Ambient activity monitoring systems produce large amounts of data, which can be used for health monitoring. The problem is that patterns in this data reflecting health status are not identified yet. In this paper the possibility is explored of predicting the functional health status (the motor score of AMPS = Assessment of Motor and Process Skills) of a person from data of binary ambient sensors. Data is collected of five independently living elderly people. Based on expert knowledge, features are extracted from the sensor data and several subsets are selected. We use standard linear regression and Gaussian processes for mapping the features to the functional status and predict the status of a test person using a leave-oneperson-out cross validation. The results show that Gaussian processes perform better than the linear regression model, and that both models perform better with the basic feature set than with location or transition based features. Some suggestions are provided for better feature extraction and selection for the purpose of health monitoring. These results indicate that automated functional health assessment is possible, but some challenges lie ahead. The most important challenge is eliciting expert knowledge and translating that into quantifiable features.
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Wireless sensor networks are becoming popular in the field of ambient assisted living. In this paper we report our study on the relationship between a functional health metric and features derived from the sensor data. Sensor systems are installed in the houses of nine people who are also quarterly visited by an occupational therapist for functional health assessments. Different features are extracted and these are correlated with a metric of functional health (the AMPS). Though the sample is small, the results indicate that some features are better in describing the functional health in the population, but individual differences should also be taken into account when developing a sensor system for functional health assessment.
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Background: Over the years, a plethora of frailty assessment tools has been developed. These instruments can be basically grouped into two types of conceptualizations – unidimensional, based on the physical–biological dimension – and multidimensional, based on the connections among the physical, psychological, and social domains. At present, studies on the comparison between uni- and multidimensional frailty measures are limited. Objective: The aims of this paper were: 1) to compare the prevalence of frailty obtained using a uni- and a multidimensional measure; 2) to analyze differences in the functional status among individuals captured as frail or robust by the two measures; and 3) to investigate relations between the two frailty measures and disability.
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In het postdoc-onderzoek gaat Dr. Machteld van Lieshout, hogeschooldocent bij de opleiding Voeding en Diëtetiek en onderzoeker in het lectoraat Gezonde Leefstijl in een Stimulerende Omgeving (GLSO) en het onderzoekscentrum van Voeding en Diëtetiek van De Haagse Hogeschool (HHs), kennis ontwikkelen over de wijze waarop persoonsgerichte mHealth ingezet kan worden ter bevordering van een gezonde(re) leefstijl van kwetsbare groepen. Dit is zeer belangrijk omdat mensen met een lage sociaaleconomische status en/of een niet-Nederlandse achtergrond een veel groter risico hebben op leefstijl-gerelateerde aandoeningen als hart- en vaatziekten, diabetes en kanker. De huidige mHealth leefstijl-activatie-tools sluiten onvoldoende aan op de wensen, behoeften en mogelijkheden van kwetsbare groepen (hier: jonge moeders en Hindoestanen) om het risico te verlagen. Het project bestaat uit vier, deels in de tijd overlappende, fasen gericht op de volgende onderzoeksvraag: Hoe kunnen kwetsbare doelgroepen gemotiveerd worden tot een gezonde(re) leefstijl middels een in co-creatie ontwikkelde mHealth leefstijl-activatie-tool? Binnen het project is een grote verwevenheid tussen onderzoek en onderwijs. Het project draagt bij aan de kennisagenda’s van het platform Kwaliteit van Leven: Mens en Technologie van de HHs, SPRONG Vitale Delta, alsmede aan de NWA-route Gezondheidszorgonderzoek, preventie en behandeling. De opgedane kennis vloeit rechtstreeks terug naar het onderwijs en werkveld. Deelonderzoeken zullen aangeboden worden als praktijkopdrachten in het reguliere curriculum. De ontwikkelde mHealth tool zal tevens ter beschikking worden gesteld aan de kwetsbare doelgroepen en het werkveld. Met haar achtergrond als voedingswetenschapper, haar ruime multidisciplinaire project- en onderzoekservaring en netwerk in binnen- en buitenland is Machteld de juiste kandidaat voor dit postdoc-onderzoek. Machteld wordt in dit onderzoek bijgestaan door de lector GLSO en het hoofd van het onderzoekscentrum van Voeding & Diëtetiek en de hierbij aangesloten onderzoeksgroepen. Daarnaast is een groot netwerk beschikbaar van samenwerkingspartners betrokken bij de thematiek van deze aanvraag.
HET 'POST INTENSIVE CARE SYNDROOM'; LANGDURIGE GEVOLGEN VAN EEN INTENSIVE CARE OPNAME Dankzij verbeteringen in de zorg overleven steeds meer patiënten de behandeling op een intensive care (IC). Keerzijde hiervan zijn de lichamelijke en mentale klachten (Post Intensive Care Syndroom - PICS) waarvoor patiënten vaak langdurige revalidatie nodig hebben i.v.m. verminderde belastbaarheid en vermoeidheid. Tijdens de Covid-19 pandemie blijkt dat relatief veel IC-patiënten een migratieachtergrond en/of lage sociaaleconomische status hebben en dat een grote groep geen nazorg ontvangt. E-HEALTH ALS ONDERSTEUNING VAN DE ZORGVERLENER: HOE ZET JE HET IN? Om de Juiste Zorg op de Juiste Plek te geven wordt eHealth met coaching en telemonitoring steeds vaker ingezet bij revalidatie in de thuissituatie. Atris is een voorbeeld van een toepassing waarbij via sensoren het activiteitenniveau en hartslag gemeten worden. Atris is een veelbelovende toepassing voor patiënten met PICS maar fysiotherapeuten hebben nog beperkt ervaring met het integreren van eHealth in de behandelaanpak en beschikken over onvoldoende kennis en vaardigheden om de applicaties optimaal in te zetten en zorg op afstand te verlenen. E-HEALTH ALS ONDERSTEUNING VAN DE PATIËNT: JUISTE ZORG OP DE JUISTE PLEK VOOR IEDEREEN? eHealth applicaties dienen de zelfredzaamheid, zelfstandigheid en eigen regie van patiënten te bevorderen. Bij patiënten die thuis herstellen na een IC opname kan eHealth door gebruik van continue monitoring van vitale parameters, patiënten ondersteunen door het gevoel van veiligheid te vergroten en inzicht te verschaffen in belasting en belastbaarheid. Echter, bestaande applicaties zijn momenteel niet voor iedereen toegankelijk zoals mensen met een migratieachtergrond of beperkte gezondheidsvaardigheden. Het doel van het Lifeline project is om, in een consortium met professionals vanuit de technologie, revalidatie en maatschappelijke organisaties, de bestaande Atris applicatie door te ontwikkelen richting een slimme, gebruiksvriendelijke en toegankelijke app en toe te passen in de fysiotherapeutische behandeling van patiënten met PICS.
In leaving the more traditional territories of the concert performance for broader societal contexts, professional musicians increasingly devise music in closer collaboration with their audience rather than present it on a stage. Although the interest for such forms of devising co-creative musicking within the (elderly) health care sector is growing, the work can be considered relatively new. In terms of research, multiple studies have sought to understand the impact of such work on musicians and participants, however little is known about what underpins the musicians’ actions in these settings. With this study, I sought to address this gap by investigating professional musicians’ emerging practices when devising co-creative musicking with elderly people. Three broad concepts were used as a theoretical background to the study: Theory of Practice, co-creative musicking, and Praxialism. Firstly, I used Theory of Practice to help understand the nature of emerging practices in a wider context of change in the field of music and habitus of musicians and participants. Theory of Practice enabled me to consider a practice as “a routinized type of behaviour which consists of several elements, interconnected to one another: forms of bodily activities, forms of mental activities, ‘things’ and their use, a background knowledge in the form of understanding, know-how, states of emotion, and motivational knowledge” (Reckwitz, 2002, p. 249). Secondly, I drew the knowledge from co-creative musicking, which is a concept I gathered from two existing concepts: co-creation and musicking. Musicking (Small, 1998), which considers music as something we do (including any mode of engagement with music), provided a holistic and inclusive way of looking at participation in music-making. The co-creation paradigm encompasses a view on enterprise that consists of bringing together parties to jointly create an outcome that is meaningful to all (Prahalad & Ramaswamy, 2004; Ramaswamy & Ozcan, 2014). The concept served as a lens to specify the jointness of the musicking and challenge issues of power in the engagement of participants in the creative-productive process. Thirdly, Praxialism considers musicking as an activity that encompasses “musical doers, musical doing, something done and contexts in which the former take place” (Elliott, 1995). Praxialism sets out a vision on music that goes beyond the musical work and includes the meanings and values of those involved (Silverman, Davis & Elliott, 2014). The concept allowed me to examine the work and emerging relationships as a result of devising co-creative musicking from an ethical perspective. Given the subject’s relative newness and rather unexplored status, I examined existing work empirically through an ethnographic approach (Hammersley & Atkinson, 2007). Four cases were selected where data was gathered through episodic interviewing (Flick, 2009) and participant observation. Elements of a constructivist Grounded Theory (Charmaz, 2014) were used for performing an abductive analysis. The analysis included initial coding, focused coding, the use of sensitizing concepts (Blumer 1969 in Hammersley, 2013) and memoing. I wrote a thick description (Geertz, 1973) for each case portraying the work from my personal experience. The descriptions are included in the dissertation as one separate chapter and foreshadow the exposition of the analysis in a next chapter. In-depth study of the creative-productive processes of the cases showed the involvement of multiple co-creative elements, such as a dialogical interaction between musicians and audience. However, participants’ contributions were often adopted implicitly, through the musicians interpreting behaviour and situations. This created a particular power dynamic and challenges as to what extent the negotiation can be considered co-creative. The implicitness of ‘making use’ of another person’s behaviour with the other not (always) being aware of this also triggered an ethical perspective, especially because some of the cases involved participants that were vulnerable. The imbalance in power made me examine the relationship that emerges between musicians and participants. As a result of a closer contact in the co-creative negotiation, I witnessed a contact of a highly personal, sometimes intimate, nature. I recognized elements of two types of connections. One type could be called ‘humanistic’, as a friendship in which there is reciprocal care and interest for the other. The other could be seen as ‘functional’, which means that the relationship is used as a resource for providing input for the creative musicking process. From this angle, I have compared the relationship with that of a relationship of an artist with a muse. After having examined the co-creative and relational sides of the interaction in the four cases, I tuned in to the musicians’ contribution to these processes and relationships. I discovered that their devising in practice consisted of a continuous double balancing act on two axes: one axis considers the other and oneself as its two ends. Another axis concerns the preparedness and unpredictability at its ends. Situated at the intersection of the two axes are the musicians’ intentionality, which is fed by their intentions, values and ethics. The implicitness of the co-creation, the two-sided relationship, the potential vulnerability of participants, and the musicians’ freedom in navigating and negotiation, together, make the devising of co-creative musicking with elderly people an activity that involves ethical challenges that are centred around a tension between prioritizing doing good for the other, associated with a eudaimonic intention, and prioritizing values of the musical art form, resembling a musicianist intention. The results therefore call for a musicianship that involves acting reflectively from an ethical perspective. Doctoral study by Karolien Dons
