Understanding changes and stability in the long-term use of technologies by seniors who are aging in place: a dynamical framework.

BACKGROUND: If technologies are to support aging in place, then it is important to develop fundamental knowledge on what causes stability and changes in the use of technologies by seniors. However, longitudinal studies on the long-term use of technologies that have been accepted into the home (i.e., post-implementation use) are very scarce. Many factors potentially could influence post-implementation use, including life events, age-related decline, changes in personal goal orientation, and various types of social influences. The aforementioned factors are likely to be interrelated, adding to the complexity. The goal of this study is to better understand changes and stability in the use of technologies by independent-living seniors, by using a dynamical systems theory approach. METHODS: A longitudinal qualitative field study was conducted involving home visits to 33 community-dwelling seniors in the Netherlands, on three occasions (2012-2014). Interviews were held on technology usage patterns, including reasons for stable, increased, declined and stopped use. Technologies were included if they required electric power in order to function, were intended to be used in or around the home, and could support activities of daily living, personal health or safety, mobility, communication, and physical activity. Thematic analysis was employed, using constant case comparison to better understand dynamics and interplay between factors. In total, 148 technology use patterns by 33 participants were analyzed. RESULTS: A core of six interrelated factors was closely linked to the frequency of technology use: emotional attachment, need compatibility, cues to use, proficiency to use, input of resources, and support. Additionally, disruptive forces (e.g., social influences, competition with alternative means, changes of personal needs) could induce change by affecting these six factors. Furthermore, long-term technology use was in some cases more resilient to disruption than in other cases. Findings were accumulated in a new framework: Dynamics In Technology Use by Seniors (DITUS). CONCLUSIONS: Similar to aging, the use of technologies by older people is complex, dynamic and personal. Periods of stability and change both occur naturally. The DITUS framework can aid in understanding stability and instability of technology use, and in developing and implementing sustainable technological solutions for aging in place.

Smart-Glasses: Exposing and Elucidating the Ethical Issues.

The objective of this study is to provide an overview over the ethical issues relevant to the assessment, implementation, and use of smart-glasses. The purpose of the overview is to facilitate deliberation, decision making, and the formation of knowledge and norms for this emerging technology. An axiological question-based method for human cognitive enhancement including an extensive literature search on smart-glasses is used to identify relevant ethical issues. The search is supplemented with relevant ethical issues identified in the literature on human cognitive enhancement (in general) and in the study of the technical aspects of smart-glasses. Identified papers were subject to traditional content analysis: 739 references were identified of which 247 were regarded as relevant for full text examinations, and 155 were included in the study. A wide variety of ethical issues with smart-glasses have been identified, such as issues related to privacy, safety, justice, change in human agency, accountability, responsibility, social interaction, power and ideology. Smart-glasses are envisioned to change individual human identity and behavior as well as social interaction. Taking these issues into account appears to be relevant when developing, deliberating, deciding on, implementing, and using smart-glasses.

Trends in television time, non-gaming PC use and moderate-to-vigorous physical activity among German adolescents 2002-2010.

BACKGROUND: Studies in youth highlight that moderate-to-vigorous physical activity (MVPA) and screen-time behaviours such as television viewing and PC use are associated with a range of health outcomes. However, little is known about recent trends in these behaviours in adolescents. This paper presents time trends in German adolescents' television time, non-gaming PC use as well as MVPA from 2002 to 2010. METHODS: Data were derived from the cross-sectional German Health Behaviour in School-aged Children (HBSC) study in 2002, 2006 and 2010. Analyses were based on 16,918 11-to 15-year olds boys (49.1%) and girls. Outcome variables were time spent in TV viewing and using a PC (weekday and weekend day) as well as the number of days achieving 60 minutes of MVPA. Changes in both screen-time behaviours and MVPA over time were analysed using sex-specific linear regression, controlling for age and family affluence. RESULTS: TV viewing on weekdays, but not at weekends, declined steadily over time with a difference between 2002 and 2010 of 12.4 min/day in girls and 18.3 min/day in boys (p for trend<.01). We found a strong increase in PC use for non-gaming purposes over time for girls only, with a difference between 2002 and 2010 of 54.1 min/weekday and 68.8 min/weekend day (p<.001). For MVPA we found a slight statistically significant increase in terms of meeting PA guidelines as well as days/week in MVPA for boys and girls (p<.001). In 2010 14.0% of girls and 19.9% of boys met PA guideline. CONCLUSION: Although MVPA increased from 2002 to 2010 in German adolescents, the time spent in MVPA was still low. Despite the observed decrease in TV viewing, there was no overall decline in the observed screen-based behaviours, especially for girls. This is mainly due to a marked increase in use of a PC for chatting on-line, internet, emailing, homework etc. among girls during the last ten years which outweighs the corresponding decrease in TV viewing. The findings highlight a need for strategies and interventions aimed at reducing screen-time behaviours and promoting MVPA.

#Nomoretextbooks? The impact of rapid communications technologies on medical education.

This paper was selected as the 2013 student essay winner by the Canadian Undergraduate Surgical Education Committee. The essay was in response to the question "How does rapid communications technology affect learning?"

Implications of smart wear technology for family caregiving relationships: focus group perceptions.

Technological advances in monitoring vulnerable care-recipients are on the rise. Recent and future development of Smart Wear technology (devices integrated into clothing that monitor care-recipients) might assist family caregivers with tasks related to caring for young children, relatives with disabilities, and frail spouses or parents. However, the development and use of this technology in family caregiving contexts is in its infancy. Focus group interviews of family caregivers were conducted to explore perspectives regarding the potential integration of Smart Wear technology into their family caregiving. Responses were analyzed qualitatively for themes related to perceptions of how Smart Wear could impact relationships between caregivers and care-recipients. Three major themes emerged: quality and quantity of interaction, boundary issues, and implications for anxiety. Implications and recommendations are discussed regarding maximizing the potential benefits of Smart Wear technology in ways that promote and protect healthy relationships among caregivers and care-recipients.

Microchip technology in mass spectrometry.

Microfabrication of analytical devices is currently of growing interest and many microfabricated instruments have also entered the field of mass spectrometry (MS). Various (atmospheric pressure) ion sources as well as mass analyzers have been developed exploiting microfabrication techniques. The most common approach thus far has been the miniaturization of the electrospray ion source and its integration with various separation and sampling units. Other ionization techniques, mainly atmospheric pressure chemical ionization and photoionization, have also been subject to miniaturization, though they have not attracted as much attention. Likewise, all common types of mass analyzers have been realized by microfabrication and, in most cases, successfully applied to MS analysis in conjunction with on-chip ionization. This review summarizes the latest achievements in the field of microfabricated ion sources and mass analyzers. Representative applications are reviewed focusing on the development of fully microfabricated systems where ion sources or analyzers are integrated with microfluidic separation devices or microfabricated pums and detectors, respectively. Also the main microfabrication methods, with their possibilities and constraints, are briefly discussed together with the most commonly used materials.

Microprocessor Recruitment to Elongating RNA Polymerase II Is Required for Differential Expression of MicroRNAs.

The cellular abundance of mature microRNAs (miRNAs) is dictated by the efficiency of nuclear processing of primary miRNA transcripts (pri-miRNAs) into pre-miRNA intermediates. The Microprocessor complex of Drosha and DGCR8 carries this out, but it has been unclear what controls Microprocessor's differential processing of various pri-miRNAs. Here, we show that Drosophila DGCR8 (Pasha) directly associates with the C-terminal domain of the RNA polymerase II elongation complex when it is phosphorylated by the Cdk9 kinase (pTEFb). When association is blocked by loss of Cdk9 activity, a global change in pri-miRNA processing is detected. Processing of pri-miRNAs with a UGU sequence motif in their apical junction domain increases, while processing of pri-miRNAs lacking this motif decreases. Therefore, phosphorylation of RNA polymerase II recruits Microprocessor for co-transcriptional processing of non-UGU pri-miRNAs that would otherwise be poorly processed. In contrast, UGU-positive pri-miRNAs are robustly processed by Microprocessor independent of RNA polymerase association.

Out with the old, out with the new--The effect of transitions in TVs and monitors technology on consumption and WEEE generation in Sweden 1996-2014.

The recycling of Waste Electrical and Electronic Equipment (WEEE) is important due to its content of valuable and hazardous compounds. This study investigates the case of the recent technology change within television sets (TVs) and monitors, its impact on the generation of WEEE, and the implications for the recycling industry. In particular, material flow analysis for the time series of 1996-2014 for TVs and monitors by type of technology (CRT, Plasma and LCD) in physical units is combined with empirical data on product lifespans. The number of consumed TVs and monitors has grown exponentially. As a result, despite a 3-fold reduction in the weight of the products, the weight of the corresponding WEEE is also growing exponentially. Out with the old, out with the new - a peak in WEEE from both CRT and flat-screen displays is expected during 2014-2020, due to the simultaneous obsolesce of the last wave of CRT products and the short-lived flat-screen products that substituted the CRTs. The lifespans of LCD and LED TVs were found to be three times shorter than of the CRT TVs, with many TVs discarded while still functional. This is the consequence of two events - replacement of the CRT TVs in combination with lifestyle purchases of TVs, i.e. the premature replacement of flat-screen displays with new sets with extra-large screens and/or new features. The throughput of TVs and monitors consumed has been estimated annually from 2014 until 2040, by quantity and type of device, as well as by component and material type. The annual economic value of the corresponding secondary materials, by material type, has also been estimated. The point in time when the final disposal of CRT products is likely to take place has been identified and should be noted by the recycling industry. Among the important contributions of this study to the accounting and predicting of amounts and types of WEEE are the lifespan distributions, size and weight distributions, and material composition for TVs and monitors of different technology. Directions for method application in other countries are given.

Gaddum Memorial Lecture 2014: receptors as an evolving concept: from switches to biased microprocessors.

This review is based on the JR Vane Medal Lecture presented at the BPS Winter Meeting in December 2014 by T. Kenakin. A recording of the lecture is included as supporting information and can also be viewed online here: https://www.youtube.com/watch?v=xrP81AQ8l-8. Pharmacological models used to describe drug agonism and antagonism have evolved over the past 20 years from a parsimonious model describing single active and inactive receptor states to models of multiconformational receptor systems modified by ligand conformational selection. These latter models describe the observed, presently underexploited, pharmacological mechanism of ligand-directed biased signalling. Biased signals can be quantified with transduction coefficients (ΔΔLog(τ/KA) values), a scale grounded in the Black/Leff operational model; this enables the optimization of biased profiles through medicinal chemistry. The past decades have also brought the availability of new technologies to measure multiple functional effects mediated by seven transmembrane receptors. These have confirmed that drugs can have many efficacies, which may be collaterally linked, that is there is no linear sequence of activities required. In addition, new functional screening assays have introduced increasing numbers of allosteric ligands into drug discovery. These molecules are permissive (they do not necessarily preclude endogenous signalling in vivo); therefore, they may allow better fine tuning of pathological physiology. The permissive quality of allosteric ligands can also change the quality of endogenous signalling efficacy ('induced bias') as well as the quantity of signal; in this regard, indices related to ΔΔLog(τ/KA) values (namely ΔLog(αß) values) can be used to quantify these effects for optimization in the drug discovery process. All of these added scales of drug activity will, hopefully, allow better targeting of candidate molecules towards therapies.

A preview of implantable cardioverter defibrillator systems in the next millennium: an integrative cardiac rhythm management approach.

The implantable cardioverter defibrillator (ICD), a primary therapeutic option for preventing sudden cardiac death, has rapidly evolved since being introduced clinically in 1980. Technologic advances in several key areas have enabled ICDs to provide more sophisticated rhythm management. Recent emphasis has been placed on dual-chamber ICDs possessing adaptive-rate pacing capabilities. Adoption of dual-chamber ICD systems has been rapid. The capabilities of future ICD systems will be governed by an integrative strategy that brings together sets of features specifically targeted at multifaceted rhythm disorders. The addition of atrial therapy will require more sophisticated rhythm discrimination algorithms. ICD technology will improve on several fronts including leads, integrated circuits, batteries, and capacitors. Additionally, state-of-the-art pacemaker technology will continue to be incorporated into ICDs. As these new ICD systems become increasingly sophisticated from an engineering viewpoint, tremendous emphasis will be placed on decreasing the complexity of programming, device interrogation, and patient monitoring during routine patient follow-up. Vast improvements in ICD programming systems may ultimately permit the 1-minute follow-up.

Extended dynamic clamp: controlling up to four neurons using a single desktop computer and interface.

The dynamic clamp protocol allows an experimenter to simulate the presence of membrane conductances in, and synaptic connections between, biological neurons. Existing protocols and commercial ADC/DAC boards provide ready control in and between < or =2 neurons. Control at >2 sites is desirable when studying neural circuits with serial or ring connectivity. Here, we describe how to extend dynamic clamp control to four neurons and their associated synaptic interactions, using a single IBM-compatible PC, an ADC/DAC interface with two analog outputs, and an additional demultiplexing circuit. A specific C++ program, DYNCLAMP4, implements these procedures in a Windows environment, allowing one to change parameters while the dynamic clamp is running. Computational efficiency is increased by varying the duration of the input-output cycle. The program simulates < or =8 Hodgkin-Huxley-type conductances and < or =18 (chemical and/or electrical) synapses in < or =4 neurons and runs at a minimum update rate of 5 kHz on a 450 MHz CPU. (Increased speed is possible in a two-neuron version that does not need auxiliary circuitry). Using identified neurons of the crustacean stomatogastric ganglion, we illustrate on-line parameter modification and the construction of three-member synaptic rings.

Interactive 3-dimensional segmentation of MRI data in personal computer environment.

We describe a method of interactive three-dimensional segmentation and visualization for anatomical magnetic resonance imaging (MRI) data in a personal computer environment. The visual feedback necessary during 3-D segmentation was provided by a ray casting algorithm, which was designed to allow users to interactively decide the visualization quality depending on the task-requirement. Structures such as gray matter, white matter, and facial skin from T1-weighted high-resolution MRI data were segmented and later visualized with surface rendering. Personal computers with central processing unit (CPU) speeds of 266, 400, and 700 MHz, were used for the implementation. The 3-D visualization upon each execution of the segmentation operation was achieved in the order of 2 s with a 700 MHz CPU. Our results suggest that 3-D volume segmentation with semi real-time visual feedback could be effectively implemented in a PC environment without the need for dedicated graphics processing hardware.

Microelectromechanical systems and neurosurgery: a new era in a new millennium.

MICROMACHINES AND MICROELECTROMECHANICAL SYSTEMS (MEMS) are terms that are new to neurosurgeons but certain to become "household terms" in neurosurgery in the near future. These new terms serve as an introduction to a new world of sensors, actuators, and "smart systems" that will change the ways in which neurosurgeons interact with their environment. Through the use of microelectronics and micromachining technologies, MEMS will allow neurosurgeons to perform familiar tasks with greater precision, perform tasks that previously were not done at all, and monitor physiological and biochemical parameters more accurately and with greater safety. This review provides the information necessary to understand the fundamental concepts of MEMS and their application to the neurosurgical arena. It defines the relevant terms and describes the history behind the "micromachine revolution," the capabilities and limitations of MEMS technology, and how this revolution is germane to neurosurgery and to neurosurgeons.

Past and future of computer-assisted sleep analysis and drowsiness assessment.

The development of computerized sleep analysis has been very much technology-driven by both mathematical tools and available hardware but, additionally and unfortunately, by the almost-30-year-old standard used for manual sleep stage scoring of paper recordings. There are no technical restrictions in terms of computing power, storage space, and costs anymore. However, the standards of visual sleep stage scoring have proven insufficient and ambiguous, and their utilization evidently provides misleading and erroneous information. The low temporal resolution provided by the one-page epoch, the crude division of the sleep processes into a few discrete stages, and the total ignorance of spatial information are the major drawbacks. It is meaningless to try to improve the computerised systems if the algorithms are based on erroneous concepts. Instead, the focus should be changed to studies dealing with the identification and modelling of true biological sleep-related processes. This work cannot be performed without the successful application of computerized methods, some of which have been used in related fields but have not yet been applied to sleep studies. It is extremely important that basic findings are confirmed with a wide variety of methods in several laboratories. The use of predetermined, fixed criteria for methods, waveforms, and states too early is scientifically erroneous and hazardous. Instead standards should describe the minimum requirements for the recording and analysis of the signals in terms of sampling rate, dynamic range, linearity, and documentation of the methods used. With the development of better technology, these standards ought to be constantly reevaluated and modified. The development toward more open commercial digital systems, including standardized programming methods and data formats, would have great positive impact to the field. These trends have long been established in many other fields of industry.

The future of computer-assisted investigation of the polysomnogram: sleep microstructure.

Previous attempts at automated analysis of sleep were mainly directed towards imitating the Rechtschaffen and Kales rules (RKR) in order to save scoring time and further objectify the procedure. RKR, however, do not take into consideration the sleep microstructure of REM, stage 2, and SWS. While the microstructure of stage 2 has been analyzed in the past decade, the microstructure of REM and SWS are virtually unknown. In stage 2 the amount and distribution of spindles, K complexes, and arousal reactions have been studied. At least two types of spindles (12/s and 14/s) with different dynamics and locations have been identified. Two different shapes for K complexes have been described: one related to external sensory stimuli with similarities to evoked potentials and another one more related to sinusoidal slow wave activity seen in SWS. These two different K complex shapes have different distributions and, obviously, different functions. The authors also suggest that one should differentiate between arousal reactions and true arousals. Recent investigations suggest two types of delta waves in SWS. The more sinusoidal 1-3/s delta waves with a frontal maximum are already seen with lower amplitude in late stage 2 and increase their amplitude and incidence towards stage 3 and Stage 4. The other delta-wave type is slower (< 1/s), polymorphic, and has varying amounts of theta and higher frequency waves superimposed. During REM sleep it seems to be important to separate phases with rapid eye movements from those with none (REM sine REM), and count the amount and distribution of sawtooth activity. Background activity during REM and REM sine REM, as well as intra- and interhemispheric coherence should be analyzed separately. Only if the microstructure of the sleep EEG can be analyzed automatically using newer techniques such as transformation into wavelets and pattern classification with neuronal networks, and only if we learn more about the importance of microstructure elements, can automated sleep analysis go beyond the limited information obtained from scoring according to RKR.

Children and computers. Approaching the twenty-first century.

The "effects" that various forms of "computer" use are likely to have on different children's learning, motivation, and social behavior have been a source of heated debate and continuing controversy. In this article, various aspects of this controversy are characterized, and sources of disagreement concerning educational computing are examined. Difficulties in the current state of empirical research in this area are then considered, and recommendations regarding directions for future research are proposed.