Telemedicine, e-Health, and Digital Health Equity: A Scoping Review.

Background: With the progressive digitization of people's lives and in the specific healthcare context, the issue of equity in the healthcare domain has extended to digital environments or e-environments, assuming the connotation of "Digital Health Equity" (DHE). Telemedicine and e-Health, which represent the two main e-environments in the healthcare context, have shown great potential in the promotion of health outcomes, but there can be unintended consequences related to the risk of inequalities. In this paper, we aimed to review papers that have investigated the topic of Digital Health Equity in Telemedicine and e-Health [definition(s), advantages, barriers and risk factors, interventions]. Methods: We conducted a scoping review according to the methodological framework proposed in PRISMA-ScR guidelines on the relationship between Digital Health Equity and Telemedicine and e-Health via Scopus and Pubmed electronic databases. The following inclusion criteria were established: papers on the relationship between Digital Health Equity and Telemedicine and/or e-Health, written in English, and having no time limits. All study designs were eligible, including those that have utilized qualitative and quantitative methods, methodology, or guidelines reports, except for meta-reviews. Results: Regarding Digital Health Equity in Telemedicine and e-Health, even if there is no unique definition, there is a general agreement on the idea that it is a complex and multidimensional phenomenon. When promoting Digital Health Equity, some people may incur some risk/s of inequities and/or they may meet some obstacles. Regarding intervention, some authors have proposed a specific field/level of intervention, while other authors have discussed multidimensional interventions based on interdependence among the different levels and the mutually reinforcing effects between all of them. Conclusion: In summary, the present paper has discussed Digital Health Equity in Telemedicine and e-Health. Promoting equity of access to healthcare is a significant challenge in contemporary times and in the near future. While on the one hand, the construct "equity" applied to the health context highlights the importance of creating and sustaining the conditions to allow anyone to be able to reach (and develop) their "health potential", it also raises numerous questions on "how this can happen". An overall and integrated picture of all the variables that promote DHE is needed, taking into account the interdependence among the different levels and the mutually reinforcing effects between all of them.

Autism and Visual impairment: A First Approach to a Complex Relationship.

Since the first half of the 20th century there has been an interest in the study of the relationship between autism and autistic-like clinical features and with visual impairments. Autism Spectrum disorders are one of the more worldwide-studied neurodevelopmental disorder with an increasing prevalence in the last ten years. Visual impairment is a condition which derives from several causes (genetic, constitutional, injuries, nutritional and environmental ones). Again, it is a kind of spectrum and an overarching category, because visual impairments range from refractive errors (myopia, hyperopia, astigmatism), to amblyopia, strabismus, and to partial and total blindness. Since the first study of Keeler (1956) which described autistic-like patterns in five preschool children who were totally blind due to retinopathy of prematurity (ROP), a growing number of researchers addressed the relationship between autism and visual impairment. In this paper we focused on it, aiming to discuss on some lessons learned in this field and to discuss some open questions since the first research in this field.

Digital determinants of health as a way to address multilevel complex causal model in the promotion of Digital health equity and the prevention of digital health inequities: A scoping review.

Background: With the progressive digitization of health services and the current spread of Telemedicine and e-Health, it became clear that promoting Digital health equity (DHE) is necessary to support health potential, to avoid that some individuals can incur in unintended inequities. In this paper, we address the complex causal process(es) that may generate risk of inequities, considering the so-called "Digital Determinants of health" (DDoH) and their relationship with determinants of health (DoH). Design and methods: We conducted a scoping review, according to methodological framework proposed in PRISMA-ScR guidelines, on the definition of DDoH (Scopus, Pubmed and Web of Science electronic databases). Inclusion criteria: papers on the definition of DDoH, no time limits, all study designs eligible. Results: There is an agreement on the link between DDoHs and "digital divide" and on their effects on a wide range of health, functioning outcomes, both as barriers and as facilitators. Authors proposed to modify or integrate with DDoHs the "Rainbow model" or other conceptual models on DoH. To promote DHE, authors suggest considering a multidimensional complex causal model, with interdependence among the different levels and the mutually reinforcing effects. Conclusion: To study DDoH and their relationship with main determinants of health could be a way to address the complex causal model in the promotion of DHE. However, as they act in a multidimensional causal context, any intervention may consider the interdependence among different involved levels, within them, and the mutually reinforcing effects. Further research is needed to gain a more complete picture of the field.

Children with autism spectrum disorders and severe visual impairments: Some general principles for intervention according to the perspective of clinical psychology of disability.

In the last decades, an increasing number of researchers addressed the relationship between autism spectrum disorders (ASD) and severe visual impairment (SVI) (like blindness or very low visual acuity) and nowadays autism could be considered one of the most reported coexisting developmental disorders in children with blindness or other severe visual impairment. As ASD and SVI' signs and symptoms affect functioning and quality of life and different domains of functioning of children with this comorbidity, it is very important to support individuals and their families as soon as possible in the cycle of life and to promote specific interventions aimed to promote developmental potential of everyone with both ASD and VI, based on the unique balance between strengths, needs and abilities of everyone. Children and individuals with SVI and ASD and SVI are a very heterogeneous group, both about the areas of social interaction, communication, and behaviour, as well as about visual abilities and about all the other aspects of their neuropsychological and functional profiles that are influenced by their visual impairments itself, their ASD itself and the combination of them. In this paper, we aim to discuss some general principles useful to design and to develop specific interventions and to promote inclusion of children with ASD and SVI.

Telemedicine: Issues in the Analysis of Its Use in Elderly People and in People with Disabilities, According to the Perspective of the Clinical Psychology of Disability.

The recent COVID-19 pandemic has led to a sudden increase in the speed of the digitization process, which has affected several areas of life (public administration, schools, universities, and healthcare, and extending to so-called "digital citizenship") [...].

Dementia and Major Neurocognitive Disorders: Some Lessons Learned One Century after the first Alois Alzheimer's Clinical Notes.

Over 100 years ago, Alois Alzheimer presented the clinical signs and symptoms of what has been later called "Alzheimer Dementia" in a young woman whose name was Augustine Deter [...].

COVID-19 and the excess of mortality in Italy from January to April 2020: what are the risks for oldest old?

In February 2020, Italy has been the first country in Europe fighting against COVID-19. In March 2020, Italian government declared national lockdown. Until May 4th, people stayed in home confinement and only the so-called "essential works and activities" were continued. Like in other countries, both for the disease severity and for the risk of death, the higher the age of people the higher the risk. In the first months of 2020, Italy saw a very high number of deaths related to COVID-19, with a huge age effect, and there is an agreement on the view that there had been also an excess of mortality and on the role of mortality as a correct way to reflect the dynamics of the virus's spread. In this paper we briefly discuss the trends of mortality during the first 4 months of 2020 according to the data by the Italian National Institute of Statistics.

Ageing, Disability, and Spinal Cord Injury: Some Issues of Analysis.

Spinal cord injury is a disabling disorder, worldwide spread, with important consequences on functioning and health conditions and impacts on physical, psychological, and social well-being. The consequences are related to the lesion itself and to other complications related to the lesion. In the last decades, there have been an increasing of the mean ages of onset and also an increase in life expectancy after the lesion. So, differently from the past, people with spinal cord injury can age after the lesion. Taking into account the need to share data and information about specific disabling conditions and their relationship with ageing, this paper aims to discuss some issues from recent literature on the relationship between aging and disability in the spinal cord injury, according to a narrative review approach. A narrative review of the literature on ageing and spinal cord injury was undertaken. Search was based on the following electronic databases: PubMed/Medline and Ovid/PsychINFO. A combination of the following keywords was used: (1) "ageing" or "aging" and (2) "spinal cord injury" or "spinal cord lesion" and (3) disability. Data on consequences of the lesion in the life of aging people, secondary health conditions, life expectancy, participation, and quality of life are discussed. Then, a brief discussion of clinical issues and the role of interventions aimed to promote wellbeing, health, quality of life, and participation of people with spinal cord injury is proposed.

[Active ageing and success: A brief history of conceptual models]. / Envejecimiento activo y de éxito o saludable: una breve historia de modelos conceptuales.

INTRODUCTION AND PURPOSE OF THE STUDY: The aim of this paper is to analyse and describe different conceptual models of successful ageing, active and healthy ageing developed in Europe and in America in the 20° century, starting from Rowe and Kahn's original model (1987, 1997). METHODOLOGY: A narrative review was conducted on the literature on successful ageing. RESULTS: Our review included definition of successful ageing from European and American scholars. Models were found that aimed to describe indexes of active and healthy ageing, models devoted to describe processes involved in successful ageing, and additional views that emphasise subjective and objective perception of successful ageing. A description is also given of critiques on previous models and remedies according to Martin et al. (2014) and strategies for successful ageing according to Jeste and Depp (2014). The need is discussed for the enhancement of Rowe and Kahn's model and other models with a more inclusive, universal description of ageing, incorporating scientific evidence regarding active ageing.

Envejecimiento activo y de éxito o saludable: una breve historia de modelos conceptuales / Active ageing and success: a brief history of conceptual models

Introducción y propósito del estudio. El objetivo de este trabajo es analizar y describir los diferentes modelos teóricos de envejecimiento exitoso, envejecimiento activo y envejecimiento saludable desarrollados en Europa y en América en el siglo XX, a partir del modelo original de Rowe y Kahn (1987, 1997). Metodología. Se ha realizado una revisión narrativa de la literatura sobre el envejecimiento exitoso. Resultados. Nuestra revisión incluyó los modelos de envejecimiento exitoso de autores europeos y americanos. Encontramos modelos que se proponen describir los índices de envejecimiento activo y saludable, modelos dedicados a describir los procesos involucrados en el envejecimiento exitoso y modelos adicionales que hacen hincapié en la percepción subjetiva y objetiva de un envejecimiento con éxito. También describimos las críticas a los modelos anteriores, las modificaciones según Martin et al. (2014) y las estrategias para un envejecimiento exitoso según Jeste y Depp (2014). La necesidad de mejorar el modelo de Rowe y Kahn y otros modelos con una descripción más inclusiva y universal del envejecimiento y la incorporación de evidencia científica sobre el envejecimiento activo son todavía argumentos en discusión (AU)

Introduction and purpose of the study. The aim of this paper is to analyse and describe different conceptual models of successful ageing, active and healthy ageing developed in Europe and in America in the 20° century, starting from Rowe and Kahn's original model (1987, 1997). Methodology. A narrative review was conducted on the literature on successful ageing. Results. Our review included definition of successful ageing from European and American scholars. Models were found that aimed to describe indexes of active and healthy ageing, models devoted to describe processes involved in successful ageing, and additional views that emphasise subjective and objective perception of successful ageing. A description is also given of critiques on previous models and remedies according to Martin et al. (2014) and strategies for successful ageing according to Jeste and Depp (2014). The need is discussed for the enhancement of Rowe and Kahn's model and other models with a more inclusive, universal description of ageing, incorporating scientific evidence regarding active ageing (AU)