A novel approach for discovering human behavior patterns using unsupervised methods.

BACKGROUND: As is well known, elderly people gradually lose the ability of self-care. The decline can be reflected in changes in their daily life behavior. A solution to assess their health status is to design sensor-enhanced living environments to observe their behavior, in which unobtrusive sensors are usually used. With respect to information extraction from the dataset collected by means of these kinds of sensors, unsupervised methods have to be relied on for practical application. Under the assumption that human lifestyle is associated with health status, this study intends to propose a novel approach to discover behavior patterns using unsupervised methods. METHODS: To evaluate the feasibility of this approach it was applied to datasets collected in the GAL-NATARS study. The study is part of the Lower Saxony research network Design of Environments for Aging (GAL) and conducted in subjects' home environments. The subjects recruited in GAL-NATARS study are older people (age ≥ 70 years), who are discharged from hospital to live alone again at their homes after treatment of a femoral fracture. RESULTS: The change of lifestyle regularity is measured. By analyzing the correlation between the extracted information and medical assessment results of four subjects, two of them exhibited impressive association and the other two showed less association. CONCLUSIONS: The approach may provide complementary information for health assessment; however, the dominant relationship between the change of behavior patterns and the health status has to be shown and datasets from more subjects must be collected in future studies. LIMITATIONS: Merely environmental data were used and no wearable sensor for activity detection or vital parameter measurement is taken into account. Therefore, this cannot comprehensively reflect reality.

Requirements engineering for cross-sectional information chain models.

Despite the wealth of literature on requirements engineering, little is known about engineering very generic, innovative and emerging requirements, such as those for cross-sectional information chains. The IKM health project aims at building information chain reference models for the care of patients with chronic wounds, cancer-related pain and back pain. Our question therefore was how to appropriately capture information and process requirements that are both generally applicable and practically useful. To this end, we started with recommendations from clinical guidelines and put them up for discussion in Delphi surveys and expert interviews. Despite the heterogeneity we encountered in all three methods, it was possible to obtain requirements suitable for building reference models. We evaluated three modelling languages and then chose to write the models in UML (class and activity diagrams). On the basis of the current project results, the pros and cons of our approach are discussed.

[The importance of biographical approaches in nursing science]. / Zur Bedeutung biografischer Ansätze in der Pflegewissenschaft.

Critical life events (e. g. disease, loss of be loved one) biographically represent important turning points, which concerned people have to cope and deal with. While biographical research, which is established in the human and social sciences, has been dealing for a long time with typical features, such as on the type of a disease-dependent burden and coping processes, biographical oriented research approaches in nursing science are in their early stages. The article at hand has its goal in discussing the connectivity, particularly the social-interpretative biographical research in nursing science and their relevance for the development of supporting concepts regarding nursing; with the intention to rehabilitate the sufferer as the author of his own life story.

[Problems of strain and coping of breast cancer patients--demands on nursing concepts of care]. / Belastungs- und Verarbeitungsprobleme bei Patientinnen mit Brustkrebs--Anforderungen an pflegerische Betreuungs- und Unterstutzungskonzepte.

Over the last decades the number of breast cancer patients has dramatically increased. Attention has been drawn especially in research literature in the field of psychological medicine to the patients ' severe problems of strain and coping. In comparison to that, at least German intervention research in nursing science has to make up for lost time. This essay is, above all, a report on research literature. It summarizes study findings concerning emotional and physical problems associated with the disease and treatment for breast cancer. They result in a need for nursing care and support. Some practical conclusions for the nursing profession will be drawn in order to evolve comprehensive concepts of care both at a cognitive-emotional and tactile level of perception.

[Nursing science and related sciences. Questions about centralization of nursing science and interdisciplinary relations]. / Pflegewissenschaft und ihre Bezugswissenschaften. Fragen pflegewissenschaftlicher Zentrierung interdisziplinären Wissens.

The thesis of this paper is that nursing science draws a lot of its innovative potential from the knowledge that has been gathered in related disciplines. This knowledge is specified and reformulated with regard to nursing practice. The thesis is developed on two levels: first under aspects of methodology and the philosophy of science, then under aspects of the adoption of interdisciplinary knowledge. The integration of various related sciences that takes place in nursing science will finally be demonstrated in an example. This example shows which qualifications the practitioners need to deal with patients who suffer from a stroke.

[Management of treatment omission. Ethical problems in terminal care]. / Handeln oder Unterlassen. Ethische Probleme der Sterbehilfe.

Causes and courses of the diseases are subjected to a change of an increasing life expectancy on the one hand and technically highly developed medicine on the other hand. Since a growing number of elderly people is denying intensive medical interventions which serve the purpose of keeping them alive despite severe diseases, the problem of euthanasia imposes direct questions. A central role is played by the active-passive difference and its moralistic legitimacy. The difficulties of this difference are discussed below on the applicable level of ethical discussions. At the same time, knowledge of the danger is being made aware that in a maximal therapeutical orientated medical care system the desire for euthanasia may become identical with the reverse side of this care system.

[Normative dimensions of nursing practice--the ethical relevance of the body]. / Normative Dimensionen pflegerischen Handelns--Zur ethischen Relevanz des Körpers.

A combination of preliminary considerations concerning a theory of action and a philosophy of science illustrates the determining influence of the scientific preconception of the subject matter, and of the approach which is presupposed by this preconception, on the normative orientation of nursing practice. The specific physical nearness involved in nursing practice ("body to body") holds problems with regard to an appropriate theoretical frame of reference and corresponding practical convictions. This background provides the context for a concluding critical examination of several representative nursing theories with regard to their implicit, normative premises.

[Helping patients to die--an ethical challenge to nursing care and to its institutional framework]. / Sterbehilfe--ethische Herausforderungen an pflegerisches Handeln und institutionelle Rahmenbedingungen.

The current discussion about the moral legitimacy of euthanasia is primarily concerned with the question of to what extent passive and active forms of euthanasia (limited legalized practice in the Netherlands) can actually be distinguished from one another. From a nursing perspective this passive/active distinction appears in a completely different way: with regard to varied conditions which would have to be fulfilled to favour another "culture of dying", in which the desire to terminate life no longer appears as the drastic alternative to a principally curative or maximum therapeutic oriented care system for the afflicted. For this purpose, new orientations within the nursing professions which equally combine instrumental, psychosocial, institutional and educational aspects, are necessary. Applied to problems of euthanasia, questions of a fundamental ethical structure in nursing appear within an enlarged framework.