'Listen to my madness':understanding the experiences of people with serious mental illness

This article explores the salience of disability theory for understanding the experiences of people with serious mental illness. Drawing on data from a focus group study, we suggest that users experience both impairment (as embodied irrationality) which can, in itself, be oppressive, and also have to manage their lives within a largely disabling society. We outline some of the strategies adopted by users to manage their situation and ensure they access and receive health services, and illustrate how these are a result of the complex relationship between disability and impairment. We suggest that using a framework of the social model of disability provides a useful way of understanding and making sense of the experience of users with serious mental illness. © Blackwell Publishing Ltd/Foundation for the Sociology of Health & Illness 2005.

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.

From the outside in:consumer anti-choice and policy implications in the mobile gaming market

Significant growth in mobile media consumption has prompted a call to better understand the socio-cultural and policy dimensions of consumer choices. Contrary to industry and technology led analysis, this study argues that to guide consumer choice and innovation via regulatory policies requires an understanding of both ex-ante as well as in ex-post consumption conditions. This study examines mobile phone gaming to uncover how consumer anti-choice shapes decision-making as a framework for closely interrogating the ways in which policy concerns impact on consumers' behavior. Through eleven focus groups (n=62), the study empirically identifies voluntary, intentional, and positive consumer anti-choice behaviors all of which impact policy initiatives when consumers, both gamers and non-gamers, self-regulate their behaviors. Findings point to four types of policy implication: regulating the self-regulated, understanding anti-choice, boundary-setting and including the self-excluded. © 2012 Elsevier Ltd.

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.

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. ^

Regulating Casino Gaming: A Checklist for States Considering It

In his essay - Regulating Casino Gaming: A Checklist for States Considering It – by Leonard E. Goodall, Professor of Management and Public Administration, College of Business and Econornics, University of Nevada, Las Vegas, Professor Goodall initially states: “Since various states are likely to continue to debate the issue of the establishment of legal casinos, and since states considering legal casinos must also decide how best to regulate them, the author discusses the similarities and contrasts in the regulatory systems already in operation.” Certainly not all states have solicited casino gaming, or what people generally refer to as gambling, but many have and the list is growing. If casinos are to be, and indications are that many more states will endorse gaming as a source of revenue, then regulating them must follow as a matter of due course says the author. Keep in mind this essay was written in 1988, and the actuality of casino gaming has indeed come to fruition in many states. “Nevada, having legalized casino gaming in 1931, has over a half-century of experience with the regulatory process,” Professor Goodall informs. “When New Jersey approved the establishment of casinos in Atlantic City in 1976, state officials studied the Nevada system carefully and adopted many of Nevada's procedures.” Professor Goodall bullet-points at least 7 key elements that states wanting to pursue gaming should, or in the cases of Nevada and New Jersey, have already addressed in regard to regulation of the industry. Goodall parses, in more detail, those essentials. The ultimate form of regulation is ownership Goodall says. Either state run, or private are the logical options. “The arguments for private ownership have been both pragmatic and political,” Goodall says. “Legislators, like the general public, are skeptical of the ability of state bureaucracies to run big businesses in an efficient manner. Many of them also believe regulation can be more effective if there is at least an arm's-length distance between regulation and ownership,” the professor opines. Additionally important to consider is the purpose of legalization, says Goodall. Are the proceeds earmarked for general funds, or to be used specifically? Geographic considerations are key, Goodall points out. “This decision will depend partly on a state's reasons for having casinos in the first place,” he expands. “New Jersey's policy, for example, is obviously consistent with its goal of using casinos to reinvigorate Atlantic City.” “In both states, one of the most important functions of the regulatory agencies is that of licensing, the process of investigating individuals or organizations and then authorizing them to participate in the gaming business,” Goodall provides. In closing, Goodall says there is no need for ensuing states to reinvent the wheel when it comes to casino gaming regulation. Nevada and New Jersey already provide two good designs from which to emulate and/or build upon.