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When facing mental health concerns, men seek help less, confront greater stigma in accessing treatment, and experience more severe consequences. Interventions targeted at men are often grounded in activity and situated in appealing contexts, such as sporting or gaming spaces. In this paper, we question how pinball---a social tangible and digital leisure activity---can support men's mental health and wellbeing, through thematic analysis of in-depth semi-structured interviews (n=15) with male pinball enthusiasts. Our contribution is threefold: first, we evidence pinball as a context that provides incidental benefits to mental health directly, and indirectly through social connectedness; second, that enthusiasts actively enhance their social lives and resulting wellbeing via pinball; and third, that pinball contexts are suited for designing interventions that provide mental health supports within subcultures that appeal to men. We situate our findings in theories of wellbeing, activity-based communication, shoulder-to shoulder self-disclosure, and the importance of third-spaces for social wellness.

Background Serious games are now widely used in many contexts, including psychological research and clinical use. One area of growing interest is that of cognitive assessment, which seeks to measure different cognitive functions such as memory, attention, and perception. Measuring these functions at both the population and individual levels can inform research and indicate health issues. Attention is an important function to assess, as an accurate measure of attention can help diagnose many common disorders, such as attention-deficit/hyperactivity disorder and dementia. However, using games to assess attention poses unique problems, as games inherently manipulate attention through elements such as sound effects, graphics, and rewards, and research on adding game elements to assessments (ie, gamification) has shown mixed results. The process for developing cognitive tasks is robust, with high psychometric standards that must be met before these tasks are used for assessment. Although games offer more diverse approaches for assessment, there is no standard for how they should be developed or evaluated. Objective To better understand the field and provide guidance to interdisciplinary researchers, we aim to answer the question: How are digital games used for the cognitive assessment of attention made and measured? Methods We searched several databases for papers that described a digital game used to assess attention that could be deployed remotely without specialized hardware. We used Rayyan, a systematic review software, to screen the records before conducting a systematic review. Results The initial database search returned 49,365 papers. Our screening process resulted in a total of 74 papers that used a digital game to measure cognitive functions related to attention. Across the studies in our review, we found three approaches to making assessment games: gamifying cognitive tasks, creating custom games based on theories of cognition, and exploring potential assessment properties of commercial games. With regard to measuring the assessment properties of these games (eg, how accurately they assess attention), we found three approaches: comparison to a traditional cognitive task, comparison to a clinical diagnosis, and comparison to knowledge of cognition; however, most studies in our review did not evaluate the game’s properties (eg, if participants enjoyed the game). Conclusions Our review provides an overview of how games used for the assessment of attention are developed and evaluated. We further identified three barriers to advancing the field: reliance on assumptions, lack of evaluation, and lack of integration and standardization. We then recommend the best practices to address these barriers. Our review can act as a resource to help guide the field toward more standardized approaches and rigorous evaluation required for the widespread adoption of assessment games.

BACKGROUND Serious games are now widely used in many contexts, including psychological research and clinical use. One area of growing interest is that of cognitive assessment, which seeks to measure different cognitive functions such as memory, attention, and perception. Measuring these functions at both the population and individual levels can inform research and indicate health issues. Attention is an important function to assess, as an accurate measure of attention can help diagnose many common disorders, such as attention-deficit/hyperactivity disorder and dementia. However, using games to assess attention poses unique problems, as games inherently manipulate attention through elements such as sound effects, graphics, and rewards, and research on adding game elements to assessments (ie, gamification) has shown mixed results. The process for developing cognitive tasks is robust, with high psychometric standards that must be met before these tasks are used for assessment. Although games offer more diverse approaches for assessment, there is no standard for how they should be developed or evaluated. OBJECTIVE To better understand the field and provide guidance to interdisciplinary researchers, we aim to answer the question: How are digital games used for the cognitive assessment of attention made and measured? METHODS We searched several databases for papers that described a digital game used to assess attention that could be deployed remotely without specialized hardware. We used Rayyan, a systematic review software, to screen the records before conducting a systematic review. RESULTS The initial database search returned 49,365 papers. Our screening process resulted in a total of 74 papers that used a digital game to measure cognitive functions related to attention. Across the studies in our review, we found three approaches to making assessment games: gamifying cognitive tasks, creating custom games based on theories of cognition, and exploring potential assessment properties of commercial games. With regard to measuring the assessment properties of these games (eg, how accurately they assess attention), we found three approaches: comparison to a traditional cognitive task, comparison to a clinical diagnosis, and comparison to knowledge of cognition; however, most studies in our review did not evaluate the game’s properties (eg, if participants enjoyed the game). CONCLUSIONS Our review provides an overview of how games used for the assessment of attention are developed and evaluated. We further identified three barriers to advancing the field: reliance on assumptions, lack of evaluation, and lack of integration and standardization. We then recommend the best practices to address these barriers. Our review can act as a resource to help guide the field toward more standardized approaches and rigorous evaluation required for the widespread adoption of assessment games.

Physiological sensing has been a prominent fixture in games user research (GUR) since the late 1990s, when researchers started to explore its potential to enhance and understand experience within digital game play. Since these early days, is has been widely argued that "affective gaming"---in which gameplay is influenced by a player's emotional state---can enhance player experience by integrating physiological sensors into play. Reflecting in 2020 on these last 20 years of progress, we systematically review the field of affective gaming to answer whether or not it has met this promise. We create a framework (the affective game loop) to classify 162 publications (included from an initial search set of 52,834 results) within affective gaming, present findings on the current state of the field, and discuss how our findings, contextualized within the affective game loop, can guide the future of affective gaming.

Cognitive tasks are increasingly being gamified in an attempt to leverage the motivational power of games; however, they are sensitive to manipulation and literature is divided on how adding game elements affects participant performance and experience. We applied two popular gamification approaches (points/feedback and theme/narrative) to a typical cognitive task (the dot probe) and measured performance and experience in two studies (N1=287, N2=321). Similar to prior work, we confirm in Study1 that points increase reaction time and error rate, and positive affect. We replicated these results in Study2, and expanded our analysis to investigate participant experience. Our findings suggest that theme creates expectations of an interesting game, which gamified tasks fail to deliver, whereas points maintain enjoyment better throughout the task itself. Important for the development of gamified cognitive tasks, our findings suggest that novel approaches to gameful assessment may be better than the status quo.

Socializing is an important part of why people choose to play games and is at the core of many game mechanics. Anxiety and fear about social interactions can lead to withdrawal from socializing in the physical world, yet players with social anxiety preferentially choose MMORPGs — a highly social genre — raising questions of whether social anxiety expresses differently during in-game interactions. In the present study (N=181), we explore whether and how social anxiety translates into MMORPGs. By developing a measure of in-game social anxiety, we find that although fear and apprehension of socializing in the physical and game worlds are related, they differently affect preferences, behaviours, and experiences. Social anxiety in the physical world drives reasons for playing, whereas in-game anxiety affects behaviours, reducing participation in activities related to socializing and difficult in-game challenges. Our findings can inform the design of social games and the links between social anxiety and social gaming.

We share lessons learned from a collaborative in situ simulation of Ebola preparedness for a large health region. The lessons are to use proactive analysis, undertake in situ simulation, and have professionals in infection prevention and control and those in human factors collaborate. These lessons are applicable as generalizable concepts, not only to Ebola preparedness but also to other infectious diseases, including the “next Ebola.” Implementing these concepts will help contribute to improvements in both patient and provider safety.

The purpose of this study was to evaluate the safety and efficiency of a specific ambulance while providers delivered basic and advanced life support. Forty-eight, Emergency Medical Service (EMS) teams were observed delivering care to a simulated patient during an anaphylaxis scenario in a moving ambulance that contained a complete compliment of medical supplies and equipment. A detailed coding system was developed and applied to the audio and video behavioural data. Patterns of interaction among EMS personnel, the patient, equipment and the ambulance interior during the patient simulation scenario were analyzed. The results revealed a number of issues associated with the patient compartment including: potentially unsafe seated and standing positions; hazardous barriers to movement around the patient; difficulties accessing equipment and supplies; and the adequacy of work surfaces and waste disposal. A number of design recommendations are made to guide provider and patient comfort, efficiency and safety.

Objective An up-to-date meta-analysis of experimental research on talking and driving is needed to provide a comprehensive, empirical, and credible basis for policy, legislation, countermeasures, and future research. Background The effects of cell, mobile, and smart phone use on driving safety continues to be a contentious societal issue. Method All available studies that measured the effects of cell phone use on driving were identified through a variety of search methods and databases. A total of 93 studies containing 106 experiments met the inclusion criteria. Coded independent variables included conversation target (handheld, hands-free, and passenger), setting (laboratory, simulation, or on road), and conversation type (natural, cognitive task, and dialing). Coded dependent variables included reaction time, stimulus detection, lane positioning, speed, headway, eye movements, and collisions. Results The overall sample had 4,382 participants, with driver ages ranging from 14 to 84 years ( M = 25.5, SD = 5.2). Conversation on a handheld or hands-free phone resulted in performance costs when compared with baseline driving for reaction time, stimulus detection, and collisions. Passenger conversation had a similar pattern of effect sizes. Dialing while driving had large performance costs for many variables. Conclusion This meta-analysis found that cell phone and passenger conversation produced moderate performance costs. Drivers minimally compensated while conversing on a cell phone by increasing headway or reducing speed. A number of additional meta-analytic questions are discussed. Application The results can be used to guide legislation, policy, countermeasures, and future research.

The transmission of Ebola Virus (EV) to health care workers (HCW) has been documented in highly-resourced care settings, even with HCW use of personal protective equipment (PPE). This research describes an observational study involving simulated Ebola Virus Disease (EVD) patient scenarios in four tertiary acute care centers. Researchers recorded and analyzed audiovisual data to identify instances of potential HCW EV contamination. Video-analysis was based on a coding taxonomy developed in collaboration with Infection Prevention and Control (IPC) professionals. The analysis focused on events and actions associated with potential HCW contamination during doffing and PPE disposal, and contributing system factors. The events and actions identified included out-of-sync doffing teams, HCW deviations from doffing protocols, and improper disposal of doffed PPE including the compression of PPE in biomedical waste containers containing potentially contaminated sharps. These observations are discussed along with recommendations for the re-design of doffing procedural aids and waste disposal.