Soundscape Awareness Intervention Reduced Neuropsychiatric Symptoms in Nursing Home Residents With Dementia: A Cluster-Randomized Trial With MoSART.

OBJECTIVES: Auditory environments as perceived by an individual, also called soundscapes, are often suboptimal for nursing home residents. Poor soundscapes have been associated with neuropsychiatric symptoms (NPS). We evaluated the effect of the Mobile Soundscape Appraisal and Recording Technology sound awareness intervention (MoSART+) on NPS in nursing home residents with dementia. DESIGN: A 15-month, stepped-wedge, cluster-randomized trial. Every 3 months, a nursing home switched from care as usual to the use of the intervention. INTERVENTION: The 3-month MoSART+ intervention involved ambassador training, staff performing sound measurements with the MoSART application, meetings, and implementation of microinterventions. The goal was to raise awareness about soundscapes and their influence on residents. SETTING AND PARTICIPANTS: We included 110 residents with dementia in 5 Dutch nursing homes. Exclusion criteria were palliative sedation and deafness. METHODS: The primary outcome was NPS severity measured with the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) by the resident's primary nurse. Secondary outcomes were quality of life (QUALIDEM), psychotropic drug use (ATC), staff workload (workload questionnaire), and staff job satisfaction (Maastricht Questionnaire of Job Satisfaction). RESULTS: The mean age of the residents (n = 97) at enrollment was 86.5 ± 6.7 years, and 76 were female (76.8%). The mean NPI-NH score was 17.5 ± 17.3. One nursing home did not implement the intervention because of staff shortages. Intention-to-treat analysis showed a clinically relevant reduction in NPS between the study groups (-8.0, 95% CI -11.7, -2.6). There was no clear effect on quality of life [odds ratio (OR) 2.8, 95% CI -0.7, 6.3], psychotropic drug use (1.2, 95% CI 0.9, 1.7), staff workload (-0.3, 95% CI -0.3, 0.8), or staff job satisfaction (-0.2, 95% CI -1.2, 0.7). CONCLUSIONS AND IMPLICATIONS: MoSART+ empowered staff to adapt the local soundscape, and the intervention effectively reduced staff-reported levels of NPS in nursing home residents with dementia. Nursing homes should consider implementing interventions to improve the soundscape.

Recurrent neural networks for hydrodynamic imaging using a 2D-sensitive artificial lateral line.

The lateral line is a mechanosensory organ found in fish and amphibians that allows them to sense and act on their near-field hydrodynamic environment. We present a 2D-sensitive artificial lateral line (ALL) comprising eight all-optical flow sensors, which we use to measure hydrodynamic velocity profiles along the sensor array in response to a moving object in its vicinity. We then use the measured velocity profiles to reconstruct the object's location, via two types of neural networks: feed-forward and recurrent. Several implementations of feed-forward neural networks for ALL source localisation exist, while recurrent neural networks may be more appropriate for this task. The performance of a recurrent neural network (the long short-term memory, LSTM) is compared to that of a feed-forward neural network (the online-sequential extreme learning machine, OS-ELM) via localizing a 6 cm sphere moving at 13 cm s-1. Results show that, in a 62 cm [Formula: see text] 9.5 cm area of interest, the LSTM outperforms the OS-ELM with an average localisation error of 0.72 cm compared to 4.27 cm, respectively. Furthermore, the recurrent network is relatively less affected by noise, indicating that recurrent connections can be beneficial for hydrodynamic object localisation.