Markus Meis

Community noise exposure and stress in children

Although accumulating evidence over the past two decades points towards noise as an ambient stressor for children, all of the data emanate from studies in high-intensity, noise impact zones around airports or major roads. Extremely little is known about the nonauditory consequences of typical, day-to-day noise exposure among young children. The present study examined multimethodological indices of stress among children living under 50 dB or above 60 dB (A-weighted, day-night average sound levels) in small towns and villages in Austria. The major noise sources were local road and rail traffic. The two samples were comparable in parental education, housing characteristics, family size, marital status, and body mass index, and index of body fat. All of the children were prescreened for normal hearing acuity. Children in the noisier areas had elevated resting systolic blood pressure and 8-h, overnight urinary cortisol. The children from noisier neighborhoods also evidenced elevated heart rate reactivity to a discrete stressor (reading test) in the laboratory and rated themselves higher in perceived stress symptoms on a standardized index. Furthermore girls, but not boys, evidenced diminished motivation in a standardized behavioral protocol. All data except for the overnight urinary neuroendocrine indices were collected in the laboratory. The results are discussed in the context of prior airport noise and nonauditory health studies. More behavioral and health research is needed on children with typical, day-to-day noise exposure.

Ambient Noise and Cognitive Processes among Primary Schoolchildren

Although the evidence of adverse impacts of ambient noise exposure on reading acquisition in children is rather strong, a less consistent picture results from attention and memory studies in children chronically exposed to ambient noise levels. This study incorporated three cognitive measures in 4th-grade schoolchildren (N = 123). The sample was carefully selected from a representative sample by stratification on residential noise and parental educational level. The two sociodemographically homogeneous samples differed only in their noise exposure range (M = 46.1 Ldn vs. M = 62 Ldn). Individual testing took place in a mobile, sound-attenuated laboratory after prescreening for hearing loss. Chronic noise exposure was significantly related to both intentional and incidental memory. Recognition memory was also worse for the chronically noise-exposed children. No effects of chronic noise exposure were seen on visual search performance. These noise effects occur at lower, more typical noise levels as found in residential areas in Europe and North America in contrast to prior noise and cognition effects around airports and other loud noise sources.

Ambient neighbourhood noise and children's mental health

Objectives: To investigate the relation between typical ambient noise levels (highway, rail, road) and multiple mental health indices of school children considering psychosocial and biological risk factors as potential moderators. Methods: With a two stage design strategy (representative sample and extreme sample) two cross sectional samples (n=1280; n=123) of primary school children (age 8–11) were studied. Individual exposure to noise at home was linked with two indices of mental health (self reporting by the child on a standard scale and rating by the teacher of classroom adjustment on a standard scale). Noise exposure was modelled firstly according to Austrian guidelines with the aid of a geographical information system and then calibrated and corrected against measurements from 31 locations. Information on potential confounders and risk factors was collected by mothers and controlled in regression modelling through a hierarchical forward stepping procedure. Interaction terms were also analysed to examine subgroups of children at risk—for example, low birth weight and preterm birth. Results: Noise exposure was significantly associated in both samples with classroom adjustment ratings. Child self reported mental health was significantly linked to ambient noise only in children with a history of early biological risk (low birth weight and preterm birth). Conclusions: Exposure to ambient noise was associated with small decrements in childrens mental health and poorer classroom behaviour. The correlation between mental health and ambient noise is larger in children with early biological risk.

The Psychological Cost of Aircraft Noise for Children

Psychological effects of aircraft noise exposure on children have only recently been addressed in the References. The current study took advantage of a natural experiment caused by the opening of a major new airport, exposing children in a formerly quiet area to aircraft noise. In this prospective longitudinal investigation, which employed non-exposed control groups, effects of aircraft noise prior to and subsequent to inauguration of the new airport as well as effects of chronic noise and its reduction at the old airport (6 and 18 month post relocation), were studied in 326 children aged 9 to 13 years. The psychological health of children was investigated with a standardized quality of life scale as well as with a motivational measure derived from the Glass and Singer stress aftereffects paradigm. In addition a self report noise annoyance scale was used. In the children studied at the two airports over three time points, results showed a significant decrease of total quality of life 18 month after aircraft noise exposure as well as a motivational deficits operationalized by fewer attempts to solve insoluble puzzles in the new airport area. Parallel shifts in childrens attributions for failure were also noted. At the old airport parallel impairments were present before the airport relocation but subsided there after. These findings are in accord with reports of impaired psychological health after noise exposure and indicate the relevance of monitoring psychological parameters as a function of environmental stressors among children.

The Lower Saxony research network design of environments for ageing: towards interdisciplinary research on information and communication technologies in ageing societies

Worldwide, ageing societies are bringing challenges for independent living and healthcare. Health-enabling technologies for pervasive healthcare and sensor-enhanced health information systems offer new opportunities for care. In order to identify, implement and assess such new information and communication technologies (ICT) the ‘Lower Saxony Research Network Design of Environments for Ageing’ (GAL) has been launched in 2008 as interdisciplinary research project. In this publication, we inform about the goals and structure of GAL, including first outcomes, as well as to discuss the potentials and possible barriers of such highly interdisciplinary research projects in the field of health-enabling technologies for pervasive healthcare. Although GALs high interdisciplinarity at the beginning slowed down the speed of research progress, we can now work on problems, which can hardly be solved by one or few disciplines alone. Interdisciplinary research projects on ICT in ageing societies are needed and recommended.

Defining the user requirements for wearable and optical fall prediction and fall detection devices for home use

One of the major problems in the development of information and communication technologies for older adults is user acceptance. Here we describe the results of focus group discussions that were conducted with older adults and their relatives to guide the development of assistive devices for fall detection and fall prevention. The aim was to determine the ergonomic and functional requirements of such devices and to include these requirements in a user-centered development process. A semi-structured interview format based on an interview guide was used to conduct three focus group discussions with 22 participants. The average age was 75 years in the first group, 68 years in the second group and 50 years in the third group (relatives). Overall, participants considered a fall prediction system to be as important as a fall detection system. Although the ambient, unobtrusive character of the optical sensor system was appreciated, wearable inertial sensors were preferred because of their wide range of use, which provides higher levels of security. Security and mobility were two major reasons for people at risk of falling to buy a wearable and/or optical fall prediction and fall detection device. Design specifications should include a wearable, non-stigmatising sensor at the users wrist, with an emergency option in case of falling.

Development of a multimodal reminder system for older persons in their residential home

To live a self-determined life at home is uncontroversally a desire of many ageing people. Decreases in motor and mental capabilities, however, frequently make daily activities more difficult for them. Older people often forget tasks and appointments, and decreased mobility can limit their social interaction. In this study, we investigate the way in which technological support can assist in the organisation, structuring and remembering of daily activities. Aiming at assistance seamlessly integrated into a persons household, we carried out an initial user study to investigate the technology and the kind of desired assistance of such a personal household assistant system should offer. We designed a reminder system for appointments and activities that uses different sounds, light colours or vibration patterns to represent different categories of calendar events such as upcoming tasks and appointments. The evaluation results show a preference for solely acoustic presentations or an acoustic presentation in combination with visual and tactile output. In our future work, we will refine the ambient and interactive presentation and implement and evaluate this technology in residential homes.

Acoustic user interfaces for ambient-assisted living technologies

This contribution discusses technologies for acoustic user interaction in ambient-assisted living (AAL) scenarios. Acoustic user interfaces allow for a natural and convenient way to interact with technical systems e.g. via sound or speech presentation or via speech input by means of automatic speech recognition (ASR) as well as by detection and classification of acoustic events. Older persons targeted by AAL technologies especially need more easy-to-use methods to interact with inherently complex supporting technology. As an example we designed and evaluated an application for acoustic user interaction with a multi-media reminder and calendar system. For this purpose, mainly older participants were involved in user studies to continuously evaluate and support the development strictly following a user-centred design process. The results suggest a wide acceptance of acoustic user interfaces by older users either for controlling inherently complex AAL systems by using robust ASR technologies or as a natural and ambient way of presenting information to the user. However, further research is needed to increase the robustness of ASR systems when using hands-free equipment, i.e. to provide a real ambient way of interaction, and to introduce personalised speech and sound presentation schemes accounting for the individual hearing capabilities and sound preferences.

Monitoring systems for the support of home care.

In this article, the design of a system for the ambient, unobtrusive and automatic monitoring of Activities of Daily Living (ADL) is described. In the context of the growing imbalance between (potentially young) caregivers and (most often older) people receiving care, technical monitoring systems may help to organise care more efficiently and to identify degrading abilities very early to trigger preventive measures. To improve the acceptance of the system described in this article, the selection process of the sensors to be integrated into the flat or to be worn by the older people has been steered by the results of focus group interviews with older people, their relatives and professional caregivers. The interviews revealed that these people would in general accept such systems, but security, mobility and communication aspects have to be clearly and appropriately addressed. In an experimental study the recognition rate of the activity ‘preparation and intake of food or beverages’ has been measured with two age groups (6 subjects, age between 25 and 40/mean 30 years and 5 subjects, age between 72 and 84/mean 75.3 years). The food preparation was detected with a sensitivity of 74.7% and a specificity of 84.2% using a vision sensor.

Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies – outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL)

Many societies across the world are confronted with demographic changes, usually related to increased life expectancy and, often, relatively low birth rates. Information and communication technologies (ICT) may contribute to adequately support senior citizens in aging societies with respect to quality of life and quality and efficiency of health care processes. For investigating and for providing answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, the Lower Saxony Research Network Design of Environments for Ageing (GAL) had been established as a five years research project, running from 2008 to 2013. Ambient-assisted living (AAL) technologies in personal and home environments were especially important. In this article we report on the GAL project, and present some of its major outcomes after five years of research. We report on major challenges and lessons learned in running and organizing such a large, inter- and multidisciplinary project and discuss GAL in the context of related research projects. With respect to research outcomes, we have, for example, learned new knowledge about multimodal and speech-based human–machine-interaction mechanisms for persons with functional restrictions, and identified new methods and developed new algorithms for identifying activities of daily life and detecting acute events, particularly falls. A total of 79 apartments of senior citizens had been equipped with specific “GAL technology”, providing new insights into the use of sensor data for smart homes. Major challenges we had to face were to deal constructively with GAL’s highly inter- and multidisciplinary aspects, with respect to research into GAL’s application scenarios, shifting from theory and lab experimentation to field tests, and the complexity of organizing and, in our view, successfully managing such a large project. Overall it can be stated that, from our point of view, the GAL research network has been run successfully and has achieved its major research objectives. Since we now know much more on how and where to use AAL technologies for new environments of living and new forms of care, a future focus for research can now be outlined for systematically planned studies, scientifically exploring the benefits of AAL technologies for senior citizens, in particular with respect to quality of life and the quality and efficiency of health care.