Healthy Competition: Multiplayer Digital Games in Health Education

The focus of this dissertation is on the role of multiplayer digital games in adult education, with a particular emphasis on health education. Although interest in the use of digital games for serious applications has been increasing since the early 2000s, there is a significant gap in understanding on the use of multiplayer digital games in adult education. In the context of health education, there has been a large amount of research conducted in to the use of repurposed commercial games for predicting performance of trainees and health students on surgical simulators. However, beyond this niche research into game based learning is notably less cohesive. There has been some research into the use of digital games in areas such as for delivering insulin management training, but understanding of the processes for widespread application of games based learning in the health sector is limited. Additionally, almost no research has been undertaken into the use of multiplayer digital games in health education, whether it be for tertiary or adult learners. In this dissertation two digital games were developed, implemented and evaluated to explore the value of multiplayer games for supporting cooperation and collaboration in health education. The first game, They Know: Anatomy, was a real time team based strategy game designed to support anatomy revision by second year medical students. The second game, the Qstream: Cancer Cup Challenge, was a team based asynchronous online program designed to reinforce understanding of how to identify and manage adverse events by oncology registrars. A design research framework informed the methodology used in this dissertation. This framework emphasises the need to use multiple iteration cycles to develop a comprehensive understanding of player experiences with the digital games they encountered. Data on participant experiences with the digital games was collected using qualitative methods, including post-game surveys and semi-structured interviews. Between iterative cycles data on participant experiences with the digital games were analysed so that future implementations of the game could be modified to maximise cooperation and collaboration between players. At the conclusion of the study period data collected across all implementations of the digital games were analysed to increase understanding of how multiplayer digital games supported cooperation and collaboration between learners. Findings from this dissertation demonstrate that multiplayer digital games can be used to engage medical students in anatomy revision and medical oncologists in adverse events retraining. This is the first study to look at the use of digital games for either of these demographics. Additionally, this dissertation identified four ways through which multiplayer digital games foster collaboration between players: through the development of a team strategy to win the game, by facilitating !iii shared decision making, by working towards a shared goal, and by creating a sense of investment in a team. Finally, findings from this dissertation contribute to the literature on the implementation of game based learning in adult education. This is an under researched area, but one that warrants further focus in future if game based learning is going to be successfully incorporated into curricula and training activities for adult learners. This dissertation adds to the literature by presenting new knowledge on how and why multiplayer games support collaboration between learners. Additionally, it appears that multiplayer digital games offer diverse, flexible and immersive experiences to adult learners in a way that single player digital games may not. Finally, multiplayer digital games provide new avenues for support self-directed learning by encouraging cooperation between large groups of students in a manner that is not normally achieved in online learning environment

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

In Ph+BCR-ABL1P210+ acute lymphoblastic leukemia the e13a2 (B2A2) transcript is prevalent

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EAACI Molecular Allergology User's Guide 2.0

Since the discovery of immunoglobulin E (IgE) as a mediator of allergic diseases in 1967, our knowledge about the immunological mechanisms of IgE-mediated allergies has remarkably increased. In addition to understanding the immune response and clinical symptoms, allergy diagnosis and management depend strongly on the precise identification of the elicitors of the IgE-mediated allergic reaction. In the past four decades, innovations in bioscience and technology have facilitated the identification and production of well-defined, highly pure molecules for component-resolved diagnosis (CRD), allowing a personalized diagnosis and management of the allergic disease for individual patients. The first edition of the "EAACI Molecular Allergology User's Guide" (MAUG) in 2016 rapidly became a key reference for clinicians, scientists, and interested readers with a background in allergology, immunology, biology, and medicine. Nevertheless, the field of molecular allergology is moving fast, and after 6 years, a new EAACI Taskforce was established to provide an updated document. The Molecular Allergology User's Guide 2.0 summarizes state-of-the-art information on allergen molecules, their clinical relevance, and their application in diagnostic algorithms for clinical practice. It is designed for both, clinicians and scientists, guiding health care professionals through the overwhelming list of different allergen molecules available for testing. Further, it provides diagnostic algorithms on the clinical relevance of allergenic molecules and gives an overview of their biology, the basic mechanisms of test formats, and the application of tests to measure allergen exposure.Peer reviewe