BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Communication technologies and cultural identity: A critical discussion of ICTs for Development

In this paper we discuss the design and deployment of information and communication technologies (ICTs) in the developing world - specifically, the issues of culturally sensitive design and subjectivity through an analysis of the hardware, software, and deployment of the One Laptop per Child (OLPC) computer. In our analysis we examine the design of the OLPC computer, and discuss its deployment within the context of information fetishism in the west. The goal of this paper is to encourage a critical discussion of the ways in which technologies are being designed for and deployed in developing nations

World of warcraft as a ludic cyborg

This paper describes World of Warcraft as a ludic cyborg - an entity that exists for play and depends on both artificial and organic components to survive. We argue that the popularity of the game arose due to the balance between the types of socialization it promotes and in-game literacies acquired by players on PvP servers. Copyright 2008 ACM

The UX of avatar customization

Avatar customization is a feature that is offered in many computer and video games. Customization options are presented to users via Character Creation Interfaces or CCIs. CCIs differ greatly between games, independent of genre, with regard to the quantity and quality of customization options available. In addition, the way in which these options are presented to users differs from game to game. Research on avatar customization is typically focused on user-avatar identity or self-representation. In general, we have found that the User Experience (UX) of avatar customization has been greatly overlooked in academic literature. As such, we look to existing research on UX in order to propose how its methodologies may be used to study the impact of CCI affordances on player experience in games

Damsel in this Dress: an analysis of the character designs of women in post-secondary game design programs

In this paper, we present a study of women (n = 10) in game design and game development programs in Ontario, Canada. The study, described herein, is an investigation of the lived experiences of women in these programs, their own experiences with gaming culture, and the kinds of female video game characters they design. Here, we are interested in whether women in post-secondary game programs are producing more nuanced playable female game characters than those typically seen in commercial video games. Preliminary results of this study indicate that women are producing generally more nuanced depictions of women in their character designs

Real ethics in a virtual world

This paper investigates the ethics of the appearance and behavior of avatars in massively multi-user online communities, in particular, avatars created for virtual business interactions in Second Life. The ethics of research conducted with avatars in 3D online environments is also discussed

Equality game, anxiety attack, and misfortune: A pedagogical post-mortem on engines, modding, and the importance of player experience

In this chapter, I present a post-mortem covering three consecutive offerings of a course on persuasive games at the university level over a three-year period from 2010 - 2013. The course, "Designing Persuasive Games," is part of a larger, multidisciplinary program on digital media and game design. In this course, students are invited to engage both with theory and praxis, the process of "practicing" theory (Shaffer, 2004), by not only reading and writing about persuasive games but also through the design and development of one. Here, I present the overall design of the course across the three offerings and describe the most significant aspects of the course, from a pedagogical perspective, that I believe to be of value to others designing similar courses. These aspects include choosing a game engine, scaling projects to retain rhetoric, modding as praxis, and player experience testing. A sample grading rubric for persuasive games is also included at the conclusion of this chapter

Virtual world professionals and avatar appearance codes

In this paper we discuss the results of a pilot study aimed at virtual world professionals in Second Life. This study was conducted in order to investigate the role avatar appearance may play in maintaining business relationships in virtual worlds. We also describe avatar "appearance codes" - corporate policies that govern the appearance of employee avatars. In our pilot study we found that only 13.5% of participants are subject to such a policy. The details of policies are discussed below

Making Mii: studying the effects of methodological approaches and gaming contexts on avatar customization

In this paper we present an analysis of the character creation interface on the Nintendo WiiU and explore the pragmatics of avatar customisation through a between-subjects, qualitative user study involving 24 participants. Our Mii research – or ‘Miisearch’ – is motivated by our desire to highlight the agency these interfaces have in self-representational practices; specifically, to understand the effects of interface affordances on avatar customisation in games. Furthermore, as self-representational practices are often studied using distance methods and self-reporting (e.g. surveys), we compare data on avatar customisation from two sources: a survey and participant observation via micro-ethnography. Results of our study reveal discrepancies between the survey data and participant observation, challenging popular methodological approaches in both the game studies and HCI communities. Most significantly, our findings illustrate the combined effects of gaming contexts and interface affordances on avatar customisation