Robots in Assisted Living Facilities: Scoping Review.

BACKGROUND: Various technological interventions have been proposed and studied to address the growing demand for care of residents in assisted living facilities, in which a preexisting shortage of professional caregivers has been exacerbated by the COVID-19 pandemic. Care robots are one such intervention with the potential to improve both the care of older adults and the work life of their professional caregivers. However, concerns about efficacy, ethics, and best practices in the applications of robotic technologies in care settings remain. OBJECTIVE: This scoping review aimed to examine the literature on robots used in assisted living facilities and identify gaps in the literature to guide future research. METHODS: On February 12, 2022, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) protocol, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, IEEE Xplore digital library, and ACM Digital Library using predetermined search terms. Publications were included if they were written in English and focused on the use of robotics in assisted living facilities. Publications were excluded if they did not provide peer-reviewed empirical data, focused on user needs, or developed an instrument to study human-robot interaction. The study findings were then summarized, coded, and analyzed using the Patterns, Advances, Gaps, Evidence for practice, and Research recommendations framework. RESULTS: The final sample included 73 publications from 69 unique studies on the use of robots in assisted living facilities. The findings of studies on older adults were mixed, with some studies suggesting positive impacts of robots, some expressing concerns about robots and barriers to their use, and others being inconclusive. Although many therapeutic benefits of care robots have been identified, methodological limitations have weakened the internal and external validity of the findings of these studies. Few studies (18/69, 26%) considered the context of care: most studies (48/69, 70%) collected data only on recipients of care, 15 studies collected data on staff, and 3 studies collected data on relatives or visitors. Theory-driven, longitudinal, and large sample size study designs were rare. Across the authors' disciplines, a lack of consistency in methodological quality and reporting makes it difficult to synthesize and assess research on care robotics. CONCLUSIONS: The findings of this study call for more systematic research on the feasibility and efficacy of robots in assisted living facilities. In particular, there is a dearth of research on how robots may change geriatric care and the work environment within assisted living facilities. To maximize the benefits and minimize the consequences for older adults and caregivers, future research will require interdisciplinary collaboration among health sciences, computer science, and engineering as well as agreement on methodological standards.

Relationship between COVID-19 vaccine hesitancy and willingness to pay for the booster dose of COVID-19 vaccine of oncology patients in Taizhou, China.

OBJECTIVE: This population-based study aimed to determine the hesitancy and willingness to pay (WTP) for the booster dose of a coronavirus disease (COVID-19) vaccine among patients with cancer in Taizhou, China. PATIENTS AND METHODS: A self-administered online questionnaire was administered to patients with cancer in Taizhou, China. The chi-square test, binary logistic regression model were used to evaluate the WTP for the booster dose of a COVID-19 vaccine. The minimum sample size was 218, determined by G*Power software (latest ver. 3.1.9.7). A total of 354 patients received the survey, and 256 (72.3%) patients responded. RESULTS: Overall, 69.9% (179/256) of respondents were willing to pay for the booster dose, and 78.8% (141/179) of these patients were willing to pay 1-99 CNY. Furthermore, 50.4% (129/256) of respondents were hesitant to receive a COVID-19 vaccine. Being unhesitant was significantly associated with WTP for the booster dose (aOR: 3.040; 95% CI: 1.669-5.540). CONCLUSION: Hesitant patients with cancer had a lower WTP for the booster dose against COVID-19 than non-hesitant participants. These results imply that further health education programmes are essential to decrease the hesitancy of patients with cancer and enhance booster dose vaccination rates for public health improvements.KEY MESSAGESOur research showed that 70% of patients with cancer are willing to pay for the booster dose of the COVID-19 vaccine, and most are willing to pay less than 100 CNY, and this result reflects the economic value and affordability of the third dose of vaccination.COVID-19 vaccine-hesitant patients with cancer had a lower willingness to pay for a booster dose against COVID-19 than non-hesitant participants and few patients are still unwilling to pay among patients do not hesitate to receive the third dose.Therefore, promoting willingness to pay among oncology patients and addressing vaccine hesitancy remains key.

Misinformation and COVID-19 vaccine hesitancy.

BACKGROUND: COVID-19 vaccine hesitancy has emerged as a major public health challenge. Although medical and scientific misinformation has been known to fuel vaccine hesitancy in the past, misinformation surrounding COVID-19 seems to be rampant, and increasing evidence suggests that it is contributing to COVID-19 vaccine hesitancy today. The relationship between misinformation and COVID-19 vaccine hesitancy is complex, however, and it is relatively understudied. METHODS: In this article, we report qualitative data from two related but distinct studies from a larger project. Study 1 included semi-structured, open-ended interviews conducted in October-November 2020 via phone with 30 participants to investigate the relationship between misinformation and COVID-19 vaccine hesitancy. Study 1's results then informed the design of open-ended questions for Study 2, an online survey conducted in May-June 2021 to consider the relationship between misinformation and vaccine hesitancy further. The data were examined with thematic analysis. RESULTS: Study 1 led to the identification of positive and negative themes related to attitudes toward COVID-19 vaccines. In Study 2, responses from vaccine-hesitant participants included six categories of misinformation: medical, scientific, political, media, religious, and technological. Across both Study 1 and Study 2, six vaccine hesitancy themes were identified from the data: concerns about the vaccines' future effects, doubts about the vaccines' effectiveness, commercial profiteering, preference for natural immunity, personal freedom, and COVID-19 denial. CONCLUSIONS: The relationship between misinformation and vaccine hesitancy is complicated. Various types of misinformation exist, with each related to a specific type of vaccine hesitancy-related attitude. Personal freedom and COVID-19 denial are vaccine attitudes of particular interest, representing important yet understudied phenomena. Medical and scientific approaches may not be sufficient to combat misinformation based in religion, media, or politics; and public health officials may benefit from partnering with experts from those fields to address harmful misinformation that is driving COVID-19 vaccine hesitancy.

Trust in COVID-19 public health information.

Understanding the factors that influence trust in public health information is critical for designing successful public health campaigns during pandemics such as COVID-19. We present findings from a cross-sectional survey of 454 US adults-243 older (65+) and 211 younger (18-64) adults-who responded to questionnaires on human values, trust in COVID-19 information sources, attention to information quality, self-efficacy, and factual knowledge about COVID-19. Path analysis showed that trust in direct personal contacts (B = 0.071, p = .04) and attention to information quality (B = 0.251, p < .001) were positively related to self-efficacy for coping with COVID-19. The human value of self-transcendence, which emphasizes valuing others as equals and being concerned with their welfare, had significant positive indirect effects on self-efficacy in coping with COVID-19 (mediated by attention to information quality; effect = 0.049, 95% CI 0.001-0.104) and factual knowledge about COVID-19 (also mediated by attention to information quality; effect = 0.037, 95% CI 0.003-0.089). Our path model offers guidance for fine-tuning strategies for effective public health messaging and serves as a basis for further research to better understand the societal impact of COVID-19 and other public health crises.

Challenges encountered in comparing international policy responses to COVID-19 and their effects.

BACKGROUND: A variety of policies have been implemented around the world in response to the COVID-19 pandemic. This study originally aimed to identify and compare policy responses of different countries and their effects on the pandemic. It quickly evolved into an identification of the heterogeneity among existing policies and the challenges in making meaningful comparisons of the impact of these policies. METHODS: The process of collecting and comparing data from different sources was analysed through inductive thematic analysis to understand the obstacles that impede research designed to compare COVID-19 data and related policies. RESULTS: We identified the following obstacles: (1) no single reputable source of information and too much noise; (2) a lack of standards for how to measure and report data across countries; (3) variations in the content, implementation and enforcement of policies; and (4) politics, instead of science, leading the efforts in pandemic management. CONCLUSION: Heterogeneity in existing policies makes it challenging to compare the effects of various policies worldwide on the COVID-19 pandemic. Our findings call for an automatically updated informatics infrastructure across the globe for collecting and maintaining standardized data from multiple sources. There is a strong need for steadfast utilization of scientific and technical experts to inform and influence health policy. Increased investment in public health and emergency planning is essential to overcome the current pandemic, as well as future public health emergencies. Focused leadership and collaboration from world leaders in a unified mission to decrease the mortality and morbidity of the COVID-19 pandemic is imperative.

Factors Associated With the Use of Telehealth in Middle-Aged and Older Adults During the COVID-19 Pandemic

The COVID-19 pandemic has promoted the adoption and use of telehealth, particularly in the early months of the pandemic. However, people with diverse characteristics may, or may not, be able to use telehealth, presenting digital divide in health care and potential health equity-related issues. This study aimed to assess the use of telehealth among middle-aged and older adults during COVID-19, and to explore factors associated with their telehealth utilization. We used publicly available data from the California Health Interview Survey collected during January 2019 and December 2020 (N=15, 279;mean age= 64.23±11.59;female: 52.7%). Approximately 11.0% of the sample used telehealth at least once. Bivariate and multivariate logistical regression analyses found that, compared with non-users, telehealth users were more likely to be having higher numbers of chronic conditions, with self-reported mental distress, living in urban areas, born in the US, with higher English proficiency, higher education, and having higher incomes. Age, race/ethnicity, and gender were not significantly correlated with telehealth usage. Logistic regression revealed that having mental distress (OR=1.48, 95% CI=1.29-1.71, p<0.01), more chronic conditions (OR=1.48, 95% CI=1.29-1.71, p<0.001) and living in an urban area (OR=1.93, 95% CI=1.36-2.74, p<0.001) were independently related to telehealth use. These findings suggest that telehealth, while being beneficial during the pandemic, might also introduce new challenges that exacerbate existing health inequity and disparities. Policy and community-based interventions are needed to promote the use of telehealth among middle-aged and older adults with diverse characteristics.

Understanding the Complexities of Community-Dwelling Older Adults’ Lived Experiences During COVID-19

Since December 2019, COVID-19 has spurred rapid and extensive research, but this research has focused on some perspectives with others understudied. In particular, studies have not yet explored the complexities of community-dwelling older adults’ lived experiences during the pandemic. This study aimed to address this gap. Community-dwelling older adults living in Central Texas (N = 200;age, 65–92 years, M = 73.6± 6.33) responded to open- and closed-ended questions over the telephone during June–August 2020. Data were analyzed using inductive thematic analysis. We identified three key themes. (1) Positive experiences, with 4 subthemes: perception that the pandemic has not changed one’s lifestyle;adjusting well—particularly with the aid of technology;being positive in perspective;and a “loner advantage” (being a “loner” pre-pandemic was advantageous during the pandemic). (2) Mixed experiences, with 4 subthemes: doing okay but unhappy about changing lifestyle routines;doing okay but unhappy about loss of in-person interactions with family and friends;doing okay but frustrated by witnessing absence of social distancing or facemask use by others;and maintaining physical health with fluctuating symptoms of depression or anxiety. (3) Negative experiences, with 3 subthemes: bitter about others/society/government not caring for older adults;feeling isolated, bored, and powerless;and worsening as time goes by. A thematic map was subsequently developed. These findings reveal the complexities of community-dwelling older adults’ lived experiences, illustrating effective coping and resilience during the pandemic and dissatisfaction owing to the pandemic’s effects on their lives and to their observations of others’ behaviors.

Older Adults' Online and Offline Social Interactions During the COVID-19 Pandemic

During the COVID-19 pandemic, much of our social interaction has transitioned from in-person to online. This study examined older adults’ social interaction during COVID-19, online and offline. Participants were recruited from community-dwelling older adults in Central Texas. Data collection took place via the telephone during June-August 2020 (N = 200;age range: 65-92 years;Mean: 73.6;SD: 6.33). Participants used a variety of communication modes, including phone or texting (used by 99% of the participants);email (44%);in person (35%);video chat (31%);social media (24%);and postal mail (4%). Most participants (77%) used more than one communication mode. Participants discussed their preferences for and challenges of technology (i.e., smart phones) and its applications (i.e., video chat, telehealth, and social media). Participants’ self-reported experiences ranged from positive (50%), mixed (35%), to negative (15%). These findings will inform policy and community interventions to promote older adults’ social interactions during the pandemic.

Factors Predicting Community-dwelling Older Adults’ COVID-19 Experiences in Central Texas

Older adults, disproportionally affected by the COVID-19 pandemic, face health, social and structural vulnerabilities. Their experiences require systematic examination. Our study aimed to examine factors predicting community-dwelling older adults’ experiences during COVID-19. We collected data via the telephone between June-August 2020 from a convenience sample of older adults in Central Texas (N= 200;age range=65-92 years;Mean=73.6, SD=6.33). We conducted multinomial logistic regression analyses to model relationships between self-reported COVID-19 experiences (positive, mixed, negative) and age, gender, race, income, education, frequency of communication with family and friends, feelings of loneliness and amount of COVID-19 information obtained. Factorial analysis revealed no statistically significant interaction effect. Multinomial logistic regression analysis revealed statistically significant main effects of annual household income, feelings of loneliness and amount of COVID-19 information obtained on predicting COVID-19 experiences. Age, gender, race, education, and frequency of communication with family and friends were not significant predictors. The odds of having a positive COVID-19 experience rather than negative experiences increased by 6.94 for an annual household of $60,000- $99,999, and by 6.02 for not feeling lonely. The odds of having a positive experience during COVID-19 rather than mixed increased by 9.90 for an annual household income of $100,000 or more. Participants who reported having “too much information” about COVID-19 were more likely to have mixed experiences compared to those with positive experiences. Our findings underscore the crucial role of financial security and social connections in reducing economic and emotional challenges older adults are facing during this crisis.

Dissemination and Refutation of Rumors During the COVID-19 Outbreak in China: Infodemiology Study.

BACKGROUND: During the outbreak of COVID-19, numerous rumors emerged on the internet in China and caused confusion among the public. However, the characteristics of these rumors in different phases of the epidemic have not been studied in depth, and the official responses to the rumors have not been systematically evaluated. OBJECTIVE: The aims of this study were to evaluate the rumor epidemic and official responses during the COVID-19 outbreak in China and to provide a scientific basis for effective information communication in future public health crises. METHODS: Data on internet rumors related to COVID-19 were collected via the Sina Weibo Official Account to Refute Rumors between January 20 and April 8, 2020, extracted, and analyzed. The data were divided into five periods according to the key events and disease epidemic. Different classifications of rumors were described and compared over the five periods. The trends of the epidemic and the focus of the public at different stages were plotted, and correlation analysis between the number of rumors and the number of COVID-19 cases was performed. The geographic distributions of the sources and refuters of the rumors were graphed, and analyses of the most frequently appearing words in the rumors were applied to reveal hotspots of the rumors. RESULTS: A total of 1943 rumors were retrieved. The median of the response interval between publication and debunking of the rumors was 1 day (IQR 1-2). Rumors in text format accounted for the majority of the 1943 rumors (n=1241, 63.9%); chat tools, particularly WeChat (n=1386, 71.3%), were the most common platform for initial publishing of the rumors (n=1412, 72.7%). In addition to text rumors, Weibo and web pages were more likely to be platforms for rumors released in multimedia formats or in a combination of formats, respectively. Local agencies played a large role in dispelling rumors among social media platforms (1537/1943, 79.1%). There were significant differences in the formats and origins of rumors over the five periods (P<.001). Hubei Province accounted for most of the country's confirmed rumors. Beijing and Wuhan City were the main centers for debunking of disinformation. The words most frequently included in the core messages of the rumors varied by period, indicating shifting in the public's concern. CONCLUSIONS: Chat tools, particularly WeChat, became the major sources of rumors during the COVID-19 outbreak in China, indicating a requirement to establish rumor monitoring and refuting mechanisms on these platforms. Moreover, targeted policy adjustments and timely release of official information are needed in different phases of the outbreak.

Emerging Severe Acute Respiratory Syndrome Coronavirus 2 Mutation Hotspots Associated With Clinical Outcomes and Transmission.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the influence of mutations in the SARS-CoV-2 gene on clinical outcomes is critical for treatment and prevention. Here, we analyzed all high-coverage complete SARS-CoV-2 sequences from GISAID database from January 1, 2020, to January 1, 2021, to mine the mutation hotspots associated with clinical outcome and developed a model to predict the clinical outcome in different epidemic strains. Exploring the cause of mutation based on RNA-dependent RNA polymerase (RdRp) and RNA-editing enzyme, mutation was more likely to occur in severe and mild cases than in asymptomatic cases, especially A > G, C > T, and G > A mutations. The mutations associated with asymptomatic outcome were mainly in open reading frame 1ab (ORF1ab) and N genes; especially R6997P and V30L mutations occurred together and were correlated with asymptomatic outcome with high prevalence. D614G, Q57H, and S194L mutations were correlated with mild and severe outcome with high prevalence. Interestingly, the single-nucleotide variant (SNV) frequency was higher with high percentage of nt14408 mutation in RdRp in severe cases. The expression of ADAR and APOBEC was associated with clinical outcome. The model has shown that the asymptomatic percentage has increased over time, while there is high symptomatic percentage in Alpha, Beta, and Gamma. These findings suggest that mutation in the SARS-CoV-2 genome may have a direct association with clinical outcomes and pandemic. Our result and model are helpful to predict the prevalence of epidemic strains and to further study the mechanism of mutation causing severe disease.

Living Through the COVID-19 Pandemic: Community-Dwelling Older Adults' Experiences.

Increasing research is investigating the COVID-19 pandemic's impact on older adults, but relatively little is known about the complexities of community-dwelling older adults' lived experiences during this historical period. This study aimed to address this gap in the literature by taking a bottom-up, theory-generating, inductive approach. Older adults living in Central Texas (N = 200; age, 65-92 years, M = 73.6 ± 6.33) responded to a telephone interview during June-August 2020. Data were analyzed using inductive thematic analysis. We identified three key themes: positive, mixed, and negative experiences, with a total of 11 subthemes. A thematic map was developed, illustrating potential connections to mental health. These findings reveal the complexities of older adults' lived experiences during COVID-19 and have implications for developing aging-related policies and community-based interventions during future public health crises. Recognizing the complexities of older adults' lived experiences, tailored policies and interventions can be developed to effectively leverage older adults' effective coping and resilience while at the same time helping overcome negative effects among specific subgroups.

Mental health conditions among the general population, healthcare workers and quarantined population during the coronavirus disease 2019 (COVID-19) pandemic.

This study sought to assess the differences in mental health conditions among the general population, quarantined population and healthcare workers during the COVID-19 outbreak in China. An online rapid assessment captured depressive and anxiety symptoms, and sleep quality data. A total of 2689 participants (n=374 general population, n=403 healthcare workers, n=1912 quarantined population) were included in the final statistical analysis. The proportion of individuals with mild and/or serious depression and anxiety were higher in the general population when compared to the quarantined population and healthcare workers (58.6% vs. 25.1%vs. 48.6%, P<0.001; 41.2% vs. 18.5% vs. 35.7%, P<0.001). The prevalence of sleep disturbance was higher among healthcare workers than the general population and quarantined population (29.8% vs. 24.1% vs. 22.7%, P=0.013). Logistic regression analysis showed that, perceived effect on daily life was associated with depression, anxiety and sleep disturbance in the general population, quarantined population and the healthcare workers. The general population had a greater risk of developing psychological problems. The healthcare workers suffered the poorest sleep quality. Future research must further explorethe targeted measures for the general population and healthcare workers while combating COVID-19.

A Double Burden of Exclusion? Digital and Social Exclusion of Older Adults in Times of COVID-19.

The COVID-19 pandemic has excluded older adults from a society based on physical social contact. Vulnerable populations like older adults also tend to be excluded from digital services because they opt not to use the internet, lack necessary devices and network connectivity, or inexperience using the technology. Older adults who are frail and are not online, many of whom are in long-term care facilities, struggle with the double burden of social and digital exclusion. This paper discusses the potential outcomes of this exclusion and provides recommendations for rectifying the situation, with a particular focus on older adults in long-term care facilities.

When Going Digital Becomes a Necessity: Ensuring Older Adults' Needs for Information, Services, and Social Inclusion During COVID-19.

Older adults are in triple jeopardy during COVID-19: compared with younger people, older adults are (1) more likely to develop serious conditions and experience higher mortality; (2) less likely to obtain high quality information or services online; and (3) more likely to experience social isolation and loneliness. Hybrid solutions, coupling online and offline strategies, are invaluable in ensuring the inclusion of vulnerable populations. Most of these solutions require no new inventions. Finding the financial resources for a rapid, well-coordinated implementation is the biggest challenge. Setting up the requisite support systems and digital infrastructure is important for the present and future pandemics.

Global health crises are also information crises: A call to action

Abstract In this opinion paper, we argue that global health crises are also information crises. Using as an example the coronavirus disease 2019 (COVID-19) epidemic, we (a) examine challenges associated with what we term ?global information crises?;(b) recommend changes needed for the field of information science to play a leading role in such crises;and (c) propose actionable items for short- and long-term research, education, and practice in information science.