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Felber NA, Lipworth W, Tian YJA, Roulet Schwab D, Wangmo T. Informing existing technology acceptance models: a qualitative study with older persons and caregivers. Eur J Ageing 2024; 21:12. [PMID: 38551677 PMCID: PMC10980672 DOI: 10.1007/s10433-024-00801-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 04/01/2024] Open
Abstract
New technologies can help older persons age in place and support their caregivers. However, they need to be accepted by the end-users to do so. Technology acceptance models, such as TAM and UTAUT and their extensions, use factors like performance expectancy and effort expectancy to explain acceptance. Furthermore, they are based on quantitative methods. Our qualitative study investigates factors fostering and hindering acceptance among older persons and their caregivers for a variety of assistive technologies, including wearables, ambient sensors at home with and without cameras and social companion robots. The goal of this paper is twofold: On the one hand, it investigates the factors of technology acceptance models in a qualitative setting. On the other hand, it informs these models with aspects currently overlooked by them. The results reveal that performance expectancy and effort expectancy are relevant for acceptance. We also find that reliability, anxiety around technology and different social aspects have an influence on acceptance of assistive technology in aged care for all end-user groups. Our findings can be used to update current technology acceptance models and provide in-depth knowledge about the currently used factors.
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Affiliation(s)
- Nadine Andrea Felber
- Institute of Biomedical Ethics, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.
- Department of Philosophy, Macquarie University, 25B Wally's Walk, Sydney, NSW, 2109, Australia.
| | - Wendy Lipworth
- Department of Philosophy, Macquarie University, 25B Wally's Walk, Sydney, NSW, 2109, Australia.
| | - Yi Jiao Angelina Tian
- Institute of Biomedical Ethics, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Delphine Roulet Schwab
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Tenzin Wangmo
- Institute of Biomedical Ethics, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
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Levenson RW, Chen KH, Levan DT, Chen Y, Newton SL, Paul D, Yee CI, Brown CL, Merrilees J, Moss D, Wang G. Evaluating In-home Assistive Technology for Dementia Caregivers. Clin Gerontol 2024; 47:78-89. [PMID: 36732317 PMCID: PMC10394113 DOI: 10.1080/07317115.2023.2169652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Dementia caregivers (CGs) are at heightened risk for developing problems with anxiety and depression. Much attention has been directed toward developing and deploying interventions designed to protect CG health, but few have been supported by rigorous empirical evidence. Technology-based interventions that are effective, scalable, and do not add greatly to the CG burden are of particular interest. METHODS We conducted a nine-month randomized controlled trial in 63 homes evaluating People Power Caregiver (PPCg), a system of sensors in the home connected to cloud-based software that alerts CGs about worrisome deviations from normal patterns (e.g., falls, wandering). RESULTS CGs in the active condition had significantly less anxiety than those in the control condition at the six-month assessment. Greater anxiety reduction in the active condition at the six-month assessment was associated with greater interaction with PPCg via SMS text messages. There were no differences in anxiety at the three-month or nine-month assessments or in depression at any assessment. CONCLUSIONS PPCg shows promise for reducing anxiety associated with caring for a =person with dementia. CLINICAL IMPLICATIONS Technology-based interventions can help reduce CG anxiety, a major adverse consequence of caregiving that may be difficult to treat due to other demands on caregiver time and energy.
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Arya SS, Dias SB, Jelinek HF, Hadjileontiadis LJ, Pappa AM. The convergence of traditional and digital biomarkers through AI-assisted biosensing: A new era in translational diagnostics? Biosens Bioelectron 2023; 235:115387. [PMID: 37229842 DOI: 10.1016/j.bios.2023.115387] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/11/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023]
Abstract
Advances in consumer electronics, alongside the fields of microfluidics and nanotechnology have brought to the fore low-cost wearable/portable smart devices. Although numerous smart devices that track digital biomarkers have been successfully translated from bench-to-bedside, only a few follow the same fate when it comes to track traditional biomarkers. Current practices still involve laboratory-based tests, followed by blood collection, conducted in a clinical setting as they require trained personnel and specialized equipment. In fact, real-time, passive/active and robust sensing of physiological and behavioural data from patients that can feed artificial intelligence (AI)-based models can significantly improve decision-making, diagnosis and treatment at the point-of-procedure, by circumventing conventional methods of sampling, and in person investigation by expert pathologists, who are scarce in developing countries. This review brings together conventional and digital biomarker sensing through portable and autonomous miniaturized devices. We first summarise the technological advances in each field vs the current clinical practices and we conclude by merging the two worlds of traditional and digital biomarkers through AI/ML technologies to improve patient diagnosis and treatment. The fundamental role, limitations and prospects of AI in realizing this potential and enhancing the existing technologies to facilitate the development and clinical translation of "point-of-care" (POC) diagnostics is finally showcased.
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Affiliation(s)
- Sagar S Arya
- Department of Biomedical Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates
| | - Sofia B Dias
- Department of Biomedical Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates; Interdisciplinary Center for Human Performance, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal.
| | - Herbert F Jelinek
- Department of Biomedical Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates; Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, P O Box 127788, Abu Dhabi, United Arab Emirates
| | - Leontios J Hadjileontiadis
- Department of Biomedical Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates; Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, P O Box 127788, Abu Dhabi, United Arab Emirates; Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, GR, 54124, Thessaloniki, Greece
| | - Anna-Maria Pappa
- Department of Biomedical Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates; Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, P O Box 127788, Abu Dhabi, United Arab Emirates; Department of Chemical Engineering and Biotechnology, Cambridge University, Cambridge, UK.
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Prieto-Avalos G, Sánchez-Morales LN, Alor-Hernández G, Sánchez-Cervantes JL. A Review of Commercial and Non-Commercial Wearables Devices for Monitoring Motor Impairments Caused by Neurodegenerative Diseases. BIOSENSORS 2022; 13:72. [PMID: 36671907 PMCID: PMC9856141 DOI: 10.3390/bios13010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
Neurodegenerative diseases (NDDs) are among the 10 causes of death worldwide. The effects of NDDs, including irreversible motor impairments, have an impact not only on patients themselves but also on their families and social environments. One strategy to mitigate the pain of NDDs is to early identify and remotely monitor related motor impairments using wearable devices. Technological progress has contributed to reducing the hardware complexity of mobile devices while simultaneously improving their efficiency in terms of data collection and processing and energy consumption. However, perhaps the greatest challenges of current mobile devices are to successfully manage the security and privacy of patient medical data and maintain reasonable costs with respect to the traditional patient consultation scheme. In this work, we conclude: (1) Falls are most monitored for Parkinson's disease, while tremors predominate in epilepsy and Alzheimer's disease. These findings will provide guidance for wearable device manufacturers to strengthen areas of opportunity that need to be addressed, and (2) Of the total universe of commercial wearables devices that are available on the market, only a few have FDA approval, which means that there is a large number of devices that do not safeguard the integrity of the users who use them.
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Affiliation(s)
- Guillermo Prieto-Avalos
- Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
| | - Laura Nely Sánchez-Morales
- CONACYT-Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
| | - Giner Alor-Hernández
- Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
| | - José Luis Sánchez-Cervantes
- CONACYT-Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
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Mc Ardle R, Jabbar KA, Del Din S, Thomas AJ, Robinson L, Kerse N, Rochester L, Callisaya M. Using digital technology to quantify habitual physical activity in community-dwellers with cognitive impairment: A systematic review (Preprint). J Med Internet Res 2022; 25:e44352. [PMID: 37200065 DOI: 10.2196/44352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Participating in habitual physical activity (HPA) can support people with dementia and mild cognitive impairment (MCI) to maintain functional independence. Digital technology can continuously measure HPA objectively, capturing nuanced measures relating to its volume, intensity, pattern, and variability. OBJECTIVE To understand HPA participation in people with cognitive impairment, this systematic review aims to (1) identify digital methods and protocols; (2) identify metrics used to assess HPA; (3) describe differences in HPA between people with dementia, MCI, and controls; and (4) make recommendations for measuring and reporting HPA in people with cognitive impairment. METHODS Key search terms were input into 6 databases: Scopus, Web of Science, Psych Articles, PsychInfo, MEDLINE, and Embase. Articles were included if they included community dwellers with dementia or MCI, reported HPA metrics derived from digital technology, were published in English, and were peer reviewed. Articles were excluded if they considered populations without dementia or MCI diagnoses, were based in aged care settings, did not concern digitally derived HPA metrics, or were only concerned with physical activity interventions. Key outcomes extracted included the methods and metrics used to assess HPA and differences in HPA outcomes across the cognitive spectrum. Data were synthesized narratively. An adapted version of the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess the quality of articles. Due to significant heterogeneity, a meta-analysis was not feasible. RESULTS A total of 3394 titles were identified, with 33 articles included following the systematic review. The quality assessment suggested that studies were moderate-to-good quality. Accelerometers worn on the wrist or lower back were the most prevalent methods, while metrics relating to volume (eg, daily steps) were most common for measuring HPA. People with dementia had lower volumes, intensities, and variability with different daytime patterns of HPA than controls. Findings in people with MCI varied, but they demonstrated different patterns of HPA compared to controls. CONCLUSIONS This review highlights limitations in the current literature, including lack of standardization in methods, protocols, and metrics; limited information on validity and acceptability of methods; lack of longitudinal research; and limited associations between HPA metrics and clinically meaningful outcomes. Limitations of this review include the exclusion of functional physical activity metrics (eg, sitting/standing) and non-English articles. Recommendations from this review include suggestions for measuring and reporting HPA in people with cognitive impairment and for future research including validation of methods, development of a core set of clinically meaningful HPA outcomes, and further investigation of socioecological factors that may influence HPA participation. TRIAL REGISTRATION PROSPERO CRD42020216744; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216744 .
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Mamchur D, Peksa J, Kolodinskis A, Zigunovs M. The Use of Terrestrial and Maritime Autonomous Vehicles in Nonintrusive Object Inspection. SENSORS (BASEL, SWITZERLAND) 2022; 22:7914. [PMID: 36298265 PMCID: PMC9611526 DOI: 10.3390/s22207914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Traditional nonintrusive object inspection methods are complex or extremely expensive to apply in certain cases, such as inspection of enormous objects, underwater or maritime inspection, an unobtrusive inspection of a crowded place, etc. With the latest advances in robotics, autonomous self-driving vehicles could be applied for this task. The present study is devoted to a review of the existing and novel technologies and methods of using autonomous self-driving vehicles for nonintrusive object inspection. Both terrestrial and maritime self-driving vehicles, their typical construction, sets of sensors, and software algorithms used for implementing self-driving motion were analyzed. The standard types of sensors used for nonintrusive object inspection in security checks at the control points, which could be successfully implemented at self-driving vehicles, along with typical areas of implementation of such vehicles, were reviewed, analyzed, and classified.
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Affiliation(s)
- Dmytro Mamchur
- Information Technologies Department, Turiba University, Graudu Street 68, LV-1058 Riga, Latvia
- Computer Engineering and Electronics Department, Kremenchuk Mykhailo Ostrohradskyi National University, Pershotravneva 20, 39600 Kremenchuk, Ukraine
| | - Janis Peksa
- Institute of Information Technology, Riga Technical University, Kalku Street 1, LV-1658 Riga, Latvia
| | - Antons Kolodinskis
- Information Technologies Department, Turiba University, Graudu Street 68, LV-1058 Riga, Latvia
| | - Maksims Zigunovs
- Information Technologies Department, Turiba University, Graudu Street 68, LV-1058 Riga, Latvia
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Lee M, Mishra RK, Momin A, El-Refaei N, Bagheri AB, York MK, Kunik ME, Derhammer M, Fatehi B, Lim J, Cole R, Barchard G, Vaziri A, Najafi B. Smart-Home Concept for Remote Monitoring of Instrumental Activities of Daily Living (IADL) in Older Adults with Cognitive Impairment: A Proof of Concept and Feasibility Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22186745. [PMID: 36146095 PMCID: PMC9501541 DOI: 10.3390/s22186745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/20/2022] [Accepted: 08/31/2022] [Indexed: 06/10/2023]
Abstract
Assessment of instrumental activities of daily living (IADL) is essential for the diagnosis and staging of dementia. However, current IADL assessments are subjective and cannot be administered remotely. We proposed a smart-home design, called IADLSys, for remote monitoring of IADL. IADLSys consists of three major components: (1) wireless physical tags (pTAG) attached to objects of interest, (2) a pendant-sensor to monitor physical activities and detect interaction with pTAGs, and (3) an interactive tablet as a gateway to transfer data to a secured cloud. Four studies, including an exploratory clinical study with five older adults with clinically confirmed cognitive impairment, who used IADLSys for 24 h/7 days, were performed to confirm IADLSys feasibility, acceptability, adherence, and validity of detecting IADLs of interest and physical activity. Exploratory tests in two cases with severe and mild cognitive impairment, respectively, revealed that a case with severe cognitive impairment either overestimated or underestimated the frequency of performed IADLs, whereas self-reporting and objective IADL were comparable for the case with mild cognitive impairment. This feasibility and acceptability study may pave the way to implement the smart-home concept to remotely monitor IADL, which in turn may assist in providing personalized support to people with cognitive impairment, while tracking the decline in both physical and cognitive function.
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Affiliation(s)
- Myeounggon Lee
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Anmol Momin
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Nesreen El-Refaei
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Amir Behzad Bagheri
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michele K. York
- Neurology and Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mark E. Kunik
- Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX 77030, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
| | | | | | - James Lim
- BioSensics LLC, Newton, MA 02458, USA
| | | | | | | | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
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