Is participatory design associated with the effectiveness of serious digital games for healthy lifestyle promotion? : a meta-analysis

Background: Serious digital games can be effective at changing healthy lifestyles, but large differences in their effectiveness exist. The extent of user involvement in game design may contribute to game effectiveness by creating a better fit with user preferences. Participatory design (PD), which represents active user involvement as informant (ie, users are asked for input and feedback) or codesigner (ie, users as equal partners in the design) early on and throughout the game development, may be associated with higher game effectiveness, as opposed to no user involvement or limited user involvement. Objective: This paper reports the results of a meta-analysis examining the moderating role of PD in the effectiveness of serious digital games for healthy lifestyle promotion. Methods: Four databases were searched for peer-reviewed papers in English that were published or in press before October 2014, using a (group-) randomized controlled trial design. Effectiveness data were derived from another meta-analysis assessing the role of behavior change techniques and game features in serious game effectiveness. Results: A total of 58 games evaluated in 61 studies were included. As previously reported, serious digital games had positive effects on healthy lifestyles and their determinants. Unexpectedly, PD (g=0.075, 95% CI 0.017 to 0.133) throughout game development was related to lower game effectiveness on behavior (Q=6.74, P<.05) than when users were only involved as testers (g=0.520, 95% CI 0.150 to 0.890, P<.01). Games developed with PD (g=0.171, 95% CI 0.061 to 0.281, P<.01) were also related to lower game effectiveness on self-efficacy (Q=7.83, P<.05) than when users were not involved in game design (g=0.384, 95% CI 0.283 to 0.485, P<.001). Some differences were noted depending on age group, publication year of the study, and on the specific role in PD (ie, informant or codesigner), and depending on the game design element. Games developed with PD were more effective in changing behavioral determinants when they included users in design elements on game dynamics (beta=.215, 95% CI .075 to .356, P<.01) and, more specifically, as an informant (beta=.235, 95% CI .079 to .329, P<.01). Involving users as informants in PD to create game levels was also related to higher game effectiveness (Q=7.02, P<.01). Codesign was related to higher effectiveness when used to create the game challenge (Q=11.23, P<.01), but to lower game effectiveness when used to create characters (Q=4.36, P<.05) and the game world (Q=3.99, P<.05). Conclusions: The findings do not support higher effectiveness of games developed with PD. However, significant differences existed among PD games. More support was found for informant roles than for codesign roles. When PD was applied to game dynamics, levels, and game challenge, this was associated with higher effectiveness than when it was applied to game aesthetics. Since user involvement may have an important influence on reach, adoption, and implementation of the intervention, further research and design efforts are needed to enhance effectiveness of serious games developed with PD

a experiência alagoana de planejamento

Este trabalho se dedica ao estudo dos Planos de Desenvolvimento de Alagoas e das principais políticas e estratégias adotadas pelo Poder Público Estadual constantes desses documentos, à luz do paradigma do desenvolvimento sustentável, a partir do seu primeiro plano, o Plano Diretor de Desenvolvimento Econômico de Alagoas, publicado em 1960, até o Plano Plurianual 2000-2003, elaborado no primeiro governo de Ronaldo Lessa. Procura delinear a visão política e estratégica do desenvolvimento dos planos em Alagoas, assim como verificar até que ponto as políticas públicas adotadas contribuíram para o processo de desenvolvimento estadual

a narrative review of reviews: implications for physical education based on a socio-ecological approach

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Intentions to the practice of physical activity

Based on the theory of planned behavior we studied the intentions to do pysical activities in teenagers and adults. We used a questionnaire that derived directly from this theory, and we applied it to 2098 participants. Results indicate that participants practice occasionally or regularly physical activities, between 17 and 41 years old, and that plan to realize physical activities in short term, and their other significant encourage exercise. They are probably feminine and with a higher academic degree. Individuals with less exercise behaviours have abandoned or do occasionally exercise, have 21 to 53 years old, don’t plan to do exercise in the short term, and their other significants don’t encourage practice

Influence of the Shading on Growth Seedlings of Louro Pirarucu (Licaria canella (Meissn.) Kosterm.)

This paper evaluates the shading effect on seedlings of "Louro Pirarucu" (Licaria canella(Meissn) Kosterm. - Lauraceae). The trial was set up in the nursery at Adolph Ducke forest reserve. The seeds were germinated in wooden boxes with washed sand as a substrate. After seed germination, the seedlings were transplanted to black polyethylene bags. Four levels of shading (0%, 30%, 50% and 70%) is analyzed. Shading treatments were obtained with plastic shade clothes of different meshes. The experimental design was the randomized blocks with split-plot. Shading levels were considered plots and period of harvesting as sub-plots. Evaluations of potted seedlings were done after 30, 60 and 90 days for the following parameters: height, leaf area, leaf area ratio, aerial dry weight and root dry weight. The results suggest that: a) potted seedlings grown under 50% of shade presented higher values of aerial weight and root weight than plants under full sunlight radiation; b) height, leaf area and leaf area ratio were not significantly influenced by shading treatments; c) higher values of height and root weight were observed after 90 days.Com o objetivo de avaliar o efeito dos níveis de sombreamento no desenvolvimento de mudas de Louro pirarucu (Licaria canella(Meissn.) Kosterm. - Lauraceae), conduziu-se um ensaio em viveiro na Reserva Florestal Adolfo Ducke. As sementes foram colocadas para germinar em caixas de madeira contendo areia lavada como substrato e posteriormente foi feito o transplante das mudas para sacos plásticos de cor preta. Utitizou-se quatro diferentes níveis de sombreamento. Os níveis de 30%, 50% e 70% de sombreamento foram obtidos por meio de telas de poliolefinas de cor preta e o nível de 0% a céu aberto. Foi empregado o delineamento em blocos ao acaso com parcelas subdivididas; os níveis de sombreamento constituíram as parcelas e os períodos de avaliação das mudas as subparcelas. Após 30,60 e 90 dias de permanência no viveiro, as mudas foram avaliadas quanto à altura, área foliar, razão de área foliar, peso de matéria seca da parte aérea e do sistema radicular. Baseando-se nos resultados obtidos, pode-se concluira) as mudas produzidas sob 50% de sombreamento apresentaram maiores valores de peso da parte aérea e do sistema radicular quando comparadas com 0% de sombreamento ; b) a altura, área foliar e razão de área foliar não foram influenciadas significativamente pelos níveis de sombreamento; c) as mudas com maior desenvolvimento em altura e maior peso do sistema radicular foram obtidas com 90 dias

Tratamentos pré-germinativos em sementes de espécies florestais da amazônia. III .Faveira-arara-tucupi (Parkia decussata Ducke) - LEGUMINOSAE.

Faveira-arara-tucupi (Parkia decussata Ducke) see.ds were submited to several treatments and data coll.ected referent the germination power; the treatments were utili zαtiοη of concentrated sulfuric acid duri.ng 2,5; 5; 10; 20 and 40 minutes, manual scari fication,hot water at 80°C during 10; 20 and 40 minutes and water at environmental temper ature during 12 and 24 hours. The sulfuric acid treatments for 20 and 40 minutes and manual scarification, were the most efficient, in order to increase, the germination. According to the results the autors indicate as the probable cause of sedd germination problems the impermeability of the tegument to water.No presente trabalho as sementes de Faveira-arara-tucupi (Parkia decussata Ducke) foram submetidas a vários tratamentos e estudadas quanto ao poder germinativo, por meio da utilização de ácido sulfúrico concentrado por (2,55; 10; 20 e 40 minutos), escari-ficação manual água quente a 8O C durante (10; 20 e 40 minutos) e água a temperatura ambiente durante (12 e 24 horas). Os tratamentos com ácido sulfúrico por 20 e 40 minutos eescarificação manual foram os mais eficientes para aumentar a germinação. Com base nestes resultados, os autores apontam como a causa provável dos problemas de germinação das sementes a impermeabilidade do tegumento ã água

Health professionals facing bad news: learning to communicate

Comunicación oral presentada en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridIntroducción: la comunicación es el único proceso por el que el profesional de la salud puede trasmitir la información de estado/situación al paciente y/o familiares, favoreciendo la alianza terapéutica. Sin embargo nos encontramos con situaciones en el que la comunicación se dificulta por la información a trasmitir: malas noticias. La forma de realizarla puede ser muy variada, pero el que sea la adecuada depende de la situación y de la persona que trasmite como la que recibe. Objetivos: identificar y determinar los métodos utilizados por los profesionales de la salud, ante la comunicación de las malas noticias, así como plantear mejoras de actuación mediante la creación de protocolos generalistas ante la transmisión de las mismas. Metodología: revisión bibliográfica de publicaciones comprendidas entre 1998 y 2015. Resultados y discusión: análisis de 20 artículos. Profesionales, caso de enfermería, van ganando terreno en la comunicación de malas noticias. Sin embargo, dentro del Área de la Salud, existen otros profesionales también capacitados para la comunicación de malas noticias, apostando para ello por un trabajo multidisciplinar. Se han encontrado protocolo de actuación ante la comunicación de malas noticias como son el “SPIKES” y el “ABCDE”, así como otros adaptados. Conclusiones: actualmente es un desafío para los profesionales de la salud la comunicación de malas noticias, tarea exclusiva de los médicos, ello no exentos de controversias. No podemos obviar que los familiares y pacientes pasan más tiempo con otros profesionales, creándose lazos de bienestar, apoyo, confianza y recibiendo una continuidad de cuidados; profesionales capacitados y formados para comunicar las malas noticias. Un planteamiento desde un prisma multidisciplinar, evitándose el enfoque paternalista, respetando derechos del paciente, resaltando la importancia que el proceso de comunicación profesional-paciente y por ende reduciendo las consecuencias del modelo actual: reclamaciones y sentencias legales por no realizarse de la manera adecuada

Consistent sleep onset and maintenance of body weight after weight loss:An analysis of data from the NoHoW trial

BackgroundSeveral studies have suggested that reduced sleep duration and quality are associated with an increased risk of obesity and related metabolic disorders, but the role of sleep in long-term weight loss maintenance (WLM) has not been thoroughly explored using prospective data.Methods and findingsThe present study is an ancillary study based on data collected on participants from the Navigating to a Healthy Weight (NoHoW) trial, for which the aim was to test the efficacy of an evidence-based digital toolkit, targeting self-regulation, motivation, and emotion regulation, on WLM among 1,627 British, Danish, and Portuguese adults. Before enrolment, participants had achieved a weight loss of ≥5% and had a BMI of ≥25 kg/m2 prior to losing weight. Participants were enrolled between March 2017 and March 2018 and followed during the subsequent 12-month period for change in weight (primary trial outcome), body composition, metabolic markers, diet, physical activity, sleep, and psychological mediators/moderators of WLM (secondary trial outcomes). For the present study, a total of 967 NoHoW participants were included, of which 69.6% were women, the mean age was 45.8 years (SD 11.5), the mean baseline BMI was 29.5 kg/m2 (SD 5.1), and the mean weight loss prior to baseline assessments was 11.4 kg (SD 6.4). Objectively measured sleep was collected using the Fitbit Charge 2 (FC2), from which sleep duration, sleep duration variability, sleep onset, and sleep onset variability were assessed across 14 days close to baseline examinations. The primary outcomes were 12-month changes in body weight (BW) and body fat percentage (BF%). The secondary outcomes were 12-month changes in obesity-related metabolic markers (blood pressure, low- and high-density lipoproteins [LDL and HDL], triglycerides [TGs], and glycated haemoglobin [HbA1c]). Analysis of covariance and multivariate linear regressions were conducted with sleep-related variables as explanatory and subsequent changes in BW, BF%, and metabolic markers as response variables. We found no evidence that sleep duration, sleep duration variability, or sleep onset were associated with 12-month weight regain or change in BF%. A higher between-day variability in sleep onset, assessed using the standard deviation across all nights recorded, was associated with weight regain (0.55 kg per hour [95% CI 0.10 to 0.99]; P = 0.016) and an increase in BF% (0.41% per hour [95% CI 0.04 to 0.78]; P = 0.031). Analyses of the secondary outcomes showed that a higher between-day variability in sleep duration was associated with an increase in HbA1c (0.02% per hour [95% CI 0.00 to 0.05]; P = 0.045). Participants with a sleep onset between 19:00 and 22:00 had the greatest reduction in diastolic blood pressure (DBP) (P = 0.02) but also the most pronounced increase in TGs (P = 0.03). The main limitation of this study is the observational design. Hence, the observed associations do not necessarily reflect causal effects.ConclusionOur results suggest that maintaining a consistent sleep onset is associated with improved WLM and body composition. Sleep onset and variability in sleep duration may be associated with subsequent change in different obesity-related metabolic markers, but due to multiple-testing, the secondary exploratory outcomes should be interpreted cautiously.Trial registrationThe trial was registered with the ISRCTN registry (ISRCTN88405328)

Caracterização de junta soldada por brasagem de liga de níquel-cromo utilizada como biomaterial odontológico

Foram obtidos os aspectos micrográficos das zonas de fusão e das zonas termicamente afetadas de juntas soldadas pelo método comumente utilizado por protéticos de uma liga Ni-Cr usada para a confecção de próteses dentárias conhecidas como pontes-fixas. O método consiste em soldagem por maçarico com gás liquefeito de petróleo (GLP) e oxigênio, metal de adição e fluxo, para soldas de liga à base de níquel comercialmente conhecida como FIT. Corpos de prova soldados da liga FITCAST- SB (261MPa, Ni 61% – Cr 25% – Mo10,5% – Si 1,5% – Ti<1%, dados do fabricante) foram  submetidos a preparação metalográfica, microscopia óptica e testes de microdureza. Os aspectos micrográficos revelaram uma zona de fusão com uma segunda fase precipitada que variava do esférico ao dendrítico e uma zona termicamente afetada fazendo uma interface nítidamente distinta da microestrutura do metal de base. A região soldada apresentou tendência a possuir menores valores para a microdureza Vickers, muito embora tal comportamento não possa ser extrapolado devido ao reduzido número de corpos de prova ainda avaliados. O método usual de soldagem dos protéticos (brasagem) parece gerar diferenças microestruturais e mecânicas significativas entre as regiões soldadas e as não soldadas das próteses à base de Ni-Cr