Technological grandparents: how communication technologies can improve the well-being of the elderly?

The ageing of the population is one of the most significant social transformations that the twenty first century is showcasing and a challenge that impacts society at large. The elderly, inasmuch as everybody else, are confronted with continuous transformations that are induced by technology, although they seldom benefit from the opportunities that technology entails. The digital divide amongst various segments of the population is often age-related and due to different reasons, including biological, psychological, social and financial ones. There is an ongoing reflection pertaining to the factors that hinders the full adoption of ICTs by the elderly and a question regarding what can be done to overcome their poor involvement in technology. This article, based on the results of a recent research, which has been conducted in Italy, aims at highlighting the importance of engaging the elderly in the use of technology as a key to building bridges between generations.

A Mobile App for the Remote Monitoring and Assistance of Patients with Parkinson's Disease and their Caregivers.

The remote monitoring of patients is based on digital systems that enable the remote collection, usually at home, of health data and its transmission to health centers. The telemedicine paradigm is of particular interest in chronic diseases, fragile population and elderly monitoring. Parkinson's disease (PD) is a neurodegenerative disorder having high impact on the lives of patients and their families. Such a disease impacts on the physical and psychological abilities of the patient and may have an effect on the relationship among family members. The strict monitoring of PD patients and their caregivers is of paramount importance in the implementation of prompt actions counteracting the worsening of the disease or that of the caring process. In this paper we present a mobile App developed for PD patients and their caregiver. The App aims at improving the communication among the patient/caregiver and the specialists, covering aspects related to both the disease symptoms and the caring process. In the paper we describe the App along with results collected during a one year experimentation on a cohort of 10 patients and 7 caregivers. The results show that the approach is accepted by patients and caregivers. Furthermore, obtained results demonstrate that the monitoring system is effective in the identification of dangerous conditions for the patient and useful in the implementation of reactive health management strategies.

Appearance distress and dysfunction in the elderly: international contrasts across Italy and the UK using DAS59.

BACKGROUND: As the global population grows, the percentage of those over 60 will escalate disproportionately. Their needs will become an ever more dominant feature of public policy and healthcare provision. Older adults' appearance is often removed from cultural ideals and stereotypes of beauty, often seen as synonymous with "youth." This has seen older adults' concerns about appearance and body image somewhat sidelined in practice and in research. This study investigates the extent to which self-consciousness of appearance is associated with distress and dysfunction in those over 60 years old. Furthermore, we contrast the extent of this phenomenon in two European nations, UK and Italy, and consider the direct impact and interaction of cultural context and participant gender. METHOD: To make an objective measurement of distress and dysfunction, we translated a widely used psychometric measure, the Derriford Appearance Scale 59 following an established and reliable translation protocol. Data were collected from community samples. RESULTS: The Italian translation was sound, with acceptability in the Italian-speaking sample and acceptable internal consistency scores for full-scale and subscales. ANOVA analysis demonstrated that for overall adjustment, and all subscale scores, the Italians were more distressed about their appearance than UK comparators. Moreover, there were significant differences between Italian women and men, with Italian women more distressed than Italian men overall, and also general self-consciousness, sexual self-consciousness, and social self-consciousness subscales. CONCLUSION: These results are considered in the context of aging and cultural and gender issues in appearance, including the Italian concept of bella figura. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Health technology assessment (HTA): ethical aspects.

"HTA is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused, and seek to achieve best value" (EUnetHTA 2007). Even though the assessment of ethical aspects of a health technology is listed as one of the objectives of a HTA process, in practice, the integration of these dimensions into reports remains limited. The article is focused on four points: 1. the HTA concept; 2. the difficult HTA-ethics relationship; 3. the ethical issues in HTA; 4. the methods for integrating ethical analysis into HTA.