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  • 1.
    Akner, Gunnar
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Karolinska Institutet.
    Larsson, Kjell
    Karolinska Institutet.
    Undernutrition state in patients with chronic obstructive pulmonary disease: A critical appraisal on diagnostics and treatment2016In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 117, 81-91 p.Article in journal (Refereed)
    Abstract [en]

    Undernutrition state’ (UNS) is an ominous condition, in particular when associated with chronic obstructive pulmonary disease (COPD). In this review we discuss pathophysiological mechanisms and how UNS is defined and diagnosed. It seems unlikely that COPD-patients with established UNS have similar potential of reversibility (treatability) upon nutrition interventions as patients at a risk of developing such a condition, i.e. patients with low energy/nutrient intake, since pathophysiological, biochemical and metabolic conditions may differ substantially.

    We summarize the results of 7 of 17 published randomized controlled trials of nutritional supplementation in COPD-patients with defined UNS in the latest Cochrane review (2012). We thus excluded 10 of 17 trials included in review (2012), mostly because those studies also included patients with ’risk of’ UNS.

    The seven included trials exhibit extensive heterogeneity for all studied variables. Most studies did not show beneficial effects of nutritional supplementation, although some reported minor increase in body weight and physical function of unclear clinical relevance.

    In contrast to the Cochrane review we conclude that it is difficult to draw firm conclusions regarding the effect of nutritional supplements in patients with COPD and UNS. Improved knowledge in this area is of utmost importance and some factors which should be considered in future studies are suggested.

  • 2.
    Andréasson, Frida
    et al.
    Swedish Family Care Competence Centre (NKA).
    Broling, Lillemor
    Primary Health Care, Kalmar County Council.
    Enhanced participation, safety and security for older people and their carers with health supportive e-services2015Conference paper (Refereed)
  • 3.
    Andréasson, Frida
    et al.
    Swedish Family Care Competence Centre (NKA).
    Hanson, Elizabeth
    Swedish Family Care Competence Centre (NKA).
    Dissemination event Sweden2015Conference paper (Other (popular science, discussion, etc.))
  • 4.
    Andréasson, Frida
    et al.
    Swedish Family Care Competence Centre (NKA).
    Hanson, Elizabeth
    Swedish Family Care Competence Centre (NKA).
    Online support for carers2016Conference paper (Other (popular science, discussion, etc.))
  • 5.
    Andréasson, Frida
    et al.
    Swedish Family Care Competence Centre (NKA).
    Hanson, Elizabeth
    Swedish Family Care Competence Centre (NKA).
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lancioni, Cristina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Poli, Arianna
    Italian National Institute of Health and Science on Aging (INRCA) ; Linköping University.
    Salzmann, Benjamin
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Döhner, Hanneli
    Eurocarers, Belgium.
    Efthymiou, Areti
    Eurocarers, Belgium.
    Anhörigstöd via internet: InformCare2015Conference paper (Other (popular science, discussion, etc.))
  • 6.
    Andréasson, Frida
    et al.
    Swedish Family Care Competence Centre (NKA).
    Hanson, Elizabeth
    Swedish Family Care Competence Centre (NKA).
    Lancioni, Cristina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Online support for carers: using a social forum and social network as a means of developing the role of informal caregiving2015Conference paper (Refereed)
  • 7.
    Andréasson, Frida
    et al.
    Swedish Family Care Competence Centre (NKA).
    Hanson, Elizabeth
    Eurocarers, Belgium.
    Lancioni, Cristina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    The INNOVAGE-Eurocarers platform and current ICT-based services for informal carers of older people in Sweden2015In: Irish Ageing Studies Review, ISSN 1649-9972, Vol. 6, no 1, 88-88 p.Article in journal (Refereed)
    Abstract [en]

    Background: Different support services for family carers are available in Sweden through information and communication technologies (ICTs) since late 1990s, like ACTION, My Joice, IPPI, ‘The Gap’, and Carer Sweden’s online ‘Carer’s Book’. The INNOVAGE-Eurocarers platform aimed to complement the offer of web services to carers through the provision of a new tailored package.

    Methods: The Swedish pilot test enrolled around 50 carers through contacts with professionals working with carers in different municipalities. They could access the following web-based services: information resources; individual support via e-mail and private messages; group support via social network and forum. Periodical writing activities were asked to active users in the forum, alternating expressive writing (EW) and time management (TM) writing tasks. Periodical reminders were sent in order to increase user involvement.

    Results: Users were predominantly older, female carers, of which two thirds were over 65 years old. The web platform was perceived as a flexible tool, potentially accessible at any time, which gave users the possibility to exploit their experience as carers with others in similar situations. This peer exchange seemed to improve self empowerment, sense of solidarity and mutual learning. However, usage of the web platform was limited due to the low level of digital skills of some carers.

    Conclusions: Although results confirmed usefulness and appropriateness of implemented web services, it is fundamental to address the issue of usability and accessibility in order to ensure a wider accessibility. An option might be to offer initial digital skill training and continuous technical support for computer novices.

  • 8.
    Andréasson, Frida
    et al.
    Swedish Family Care Competence Centre (NKA).
    Hanson, Elizabeth
    Eurocarers, Belgium.
    Lancioni, Cristina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    The INNOVAGE-Eurocarers platform and current ICT-based services for informal carers of older people in Sweden2015Conference paper (Refereed)
    Abstract [en]

    Background: Different support services for family carersare available in Sweden through information andcommunication technologies (ICTs) since late 1990s, likeACTION, My Joice, IPPI, ‘The Gap’, and Carer Sweden’son-line ‘Carer’s Book’. The INNOVAGE-Eurocarersplatform aimed to complement the offer of web services tocarers through the provision of a new tailored package.

    Methods: The Swedish pilot test enrolled around 50carers through contacts with professionals working withcarers in different municipalities. They could access thefollowing web-based services: information resources;individual support via e-mail and private messages; groupsupport via social network and forum. Periodical writingactivities were asked to active users in the forum,alternating expressive writing (EW) and time management(TM) writing tasks. Periodical reminders were sent in orderto increase user involvement.

    Results: Users were predominantly older, female carers,of which two thirds were over 65 years old. The webplatform was perceived as a flexible tool, potentiallyaccessible at any time, which gave users the possibility toexploit their experience as carers with others in similarsituations. This peer exchange seemed to improve selfempowerment,sense of solidarity and mutual learning.However, usage of the web platform was limited due to thelow level of digital skills of some carers.

    Conclusions: Although results confirmed usefulness andappropriateness of implemented web services, it isfundamental to address the issue of usability andaccessibility in order to ensure a wider accessibility. Anoption might be to offer initial digital skill training andcontinuous technical support for computer novices.

  • 9. Barbabella, Francesco
    Family carers: Technology-based support services2015Book (Refereed)
  • 10.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy ; Lund University.
    Di Rosa, Mirko
    Marche Polytechnic University, Italy ; National Institute of Health and Science on Ageing (INRCA), Italy.
    La bussola di NNA: lo stato dell'arte basato sui dati2015In: L'assistenza agli anziani non autosufficienti in Italia: 5° Rapporto, Un futuro da ricostruire / [ed] N.N.A., Rimini: Maggioli Editore, 2015, 15-33 p.Chapter in book (Refereed)
  • 11.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy ; Marche Polytechnic University, Italy ; Lund University.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA).
    Gori, Cristiano
    Università Cattolica del Sacro Cuore, Italy ; Istituto per la ricerca sociale, Italy ; London School of Economics, UK.
    La bussola di N.N.A.: lo stato dell'arte basato sui dati2013In: L'assistenza agli anziani non autosufficienti in Italia: 4° Rapporto, Tra crisi e ripartenza / [ed] N.N.A., Rimini: Maggioli Editore, 2013, 11-28 p.Chapter in book (Refereed)
  • 12.
    Barbabella, Francesco
    et al.
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Martin-Matthews, Anne
    University of British Columbia, Canada.
    Papa, Roberta
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Svensson, Torbjörn
    Lund University.
    Launching an interdisciplinary “International Summer School on Ageing” (ISSA): Aims, methodology and outcomes2016In: Educational gerontology, ISSN 0360-1277, E-ISSN 1521-0472, Vol. 42, no 4, 253-264 p.Article in journal (Refereed)
    Abstract [en]

    Despite the increasing availability of gerontological training programmes, knowledge of theircontents, characteristics, methods and outcomes remains limited. However, the transitionfrom multidisciplinarity to interdisciplinary orientations is now fundamental to such training,providing participants from diverse academic orientations and professional backgrounds withopportunities to interact ‘across boundaries’. In response to recommendations of the EUFuturage Road Map for European Ageing Research (2011) concerning training and careerdevelopmentneeds of future cohorts of practitioners and scholars in aging, an InternationalSummer School on Ageing (ISSA) was developed in 2012. Its aim was to initiate the practicalimplementation of some of the capacity building goals identified by Futurage. The design andstructure of the ISSA was informed by the experience of Canada’s Summer Programme inAgeing - run by the Institute of Aging of the Canadian Institutes of Health Research – and bythe cross-border academic training activities organized by Lund University (Sweden) inScandinavian countries. As Italy has lacked a tradition of comprehensive, interdisciplinarytraining programmes in gerontology, the Italian National Institute of Health and Science onAgeing undertook to launch the inaugural ISSA. In this article, the core aims andmethodology of the ISSA are presented, together with an analysis of its main outcomes, asmeasured by participant evaluations. These are discussed in the context of internationaldebate on this topic.

  • 13.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy ; Marche Polytechnic University, Italy ; Lund University.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Pelliccia, Laura
    Alcuni profili dell’assistenza nelle regioni2013In: L'assistenza agli anziani non autosufficienti in Italia: 4° Rapporto, Tra crisi e ripartenza / [ed] N.N.A., Rimini: Maggioli Editore, 2013, 29-43 p.Chapter in book (Refereed)
  • 14.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Increasing inclusion and participation of the young-old and the old-old2013In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no Supplement, June/July, S132-S132 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: While healthy ageing represents a pre-condition for older people to enjoy a longer and disability-free life span, quality of life in older age is dependent also upon society’s ability to grant individuals social protection, as well as to promote their active participation in the community until the very end of life. These issues constitute a challenge for current and future research on ageing.

    Method: A 2-year consultation process with over 70 international experts was conducted within the FUTURAGE work-stream focussedon social and economic resources in ageing research. This process allowed a comprehensive discussion on most relevant social participation and protection issues involving scientists, users’ organisations, policy makers and other stakeholders, which led to a set of specific research priorities.

    Results: The main challenges identified for future ageing research concerning social participation are: ageism; migration; life-long learning; digital divide; spirituality; volunteering; mobility and accessibility; discrimination in the labour market; consumption and access to products and services; and work-life balance. As for social protection, the following core issues have been spotted: sustainability; support to informal carers (also through ICT-based services); efficiency; access to care; cost-effectiveness and quality of interventions; initiatives to improve intergenerational solidarity.

    Conclusion: Societal challenges related to social participation and sustainability of social protection systems clearly urge new actions in research, practices and policy on ageing. In particular, the identification of over-arching issues, barriers and enablers contributes to strengthen scientific research in the field, as well as to support policy makers in improving social life and quality of life of older people.

  • 15.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Masera, Filippo
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Bonfranceschi, Franco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Rimland, Joseph M.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Bartulewicz, Kristian
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Rossi, Lorena
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lattanzio, Fabrizia
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Experimentation of an integrated system of services and AAL solutions for Alzheimer’s Disease patients and their caregivers in Marche: The UP-TECH project2014In: Ambient Assisted Living: Italian Forum 2013 / [ed] Sauro Longhi, Pietro Siciliano, Michele Germani, Andrea Monteriù, New York: Springer, 2014, 157-165 p.Conference paper (Refereed)
  • 16.
    Barbabella, Francesco
    et al.
    Italian National Institute of Health and Science on Ageing (INRCA), Italy..
    Chiatti, Carlos
    Italian National Institute of Health and Science on Ageing (INRCA), Italy..
    Rimland, Joseph M
    Italian National Institute of Health and Science on Ageing (INRCA), Italy..
    Melchiorre, Maria Gabriella
    Italian National Institute of Health and Science on Ageing (INRCA), Italy..
    Lamura, Giovanni
    Italian National Institute of Health and Science on Ageing (INRCA), Italy..
    Lattanzio, Fabrizia
    Italian National Institute of Health and Science on Ageing (INRCA), Italy..
    Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients: Evidence From the Up-Tech Study2016In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 71, no 3, 514-525 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs.

    METHOD: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers).

    RESULTS: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW.

    DISCUSSION: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.

  • 17.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Opportunities and challenges of migrant work in the Italian long-term care system2013In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no Supplement, Juny/july, S133-S133 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: Italy is one of the most aged countries in the world, with a longstanding tradition of family care of the dependent elderly. Inrecent times, however, Italy has been witnessing in-depth social and cultural changes, which have been negatively impacting on informal care provision. In addition, the public long-term care (LTC) system highly relies on cash-for-care schemes for supporting older people, whereas “formal” care services are characterised by weak coverage and intensity. This situation has led to a remarkable increase in theprivate employment of migrant care workers (MCWs), whose number increased by four times in the last two decades.

    Method: An overview of MCWs phenomenon in Italy is provided through the analysis of empirical data retrieved by available official sources at national level, as well as by results from own surveys conducted in recent years on large samples of MCWs.

    Results: The following opportunities and challenges concerning MCWs’ employment in the LTC sector were identified: improve MCW’s capacity to deliver quality care; reduce therisk of elder abuse and neglect and of meeting MCWs’ own care needs; increase their social integration in destination countries and reduce “care drain” in sending countries; and how to improve stakeholders’ involvement for a better exchange of good practices and more effective policy measures.

    Conclusion: In these years, privately employed MCWs have contributed to change the traditional Italian “family care model” into a new “migrant-in-the-family care model”. However, the issue concerning the sustainability of this model within the Italian LTC system in the future is still open.

  • 18.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy ; Marche Polytechnic University, Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Come opera l’assistenza domiciliare negli altri paesi europei?2013In: Welfare Oggi, ISSN 2240-3590, no 4, 30-34 p.Article in journal (Refereed)
  • 19.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    The employment of migrant workers in Italy’s elder care: Opportunities and challenges2016In: Ageing in Contexts of Migration / [ed] Ute Karl, Sandra Torres, London: Routledge, 2016, 159-171 p.Chapter in book (Other academic)
  • 20.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Efthymiou, Areti
    Eurocarers, Belgium.
    Poli, Arianna
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lancioni, Cristina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Andréasson, Frida
    Swedish Family Care Competence Centre (NKA).
    Salzmann, Benjamin
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Hanson, Elizabeth
    Swedish Family Care Competence Centre (NKA).
    Döhner, Hanneli
    Eurocarers, Belgium.
    Goodwin, Frank
    Eurocarers, Belgium.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    A multilingual web platform supporting informal carers in 27 EU member states2015In: Broader, bigger, better: AAL solutions for Europe. Proceedings of the 6th AAL Forum 2014 / [ed] Adrian Curaj & Ioana Trif, Bucharest: UEFISCDI , 2015, 169-172 p.Conference paper (Refereed)
    Abstract [en]

    Informal care is a hot topic in research and policy agendas at European and national level, since it greatly contributes to the sustainability and efficiency of national health care systems. A specific intervention – part of the wider INNOVAGE project funded by FP7 – was planned for developing and testing a new multilingual web platform for informal carers of dependent older people in the EU-27. Preliminary results of the pilot study, conducted in Italy, Germany and Sweden will be discussed. The final platform will be accessible in all official languages of the EU-27 and publicly available in spring 2015.

  • 21.
    Barbabella, Francesco
    et al.
    Italian National Institute of Health and Science on Aging (INRCA), Italy.
    Lamura, Giovanni
    Italian National Institute of Health and Science on Aging (INRCA), Italy.
    Schmidt, Andrea E.
    European Centre for Social Welfare Policy and Research, Austria.
    Personnes âgées dépendantes: la technologie au service desproches soignants2013In: Securité Sociale - CHSS, ISSN 1420-2689, Vol. 6, 325-328 p.Article in journal (Refereed)
    Abstract [fr]

    Si la Suisse dispose d’un réseau bien organisé de structures de soins professionnelles, elle manque en revanche toujours de services d’assistance aux proches soignants. Les technologies de l’information et de la communication (TIC), connues pour leur souplesse et leur disponibilité, pourraient contribuer à combler cette lacune, puisqu’elles apportentde nouvelles réponses aux besoins des usagers. Toutefois, pour que leur potentiel et leur efficacité puissent être pleinement compris, il faut que les recherches se poursuivent, comme le montre une étude européenne récente.

  • 22.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lancioni, Cristina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Andréasson, Frida
    Swedish Family Care Competence Centre (NKA).
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Poli, Arianna
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Salzmann, Benjamin
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Efthymiou, Areti
    Eurocarers, Belgium.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    How web-based services can support family carers of older people: New ways to promote social inclusion and quality of life2015In: Irish Ageing Studies Review, ISSN 1649-9972, Vol. 6, no 1, 87-87 p.Article in journal (Refereed)
    Abstract [en]

    Background: Family carers can be negatively influenced by their situation, in terms of stress, social isolation, economic constraints and other difficulties. Web-based services addressing carers’ needs represent an efficient support. The goal of the INNOVAGE work package 3(WP3) study was to develop and test a new multilingual web platform for supporting family carers of older people, to be implemented in 27 European countries.

    Methods: A review of good practices and a consultation with stakeholders were conducted for identifying most appropriate types of services to be developed and tested. The prototype of web platform included information resources and interactive services for both peer and professional support. A convenient, overall sample of around 130 family carers was enrolled in three countries (Italy, Germany and Sweden) and could access services for 12-17 weeks. Data were collected through questionnaires and focus groups concerning impact onquality of life, social support, self-perception of carer’s role, as well as usability, usefulness and appropriateness of services.

    Results: Active users were generally satisfied with support (information, advice, counselling) provided by moderators (social workers or psychologists) and peers. Usability and appropriateness were confirmed, although some refinements were suggested and users with low digital skills often needed technical support. A portion of the sample remained inactive even if stimulation strategies were adopted.

    Conclusions: The pilot study confirmed the INNOVAGE Eurocarers web platform is a useful tool for family carers. Some challenges still exist for implementation in relation to digital skills required and users’ preferences on services at country level.

  • 23.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Quattrini, Sabrina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Using eHealth to improve integrated care for older people with multimorbidity: Francesco Barbabella2015In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, no Supplement 3, 48-48 p.Article in journal (Refereed)
    Abstract [en]

    Issue

    The exploitation of eHealth tools in integrated care practices addressing multimorbidity might be a strong driver for facilitating access to the services provided to people with multiple chronic diseases. This is particularly true in the case of older people living in the community, since eHealth could enhance and reinforce care services at home, improving independent living and security of patients.

    Description of the problem

    One of the ICARE4EU project aims, was to explore whether and which kind of eHealth tools are implemented in integrated care practices for older people with multimorbidity across Europe. In fact, eHealth tools could differ widely across practices, requiring specific know-how by users and health professionals for using and maintaining technology-based solutions, adequate financial resources, compatible organisational and cultural environment with innovations.

    Results

    The ICARE4EU project selected 101 integrated care practices in 24 European countries, of which 85 included the provision of at least one eHealth tool. Out of 50 practices addressing needs of older people, 42 included some eHealth solution aimed at: enhancing digital communication (64%); monitoring care processes (58%); providing decision support systems (60%); supporting patients' self-management (32%). Two promising approaches exploiting eHealth are presented in detail: the ‘TeleRehabilitation project: Post ICU patient telerehabilitation services' at the Nicosia General Hospital and the ‘Strategy for chronic care' by the Regional Department of Health in Valencia.

    Lessons

    The use of eHealth seems to have many benefits in terms of improvement of integration and management of care, as well as quality of care. However, to realize this benefits, it is important to arrange adequate technical support, legislative frameworks and training of users and health professionals.

  • 24.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Quattrini, Sabrina
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lattanzio, Fabrizia
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Caring For People With Multiple Chronic Conditions In Italy: Policy And Practices2015In: Irish Ageing Studies Review, ISSN 1649-9972, Vol. 6, no 1, 71-71 p.Article in journal (Refereed)
    Abstract [en]

    Background: An estimated 50 million people in the European Union live with multiple chronic diseases. In Italy, around 26.6% of the population aged 16 to 64 years, reported to have at least one long-standing illness or health problem in 2011. Moreover, around 46% of the population over 50 is suffering from multimorbidity. Some programmes addressing adult or older people with multimorbidity have been introduced.

    Methods: Data for the ICARE4EU study were collected in the first half of 2014. Eligible programmes focussed on providing care for adult people with two or more medically diagnosed chronic or long lasting diseases (at least onesomatic), involved formalised cooperation between two or more services (at least one medical) and evaluation was available. For each programme an on-line questionnaire was completed and included four main subjects: Patientcentredness, Management, Use of E-health technologies, and Financing systems.

    Results: In Italy, four programmes met the inclusion criteria. They address both daily patient care and policy/managerial levels. Integration of care services, improved collaboration between care providers, changes in resource utilisation and involvement of informal carers have been observed. In two programmes, older patients are addressed as specific subgroup and in two cases animprovement in the use of E-health tools has emerged.

    Conclusions: In Italy, new policies and integrated care programmes addressing multimorbidity have been recently introduced in some areas, with good preliminary results.

  • 25.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Schmidt, Andrea
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    A theoretical framework for assessing the impact of ICT-based interventions for carers2012In: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 11, no 2, 393-393 p.Article in journal (Refereed)
    Abstract [en]

    Purpose Initiatives using information and communication technologies (ICTs) as support for carers of dependent older people are reported since the early 1990s, mainly in form of phone services, computer networks, and video respite. Although the role of ICTs in home care gained increasing relevance in the last decades – for instance in the areas of social integration, care coordination and ambient assisted living (AAL) – few attempts have been made to systematically understand the potentialities of such technologies, overcoming single technology or intervention domains. In this respect, the issues of terminology ambiguity and lack of comparability represented major barriers, so that most of evaluation studies in this area led to mixed and/or inconclusive results. Drawing on the findings of the CARICT-project, this paper discusses the development of a theoretical and conceptual framework to assess the impact ofI CT-based interventions for carers. Method Literature review and a mapping exercise of 52 ICT-based initiatives for carers in 8 countries. Results & Discussion We will provide the results of a mapping exercise of 52 case studies, showing the diversity of existing good practices across Europe and carrying out a review of available impact assessment of these initiatives from a social ecological perspective (at micro-, meso- and macro-level). Subsewquently, we will discuss a theoretical and conceptual framework that is built on the basis of available evidence, leading toa proper classification of ICT-based interventions in relation to types of interactions between actors they support: an attempt is made to group the solutions in coherent and comprehensive classes, with related implications for impact assessments and comparative analysis. Main classes include: alarms, home automation, auto-communication, meta-services, information and training, cognitive stimulations and mental exercises, support group sessions, individual care and support services, and social participation tools. Finally, recommendations for future research in the field are formulated with regard to the assessment and comparability of these services, as well as to the testing and development of new solutions.

  • 26.
    Barbabella, Francesco
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Schmidt, Andrea
    European Centre for Social Welfare Policy and Research, Austria.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Impact of ICT-based interventions on family caregivers: A cross-analysis of 54 good practices in Europe2013In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no Supplement, June/July, S447-S447 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: Information and communication technologies (ICTs) have gained an increasing relevance for delivering innovative care and support services for dependent older people and their family caregivers. Although ICT-based interventions can vary remarkably in terms of functions, target users, operational aspects and technologies used, little knowledge is available concerning their implementationand impact in Europe, a gap that the CARICT project (http://is.jrc.es/pages/EAP/eInclusion/carers.html) has tried to fill.

    Method: 54 ICT-based interventions addressing needs of older peopleor their family caregivers have been identified in 12 European countries through internet search, literature review and expert interviews. Reports have been delivered for each case studied, and cross-analysed to better understand their potential impact at micro, meso and macro level.

    Results: Little evidence was found for positive outcomes at micro-level, including improvements in users’ health relatedquality of life and social inclusion. At meso-level, implementation of 1st/2nd generation telecare contributes to reduce hospitalization and institutionalization rates of older users, as well asto cost savings for local care providers. At macro-level, only one intervention shows concrete effects on a larger scale through a targeted program evaluation, while most ICT-based interventions do not useany tool to assess their impact, and can thus demonstrate only technology acceptance or users’ satisfaction.

    Conclusion: The lack of relevant evidence at all levels, as well as difficulties in comparing and generalising results, strongly urge practitioners to improve impact assessment methodologies and researchers to develop a better general framework of ICT potentials at a conceptual, theoretical and methodological level in this area.

  • 27.
    Barbabella, Francesco
    et al.
    European Centre for Social Welfare Policy and Research, Austria ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Schmidt, Andrea
    European Centre for Social Welfare Policy and Research, Austria.
    Lamontagne-Godwin, Frédérique
    European Centre for Social Welfare Policy and Research, Austria.
    Rodrigues, Ricardo
    European Centre for Social Welfare Policy and Research, Austria.
    Ruppe, George
    European Centre for Social Welfare Policy and Research, Austria.
    Lamura, Giovanni
    European Centre for Social Welfare Policy and Research, Austria ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Assessing the Impact of ICT-based Solutions for Carers in Europe: Preliminary Findings from the CARICT Project2012In: Conference “Challenge Social Innovation: Innovating innovation by research – 100 years after Schumpeter”, ZSI , 2012Conference paper (Refereed)
    Abstract [en]

    Some evidence suggests that information and communication technologies (ICT) can be an efficient mean to improve not only the quality of care provided to dependent older people but also the support for informal carers and privately employed care workers. However, there is a lack of research on ICT-based initiatives and their impact on carers in the European context. Moving from the preliminary findings of the CARICTproject, the paper discusses the first attempt that has been made in Europe to assess the impact of ICTbased initiatives for carers. First, an overview of the developed methodological framework is presented: it includes both a conceptual framework and an impact assessment methodology (IAM) for evaluating multidimensional outcome. Furthermore, an overview of ICT-based solutions in Europe is provided through the analysis of 52 operational initiatives and selected as good practices. Finally, some recommendations and guidelines for further research in the field are discussed.

  • 28.
    Berner, Jessica
    et al.
    Blekinge Tekniska Högskola.
    Rennemark, Mikael
    Blekinge Tekniska Högskola.
    Jogreus, Claes
    Blekinge Tekniska Högskola.
    Berglund, Johan
    Blekinge Tekniska Högskola.
    Factors associated with change in Internet usage of the swedish older adults between 2004 and 20102012In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 19, no 2, 152-162 p.Article in journal (Refereed)
    Abstract [en]

    Abstract: The increased reliance on Internet use in social functions has presumably left out a part of the population: the oldest-older adults. These are people who have not kept themselves up to date with the technological developments for various reasons. There are, however, exceptions from whom we have something to learn. This study investigates the older people in Sweden who started to use the Internet over a period of 6 years. Cognition, extraversion, openness, functional disability, household economy, sex, age and education were investigated in relation to starting to use the Internet. A chi-square test, Spearman correlation and a logistic regression analysis were conducted. It was found that higher cognition, being male and being between the ages of 60 and 80 years were determining factors in starting to use the Internet for the Swedish older adult. Our results indicate that the oldest-older adults are slow to adapt to using the Internet and more attention should be paid on how to support this group.

  • 29.
    Bevilacqua, Roberta
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Felici, Elisa
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Stara, Vera
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Rossi, Lorena
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Towards an impact assessment framework for ICT-based systems supporting older people: Making evaluation comprehensive through appropriate concepts and metrics2014In: Ambient Assisted Living: Italian Forum 2013 / [ed] Sauro Longhi, Pietro Siciliano, Michele Germani, Andrea Monteriù, New York: Springer, 2014, 215-222 p.Conference paper (Refereed)
  • 30.
    Campbell, John
    et al.
    Tokyo University, Japan ; University of Michigan, USA.
    Ikegami, Naoki
    Keio University, Japan.
    Gori, Cristiano
    London School of Economics, UK ; Catholic University of Milan, Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    D'Amico, Francesco
    London School of Economics, UK.
    Holder, Holly
    The Nuffield Trust, UK.
    Ishibashi, Tomoaki
    Dia Foundation for Research on Ageing Societies, Japan.
    Johansson, Lennarth
    Jönköping University.
    Komisar, Harriet
    AARP’s Public Policy Institute, USA.
    Ring, Magnus
    Lund University.
    Theobald, Hildegard
    University of Vechta, Germany.
    How different countries allocate long-term care resources to older users: a comparative snapshot2016In: Long-term care reforms in OECD countries: Successes and failures / [ed] Cristiano Gori, José-Luis Fernandez, Raphael Wittenberg, Bristol: Policy Press, 2016, 47-76 p.Chapter in book (Refereed)
  • 31. Carretero, Stephanie
    et al.
    Stewart, James
    Centeno, Clara
    Barbabella, Francesco
    Schmidt, Andrea
    Lamontagne-Godwin, Frédérique
    Lamura, Giovanni
    Can Technology-based Services support Long-term Care Challenges in Home Care?: Analysis of evidence from social innovation good practices across the EU : CARICT project summary report2012Book (Other (popular science, discussion, etc.))
    Abstract [en]

    Deployment and use of technological services for informal carers is still limited, mainly due to users' low digital skills, the lack of demonstrated business cases, and the poor evidence of the impact and sustainability of these services. The CARICT project aimed to collect evidence-based results on the impact of ICT-enabled domiciliary care services, and to make policy recommendations to develop, scale and replicate them in the European Union. The methodology was based on a mapping of 52 ICT-based services for informal carers developed in Europe, and a cross–analysis of 12 of these initiatives to get data on their impacts, drivers, business models, success factors, and challenges. The main results show that there is a wide range of successful, not very costly and beneficial examples of ICT-based support for carers across Europe. The cross-analysis indicated that these services had positive impacts on the quality of life of elderly people and informal carers, the quality of care and the financial sustainability of the health and social systems. The data also confirm that policy at European, national, regional and local levels can promote the successful development, implementation and transferability of these services through funding, policy leadership and by promoting stronger cooperation among stakeholders including end-users, mainly from the third sector and informal carers, to create a new value chain in the provision of long-term care. These findings help to achieve the objectives of European policy defined by the 2020 Strategy, and more specifically the Digital Agenda for Europe (DAE) and the European Innovation Partnership on Healthy and Active Ageing (EIP AHA)

  • 32.
    Carretero, Stephanie
    et al.
    Institute for Prospective Technological Studies (IPTS), Spain.
    Stewart, James
    Institute for Prospective Technological Studies (IPTS), Spain.
    Centeno, Clara
    Institute for Prospective Technological Studies (IPTS), Spain.
    Barbabella, Francesco
    European Centre for Social Welfare Policy and Research, Austria.
    Schmidt, Andrea
    European Centre for Social Welfare Policy and Research, Austria.
    Lamontagne-Godwin, Frédérique
    European Centre for Social Welfare Policy and Research, Austria.
    Lamura, Giovanni
    European Centre for Social Welfare Policy and Research, Austria.
    Can Technology-based Services support Long-term Care Challenges in Home Care?: Analysis of Evidence from Social Innovation Good Practices across the EU: CARICT Project Summary Report2012Report (Other (popular science, discussion, etc.))
    Abstract [en]

    Deployment and use of technological services for informal carers is still limited, mainly due to users' low digital skills, the lack of demonstrated business cases, and the poor evidence of the impact and sustainability of these services. The CARICT project aimed to collect evidence-based results on the impact of ICT-enabled domiciliary care services, and to make policy recommendations to develop, scale and replicate them in the European Union. The methodology was based on a mapping of 52 ICT-based services for informal carers developed in Europe, and a cross–analysis of 12 of these initiatives to get data on their impacts, drivers, business models, success factors, and challenges. The main results show that there is a wide range of successful, not very costly and beneficial examples of ICT-based support for carers across Europe. The cross-analysis indicated that these services had positive impacts on the quality of life of elderly people and informal carers, the quality of care and the financial sustainability of the health and social systems. The data also confirm that policy at European, national, regional and local levels can promote the successful development, implementation and transferability of these services through funding, policy leadership and by promoting stronger cooperation among stakeholders including end-users, mainly from the third sector and informal carers, to create a new value chain in the provision of long-term care. These findings help to achieve the objectives of European policy defined by the 2020 Strategy, and more specifically the Digital Agenda for Europe (DAE) and the European Innovation Partnership on Healthy and Active Ageing (EIP AHA)

  • 33.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Martin-Matthews, Anne
    University of British Columbia, Canada.
    Papa, Roberta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Svensson, Torbjörn
    Lund University.
    ISSA 2012: The medium-term impact of the first ISSA in the eyes of its participants2015In: Irish Ageing Studies Review, ISSN 1649-9972, Vol. 6, no 1, 44-44 p.Article in journal (Refereed)
    Abstract [en]

    Background: This contribution aims at illustrating the perspective of students attending the first International Summer School on Ageing (ISSA), highlighting the midterm impact exerted by this initiative on their own educational career.

    Methods: The reported findings are based on a follow-up assessment questionnaire sent out to and filled-in by ISSA participants (n= 20) six months after the Summer School’s conclusion, with the aim of identifying whether participation in the ISSA had brought any advantage to each participant's professional and educational life.

    Results: Among the ISSA-related aspects identified as “important” for their future research activity, the main ones were “interacting with established researchers” (100%) and “being part of a research network” (85%), followed by “use of different approaches” and “training environment”. As for the aspects “influenced” by the ISSA, the “development of a professional network” was the most frequently mentioned (100%), followed by “research training” (84%), “research interest” (79%) and “career” (71%). The majority of participants reported that, since their ISSA attendance, had remained in contact with each other for study-related (65%) or work-related (60%) purposes. This networking activity has led to joint scientific collaborations with both mentors (one joint conference presentation and two peer-review publications) and fellow students (preparation of a project proposal in response toa research call and organisation of a scientific event).

    Conclusions: The reported findings show that the ISSA has been useful in creating a collaborative multidisciplinary network of younger and older researchers on ageing-related issues, which is likely to bear more fruitin the long-term.

  • 34.
    Chiatti, Carlos
    et al.
    Marche Polytechnic University, Italy ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    Università degli Studi di Macerata, Italy ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy ; European Centre for Social Welfare Policy and Research, Austria.
    Gori, Cristiano
    Università Cattolica del Sacro Cuore, Italy ; Istituto per la ricerca sociale, Italy ; London School of Economics, UK.
    La "bussola" di NNA: lo stato dell'arte basato sui dati2010In: L'assistenza agli anziani non autosufficienti in Italia: 2° Rapporto, Rapporto promosso dall’IRCCS-INRCA per il Network nazionale per l’invecchiamento / [ed] N.N.A., Rimini: Maggioli Editore, 2010, 13-39 p.Chapter in book (Refereed)
  • 35.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy ; University of Newcastle upon Tyne, UK.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA) ; European Centre for Social Welfare Policy and Research of Vienna, Austria.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA) ; European Centre for Social Welfare Policy and Research of Vienna, Austria.
    Gori, Cristiano
    London School of Economics, UK.
    La "bussola" di N.N.A.: lo stato dell'arte basato sui dati2011In: L'assistenza agli anziani non autosufficienti in Italia: 3° Rapporto, Il monitoraggio degli interventie il punto sulla residenzialità / [ed] N.N.A., Rimini: Maggioli Editore, 2011, 13-34 p.Chapter in book (Refereed)
  • 36.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy Marche Polytechnic University, Italy ; Lund University.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Masera, Filippo
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Gli standard ed i requisiti di qualità nei servizi di assistenza residenziale2013In: L'assistenza agli anziani non autosufficienti in Italia: 4° Rapporto, Tra crisi e ripartenza / [ed] N.N.A., Rimini: Maggioli Editore, 2013, 71-91 p.Chapter in book (Refereed)
  • 37.
    Chiatti, Carlos
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy ; Lund University.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Greco, Cosetta
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Principi, Andrea
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Santini, Sara
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lamura, Giovanni
    Migrant care work for elderly households in Italy2013In: Ageing in the Mediterranean / [ed] Joseph Troisi, Hans-Joachim von Kondratowitz, Bristol: Policy Press, 2013, 235-256 p.Chapter in book (Other academic)
    Abstract [en]

    This paper aims at pointing out the need for a more equitable, internationally driven approach to solve elder care staff shortages, on the background of the implications deriving from the widespread phenomenon of employing migrant care workers in the Italian elder care sector. The paper describes at first how this form of care provision has become so popular in this country to face the long term care needs characterising its ageing population. Main reasons are identified, on the one hand, in the decreasing availability of informal care, due to the increasing female participation in the labor market, a longer working life and a reduction in the support provided by social networks. On the “formal” side, a major role has been played also by the lack of appropriate long term care services, such as residential and public home care, as well as by a chronic shortage of nursing staff and a shorter length of hospital stays. The traditionally “cash-oriented” profile of the Italian welfare system – more based on cash-for-care measures rather than in-kind services – has ended up with perpetuating familistic tendencies stimulating the employment of foreign migrant care workers, often on a live-in, undeclared basis. The paper’s conclusions focus on the analysis of the main opportunities and challenges raised by this phenomenon, trying to catch all involved parties’ perspectives: the older care recipients’ families; the migrant care workers; the receiving and the sending societies. This approach allows to identify core advantages of this solution in the possibility to increase ageing in place opportunities (thus reducing institutionalisation rates) and to provide a more personalised home care at reasonable costs. On the other hand, drawbacks can occur in terms of low quality of care, risk of widespread undeclared labour conditions, possible exploitation of foreign migrants and abuse of older people, as well as “brain and care drain” effects in sending countries. A more neutral, internationally driven governance is therefore suggested in order to minimize these risks and promote equitable solutions to solve care provision shortages in some countries without “plundering the future” of other nations.

  • 38.
    Di Rosa, Mirko
    et al.
    National Institute of Health and Science on Aging (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Aging (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Aging (INRCA), Italy.
    Melchiorre, Maria Gabriella
    National Institute of Health and Science on Aging (INRCA), Italy.
    Lamura, Giovanni
    National Institute of Health and Science on Aging (INRCA), Italy.
    Private employment of home care workers and use of health services by disabled older people in Italy2013In: Euroregional Journal of Socio-Economic Analysis, ISSN 2344-6404, Vol. 1, no 1, 33-42 p.Article in journal (Refereed)
    Abstract [en]

    Home care workers privately employed by households have become today the “third rail” of longtermcare policies in several industrialised countries. In Italy, estimates suggested that they might be asmany as over 840,000, most of them being foreign-born migrants living with the cared for person. So far, littleattention has been paid to the integration and coordination of these workers within the formal care sector.We analysed a cross-sectional sample of 4,814 disabled older Italians living in the community to assess theassociation between the private employment of home care workers and the likelihood of using other formalservices. After controlling for possible confounding effects of predisposing characteristics and need factors,we found that using private assistance at home is strongly associated with the use of all services. Thesecorrelations suggests that a “crowding-in” effect exists between the use of private care and public formalservices, and a clear pattern of care tasks allocation can be identified in Italy, where family and privatecarers are responsible for assisting the older person with basic tasks of daily living, while the residualcompetences of public formal sector relate to specialised health care services.

  • 39.
    Di Rosa, Mirko
    et al.
    Marche Polytechnic University, Italy ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Poli, Arianna
    Linköping University ; National Institute of Health and Science on Ageing (INRCA), Italy.
    Balducci, Francesco
    Marche Polytechnic University, Italy ; National Institute of Health and Science on Ageing (INRCA).
    L’altra bussola: le strategie di sostegno familiare e privato2015In: L'assistenza agli anziani non autosufficienti in Italia: 5° Rapporto, Un futuro da ricostruire / [ed] N.N.A., Rimini: Maggioli Editore, 2015, 35-54 p.Chapter in book (Refereed)
  • 40.
    Efthymiou, Areti
    et al.
    Eurocarers, Belgium.
    Poli, Arianna
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Döhner, Hanneli
    Eurocarers, Belgium.
    Hanson, Elizabeth
    Eurocarers, Belgium.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Goodwin, Frank
    Eurocarers, Belgium.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    The role of Eurocarers in promoting web-based support services for informal carers in Europe2015In: Irish Ageing Studies Review, ISSN 1649-9972, Vol. 6, no 1, 88-89 p.Article in journal (Refereed)
    Abstract [en]

    Background: Eurocarers is an European non-profit association representing informal carers. It was officially established in 2006 and includes user organisations, research institutions and individual members addressing and working on the issue of informal care. Eurocarers participates in the work package 3 (WP3) of the INNOVAGE project, aiming to develop and disseminate a multilingual web platform for informal carers in 27 Member States of the European Union (EU).

    Methods: A wide networking activity was carried out in 2013-2014 for identifying and involving at least one user organisation in each country of the EU-27, which could take over responsibility of single national versions of the platform. 29 carers organisations were involved in implementation, as well as in developing country-based contents for the information resources area.

    Results: Information resource area will be implemented in the EU-27 in all official languages and updated progressively by organisations. Each organisation will implement a set of interactive services, depending on country peculiarities and available resources. A further dissemination phase will follow, based on a multilayered approach: one EU event will take place in 2015, followed by national events and other local activities.

    Conclusions: A fundamental role in the development and dissemination of web-based support services for carers is played by the activation of a strong and comprehensive network of organisations. Characteristics of the internet have the potential to strengthen collaboration between stakeholders and converge efforts for improving level of support services in countries with less cultural, social and policy recognition of carers’ role in the society.

  • 41.
    Efthymiou, Areti
    et al.
    Athens Association of Alzheimer's Disease and Related Disorders, Greece.
    Vlachogiann, Aggeliki
    Athens Association of Alzheimer's Disease and Related Disorders, Greece.
    Nika, Aspasia
    Athens Association of Alzheimer's Disease and Related Disorders, Greece.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Poli, Arianna
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Salzmann, Benjamin
    wir pflegen, Germany.
    Andréasson, Frida
    Swedish Family Care Competence Centre (NKA).
    Hanson, Elizabeth
    Swedish Family Care Competence Centre (NKA).
    Doehner, Hanneli
    Eurocarers, Belgium.
    Lamura, Giovanni
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Web services for Greek informal carers2015In: Hellenic Journal of Nuclear Medicine, ISSN 1790-5427, Vol. 18, 51-53 p.Article in journal (Refereed)
    Abstract [en]

    The INNOVAGE project is dedicated to developing, surveying and cataloguing, social innovations for older people. Four new innovations will be developed and tested: a) social innovation for user – driven housing of older people, b) a web-platform for informal carers of older people, c) social intervention for improving obesity in old age, d) social innovation for activation of people with dementia living in long term care institutions. Italian National Institute of Health and Science on Aging (INRCA) (www.inrca.it) and Eurocarers Association (www.eurocarers.org) are the partners responsible for developing and implementing a multilingual web platform for informal carers in 27 EU Member States. An innovAge carers associations network has been established based on the Eurocarers organisations network. National organizations, members of INNOVAGE network, are responsible for developing national information and disseminating the web platform at national level. Athens Association of Alzheimer‘s Disease and Related Disorders is an official member of the INNOVAGE network and participates in the development of the Greek version of the INNOVAGE web platform. The platform will provide to end-users services such as: national information on care and support services, legal and financial information, information about the most common impairments of older people, strategies and information about coping with caregiving. Interactive services, social network, forum, chat, video conferencing tools will be also available. The Greek version of the web platform will be available in May 2015.

  • 42.
    Fagerström, Cecilia
    et al.
    Blekinge Tekniska Högskola.
    Lindwall, Magnus
    Göteborgs Universitet.
    Berg, Anne-Ingeborg
    Göteborgs Universitet.
    Rennemark, Mikael
    Blekinge Tekniska Högskola.
    Factorial validity and invariance of the Life Satisfaction Index in older people across groups and time: Addressing the heterogeneity of age, functional ability, and depression.2012In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 55, no 2, 349-356 p.Article in journal (Refereed)
    Abstract [en]

    In the last decades, extensive research efforts have been directed at exploring life satisfaction in old age, and the Life Satisfaction Index A scale (LSIA), developed by Neugarten et al. in the 1960s, is one of the most commonly used instruments. However, studies have focused on predicting and comparing changes in people’s life satisfaction without testing if the LSIA instrument is equally valid for different subgroups of people. The present study investigated the underlying dimensions of the LSIA in a Swedish population (n=1402) of people 60−96 years of age. The study also examined factorial invariance across age, gender, functional ability and depression during a six-year period. The results showed that while a five-factor solution of the LSIA did not exhibit an acceptable fit to the data, a three-factor solution did show a close fit. The two three-factor models that demonstrated the best fit showed invariance across gender and across time, but noninvariance across groups with different levels of reduced functional ability, depressive symptoms and age. These findings suggest that the psychometric properties of life satisfaction instruments like the LSIA need to be taken into consideration before drawing conclusions about life satisfaction when comparing older people of different ages and with different depression and function levels.

     

  • 43.
    Feng, Lei
    et al.
    Yong Loo Lin School of Medicine, Singapore.
    Ng, Xue-Ting
    National University of Singapore, Singapore.
    Yap, Philip
    Khoo Teck Puat Hospital, Singapore.
    Li, Jialiang
    National University of Singapore, Singapore.
    Lee, Tih-Shih
    Duke-NUS Graduate Medical School, Singapore.
    Håkansson, Krister
    Karolinska Institutet, Sweden.
    Kua, Ee-Heok
    Yong Loo Lin School of Medicine, Singapore.
    Ng, Tze-Pin
    Yong Loo Lin School of Medicine, Singapore.
    Marital Status and Cognitive Impairment among Community-Dwelling Chinese Older Adults: The Role of Gender and Social Engagement2014In: Dementia and geriatric cognitive disorders extra, E-ISSN 1664-5464, Vol. 4, no 3, 375-384 p., 25473404Article in journal (Refereed)
    Abstract [en]

    Aims: To examine the association between marital status and cognitive impairment among community-dwelling Chinese older adults. Methods: We analyzed data from 2,498 Chinese aged 55 and older from the Singapore Longitudinal Aging Study cohort. Cognitive impair- ment was defined as a Mini-Mental State Examination total score of 23 or below. Odds ratios of associations were reported and adjusted for potential confounders in logistic regression models. Results: The prevalence of cognitive impairment was 12.2% (n = 306). Being single was associated with about 2.5 times increased odds of cognitive impairment compared to be- ing married (adjusted OR = 2.53, 95% CI: 1.41–4.55). The association between marital status and cognitive impairment was much stronger in men compared to that in women, and was indeed statistically significant only for men. Among the single and widowed persons social engagement was associated with a lower risk of cognitive impairment. Compared with sub- jects in the lowest tertile of social engagement scores, the odds of having cognitive impair- ment was lowered by 50% for subjects in the second and the third tertile. Conclusion: Being single or widowed was associated with higher odds of cognitive impairment compared to be- ing married in a cohort of older Chinese men but not women.

  • 44.
    Gori, Cristiano
    et al.
    London School of Economics, UK ; Catholic University of Milan, Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Campbell, John
    Tokyo University, Japan ; University of Michigan, USA.
    Ikegami, Naoki
    Keio University, Japan.
    D'Amico, Francesco
    London School of Economics, UK.
    Holder, Holly
    The Nuffield Trust, UK.
    Ishibashi, Tomoaki
    Dia Foundation for Research on Ageing Societies, Japan.
    Johansson, Lennarth
    Jönköping University ; National Board of Health and Welfare ; Karolinska Institutet ; Stockholm University.
    Komisar, Harriet
    AARP’s Public Policy Institute, USA.
    Theobald, Hildegard
    University of Vechta, Germany.
    How different countries allocate long-term care resources to older users: changes over time2016In: Long-term care reforms in OECD countries: Successes and failures / [ed] Cristiano Gori, José-Luis Fernandez, Raphael Wittenberg, Bristol: Policy Press, 2016, 77-116 p.Chapter in book (Refereed)
    Abstract [en]

    A key policy debate in long-term care (LTC) policies across OECD countriestoday can be summarised by the following question: what measures and strategiescan be adopted to optimise resources? New policies are required for balancingfinances and access to care, with different options on the table and waiting forgovernments’ decisions.This chapter looks at changes over time in public resource allocation amongLTC users in the same OECD countries considered in the previous chapter (exceptfor Australia). As in Chapter Four, this chapter focuses exclusively on publiccare inputs, defined as those inputs that are (at least partially) publicly funded,and looks at users aged 65 and over. Chapter Four led the way to reconsideringhow public resources are allocated in different LTC systems through an in-depthanalysis of current spending. To complement that analysis, this chapter adopts along-term perspective, investigating the changes that have occurred over the last20–25 years in three crucial dimensions of resource allocation: the mix of LTCservices for older people, their intensity, and their coverage.The countries considered are representative of the OECD environment withrespect to both the overall welfare models and the models of LTC policies.Concerning the former, as Campbell et al have noted in Chapter Four, ‘wehave Sweden in social-democratic Northern Europe, Italy in familial SouthernEurope, Germany in corporatist mid-continent, Australia, the US and Englandas quite different versions of the Anglo-Saxon “residual” model, and Japan as therelatively new entry that shares aspects of all the other models.’ From the pointof view of LTC policies, the sample of countries selected represents the differentmodels in the OECD context:

    • Universal coverage within a single programme: this model guarantees people access toformal services without taking into account users’ income or assets as eligibilitycriteria. It is also organised as a single system, separated or integrated with theoverall health system (Germany, Japan and Sweden).

    • Mixed systems: in this case, LTC is provided through a mix of different universalprogrammes and benefits operating alongside, or a mix of universal and meanstestedLTC entitlements (England and Italy).

    • Means-tested systems: under this type of scheme, LTC coverage is providedthrough safety-net programmes. In countries using this system, income and/or asset tests are used to define thresholds for eligibility to publicly fundedcare. Only those falling below a set threshold are entitled to publicly fundedservices or benefits (the US) (Colombo et al, 2011).

    This chapter is organised as follows. First, it addresses the issue of resourceallocation, providing a definition of the topic and the methodology used. Themain policies implemented in each of the six countries are then examined. Finally,a comparative discussion on the trends emerging across our sample is presented,followed by a final paragraph looking ahead.

  • 45.
    Greco, Cosetta
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Lucchetti, Maria
    National Institute of Health and Science on Ageing (INRCA), Italy.
    La promozione della salute alla sfida del web2010In: Prospettive Sociali e Sanitarie, ISSN 0393-9510, Vol. 14, 11-14 p.Article in journal (Refereed)
  • 46.
    Håkansson, Krister
    et al.
    Karolinska Institutet.
    Soininen, Hilkka
    Eastern University of Finland.
    Winblad, Bengt
    Kivipelto, Miia
    Karolinska Institutet.
    Feelings of Hopelessness in Midlife and Cognitive Health in Later Life: A Prospective Population-Based Cohort Study.2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 10, 1-16 p., e0140261Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Several studies have found depression and depressive feelings to be associated with subsequent dementia. As dementias typically have a long preclinical development phase, it has been difficult to determine whether depression and depressive feelings reflect a concurrent underlying dementia disease, rather than playing a causative role. Our aim was to investigate hopelessness, one dimension of depressive feelings, and evaluate the likelihood of a prodromal versus a causative role of hopelessness feelings in dementia development.

    METHODS: We invited a random sample of 2000 survivors from a representative population in Eastern Finland, originally investigated in midlife between 1972 and 1987, for re-examination an average of 21 years later. The age of the 1449 persons who accepted the invitation was between 39 and 64 years (mean 50.4 years) in midlife and between 65 and 80 (mean 71.3) at follow-up. To measure feelings of hopelessness in midlife and at follow-up, the participants indicated their level of agreement to two statements about their own possible future. We used logistic regression to investigate the association between the combined scores from these two items and cognitive health at follow-up, while adjusting for several health and life-style variables from midlife and for apolipoprotein E4 (ApoE4) status, depression and hopelessness feelings at follow-up. We compared the associations with late-life cognitive health when feelings of hopelessness were either measured in midlife or at the follow-up. In addition we analyzed the changes in hopelessness scores from midlife to follow-up in participants who were either cognitively healthy or impaired at follow-up.

    RESULTS: We found higher levels of hopelessness in midlife, but not at follow-up, to be associated with cognitive impairment at follow-up; the adjusted odds ratio for each step of the five-level hopelessness scale was 1.30 (95% confidence interval 1.11-1.51) for any cognitive impairment and 1.37 (1.05-1.78) for Alzheimer's disease. These associations remained significant also after the final adjustments for depressive feelings and for hopelessness at follow-up. The individual changes in hopelessness scores between midlife and follow-up were not systematically related to cognitive health at the follow-up.

    CONCLUSION: Our results suggest that feelings of hopelessness already in midlife may have long-term implications for cognitive health and increase the risk of Alzheimer's disease in later life.

  • 47.
    Lamura, Giovanni
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Le politiche per la cura della popolazione anziana: il quadro internazionale2013In: I luoghi della cura, ISSN 1723-7750, Vol. XI, no 4, 9-12 p.Article in journal (Refereed)
    Abstract [it]

    Una delle grandi sfide che l’Italia e molti altri Paesi europeisi trovano oggi ad affrontare riguarda l’adeguamentodelle politiche per la non autosufficienza (olong-term care, con termine invalso nel dibattito internazionale),in un contesto di difficile congiuntura economicae necessità di ottimizzare l’uso delle risorse rispettoalle conseguenze dell’invecchiamento demografico.Nell’auspicio che l’agenda politica italiana possapresto dedicare maggiore attenzione al settore, siritiene utile proporre in questo contributo un quadrodegli approcci prevalenti in materia a livello internazionale,e soprattutto europeo, al fine di favorire unapiù ampia e approfondita riflessione sulle opzioni dipolicy disponibili. Se non diversamente indicato, le informazioniriportate sono da considerarsi tratte dauna recente pubblicazione in materia curata da Rodrigueset al. (2012), a cui si rimanda per il dettaglio deidati illustrati.

  • 48.
    Lamura, Giovanni
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Social Exclusion And Service Use Amongst Older Europeans2015In: Irish Ageing Studies Review, ISSN 1649-9972, Vol. 6, no 1, 38-38 p.Article in journal (Refereed)
    Abstract [en]

    Background: This contribution aims to provide an overview of the main trends and phenomena contributing to the association between social exclusion and (health, social and long-term) care service use among older Europeans.

    Methods: Data comes from measures on health, social and long-term care service usage, and related outcome indicators, from within a series of quantitative cross-European survey studies and from secondary data sources.

    Results: Findings show that the lack of crucial services – such as transportation, primary health care services, or banking services – might represent a risk of exclusion in older age, this being true for instance in countries with large rural communities (e.g. Ireland, Poland, Lithuania, but also Norway). Nordic countries, such as the Netherlands, Iceland, Norway and Denmark, reveal to be particularly advanced in terms of home care provision. In this regard, data seem to suggest that the availability of formal care services and that of informal care are positively correlated, thus suggesting the existence of acrowding-in effect. The access to web-based services represents an additional field in which new and old exclusion risks might accumulate, as highlighted by the lack of such services in Southern and Eastern European countries.

    Conclusions: Limitations in accessing services which are necessary in everyday life can heavily affect older people’s ability to remain independent and active, and thereby contribute to experiences of exclusion. The illustrated data show the critical areas in which policy should focus on to tackle current challenges that service exclusion poses for older people across Europe.

  • 49.
    Lamura, Giovanni
    et al.
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health and Science on Ageing (INRCA), Italy.
    Current LTC challenges in Italy2013In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no Supplement 1, June/july, S227-S227 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: The rapid ageing of the Italian population is reflected by a growing demand for LTC services. As families are facing increasing difficulties in providing everyday elder care, the pressure on formal services is growing. At the same time, the current financial crisis is making the public response less and less able to provide the needed resources. As a consequence, the current approach of indirect public support to the private employment of migrant care workers (MCWs) through cash-for-care schemes is likely to continue.

    Method: The presentation is based on a detailed analysis of empirical findings and policy documents, outlining the crucial features characterising the Italian LTC system and describing also some of the main differences existing between different regional care approaches.

    Results: After adecade of increasing availability of publicly funded LTC services for older people, in some sectors, such as integrated home care, the audience of recipients has started receiving a lower number of hours of care. The mainly monetary focus of the Italian care regime has a clear incentivizing effect to employ foreign migrant care workers, often on an undeclared basis, to provide everyday elder care in Italian homes. Another crucial characteristic is the strong heterogeneity of Italian regions, according to which today different clusters of regions can beidentified, with strong inequalities in LTC provision.

    Conclusion : Thelack of a coherent national LTC policy has been recently accompaniedby an increasing focus on cash-for-care payments, which in the future will require a stronger attention to care quality issues.

  • 50.
    Lamura, Giovanni
    et al.
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Chiatti, Carlos
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Barbabella, Francesco
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Di Rosa, Mirko
    National Institute of Health & Science on Ageing (INRCA), Italy.
    Filling the gap in long-term professional care through systematic migration policies: Synthesis report2014Book (Other (popular science, discussion, etc.))
    Abstract [en]

    Many EU countries face the challenge of providing elderly care in the context of shortages of trained personnel. The Peer Review in Berlin (23-24 October) provided the opportunity for peer countries to explore the German approach of recruiting and training non-EU migrants. This report summarises the key issues discussed and the lessons learned. It is available in electronic format in English, French and German

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