A Thing of Beauty: Steering Behavior in an Interactive Playground

Interactive playgrounds are spaces where players engage in collocated, playful activities, in which added digital technology can be designed to promote cognitive, social, and motor skills development. To promote such development, different strategies can be used to implement game mechanics that change player's in-game behavior. One of such strategies is enticing players to take action through incentives akin to game achievements. We explored if this strategy could be used to influence players' proxemic behavior in the Interactive Tag Playground, an installation that enhances the traditional game of tag. We placed the ITP in an art gallery, observed hundreds of play sessions, and refined the mechanics, which consisted in projecting collectible particles around the tagger that upon collection by runners resulted only in the embellishment of their circles. We implemented the refined mechanics in a study with 48 children. The playground automatically collected the players' positions, and analyses show that runners got closer to and moved more towards taggers when using our enticing strategy. This suggests an enticing strategy can be used to influence physical in-game behavior

SEmFire onderzoek naar duurzame inzetbaarheid en arbeidsparticipatie van repressief brandweerpersoneel.:Een eerste inventarisatie; bevindingen uit de interviews.

Deze rapportage is een weergave van de bevindingen uit interviews met repressieve brandweermedewerkers. De interviews zijn gehouden als onderdeel van het Sustainable Employability Firefighters (SEmFire) onderzoek, een onderzoek naar belemmerende en bevorderende factoren voor duurzame inzetbaarheid en arbeidsparticipatie van mannen en vrouwen in de repressieve brandweerfunctie. De interviews werden gehouden om meer inzicht te krijgen in de ervaren belasting van repressieve brandweermedewerkers en factoren die de duurzame inzetbaarheid beïnvloeden. Hiertoe zijn er in de periode eind augustus – begin oktober 2021 tien semi-gestructureerde interviews gehouden met medewerkers in de repressieve brandweerfunctie. Overall kunnen we uit de interviews opmaken dat in het werk van medewerkers in de repressieve brandweerfunctie een aantal verschillende soorten belasting een rol spelen. Dit zijn factoren uit zowel de werkomgeving, als uit de privé situatie. Daarnaast spelen gezondheidsfactoren en leeftijd een rol. De mate van voorkomen van verschillende belastende factoren blijkt redelijk gelijk onder alle deelnemers, met uitzondering van de factoren die leeftijds- of plaatsgebonden zijn. De mate waarin deelnemers deze factoren zelf als belastend ervaren kan echter enorm variëren. Wat door de ene deelnemer als behoorlijk belastend wordt benoemd is voor een andere deelnemer mogelijk geen issue. De oudere deelnemers ervaren meer belastende factoren in hun werk dan de jongere deelnemers. Wanneer het gaat over de helpende/ bevorderende factoren zitten de deelnemers meer op een lijn. Als we dan kijken naar de visie van de deelnemers over hoe deze factoren duurzame inzetbaarheid en arbeidsparticipatie beïnvloeden, zien we de verschillen weer terugkeren. Daar waar de jongeren al minder belasting zeggen te ervaren geven ze ook minder vaak aan dat deze belasting een rol zou spelen in de bepaling van duurzame inzetbaarheid en arbeidsparticipatie. De bevindingen uit de interviews zijn een eerste inventarisatie, er worden door de onderzoekers geen verdere conclusies aan verbonden. De interviews bevestigden het belang van onderzoek naar de ergonomische, fysieke, mentale en emotionele belasting en gezondheid van brandweer medewerkers in relatie tot de duurzame inzetbaarheid. Daarbij werd door de geïnterviewden ook aandacht gevraagd voor nieuwe belastingen in het werk, bijv. onjuiste bejegening en ongewenst filmen door omstanders. Tenslotte bevestigen deze bevindingen nogmaals dat ervaren belasting niet gelijk hoeft te staan aan bezwarende factorenDe bevindingen uit de interviews dienen als input voor het opstellen van vragenlijsten. Deze vragenlijsten zullen later in het SEmFire onderzoek herhaaldelijk worden uitgezet onder alle beroeps en vrijwillige randweermedewerkers in Nederland. Middels dit vragenlijstonderzoek zal er een goed beeld gevormd kunnen worden van alle belemmerende en bevorderende factoren die een rol spelen in het repressieve brandweerwerk en inzicht verkregen worden in de manier waarop deze duurzame inzetbaarheid en arbeidsparticipatie beïnvloeden

ANIM3: ANIMated ANIMals as A Numbing Immersive Mechanic

A high prevalence of "acute pain"within hospital emergency departments and side-effects of current practices calls for new additional treatment measures. Alternatives to analgesics include Animal Assisted Therapy (AAT) and Virtual Reality (VR). Whereas proven effectively separately, the combination AAT techniques and VR analgesia has received no or scant attention. In this paper we focus on exploring this field through exploring the literature from the separate approaches and show how they would fit together, conceptualized in a new VR application ANIM3. Leading in this development process, besides the extensive literature review, were stakeholder interviews. Our first user encounters gained positive responses to the prototype. As a whole, we see strong indications that "acute pain"reduction in the hospital based on AAT principles in Virtual Reality is a promising technique. We postulate that these experiences should add well timed heightened distractions, while keeping the contextual factors in mind leading to interactions of a maximum of about 15 mins, with limited or no need for explanations, and limit need of locomotion and two-hand controls. We recommend the creation of proposals to further development and research to explore these possibilities to their full potential

The ability of intensive care unit physicians to estimate long-term prognosis in survivors of critical illness

Purpose To assess the reliability of physicians' prognoses for intensive care unit (ICU) survivors with respect to long-term survival and health related quality of life (HRQoL). Methods We performed an observational cohort-study in a single mixed tertiary ICU in The Netherlands. ICU survivors with a length of stay > 48 h were included. At ICU discharge, one-year prognosis was estimated by physicians using the four-option Sabadell score to record their expectations. The outcome of interest was poor outcome, which was defined as dying within one-year follow-up, or surviving with an EuroQoL5D-3 L index < 0.4. Results Among 1399 ICU survivors, 1068 (76%) subjects were expected to have a good outcome; 243 (18%) a poor long-term prognosis; 43 (3%) a poor short-term prognosis, and 45 (3%) to die in hospital (i.e. Sabadell score levels). Poor outcome was observed in 38%, 55%, 86%, and 100% of these groups respectively (concomitant c-index: 0.61). The expected prognosis did not match observed outcome in 365 (36%) patients. This was almost exclusively (99%) due to overoptimism. Physician experience did not affect results. Conclusions Prognoses estimated by physicians incorrectly predicted long-term survival and HRQoL in one-third of ICU survivors. Moreover, inaccurate prognoses were generally the result of overoptimistic expectations of outcome

The predictive value of early acute kidney injury for long-term survival and quality of life of critically ill patients

BACKGROUND: Prognostic factors for the combination of long-term survival and health-related quality of life (HRQoL) after intensive care unit (ICU) stay have not yet been studied. Our aim was to assess whether early acute kidney injury (eAKI), AKI occurring on the first day of ICU admission, is an independent predictor of this combined one-year outcome. METHODS: We included all patients admitted to the mixed ICU of the University Medical Centre Utrecht between July 2009 and April 2013, excluding patients with chronic dialysis, cardiac surgery, and length of stay shorter than 24 hours. eAKI was defined using the risk, injury, failure, loss, end-stage renal failure (RIFLE) classification, using a newly developed algorithm to classify AKI based on routinely collected patient data. In one-year survivors, HRQoL was measured using the EuroQoL 5D-3L™ (EQ-5D) questionnaire. The primary outcome measure was "poor outcome", defined as an EQ-5D index score <0.4 or death after one year follow up. A multivariable Poisson regression model was performed to adjust for age, comorbidities, admission type and severity of disease factors. RESULTS: We enrolled 2,420 patients, of whom 871 (36.0 %) died within one year. An additional 286 of 1549 one-year survivors (11.8 %) experienced low HRQoL. The respective incidence of the RIFLE classes, risk, injury and failure, were 456 (18.8 %), 253 (10.5 %) and 123 (5.1 %). After adjustment for other covariates, the RIFLE classes, injury and failure, were independently associated with poor outcome (adjusted relative risk 1.14, 95 % CI 1.01, 1.29; p = 0.03, and 1.25, 95 % CI 1.01, 1.55; p = 0.04), when compared to no eAKI patients . The constituents of this composite outcome were also analysed separately. In a Cox regression model the RIFLE classes, injury and failure, were significantly associated with mortality (adjusted hazard ratio 1.35, 95 % CI 1.11, 1.65; p <0.01, and 1.78, 95 % CI 1.38, 2.30; p <0.01). In one-year survivors specifically, none of the RIFLE classes were significantly associated with low HRQoL. CONCLUSIONS: ICU patients with moderate or severe AKI during the first 24 hours have a higher probability of mortality or low HRQoL (combined poor outcome), one year after ICU admission. Together with other available early prognostic factors, information on early acute kidney injury could improve informed decision-making on the continuation or withdrawal of treatment in ICU patients

Longitudinal associations of physical activity with plasma metabolites among colorectal cancer survivors up to 2 years after treatment

We investigated longitudinal associations of moderate-to-vigorous physical activity (MVPA) and light-intensity physical activity (LPA) with plasma concentrations of 138 metabolites after colorectal cancer (CRC) treatment. Self-reported physical activity data and blood samples were obtained at 6 weeks, and 6, 12 and 24 months post-treatment in stage I-III CRC survivors (n = 252). Metabolite concentrations were measured by tandem mass spectrometry (BIOCRATES AbsoluteIDQp180 kit). Linear mixed models were used to evaluate confounder-adjusted longitudinal associations. Inter-individual (between-participant differences) and intra-individual associations (within-participant changes over time) were assessed as percentage difference in metabolite concentration per 5 h/week of MVPA or LPA. At 6 weeks post-treatment, participants reported a median of 6.5 h/week of MVPA (interquartile range:2.3,13.5) and 7.5 h/week of LPA (2.0,15.8). Inter-individual associations were observed with more MVPA being related (FDR-adjusted q-value < 0.05) to higher concentrations of arginine, citrulline and histidine, eight lysophosphatidylcholines, nine diacylphosphatidylcholines, 13 acyl-alkylphosphatidylcholines, two sphingomyelins, and acylcarnitine C10:1. No intra-individual associations were found. LPA was not associated with any metabolite. More MVPA was associated with higher concentrations of several lipids and three amino acids, which have been linked to anti-inflammatory processes and improved metabolic health. Mechanistic studies are needed to investigate whether these metabolites may affect prognosis