MINI-PUBLIC SOM METODISK EKSPERIMENT I STUDIER AF FREMTIDSTEKNOLOGIER OG SOCIALE ROBOTTER

Denne artikel udspringer af spørgsmålet om, hvordan man som antropolog kan arbejde med fremtiden som forskningsobjekt, når det, som man ønsker at undersøge, endnu ikke er og derfor ej heller kan observeres med klassiske antropologiske metoder. Artiklens formål er at præsentere mini-public som en alternativ metode til kvalitativ dataindsamling og vidensformidling i antropologisk forskning af fremtidsscenarier. Dette sker ved en beskrivelse af et mini-public-event, der blev afviklet for frivillige repræsentanter fra forskellige samfundsgrupper i Aarhus i efteråret 2018 som led i et større tværfagligt forskningsprojekt på Aarhus Universitet om udviklingen og brugen af sociale robotter. Søgeord: metodediskussion, fremtidsteknologier, eksperimenterende metoder, sociale robotter, „foreign entanglements

Innovationens Politik: Om Babysimulatorer, sårbare unge og drømmen om et barn

Denne artikel retter opmærksomheden mod „innovationens politik“ med det argument, at enhver innovativ bestræbelse er iboende politisk og rejser moralske og etiske spørgsmål. Artiklens forfattere argumenterer for, at innovation grundlæggende udgør et forsøg på at formgive og styre fremtiden i nye retninger, som ønskeligt adskiller sig fra det nuværende. Innovation indebærer derfor en form for dekonstruktion eller kritik af etablerede opfattelser og praksisser og kan som sådan ikke undgå at være politisk. Med afsæt i et feltarbejde i en dansk kommune, der har igangsat pasningsforløb med teknologiske babysimulatorer for sårbare unge, som drømmer om at få et barn, viser artiklen, hvordan innovationens politik særligt kommer til udtryk i innovative tiltag, hvor „nogen vil noget med nogen“. I artiklen beskrives det, hvordan kommunale rådgivere anvender babysimulatorer som værktøj til at skabe klarhed og oplysning for de sårbare unge om, hvad virkeligheden som forældre reelt vil indebære. I denne proces dirigeres de unge til særlige erfaringer og erkendelser, hvorved der skabes særlige former for mennesker: unge „normale“ subjekter med en „ny“, „rigtig“ og „sund“ forståelse af forældreskabets realiteter i overensstemmelse med kommunens rationaler. Innovation er således aldrig uskyldig, men altid et politisk og etisk anliggende.Søgeord: innovation, teknologi, babysimulator, sårbare unge, politik, fremtide

Economic evaluation alongside a randomized controlled trial of blended cognitive-behavioral therapy for patients suffering from major depressive disorder

OBJECTIVE: This study aimed to investigate the cost-effectiveness of blended cognitive-behavioral therapy (CBT) compared to standard CBT for adult patients suffering from major depressive disorder (MDD). DESIGN: A cost-utility analysis alongside the randomized controlled ENTER trial. SETTING: Center for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Denmark. PARTICIPANTS: The study included 76 patients suffering from MDD. INTERVENTIONS: The patients in the intervention group received blended CBT treatment comprising a combination of online modules and face-to-face consultations with a psychologist. The patients in the control group received standard CBT treatment, that is, solely face-to-face consultations with a psychologist. The treatment period was 12 weeks. OUTCOME MEASURES: Cost-effectiveness was reported as incremental cost-effectiveness ratio. A micro-costing approach was applied to evaluate the savings derived. Changes in quality-adjusted life-years (QALYs) were estimated using the EuroQol 5-Dimensions 5-Levels questionnaire at the baseline and the six-month follow-up. RESULTS: Data for 74 patients were included in the primary analysis. The adjusted QALY difference between blended CBT and standard CBT was −0.0291 (95% CI: −0.0535 to −0.0047), and the adjusted difference in costs was -£226.32 (95% CI: −300.86 to −151.77). Blended CBT was estimated to have a 6.6% and 3.1% probability of being cost-effective based on thresholds of £20,000 and £30,000. CONCLUSION: Compared to standard CBT, blended CBT represents a cost-saving but also a loss in QALYs for patients suffering from MDD. However, results should be carefully interpreted, given the small sample size. Future research involving larger replication studies focusing on other aspects of blended CBT with more patient involvement is advised. TRIAL REGISTRATION NUMBER: ClinicalTrial.gov: S-20150150

Mobile Diary App Versus Paper-Based Diary Cards for Patients With Borderline Personality Disorder:Economic Evaluation

BACKGROUND: The cost-effectiveness of using a mobile diary app as an adjunct in dialectical behavior therapy (DBT) in patients with borderline personality disorder is unknown. OBJECTIVE: This study aims to perform an economic evaluation of a mobile diary app compared with paper-based diary cards in DBT treatment for patients with borderline personality disorder in a psychiatric outpatient facility. METHODS: This study was conducted alongside a pragmatic, multicenter, randomized controlled trial. The participants were recruited at 5 Danish psychiatric outpatient facilities and were randomized to register the emotions, urges, and skills used in a mobile diary app or on paper-based diary cards. The participants in both groups received DBT delivered by the therapists. A cost-consequence analysis with a time horizon of 12 months was performed. Consequences included quality-adjusted life years (QALYs), depression severity, borderline severity, suicidal behavior, health care use, treatment compliance, and system usability. All relevant costs were included. Focus group interviews were conducted with patients, therapists, researchers, and industry representatives to discuss the potential advantages and disadvantages of using a mobile diary app. RESULTS: A total of 78 participants were included in the analysis. An insignificantly higher number of participants in the paper group dropped out before the start of treatment (P=.07). Of those starting treatment, participants in the app group had an average of 37.1 (SE 27.55) more days of treatment and recorded an average of 3.16 (SE 5.10) more skills per week than participants in the paper group. Participants in both groups had a QALY gain and a decrease in depression severity, borderline severity, and suicidal behavior. Significant differences were found in favor of the paper group for both QALY gain (adjusted difference −0.054; SE 0.03) and reduction in depression severity (adjusted difference −1.11; SE 1.57). The between-group difference in total costs ranged from US $107.37 to US$322.10 per participant during the 12 months. The use of services in the health care sector was similar across both time points and groups (difference: psychiatric hospitalization <5 and <5; general practice −1.32; SE 3.68 and 2.02; SE 3.19). Overall, the patients showed high acceptability and considered the app as being easy to use. Therapists worried about potential negative influences on the therapist-patient interaction from new work tasks accompanying the introduction of the new technology but pointed at innovation potential from digital database registrations. CONCLUSIONS: This study suggests both positive and negative consequences of mobile diary apps as adjuncts to DBT compared with paper diary cards. More research is needed to draw conclusions regarding its cost-effectiveness. TRIAL REGISTRATION: ClinicalTrials.gov NCT03191565; http://clinicaltrials.gov/ct2/show/NCT03191565 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/1773

Robotter i Folkeskolen: Begrundelser, visioner, faktisk brug og udfordringer i normalklasser

I denne rapport præsenter vi resultaterne af et mini-projekt koblet til Technucation-projektet  (2011-2015) med yderligere støtte fra DPU, Aarhus Universitet. I forbindelse med Technucations forskning, og vores øvrige forskning i robotter som fremtidsteknologi, bliver vi opmærksomme på, at mange skoler enten har lånt eller købt robotter i uddannelsesøjemed. Der er mange ambitioner bag robotters indtog i skolerne, ligesom der investeres store summer i det, og mange interessenter er involverede (såsom skoler, kommuner, udviklere, sælgere, fonde mv.).Projektet Robotter i Folkeskolen (RIF) blev igangsat i sommeren 2015 af forskere fra forskningsprogrammet Fremtidsteknologi, Kultur og Læreprocesser, samt en række studenterassistenter fra DPU, Aarhus Universitet. Hovedrapporten har to dele, der er blevet bearbejdet hver for sig: en del der omhandler robotter almenundervisningen og en del der omhandler robotter i specialundervisningen. I denne rapport præsenteres fortrinsvis robotter i almenundervisningen

The Clinical Effectiveness of Blended Cognitive Behavioral Therapy Compared with Face-to-Face Cognitive Behavioral Therapy for Adult Depression: Randomized Controlled Noninferiority Trial

Background: Internet-based cognitive behavioral therapy (iCBT) has been demonstrated to be cost- and clinically effective. There is a need, however, for increased therapist contact for some patient groups. Combining iCBT with traditional face-to-face (FtF) consultations in a blended format may produce a new treatment format (B-CBT) with multiple benefits from both traditional CBT and iCBT, such as individual adaptation, lower costs than traditional therapy, wide geographical and temporal availability, and possibly lower threshold to implementation. Objective: The primary aim of this study is to compare directly the clinical effectiveness of B-CBT with FtF-CBT for adult major depressive disorder. Methods: A 2-arm randomized controlled noninferiority trial compared B-CBT for adult depression with treatment as usual (TAU). The trial was researcher blinded (unblinded for participants and clinicians). B-CBT comprised 6 sessions of FtF-CBT alternated with 6-8 web-based CBT self-help modules. TAU comprised 12 sessions of FtF-CBT. All participants were aged 18 or older and met the diagnostic criteria for major depressive disorder and were recruited via a national iCBT clinic. The primary outcome was change in depression severity on the 9-item Patient Health Questionnaire (PHQ-9). Secondary analyses included client satisfaction (8-item Client Satisfaction Questionnaire [CSQ-8]), patient expectancy (Credibility and Expectancy Questionnaire [CEQ]), and working (Working Alliance Inventory [WAI] and Technical Alliance Inventory [TAI]). The primary outcome was analyzed by a mixed effects model including all available data from baseline, weekly measures, 3-, 6, and 12-month follow-up. Results: A total of 76 individuals were randomized, with 38 allocated to each treatment group. Age ranged from 18 to 71 years (SD 13.96) with 56 (74%) females. Attrition rate was 20% (n=15), which was less in the FtF-CBT group (n=6, 16%) than in the B-CBT group (n=9, 24%). As many as 53 (70%) completed 9 or more sessions almost equally distributed between the groups (nFtF-CBT=27, 71%; nB-CBT=26, 68%). PHQ-9 reduced 11.38 points in the FtF-CBT group and 8.10 in the B-CBT group. At 6 months, the mean difference was a mere 0.17 points. The primary analyses confirmed large and significant within-group reductions in both groups (FtF-CBT: β=–.03; standard error [SE] 0.00; P<.001 and B-CBT: β=–.02; SE 0.00; P<.001). A small but significant interaction effect was observed between groups (β=.01; SE 0.00; P=.03). Employment status influenced the outcome differently between groups, where the B-CBT group was seen to profit more from not being full-time employed than the FtF group. Conclusions: With large within-group effects in both treatment arms, the study demonstrated feasibility of B-CBT in Denmark. At 6 months’ follow-up, there appeared to be no difference between the 2 treatment formats, with a small but nonsignificant difference at 12 months. The study seems to demonstrate that B-CBT is capable of producing treatment effects that are close to FtF-CBT and that completion rates and satisfaction rates were comparable between groups. However, the study was limited by small sample size and should be interpreted with caution