Locative-Media Ethics: A Call for Protocols to Guide Interactions of People, Place, and Technologies

Imagine yourself wherever you were 20 years ago, and that an entrepreneurial, fresh-faced, and friendly young newsboy comes to your doorstep. He asks you to subscribe to the local paper. There is no cost to this subscription, he says, but, in exchange for community news, the boy must be allowed to come into your house and look at all of your photos, even the most intimate ones, making duplicates for his boss as he sees fit. As a part of this transaction, he also gets to copy down all of the details from your desk calendar, your Rolodex, your letters, your diary, your to-do lists, your bookcase, your documents from work, anything he comes across that he finds interesting. He gets to follow you around and gather even more information about what you do, where you go, and when. He can do all of this for as long as he wants, in whatever depth he wants, and however he wants, and then can use this information freely for some vague commercial purpose. For just a free subscription, would you have taken this deal

‘Godrevy Project’: virtual reality for symptom control and well-being in oncology and palliative care – a non-randomised pre-post interventional trial

OBJECTIVE: The ‘Godrevy Project’ is an interventional trial designed to determine the effectiveness of immersive virtual reality (VR) on the holistic symptom control and well-being in oncology and palliative care patients. The primary objective of this study was to determine whether VR changed the revised Edmonton Symptom and Assessment System (ESAS-r) score representing an effective improvement in symptom control and well-being. METHODS AND ANALYSIS: This study reports on 60 participants recruited from hospital inpatient oncology and palliative care lists, to participate in an unblinded, VR intervention. Participants were included aged >18 years with a diagnosis of cancer, receiving inpatient treatment of systemic anticancer therapy. Impact evaluation on symptoms was measured using the ESAS-r pre-VR and post-VR intervention. For ethical reasons, participants were not randomised. RESULTS: From the 60 inpatients recruited, 58 participants were included for analysis. Participants recruited were aged 19–84 years with female (58%) and male (42%) participation. The primary outcome of the study demonstrated significant improvement in ESAS-r scores for symptoms and well-being. Total ESAS-r scores showed an improvement of 42% compared with baseline, with well-being ESAS-r scores improving 51%. The most common side effect was drowsiness. There were no adverse events related to study participation. CONCLUSION: The ‘Godrevy Project’ successfully demonstrates the feasible, effective use of VR on symptom control and well-being in oncology and palliative care patients. This study demonstrates VR as an effective, patient controlled, non-pharmacological intervention without significant side effects. This interventional trial is well placed to support future research and improve clinical practice. TRIAL REGISTRATION NUMBER: NCT04821466

Comparison of Outcomes of antibiotic Drugs and Appendectomy (CODA) trial: a protocol for the pragmatic randomised study of appendicitis treatment.

INTRODUCTION: Several European studies suggest that some patients with appendicitis can be treated safely with antibiotics. A portion of patients eventually undergo appendectomy within a year, with 10%-15% failing to respond in the initial period and a similar additional proportion with suspected recurrent episodes requiring appendectomy. Nearly all patients with appendicitis in the USA are still treated with surgery. A rigorous comparative effectiveness trial in the USA that is sufficiently large and pragmatic to incorporate usual variations in care and measures the patient experience is needed to determine whether antibiotics are as good as appendectomy. OBJECTIVES: The Comparing Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial for acute appendicitis aims to determine whether the antibiotic treatment strategy is non-inferior to appendectomy. METHODS/ANALYSIS: CODA is a randomised, pragmatic non-inferiority trial that aims to recruit 1552 English-speaking and Spanish-speaking adults with imaging-confirmed appendicitis. Participants are randomised to appendectomy or 10 days of antibiotics (including an option for complete outpatient therapy). A total of 500 patients who decline randomisation but consent to follow-up will be included in a parallel observational cohort. The primary analytic outcome is quality of life (measured by the EuroQol five dimension index) at 4 weeks. Clinical adverse events, rate of eventual appendectomy, decisional regret, return to work/school, work productivity and healthcare utilisation will be compared. Planned exploratory analyses will identify subpopulations that may have a differential risk of eventual appendectomy in the antibiotic treatment arm. ETHICS AND DISSEMINATION: This trial was approved by the University of Washington\u27s Human Subjects Division. Results from this trial will be presented in international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT02800785

Exploring the Impact of Home-Schooling on the Psychological Wellbeing of Irish Families During the Novel Coronavirus (COVID-19) Pandemic: A Qualitative Study Protocol

Background: The COVID-19 pandemic has placed severe restrictions on people’s behavior worldwide with school closures in many countries. These closures have shifted education from the classroom to the home. This change is unprecedented, and home-schooling has placed substantial stress on families across the world. As of 9 April 2020, 1.57 billion children were being educated by families that had little or no experience of protracted home-schooling. An essential but neglected issue related to COVID-19 is the psychological impact of home-schooling on family wellbeing, especially considering the other stressors they are experiencing including social isolation, fears of infection, frustration, boredom, inadequate information, and financial stress. This study explores the impact of home-schooling on family psychological wellbeing during COVID-19. These findings will help develop supports and interventions for this population. Methods: An exploratory qualitative study will be conducted using semistructured interviews with a convenience sample of families (at least one parent and one child). Participants will be recruited using social media outlets, contacts of academic members and snowball sampling. Interviews will take place using Microsoft Teams and via telephone and recorded for transcription purposes. These transcripts will be analyzed using interpretative phenomenological analysis (IPA). Ethical approval has been granted by the Social Research Ethics Subcommittee (SRESC) Maynooth University (2407411). The Science Foundation Ireland (SFI) has funded the research with the COVID-19 rapid response grant. The dissemination of findings will be through open access journal publications, distribution of lay summaries, press release and policy papers. Discussion: The research findings will discuss the impact that home-schooling has had on family psychological wellbeing. It will examine how parents are managing their children’s education and learning while handling the other stresses associated with COVID-19. A deeper understanding of the impact of school closures and home-schooling on family processes is essential if the psychological wellbeing of families is to be protected and supported during challenging times such as health-related disasters

“All My Problems Go Away for 90 Minutes”: How Football and Psychotherapy Improves Young Men’s Mental Health

This qualitative research sought to establish the impact of an 8-week program combining football and one-to-one psychotherapy on young males’ mental health, determining the factors that predict help-seeking behaviors in this group of men. Pre- and post-participation focus groups were used as the method of data collection. Six males (19–35 years old; M = 25.5) completed both pre-intervention and follow-up focus groups. Help-seeking behaviors were influenced by the appeal of football and the perception of the counselor being accessible. Barriers included gender norms, socialization, financial difficulties, and challenging social landscapes. Post-participation focus groups revealed that positive social and counseling relationships facilitated improved mental health. Sport was deemed an acceptable medium to deliver a mental health intervention as it increased social connections and facilitated help-seeking. Findings support previous research indicating that combining sports and psychotherapy positively impacts young males’ mental health

Using a systems thinking approach to understand teachers perceptions and use of assistive technology in the republic of Ireland

Purpose: Assistive technology (AT) enables and promotes inclusion and participation, especially for persons with a disability, ageing populations, and those with non-communicable diseases. AT is essential for generating collaborative learning environments, inclusive of students with a range of specific needs and required supports. However, many teachers lack the training, resources, and skills to use AT in the class. This study uses a systems thinking approach to consider teachers AT needs in the Irish classroom. Methods: Three hundred and five teachers completed an online survey, and 10 took part in semi-structured focus groups. The survey examined teachers experiences with AT, their training needs, and the context within which they need support. Results: Teachers reported low levels of AT knowledge, skills, and confidence. Many described limited access to training and support for AT use. Results also reveal non-systems thinking, whereby there is no meaningful linking across the main strategic drivers of AT - policy, products, provision, and personnel, to support the people at the centre of the AT system – between these and the contextual factors that influence their effectiveness. Conclusion: An AT system which is easy to navigate, which has policies and provision that supports educators, and has expert personnel on hand to support teachers, is crucial if AT is to become embedded in Irish classrooms. This research shows that a comprehensive AT system in education should include policies, practices, personnel, and products that interact to support people to engage easily and successfully with AT in the classroo

“You’re a teacher you’re a mother, you’re a worker”: Gender inequality during COVID‐19 in Ireland

The novel coronavirus (COVID-19) was declared a global pandemic in March 2020. Unlike previous highly contagious diseases that brought the threat of global instability this century such as SARS-CoV, Zika virus (ZIKV), Swine flu (H1N1), and the Avian flu (H5N1), COVID-19 was unable to be contained. Global restrictions were implemented to curb the spread of the virus, which included but were not limited to the closure of all educational institutions and the advice to engage in remote working. This study aims to understand the experience of working mothers who managed work and home duties during the COVID-19 pandemic in Ireland. Thirty working mothers were interviewed in this study, and qualitative analyses were conducted to gain insight into their work and family life during the restrictions. The findings of the analysis indicate that working mothers have been negatively impacted by COVID-19 in relation to their psychological well-being, experiences of negative emotions, and the redefinition of family dynamics, in which working mothers have adopted additional and disproportionate care burden. These findings are consistent with the current research arguing that COVID-19 has highlighted an increase in the gender gap in domestic labor as well as the undermining of career advancement for working mothers

A Qualitative Study of Child and Adolescent Mental Health during the COVID-19 Pandemic in Ireland

Mitigating the adverse physical health risks associated with COVID-19 has been a priority of public health incentives. Less attention has been placed on understanding the psychological factors related to the global pandemic, especially among vulnerable populations. This qualitative study sought to understand the experiences of children and adolescents during COVID-19. This study interviewed 48 families during the COVID-19 pandemic restrictions, and a national lockdown, to understand its impacts. The study used an Interpretative Phenomenological Analysis (IPA) methodology. Parents and children discussed the negative impact of the restrictions on young people’s wellbeing. Children and adolescents experienced adverse mental health effects, including feelings of social isolation, depression, anxiety, and increases in maladaptive behaviour. Families with children with Autism Spectrum Disorders reported increased mental health difficulties during this period mostly due to changes to routine. The findings highlight the impact of severe restrictions on vulnerable populations’ wellbeing and mental health outcomes, including children, adolescents, and those with Autism spectrum disorder (ASD)

‘Godrevy Project’: virtual reality for symptom control and well-being in oncology and palliative care – a non-randomised pre-post interventional trial

Objective The ‘Godrevy Project’ is an interventional trial designed to determine the effectiveness of immersive virtual reality (VR) on the holistic symptom control and well-being in oncology and palliative care patients. The primary objective of this study was to determine whether VR changed the revised Edmonton Symptom and Assessment System (ESAS-r) score representing an effective improvement in symptom control and well-being.Methods and analysis This study reports on 60 participants recruited from hospital inpatient oncology and palliative care lists, to participate in an unblinded, VR intervention. Participants were included aged >18 years with a diagnosis of cancer, receiving inpatient treatment of systemic anticancer therapy. Impact evaluation on symptoms was measured using the ESAS-r pre-VR and post-VR intervention. For ethical reasons, participants were not randomised.Results From the 60 inpatients recruited, 58 participants were included for analysis. Participants recruited were aged 19–84 years with female (58%) and male (42%) participation. The primary outcome of the study demonstrated significant improvement in ESAS-r scores for symptoms and well-being. Total ESAS-r scores showed an improvement of 42% compared with baseline, with well-being ESAS-r scores improving 51%. The most common side effect was drowsiness. There were no adverse events related to study participation.Conclusion The ‘Godrevy Project’ successfully demonstrates the feasible, effective use of VR on symptom control and well-being in oncology and palliative care patients. This study demonstrates VR as an effective, patient controlled, non-pharmacological intervention without significant side effects. This interventional trial is well placed to support future research and improve clinical practice.Trial registration number NCT04821466