Co-designing design fictions:a new approach for debating and priming future healthcare technologies and services

Background Design fictions (DFs) are emerging as a tool aimed at engaging people in debating and questioning the direction of future technologies, services and possible societies. Following the challenges placed on healthcare provision by an ageing population, governments are introducing policies related to ageing that will shape future healthcare services. The exploratory ProtoPolicy project, investigated how co-created DFs might be used to help older citizens imagine the future implications of policy initiatives through the lens of technology in an ageing society. Methods A co-design research approach was employed. In collaboration with older citizens (n=21, 65-94 years old) the project team co-created two DFs based on citizen responses to government policy, which explored the issues of assisted living/smart-homes and assisted dying/ euthanasia in the UK. Feedback on the DFs was sought from citizens at a co-design workshop. Results Five themes emerged from the thematic analysis of the workshop engagements with citizens: increasing the plausibility and acceptance of future healthcare technologies and services, raising ethical concerns and questions, conceptualising new healthcare producs and services, helping with understanding and decision-making, and service/technology requirements capture. Conclusions Understanding and engaging with more complex social healthcare technologies through a co-design design fiction approach might provide added value for citizens in priming new technology introduction in healthcare services. Co-designing design fictions can also provide researchers with more in-depth insights about the preferable futures articulated by different groups within the context of technology and healthcare services

Disease network data for the pesticide fipronil in rat dopamine cells

Transcriptome data were collected in rat dopamine cells exposed to fipronil for 24 h using microarray analysis. Fipronil is a phenylpyrazole pesticide that acts to inhibit gamma-aminobutyric acid (GABA), blocking inhibitory synaptic transmission in the central nervous system. Transcriptome data were subjected to pathway analysis and subnetwork enrichment analysis. We report that 25 mu M fipronil altered transcriptional networks in dopamine-synthesizing cells that are associated with Alzheimer's Disease, Huntington Disease, and Schizophrenia. Data analysis revealed that nerve fibre degeneration, nervous system malformations, neurofibrillary tangles, and neuroinflammation were all disease processes related to the transcriptome profile observed in the rat neuronal cells. Other disease networks altered by fipronil exposure at the transcript level were associated with the mitochondria, including mitochondrial DNA depletion syndrome and mitochondrial encephalomyopathies. These data, along with those presented in Souders et al. (2021), are significant because they increase understanding into the molecular mechanisms underlying human disease following exposures to neuroactive pesticides. These data can be reused to inform adverse outcome pathways for neurotoxic pesticides

Using design fictions as a tool for engaging citizens in debating future pervasive health systems and services

The benefits provided by health-related technologies are often counterbalanced by the societal, legal and ethical challenges connected with the pervasive monitoring of people, as necessitated by such technological interventions. Through the ProtoPolicy research project we explored the co-creation and use of design fictions as a tool for open debate of pervasive health systems. Design fictions were co-created and tested in a series of design workshops with community groups in the UK. A thematic analysis of a debate among older people on a smart home and assisted living design fiction highlighted societal and ethical issues relevant to personal and pervasive health system design. We conclude that ethics, like ‘usability’, may be usefully based on engagement with directly or indirectly implicated publics and should not be designed into innovation by experts alone

Changes in patient activation following cardiac rehabilitation using the Active+me digital healthcare platform during the COVID-19 pandemic: a cohort evaluation.

BACKGROUND: Restrictions on face-to-face contact, due to COVID-19, led to a rapid adoption of technology to remotely deliver cardiac rehabilitation (CR). Some technologies, including Active+me, were used without knowing their benefits. We assessed changes in patient activation measure (PAM) in patients participating in routine CR, using Active+me. We also investigated changes in PAM among low, moderate, and high risk patients, changes in cardiovascular risk factors, and explored patient and healthcare professional experiences of using Active+me. METHODS: Patients received standard CR education and an exercise prescription. Active+me was used to monitor patient health, progress towards goals, and provide additional lifestyle support. Patients accessed Active+me through a smart-device application which synchronised to telemetry enabled scales, blood pressure monitors, pulse oximeter, and activity trackers. Changes in PAM score following CR were calculated. Sub-group analysis was conducted on patients at high, moderate, and low risk of exercise induced cardiovascular events. Qualitative interviews explored the acceptability of Active+me. RESULTS: Forty-six patients were recruited (Age: 60.4 ± 10.9 years; BMI: 27.9 ± 5.0 kg.m2; 78.3% male). PAM scores increased from 65.5 (range: 51.0 to 100.0) to 70.2 (range: 40.7 to 100.0; P = 0.039). PAM scores of high risk patients increased from 61.9 (range: 53.0 to 91.0) to 75.0 (range: 58.1 to 100.0; P = 0.044). The PAM scores of moderate and low risk patients did not change. Resting systolic blood pressure decreased from 125 mmHg (95% CI: 120 to 130 mmHg) to 119 mmHg (95% CI: 115 to 122 mmHg; P = 0.023) and waist circumference measurements decreased from 92.8 cm (95% CI: 82.6 to 102.9 cm) to 85.3 cm (95% CI 79.1 to 96.2 cm; P = 0.026). Self-reported physical activity levels increased from 1557.5 MET-minutes (range: 245.0 to 5355.0 MET-minutes) to 3363.2 MET-minutes (range: 105.0 to 12,360.0 MET-minutes; P < 0.001). Active+me was acceptable to patients and healthcare professionals. CONCLUSION: Participation in standard CR, with Active+me, is associated with increased patient skill, knowledge, and confidence to manage their condition. Active+me may be an appropriate platform to support CR delivery when patients cannot be seen face-to-face. TRIAL REGISTRATION: As this was not a clinical trial, the study was not registered in a trial registry

Distribution of Vulnerable Marine Ecosystems at the South Sandwich Islands: Results From the Blue Belt Discovery Expedition 99 Deep-Water Camera Surveys

The South Sandwich Islands (SSI) are a chain of volcanic islands located to the east of the Scotia Sea, approximately 700 km south-east of South Georgia. To date, knowledge of the SSI benthic environment remains limited. In this context, the Blue Belt Programme conducted a scientific survey in the SSI Marine Protected Area (MPA) during February/March 2019 to examine the biodiversity and distribution of benthic communities and their potential vulnerability to licensed longline research fisheries. Here we report results from analysis of multibeam echosounder (MBES) data and drop camera imagery data collected in selected locations around the SSI. A total of eight vulnerable marine ecosystem (VME) indicator morphotaxa were mapped along the slopes of the SSI, showing a substantial variation in taxon composition and frequency of occurrence, both along bathymetric and latitudinal gradients. Our results suggest that VME indicator taxa are mostly restricted to waters shallower than 700 m. As such, based on our present understanding of the region’s benthic environment the MPA, as currently established, offers effective protection for the majority of the VME indicator taxa

Festes sense escenari : Reportatge sobre la diàspora de la cultura soundsystem des dels guetos jamaicans a Catalunya

Aquest treball està format per un reportatge sobre l'arribada i l'establiment de la cultura soundsystem jamaicana al territori català. "Festes sense escenari" és un reportatge que té la intenció de mostrar l'escena soundsystem des dels seus orígens i entendre perquè aquest tipus de festa compagina tan bé amb la realitat sociocultural catalana.Este trabajo está formado por un reportaje sobre la llegada y el establecimiento de la cultura soundsystem jamaicana al territorio catalán. "Fiestas sin escenario" es un reportaje que tiene la intención de mostrar la escena soundsystem desde sus orígenes y entender por qué este tipo de fiesta compagina tan bien con la realidad sociocultural catalana.This work consists of a report about the arrival and establishment of the Jamaican soundsystem culture to Catalan territory. "Stage-free parties" is a report aiming to show the soundsystem scene from its origins and understand why this type of parties combine so well with the Catalan sociocultural reality

Collective intelligence for promoting changes in behaviour: a case study on energy conservation

Climate change is one of the biggest challenges humanity faces today. Despite of high investments in technology, battling climate change is futile without the participation of the public, and changing their perception and habits. Collective intelligence tools can play an important role in translating this “distant” concept that is climate change into practical hints for everyday life. In this paper, we report a case study grounded on collective intelligence tools to collaboratively build knowledge around energy conservation. A preliminary study to raise energy awareness in an academic environment is summarised, setting the scene to a more ambitious initiative based on personal stories to transform energy awareness into behaviour change. The role of the collective intelligence tools and other technical artefacts involved are discussed, suggesting strategies and features that contributed (or not) to users’ engagement and collective awareness. Lessons learned from both studies are reported with a sociotechnical approach as implications for design pursuing behaviour change

Best practices in research mentoring in clinical science.

The growth of clinical science as a field depends on the work of engaged mentors nurturing future generations of scientists. Effective research mentoring has been shown to predict positive outcomes, including greater scholarly productivity, reduced attrition, and increased satisfaction with training and/or employment, which ultimately may enhance the quality of the clinical-science research enterprise. Barriers to effective research mentoring, however, pose significant challenges for both mentees and mentors, as well as for labs, training programs, and/or departments. We discuss some key issues as they apply to clinical-science mentoring and note how they are affected across different developmental levels (undergraduate, postbaccalaureate, doctoral, internship, postdoctoral associates, and early career faculty). Although we do not proclaim expertise on these issues-and have struggled with them in our own careers-we believe an open discussion around best mentoring practices will enhance our collective effectiveness and help mentees and our field to flourish. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: Data linkage study of 11 million Australians

Objective To assess the cancer risk in children and adolescents following exposure to low dose ionising radiation from diagnostic computed tomography (CT) scans. Design Population based, cohort, data linkage study in Australia. Cohort members 10.9 million people identified from Australian Medicare records, aged 0-19 years on 1 January 1985 or born between 1 January 1985 and 31 December 2005; all exposures to CT scans funded by Medicare during 1985-2005 were identified for this cohort. Cancers diagnosed in cohort members up to 31 December 2007 were obtained through linkage to national cancer records. Main outcome Cancer incidence rates in individuals exposed to a CT scan more than one year before any cancer diagnosis, compared with cancer incidence rates in unexposed individuals. Results 60 674 cancers were recorded, including 3150 in 680 211 people exposed to a CT scan at least one year before any cancer diagnosis. The mean duration of follow-up after exposure was 9.5 years. Overall cancer incidence was 24% greater for exposed than for unexposed people, after accounting for age, sex, and year of birth (incidence rate ratio (IRR) 1.24 (95% confidence interval 1.20 to 1.29); P<0.001). We saw a dose-response relation, and the IRR increased by 0.16 (0.13 to 0.19) for each additional CT scan. The IRR was greater after exposure at younger ages (P<0.001 for trend). At 1-4, 5-9, 10-14, and 15 or more years since first exposure, IRRs were 1.35 (1.25 to 1.45), 1.25 (1.17 to 1.34), 1.14 (1.06 to 1.22), and 1.24 (1.14 to 1.34), respectively. The IRR increased significantly for many types of solid cancer (digestive organs, melanoma, soft tissue, female genital, urinary tract, brain, and thyroid); leukaemia, myelodysplasia, and some other lymphoid cancers. There was an excess of 608 cancers in people exposed to CT scans (147 brain, 356 other solid, 48 leukaemia or myelodysplasia, and 57 other lymphoid). The absolute excess incidence rate for all cancers combined was 9.38 per 100 000 person years at risk, as of 31 December 2007. The average effective radiation dose per scan was estimated as 4.5 mSv. Conclusions The increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. Because the cancer excess was still continuing at the end of follow-up, the eventual lifetime risk from CT scans cannot yet be determined. Radiation doses from contemporary CT scans are likely to be lower than those in 1985-2005, but some increase in cancer risk is still likely from current scans. Future CT scans should be limited to situations where there is a definite clinical indication, with every scan optimised to provide a diagnostic CT image at the lowest possible radiation dose