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Declercq IJN, Leontjevas R, Verboon P, De Vriendt P, Gerritsen DL, van Hooren S. A bayesian network meta-analysis to explore modifying factors in randomized controlled trials: what works for whom to reduce depression in nursing home residents? BMC Geriatr 2024; 24:518. [PMID: 38872075 DOI: 10.1186/s12877-024-05117-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/29/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Reviews of depression interventions in nursing home residents resulted in positive findings. However, because of the heterogeneity of the studies, it remains unclear what works for whom. Considering moderator effects may contribute to a comprehensive understanding of depression treatment in residents. Therefore, this study aims to review depression interventions, examining moderator effects of (1) residents' factors, and (2) components specific of interventions. METHODS A Bayesian network meta-analysis of randomized controlled trials primarily aimed at reducing depressive symptoms among residents was conducted. First, intervention types, e.g., exercise interventions, were compared to care as usual. Second, meta-regression analyses were conducted for moderator effects of residents' factors (i.e., severity of depressive symptoms, physical dependency, and cognitive impairment) and components identified as specific to an intervention (e.g., music, creativity, positivity). RESULTS Our search across six databases resulted in 118 eligible studies: 16 on neurobiological interventions, 102 on non-pharmacological interventions. Compared to care as usual, cognitive interventions, such as cognitive behavioral therapy and goal-oriented therapy, showed the strongest effects (MD = -1.00, 95% CrI [-1.40 to -0.66]). Furthermore, the severity of depressive symptoms moderated the effect of interventions (ƅ = -0.63, CrI 95% [-1.04 to -0.22]), while none of fifteen identified intervention-specific components did. In residents with a depression diagnosis, there were larger effect sizes for interventions including daily structure, psychoeducation, healthy food, creativity, positivity, and an activating/encouraging environment, whereas interventions focusing on distraction and relaxation had larger effect sizes in those residents without. CONCLUSIONS By examining the moderator effects, we provided an integrative perspective on the observed variations in effects across different target groups, and components of depression interventions. This approach underscores the complex nature of interventions, emphasizing the need for continued transdisciplinary research, and the exploration of potential moderators. Future investigations should carefully assess residents' factors and choose interventions and their components accordingly.
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Affiliation(s)
- Ine J N Declercq
- Department of Primary and Community Care, Radboud University Medical Center, Gelderland, 6500 HBNijmegen, The Netherlands.
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands.
- Department of Gerontology and Frailty in Ageing (FRIA) and Mental Health and Wellbeing (MENT) Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Gelderland, 6500 HBNijmegen, The Netherlands
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Patricia De Vriendt
- Department of Gerontology and Frailty in Ageing (FRIA) and Mental Health and Wellbeing (MENT) Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Gelderland, 6500 HBNijmegen, The Netherlands
| | - Susan van Hooren
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
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Yen HY, Huang CW, Chiu HL, Jin G. The Effect of Social Robots on Depression and Loneliness for Older Residents in Long-Term Care Facilities: A Meta-Analysis of Randomized Controlled Trials. J Am Med Dir Assoc 2024; 25:104979. [PMID: 38614134 DOI: 10.1016/j.jamda.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVES Depression and loneliness are challenges facing older residents living in long-term care facilities. Social robots might be a solution as nonpharmacologic interventions. The purpose of this study was to explore the effects of concrete forms of social robots on depression and loneliness in older residents in long-term care facilities by a systematic review and meta-analysis of randomized controlled trials. DESIGN This is a systematic review and meta-analysis. SETTING AND PARTICIPANTS Older residents in long-term care facilities. METHODS Six electronic databases of PubMed, Embase, Scopus, Web of Science, MEDLINE, and CINAHL plus were searched in August 2023. Random effect models of meta-analyses, subgroup analyses, and meta-regressions were performed for statistical analyses. RESULTS After evaluation, 8 studies were selected for both qualitative and quantitative synthesis. Social robot interventions had significant positive effects on decreasing depression and loneliness with large effect sizes. Group-based robot activities had a better effect on improving depression than individual-based robot activities. Longer durations of interventions produced significantly more improvement in depression. CONCLUSION AND IMPLICATION Social robots with physical manifestation provide the opportunity for older adults' social engagement and interactions with robots and others. Social robot interventions are recommended for older residents in long-term care facilities to promote psychosocial well-being in daily care routines.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan; International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chih Wei Huang
- International Center for Health Information Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Huei-Ling Chiu
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan; International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Grace Jin
- Stanford University School of Medicine, Stanford, CA, USA
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Brookman R, Parker S, Hoon L, Ono A, Fukayama A, Matsukawa H, Harris CB. Technology for dementia care: what would good technology look like and do, from carers' perspectives? BMC Geriatr 2023; 23:867. [PMID: 38104074 PMCID: PMC10725604 DOI: 10.1186/s12877-023-04530-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The development of technology in dementia care has largely been without consultation with carers, and has primarily focused on safety, monitoring devices, and supporting activities of daily living. Further, while involving end-users in the design of technology has been recommended, this is yet to become common practice. METHOD We conducted a mixed methods study with the aim of investigating carers' values and priorities for technology development, including prior experiences, barriers to use, and what they would like technology to do. Importantly, we asked carers for their design ideas and bespoke technology solutions for future development. RESULTS Carers of people living with dementia (N = 127), including both unpaid (n = 102) and paid carers (n = 25) residing in Australia, completed an online survey. In addition, a subsample of carers (n = 23) participated in semi-structured interviews. Findings demonstrate that carers want technology to be person-centred, customisable, and to increase opportunities for meaningful social connection. Findings also demonstrate the ability of carers to generate creative design solutions for dementia care. CONCLUSIONS These findings and implications will be discussed in relation to the importance of co-design with carers and engineers during the design phase of assistive technology. Also, the importance of technology to enhance, not replace, human-to-human social interactions is highlighted.
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Affiliation(s)
- Ruth Brookman
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia.
| | | | | | - Asuka Ono
- Nippon Telegraph and Telephone (NTT), Tokyo, Japan
| | | | | | - Celia B Harris
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia
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4
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Welch V, Ghogomu ET, Barbeau VI, Dowling S, Doyle R, Beveridge E, Boulton E, Desai P, Huang J, Elmestekawy N, Hussain T, Wadhwani A, Boutin S, Haitas N, Kneale D, Salzwedel DM, Simard R, Hébert P, Mikton C. Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1369. [PMID: 38024780 PMCID: PMC10681039 DOI: 10.1002/cl2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Social isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions. Objectives To map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. Search Methods We searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos. Selection Criteria Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria. Data Collection and Analysis We developed and pilot tested a data extraction code set in Eppi-Reviewer and data were individually extracted and coded based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map. Main Results We included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic. The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories. Authors' Conclusions The restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Sierra Dowling
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | - Ella Beveridge
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Elisabeth Boulton
- School of Health Sciences, Division of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Payaam Desai
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Jimmy Huang
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Arpana Wadhwani
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Dylan Kneale
- Social Science Research Unit, EPPI‐Centre, UCL Institute of EducationUniversity College LondonLondonUK
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Paul Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
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Bayuo J, Abu-Odah H, Su JJ, Aziato L. Technology: A metaparadigm concept of nursing. Nurs Inq 2023; 30:e12592. [PMID: 37563996 DOI: 10.1111/nin.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. Using these requirements, we examined the onto-epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective-neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto-epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Lydia Aziato
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Hohoe, Ghana
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6
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Ghafurian M, Ellard C, Dautenhahn K. An investigation into the use of smart home devices, user preferences, and impact during COVID-19. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2023:100300. [PMID: 37360307 PMCID: PMC10241656 DOI: 10.1016/j.chbr.2023.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/12/2022] [Accepted: 05/21/2023] [Indexed: 06/28/2023] Open
Abstract
With the goal of designing smart environments that can support users' physical/mental well-being, we studied users' experiences and different factors that can influence success of smart home devices through an online study conducted during and after the COVID-19 restrictions in June 2021 (109 participants) and March 2022 (81 participants). We investigated what motivates users to buy smart home devices, and if smart home devices may have the potential to improve different aspects of users' well-being. As COVID-19 emphasized a situation where people spent a significant amount of time at home in Canada, we also asked if/how COVID-19 motivated purchase of smart-home devices and how these devices affected participants during the pandemic. Our results provide insights into different aspects that may motivate the purchase of smart home devices and users' concerns. The results also suggest that there may be correlations between the use of specific types of devices and psychological well-being.
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Affiliation(s)
- Moojan Ghafurian
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Colin Ellard
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Kerstin Dautenhahn
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, ON, Canada
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Igarashi T, Sugawara I, Inoue T, Nihei M. Research Participant Selection Bias in the Workshop Using Socially Assistive Robots for Older Adults and Its Effect on Population Representativeness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105915. [PMID: 37239641 DOI: 10.3390/ijerph20105915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 05/28/2023]
Abstract
Every research participant has their own personality characteristics. For example, older adults assisted by socially assistive robots (SAR) may have their own unique characteristics and may not be representative of the general population of older adults. In this research, we compared the average personality characteristics of participants in a workshop on robotics recruited directly through posting with those of older Japanese adults to examine participant selection bias and group representativeness for future study of SARs. After a one-week recruitment period, the workshop was attended by 20 older participants (nine males and 11 females) aged between 62 and 86 years. Extroversion among workshop participants was 4.38, 0.40 higher than the average for older adults in Japan. The workshop participants' openness was 4.55, 1.09 higher than the average for the Japanese elderly. Thus, the results indicate a slight selection bias in the personal characteristics of the participants depending on the recruitment method when compared to the Japan national average for older adults. In addition, only one of 20 participants was below the cutoff on the LSNS-6 score and considered to have a tendency toward social isolation. The development and introduction of socially assistive robots is often being considered to support people in social isolation in their daily lives; however, the results of this study showed that it is difficult to recruit people who tend to be socially isolated when gathering research participants by methods such as posting. Therefore, the effectiveness of the method of recruiting participants should be carefully verified in research regarding socially assistive robots.
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Affiliation(s)
- Toshiharu Igarashi
- Department of Human and Engineered Environmental Studies, The University of Tokyo, Kashiwanoha 5-1-5, Chiba 277-8563, Japan
| | - Ikuko Sugawara
- Faculty of Service Management, Bunri University of Hospitality, 311-1, Kashiwabara-shinden, Sainatama 350-1336, Japan
| | - Takenobu Inoue
- Research Institute of National Rehabilitation, Center for the Persons with Disabilities, 1, Namiki 4-chome, Saitama 359-8555, Japan
| | - Misato Nihei
- Institute of Gerontology, The University of Tokyo, 3-1, Hongo 7-chome, Bunkyo-ku, Tokyo 113-8654, Japan
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8
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Paquet C, Whitehead J, Shah R, Adams AM, Dooley D, Spreng RN, Aunio AL, Dubé L. Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources. J Med Internet Res 2023; 25:e40213. [PMID: 37195738 PMCID: PMC10233446 DOI: 10.2196/40213] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community. OBJECTIVE This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults. METHODS A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources. RESULTS The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services. CONCLUSIONS A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.
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Affiliation(s)
- Catherine Paquet
- Département de Marketing, Faculté des Sciences de l'Administration, Université Laval, Québec, QC, Canada
- Centre de Recherche, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec, QC, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Quebec, QC, Canada
| | - Jocelyne Whitehead
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Rishabh Shah
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Alayne Mary Adams
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Damion Dooley
- Centre for Infectious Disease Genomics and One Health, Simon Fraser University, Vancouver, BC, Canada
| | - R Nathan Spreng
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | | | - Laurette Dubé
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
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9
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Reininghaus EZ, Dalkner N. Robotics in psychiatry - Fiction or reality? Eur Neuropsychopharmacol 2023; 70:17-18. [PMID: 36806883 DOI: 10.1016/j.euroneuro.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/17/2023]
Affiliation(s)
- E Z Reininghaus
- Medical University Graz, Clinical Department of Psychiatry and Psychotherapeutic Medicine, Graz, Austria
| | - N Dalkner
- Medical University Graz, Clinical Department of Psychiatry and Psychotherapeutic Medicine, Graz, Austria.
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10
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González AL, Geiskkovitch DY, Young JE. Say what you want, I’m not listening! I-COM 2023; 22:19-32. [PMID: 37041972 PMCID: PMC10081923 DOI: 10.1515/icom-2022-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/17/2023] [Indexed: 03/12/2023]
Abstract
Abstract
We present a conversational social robot behaviour design that draws from psychotherapy research to support individual self-reflection and wellbeing, without requiring the robot to parse or otherwise understand what the user is saying. This simplicity focused approached enabled us to intersect the well-being aims with privacy and simplicity, while achieving high robustness. We implemented a fully autonomous and standalone (not network enabled) prototype and conducted a proof-of-concept study as an initial step to test the feasibility of our behaviour design: whether people would successfully engage with our simple behaviour and could interact meaningfully with it. We deployed our robot unsupervised for 48 h into the homes of 14 participants. All participants engaged with self-reflection with the robot without reporting any interaction challenges or technical issues. This supports the feasibility of our specific behaviour design, as well as the general viability of our non-parsing simplicity approach to conversation, which we believe to be an exciting avenue for further exploration. Our results thus pave the way for further exploring how conversational behaviour designs like ours may support people living with loneliness.
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Affiliation(s)
| | | | - James E. Young
- Department of Computer Science , University of Manitoba , Winnipeg , Canada
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11
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Schneider C, Bousbiat H. Coaching Robots for Older Seniors: Do They Get What They Expect? Insights from an Austrian Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2965. [PMID: 36833659 PMCID: PMC9963592 DOI: 10.3390/ijerph20042965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
To support the increasing number of older people, new (assistive) technologies are constantly being developed. For these technologies to be used successfully, future users need to be trained. Due to demographic change, this will become difficult in the future, as the resources for training will no longer be available. In this respect, coaching robots could have great potential to support younger seniors in particular. However, there is little evidence in the literature about the perceptions and potential impact of this technology on the well-being of older people. This paper provides insights into the use of a robot coach (robo-coach) to train younger seniors in the use of a new technology. The study was carried out in Austria in autumn 2020, involving 34 participants equally distributed among employees in their last three years of service and retirees in their first three years of retirement (23 female; 11 male). The aim was to assess participants' expectations and perceptions by examining the perceived ease of use and user experience of the robot in providing assistance during a learning session. The findings reveal a positive impression of the participants and promising results for using the robot as a coaching assistant in daily tasks.
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Affiliation(s)
- Cornelia Schneider
- Institute of Computer Science, University of Applied Sciences Wiener Neustadt, 2700 Wiener Neustadt, Austria
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12
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Zhao Y, Wu X, Tang M, Shi L, Gong S, Mei X, Zhao Z, He J, Huang L, Cui W. Late-life depression: Epidemiology, phenotype, pathogenesis and treatment before and during the COVID-19 pandemic. Front Psychiatry 2023; 14:1017203. [PMID: 37091719 PMCID: PMC10119596 DOI: 10.3389/fpsyt.2023.1017203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/15/2023] [Indexed: 04/25/2023] Open
Abstract
Late-life depression (LLD) is one of the most common mental disorders among the older adults. Population aging, social stress, and the COVID-19 pandemic have significantly affected the emotional health of older adults, resulting in a worldwide prevalence of LLD. The clinical phenotypes between LLD and adult depression differ in terms of symptoms, comorbid physical diseases, and coexisting cognitive impairments. Many pathological factors such as the imbalance of neurotransmitters, a decrease in neurotrophic factors, an increase in β-amyloid production, dysregulation of the hypothalamic-pituitary-adrenal axis, and changes in the gut microbiota, are allegedly associated with the onset of LLD. However, the exact pathogenic mechanism underlying LLD remains unclear. Traditional selective serotonin reuptake inhibitor therapy results in poor responsiveness and side effects during LLD treatment. Neuromodulation therapies and complementary and integrative therapies have been proven safe and effective for the treatment of LLD. Importantly, during the COVID-19 pandemic, modern digital health intervention technologies, including socially assistive robots and app-based interventions, have proven to be advantageous in providing personal services to patients with LLD.
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Affiliation(s)
- Yuanzhi Zhao
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Xiangping Wu
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Min Tang
- Department of Neurology, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang, China
| | - Lingli Shi
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Shuang Gong
- Department of Neurology, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang, China
| | - Xi Mei
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Zheng Zhao
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Jiayue He
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Ling Huang
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Wei Cui
- Ningbo Key Laboratory of Behavioral Neuroscience, Zhejiang Provincial Key Laboratory of Pathophysiology, Translational Medicine Center of Pain, Emotion and Cognition, School of Medicine, Ningbo University, Ningbo, Zhejiang, China
- *Correspondence: Wei Cui,
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13
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Developing a Multimodal Monitoring System for Geriatric Depression: A Feasibility Study. COMPUTERS, INFORMATICS, NURSING : CIN 2023; 41:46-56. [PMID: 36634234 DOI: 10.1097/cin.0000000000000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The Internet of Medical Things is promising for monitoring depression symptoms. Therefore, it is necessary to develop multimodal monitoring systems tailored for elderly individuals with high feasibility and usability for further research and practice. This study comprised two phases: (1) methodological development of the system; and (2) system validation to evaluate its feasibility. We developed a system that includes a smartphone for facial and verbal expressions, a smartwatch for activity and heart rate monitoring, and an ecological momentary assessment application. A sample of 21 older Koreans aged 65 years and more was recruited from a community center. The 4-week data were collected for each participant (n = 19) using self-report questionnaires, wearable devices, and interviews and were analyzed using mixed methods. The depressive group (n = 6) indicated lower user acceptance relative to the nondepressive group (n = 13). Both groups experienced positive emotions, had regular life patterns, increased their self-interest, and stated that a system could disturb their daily activities. However, they were interested in learning new technologies and actively monitored their mental health status. Our multimodal monitoring system shows potential as a feasible and useful measure for acquiring mental health information about geriatric depression.
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14
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Fraune MR, Komatsu T, Preusse HR, Langlois DK, Au RHY, Ling K, Suda S, Nakamura K, Tsui KM. Socially facilitative robots for older adults to alleviate social isolation: A participatory design workshop approach in the US and Japan. Front Psychol 2022; 13:904019. [PMID: 36337527 PMCID: PMC9629871 DOI: 10.3389/fpsyg.2022.904019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/16/2022] [Indexed: 06/29/2024] Open
Abstract
Social technology can improve the quality of older adults' social lives and mitigate negative mental and physical health outcomes associated with loneliness, but it should be designed collaboratively with this population. In this paper, we used participatory design (PD) methods to investigate how robots might be used as social facilitators for middle-aged and older adults (age 50+) in both the US and Japan. We conducted PD workshops in the US and Japan because both countries are concerned about the social isolation of these older adults due to their rapidly aging populations. We developed a novel approach to participatory design of future technologies that spends 2/3 of the PD session asking participants about their own life experiences as a foundation. This grounds the conversation in reality, creates rapport among the participants, and engages them in creative critical thinking. Then, we build upon this foundation, pose an abstract topic, and ask participants to brainstorm on the topic based on their previous discussion. In both countries, participants were eager to actively discuss design ideas for socially facilitative robots and imagine how they might improve their social lives. US participants suggested design ideas for telepresence robots, social distancing robots, and social skills artificial intelligence programs, while Japanese participants suggested ideas for pet robots, robots for sharing experiences, and easy-to-operate instructor robots. Comparing these two countries, we found that US participants saw robots as tools to help facilitate their social connections, while Japanese participants envisioned robots to function as surrogate companions for their parents and distract them from loneliness when they were unavailable. With this paper, we contribute to the literature in two main ways, presenting: (1) A novel approach to participatory design of future technologies that grounds participants in their everyday experience, and (2) Results of the study indicating how middle-aged and older adults from the US and Japan wanted technologies to improve their social lives. Although we conducted the workshops during the COVID-19 pandemic, many findings generalized to other situations related to social isolation, such as older adults living alone.
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Affiliation(s)
- Marlena R. Fraune
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Takanori Komatsu
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
| | - Harrison R. Preusse
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Danielle K. Langlois
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Rachel H. Y. Au
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Katrina Ling
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Shogo Suda
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
| | - Kiko Nakamura
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
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15
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Igarashi T, Nihei M, Inoue T, Sugawara I, Kamata M. Eliciting a User's Preferences by the Self-Disclosure of Socially Assistive Robots in Local Households of Older Adults to Facilitate Verbal Human-Robot Interaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11319. [PMID: 36141591 PMCID: PMC9517098 DOI: 10.3390/ijerph191811319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/25/2022] [Accepted: 08/27/2022] [Indexed: 06/16/2023]
Abstract
To realize a society in which older adults can live independently in their homes and familiar environments for as long as possible, their lives can be supported by providing appropriate technology. In this case, a new intervention for older people using socially assistive robots (SARs) is proposed; however, previous research has demonstrated that individual differences exist in the use and response to SAR interventions, and it has also been reported that SARs are not used by users in some cases. Therefore, in this study, we developed a self-disclosure function to promote continuous interaction with robots, using a Japanese corpus and self-disclosure items. In this study, we defined the specific requirements and functions of self-disclosure in SARs and developed ten non-arbitrary speech scripts from the field of social psychology using a Japanese corpus and self-disclosure items. To evaluate the effect of self-disclosure in SARs, an SAR was introduced to each household for 20 days, with the consent of seven community-dwelling older adults. Based on the recorded voice interaction data, we analyzed how the number, total time, and quality of verbal interactions changed with the SAR's self-disclosure. Furthermore, we conducted group interviews with the participants and received positive comments regarding the robot's self-disclosure. Some participants considered the specific personality of the SAR by accumulating its behavioral characteristics. As a consequence, these results indicate that the robot's self-disclosure feature is effective in significantly increasing the quantity and quality of verbal interactions with older adults.
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Affiliation(s)
- Toshiharu Igarashi
- Department of Human and Engineered Environmental Studies, The University of Tokyo, Kashiwanoha 5-1-5, Kashiwa 277-8563, Chiba, Japan
| | - Misato Nihei
- Department of Human and Engineered Environmental Studies, The University of Tokyo, Kashiwanoha 5-1-5, Kashiwa 277-8563, Chiba, Japan
- Institute of Gerontology, The University of Tokyo, 3-1, Hongo 7-Chome, Bunkyo-ku 113-8654, Tokyo, Japan
| | - Takenobu Inoue
- Research Institute of National Rehabilitation Center for the Persons with Disabilities, 1, Namiki 4-Chome, Tokorozawa 359-8555, Saitama, Japan
| | - Ikuko Sugawara
- Bunri University of Hospitality, 311-1, Kashiwabara-Shinden, Sayama 350-1336, Saitama, Japan
| | - Minoru Kamata
- Department of Human and Engineered Environmental Studies, The University of Tokyo, Kashiwanoha 5-1-5, Kashiwa 277-8563, Chiba, Japan
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16
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Chen SC, Jones C, Moyle W. The Impact of Engagement with the PARO Therapeutic Robot on the Psychological Benefits of Older Adults with Dementia. Clin Gerontol 2022:1-13. [PMID: 36062840 DOI: 10.1080/07317115.2022.2117674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study aimed to examine the effect of 8-weeks of a 60-minute PARO intervention to reduce depressive symptoms and loneliness in older adults with dementia and investigated changes in their emotional or behavioral expressions and level of engagement with the PARO robot. METHODS This was a quasi-experimental study with a repeated measures design. The outcome measures were evaluated at four time-points: before the intervention, week 4, immediately after the intervention, and one month after the PARO intervention. RESULTS Fifty-two participants were recruited. The age of the participants ranged from 65 to 96 years, with a mean age of 81.81 years (SD = 8.54) in the PARO group and 79.08 years (SD = 7.71) in the control group. Using a mixed between-within subjects' analysis of variance, the results showed that there were significant interaction effects between the groups and time-periods for depression (p < .000), loneliness (p < .000), and engagement (p < .000). CONCLUSIONS The PARO intervention alleviated depression and loneliness for older adults. Furthermore, the process of engagement with PARO may play an important role in the PARO effects. CLINICAL IMPLICATIONS A tailored PARO intervention of at least 4 weeks could engender positive psychological benefits for older adults.
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Affiliation(s)
- Shu-Chuan Chen
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan R.O.C
| | - Cindy Jones
- Faculty of Health Sciences & Medicine, Bond University, Queensland, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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17
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Pollak C, Wexler SS, Drury L. Effect of a Robotic Pet on Social and Physical Frailty in Community-Dwelling Older Adults: A Randomized Controlled Trial. Res Gerontol Nurs 2022; 15:229-237. [PMID: 36113009 DOI: 10.3928/19404921-20220830-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current randomized controlled trial investigated the effect of a robotic pet on social and physical frailty in community-dwelling older adults. The intervention group (n = 107) received a robotic pet and the control group (n = 113) received usual care following hospital discharge. Social and physical frailty were measured using the Questionnaire to Define Social Frailty Status and the FRAIL questionnaire. Cognitive function and depression were assessed using the Short Portable Mental Status Questionnaire and Geriatric Depression Scale, respectively. Continuous outcomes were compared between groups using t tests or Wilcoxon rank sum tests, as appropriate. Categorical outcomes were compared between groups using chi-square tests or Fisher's exact tests, as appropriate. Main findings showed the robotic pet positively impacted cognitive status in participants who reported they enjoyed engaging with their pet. This finding supported the theoretical premise of the current study that greater engagement with the robotic pet would yield greater improvement in study outcomes. [Research in Gerontological Nursing, 15(5), 229-237.].
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18
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Obst L, Bielefeldt F, von der Weth R, Dick M. Service Robots in Nursing Homes (SeRoNu): a holistic model of influencing factors. GIO-GRUPPE-INTERAKTION-ORGANISATION-ZEITSCHRIFT FUER ANGEWANDTE ORGANISATIONSPSYCHOLOGIE 2022. [PMCID: PMC9247902 DOI: 10.1007/s11612-022-00639-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This article in the journal Gruppe. Interaktion. Organisation. introduces a model that provides an overview and orientation for science and practice regarding robots in elderly care. Aging societies and the lack of professionals working in elderly care put strain on the care sector in many countries worldwide. Robots can be a possible support for caregivers and assistance for people in need of care. However, their (future) usage comes along with various challenges and currently there are only few examples of use in practice. The data of the developed holistic triple-layered shell model SeRoNu (Service Robots in Nursing Homes) is based on three conducted studies: (I) A work analysis (HTO-Approach; Strohm and Ulich 1997), (II) future workshops (Jungk and Müllert 1989) and (III) expert interviews. Social robot Pepper is used as an example of application, as the model offers a framework for different service robots. The article illustrates the influencing factors and the diversity of robotic solutions to the care crisis. As a result, a multi-professional approach is required as the different aspects need to be considered individually.
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Affiliation(s)
- Lisa Obst
- Hochschule für Technik und Wirtschaft Dresden, Dresden, Germany
| | | | | | - Michael Dick
- Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany
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19
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The Use of Robotic Pets by Community-Dwelling Older Adults: A Scoping Review. Int J Soc Robot 2022. [DOI: 10.1007/s12369-022-00892-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Ghafurian M, Hoey J, Dautenhahn K. Social Robots for the Care of Persons with Dementia. ACM TRANSACTIONS ON HUMAN-ROBOT INTERACTION 2021. [DOI: 10.1145/3469653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Intelligent assistive robots can enhance the quality of life of people with dementia and their caregivers. They can increase the independence of older adults, reduce tensions between a person with dementia and their caregiver, and increase social engagement. This article provides a review of assistive robots designed for and evaluated by persons with dementia. Assistive robots that only increased mobility or brain-computer interfaces were excluded. Google Scholar, IEEE Digital Library, PubMed, and ACM Digital Library were searched. A final set of 53 articles covering research in 16 different countries are reviewed. Assistive robots are categorized into five different applications and evaluated for their effectiveness, as well as the robots’ social and emotional capabilities. Our findings show that robots used in the context of therapy or for increasing engagement received the most attention in the literature, whereas the robots that assist by providing health guidance or help with an activity of daily living received relatively limited attention. PARO was the most commonly used robot in dementia care studies. The effectiveness of each assistive robot and the outcome of the studies are discussed, and particularly, the social/emotional capabilities of each assistive robot are summarized. Gaps in the research literature are identified and we provide directions for future work.
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Affiliation(s)
- Moojan Ghafurian
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Jesse Hoey
- David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Kerstin Dautenhahn
- Departments of Electrical and Computer Engineering/Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
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21
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Chen SC, Davis BH, Kuo CY, Maclagan M, Chien CO, Lin MF. Can the Paro be my Buddy? Meaningful experiences from the perspectives of older adults. Geriatr Nurs 2021; 43:130-137. [PMID: 34883391 DOI: 10.1016/j.gerinurse.2021.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to explore meaningful experiences of older Taiwanese adults who had received a Paro (social robot) companion. Semi-structured qualitative interviews elicited the perspectives of 25 older adults living in a long-term care facility after they had interacted with an individual Paro companion for 8 weeks. Thematic analysis was used in this study as it allows for rich, detailed, and complex descriptions of qualitative data. Analysis identified four themes: Bridging my social bonds; Acting as a comfort Buddy; Relieving my emotional distress; and Encountering Paro with distancing. Although Paro's functioning has some limits, such as lacking speech, most participants expressed that the experience was positive. These findings revealed that the meaningful experiences expressed by participants at the end of the intervention with Paro might provide the value of companionship and improve interpersonal relationships for older adults in geriatric nursing.
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Affiliation(s)
- Shu-Chuan Chen
- Department of Nursing, National Tainan Junior College of Nursing, 78, Sec 2, Minzu Rd., Tainan City, 700, Tainan, Taiwan, ROC
| | - Boyd H Davis
- Applied Linguistics/English, University of North Carolina-Charlotte, 61 Henan 3rd Rd, Taichung City, 407, Taiwan, ROC
| | - Ching-Yi Kuo
- MA in Counseling, University of North Texas, Denton, TX, USA
| | - Margaret Maclagan
- School of Psychology, Speech and Hearing
- Te Kura Mahi ā-Hirikapo, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Chun-O Chien
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, No. 1, Tai-Hsueh Road, Tainan City 701, Taiwan, ROC.
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22
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Kim J, Kim S, Kim S, Lee E, Heo Y, Hwang CY, Choi YY, Kong HJ, Ryu H, Lee H. Companion robots for older adults: Rodgers' evolutionary concept analysis approach. INTEL SERV ROBOT 2021; 14:729-739. [PMID: 34804242 PMCID: PMC8593639 DOI: 10.1007/s11370-021-00394-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 10/15/2021] [Indexed: 12/30/2022]
Abstract
This study aims to analyze the concept of companion robots for older adults from the perspective of nursing. This study employed a concept analysis. The literature from July 2011 to June 2021 was sought from databases using specific keywords. Any quantitative or qualitative study published in English or Korean focusing on companion robots for older adults was included in the study. Rodgers' evolutionary concept analysis was used to clarify the antecedents, attributes, and consequences. Seventy-five eligible articles were studied. The findings were categorized into antecedents, attributes, and consequences. Companion robot antecedents were classified into individual factors, attitude toward robots, and caregiver and social factors. The defining attributes included human-robot interaction, function, features, structure, cost, and management of the robot being a companion. Consequences were categorized into user, caregiver, and health related. Companion robots are designed to enhance well-being, quality of life, and independence by providing service and companionship and assisting daily life. This mainly includes cognitive and social support, mobility support, relaxation, health monitoring, and self-care support through human-robot interaction. The attributes, antecedents, and consequences of companion robots identified in this study can inform future decision making and interventions by caregivers for aging in place.
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Affiliation(s)
- Jeongeun Kim
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Sukwha Kim
- Department of Reconstructive Plastic Surgery, Medical Big Data Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seongheui Kim
- College of Fine Arts, Seoul National University, Seoul, Republic of Korea
| | - Euehun Lee
- Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Yoonjeong Heo
- College of Music, Seoul National University, Seoul, Republic of Korea
| | - Cheol-Yong Hwang
- College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Yun-Young Choi
- College of Humanities, Seoul National University, Seoul, Republic of Korea
| | - Hyoun-Joong Kong
- Transdisciplinary Department of Medicine and Advanced Technology (TDMAT), Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeongju Ryu
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeongsuk Lee
- College of Nursing, Gachon University, Seoul, Republic of Korea
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23
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Carradore M. People’s Attitudes Towards the Use of Robots in the Social Services: A Multilevel Analysis Using Eurobarometer Data. Int J Soc Robot 2021. [DOI: 10.1007/s12369-021-00831-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AbstractRobots have been employed in the industrial sectors for over half a century; however, their appearance in the domestic sphere is a modern phenomenon, occurring in just the last decade. These so-called social robots are carrying out a variety of tasks traditionally carried out by humans, and in contexts in which they must interact with human beings. These kinds of social robots are now being used in the welfare services, providing assistive services and companionship for the infirm or elderly, and even children. Thus, the use of social robots in everyday life has triggered an animated debate about the acceptance of these devices by their end users. In this paper, multilevel analysis is applied using data from the Eurobarometer survey (sample size 27,901, covering 28 countries) to investigate how socio-demographic characteristics and country-level indicators of technological and economic development (the rate of high-technology manufactured exports, the cellular phone subscriptions rate and GDP) influence how robots are accepted in the realm of the social services. The results show that only individual (socio-demographic) and technology acceptance model (TAM) factors influence attitudes towards social robots. The effects of the contextual variables considered were not statistically strong enough to explain the attitudes towards social robots for social services.
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24
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Context-Enhanced Human-Robot Interaction: Exploring the Role of System Interactivity and Multimodal Stimuli on the Engagement of People with Dementia. Int J Soc Robot 2021. [DOI: 10.1007/s12369-021-00823-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractEngaging people with dementia (PWD) in meaningful activities is the key to promote their quality of life. Design towards a higher level of user engagement has been extensively studied within the human-computer interaction community, however, few extend to PWD. It is generally considered that increased richness of experiences can lead to enhanced engagement. Therefore, this paper explores the effects of rich interaction in terms of the role of system interactivity and multimodal stimuli by engaging participants in context-enhanced human-robot interaction activities. The interaction with a social robot was considered context-enhanced due to the additional responsive sensory feedback from an augmented reality display. A field study was conducted in a Dutch nursing home with 16 residents. The study followed a two by two mixed factorial design with one within-subject variable - multimodal stimuli - and one between-subject variable - system interactivity. A mixed method of video coding analysis and observational rating scales was adopted to assess user engagement comprehensively. Results disclose that when additional auditory modality was included besides the visual-tactile stimuli, participants had significantly higher scores on attitude, more positive behavioral engagement during activity, and a higher percentage of communications displayed. The multimodal stimuli also promoted social interaction between participants and the facilitator. The findings provide sufficient evidence regarding the significant role of multimodal stimuli in promoting PWD’s engagement, which could be potentially used as a motivation strategy in future research to improve emotional aspects of activity-related engagement and social interaction with the human partner.
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25
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Zhang D, Shen J, Li S, Gao K, Gu R. I, robot: depression plays different roles in human-human and human-robot interactions. Transl Psychiatry 2021; 11:438. [PMID: 34420040 PMCID: PMC8380250 DOI: 10.1038/s41398-021-01567-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/04/2021] [Accepted: 08/13/2021] [Indexed: 02/07/2023] Open
Abstract
Socially engaging robots have been increasingly applied to alleviate depressive symptoms and to improve the quality of social life among different populations. Seeing that depression negatively influences social reward processing in everyday interaction, we investigate this influence during simulated interactions with humans or robots. In this study, 35 participants with mild depression and 35 controls (all from nonclinical populations) finished the social incentive delay task with event-related potential recording, in which they received performance feedback from other persons or from a robot. Compared to the controls, the mild depressive symptom (MDS) group represented abnormalities of social reward processing in the human feedback condition: first, the MDS group showed a lower hit rate and a smaller contingent-negative variation (correlated with each other) during reward anticipation; second, depression level modulated both the early phase (indexed by the feedback-related negativity (FRN)) and the late phase (indexed by the P3) of reward consumption. In contrast, the effect of depression was evident only on FRN amplitude in the robot feedback condition. We suggest that compared to human-human interaction, the rewarding properties of human-robot interaction are less likely to be affected by depression. These findings have implications for the utilization of robot-assisted intervention in clinical practice.
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Affiliation(s)
- Dandan Zhang
- School of Psychology, Shenzhen University, 518060, Shenzhen, China.
- Magnetic Resonance Imaging Center, Shenzhen University, 518060, Shenzhen, China.
| | - Junshi Shen
- School of Psychology, Shenzhen University, 518060, Shenzhen, China
| | - Sijin Li
- School of Psychology, Shenzhen University, 518060, Shenzhen, China
| | - Kexiang Gao
- School of Psychology, Shenzhen University, 518060, Shenzhen, China
| | - Ruolei Gu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 100101, Beijing, China.
- Department of Psychology, University of Chinese Academy of Sciences, 100049, Beijing, China.
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26
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Shourmasti ES, Colomo-Palacios R, Holone H, Demi S. User Experience in Social Robots. SENSORS (BASEL, SWITZERLAND) 2021; 21:5052. [PMID: 34372289 PMCID: PMC8348916 DOI: 10.3390/s21155052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022]
Abstract
Social robots are increasingly penetrating our daily lives. They are used in various domains, such as healthcare, education, business, industry, and culture. However, introducing this technology for use in conventional environments is not trivial. For users to accept social robots, a positive user experience is vital, and it should be considered as a critical part of the robots' development process. This may potentially lead to excessive use of social robots and strengthen their diffusion in society. The goal of this study is to summarize the extant literature that is focused on user experience in social robots, and to identify the challenges and benefits of UX evaluation in social robots. To achieve this goal, the authors carried out a systematic literature review that relies on PRISMA guidelines. Our findings revealed that the most common methods to evaluate UX in social robots are questionnaires and interviews. UX evaluations were found out to be beneficial in providing early feedback and consequently in handling errors at an early stage. However, despite the importance of UX in social robots, robot developers often neglect to set UX goals due to lack of knowledge or lack of time. This study emphasizes the need for robot developers to acquire the required theoretical and practical knowledge on how to perform a successful UX evaluation.
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Affiliation(s)
| | - Ricardo Colomo-Palacios
- Department of Computer Science, Østfold University College, 1783 Halden, Norway; (E.S.S.); (H.H.); (S.D.)
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27
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Bhat AS, Boersma C, Meijer MJ, Dokter M, Bohlmeijer E, Li J. Plant Robot for At-Home Behavioral Activation Therapy Reminders to Young Adults with Depression. ACM TRANSACTIONS ON HUMAN-ROBOT INTERACTION 2021. [DOI: 10.1145/3442680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adolescents with depression who participate in behavioral activation therapy may find it hard to be motivated to perform tasks at home that their therapists recommend. We describe the initial design and usability evaluation of a home device (“PlantBot”) that could be used to remind young adults with depression at home of their behavioral activation therapy-related tasks. The prototype features electronics in a two-layer base, with a fake plant on top and supported using the Amazon Echo voice agent. We use an online panel study to evaluate the usability of our system with youth with past depression (
N
= 30). Initial findings highlight the device’s usability, potential benefit, and attractiveness of the plant component, as well as multiple improvements to be made.
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Affiliation(s)
| | | | | | | | | | - Jamy Li
- University of Twente, The Netherlands
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Barriers and facilitators to the implementation of social robots for older adults and people with dementia: a scoping review. BMC Geriatr 2021; 21:351. [PMID: 34107876 PMCID: PMC8191065 DOI: 10.1186/s12877-021-02277-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Abstract
Background Psychosocial issues, such as social isolation and loneliness among older adults and people with dementia, continue to pose challenges with a rapidly aging population worldwide. Social robots are a rapidly emerging field of technology, developed to help address the psychosocial needs of this population. Although studies have reported positive findings regarding their psychosocial benefits, their implementation in real-world practice remains a challenge. Nevertheless, little is known about the factors affecting their implementation. The purpose of this review is to provide a systematic overview of the barriers and facilitators affecting the implementation of social robots for older adults and people with dementia. Method The Arksey and O’Malley approach with methodological enhancement by Levac et al. was used to guide the conduct of this review. Seven electronic databases were searched. In addition, hand searching and backward citation tracing was conducted. Three independent reviewers were involved in the screening and data charting process. Findings were synthesised and categorised into the five domains outlined in the Consolidated Framework of Implementation Research (CFIR). Results A total of 53 studies were included in the final review. Most of the included studies were based in participants’ homes and in care facilities. Barriers and facilitators were mapped onto 18 constructs in the five domains of the CFIR. The most frequently cited barriers were mapped to the constructs within the domain of “Intervention characteristics”, where issues such as the complexity of using the technology and technical obstacles impeded implementation. Most facilitators were mapped onto the domain “Patient needs and resources”. Overall, existing research are disproportionately focused on the internal validity (i.e. characteristics) of social robots, and there is significantly less research investigating their external validity, such as organisational or wider contextual factors that can affect their implementation in real-world practice. Conclusion This review has identified and synthesised the breadth of evidence on the barriers and facilitators to the implementation of social robots for older adults and people with dementia. Future research should pay more attention to investigating the contextual factors, using an implementation framework, to identify barriers and facilitators to guide the implementation of social robots. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02277-9.
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Atashzar SF, Carriere J, Tavakoli M. Review: How Can Intelligent Robots and Smart Mechatronic Modules Facilitate Remote Assessment, Assistance, and Rehabilitation for Isolated Adults With Neuro-Musculoskeletal Conditions? Front Robot AI 2021; 8:610529. [PMID: 33912593 PMCID: PMC8072151 DOI: 10.3389/frobt.2021.610529] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Worldwide, at the time this article was written, there are over 127 million cases of patients with a confirmed link to COVID-19 and about 2.78 million deaths reported. With limited access to vaccine or strong antiviral treatment for the novel coronavirus, actions in terms of prevention and containment of the virus transmission rely mostly on social distancing among susceptible and high-risk populations. Aside from the direct challenges posed by the novel coronavirus pandemic, there are serious and growing secondary consequences caused by the physical distancing and isolation guidelines, among vulnerable populations. Moreover, the healthcare system's resources and capacity have been focused on addressing the COVID-19 pandemic, causing less urgent care, such as physical neurorehabilitation and assessment, to be paused, canceled, or delayed. Overall, this has left elderly adults, in particular those with neuromusculoskeletal (NMSK) conditions, without the required service support. However, in many cases, such as stroke, the available time window of recovery through rehabilitation is limited since neural plasticity decays quickly with time. Given that future waves of the outbreak are expected in the coming months worldwide, it is important to discuss the possibility of using available technologies to address this issue, as societies have a duty to protect the most vulnerable populations. In this perspective review article, we argue that intelligent robotics and wearable technologies can help with remote delivery of assessment, assistance, and rehabilitation services while physical distancing and isolation measures are in place to curtail the spread of the virus. By supporting patients and medical professionals during this pandemic, robots, and smart digital mechatronic systems can reduce the non-COVID-19 burden on healthcare systems. Digital health and cloud telehealth solutions that can complement remote delivery of assessment and physical rehabilitation services will be the subject of discussion in this article due to their potential in enabling more effective and safer NMSDK rehabilitation, assistance, and assessment service delivery. This article will hopefully lead to an interdisciplinary dialogue between the medical and engineering sectors, stake holders, and policy makers for a better delivery of care for those with NMSK conditions during a global health crisis including future pandemics.
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Affiliation(s)
- S. Farokh Atashzar
- Department of Electrical and Computer Engineering, Department of Mechanical and Aerospace Engineering, New York University, New York, NY, United States
| | - Jay Carriere
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada
| | - Mahdi Tavakoli
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada
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30
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Effects of social robots on depressive symptoms in older adults: a scoping review. LIBRARY HI TECH 2021. [DOI: 10.1108/lht-09-2020-0244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This review scopes evidence on the use of social robots for older adults with depressive symptoms, in the scenario of smart cities, analyzing the age-related depression specificities, investigated contexts and intervention protocols' features.
Design/methodology/approach
Studies retrieved from two major databases were selected against inclusion and exclusion criteria. Studies were included if used social robots, included older adults over 60, and reported depressive symptoms measurements, with any type of research design. Papers not published in English, published as an abstract or study protocol, or not peer-reviewed were excluded.
Findings
28 relevant studies were included, in which PARO was the most used robot. Most studies included very older adults with neurocognitive disorders living in long-term care facilities. The intervention protocols were heterogeneous regarding the duration, session duration and frequency. Only 35.6% of the studies had a control group. Finally, only 32.1% of the studies showed a significant improvement in depression symptoms.
Originality/value
Despite the potential for using social robots in mental health interventions, in the scenario of smart cities, this review showed that their usefulness and effects in improving depressive symptoms in older adults have low internal and external validity. Future studies should consider factors as planning the intervention based on well-established supported therapies, characteristics and needs of the subjects, and the context in which the subjects are inserted.
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31
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Wu PY, Chen KM, Tsai WC. The Mediterranean Dietary Pattern and Inflammation in Older Adults: A Systematic Review and Meta-analysis. Adv Nutr 2021; 12:363-373. [PMID: 33002104 PMCID: PMC8009747 DOI: 10.1093/advances/nmaa116] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/23/2020] [Accepted: 08/26/2020] [Indexed: 01/19/2023] Open
Abstract
This systematic review and meta-analysis aimed to explore the association between the Mediterranean dietary pattern and inflammation in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A search of the literature was conducted up to June 2020 in 7 electronic databases, namely PubMed, Embase, Web of Science, Scopus, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and ProQuest. The Joanna Briggs Institute Critical Appraisal Checklists and the Newcastle-Ottawa Scale were used to assess the methodological quality. The overall standardized mean difference (SMD) and 95% CIs were estimated in random-effects meta-analyses. Thirteen studies were identified as having acceptable quality and were included in this systematic review: 3 randomized controlled trials (RCTs), 1 quasi-experimental study, 1 cohort study, and 8 cross-sectional studies. The circulating C-reactive protein (CRP) concentration was the most common inflammation indicator used. Results of the meta-analysis on 5 cross-sectional studies revealed a significant inverse association between the Mediterranean dietary pattern and inflammation as assessed by CRP (SMD = -0.26; 95% CI: -0.41, -0.11; P < 0.001). Other studies that investigated a variety of inflammation indicators other than CRP showed mixed results with regard to the relation between the Mediterranean dietary pattern and inflammation in older adults. Our findings suggest that the Mediterranean dietary pattern may be associated with lower inflammation in older adults. However, more long-term RCTs are required to demonstrate the effects of the Mediterranean dietary pattern on multiple inflammation parameters in older adults. The study has been registered on PROSPERO (#CRD42020140145).
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Affiliation(s)
- Pei-Yu Wu
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Chi Tsai
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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32
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Lin TY, Lin CT, Chen KM, Hsu HF. Information technology on hand hygiene compliance among health care professionals: A systematic review and meta-analysis. J Nurs Manag 2021; 29:1857-1868. [PMID: 33772923 DOI: 10.1111/jonm.13316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 12/25/2022]
Abstract
AIM To determine the effectiveness of information technology interventions on hand hygiene compliance among health care professionals. BACKGROUND Performing hand hygiene is the optimal approach to prevent the transmission of health care-associated infections. However, results regarding the effectiveness of information technology interventions on hand hygiene compliance were inconsistent to date. EVALUATION A search for studies published up to May 2020 was undertaken. A meta-analysis was conducted using RevMan 5.3 software. KEY ISSUES The most commonly used information technology systems were as follows: automated training, electronic counting devices and remote monitoring, real-time hand hygiene reminders and feedback, and automated monitoring. These four types of technology systems can significantly improve hand hygiene compliance among health care professionals (odds ratio = 3.06, p < .001). CONCLUSION The four types of information technology can be effectively used to change the hand hygiene behaviour. Because the information systems can monitor personnel and conduct statistical analyses automatically, they save labour costs of human monitors, are more time efficient and eliminate accompanying human error. IMPLICATIONS FOR NURSING MANAGEMENT The use of the four types of information technology is convenient and could reduce health care-associated infections; thus, they could be widely used in the future as the key to increase hand hygiene compliance rate.
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Affiliation(s)
- Tang-Yu Lin
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Ting Lin
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Fen Hsu
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
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33
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Affiliation(s)
- J E Morley
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University, SLUCare Academic Pavilion, Section 2500, 1008 S. Spring Ave., 2nd Floor St. Louis, MO 63110, , Twitter: @drjohnmorley
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Smith E, Storch EA, Vahia I, Wong STC, Lavretsky H, Cummings JL, Eyre HA. Affective Computing for Late-Life Mood and Cognitive Disorders. Front Psychiatry 2021; 12:782183. [PMID: 35002802 PMCID: PMC8732874 DOI: 10.3389/fpsyt.2021.782183] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/29/2021] [Indexed: 12/20/2022] Open
Abstract
Affective computing (also referred to as artificial emotion intelligence or emotion AI) is the study and development of systems and devices that can recognize, interpret, process, and simulate emotion or other affective phenomena. With the rapid growth in the aging population around the world, affective computing has immense potential to benefit the treatment and care of late-life mood and cognitive disorders. For late-life depression, affective computing ranging from vocal biomarkers to facial expressions to social media behavioral analysis can be used to address inadequacies of current screening and diagnostic approaches, mitigate loneliness and isolation, provide more personalized treatment approaches, and detect risk of suicide. Similarly, for Alzheimer's disease, eye movement analysis, vocal biomarkers, and driving and behavior can provide objective biomarkers for early identification and monitoring, allow more comprehensive understanding of daily life and disease fluctuations, and facilitate an understanding of behavioral and psychological symptoms such as agitation. To optimize the utility of affective computing while mitigating potential risks and ensure responsible development, ethical development of affective computing applications for late-life mood and cognitive disorders is needed.
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Affiliation(s)
- Erin Smith
- The PRODEO Institute, San Francisco, CA, United States.,Organisation for Economic Co-operation and Development (OECD), Paris, France.,Department of Neurology & Neurological Sciences, Stanford University, Stanford, CA, United States.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Ipsit Vahia
- Division of Geriatric Psychiatry, McLean Hospital, Boston, MA, United States.,Division of Geriatric Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Stephen T C Wong
- Systems Medicine and Biomedical Engineering Houston Methodist, Houston, TX, United States
| | - Helen Lavretsky
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jeffrey L Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas (UNLV), Las Vegas, NV, United States
| | - Harris A Eyre
- The PRODEO Institute, San Francisco, CA, United States.,Organisation for Economic Co-operation and Development (OECD), Paris, France.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.,IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
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35
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Hsu HF, Chen KM, Belcastro F, Chen YF. Polypharmacy and pattern of medication use in community-dwelling older adults: A systematic review. J Clin Nurs 2020; 30:918-928. [PMID: 33325067 DOI: 10.1111/jocn.15595] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/13/2020] [Accepted: 12/04/2020] [Indexed: 12/12/2022]
Abstract
AIM To synthesise current study findings on the diseases and the corresponding medications that are potentially associated with polypharmacy in community-dwelling older adults. BACKGROUND Polypharmacy is receiving increased attention as a potential problem for the older population. Although several scientific investigations have studied polypharmacy, most of them were carried out in long-term care facilities or mixed settings rather than in community settings solely. METHODS This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant studies published in the English language in peer-reviewed journals were identified from searches of seven electronic databases for the period of January 2000 through December 2019. Inclusion criteria were: (1) Participants were older adults aged 65 years and older; (2) Polypharmacy was defined by medication count; (3) Medication classes associated with polypharmacy were revealed; (4) Studies were conducted in outpatient care or community settings. The Joanna Briggs Institute critical appraisal checklists for cross-sectional studies and for cohort studies were used to assess the methodological quality. RESULTS Ten studies were considered having appropriate and acceptable quality to be reviewed, comprising nine cross-sectional studies and one cohort study. Polypharmacy was most defined as concurrently using five or more medications. Polypharmacy prevalence ranged between 7%-45%. Older age, comorbidity, poor self-perceived health status, limitations in physical activity, history of falls, depression, and pain were positively associated with polypharmacy. The most prevalent medication taken by older adults with polypharmacy was cardiovascular drugs. CONCLUSIONS The prevalence of polypharmacy in older adults varying widely may be due to geographical locations, clinical practice guidelines, and polypharmacy definition used. RELEVANCE TO CLINICAL PRACTICE Validated measurements to investigate medications associated with polypharmacy are required. How polypharmacy develops over time needs to be investigated in longitudinal studies in order to formulate strategies for reducing polypharmacy.
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Affiliation(s)
- Hui-Fen Hsu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, Dubuque, IA, USA
| | - Yih-Fung Chen
- Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
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36
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Wu PY, Chen KM, Belcastro F. Dietary patterns and depression risk in older adults: systematic review and meta-analysis. Nutr Rev 2020; 79:976-987. [PMID: 33236111 DOI: 10.1093/nutrit/nuaa118] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
CONTEXT Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations. OBJECTIVE The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults. DATA SOURCES Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design. DATA EXTRACTION Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. DATA ANALYSIS Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78-0.92; P < 0.001). There was high heterogeneity (I2 = 64.9%; P < 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity. CONCLUSIONS An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD 42020169195.
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Affiliation(s)
- Pei-Yu Wu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,College of Nursing; and the Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, Dubuque, Iowa, USA
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37
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Kelly JT, Campbell KL, Gong E, Scuffham P. The Internet of Things: Impact and Implications for Health Care Delivery. J Med Internet Res 2020; 22:e20135. [PMID: 33170132 PMCID: PMC7685921 DOI: 10.2196/20135] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/16/2020] [Accepted: 09/15/2020] [Indexed: 01/19/2023] Open
Abstract
The Internet of Things (IoT) is a system of wireless, interrelated, and connected digital devices that can collect, send, and store data over a network without requiring human-to-human or human-to-computer interaction. The IoT promises many benefits to streamlining and enhancing health care delivery to proactively predict health issues and diagnose, treat, and monitor patients both in and out of the hospital. Worldwide, government leaders and decision makers are implementing policies to deliver health care services using technology and more so in response to the novel COVID-19 pandemic. It is now becoming increasingly important to understand how established and emerging IoT technologies can support health systems to deliver safe and effective care. The aim of this viewpoint paper is to provide an overview of the current IoT technology in health care, outline how IoT devices are improving health service delivery, and outline how IoT technology can affect and disrupt global health care in the next decade. The potential of IoT-based health care is expanded upon to theorize how IoT can improve the accessibility of preventative public health services and transition our current secondary and tertiary health care to be a more proactive, continuous, and coordinated system. Finally, this paper will deal with the potential issues that IoT-based health care generates, barriers to market adoption from health care professionals and patients alike, confidence and acceptability, privacy and security, interoperability, standardization and remuneration, data storage, and control and ownership. Corresponding enablers of IoT in current health care will rely on policy support, cybersecurity-focused guidelines, careful strategic planning, and transparent policies within health care organizations. IoT-based health care has great potential to improve the efficiency of the health system and improve population health.
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Affiliation(s)
- Jaimon T Kelly
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Centre of Applied Health Economics, Griffith University, Brisbane, Australia
| | - Katrina L Campbell
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Centre of Applied Health Economics, Griffith University, Brisbane, Australia
- Metro North Hospital and Health Service, Brisbane, Australia
| | - Enying Gong
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Paul Scuffham
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Centre of Applied Health Economics, Griffith University, Brisbane, Australia
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Vikkelsø S, Hoang TH, Carrara F, Hansen KD, Dinesen B. The telepresence avatar robot OriHime as a communication tool for adults with acquired brain injury: an ethnographic case study. INTEL SERV ROBOT 2020. [DOI: 10.1007/s11370-020-00335-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Impact of the introduction of a verbal socially assistive robot on the relationship between older people and their caregivers in a nursing home. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-03434-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractThis study was aimed at investigating the changes in relationship between older people and caregivers caused by the introduction of a verbal socially assistive robot (SAR) in a nursing home. Twenty-one older people residing on one floor of the nursing home and eight caregivers working at the nursing home participated in the study. A time study was conducted, and behaviours were observed before the introduction of the verbal SAR, on day 1 of the introduction, and on day 14 after the introduction. Pepper (Softbank Co. Ltd.) was used in this study. The conversation time between residents and caregivers increased after the introduction of the verbal SAR. At the time of introduction of the verbal SAR, caregivers were providing personalized care to residents during group gymnastics activities (e.g., talking to them and providing movement instructions). The results of the study indicate that the introduction of the verbal SAR improved the relationship between the residents and caregivers and contributed in improving the delivered quality of care.
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40
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Rantanen T, Leppälahti T, Porokuokka J, Heikkinen S. Impacts of a Care Robotics Project on Finnish Home Care Workers' Attitudes towards Robots. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197176. [PMID: 33007993 PMCID: PMC7579177 DOI: 10.3390/ijerph17197176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/21/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022]
Abstract
Technological advances in elderly care have been rapid, and the introduction of robots in care will be a topical issue in the near future. There has been little research into the possibility of influencing care workers’ attitudes towards robots by project activities, and how to make the change easier for work communities. This study focuses on a robotics project that took place in elderly and home care services in one municipality in Finland (total of 45 care workers). During the project, four robotics workshops and one extended pilot session were implemented. The study follows quasi-experimental settings, and it included two measurements (before and after project activities) and a control group, but no randomization. The data were collected by questionnaires and were analyzed statistically. The project under study brought about minor positive changes in home care workers’ attitudes towards the usefulness of care robots. In the final measurement, the difference between the test group and the control group was significant in the two dimensions of positive attitudes. The research supports the hypothesis that project activities can be used to influence home care workers’ attitudes towards robots. This can also facilitate the introduction of care robots in home care services. However, the construction of a technology-positive care culture is a long-term process, which requires training and development, technological development and strong strategic management at various levels.
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Affiliation(s)
- Teemu Rantanen
- Tikkurila Campus, Laurea University of Applied Sciences, Ratatie 22, 01300 Vantaa, Finland;
- Correspondence:
| | - Teppo Leppälahti
- Hyvinkää Campus, Laurea University of Applied Sciences, Uudenmaankatu 22, 05800 Hyvinkää, Finland;
| | - Jaakko Porokuokka
- The Finnish Innovation Fund Sitra, Itämerenkatu 11-13, 00181 Helsinki, Finland;
| | - Sari Heikkinen
- Tikkurila Campus, Laurea University of Applied Sciences, Ratatie 22, 01300 Vantaa, Finland;
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41
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Affiliation(s)
- Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
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A social robot intervention on depression, loneliness, and quality of life for Taiwanese older adults in long-term care. Int Psychogeriatr 2020; 32:981-991. [PMID: 32284080 DOI: 10.1017/s1041610220000459] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To investigate the effect of a social robot intervention on depression, loneliness, and quality of life of older adults in long-term care (LTC) and to explore participants' experiences and perceptions after the intervention. DESIGN A mixed-methods approach consisting of a single group, before and after quasi-experimental design, and individual interview. PARTICIPANTS Twenty older adults with depression from four LTC facilities in Taiwan were recruited. INTERVENTION Each participant participated in 8 weeks of observation and 8 weeks of intervention. In the observation stage, participants received usual care or activities without any research intervention. In the intervention stage, each participant was given a Paro (Personal Assistive RobOt) to keep for 24 hours, 7 days a week. MEASUREMENTS The Geriatric Depression Scale, the UCLA Loneliness Scale Version 3, and the World Health Organization Quality of Life Questionnaire for older adults were administered at four time points. Individual qualitative interviews with thematic analysis followed. RESULTS A repeated multivariate analysis of variance and Friedman's test showed no significant changes during the observation stage between T1 and T2 for depression and quality of life (p >.5). For the intervention stage, statistically significant changes in decreasing depression and loneliness and improving quality of life over time were identified. Three themes emerged from the interviews: (i) humanizing Paro through referring to personal experiences and engagement; (ii) increased social interaction with other people; and (iii) companionship resulting in improved mental well-being. CONCLUSIONS There were significant improvements in mental well-being in using Paro. Further research may help us to understand the advantages of using a Paro intervention as depression therapy.
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Chen SC, Jones C, Moyle W. Health Professional and Workers Attitudes Towards the Use of Social Robots for Older Adults in Long-Term Care. Int J Soc Robot 2019. [DOI: 10.1007/s12369-019-00613-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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44
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Pu L, Moyle W, Jones C. How people with dementia perceive a therapeutic robot called PARO in relation to their pain and mood: A qualitative study. J Clin Nurs 2019; 29:437-446. [PMID: 31738463 DOI: 10.1111/jocn.15104] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/19/2019] [Accepted: 11/10/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Interacting with social robots, such as the robotic seal PARO, has been shown to improve mood and acute pain for people with dementia. Little attention has been paid to the effect of PARO on people with dementia and chronic pain. OBJECTIVE To explore how people with mild to moderate dementia and chronic pain perceive PARO as an alternative intervention to manage their pain and mood. DESIGN A descriptive qualitative approach nested within a pilot randomised controlled trial. METHODS Participants with dementia and chronic pain were recruited from three residential aged care facilities. They interacted with PARO for 30 min, 5 days a week over a 6-week period. A sample of 11 participants completed individual semi-structured interviews at the end of the intervention. Data were collected from January 2018-January 2019. Inductive thematic analysis was undertaken. Reporting of findings followed the COREQ checklist. RESULTS Four themes emerged from the data: (a) perceptions of PARO; (b) therapeutic effects of PARO; (c) limitations of PARO; and (d) programme improvement. Residents with dementia expressed positive attitudes towards the use of PARO and acknowledged the therapeutic benefits of PARO on mood improvement and relaxation for pain relief but also mentioned the limitations of its weight, voice and characteristics. Residents' responses could also fluctuate during the intervention process, and individual preferences need to be considered. CONCLUSIONS The PARO intervention is a promising intervention to improve positive emotion, and there is some anecdotal evidence that pain may be decreased from the perspectives of people living with chronic pain and dementia. RELEVANCE TO CLINICAL PRACTICE Long-term care staff may incorporate PARO therapy into daily dementia care. Understanding of individual's preferences may enhance the implementation of PARO for pain management in this group.
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Affiliation(s)
- Lihui Pu
- School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia
| | - Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,Faculty of Health Sciences & Medicine, Bond University, Robina, Qld, Australia
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Fortuna KL, Torous J, Depp CA, Jimenez DE, Areán PA, Walker R, Ajilore O, Goldstein CM, Cosco TD, Brooks JM, Vahia IV, Bartels SJ. A Future Research Agenda for Digital Geriatric Mental Healthcare. Am J Geriatr Psychiatry 2019; 27:1277-1285. [PMID: 31196619 PMCID: PMC7059198 DOI: 10.1016/j.jagp.2019.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 12/23/2022]
Abstract
The proliferation of mobile, online, and remote monitoring technologies in digital geriatric mental health has the potential to lead to the next major breakthrough in mental health treatments. Unlike traditional mental health services, digital geriatric mental health has the benefit of serving a large number of older adults, and in many instances, does not rely on mental health clinics to offer real-time interventions. As technology increasingly becomes essential in the everyday lives of older adults with mental health conditions, these technologies will provide a fundamental service delivery strategy to support older adults' mental health recovery. Although ample research on digital geriatric mental health is available, fundamental gaps in the scientific literature still exist. To begin to address these gaps, we propose the following recommendations for a future research agenda: 1) additional proof-of-concept studies are needed; 2) integrating engineering principles in methodologically rigorous research may help science keep pace with technology; 3) studies are needed that identify implementation issues; 4) inclusivity of people with a lived experience of a mental health condition can offer valuable perspectives and new insights; and 5) formation of a workgroup specific for digital geriatric mental health to set standards and principles for research and practice. We propose prioritizing the advancement of digital geriatric mental health research in several areas that are of great public health significance, including 1) simultaneous and integrated treatment of physical health and mental health conditions; 2) effectiveness studies that explore diagnostics and treatment of social determinants of health such as "social isolation" and "loneliness;" and 3) tailoring the development and testing of innovative strategies to minority older adult populations.
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Affiliation(s)
- Karen L Fortuna
- Geisel School of Medicine, Department of Psychiatry, Dartmouth College, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH.
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Colin A Depp
- Stein Institute for Research on Aging, Department of Psychiatry, University of California, San Diego, CA
| | - Daniel E Jimenez
- University of Miami Miller School of Medicine, Center for Cognitive Neuroscience and Aging, Miami, FL
| | - Patricia A Areán
- University of Washington, Department of Psychiatry & Behavioral Sciences, Seattle, WA
| | - Robert Walker
- Office of Recovery and Empowerment, Massachusetts Department of Mental Health, Boston, MA
| | - Olu Ajilore
- Mood and Anxiety Disorders Program, Department of Mental Health, University of Illinois, Chicago, IL
| | - Carly M Goldstein
- The Miriam Hospital, The Weight Control and Diabetes Research Center, Providence, RI; Alpert Medical School of Brown University, Department of Mental Health & Human Behavior, Providence, RI
| | - Theodore D Cosco
- Gerontology Research Center, Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada; Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Jessica M Brooks
- James J. Peters VA Medical Center, Geriatric Research, Education and Clinical Center, The Bronx, NY
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Jensen EAG, Smith J, Kovach CR. Social Robots, Robotic Assistants, and Home Health Monitoring Devices: A Gerontological Research Perspective. Res Gerontol Nurs 2019; 12:163-166. [PMID: 31335961 DOI: 10.3928/19404921-20190612-02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Laird KT, Krause B, Funes C, Lavretsky H. Psychobiological factors of resilience and depression in late life. Transl Psychiatry 2019; 9:88. [PMID: 30765686 PMCID: PMC6375932 DOI: 10.1038/s41398-019-0424-7] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/28/2018] [Accepted: 01/26/2019] [Indexed: 12/18/2022] Open
Abstract
In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is now recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources. We review psychosocial and neurobiological factors associated with resilience to late-life depression (LLD). Recent research has identified both psychosocial characteristics associated with elevated LLD risk (e.g., insecure attachment, neuroticism) and psychosocial processes that may be useful intervention targets (e.g., self-efficacy, sense of purpose, coping behaviors, social support). Psychobiological factors include a variety of endocrine, genetic, inflammatory, metabolic, neural, and cardiovascular processes that bidirectionally interact to affect risk for LLD onset and course of illness. Several resilience-enhancing intervention modalities show promise for the prevention and treatment of LLD, including cognitive/psychological or mind-body (positive psychology; psychotherapy; heart rate variability biofeedback; meditation), movement-based (aerobic exercise; yoga; tai chi), and biological approaches (pharmacotherapy, electroconvulsive therapy). Additional research is needed to further elucidate psychosocial and biological factors that affect risk and course of LLD. In addition, research to identify psychobiological factors predicting differential treatment response to various interventions will be essential to the development of more individualized and effective approaches to the prevention and treatment of LLD.
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Affiliation(s)
- Kelsey T Laird
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
| | - Beatrix Krause
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
| | - Cynthia Funes
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA.
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