New online stores and digital distribution methods have led to the development of alternative monetization models for video-games, such as free-to-play games with advertisements. Although there are many games using such models, until now the effect on the player experience from such interruptions has not been studied. In this controlled experiment, we requested that participants (N=236) play one of three different versions of a platformer game with: 1) no interruptions, 2) 30-second video advertisements, and 3) a multiple-choice questionnaire. We then evaluated the effects on the player experience. The study shows differences in their experiences, namely in: competence, immersion, annoyance, affects, and the reliability of the questionnaire answers. The contribution of this work is to identify which player experience variables are affected by interruptions, which can be valuable for selecting the business model and guiding the game design process.
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The research studies informal learning in cooperative art practices. It describes the way artists and artistically skilled amateurs get together to produce culture and in that way give shape and meaning to their own public lives. In many ways the "cooperative art practices" of these "communities of creative citizens" interrupt the habits of seeing, thinking and doing in our formal society that is based on economic functionalism, technologic reasoning and mediazation of public relations. These interruptions challenge further questioning of these habits developing a repertoire of alternative action that is based on subjective relations between people, things and the world. But above all these interruptions offer an opportunity for the participants to manifest themselves publicly, discuss their subjective human being and ultimately learn from that.First the dissertation explores literature on the power of imagination and a progressive force is contributed to art and the role of esthetics, symbolism and drama in our contemporary western society. Next it treats art as a social practice that creates opportunities for human growth and development. After an explanation of the methodological matters of the research the study continues with a report of three cases of learning and culture producing communities that are initiated and guided by artists. The social settings of these cases are analyzed according to their social features and subsequently investigated through the lens of pedagogical theory. The dissertation concludes with recommendations for artists, art institutions and policy makers who strive to promote the developmental quality of art.
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BACKGROUND: The use of drug round tabards is a widespread intervention that is implemented to reduce the number of interruptions and medication administration errors (MAEs) by nurses; however, evidence for their effectiveness is scarce.PURPOSE: Evaluation of the effect of drug round tabards on the frequency and type of interruptions, MAEs, the linearity between interruptions and MAEs, as well as to explore nurses' experiences with the tabards.STUDY DESIGN: A mixed methods before-after study, with three observation periods on three wards of a Dutch university hospital, combined with personal inquiry and a focus group with nurses.METHODS: In one pre-implementation period and two post-implementation periods at 2 weeks and 4 months, interruptions and MAEs were observed during drug rounds. Descriptive statistics and univariable linear regression were used to determine the effects of the tabard, combined with personal inquiry and a focus group to find out experiences with the tabard.FINDINGS: A total of 313 medication administrations were observed. Significant reductions in both interruptions and MAEs were found after implementation of the tabards. In the third period, a decrease of 75% in interruptions and 66% in MAEs was found. Linear regression analysis revealed a model R2 of 10.4%. The implementation topics that emerged can be classified into three themes: personal considerations, patient perceptions, and considerations regarding tabard effectiveness.CONCLUSIONS: Our study indicates that this intervention contributes to a reduction in interruptions and MAEs. However, the reduction in MAEs cannot be fully explained by the decrease in interruptions alone; other factors may have also influenced the effect on MAEs. We advocate for further research on complementary interventions that contribute to a further reduction of MAEs.CLINICAL RELEVANCE: We can conclude that drug round tabards are effective to improve medication safety and are therefore important for the quality of nursing care and the reduction of MAEs.
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Learning environment designs at the boundary of school and work can be characterised as integrative because they integrate features from the contexts of school and work. Many different manifestations of such integrative learning environments are found in current vocational education, both in senior secondary education and higher professional education. However, limited research has focused on how to design these learning environments and not much is known about their designable elements (i.e. the epistemic, spatial, instrumental, temporal and social elements that constitute the learning environments). The purpose of this study was to examine manifestations of two categories of integrative learning environment designs: designs based on incorporation; and designs based on hybridisation. Cross-case analysis of six cases in senior secondary vocational education and higher professional education in the Netherlands led to insights into the designable elements of both categories of designs. We report findings about the epistemic, spatial, instrumental, temporal and social elements of the studied cases. Specific characteristics of designs based on incorporation and designs based on hybridisation were identified and links between the designable elements became apparent, thus contributing to a deeper understanding of the design of learning environments that aim to connect the contexts of school and work.
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The number of people who combine work and unpaid care is increasing rapidly as more people need care, public and private care systems are progressively under pressure and more people are required to work for longer. Without adequate support, these working carers may experience detrimental effects on their well-being. To adequately support working carers, it is important to first understand the challenges they face. A scoping review was carried out, using Arksey and O’Malley's framework, to map the challenges of combining work and care and solutions described in the literature to address these challenges. The search included academic and grey literature between 2008 and 2018 and was conducted in April 2018, using electronic academic databases and reference list checks. Ninety-two publications were mapped, and the content analysed thematically. A conceptual framework was derived from the analysis which identified primary challenges (C1), directly resulting from combining work and care, primary solutions (S1) aiming to address these, secondary challenges (C2) resulting from solutions and secondary solutions (S2) aiming to address secondary challenges. Primary challenges were: (a) high and/or competing demands; (b) psychosocial/-emotional stressors; (c) distance; (d) carer's health; (e) returning to work; and (f) financial pressure. This framework serves to help those aiming to support working carers to better understand the challenges they face and those developing solutions for the challenges of combining work and care to consider potential consequences or barriers. Gaps in the literature have been identified and discussed.
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Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification (‘organization-related’, ‘prescriber-related’, ‘prescription-related’, ‘technologyrelated’ and ‘unclassified’) and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was ‘insufficient (drug) knowledge, prescribing skills and/or experience of prescribers’. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs.
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The American company Amazon has made headlines several times for monitoring its workers in warehouses across Europe and beyond.1 What is new is that a national data protection authority has recently issued a substantial fine of €32 million to the e-commerce giant for breaching several provisions of the General Data Protection Regulation (gdpr) with its surveillance practices. On 27 December 2023, the Commission nationale de l’informatique et des libertés (cnil)—the French Data Protection Authority—determined that Amazon France Logistique infringed on, among others, Articles 6(1)(f) (principle of lawfulness) and 5(1)(c) (data minimization) gdpr by processing some of workers’ data collected by handheld scanner in the distribution centers of Lauwin-Planque and Montélimar.2 Scanners enable employees to perform direct tasks such as picking and scanning items while continuously collecting data on quality of work, productivity, and periods of inactivity.3 According to the company, this data processing is necessary for various purposes, including quality and safety in warehouse management, employee coaching and performance evaluation, and work planning.4 The cnil’s decision centers on data protection law, but its implications reach far beyond into workers’ fundamental right to health and safety at work. As noted in legal literature and policy documents, digital surveillance practices can have a significant impact on workers’ mental health and overall well-being.5 This commentary examines the cnil’s decision through the lens of European occupational health and safety (EU ohs). Its scope is limited to how the French authority has interpreted the data protection principle of lawfulness taking into account the impact of some of Amazon’s monitoring practices on workers’ fundamental right to health and safety.
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