Early detection of agitation in individuals with dementia can lead to timely interventions, preventing the worsening of situations and enhancing their quality of life. The emergence of multi-modal sensing and advances in artificial intelligence make it feasible to explore and apply technology for this goal. We conducted a literature review to understand the current technical developments and challenges of its integration in caregiving institutions. Our systematic review used the Pubmed and IEEE scientific databases, considering studies from 2017 onwards. We included studies focusing on linking sensor data to vocal and/or physical manifestations of agitation. Out of 1622 identified studies, 12 were selected for the final review. Analysis was conducted on study design, technology, decisional data, and data analytics. We identified a gap in the standardized semantic representation of both behavioral descriptions and system event generation configurations. This research highlighted initiatives that leverage existing information in a caregiver's routine, such as correlating electronic health records with sensor data. As predictive systems become more integrated into caregiving routines, false positive reduction needs to be addressed as those will discourage their adoption. Therefore, to ensure adaptive predictive capacity and personalized system re-configuration, we suggest future work to evaluate a framework that incorporates a human-in-the-loop approach for detecting and predicting agitation.
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Light therapy for older persons with dementia is often administered with light boxes, even though indoor ambient light may more comfortably support the diverse lighting needs of this population. Our objective is to investigate the influence of indoor daylight and lighting on the health of older adults with dementia living in long-term care facilities. A systematic literature search was performed within PubMed, CINAHL, PsycINFO, Web of Science and Scopus databases. The included articles (n=37) were published from 1991 to 2020. These articles researched the influence of existing and changed indoor light conditions on health and resulted in seven categories of health outcomes. Although no conclusive evidence was found to support the ability of indoor light to decrease challenging behaviors or improve circadian rhythms, findings of two studies indicate that exposure to (very) cool light of moderate intensity diminished agitation. Promising effects of indoor light were to reduce depressive symptoms and facilitate spatial orientation. Furthermore, there were indications that indoor light improved one’s quality of life. Despite interventions with dynamic lighting having yielded little evidence of its efficacy, its potential has been insufficiently researched among this study population. This review provides a clear and comprehensive description of the impact of diverse indoor light conditions on the health of older adults with dementia living in long-term care facilities. Variation was seen in terms of research methods, (the description of) light conditions, and participants’ characteristics (types and severity of dementia), thus confounding the reliability of the findings. The authors recommend further research to corroborate the beneficial effects of indoor light on depression and to clarify its role in supporting everyday activities of this population. An implication for practice in long-term care facilities is raising the awareness of the increased lighting needs of aged residents. Original article at: https://doi.org/10.2147/CIA.S297865
MULTIFILE
Purpose Worldwide, there are 30 million people with dementia (PWD) in 2009 and 100 million in 2050, respectively.These numbers show the need for a change in care for PWD. Leisure is one of these care aspects. Leisure activities can support PWD in several ways: meeting basic needs, providing comfort and social interaction, and reducing boredom, agitation, and isolation. An exemplary activity targeted at meeting these needs is ‘De Klessebessers (KB)’ (The Chitchatters), which aims to stimulate social interaction among PWD and provide comfort with supporting technology. This is innovative since technology for PWD generally concentrates on safety and monitoring activities. The activity comprises a radio, television, telephone, and treasure box. Method This study’s focus follows from the original aim of the KB-designers; to stimulate social interaction. In a nursing home and day care centre, the KB game was played with different groups of PWD (n=21: 12 females, 9 males, mean MMSE=17, range 3-28). In the morning KB (with technology), and in the afternoon an activity called ‘Questiongame’ (without technology) were played for 45 minutes. These activities were played twice in a two-month period, and outcomes were compared in terms of impact on social interaction. Group sizes ranged from 3 to 8 PWD assisted by 1 or 2 activity therapists. Two researchers observed the players during the activity with the Oshkosh Social Behavior Coding (OSBC) scale, which encompasses both verbal and nonverbal social and nonsocial behaviour. These behaviours can have a person-initiated and otherinitiated character (quantitative study). A total of 6 activity therapists were interviewed on the KB afterwards (qualitative study). Results & Discussion The quantitative results showed significantly higher scores for KB for the total of social interaction compared to Questiongame. Most of the behaviour is other-initiated (activity therapist). PWD with a lower MMSE score showed more non-verbal behaviour. For PWD with a MMSE score below 7, there was no difference in social interaction between the two activities. According to the qualitative research, KB triggered more social interaction, since the movies and music were stimulating the players to initiate a conversation, to which other players responded. The results of this research correspond with earlier research, which concludes that leisure activities with technology can show positive results on well-being.
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Dit project richt zich op de ontwikkeling van de biotechnologische en chemische procesvoering om op basis van mycelium een alternatief voor leer te produceren. In vergelijking met leer is het voordeel van mycelium dat geen runderen nodig zijn, de productie kan plaatsvinden onder industriële condities en met gebruik van reststromen, de CO2 uitstoot alsook hoeveelheid afval verlaagd wordt, en het gebruik van toxische stoffen zoals chroom wordt vervangen door biobased alternatieven. In het project zullen de procescondities worden bepaald die leiden tot de vorming van optimaal mycelium. Daartoe zullen twee verschillende schimmels worden gekweekt in bioreactoren bij de Hogeschool Arnhem Nijmegen (HAN), waarbij specifiek de effecten van de procescondities (temperatuur, pH, shear, beluchting) en de samenstelling van het kweekmedium op groei van het mycelium en materiaal eigenschappen zullen worden onderzocht. De meest optimale condities zullen vervolgens worden opgeschaald. Op het op deze wijze verkregen materiaal zal Mylium BV een aantal nabehandelingsstappen uitvoeren om de sterkte, elasticiteit, en duurzaamheid van het product te vergroten. Daartoe worden biobased plasticizers, cross-linkers en/of flexibility agents gebruikt. Het resulterende eindproduct zal middels specifiek fysieke testen vergeleken worden met leer alsook worden voorgelegd aan mogelijke klanten. Indien beide resultaten positief zijn kan het betreffende proces na het project verder worden opgeschaald voor toepassing naar de markt.
This proposal is a resubmission of an earlier proposal (Dossier nr: GOCH.KIEM.KGC02.079) which was not approved because of the too ambitious planning. As advised by the commission, the focus is kept only on the recycling of the mattress cover. The Netherlands has 180,000+ waterproof mattresses in the healthcare sector, of which yearly 40,000+ mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these waterproof mattresses in the consumer sector as well. Considering the complex nature of functional mattresses, these valuable resources are partly incinerated. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials in five key economic sectors including ‘consumer products’ by 2030. Within the scope of this research, Saxion together with partners (CFC BV, Deron BV, MRE BV & Klieverik Heli BV) will bring emphasis on Recycling (sustainable chemistry) of mattress covers. Other aspects such as reuse and re-designing are beyond the scope of this project proposal, for which a bigger consortium will be built during the course of this project. A case under study is a water-impermeable mattress cover made of 100% polyester with polyurethane (PU) coatings. The goal is to enable the circular use of textiles with (multilayer) ‘coatings’, which are not recyclable yet. These ‘coatings’ comprise functional coatings as well as adhesion layers. Therefore, novel triggerable molecular systems and the corresponding recycling processes will be developed. The coatings will be activated by a specific trigger (bio)-chemical solvation, heat, pressure, humidity, microwave, or combination of thereof. The emphasis is to develop a scalable coating removal process. Learnings will be used to build larger (inter)-national consortia to develop multiple industry closed-loop solutions required for 100% mattress circularity with desired functionality. The generated knowledge will be used for education at Saxion.
