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Our experiences with experience-based co-design

Emergency care (from ambulance to emergency room) is focused on somatic care: fixing the body. When a patient with mental dysregulation who experiences ‘disproportionate feelings like fear, anger, sadness or confusion, possibly with associated behaviours’ (Van de Glind et al. 2023) does not get appropriate attention, this can result in the disruption of treatment and even psychological trauma upon trauma. To improve the emergency care process, the authors of this paper - health researchers and design researchers engaged in a project based on the experience-based co-design (EBCD) approach (Donetto et al. 2015; Bate and Robert 2007). EBCD is a method used to design better experiences in healthcare settings, in cooperation with (former) patients and healthcare professionals. The process of EBCD involves partnerships between stakeholders and the discovery and sensemaking of experiences through specialized methods to gain an understanding of the interface between user and service, to design new experiences (Bate and Robert 2007, 31). There is, however, an interesting challenge in bringing patients and care professionals together. In emergency care, patients depend greatly on their healthcare providers. The patients in this study had existing mental vulnerabilities and may have been traumatized by previous visits. We needed to enable these stakeholders to be equal partners with ownership and power, one of the characteristics of co-design in EBCD (Donetto et al. 2015). In this paper, we describe how we adapted and applied the EBCD method, with a focus on creating equal partnerships. We also reflect on the extent of our success and the diBiculties we encountered in attaining this objective.

Interventions to reduce interpersonal stigma towards patients with a mental dysregulation for ambulance and emergency department healthcare professionals: review protocol for an integrative review

Introduction: Worldwide, there is an increase in the extent and severity of mental illness. Exacerbation of somatic complaints in this group of people can result in recurring ambulance and emergency department care. The care of patients with a mental dysregulation (ie, experiencing a mental health problem and disproportionate feelings like fear, anger, sadness or confusion, possibly with associated behaviours) can be complex and challenging in the emergency care context, possibly evoking a wide variety of feelings, ranging from worry or pity to annoyance and frustration in emergency care staff members. This in return may lead to stigma towards patients with a mental dysregulation seeking emergency care. Interventions have been developed impacting attitude and behaviour and minimising stigma held by healthcare professionals. However, these interventions are not explicitly aimed at the emergency care context nor do these represent perspectives of healthcare professionals working within this context. Therefore, the aim of the proposed review is to gain insight into interventions targeting healthcare professionals, which minimise stigma including beliefs, attitudes and behaviour towards patients with a mental dysregulation within the emergency care context. Methods and analysis: The protocol for a systematic integrative review is presented, using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A systematic search was performed on 13 July 2023. Study selection and data extraction will be performed by two independent reviewers. In each step, an expert with lived experience will comment on process and results. Software applications RefWorks-ProQuest, Rayyan and ATLAS.ti will be used to enhance the quality of the review and transparency of process and results. Ethics and dissemination: No ethical approval or safety considerations are required for this review. The proposed review will be submitted to a relevant international journal. Results will be presented at relevant medical scientific conferences.

Sad by Design (the essay)

We are not sick

We Are Not Sick is a hybrid lecture/music performance by Geert Lovink and John Longwalker. Combining a diversity of text-, image-, and music-genres, the project reflects on the encroaching sadness provoked by social media architectures.Through this project they push for new modalities in both music and critical theory, to shake up both the dance floor and the lecture circuit. Utilizing a range of electronic musical genres for maximum reach, the Sad By Design album is not a soundtrack to a book of theory but rather a new attempt at expressing those same themes, using the same words but achieving different vectors of critique. Sad By Design is a ‘carrier wave for critical theory,’ crafted over two years of refining our answer to the question of what this new ‘critical music’ hybrid feels like to experience.

Sad by Design

Sadness is now a design problem. The highs and lows of melancholy are coded into social media platforms. After all the clicking, browsing, swiping and liking, all we are left with is the flat and empty aftermath of time lost to the app. Sad by Design offers a critical analysis of the growing social media controversies such as fake news, toxic viral memes and online addiction. The failed search for a grand design has resulted in depoliticised internet studies unable to generate either radical critique or a search for alternatives. Geert Lovink calls for us to embrace the engineered intimacy of social media, messenger apps and selfies, because boredom is the first stage of overcoming ‘platform nihilism’. Then, after the haze, we can organise to disrupt the data extraction industries at their core.

Decoding the neural responses to experiencing disgust and sadness.

Being able to classify experienced emotions by identifying distinct neural responses has tremendous value in both fundamental research (e.g. positive psychology, emotion regulation theory) and in applied settings (clinical, healthcare, commercial). We aimed to decode the neural representation of the experience of two discrete emotions: sadness and disgust, devoid of differences in valence and arousal. In a passive viewing paradigm, we showed emotion evoking images from the International Affective Picture System to participants while recording their EEG. We then selected a subset of those images that were distinct in evoking either sadness or disgust (20 for each), yet were indistinguishable on normative valence and arousal. Event-related potential analysis of 69 participants showed differential responses in the N1 and EPN components and a support-vector machine classifier was able to accurately classify (58%) whole-brain EEG patterns of sadness and disgust experiences. These results support and expand on earlier findings that discrete emotions do have differential neural responses that are not caused by differences in valence or arousal.