Proxemics of screen mediation: engagement with reading on screen manifests as diminished variation due to self-control, rather than diminished mean distance from screen

Objective: Burgoon's theory of conversational involvement suggest that when people engage with a person, they will move slightly closer to them, often subtly and subconsciously. However, some studies have failed to extend this to human-computer interaction. Our hypothesis is that during online reading, engagement is associated with an expenditure of effort to hold the head upright, still and centrally. Method: We presented to 27 participants (ages 21.00 ± 2.89, 15 female) seated in front of 47.5x27 cm monitor two reading stimuli in a counterbalanced order, one (interesting) based on a best selling novel and the other (boring) based on European Union banking regulations. The participants were video-recorded during their reading while they wore reflective motion tracking markers. The markers were video-tracked off-line using Kinovea 0.8. Results: Subjective VAS ratings showed that the stimuli elicited the bored and interested states as expected. Video tracking showed that the boring stimulus (compared to the interesting reading) elicited a greater head-to-screen velocity, a greater head-to-screen distance range, a greater head-to-screen distance standard deviation, but not a further away head-to-screen mean distance. Conclusions: The more interesting reading led to efforts to control the head to a more central viewing position while suppressing head fidgeting

Experience design: video without faces increases engagement but not empathy

Counter to prior claims that empathy is required for higher levels of engagement in human-computer interaction, our team has previously found that, in an analysis of 844 stimulus presentations, empathy is sufficient for high engagement, but is not necessary. Here, we ran a carefully controlled study of human-computer interactions with musical stimuli --- with and without visuals, and with and without recognizable people -- to directly test whether we could design an engaging stimulus that did not elicit empathy, by avoiding human faces or personal interaction. We measured subjective responses by visual analogue scale and found that the faceless stimulus was as engaging as the face-containing stimulus, but much less empathy-provoking. Therefore, we propose that empathy and engagement be considered independently during interaction design, because they are not monotonically related

The complex relationship between empathy, engagement and boredom

In human computer interactions — especially gaming — the role of empathy has been mooted as a necessary prerequisite for higher levels of engagement and immersion. More recently other forms of engagement, including intellectual/cognitive engagement, have been proposed. In this study we present a carefully controlled dataset of human-computer interactions with a wide range of stimuli that ranged from highly engaging to boring to test these two theories. Analyzing 844 response sets to visual analogue scales (VAS) for empathy, interest, boredom, and engagement, we found that high empathy was sufficient for high engagement but is not necessary, whilst the converse was not true. We also found that empathy and boredom were incompatible with each other, but low levels of either were permissive rather than causal to the other. We conclude that there is no monotonic relationship between increasing empathy and engagement; either empathy is a sufficient (but not necessary) cause of engagement, or engagement is a necessary precursor to high empathy

Non-Instrumental Movement Inhibition (NIMI) Differentially Suppresses Head and Thigh Movements during Screenic Engagement: Dependence on Interaction.

BACKGROUND Estimating engagement levels from postural micromovements has been summarized by some researchers as: increased proximity to the screen is a marker for engagement, while increased postural movement is a signal for disengagement or negative affect. However, these findings are inconclusive: the movement hypothesis challenges other findings of dyadic interaction in humans, and experiments on the positional hypothesis diverge from it. HYPOTHESES (1) Under controlled conditions, adding a relevant visual stimulus to an auditory stimulus will preferentially result in Non-Instrumental Movement Inhibition (NIMI) of the head. (2) When instrumental movements are eliminated and computer-interaction rate is held constant, for two identically-structured stimuli, cognitive engagement (i.e., interest) will result in measurable NIMI of the body generally. METHODS Twenty-seven healthy participants were seated in front of a computer monitor and speakers. Discrete 3-min stimuli were presented with interactions mediated via a handheld trackball without any keyboard, to minimize instrumental movements of the participant's body. Music videos and audio-only music were used to test hypothesis (1). Time-sensitive, highly interactive stimuli were used to test hypothesis (2). Subjective responses were assessed via visual analog scales. The computer users' movements were quantified using video motion tracking from the lateral aspect. Repeated measures ANOVAs with Tukey post hoc comparisons were performed. RESULTS For two equivalently-engaging music videos, eliminating the visual content elicited significantly increased non-instrumental movements of the head (while also decreasing subjective engagement); a highly engaging user-selected piece of favorite music led to further increased non-instrumental movement. For two comparable reading tasks, the more engaging reading significantly inhibited (42%) movement of the head and thigh; however, when a highly engaging video game was compared to the boring reading, even though the reading task and the game had similar levels of interaction (trackball clicks), only thigh movement was significantly inhibited, not head movement. CONCLUSIONS NIMI can be elicited by adding a relevant visual accompaniment to an audio-only stimulus or by making a stimulus cognitively engaging. However, these results presume that all other factors are held constant, because total movement rates can be affected by cognitive engagement, instrumental movements, visual requirements, and the time-sensitivity of the stimulus

Income deprivation and groin wound surgical site infection: cross-sectional analysis from the groin wound infection after vascular exposure multicenter cohort study

Background: Living in deprived areas is associated with poorer outcomes after certain vascular procedures and surgical site infection in other specialties. Our primary objective was to determine whether living in more income-deprived areas was associated with groin wound surgical site infection after arterial intervention. Secondary objectives were to determine whether living in more income-deprived areas was associated with mortality and clinical consequences of surgical site infection. Methods: Postal code data for patients from the United Kingdom who were included in the Groin Wound Infection after Vascular Exposure (GIVE) multicenter cohort study was used to determine income deprivation, based on index of multiple deprivation (IMD) data. Patients were divided into three IMD groups for descriptive analysis. Income deprivation score was integrated into the final multivariable model for predicting surgical site infection. Results: Only patients from England had sufficient postal code data, analysis included 772 groin incisions (624 patients from 22 centers). Surgical site infection occurred in 9.7% incisions (10.3% of patients). Surgical site infection was equivalent between income deprivation tertiles (tertile 1 = 9.5%; tertile 2 = 10.3%; tertile 3 = 8.6%; p = 0.828) as were the clinical consequences of surgical site infection and mortality. Income deprivation was not associated with surgical site infection in multivariable regression analysis (odds ratio [OR], 0.574; 95% confidence interval [CI], 0.038–8.747; p = 0.689). Median age at time of procedure was lower for patients living in more income-deprived areas (tertile 1 = 68 years; tertile 2 = 72 years; tertile 3 = 74 years; p < 0.001). Conclusions: We found no association between living in an income-deprived area and groin wound surgical site infection, clinical consequences of surgical site infection and mortality after arterial intervention. Patients living in more income-deprived areas presented for operative intervention at a younger age, with similar rates of comorbidities to patients living in less income-deprived areas. Groin wound surgical site infection (SSI) after arterial surgery is common [1], and research into reducing SSIs in vascular surgery is recognized as a priority by both clinicians and patient/caregiver representatives [2]. Despite the substantial potential morbidity and mortality of these SSIs [3,4], the available evidence relating to contributory factors is largely historic or reliant on retrospective data [5–7]. Further research on the epidemiology of SSI in this patient group is needed to allow better risk stratification, improve pre-operative discussions of risk with patients, and to guide targeted SSI prevention strategies that often include expensive prophylactic interventions [8]. However, little is currently known about the impact of socioeconomic characteristics on groin wound SSIs in this population. Socioeconomic deprivation is linked to health [9], and lifestyle-influenced cardiovascular diseases are more prevalent in more deprived areas [10]. Higher rates of unhealthy lifestyles (smoking, poor diet, and lack of physical exercise) in deprived areas are postulated to cause higher rates of cardiovascular risk increasing comorbidities, such as obesity and hyperlipidemia [10–12]. Several cardiovascular risk factors (e.g., smoking, body mass index, and diabetes mellitus), and peripheral arterial disease itself, are well recognized risk factors for SSI [13–16]. The association between socioeconomic deprivation and SSIs has previously been demonstrated in orthopedic surgery, cardiac surgery, and general surgery [17–19]. It is currently unknown whether living in an income-deprived area is associated with groin wound SSIs after arterial intervention. It was recently demonstrated in a large registry study in the United Kingdom, that outcomes following endovascular intervention for occlusive peripheral arterial disease were worse for patients living in deprived areas [20]. To the best of our knowledge, this aspect of outcomes after arterial intervention through a groin incision has not been investigated. Furthermore, studies demonstrating higher prevalence of cardiovascular disease risk factors in more deprived areas are now mostly historic and have not specifically investigated those presenting for arterial intervention through a groin incision for demographic differences in relation to deprivation [9–12]. Updated, prospective evidence is required to determine whether health inequalities persist for such patients today. Our primary objective was to determine whether residing in a more income-deprived area was associated with a higher risk of groin wound SSI after arterial intervention, by analyzing a subset of patients enrolled in the Groin wound Infection after Vascular Exposure (GIVE) multicenter cohort study [1,21]. Secondary objectives were to determine whether living in more income-deprived areas was associated with 30-day mortality and the clinical sequelae of SSI, and whether patients living in more income-deprived areas differed in terms of demographics and comorbidities compared with patients from less income-deprived areas