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Background: An emerging area of psycho-cardiology explores fear of disease progression in cardiac patients, following extensive research of this topic in psycho-oncology. Novel interventions that target cardiac fear of progression(FoP) may be valuable in bridging the gap between the high psychological support needs in cardiac care and limitations surrounding the efficacy of standard psychosocial treatments. However, there appears to be limited research characterizing FoP in cardiac patients with which to inform potential interventions. Aims: Using a mixed methods approach in two inter-related studies, we aimed to develop a preliminary conceptualization of cardiac-FoP. Methods: Study 1 involved a scoping review of existing qualitative research to identify the range of fears relating to disease progression reported by cardiac patients. Study 2 investigated the prevalence and distress levels associated with a selection of fears identified in Study 1 through a quantitative study of 194 cardiac patient admissions at two Australian hospitals. Results: Study 1 conceptualized cardiac-FoP in two ways, by the content of the fears and by the behavioral responses to the fears. Fears were categorized into seven broad domains: fears associated with death, health, interpersonal relationships, treatment, accessing help, role responsibilities, and physical activity. Five categories of behavioral responses were identified: avoidance, hyperawareness, symptom misattribution, seeking help, and lifestyle changes. Study 2 indicated a high prevalence of fear, with an average endorsement of 40.9%. When fear was endorsed, an average of 45.2% of cardiac patients experienced moderate-to-severe distress. Discussion: This paper provides an initial conceptualization of FoP in cardiac patients, providing preliminary evidence of the rates of fear and associated distress in this population. Drawing on this conceptualization, unique measurement tools and interventions should be developed to

Social programs run by community organizations provide an important outlet for social connectedness among older adults. However, these programs were disrupted by the COVID-19 pandemic restrictions. In this study, we aimed to understand how community organizations used digital technologies to continue running social programs online for older adults during COVID-19. We conducted semi-structured interviews with 12 staff members from local councils, libraries, community groups and care providers. We found that the use of technology benefited organizations by revealing new program delivery opportunities, and by strengthening their social bonds with older adults. However, organizations experienced challenges when transitioning social programs online. Some organizations lacked financial and human resources to support online programs; staff needed to upskill themselves and put significant effort into transferring older adults online; and it was difficult to replicate in-person experiences in online settings. Staff developed ad-hoc strategies to help older adults participate by providing extra guidance and training to increase digital literacy, and by offering accessible technical support. We discuss the significance of continuing online social programs beyond the pandemic and the importance of scaffolding to enable the online participation of older people in social programs. We outline design considerations for technology-mediated social programs run by community organizations.

Within the last decade, Let’s Plays, recordings of gameplay with commentary by the person playing, have grown in popularity and attention. The current research examining Let’s Plays has focused on the contemporary popularity of the phenomenon on YouTube. However, the origins of Let’s Plays as an influential media practice have not been fully investigated. In order to address this gap, we conducted a series of interviews with 34 creators from the Something Awful LP subforum—commonly identified to have originated the media form. Transcripts of these interviews were analyzed using concepts of serious leisure studies and cultural/subcultural capital. As a form of serious leisure culture, the members of the Something Awful LP community displayed motivations related to extrinsic and intrinsic rewards, such as increased sense of self-worth and recognition. The analysis of this Serious leisure culture highlights how this subculture was subsequently adopted by larger YouTube communities.

Increasing numbers of people have turned to playing boardgames with physically distant friends and family via technological tools, particularly since the start of the COVID-19 pandemic. However, commercial hybrid digital boardgames (HDBs) are designed for co-located, rather than distanced, play and there is a need for more specific tools to support hybrid game design. This paper introduces the SMeFT Decks, a set of card decks to aid in the design of HDBs for distanced play, which support Story, Mechanism, Function and Technology. We describe the use of these cards for design ideation and demonstrate four game concepts for distanced play stemming from the use of these decks in participatory workshops. We report evaluative feedback from a pilot study and from 46 participants who used these cards across nine design workshops and reflect on what we learned from observing this process. Results suggest that the SMeFT Decks are a productive ideation tool for aiding in the design of HDBs for distanced play in collaborative workshop settings.

BACKGROUND: ME/CFS is a disorder characterized by recurrent fatigue and intolerance to exertion which manifests as profound post-exertional malaise. Prevalence studies internationally have reported highly variable results due to the 20 + diagnostic criteria. For Australia, the prevalence of ME/CFS based on current case definitions is unknown. OBJECTIVES: To report prevalence of ME/CFS in patients aged ≥ 13 years attending Australian primary care settings for years 2015-2019, and provide context for patterns of primary care attendance by people living with ME/CFS. METHODOLOGY: Conducted in partnership with the Patient Advisory Group, this study adopted a mixed methods approach. De-identified primary care data from the national MedicineInsight program were analyzed. The cohort were regularly attending patients, i.e. 3 visits in the preceding 2 years. Crude prevalence rates were calculated for years 2015-2019, by sex, 10-year age groups, remoteness and socioeconomic status. Rates are presented per 100,000population (95% confidence intervals (CI)). Qualitative data was collected through focus groups and in-depth 1:1 interview. RESULTS: Qualitative evidence identified barriers to reaching diagnosis, and limited interactions with primary care due to a lack of available treatments/interventions, stigma and disbelief in ME/CFS as a condition. In each year of interest, crude prevalence in the primary care setting ranged between 94.9/100,000 (95% CI: 91.5-98.5) and 103.9/100,000 population (95%CI: 100.3-107.7), equating to between 20,140 and 22,050 people living with ME/CFS in Australia in 2020. Higher rates were observed for age groups 50-59 years and 40-49 years. Rates were substantially higher in females (130.0-141.4/100,000) compared to males (50.9-57.5/100,000). In the context of the qualitative evidence, our prevalence rates likely represent an underestimate of the true prevalence of ME/CFS in the Australian primary care setting. CONCLUSION: ME/CFS affects a substantial

The ice-rafted-debris (IRD) record of the open Northwest Pacific points towards the existence of substantial glacial ice on the Northeast Siberian coast during the late Quaternary. However, the scale and timing of glaciation and de-glaciation remains controversial due to the dearth of both onshore and offshore records. Existing IRD data suggests at least one event of dynamic and abrupt change during mid-late Marine Isotope Stage (MIS 3) which mimics the massive collapse of the Laurentide ice sheet during Heinrich Events. It is uncertain whether other events of this magnitude occurred during the late Quaternary. Here we present a ∼160,000 yr IRD series, planktic foraminiferal counts and an age model, derived from a benthic O curve, radiocarbon dates and tephrochronology, from core ODP 1207A (37.79°N, 162.75°E), revealing the presence of low but episodic flux of IRD. We conclude that glacial Northwest Pacific icebergs spread further south than previously thought, with icebergs emanating from Northeast Siberia being transported to the transition region between the subpolar and subtropical waters, south of the subarctic front during at least the Quaternary's last two glacial periods. The episodic nature of the 1207A IRD record during the last glacial, combined with coupled climate-iceberg modelling, suggests occasional times of much enhanced ice flux from the Kamchatka-Koryak coast, with other potential sources on the Sea of Okhotsk coast. These findings support the hypothesis of a variable but extensive ice mass during the last glacial over Northeast Siberia, particularly early in the last glacial period, behaving independently of North American and Eurasian ice masses. In strong contrast, IRD was absent during much of the penultimate glacial Marine Isotope Stage (MIS) 6 suggesting the possibility of very different Northeast Siberian ice coverage between the last two glacial periods.

Just as each Dungeons and Dragons character is unique and special, so too is the face of each player. The Biometric D&D project explores how players’ facial biometrics can be used to generate playable characters for RPGs through a focus on D&D. We will use these generated characters to explore how the relationship between the generated character and the player’s own persona impacts the gameplay experience. Our goal for this research is to explore the experience of being assessed and constrained by facial biometric tools as a key component of an RPG.

Highlights: • NW Pacific ice-rafted debris found further south than previously thought. • Largest iceberg events were comparable in magnitude to N Atlantic Heinrich Events. • Iceberg flux to ODP Site 1207 was episodic throughout the late Quaternary. • Kamchatka-Koryak bergs frequently reached south of the N Pacific Subarctic Front. • Ice-rafting and climate contrast sharply between the last two glacial periods. Abstract: The ice-rafted-debris (IRD) record of the open Northwest Pacific points towards the existence of substantial glacial ice on the Northeast Siberian coast during the late Quaternary. However, the scale and timing of glaciation and de-glaciation remains controversial due to the dearth of both onshore and offshore records. Existing IRD data suggests at least one event of dynamic and abrupt change during mid-late Marine Isotope Stage (MIS 3) which mimics the massive collapse of the Laurentide ice sheet during Heinrich Events. It is uncertain whether other events of this magnitude occurred during the late Quaternary. Here we present a ∼160,000 yr IRD series, planktic foraminiferal counts and an age model, derived from a benthic O curve, radiocarbon dates and tephrochronology, from core ODP 1207A (37.79°N, 162.75°E), revealing the presence of low but episodic flux of IRD. We conclude that glacial Northwest Pacific icebergs spread further south than previously thought, with icebergs emanating from Northeast Siberia being transported to the transition region between the subpolar and subtropical waters, south of the subarctic front during at least the Quaternary's last two glacial periods. The episodic nature of the 1207A IRD record during the last glacial, combined with coupled climate-iceberg modelling, suggests occasional times of much enhanced ice flux from the Kamchatka-Koryak coast, with other potential sources on the Sea of Okhotsk coast. These findings support the hypothesis of a variable but extensive ice mass during the last glacial over Northeast S

IntroductionDistress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event.Methods and analysisAn item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers; review of generic and condition-specific distress measures; focus group testing with cardiac rehabilitation professionals; feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI’s psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress.Ethics and disseminationApproved by the Monash Health Human Research Ethics Committee (approval number—RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups; academic and medical communities via publications and presentations; in the training of cardiac secondary prevention professionals; and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals.

This paper describes the intergenerational play of an Escape Room-style boardgame in a family setting. Through analysis of five key moments during play, it shows that this style of game is congruent with the ‘core’ model of family leisure, and highlights the importance of naïve operation to avoid privileging particular social and cultural knowledge as a prerequisite for successful completion of a game. This is important for the design of games that can be played by intergenerational groups, as it focuses attention on the play of the game rather than on prior, frequently age-dependent knowledge.

Background Safety at work is a core issue for mental health staff working on in-patient units. At present, there is a limited theoretical base regarding which factors may affect staff perceptions of safety. Aims This study attempted to identify which factors affect perceived staff safety working on in-patient mental health wards. Method A cross-sectional design was employed across 101 forensic and non-forensic mental health wards, over seven National Health Service trusts nationally. Measures included an online staff survey, Ward Features Checklist and recorded incident data. Data were analysed using categorical principal components analysis and ordinal regression. Results Perceptions of staff safety were increased by ward brightness, higher number of patient beds, lower staff to patient ratios, less dayroom space and more urban views. Conclusions The findings from this study do not represent common-sense assumptions. Results are discussed in the context of the literature and may have implications for current initiatives aimed at managing in-patient violence and aggression.

The practice of boardgaming is thoroughly material, with abundant pawns, cubes, cards, dice, tiles and other game components contained within the box. However, this rich material engagement is surrounded by a “digital hinterland” of online practices that sits behind and frames the way that boardgamers experience games and gaming. Although boardgames are, increasingly, playable in digital form, in this paper we focus on the digital practices that surround offline play but are not themselves play. Using the example of BoardGameGeek.com, we demonstrate that these practices provide an environment for knowledge-sharing, collaboration and co-operation in which participants accrue a form of gaming capital. We extend these findings to show that similar practices exist for other offline hobbies, notably reading (Goodreads.com) and yarn crafting (Ravelry.com).