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Objective Pulmonary telerehabilitation (PTR) has emerged as a promising mobile health approach to address post-discharge challenges faced by patients with chronic pulmonary disease (CPD), including limited professional support, physical discomfort, and declining motivation that may compromise adherence and lung function. Challenges exist in traditional hospital-based rehabilitation, constrained by logistics, limited capacity, and accessibility, especially for elderly or mobility-impaired individuals. This study aimed to investigate the feasibility and usability of a novel home-based PTR system (Intelligent Pulmonary Rehabilitation Exercise System (IPRES)), eliciting user experience reported by a cohort of outpatients with relevant respiratory diseases. Methods This questionnaire-based, quantitative, single-group pretest–posttest pilot study involved 36 post-discharge CPD patients, predominantly at GOLD stage 3, transitioning from hospital-based to home-based pulmonary rehabilitation. Participants completed structured IPRES exercise sessions, including recumbent cycling with gamified modules and real-time physiological monitoring. Usability was assessed using the System Usability Scale (SUS) and complementary questionnaires on engagement, motivation, and behavioral intention, providing insights into technical usability and patient-centered facilitators and barriers. Results Participants reported high usability, with a mean SUS score of 78.87 ± 6.32. Qualitative feedback indicated that personalized feedback, collaborative goal-setting, and gamified interactions enhanced engagement and motivation, with participants highlighting improved understanding of exercise goals, increased confidence in self-managing rehabilitation, and enjoyment of interactive training tasks. Conclusion This pilot study demonstrates that IPRES is feasible and well-received, highlighting usability strengths and engagement factors that can inform future optimization and randomized controlled trials. While medium- and long-term effectiveness requires further evaluation, these findings support the potential of IPRES as a scalable, patient-centered tool for home-based pulmonary rehabilitation.

A major public health challenge is to communicate effectively with vulnerable populations about preparing for disasters and other health emergencies. People who are Deaf or Hard of Hearing (Deaf/HH) and older adults are particularly vulnerable during health emergencies and require communications that are accessible and understandable. Although health literacy studies indicate that the readability of health communication materials often exceeds people's literacy levels, we could find no research about the readability of emergency preparedness materials (EPM) intended for Deaf/HH and older adult populations. The objective of this study was to explore issues related to EPM for Deaf/HH and older adult populations, to assess the availability and readability of materials for these populations, and to recommend improvements. In two California counties, we interviewed staff at 14 community-based organizations (CBOs) serving Deaf/HH clients and 20 CBOs serving older adults selected from a stratified, random sample of 227 CBOs. We collected 40 EPM from 10 CBOs and 2 public health departments and 40 EPM from 14 local and national websites with EPM for the public. We used computerized assessments to test the U.S. grade reading levels of the 16 eligible CBO and health department EPM, and the 18 eligible website materials. Results showed that less than half of CBOs had EPM for their clients. All EPM intended for clients of Deaf/HH-serving CBOs tested above the recommended 4(th) grade reading level, and 91% of the materials intended for clients of older adult-serving CBOs scored above the recommended 6(th) grade level. EPM for these populations should be widely available through CBOs and public health departments, adhere to health literacy principles, and be accessible in alternative formats including American Sign Language. Developers should engage the intended users of EPM as co-designers and testers. This study adds to the limited literature about EPM for these populations.

Abstract Objective. Playing games has become a new way to enhance the physical activity, quality of life, social engagement of older adults. This study aims to conduct a 6-month somatosensory game program, inviting older adults to play Microsoft Xbox Kinect games and study whether games can bring benefits to them. Methods. A total of 70 community-dwelling older adults (35 as experimental group, 35 as controls) were recruited. The experiment group played somatosensory games twice per week in a local health center. These games contained three types of categories: 1) Tournament games (for upper limb and lower limb); 2) Single games (for aerobic exercise and muscle training);3) Puzzle games (for collaboration and group dynamics): Results. After 6 months, in the experiment group, the body mass index decreased from 23.45 to 23.29 (p<0.03). In muscular endurance category, 30 second chair rise jumped from 18 to 23.07 (p<0.0001). And 2 min leg lifting increased from 119.48 to 137.75 (p<0.001). In the flexibility category, back scratch test from right hand on top and left hand on top both improved (p<0.026; p<0.46, respectively). Trend analysis indicates that the improvements in 30 second chair rise (p<0.0001) and 2 min leg lifting (p<0.001) is linear. The intensity of social interactions increased noticeably in the experiment group. The SF8 health survey also revealed that experimental group perceived lower level of bodily pain. No significant improvement in the control group in all categories. Conclusion. Playing somatosensory games regularly may help older adults physically and socially.

Abstract Global migration has greatly affected intergenerational family support beyond national borders, in particular adult children's transnational family caregiving for elderly parents. Specifically, the COVID-19 pandemic has largely influenced transnational caregiving due to the travel restrictions. Transnational caregiving for older adults includes adult children's periodical returning to their home country and/or adult children's caregiving for their parents in their settled country. The goal of this study was to identify trajectories between adult children's transnational caregiving for their parents and caregivers' wellness in Japanese Americans before and during the pandemic. We conducted semi-structured interviews with Japanese Americans 40 to 59 years of age (N=20) in California before the lockdown and during the increasing number of patients infected with the Delta variant. The qualitative data analysis showed some Japanese Americans periodically returned to Japan to provide caregiving for their parents before the pandemic, while others didn't. However, the former group currently relied on their families in their home country more than before. The limitations led to not only distress over uncertainty but also release from a strong sense of reciprocity and filial responsibility, by changing from physical support to emotional and financial support via online. They also enhanced cultural identity as Japanese Americans, by thriving from discrimination against Asian Americans. Thus, our findings demonstrate important factors that impacted on transnational caregiving and caregivers' wellness, including cultural identity, family norms, beliefs and practices of intergenerational support, social and historical contexts, financial remittance, ICT use, and healthcare policies among the underrepresented populations across the Pacific.

The feasibility of implementing home-based pulmonary rehabilitation (PR) can be assessed from the perspectives of patients with chronic lung disease and health care professionals involved in PR. Through a qualitative inquiry using interviews and the adoption of the people-object-environment framework, this study aims to understand the influences of interpersonal, environmental, and situational factors on the perceptions and considerations of individuals involved in home-based PR for patients with chronic lung disease. One-on-one interviews were conducted with 20 patients with chronic lung disease and 20 health care professionals for investigating their attitudes and opinions based on their experiences regarding home-based PR as well as for identifying the key factors affecting the benefits and drawbacks of such therapies. This study further evaluates the feasibility of using digital tools for medical diagnosis and treatment by examining the technology usage of both parties. The 4 key issues that all participants were the most concerned about were as follows: distance to outpatient medical care, medical efficiency, internet connectivity and equipment, and physical space for diagnosis and treatment. Interviews with patients and health care professionals revealed that the use of technology and internet was perceived differently depending on age and area of residence. Most participants reported that digital tools and internet connectivity had many benefits but still could not solve all the problems; moreover, these same digital tools and network transmission could lead to problems such as information security and digital divide concerns. This study also emphasizes the significant impact of human behavior and thinking on shaping the design of health care interventions and technologies. Understanding user perspectives and experiences is crucial for developing effective solutions for unmet needs. The results of this study indicate that despite the different perspectives of patients and health care professionals, their considerations of the key issues are very similar. Therefore, the implementation of plans related to telemedicine diagnosis, treatment, or rehabilitation should take the suggestions and considerations of both parties into account as crucial factors for telehealth care design.

As coronavirus disease 2ů19 (COVID-19) has rapidly spread across the United States, so has xenophobia and discriminatory acts against Asian Americans. From March 19, 2Ů2U. to May 13, 2Ů2Ů, more than 17ŮŮ anti-Asian hate incidents were documented across the United States. according to reports by the STOP AAPI Hate campaign from the Asian Pacific Policy and Planning Council. In one incident. a trucker threw a drink atan Asian American wearing a mask and gloves and yelled. \"Hey Chink, you're f-ing nasty.\"1Although this new rise of racism is alarming, the association between disease, racism. and Asian Americans isnot new in US history. \"Yellow Peril,\" or the tear that Chinese and other Asian immigrants were a threat to America and Western culture. led to the Chinese Exclusion Act of 1882-the first racial-based exclusion law in American history. At the turn of the 2ůth century. public health officials perceived Chinese and other \"Orientals\" as infested with disease, subjecting them to undue quarantine, medical examinations, and interrogations. For example, during the 19ůů to 19Ů4 bubonic plague in San Francisco, California. a Chinese American man. found dead in his apartment in San Francisco's Chinatown. was falsely accused of being the source of this plague; disease transmission was later found to be from rats and fleas. Nevertheless, ungrounded public xenophobia and bias against Chinese Americans resulted in the entire Chinatown area being quarantined and forced vaccinations during this period.

Objective: Previous studies suggest older patients with multiple health conditions and medications may experience adverse interactions, leading to negative outcomes. However, there’s limited research on this in older adults receiving home medical care. This study assesses whether polypharmacy is linked to falls or other clinical outcomes. Methods: The study population included 217 participants, aged ≥65 years, receiving home medical care, who consented to participate in the Osaka Home Care Registry (OHCARE) study in Japan. The survey examined the association between polypharmacy and clinical outcomes. We defined “polypharmacy” as six or more medications taken regularly. Results: Of the participants, 135 (62.6%) had polypharmacy and were significantly more likely to have hypertension or diabetes. Common medications included those for hypertension, diabetes, and mental disorders. Participants with polypharmacy experienced significantly more falls. Multivariate analysis showed an association between polypharmacy and falls (odds ratio: 2.81, 95% confidence interval [1.34, 5.92]). Conclusion: Even in older patients receiving home health care, the use of six or more medications poses a risk of falls. Careful observations and life support by medical stuffs are necessary to prevent falls in older patients with polypharmacy receiving home medical care.

Due to chronic exposure to elevated levels of arsenic in drinking water, thousands of Californians have increased risk for internal cancers and other adverse health effects. The mortality risk of cancer is 1 in 400 people exposed to above 10 μg/L of arsenic in their drinking water. The purpose of this community assessment was to understand the perceptions and awareness of the residents and public water representatives in rural, unincorporated farming communities of color in San Joaquin Valley, California. In our research, we asked 27 community informants about their (1) available water sources, (2) knowledge about the health impacts of arsenic, and (3) preferences for risk communication and education regarding the health impacts of arsenic-contaminated drinking water. Through our qualitative coding and analysis, we found that most community informants indicated that there was limited community awareness about the health effects of drinking water with elevated arsenic levels. Preferences for risk communication included using in-language, culturally relevant, and health literate health promotion strategies and teaching these topics through the local K-8 schools’ science curriculum with a language brokerage approach to transfer student knowledge to family members. Key recommendations include implementing these communication preferences to increase community-wide knowledge about safe drinking water.

Abstract Villages are a relatively new consumer-driven model that promotes aging in place for community-dwelling seniors. Villages promote social engagement, civic engagement, member-to-member-support, and collectively bargain for services of their members. Members report improved social support and more confidence aging in their own homes. Currently, there are over 200 operational villages nationwide and the model is proliferating rapidly. Most Villages members are white, well-educated, and well resourced. Researchers at UC Berkeley conducted 6 focus groups with Latino, African American and Asian seniors (N=58) who have not joined Villages in their regions. Focus group findings describe a lack of awareness of the Village model among underrepresented groups; and barriers to membership including the cost of membership, lack of language inclusion, and lack of diversity. The national anti-immigrant discourse emerged as a barrier to membership for non-white seniors. Participants describe how Villages could make programmatic changes to attract a more diverse membership.