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Della Monica C, Ravindran KKG, Atzori G, Lambert DJ, Rodriguez T, Mahvash-Mohammadi S, Bartsch U, Skeldon AC, Wells K, Hampshire A, Nilforooshan R, Hassanin H, The Uk Dementia Research Institute Care Research Amp Technology Research Group, Revell VL, Dijk DJ. A Protocol for Evaluating Digital Technology for Monitoring Sleep and Circadian Rhythms in Older People and People Living with Dementia in the Community. Clocks Sleep 2024; 6:129-155. [PMID: 38534798 DOI: 10.3390/clockssleep6010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/12/2024] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
Sleep and circadian rhythm disturbance are predictors of poor physical and mental health, including dementia. Long-term digital technology-enabled monitoring of sleep and circadian rhythms in the community has great potential for early diagnosis, monitoring of disease progression, and assessing the effectiveness of interventions. Before novel digital technology-based monitoring can be implemented at scale, its performance and acceptability need to be evaluated and compared to gold-standard methodology in relevant populations. Here, we describe our protocol for the evaluation of novel sleep and circadian technology which we have applied in cognitively intact older adults and are currently using in people living with dementia (PLWD). In this protocol, we test a range of technologies simultaneously at home (7-14 days) and subsequently in a clinical research facility in which gold standard methodology for assessing sleep and circadian physiology is implemented. We emphasize the importance of assessing both nocturnal and diurnal sleep (naps), valid markers of circadian physiology, and that evaluation of technology is best achieved in protocols in which sleep is mildly disturbed and in populations that are relevant to the intended use-case. We provide details on the design, implementation, challenges, and advantages of this protocol, along with examples of datasets.
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Affiliation(s)
- Ciro Della Monica
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
| | - Kiran K G Ravindran
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
| | - Giuseppe Atzori
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
| | - Damion J Lambert
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
| | - Thalia Rodriguez
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
- School of Mathematics & Physics, University of Surrey, Guildford GU2 7XH, UK
| | - Sara Mahvash-Mohammadi
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford GU2 7XH, UK
| | - Ullrich Bartsch
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
| | - Anne C Skeldon
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
- School of Mathematics & Physics, University of Surrey, Guildford GU2 7XH, UK
| | - Kevin Wells
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford GU2 7XH, UK
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College, London W12 0NN, UK
| | - Ramin Nilforooshan
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
- Surrey and Borders Partnership NHS Foundation Trust Surrey, Chertsey KT16 9AU, UK
| | - Hana Hassanin
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
- Surrey Clinical Research Facility, University of Surrey, Guildford GU2 7XP, UK
- NIHR Royal Surrey CRF, Royal Surrey Foundation Trust, Guildford GU2 7XX, UK
| | | | - Victoria L Revell
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, Guildford GU2 7XP, UK
- UK Dementia Research Institute Care Research & Technology Centre (CR&T), Imperial College London and the University of Surrey, London W12 0NN, UK
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Guiang SF, Georgieff MK, Lambert DJ, Schmidt RL, Widness JA. Intravenous iron supplementation effect on tissue iron and hemoproteins in chronically phlebotomized lambs. Am J Physiol 1997; 273:R2124-31. [PMID: 9435670 DOI: 10.1152/ajpregu.1997.273.6.r2124] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chronic phlebotomy is an important mechanism of iron loss in premature infants. We studied inter- and intraorgan iron allocation in 10 twin lamb pairs undergoing an acute 40-50% reduction in red cell volume followed by smaller intermittent phlebotomies over an 11-day period. One twin received no supplemental iron sucrose, while the other received an average daily intravenous dose of iron sucrose of either 1 (n = 3), 2 (n = 3), 5 (n = 3), or 15 (n = 1) mg.kg-1.day-1. The total iron content of the red blood cells, liver, skeletal muscle, heart, and brain was directly related to iron dose up to 2 mg.kg-1.day-1. Tissue iron concentrations remained stable until liver iron was < 200 g/g dry wt, after which iron was preferentially directed to red blood cells over skeletal muscle, heart, and brain. Hemoprotein concentrations decreased proportionately to tissue iron, except myocardial cytochrome c, which remained preserved. Any available iron in phlebotomized, rapidly growing lambs is preferentially directed to red blood cells, and lambs require iron supplementation to maintain tissue iron and hemoprotein concentrations. A decrease in nonheme tissue iron results in the high prioritization of iron among iron-containing proteins.
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Affiliation(s)
- S F Guiang
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis 55455, USA
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Widness JA, Burmeister LF, Schmidt RL, Lambert DJ. Increased plasma erythropoietin levels in lambs treated with parenteral iron. Br J Haematol 1997; 97:686-7. [PMID: 9207424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Bauer DA, Belcinski R, Berg RC, Bingham HH, Bloom ED, Buchanan CD, Caldwell DO, Chun SB, Clark AR, Dahl OI, Eastman JJ, Eberhard PH, Eisner AM, Fairfield KH, Godfrey G, Greenbaum GS, Hauptman JM, Hofmann W, Holtzapple RL, Khacheryan S, Knöpfle KT, Kofler RR, Lambert DJ, Loken SC, Lu A, Lynch GR, Lys JE, Madaras RJ, Marsiske H, Masek GE, Miller ES, Nicol NA, Nygren DR, Oyang YT, Paar HP, Palounek AP, Pellett DE, Ronan MT, Ross RR, Shapiro G, Stephens RW, Stevenson ML, Strauss MG, Sullivan MK, Vernon W, Wang EM, Wang YX, Wenzel WA, Yamamoto H, Yellin SJ, Yost GP, Zapalac G. Measurement of the kaon content of three-prong tau decays. Phys Rev D Part Fields 1994; 50:R13-R17. [PMID: 10017569 DOI: 10.1103/physrevd.50.r13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Bauer DA, Belcinski R, Berg RC, Bingham HH, Buchanan CD, Caldwell DO, Chun SB, Clark AR, Dahl OI, Daoudi M, Eastman JJ, Eisner AM, Fairfield KH, Godfrey G, Greenbaum GS, Hauptman JM, Hofmann W, Holtzapple RL, Khacheryan S, Knöpfle KT, Kofler RR, Lambert DJ, Layter JG, Lin WT, Loken SC, Lu A, Lynch GR, Lys JE, Madaras RJ, Masek GE, Miller ES, Nicol NA, Nygren DR, Oyang JY, Paar HP, Palounek AP, Pellett DE, Ronan MT, Ross RR, Shapiro G, Shen BC, Stephens RW, Stevenson ML, Strauss MG, Sullivan MK, Vernon W, Wang EM, Wang YX, Wenzel WA, Yamamoto H, Yellin SJ, Yost GP, Zapalac G, Zeitlin C. Evidence for spin-one resonance production in the reaction gamma gamma *--> pi + pi - pi 0 pi 0. Phys Rev D Part Fields 1993; 48:3976-3986. [PMID: 10016677 DOI: 10.1103/physrevd.48.3976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Bluth EI, Lambert DJ, Lohmann TP, Franklin DN, Bourgeois M, Kardinal CG, Dalovisio JR, Williams MM, Becker AS. Improvement in 'stat' laboratory turnaround time. A model continuous quality improvement project. Arch Intern Med 1992; 152:837-40. [PMID: 1558443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Continuous quality improvement is being advocated as the process that, if adopted, would improve the efficiency, productiveness, and quality of medical institutions, thereby helping to solve the health care crisis our country is facing. To determine if these techniques could be effective in a tertiary-care multispecialty group practice, a model project was undertaken. The model project chosen was to determine if we could improve the turnaround time for "stat" laboratory examinations performed in our large outpatient facility. METHODS A 10-member team consisting of everyone involved in the process of laboratory testing was empowered to evaluate the present process and make appropriate changes. With traditional techniques of quality improvement, the process was assessed, data were collected and statistically analyzed, changes were introduced, and data were recollected and analyzed. RESULTS After intervention, the preanalytic delays were reduced by 76% and the postanalytic delays by 88%. Waiting time for patients was reduced by an average of 62%. By instituting the changes suggested, the institution saved $225,000 on a one-time basis and $40,000 to $50,000 on a recurring basis. CONCLUSION Adoption of quality improvement techniques appears to be a desirable management paradigm that should be explored by all medical institutions interested in maximizing the quality of care offered while at the same time minimizing its cost.
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Affiliation(s)
- E I Bluth
- Department of Radiology, Ochsner Clinic, New Orleans, LA 70121
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Aihara H, Alston-Garnjost M, Avery RE, Barker AR, Bauer DA, Bay A, Belcinski R, Bingham HH, Bloom ED, Buchanan CD, Caldwell DO, Chao HY, Chun SB, Clark AR, Cowan GD, Crane DA, Dahl OI, Daoudi M, Derby KA, Eastman JJ, Eberhard PH, Edberg TK, Eisner AM, Erné FC, Fairfield KH, Fridman A, Godfrey G, Hauptman JM, Ho C, Hofmann W, Kamae T, Kenney RW, Khacheryan S, Kofler RR, Lambert DJ, Langeveld WG, Layter JG, Lin WT, Linde FL, Loken SC, Lu A, Lynch GR, Lys JE, Madaras RJ, Magnuson BD, Marsiske H, Masek GE, Mathis LG, Maxfield SJ, Miller ES, Nicol NA, Nygren DR, Oddone PJ, Oh H, Oyang YT, Paar HP, Palounek AP, Park SK, Pellett DE, Pripstein M, Ronan MT, Ross RR, Rouse FR, Schwitkis KA. Test of spin dependence in charm-quark fragmentation to D*. Phys Rev D Part Fields 1991; 43:29-33. [PMID: 10013225 DOI: 10.1103/physrevd.43.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Abstract
A program for preschoolers and elders was designed to promote three types of prosocial behavior in the children: sharing, cooperating, and helping. The program used five types of contact: contact with natural grandparents in the preschool, regular elderly volunteers in the preschool, competent elderly visitors who shared their expertise, contact with less able elders through regular visits to a nursing home, and classroom activities providing positive and realistic information about older people and aging. The program resulted in increased prosocial behaviors in the children.
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Aihara H, Alston-Garnjost M, Avery RE, Barker AR, Bauer DA, Bay A, Belcinski R, Bingham HH, Bloom ED, Buchanan CD, Caldwell DO, Chao HY, Chun SB, Clark AR, Cowan GD, Crane DA, Dahl OI, Daoudi M, Derby KA, Eastman JJ, Eberhard PH, Edberg TK, Eisner AM, Erné FC, Fairfield KH, Fridman A, Godfrey G, Hauptman JM, Ho C, Hofmann W, Kamae T, Kenney RW, Khacheryan S, Kofler RR, Lambert DJ, Langeveld WG, Layter JG, Lin WT, Linde FL, Loken SC, Lu A, Lynch GR, Lys JE, Madaras RJ, Magnuson BD, Marsiske H, Masek GE, Mathis LG, Maxfield SJ, McNeil RR, Miller ES, Nicol NA, Nygren DR, Oddone PJ, Oh H, Oyang YT, Paar HP, Palounek AP, Park SK, Pellett DE, Pripstein M, Ronan MT, Ross RR, Rouse FR. Measurement of the total hadronic cross section in tagged gamma gamma reactions. Phys Rev D Part Fields 1990; 41:2667-2674. [PMID: 10012660 DOI: 10.1103/physrevd.41.2667] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Gansen AP, Wegerbauer LF, Lambert DJ. Wisconsin Dental Service--another year? or a new year! J Wis Dent Assoc 1976; 52:23. [PMID: 1069145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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