Games to engage: increasing mental health awareness

In recent years there has been rapid growth in the development and use of digital tools in healthcare. One area of research interest is the use of games as tools to improve health and education. Gamification of health is a broad area that includes games aimed at encouraging healthy behaviours through motivation, 'exergaming, ' which explicitly aims to improve health through physical activity, 'serious games' that are intended to support therapies and rehabilitation, and games that support training, for example through simulation. Another area is public health awareness and education which is an area of current research in MindTech. [...] If done with care and sensitivity, bringing game elements into the toolkit of user-centred design methodologies for engaging people with research and mental health awareness has good potential and is worthy of continued attention

Games to engage: increasing mental health awareness

In recent years there has been rapid growth in the development and use of digital tools in healthcare. One area of research interest is the use of games as tools to improve health and education. Gamification of health is a broad area that includes games aimed at encouraging healthy behaviours through motivation, 'exergaming, ' which explicitly aims to improve health through physical activity, 'serious games' that are intended to support therapies and rehabilitation, and games that support training, for example through simulation. Another area is public health awareness and education which is an area of current research in MindTech. [...] If done with care and sensitivity, bringing game elements into the toolkit of user-centred design methodologies for engaging people with research and mental health awareness has good potential and is worthy of continued attention

Are online symptoms checkers useful for patients with inflammatory arthritis?

BACKGROUND: Online symptom checkers are increasingly used by patients however there is little published evidence of their effectiveness in real patients. The aim of this study was to evaluate how patients with inflammatory arthritis and inflammatory arthralgia use the internet to look for health information and to assess the advice given and diagnoses suggested by the NHS and WebMD symptom checkers in relation to the patients’ actual diagnoses. METHODS: Thirty-four patients with inflammatory arthritis (rheumatoid arthritis (n = 13), psoriatic arthritis (n = 4), unclassified arthritis (n = 4)) and inflammatory arthralgia (n = 13) newly presenting to a secondary care based clinic were identified using a consecutive sampling approach. Consenting patients were asked questions about their internet use in relation to their presenting symptoms. They then completed the NHS and the WebMD symptom checkers and their answers and the outcomes were recorded. RESULTS: Sixteen patients had previously consulted the internet regarding their symptoms. Neither age nor gender significantly influenced internet usage. Actions advised via the NHS symptom checker were: call an ambulance (n = 11), attend A&E (n = 4), contact your GP straight away (n = 2), see your GP today (n = 6), or see your GP within 36 h (n = 11). The 5 most common differential diagnoses given by Web MD were gout (n = 28), rheumatoid arthritis (n = 24), psoriatic arthritis (n = 22), osteoarthritis (n = 18) and finger dislocation (n = 10). The most common first differential diagnosis was osteoarthritis (n = 12). Only 4 out of 21 patients with inflammatory arthritis were given a first diagnosis of rheumatoid arthritis or psoriatic arthritis. CONCLUSIONS: Our data highlight that help seeking advice given online is often inappropriate and that the diagnoses suggested are frequently inaccurate. Recommendations to seek emergency advice may cause inappropriate healthcare utilization. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-016-1189-2) contains supplementary material, which is available to authorized users

Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers' Perspectives

Children with profound cognitive impairment (PCI) are a heterogenous group who often experience frequent and persistent pain. Those people closest to the child are key to assessing their pain. This mixed method study aimed to explore how parents acquire knowledge and skills in assessing and managing their child's pain. Eight mothers completed a weekly pain diary and were interviewed at weeks 1 and 8. Qualitative data were analysed using thematic analysis and the quantitative data using descriptive statistics. Mothers talked of learning through a system of trial and error ("learning to get on with it"); this was accomplished through "learning to know without a rule book or guide"; "learning to be a convincing advocate"; and "learning to endure and to get things right." Experiential and reflective learning was evident in the way the mothers developed a "sense of knowing" their child's pain. They drew on embodied knowledge of how their child usually expressed and responded to pain to help make pain-related decisions. Health professionals need to support mothers/parents to develop their knowledge and skills and to gain confidence in pain assessment and they should recognise and act on the mothers' concerns

Navigating Uncertainty: Health Professionals' Knowledge, Skill and Confidence in Assessing and Managing Pain in Children with Profound Cognitive Impairment

There is limited evidence to underpin the assessment and management of pain in children with profound cognitive impairment and these children are vulnerable to poor pain assessment and management. Health professionals working with children with profound cognitive impairment from a single paediatric tertiary referral centre in England were interviewed to explore how they develop and acquire knowledge and skills to assess and manage pain in children with cognitive impairment. The interviews were transcribed and subjected to thematic analysis. Nineteen health professionals representing different professional groups and different levels of experience participated in the study. A metatheme “navigating uncertainty; deficits in knowledge and skills” and two core themes “framing as different and teasing things out” and “the settling and unsettling presence of parents” were identified. Uncertainty about aspects of assessing and managing the pain of children with cognitive impairment tended to erode professional confidence and many discussed deficits in their skill and knowledge set. Uncertainty was managed through engaging with other health professionals and the child’s parents. Most health professionals stated they would welcome more education and training although many felt that this input should be clinical and not classroom oriented

Episodic Memory Deficits in Obesity

Obesity has become an international health crisis. There is accumulating evidence that excess bodyweight is associated with changes to the structure and function of the brain and with a number of cognitive deficits. In particular, research suggests that obesity is associated with hippocampal and frontal lobe dysfunction, which would be predicted to impact memory. However, evidence for such memory impairment is currently limited. We hypothesised that higher body mass index (BMI) would be associated with reduced performance on a test of episodic memory that assesses not only content, but also context and feature integration. A total of 50 participants aged 18-35 years, with BMIs ranging from 18 to 51, were tested on a novel what-where-when style episodic memory test: the "Treasure-Hunt Task". This test requires recollection of object, location, and temporal order information within the same paradigm, as well as testing the ability to integrate these features into a single event recollection. Higher BMI was associated with significantly lower performance on the what-where-when (WWW) memory task and all individual elements: object identification, location memory, and temporal order memory. After controlling for age, sex, and years in education, the effect of BMI on the individual what, where, and when tasks remained, while the WWW dropped below significance. This finding of episodic memory deficits in obesity is of concern given the emerging evidence for a role for episodic cognition in appetite regulation.This study was funded by an MRC Centenary Early Career Award. LGC was funded by the Sarah Woodhead Research Fellowship at Girton College Cambridge. JSS was funded by a James S. McDonnell Foundation Scholar Award, and NSC was funded by an Experimental Psychology Society Mid Career Award

Shifting the focus: sequential methods of analysis with qualitative data

The purpose of this article is to illustrate both the processes of data analysis and the methodological development involved in adopting the sequential use of two data analysis methods applied to the same data set. Understanding of the phenomena of interest was sought through examining both the content and the form of nurses’ accounts of practice experiences. Initially, a method of thematic content analysis was applied to understand what the nurses said about their experiences. The core theme of nurses’ change agency derived from this analysis was examined further through a method of narrative analysis. In the second analysis, the focus was shifted to how the nurses accounted for their experiences. The innovative use of iterative, sequential methods of analysis revealed greater complexity and depth of understanding of the phenomena than would have been achieved with one method alone

From SnappyApp to Screens in the Wild: gamifying an Attention Hyperactivity Deficit Disorder continuous performance test for public engagement and awareness

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that is characterised by three core behaviours: inattention, hyperactivity and impulsivity. It is typically thought that around 3-5% of school aged children have ADHD, with lifetime persistence for the majority. A psychometric Continuous Performance Test (CPT) had recently been incorporated into an interactive smartphone application (App), SnappyApp, to allow the measurement of the three ADHD symptom domains. SnappyApp presents a sequence of letters of the alphabet in a pseudo-random manner with responses via the device’s touch screen. Following a pilot test in the general population where the CPT showed sensitivity to ADHD-related symptoms (self-reported impulsive behaviour related to CPT measures), a new project was begun to convert the App into a game Attention Grabber based on the functionality of the test, focussing on the attention and impulsivity domains. The Screens in the Wild (SITW) platform is in the process of being employed for public engagement in awareness about ADHD through interactive technology. SITW has deployed a network of four public touch-screens in urban places. Each of the four nodes has a large (46 inch) display, a camera, a microphone and a speaker. The SnappyApp web-app was translated for presentation on to the SITW platform. The browser-based App was redesigned, with the input of a commercial graphics design company, based on an initial proof-of-concept whereby the original App was reprogrammed to present sequences of graphical objects (fruit) and to introduce further engagement features including animations. A shortened video about Adult ADHD and a brief questionnaire were incorporated to form a stand-alone edutainment package. The earlier design and user testing of SnappyApp is briefly described and details are then provided of the process of gamification to produce Attention Grabber. An evaluation process is described whereby awareness of ADHD and its related symptoms are to be probed. In general, finding out whether and how people engage with interactive screen technology can help in the design of future public engagement and health promotion activities. Ethical considerations are discussed, since public access to this kind of game could potentially raise health anxiety related to self-interpretation of game performance. This risk is balanced with the need to provide health information