AI-driven lifestyle monitoring systems collect data from ambient, motion, contact, light, and physiological sensors placed in the home, enabling AI algorithms to identify daily routines and detect deviations to support older adults "aging in place." Despite its potential to support several challenges in long-term care for older adults, implementation remains limited. This study explored the facilitators and barriers to implementing AIdriven lifestyle monitoring in long-term care for older adults, as perceived by formal and informal caregivers, as well as management, in both an adopting and non-adopting healthcare organization. A qualitative interview study using semi-structured interviews was conducted with 22 participants (5 informal caregivers, 10 formal caregivers, and 7 participants in a management position) from two long-term care organizations. Reflexive thematic analysis, guided by the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, structured findings into facilitators and barriers. 12 facilitators and 16 barriers were identified, highlighting AI-driven lifestyle monitoring as a valuable, patient-centred, and unobtrusive tool enhancing care efficiency and caregiver reassurance. However, barriers such as privacy concerns, notification overload, training needs, and organizational alignment must be addressed. Contextual factors, including regulations, partnerships, and financial considerations, further influence implementation. This study showed that to optimize implementation of AI-driven lifestyle monitoring, organizations should address privacy concerns, provide training, engage in system (re)design and create a shared vision. A comprehensive multi-level approach across all levels is essential for successful AI integration in long-term care for older adults.
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Background: As more and more older adults prefer to stay in their homes as they age, there’s a need for technology to support this. A relevant technology is Artificial Intelligence (AI)-driven lifestyle monitoring, utilizing data from sensors placed in the home. This technology is not intended to replace nurses but to serve as a support tool. Understanding the specific competencies that nurses require to effectively use it is crucial. The aim of this study is to identify the essential competencies nurses require to work with AI-driven lifestyle monitoring in longterm care. Methods: A three round modified Delphi study was conducted, consisting of two online questionnaires and one focus group. A group of 48 experts participated in the study: nurses, innovators, developers, researchers, managers and educators. In the first two rounds experts assessed clarity and relevance on a proposed list of competencies, with the opportunity to provide suggestions for adjustments or inclusion of new competencies. In the third round the items without consensus were bespoken in a focus group. Findings: After the first round consensus was reached on relevance and clarity on n = 46 (72 %) of the competencies, after the second round on n = 54 (83 %) of the competencies. After the third round a final list of 10 competency domains and 61 sub-competencies was finalized. The 10 competency domains are: Fundamentals of AI, Participation in AI design, Patient-centered needs assessment, Personalisation of AI to patients’ situation, Data reporting, Interpretation of AI output, Integration of AI output into clinical practice, Communication about AI use, Implementation of AI and Evaluation of AI use. These competencies span from basic understanding of AIdriven lifestyle monitoring, to being able to integrate it in daily work, being able to evaluate it and communicate its use to other stakeholders, including patients and informal caregivers. Conclusion: Our study introduces a novel framework highlighting the (sub)competencies, required for nurses to work with AI-driven lifestyle monitoring in long-term care. These findings provide a foundation for developing initial educational programs and lifelong learning activities for nurses in this evolving field. Moreover, the importance that experts attach to AI competencies calls for a broader discussion about a potential shift in nursing responsibilities and tasks as healthcare becomes increasingly technologically advanced and data-driven, possibly leading to new roles within nursing.
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As more and more older adults prefer to stay in their homes as they age, there’s a need for technology to support this. A relevant technology is Artificial Intelligence (AI)-driven lifestyle monitoring, utilizing data from sensors placed in the home. This technology is not intended to replace nurses but to serve as a support tool. Understanding the specific competencies that nurses require to effectively use it is crucial. The aim of this study is to identify the essential competencies nurses require to work with AI-driven lifestyle monitoring in longterm care. Methods: A three round modified Delphi study was conducted, consisting of two online questionnaires and one focus group. A group of 48 experts participated in the study: nurses, innovators, developers, researchers, managers and educators. In the first two rounds experts assessed clarity and relevance on a proposed list of competencies, with the opportunity to provide suggestions for adjustments or inclusion of new competencies. In the third round the items without consensus were bespoken in a focus group. Findings: After the first round consensus was reached on relevance and clarity on n = 46 (72 %) of the competencies, after the second round on n = 54 (83 %) of the competencies. After the third round a final list of 10 competency domains and 61 sub-competencies was finalized. The 10 competency domains are: Fundamentals of AI, Participation in AI design, Patient-centered needs assessment, Personalisation of AI to patients’ situation, Data reporting, Interpretation of AI output, Integration of AI output into clinical practice, Communication about AI use, Implementation of AI and Evaluation of AI use. These competencies span from basic understanding of AIdriven lifestyle monitoring, to being able to integrate it in daily work, being able to evaluate it and communicate its use to other stakeholders, including patients and informal caregivers. Conclusion: Our study introduces a novel framework highlighting the (sub)competencies, required for nurses to work with AI-driven lifestyle monitoring in long-term care. These findings provide a foundation for developing initial educational programs and lifelong learning activities for nurses in this evolving field. Moreover, the importance that experts attach to AI competencies calls for a broader discussion about a potential shift in nursing responsibilities and tasks as healthcare becomes increasingly technologically advanced and data-driven, possibly leading to new roles within nursing.
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Technology has a major impact on the way nurses work. Data-driven technologies, such as artificial intelligence (AI), have particularly strong potential to support nurses in their work. However, their use also introduces ambiguities. An example of such a technology is AI-driven lifestyle monitoring in long-term care for older adults, based on data collected from ambient sensors in an older adult’s home. Designing and implementing this technology in such an intimate setting requires collaboration with nurses experienced in long-term and older adult care. This viewpoint paper emphasizes the need to incorporate nurses and the nursing perspective into every stage of designing, using, and implementing AI-driven lifestyle monitoring in long-term care settings. It is argued that the technology will not replace nurses, but rather act as a new digital colleague, complementing the humane qualities of nurses and seamlessly integrating into nursing workflows. Several advantages of such a collaboration between nurses and technology are highlighted, as are potential risks such as decreased patient empowerment, depersonalization, lack of transparency, and loss of human contact. Finally, practical suggestions are offered to move forward with integrating the digital colleague
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Evaluation of the hydrological performance of grassed swales usually needs long-term monitoring data. At present, suitable techniques for simulating the hydrological performance using limited monitoring data are not available. Therefore, current study aims to investigate the relationship between saturated hydraulic conductivity (Ks) fitting results and rainfall characteristics of various events series length. Data from a full-scale grassed swale (Enschede, the Netherlands) were utilized as long-term rainfall event series length (95 rainfall events) on the fitting outcomes. Short-term rainfall event series were extracted from these long-term series and used as input in fitting into a multivariate nonlinear model between Ks and its influencing rainfall indicators (antecedent dry days, temperature, rainfall, rainfall duration, total rainfall, and seasonal factor (spring, summer, autumn, and winter, herein refer as 1, 2, 3, and 4). Comparison of short-term and long-term rainfall event series fitting results allowed to obtain a representative short-term series that leads to similar results with those using long-term series. A cluster analysis was conducted based on the fitting results of the representative rainfall event series with their rainfall event characteristics using average values of influencing rainfall indicators. The seasonal index (average value of seasonal factors) was found to be the most representative short rainfall event series indicator. Furthermore, a Bayesian network was proposed in the current study to predict if a given short-term rainfall event series is representative. It was validated by a data series (58 rainfall events) from another full-scale grassed swale located in Utrecht, the Netherlands. Results revealed that it is quite promising and useful to evaluate the representativeness of short-term rainfall event series used for long-term hydrological performance evaluation of grassed swales.
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Triggered by recent flood catastrophes and increasing concerns about climate change, scientists as well as policy-makers increasingly call for making long-term water policies to enable a transformation towards flood resilience. A key question is how to make these long-term policies adaptive so that they are able to deal with uncertainties and changing circumstances. The paper proposes three conditions for making long-term water policies adaptive, which are then used to evaluate a new Dutch water policy approach called 'Adaptive Delta Management'. Analysing this national policy approach and its translation to the Rotterdam region reveals that Dutch policy-makers are torn between adaptability and the urge to control. Reflecting on this dilemma, the paper suggests a stronger focus on monitoring and learning to strengthen the adaptability of long-term water policies. Moreover, increasing the adaptive capacity of society also requires a stronger engagement with local stakeholders including citizens and businesses.
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Background: Research into termination of long-term psychosocial treatment of mental disorders is scarce. Yearly 25% of people in Dutch mental health services receive long-term treatment. They account for many people, contacts, and costs. Although relevant in different health care systems, (dis)continuation is particularly problematic under universal health care coverage when secondary services lack a fixed (financially determined) endpoint. Substantial, unaccounted, differences in treatment duration exist between services. Understanding of underlying decisional processes may result in improved decision making, efficient allocation of scarce resources, and more personalized treatment.
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Future work processes are going to change in several aspects. The working population (at least in Western European countries) is decreasing, while average age of employees increases. Their productivity is key to continuity in sectors like healthcare and manufacturing. Health and safety monitoring, combined with prevention measures must contribute to longer, more healthy and more productive working careers. The ‘tech-optimist’ approach to increase productivity is by means of automation and robotization, supported by IT, AI and heavy capital investments. Unfortunately, that kind of automation has not yet fulfilled its full promise as productivity enhancer as the pace of automation is significantly slower than anticipated and what productivity is gained -for instance in smart industry and healthcare- is considered to be ‘zero-sum’ as flexibility is equally lost (Armstrong et al., 2023). Simply ‘automating’ tasks too often leads to ‘brittle technology’ that is useless in unforeseen operational conditions or a changing reality. As such, it is unlikely to unlock high added-value. In healthcare industry we see “hardly any focus on research into innovations that save time to treat more patients.” (Gupta Strategists, 2021). Timesaving, more than classic productivity, should be the leading argument in rethinking the possibilities of human-technology collaboration, as it allows us to reallocate our human resources towards ‘care’, ’craft’ and ’creativity’.
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In the Netherlands, client and family participation in care for people with intellectual disabilities has been in vogue for a long time, and increasingly receives attention (KPMG and Vilans 2017). However, the perspective and experiential knowledge of service users and relatives is often still insuBiciently used for the co-creation of care. The professional perspective is often still dominant. In addition, professionals mainly focus on clients and less on relatives, even though relatives often play an important role in the client’s (quality of) life (Wiersma 2017). The project ‘Inclusive Collaboration in Disability Care’[1] (ICDC) focusses on enhancing equal communication between people with intellectual disabilities, their relatives, and professional caregivers, and hence contributes to redressing power imbalances in longterm care. It investigates the question: “How can the triangle of client, relative and professional caregiver together co-create better care and support?”.
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Objectives: Decline in the performance of instrumental activities of daily living (IADL) and mobility may be preceded by symptoms the patient experiences, such as fatigue. The aim of this study is to investigate whether self-reported non-task-specific fatigue is a long-term risk factor for IADL-limitations and/or mobility performance in older adults after 10 years. Methods: A prospective study from two previously conducted cross-sectional studies with 10-year follow-up was conducted among 285 males and 249 females aged 40–79 years at baseline. Fatigue was measured by asking “Did you feel tired within the past 4 weeks?” (males) and “Do you feel tired?” (females). Self-reported IADLs were assessed at baseline and follow-up. Mobility was assessed by the 6-minute walk test. Gender-specific associations between fatigue and IADL-limitations and mobility were estimated by multivariable logistic and linear regression models. Results: A total of 18.6% of males and 28.1% of females were fatigued. After adjustment, the odds ratio for fatigued versus non-fatigued males affected by IADL-limitations was 3.3 (P=0.023). In females, the association was weaker and not statistically significant, with odds ratio being 1.7 (P=0.154). Fatigued males walked 39.1 m shorter distance than those non-fatigued (P=0.048). For fatigued females, the distance was 17.5 m shorter compared to those non-fatigued (P=0.479). Conclusion: Our data suggest that self-reported fatigue may be a long-term risk factor for IADL-limitations and mobility performance in middle-aged and elderly males but possibly not in females.
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