Pervasive Care Research Articles

Enforced Conviviality and the Violence of Care in Han Kang’s The Vegetarian

ABSTRACT Care can itself be a form of violence that masks hierarchical control and violates ethical singularity. Drawing on feminist philosophies of care, I argue that structural modes of violence are embedded in pervasive care ethics. Han Kang’s novel The Vegetarian (2007) demonstrates two contradictory responses to care ethics. The protagonist Yeong-hye leans into her moral values through radical vegetarianism, believing that her eating practices free her from acts of violence not only toward humans but also toward animals. Her ethical decision, however, creates family conflicts, as her moral stand is considered an ethical evasion of wifely and daughterly care obligations. Han Kang’s novel indicates that maternal figures can also inadvertently support hierarchical culture and patriarchal norms embedded in daily caring practices. Her family’s care imperative attempts to normalize Yeong-hye’s diet and thus violates her ethics. My reading of The Vegetarian not only informs my theory of gendered care – considering the normative reflection of social expectation in care relations – but also proffers an intervention in the subtle forms of naturalized care violence in the postcolonial South Korean imaginary of a convivial future.

Adaptive mobility-aware and reliable routing protocols for healthcare vehicular network.

Healthcare vehicles such as ambulances are the key drivers for digital and pervasive remote care for elderly patients. Thus, Healthcare Vehicular Ad Hoc Network (H-VANET) plays a vital role to empower the digital and Intelligent Transportation System (ITS) for the smart medical world. Quality of Service (QoS) performance of vehicular communication can be improved through the development of a robust routing protocol having enhanced reliability and scalability. One of the most important issues in vehicular technology is allowing drivers to make trustworthy decisions, therefore building an efficient routing protocol that maintains an appropriate level of Quality of Service is a difficult task. Restricted mobility, high vehicle speeds, and continually changing topologies characterize the vehicular network environment. This paper contributes in four ways. First, it introduces adaptive, mobility-aware, and reliable routing protocols. The optimization of two routing protocols which are based on changing nature topologies of the network used for vehicular networks has been performed, amongst them, Optimized Link State Routing (Proactive) and Ad-hoc on Demand Distance Vector (Reactive) are considered for Packet Delivery Ratio (PDR) and throughput. Furthermore, Packet Loss Ratio (PLR), and end-to-end (E2E) delay parameters have also been calculated. Second, a healthcare vehicle system architecture for elderly patients is proposed. Third, a Platoon-based System model for routing protocols in VANET is proposed. Fourth, a dynamic channel model has been proposed for the vehicle to vehicle communication using IEEE8011.p. To optimize the QoS, the experimental setup is conducted in a discrete Network Simulator (NS-3) environment. The results reveal that the AODV routing protocol gives better performance for PDR as well as for PLR and the communication link established is also reliable for throughput. Where OLSR produces a large average delay. The adoptive mobility-aware routing protocols are potential candidates for providing Intelligent Transportation Systems with acceptable mobility, high reliability, high PDR, low PLR, and low E2E delay.

Telepsychiatry in Low- and Middle-Income Countries During COVID-19: Pandemic, Barriers, and Road Model.

To date, there is lack of specific effective treatment or vaccine for the SARS-CoV-2, and clinical and laboratory research is still ongoing to find successful drugs. Therefore, prevention to be infected through social distancing and isolation is the most effective way. However, all the other physical and mental illnesses continue to exist, if possible even more burdened by the emergency situation and social distancing. The COVID-19 pandemic, especially in many low- and middle-income countries, has caused a deeper gap in seeking psychiatric help. In this scenario, telepsychiatry could play a decisive role in implementing clinical care for frail patients and ensuring continuous mental care. Therefore, we felt the urge to write this article to express our hope that the old health care system at this time of crisis, as we know it, can offer the chance to implement pervasive care technologies that perfectly fit current psychiatric needs.

48 Systematic Approaches to Fragility Fracture Care and Prevention: A Global Perspective

Abstract Fracture begets fracture. Since the 1980s, we have known that approximately half of individuals who sustain a hip fracture break another bone in the months or years before breaking their hip. More recently, investigators in Australia, the United Kingdom and the United States have reported similar findings. Meta-analyses have demonstrated that a prior fracture at any site is associated with a doubling of future fracture risk. Individuals who sustain fragility fractures usually present to healthcare services to seek medical attention and, as such, represent an obvious group to target for osteoporosis assessment and falls prevention. However, a persistent and pervasive care gap is evident in the secondary prevention of fragility fractures throughout the world. The care gap is well documented in countries in Asia-Pacific. A Fracture Liaison Service (FLS) is a system to ensure fracture risk assessment, and treatment where appropriate, is delivered to all patients with fragility fractures. A FLS is usually comprised of a dedicated case worker, often a clinical nurse specialist, who works to pre-agreed protocols to case-find and assess fracture patients. While FLS are usually based in hospital, some primary care based FLS have been developed. A FLS requires support from a medically qualified practitioner. The FLS model of care has been endorsed and advocated for by governments, healthcare professional organisations and national osteoporosis societies, and national alliances comprised of these and other groups. This presentation will provide a global perspective on implementation of FLS as a central component of a broader systematic approach to fragility fracture care and prevention. References Fracture Liaison Services (FLS) Toolbox for Asia Pacific. Asia Pacific Bone Academy. 2017.

Technology adoption potential of medical devices: The case of wearable sensor products for pervasive care in neurosurgery and orthopedics

ObjectivesThis research focuses on assessing the potential technology adoption of medical devices particular to tracking the mobility of neurosurgery and orthopedics patients. Wearable medical devices that track the mobility of patients after spinal procedures could help surgeons to provide post-operative care, analysis of treatment outcomes, and patient mobility. MethodsThe assessment of medical devices by physicians is a complex process associated with various criteria and sub criteria. The hierarchical decision model (HDM) is used to break down the problem into hierarchical levels, and alternatives are calculated by using pairwise comparison scales and the judgment quantification technique. Inconsistencies, disagreement, sensitivity, and scenario analysis are performed as well. HDM research software is created by Ruby and R Studio. ResultsPatient perspective dominates in the main criteria for technology adoption potential of wearable devices for pervasive care in neurosurgery and orthopedics, followed by technical and financial criteria. The Valedo – wearable device, which aims to relieve back pain through exercises, motivation, and mobility tracking, received the highest ranking for adoption potential, while other devices also received high relative scores. ConclusionsThe framework could serve as a supplementary technology assessment tool, and could be tested in other settings: private clinics, small clinics etc. by taking into account the experts and special needs of the physicians in particular healthcare departments.

Mobile Robots and Autonomic Ambient Assisted Living

Abstract The use of Smart Environments in the delivery of pervasive care is a research topic that has witnessed increasing interest in recent years. These environments aim to deliver pervasive care through ubiquitous sensing by monitoring the occupants Activities of Daily Living. In order for these environments to succeed in achieving their goal, it is crucial that sensors deployed in the environment perform faultlessly. In this research we investigate addressing anomalous sensor behavior through the utilization of a mobile robot. The robot’s role is twofold; it must provide substitution in the presence of suspected sensor faults and act as an observer of anomalous sensor behavior in order to understand the changes that occur in the behavior of sensors deployed within the environment over time. The aim of this work is to explore a paradigm shift to the use of Autonomic Ambient Assisted Living.We have discovered that the use of a mobile robot is a viable means of introducing this paradigm to a Smart Environment.

Pervasive community care platform: Ambient Intelligence leveraging sensor networks and mobile agents

Several powerful trends are contributing to an aging of much of the world's population, especially in economically developed countries. To mitigate the negative effects of rapidly ageing populations, societies must act early to plan for the welfare, medical care and residential arrangements of their senior citizens, and for the manpower and associated training needed to execute these plans. This paper describes the development of an Ambient Intelligent Community Care Platform (AICCP), which creates an environment of Ambient Intelligence through the use of sensor network and mobile agent (MA) technologies. The AICCP allows caregivers to quickly and accurately locate their charges; access, update and share critical treatment and wellness data; and automatically archive all records. The AICCP presented in this paper is expected to enable caregivers and communities to offer pervasive, accurate and context-aware care services.

MPHASiS: Mobile patient healthcare and sensor information system

Pervasive care and chronic disease management to reduce institutionalization is a priority for most western countries. The realization of next generation ubiquitous and pervasive healthcare systems will be a challenging task, as these systems are likely to involve a complex structure. Such systems will consist of various devices, ranging from resource-constrained sensors and actuators to complex multimedia devices, supporting time critical applications. This is further compounded by cultural and socio-economical factors that must be addressed for next generation healthcare systems to be widely diffused and used. In this study, the requirements for a vital sign monitoring solution space is derived and mPHASiS is developed based on these requirements. mPHASiS is an end to end solution not only providing sensor networking and vital sign monitoring but also closing the loop by signaling alert messages to the caregiver and allowing pervasive access to vital signs of a patient using smartphones over a heterogeneous network. A role based access control mechanism is developed to limit access to sensitive data. The end to end delay and delay variations for both vital sign data collection and pervasive access are analyzed. mPHASiS is developed as a complementary solution augmenting functionality of a hospital information system and can be loosely couple with the hospital information system using webservices.

Requirements and design spaces of mobile medical care

Pervasive care and chronic disease management to reduce institutionalization is a priority for most western countries. The realization of next generation ubiquitous and pervasive healthcare systems will be a challenging task, as these systems are likely to involve a complex structure. Such systems will consist of various devices, ranging from resource-constrained sensors and actuators to complex multimedia devices, supporting time critical applications. This is further compounded by cultural and socio-economical factors that must be addressed for next generation healthcare systems to be widely diffused and used. These factors have a direct impact on the system and security models and will require further understanding to encourage users to embrace and adopt the new technology. These models must capture not only the perceived value of the new technology and its ease of use, but most importantly the perceived risk of using this technology. This paper outlines the design space of pervasive health monitoring with body sensor networks and derives the requirements for connected pervasive medical care systems. Commercial and academic mobile medical sensor systems have been mapped to the requirements derived and a comparative analysis of state of the technology is given.