An interactive exploration into virtual liminality and the impact it has on users.

This study delves into the realm of digital liminal experiences, investigating how environmental design influences users' comfort in digital liminal spaces. Three distinct digital environments were created and tested for this study consisting of a desolate train station, a vacuous supermarket, and a forest full of mysterious structures shrouded in fog. Participant feedback from this testing showed pronounced variations in comfort levels. Notably, level ambience, theming, and the absence of others emerged as pivotal factors shaping users’ emotional responses. The empty train station and shop, designed to replicate bustling social settings, evoked discomfort, while the forest environment came across as relaxation. Sound and visuals, particularly in the forest, played a crucial role in shaping comfort. Despite limitations in participant numbers, the insights contribute to a nuanced understanding of impactful design elements in digital liminality and provide the groundworks for future studies into liminality to build upon

Running out of time : the temporal case against the kalam

In this dissertation, I argue that if the kalam cosmological argument works, then it must work on either the A-theory of time or the B-theory of time. I offer several arguments for thinking that the kalam does not work on either the A-theory of time or the B-theory of time. The two main versions of the A-theory, presentism and the growing block theory, are considered. Even though I argue that the growing block theorist has the greatest chance of making the kalam work, I nonetheless argue that their attempts fail for various reasons. In the end, the kalam is left unsupported by any major theory of time and is therefore vitiated

Development of the Wheelchair outcomes Assessment Tool for Children (WATCh):A patient-centred outcome measure for young wheelchair users

<div><p>Objective</p><p>To develop a patient-centred outcome measure (PCOM) for use with children and young people accessing National Health Service (NHS) wheelchair and posture services. Identifying and addressing outcomes of most importance to young wheelchair users (≤ 18 years) will help services maximise the benefits achievable within available resources.</p><p>Methods</p><p>A mixed-methods approach was used, involving questionnaire surveys and qualitative interviews, and building on previous work identifying how young wheelchair users define health-related quality of life (HRQoL). Framework analysis was used to analyse the interview transcripts. Survey questionnaires seeking views on the importance of a range of outcomes were completed by 21 young wheelchair users or their parents. Subsequent face-to-face interviews with 11 parents or dyads of parents and young wheelchair users explored these responses and identified novel outcomes. Interviewees also scored and recorded satisfaction levels for their key outcomes.</p><p>Results</p><p>All outcomes proposed in the survey were rated as ‘extremely important’ by at least one respondent, as were additional outcomes uncovered in the qualitative data. In consultation with the service providers and service users, the Wheelchair outcomes Assessment Tool for Children (WATCh) was developed to allow service users and providers to identify, score and monitor individual users’ most important outcomes. The final WATCh tool comprises 16 outcome options, of which service users select five to be monitored. The tool will be used to measure key outcomes identified by service users before and after wheelchair provision.</p></div

Perceptions of the impact of disability and impairment on health, quality of life and capability

Additional file 5: Table S4. Individual item score proportions (%) on the B-IPQ (visual impairment scenario). This table shows perceived individual item scores on the B-IPQ for a hypothetical state of visual impairment

Measuring the health-related quality of life of children with impaired mobility:examining correlation and agreement between children and parent proxies

Abstract Objective The objective of this research project was to evaluate the validity of proxy health-related quality of life measures in the context of paediatric mobility impairment. Accurate health-related quality of life data is essential for quality-adjusted life year calculation; a key outcome in economic evaluation. Thirteen child-parent dyads (13 children with mobility impairments, 13 parent proxies) were asked to complete a range of outcome measures (EQ-5D-Y, VAS and HUI2/3) relating to the child’s health. The relationship between respondent outcomes was examined using tests of respondent type effect (Wilcoxon signed-rank), correlation (Spearman’s rank-order) and agreement (Bland–Altman plots). Results Parent proxies significantly undervalued the health-related quality of life of their mobility-impaired children: children rated their health-related quality of life higher than their parents by proxy on all measures. The VAS had the highest overall mean score for children and proxies (79.50 [SD = 15.01] and 75.77 [SD = 14.70] respectively). Child and proxy results were significantly different (p < 0.05) for all measures besides the VAS (p = 0.138). Strong correlation and acceptable agreement were observed for equivalent child/proxy VAS and HUI measures. The EQ-5D-Y exhibited the least agreement between children and proxies. Sufficient association between child/proxy VAS and HUI measures indicated a degree of interchangeability

Defining health-related quality of life for young wheelchair users:A qualitative health economics study

Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use.The sampling frame was children with impaired mobility (≤18 years) who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life.Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1) participation and positive experiences; 2) self-worth and feeling fulfilled; 3) health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age.Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this population. Development of a mobility-related quality of life outcome measure for children is recommended