`Everyone is a winner, help is just a push of a button away. . . ' : the Telecare Plus service in Malta

This paper reports on a research study on the role of assistive technologies in later life. Re- search questions included what is the impact of assistive technologies on the quality of life of older service-users, and to what extent does assistive technology lead to an improved quality of life for subscribers and in- formal carers? The chosen method of enquiry was a case-study of the Telecare Plus service in Malta. A total of 26 semi-structured interviews were held with a convenience sample of 26 people aged 60-plus about their use and experience of this particular telecare system. The Telecare Plus service was found to contribute positively to subscribers' levels of emotional and physical wellbeing, interpersonal relations and personal develop- ment, as well as towards the quality of life of informal carers. However, research also highlighted a range of challenges that stood in the way of increased adoption rates of the Telecare Plus service by older people. The fact that the fi eld of assistive technologies in Malta lacks effi cient and clear business models constitutes another barrier towards the take up of such services.peer-reviewe

Connected Women: How Mobile Can Support Women's Economic and Social Empowerment

This report explores how mobile services provided by Vodafone and the Vodafone Foundation are enabling women to seize new opportunities and improve their lives. Accenture Sustainability Services were commissioned to conduct research on the services and to assess their potential social and economic impact if they were widely available across Vodafone's markets by 2020. It showcases the projects and the work of those involved and also poses the question -- what would the benefit to women and to society at large be if projects such as these were taken to scale and achieved an industrialscale of growth? This reflects the Foundation's commitment not solely to the development of pilots but rather the Trustees' ambition to see projects which lead to transformational change. In order to understand this more deeply, the Report looks at the benefits for women and society and providessome financial modelling for how the engagement of commercial players could achieve industrial, sustainable growth in these areas. Accenture has provided the modelling and, given the public benefit and understanding which the report seeks to generate, these are shared openly for all in the mobile industry to understand and share. It is the Trustees' hope that the collaboration with Oxford University and Accenture in the delivery of this Report will stimulate not only the expansion of existing charitable programmes but will also seed other philanthropic, social enterprise or commercial initiatives

What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare

Telehealth and telecare research has been dominated by efficacy trials. The field lacks a sophisticated theorisation of [a] what matters to older people with assisted living needs; [b] how illness affects people's capacity to use technologies; and [c] the materiality of assistive technologies. We sought to develop a phenomenologically and socio-materially informed theoretical model of assistive technology use. Forty people aged 60–98 (recruited via NHS, social care and third sector) were visited at home several times in 2011–13. Using ethnographic methods, we built a detailed picture of participants' lives, illness experiences and use (or non-use) of technologies. Data were analysed phenomenologically, drawing on the work of Heidegger, and contextualised using a structuration approach with reference to Bourdieu's notions of habitus and field. We found that participants' needs were diverse and unique. Each had multiple, mutually reinforcing impairments (e.g. tremor and visual loss and stiff hands) that were steadily worsening, culturally framed and bound up with the prospect of decline and death. They managed these conditions subjectively and experientially, appropriating or adapting technologies so as to enhance their capacity to sense and act on their world. Installed assistive technologies met few participants' needs; some devices had been abandoned and a few deliberately disabled. Successful technology arrangements were often characterised by ‘bricolage’ (pragmatic customisation, combining new with legacy devices) by the participant or someone who knew and cared about them. With few exceptions, the current generation of so-called ‘assisted living technologies’ does not assist people to live with illness. To overcome this irony, technology providers need to move beyond the goal of representing technology users informationally (e.g. as biometric data) to providing flexible components from which individuals and their carers can ‘think with things’ to improve the situated, lived experience of multi-morbidity. A radical revision of assistive technology design policy may be needed

'A bed in the middle of nowhere': parents' meanings of place of death for adults with cystic fibrosis

As populations age and chronic conditions become more prevalent, an individual's ability to choose the location of their end-of-life care and death is increasingly considered important in the provision of good healthcare, with home implied as the 'best' place of death through UK government policy and specialist and voluntary palliative care services. However, considering meanings of place of end-of-life care and death is complex for young adults with life-limiting conditions where the disease course is variable and uncertain, and aggressive and palliative treatments are administered both at home and in hospital often until death. Although 'place' is a pivotal element in healthcare practice, research and policy, there has been little attempt to understand the meaning and importance of place in understanding experiences of care at end of life. Through analysis of in-depth interviews and letters received from parents of 27 young adults in England, Scotland and Wales who died from cystic fibrosis from 1999 to 2002 aged 17-36 years, key factors that influence families' meanings of place at end of life are presented. Both home and hospital deaths are reported, with no deaths in hospices. Preferences for possible locations of death are generally limited early in the disease course by choice of aggressive treatment, particularly lung transplantation. Rate of health decline, organisation and delivery of services, and relationships with specialist and general healthcare staff strongly influence parents' experience of death at home or in hospital, although no physical location was regarded a 'better' place of death. Meanings of, and attachment to place are mediated for families through these factors, questioning the appropriateness of a 'home is best' policy for those dying from life-limiting conditions. © 2009 Elsevier Ltd. All rights reserved

Designing Robots for Care: Care Centered Value-Sensitive Design

The prospective robots in healthcare intended to be included within the conclave of the nurse-patient relationship—what I refer to as care robots—require rigorous ethical reflection to ensure their design and introduction do not impede the promotion of values and the dignity of patients at such a vulnerable and sensitive time in their lives. The ethical evaluation of care robots requires insight into the values at stake in the healthcare tradition. What’s more, given the stage of their development and lack of standards provided by the International Organization for Standardization to guide their development, ethics ought to be included into the design process of such robots. The manner in which this may be accomplished, as presented here, uses the blueprint of the Value-sensitive design approach as a means for creating a framework tailored to care contexts. Using care values as the foundational values to be integrated into a technology and using the elements in care, from the care ethics perspective, as the normative criteria, the resulting approach may be referred to as care centered value-sensitive design. The framework proposed here allows for the ethical evaluation of care robots both retrospectively and prospectively. By evaluating care robots in this way, we may ultimately ask what kind of care we, as a society, want to provide in the futur

If telecare is the answer, what was the question? Storyline, tensions and the unintended consequences of technology-supported care

This document is the Accepted Manuscript version. The final, definitive version of this paper has been published in Critical Social Policy, March 2018, published by SAGE Publishing. Content in the UH Research Archive is made available for personal research, educational, and non-commercial purposes only. Unless otherwise stated, all content is protected by copyright, and in the absence of an open license, permissions for further re-use should be sought from the publisher, the author, or other copyright holder.Telecare—services employing technology to monitor people’s movement, medication and home environment at a distance—has emerged as a key component of global social care and health policies. The relationship between policies about telecare and the experiences and aspirations of service users has been under-interrogated. This paper draws on findings from an organisational case study involving people living with complex conditions using various telecare devices and employs Hajer’s (1995) concept of argumentative discourse analysis to identify two key storylines arguing that telecare improves people’s quality of life and promotes independence. While these storylines point to seemingly logical and incontestable objectives, uncritical policy and practice fails to recognise and prioritise the aspirations of service users, leading to unintended consequences that can deepen people’s isolation and minimise organisational benefits.Peer reviewedFinal Accepted Versio

Total skin self-examination at home for people treated for cutaneous melanoma : development and pilot of a digital intervention

This work was funded by the RCUK Digital Economy award to the dot.rural Digital Economy Hub, University of Aberdeen; award reference: EP/G066051/1. The Experience Laboratory event was supported in part by a separate award from the University of Aberdeen Knowledge Exchange and Transfer Fund; award reference: GP057 UZZ0101.Peer reviewedPublisher PD

Occupational therapists’ views of using a virtual reality interior design application within the pre-discharge home visit process

This article has been made available through the Brunel Open Access Publishing Fund.Background: A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment, to enable patients to function independently after hospital-home discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualise changes prior to implementing them. Customised VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration if developed effectively and integrated into the PHV process. Objective: To explore the perceptions of occupational therapists with regards to using VRIDAs as an assistive tool within the PHV process. Methods: Task-oriented interactive usability sessions, utilising the think-aloud protocol and subsequent semi-structured interviews were carried out with seven Occupational Therapists who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centring around the parameters that impact upon the acceptance, adoption and use of this technology in practice as indicated by the Technology Acceptance Model (TAM). Results: OTs’ perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential to increase understanding, enrich communications and patient involvement, and improved patient/practitioner shared understanding. However, it was unlikely that VRIDAs would be suitable for use with cognitively impaired patients. For PEoU, all OTs were able to use the software and complete the tasks successfully, however, participants noted numerous specialist equipment items that could be added to the furniture library. AU perceptions were positive regarding use of the application across a range of clinical settings including children/young adults, long-term conditions, neurology, older adults, and social services. However, some “fine tuning” may be necessary if the application is to be optimally used in practice. Conclusions: Participants perceived the use of VRIDAs in practice would enhance levels of patient/practitioner collaboration and provide a much needed mechanism via which patients are empowered to become more equal partners in decisions made about their care. Further research is needed to explore patient perceptions of VRIDAs, to make necessary customisations accordingly, and to explore deployment of the application in a collaborative patient/practitioner-based context

The Review - Spring 2003

In This Issue 3 Message From the Dean 4 Special Occasions 5 Gail Seygal (OT ’86) - Animal Touch 6 War Stories 6 JAVA Night 8 Federal Stafford and Consolidation Loans 9 OT Students Visit Cuba 10 Penny Kroll, New PT Chair 10 New DPT 11 TJU Nursing Reimbursement 11 Lab Sciences Changes Its Name 12 Jeff-At-Night 12 Lambda Nu 13 Alumni Events 19 JCHP Awards 21 Student Life Award 22 PT Convocation 23 JCHP Commencemen

Digital Orthopaedics: A Glimpse Into the Future in the Midst of a Pandemic.

BackgroundThe response to COVID-19 catalyzed the adoption and integration of digital health tools into the health care delivery model for musculoskeletal patients. The change, suspension, or relaxation of Medicare and federal guidelines enabled the rapid implementation of these technologies. The expansion of payment models for virtual care facilitated its rapid adoption. The authors aim to provide several examples of digital health solutions utilized to manage orthopedic patients during the pandemic and discuss what features of these technologies are likely to continue to provide value to patients and clinicians following its resolution.ConclusionThe widespread adoption of new technologies enabling providers to care for patients remotely has the potential to permanently change the expectations of all stakeholders about the way care is provided in orthopedics. The new era of Digital Orthopaedics will see a gradual and nondisruptive integration of technologies that support the patient's journey through the successful management of their musculoskeletal disease