A serious-game for child sexual abuse prevention: An evaluation of orbit.

BACKGROUND: Greater public and professional awareness of the extent and impact of child sexual abuse (CSA) has prompted the inclusions of prevention initiatives within school curricula. However CSA education is not always soundly grounded in empirical evidence, and evaluations of the impact of programs often inadequate. OBJECTIVE: This paper reports on a randomized-control trial of an empirically informed serious-game for CSA prevention, for children aged 8-10 years. The study also evaluates the impact on learning of complementary classroom lessons and part completion of the Orbit game. PARTICIPANTS AND SETTING: The evaluation involved 139 students (female = 78; male = 61) aged 8-10 years (Mage = 9.64, SD = 0.33), from an elementary school in Queensland, Australia. METHOD: All children were pre-tested and post-tested (at 3 months) for knowledge of abuse prevention using the Children's Knowledge of Abuse Questionnaire-Revised (CKAQ-R-III), and a short form (SF) mapped to the learning objectives of Orbit . Children were assigned to one of three groups; i) play Orbit (n = 50); ii) play Orbit and CSA lessons (n = 55); and iii) control (n = 34). RESULTS: Children in the Orbit play, and Orbit play and lesson groups, significantly (p < .001) increased their CKAQ SF scores, whereas those in the control group did not. Furthermore, those children who completed all of Orbit significantly (p < .001) increased their post-test CKAQ scores, whereas those who didn't complete the game did not. CONCLUSIONS: This study shows the strength of a serious-games approach for school CSA prevention whilst reporting how child completion can impact learnings.

Examining key design decisions involved in developing a serious game for child sexual abuse prevention.

This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitizing game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken.

The crisis in human resources for health care and the potential of a 'retired' workforce: case study of the independent midwifery sector in Tanzania.

The human resource crisis in health care is an important obstacle to attainment of the health-related targets for the Millennium Development Goals. One suggested strategy to alleviate the strain upon government services is to encourage new forms of non-government provision. Detail on implementation and consequences is often lacking, however. This article examines one new element of non-government provision in Tanzania: small-scale independent midwifery practices. A multiple case study analysis over nine districts explored their characteristics, and the drivers and inhibitors acting upon their development since permitted by legislative change. Private midwifery practices were found concentrated in a 'new' workforce of 'later life entrepreneurs': retired, or approaching retirement, government-employed nursing officers. Provision was entirely facility-based due to regulatory requirements, with approximately 60 'maternity homes' located mainly in rural or peri-urban areas. Motivational drivers included fear of poverty, desire to maintain professional status, and an ethos of community service. However, inhibitors to success were multiple. Start-up loans were scarce, business training lacking and registration processes bureaucratic. Cost of set-up and maintenance were prohibitively high, registration required levels of construction and equipping similar to government sector dispensaries. Communities were reluctant to pay for services that they expected from government. Thus, despite offering a quality of basic maternity care comparable to that in government facilities, often in poorly-served areas, most private maternity homes were under-utilized and struggling for sustainability. Because of their location and emphasis on personalized care, small-scale independent practices run by retired midwives could potentially increase rates of skilled attendance at delivery at peripheral level. The model also extends the working life of members of a professional group at a time of shortage. However, the potential remains unrealized. Successful multiplication of this model in resource-poor communities requires more than just deregulation of private ownership. Prohibitive start-up expenses need to be reduced by less emphasis on facility-based provision. On-going financing arrangements such as micro-credit, contracting, vouchers and franchising models require consideration.

Critical assessment of a device to measure incisor crown inclination.

The aims of this study were to critically assess the use of a disposable device--the tooth inclination protractor (TIP)--to record incisor crown inclination and to compare its reliability and validity with that of traditional cephalometric radiographic analysis. The sample comprised 30 dental students with lateral cephalometric radiographs and dental casts. Four examiners were trained and calibrated to digitize radiographs and to use intraoral (on patients and dental casts) and extraoral (on dental casts) TIPs. The following angles were measured on the radiographs: maxillary incisor to maxillary plane, mandibular incisor to mandibular plane, maxillary incisor to occlusal plane, and mandibular incisor to occlusal plane. Measurements were also made with the TIP: maxillary incisor to occlusal plane and mandibular incisor to occlusal plane. All techniques were reliable between examiners. There were statistically significant systematic differences between the TIP and the radiographic assessments. The following differences were found. The TIP tended to record maxillary incisor crown inclination an average of 14 degrees less than maxillary incisor to maxillary plane. The TIP tended to record mandibular incisor crown inclination as similar to mandibular incisor to mandibular plane. The TIP recorded mandibular crown inclination 19 degrees less than mandibular incisor to occlusal plane. The disposable TIP was shown to be a simple, inexpensive, reliable, and valid method of assessing incisor inclination.