampled. Significant variability was found in the home-range area predictions made by analysis of the first foraging trip and the first four foraging trips combined. For shags, the first foraging trip predicted a 56% smaller area of active use when compared to the predictions made by combining the first four foraging trips. For kittiwakes, a 43% smaller area was predicted when comparing the first foraging trip with the four combined trips. The number of individuals that would be required to predict the home range area of the colony depends greatly on the number of trips included in the analysis. This analysis predicted that 39 (confidence interval 29-73) shags and 83 (CI: 109-161) kittiwakes would be required to predict 95% of the area of active use when the first four foraging trips are included in the sample compared with 135 (CI 96-156) shags and 248 (164-484) kittiwakes when only the first trip is included in the analysis. Synthesis and applications. Seabird and marine mammal tracking studies are increasingly being used to aid the designation of marine conservation zones and to predict important foraging areas. We suggest that many studies may be underestimating the size of these foraging areas and that better estimates could be made by considering both the duration and number of data logger deployments. Researchers intending to draw conclusions from tracking data should conduct a similar analysis of their data as used in this study to determine the reliability of their home-range area predictions.

Managing post-discharge care at home: an analysis of patients' and their carers' perceptions of information received during their stay in hospital

This small-scale study carried out in a Melbourne metropolitan hospital explored patients’ and their carers’ perceptions of information, adequacy of information, and their utilization of information concerning post-discharge care received from health professionals during their stay in hospital. The research design consisted of two stages. Stage one involved a qualitative approach using focused interviews of five pairs of patients and their carers, 2 weeks after discharge from hospital. Five main themes emerged from the content analysis of the interview transcripts: information given by health professionals to patients and carers, patients’ and carers’ psychological well-being, activities of daily living, caring tasks of the patients, and community linkages. A quantitative approach was used for stage two involving two sets of questionnaires, one for the patient and one for the carer, developed from the themes identified in stage one. A pilot study was conducted on three pairs of patients and their carers, 2 weeks after discharge from hospital. The main study consisted of a convenience sample of 40 pairs of patients and their carers who completed the questionnaires 2 weeks post-discharge. Data analysis of stage two of the study consisted of descriptive statistics and cross-tabulations. The main findings suggested that carers received very little information from health professionals concerning their patients’ health problems and care at home. The carers’ health and employment states were often not considered in their patients’ discharge plan. Carers who were present with their patients when they received information concerning post-discharge care experienced a decrease in anxiety during their patients’ convalescence at home, greater satisfaction with the information they received, and their patients experienced fewer medical problems post-discharge. The implications for nursing practice and research include recommendations for a more effective system of discharge planning, and further research to include a larger population with a more varied group of participants.

Assessment of measures of physical activity of children with cerebral palsy at home and school: a pilot study

ABSTRACT
Home and school are important settings where children can accrue health promoting physical activity (PA). Little is known about the PA levels and associated environmental characteristics at home and school in children with cerebral palsy (CP). An observational tool - Behaviors of Eating and Activity for Children’s Health Evaluation System (BEACHES) - offers potential for providing information.

Smart technologies to enhance social connectedness in older people who live at home

To examine the effectiveness of smart technologies in improving or maintaining the social connectedness of older people living at home.