Evaluating a novel hospital-based online health community to address palliative and psychosocial care factors for chronically ill adolescent and young adult patients

OBJECTIVES

Chronically ill adolescent and young adult (AYA) patients experience barriers to accessing psychosocial care. AYAs who receive palliative and psychosocial care experience numerous benefits from these services. However, we still lack research investigating age-appropriate programs targeting AYAs' psychosocial needs that are delivered virtually and extend beyond the hospital setting. Streetlight is a palliative care program designed for chronically ill AYAs that offers the Streetlight Gaming League (SGL), an online health community (OHC) combining peer-based support, online gaming, and community events. We evaluated the usefulness, acceptability, and potential effectiveness of SGL through an assessment of chronically ill AYAs' lived experiences.

METHODS

We used a qualitative evaluation approach grounded in hermeneutic phenomenology. Questionnaires and interviews were conducted with 9 chronically ill AYAs to elicit in-depth accounts of their lived experiences of using SGL. Descriptive statistical analysis was performed on questionnaire data. Phenomenological data analysis, informed by hermeneutic analysis, was used to analyze interviews.

RESULTS

AYAs reported positive experiences with SGL and valued the ability to engage in various content while having few participation expectations. They also described psychosocial benefits, including reprieve from illness, sense of community, and solidarity through mutual understandings and shared experiences.

SIGNIFICANCE OF THE RESULTS

Findings highlight the usefulness and acceptability of a virtual palliative psychosocial care program for chronically ill AYAs. Findings also suggest the effectiveness of SGL and support using an OHC to meet the psychosocial needs of AYAs. This study can guide future programming and implementation of online palliative psychosocial care programs in other hospital settings, resulting in similar beneficial and meaningful experiences.

The effect of online learning in modern history education

Interactive digital technologies have become relevant in modern education. The use of these technologies in the classroom contributes to the development of professional competencies and skills. The purpose of the study is to analyze the effectiveness of interactive learning environments and online platforms in learning history. The features of modern online learning platforms and the possibilities of their use in the study of history have been analyzed. The research was carried out at the Department of National History of Moscow City University (Moscow, the Russian Federation). The experiment involved 623 history students of different years of study of the following training profiles: "History" (124 students of 1–4 years of study) and "Pedagogical education" ("History and a foreign language", "History and social studies" – 399 students of 1–5 years of study). Also, the survey was addressed to 29 faculty members from the university under consideration. The results of the first survey show that the majority of students (62%) noted the use of traditional methods and 38% of respondents indicated the use of the modern ones. The majority of students (52%) also answered that digital tools are rarely used in the study of history while 71% of respondents reported that digital technology affects their motivation to learn. Therefore, the majority of students rated their level of motivation as average (43%) or low (47%). The most frequent professional competencies and skills are “technical competence (modern technologies)” (62%), “creativity” (65%), “critical thinking” (60%), “strategic thinking” (55%), and “practical skills” (78%). Based on the results obtained in the first survey, a program was developed to increase the motivation of students to study history and archeology, as well as to familiarize themselves with modern educational technologies that can be used in the learning process. The second survey showed an increase in the indicators of students' motivation to learn, which indicates the effectiveness of the developed program for the study of history. The majority of students (85%) answered that digital tools affect their motivation to learn. Thus, they rated it as medium (50%), high (20%) and low (30%). Accordingly, the indicators of professional competencies and skills increased by 10%: “technical competence (modern technologies)” (72%), “creativity” (75%), “critical thinking” (71%), “strategic thinking” (65%), and “practical skills” (88%). No less significant were the shifts in students’ creative thinking development indicators – they changed from 18% (before the experiment) to 58% (after the experiment). The practical significance and prospects for further research are explained by the possibility of using the developed program for the study of history in other universities located in different countries. Also, the methodological basis of the proposed program can be used to study not only history but also other subjects as digital technologies are relevant in the modern education system.

The Unreliability of Online Review Mechanisms

Online reviews have an undeniable impact on the market and are an important source of consumer information. From a legal perspective, online reviews actively influence consumers' decisions to enter into a contract. Moreover, online reviews convey pre-contractual information that consumers find relevant and easy to understand, unlike the pre-contractual information disclosed as a result of EU law-based information duties. From this perspective, online reviews could potentially be seen as a complement of the flawed EU law-based information paradigm and regulatory improvement options based on reviews could be explored. However, the unreliability of online reviews is an obstacle that haunts consumers, practitioners, regulators, and academics alike. This unreliability has previously been identified as a reason not to award online reviews a more significant role in the EU law-based regulatory framework of pre-contractual information in consumer contracts. This paper explores the merits of this argument by discussing how the unreliability of online reviews is currently regulated. This paper takes a broad perspective on regulation, focusing not only on EU consumer legislation, but also looking at standardization, soft law, self-regulation, and the role of national consumer authorities. Overall, this paper argues that there are sufficient measures in place to shift the debate from the unreliability of reviews to reviews' potential role in the protection of consumer informational interests.

Effectiveness of Online Learning vs Traditional Learning during COVID-19 Pandemic in Chennai: A Questionnaire Study

BACKGROUND

Digitalization of education became a need of the hour when the COVID-19 pandemic affected the traditional modalities of learning, and it was widely implemented in various fields including dentistry.

AIMS

The aim of this study was to assess the effectiveness of online learning against traditional learning systems among dental students in Chennai.

METHODS AND MATERIALS

A Google Form questionnaire comprising 29 dental learning-based questions was designed and distributed to dental students across colleges in Chennai using online distribution platforms. The study responses were closed after the stipulated period of 1 month. The data were analyzed using SPSS software version 17.

RESULTS

The survey was answered by 834 participants comprising 76.9% females and 22.3% males. Of the total study population, 71.1% of them did not have previous online learning experiences. Approximately, 15.5% of the study population were not satisfied with the facilities provided by the online learning platforms. Also, one-third of the study population reported difficulty during the presentation. Three-fourths of the study participants did not prefer online learning over traditional learning and reported that the attention span and communication between the students and teachers were lower in online classes. Overall, 43% of the study participants rated the quality of online video-based learning to be good and 8.5% found it to be poor.

CONCLUSION

Online-based learning systems are evolving and can provide a wide array of knowledge from global experts. However, structured planning and technique may be needed for the dental curriculum.

The economics of platform liability

Public authorities in many jurisdictions are concerned about the proliferation of illegal content and products on online platforms. One often discussed solution is to make the platform liable for third parties' misconduct. In this paper, we first identify platform incentives to stop online misconduct in the absence of liability. Then, we provide an economic appraisal of platform liability that highlights the intended and unintended effects of a more stringent liability rule on several key variables such as prices, terms and conditions, business models, and investments. Specifically, we discuss the impact of the liability regime applying to online platforms on competition between them and the incentives of third parties relying on them. Finally, we analyze the potential costs and benefits of measures that have received much attention in recent policy discussions.

Fake reviews on online platforms: perspectives from the US, UK and EU legislations

User-generated online reviews have become essential sources of information for potential consumers. Given the increasing importance of online reviews on consumer purchases, some traders try to publish or promote fake reviews on online platforms to improve the reputation of their goods or services, or to damage the reputation of their competitors. This paper aims (1) to analyse whether and how fake reviews violate the main legal and ethical principles of advertising, according to the legislations of the US, UK and EU as well as the International Advertising and Marketing Communications Code; (2) to assess how the EU, the UK and the US are dealing with them, and find out which approaches and actions are working best; and (3) to offer normative recommendations for effective prosecution of fake reviews. The paper uses a combination of theoretical and sociological approaches (section 1), black letter analysis of law (sections 2 and 3) and a comparative approach (sections 2 and 3). Among others, the article observes (1) that fake reviews are a form of illegal advertising and (2) that the European regulatory instruments provide more protection against fake reviews than the US and argues (3) that an effective fight against fake reviews requires strong administrative bodies, endowed with sufficient resources.

Cognitive Network Science for Understanding Online Social Cognitions: A Brief Review

Social media are digitalizing massive amounts of users' cognitions in terms of timelines and emotional content. Such Big Data opens unprecedented opportunities for investigating cognitive phenomena like perception, personality, and information diffusion but requires suitable interpretable frameworks. Since social media data come from users' minds, worthy candidates for this challenge are cognitive networks, models of cognition giving structure to mental conceptual associations. This work outlines how cognitive network science can open new, quantitative ways for understanding cognition through online media like: (i) reconstructing how users semantically and emotionally frame events with contextual knowledge unavailable to machine learning, (ii) investigating conceptual salience/prominence through knowledge structure in social discourse; (iii) studying users' personality traits like openness-to-experience, curiosity, and creativity through language in posts; (iv) bridging cognitive/emotional content and social dynamics via multilayer networks comparing the mindsets of influencers and followers. These advancements combine cognitive-, network- and computer science to understand cognitive mechanisms in both digital and real-world settings but come with limitations concerning representativeness, individual variability, and data integration. Such aspects are discussed along with the ethical implications of manipulating sociocognitive data. In the future, reading cognitions through networks and social media can expose cognitive biases amplified by online platforms and relevantly inform policy-making, education, and markets about complex cognitive trends.

Harm reduction via online platforms for people who use drugs in Russia: a qualitative analysis of web outreach work

Background

Harm reduction services to people who use drugs (PWUD) in Russia are insufficient in terms of quantity, government endorsement, and accessibility. The situation has recently deteriorated even further because of social distancing measures of the COVID-19 pandemic. Several organizations have started to provide some harm reduction services via online platforms by web outreach. However, little is known on how online outreach services are organized and implemented. Drawing on the example of St. Petersburg-based NGO “Humanitarian Action,” we explored web outreach work in Telegram instant messenger.

Methods

Our data were comprised of 4 semi-structured interviews with the NGO staff and 301 cases of web outreach work with PWUD. We used thematic analysis to study the process of web outreach, harm reduction service provision, and needs of PWUD.

Results

Three stages of the process of web outreach work were identified: clients initiating communication, NGO workers addressing clients’ needs, and NGO workers receiving clients’ feedback. Communication proceeded in group chat or direct messages. Challenges in addressing clients’ needs happened when clients turned for help after hours, sent recorded voice messages, sent unclear messages, and/or were unwilling to transition to telephone communication. All web outreach workers reported receiving only positive feedback on their work. The needs of PWUD were categorized into two major themes, depending on whether they can be addressed fully or partially online. In cases of online only provision of services, web outreach workers helped PWUD treat minor injection drug use complications, obtain verified harm reduction information and receive general psychological support. In instances of partial online services provision, PWUD were assisted in getting treatment of severe injection drug use complications, overdoses, and in accessing offline medical, psychological, social, legal and harm reduction services.

Conclusions

Our research demonstrated that web outreach work is a convenient tool for delivering some harm reduction services to PWUD either partially or completely online and for recruiting new clients (including hard-to-reach PWUD that avoid attending brick-and-mortar facilities). Harm reduction organizations should consider incorporating online harm reduction services into their activities. However, further research is needed to explore relative advantages and disadvantages of online harm reduction services.

Is the American College of Surgeons Online Communities a safe and useful venue to ask for surgical advice?

BACKGROUND

Many surgeons rely on the American College of Surgeons (ACS) Community Forums for advice on managing complex patients. Our objective was to assess the safety and usefulness of advice provided on the most popular surgical forum.

METHODS

Overall, 120 consecutive, deidentified clinical threads were extracted from the General Surgery community in reverse chronological order. Three groups of three surgeons (mixed academic and community perspectives) evaluated the 120 threads for unsafe or dangerous posts. Positive and negative controls for safe and unsafe answers were included in 20 threads, and reviewers were blinded to their presence. Reviewers were free to access all online and professional resources.

RESULTS

There were 855 unique responses (median 7, 2-15 responses per thread) to the 120 clinical threads/scenarios. The review teams correctly identified all positive and negative controls for safety. While 58(43.3%) of threads contained unsafe advice, the majority (33, 56.9%) were corrected. Reviewers felt that a there was a standard of care response for 62/120 of the threads of which 50 (80.6%) were provided by the responses. Of the 855 responses, 107 (12.5%) were considered unsafe/dangerous.

CONCLUSION

The ACS Community Forums are generally a safe and useful resource for surgeons seeking advice for challenging cases. While unsafe or dangerous advice is not uncommon, other surgeons typically correct it. When utilizing the forums, advice should be taken as a congregate, and any single recommendation should be approached with healthy skepticism. However, social media such as the ACS Forums is self-regulating and can be an appropriate method for surgeons to communicate challenging problems.

Coronavirus as a Catalyst to Transform Consumer Policy and Enforcement

A review of the unfair commercial practices (including price gouging) that have emerged in the context of the pandemic lead us to reflect on how effective consumer law enforcement is at this juncture. This article calls for the pandemic to act as a catalyst to review the way consumer law has so far approached markets and their regulation. It argues that now, more than ever, consumer law needs to protect the vulnerable and public enforcement mechanisms must be able to prevent harm as much as possible rather than repair it. Fairness should be by design and not something that is offered to consumers simply as a remedy. The article explores some viable solutions to effect this transformation of consumer policy and enforcement beyond the pandemic.