Ageing in place and the internet of things – how smart home technologies, the built environment and caregiving intersect

© 2018, The Author(s). Smart technologies and the Internet of Things (IoT), have the potential to play a significant role in enabling older people to age in place. Although there has been substantial development of new applications of sensor technology in the home, this has tended to be tele-health focused, and there has been less work done on the role of IoT and ageing in place that more broadly considers caregiving and the built environment. Research in the field of IoT development and evaluation has recognised a number of challenges and limitations associated with past smart technology developments to support Ageing in Place, calling for user centeredness and better integration with broader systems. Compounding this, research into Ageing in Place and home environments has focused on built environments and largely ignored the impact of technology in the lives of older people staying at home. Recognising a gap in acknowledging the potential impact of technology on Ageing in Place theories, the purpose of this paper is to conceptualise a way of framing smart technology within an Ageing in Place model that acknowledges the interaction of smart technology with the built environment and caregiving and to present a framework for visualising the interactions that take place. A review of Environmental Gerontology model development is undertaken and a new model is presented that recognises the role of technology in Ageing in Place. Based on this model, a template is developed and three case studies of older people’s experiences of smart home technology, home modifications and caregiving are mapped out. These are used to demonstrate “proof of concept” of the relationships put forward in the HAST model and the pre-curser for a template to help people map smart technology and its role in supporting caregiving and ageing in place. This paper’s position is that technologies such as IoT further support the role of the built environment and caregiving to produce outcomes that enable older people to remain autonomous, independent, safe and well at home. However, a number of risks were also identified through the case studies, the issues of maintenance, cost and ease of use, and willingness to use are considerations and potential barriers to the benefits of smart technology

Individualized Apartment Accommodation for People With Intellectual Disability: Protocol for a Qualitative Study Examining the Well-Being and Support Outcomes Linking Housing and Health.

BACKGROUND:Understanding the outcomes associated with both receiving and providing support to people with intellectual disability in specific settings can facilitate the alignment of health providers, community care providers, architects, and urban planners to strengthen levels of autonomy and community participation of people with intellectual disability living in the community. This study explores the impact of providing support (available 24 hours a day) for people with intellectual disability in a high-density apartment. It seeks the perspectives of people with intellectual disability who have moved into an apartment from a group home (where 4-6 people with disability live), their families, and support staff. It will enable comparison between two models of supported accommodation, group homes and individualized apartments, in a community setting. OBJECTIVE:The aims of this study are to explore the impact of an individualized apartment model of supported accommodation in a high-density setting on the well-being, autonomy, and participation of people with intellectual disability living and receiving support; the experience of providing care or support; and how this setting impacts the logistics of how quality support is provided. METHODS:Qualitative research methods were employed as the primary means of collecting and analyzing data. There are two main sources of data in this study: (1) semistructured interviews with participants in up to 3 waves (pre, post 1, and post 2) and (2) pre- and postoccupancy evaluation data on the design, layout, and location details of the built environments. Coded interview data will be paired with pre- and postoccupancy evaluations of the two accommodation settings. RESULTS:As of May 2020, we have recruited 55 participants. There have been 96 interviews conducted in 2 waves with people who have moved into supported accommodation, families, and staff. Collected data are currently being analyzed. We expect the results of the trial to be published in a peer-reviewed journal in late 2020. CONCLUSIONS:This paper sets out a study of an alternative housing and support model for people with intellectual disability. It will capture personal experiences of people with intellectual disability receiving support in an apartment compared to their experiences in a group home. It will also capture the experiences of support staff working in the new setting and reveal how this differs from a group home setting. The inclusion of pre (group home) and post (apartment integrated into a community setting) measures addresses evaluative and comparative questions around the nature and impacts of the small-scale apartment and support model for both those who live and receive support, and those who support them. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/18248

Housing design and community care: How home modifications reduce care needs of older people and people with disability

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. The extent to which housing design can minimise levels of community caregiving has remained largely unmeasured. This paper reports the potential for home modifications to reduce caregiving in the peoples’ homes, particularly older people and people with a disability. It contributes to new knowledge in understanding how housing can play a role in community caregiving and acknowledges the role of the built environment in managing care levels in ageing societies. This paper analyses self-reported care data from 157 Australian community care recipients (average age: 72 years) who had received home modifications within the past 6 months. A before/after comparison of care provided revealed that home modifications reduced hours of care provided by 42% per week. More detailed analysis revealed that the positive association of home modifications with care reduction is stronger with informal care (46% reduction) followed by formal care (16% reduction). These results suggest the role that home modifications, and housing design in general, play in reducing care needs in a community setting

Outcomes Associated with Providing Secure, Stable, and Permanent Housing for People Who Have Been Homeless: An International Scoping Review

As governments and service agencies across the world grapple with chronic rates of homelessness and housing instability, there is a growing need to understand the value that providing secure, stable housing brings to the lives of people who are homeless and the broader community. The complex nature of homelessness is revealed across a variety of academic fields including planning, pharmacology, urban affairs, housing policy, nutrition, psychiatry, sociology, public health, urban health, and criminology. We undertook a scoping review according to PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-analysis) that mapped the breadth and scale of the evidence-base and identified themes and gaps. We identified 476 reports and after excluding duplicates and ones that did not relate to our criteria, were left with 100 studies from eight countries. Each of them identified benefits and/or changes that occurred when people experiencing homelessness or housing insecurity transitioned into a secure, stable home. Outcomes measured were distributed across a range of domains including physical and mental health, well-being, mortality rates, criminal justice interaction, service use, and cost-effectiveness. Findings varied by degree but overwhelmingly found improvements in all domains once people were permanently housed. Housing provided a foundation for people to envisage a better life and make plans for the future. As one woman who had fled a violent home was quoted as saying: “housing made everything else possible.” The research identified savings for taxpayers and the wider community once people left homelessness for the stability of a permanent home, even after factoring in the cost of housing and rental help. We found numerous gaps. For example, there was a prevalence of studies that focused on those who are visibly homeless, in particular chronically homeless men with mental illness and/or substance use issues. Much less research looked at women whose patterns of homelessness are more varied and even less at homelessness involving children and families. Women who had left domestic and family violence were investigated in a very small number of studies and sample sizes were small. Few reports undertook the complex task of quantifying and comparing cost savings. Other notable gaps were older women, older people more generally, refugees, recent migrants, veterans, Indigenous people and those with a disability

Therapy-induced antitumor vaccination in neuroblastomas by the combined targeting of IL-2 and TNF alpha

L19-IL2 and L19TNF are fusion proteins composed of L19(scFv), specific for the angiogenesis-associated ED-B containing fibronectin isoform and IL-2 or TNF. Because of the tumor targeting properties of L19, IL-2 and TNF concentrate at therapeutic doses at the tumor vascular level. To evaluate the therapeutic effects of L19-IL2 and L19mTNF in neuroblastoma (NB)-bearing mice, A/J mice bearing Neuro2A or NIE115 NB were systemically treated with L19-IL2 and L19mTNF, alone or in combination protocols. Seventy percent of Neuro2A- and 30% of NIE115-bearing mice were cured by the combined treatment with L19-IL2 and L19mTNF, and further rejected a homologous tumor challenge, indicating specific antitumor immune memory. The immunological bases of tumor cure and rejection were studied. A highly efficient priming of CD4+ T helper cells and CD8+ CTL effectors was generated, paralleled by massive infiltration in the tumor tissue of CD4+ and CD8+ T cells at day 16 after tumor cell implantation, when, after therapy, tumor volume was drastically reduced and tumor necrosis reached about 80%. The curative treatment resulted in a long-lasting antitumor immune memory, accompanied by a mixed Th1/Th2 type of response. Concluding, L19-IL2 and L19mTNF efficiently cooperate in determining a high percentage of NB cure that, in our experimental models, is strongly associated to the generation of adaptive immunity involving CD4+ and CD8+ T cells

Prevalence of intellectual disability in New South Wales, Australia: a multi-year cross-sectional dataset by Local Government Area (LGA)

© 2020 The Author(s) The presented dataset relates to a research project titled “My Home My Community” undertaken at University of Technology Sydney (UTS) which has been funded by the National Disability Insurance Agency (NDIA) Australia. The dataset reports estimated prevalence rates of Intellectual Disability in NSW by local government area (LGA) from 2010 – 2015. The dataset is a re-examination of a cohort of 92, 542 people with intellectual disability from a larger linked research dataset built by the Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW. The dataset in this paper is presented in a multi-year cross-sectional format. The cohort of people with Intellectual Disability was analysed to estimate, quantify and visualise where people with intellectual disability live in New South Wales (NSW). The cohort analysed in this dataset had been generated in an earlier project undertaken by the UNSW-based authors. This dataset was generated to share with local governments in Australia and has the potential to be more widely used in a range of health policy and planning research, and city and regional planning research environments. It represents one of the only datasets currently available in Australia on Intellectual Disability describing prevalence rates at a local government area level. This dataset allows for population comparisons in other Australian states and internationally and can be examined in combination with other social and economic datasets to continue to build evidence about disability, planning and geography

L19-IL2 immunocytokine in combination with the anti-syndecan-1 46F2SIP antibody format: A new targeted treatment approach in an ovarian carcinoma model

Epithelial ovarian cancer (EOC) is the fifth most common cancer affecting the female population. At present, different targeted treatment approaches may improve currently employed therapies leading either to the delay of tumor recurrence or to disease stabilization. In this study we show that syndecan-1 (SDC1) and tumor angiogenic-associated B-fibronectin isoform (B-FN) are involved in EOC progression and we describe the prominent role of SDC1 in the vasculogenic mimicry (VM) process. We also investigate a possible employment of L19-IL2, an immunocytokine specific for B-FN, and anti-SDC1 46F2SIP (small immuno protein) antibody in combination therapy in a human ovarian carcinoma model. A tumor growth reduction of 78% was obtained in the 46F2SIP/L19-IL2-treated group compared to the control group. We observed that combined treatment was effective in modulation of epithelial-mesenchymal transition (EMT) markers, loss of stemness properties of tumor cells, and in alleviating hypoxia. These effects correlated with reduction of VM structures in tumors from treated mice. Interestingly, the improved pericyte coverage in vascular structures suggested that combined therapy could be efficacious in induction of vessel normalization. These data could pave the way for a possible use of L19-IL2 combined with 46F2SIP antibody as a novel therapeutic strategy in EOC