A comparison of green space indicators for epidemiological research

<p><b>Background</b> The potential for natural environments to be salutogenic has received growing interest from epidemiologists, but there has been no critical examination of the extent to which associations between green space and health might vary according to the indicator of green space coverage used.</p> <p><b>Methods</b> Three different indicators of green space coverage were derived for a set of 268 small areas in four cities within Britain. The indicators had different origins and provided a spectrum of sensitivity from larger spaces only, through to ambient greenery. Two indicators reproducible for anywhere in Europe were included. Agreement between the indicators on the quantity of green space in a small area, and their independent association with measures of mortality and self-reported morbidity, were compared.</p> <p><b>Results</b> Overall, the indicators showed relatively close overall agreement (all r2>0.89, p<0.001). However, agreement varied by level of area socioeconomic deprivation (p<0.001). The indicator that detected larger spaces only found less green space in areas of socioeconomic deprivation than the other two. Despite this difference, all indicators showed similar protective associations with the risk of mortality and self-reported morbidity suggesting that larger green spaces may be more important for health effects than smaller spaces.</p> <p><b>Conclusions</b> Associations between green space indicator and health were not sensitive to indicator origin and type. This raises the possibility of trans-European epidemiological studies. Larger green spaces may be the most important for health effects, but may also be less prevalent in more deprived areas.</p&gt

Technology-supported group activity to promote communication in dementia : a protocol for a within-participants study

Background. CIRCA (Computer Interactive Reminiscence and Conversation Aid; Alm et al., 2004) is an interactive conversation support for people living with dementia. CIRCA facilitates one-to-one conversations and caregiving relationships in formal care environments (Astell, 2009). Originally developed as a standalone device, a new web-based version of CIRCA has been created to increase availability. The potential of CIRCA to support group activities and conversation between people living with dementia and a facilitator has not previously been explored. Objectives. The two objectives of this study are: (i) To validate the new web-based version of CIRCA against the original standalone device; (ii) To explore the efficacy of CIRCA to support group activity with people with dementia in a formal care setting. Methods. This mixed methods study comprises two parts: (i) 8-session group activity using the CIRCA stand-alone device; (ii) 8-session group activity using the web-based CIRCA. One hundred and eighty people with dementia will be recruited: 90 for part (i) and 90 for part (ii). Measures of cognition and quality of life will be taken at baseline, post-CIRCA intervention and three-months later, plus video recordings of the group sessions. Results. Both parts of the study will be completed in February 2018. Discussion. The study will provide evidence on two issues: (i) a validation of the new web-based version of CIRCA; and (ii) the suitability of CIRCA to support group activities in formal care settings for people living with dementia

Computer Interactive Reminiscence and Conversation Aid groups – delivering cognitive stimulation with technology

INTRODUCTION: Group-based cognitive stimulation is the only nonpharmacological intervention recommended by the UK National Institute for Clinical and Health Excellence (NICE) for people with dementia. The potential of technology to extend the availability of group-based cognitive stimulation has not been tested. METHOD: One hundred and sixty-one people with dementia participated in an 8-session group activity using Computer Interactive Reminiscence and Conversation Aid (CIRCA). Cognition, quality of life and general health were assessed pre-, post- and three-months later. RESULTS: There was a significant improvement in cognition and quality of life at the end of the CIRCA group intervention, which was further improved at three-month follow-up. CONCLUSION: CIRCA group sessions improved cognition and quality of life similar to group-base cognitive stimulation approved by NICE. These benefits were maintained at three-month follow-up. The data confirm the potential of CIRCA, which can be populated with different cultural and language contents for different user groups

Wellbeing and HCI in later life – what matters?

As part of the Challenging Obstacles and Barriers to Assisted Living Technologies (COBALT) project, we developed the COBALT Tools for EngagementTM, a number of innovative techniques to engage older people in all stages of technology development process. In the present study we used Technology Tours of the homes of eight older adults to look at their daily usage and examine the ways in which tech-nology influences well-being. All of the participants use multiple tech-nologies every day both inside the home and out. The data highlighted how technology contributes to well-being in a number of ways, includ-ing enabling them to maintain current activities; providing a means of staying in touch with families and friends; being easy to access and learn to use; and enhancing their lives. These can be divided into two types of factors: ones that relate to the direct outcomes of technology use and how these contribute to feelings of wellbeing and factors that relate to meeting an individual’s needs, which if met contribute to their well-being. The findings indicate that well-being is a multi-faceted con-struct that includes autonomy, i.e. remaining independent, competence both in continuing to complete activities and learning new ones, and communication with other people. The study also indicates that Tech-nology Tours provide an easily applicable and accessible means for en-abling older adults to speak as ‘experts’ on technology

The use of motion-based technology for people living with dementia or mild cognitive impairment: a literature review

Background: The number of people living with dementia and mild cognitive impairment (MCI) is increasing substantially. Although there are many research efforts directed toward the prevention and treatment of dementia and MCI, it is also important to learn more about supporting people to live well with dementia or MCI through cognitive, physical, and leisure means. While past research suggests that technology can be used to support positive aging for people with dementia or MCI, the use of motion-based technology has not been thoroughly explored with this population. Objective: The aim of this study was to identify and synthesize the current literature involving the use of motion-based technology for people living with dementia or MCI by identifying themes while noting areas requiring further research. Methods: A systematic review of studies involving the use of motion-based technology for human participants living with dementia or MCI was conducted. Results: A total of 31 articles met the inclusion criteria. Five questions are addressed concerning (1) context of use; (2) population included (ie, dementia, MCI, or both); (3) hardware and software selection; (4) use of motion-based technology in a group or individual setting; and (5) details about the introduction, teaching, and support methods applied when using the motion-based technology with people living with dementia or MCI. Conclusions: The findings of this review confirm the potential of motion-based technology to improve the lives of people living with dementia or MCI. The use of this technology also spans across several contexts including cognitive, physical, and leisure; all of which support multidimensional well-being. The literature provides evidence that people living with dementia or MCI can learn how to use this technology and that they enjoy doing so. However, there is a lack of information provided in the literature regarding the introduction, training, and support methods applied when using this form of technology with this population. Future research should address the appropriate introduction, teaching, and support required for people living with dementia or MCI to use the motion-based technology. In addition, it is recommended that the diverse needs of these specific end-users be considered in the design and development of this technology

Green cities and health: a question of scale?

<p><b>Background:</b> Cities are expanding and accommodating an increasing proportion of the world's population. It is important to identify features of urban form that promote the health of city dwellers. Access to green space has been associated with health benefits at both individual and neighbourhood level. We investigated whether a relationship between green space coverage and selected mortality rates exists at the city level in the USA.</p> <p><b>Methods:</b> An ecological cross-sectional study. A detailed land use data set was used to quantify green space for the largest US cities (n=49, combined population of 43 million). Linear regression models were used to examine the association between city-level ‘greenness’ and city-level standardised rates of mortality from heart disease, diabetes, lung cancer, motor vehicle fatalities and all causes, after adjustment for confounders.</p> <p><b>Results:</b> There was no association between greenness and mortality from heart disease, diabetes, lung cancer or automobile accidents. Mortality from all causes was significantly higher in greener cities.</p> <p><b>Conclusions:</b> While considerable evidence suggests that access to green space yields health benefits, we found no such evidence at the scale of the American city. In the USA, greener cities tend also to be more sprawling and have higher levels of car dependency. Any benefits that the green space might offer seem easily eclipsed by these other conditions and the lifestyles that accompany them. The result merits further investigation as it has important implications for how we increase green space access in our cities.</p&gt

Studies involving people with dementia and touchscreen technology: a literature review

Background: Devices using touchscreen interfaces such as tablets and smartphones have been highlighted as potentially suitable for people with dementia due to their intuitive and simple control method. This population experience a lack of meaningful, engaging activities, yet the potential use of the touchscreen format to address this issue has not been fully realized. Objective: To identify and synthesize the existing body of literature involving the use of touchscreen technology and people with dementia in order to guide future research in this area. Methods: A systematized review of studies in the English language was conducted, where a touchscreen interface was used with human participants with dementia. Results: A total of 45 articles met the inclusion criteria. Four questions were addressed concerning (1) the context of use, (2) reasons behind the selection of the technology, (3) details of the hardware and software, and (4) whether independent use by people with dementia was evidenced. Conclusions: This review presents an emerging body of evidence demonstrating that people with dementia are able to independently use touchscreen technology. The intuitive control method and adaptability of modern devices has driven the selection of this technology in studies. However, its primary use to date has been as a method to deliver assessments and screening tests or to provide an assistive function or cognitive rehabilitation. Building on the finding that people with dementia are able to use touchscreen technology and which design features facilitate this, more use could be made to deliver independent activities for meaningful occupation, entertainment, and fun

Kinect Project: people with dementia or mild cognitive impairment learning to play group motion-based games

Introduction: Motion-based technologies (MBT) could provide nonpharmacological interventions for people with dementia or mild cognitive impairment (PCI). This study examined the use of errorless learning techniques to empower PCI to use MBT. Methods: Thirty-eight PCI were recruited to a 10-week (20 x 1-hour sessions) Xbox Kinect bowling group. Video recorded data from first, middle, and final sessions were coded to track: (1) number of prompts per turn, (2) independent turn completion, and (3) duration of turns. were compared using repeated measures ANOVA. Results: Learning and improvement over time was demonstrated in 23 participants who were available for final analysis by significant decreases in number of prompts per turn and turn duration and significant increases in turns completed independently. Discussion: Errorless learning supported PCI to learn MBT and improve over time as evidenced by their need for fewer prompts, shorter turns, and more turns completed independently, confirming the potential of MBT to provide leisure activities for PCI

Comparing recent reviews about touch screen for Dementia with lessons learnt from the field

Conclusions were synthesised from recent reviews on (touchscreen)technologies and people with dementia and lessons learnt, using these devices in projects in the UK, the Netherlands and Canada. The combined findings provide a strong basis for defining new strategies for exploiting touchscreen technology for people with dementia