Telerheumatology: Origins, current practice, and future directions

This book details the practice of telerheumatology. Telemedicine is defined as the delivery of healthcare and the exchange of healthcare information across distances. Following, telerheumatology is the delivery of rheumatology care through telemedicine. There exists an increasing demand from patients, caregivers, and healthcare systems for access to academic specialists through telemedicine. This has been the case for the past several years and the demand has only increased with the ongoing COVID-19 pandemic. There is currently a lack of rheumatologists in rural areas and that is expected to spread to a general lack by 2025. Telerheumatology offers an excellent and timely solution to fill these gaps and provide care. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

Investigating Older Adults' Atitudes towards Crisis Informatics Tools: Opportunities for Enhancing Community Resilience during Disasters

The world population is projected to rapidly age over the next 30 years. Given the increasing digital technology adoption amongst older adults, researchers have investigated how technology can support aging populations. However, little work has examined how technology can support older adults during crises, despite increasingly common natural disasters, public health emergencies, and other crisis scenarios in which older adults are especially vulnerable. Addressing this gap, we conducted focus groups with older adults residing in coastal locations to examine to what extent they felt technology could support them during emergencies. Our fndings characterize participants' desire for tools that enhance community resilience-local knowledge, preparedness, community relationships, and communication, that help communities withstand disasters. Further, older adults' crisis technology preferences were linked to their sense of control, social relationships, and digital readiness. We discuss how a focus on community resilience can yield crisis technologies that more efectively support older adults.

Assessing the Benefits of a Teleassessment Solution Using a FVM Perspective

The recent COVID-19 pandemic has served to highlight the benefits of digital health in general and telehealth in particular. One area of telehealth that is particularly important is that of teleassessment. Currently, we are witnessing an exponential growth in total knee and total hip replacements (TKR) (THR) due to an aging population coupled with longer life expectancy which is leading to a high likelihood of an unsustainable burden for healthcare delivery in Australia. To address this imminent challenge, the following proffers a tele-assessment solution, ARIADNE (Assist foR hIp AnD kNEe), that can provide high quality care, with access for all and support for high value outcomes. A fit viability assessment is provided to demonstrate benefits of the proffered solution. © 2022 IEEE Computer Society. All rights reserved.

Global Trends in Social Prescribing: Web-Based Crawling Approach.

BACKGROUND: Social loneliness is a prevalent issue in industrialized countries that can lead to adverse health outcomes, including a 26% increased risk of premature mortality, coronary heart disease, stroke, depression, cognitive impairment, and Alzheimer disease. The United Kingdom has implemented a strategy to address loneliness, including social prescribing-a health care model where physicians prescribe nonpharmacological interventions to tackle social loneliness. However, there is a need for evidence-based plans for global social prescribing dissemination. OBJECTIVE: This study aims to identify global trends in social prescribing from 2018. To this end, we intend to collect and analyze words related to social prescribing worldwide and evaluate various trends of related words by classifying the core areas of social prescribing. METHODS: Google's searchable data were collected to analyze web-based data related to social prescribing. With the help of web crawling, 3796 news items were collected for the 5-year period from 2018 to 2022. Key topics were selected to identify keywords for each major topic related to social prescribing. The topics were grouped into 4 categories, namely Healthy, Program, Governance, and Target, and keywords for each topic were selected thereafter. Text mining was used to determine the importance of words collected from new data. RESULTS: Word clouds were generated for words related to social prescribing, which collected 3796 words from Google News databases, including 128 in 2018, 432 in 2019, 566 in 2020, 748 in 2021, and 1922 in 2022, increasing nearly 15-fold between 2018 and 2022 (5 years). Words such as health, prescribing, and GPs (general practitioners) were the highest in terms of frequency in the list for all the years. Between 2020 and 2021, COVID, gardening, and UK were found to be highly related words. In 2022, NHS (National Health Service) and UK ranked high. This dissertation examines social prescribing-related term frequency and classification (2018-2022) in Healthy, Program, Governance, and Target categories. Key findings include increased "Healthy" terms from 2020, "gardening" prominence in "Program," "community" growth across categories, and "Target" term spikes in 2021. CONCLUSIONS: This study's discussion highlights four key aspects: (1) the "Healthy" category trends emphasize mental health, cancer, and sleep; (2) the "Program" category prioritizes gardening, community, home-schooling, and digital initiatives; (3) "Governance" underscores the significance of community resources in social prescribing implementation; and (4) "Target" focuses on 4 main groups: individuals with long-term conditions, low-level mental health issues, social isolation, or complex social needs impacting well-being. Social prescribing is gaining global acceptance and is becoming a global national policy, as the world is witnessing a sharp rise in the aging population, noncontagious diseases, and mental health problems. A successful and sustainable model of social prescribing can be achieved by introducing social prescribing schemes based on the understanding of roles and the impact of multisectoral partnerships.

Socio-ecological determinants of older people's mental health and well-being during COVID-19: A qualitative analysis within the Irish context.

Background: Evidence indicates that older people with biological and social vulnerabilities are at high risk of short- and long-term consequences related to the COVID-19 pandemic. However, studies have also highlighted that the crisis may present opportunities for personal growth if older individuals are met with appropriate resources and support. Objective: The aim of this study was to explore the perceptions of older people regarding how individual, social, and environmental factors have supported or hindered their well-being and health during COVID-19. Methods: We analyzed data collected between April-May and October-November 2021 from the Well-being, Interventions and Support during Epidemics (WISE) study, a qualitative investigation of community-dwellers based in Ireland and aged 65 years or over. Participants (n = 57) completed written submissions, narrative interviews and/or go-along interviews detailing their experiences during the pandemic. Framework analysis was carried out in NVivo 12 to identify determinants, linkages, and explanations within Bronfenbrenner's socio-ecological model. Results: The mean age of participants was 74.9 years, 53% were female, 45% lived alone, and 86% lived in areas with high urban influence. Our findings highlight the heterogeneous effect of COVID-19 across diverse older individuals who held distinct concerns, capabilities, and roles in society before and during the pandemic. Multi-scalar contextual characteristics such as individual's living arrangements, neighborhood social and built environments, as well as social expectations about aging and help seeking, had an influential role in participants' well-being and available supports. We identified mixed views regarding public health restrictions, but a consensus emerged questioning the suitability of one-size-fits-all approaches based on chronological age. Conclusions: Our results suggest that some negative pandemic consequences could have been avoided by increasing collaboration with older people and with the provision of clearer communications. The interdependencies identified between individual characteristics and socio-ecological factors that influenced participants' availability of supports and development of adaptive strategies represent areas of opportunity for the development of age-friendly interventions during and beyond public health crises.

Deep Learning Approach for Loneliness Identification from Speech using DNN-LSTM

Perceived loneliness and social isolation have been on the rise over the past decade, especially in countries with rapidly ageing populations and, most notably, as a result of the stress of dealing with the COVID-19 outbreak over the past two years. By using a natural language processing (NLP) approach to quantify sentiment and variables that signal loneliness in transcribed spoken text of older persons, this paper investigates the use of deep learning technology in the evaluation of interviews on loneliness. We conducted loneliness state detection using Deep Neural Network (DNN) and Long Short-Term Memory (LSTM). Participants who were lonely and those who weren't were compared (using both qualitative and quantitative measures). Individuals who were lonelier (as determined by qualitative measures) took longer to respond to questions about their loneliness and expressed more grief in their answers. When asked about loneliness, more women than men admitted it during the qualitative interview. When responding, men were more likely to utilize expressions of dread and happiness. When trained on textual data, DNN models were 100% accurate at predicting qualitative loneliness and LSTM models were 75.42% accurate at predicting loneliness on textual data. © 2022 IEEE.

Interior Design: A New Perspective in Supportive Care of Patients with Acute Onset of Debilitating Diseases.

Background: Upon the onset of a debilitating rapidly evolving condition (such as cancer or a rapidly progressing myopathy, neuropathy, respiratory disease, or a severe traumatic injury), individuals have limited time to find a new home or make radical structural modifications in their residence. How the affected patients can continue sharing the same house with their families, while meeting their own special requirements, is thus rising as a critical issue. Household and daily routine rearrangements, either temporary or permanent, may be necessary, to ameliorate the life of patients with impairments, lasting for months or even years. Objectives: Interior design may provide a highly efficient "living" palliation for debilitating medical conditions directly at patients' home-site. Methods: Research of relevant literature, using keywords "debilitating conditions," "home care," "end of life care," "care of advanced cancer patients," "care of patients with mental disorders," "home care of covid-19 affected patients," and "care of patients with degenerative illnesses." Results: We found that patients and their relatives may not be aware of the probable interior design solutions to their daily life challenges, imposed by a disease-related impairment. In parallel, interior design experts may equally be unaware of these issues, as well as of who needs the available solutions.Similarly, medical and architectural sciences are not connected, eventually failing to meet patients' everyday needs. Conclusions: Interior architecture and health scientists are called to cooperate, aiming to provide a highly efficient and meaningful support to patients and families affected by unforeseen debilitating medical conditions.

Confronting COVID-19 and Prioritizing Aging Population.

Over the past three years, China has implemented rapid, vigorous, and coordinated control measures to limit the spread of coronavirus disease 2019 (COVID-19) effectively. These measures include active containment, graded management, rational resource allocation, rapid contact tracing and disposal, and targeted vaccination of key populations. These efforts have contributed to the prompt and effective control of outbreaks, protecting the health and well-being of older adults. This review provides a comprehensive summary of the changes in China's COVID-19 prevention and control experiences and other public health measures since the outbreak of the pandemic, and assesses their impact on older adults. It may serve as a valuable reference for future epidemic prevention and control efforts.

A Comprehensive Study to Analyze Trends in Web Search Interests Related to Fall Detection Before and After COVID-19

Falls, considered a serious health-related concern for the elderly people, are associated with multiple diverse and dynamic needs for the elderly people themselves, their caregivers, their family members, and healthcare professionals. The modern-day Internet of Everything lifestyle is characterized by people using the internet for a multitude of reasons which also includes seeking and sharing information related to such needs. Such activity on the internet results in the generation of tremendous amounts of web behavior-based Big Data which can be studied and analyzed to investigate the trends in the underlining needs and the associated web search interests. The COVID-19 pandemic that the world is facing right now has impacted the elderly population to a significant extent. In fact, the elderly population is considered a demographic group that is most likely to get infected by this virus and develop serious symptoms, which could lead to hospitalizations and death. There hasn't been any study conducted in the field of aging research thus far that investigates how the COVID-19 pandemic may or may not have impacted the needs related to fall detection in the elderly. This work aims to address this research challenge. A dedicated methodology based on Google Trends is proposed in this paper that studies the web behavior-based Big Data related to fall detection from different countries both before and after the pandemic. The preliminary results presented from the analysis of the web behavior-based Big Data from 14 countries - USA, India, Germany, United Kingdom, Spain, Australia, Indonesia, Malaysia, Thailand, South Africa, Canada, Philippines, Sweden, and Ireland, which are amongst the countries worst hit by COVID-19, shows evidence that the pandemic had an impact towards increasing the web search interests related to fall detection in multiple countries. © 2022 ACM.

Call for the Ageing-inclusive Digital Economy and Related Standards: Based on a Global Survey

The increasingly severe situation of ageing population has caused great pressure on the global wealth reserve, population security, economic construction, and social stability. Under this background, it is of great importance to realize the ideological, institutional, and economic changes from raising & nursing the elderly to actively ageing as soon as possible. The concept of active ageing was written in the Political Declaration and Madrid International Plan of Action on Ageing of the UN at the beginning of this century, which is a global policy framework to deal with the problem of population ageing in the 21st century. Active ageing believes that the elderly have great potential and energy and are valuable social resources. By stimulating their potential, the elderly could not only realize their self-worth but also contribute to society, instead of blindly needing social care. Digital technology is an important technology to support active ageing. However, the digital divide in front of the elderly has greatly affected the role and effect of digital technology in an ageing society. The sudden COVID-19 also highlights the seriousness of the digital divide among the elderly and the importance of building an ageing-inclusive digital economy. Under this background, it is of great significance to carry out the related research and other actives of the ageing-inclusive digital economy, which will provide solutions for actively responding to the global challenge of ageing and help all parts of the world to effectively turn the ageing pressure into driving force of the economy. This paper introduces the global survey on ageing-inclusive digital economy and related standards conducted in early 2021, which aimed to clarify the influence and challenges of the digital economy on the elderly, and the expectations and demands of building an ageing-inclusive digital economy. The results from this survey show that the digital economy has a high impact on the elderly, but on the contrary, the participation of the elderly is low although there are strong will. © 2022 ACM.

Multidimensional frailty as an outcome of biological aging: immunosenescence and inflammaging in the life course perspective

Immunosenescence and inflammaging are two fundamental age-related changes substantially paving the way to accelerated aging, multidimensional frailty, and poor outcomes of several illnesses including COVID-19. A common misbelief is that immunosenescence and inflammaging, like other age-related changes, are exclusively detrimental. However, they are inserted in a highly complex landscape of physiological changes occurring with increasing age at the biomolecular, organismal, psychosocial, and functional level. The understanding of this complex picture is fundamental to develop strategies aimed at maintaining robustness. Groundbreaking descriptions of frailty paved the way to successful interventions to maintain and restore robustness. To date, frailty is well established as the very core of geriatric medicine, going far beyond multimorbidity and chronological age. © 2023 Elsevier Inc. All rights reserved.

Identifying and Addressing Implicit Ageism in the Co-Design of Services for Aging People.

In a world with an increasingly aging population, design researchers and practitioners can play an essential role in shaping better future societies, by designing environments, tools, and services that positively influence older adults' everyday experiences. The World Health Organization (WHO) has proposed a framework called Healthy Ageing, which can be adopted as the basis for designing for an aging society. There are, however, many challenges in achieving this goal. This article addresses one of these challenges identified by WHO, which is overcoming ageism as a form of discrimination based on age. In contrast with most other types of discrimination, ageism is not always easy to detect and overcome because of its generally implicit nature. This paper investigates adopting storytelling as a method for detecting implicit ageism and proposes a co-design process that utilizes this method to better address older adults' needs and requirements. The use of this method is discussed through two example case studies aimed at improving the design of assistive services and technologies for aging people. The findings from these case studies indicate that the proposed method can help co-design teams better identify possible implicit ageist biases and, by doing so, try to overcome them in the design process.

Effect of a Digital Literacy Program on Older Adults' Digital Social Behavior: A Quasi-Experimental Study.

In South Korea, digital literacy education programs are expected to help its older population participate in online welfare services to increase their social support, self-esteem and well-being. This quasi-experimental study assesses the effects of digital literacy education on digital device usage among rural-dwelling adults aged 65 and above and evaluates the positive effects of digital literacy education on depression, happiness, quality of life, self-efficacy and cognitive function. A digital literacy education program and a customized questionnaire survey were conducted to evaluate smartphone use competency and the program's effects, respectively. We also conducted a chi-square test, paired t-test and difference-in-differences regression analysis. The experimental group showed a significant increase in smartphone usage and video recording capacity than the control group. The happiness and cognitive function scores for dementia screening increased significantly by a mean of 3.7 and 1.1 points, respectively, after digital literacy education. Cognitive function increased significantly by 1.305 points in the experimental group compared to the control group (ß = 1.305, p = 0.05 *). Digital literacy education for older adults in rural areas greatly increased smartphone use, video recording capacity, happiness and cognitive function. Based on these findings, it is recommended that the government should implement digital literacy education for older adults in rural areas to increase their happiness and cognitive function.

Federated Remote Physiological Measurement with Imperfect Data

The growing need for technology that supports remote healthcare is being acutely highlighted by an aging population and the COVID-19 pandemic. In health-related machine learning applications the ability to learn predictive models without data leaving a private device is attractive, especially when these data might contain features (e.g., photographs or videos of the body) that make identifying a subject trivial and/or the training data volume is large (e.g., uncompressed video). Camera-based remote physiological sensing facilitates scalable and low-cost measurement, but is a prime example of a task that involves analysing high bit-rate videos containing identifiable images and sensitive health information. Federated learning enables privacy-preserving decentralized training which has several properties beneficial for camera-based sensing. We develop the first mobile federated learning camera-based sensing system and show that it can perform competitively with traditional state-of-the-art supervised approaches. However, in the presence of corrupted data (e.g., video or label noise) from a few devices the performance of weight averaging quickly degrades. To address this, we leverage knowledge about the expected noise profile within the video to intelligently adjust how the model weights are averaged on the server. Our results show that this significantly improves upon the robustness of models even when the signal-to-noise ratio is low. © 2022 IEEE.

The Positive Impact of Public Health Engagement in Healthy Aging During the COVID-19 Pandemic

The COVID-19 pandemic has made starkly clear that the public health system in the United States can significantly impact the health and well-being of older adults. Prior to the pandemic, healthy aging was not prioritized by public health agencies, despite the growing population of individuals ages 65 and older. Trust for America's Health, in partnership with The John A. Hartford Foundation, has been working to expand the public health role in healthy aging, as well as better coordinate with age-friendly movements, both of which have contributed to a more efficient and effective COVID-19 response. © 2022 American Society on Aging.

Multidimensional frailty as an outcome of biological aging: immunosenescence and inflammaging in the life course perspective

Immunosenescence and inflammaging are two fundamental age-related changes substantially paving the way to accelerated aging, multidimensional frailty, and poor outcomes of several illnesses including COVID-19. A common misbelief is that immunosenescence and inflammaging, like other age-related changes, are exclusively detrimental. However, they are inserted in a highly complex landscape of physiological changes occurring with increasing age at the biomolecular, organismal, psychosocial, and functional level. The understanding of this complex picture is fundamental to develop strategies aimed at maintaining robustness. Groundbreaking descriptions of frailty paved the way to successful interventions to maintain and restore robustness. To date, frailty is well established as the very core of geriatric medicine, going far beyond multimorbidity and chronological age.

Older Adults' concerns regarding Hurricane-Induced evacuations during COVID-19: Questionnaire findings.

The COVID-19 pandemic has drastically affected our day-to-day life in the last few years. This problem becomes even more challenging when older adults are considered due to their less powerful immune system and vulnerability to infectious diseases, especially in Florida where 4.5 million people aged 65 and over reside. With its long coastline, large and rapidly growing of older adult population, and geographic diversity, Florida is also uniquely vulnerable to hurricanes, which significantly increases the associated risks of COVID-19 even further. This study investigates older adults' evacuation-related concerns during COVID-19 using statistical analysis of a questionnaire conducted among 389 older adult Florida residents. The questionnaire includes questions concerning demographic information and older adults' attitudes toward hurricane-induced evacuations during the COVID-19 pandemic. Ordered Probit regression models were developed to investigate the impacts of demographic parameters on older adults' tendencies toward evacuating as well as their preferences to stay at home or shelter during the pandemic. The model results reveal that male participants felt safer to evacuate compared to females. Also, any decrease in the level of income was associated with an increase in the need for help for evacuation by 18%. Findings indicated that the participants who found the evacuation safe normally also had a positive attitude toward staying in their vehicle, hotel, or even shelters if maintaining social distance was possible. Emergency management policies can utilize these findings to enhance hurricane preparations for dealing with the additional health risks posed by the pandemic for older adults, a situation that could be exacerbated by the upcoming hurricane season in Florida.

Understanding the Experience of Geriatric Care Professionals in Using Telemedicine to Care for Older Patients in Response to the COVID-19 Pandemic: Mixed Methods Study.

BACKGROUND: Geriatric care professionals were forced to rapidly adopt the use of telemedicine technologies to ensure the continuity of care for their older patients in response to the COVID-19 pandemic. However, there is little current literature that describes how telemedicine technologies can best be used to meet the needs of geriatric care professionals in providing care to frail older patients, their caregivers, and their families. OBJECTIVE: This study aims to identify the benefits and challenges geriatric care professionals face when using telemedicine technologies with frail older patients, their caregivers, and their families and how to maximize the benefits of this method of providing care. METHODS: This was a mixed methods study that recruited geriatric care professionals to complete an online survey regarding their personal demographics and experiences with using telemedicine technologies and participate in a semistructured interview. Interview responses were analyzed using the Consolidated Framework for Implementation Research (CFIR). RESULTS: Quantitative and qualitative data were obtained from 30 practicing geriatric care professionals (22, 73%, geriatricians, 5, 17%, geriatric psychiatrists, and 3, 10%, geriatric nurse practitioners) recruited from across the Greater Toronto Area. Analysis of interview data identified 5 CFIR contextual barriers (complexity, design quality and packaging, patient needs and resources, readiness for implementation, and culture) and 13 CFIR contextual facilitators (relative advantage, adaptability, tension for change, available resources, access to knowledge, networks and communications, compatibility, knowledge and beliefs, self-efficacy, champions, external agents, executing, and reflecting and evaluating). The CFIR concept of external policy and incentives was found to be a neutral construct. CONCLUSIONS: This is the first known study to use the CFIR to develop a comprehensive narrative to characterize the experiences of Ontario geriatric care professionals using telemedicine technologies in providing care. Overall, telemedicine can significantly enable most of the geriatric care that is traditionally provided in person but is less useful in providing specific aspects of geriatric care to frail older patients, their caregivers, and their families.

The Behavioral Factors That Influence Person-Centered Social Care: A Literature Review and Conceptual Framework.

The last decade has seen numerous policy reforms to emplace person-centered social care. Consequently, the public has been given more information, choice, and autonomy to decide how best they want to be cared for later in life. Despite this, adults generally fail to plan or prepare effectively for their future care needs. Understanding the behavioral antecedents of person-centered decision-making is thus critical for addressing key gaps in the provision of quality social care. To this end, we conducted a literature review of the psychological and health sciences with the aim of identifying the aspects that influence person-centered decision-making in social care. Using an established theoretical framework, we distilled nine behavioral factors-knowledge, competency, health, goal clarity, time discounting, familiarity, cognitive biases, cognitive overload, and emotion-associated with "Capability," "Opportunity," "Motivation," and "Behavior" that explained person-centered decision-making in social care. These factors exist to different degrees and change as a person ages, gradually impacting their ability to obtain the care they want. We discuss the role of carers and the promise of shared decision-making and conclude by advocating a shift from personal autonomy to one that is shared with carers in the delivery of quality social care.