Managing crisis:the role of primary care for people with serious mental illness

Background and Objectives: More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Methods: Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Results: Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Conclusions: Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

iServe:a serious game for servitization

Servitization concerns the process of manufacturers shifting from a focus on producing and selling tangible goods to service-based business models. Factors that drive adoption of servitization are financial, strategic (competitive advantage) and marketing. However, uptake is slow and active efforts are being made to transfer knowledge about servitization to the manufacturing sector. This paper presents early results from the first test of a serious computer game which has the goal of educating managers about what advanced services are and how they fit in supply chains. Results suggest the role-play scenario tested is appropriate for an audience of largely non-expert gamers, and that the approach has the potential to instruct users about the role of services in the supply chain.

Warfarin toxicity: do discharge ICD-10 codes and yellow cards accurately identify serious adverse drug reactions?

Focal points: ICD-10 codings and spontaneous yellow card reports for warfarin toxicity were compared retrospectively over a one-year period Eighteen cases of ICD-10 coded warfarin toxicity were identified from a total of 55,811 coded episodes More than three times as many ADRs to warfarin were found by screening ICD-10 codes as were reported spontaneously using the yellow card scheme Valuable information is being lost to regulatory authorities and as recognised reporters to the yellow card scheme, pharmacists are well placed to report these ADRs, enhancing their role in the safe and appropriate prescribing of warfarin

Serious games for energy social science research

This paper proposes a set of criteria for evaluation of serious games (SGs) which are intended as effective methods of engaging energy users and lowering consumption. We discuss opportunities for using SGs in energy research which go beyond existing feedback mechanisms, including use of immersive virtual worlds for learning and testing behaviours, and sparking conversations within households. From a review of existing SG evaluation criteria, we define a tailored set of criteria for energy SG development and evaluation. The criteria emphasise the need for the game to increase energy literacy through applicability to real-life energy use/management; clear, actionable goals and feedback; ways of comparing usage socially and personal relevance. Three existing energy games are evaluated according to this framework. The paper concludes by outlining directions for future development of SGs as an effective tool in social science research, including games which inspire reflection on trade-offs and usage at different scales.

A quiz-based game for addressing growing population issues:linking learning mechanics to the GROWTH serious game

This paper discusses the integration of quiz mechanism into digital game-based learning platform addressing environmental and social issues caused by population growth. 50 participants' learning outcomes were compared before and after the session. Semi-structured interview was used to gather participants' viewpoints regarding of issues presented in the game. Phenomenography was used as a methodology for data collection and analysis. Preliminary outcomes have shown that the current game implementation and quiz mechanism can be used to: (1) promote learning and awareness on environmental and social issues and (2) sustain players' attention and engagements.

Comparing interaction techniques for serious games through brain-computer interfaces:a user perception evaluation study

This paper examines the application of commercial and non-invasive electroencephalography (EEG)-based brain-computer (BCIs) interfaces with serious games. Two different EEG-based BCI devices were used to fully control the same serious game. The first device (NeuroSky MindSet) uses only a single dry electrode and requires no calibration. The second device (Emotiv EPOC) uses 14 wet sensors requiring additional training of a classifier. User testing was performed on both devices with sixty-two participants measuring the player experience as well as key aspects of serious games, primarily learnability, satisfaction, performance and effort. Recorded feedback indicates that the current state of BCIs can be used in the future as alternative game interfaces after familiarisation and in some cases calibration. Comparative analysis showed significant differences between the two devices. The first device provides more satisfaction to the players whereas the second device is more effective in terms of adaptation and interaction with the serious game.

Facilitating intuitive-guided learning in a serious game through integration with a learning content management system

Increased global uptake of entertainment gaming has the potential to lead to high expectations of engagement and interactivity from users of technology-enhanced learning environments. Blended approaches to implementing game-based learning as part of distance or technology-enhanced education have led to demonstrations of the benefits they might bring, allowing learners to interact with immersive technologies as part of a broader, structured learning experience. In this article, we explore how the integration of a serious game can be extended to a learning content management system (LCMS) to support a blended and holistic approach, described as an 'intuitive-guided' method. Through a case study within the EU-Funded Adaptive Learning via Intuitive/Interactive, Collaborative and Emotional Systems (ALICE) project, a technical integration of a gaming engine with a proprietary LCMS is demonstrated, building upon earlier work and demonstrating how this approach might be realized. In particular, how this method can support an intuitive-guided approach to learning is considered, whereby the learner is given the potential to explore a non-linear environment whilst scaffolding and blending provide guidance ensuring targeted learning objectives are met. Through an evaluation of the developed prototype with 32 students aged 14-16 across two Italian schools, a varied response from learners is observed, coupled with a positive reception from tutors. The study demonstrates that challenges remain in providing high-fidelity content in a classroom environment, particularly as an increasing gap in technology availability between leisure and school times emerges.

Serious Games in Economics

The European Leonardo da Vinci Transfer of Innovation project “Teacher training to improve attractiveness and quality of management education through the simulation tool ‘Emerald Forest’” which emphases on using the computer simulation tool for increasing attractiveness of teaching and learning in economics is presented in this paper. The observation of using computer systems and especially serious games in education is provided as well. “Education is not the filling of a pail, but the lighting of a fire” - William Butler Yeats

Developing a serious game for PSS

Purpose: This paper presents the system architecture of a serious game, which is going to be run in parallel to Rolls Royce tra ining on product-service systems (PSS). Design/methodology/approach: The original game is outlined, requirements for an onl ine version are defined, and the architecture is proposed. Findings: The games approach has proven its value in design for service tra ining but an online version is needed to improve the opportunit ies to deliver the game. Originality/value: Such a system presents opportunities for the acquisition and development of specific professional knowledge, skills, and competencies

Patient experiences of serious adverse drug reactions and their attitudes to medicines:a qualitative study of survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis in the UK

Background: Adverse drug reactions (ADRs) cause significant morbidity and mortality and account for around 6.5% of hospital admissions. Patient experiences of serious ADRs and their long-term impact on patients' lives, including their influence on current attitudes towards medicines, have not been previously explored. Objective: The aim of the study was to explore the experiences, beliefs, and attitudes of survivors of serious ADRs, using drug-induced Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) as a paradigm. Methods: A retrospective, qualitative study was undertaken using detailed semi-structured interviews. Fourteen adult survivors of SJS and TEN, admitted to two teaching hospitals in the UK, one the location of a tertiary burns centre, were interviewed. Interview transcripts were independently analysed by three different researchers and themes emerging from the text identified. Results: All 14 patients were aware that their condition was drug induced, and all but one knew the specific drug(s) implicated. Several expressed surprise at the perceived lack of awareness of the ADR amongst healthcare professionals, and described how the ADR was mistaken for another condition. Survivors believed that causes of the ADR included (i) being given too high a dose of the drug; (ii) medical staff ignoring existing allergies; and (iii) failure to monitor blood tests. Only two believed that the reaction was unavoidable. Those who believed that the condition could have been avoided had less trust in healthcare professionals. The ADR had a persisting impact on their current lives physically and psychologically. Many now avoided medicines altogether and were fearful of becoming ill enough to need them. © 2011 Adis Data Information BV. All rights reserved. Conclusions: Life-threatening ADRs continued to affect patients’ lives long after the event. Patients’ beliefs regarding the cause of the ADR differed, and may have influenced their trust in healthcare professionals and medicines. We propose that clear communication during the acute phase of a serious ADR may therefore be important.

Essential features of serious games design in higher education:linking learning attributes to game mechanics

This paper consolidates evidence and material from a range of specialist and disciplinary fields to provide an evidence-based review and synthesis on the design and use of serious games in higher education. Search terms identified 165 papers reporting conceptual and empirical evidence on how learning attributes and game mechanics may be planned, designed and implemented by university teachers interested in using games, which are integrated into lesson plans and orchestrated as part of a learning sequence at any scale. The findings outline the potential of classifying the links between learning attributes and game mechanics as a means to scaffold teachers’ understanding of how to perpetuate learning in optimal ways while enhancing the in-game learning experience. The findings of this paper provide a foundation for describing methods, frames and discourse around experiences of design and use of serious games, linked to methodological limitations and recommendations for further research in this area.

Mental health pharmacists views on shared decision-making for antipsychotics in serious mental illness

Background People diagnosed with serious mental illnesses (SMIs) such as schizophrenia and bipolar affective disorder are frequently treated with antipsychotics. National guidance advises the use of shared decision-making (SDM) in antipsychotic prescribing. There is currently little data on the opinions of health professionals on the role of SDM. Objective To explore the views and experiences of UK mental health pharmacists regarding the use of SDM in antipsychotic prescribing in people diagnosed with SMI. Setting The study was conducted by interviewing secondary care mental health pharmacists in the UK to obtain qualitative data. Methods Semi-structured interviews were recorded. An inductive thematic analysis was conducted using the method of constant comparison. Main outcome measure Themes evolving from mental health pharmacists on SDM in relation to antipsychotic prescribing in people with SMI. Results Thirteen mental health pharmacists were interviewed. SDM was perceived to be linked to positive clinical outcomes including adherence, service user satisfaction and improved therapeutic relations. Despite more prescribers and service users supporting SDM, it was not seen as being practised as widely as it could be; this was attributed to a number of barriers, most predominantly issues surrounding service user’s lacking capacity to engage in SDM and time pressures on clinical staff. The need for greater effort to work around the issues, engage service users and adopt a more inter-professional approach was conveyed. Conclusion The mental health pharmacists support SDM for antipsychotic prescribing, believing that it improves outcomes. However, barriers are seen to limit implementation. More research is needed into overcoming the barriers and measuring the benefits of SDM, along with exploring a more inter-professional approach to SDM.

Investigation of the causes of serious injury and fatal crashes: An analysis using econometric models

The rate of fatal crashes in Florida has remained significantly higher than the national average for the last several years. The 2003 statistics from the National Highway Traffic Safety Administration (NHTSA), the latest available, show a fatality rate in Florida of 1.71 per 100 million vehicle-miles traveled compared to the national average of 1.48 per 100 million vehicle-miles traveled. The objective of this research is to better understand the driver, environmental, and roadway factors that affect the probability of injury severity in Florida. ^ In this research, the ordered logit model was used to develop six injury severity models; single-vehicle and two-vehicle crashes on urban freeways and urban principal arterials and two-vehicle crashes at urban signalized and unsignalized intersections. The data used in this research included all crashes that occurred on the state highway system for the period from 2001 to 2003 in the Southeast Florida region, which includes the Miami-Dade, Broward and Palm Beach Counties.^ The results of the analysis indicate that the age group and gender of the driver at fault were significant factors of injury severity risk across all models. The greatest risk of severe injury was observed for the age groups 55 to 65 and 66 and older. A positive association between injury severity and the race of the driver at fault was also found. Driver at fault of Hispanic origin was associated with a higher risk of severe injury for both freeway models and for the two-vehicle crash model on arterial roads. A higher risk of more severe injury crash involvement was also found when an African-American was the at fault driver on two-vehicle crashes on freeways. In addition, the arterial class was also found to be positively associated with a higher risk of severe crashes. Six-lane divided arterials exhibited the highest injury severity risk of all arterial classes. The lowest severe injury risk was found for one way roads. Alcohol involvement by the driver at fault was also found to be a significant risk of severe injury for the single-vehicle crash model on freeways. ^

For the win (FTW)! Contribuições de um serious game para o ensino-aprendizagem de argumentação

This is a qualitative and reflexive research with focus on digital literacy. Among the digital media that could support the teaching of argumentation in the Science & Technology and Information Technology undergraduate courses of the Federal University of Rio Grande do Norte, we chose a serious game as object of research. Given the object of study in the discipline of reading and writing II – argumentation and genre from the order of argumentative writing -, common to the undergraduate courses mentioned, we invest on the development of a serious game, named ArgumentACTION, because we believe that it may, in fact, become a promising didactic instrument. Therefore we intend to understand whether and how this game can help students develop their reading and writing skills more independently, specifically towards an argumentative order genre: the opinion piece. With this research, we intend to contribute to the teaching of the Portuguese language on three bases: extending theoretical scope, in order to generate greater intelligibility on the teaching-learning process of argumenting; proposing a new methodological possibility, with the incorporation of a serious games to teaching; perfecting the game with which we are working, in order to build – and make available – a more refined digital tool to subsidize the teaching and learning of reading and writing of opinion pieces. To do so, we use the following as theoretical-methodological: Studies of Literacy (KLEIMAN, 2012b; TINOCO, 2008; OLIVEIRA, 2010; GEE, 2009; 2010; ROJO, 2012), The Applied Linguistics (KLEIMAN, 1998; BUSH-LEE, 2009), The Philosophy of Language (BAKHTIN, VOLOSHINOV, 2012) and Critical Pedagogy (DEWEY, 2010). A group of students from the upper mentioned undergraduate courses collaborated with this research by playing and analyzing the game. They were also interviewed about their experience in this matter. From the data generated, we established the categories of analysis: decollection, interest, multimodality/multisemiosis and interactivity, agent of literacy, learning principles. The conclusions we obtained show that the investment in applications, especially games, can bring real benefits to the teaching/learning of the Portuguese language; moreover they reveal that the work on argumenting has much to gain with the incorporation of serious games; however the possible advantages depend on a focused teaching practice and constant improvements and updates of this type of interactive tool, as well as the pedagogical practice from those who use and develop the games.

Serious Game no tratamento de obesidade infantil: uma proposta de interação natural com monitoramento remoto

The number of overweight people has increased in the last few years. Factors such as attention to diet and changes in lifestyle are crucial in the prevention and control of obesity and diseases related to it. Experts believe that such actions are most effective when initiated during childhood, and that children raised in an environment that encourages physical activity ultimately become healthier adults. However, to arouse and maintain interest in such activities represent a major challenge, which are initially perceived as repetitive and boring, and, thus, soon abandoned. Computer games, traditionally seen as stimulants to a sedentary lifestyle are changing this perception using non-conventional controls that require constant movement of the player. Applications that combine the playfulness of such games to physical activity through devices, like Microsoft Kinect, might become interesting tools in this scenario, by using the familiarity of Natural User Interfaces along with the challenge and the fun of video games, in order to make attractive exercise routines for schoolchildren. The project carried out consists of an exergame composed of several activities designed and implemented with the participation of a Physical Educator, aimed at children between eight and ten years old, whose performance and progress can be remotely monitored by a professional via web interface. The application arising from this work was accompanied by tests with a group of graduating Physical Education students from the University of Rio Verde GO, and subsequently validated through questionnaires whose results are shown on this work.