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Published on 16.6.2017 in Vol 6 , No 6 (2017) :June
Assessment of Active Video Gaming Using Adapted Controllers by Individuals With Physical Disabilities: A Protocol
Laurie A Malone 1 ; Sangeetha Padalabalanarayanan 1 ; Justin McCroskey 1 ; Mohanraj Thirumalai 1
Article Authors Cited by (3) Tweetations (4) Metrics
Laurie A Malone, PhD ;
Sangeetha Padalabalanarayanan, MS ;
Justin McCroskey, MEd ;
Mohanraj Thirumalai, PhD
University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
Laurie A Malone, PhD
University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative
1720 2nd Ave S.
Fax:1 205 975 7787
Email: lamalone@uab.edu
Background: Individuals with disabilities are typically more sedentary and less fit compared to their peers without disabilities. Furthermore, engaging in physical activity can be extremely challenging due to physical impairments associated with disability and fewer opportunities to participate. One option for increasing physical activity is playing active video games (AVG), a category of video games that requires much more body movement for successful play than conventional push-button or joystick actions. However, many current AVGs are inaccessible or offer limited play options for individuals who are unable to stand, have balance issues, poor motor control, or cannot use their lower body to perform game activities. Making AVGs accessible to people with disabilities offers an innovative approach to overcoming various barriers to participation in physical activity.
Objective: Our aim was to compare the effect of off-the-shelf and adapted game controllers on quality of game play, enjoyment, and energy expenditure during active video gaming in persons with physical disabilities, specifically those with mobility impairments (ie, unable to stand, balance issues, poor motor control, unable to use lower extremity for gameplay). The gaming controllers to be evaluated include off-the-shelf and adapted versions of the Wii Fit balance board and gaming mat.
Methods: Participants (10-60 years old) came to the laboratory a total of three times. During the first visit, participants completed a functional assessment and became familiar with the equipment and games to be played. For the functional assessment, participants performed 18 functional movement tasks from the International Classification of Functioning, Disability, and Health. They also answered a series of questions from the Patient Reported Outcomes Measurement Information System and Quality of Life in Neurological Conditions measurement tools, to provide a personal perspective regarding their own functional ability. For Visit 2, metabolic data were collected during an initial 20-minute baseline, followed by 40 minutes of game play. The controller (balance board or gaming mat) played was randomly selected. A set of games was played for 10 minutes, followed by 5 minutes of rest, and then another set of games was played for 10 minutes, followed by rest. Quality of game play was observed and documented for each set. During rest, the participant completed questions regarding enjoyment. Following the same procedures, the participant then played the two sets of games using the other version (off-the-shelf or adapted) of the controller. The entire procedure was repeated during Visit 3 with the controller that was not played.
Results: Enrollment began in February 2016 and ended in September 2016. Study results will be reported in late 2017.
Conclusions: We hypothesized that the adapted versions of the Wii Fit balance board and gaming mat would produce greater quality of game play, enjoyment, and energy expenditure in persons with mobility impairments compared to off-the-shelf versions.
Trial Registration: ClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by WebCite at http://www.webcitation.org/6qpPszPJ7)
JMIR Res Protoc 2017;6(6):e116
doi:10.2196/resprot.7621
video games; exercise; physical activity; disability; energy expenditure; enjoyment
Physical activity options for individuals with physical disabilities are limited, and existing community fitness programs and available exercise equipment are often inaccessible [1]. With these and other existing barriers (eg, transportation, program cost, staff knowledge), individuals with disabilities are more likely to be physically inactive [2-6] and demonstrate higher rates of obesity [7-11] than their counterparts without disabilities. Development of creative strategies by which to actively engage people with physical disabilities in leisure-time physical activity is vital given the high prevalence of physical inactivity and obesity in this population. One option for increasing the amount of physical activity acquired each week is to replace sedentary behaviors during leisure time with active video game (AVG) play [12-14].
Video game play typically requires only simple pushbutton or joystick actions for player engagement. AVGs, on the other hand, also known as exergames, refer to a category of video games in which game play, progress, and scoring require substantially greater levels of body movement. Since their introduction, AVGs have become popular with people of all ages and have been used in home, community, education, and rehabilitation settings to increase physical activity [13,15-20]. Furthermore, a growing body of literature indicates that AVGs show promise as an enjoyable physical activity alternative for individuals with physical disabilities—one that overcomes some of the common barriers to activity participation such as transportation and facility access [21-26].
It is important to determine whether AVGs can provide a level of physical activity commensurate with achieving health and fitness benefits. A few studies have reported that increases in energy expenditure can be achieved during AVG play in people with physical disabilities, more specifically those with mobility impairments such as cerebral palsy (CP) [27-30], spinal cord injury (SCI) [31,32], and stroke [33-35]. A study by Hurkmans et al [27] measured energy expenditure using indirect calorimetry in adults with CP during Nintendo Wii tennis and boxing games. Participants played in a standing position and achieved moderate intensity exercise during both games. Similarly, two AVG studies on ambulatory youth with CP found that participants were able to achieve moderate intensity exercise with various Nintendo Wii games [28-29] as well as Dance Dance Revolution [28]. A case study on two young adults with CP and one with spina bifida in which participants played Nintendo Wii games and Dance Dance Revolution (adapted for arm use) in a seated position found that only light intensity exercise was achieved during gameplay [30]. Another case study on two young adults with SCI measured heart rate during Nintendo Wii boxing in a seated position and recorded moderate intensity heart rate levels [31]. Additionally, a study of adults with SCI compared seated heavy bag boxing and AVG boxing and found participants achieved moderate intensity exercise levels during both types of boxing and reported AVG boxing to be more enjoyable [32]. Using the Borg Scale of Perceived Exertion, adults post-stroke scored a variety of Nintendo Wii and Sony PlayStation EyeToy AVGs played in a standing position as light to moderate intensity [34]. Two other studies on adults post-stroke using indirect calorimetry during Nintendo Wii [33,35] and Sony Xbox 360 [33] found AVG gameplay while standing to produce moderate intensity exercise. Kafri et al [33] also had participants post-stroke play Nintendo Wii boxing in both a standing and a seated position and found that in the sitting position participants approached anaerobic metabolism.
While it appears that AVGs hold promise as a means for improving health and fitness, there are technical issues associated with their access and utility in individuals with more severe physical disabilities. For instance, the studies noted above for individuals with CP and post-stroke were composed mostly of community ambulators with mild to moderate motor impairments. Unfortunately, however, for individuals with mobility impairments, specifically those who are unable to stand, have balance issues, poor motor control, or cannot use their lower body to perform game activities, gaming hardware for AVG play is typically inaccessible or the game itself offers limited play options [22-23]. AVGs using floorpad game controllers (eg, Dance Dance Revolution, Active Life Outdoor Challenge) have obvious accessibility limitations. The quick and precise motions required for successful AVG play using hand controllers (eg, Sony PlayStation Move motion controller, Nintendo Wii remote and nunchuck) limits their use for many people as well. Systems such as the Microsoft Xbox Kinect, which use a camera-based controller, also pose problems for successful gameplay, as they typically require the player to be standing for the game to function properly.
Rehabilitation engineers and assistive technology specialists have developed a variety of creative and successful adaptations to game controllers and interfaces that allow people with disabilities to play video games. However, successful adaptations of game controllers to allow people with mobility impairments to play AVGs require not only modifications to allow satisfactory game play but also redesigns to assure that the player with a disability experiences a similar level of energy expenditure. Making AVG hardware accessible for people with physical disabilities offers an innovative approach to overcoming a number of barriers to participation and provides an enjoyable and beneficial physical activity option. Our Rehabilitation Engineering Research Center on Interactive Exercise Technologies and Exercise Physiology for Persons with Disabilities (RERC RecTech) team developed two adapted controllers including an adapted balance board for Wii Fit as well as an adapted gaming mat.
Off-the-shelf (OTS) Wii Fit balance boards are designed for play to occur in a standing position. The small platform area (19.5 inches x 12 inches) is only large enough for a player to stand on with feet approximately shoulder width apart. In addition, because the board uses load cells to detect the player's weight and center of balance, all of the player's weight must bear on the top of platform. This makes the board less responsive to those who require the use of stabilization devices (eg, cane, walker) that bear on the floor around the platform and not usable for someone seated in a wheelchair. Furthermore, to fully engage in gameplay, the player must lean and maintain balance in all directions (forward, backward, side-to-side). To increase the level of usability for those with various forms of mobility impairment, an adapted balance board was designed to provide a large platform area (40 inches x 38 inches), built-in lateral stabilization supports (ie, handrails), and an adjustable sensitivity for shifting the center of balance.
Like the boards, OTS gaming mats are designed for players who can stand and have little to no lower extremity mobility impairment, having a 3 foot x 3 foot playing surface over which eight controller buttons and two menu buttons are widely distributed. This design poses several issues given that many players with mobility impairments would be better accommodated by playing in a seated position. The large playing surface makes it difficult to reach all of the buttons when seated at a table. Furthermore, the buttons are designed for high actuation force as would be common when used by a standing player, thereby becoming very difficult for use with the hands and/or fingers. In addition, the underlying design of the mat buttons is such that "dead" spots exist in the area of each button, which may not be triggered if a player were to try and depress a button with a couple of fingers rather than a whole foot or hand. To increase the level of usability for players with various forms of mobility impairment, an adapted gaming mat was designed with moveable Velcro buttons that could be positioned more closely to each other, with a gauge for reducing the actuation force required, and elimination of the dead spots resulting in a consistent button response over the entire button area.
Our aim was to compare the effect of off-the-shelf and adapted game controllers on quality of game play, enjoyment, and energy expenditure during active video gaming in persons with physical disabilities, specifically those with mobility impairments (ie, unable to stand, balance issues, poor motor control, unable to use lower extremity for gameplay). The gaming controllers evaluated included off-the-shelf and adapted versions of the Wii Fit balance board and gaming mat.
Design and Setting
All aspects of the study took place at Lakeshore Foundation in Birmingham, Alabama. Lakeshore Foundation is a community organization that provides physical activity, sport, and recreation opportunities for individuals with physical disability and chronic health conditions. Within Lakeshore is the Exercise and Sport Science Laboratory, which houses a variety of equipment dedicated to comprehensive health promotion and sport science research. For the purposes of this study, participants came to the lab a total of three times.
Following distribution of a flyer, the project recruitment coordinator answered calls or met with interested individuals. At that time, she reviewed the inclusion and exclusion criteria with them using a screening form to determine if they were eligible to participate. Our aim was to enroll 80 participants (15 youth, aged 10-17 years; 65 adults, aged 18-60 years) into the study. Participants were included in the study if they had a confirmed diagnosis of lower extremity mobility limitation (eg, spina bifida, CP, muscular dystrophy, 1 year post-SCI, multiple sclerosis, stroke, or limb loss) with partial or full use of upper extremities and use of an assistive device (eg, cane, walker, wheelchair) or problems with gait, balance, and/or coordination. Participants were excluded if they had an unstable cardiovascular condition, a visual impairment that interferes with playing video games (eg, complete blindness; inability to read game commands on a 52-inch television screen from a distance of 10 feet), or weighed over 350 lbs including their assistive device.
During the first visit, informed consent/assent was obtained and demographic and health history information was documented. We conducted an assessment of each participant's functional ability as described below. In addition, participants were familiarized with the equipment (Cosmed K4b2 portable metabolic system) used for the study and the video games that would be played during subsequent visits. Participants played a portion of or the entire game for all those that would be used during testing.
For assessment of physical function, which was conducted during the first visit, each participant performed 18 functional tasks from the International Classification of Functioning, Disability and Health (ICF) [36,37]. Participants completed each task individually and were scored according to their difficulty in completing the task on a scale ranging from 0-4. As defined in the ICF manual, the scoring was as follows: 0=No difficulty, 1=Mild difficulty, 2=Moderate difficulty, 3=Severe difficulty, and 4=Complete difficulty. The specific ICF tasks selected for use in this study were based on a consensus among the research staff. Following observations during pilot testing, staff selected mobility activities listed in the ICF that had the potential to be required for AVG play (eg, standing, reaching, throwing, and jumping). Tasks were grouped to assess participants' lower extremity function and trunk control, and upper extremity function (Table 1). Scores for upper and lower function were obtained by adding the numeric value received on each of the tasks performed. A higher physical function score indicated less functional ability on the selected tasks. Answer to a single question, one for ambulatory and one for wheelchair use, stood alone to represent general mobility.
Table 1. Select ICF mobility activities assessed to calculate mobility function scores relevant to AVG play for each participant.
Category ICF code ICF mobility activity ICF activity description Test instructions given to participant
Lower Extremity and Trunk Control
d4101 Squatting Getting into and out of the seated or crouched posture on one's haunches with knees closely drawn up or sitting on one's heels, such as may be necessary in toilets that are at floor level or changing body position from squatting to any other position such as standing up. "Cross your arms on your chest, and crouch down and touch your buttocks on top of the risers and stand back up. If you can, keep your arms crossed."
d4103 Sitting Getting into and out of a seated position and changing body position from sitting down to any other position, such as standing up or lying down. Participant able to stand: "Please sit down in this chair and then stand back up." Participant unable to stand: "Please lie down and then sit up. Now lie back down."
d4104 Standing Getting into and out of a standing position or changing body position from standing to any other position, such as lying down or sitting down. "Please stand up from the chair and then sit back down."
d4105 Bending Tilting the back downwards or to the side, at the torso, such as in bowing or reaching down for an object. "Please bend forward and reach for the tape."
d4106 Shifting the body's center of gravity Adjusting or moving the weight of the body from one position to another while sitting, standing or lying, such as moving from one foot to another while standing. "Shift your weight over to the left foot (hip if in chair) and come back to the center." Repeat with the right side.
d4351 Kicking Using the legs and feet to propel something away, such as kicking a ball. "Please kick the ball."
d4500 Walking short distances Walking for less than a kilometer, such as walking around rooms or hallways, within a building or for short distances outside. "Walk from this piece of tape to the other one at the end of the room and stop when you get there." Distance is 10 m.
d4508 Walking other (marching in place) Not applicable "While standing bring your knees up to hip level one at a time, like you're walking up really big steps."
d4552 Running Moving with quick steps so that both feet may be simultaneously off the ground. "Run from this piece of tape to the other piece of tape at the end of the room." Distance is 10 m.
d4553 Jumping Moving up off the ground by bending and extending the legs, such as jumping on one foot, hopping, skipping, and jumping or diving into water. "Try to jump over this piece of tape to the other side of the floor." Colored tape on floor, 1.6 inches wide.
Upper Extremity Function
d4452 Reaching Using the hands and arms to extend outwards and touch and grasp something, such as when reaching across a table or desk for a book. A water bottle is placed on a table. Participant sits just within reaching distance of the table. "Reach for the water bottle and grab it without stepping (rolling) forward."
d4401 Grasping Using one or both hands to seize and hold something, such as when grasping a tool or a door knob. "Please pick the water bottle up and hold it."
d4300 Lifting Raising up an object in order to move it from a lower to a higher level, such as when lifting a glass from the table. "Please pick up the water bottle and raise it above your head."
d4453 Turning or twisting the hands or arms Using fingers, hands and arms to rotate, turn or bend an object, such as is required to use tools or utensils. A water bottle is placed in the participant's hands. "Please remove the lid from the bottle."
d4454 Throwing Using fingers, hands, and arms to lift something and propel it with some force through the air, such as when tossing a ball. A tennis ball is placed on the table directly in front of the participant. "Pick the ball up and throw it."
d4450 Pulling Using fingers, hands, and arms to bring an object towards oneself, or to move it from place to place, such as when pulling a door closed. The participant stands behind a marked spot on the floor. Using green exercise tubing, the tester hands the grip to the participant. Tester takes up the slack of the tubing but does not create tension in the tubing. "Please grab the hand grip and pull it toward you."
d4451 Pushing Using fingers, hands, and arms to move something away from oneself, or to move it from place to place, such as when pushing an animal away. A rolling chair is placed in front of the participant while they are seated. Tester steps back 4-5 ft and instructs the participant to push the chair away. "Push the chair towards me."
Select d4503 OR d465 depending on primary mode of mobility (ambulatory or wheelchair)
d4503 Walking around obstacles Walking in ways required to avoid moving and immobile objects, people, animals, and vehicles, such as walking around a marketplace or shop, around or through traffic, or other crowded areas. Three cones evenly spaced in a straight line. "Weave around the cones to the other end and then come back around the cones to the start line." Distance is 10 m. Participant performs this task walking with assistive device (eg, cane, crutches, walker) if needed.
d465 Moving around using equipment Moving the whole body from place to place, on any surface or space, by using specific devices designed to facilitate moving or create other ways of moving around such as with skates, skis, or scuba equipment, or moving down the street in a wheelchair or a walker. Three cones evenly spaced in a straight line. "Weave around the cones to the other end and then come back around the cones to the start line." Distance is 10 m. Participant performs this task using their own wheelchair.
In addition to the functional assessment, participants also completed a series of questions from the HealthMeasures resources [38], which were used as an assessment of the individual's own perspective regarding their functional ability. Questions came from the Patient Reported Outcomes Measurement Information System (PROMIS) and Quality of Life in Neurological Conditions (Neuro-QoL). For adults (18+ years of age), the series comprised questions from PROMIS short-form v1.0 Physical Function 20a and from PROMIS short-form v1.0 Physical Function Samples with Mobility Aid. For youth (10-17 years of age), the questions came from the PROMIS Ped short-form v2.0 Upper Extremity and Neuro-QoL PedScale v1.1‒LE Function (Mobility) scales. For adults, the questions asked how difficult a variety of daily tasks (eg, vacuuming, yard work, walking, bathing) were to complete (5-point scale, "without any difficulty" to "unable to do", 14 questions), whether their health limited them in their ability to complete certain activities (eg, carry groceries, strenuous sports, walking a mile) (5-point scale, "not at all" to "cannot do", 6 questions), and could they stand and move with and without support ("yes" or "no", 1 question; 5-point scale, "without any difficulty" to "unable to do", 10 questions). For youth, questions asked how difficult a variety of daily tasks (eg, get dressed, open school binder, bend, reach, walk, get on and off low chair) were to complete (5-point scale, "with no trouble" to "not able to do", 28 questions).
Visits 2 and 3
Visits 2 and 3 consisted of exercise testing to assess energy expenditure during AVG play. Upon arrival for these visits, participants were set up with the Cosmed K4B2 portable metabolic system and a Polar heart rate monitor to assess pulmonary gas exchange and indirect calorimetry. Data collection began with a 20-minute rest period to measure resting energy expenditure. For the rest period, participants sat quietly with no speaking or distractions besides light reading of a magazine or viewing their mobile phone. Next, gameplay began with continued Cosmed data collection.
The Nintendo Wii video game console was used for gameplay, with 3 separate video game discs including 1 video game disc for the Wii Balance Board (Wii Fit Plus, Nintendo) and 2 video game discs for the Wii Gaming Mat (Active Life Explorer and Active Life Outdoor Challenge, Bandai Namco Entertainment). Four game sets were created as outlined in Tables 2 and 3. The sets of games played on the balance boards are presented in Table 2, and those played on the gaming mats are presented in Table 3. The games selected for use in this study were chosen in an effort to provide moderate level physical activity during gameplay.
Table 2. Description of each AVG played using the OTS and adapted balance boards.
Mini games Description
Wii Fit Plus: Set A
Rhythm Kung Fu The participant follows the Kung Fu movements of avatar characters in time with the rhythm. Movements include left and right punches, two hand punches, and left and right kicks.
Rhythm Parade The participant marches in place to the rhythm of the parade while directing the parade with arm movements in coordination with the game.
Obstacle Course The participant marches in place to run the character through an obstacle course of swinging balls, moving platforms, and jumps.
Bird's-Eye Bull's-Eye The participant flaps their arms and moves their body to fly through the course landing on targets spread across the map.
Wii Fit Plus: Set B
Island Cycling The participant marches in place on the board to pedal the bike throughout the map while capturing flags that are spread across the island.
Penguin Slide The participant catches fish by leaning left and right on the balance board to control the avatar.
Hula Hoop The participant rotates their trunk/hips in a circular motion on the board to control the avatar hula hooping.
Ski Slalom The participant skis down the slope by leaning left and right to control the avatar skiing the course.
Table 3. Description of each AVG played using the OTS and adapted gaming mats.
Active Life Explorer: Set C
Crocodile Stomper The participant steps on or hits the crocodiles on the game by pressing the corresponding mat button.
Air Plane Panic The participant steps on or hits the button prompts as they fly an airplane across a course.
Kraken Battle The participant steps on or hits the button prompts as they fight a kraken in attempt to defeat the boss.
Mummy's Tomb The participant runs in place to escape the mummy as the character attempts to escape with the gold.
Jungle Vine Ruins The participant runs in place and jumps to navigate the character through the ruins.
Active Life Outdoor Challenge: Set D
Sprint Challenge The participant runs in place to sprint and finish the course.
Jump Rump The participant jumps in place to control the character jump roping.
Conveyor Belt Runner The participant runs in place and jumps over obstacles to navigate the character through the course.
Log Leaper The participant jumps in place to control the character jumping over the logs.
Hurdles The participant runs in place and jumps to navigate the character through the hurdles.
The controller (Wii balance board or gaming mat), version of the controller (adapted or OTS), and order of the game sets (Board: Game Set A or B; Mat: Game Set C or D) were determined by the participant drawing one of two small pieces of paper out of a cup, which had a number on it (1 or 2). At the start of the second visit, the participant would first draw a number out of the cup to determine which controller (balance board or gaming mat) they would use for that visit. The non-selected controller was played on the subsequent visit. After placing the number back in the cup, the participant would then pull a number to determine which version of the controller they would play first (adapted or OTS). Finally, the participant would draw a number to determine which game set (Board: Set A or B; Mat: Set C or D) they would play first. For the gaming mat, whichever game set was selected first would be played on both versions of the mat (adapted and OTS), and then the second game set would be played on each version. For the balance board, which was difficult to switch between versions because of connectivity and being time consuming, participants played the two set of games on one version (adapted or OTS) and then played on the other version. For each session, gameplay consisted of four 10-minute sets with a rest period of 5 minutes after each game set (Table 4). Visit 3 consisted of the same protocol using the controller that was not played during the previous visit, with numbers drawn for order of play regarding version of the controller and game sets. Data collection for each visit took approximately 75 minutes as follows: baseline energy expenditure‒20 minutes; gameplay‒4 sets x 10 min=40 minutes; rest periods between games‒3 periods x 5 minutes=15 minutes.
Table 4. Example of randomized AVG play during balance board session.
Controller Activity Time (minutes)
Adapted Balance Board Gameplay: Set B 10
Adapted Balance Board Gameplay: Set A 10
OTS Balance Board Gameplay: Set B 10
OTS Balance Board Gameplay: Set A 10
During gameplay, research staff observed and rated ability to use the game controller (mat or board) and quality of gameplay during each visit. Ability to use the game controller assessed the participant's difficulty/ease of using the controller as required for the game and was rated on a scale of 0-5 (0=Unable, 1=Extreme difficulty, 2=Severe difficulty, 3=Moderate difficulty, 4=Mild difficulty, 5=No difficulty). To assess quality of game play, research staff considered the participants' degree of general game manipulation and user actions as prompted by the game in comparison to how a gamer without a physical disability would play. Quality of gameplay ranged on a scale from 0-5 (0=Unable, 1=Poor, 2=Fair, 3=Moderate, 4=Good, 5=Excellent). Two research staff worked together for all testing sessions, both recorded scores for quality of gameplay and controller usage, and came to a consensus for the final scores at the end of the session. All sessions were videotaped, so in the event that testers could not come to a consensus, the recording would be available for review.
At the end of each game set, participants reported their rating of perceived exertion on a scale from 0-10, with 0=Not Tired at All and 10=Very, Very Tired. During rest periods, participants completed a feedback survey that included the Physical Activity Enjoyment Scale (PACES) [39]. The PACES includes 16 statements such as "I enjoyed it," "It was very exciting," "I felt bored," and "It was no fun at all." All items were rated by the participant on a 5-point scale ranging from 1=Strongly Disagree to 5=Strongly Agree. After reverse scoring 7 items, a final score was computed by calculating the average of the 16 items.
Enrollment started in February 2016 and ended in September 2016. Study results will be reported in late 2017. Outcomes of interest include quality of game play, enjoyment, and energy expenditure. As part of the data analysis, paired comparisons using parametric paired t tests will first be conducted. If assumptions of normality are violated then the use of nonparametric tests will be explored. In addition, regression models will be fit that account for covariates such as age and gender. We will evaluate if there is an effect modification by including interaction terms for gender and age. If there is no statistical significance at .05 level for effect modification, an adjustment will be made for these covariates and findings reported based on models that include age and gender as main effects. All statistical testing for prespecified analyses will be conducted at .05 level. Additional post-hoc comparisons will also be conducted and reported. The original P value and number of comparisons computed will be reported so that appropriate multiple testing can be performed.
Principal Considerations
AVGs can provide a fun and engaging activity for improving health and fitness; however, there are technical issues associated with their access and utility for individuals with physical disabilities. The objective of our study is to compare the effect of OTS and adapted game controllers on quality of game play, enjoyment, and energy expenditure during active video gaming in persons with physical disabilities, specifically mobility impairments. The gaming controllers under evaluation include OTS and adapted versions of the Wii Fit balance board and gaming mat.
This is an observational study; therefore, inherent limitations exist and findings will not be generalizable to the broader community based on this study alone. All participants were recruited from the membership of a community physical activity and recreation center for individuals with physical disabilities. All participants were to some degree physically active and varied in their experience with AVGs. Although a familiarization period was provided, some degree of game play learning may have been occurring during data collection. In addition, participants played only a select group of AVGs. Therefore, potential differences in enjoyment and energy expenditure between OTS and adapted controllers may not have been fully captured. Future studies should expand the participant recruitment pool, examine a broader range of AVGs, provide a more extensive familiarization period, and compare AVG play utilizing the adapted controllers to other leisure-time physical activities,
We hypothesize that the adapted versions of the Wii Fit balance board and gaming mat will produce greater quality of game play, enjoyment, and energy expenditure in persons with mobility impairments compared to OTS versions. Making AVGs accessible to people with disabilities offers an innovative approach to overcoming a number of barriers to participation in physical activity.
The contents of this paper were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; grant number 90RE5009-01-00). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this article do not necessarily represent the policies of NIDILRR, ACL, HHS, and one should not assume endorsement by the federal government. Thanks to Whitney Neal and Brandon Kane for their assistance with this project as part of the research staff.
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Maloney AE, Stempel A, Wood ME, Patraitis C, Beaudoin C. Can dance exergames boost physical activity as a school-based intervention? Games Health J 2012 Dec;1(6):416-421. [CrossRef] [Medline]
Christison A, Khan HA. Exergaming for health: A community-based pediatric weight management program using active video gaming. Clin Pediatr (Phila) 2012 Apr;51(4):382-388. [CrossRef] [Medline]
Vallabhajosula S, Holder JB, Bailey EK. Effect of Exergaming on Physiological Response and Enjoyment During Recess in Elementary School-Aged Children: A Pilot Study. Games for Health Journal 2016 Oct;5(5):325-332. [CrossRef] [Medline]
McNulty PA. Games for rehabilitation: Wii-based movement therapy improves poststroke movement ability. Games Health J 2012 Oct;1(5):384-387. [CrossRef] [Medline]
Trinh T, Scheuer SE, Thompson-Butel AG, Shiner CT, McNulty PA. Cardiovascular fitness is improved post-stroke with upper-limb Wii-based Movement Therapy but not dose-matched constraint therapy. Top Stroke Rehabil 2016 Jun;23(3):208-216. [CrossRef] [Medline]
Malone LA, Rowland JL, Rogers R, Mehta T, Padalabalanarayanan S, Thirumalai M, et al. Active videogaming in youth with physical disability: Gameplay and enjoyment. Games Health J 2016 Oct;5(5):333-341. [CrossRef] [Medline]
Rowland JL, Malone LA, Fidopiastis CM, Padalabalanarayanan S, Thirumalai M, Rimmer JH. Perspectives on active video gaming as a new frontier in accessible physical activity for youth with physical disabilities. Phys Ther 2016 Apr;96(4):521-532 [FREE Full text] [CrossRef] [Medline]
Wiemeyer J, Deutsch J, Malone LA, Rowland JL, Swartz MC, Xiong J, et al. Recommendations for the optimal design of exergame interventions for persons with disabilities: Challenges, best practices, and future research. Games Health J 2015 Feb;4(1):58-62 [FREE Full text] [CrossRef] [Medline]
Rimmer JH, Lai B, Young HJ. Bending the arc of exercise and recreation technology toward people with disabilities. Arch Phys Med Rehabil 2016 Sep;97(9 Suppl):S247-S251. [CrossRef] [Medline]
Mat Rosly M, Mat Rosly H, Davis Oam GM, Husain R, Hasnan N. Exergaming for individuals with neurological disability: A systematic review. Disabil Rehabil 2017 Apr;39(8):727-735. [CrossRef] [Medline]
Deutsch JE, Guarrera-Bowlby P, Myslinski MJ, Kafri M. Is there evidence that active videogames increase energy expenditure and exercise intensity for people poststroke and with cerebral palsy? Games Health J 2015 Feb;4(1):31-37. [CrossRef] [Medline]
Hurkmans HL, van den Berg-Emons RJ, Stam HJ. Energy expenditure in adults with cerebral palsy playing Wii Sports. Arch Phys Med Rehabil 2010 Oct;91(10):1577-1581. [CrossRef] [Medline]
Howcroft J, Klejman S, Fehlings D, Wright V, Zabjek K, Andrysek J, et al. Active video game play in children with cerebral palsy: Potential for physical activity promotion and rehabilitation therapies. Arch Phys Med Rehabil 2012 Aug;93(8):1448-1456. [CrossRef] [Medline]
Robert M, Ballaz L, Hart R, Lemay M. Exercise intensity levels in children with cerebral palsy while playing with an active video game console. Phys Ther 2013 Aug;93(8):1084-1091 [FREE Full text] [CrossRef] [Medline]
Rowland JL, Rimmer JH. Feasibility of using active video gaming as a means for increasing energy expenditure in three nonambulatory young adults with disabilities. PM R 2012 Aug;4(8):569-573. [CrossRef] [Medline]
Roopchand-Martin S, Nelson G, Gordon C. Can persons with paraplegia obtain training heart rates when boxing on the Nintendo Wii? N Z J Physiother 2014 Mar;42(1):28-32 [FREE Full text]
Mat Rosly M, Mat Rosly H, Hasnan N, Davis GM, Husain R. Exergaming boxing versus heavy bag boxing: are these equipotent for individuals with spinal cord injury? Eur J Phys Rehabil Med 2017 Jan 13 [FREE Full text] [CrossRef] [Medline]
Kafri M, Myslinski MJ, Gade VK, Deutsch JE. Energy expenditure and exercise intensity of interactive video gaming in individuals poststroke. Neurorehabil Neural Repair 2014 Jan;28(1):56-65. [CrossRef] [Medline]
Neil A, Ens S, Pelletier R, Jarus T, Rand D. Sony PlayStation EyeToy elicits higher levels of movement than the Nintendo Wii: Implications for stroke rehabilitation. Eur J Phys Rehabil Med 2013 Feb;49(1):13-21 [FREE Full text] [Medline]
Hurkmans HL, Ribbers GM, Streur-Kranenburg MF, Stam HJ, van den Berg-Emons RJ. Energy expenditure in chronic stroke patients playing Wii Sports: A pilot study. J Neuroeng Rehabil 2011 Jul 14;8:38 [FREE Full text] [CrossRef] [Medline]
World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization; 2001. URL: http://www.who.int/classifications/icf/icf_more/en/ [accessed 2017-06-12] [WebCite Cache]
World Health Organization. How to use the ICF: A practical manual for using the International Classification of Functioning, Disability and Health (ICF). Exposure draft for comment. Geneva: World Health Organization; 2013. URL: http://www.who.int/classifications/drafticfpracticalmanual.pdf [accessed 2017-06-06] [WebCite Cache]
HealthMeasures: Transforming How Health is Measured.: Northwestern University URL: http://www.healthmeasures.net/ [accessed 2017-02-01] [WebCite Cache]
Moore JB, Yin Z, Hanes Jr J, Duda J, Gutin B, Barbeau P. Measuring Enjoyment of Physical Activity in Children: Validation of the Physical Activity Enjoyment Scale. J Appl Sport Psychol 2009 Jan 01;21(S1):S116-S129 [FREE Full text] [CrossRef] [Medline]
ACL: Administration for Community Living
AVG: active video game
CP: cerebral palsy
HHS: Department of Health and Human Services
ICF: International Classification of Functioning, Disability and Health
Neuro-QoL: Quality of Life in Neurological Conditions
NIDILRR: National Institute on Disability, Independent Living, and Rehabilitation Research
OTS: off-the-shelf
PACES: Physical Activity Enjoyment Scale
PROMIS: Patient Reported Outcomes Measurement Information System
SCI: spinal cord injury
Edited by G Eysenbach; submitted 01.03.17; peer-reviewed by S Jeske, K Ng; comments to author 21.03.17; revised version received 04.04.17; accepted 05.04.17; published 16.06.17
©Laurie A Malone, Sangeetha Padalabalanarayanan, Justin McCroskey, Mohanraj Thirumalai. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 16.06.2017.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
Malone LA, Padalabalanarayanan S, McCroskey J, Thirumalai M
doi: 10.2196/resprot.7621 PMID: 28623186 PMCID: 5493786
JMIR Research Protocols ISSN 1929-0748


Welcome to Lyons Road Family Chiropractic - your local Canada Bay Chiropractor. We understand that the health of you and your family is so important. That's why we have developed an excellent system that provides cost effective care to address your health complaints. Chiropractors commonly help with musculoskeletal injuries and problems including back pain, sciatica, scoliosis, headaches and migraines. If you're looking for a chiropractor close to Canada Bay, the team at Lyons Road Family Chiropractic are looking forward to hearing from you.
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Results of a study released today by consumer risk management company ID Analytics show the use of alternative credit scores can significantly increase the number of people considered eligible for credit.
Millennials, immigrants and people with lower incomes are among the groups traditional methods find hard to score. Such methods use credit card, mortgage, student loan and auto loan records, but they do not avail themselves of such predictive items as utility, cable and wireless accounts, alternative lending records, checking accounts and other alternative data sources.
ID Analytics developed a two-part study that studied credit applicants at key lenders in auto, telecommunications, credit card and marketplace lending industries from 2012-2016 using its Credit Optics Full Spectrum. Through the use of alternative data they were able to predictively score 75 per cent of those previously deemed unscoreable. Between 10 and 40 per cent of those would have been seen as credit eligible without a risk increase.
A top-10 American credit card issuer's credit applications were assessed. ID Analytics determined six per cent of applicants previously considered unscoreable could have been activated with no additional risk to that lender. As many as half of applicants depending on the lender were considered to be subprime, but Credit Optics Full Spectrum classified 14 per cent of them as credit eligible.


Found 20 entries in 0.056 seconds.
What was your design process for designing all of the star systems for each of the worlds?
I am lucky enough to have on staff one of my good friends, Isaac. He actually introduced me to my wife. He sent me on a blind date with Emily. He was one of my students, my second year teaching the class. He's a really good friend. At the time, he was an illustrator for a video game company who was just interested in fantasy books. And he saw that there was a class at BYU and he was like, "I'm gonna take that."
He now works for me full-time. Though, fun story on this. You know how some people joke that in their marriage there's one person they could cheat with, like a celebrity? When I hired Isaac, he was like, "I will come and do things for you full time. But if Tad Williams ever asks me, I'm doing something for Tad Williams," his favorite book series. This summer, Tad Williams needed a map for the new Osten Ard books. Isaac is like, "So, I do maps for Sanderson." He's like, "Sure, do one for me. Great!" So Isaac's been working on that and it has been a dream come true for him.
Isaac and I, we sit down and we do brainstorming sessions for the art. He's done almost all of the symbols and maps in my books, except the ones that he commissions someone else to do because he wanted to get a different style for it or the first book, Elantris, I did the symbols. That's why the Elantris symbols are not quite as visually interesting as some of Isaac's. They fit the world but I drew those and my artistic chops are... So Isaac and I sit down, we brainstorm and we say, "What do we want this to look like? What's the feel of it?" So I'll outline what the planets and the world are and then he will bring up historical- like he went and got Renaissance star charts and said, "Do any of these work? What do you like?" We kind of narrowed it down to ones that have the right feel but I said, "I want it more like this, more like this." He took that and ran with it and gave me iterations. He's like, "Here's four different versions of a map for Scadrial. Which one do you like?" And then I'll give him that and he'll then do four iterations on that, saying, "Here are different designs of this. Which one of these do you like?" Anyone who's an artist knows that illustrators, that's what they do. So we come up with it and then I say, "This style, go," and then he does all the maps.
Speaking of The Scar, all the other names on the map refer to a specific planet, right? Roshar, Sel, Nalthis, etc. The scar, as far as know, is more a region, yet it uses the same typography as the planets. What's up with that?
Same typography because when I used other fonts, it looked way out of place. If there were more labels on this map, I would've used italics probably for this feature.
Footnote: This is from a private email exchange between Argent and Isaac Stewart.
Is Vax present (lurking) in any of the star systems explained in Arcanum Unbounded? Personally I think there will be more star systems that would be discovered in the future and Vax might be part of them. Comment?
RAFO for Vax. Yes, there might be more stars. The picture on the cover is the sight observed from one particular place.
RAFO. Let's just say that there are more planetary systems present in the existing star chart itself that you don't know yet.
Is Yolen present in the dragon constellation?
Roshar - Shardbearer (or maybe Herald). Pretty obvious, considering how dominant those are.
Nalthis - someone exhaling or giving Breath. Again, straightforward.
Threnody - a grieving woman? Because Threnody, like the other inner planets in the Threnodite system, all bear names related to grieving, mourning, that kind of stuff.
Taldain - a tree? Because of the importance of water on the world?
A one tree. This is a symbolic reference to the Shard that resides on that world. The Coppermind says this: "Khriss writes that Bavadin supports a policy of strict isolationism for Taldain."
First of the Sun - a sailor? Because of how the natives live, traveling between the isles?
A fisherman, actually. He's throwing his net out among the stars.
Just repeating what I mentioned before in case I ever make this into a blog post. Sel's constellation is symbolic (as is the constellation Threnody is found in). As for the lamp, notice that Sel is not exactly part of the lamp. It's part of the flame. How does Aon Dor work? An Elantrian creates an opening for it to pour through and affect the world. Think of the flame as a symbol for the Dor. Does that make sense?
Scadrial - why is it absent? And is it really absent, or there but just not labeled (for whatever reason)?
Scadrial's there. It's just part of the constellation I've been calling the Giver. Some worlds are closer together than others, so there wasn't room to give each world its own constellation.
I know I mentioned my tattoo that I wanted to get yesterday, and I was wondering what, cause I want the planets that feature in that system to be colored and everything is black and white, and so I was wondering what color I could get for each of them.
Wow, ok, I don't know if I can answer that right here, you probably want to email that to us. I can give you an off the cuff answer. I don't know if it'll be like a canonical answer or something like that. Give them to me and I'll tell you what my instincts say.
I would do Sel as a blue color. Probably a light blue.
Nalthis i would do as like a vibrant pink, orange, or something like that.
Taldain I would do as yellow.
Would I do like the half and half or?
I would do half and half, yeah, or if you wanna do black and white. Black and white would work very well for them.
Scadrial I would do as a rust red, like a deep red.
I was thinking like a dark blue/green mix as well.
The problem is you would want to do Roshar as either a brown or a Kholin blue. Probably a brown for the stone, so in that case you could Threnody as like a dark blue and you could do Sel as light blue. You don't have a green in there, so Sel could go green if you wanted it to.
I forgot to ask about Sixth of the Dusk.
Oh, that would be mostly water, so that's a blue one.
Vibrant blue. So we've got three blues. But you can change one of those to green, and I would say Sel goes green.
Like a grass green. Because a lot of people are concentrating on the *inaudible*.
Yet Sel gets a lamp?
Sel gets a lamp, yes.
Ask Isaac about that, he came up with the symbolism. And I like all the symbolism. But I would go to him about the symbolism of that. Ask him to write an essay for my website about it, because he has really cool-- Cause again, cause I said to him, "I want a star map" and I wasn't gonna put constellations on it, right? Just, the one in the back cover that doesn't have constellations, that's what I asked for and he came back and said "I did a constellation map with these things, what do you think?" and I'm like "that's cool! Can you explain these to me?" so I'm just gonna let Isaac go with that, he chose it, he chose the perspective and the point of view, so it's his map, and he's canon on that.
Footnote: You can find the follow-up conversation between Argent and Isaac Stewart in the Miscellaneous 2017 event.
Yes, we will do a star chart… Isaac is working on how to design those.
I had been thinking about the Cosmere constellations map, and why certain constellations are what they are. Some look pretty obvious to me - of course the one that includes Roshar would be a Shardbearer, and of course the one with Nalthis would be somebody exhaling or giving Breath. But others? Threnody is maybe a part of a grieving woman, so that could kind of make sense, but Sel being featured in a lamp?!
So I asked Brandon, and he said the constellations were all you. He also encouraged me to convince you to write an essay for the website about this map, but I wanted to see if you could answer some questions about this map.
Is this alright with you?
Thanks for the email. I'll try to answer some of your questions, and you're right, an essay about the map on the website might eventually be the way to go. (Got to find time to write it.) The constellations weren't really all me. I had several discussions with Brandon, who made many suggestions. Maybe he forgets how much input he had. :) Unless he means the actual lines of the constellations. Those are purely me.
Sel's constellation is symbolic (as is the constellation Threnody is found in). As for the lamp, notice that Sel is not exactly part of the lamp. It's part of the flame. How does Aon Dor work? An Elantrian creates an opening for it to pour through and affect the world. Think of the flame as a symbol for the Dor. Does that make sense?
Are the reds [in the cosmere star chart] anything to do with the red stuff in Bands of Mourning, the one where he goes and talks to Harmony?
It's more, if you look in the sky, in certain places, you will see red stars in the sky.
On the map here, are the other cosmere worlds on the map and just unlabeled, or is there a bigger map?
There are stars on there that are unlabeled that have inhabited planets around them.
Some stars are yellow, while others are red - is that significant?
Yes. There are other colors in there too.
Is there significance in the star chart there where Nalthis and Scadrial are connected? They're the only ones that are.
I'm gonna say, not huge significance. We didn't put that in as an Easter egg, it was more like, "This looked right."
Is the relative positioning of the constellations' images significant in any way? For example, the Shardbearer is pointing his blade at the dragon/serpent/monster of the Scar, while Nalthian lady looks like she is blowing Sel's fire out. Do we need to be paying attention to those?
This is more compositional than anything else. Though I wouldn't discount their positions entirely.
How old is that picture that's hanging in Silverlight?
The picture in Silverlight is... Okay, so on cosmere-times it's very recent. But, the cosmere scale is very large. Khriss's essays are older than it, but not by much. She had that-- It is in existence when she wrote the essays, but the essays are much older than Sixth of the Dusk. Okay? Sixth of the Dusk had not happened yet, that story, when she was writing these essays. We're going to need some dating periods, we'll eventually get that.
Do the constellations have actual names you can share with us?
Clockwise from Threnody: the Mourner, the Dragon, the Fisherman, the Giver, the Lamp, the Knight, and the One Tree. The names are a bit generic, mostly because they are working names I used to refer to the different constellations during the process of painting the piece. It should be noted that the people from the spot in the Cosmere where the night sky does look like this would not see these pictures in the constellations nor give them these names. The pictures the patron saw in the stars here are based on their own observations and knowledge about the Cosmere as a whole. The locals would see entirely different pictures in their stars, for those who can even see the stars from their vantage.
One tidbit I should mention is that the lamp used to be a constellation called the Lover and was a man receiving breath from the Giver. I dropped it mostly because it's reference to Devotion wasn't working visually. Another thing to note: Not all the stars on this chart are physically within the Cosmere. Some are in the parts of Space beyond the Cosmere.
Does Silverlight have a permanent Perpendicularity on it?
Silverlight has weird. So I'm gonna give a RAFO to that.
It's got a physical constellation map. So they've gotta go to the Physical somehow right?
No, no, no. That can be in the Cognitive Realm.
The constellation map can be a picture from the Cognitive?
Well, yeah, I mean, it can be a picture in the Cognitive. That is a picture that exists in Silverlight.
Right, sure, but they need to be somewhere to view those things.
Right, I didn't say that that's from the perspective Silverlight, but what we say is the picture is hanging there.
So that was a mis-interpretation on our part.
Yeah, the picture is hanging there in Silverlight. Okay?
Is there actually anything on the Physical end of Silverlight?
That is-- That's the RAFO part... That's what I'm not answering. If there's anything Physical. There can't be a Perpen--well, there could be a Perpendicularity, but then you'd have to go someplace in the Physical, and it gets all-- Silverlight is really weird.
You know we have-- I actually have that same Ankh-Morpork map and I'm like "We gotta do something like this" but it's-- that's down the road because that is so detailed.
The thing that I would like to do would be a cosmere star chart, that's large scale, but we have to get a little further, introduce you to a few more planets before we can do that.
At the very front cover of the Arcanum Unbounded there is a constellation map, that has a lot of the cosmere stars on it. What point-of-view is that from?
So the question is, in Arcanum Unbounded... Yes, the cover of Arcanum Unbounded has a star chart in it, a map. And the question is, is this from a specific viewpoint, and if so, what is that viewpoint. So, yes, it is from a specific viewpoint. It's the sky as seen from-- Some of the stars are enhanced a bit-- But it's the sky as seen from a specific point of reference that Isaac came up with when I told-- gave him this assignment. He's my illustrator for a lot of the interior art of the books and he RAFO'd it when we were asked at the release party. So I'm going to RAFO it until he decides he wants to reveal it.
What perspective is this constellation map seen/drawn from? Somebody from an earlier signing in this tour said they spoke with you about this, and you mentioned Silverlight, but not exactly... I got the impression that your reply wasn't transcribed verbatim Can you address the perspective issue here? We now know that Silverlight is in the Cognitive Realm (where the stars don't necessarily match their physical arrangement, if they are visible at all), so if you worried about accidentally revealing that earlier, it's no longer an issue.
The map was created to reside in Silverlight and represents a partial view of the night sky from a point we have not yet revealed. So, no, this is not a view of the night sky from Silverlight. This is a mural painted for a patron whose travels have taken them far far afield.


Plaintiff MICHAEL F. MAYO-SMITH M.D.
Case Description Michael Mayo-Smith submitted a FOIA request to the Veterans Health Administration for records concerning an Office of Accountability and Whistleblower Protection report on the Manchester, New Hampshire VA Medical Center. The agency acknowledged receipt of the request, but after hearing nothing further from the agency, Mayo-Smith filed suit.


text:
Follow Kelly McGillis
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We Are What We Are Trailer
Frank Parker is a formidable and highly religious man who takes his family traditions very seriously. He, his wife and two daughters Rose and Iris live comfortably in a small shack in a remote part of the Delaware County, but their security is threatened when a disastrous storm strikes and the river begins to flood. Mrs Parker suffers from a rare neurological disease and soon passes away leaving her family devastated. They vow to carry on the family customs, however, as Frank lands Iris with a huge responsibility. They are ritualistic cannibals, and she must be the one to bring in the food this time. However, when bones wash up on a nearby river bank after the floods, the authorities are drawn near and suspicion starts to arise surrounding the mysterious family.
Continue: We Are What We Are Trailer
We Are What We Are Review
Even though this is an extremely well-made film, it's difficult to know who will enjoy it, as it's far too arty for horror genre fans and much too grisly for arthouse moviegoers. But those who like something a bit different will enjoy it, especially since this remake takes a very different approach to the original 2010 Mexican film. Both films are about families who indulge in cannibalism as a long-standing tradition, but the similarities end there.
This version is set in small-town America, where an unusual number of young women have gone missing over the years, and a recent flood has unearthed human remains downriver from the Parker family farm. Frank Parker (Sage) is in mourning after his wife dies in the storm, and responsibility for the family's Lambs Day feast now falls to eldest daughter Iris (Childers), assisted by younger siblings Rose and Rory (Garner and Gore). But Iris is reluctant to carry out the gruesome tradition, and would rather hang out with cute young Deputy Anders (Russell). Meanwhile, Frank is increasingly worried about nosey neighbour Marge (McGillis) and the investigations of the local doctor (Parks) and sheriff (Damici).
"This is what we do," the Parkers remind themselves as they prepare their dinner of human stew. And screenwriters Mickle and Damici really dig into the family's past, which stretches to events nearly 240 years earlier, stirring American history into the intriguing cultural subtext. Mickle also remembers to freak us out with hints and suggestions in every scene, from ominous noises in the Parker's shed to a secret journal that outlines the family's traditions. The actors play their roles just below the surface, with muted emotions and subtle glances that tell us more than dialogue ever could.
Continue reading: We Are What We Are Review
Top Gun Trailer
Maverick is a reckless but extremely skilled fighter pilot whose father died after his plane was shot down in the Vietnam War. Because of his talent, he is asked to attend the Top Gun school with co-pilot Goose. It is there he competes to be the top student on the program while simultaneously attempting to woo his chief instructor Charlie Blackwood who, although appearing critical at first, secretly admires his flying methods. His journey to become the greatest pilot in the world is tarnished with tragedy and the frustration that rumours of his father dying due to his own errors could be true.
This classic romantic drama flick will soon be available to own on Blu-Ray from February 19th 2013. The movie was based on the California magazine article 'Top Guns' by Ehud Yonay and directed by Tony Scott ('Beverly Hills Cop II', 'Enemy of the State', 'Domino') in 1986 with writing credits to Jim Cash and Jack Epps Jr. ('Dick Tracy', 'Anaconda'). It won an Oscar and a Golden Globe on its release as well as a Brit award for Best Soundtrack. 'Top Gun' will appear in 3D cinemas for six days only between February 8th and 13th 2013.
Starring: Tom Cruise, Kelly McGillis, Val Kilmer, Anthony Edwards, Tom Skerritt, Michael Ironside, John Stockwell, Barry Tubb, Rick Rossovich, Tim Robbins, Clarence Gilyard Jr., Whip Hubley, James Tolkan, Meg Ryan, Adrian Pasdar, Randall Brady, Duke Stroud & Frank Pesce
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Stake Land Trailer
In this world the most dangerous thing is to be alive!
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Top Gun Review
Anyone fondly remembering Top Gun as a prototypical action-packed Jerry Bruckheimer 'nad-fest probably hasn't seen it in awhile. Newly released as a mega-deluxe DVD, it's time to remember what Top Gun really is: From "You've Lost That Lovin' Feeling" to "Take My Breath Away," it's mushy love story first, fighter-pilots-in-training movie second.
Ironically, the early 1990s would bring to light the fact that carousing was what naval pilots seemed to do best: The 1986 Tailhook scandal occured during the same year Top Gun was released.
Continue reading: Top Gun Review
The Monkey's Mask Review
By Rob Blackwelder
"The Monkey's Mask" is an old-fashioned film noir murder mystery, complete with a hard-boiled private eye narrator, a pretty young victim, a host of nebulous suspects and a smoky, enigmatic femme fatale.
With whispered intensity, it oozes 21st Century Raymond Chandler ambiance as the detective probes the apparently gruesome strangulation slaying of a tormented poetry student, makes stunning discoveries about her sordid sex life and falls for the girl's voluptuous professor in spite of knowing full well it's a bad idea.
The film is a brilliantly modern homage to everything that was great about the golden era of gritty gumshoe flicks, with two significant twists: 1) its inventive, gorgeously coarse, full-color cityscape cinematography, and 2) the detective...is a woman.
Continue reading: The Monkey's Mask Review
Kelly Mcgillis And Girlfriend Joined In Civil Union
Rapist Apologises To McGillis
Kelly McGillis Movies
Frank Parker is a formidable and highly religious man who takes his family traditions very...
We Are What We Are Movie Review
Even though this is an extremely well-made film, it's difficult to know who will enjoy...
Maverick is a reckless but extremely skilled fighter pilot whose father died after his plane...
In this world the most dangerous thing is to be alive! Horror director Jim Mickle...
The Monkey's Mask Movie Review
"The Monkey's Mask" is an old-fashioned film noir murder mystery, complete with a hard-boiled private...

redpajama_set_name: RedPajamaCommonCrawl


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Component to display a big play button over the video.

## Inputs

| Input | Description |
|--- |--- |
| vgFor | Target media `id` property to play/pause the specified media. This parameter is optional and only necessary if you have more than one media registered into `VgAPI`. |

## HTML Definition

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           type="video/mp4">
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</vg-player>
```

redpajama_set_name: RedPajamaGithub


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Retroactive Name Changes in Astronomical Publications
by Macy Huston | Jun 11, 2021 | Current Events, Personal Experiences | 0 comments
If you're active on astronomy Twitter, you've probably seen a lot of discussion lately about academic journals' policies about retroactively changing names on publications. The labor and roadblocks in the process can add a great deal of difficulty to the academic lives of transgender and nonbinary* researchers. Many transgender people change their name from that assigned at birth to one that better fits their gender, but if they do so after having any work published they may face a difficult situation. In some journals, one can retroactively have publications corrected to show their true/chosen name. For other journals, people are left with the choice between either revealing their deadname and outing themselves, or no longer claiming certain past work on their CVs. Additionally, some cisgender astronomers may change their names for reasons such as marriage or religion.
There are two parts to resolving the disconnection between publications with different names. First, it can be difficult to find all of a person's past work by searching their current name, if certain publications still use their old name. But, even with this problem resolved, the problem of outing trans people remains when their old name is visible. So the second part of the solution is to have the instances of their previous name changed on old papers.
Some recent discussions were sparked by a series of tweets from Dr. Elspeth Lee. Her experiences caught the attention of many friends and allies, who have since been pushing for change (more on that later).
I have been informed that the policy of the publisher of MNRAS (OUP) is to update the HTML of a paper, but not the PDF for trans individuals. 1/4
— Elsie Lee (@EleeAstro) May 27, 2021
A&A have got back to me, their policy is to not change anything on the publication, quote: "A&A takes the position that what is published is published and cannot be altered…"
— Elsie Lee (@EleeAstro) June 1, 2021
The Committee on Publication Ethics (COPE) is currently developing guidance for author name changes after article publication. They have already, however, published a post led by Professor Tess Tanenbaum about five guiding principles and best practices for the process:
Accessibility: Name changes should not require legal documents or unnecessary labor from the author making the request.
Comprehensiveness: The change should remove all instances of the author's previous name from the publisher's records.
Invisibility: The change should not draw attention to the author's changed name or gender identity.
Expediency and simplicity: The process should be quick and non-bureaucratic.
Recurrence and maintenance: Publishers should regularly audit their materials to ensure that changed names are maintained.
Professor Tanenbaum also wrote an insightful article in Nature about why this matters to her and to other transgender astronomers.
Here are the policies of a few major astronomy publishers & article hosts (as of June 10, 2021):
American Astronomical Society (AAS) Journals (Astrophysical Journal, Astronomical Journal, Astrophysical Journal Letters, Astrophysical Journal Supplement Series, Planetary Science Journal, Research Notes) [IOP Publishing]: An author can fill out a form to request a name change, which does not require legal documentation or a reason for the request (more info here).
Astronomy & Astrophysics (A&A) [EDP Sciences]: Currently, no post-publication name changes are allowed. Note: On June 4, 2021 A&A tweeted that their editors are in contact with the EDP Board of Directors about changing this.
Monthly Notices of the Royal Astronomical Society (MNRAS) [Oxford University Press]: Currently, at an author's request, they will update their name on the HTML version but not the PDF. Note: They have stated on Twitter that they are working toward a solution with OUP.
arXiv.org [Cornell University]: An author may request a name change through the user support portal or their help email. They will incorporate name changes into the original LaTeX file and recompile PDFs.
Astrophysical Data System (ADS) [Harvard]: An author may email them all the names they have published under, and ADS will store the names as synonyms, showing results for all of the listed names when one is searched. They also plan to follow the COPE policies and change authors' names, regardless of whether the original publisher does so.
For information on more journals/publishers, check out this spreadsheet compiled by Dr. Jost Migenda with help from the community to track which follow COPE principles.
Trans authors' experiences
At the AAS Meeting 238, the Committee for Sexual and Gender Minorities in Astronomy (SGMA) met and discussed this issue. Jessica Mink from the Harvard & Smithsonian Center for Astrophysics presented the history and state of the issue, as well as her personal experiences. She acknowledged that much of this has been easier for her, as a senior astronomical software developer, than for early career people and those on the job market. She was able to get ADS updated very easily, as she personally knew and worked down the hall from the person responsible. All of her work on ADS can now be found by searching either her current or previous name. ORCiD is another way to help pull together publications, as each person is assigned a number that won't need to change when names do, but names are still used in citations, so it's not a complete solution.
Jessica made the personal decision not to change her name in previous publications because she is an activist and wants people to know she is trans. Dr. Anne Archibald transitioned near the start of graduate school, but had one paper published under her previous name, limiting how secretive she can be about being transgender. She decided early on to assume that everyone knows she is transgender and, now that she has a faculty position, has decided to be a bit more out as it could make a difference for younger trans astronomers. Professor Jan Eldridge has also changed her current name but not that on older publications. She has been publishing under her initials for some time (JJ), but plans to go back and get the older papers updated, especially those with her full old name.
A common theme among my conversations with transgender astronomers is that they have been able to make some progress on replacing their old name professionally, but they haven't been able to thoroughly have every old paper updated. Adding the synonyms on ADS seems to be one of the earliest/easiest steps for them, but certain publications just do not change names of past papers under any circumstances. These policies must be changed in order for transgender people to be safe and comfortable with the collection of their past work.
What is being done to fix this?
In early June 2021, a community of astronomers came together to push for change in these outdated policies. One personal action many astronomers have taken is somewhat of a boycott, where they refuse to review for or submit work to Astronomy & Astrophysics until they allow name changes. Coincidentally, one such astronomer, Professor Caroline Morley, received a request to review right as these conversations started and shared their response:
Ah, the moment for action doesn't usually come so quickly. Thanks for your openness @EleeAstro and for several people including @StellarPlanet who suggested that we could push back by withholding publications and/or the unpaid labor of peer review. Sent to the editor today! https://t.co/jl1GyurYNc pic.twitter.com/YMSYOOOa9S
— Caroline Morley (@AstroCaroline) June 2, 2021
PhD student Emily Hunt led a group of astronomers in writing an open letter to the A&A Board of Directors, which anyone can sign on to. They have had over 700 signatures as of Wednesday morning, June 9. At the SGMA meeting, members also shared that AAS journal editors and the Committee on the Status of Women in Astronomy (CWSA) are working on letters to the A&A and MNRAS editors. CWSA also shared a statement on their Women In Astronomy blog.
Many of the astronomers who contributed their experiences to this work have emphasized what a large allied and collaborative effort it has been to work toward improved policies. An easy thing allies can do to help is to have conversations with editors and colleagues to help them understand the issue and why it matters. In addition to the professional concerns of papers under multiple names, Professor Jan Eldridge emphasized that, "just that by recognizing the new name of a person who changes it re-affirms their identity. Beyond any of the other things it's a very simple way to accept and support a trans person."
*I have used the word "transgender" throughout the article to describe people who have changed their name due to their gender identity, but it is important to note that not all nonbinary people identify as transgender, and that not all transgender and nonbinary people change their names.
Edited by Alex Gough, Lili Alderson, Luna Zagorac
Cover image credit: Laurie Raye
About Macy Huston
I am a fifth year graduate student at Penn State University studying Astronomy & Astrophysics. My current projects focus on technosignatures, also referred to as the Search for Extraterrestrial Intelligence (SETI), and on microlensing searches for exoplanets.
Distilling Astronomy
star formation solar system dwarf galaxies AAS stars protoplanetary disks galaxy evolution planetary science astrophysics dark matter stellar evolution galaxies Kepler planet formation simulations observations theory binary stars black holes AGN habitability Milky Way exoplanets cosmology gravitational waves transits spectroscopy supernovae astronomy radio astronomy


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This entry is part of the PBM List.
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Home ENGLISH SECTION After Sunil Grover, Is Kapil Sharma's New Co-Star Raju Srivastava?
After Sunil Grover, Is Kapil Sharma's New Co-Star Raju Srivastava?
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