BackgroundIn Europe, the population of older people is increasing rapidly. Many older people prefer to remain in their homes but living alone could be a risk for their safety. In this context, robotics and other emerging technologies are increasingly proposed as potential solutions to this societal concern. However, one-third of all assistive technologies are abandoned within one year of use because the end users do not accept them.ObjectiveThe aim of this study is to investigate the acceptance of the Robot-Era system, which provides robotic services to permit older people to remain in their homes.MethodsSix robotic services were tested by 35 older users. The experiments were conducted in three different environments: private home, condominium, and outdoor sites. The appearance questionnaire was developed to collect the users’ first impressions about the Robot-Era system, whereas the acceptance was evaluated through a questionnaire developed ad hoc for Robot-Era.ResultsA total of 45 older users were recruited. The people were grouped in two samples of 35 participants, according to their availability. Participants had a positive impression of Robot-Era robots, as reflected by the mean score of 73.04 (SD 11.80) for DORO’s (domestic robot) appearance, 76.85 (SD 12.01) for CORO (condominium robot), and 75.93 (SD 11.67) for ORO (outdoor robot). Men gave ORO’s appearance an overall score higher than women (P=.02). Moreover, participants younger than 75 years understood more readily the functionalities of Robot-Era robots compared to older people (P=.007 for DORO, P=.001 for CORO, and P=.046 for ORO). For the ad hoc questionnaire, the mean overall score was higher than 80 out of 100 points for all Robot-Era services. Older persons with a high educational level gave Robot-Era services a higher score than those with a low level of education (shopping: P=.04; garbage: P=.047; reminding: P=.04; indoor walking support: P=.006; outdoor walking support: P=.03). A higher score was given by male older adults for shopping (P=.02), indoor walking support (P=.02), and outdoor walking support (P=.03).ConclusionsBased on the feedback given by the end users, the Robot-Era system has the potential to be developed as a socially acceptable and believable provider of robotic services to facilitate older people to live independently in their homes.

This training has potential for wider application in education and practice in Europe.

BackgroundObesity is a complex multifactorial disease, which also has an impact on quality of life. The aim of this paper is to identify the correlates of perceived health related quality of life in obese, overweight and normal weight Italians older adults.Methods205 subjects at the age ≥ 60 yrs. were recruited into the Division of Endocrinology of the Polytechnic University of Marche Region, Ancona (Italy). A protocol of questionnaires was constructed for data collection, and included domains such as physical activity, quality of life, socio-psychological aspects. The association of the latter variables with SF-36 Health Survey physical component (PCS-36) were evaluated in the whole sample. Multiple linear regression models were used to assess the effect of independent variables on PCS-36 and the physical subscales of SF-36.ResultsPCS-36 showed a lower score in the obese and overweight subjects than the normal weight group (post-hoc test, p < 0.001 and p < 0.05 respectively). Age, gender (male), Body Mass Index, years of education, Physical Activity Scale for the Elderly (PASE) total score, Hospital Anxiety and Depression Scale anxiety, Hospital Anxiety and Depression Scale depression, number of medications prescribed and number of diseases were included in the model. Negative and significant PCS-associated variables included depression (p = 0.009), BMI (p = 0.001), age in years (p = 0.007), whereas positive and significant PCS-associated independent variables were years of education (p = 0.022), physical activity (p = 0.026). BMI was negatively associated with all the physical subscales of SF-36 (p < 0.05).ConclusionsResearch funding should be invested in the study of the benefits accruing from reducing obesity in the elderly.

Purposeto investigate the added value of qualitative and quantitative evaluation of diffusion weighted (DW) magnetic resonance (MR) imaging in response assessment after neoadjuvant chemo-radiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).Methods31 patients with LARC (stage ≥ T3) were enrolled in the study. All patients underwent conventional MRI and DWI before starting therapy and after neoadjuvant CRT. All patients underwent surgery; pathologic staging represented the reference standard. For qualitative analysis, two radiologists retrospectively reviewed conventional MR images and the combined set of conventional and DW MR images and recorded their confidence level with respect to complete response (ypCR). For quantitative analysis, tumor’s apparent diffusion coefficient (ADC) values were measured at each examination. ADC pre-CRT, ADC post-CRT and Δ ADC post−ADC pre of the three groups of response (ypCR, partial response ypPR, stable disease ypSD) were compared. Receiver-operating characteristics (ROC) curve analysis was employed to investigate the discriminatory capability for ypCR, responders (ypCR, ypPR) and ypSD of each measure.Resultsaddition of DWI to conventional T2-weighted sequences improved diagnostic performance of MRI in the evaluation of ypCR. A low tumor ADC value in the pre-CRT examination, a high ADC value in the post-CRT examination, a high Δ ADC post−ADC pre [>0.3 (×10−3 mm2/s)] were predictive of ypCR.ConclusionsDW sequences improve MR capability to evaluate tumor response to CRT. Nevertheless, no functional MR technique alone seems accurate enough to safely select patients with ypCR.

Objective: the objective of this review is to analyze the advances in the field of rehabilitation through virtual reality, while taking into account non-immersive systems, as evidence have them shown to be highly accepted by older people, due to the lowest “cibersikness” symptomatology. Data sources: a systematic review of the literature was conducted in June 2019. The data were collected from Cochrane, Embase, Scopus, and PubMed databases, analyzing manuscripts and articles of the last 10 years. Study selection: we only included randomized controlled trials written in English aimed to study the use of the virtual reality in rehabilitation. We selected 10 studies, which were characterized by clinical heterogeneity. Data extraction: quality evaluation was performed based on the Physioterapy Evidence Database (PEDro) scale, suggested for evidence based review of stroke rehabilitation. Of 10 studies considered, eight were randomized controlled trials and the PEDro score ranged from four to a maximum of nine. Data synthesis: VR (Virtual Reality) creates artificial environments with the possibility of a patient interaction. This kind of experience leads to the development of cognitive and motor abilities, which usually positively affect the emotional state of the patient, increasing collaboration and compliance. Some recent studies have suggested that rehabilitation treatment interventions might be useful and effective in treating motor and cognitive symptoms in different neurological disorders, including traumatic brain injury, multiple sclerosis, and progressive supranuclear palsy. Conclusions: as it is shown by the numerous studies in the field, the application of VR has a positive impact on the rehabilitation of the most predominant geriatric syndromes. The level of realism of the virtual stimuli seems to have a crucial role in the training of cognitive abilities. Future research needs to improve study design by including larger samples, longitudinal designs, long term follow-ups, and different outcome measures, including functional and quality of life indexes, to better evaluate the clinical impact of this promising technology in healthy old subjects and in neurological patients.

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Skills, knowledge, and awareness of digital and technological tools are essential to improve the state of well-being and health of older adults and also to mitigate the condition of social isolation in the aging process. For this reason, it is necessary to implement a social learning of electronic/digital tools for health of older people to support the achievement of eHealth and digital competences. The paper reports the results of an Italian innovative eHealth training for the European project ACCESS. The training has been based on blended didactical and interactive educational techniques, aimed at collecting as many points of view as possible from older adults. A total of 58 older adults were recruited to attend a four-week training program, which included five modules. The results showed a statistical significant difference between the eHealth Literacy Scale (eHEALS) mean value before and after the course. A significant negative correlation was found between eHEALS and positive/total Survey of Technology Use (SOTU), suggesting an inverse relationship between positive/total SOTU and eHEALS. There is a strong positive and statistically significant relationship between satisfaction with the training and eHEALS. The results indicate that the intervention increased the digital competences of participants connected to health.

Background: Despite the evidence on the positive role of self-management, the adoption of health coaching strategies for older people is still limited. To address these gaps, recent efforts have been made in the ICT sector in order to develop systems for delivering coaching and overcoming barriers relating to scarcity of resources. The aim of this review is to examine the efficacy of personal health coaching systems for older adults using digital virtual agents. Methods: A systematic review of the literature was conducted in December 2019 analyzing manuscripts from four databases over the last 10 years. Nine papers were included. Results: Despite the low number of studies, there was evidence that technology-integrated interventions can deliver benefits for health over usual care. However, the review raises important questions about how to maintain benefits and permanence of behavior change produced by short-term interventions. Conclusion: These systems offer a potential tool to reduce costs, minimize therapist burden and training, and expand the range of clients who can benefit from them. It is desirable that in the future the number of studies will grow, considering other aspects such as the role of the virtual coaches’ characteristics, social-presence, empathy, usability, and health literacy.