Given the growing number of older people, society as a whole should ideally provide a higher quality of life (QoL) for its ageing citizens through the concept of personalised ageing. Information and communication technologies (ICT) are subject to constant and rapid development, and can contribute to the goal of an improved QoL for older adults. In order to utilise future ICT solutions as a part of an age-friendly smart environment that helps achieve personalised ageing with an increased QoL, one must first determine whether the existing ICT solutions are satisfying the needs of older people. In order to accomplish that, this study contributes in three ways. First, it proposes a framework for the QoL of older adults, in order to provide a systematic review of the state-of-the-art literature and patents in this field. The second contribution is the finding that selected ICT solutions covered by articles and patents are intended for older adults and are validated by them. The third contribution of the study are the six recommendations that are derived from the review of the literature and the patents which would help move the agenda concerning the QoL of older people and personalised ageing with the use of ICT solutions forward. Original article at MDPI; DOI: http://dx.doi.org/10.3390/ijerph17082940 (This article belongs to the Special Issue Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives")
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Purpose: Breast cancer follow-up (surveillance and aftercare) varies from one-size-fits-all to more personalised approaches. A systematic review was performed to get insight in existing evidence on (cost-)efectiveness of personalised follow-up. Methods: PubMed, Scopus and Cochrane were searched between 01–01-2010 and 10–10-2022 (review registered in PROSPERO:CRD42022375770). The inclusion population comprised nonmetastatic breast cancer patients≥18 years, after completing curative treatment. All intervention-control studies studying personalised surveillance and/or aftercare designed for use during the entire follow-up period were included. All review processes including risk of bias assessment were performed by two reviewers. Characteristics of included studies were described. Results: Overall, 3708 publications were identifed, 64 full-text publications were read and 16 were included for data extraction. One study evaluated personalised surveillance. Various personalised aftercare interventions and outcomes were studied. Most common elements included in personalised aftercare plans were treatment summaries (75%), follow-up guidelines (56%), lists of available supportive care resources (38%) and PROs (25%). Control conditions mostly comprised usual care. Four out of seven (57%) studies reported improvements in quality of life following personalisation. Six studies (38%) found no personalisation efect, for multiple outcomes assessed (e.g. distress, satisfaction). One (6.3%) study was judged as low, four (25%) as high risk of bias and 11 (68.8%) as with concerns. Conclusion: The included studies varied in interventions, measurement instruments and outcomes, making it impossible to draw conclusions on the efectiveness of personalised follow-up. There is a need for a definition of both personalised surveillance and aftercare, whereafter outcomes can be measured according to uniform standards.
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Patients with coronary artery disease (CAD) are more sedentary compared with the general population, but contemporary cardiac rehabilitation (CR) programmes do not specifically target sedentary behaviour (SB). We developed a 12-week, hybrid (centre-based+home-based) Sedentary behaviour IntervenTion as a personaLisEd Secondary prevention Strategy (SIT LESS). The SIT LESS programme is tailored to the needs of patients with CAD, using evidence-based behavioural change methods and an activity tracker connected to an online dashboard to enable self-monitoring and remote coaching. Following the intervention mapping principles, we first identified determinants of SB from literature to adapt theory-based methods and practical applications to target SB and then evaluated the intervention in advisory board meetings with patients and nurse specialists. This resulted in four core components of SIT LESS: (1) patient education, (2) goal setting, (3) motivational interviewing with coping planning, and (4) (tele)monitoring using a pocket-worn activity tracker connected to a smartphone application and providing vibrotactile feedback after prolonged sedentary bouts. We hypothesise that adding SIT LESS to contemporary CR will reduce SB in patients with CAD to a greater extent compared with usual care. Therefore, 212 patients with CAD will be recruited from two Dutch hospitals and randomised to CR (control) or CR+SIT LESS (intervention). Patients will be assessed prior to, immediately after and 3 months after CR. The primary comparison relates to the pre-CR versus post-CR difference in SB (objectively assessed in min/day) between the control and intervention groups. Secondary outcomes include between-group differences in SB characteristics (eg, number of sedentary bouts); change in SB 3 months after CR; changes in light-intensity and moderate-to-vigorous-intensity physical activity; quality of life; and patients’ competencies for self-management. Outcomes of the SIT LESS randomised clinical trial will provide novel insight into the effectiveness of a structured, hybrid and personalised behaviour change intervention to attenuate SB in patients with CAD participating in CR.
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In Europe nearly 10% of the population suffers from diabetes and almost 1% from Rheumatoid Arthritis which can lead to serious problems with mobility and active participation, especially in the ageing population. Pedorthists deliver personalised designed and manufactured orthopaedic footwear or insoles for these patients. However, despite their often laborious efforts upfront, the industry has very little means to quantify how successful the fitting and function of a shoe is. They have to rely on subjective, qualitative measures such as client satisfaction and diminishing of complaints. Although valuable, the need for objective quantitative data in this field is growing. Foot plantar pressure and shear forces are considered major indicators of potential foot problems. Devices to measure plantar pressure slowly gain terrain as providers of objective quantitative data to guide orthotic design and manufacturing. For shear forces however, measuring devices are not yet commercial available. Although shear forces are considered as a major contributor to ulcer formation in diabetic feet, their exact role still requires elucidation and quantification. This project aims to develop a prototype of an in-shoe wearable device that measures both shear forces and pressure using state-of-the-art developments in sensor technologies, smart textiles and wireless data transfer. The collaboration of pedorthists’ small and medium-sized enterprises (SME)’s with medical device engineering companies, knowledge institutes,technical universities and universities of applied sciences in this project will bring together the different fields of expertise required to create an innovative device. It is expected that the tool will be beneficial to improve the quality of pedorthists’ services and potentially reduce health insurance costs. Furthermore, it can be used in new shear forces research and open new business potential. However, the eventual aim is to improve patient care and help maintain personal mobility and participation in society.
Hoe kan zorgvernieuwing structureel en efficiënt gerealiseerd worden door inzet van 3D technieken en welke praktische medische vraagstukken kunnen hiermee worden opgelost? Dat is een vraag die voortkomt uit experimenten van Medisch Spectrum Twente (MST-afdeling Radiotherapie) samen met Saxion FabLab Enschede naar 3D geprinte opbouw voor radiotherapie behandelingen. De experimenten waren zeer succesvol, maar riepen tevens nieuwe technische en organisatorische vragen op. De huidige planningssoftware is (nog) niet compatibel en er is beperkte 3D expertise binnen het team. Daarnaast vraagt de implementatie van 3D technieken om een aanzienlijke investering qua tijd en geld en verandering van werkwijze. De conclusie van de afdeling radiotherapie is dat zij deze vraag niet zelfstandig kunnen oppakken om in te passen in hun eigen processen. Voortbouwend hierop hebben zorgstudenten breder gekeken naar de huidige ontwikkelingen van 3d printen op het gebied van de gezondheidzorg (Brinkman, Garstenveld, de Rijk, Rutgers, Timmershuis, 2017). Binnen MST heeft dit geleid tot een groep van meerdere afdelingen die actief geïnteresseerd zijn om samen vervolgonderzoek te doen naar het toepassen van 3D technieken. De ontwikkelingen op het gebied van 3D technologie zijn als individuele afdeling niet bij te benen. Dit vraagt om een duurzame samenwerking met lokale kennispartners. De uitdaging van de creatieve industrie is om met moderne technologieën succesvolle innovaties te realiseren binnen de complexe wereld van het ziekenhuis. Het bedrijf 4C ondervindt dat door de toenemende technische mogelijkheden er behoefte is aan hoogwaardig maatwerk door creatieve oplossingen. Saxion en FabLab Enschede bundelen de krachten met bovenstaande partners om de kennispositie van de hogeschool te versterken in het kader van het FieldLab UPPS (Ultra Personalised Products & Services). Doel van dit project is drieledig: 1) Het ontwikkelen van een roadmap voor kansrijke Ultra Persoonlijke klinische zorg binnen het MST door inzet van 3D technieken. 2) Door het uitwerken van een tweetal cases meer zicht te krijgen in de technische en organisatorische consequenties. 3) Het bijeenbrengen van kennispartners in een netwerk dat de roadmap verder op kan pakken en implementeren.
