A Virtual Joystick as a Novel Interaction Modality for Surgeon-Computer Interaction During Computer-Assisted Surgical Procedures

Interacting with a computer system in the operating room (OR) can be a frustrating experience for a surgeon, who currently has to verbally delegate to an assistant every computer interaction task. This indirect mode of interaction is time consuming, error prone and can lead to poor usability of OR computer systems. This thesis describes the design and evaluation of a joystick-like device that allows direct surgeon control of the computer in the OR. The device was tested extensively in comparison to a mouse and delegated dictation with seven surgeons, eleven residents, and five graduate students. The device contains no electronic parts, is easy to use, is unobtrusive, has no physical connection to the computer and makes use of an existing tool in the OR. We performed a user study to determine its effectiveness in allowing a user to perform all the tasks they would be expected to perform on an OR computer system during a computer-assisted surgery. Dictation was found to be superior to the joystick in qualitative measures, but the joystick was preferred over dictation in user satisfaction responses. The mouse outperformed both joystick and dictation, but it is not a readily accepted modality in the OR.

The Use of Nudges in Exergames to Moderate Player Exertion

Exergames are digital games with a physical exertion component. Exergames can help motivate fitness in people not inclined toward exercise. However, players of exergames sometimes over-exert, risking adverse health effects. These players must be told to slow down, but doing so may distract them from gameplay and diminish their desire to keep exercising. In this thesis we apply the concept of nudges—indirect suggestions that gently push people toward a desired behaviour—to keeping exergame players from over-exerting. We describe the effective use of nudges through a set of four design principles: natural integration, comprehension, progression, and multiple channels. We describe two exergames modified to use nudges to persuade players to slow down, and describe the studies evaluating the use of nudges in these games. PlaneGame shows that nudges can be as effective as an explicit textual display to control player over-exertion. Gekku Race demonstrates that nudges are not necessarily effective when players have a strong incentive to over-exert. However, Gekku Race also shows that, even in high-energy games, the power of nudges can be maintained by adding negative consequences to the nudges. We use the term "shove" to describe a nudge using negative consequences to increase its pressure. We were concerned that making players slow down would damage their immersion—the feeling of being engaged with a game. However, testing showed no loss of immersion through the use of nudges to reduce exertion. Players reported that the nudges and shoves motivated them to slow down when they were over-exerting, and fit naturally into the games.

Investigating the Association Between Computer-Mediated Communication (CMC) and the Health of Canadian Young People: A Mixed Methods Study

Canadian young people are increasingly more connected through technological devices. This computer-mediated communication (CMC) can result in heightened connection and social support but can also lead to inadequate personal and physical connections. As technology evolves, its influence on health and well-being is important to investigate, especially among youth. This study aims to investigate the potential influences of computer-mediated communication (CMC) on the health of Canadian youth, using both quantitative and qualitative research approaches. This mixed-methods study utilized data from the 2013-2014 Health Behaviour in School-aged Children survey for Canada (n=30,117) and focus group data involving Ontario youth (7 groups involving 40 youth). In the quantitative component, a random-effects multilevel Poisson regression was employed to identify the effects of CMC on loneliness, stratified to explore interaction with family communication quality. A qualitative, inductive content analysis was applied to the focus group transcripts using a grounded theory inspired methodology. Through open line-by-line coding followed by axial coding, main categories and themes were identified. The quality of family communication modified the association between CMC use and loneliness. Among youth experiencing the highest quartile of family communication, daily use of verbal and social media CMC was significantly associated with reports of loneliness. The qualitative analysis revealed two overarching concepts that: (1) the health impacts of CMC are multidimensional and (2) there exists a duality of both positive and negative influences of CMC on health. Four themes were identified within this framework: (1) physical activity, (2) mental and emotional disturbance, (3) mindfulness, and (4) relationships. Overall, there is a high proportion of loneliness among Canadian youth, but this is not uniform for all. The associations between CMC and health are influenced by external and contextual factors, including family communication quality. Further, the technologically rich world in which young people live has a diverse impact on their health. For youth, their relationships with others and the context of CMC use shape overall influences on their health.