Chapter 1 Introduction

Digital technologies shape our embodied lives and affect our knowledge of the self and the world. The introductory chapter of the book presents the state of the art in the research on digitalisation of health and social care work, with a focus on care for older people. In ageing societies, understanding what it takes to introduce and use digital technologies can pave the way to a successful, sustainable, and equally accessible system of social care and healthcare provision for older people. The chapter discusses some of the limitations in the present discussion and how the book at hand aims to address these gaps. The chapter proposes that living in an increasingly digitalised world requires digital agency, that is the individual’s ability to control and adapt to their surroundings, and to critically address technological determinism in the everyday life. The chapter ends with an overview of the book’s subsequent chapters that demonstrate different aspects to service users’ and care workers’ digital agency based on recent studies of digital technologies in care for older people

An “ultimate partnership”:Older persons’ perspectives on age-stereotypes and intergenerational interaction in co-designing digital technologies

AimThere is often a gap between the ideal of involving older persons iteratively throughout the design process of digital technology, and actual practice. Until now, the lens of ageism has not been applied to address this gap. The goals of this study were: to voice the perspectives and experiences of older persons who participated in co-designing regarding the design process; their perceived role in co-designing and intergenerational interaction with the designers; and apparent manifestations of ageism that potentially influence the design of digital technology.MethodsTwenty-one older persons participated in three focus groups. Five themes were identified using thematic analysis which combined a critical ageism ‘lens’ deductive approach and an inductive approach.ResultsAgeism was experienced by participants in their daily lives and interactions with the designers during the design process. Negative images of ageing were pointed out as a potential influencing factor on design decisions. Nevertheless, positive experiences of inclusive design pointed out the importance of “partnership” in the design process. Participants defined the “ultimate partnership” in co-designing as processes in which they were involved from the beginning, iteratively, in a participatory approach. Such processes were perceived as leading to successful design outcomes, which they would like to use, and reduced intergenerational tension.ConclusionsThis study highlights the potential role of ageism as a detrimental factor in how digital technologies are designed. Viewing older persons as partners in co-designing and aspiring to more inclusive design processes may promote designing technologies that are needed, wanted and used

Chapter 1 Introduction

Digital technologies shape our embodied lives and affect our knowledge of the self and the world. The introductory chapter of the book presents the state of the art in the research on digitalisation of health and social care work, with a focus on care for older people. In ageing societies, understanding what it takes to introduce and use digital technologies can pave the way to a successful, sustainable, and equally accessible system of social care and healthcare provision for older people. The chapter discusses some of the limitations in the present discussion and how the book at hand aims to address these gaps. The chapter proposes that living in an increasingly digitalised world requires digital agency, that is the individual’s ability to control and adapt to their surroundings, and to critically address technological determinism in the everyday life. The chapter ends with an overview of the book’s subsequent chapters that demonstrate different aspects to service users’ and care workers’ digital agency based on recent studies of digital technologies in care for older people

Wearables measuring electrodermal activity to assess perceived stress in care:A scoping review

Background:Chronic stress responses can lead to physical and behavioural health problems, often experienced and observed in the care of people with intellectual disabilities or people with dementia. Electrodermal activity (EDA) is a bio-signal for stress, which can be measured by wearables and thereby support stress management. However, the how, when and to what extent patients and healthcare providers can benefit is unclear. This study aims to create an overview of available wearables enabling the detection of perceived stress by using EDA.Methods:Following the PRISMA-SCR protocol for scoping reviews, four databases were included in the search of peer-reviewed studies published between 2012 and 2022, reporting detection of EDA in relation to self-reported stress or stress-related behaviours. Type of wearable, bodily location, research population, context, stressor type and the reported relationship between EDA and perceived stress were extracted.Results:Of the 74 included studies, the majority included healthy subjects in laboratory situations. Field studies and studies using machine learning (ML) to predict stress have increased in the last years. EDA is most often measured on the wrist, with offline data processing. Studies predicting perceived stress or stress-related behaviour using EDA features, reported accuracies between 42% and 100% with an average of 82.6%. Of these studies, the majority used ML.Conclusion:Wearable EDA sensors are promising in detecting perceived stress. Field studies with relevant populations in a health or care context are lacking. Future studies should focus on the application of EDA-measuring wearables in real-life situations to support stress management

Dietary restraint and control over "wanting" following consumption of "forbidden" food.

Eating behavior can be influenced by the rewarding value of food, i.e., "liking" and "wanting." The objective of this study was to assess in normal-weight dietary restrained (NR) vs. unrestrained (NU) eaters how rewarding value of food is affected by satiety, and by eating a nonhealthy perceived, dessert-specific food vs. a healthy perceived, neutral food (chocolate mousse vs. cottage cheese). Subjects (24NR age = 25.0 +/- 8.2 years, BMI = 22.3 +/- 2.1 kg/m(2); 26NU age = 24.8 +/- 8.0 years, BMI = 22.1 +/- 1.7 kg/m(2)) came to the university twice, fasted (randomized crossover design). Per test-session "liking" and "wanting" for 72 items divided in six categories (bread, filling, drinks, dessert, sweets, stationery (placebo)) was measured, before and after consumption of chocolate mousse/cottage cheese, matched for energy content (5.6 kJ/g) and individual daily energy requirements (10%). Chocolate mousse was liked more than cottage cheese (P < 0.05). After consumption of chocolate mousse or cottage cheese, appetite and "liking" vs. placebo were decreased in NR and NU (P < 0.03), whereas "wanting" was only decreased in NR vs. NU (P </= 0.01). In NR vs. NU "wanting" was specifically decreased after chocolate mousse vs. cottage cheese; this decrease concerned especially "wanting" for bread and filling (P < 0.05). To conclude, despite similar decreases in appetite and "liking" after a meal in NR and NU, NR decrease "wanting" in contrast to NU. NR decrease "wanting" specifically for a nonhealthy perceived, "delicious," dessert-specific food vs. a nutritional identical, yet healthy perceived, slightly less "delicious," "neutral" food. A healthy perceived food may thus impose greater risk for control of energy intake in NR

Gebruik van de RAND-36 bij zelfstandig wonende ouderen kan leiden tot een onderschatting van de ervaren gezondheidstoestand

De algemene gezondheidstoestand van de bevolking wordt veelal gemeten met de RAND-36 item Health Survey. De afkorting RAND verwijst naar de Amerikaanse onderzoeksorganisatie voor ‘Research and Development’ die de vragenlijst ontwikkelde. In 2012 is door Fontys en partners een longitudinaal veldonderzoek gestart met als doelstelling het in kaart brengen van factoren die van invloed zijn op het gebruik van technologie ter bevordering van het zelfstandig wonen door ouderen. In totaal worden 50 deelnemers van 70 jaar of ouder, vier jaar lang elke acht maanden geïnterviewd. Tevens worden er enkele vragenlijsten afgenomen waaronder twee vragen uit de RAND- 36 waarvan een item luidt: ‘Ik ben net zo gezond als andere mensen die ik ken’. Tijdens dit onderzoek is gebleken dat sommige deelnemers die zichzelf gezonder vinden dan andere mensen die zij kennen, de stelling ontkennend beantwoorden maar daarmee onbedoeld een antwoordcategorie invullen die zich vertaalt in een lagere score voor de ervaren gezondheidstoestand. Het op deze manier invullen van dit item kan daardoor leiden tot een onderschatting van de algemene gezondheidstoestand van ouderen

DNA Methylation Signatures Identify Biologically Distinct Subtypes in Acute Myeloid Leukemia

Abstract: We hypothesized that DNA methylation distributes into specific patterns in cancer cells, which reflect critical biological differences. We therefore examined the methylation profiles of 344 patients with acute myeloid leukemia (AML). Clustering of these patients by methylation data segregated patients into 16 groups. Five of these groups defined new AML subtypes that shared no other known feature. In addition, DNA methylation profiles segregated patients with CEBPA aberrations from other subtypes of leukemia, defined four epigenetically distinct forms of AML with NPM1 mutations, and showed that established AML1-ETO, CBFb-MYH11, and PML-RARA leukemia entities are associated with specific methylation profiles. We report a 15 gene methylation classifier predictive of overall survival in an independent patient cohort (p < 0.001, adjusted for known covariates)

Outcomes After Major Surgical Procedures in Octogenarians:A Nationwide Cohort Study

Introduction: Aging of the worldwide population has been observed, and postoperative outcomes could be worse in elderly patients. This nationwide study assessed trends in number of surgical resections in octogenarians regarding various major surgical procedures and associated postoperative outcomes. Methods: All patients who underwent surgery between 2014 and 2018 were included from Dutch nationwide quality registries regarding esophageal, stomach, pancreas, colorectal liver metastases, colorectal cancer, lung cancer and abdominal aortic aneurysms (AAA). For each quality registry, the number of patients who were 80 years or older (octogenarians) was calculated per year. Postoperative outcomes were length of stay (LOS), 30 day major morbidity and 30 day mortality between octogenarians and younger patients. Results: No increase in absolute number and proportion of octogenarians that underwent surgery was observed. Median LOS was higher in octogenarians who underwent surgery for colorectal cancer, colorectal liver metastases, lung cancer, pancreatic disease and esophageal cancer. 30 day major morbidity was higher in octogenarians who underwent surgery for colon cancer, esophageal cancer and elective AAA-repair. 30 day mortality was higher in octogenarians who underwent surgery for colorectal cancer, lung cancer, stomach cancer, pancreatic disease, esophageal cancer and elective AAA-repair. Median LOS decreased between 2014 and 2018 in octogenarians who underwent surgery for stomach cancer and colorectal cancer. 30 day major morbidity decreased between 2014 and 2018 in octogenarians who underwent surgery for colon cancer. No trends were observed in octogenarians regarding 30 day mortality between 2014 and 2018. Conclusion: No increase over time in absolute number and proportion of octogenarians that underwent major surgery was observed in the Netherlands. Postoperative outcomes were worse in octogenarians