Smart homecare technologies for the visually impaired: recent advances Bruno Andò, Salvatore Baglio, Cristian Orazio Lombardo, Vincenzo Marletta Department of Electric, Electronic and Informatics Engineering, University of Catania, Catania, Italy Abstract: Accessibility and autonomy are fundamental needs for people with visual impairments wishing to enjoy their rights as citizens and to access buildings, premises, and other facilities. Dealing with the possibility of autonomously performing activities of daily living, two main aspects are mandatory: autonomous mobility and living independently. In particular, dealing with autonomous accessibility is strictly related to the possibility to perceive the environment and to gain a realistic and intuitive awareness of ongoing events and hazards. In order to promote living independently, caregivers (whether relatives or assistive services) need to be aware of the user's physical surroundings. The literature is rich in attempts to provide technical solutions to improve quality of life and autonomy for frail people, particularly with regard to the visually impaired. This review summarizes “state of the art” electronic aids for the visually impaired, and aims to to highlight the benefits and drawbacks of these aids. Keywords: assistive systems, blindness, multisensor architecture, localization, activities of daily living&nbsp

Effect of telehealth-to-home interventions on quality of life for individuals with depressive and anxiety disorders Logan Durland,1 Alejandro Interian,1,2 Ingrid Pretzer-Aboff,3 Roseanne D Dobkin11Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School, Department of Psychiatry, Piscataway, NJ, 2The New Jersey Healthcare System, Veteran Affairs Medical Center, Lyons, NJ, 3University of Delaware, School of Nursing and Biomechanics and Movement Sciences Program, Newark, DE, USAAbstract: Although millions of individuals suffer from mental health problems worldwide, only a small fraction receives adequate treatment. The high prevalence of depression and anxiety observed worldwide, in conjunction with very low rates of treatment utilization, are of great clinical significance, as these psychiatric conditions are two of the most important determinants of quality of life (QoL). Telehealth interventions have been touted as potential solutions to these mental health care disparities, with great interest and utility demonstrated across a diverse array of medical and psychiatric populations. Telehealth interventions may be clinic-based or home-based. The primary objective of this paper is to highlight the extent to which telehealth-to-home interventions positively impact multiple facets of QoL for individuals with depression and anxiety disorders, including those with comorbid medical conditions. While QoL outcomes are important to consider in any assessment of treatment effectiveness, QoL enhancement has received limited attention in the telemental health literature to date. All studies included in the present review evaluate telehealth-to-home treatments, assess QoL outcomes, and incorporate some degree of live, synchronous therapist-patient contact. Recommendations to advance the application of telehealth-to-home approaches are proposed and include: additional research on video-to-home telehealth platforms, strategies to increase the adoption of telehealth-to-home interventions amongst mental health treatment providers, national legislative reform to establish fair and appropriate reimbursement parameters for telehealth-to-home care, standardized definitions of telehealth-to-home services to facilitate provider engagement and reimbursement, and systematic approaches for measuring the cost-effectiveness of telehealth-to-home treatments.Keywords: telehealth-to-home, quality of life, depression and anxiety disorders

Palliative home-based technology from a practitioner's perspective: benefits and disadvantages Bridget M Johnston Sue Ryder Care Centre for the Study of Supportive, Palliative, and End of Life Care, School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK Abstract: This critical review paper explores the concept of palliative home-based technology from a practitioner's perspective. The aim of the critical review was to scope information available from published and unpublished research on the current state of palliative home-based technology, practitioner-focused perspectives, patient-focused perspectives, quality of life, and the implications for clinical practice. Published and unpublished studies were included. An example of one UK patient-centered home-based technology is explored as an exemplar. The evidence suggests that despite the challenges, there are numerous examples of good practice in relation to palliative home-based technology. Improvements in technology mean that telehealth has much to offer people being cared for at home with palliative needs. However, some of the evaluative evidence is limited, and further rigor is needed when evaluating future technology-based solutions innovations. Keywords: technology, telehealth, telemedicine, information technology, palliative care, hospice, terminal illness

Home telehealth in older patients with heart failure – costs, adherence, and outcomes Susanna Spinsante Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, Ancona, Italy Abstract: This short review discusses the role of telehealth technologies in the management of older patients with heart failure, from different perspectives. Instead of providing a systematic overview of existing literature in the field, this paper provides evidence for a simple, but effective, paradigm upon which a telehealth system may be built, and highlights how such a model may successfully apply to heart failure management, to improve patients' quality of life after discharge, increase independency, and reduce readmissions and costs for the public health institutions. A few examples are discussed, to show the real applicability of the proposed model and further confirm the effectiveness of telehealth, when properly designed and tailored to users' needs. Keywords: remote health care, workflow, requirements

Homecare user needs from the perspective of the patient and carers: a review Debbie Isobel Keeling School of Business and Economics, Loughborough University, Loughborough, UK Abstract: There is a global shift towards a blending of care delivery within formal and informal environments in direct response to economic and demographic pressures. Homecare is at the hub of this activity, enabling people to age in place and keeping families intact. However, our understanding of patient and carer needs is fragmented; understandably so, given the complexity of these needs. This descriptive review offers a content analysis of papers focused on patients' and carers' needs and homecare published between January 2010 and October 2013. It is evident that homecare is an intensely researched area, yet it is disjointed. Emerging research emphasizes the need to take a holistic approach. Firstly, incorporating emotional psychosocial and cultural elements will help to draw together our current understanding within a more cohesive framework. Secondly, tensions that hinder communication and collaboration between stakeholders must be resolved. Thirdly, information and communications technology is rapidly becoming synonymous with homecare, and offers solutions for facilitating care delivery, collaboration, and training of future professionals. The rate of international activity promises much for future research collaborations to compare, contrast, and identify best practices for the future of homecare as we endeavor to meet the ever-increasing pressures on health and social care systems. Keywords: homecare, home health care, patient needs, caregiver needs, telehealth, telemonitoring, patient-centered care

Smart applications to track and record physical activity: implications for obesity treatment Siew Sun Wong,1 Yu Meng,1 Paul D Loprinzi,2 Nobuko Hongu3 1School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA; 2Department of Exercise Science, Donna and Allan Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY, USA; 3Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA Abstract: The primary purpose of this review is to answer three research questions: 1) What are the most popular features of physical activity (PA) tracking and recording mobile applications (apps); 2) what features drive the app cost, peak rank, or gross sales; and 3) to what extent are evidence-based weight loss recommendations used in PA apps? Two hundred top grossing iOS health care and fitness apps were screened using a systematic review method. Fifty-five apps met the criteria as PA tracking and recording apps. Nearly half of these iOS PA apps are also available in Android. Two separate reviewers evaluated each PA app using 48 features. The top three most popular features are the use of behavioral strategies, use of the FITT Principles (frequency, intensity, time, type), and the use of the Principles for Physical Fitness. Free apps contain a mean of nine of the ten most popular features in paid apps, making them good bargains in PA promotion. Better peak rank is associated with the use of Fitness Principles, weight loss goal setting, or training videos. Ten PA apps met at least four of eight of the American College of Sports Medicine (ACSM) recommendations for weight loss and prevention of weight regain for adults. The least popular features were PA safety and workouts for special need populations. Implications for obesity treatment are discussed in relationship to individual end-users, health care providers, and app developers. Because current PA apps still lack validity and compliance to standards for PA safety and data security, medical consultation for weight loss is recommended. The quality of PA apps on the market will improve through innovative support from the government, industry, and academia. The future of PA apps is bright, especially with the potential of using emerging technologies that involve low-cost wearable sensors, global information systems, and immersive technology such as virtual worlds and virtual reality. Keywords: Android, exercise, iOS, mHealth, self-monitoring, technology

Telemedicine: an enhanced emergency care program for older adults Paul Y Takahashi,1 Anupam Chandra,1 Frederick North,1 Jennifer L Pecina,2 Benjavan Upatising,3 Gregory J Hanson11Mayo Clinic Division of Primary Care Internal Medicine, 2Mayo Clinic Department of Family Medicine, Rochester, MN, USA; 3Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, USAAbstract: Recent changes and consolidations in health care systems have resulted in an increase in new health care delivery models. Telemedicine holds great promise as one of these models. There is a great potential for new patient evaluation and treatment models in emergency care (EC), especially when patients are miles away from a medical team. Evaluations can be performed in a patient's home, a nursing care facility, and in hospitals that focus on advanced subspecialty care. Due to rapid developments in this area, current care models are constantly being evaluated and modified. This review article outlines current telemedicine models for EC and summarizes their potential benefits to patients and the health care system. The review examines the role that the telephone, a fundamental tool of telemedicine, plays in these new models. The review also examines evidence of improved health care outcomes by highlighting the role of telemedicine in reducing hospitalizations. The patient is the primary focus; as a result, this review also examined patient experiences and satisfaction levels regarding telemedicine health care teams. The authors support these technological advances and their potential for information transfer. Health care providers need to continue developing these models by making use of increasing amounts of information. One of the main implementation barriers of these new models in the US and other countries is the issue of payment and reimbursement. Despite this, advancements in EC telemedicine continue.Keywords: telemedicine, emergency care, geriatric, patient evaluation models

Managing hemophilia: the role of mobile technology Kate Khair,1 Mike Holland21Haemophilia Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, 2Haemnet Ltd, London, UKAbstract: The ubiquity of mobile technology offers the potential for instantaneous and two-way transfer of information, as well as the potential for improving medical care delivery and extending it to those in countries and regions with a less developed medical infrastructure. This review considers the role of mobile health (mHealth) technology in managing hemophilia. This is a disease area in which good record-keeping is an essential component of home-based hemophilia care. Health care professionals contribute patients' data to national registries and databases and frequently interrogate those data for commercial and academic purposes. Only rarely are the data used to directly improve the care of the individual patient. Patient-focused apps designed to respond to an individual's personal data may offer the potential to empower patients to live healthier lifestyles, reinforcing the care provided by health care professionals and offering a mechanism for peer-support and promoting adherence to an individualized management plan.Keywords: mHealth, hemophilia, peer-support, adherence

Chronic diseases (CD) - such as cardiovascular, diabetes, cancer, and chronic respiratory diseases - are projected to be the most common causes of mortality and morbidity by 2030. Use of a participatory decision-making model that emphasizes a partnership among practitioners, patients, and their families to achieve desired goals is a key strategy in achieving optimal outcomes. The Interactive Health Communication Applications (IHCAs) can support participatory decision making by providing the unique infrastructure needed to deliver support for the multiple requirements of patients with CD. The aim of this paper is to provide a descrip- tive review of the use of IHCAs in the treatment of chronic disease. Patient acceptability and satisfaction were identified as key issues that can be enhanced by ensuring that IHCAs provide: 1) emotional support and empowerment; 2) education and information from health profession- als; and 3) telecommunication instead of onsite visiting. An important benefit of IHCAs can be an improved quality of communication between the patients and the health care professionals, which is a critical and predictive factor of treatment outcomes for many patients with CD. Similarly, there is good evidence to suggest that IHCAs can improve the patients' adherence to both medication and behavioral regimens designed to both treat and manage CDs. However, it is important to recognize that the technological development and effective implementation of an ICHA is a complex multidisciplinary operation that needs to take into account the needs of the various stakeholders as well as making use of the most suitable technology.