Oral and Dental Needs and Teledentistry Applications in the Elderly: Real-Time Surveillance Using Google Trends

Featured ApplicationThe present cross-sectional analysis aimed to evaluate the level of interest in oral and dental needs and teledentistry applications among the elderly, as well as whether COVID-19 pandemic outbreaks were influenced by real-time surveillance, using Google Trends. As the number of elderly dental patients continues to increase, there is a growing need for specific interventions that address the biological and psychological issues of this population. Teledentistry represents a healthcare delivery system that can overcome these problems, although the oral and dental care provision methods involved are still unknown to most people. Indeed, there is a need to raise awareness of the indications for teledentistry, the available interventions, and the potential benefits for the oral and dental care of elderly patients.Considering the increasing need for oral and dental care in the elderly, teledentistry has been proposed to improve the education of elderly patients in oral health maintenance and risk factor control, identify patients' concerns in advance, facilitate monitoring, and save time and money. The present cross-sectional analysis of Google search data through real-time surveillance with Google Trends aimed to determine Google users' interest in oral and dental needs and teledentistry applications in the elderly, and to compare search volumes before and after the COVID-19 outbreak. Extracted CVS data were qualitatively analyzed. Pearson and Spearman correlation analyses were performed between searches for "elderly” and "teledentistry”, and all the oral and dental needs and teledentistry applications. The Mann–Whitney U test compared search volumes in the 36 months before and after the beginning of the COVID-19 pandemic. Google users' interest in the elderly and related oral and dental needs was diffusely medium–high, while teledentistry and its applications were of lower interest. Interest in teledentistry and its applications was strongly related to interest in the older population, which is consistent with the assumption that older adults represent the population segment that could benefit most from these tools. A positive correlation was also found between searches for "Elderly” and searches for almost all oral and dental needs typical of the geriatric population. Search volumes increased significantly after the outbreak of the COVID-19 pandemic. More information about teledentistry should be disseminated to increase knowledge and awareness, especially among older patients, about its indications, applications, and advantages.

Teleassistance and telerehabilitation: COVID-19, other epidemic situations and future prospects

Persons with intellectual disability (PwID) and/or and autism spectrum disorder with high support needs (ASD-HSN) have resulted to be among the most vulnerable populations to COVID-19 and distress factors associated to the measures for containing its spread. Telemedicine, particularly teleassistance (TA) and telerehabilitation (TR), was used to manage several health, rehabilitation, and assistance needs, in respect to both the prevention and treatment of the epidemic illness and the continuity of care necessary for the condition of developmental disability and co-occurrent physical or mental disorders. TA and TR can be operated through direct or indirect interaction with the PwID/ASD, in the latter way, intermediation on the local side is provided by a family member, a habitual caregiver or a technician. The present chapter reviews the most frequent TA and TR activities, their prerequisites, ways of use, and objectives, which must be aligned with the more general aim of every individualized therapeutic and rehabilitation plan, which is to promote and favor PwID/ASD's quality of life. Studies on TA and TR efficacy for PwID/ASD are limited, especially concerning adulthood. The few available findings show effectiveness in maintenance or slight improvement of cognitive, adaptive, and occupational skills. Family members and other caregivers reported empowerment of their educational and relational skills with the PwID/ASD, including the management of ordinary and extraordinary activities and critical episodes. In comparison with traditional face-to-face services, main advantages have been identified in higher availability and accessibility, and shorter physical and psychological distance. Main limits are represented by the lack of all aspects of the therapeutic relationship related to physical interaction, possible poor ability to use technology, availability of the technology itself, privacy issue, and distracting factors associated to the home environment. Although feasibility and effectiveness are shown so far, it is unlikely that telemedicine will be able to replace traditional practices, at least in the near future. However, it could represent a valid supplement, integration, or temporary alternative. Future research should provide insights on indications, efficacy assessment, contextual implementation, and operational stability over time of specific TA and TR activities as well as on the use of artificial intelligence, machine learning, and interactive avatars. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Teleassistance and telerehabilitation: COVID-19, other epidemic situations and future prospects

Persons with intellectual disability (PwID) and/or and autism spectrum disorder with high support needs (ASD-HSN) have resulted to be among the most vulnerable populations to COVID-19 and distress factors associated to the measures for containing its spread. Telemedicine, particularly teleassistance (TA) and telerehabilitation (TR), was used to manage several health, rehabilitation, and assistance needs, in respect to both the prevention and treatment of the epidemic illness and the continuity of care necessary for the condition of developmental disability and co-occurrent physical or mental disorders. TA and TR can be operated through direct or indirect interaction with the PwID/ASD, in the latter way, intermediation on the local side is provided by a family member, a habitual caregiver or a technician. The present chapter reviews the most frequent TA and TR activities, their prerequisites, ways of use, and objectives, which must be aligned with the more general aim of every individualized therapeutic and rehabilitation plan, which is to promote and favor PwID/ASD's quality of life. Studies on TA and TR efficacy for PwID/ASD are limited, especially concerning adulthood. The few available findings show effectiveness in maintenance or slight improvement of cognitive, adaptive, and occupational skills. Family members and other caregivers reported empowerment of their educational and relational skills with the PwID/ASD, including the management of ordinary and extraordinary activities and critical episodes. In comparison with traditional face-to-face services, main advantages have been identified in higher availability and accessibility, and shorter physical and psychological distance. Main limits are represented by the lack of all aspects of the therapeutic relationship related to physical interaction, possible poor ability to use technology, availability of the technology itself, privacy issue, and distracting factors associated to the home environment. Although feasibility and effectiveness are shown so far, it is unlikely that telemedicine will be able to replace traditional practices, at least in the near future. However, it could represent a valid supplement, integration, or temporary alternative. Future research should provide insights on indications, efficacy assessment, contextual implementation, and operational stability over time of specific TA and TR activities as well as on the use of artificial intelligence, machine learning, and interactive avatars. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Video-Feedback Approach Improves Parental Compliance to Early Behavioral Interventions in Children with Autism Spectrum Disorders during the COVID-19 Pandemic: A Pilot Investigation.

In the field of autism intervention, a large amount of evidence has demonstrated that parent-mediated interventions are effective in promoting a child's learning and parent caring skills. Furthermore, remote delivery treatments are feasible and can represent a promising opportunity to reach families at distance with positive results. Recently, the sudden outbreak of COVID-19 dramatically disrupted intervention services for autism and forced an immediate reorganization of the territory services toward tele-assisted intervention programs, according to professional and local resources. Our study aimed to conduct a retrospective pilot exploratory investigation on parental compliance, participation, and satisfaction in relation to three different telehealth intervention modalities, such as video feedback, live streaming, and psychoeducation, implemented in the context of a public community setting delivering early autism intervention during the COVID-19 emergency. We found that parents who attended video feedback expressed the highest rate of compliance and participation, while parental psychoeducation showed significantly lower compliance and the highest drop-out rate. Regardless of the tele-assistance modality, all the participants expressed satisfaction with the telehealth experience, finding it useful and effective. Potential benefits and advantages of different remote modalities with reference to parent involvement and effectiveness are important aspects to be taken into account and should be further investigated in future studies.

The experience of patients with diabetes with the use of telemedicine and teleassistance services during the COVID-19 pandemic in Italy: Factors associated with perceived quality and willingness to continue.

AIM: The purpose of this study is to investigate the individual and contextual determinants of the perceived quality (PQ) of the telemedicine and teleassistance (TMTA) services and the willingness to continue (WC) with them among patients with diabetes using TMTA services during the COVID-19 pandemic in one large region of Italy. METHODS: A structured survey was administered to patients with type 1 and 2 diabetes who used TMTA during the first wave of the COVID-19 pandemic. The questionnaire contained questions on TMTA service experience and participants' socio-demographic characteristics. Multiple regression models investigated the independent factors associated with PQ and WC. RESULTS: The final analysis included 569 patients with diabetes (54.7% female), with an average age of 58.1 years. TMTA services' PQ and WC were high. A higher education and being unemployed were factors associated with an increased WC. Older age was negatively related to PQ. Perceived support from TMTA service was positively associated with PQ and WC. Perceived increase in disease self-management was positively associated with PQ and WC. CONCLUSIONS: Our study identified several determinants of PQ and WC. These socio-demographic and TMTA-related factors should be considered in the implementation of care pathways integrating in-person visits with TMTA.

Usage of a Web-Based Platform for Home Care Providers in the Pandemic Context.

The paper presents the usage of a platform for home care providers that integrates telemonitoring functionalities in the context of the recent COVID-19 pandemic.

Patients' Perceived Satisfaction Through Telephone-Assisted Tele-Consultation During the SARS-CoV-2 Pandemic Period: Observational Single-Centre Study at a Tertiary-Referral Colorectal Surgery Department.

Introduction: The pandemic produced by SARS-CoV-2 has obliged us to set up the tele-assistance to offer a continuity of care. This implies an innovation, being the degree of satisfaction of patients unknown. Methods: A telephonic survey was conducted with the validated in the Spanish tool Telehealth Usability Questionnaire (Telehealth Usability Questionnaire; rating from 1-7) of all candidate patients assisted consecutively in the Coloproctology Unit. We included demographic variables, education level, job status, diagnosis and consultation type. A descriptive study was done. The relationship between the willingness of consultation model in the future (telemedicine vs traditional) and the categorical variables was analysed through the chi-squared test. Results: A total of 115 patients were included. The average age was 59.9 years, being 60% women. The average score in each of the survey items was higher than 6 in all the questions but 1. 26.1% of the surveyed patients confessed being advocated to tele-assistance in the future. The only factors related to greater willingness to tele-assistance were male gender (37% vs 18.8%; P = .03) and a higher academic preparation level in favour of higher technical studies (35.9%) and university studies (32.4%) opposite to the rest (P = .043). The rest of variables studied, job status, labour regimen, diagnostic group and consultation type did not show any relationship. Conclusions: A vast majority of patients answered favourably to almost all the items of the survey. However, only 26.1% of them would choose a model of tele-assistance without restrictions.

Teleassistance for Patients With Type 1 Diabetes During the COVID-19 Pandemic: Results of a Pilot Study.

BACKGROUND: Telemedicine use in chronic disease management has markedly increased during health emergencies due to COVID-19. Diabetes and technologies supporting diabetes care, including glucose monitoring devices, software analyzing glucose data, and insulin delivering systems, would facilitate remote and structured disease management. Indeed, most of the currently available technologies to store and transfer web-based data to be shared with health care providers. OBJECTIVE: During the COVID-19 pandemic, we provided our patients the opportunity to manage their diabetes remotely by implementing technology. Therefore, this study aimed to evaluate the effectiveness of 2 virtual visits on glycemic control parameters among patients with type 1 diabetes (T1D) during the lockdown period. METHODS: This prospective observational study included T1D patients who completed 2 virtual visits during the lockdown period. The glucose outcomes that reflected the benefits of the virtual consultation were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability. This metric was generated using specific computer programs that automatically upload data from the devices used to monitor blood or interstitial glucose levels. If needed, we changed the ongoing treatment at the first virtual visit. RESULTS: Among 209 eligible patients with T1D, 166 completed 2 virtual visits, 35 failed to download glucose data, and 8 declined the visit. Among the patients not included in the study, we observed a significantly lower proportion of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) users (n=7/43, 16% vs n=155/166, 93.4% and n=9/43, 21% vs n=128/166, 77.1%, respectively; P<.001) compared to patients who completed the study. TIR significantly increased from the first (62%, SD 18%) to the second (65%, SD 16%) virtual visit (P=.02); this increase was more marked among patients using the traditional meter (n=11; baseline TIR=55%, SD 17% and follow-up TIR=66%, SD 13%; P=.01) than among those using CGM, and in those with a baseline GMI of ≥7.5% (n=46; baseline TIR=45%, SD 15% and follow-up TIR=53%, SD 18%; P<.001) than in those with a GMI of <7.5% (n=120; baseline TIR=68%, SD 15% and follow-up TIR=69%, SD 15%; P=.98). The only variable independently associated with TIR was the change of ongoing therapy. The unstandardized beta coefficient (B) and 95% CI were 5 (95% CI 0.7-8.0) (P=.02). The type of glucose monitoring device and insulin delivery systems did not influence glucometric parameters. CONCLUSIONS: These findings indicate that the structured virtual visits help maintain and improve glycemic control in situations where in-person visits are not feasible.

Available Technologies, Applications and Benefits of Teleorthodontics. A Literature Review and Possible Applications during the COVID-19 Pandemic.

BACKGROUND: COVID-2019 spread rapidly throughout the world from China. This infection is highly contagiousness, has a high morbidity, and is capable of evolving into a potentially lethal form of interstitial pneumonia. Numerous countries shut-down various activities that were considered "not essential." Dental treatment was in this category and, at the time of writing, only non-deferrable emergencies are still allowed in many countries. Therefore, follow-up visits of ongoing active therapies (e.g., orthodontic treatment) must be handled taking special precautions. This literature review aims at reducing in-office appointments by providing an overview of the technologies available and their reliability in the long-distance monitoring of patients, i.e., teledentistry. METHODS: A literature review was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Randomized clinical trials, cross sectional, observational, and case-control studies were evaluated with the Mixed Methods Appraisal Tool for quality assessment and study limitations. RESULTS: A primary search found 80 articles, 69/80 were excluded as non-relevant on the basis of: the abstract, title, study design, bias, and/or lack of relevance. Twelve articles were included in the qualitative analysis. CONCLUSIONS: Teleorthodontics can manage most emergencies, reassuring and following patients remotely. The aim set by dental teleassistance was met as it reduced patients' office visits whilst maintaining regular monitoring, without compromising the results. Although our preliminary findings should be further investigated to objectively evaluate the efficacy, cost-effectiveness, and long-term results, we are confident that teleassistance in orthodontics will have a role to play in the near future.