Health promotion and disease prevention with digital technologies for older people: Scoping review

Background

In the aging world digital technologies are needed to target the health needs of older people. This study aimed to identify digital technologies for health promotion and disease prevention for older people by performing a scoping review.

Methods

A search of MEDLINE, PsycINFO, CINAHL and SCOPUS on 09.03.2022 identified 2150 studies. The inclusion criteria were: 1) Population: older people, 2) Concept: any digital health technology, 3) Context: health promotion and disease prevention in home or community settings. Preliminary study selection was performed automatically using the smart groups function in EndNote. Studies were clustered by digital technology type, health target, study design and study focus. Final study selection and data coding will be performed manually by two authors.

Results

Of the 2150 studies, 1874 studies were excluded, 159 studies met the inclusion criteria 1) and 2), but addressed different contexts (digital competence, digital technology development, disease management) or setting (care) and 117 studies were included. Digital technology types were: 1) any technologies (digital, virtual, video, eHealth or telehealth), 2) internet websites accessed via computer, 3) SMS or mobile phones, 4) exergaming or 5) smartphones or wearables. Health targets were: 1) physical activity, 2) mental health and wellness, 3) nutrition or 4) cognitive functioning. Study designs included primary studies (randomized-controlled trials) or reviews (systematic or scoping). Study focus was on effectiveness, feasibility or evaluation of digital technologies.

Conclusions

The health needs of older people are addressed by older technologies. Newer studies use heterogeneous terminology when referring to digital technologies. Future studies should focus on multiple aspects of healthy aging beyond mobility. More work is also needed to understand if and how a shift towards newer technologies occurs and if that is associated with health benefits in older people.

Key messages

• Older digital technologies (computers and mobile phones) address the health needs of older people.

• Mobility is the main health target of digital technologies for older people in the context of health promotion and disease prevention.

Health literacy needs among unemployed adults: Triangulating interview and scoping review data

 

Disadvantaged populations, including unemployed adults, often exhibit low levels of health literacy. Exploring subjectively perceived health literacy needs in these populations can serve as an entry point for participatory intervention development. We aimed to assess health literacy needs of unemployed adults by triangulating qualitative interviews data and a scoping review. Using a parallel approach, we combined results of an interview study with 10 participants of a job-reintegration program in Germany and a scoping review. The interviews, conducted in early 2021, focused on health topics of interest to the participants and their sources of health-related information. Data were analysed using thematic analysis. For the scoping review, we searched MEDLINE, CINAHL, PsycInfo and SCOPUS up to January 2021 for studies containing “unemployed” AND “health literacy” in titles/abstracts. Study selection and data extraction were done independently by two researchers. Nutrition and physical activity emerged as core themes during the interviews, with some participants referring to the importance of both for mental health. Doctors and the institution running the job-reintegration program were the sources of health-related information often mentioned. The Corona pandemic was reported to have limited physical activity and affected psycho-social well-being. Five out of 2696 studies were included in the review. Four focused on mental health literacy, the fifth assessed information seeking practices in unemployed adults. The qualitative analysis revealed that health literacy needs of unemployed adults go beyond mental health literacy. As nutrition and physical activity impact mental health, interventions targeting such topics might also improve mental health literacy in unemployed adults. Study findings will be discussed with unemployed persons and social workers in co-production workshops that aim to identify and prioritize health literacy needs for intervention development.

Key messages

Health literacy programs for unemployed adults should target nutrition and physical activity. Workforce re-integration programs play a pivotal role in improving health literacy of unemployed adults.

Impact of P inputs on source-sink P dynamics of sediment along an agricultural ditch network

Phosphorus (P) loss from intensive dairy farms is a pressure on water quality in agricultural catchments. At farm scale, P sources can enter in-field drains and open ditches, resulting in transfer along ditch networks and delivery into nearby streams. Open ditches could be a potential location for P mitigation if the right location was identified, depending on P sources entering the ditch and the source-sink dynamics at the sediment-water interface. The objective of this study was to identify the right location along a ditch to mitigate P losses on an intensive dairy farm. High spatial resolution grab samples for water quality, along with sediment and bankside samples, were collected along an open ditch network to characterise the P dynamics within the ditch. Phosphorus inputs to the ditch adversely affected water quality, and a step change in P concentrations (increase in mean dissolved reactive phosphorus (DRP) from 0.054 to 0.228 mg L^-1) midway along the section of the ditch sampled, signalled the influence of a point source entering the ditch. Phosphorus inputs altered sediment P sorption properties as P accumulated along the length of the ditch. Accumulation of bankside and sediment labile extractable P, Mehlich 3 P (M3P) (from 13 to 97 mg kg^-1) resulted in a decrease in P binding energies (k) to < 1 L mg^-1 at downstream points and raised the equilibrium P concentrations (EPC₀) from 0.07 to 4.61 mg L^-1 along the ditch. The increase in EPC₀ was in line with increasing dissolved and total P in water, demonstrating the role of sediment downstream in this ditch as a secondary source of P to water. Implementation of intervention measures are needed to both mitigate P loss and remediate sediment to restore the sink properties. In-ditch measures need to account for a physicochemical lag time before improvements in water quality will be observed.

The effects of iodine blocking on thyroid cancer, hypothyroidism and benign thyroid nodules following nuclear accidents: a systematic review

A potential radiation protection method to reduce the risk of adverse health outcomes in the case of accidental radioactive iodine release is the administration of potassium iodide (KI). Although KI administration is recommended by WHO's Guidelines for Iodine Prophylaxis following Nuclear Accidents, a systematic review of the scientific evidence for the guidelines is lacking. Therefore, this study aims to systematically review the effects of KI administration in the case of accidental radioactive iodine release on thyroid cancer, hypothyroidism and benign thyroid nodules. We applied standard systematic review methodology for a search of the literature, selection of eligible studies, data extraction, assessment of risk of bias, assessment of heterogeneity, data synthesis, and the assessment of the quality of the evidence. We searched MEDLINE (via PubMed) and EMBASE. We found one cross-sectional study, one analytic cohort study and two case-control studies relating to our question. The number of participants ranged from 886-12 514. Two studies were conducted in children and two other studies in children and adults. It was not possible to conduct a meta-analysis. We identified low to very low-quality evidence that KI administration after a nuclear accident resulted in a reduction of the risk of thyroid cancer in children; however, the KI administration and dose was not well described in the studies. None of the studies investigated the effects of KI administration in the case of a nuclear accident on hypothyroidism and benign thyroid nodules. Low to very low-quality evidence suggests that KI intake following a nuclear accident may reduce the risk of thyroid cancer in children. No conclusions can be drawn about the effectiveness of KI intake with respect to the prevention of hypothyroidism and benign thyroid nodules.

Acute carcinoid syndrome: a complication of flexible fiberoptic bronchoscopy

We report the case of a patient with functioning bronchial carcinoid tumor found as a solitary nodule. Acute carcinoid syndrome developed during transbronchial biopsy, and life-threatening hypotension occurred during operation. We emphasize that carcinoid tumors should be considered in the differential diagnosis of solitary nodules, and such a complication should be kept in mind when endobronchial or transbronchial biopsy is performed.