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It is estimated that up to 60% of people living with dementia go missing at least once during the course of their disease. Databases on missing incidents involving people living with dementia are managed in silos with minimal or incomplete data. A national strategy for the collection of data on missing incidents of people living with dementia would optimize time and resources spent on police and search and rescue and enhance chances of saving lives of those who go missing. Such a strategy would be a first step toward developing strategies to prevent future missing person incidents among this population. The objectives of this manuscript are to: (1) describe the issues and challenges related to the lack of integrated data on people living with dementia at risk of going missing, and (2) propose directions to create a national database.

Background Although information and communication technologies (ICT) are becoming more common among health care providers, there is little evidence on how ICT can support health care aides. Health care aides, also known as personal care workers, are unlicensed service providers who encompass the second largest workforce, next to nurses, that provide care to older adults in Canada. Objective The purpose of this literature review is to examine the range and extent of barriers and benefits of ICT used by health care workers to manage and coordinate the care-delivery workflow for their clients. Methods We conducted a literature review to examine the range and extent of ICT used by health care aides to manage and coordinate their care delivery, workflow, and activities. We identified 8,958 studies of which 40 were included for descriptive analyses. Results We distinguished the following five different purposes for the use and implementation of ICT by health care aides: (1) improve everyday work, (2) access electronic health records for home care, (3) facilitate client assessment and care planning, (4) enhance communication, and (5) provide care remotely. We identified 128 barriers and 130 benefits related to adopting ICT. Most of the barriers referred to incomplete hardware and software features, time-consuming ICT adoption, heavy or increased workloads, perceived lack of usefulness of ICT, cost or budget restrictions, security and privacy concerns, and lack of integration with technologies. The benefits for health care aides' adoption of ICT were improvements in communication, support to workflows and processes, improvements in resource planning and health care aides' services, and improvements in access to information and documentation. Conclusion Health care aides are an essential part of the health care system. They provide one-on-one care to their clients in everyday tasks. Despite the scarce information related to health care aides, we identified many benefits of ICT adoption.

A growing number of Canadians live with dementia. Strategies to reduce the risks of getting lost include physical barriers, restraints and medications. However, these strategies can restrict one’s participation in meaningful activities and reduce quality of life. Locator devices can be used to manage safety risks while also supporting engagement and independence among persons living with dementia. As more locator devices become available on the market, adoption rates would be affected by certain factors. There is no clear, standardized approach to identify the factors that have an influence on the acceptance and usability of locator devices for persons with dementia and their care partners. This project aimed to identify factors related to acceptance and usability of locator devices that are important to individuals with dementia, their care partners, service providers and technology developers. Qualitative description and conventional content analysis guided our approach. We conducted 5 focus groups with 21 participants. Trustworthiness strategies included multiple data sources, data verification for accuracy and peer debrief. Five overarching factors emerged as critical aspects in the acceptance and usability of locator devices. These factors were inclusivity, simplicity, features, physical properties and ethics. Participants thought that locator devices do not adequately consider privacy and stigma. Therefore, the acceptance and usability of locator devices could be enhanced if privacy and stigma are addressed. The factors identified will inform the creation of an acceptance and usability scale for locator devices used by persons living with dementia, their care partners and service providers.

The number of older adults with dementia and related cognitive impairments continues to rise worldwide. Decline in certain cognitive skills, memory, and attention in this population is associated with deterioration in functioning in daily activities and a reduced quality of life. Engagement in cognitively stimulating activities can help prevent cognitive decline in older adults [1]. Research suggests that regularly playing mobile games could improve several cognitive functions that naturally deteriorate with age and even more with dementia. If mobile games are easy-to-use and engaging enough, they may be a valid intervention and assessment tool for cognitive functioning in older adults with cognitive impairment or dementia [2]–[4]. The level of engagement may influence the therapeutic effect of mobile game interventions [5]. Engagement is the degree of absorption, immersion, and involvement in a task. The theoretical foundation of engagement lies in Flow Theory [6]. Flow has been described as a subjective state that people report when they are completely involved in something to the point of forgetting time, fatigue, and everything else but the activity itself [6]. The literature shows that engagement is mainly recognized through analyzing participants' bio-signals, principally in young people [7]–[8]. The development of methods to recognize engagement in older adults is needed. The aim of this study was to investigate the factors that influence engagement in older adults who play mobile games.

Background Family caregivers are unpaid individuals who provide care to people with chronic conditions or disabilities. Family caregivers generally do not have formal care-related training. However, they are an essential source of care. Mobile technologies can benefit family caregivers by strengthening communication with care staff and supporting the monitoring of care recipients. Objective We conducted a mixed-method study to evaluate the acceptance and usability of a mobile technology called the Smart Care System. Methods Using convenience sampling, we recruited 27 family caregivers to evaluate the mobile Smart Care System (mSCS). In the quantitative phase, we administered initial and exit questionnaires based on the Unified Theory of Acceptance and Use of Technology. In the qualitative phase, we conducted focus groups to explore family caregivers' perspectives and opinions on the usability of the mSCS. With the quantitative data, we employed univariate, bivariate, and partial least squares analyses, and we used content analysis with the qualitative data. Results We observed a high level of comfort using digital technologies among participants. On average, participants were caregivers for an average of 6.08 years (standard deviation [SD] = 6.63), and their mean age was 56.65 years (SD = 11.62). We observed a high level of technology acceptance among family caregivers (7.69, SD = 2.11). Behavioral intention (β = 0.509, p-value = 0.004) and facilitating conditions (β = 0.310, p-value = 0.049) were statistically significant and related to usage behavior. In terms of qualitative results, participants reported that the mobile application supported care coordination and communication with staff and provided peace of mind to family caregivers. Conclusion The technology showed high technology acceptance and intention to use among family caregivers in a long-term care setting. Facilitating conditions influenced acceptance. Therefore, it would be important to identify and optimize these conditions to ensure technology uptake.

Background Upper extremity function plays a critical role in completing activities of daily living, employment, and participating in recreational activities. The FEPSim device is a medical device for hand and wrist rehabilitation that can be adjusted according to the patient’s requirements in rehabilitation. Furthermore, the FEPSim can be used to assess the patient’s strength and range of motion of the forearm, wrist, and hand. At present, the acceptance and usability of the FEPSim have not been tested in a clinical setting, with limited perspectives from rehabilitation-providing clinicians. Objective This study aims to understand the factors related to the acceptance and usability of the FEPSim device. Upper limb disorders are prevalent across populations. The impact of upper limb disorders, both acute and chronic, puts a significant burden on the Canadian health care system. Methods A qualitative descriptive study was conducted that involved face-to-face semistructured interviews with hand therapists from hand therapy services who used the FEPSim device. We used purposive sampling to recruit 10 participants over a period of 14 months. Semistructured interview questions (topic-guided) examined the technology acceptance and usability of the FEPSim device. Results We found 6 factors to be critical aspects of the acceptance and usability of the FEPSim device. These factors were (1) useful for therapy, (2) effortlessness, (3) environmental conditions, (4) internal encouragement, (5) technological aesthetics, and (6) use. Conclusions The FEPSim device was widely accepted by the therapists. The use of the FEPSim device is a feasible alternative for supporting hand therapy. Trial Registration ISRCTN Registry ISRCTN13656014; https://www.isrctn.com/ISRCTN13656014

BACKGROUND Upper extremity function is critical for daily living across domains; this may include completing activities of daily living, employment, and participating in recreational activities. The FEPSim device is a medical device for hand and wrist rehabilitation which can be adjusted according to the patient’s requirements in rehabilitation. Furthermore, the FEPSim can be used to assess the patient’s strength and range of motion of the forearm, wrist, and hand. At present, the acceptance and usability of the FEPSim have not been tested in a clinical setting, with limited perspectives from rehabilitation-providing clinicians OBJECTIVE To understand the factors related to the acceptance and usability of the FEPSim device. Upper limb disorders are prevalent across populations. The impact of upper limb disorders, both acute and chronic, puts a significant burden on the Canadian healthcare system METHODS A qualitative descriptive study was conducted that involved face-to-face semi-structured interviews with hand therapists from hand therapy services who used the FEPSim device. We used purposive sampling to recruit ten participants over a period of fourteen months. Semi-structured interview questions (topic guided) examined the technology acceptance and usability of the FEPSim device. RESULTS Six factors were found to be critical aspects of the acceptance and usability of the FEPSim device. These factors were useful for therapy, effortlessness, environmental conditions, internal encouragement, technological aesthetics, and use. CONCLUSIONS The FEPSim device was widely accepted by therapists. The use of the FEPSim device is a feasible alternative for supporting hand therapy. CLINICALTRIAL Not applicable

Children with severe motor impairment due to cerebral palsy have difficulties engaging in play, although they want to play games that typically developing children play. The barriers imposed by motor impairments against engaging in play can be addressed through the use of robots. We aim to identify how children, who have extensive experience of play, imagine what a robot is and what features would make a robot good to play with. Using a qualitative description design, 19 children from urban and rural settings participated in focus groups to draw and talk about the robots they would like to exist. The data were coded and analyzed using a summative approach to content analysis. The findings revealed that the children imagined that a good robot to play with is one that has an anthropomorphic appearance, is tough and strong, has controls, and that is able to move, grab, speak, and play popular children’s games. In particular, the girls imagined that robots should be able to express positive emotions towards children. Age, gender, culture, and the physical environment in which the children lived influenced what they expected to find in a robot for playing with and how they imagined child–robot interactions.

Frailty is a prevalent condition among Canadians; over one million are diagnosed as medically frail, and in the next ten years this number will double. Information and telecommunication technologies can provide a low-cost method for managing frailty more proactively. This study aims to examine the range and extent of information and telecommunication technologies for managing frailty in older adults, their technology readiness level, the evidence, and the associated outcomes. A systematic literature review was conducted. Four databases were searched for studies: Medline, EMBASE, CINAHL, and Web of Science. In total, we included 19 studies (out of 9,930) for the data abstraction. Overall, our findings indicate that (1) the proposed frailty phenotype is the most common ground truth to be used for assessing frailty; (2) the most common uses of information and telecommunication technologies for managing frailty are detection, and monitoring and detection, while interventional studies on frailty are very rare; (3) the five main types of information and telecommunication technologies for managing frailty in older adults are information and telecommunication technology-based platforms, smartphones, telemonitoring (home monitoring), wearable sensors and devices (commercial off-the-shelf), and multimedia formats for online access; (4) the technology readiness level of information and telecommunication technologies for managing frailty in older adults is the “Technology Demonstration” level, i.e., not yet ready to be operated in an actual operating environment; and (5) the level of evidence is still low for information and telecommunication technology studies that manage frailty in older adults. In conclusion, information and telecommunication technologies for managing frailty in the older adult population are not yet ready to be full-fledged technologies for this purpose.INGENIERÍA•ISSN impreso: 1794-4953 • ISSN online: 2619-6581 • Vol. 15 (1) • DOI: https://doi.org/10.18041/avances.v15i1 • pp 171-179 (2018), La fragilidad es una condición prevalente entre los canadienses; más de un millón son diagnosticados como médicamente frágiles, y en los próximos diez años esta cifra se duplicará. Las tecnologías de la información y las telecomunicaciones pueden proporcionar un método de bajo coste para gestionar la fragilidad de forma más proactiva. Este estudio tiene como objetivo examinar la gama y el alcance de las tecnologías de la información y las telecomunicaciones para la gestión de la fragilidad en los adultos mayores, su nivel de preparación tecnológica, la evidencia y los resultados asociados. Se realizó una revisión sistemática de la literatura. Se buscaron estudios en cuatro bases de datos: Medline, EMBASE, CINAHL y Web of Science. En total, se incluyeron 19 estudios (de 9.930) para la extracción de datos. En general, nuestros resultados indican que (1) el fenotipo de fragilidad propuesto es la verdad básica más comúnmente utilizada para evaluar la fragilidad; (2) los usos más comunes de las tecnologías de la información y las telecomunicaciones para gestionar la fragilidad son la detección, y la monitorización y detección, mientras que los estudios de intervención sobre la fragilidad son muy raros; (3) los cinco tipos principales de tecnologías de la información y las telecomunicaciones para la gestión de la fragilidad en los adultos mayores son las plataformas basadas en la tecnología de la información y las telecomunicaciones, los teléfonos inteligentes, la telemonitorización (seguimiento en el hogar), los sensores y dispositivos portátiles (comerciales), y los formatos multimedia para el acceso en línea; (4) el nivel de preparación tecnológica de las tecnologías de la información y las telecomunicaciones para la gestión de la fragilidad en los adultos mayores es el nivel de "Demostración de Tecnología", es decir. e., (5) el nivel de evidencia es todavía bajo para los estudios de las tecnologías de la información y las telecomunicaciones que gestionan la fragilidad en los adultos mayores. En conclusión, las tecnologías de la información y las telecomunicaciones para gestionar la fragilidad en la población de adultos mayores aún no están listas para ser tecnologías de pleno derecho para este fin.INGENIERÍA-ISSN impreso: 1794-4953 - ISSN online: 2619-6581 - Vol. 15 (1) - DOI: https://doi.org/10.18041/avances.v15i1 - pp 171-179 (2018), 1Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada. 2Glenrose Rehabilitation Research, Innovation & Technology (GRRIT) Hub, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada. 3Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada. 4School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia, [Received September 27, 2020; Revised November 14, 2020; Accepted November 15, 2020]

The global pandemic expedited the adoption of AgeTech solutions that aim to help older adults maintain their autonomy and independence. This article examines the negative impact of the Western worldview of autonomy and independence on older adults. Negative impact can manifest as ageism and may be compounded by intersections of identities with race, gender, and culture. We propose an inclusive framework for health leaders, one that is not binary or categorical, but instead, on a continuum: (1) relational autonomy which assumes that relationships form one’s identity; therefore, no one is autonomous to the exclusion of others, and (2) interdependence which proposes that one’s lifestyle choice is supported by interreliance with aspects of one’s environment. We examine two examples of AgeTech from the perspective of relational autonomy and interdependence and discuss how health leaders can use this inclusive framework to ensure that their services do not discriminate against older adults.

BACKGROUND: Evidence for the adoption and acceptance of assistive devices for ladder lifting tasks by workers is scarce. OBJECTIVE: This study aims to investigate the technology acceptance and usability of a powered and automated cargo management system (RazerLift®) used by workers who need to lift ladders as part of their daily duties, as compared to mechanical cargo management systems (traditional). METHODS: We used a one-way repeated measures design in this study. Our primary outcome variable was a usability performance measurement measured as time (in seconds) for unloading and loading ladders using both systems. Our secondary outcome was technology acceptance, measured using questionnaires with a 5-point Likert scale: “strongly disagree (1)” to “strongly agree (5)”. RESULTS: The participants conducted the combined unloading and loading time using the powered and automated system (RazerLift®) 20.85 seconds faster than the traditional system (p-value = 0.000, t-value (df) = –5.730 (6), d = 2.713). Overall, the RazerLift® system (mean = 44.28, SD 5.58) had a higher technology acceptance compared to the traditional system (mean = 30.00, SD 7.91), (p = 0.041, t-value (df) = 6.589 (6), d = 4.60). CONCLUSIONS: The RazerLift® was more time efficient compared with the traditional system, and (2) the RazerLift® was superior in terms of technology acceptance compared to the traditional system.

In this study, we propose the use of electroencephalography (EEG), electrooculography (EOG), and kinematic motion data captured through wearable sensors to classify emotional states, while individuals are playing a serious computer game (Whack-a-Mole). Twenty-one participants wore an OpenBCI headset and JINS MEME eyewear while playing the Whack-a-Mole game at three levels of difficulty. We used a variety of classifiers [i.e., a support vector machine (SVM), logistic regression (LR), random forest (RF), and ensemble classifier (EC)] to classify the participants’ emotional states based on their EEG, EOG, and kinematic motion data. The classifiers were trained using the International Affective Picture System (IAPS). The EC and RF showed the best results in terms of their overall performance. Using tenfold cross-validation for all the subjects, the accuracies obtained were 73% for Arousal and 80% for Valence. Our results suggest that EEG and EOG biosignals, as well as kinematic motion data acquired using off-the-shelf wearable sensors in combination with machine-learning techniques such as EC, can be used to classify emotional states, while the individuals were playing the Whack-a-Mole game.

This article presents an overview of the effects of the COVID-19 pandemic on the adoption and diffusion of technologies including within healthcare. Consumer technologies have been rapidly applied to mitigate negative health impacts such as social isolation, or to monitor the health and function of family members separated by quarantine. As the lines between consumer technologies and professional health technologies blur, there is an opportunity to examine the outcomes of accessible and familiar technologies used by consumers. The rapid diffusion of technology uptake challenges traditional frameworks that describe technology acceptance and adoption. There is an opportunity to understand the impact of experience of use and involuntariness on technology diffusion. Beyond the onset of the pandemic, the management of post-COVID syndrome, which some see as the next public health crisis, is an opportunity to accelerate the diffusion of home monitoring technologies already benefiting people living with other chronic health conditions.

Purpose We aimed to identify evidence supporting emergency vehicle technology in out-of-vehicle systems and in-vehicle-systems that can be used by people with hearing impairment. Methods We conducted a systematized review to determine what technologies, at any readiness level, are currently being developed in the area of emergency vehicle detection technology. The studies and websites of technologies for emergency vehicles that are currently available to the general public were identified by searching in one electronic database, Scopus and grey literature using Google, respectively. Results A total of 359 studies were retrieved from Scopus. The grey literature search identified 189 websites related to the search terms under study. Technological devices have included satellite, out-of-vehicle and in-vehicle technology. The analysis shows that most of the technologies are at the stage of laboratory testing. Knowing the availability and the level of readiness of devices, as well as their effectiveness, provides rehabilitation professionals with tools for making evidence-based recommendations to clients with hearing impairment. Knowing which devices are available also provides information to individuals living with hearing impairment so that they can play an active role in the decision-making process of acquiring the existing technologies. Conclusions So far, few technologies have been identified, and most of them are in the laboratory development stage (i.e., low product readiness level). These results indicate a justified need for the development of new in-vehicle technologies to detect emergency vehicles and actions to transform the new devices into products that are available for people with hearing impairment. IMPLICATIONS FOR REHABILITATION There is a need to design new assistive technology devices that are intended to detect emergency service vehicles, which in turn may reduce stress and anxiety related to driving for people with hearing impairment. The majority of the included articles discussed siren detection, with only three discussing the necessary next step of communication to humans. Due to the research being in its early stages, the evidence for emergency vehicle technology on health and participation-related outcomes in people living with hearing impairment is unknown. Most websites do not include information on where to purchase emergency vehicle technology or how much the devices cost, thus making it difficult for people with hearing impairment or rehabilitation professionals to make informed decisions about acquiring these technologies.

To review the rating scales used to evaluate usability and quality of mobile health applications, and to compare their purpose, content, and intended target users (i.e., patients, caregivers, or researchers). We conducted a systematic review of the literature in accordance with the PRISMA statement on Medline, CINAHL, PsycINFO, IEEE Explore databases, as well as a review of the grey literature to identify rating scales used to evaluate usability and quality of mobile health applications (m-health apps), between January 1, 2000 and July 31, 2018. Two researchers screened the titles and abstracts of articles that met inclusion criteria, and retrieved usability and quality rating scales from the articles. We identified 24 usability scales and 25 quality rating scales in 87 peer-reviewed articles. We identified only one quality rating scale designed for non-expert users (i.e., patients or caregivers). None of the studies used a theoretical framework for app evaluation to support the scales. The validity of existing quality rating scales is yet to be investigated. Existing usability and quality rating scales are targeted at professionals, not end users who are patients or caregivers. Rating scales that are usable by all end-users would make mobile health apps accessible and meaningful to consumers.Implications for rehabilitationThe number of mobile health applications on app stores that can be used for rehabilitation is increasing.Most healthcare providers lack the training to identify m-health apps with high quality to be used in rehabilitation.This study has reviewed the current rating scales that can help clinicians and care providers rate the quality of m-health apps and identify the ones that are most appropriate for their practice. The number of mobile health applications on app stores that can be used for rehabilitation is increasing. Most healthcare providers lack the training to identify m-health apps with high quality to be used in rehabilitation. This study has reviewed the current rating scales that can help clinicians and care providers rate the quality of m-health apps and identify the ones that are most appropriate for their practice.

BACKGROUND Health care aides are unlicensed support personnel who provide direct care, personal assistance, and support to people with health conditions. The shortage of health care aides has been attributed to recruitment challenges, high turnover, an aging population, the COVID-19 pandemic, and low retention rates. Mobile apps are among the many information communication technologies that are paving the way for eHealth solutions to help address this workforce shortage by enhancing the workflow of health care aides. In collaboration with Clinisys EMR Inc, we developed a mobile app (Mobile Smart Care System [mSCS]) to support the workflow of health care aides who provide services to older adult residents of a long-term care facility. OBJECTIVE The purpose of this study was to investigate the technology acceptance and usability of a mobile app in a real-world environment, while it is used by health care aides who provide services to older adults. METHODS This pilot study used a mixed methods design: sequential mixed methods (QUANTITATIVE, qualitative). Our study included a pre– and post–paper-based questionnaire with no control group (QUAN). Toward the end of the study, 2 focus groups were conducted with a subsample of health care aides (qual, qualitative description design). Technology acceptance and usability questionnaires used a 5-point Likert scale ranging from disagree (1) to agree (5). The items included in the questionnaires were validated in earlier research as having high levels of internal consistency for the Unified Theory of Acceptance and Use of Technology constructs. A total of 60 health care aides who provided services to older adults as part of their routine caseloads used the mobile app for 1 month. Comparisons of the Unified Theory of Acceptance and Use of Technology constructs’ summative scores at pretest and posttest were calculated using a paired t test (2-tailed). We used the partial least squares structural regression model to determine the factors influencing mobile app acceptance and usability for health care aides. The α level of significance for all tests was set at P≤.05 (2-tailed). RESULTS We found that acceptance of the mSCS was high among health care aides, performance expectancy construct was the strongest predictor of intention to use the mSCS, intention to use the mSCS predicted usage behavior. The qualitative data support the quantitative findings and showed health care aides’ strong belief that the mSCS was useful, portable, and reliable, although there were still opportunities for improvement, especially with regard to the mSCS user interface. CONCLUSIONS Overall, these results support the assertion that mSCS technology acceptance and usability are high among health care aides. In other words, health care aides perceived that the mSCS assisted them in addressing their workflow issues.

With ageing, people may experience loss of function which may be compensated for by using technology. This review aims to examine the range and extent of personal voice assistants used for older adults living in the community, their technology readiness level, associated outcomes, and the strength of evidence. This study complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The CINAHL, EMBASE, IEEE Xplore, MEDLINE, APA PsycInfo, Scopus, and Web of Science databases were used to identify studies that explored the use of personal voice assistant technology with older adults living in the community. The search yielded 499 studies, 22 of which were included for final analysis. Consumer technologies (e.g., Amazon Alexa) were evaluated in 18 studies, while four studies evaluated novel technologies. Most of the studies exploring the use of personal voice assistants with older adults evaluated technology usability and acceptance. Personal voice assistants were most commonly used by older adults for setting up reminders, searching for information, and checking the weather. None of the included studies evaluated the effectiveness of the technologies' ability to improve the management of health conditions or to facilitate the functional capacity of older adults. More research is needed to determine the possible impact of using personal voice assistants for older adults living in the community. IMPLICATIONS FOR REHABILITATIONThe TRL for personal voice assistants is high.Personal voice assistants are currently being used by older adults for a range of activities including setting up reminders, searching for information, and checking the weather.Whether personal voice assistants can support older adults' ability to age in place is still unknown.The use of personal voice assistants in older adults is ripe for future enquiry and intervention-based research. The TRL for personal voice assistants is high. Personal voice assistants are currently being used by older adults for a range of activities including setting up reminders, searching for information, and checking the weather. Whether personal voice assistants can support older adults' ability to age in place is still unknown. The use of personal voice assistants in older adults is ripe for future enquiry and intervention-based research.

Background. Chronic pain impacts people's activity participation, productivity, mental health, and sense of wellbeing. Purpose. This study aimed to (1) evaluate the feasibility of the Mindfulness-Based Chronic Pain Management (MBCPMTM) program on reducing pain perception and enhancing the quality of life, and (2) understand veterans’ experience with the program. Method. The pretest-posttest single-group, mixed-methods design was used. Thirty-one veterans were offered the 12-week intervention. The Pain Catastrophizing Scale (PCS) and the Patient-Reported Outcomes Measurement Information System-29 were administered before and after the program. Focus groups and individual interviews were conducted to understand the experience. Findings. Participants’ PCS scores improved ( Z = −3.116, p = .002), but the pain intensity did not change significantly. Themes from qualitative data include: (1) We are not alone! (2) I have a sense of awareness, choices, and control; and (3) It does work! Implications. The study shows preliminary feasibility of MBCPMTM for veterans. This promising effect supports future rigorous testing of this intervention.

The Internet of Things (IoT) is considered the most efficient way of sending information from devices or smart sensors to the Internet. Monitoring of failures in biomedical equipment is essential to react promptly and avoid adverse events to patients. This study focuses on designing and implementing an IoT system to capture and monitor the environmental variables that influence a highly complex medical device (i.e., computerized axial tomography). The aim of this study is to design and implement a system with a robust and secure three-layer architecture based on service-oriented architecture (SOA) and representational state transfer (REST and RESTful), which allows the safe continuous monitoring of environmental variables in a location where computerized axial tomography (CAT) equipment is installed. The system’s prototype was implemented in a real-context hospital in Bogota, Colombia. The solution was based on a network of sensors and an electronic circuit board capable of acquiring, processing, and wirelessly sending data associated with the environmental variables to a web service developed for that purpose. The architecture’s implementation was designed to have five sensors recording variables, including the temperature, humidity, vibration, sound, and current of the powered node the CAT was plugged into. The system was tested for 1 month, producing 1,285,257 raw data. In conclusion, having implemented the three-layer architecture based on SOA and the RESTful architecture styles, it was possible to monitor in real time the environmental variables of the location where the medical device was installed.

BACKGROUND Military members and veterans exhibit higher rates of injuries and illnesses such as posttraumatic stress disorder (PTSD) because of their increased exposure to combat and other traumatic scenarios. Novel treatments for PTSD are beginning to emerge and increasingly leverage advances in gaming and other technologies, such as virtual reality. Without assessing the degree of technology acceptance and perception of usability to the end users, including the military members, veterans, and their attending therapists and staff, it is difficult to determine whether a technology-based treatment will be used successfully in wider clinical practice. The Unified Theory of Acceptance and Use of Technology model is commonly used to address the technology acceptance and usability of applications in 5 domains. OBJECTIVE Using the Unified Theory of Acceptance and Use of Technology model, the purpose of this study was to determine the technology acceptance and usability of multimodal motion-assisted memory desensitization and reconsolidation (3MDR) on a virtual reality system in the primary user group (military members and veterans with treatment-resistant PTSD, 3MDR therapists, and virtual reality environment operators). METHODS This mixed methods embedded pilot study included military members (n=3) and veterans (n=8) with a diagnosis of combat-related PTSD, as well as their therapists (n=13) and operators (n=5) who completed pre-post questionnaires before and on completion of 6 weekly sessions of 3MDR. A partial least squares structural equation model was used to analyze the questionnaire results. Qualitative data from the interviews were assessed using thematic analysis. RESULTS Effort expectancy, which was the most notable predictor of behavioral intention, increased after a course of 3MDR with the virtual reality system, whereas all other constructs demonstrated no significant change. Participants’ expectations of the technology were met, as demonstrated by the nonsignificant differences in the pre-post scores. The key qualitative themes included feasibility and function, technical support, and tailored immersion. CONCLUSIONS 3MDR via a virtual reality environment appears to be a feasible, usable, and accepted technology for delivering 3MDR to military members and veterans who experience PTSD and 3MDR therapists and operators who facilitate their treatment.

Persons living with dementia are at higher risk of getting lost and going missing. The adverse outcomes of missing incidents are stressful for persons living with dementia and those who care for them. This study aimed to identify and describe the perspectives of persons with dementia, caregivers and community support organizations on risk factors. Generic qualitative description informed our methods. We conducted 30 virtual interviews with persons who live with dementia, professional and family caregivers and community support organization representatives. We used a card sort to elicit and describe perspectives on the importance of 27 risk factors commonly associated with missing incidents in persons living with dementia. Interviews were digitally recorded, transcribed verbatim, and subjected to content analysis to determine the presence of relevant words, themes, and concepts. Participants reported multiple experiences of a person going missing, impressions, and suggested relationships between factors such as environmental contexts. The most critical risk factors associated with getting lost and going missing were cognitive impairment, unmet needs, and inadequate concentration of services and resources. In contrast, race, education, and gender were perceived as unimportant pertaining to risk factors related to missing incidents in persons living with dementia. An understanding of the perceived importance of risks associated with missing incidents enhances a person-centered approach to addressing unmet needs, services and resources that balances quality of life with maintaining safety.

Healthcare aides are unlicensed support personnel who provide direct care, personal assistance and support to persons living with health conditions. Workflow issues have a negative impact on health care aides’ job satisfaction and quality of care. The implementation of information communication technologies could improve workflow. In collaboration with an industry partner, we developed a mobile application intended to support the workflow of health care aides who provide services to long-term care residents living with dementia. The purpose of this study was to investigate the technology acceptance and usability of a mobile application in a real-world environment when used by health care aides of a care facility. We used a sequential explanatory mixed methods approach. Our study included pre and post paper-based questionnaires with no control group (n=60). This was followed by two focus groups with a subsample of health care aides informed by qualitative description (n=12). We found: (a) acceptance of the mobile application was high; (b) usefulness was the strongest predictor of intention to use the mobile application, and (c) intention to use the mobile application predicted usage behaviour. Focus group findings supported the quantitative findings and highlighted participants’ strong belief that the mobile application was useful, portable, and reliable. An area for improvement was user interface adjustments. Overall, these results support the assertion that our mobile application assisted health care aides in addressing their workflow issues and thus, has potential to improve the quality of care provided.

The prevalence of persons living with dementia and at risk of going missing is rising. In this study, we engaged persons living with dementia, care partners, police services, search and rescue organizations, and health and social service providers to develop Community ASAP, a mobile alert system that engages community citizens, as volunteers, to look out for persons with dementia reported missing. We completed three phases of development and evaluation of the usability and functionality of the alert system with stakeholders in three Canadian provinces. In this paper we describe features of the Community ASAP and the findings of these evaluation phases.

This study aims to examine the effects of maintenance service firms’ resources and capabilities on maintenance performance, measured by the turnaround time of medical devices (TAT). The theoretical framework used in this study is based on the resource-based view (RBV) and agency theory (AT). The hypotheses were tested using information on 764 medical devices and 60 maintenance service providers, resulting in 1403 maintenance transactions. As such, our data sample is significantly larger than those used in previous studies in this area. For this study we used a variation of the proportional hazards model, the conditional frailty gap time hazards model. The empirical analysis of this research is among the first to quantify how the performance of maintenance providers is affected by the core constructs of both the resource-based view and agency theory, using statistical evidence.

Critical wandering is common in persons living with dementia, it is defined as wandering that results in an individual going missing. This exposes the missing vulnerable older adult to risks and dangers. Persons with dementia who become lost and go missing and get lost can face adverse outcomes, such as injury and death, yet the amount of information available on the risk factors associated with these incidents is scarce. The aim of this study was to identify the risk factors associated with critical wandering in persons living with dementia. We used Tricco et al.’s (2018) approach for scoping reviews and searched the following databases: Medline, EMBASE, CINAHL, and Scopus. We included studies that referred to critical wandering in persons with dementia, cognitive impairment, or Alzheimer, and published since 1980. We identified 3,376 publications, which was reduced to 1641 publications after we removed duplications. A total of 78 studies met the inclusion and exclusion criteria for analysis and extraction. A rigorous process to synthesize and categorize the research evidence was followed. We identified four different types of risk factors associated with going missing: (1) personal, (2) physical environment and geographical location, (3) cultural environment, and (4) social environment and support resources. Recognition of these risk factors can help persons living with dementia and their care partners identify interventions and proactive strategies to mitigate or prevent critical wandering. This will support persons with dementia, their care partners, and community organizations to balance safety, autonomy, and independence to maximize quality of life.

While it is commonly cited that 60% of persons living with dementia (PLWD) wander, it is unclear whether this number reflects global contexts. Population aging has created a pressing need for the development of programs to mitigate the risks of PLWD from getting lost and going missing. Such programs would require a national strategy for the collection and integration of data on missing incidents involving this population. This study is a first step to inform such a strategy. The purposes were to: 1) identify approaches to data collection on missing persons incidents involving PLWD among Canadian police and search and rescue (SAR) organizations; 2) describe the foreseeable challenges associated with developing a national data collection strategy. We used generic qualitative description to generate data with fifteen key informants. Virtual semi-structured interviews were completed and transcribed verbatim. Content analysis and trustworthiness strategies guided analysis and rigor. Our findings indicate that police and SAR organizations collect a multitude of data pertaining to missing incidents involving PLWD. However, there is a lack of standardization in data collection, entry and analysis. Privacy legislation, limited resources, and incompatible data management systems pose challenges to data sharing and interoperability. Underreporting of missing incidents to police results in an underestimation of missing incidents. An intersectoral, uniform approach to data collection would enable the storage, analysis and comparison of national data. Accurate data on critical wandering can inform prevention, search strategies, resource allocation and effectiveness of programs.

Background App-based strategies are a promising solution to deliver nutrition and exercise interventions during social distancing. With limited RCT data in individuals with chronic disease, further information is required both to determine impact, and to guide delivery. The Heal-Me app is an evidence-based, theoretically informed nutrition and exercise solution that can be tailored for use across a range of individuals with chronic disease. As compared to controls receiving educational material, the aim of this study is to assess the acceptability, effectiveness, and cost of Heal-Me app programming delivered alongside two levels of dietitian and exercise-specialist support. Methods Heal-Me PiONEer is a 12-week, 3-arm RCT with randomization to one of three study groups (n=72 per group, 216 total). Group 1 (control: educational material), Group 2 (Heal-Me app + virtual group dietitian/exercise-specialist sessions), Group 3 (Heal-Me app + virtual group and 1-to-1 dietitian/exercise-specialist sessions). Inclusion criteria: adults with cancer, chronic lung disease or status post-transplantation from liver or lung transplant; previous completion of an exercise rehabilitation program; access to an internet-connected device. Study outcomes measured at study weeks 0 and 12 include: Primary - Lower Extremity Functional Scale; Secondary - virtual physical function tests, loneliness, resilience, anxiety, well-being and health-related quality of life; Exploratory outcomes - protein intake, behavioral beliefs around exercise and nutrition, adherence, adverse events, acceptability, and cost-utility. Conclusions The Heal-Me PiONEer RCT holds promise to provide a comprehensive understanding of the delivery and impact of app-based nutrition and exercise programming in a diverse group of participants with chronic disease.

The rates of dementia are on the rise as populations age. Storytelling is commonly used in therapies for persons living with dementia and can be in the form of life review, and reminiscence therapy. A systematic literature review was conducted to examine the range and extent of the use of digital technologies for facilitating storytelling in older adults and their care partners, and to identify the processes and methods, the technologies used and their readiness levels, the evidence, and the associated outcomes. Eight electronic databases were searched: Medline, EMBASE, PsycINFO, CINAHL, Abstracts in Social Gerontology, ERIC, Web of Science, and Scopus. We included 34 studies. Mild cognitive impairment or dementia represented over half of medical conditions reported in the studies. Overall, our findings indicate that the most common use of digital storytelling was to support older adults’ memory, reminiscence, identity, and self-confidence; however, the level of evidence of its effectiveness was low.