Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

On the use of implicit methods for evaluating the impact of interactive narratives on attitudes and behavior (Position paper)

While dominant in research on user experience, the use of self-report methods such as questionnaires or surveys involves some significant limitations for scrutinizing the transformative potential of narratives on users’ attitudes and behavior. Here I defend the use of implicit methods, which avoid directly asking the user, as a way to obtain a more detailed picture of such effects, allowing researchers to understand dimensions of the transformative processes beyond what can be verbally expressed by user

Easily applicable social virtual reality and social presence in online higher education during the covid-19 pandemic: A qualitative study

Social virtual reality (social VR) platforms gained popularity among users over the last few years. They provide users with a sense of social presence, potentially stimulating social interaction in distance education. Insights on how VR enhances the social aspects of learning are scarce, however, and past examinations often focused on the effects of short usage times of self-developed VR learning applications. To analyze the potential of a simple-to-apply off-the-shelf social VR environment in distance education, in this qualitative study, a sample of 35 master's students employed the AltspaceVR platform for university seminars and group work over a six-week while campus access was restricted due to the covid-19 pandemic, and 23 of them were interviewed to examine their perception of the technology. The results show that social VR facilitated feelings of social presence, a more natural and spontaneous way of communicating with peers and teachers, and an increased sense of community in the classroom, compared to the alternative of videoconferencing. Participants reported high acceptance of the technology for teaching and learning tasks, particularly for interactive activities (e.g., workgroups) in small groups, but also identified limitations related to aspects such as image resolution, lack of note-taking tools, or the feeling of dizziness and fatigue after prolonged use. These results highlight the potential advantages of social VR for stimulating the social dimensions of online education, as well as the remaining challenges that need to be addressed to enable its use in higher education

Feelings of presence and perceived social support in social virtual reality platforms

Social virtual reality (social VR) platforms are gaining popularity among users. Previous qualitative research suggests that feelings of presence can make these platforms an attractive environment to obtain social support from others. Building on these exploratory insights, we carried out a quantitative study to illuminate how different types of presence in social VR platforms facilitate social support. The results of a large survey conducted among users (N = 1231) show that feelings of social presence and self-presence are predictors of perceived social support and that this perception of social support is positively associated with users' subjective well-being. Perceived social support is greater for women than for men, and it differs across platforms, although with small effect sizes. These results underline the role of presence in the perception of computer-mediated social support, suggesting that the affordances of social VR make it a particularly well-suited medium for facilitating beneficial interactions among users

Virtual reality storytelling as a double-edged sword:Immersive presentation of nonfiction 360°-video is associated with impaired cognitive information processing

This study examines the effects of the immersive presentation of nonfiction omnidirectional video on audiences’ cognitive processing. Participants watched a sample of 360°-video nonfiction content, presented either in a virtual reality headset or on a computer screen. Measures of heart rate variability and electrodermal activity were collected, together with self-reported ratings of presence, information recognition, and memory. The results indicate that the immersive presentation elicits higher arousal and presence, but also lower focused attention, recognition, and cued recall of information. These effects on focused attention and memory were not mediated by variations on arousal or presence. Implications are discussed in terms of the psychological effects of immersive media, as well as their relevance for media practitioners

Modelling effects of S3D visual discomfort in human emotional state using data mining techniques

In recent years, the rapid development of diverse media has been evident in disparate fields such as consumer electronics, automotive infotainment and healthcare software. There is a need for innovative methods to assess user perceived Quality of Experience (QoE), as a proxy for consumer satisfaction with such systems and services. Users emotional state plays a key role in QoE; thus, it is necessary to consider it in user experience evaluation and the design process of stereoscopic 3D video content. In the present article we introduce the use of a specially designed model based on a feedforward Multilayer Perception Artificial Neural Network as an appropriate Machine Learning technique for the estimation of human emotional state while viewing various categories of stereoscopic 3D video content. The goal is to design an emotional state estimator based on direct psychophysiological measurements. The considered psychophysiological signals include heart rate (HR) calculated from an echocardiogram (ECG), electro-dermal activity (EDA), and brain activity (BA) in EEG signals. Participants watched a series of 3D video contents varying in terms of visual quality, while the mentioned psychophysiological signals were recorded, and self-reported subjectively experienced emotions using a Self-Assessment Manikin (SAM) questionnaire. The obtained results show that it is possible to construct such a highly precise estimator of emotional states

The impact of the sonic logo’s acoustic features on orienting responses, emotions and brand personality transmission

Purpose: The purpose of this study is to determine how sonic logo’s acoustic features (intensity, pitch and pace) based on melodic tunes with no voice orient the response of consumers, attract attention, elicit levels of pleasantness and calmness and transmit brand personality traits. Design/methodology/approach: A within-subject experimental factorial design is applied to measure emotional arousal (indexed as electrodermal activity) and enhancement on perceptual processing (indexed as heart rate), as well as self-reported factors, namely, calmness/excitement, pleasantness and brand personality scales. Findings: Results show a significant increase on electrodermal activity associated with fast-paced sonic logos and a decrease in heart rate in slow-paced long sonic logos. Also, fade-up, pitch-ascending fast sonic logos are defined as more exciting and descending-pitch sonic logos as more pleasant. Research limitations/implications: The use of sonic logos with no voice does limit its implications. Besides, the use of three variables simultaneously with 18 versions of sonic logos in a laboratory setting may have driven participants to fatigue; hence, findings should be cautiously applied. Practical implications: First, sonic logos are best processed in a fade-up form. Second, fast pace is recommended to orient response, whereas slow pace is recommended to transmit calmness. Practitioners may opt for fast-paced sonic logos if the design is new or played in a noisy environment and opt for slow-paced sonic logos in already highly recognized sound designs. Originality/value: To the best of authors’ knowledge, this study is the first to combine psychophysiological measures and self-reported scales in a laboratory experiment on how sonic logo’s acoustic features orient response, transmit emotions and personality traits

Exploring the effects of 3D visual discomfort on viewers' emotions

International audienceMuch of the research on stereoscopic 3D (S3D) QoE has dealt with the effects of image features over user's visual discomfort. Nevertheless, the relationships between visual discomfort and other high-level perceptual dimensions such as the viewers' emotional reactions have not been yet explored. Since emotions play a key role on media reception processes, and especially in entertainment contents consumption, this question deserves to be thoroughly addressed to improve the design of image processing techniques. This paper raises and investigates the possible relationship between image distortions and its impact on the emotion context of S3D. We implemented an experimental design in which participants watched a series of 3D contents with different levels of visual distortions supposed to induce visual discomfort, while self-reported and psychophysiological measures of emotions were recorded. Results showed that physiological correlates of emotions were affected by visual discomfort conditions, and that these measures were more sensitive than traditional self-reported measures