Co-designing Assistive Technology with and for Persons Living with Dementia

Dementia is a chronic and progressive neurodegenerative illness, which can lead to significant difficulties in a person’s capacity to perform activities of daily living (ADLs) and engage in meaningful activities. There is an acute need, which digital health technologies can potentially fulfil, to provide proactive support for persons living with dementia (PLwD) and their caregivers. However, there is limited involvement of PLwD in the design of technology that could be used to support their personal plans for independent living at home. In this paper, we describe how we are employing a co-design methodology to support engagement in an assistive technology toolkit for managing ADLs for people living with the early stages of dementia

Single dose oral dexamethasone versus multi-dose prednisolone in the treatment of acute exacerbations of asthma in children who attend the emergency department: study protocol for a randomized controlled trial.

BACKGROUND: Asthma is a major cause of pediatric morbidity and mortality. In acute exacerbations of asthma, corticosteroids reduce relapses, subsequent hospital admission and the need for ß2-agonist therapy. Prednisolone is relatively short-acting with a half-life of 12 to 36 hours, thereby requiring daily dosing. Prolonged treatment course, vomiting and a bitter taste may reduce patient compliance with prednisolone. Dexamethasone is a long-acting corticosteroid with a half-life of 36 to 72 hours. It is used frequently in children with croup and bacterial meningitis, and is well absorbed orally. The purpose of this trial is to examine whether a single dose of oral dexamethasone (0.3 mg/kg) is clinically non-inferior to prednisolone (1 mg/kg/day for three days) in the treatment of exacerbations of asthma in children who attend the Emergency Department. METHODS/DESIGN: This is a randomized, non-inferiority, open-label clinical trial. After informed consent with or without assent, patients will be randomized to either oral dexamethasone 0.3 mg/kg stat or prednisolone 1 mg/kg/day for three days. The primary outcome measure is the comparison between the Pediatric Respiratory Assessment Measure (PRAM) across both groups on Day 4. The PRAM score, a validated, responsive and reliable tool to determine asthma severity in children aged 2 to 16 years, will be performed by a clinician blinded to treatment allocation. Secondary outcomes include relapse, hospital admission and requirement for further steroid therapy. Data will be analyzed on an intention-to-treat and a per protocol basis. With a sample size of 232 subjects (105 in each group with an estimated 10% loss to follow-up), we will be able to reject the null hypothesis - that the population means of the experimental and control groups are equal with a probability (power) of 0.9. The Type I error probability associated with this test (of the null hypothesis) is 0.05. DISCUSSION: This clinical trial may provide evidence that a shorter steroid course using dexamethasone can be used in the treatment of acute pediatric asthma, thus eliminating the issue of compliance to treatment. REGISTRATION: ISRCTN26944158 and EudraCT Number 2010-022001-18

Intranasal fentanyl versus intravenous morphine in the emergency department treatment of severe painful sickle cell crises in children: study protocol for a randomised controlled trial.

BACKGROUND: Children with sickle cell disease (SCD) frequently and unpredictably present to the emergency department (ED) with pain. The painful event is the hallmark acute clinical manifestation of SCD, characterised by sudden onset and is usually bony in origin. This study aims to establish if 1.5mcg/kg of intranasal fentanyl (INF; administered via a Mucosal Atomiser Device, MAD™) is non-inferior to intravenous morphine 0.1 mg/kg in severe SCD-associated pain. METHODS/DESIGN: This study is a randomised,double-blind, double-dummy active control trial of children (weighing more than 10 kg) between 1 year and 21 years of age with severe painful sickle cell crisis. Severe pain is defined as rated seven or greater on a 0 to 10 age-appropriate numeric pain scale or equivalent. The trial will be conducted in a single tertiary urban paediatric ED in Dublin, Ireland. Each patient will receive a single active agent and a single placebo via the intravenous and intranasal routes. All clinical and research staff, patients and parents will be blinded to the treatment allocation. The primary endpoint is severity of pain scored at 10 min from administration of the study medications. Secondary endpoints include pain severity measured at 0, 5, 15, 20, 30, 60 and 120 min after the administration of analgesia, proportion of patients requiring rescue analgesia and incidence of adverse events. The trial ends at 120 min after the administration of the study drugs. A clinically meaningful difference in validated pain scores has been defined as 13 mm. Setting the permitted threshold to 50% of this limit (6 mm) and assuming both treatments are on average equal, a sample size of 30 patients (15 per group) will provide at least 80% power to demonstrate that INF is non-inferior to IV morphine with a level of significance of 0.05. DISCUSSION: This clinical trial will inform of the role of INF 1.5mcg/kg via MAD in the acute treatment of severe painful sickle cell crisis in children in the ED setting. TRIAL REGISTRATION: Current Controlled Trials ISRCTN67469672 and EudraCT no. 2011-005161-20

[Review] Stray: Human-Animal Ethics in the Anthropocene Barbara Creed, Stray: Human-Animal Ethics in the Anthropocene

Barbara Creed is well known for her contribution to the field of Film Studies, as well as feminist thought more generally. Books such as The Monstrous-Feminine: Film, Feminism, Psychoanalysis (1993, Routledge) and Phallic Panic: Film, Horror and the Primal Uncanny (2005, University of Melbourne Press) established Creed as a leading international thinker. They also attest to Creed’s willingness to push boundaries and to take on challenging and controversial topics. In recent years Creed has turned her attention to the lives of nonhuman animals, and the multitude of ways in which humans engage with, oppress, and may learn from their nonhuman animal kin. Stray, Creed’s latest monograph, brings together many aspects of her work in an engaging, informed, challenging and complex way

The Ethics and Politics of Drones in Animal Activism

This paper considers the use of drones in animal advocacy and aims to provide a moral and political justification for their use. We focus on animal protection groups who fly drones over farms to take pictures and videos of the way animals are used in agriculture and who then share these images publicly with a view to changing either consumer behaviour, the laws which regulate animal agriculture, or both. We identify unique moral issues associated with drone use and provide an argument to support their use in animal protection, in the ways spearheaded by Will Potter and other animal advocates worldwide. We then analyse privacy issues associated with drone use and consider whether the potential harms outweigh the benefits. We conclude that while privacy concerns are legitimate, they do not outweigh the public good generated by drones. Moreover, animal advocates can easily manage those concerns. Finally, we illustrate our argument in practice with a recent case study from Australia

Should We Eat Our Research Subjects? Advocacy and Animal Studies

This paper examines data from a survey of Animal Studies scholars undertaken by the authors in 2015. While the survey was broad ranging, this paper focuses on three interconnected elements; the respondents’ opinions on what role they think the field should play in regard to animal advocacy, their personal commitment to animal advocacy, and how their attitudes toward advocacy in the field differ depending on their dietary habits. While the vast majority of respondents believe that the field should demonstrate a commitment to animal wellbeing, our findings suggest that respondents’ level of commitment to animal advocacy is informed by whether they choose to eat animal products or not. We conclude that this reflects the breadth of the field as well as the fact that it is a relatively new area of study and as such is still evolving. In relation to the question posed in the title of this article – should we eat our research subjects? – it seems that Animal Studies scholars are divided on that issue; some do, some don’t, but for those who do eat their research subjects there is a degree of unease about the contradictions that such a choice implies

Findings from a longitudinal qualitative study of child protection social workers\u27 retention: Job embeddedness, professional confidence and staying narratives

The retention of social workers in child protection and welfare is an ongoing concern in many countries. While our knowledge based on the turnover of child protection and welfare social workers is growing, much less is known about ‘stayers’—those who undertake this work for over 10+ years. This article draws on the data gathered over a decade in Ireland on these social workers. The article addresses three questions: (i) What can we learn from social workers with 10+ years’ experience of child protection and welfare about their retention? (ii) Does job embeddedness theory help explain their choices to stay? (iii) Does the ‘career preference typology’ (Burns, 2011. British Journal of Social Work, 41(3), pp. 520–38) helps to explain social workers’ retention? The main findings are that if you can retain social workers beyond the 5-year point, their retention narrative intensifies, their embeddedness in the organisation and community strengthens and they have a stronger sense of professional confidence as they move out of the early professional stage. A surprising finding of this study was that nearly all of the social workers in this study had a staying narrative that changed little between their interviews a decade apart

\u27Pussy Panic\u27 and Glass Elevators: How Gender is Shaping the Field of Animal Studies

The \u27pussy panic\u27 of our title is a phrase that belongs to Susan Fraiman. It is a diagnosis, a lament, and a warning about how Animal Studies (AS) is currently torn between rising academic respectability bestowed through the \u27installation of Derrida as founding father\u27, and the neglect that this entails for AS\u27s deep roots in feminist scholarship going back decades, and across a number of disciplines. Finding that a \u27proximity to this feminized realm\u27 of \u27siding with animals\u27 can bring about a \u27pussy panic\u27 in male scholars, Fraiman draws a parallel between academic mainstreaming and the suppression of the \u27emotionally and politically engaged\u27 work of earlier feminist writers (93). Inspired by Fraiman\u27s reading and her sense of a lingering pussy panic in the field of AS, we were interested to inquire whether or not the academic legitimacy the field deserves has also brought with it a privileging of men\u27s voices as it has developed over the years. We conducted a large, broad-ranging international survey of AS scholars. From that larger survey, the issue of gender stood out and enabled us to investigate Fraiman\u27s observations further. Our data lend support to the idea that \u27pussy panic\u27 has indeed shaped the direction of the field so far

Supporting systems innovation

Many researchers and practitioners contend that organisations should respond to changing market need and create competitive advantage through innovation and creativity. Each year, organisations expend significant resources developing new products and processes and yet research shows that more than half of these initiatives fail. Successful organisations are not innovative by accident; they deliberately manage their innovation process. In order to effectively manage the innovation process, organisations must utilise proven approaches to "lever" innovation within the organisation. This paper proposes an approach to managing systems innovation that centres on the process of organisational innovation and good management practice. This approach aims to provide a more integrated approach to systems innovation that will make it more systemic and improve its likelihood of success. This paper\u27s main objective is to present a Systems Innovation Self-Assessment (SISA) tool. This tool is derived from the Systems Innovation Management approach, together with the findings of a series of case studies undertaken of the Irish manufacturing industry. This tool allows organisations to assess their progress towards developing an environment supportive of systems innovation. A number of observations obtained from these case studies are also presented

Systems innovation management: Supporting innovation in a manufacturing environment

Each year organisations spend a significant amount of money developing new products and processes in an effort to satisfy customer demands and manufacture high quality products efficiently. Both development processes - product and process, are complex, resource intensive and thrive on innovation. They demand a variety of skills and resources but in particular, participation, among all staff in generating ideas, managing projects and implementing change. There are currently a number of software tools, and methods that facilitate change in a systems environment. These range from complex modeling tools to information management tools. The tools have been developed around paradigms such as world class manufacturing, total quality management and business process reengineering. They are often complex, requiring the efforts of skilled designers and managers. Current thinking within a systems environment reflects a more participative and less technical approach to managing innovation and change. There is a need to compromise between detailed project engineering and good management practice. This paper introduces a new paradigm centred on good management practice and addresses the critical issues of innovation and change. The paradigm is articulated through a series of change levers and a methodology that guides managers and designers. It is supported by a series of software tools that together bring innovation management to life within the industrial organisation