This article explores mixed methods data gathered from a pilot of a communication system prototype in the homes of 19 older adults over a period of 10 weeks. The system has been designed to enhance communication among both friends and strangers and has been developed as a possible tool to increase interaction in older adults suffering from social isolation and loneliness. The paper uses remote logging data to inform discussion of how such a technology was received and utilised over time in a home setting. Qualitative data gathered via entry and exit interviews, and weekly checkpoint calls were used to provide deeper insight into patterns and practices identified via the logs.
Falls are the most common cause of injury and hospitalization and one of the principal causes of death and disability in older adults worldwide. Measures of postural stability have been associated with the incidence of falls in older adults. The aim of this study was to develop a model that accurately classifies fallers and non-fallers using novel multi-sensor quantitative balance metrics that can be easily deployed into a home or clinic setting. We compared the classification accuracy of our model with an established method for falls risk assessment, the Berg balance scale. Data were acquired using two sensor modalities--a pressure sensitive platform sensor and a body-worn inertial sensor, mounted on the lower back--from 120 community dwelling older adults (65 with a history of falls, 55 without, mean age 73.7 ± 5.8 years, 63 female) while performing a number of standing balance tasks in a geriatric research clinic. Results obtained using a support vector machine yielded a mean classification accuracy of 71.52% (95% CI: 68.82-74.28) in classifying falls history, obtained using one model classifying all data points. Considering male and female participant data separately yielded classification accuracies of 72.80% (95% CI: 68.85-77.17) and 73.33% (95% CI: 69.88-76.81) respectively, leading to a mean classification accuracy of 73.07% in identifying participants with a history of falls. Results compare favourably to those obtained using the Berg balance scale (mean classification accuracy: 59.42% (95% CI: 56.96-61.88)). Results from the present study could lead to a robust method for assessing falls risk in both supervised and unsupervised environments.
The exponential accumulation, processing and accrual of big data in healthcare are only possible through an equally rapidly evolving field of big data analytics. The latter offers the capacity to rationalize, understand and use big data to serve many different purposes, from improved services modelling to prediction of treatment outcomes, to greater patient and disease stratification. In the area of infectious diseases, the application of big data analytics has introduced a number of changes in the information accumulation models. These are discussed by comparing the traditional and new models of data accumulation. Big data analytics is fast becoming a crucial component for the modelling of transmission-aiding infection control measures and policies-emergency response analyses required during local or international outbreaks. However, the application of big data analytics in infectious diseases is coupled with a number of ethical impacts. Four key areas are discussed in this paper: (i) automation and algorithmic reliance impacting freedom of choice, (ii) big data analytics complexity impacting informed consent, (iii) reliance on profiling impacting individual and group identities and justice/fair access and (iv) increased surveillance and population intervention capabilities impacting behavioural norms and practices. Furthermore, the extension of big data analytics to include information derived from personal devices, such as mobile phones and wearables as part of infectious disease frameworks in the near future and their potential ethical impacts are discussed. Considered together, Philos. Technol. DOI 10.1007/s13347-017-0278-y Chiara Garattini and Jade Raffle contributed equally to this work. Profiscio Ltd., 10 Great Russell Street, London WC1B 3BQ, UK the need for a constructive and transparent inclusion of ethical questioning in this rapidly evolving field becomes an increasing necessity in order to provide a moral foundation for the societal acceptance and responsible development of the technological advancement.
Ad hoc approaches mix and match existing components
Approximately one in three people over the age of 65 will fall each year, resulting in significant financial, physical, and emotional cost on the individual, their family, and society. Currently, falls are managed using on-body sensors and alarm pendants to notify others when a falls event occurs. However these technologies do not prevent a fall from occurring. There is now a growing focus on falls risk assessment and preventative interventions. Falls risk is currently assessed in a clinical setting by expert physiotherapists, geriatricians, or occupational therapists following the occurrence of an injurious fall. As the population ages, this reactive model of care will become increasingly unsatisfactory, and a proactive community-based prevention strategy will be required. Recent advances in technology can support this new model of care by enabling community-based practitioners to perform tests that previously required expensive technology or expert interpretation. Gait and balance impairment is one of the most common risk factors for falls. This paper reviews the current technical and non-technical gait and balance assessments, discusses how low-cost technology can be applied to objectively administer and interpret these tests in the community, and reports on recent research where body-worn sensors have been utilized. It also discusses the barriers to adoption in the community and proposes ethnographic research as a method to investigate solutions to these barriers.
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