GAMING THE SYSTEM: USING DIGITAL TRAINING GAMES TO ENHANCE DECISION-MAKING

Computer games provide digital training tools; however, their effectiveness requires well-defined learning objectives and realistic scenario development. This thesis addresses how digital training tool Threat Identification Decision Environment (TIDE) could be used to enhance the decision making of combat watchstanders. United States Navy Information Warfare, Surface Warfare, and Aviation officers at the Naval Postgraduate School played different scenarios provided by the game TIDE. Their performance was evaluated by the game following each scenario providing scores. Score data was assessed for effectiveness of the game in providing training. Through surveys addressing player experience, users deemed it effective training. TIDE is a tool that could be used for developing trained and ready sailors for fleet operations using reusable and deployment ready toolsets meeting the Ready, Relevant Learning requirements.Lieutenant, United States NavyApproved for public release. Distribution is unlimited

Description strategies to make an interactive science simulation accessible

Interactive simulations are increasingly important in science education, yet most are inaccessible to blind learners. In developing an accessible prototype of a PhET interactive science simulation, we encountered significant challenges in providing screen reader access, including the need to: 1) describe unpredictable event sequences, 2) cue productive interactions, and 3) to simultaneously convey multiple changes. To address these challenges, we extended existing practices for verbal description of visual interactive content, and we created new strategies for developing rich description for accessible interactive science simulations

Practical Considerations in Developing Bioenergy Crops

Biofuels represent a significant challenge and opportunity for agriculture. Producing liquid fuels from cellulosic biomass affords a number of potential environmental benefits. Biofuels result in lower greenhouse gas emissions than fuels derived from petroleum. Growing perennial biomass crops reduces soil erosion and sequesters more carbon than annual crops grown for grain or biomass. Corn and sorghum are crops that have high near-term potential as annual biomass crops. Dedicated biomass crops with very high yields will produce more fuel per acre, helping to balance land for food and fuel. Switchgrass and Miscanthus are perennial species that have been broadly evaluated as potential biomass crops, but will benefit from further development for widespread use. New crops and cropping systems developed specifically for bioenergy production will be necessary to meet biofuel production targets. Bioenergy crops should be developed that use inputs efficiently, have high and stable productivity, have positive environment impact, and are compatible with existing cropping systems. Most importantly, biomass crop portfolios must be developed that allow for sustained energy supply throughout the year

Research design of job satisfaction in an East African medical research center

For years, I-O research has used surveys and scales to measure job satisfaction; however, a traditional survey may not always be the best option. Therefore, our research team utilized interviews as well as surveys to understand job satisfaction at the National Institute of Medical Research, Amani Centre (NIMR-AC). The Centre is in Muheza, Tanzania, a rural town one hour from the East African coast. We used a mixed methods approach with an aim to distinguish the key characteristics and variations of job satisfaction among the employees of NIMR-AC. The nature of the surveys, one-on-one interviews, and a focus group discussion were inductive. Due to the cultural context and the limited amount of I-O related research done in the region, we wanted to take a holistic approach in the search for significant themes. The current project discusses the influence that language and culture had on our research design. The end goal of the instrumentation design was for it to be culturally literate for the participants. We started the design process with a literature review of both job satisfaction and the few papers similar to the I-O psychology field that were in the East African context. This enabled us to better understand job satisfaction and how we could best investigate it for this site. Then, we gathered information regarding the interpersonal dynamics of the employees at NIMR-AC and the culture of the region’s workplaces to further direct our research. This gave us a better idea of what words and phrases would be best to use when translating to Swahili. Since we conducted the interviews and administered the surveys in Swahili, we had to pay careful attention to the translation of all the instrumentation. Lastly, and repeatedly throughout the design process, we sought the advice from experts in seemingly unrelated fields. The data will be analyzed using MAXQDA and SPSS in order to find themes. Analyses will provide the lab with real data pinpointing problems with job satisfaction and illuminating solutions. The current study aims to distinguish some of the differences of the design process when researching in a foreign context with the ultimate goal of encouraging other I-O researchers to investigate the workplace outside the Western world

Grief in family carers of people living with dementia: A systematic review

OBJECTIVES: Grief research in family carers of people with dementia has increased. We aimed to report the prevalence of pre-death and post-death grief and to synthesize associated factors and the relationship between pre-death factors and post-death grief and services used to manage grief. DESIGN: (Prospero protocol: CRD42020165071) We systematically reviewed literature from PsycINFO, MEDLINE, CINAHL, and ASSIA until April 2020. Effectiveness of intervention data and studies not written in English were excluded; qualitative studies were additionally excluded during study selection. Study quality was assessed using the Mixed Methods Appraisal Tool. Evidence was narratively summarized. PARTICIPANTS: Family non-paid carers of somebody with any dementia type. MEASUREMENTS: Validated measures of pre-death and/or post-death grief. RESULTS: We included quantitative data from 55 studies (44 rated as high quality). Most included solely spouse or adult child carers. Forty-one studies reported pre-death grief, 12 post-death grief, and 6 service use; eight were longitudinal. 17% met the Prolonged Grief Disorder criteria pre-death (n = 1) and 6-26% (n = 4) of participants met the Complicated Grief criteria post-death. Being a spouse, less educated, caring for somebody with advanced dementia, and greater burden and depression were associated with higher pre-death grief. Lower education level and depression were predictive of higher post-death grief. Pre-death factors found to influence post-death grief were grief and depression. Limited service use evidence was reported. CONCLUSION: Awareness of characteristics which increase the likelihood of higher grief can help identify those in need of support. Future research should focus on what supports or services are beneficial to grief experiences

Implementation of a Nurse-Led Family Centered Engagement Intervention for Caregivers of Extremely Premature Infants in the Neonatal Intensive Care Unit

Objective: The objective of this feasibility study was to examine the implementation and usefulness of an intervention for extremely premature infant (EPI) caregivers. Results: One caregiver and five nurses provided feedback with a mean score of 4.4 out of 5 pertaining to helpfulness. Conclusions: Implementation of the Caregiver’s Guide was feasible and was positively received by NICU nurses and caregivers. We recommend implementing a revised version of this tool based on nurse and caregiver feedback. The delivery of education should be divided between dayshift and nightshift nurses so that one nurse is not responsible for providing all the information. The education should be categorized by gestational age and day of life and only given when it is pertinent to the care of the child. A section should be added to include a quick reference guide for the medical jargon used in the NICU

Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care

<b>Background</b><p></p> There is a need for cost-effective weight management interventions that primary care can deliver to reduce the morbidity caused by obesity. Automated web-based interventions might provide a solution, but evidence suggests that they may be ineffective without additional human support. The main aim of this study was to carry out a feasibility trial of a web-based weight management intervention in primary care, comparing different levels of nurse support, to determine the optimal combination of web-based and personal support to be tested in a full trial.<p></p> <b>Methods</b><p></p> This was an individually randomised four arm parallel non-blinded trial, recruiting obese patients in primary care. Following online registration, patients were randomly allocated by the automated intervention to either usual care, the web-based intervention only, or the web-based intervention with either basic nurse support (3 sessions in 3 months) or regular nurse support (7 sessions in 6 months). The main outcome measure (intended as the primary outcome for the main trial) was weight loss in kg at 12 months. As this was a feasibility trial no statistical analyses were carried out, but we present means, confidence intervals and effect sizes for weight loss in each group, uptake and retention, and completion of intervention components and outcome measures.<p></p> <b>Results</b><p></p> All randomised patients were included in the weight loss analyses (using Last Observation Carried Forward). At 12 months mean weight loss was: usual care group (n = 43) 2.44 kg; web-based only group (n = 45) 2.30 kg; basic nurse support group (n = 44) 4.31 kg; regular nurse support group (n = 47) 2.50 kg. Intervention effect sizes compared with usual care were: d = 0.01 web-based; d = 0.34 basic nurse support; d = 0.02 regular nurse support. Two practices deviated from protocol by providing considerable weight management support to their usual care patients.<p></p> <b>Conclusions</b><p></p> This study demonstrated the feasibility of delivering a web-based weight management intervention supported by practice nurses in primary care, and suggests that the combination of the web-based intervention with basic nurse support could provide an effective solution to weight management support in a primary care context

Exploring how family carers of a person with dementia manage pre-death grief: A mixed methods study

Objectives: Many family carers of a person with dementia experience pre-death grief. We aimed to identify strategies that help carers manage pre-death grief. We hypothesised that emotion and problem focussed styles would be associated with lower, and dysfunctional coping with higher grief intensity. Methods: Mixed methods observational study using structured and semi-structured interviews with 150 family carers of people with dementia living at home or in a care home. Most participants were female (77%), caring for a parent (48%) or partner/spouse (47%) with mild (25%), moderate (43%) or severe (32%) dementia. They completed the Marwit-Meuser Caregiver Grief Inventory Short Form and the Brief Coping Orientation to Problems Experienced (Brief-COPE) questionnaire. We asked carers to identify strategies used for managing grief. We recorded field notes for 150 interviews and audio-recorded additional interviews with a sub-sample of 16 participants. Results: Correlations indicated that emotion-oriented coping was associated with lower grief (R = −0.341), and dysfunctional coping with higher grief (R = 0.435), with a small association with problem-focused strategies (R = −0.109), partly supporting our hypothesis. Our qualitative themes broadly match the three Brief-COPE styles. Unhelpful strategies of denial and avoidance align with dysfunctional coping strategies. Psychological strategies (including acceptance and humour) and seeking support were consistent with emotion-focused strategies, but we did not identify a theme relating to problem-focused strategies. Conclusion: Most carers identified multiple strategies for processing grief. Carers could readily identify supports and services that they found helpful for managing pre-death grief, yet current services appear under-resourced to meet growing demand. (ClinicalTrials.gov ID: NCT03332979)

Practical and emotional preparation for death: A mixed methods study investigating experiences of family carers of people with dementia

BACKGROUND: When family carers are more prepared for the end of the life of a person they care for, they report improved bereavement outcomes. Few studies have explored how carers prepare for the death of a person with dementia. We aimed to explore how carers for people with all stages of dementia experience preparing for end of life care and death. METHODS: This was a mixed methods cross-sectional study. Family carers of people with dementia (n = 150) completed a structured interview with validated scales, alongside questions about death preparedness and advance decisions. A sub-sample (n = 16) completed qualitative interviews exploring their experiences of planning for end of life. We fitted logistic regression models to explore associations with preparedness, and thematically analysed qualitative data. RESULTS: We addressed practical and emotional preparation separately for 143 participants. Fifty seven percent of participants were very practically prepared for death, while only 29% were very emotionally prepared. Male carers were more likely than female carers to report being very emotionally and practically prepared. Higher engagement with healthcare professionals was associated with feeling very practically prepared; although we found that formal discussions of end of life care issues with healthcare professionals did not impact carers’ feelings of preparation. Higher levels of dementia severity and carer depression were associated with feeling very emotionally prepared. Three qualitative themes related to practical and emotional preparation were identified: (1) ambiguity and uncertainty; (2) support from the system; and (3) how death is perceived by the carer. CONCLUSIONS: While most carers felt practically prepared for death, emotional preparation was much lower. Further research is needed to understand how engagement with healthcare professionals or other forms of social or emotional support could help carers, particularly female carers, to emotionally prepare for their relative’s death