Background: Shape Coding is a visual coding system that has been used to teach English syntax and morphology to school-aged children with language impairment but has the potential to support the language output of people with aphasia. While visual coding has been used effectively in a number of studies targeting basic sentence structure, these approaches are difficult to expand to include more than a limited number of arguments or to encourage individuals to produce more complex sentences. Shape Coding allows the user to work with more complex structures and verb morphology and may be valuable in improving awareness of sentence structure in adults with acquired agrammatism. Aims: The aim of the current study is to investigate whether Shape Coding could improve the verbal output of two adult chronically agrammatic speakers. Methods & Procedures: The study involves two men with chronic non-fluent aphasia, one of whom had previously worked with Shape Coding. Repeated baseline measures were collected three times before eight sessions of therapy and once immediately after the programme. These measured single word, sentence and narrative output, as well as communicative effectiveness. Data were analysed by examining the number of verbs used, the number of arguments included in sentences and the thematic completeness of utterances. Outcomes & Results: For the individual introduced to Shape Coding, improvements in verb retrieval and sentence generation were observed particularly in structured tasks, with the number of obligatory arguments increasing. In tasks requiring more spontaneous production, however, marked difficulties with sentence production remained. The second participant (previously exposed to Shape Coding) was able to produce much richer language after intervention, including a greater number of both obligatory and optional arguments post-Running head: SHAPE CODING IN APHASIA therapy, including in the unconstrained tasks. Neither participant made a significant change on the measure of functional communication. Conclusions: This small-scale study shows encouraging signs that Shape Coding has the potential to be of real value to adults with agrammatic aphasia. The intervention had a positive impact on both participants' output. Anecdotal evidence also suggested that the framework could be used as a prosthesis in everyday conversations, with the shapes acting as an 'internal prompt' to generating sentences. More research is needed to determine the optimal amount of Shape Coding therapy needed: a higher dosage over a longer period would give individuals more time to increase familiarity with the shapes; extending the sentence structures included would increase relevance to the person's communication needs.

Objectives The aims of this study were to explore individuals’ experiences of contributing to health research and to identify the types of impact that are perceived as important by participants or patient and public advisors. Specifically, research led by NMAHPP clinicians (Nursing, Midwifery, Allied health professions, Healthcare science, Psychology and Pharmacy). Methods Semi-structured one-to-one interviews were conducted with health research participants and patient or public advisors. Interviewees were recruited from five UK sites and via social media. Interview transcripts were analysed using Thematic Analysis to identify key themes and areas of disagreement. Results Twenty-one interviews were completed, and four main themes were identified. The first, optimising research experiences, included personal reflections and broader recommendations to improve participant experiences. The second, connecting health research with healthcare, described research as key for the continued development of healthcare, but illustrated that communication between research teams, participants, and clinicians could be improved. The third theme explored the personal impacts of contributing to research, with interviewees recalling common positive experiences. The final theme discussed capturing research impacts. Interviewees highlighted potential priorities for different stakeholders, but emphasised that financial impacts should not be the sole factor. Conclusion Individuals who were involved in NMAHPP health research recalled positive experiences and reported good relationships with their research teams. They felt that their contributions were valued. Suggested strategies to optimise the research experience focused on simplifying documentation, clear signposting of the research activities involved, and feedback on the research findings. Routine sharing of relevant research data with clinicians was also recommended. Personal impacts included a deeper understanding of their health condition or health more broadly, and increased confidence interacting with healthcare and other professionals. These findings will be used to inform development of a framework to capture the impact of NMAHPP research.

BACKGROUND Technology-related research for people with dementia and their carers often aims to enable people to remain living at home for longer and to prevent unnecessary hospital admissions. To develop research that is person-centred, effective and ethical, patient and public involvement (PPI) is necessary, though may be perceived as more difficult with this cohort. With recent and rapid expansions in health and care related technology, this review explores how, and with what impact, collaborations between researchers and stakeholders such as people with dementia have taken place. OBJECTIVE To describe approaches to PPI used to date in technology-related dementia research, along with the barriers and facilitators and impact of PPI in this area. METHODS A scoping review of literature relating to dementia, technology and patient and public involvement was conducted using Medline, PsycINFO, EMBASE and CINAHL. Papers were screened for inclusion by two authors. Data was then extracted using a pre-designed data extraction table by the same two authors; a third author supported resolution of any conflicts at each stage. Barriers and facilitators of undertaking PPI were then examined and themed. RESULTS Thirty-one papers were included for analysis. The majority (21/31) did not make clear distinctions between activities undertaken as PPI and activities undertaken by research participants, and as such their involvement did not fit easily into the NIHR definition of PPI. Most of this mixed involvement focused on the reviewing or evaluating of technology prototypes. A range of approaches was described, most typically using focus groups or co-design workshops. Nine studies described involvement at multiple stages through the research cycle, sometimes with evidence of sharing of decision-making power. Some studies commented on barriers or facilitators to effective PPI. Challenges identified were often around issues of working with people with significant cognitive impairments, and pressures on time and resources. Most studies did not evaluate the impact of involvement. Where reported, impact was largely reported as positive, including the experiences for patient and public partners, the impact on research quality, and the learning experience it provided for researchers. CONCLUSIONS Researchers often involve people with dementia and other stakeholders in technology research. At present involvement is often limited in scope despite aspirations for high levels of involvement and partnership working. Involving people with dementia, their carers and other stakeholders can have a positive impact on the research, patient and public partners and researchers. Wider reporting of methods and facilitative strategies along with more formalised methods for recording and reporting on meaningful impact would be helpful so that all those involved – researchers, patients, and other stakeholders – can learn how together we can best conduct research.

Background Sleep disorders are common among the aging population and people with neurodegenerative diseases. Sleep disorders have a strong bidirectional relationship with neurodegenerative diseases, where they accelerate and worsen one another. Although one-to-one individual cognitive behavioral interventions (conducted in-person or on the internet) have shown promise for significant improvements in sleep efficiency among adults, many may experience difficulties accessing interventions with sleep specialists, psychiatrists, or psychologists. Therefore, delivering sleep intervention through an automated chatbot platform may be an effective strategy to increase the accessibility and reach of sleep disorder intervention among the aging population and people with neurodegenerative diseases. Objective This work aims to (1) determine the feasibility and usability of an automated chatbot (named MotivSleep) that conducts sleep interviews to encourage the aging population to report behaviors that may affect their sleep, followed by providing personalized recommendations for better sleep based on participants’ self-reported behaviors; (2) assess the self-reported sleep assessment changes before, during, and after using our automated sleep disturbance intervention chatbot; (3) assess the changes in objective sleep assessment recorded by a sleep tracking device before, during, and after using the automated chatbot MotivSleep. Methods We will recruit 30 older adult participants from West London for this pilot study. Each participant will have a sleep analyzer installed under their mattress. This contactless sleep monitoring device passively records movements, heart rate, and breathing rate while participants are in bed. In addition, each participant will use our proposed chatbot MotivSleep, accessible on WhatsApp, to describe their sleep and behaviors related to their sleep and receive personalized recommendations for better sleep tailored to their specific reasons for disrupted sleep. We will analyze questionnaire responses before and after the study to assess their perception of our proposed chatbot; questionnaire responses before, during, and after the study to assess their subjective sleep quality changes; and sleep parameters recorded by the sleep analyzer throughout the study to assess their objective sleep quality changes. Results Recruitment will begin in May 2023 through UK Dementia Research Institute Care Research and Technology Centre organized community outreach. Data collection will run from May 2023 until December 2023. We hypothesize that participants will perceive our proposed chatbot as intelligent and trustworthy; we also hypothesize that our proposed chatbot can help improve participants’ subjective and objective sleep assessment throughout the study. Conclusions The MotivSleep automated chatbot has the potential to provide additional care to older adults who wish to improve their sleep in more accessible and less costly ways than conventional face-to-face therapy. International Registered Report Identifier (IRRID) PRR1-10.2196/45752

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