Thesis aims. The following will provide a brief description of the purpose of each study included in this thesis. Various factors such as age-related decline in cognitive function (Yogev-Seligmann et al., 2008; Lacour et al., 2008; Al-Yahya et al., 2011), balance confidence (Powell and Myers, 1995; Lajoie and Gallagher, 2004) and hearing capacity (Loughrey et al., 2018; Bruce et al., 2019), reduced PA levels (Garcia Meneguci et al., 2021), poor sleep (Fabrega-Cuadros et al., 2020), and anxiety and depression (Silva et al., 2020) may affect gait and DT performance which are essential for maintaining postural stability and navigating an independent life. Also, people with CVD show significantly greater attentional interference when walking under DT conditions compared to healthy controls (Roberts et al., 2011; Bessot et al., 2012; Lin et al., 2018). Gaining a better understanding of factors that predict better gait and DT performance in healthy adults and people with CVD, may help provide advice on preventative approaches for maintaining better functional gait, and appropriate assessment and treatment interventions in people with vestibular disorders, respectively. Thus, the Chapter 2 aimed to investigate the predictive factors for functional gait and DT gait performance in healthy adults while Chapter 3 in people with CVD. Chapter 4 focused on VRT. DT training has been used in balance programmes for older adults at increased falls risk (Woollesen et al., 2017), and people with Parkinson’s (De Freitas et al., 2020) and Alzheimer’s disease (Coelho et al., 2013), stroke (Plummer and Iyigün, 2018), and multiple sclerosis (Postigo-Alonso et al., 2019). People with CVD show significant gait and balance impairments and perform poorer in DT paradigms compared to healthy age-matched controls (Roberts et al., 2011; Bessot et al., 2012; Lin et al., 2018). Currently, these is no evidence on DT training in people with CVD. Therefore, Chapter 4 aimed to investigate the effect of VRT with and without additional DT exercises on treatment outcomes including firstly the Functional Gait Assessment (FGA) and average FGA DTC score and then, subjective symptoms, cognitive function performance, sleep, anxiety, and depression. The last experiment of this thesis (Chapter 5) was developed because of the COVID-19 outbreak in 2020 (WHO, 2022) and the need to understand better the relationship of this disease with dizziness, unsteadiness, and falls as well as the clinical characteristics of these s...
Thesis aims. This thesis investigates whether using ESM and passive remote monitoring in a forensic mental health service can identify short-term variability in dynamic risk factors and predict future aggression. This method could provide a clearer understanding of how dynamic risk factors for aggression vary over short time periods than is currently available through existing structured risk assessments. Identifying the time periods over which this association with aggression exists could also provide a window of opportunity to de-escalate aggressive situations and provide appropriate support to service users (see Figure 2). ‘Build-up’ period Aggression Electrodermal Activity Heart Rate Variability Mood, Thoughts and Attitudes Risk Factor Intensity Figure 2 Theoretical illustration of short-term build-up in psychophysiological arousal and other dynamic risk factors for aggression The overall thesis structure is:
