IntroductionIntravenous medication administration has traditionally been regarded as error prone, with high potential for harm. A recent US multisite study revealed few potentially harmful errors despite a high overall error rate. However, there is limited evidence about infusion practices in England and how they relate to prevalence and types of error.ObjectivesTo determine the prevalence, types and severity of errors and discrepancies in infusion administration in English hospitals, and to explore sources of variation, including the contribution of smart pumps.MethodsWe conducted an observational point prevalence study of intravenous infusions in 16 National Health Service hospital trusts. Observers compared each infusion against the medication order and local policy. Deviations were classified as errors or discrepancies based on their potential for patient harm. Contextual issues and reasons for deviations were explored qualitatively during observer debriefs.ResultsData were collected from 1326 patients and 2008 infusions. Errors were observed in 231 infusions (11.5%, 95% CI 10.2% to 13.0%). Discrepancies were observed in 1065 infusions (53.0%, 95% CI 50.8% to 55.2%). Twenty-three errors (1.1% of all infusions) were considered potentially harmful; none were judged likely to prolong hospital stay or result in long-term harm. Types and prevalence of errors and discrepancies varied widely among trusts, as did local policies. Deviations from medication orders and local policies were sometimes made for efficiency or patient need. Smart pumps, as currently implemented, had little effect, with similar error rates observed in infusions delivered with and without a smart pump (10.3% vs 10.8%, p=0.8).ConclusionErrors and discrepancies are relatively common in everyday infusion administrations but most have low potential for patient harm. Better understanding of performance variability to strategically manage risk may be a more helpful tactic than striving to eliminate all deviations.

Online citizen science projects have demonstrated their usefulness for research, however little is known about the potential benefits for volunteers. We conducted 39 interviews (28 volunteers, 11 researchers) to gain a greater understanding of volunteers' motivations, learning and creativity (MLC). In our MLC model we explain that participating and progressing in a project community provides volunteers with many indirect opportunities for learning and creativity. The more aspects that volunteers are involved in, the more likely they are to sustain their participation in the project. These results have implications for the design and management of online citizen science projects. It is important to provide users with tools to communicate in order to supporting social learning, community building and sharing. AbstractCitizen science; Informal learning; Public engagement with science and technology Keywords

Increasingly, games are being incorporated into online citizen science (CS) projects as a way of crowdsourcing data; yet the influence of gamification on volunteer motivations and engagement in CS projects is still unknown. In an interview study with 8 CS volunteers (4 from Foldit, 4 from Eyewire), we found that game elements and communication tools are not necessary for attracting new volunteers to a project; however they may help to sustain engagement over time, by allowing volunteers to participate in a range of social interactions and through enabling meaningful recognition of achievements.

HCI has become increasingly interested in the use of technology during diicult life experiences. Yet despite considerable popularity, little is known about how and why people engage with games in times of personal diiculty. Based on a qualitative analysis of an online survey (N=95), our indings indicate that games ofered players much needed respite from stress, supported them in dealing with their feelings, facilitated social connections, stimulated personal change and growth, and provided a lifeline in times of existential doubt. However, despite an emphasis on gaming as being able to support coping in ways other activities did not, participants also referred to games as unproductive and as an obstacle to living well. We discuss these indings in relation to both coping process and outcome, while considering tensions around the potential beneits and perceived value of gaming.

BackgroundLesbian, gay, bisexual, and transgender (LGBT) youth and other young people diverse in terms of their sexuality and gender (LGBT+) are at an elevated risk of mental health problems such as depression. Factors such as isolation and stigma mean that accessing mental health services can be particularly challenging for LGBT+ young people, and previous studies have highlighted that many prefer to access psychological support on the Web. Research from New Zealand has demonstrated promising effectiveness and acceptability for an LGBT+ focused, serious game–based, computerized cognitive behavioral therapy program, Rainbow Smart, Positive, Active, Realistic, X-factor thoughts (SPARX). However, there has been limited research conducted in the area of electronic therapy (e-therapy) for LGBT+ people.ObjectiveThis study aimed to explore how and why LGBT+ young people use the internet to support their mental health. This study also sought to explore LGBT+ young people’s and professionals’ views about e-therapies, drawing on the example of Rainbow SPARX.MethodsA total of 3 focus groups and 5 semistructured interviews were conducted with 21 LGBT+ young people (aged 15-22 years) and 6 professionals (4 health and social care practitioners and 2 National Health Service commissioners) in England and Wales. A general inductive approach was used to analyze data.ResultsLGBT+ youth participants considered that the use of the internet was ubiquitous, and it was valuable for support and information. However, they also thought that internet use could be problematic, and they highlighted certain internet safety and personal security considerations. They drew on a range of gaming experiences and expectations to inform their feedback about Rainbow SPARX. Their responses focused on the need for this e-therapy program to be updated and refined. LGBT+ young people experienced challenges related to stigma and mistreatment, and they suggested that strategies addressing their common challenges should be included in e-therapy content. Professional study participants also emphasized the need to update and refine Rainbow SPARX. Moreover, professionals highlighted some of the issues associated with e-therapies needing to demonstrate effectiveness and challenges associated with health service commissioning processes.ConclusionsLGBT+ young people use the internet to obtain support and access information, including information related to their mental health. They are interested in LGBT-specific e-therapies; however, these must be in a contemporary format, engaging, and adequately acknowledge the experiences of LGBT+ young people.