Behavioral analysis to reveal differences between trained and untrained caregivers in robot therapy

Background:Family caregivers of operated neurosurgery patients function as informal extensions of the health system. But they are untrained and unprepared for their new role. It has been felt that their problems related to care provision can be resolved by appropriate training.Aim:This study aimed to compare the impact of self-instruction manual-based training of family caregivers of operated neurosurgery patients on their knowledge regarding care provision and care practices.Setting:Tertiary care hospital setting located in North India.Design:Randomized controlled trial.Materials and Methods:A randomized controlled trial was done among the operated neurosurgery patients and their caregiver dyads (n = 90). They were randomly allocated to receive either self-instruction manual and one-to-one training (TP1) or self-instruction manual only (TP2). Block randomization method was used. Sequentially numbered sealed envelope was used for allocation concealment. Monthly follow-up was done for 3 months. The primary outcome measure was knowledge gain of the caregivers.Statistical Analysis Used:Chi-square test, Student's t-test, paired t-test, repeated measures analysis of variance, and Bonferroni's correction were used.Results:The attrition rate was 15.5%. Intention-to-treat analysis was followed. Caregivers in the TP1 group had significant knowledge gain (95% confidence interval of mean difference 9.4–14.5, P < 0.05). The number of caregivers who had followed correct caregiving practices was significantly more in the TP1 group.Conclusion:Training of caregivers by providing information along with one-to-one training is an effective strategy for improving the knowledge and skills of caregivers regarding care provision of the operated neurosurgery patients.

VR is increasingly being utilized in various domains, including education, due to its unique characteristics. Research in this area often relies on physiological sensors, eye-trackers, VR device orientation, human observers, and pre-test and post-test to collect data for quantitative studies and on questionnaires, surveys, and interviews to collect data for qualitative studies in VR Learning. However, there is a dearth of reliable data sources for studying learner behavior in VRLE, and minimal efforts have been made to automatically collect behavioral data in this context. Furthermore, there is a lack of studies that investigate learning processes through the lens of learners' dynamic interaction behavior in VRLE. To address these gaps, we have developed a real-time data collection mechanism that automatically logs learners' interaction behavior in VRLE, including timestamps. This mechanism was deployed in a room-scale VRLE called MaroonVR, and a study was conducted involving undergraduate engineering students. The main objectives of this paper are to identify differences in interaction behavior between high and low performers and to develop an optimal predictor model to predict the learning outcome using learners' interaction behavior in VRLE. Furthermore, we propose that the study's findings can be utilized to model learners' behavior in VR and to provide scaffolding and adaptive personalized VR learning content.

Autism spectrum disorders (ASD) is characterized by atypical social interaction, communication, and behavioral development (American Psychiatric Association, 1994). In addition, motor deficits in children with ASD are well recognized throughout the ASD literature (Green et al., 2009; Staples & Reid, 2010). Research has demonstrated that utilizing either peers or siblings as intervention agents can be successful in improving the motor skills performances (Ward & Ayvazo, 2006) and interaction behaviors of children with disabilities (Klavina & Block, 2008; Knott, Lewis, & Williams, 2007). PURPOSE: To assess the effect of peer- and sibling-assisted aquatic program on aquatic skills and interaction behaviors in children with ASD. METHODS: Twenty-one dyads (one child with ASD and one typically developing peer or sibling) participated: peer-assisted (n=6), sibling-assisted (n=7), and control (n=8). The aquatic program was 60 min in length and held twice per week for 12 weeks. It consisted 10 min of the warm-up period, 20 min of the teacher-directed condition, 15 min of the peer- or sibling-assisted conditions, and 15 min of group games (voluntary peer or sibling support condition). The nonparametric Kruskal Wallis tests and Wilcoxon signed ranks tests were performed to compare aquatic skills between and within groups. Differences in interaction behaviors for each condition between groups were also analyzed via the Kruskal Wallis tests. RESULTS: Findings indicate that (a) each group demonstrated significantly higher scores on aquatic skills after the program (all p's<0.05), and no between-group differences after the program, (b) both peer- and sibling-assisted groups had higher physical (χ2 =14.57, p<0.01) and social (χ2=10.30, p<0.01) interaction behaviors than the control group on the intervention condition, and (c) both experimental groups maintained the improvements on the physical (χ2 =14.35, p<0.01) and social (χ2 =3.51, p<0.01) interaction skills they attained during voluntary peer or sibling support condition. CONCLUSION: The present results emphasize the importance of promoting motor skills and interaction behaviors through peer or sibling assisted physical activity program in children with ASD. Supported by Taiwan NSC grants 97-2410-H-017-027-SSS and 98-2410-H-017-025.

BackgroundLecanemab is a novel, humanized immunoglobulin G (IgG) 1 monoclonal antibody, which has demonstrated the ability to substantially reduce markers of amyloid and slow clinical decline in early Alzheimer’s disease (AD). Subcutaneous administration using an autoinjector improves convenience and eliminates burden on patients, providers and healthcare systems necessitated by intravenous infusion, thereby broadening access. Herein, we share results from the human factors (HF) program implemented to support the lecanemab autoinjector clinical program.MethodsThe HF validation study evaluated whether the lecanemab autoinjector could be used safely and effectively – with and without training – under expected use environments. It characterized the type, frequency, and severity of potential use errors (including incomplete dosing) as well as labelling comprehension. The study participants (n=110; patients with self‐ or caregiver‐reported diagnosis of mild cognitive impairment or mild AD [n=63], caregivers [n=32], and healthcare providers [HCPs; n=15]) represented lecanemab autoinjector end users and included a mix of injection‐experienced and injection‐naïve. The patients were administered the Mini Mental State Examination (MMSE) and subsequently divided into low MMSE (22‐26) and high MMSE (27‐30) groups. Patients and caregivers were evaluated under trained and untrained conditions, while HCPs were always untrained.ResultsOverall, 94.5% (n=104/110) of participants were successful at delivering the first of 2 injections: untrained, low MMSE patients (93.3%, n=14/15); trained, low MMSE patients (100%, n=15/15); untrained, high MMSE patients (100%, n=16/16); trained, high MMSE patients (94.1%, n=16/17); untrained caregivers (100%, n=15/15); trained caregivers (100%, n=17/17); HCPs (100%, n=15/15). Furthermore, 82.7% (n=91/110) of participants were successful at delivering 2 consecutive injections: untrained, low MMSE patients (53.3%, n=8/15); trained, low MMSE patients (93.3%, n=14/15); untrained, high MMSE patients (93.8%, n=15/16); trained, high MMSE patients (88.2%, n=15/17); untrained caregivers (73.3%, n=11/15); trained caregivers (94.1%, n=16/17); HCPs (80%, n=12/15). Training increased injection success in caregivers and low MMSE patients. Critical information in the labelling was understood by 91.8% (n=101/110) of overall participants. No device malfunctions or harmful events occurred.ConclusionsThe HF validation study confirms that the lecanemab autoinjector is safe and effective for the intended users, uses, and use environments.

Graphene has been thought to be an ideal reinforcement material for metal matrix composite due to its superior mechanical properties and unique two-dimensional geometry. However, the deformation mechanism of graphene/aluminum matrix composite is still unclear. In this paper, molecular dynamics simulation is used to elucidate the evolution details of the dislocation microstructure and the underlying interaction behavior between dislocation and graphene during nanoindentation of the graphene/aluminum matrix composite with various graphene orientations. To this end, four different cases, i.e. the pure aluminum and the graphene/aluminum matrix composite with the graphene orientation of 90°, 45° and 0° are examined, respectively. Based on the force-indentation depth curve, the interaction behavior between dislocation and graphene and its effect on the plastic zone are analyzed. The results indicate that the graphene can act as an effective dislocation motion barrier, and the elastic deformation of graphene can occur locally along the direction of dislocation slip. Using the visualization technique of dislocation extraction algorithm, the nucleation and propagation of dislocation are investigated. The results show that the differences in interaction behavior between dislocation and graphene with various orientations affect the spreading trend of the plastic zone and the blocking strength of graphene to dislocation. For the composite with the graphene orientations of 45° and 0°, the interaction between graphene and dislocation causes the number of dislocations to increase. Additionally, the plastic zone of the composite with the graphene orientation of 45° is tangent to two symmetrical graphene sheets. For the composite with the graphene orientation of 90°, the interaction between graphene and dislocation shortens the total length of the dislocation line, and the volume shrinkage of plastic zone is most significant after indenter retraction. Here, the hardness is also calculated to quantitatively evaluate the influence of graphene orientation on the mechanical properties of graphene/aluminum matrix composite. The hardness of the composite with the graphene orientation of 45° is highest, which is due to the decrease of the volume of the plastic zone and the increase of dislocation number. The decrease of the hardness of the composite with the graphene orientation of 90° is attributed to the reduction of dislocation number in the plastic zone. However, for the composite with the graphene orientation of 0°, the interaction between graphene and dislocation results in the softening effect, because of a wide range of elastic deformation in the graphene plane. The study can provide a certain theoretical guidance for designing and preparing the high-performance graphene/metal matrix composites.

Factors associated with receipt of caregiver training among family and unpaid caregivers of people living with dementia

This paper elucidates and discusses some aspects of cultural adaptability. It describes the concept, influence and Use Cases of cultural adaptability in driver information and assistance systems exemplified by driver navigation systems. Thereby, the reasons, advantages and problems of using adaptability regarding driving safety and driver preferences will be addressed. The results of two online studies concerning use cases of navigation systems revealed differences in interaction behavior, which depend on the cultural background of the users (e.g. attitude, preference, skill etc.). Furthermore, cultural adaptability can improve usability and share in universal access.

This study examined the quality of caregiver-child interaction as measured by the Parent/ Caregiver Involvement Scale (PCIS), with a sample of 41 preschoolers who were prenatally exposed to cocaine and 39 nonexposed preschoolers. Within the cocaine group, 19 children were in the care of relatives or foster caregivers and 22 were in the care of their biological mothers. Results suggest that mothers of nonexposed children were significantly more emotionally and developmentally appropriate than caregivers of prenatally cocaine-exposed children, and no significant differences in interaction behavior were found between biological mothers and foster caregivers of prenatally cocaine-exposed children. The importance of conceptualizing this population of children within the context of their environment is stressed.

This paper describes a tool for analyzing cross-cultural human computer interaction (HCI). From literature and reasoning possible cultural HCI indicators have been identified and measured with this tool to compare them in respect to the different culture of the users. Concept, implementation, usage, benefit and implications of this tool will be presented. Two online studies using this tool concerning cultural adaptability exemplified by use cases of navigation systems revealed differences in interaction behavior that depend on the cultural background of the users (e.g. attitude, preference, skill etc.) and proved that the tool is working properly.

The general availability of large language models and thus unrestricted usage in sensitive areas of everyday life, such as education, remains a major debate. We argue that employing generative artificial intelligence (AI) tools warrants informed usage and examined their impact on problem solving strategies in higher education. In a study, students with a background in physics were assigned to solve physics exercises, with one group having access to an internet search engine (N=12) and the other group being allowed unrestricted use of ChatGPT (N=27). We evaluated their performance, strategies, and interaction with the provided tools. Our results showed that nearly half of the solutions provided with the support of ChatGPT were mistakenly assumed to be correct by students, indicating that they overly trusted ChatGPT even in their field of expertise. Likewise, in 42% of cases, students used copy &amp; paste to query ChatGPT — an approach only used in 4% of search engine queries — highlighting the stark differences in interaction behavior between the groups and indicating limited task reflection when using ChatGPT. In our work, we demonstrated a need to (1) guide students on how to interact with LLMs and (2) create awareness of potential shortcomings for users.

A robotic simulator for elderly caregiver training has an important role with the continuous increase in the proportion of the elderly in the society. Caregivers or therapists, especially the novices, need training in caregiving skills. While one of the best methods is to practice the skills with a real elderly person, there are obstacles such as recruitment of subjects and the fatigue experienced by them from repeated training sessions. To improve the effectiveness of caregiver training, we developed an elderly joint simulator of a body part for training purposes. In this study, three experts with years of experience in elderly care participated in the acquisition of data, such as elbow joint angle, force torque, and pressure value, while performing the range of motion exercise using the proposed elderly elbow joint robot for comparison with those from novices. Furthermore, experiments were conducted as pre-evaluation, post-evaluation I (after 30 min), and post-evaluation II (after 1 month). For quantitative assessment of caregiver training, two parameters as the mean of range of elbow joint angle and the mean of range of force torque were extracted, and the results of the experts and trainees were compared. The comparison showed a statistically significant difference between pre- and post-evaluation. Hence, in this study, we conclude that our proposed approach can potentially improve caregiving and nursing skills, after further research.

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary education. Data were collected through a telephone-based, focus group interview with nine ACTS 2 facilitators deploying grounded theory techniques. We identified six themes: personal reflections on facilitator roles and responsibilities, satisfaction with existing written materials, desire for supplementary audiovisual training materials, desire for additional training on data management and reporting, importance of peer support, and fostering a faith-integrated culture within the program. Our findings underscore the importance of engaging African American faith communities in fostering dementia caregiving skills training and support. We further highlight the implications of providing community-based training for African American facilitators to foster caregiver emotional well-being and physical health.

BackgroundDementia is considered a public health problem due to the exponential increase in cases in recent years, as it not only has an impact on health services, but also affects the social and economic level, especially in low and middle income countries. Evidence has shown that a trained caregiver improves the patient’s quality of life, reduces behavioural symptoms and decreases the likelihood of the caregiver developing burnout. Currently scarce research has reported on the level of knowledge of dementia, specifically targeting caregivers in LMIC, that’s why we aimed to measure the level of knowledge of caregivers attending to monthly training compared to untrained caregivers.MethodThis is a cross‐sectional analysis, comparing the level of knowledge between trained and untrained dementia caregivers in Lima, Peru. The training program (Lonchecito para cuidadores) consists of 10 virtual meetings per year, led by a healthcare professional, where the main topics are: types of dementia, management of behavioural symptoms, application of non‐pharmacological measures and caregiver well being. The instrument used was the Dementia Knowledge Assessment Scale (DKAS‐Spanish version), a validated scale with 25 true or false statements. A Student’s T test was performed to compare the mean scores of DKAS‐S between the trained versus untrained caregivers.ResultTo date, 46 caregivers have participated in the study, representing 45% of the total sample. 80% of caregivers are women and 85% are informal caregivers. (Table 1) The preliminary results show a difference of two points on DKAS‐S between trained (mean score 16.22 ± 2.29) compared with untrained caregivers (mean score 18.21 ± 3.15). (Figure 1) A relevant finding is that 65% or more of the caregivers answered incorrectly questions 13, 15 and 19, which are related to onset symptoms of dementia, care in advanced stages and management of behavioural symptoms, respectively.ConclusionThe training program (Lonchecito para cuidadores) provides an increase in dementia knowledge. Training makes a difference between the two groups of caregivers, a reinforcement or different approach should be considered for the topics where both groups had the highest number of incorrect answers.

The aim of the present study was to investigate the effectiveness of a training program on language support strategies and dialogic reading for caregivers working in specialized preschool programs. These programs serve children without a regular childcare place who grow up with one or more languages other than German as the environmental language. Recent studies investigating the development of children attending these programs found only moderate improvements in German receptive language skills, while language support quality of the programs was rated as average. We assessed receptive second language competencies in vocabulary and grammar of n = 48 children and language support competencies of n = 15 caregivers using an interventional pre-posttest design. Receptive vocabulary skills of children supported by trained caregivers (intervention group) were compared to children supported by untrained caregivers (control group, n = 43). We found that both children’s and caregivers’ competencies increased from pre- to posttest, whereas the control group’s receptive vocabulary skills did not increase noticeably. The caregivers’ language support competencies influenced the increase of children’s receptive grammar but not vocabulary skills. The comparison between the intervention group and control group consistently showed no effect of group membership on children’s receptive vocabulary acquisition over time. Since the control group data came from a secondary analysis, only receptive vocabulary skills could be compared. The preliminary results of our study suggest that a caregivers’ training on language support strategies and dialogic reading in everyday educational situations support bilingual children’s grammar acquisition.

BackgroundA framework for increasing elderly participation in Primary Health Care (PHC) is a vital issue considering the growing population. After examining the situation and elderly participation in the provision of PHC in the health complexes of Tabriz City, the present study presents the framework of elderly participation in PHC.MethodsThis is a mixed-method study. First, we reviewed the models of elderly participation in PHC worldwide using a comprehensive search of literature. Then, we extracted the service providers’ and the elderly's views regarding the obstacles and solutions for the elderly participation in PHC in Iran using the interviews and focus group discussions (FGD). We conducted three FGDs (8–10 people) and seven individual interviews. Data were analyzed using the content analysis method. We developed the proposed framework for the participation of the elderly in PHC using a panel of experts and checked and confirmed the framework's validity using the Delphi technique with 11 experts from the content validity index and modified kappa coefficient.ResultsBased on the result of included studies in the systematic review, the characteristics of the participation models were classified into five areas: the characteristics of the service user, the main facilitator of the intervention, the type of ownership of the center, the subject and the method of participation. The solutions and obstacles, and problems presented by the service providers and users in different areas include 12 themes (elderly participation, home care, and self-care, respect for the elderly, cooperation of different organizations, service package for the elderly, referral system, planning for the elderly, considering insurance for the elderly, the role of informing the elderly, mental health of the elderly, physical space of centers and training of elderly caregivers) and 46 sub-themes. The final framework also includes five themes (approaches and strategies to attract participation, indicators, and consequences of participation of the elderly, implementation strategies of elderly care, implementation infrastructure and goals and areas of participation of the elderly) and sub-themes.ConclusionThe results of the study indicate that the final framework obtained should be used based on a systematic model for elderly participation in PHC and should be implemented and followed up based on local strategies and specific indicators, considering all capacities.