scholarly journals Attitudes Towards Digital Health Technology: Introducing the Digital Health Scale

2021 ◽  
Author(s):  
Ridley Cassidy
Keyword(s):  
Digital Health ◽  
Health Technology ◽  
Healthcare Services ◽  
Older Individuals ◽  
Cross Sectional ◽  
Frequent Use ◽  
Age Related ◽  
Frequency Of Use ◽  
The Uk ◽  
Digital Healthcare

Objective: The study sought to investigate the relationship between attitude towards digital health technology and age, gender and frequency of use of digital health technology and to consider whether age, gender and frequency of use present potential barriers to accessing future healthcare in the UK. Differences in technological affinity are likely to lead to differences in the adoption of digital health technology and subsequent inequalities in healthcare between older and younger people and between men and women. Design: The study represents an example of a technology adoption study employing a survey-based cross sectional correlational design. Attitude towards digital health technology was measured using the 20 item Digital Health Scale. Age, gender, frequency of use of health technology and employment status data were gathered using a demographics questionnaire. The opportunity sample (N = 247) included volunteer participants aged 16-84 years (M = 31.7, SD = 19.35, 156 females and 91 males). Results: Results indicated a significant negative correlation between age and positive attitude towards digital health technology (r = -0.24, p < .01). Gender differences in attitudes towards digital health technology were non-significant (p > .05). Significant differences in frequency of use were also found, where occasional and frequent use resulted in more positive attitudes than never having used digital health technology (p < 0.05) and participants reporting frequent use were significantly older than those reporting never or occasional use (p < .05) Conclusion: Findings identified age, but not gender, as a significant factor in attitude towards digital health technology, suggesting that continued and increased reliance on digital technology in healthcare may lead to age, but not gender, related inequalities in access to healthcare in the UK. That frequent users of digital health technology were also older, highlights the greater demand for healthcare services by older individuals and is further evidence for the potential of digital healthcare to lead to age related inequalities in access to and provision of healthcare. Recommendations for successful application of digital healthcare technology are considered in the light of these findings.

scholarly journals Digi-HTA: Health technology assessment framework for digital healthcare services

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Jari Haverinen ◽  
Niina Keränen ◽  
Petra Falkenbach ◽  
Anna Maijala ◽  
Timo Kolehmainen ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
State Of The Art ◽  
Health Technology ◽  
Healthcare Services ◽  
The State ◽  
Systematic Evaluation ◽  
Health Technologies ◽  
Digital Healthcare ◽  
And Robotics

Health technology assessment (HTA) refers to the systematic evaluation of the properties, effects, and/or impacts of health technology. The main purpose of the assessment is to inform decisionmakers in order to better support the introduction of new health technologies. New digital healthcare solutions like mHealth, artificial intelligence (AI), and robotics have brought with them a great potential to further develop healthcare services, but their introduction should follow the same criteria as that of other healthcare methods. They must provide evidence-based benefits and be safe to use, and their impacts on patients and organizations need to be clarified. The first objective of this study was to describe the state-of-the-art HTA methods for mHealth, AI, and robotics. The second objective of this study was to evaluate the domains needed in the assessment. The final aim was to develop an HTA framework for digital healthcare services to support the introduction of novel technologies into Finnish healthcare. In this study, the state-of-the-art HTA methods were evaluated using a literature review and interviews. It was noted that some good practices already existed, but the overall picture showed that further development is still needed, especially in the AI and robotics fields. With the cooperation of professionals, key aspects and domains that should be taken into account to make fast but comprehensive assessments were identified. Based on this information, we created a new framework which supports the HTA process for digital healthcare services. The framework was named Digi-HTA.

scholarly journals Human skeletal muscle metabolic economy in vivo: effects of contraction intensity, age, and mobility impairment

2014 ◽  
Vol 307 (9) ◽  
pp. R1124-R1135 ◽  
Author(s):  
Anita D. Christie ◽  
Anne Tonson ◽  
Ryan G. Larsen ◽  
Jacob P. DeBlois ◽  
Jane A. Kent
Keyword(s):  
Functional Mobility ◽  
Older Individuals ◽  
Mobility Impairment ◽  
Cross Sectional ◽  
Age Related ◽  
Creatine Kinase Reaction ◽  
Voluntary Contractions ◽  
In Vivo Effects ◽  
Muscle Cross Sectional Area

We tested the hypothesis that older muscle has greater metabolic economy (ME) in vivo than young, in a manner dependent, in part, on contraction intensity. Twenty young (Y; 24 ± 1 yr, 10 women), 18 older healthy (O; 73 ± 2, 9 women) and 9 older individuals with mild-to-moderate mobility impairment (OI; 74 ± 1, 7 women) received stimulated twitches (2 Hz, 3 min) and performed nonfatiguing voluntary (20, 50, and 100% maximal; 12 s each) isometric dorsiflexion contractions. Torque-time integrals (TTI; Nm·s) were calculated and expressed relative to maximal fat-free muscle cross-sectional area (cm2), and torque variability during voluntary contractions was calculated as the coefficient of variation. Total ATP cost of contraction (mM) was determined from flux through the creatine kinase reaction, nonoxidative glycolysis and oxidative phosphorylation, and used to calculate ME (Nm·s·cm−2·mM ATP−1). While twitch torque relaxation was slower in O and OI compared with Y ( P ≤ 0.001), twitch TTI, ATP cost, and economy were similar across groups ( P ≥ 0.15), indicating comparable intrinsic muscle economy during electrically induced isometric contractions in vivo. During voluntary contractions, normalized TTI and total ATP cost did not differ significantly across groups ( P ≥ 0.20). However, ME was lower in OI than Y or O at 20% and 50% MVC ( P ≤ 0.02), and torque variability was greater in OI than Y or O at 20% MVC ( P ≤ 0.05). These results refute the hypothesis of greater muscle ME in old age, and provide support for lower ME in impaired older adults as a potential mechanism or consequence of age-related reductions in functional mobility.

scholarly journals Exploring awareness of age-related changes among over 50s in the UK: findings from the PROTECT study

2021 ◽  
pp. 1-15
Author(s):  
Serena Sabatini ◽  
Obioha C. Ukoumunne ◽  
Clive Ballard ◽  
Rachel Collins ◽  
Anne Corbett ◽  
...  
Keyword(s):  
Thought Processes ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Written Comments ◽  
Age Related ◽  
Perceived Age ◽  
The Uk ◽  
Protect Study ◽  
Age Related Changes ◽  
Theoretical Conceptualization

ABSTRACT Objectives: Older people describe positive and negative age-related changes, but we do not know much about what contributes to make them aware of these changes. We used content analysis to categorize participants’ written comments and explored the extent to which the identified categories mapped onto theoretical conceptualizations of influences on awareness of age-related change (AARC). Design: Cross-sectional observational study. Participants: The study sample comprised 609 UK individuals aged 50 years or over (mean (SD) age = 67.9 (7.6) years), enrolled in the PROTECT study. Measurements: Between January and March 2019, participants provided demographic information, completed a questionnaire assessing awareness of age-related change (AARC-10 SF), and responded to an open-ended question asking them to comment on their responses. Results: While some of the emerging categories were in line with the existing conceptual framework of AARC (e.g. experiencing negative changes and attitudes toward aging), others were novel (e.g. engagement in purposeful activities or in activities that distract from age-related thoughts). Analysis revealed some of the thought processes involved in selecting responses to the questionnaire items, demonstrating different ways in which people make sense of specific items. Conclusions: Results support the ability of the AARC questionnaire to capture perceived age-related changes in cognitive functioning, physical and mental health, and engagement in social activities and in healthy and adaptive behaviors. However, findings also suggest ways of enriching the theoretical conceptualization of how AARC develops and offer insights into interpretation of responses to measures of AARC.

scholarly journals Mild Cognitive Impairment or Attention-Deficit/Hyperactivity Disorder in Older Adults? A Cross Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Felippe Mendonca ◽  
Felipe Kenji Sudo ◽  
Gustavo Santiago-Bravo ◽  
Natalia Oliveira ◽  
Naima Assuncao ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Attention Deficit ◽  
Cross Sectional Study ◽  
Older Individuals ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hyperactivity Disorder ◽  
Age Related

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental condition, which may be associated with life-enduring cognitive dysfunction. It has been hypothesized that age-related cognitive decline may overlap with preexisting deficits in older ADHD patients, leading to increased problems to manage everyday-life activities. This phenomenon may mimic neurodegenerative disorders, in particular Mild Cognitive Impairment (MCI). This cross-sectional study aims to assess cognitive and behavioral differences between older subjects with ADHD and MCI.Methods: A total of 107 older participants (41 controls; 40 MCI and 26 ADHD; mean age = 67.60 ± 7.50 years; mean schooling = 15.14 ± 2.77 years; 65.4% females) underwent clinical, cognitive, and behavioral assessments by a multidisciplinary team at the Memory Clinic, D'Or Institute for Research and Education, Rio de Janeiro, Brazil. Mean scores in neuropsychological tasks and behavioral scales were compared across groups.Results: Participants with ADHD showed poorer performances than controls in episodic memory and executive function with large effect-sizes. Performances were comparable between MCI and ADHD for all domains.Discussion: MCI and ADHD in older individuals are dissociated clinical entities with overlapping cognitive profiles. Clinicians ought to be aware of these converging phenotypes to avoid misdiagnosis.

scholarly journals A survey examining the use of mechanical insufflation-exsufflation on adult intensive care units across the UK

2019 ◽  
Vol 21 (4) ◽  
pp. 283-289 ◽  
Author(s):  
Ema Swingwood ◽  
Lyvonne Tume ◽  
Fiona Cramp
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Perceived Barriers ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Geographical Spread ◽  
Frequency Of Use ◽  
Potential Benefits ◽  
The Uk

Introduction Despite potential benefits, it is not known how widely physiotherapists use mechanical insufflation-exsufflation devices on UK adult intensive care units. This survey aimed to describe mechanical insufflation-exsufflation use in UK adult intensive care units. Methods Cross-sectional electronic survey of physiotherapists working in a permanent post on adult intensive care units. Results One hundred and sixty-six complete surveys were available for analysis, reflecting a diverse geographical spread. Nearly all (98%; 163/166) clinicians had access to mechanical insufflation-exsufflation. The estimated frequency of use varied, with the majority reporting weekly or monthly use (52/163, 32%; 50/163, 31%, respectively). Nearly all clinicians (99%) used mechanical insufflation-exsufflation with extubated patients. In contrast, around half of respondents (86/163, 53%) used mechanical insufflation-exsufflation with intubated patients, with a range of perceived barriers reported. Conclusions Mechanical insufflation-exsufflation devices are widely available on UK adult intensive care units, with use more common in extubated patients. Barriers to mechanical insufflation-exsufflation use in the intubated population warrant further investigation

Muscular Strength is Independently Associated with Cystatin C: The KORA-Age Study

2018 ◽  
Vol 39 (03) ◽  
pp. 225-231 ◽  
Author(s):  
Konstantinos Volaklis ◽  
Barbara Thorand ◽  
Anette Peters ◽  
Martin Halle ◽  
Heier Margot ◽  
...  
Keyword(s):  
Older Adults ◽  
Cystatin C ◽  
Muscular Strength ◽  
Smoking Status ◽  
Fat Free Mass ◽  
Older Individuals ◽  
Cross Sectional ◽  
Age Related ◽  
Health Related ◽  
Hs Crp

AbstractThe purpose of this study was to investigate if there is a link between muscular strength (MS) and markers of chronic kidney disease (CKD) among older adults. The cross-sectional analysis based on 1041 men and women, aged 65–94 years, who participated in the KORA-Age study. Participants underwent an interview and extensive examinations including anthropometric measurements, diseases and drug intake registration, determination of health-related behaviors, collection of blood samples for measurements of cystatin C and maximal muscle strength evaluation. One-Way ANOVA revealed significant differences in both mean cystatin C (1.16±0.37 vs. 1.03±0.29 vs. 0.93±0.24 mg/L, p<0.001) and mean eGFRcysC (63.61±18.61 vs. 72.14±18.92 vs. 79.87±18.19 ml/min/1.73 m2, p<0.05) across thirds of maximal muscular strength (from lowest to highest). MS in the lowest third was significantly associated with increased odds of having elevated cystatin C (OR: 1.70, 95% CI: 1.01–2.85, p=0.043) after controlling for age, gender, fat mass, fat-free mass, alcohol intake, smoking status, number of regularly used medications, multimorbidity status, hs-CRP, telomere length and levels of physical activity. Lower levels of MS are independently associated with higher concentrations of cystatin C and lower eGFRcysC in older individuals. Increasing the levels of muscular strength may be useful to prevent the age-related CKD disease of older adults.

scholarly journals Age-related association of small intestinal mucosal enteropathy with nutritional status in rural Gambian children

2002 ◽  
Vol 88 (5) ◽  
pp. 499-505 ◽  
Author(s):  
David I. Campbell ◽  
Peter. G. Lunn ◽  
Marinos Elia
Keyword(s):  
Small Bowel ◽  
Nutritional Status ◽  
Mean Value ◽  
Cross Sectional ◽  
Nutritional Effect ◽  
Gut Barrier Function ◽  
Growth Faltering ◽  
Age Related ◽  
The Uk ◽  
Height For Age

Small bowel enteropathy (assessed by the lactulose (L): mannitol (M) permeability test) is a major factor in infant growth faltering and malnutrition in The Gambia. However, little is known about its persistence and nutritional effect beyond 2 years of age. This was addressed by two cross-sectional studies of intestinal permeability and nutritional status in 162 residents, aged 2–60 years, living in three villages in rural Gambia. L:M ratio was found to be highest in the youngest children and although there was a significant improvement with age (P<0·0001), values were always greater than the range found in UK counterparts. M recovery (mean value 5·68 (SE 0·12)%) was at all times between one-third and one-half of expected UK values and showed no improvement with age. Gut barrier function, assessed by L uptake, improved with age (P<0·001) and fell within the UK normal range beyond age 10 years. Both the L:M permeability ratio and L recovery were significantly associated with height-for-age z-scores (r−0·31 and −0·22 respectively, P<0·001), a relationship that persisted throughout childhood and into adulthood. Change in height-for-age z-score beween the two visits was also related to the L:M ratio (r−0·24, P=0·018). The close within-subject correlation of permeability variabilities between the two visits suggests a long-term persistence of enteropathy within individuals. It appears that the small bowel enteropathy previously described in Gambian infants persists through to adulthood. Although the lesion improves with age, the relationship between attained height and L:M permeability raises the possibility that enteropathy may continue to limit growth throughout childhood and puberty.

Inhibition and Switching in Healthy Aging: A Longitudinal Study

2016 ◽  
Vol 23 (1) ◽  
pp. 90-97 ◽  
Author(s):  
Steinunn Adólfsdóttir ◽  
Daniel Wollschlaeger ◽  
Eike Wehling ◽  
Astri J. Lundervold
Keyword(s):  
Processing Speed ◽  
Predictive Value ◽  
Healthy Aging ◽  
Older Individuals ◽  
Longitudinal Models ◽  
Cross Sectional ◽  
Gender And Education ◽  
Age Related ◽  
Speed Measure ◽  
Interference Test

AbstractObjectives: Discrepant findings of age-related effects between cross-sectional and longitudinal studies on executive function (EF) have been described across different studies. The aim of the present study was to examine longitudinal age effects on inhibition and switching, two key subfunctions of EF, calculated from results on the Color Word Interference Test (CWIT). Methods: One hundred twenty-three healthy aging individuals (average age 61.4 years; 67% women) performed the CWIT up to three times, over a period of more than 6 years. Measures of inhibition, switching, and combined inhibition and switching were analyzed. A longitudinal linear mixed effects models analysis was run including basic CWIT conditions, and measures of processing speed, retest effect, gender, education, and age as predictors. Results: After taking all predictors into account, age added significantly to the predictive value of the longitudinal models of (i) inhibition, (ii) switching, and (iii) combined inhibition and switching. The basic CWIT conditions and the processing speed measure added to the predictive value of the models, while retest effect, gender, and education did not. Conclusions: The present study on middle-aged to older individuals showed age-related decline in inhibition and switching abilities. This decline was retained even when basic CWIT conditions, processing speed, attrition, gender, and education were controlled. (JINS, 2017, 23, 90–97)

scholarly journals Age Differences and Longitudinal Change in Exposure to Daily Stressors: Three Waves of Diary Data Across 20 Years

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 215-215
Author(s):  
Eric Cerino ◽  
Jonathan Rush ◽  
Robert Stawski
Keyword(s):  
Age Differences ◽  
Healthy Aging ◽  
Later Life ◽  
Longitudinal Change ◽  
National Study ◽  
Older Individuals ◽  
Daily Stress ◽  
Cross Sectional ◽  
Telephone Interviews ◽  
Age Related

Abstract Exposure to daily stress is an important risk factor for healthy aging. We examined cross-sectional age-related differences and longitudinal aging-related change in stressor exposure across three waves of the National Study of Daily Experiences (N=2,914, M=51.53 years, SD=13.55, 56.35% Female) spanning 20 years. Exposure to six types of stressors (arguments, avoided arguments, work overloads, home overloads, network stressors, other) were obtained from telephone interviews over 8 consecutive days in waves conducted in ~1996, ~2008, and ~2017. Longitudinal analyses revealed declines in stressor exposure across 20 years (p&lt;.01), driven by declines in arguments, work overloads, and network stressors specifically. Cross-sectional analyses indicated that older individuals reported stressors less frequently (p&lt;.01), driven by decreases in arguments, avoided arguments, work overloads, and home overloads specifically. Rates of longitudinal decline did not depend on age at baseline. Results suggest that aging-related changes and baseline age differences inform daily stress trajectories in mid- and later-life.

A roadmap for remote digital health technology for Motor Neuron Disease (Preprint)

2021 ◽  
Author(s):  
Ruben P.A. van Eijk ◽  
Anita Beelen ◽  
Esther T. Kruitwagen ◽  
Deirdre Murray ◽  
Ratko Radakovic ◽  
...  
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Real World ◽  
Clinical Decision Making ◽  
Digital Health ◽  
Health Technology ◽  
Innovative Technology ◽  
Progression Rate ◽  
Healthcare Technology ◽  
Digital Healthcare

UNSTRUCTURED Despite recent and compelling technological advances, the real-world implementation of remote digital health technology in care and monitoring of patients with motor neuron disease (MND) has not yet been realized. Digital health technology may increase the accessibility to and personalization of care, whereas remote biosensors could optimize the collection of vital clinical parameters, irrespective of the patients’ ability to visit the clinic. To facilitate wide-scale adoption of digital healthcare technology, and to align current initiatives, we outline a roadmap that (1) will identify clinically relevant digital parameters, (2) mediate the development of benefit-to-burden criteria for innovative technology and (3) direct the validation, harmonization and adoption of digital healthcare technology in real-world settings. We define two key end-products of the roadmap: (1) a set of reliable digital parameters to capture data, collected under free-living conditions, that reflect patient-centric measures and facilitate clinical decision-making, and (2) an integrated, open-source system that provides personalized feedback to patients, healthcare providers, clinical researchers and caregivers, linked to a flexible and adaptable ICT platform that integrates patient data in real time. Given the ever-changing care needs of patients and the relentless progression rate of MND, the adoption of digital healthcare technology will significantly benefit the delivery of care and accelerate the development of effective treatments.

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