Digital healthcare interventions to support parents with acutely ill children at home: a systematic review.

Background Short lived acute illness in children is common, yet their parents often feel uncertain about recognising signs symptoms of acute illness and knowing when to seek medical intervention. This has led to seeking unscheduled or delayed support. Digital and mobile technologies are being used to support individuals with healthcare needs, known as digital health interventions. Parents have access to digital health interventions that provide information regarding children’s health, yet there is limited exploration of how these are used to support decision-making when caring for acutely ill children. This systematic review was undertaken to explore digital interventions to support parents with acutely ill children at home. Methods Studies were identified by following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A search of five databases (MEDLINE, CINAHL, Embase, PsycNET, and Web of Knowledge) was conducted using search terms (Medical Subject Headings and keywords) relating to digital interventions, children, acute illness, and health information. Forty-eight papers were screened; seven were included in the review and critically appraised using the Mixed Method Appraisal Tool. Results In total, 3,558 parents were included. Meta-analysis was not possible due to heterogeneity of papers; thus, narrative synthesis was used to synthesize results and explore relationships between studies. The following aspects were documented: types and characteristics of interventions; how interventions were developed; accessibility, usability and acceptability; measures of impact upon parental knowledge, confidence; and satisfaction with the intervention and usefulness. ConclusionLimited evidence exists on the availability, impact and efficacy of digital interventions supporting parents caring for acutely ill children at home. Barriers exist regarding accessibility, health literacy and there is limited representation of the diverse needs of parents from different countries, cultures and populations beyond mothers. Further research is needed to co-design and evaluate digital interventions designed with, and for, these parents

The Ability of Monitor-Independent Movement Summary Units, Euclidean Norm Minus One, and Mean Amplitude Deviation to Harmonize Accelerometry Data Across Research-Grade and Consumer Wearable Devices During Simulated Free-Living Physical Activity in Children

Background: Epoch-level accelerometry summary metrics have the potential to be device-agnostic, meaning that similar estimates should be obtained regardless of the device used. The objective of this study was to identify which metric (Euclidean Norm Minus One [ENMO], mean amplitude deviation [MAD], and Monitor-Independent Movement Summary [MIMS] units) best harmonizes data across devices in an applied setting measuring children’s activity. Methods: Children (n = 239; 9.3 ± 2.1 years, 47% female, 30% Black) wore ActiGraph GT9X (+/−8 g, 50 Hz) accelerometers and were randomized to wear two of three consumer wearables, including Apple Watch Series 7 (+/−16 g, 50 Hz), Garmin Vivoactive 4S (+/−8 g, 25 Hz), and Fitbit Sense (+/−4 g, 50 Hz) on their nondominant wrist while participating in 60 min of simulated free-living activities (i.e., walking, running, and soccer). The standard deviation across z scores for ENMO, MAD, and MIMS of each device was calculated at the second level to quantify variability across devices. Lin’s concordance correlation coefficient was calculated for each combination of devices by metric to determine agreement. Multilevel intraclass correlation coefficients were additionally used to quantify harmonization. Results: The standard deviation of z score across devices was the lowest, indicating better harmonization, for MAD (0.13 ± 0.23), followed by ENMO (0.24 ± 0.50), and then MIMS (0.26 ± 0.39). Lin’s concordance correlation coefficient was strongest for MAD, with coefficients ranging from .89 to .96. Lin’s concordance correlation coefficient for MIMS ranged from .70 to .83 and was lowest for ENMO, ranging from .62 to .76. Overall intraclass correlation coefficient was highest for MAD (.88), followed by MIMS (.73), and ENMO (.62). Conclusions: MAD appears to perform best at harmonizing across all the sampled research-grade and consumer devices in children

“Fail fast to learn fast”: integrating lean startup thinking to manage innovations in performance support workflows

Professional sport organisations continuously innovate to gain a competitive advantage, as it enables leveraging cutting-edge technology, advanced research and data-informed strategies to business management. Practitioners in those environments are frequently exposed to early inventions and are responsible for operationalising them as innovations in performance support workflows. Accordingly, this article highlights the importance of adopting a “fail fast to learn fast” mindset when managing sports innovation and outlines a process to operationalise it based on the entrepreneurial lean startup framework. When adopting this philosophy, it is vital to initially define clear value hypotheses, which can trigger iterative build-measure-learn cycles from the lean startup. This allows systematic evaluation of the innovation potential of an invention. Specifically, by developing a minimum viable product (MVP) of the invention and measuring its potential to achieve the value propositions that were defined initially. If sufficient value is created, the invention transforms as an innovation and the lifecycle continues to the next stages (i.e. diffusion). If not, the process is repeated by creating a new MVP by swiftly pivoting to a fresh build-measure-learn cycle. This leads to validated learning about the invention through active experimentation before investing significant time and resources on an innovation lifecycle

Matrescence performance repetitions: towards ‘letting go’

In this article we explore the work of artists engaging with matrescence to consider the (im)possibility of repetition in maternal art making and performance. We are keen to think through matrescence and artmaking processes together towards an eventual ‘letting go’ as both the mothers and the children move into a new life stage. We draw on the work of Young, Iris Marion [2005. On Female Body Experience: Throwing Like a Girl and Other Essays. USA: Oxford University Press] to introduce concepts around the home, Halberstam, J. [2011. The Queer Art of Failure. London: Duke University Press] to examine the notion of futurity, repetition and return, and apply a psychoanalytical framing, in particular, the work of Ferenczi, Sándor [1988. “Confusion of Tongues between Adults and the Child.” Contemporary Psychoanalysis 24 (2): 196–206. doi:10.1080/00107530.1988.10746234]. We consider two contemporary shows – GOO:GA (Ballou, Hannah. 2021. GOO:GA (film)) by Hannah Ballou and the 2021 video re-working of Tender (Long, Josie. 2019. Tender (performance)) by Josie Long. In order to aid our engagement with the matrescence in various media representations, we also re-think certain historical examples of maternal creativity and artmaking including both our own and those of renowned women artists Susan Hiller, Mary Kelly and Bobby Baker

Association between diabetes self‐management education attendance, hospital admissions and mortality in type 2 diabetes: A cohort analysis protocol

Introduction: Type 2 diabetes is associated with excess hospital admissions and increased mortality. Structured diabetes self‐management education (DSME) is recommended internationally and is associated with improved self‐management skills, well‐being and minor improvements in glycated haemoglobin (HBA1c), but does it reduce hospital admissions or prevent premature mortality? Our aim is to examine the relationship between DSME attendance, hospitalisations, mortality and 3‐point major adverse cardiovascular events (MACE) in people with type 2 diabetes to inform future healthcare policy and diabetes care. Methods and Analysis: This protocol details a 10‐year retrospective open cohort study of patients aged over 18 years old who have a clinical diagnosis of type 2 diabetes and were registered to an English GP practice from 29 March 2011 to 29 March 2021 and have attended DSME. Patients in the 'ever' cohort will be matched at baseline for age, sex, age at diagnosis and diabetes duration, to those who have 'never' attended DSME. Data will be identified via the UK Clinical Practice Research Datalink and linked to Hospital Episode Statistics Admitted Patient Care data, Office for National Statistics death registrations and patient Index of Multiple Deprivation deciles. Patients will be followed‐up through serial cross‐sections. Multiple imputation will be considered to manage covariates where data are >12‐months from baseline or are not expected to be missing at random. Cox proportional hazard regression and time to event modelling adjusted a priori for cofounding during multivariate analysis will be used. Ethics and Dissemination: This study was approved by CPRD (24_003744). Study findings will be disseminated through peer‐reviewed publications and international conferences

Holocaust Memory and the Universal Sovereignty of the Liberal Democratic State

Despite the large body of scholarship on global Holocaust memorialization and recent writing on the West’s preoccupation with antisemitism, the interconnection between the two issues has been largely neglected. This article seeks to fill that gap. It argues that the previous focus on the politics of identity as an explanation of global Holocaust memory politics has been misplaced. Instead, the article contends that Western states established the idea of the Holocaust’s universal meaning as central to a new political philosophy of the liberal democratic state after the Cold War. As Western policy elites anxiously attempted to assert the global sovereignty of this political form, the conceit of the Holocaust’s universal meaning played a critical role. The article goes on to argue that the systemic shock of 9/11 led to the securitization of Holocaust memory as part of the ideational defence of the liberal democratic state, and its absorption into the global surveillance order. This is the genealogy of the global North’s preoccupation with anti-Zionism as antisemitism, in which the State of Israel is protected as a totem of the liberal democratic state’s philosophical essence, and its war against the figure of the extremist. The intergovernmental act of defining antisemitism should be understood, therefore, as a feature of the state and inter-state surveillance system established in the war on terror

Are challenging walking environments linked to falls or risk of falling in children with cerebral palsy?:A systematic review

Background: Children with cerebral palsy (CP) regularly fall over and this has negative effects on their physical and psychosocial wellbeing (e.g., reduced activity participation). However, the reasons for falls are not well understood. The way in which children negotiate challenging walking environments (e.g., uneven surfaces), may reveal more about how falls occur as these environments require gait modifications to maintain stability. Stability in challenging walking environments has been explored for children with CP; however, it remains unclear how these lead to falls. Research question: Do challenging walking environments that mimic those faced in the real-world, contribute to increased fall occurrence and fall risk in children with CP? Methods: Five databases were searched, and 1386 records screened to include ambulatory children with CP, aged 5-18 years old, investigating dynamic walking in challenging environments, with outcomes of fall occurrence or fall risk. The full protocol for this review was r

Feeling Old in Eighteenth-Century Britain

This article examines the lived experiences of the older body - the embodiment of old age - from the perspective of older people. It uses letters written from 1680 to 1820 by twenty-two women and men aged between sixty and eighty-nine, selected from a corpus of over 391 letter writers. We begin by exploring the embodied experiences discussed by older people, as well as their understanding of the relationship between these experiences and their later years. The article finds that old age was experienced as highly variable and was subject to an ongoing process of recalibration. Central to that process was the corporeality of the aging body as experienced in the context of a range of social factors. The corporeality of the body was a factor for all but was not always framed negatively or even situated in the context of aging. The article then turns to the responses of older people to the life-stage of old age. The article finds them self-directed and proactive in continuing to live well. This is significant evidence for a self-consciously active, engaged, and embodied old age in early modernity. These older letter writers tended not to disavow old age but to accommodate and even embrace it.</p

Algorithmic emergence? Epistemic in/justice in AI-directed transformations of healthcare

Moves toward integration of Artificial Intelligence (AI), particularly deep learning and generative AI-based technologies, into the domains of healthcare and public health have recently intensified, with a growing body of literature tackling the ethico-political implications of this. This paper considers the interwoven epistemic, sociopolitical and technical ramifications of healthcare-AI entanglements, examining how AI materialities shape emergence of particular modes of healthcare organization, governance and roles, and reflecting on how to embed participatory engagement within these entanglements. We discuss the implications of socio-technical entanglements between AI and Evidence-Based Medicine (EBM) for equitable development and governance of health AI. AI applications invariably center on the domains of medical knowledge and practice that are amenable to computational workings. This, in turn, intensifies the prioritization of these medical domains and furthers the assumptions which support the development of AI, a move which decontextualizes the qualitative nuances and complexities of healthcare while simultaneously advancing infrastructure to support these medical domains. We sketch the material and ideological reconfiguration of healthcare which is being shaped by the move toward embedding health AI assemblages in real-world contexts. We then consider the implications of this, how AI might be best employed in healthcare, and how to tackle the algorithmic injustices which become reproduced within health AI assemblages