The definition of ‘Assistive Technology’ (AT) includes both assistive products and the services or actions necessary for safe and effective provision of the assistive products to people who need them. International standards and product specifications exist for assistive products. Despite huge unmet need for effective AT provision, a variety of service delivery models across different countries, and a shortage of personnel trained in this field, nowidely useable and accepted AT service provision guidelines currently exist. Aligned with contemporary global initiatives to improve access to AT, a scoping review was commissioned to inform the development of globally useable provision guidance. The aim was to deliver a rapid scoping review of the literature regarding quality guidelines for AT service provision. Method: The rapid scoping review utilised a two-tiered approach to identifying relevant publications: 1) systematic search of academic databases; 2) consultation with assistive technology organisations. The review was conducted in March 2023 across four databases (Medline, CINAHL, SCOPUS and Google Scholar) with no date limitations. Systematic outreach to international and global AT networks was used to access expert informants. Non-English publications were included utilizing Google Translate and support from expert informants to verify content. Analysis was guided by the body of work on quality AT provision and service delivery processes in Europe, as well as the World Health Organization-GATE 5P framework for strengthening access to AT. Results: The search strategies yielded 41 publications from diverse countries, and directed at differing assistive products, personnel and provision contexts. Results are reported from the charted data through to the data extraction framework, including type of publication, study design, audience and reach. We report on the type of AT and the AT provision ecosystem elements discussed, and service delivery process or steps and quality criteria service delivery. Conclusion: This review did not find established guidelines or standards for service provision, but it did identify key service delivery steps which may form part of such guidelines, and many of the 3 publications included mentioned the need for practice guidelines. Despite different contexts such as type of assistive product, recipient of the guidance, language, location and authorship, core elements of AT provision including service delivery steps can be identified. Consideration regarding the nuances of vocabulary, of process, and of enabling flexible foci, is recommended in systematizing globally applicable guidance. This review offers a strong starting point for developing guidance for assistive technology provision to meet global need.
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Purpose Building services technologies such as home automation systems and remote monitoring are increasingly used to support people in their own homes. In order for these technologies to be fully appreciated by the endusers (mainly older care recipients, informal carers and care professionals), user needs should be understood1,2. In other words, supply and demand should match. Steele et al.3 state that there is a shortage of studies exploring perceptions of older users towards technology and the acceptance or rejection thereof. This paper presents an overview of user needs in relation to ambient assisted living (AAL) projects, which aim to support ageing-in-place in The Netherlands. Method A literature survey was made of Dutch AAL projects, focusing on user needs. A total of 7 projects concerned with older persons, with and without dementia, were included in the overview. Results & Discussion By and large technology is considered to be a great support in enabling people to age-in-place. Technology is, therefore, accepted and even embraced by many of the end-users and their relatives. Technology used for safety, security, and emergency response is most valued. Involvement of end-users improves the successful implementation of ambient technology. This is also true for family involvement in the case of persons with dementia. Privacy is mainly a concern for care professionals. This group is also key to successful implementation, as they need to be able to work with the technology and provide information to the end-users. Ambient technologies should be designed in an unobtrusive way, in keeping with indoor design, and be usable by persons with sensory of physical impairments. In general, user needs, particularly the needs of informal carers and care professionals, are an understudied topic. These latter two groups play an important role in implementation and acceptance among care recipients. They should, therefore, deserve more attention from the research community.
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Creative arts engagement has been shown to be related to maintaining wellbeing in older adulthood (Tymoszuk et al., 2019). For people living with dementia, music can be engaging and rewarding (Baird & Thompson, 2018), and is often presented as a therapeutic activity. It is theorised that music’s capacity to effect change is due to its engaging, emotional, physical, personal, social and persuasive qualities (Brancatisano et al., 2020). However, music itself is a complex intervention (Loui, 2020) and the ‘creative’ in music activities in the small number of studies with people living with dementia is rarely described or critiqued (Creech et al., 2020). Music is often described as passive (receptive)/active to reflect different listening or playing activities. Only a few studies detail opportunities for people living with dementia to exercise creativity (e.g. Zeilig et al., 2019).Technology to assist these musical interactions in dementia falls under distinct categories of listening to music, or playing music, with very little afforded in the way of agency, choice or control (MacRitchie et al., 2023). A few possible explanations could be: i) the musical activity is valued in terms of pre/post cognitive or social changes (Kontos & Grigorovich, 2018) i.e., the activity itself is not particularly critiqued, ii) creativity is assumed to be embedded in the activity and does not need to be enhanced or supported, iii) the locus of creativity is in cognitive processes occurring in the brain, so people living with dementia are often ascribed a passive role in creative musical interactions (Zeilig et al., 2019). We propose a new way of thinking about musical interactions for people living with dementia, building from the enactive, embodied experience of music (Schiavio et al., 2022), and considering a more relational view. Leaving aside the framing where the person with dementia is limited in what creativity they can offer, we propose instead a framework of design where subtle acts of agency and (mini-C) creativity are afforded, supporting a myriad of musical interactions that sit between listening and performing.
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Abstract: Background: Chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence and disease burden. Blended self-management interventions, which combine eHealth with face-to-face interventions, can help reduce the disease burden. Objective: This systematic review and meta-analysis aims to examine the effectiveness of blended self-management interventions on health-related effectiveness and process outcomes for people with COPD or asthma. Methods: PubMed, Web of Science, COCHRANE Library, Emcare, and Embase were searched in December 2018 and updated in November 2020. Study quality was assessed using the Cochrane risk of bias (ROB) 2 tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Results: A total of 15 COPD and 7 asthma randomized controlled trials were included in this study. The meta-analysis of COPD studies found that the blended intervention showed a small improvement in exercise capacity (standardized mean difference [SMD] 0.48; 95% CI 0.10-0.85) and a significant improvement in the quality of life (QoL; SMD 0.81; 95% CI 0.11-1.51). Blended intervention also reduced the admission rate (relative ratio [RR] 0.61; 95% CI 0.38-0.97). In the COPD systematic review, regarding the exacerbation frequency, both studies found that the intervention reduced exacerbation frequency (RR 0.38; 95% CI 0.26-0.56). A large effect was found on BMI (d=0.81; 95% CI 0.25-1.34); however, the effect was inconclusive because only 1 study was included. Regarding medication adherence, 2 of 3 studies found a moderate effect (d=0.73; 95% CI 0.50-0.96), and 1 study reported a mixed effect. Regarding self-management ability, 1 study reported a large effect (d=1.15; 95% CI 0.66-1.62), and no effect was reported in that study. No effect was found on other process outcomes. The meta-analysis of asthma studies found that blended intervention had a small improvement in lung function (SMD 0.40; 95% CI 0.18-0.62) and QoL (SMD 0.36; 95% CI 0.21-0.50) and a moderate improvement in asthma control (SMD 0.67; 95% CI 0.40-0.93). A large effect was found on BMI (d=1.42; 95% CI 0.28-2.42) and exercise capacity (d=1.50; 95% CI 0.35-2.50); however, 1 study was included per outcome. There was no effect on other outcomes. Furthermore, the majority of the 22 studies showed some concerns about the ROB, and the quality of evidence varied. Conclusions: In patients with COPD, the blended self-management interventions had mixed effects on health-related outcomes, with the strongest evidence found for exercise capacity, QoL, and admission rate. Furthermore, the review suggested that the interventions resulted in small effects on lung function and QoL and a moderate effect on asthma control in patients with asthma. There is some evidence for the effectiveness of blended self-management interventions for patients with COPD and asthma; however, more research is needed. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019119894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=119894
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Het aantal digitale documenten in bedrijfsomgevingen neemt dermate toe dat men het beoordelen ervan niet kan overlaten aan experts. Met behulp van slimme software kan men de relevantie van elektronische documenten voorspellen. Een van de nieuwste technieken is predictive coding die de voorspelling doet aan de hand van een model.
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Background. A number of parenting programs, aimed at improving parenting competencies, have recently been adapted or designed with the use of online technologies. Although web-based services have been claimed to hold promise for parent support, a meta-analytic review of online parenting interventions is lacking. Method. A systematic review was undertaken of studies (n = 19), published between 2000 and 2010, that describe parenting programs of which the primary components were delivered online. Seven programs were adaptations of traditional, mostly evidencebased, parenting interventions, using the unique opportunities of internet technology. Twelve studies (with in total 54 outcomes, Ntot parents = 1,615 and Ntot children = 740) were included in a meta-analysis. Results. The meta-analysis showed a statistically signifi cant medium effect across parents outcomes (ES = 0.67; se = 0.25) and child outcomes (ES = 0.42; se = 0.15). Conclusions. The results of this review show that web-based parenting programs with new technologies offer opportunities for sharing social support, consulting professionals and training parental competencies. The metaanalytic results show that guided and self-guided online interventions can make a signifi cant positive contribution for parents and children. The relation with other metaanalyses in the domains of parent education and web-based interventions is discussed.
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Abstract: Teledentistry offers possibilities for improving efficiency and quality of care and supporting cost-effective healthcare systems. This umbrella review aims to synthesize existing systematic reviews on teledentistry and provide a summary of evidence of its clinical- and cost-effectiveness. A comprehensive search strategy involving various teledentistry-related terms, across seven databases, was conducted. Articles published until 24 April 2023 were considered. Two researchers independently reviewed titles, abstracts and full-text articles. The quality of the included reviews was critically appraised with the AMSTAR-2 checklist. Out of 749 studies identified, 10 were included in this umbrella review. Two reviews focusing on oral-health outcomes revealed that, despite positive findings, there is not yet enough evidence for the long-term clinical effectiveness of teledentistry. Ten reviews reported on economic evaluations or costs, indicating that teledentistry is cost-saving. However, these conclusions were based on assumptions due to insufficient evidence on cost-effectiveness. The main limitation of our umbrella review was the critically low quality of the included reviews according to AMSTAR-2 criteria, with many of these reviews basing their conclusions on low-quality studies. This highlights the need for high-quality experimental studies (e.g., RCTs, factorial designs, stepped-wedge designs, SMARTs and MRTs) to assess teledentistry’s clinical- and cost-effectiveness.
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Integrated curricula seem promising for the increase of attention on science and technology in primary education. A clear picture of the advantages and disadvantages of integration efforts could help curriculum innovation. This review has focussed on integrated curricula in primary education from 1994 to 2011. The integrated curricula were categorized according to a taxonomy of integration types synthesized from the literature. The characteristics that we deemed important were related to learning outcomes and success/fail factors. A focus group was formed to facilitate the process of analysis and to test tentative conclusions. We concluded that the levels in our taxonomy were linked to (a) student knowledge and skills, the enthusiasm generated among students and teachers, and the teacher commitment that was generated; and (b) the teacher commitment needed, the duration of the innovation effort, the volume and comprehensiveness of required teacher professional development, the necessary teacher support, and the effort needed to overcome tensions with standard curricula. Almost all projects were effective in increasing the time spent on science at school. Our model resolves Czerniac’s definition problem of integrating curricula in a productive manner, and it forms a practical basis for decision-making by making clear what is needed and what output can be expected when plans are being formulated to implement integrated education.
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In dit review wordt een overzicht gegeven van effect van mobiele applicaties en activity trackers op een gezonde leefstijl. 17 artikelen werden geïncludeerd. De effecten van apps op beweeggedrag lijken positief. Het effect van apps op voeding en gewicht was wisselend. Maar er leek een trend te zijn voor verbetering van het voedingspatroon. Er is nog weinig onderzoek gedaan naar effect van activity trackers op leefstijl, maar eerste resultaten laten een positieve invloed zien op beweeggedrag. Voor apps aanbevolen kunnen worden, is verder onderzoek nodig. Hiervoor is grootschalig onderzoek nodig met uitgebalanceerde controlegroepen en lange termijn follow-up testen.
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Transitions in health care and the increasing pace at which technological innovations emerge, have led to new professional approach at the crossroads of health care and technology. In order to adequately deal with these transition processes and challenges before future professionals access the labour market, Fontys University of Applied Sciences is in a transition to combining education with interdisciplinary practice-based research. Fontys UAS is launching a new centre of expertise in Health Care and Technology, which is a new approach compared to existing educational structures. The new centre is presented as an example of how new initiatives in the field of education and research at the intersection of care and technology can be shaped.
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