Occupational Science & Occupational Therapy - Journal articles
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Item Treatment effect analysis of the Frailty Care Bundle (FCB) in a cohort of patients in acute care settings(Springer, 2024) Crowe, Colum; Naughton, Corina; de Foubert, Marguerite; Cummins, Helen; McCullagh, Ruth; Skelton, Dawn A.; Dahly, Darren L.; Palmer, Brendan A.; O'Flynn, Brendan; Tedesco, Salvatore; Health Research Board; South South-West Hospital; Science Foundation IrelandPurpose: The aim of this study is to explore the feasibility of using machine learning approaches to objectively differentiate the mobilization patterns, measured via accelerometer sensors, of patients pre- and post-intervention. Methods: The intervention tested the implementation of a Frailty Care Bundle to improve mobilization, nutrition and cognition in older orthopedic patients. The study recruited 120 participants, a sub-group analysis was undertaken on 113 patients with accelerometer data (57 pre-intervention and 56 post-intervention), the median age was 78 years and the majority were female. Physical activity data from an ankle-worn accelerometer (StepWatch 4) was collected for each patient during their hospital stay. These data contained daily aggregated gait variables. Data preprocessing included the standardization of step counts and feature computation. Subsequently, a binary classification model was trained. A systematic hyperparameter optimization approach was applied, and feature selection was performed. Two classifier models, logistic regression and Random Forest, were investigated and Shapley values were used to explain model predictions. Results: The Random Forest classifier demonstrated an average balanced accuracy of 82.3% (± 1.7%) during training and 74.7% (± 8.2%) for the test set. In comparison, the logistic regression classifier achieved a training accuracy of 79.7% (± 1.9%) and a test accuracy of 77.6% (± 5.5%). The logistic regression model demonstrated less overfitting compared to the Random Forest model and better performance on the hold-out test set. Stride length was consistently chosen as a key feature in all iterations for both models, along with features related to stride velocity, gait speed, and Lyapunov exponent, indicating their significance in the classification. Conclusion: The best performing classifier was able to distinguish between patients pre- and post-intervention with greater than 75% accuracy. The intervention showed a correlation with higher gait speed and reduced stride length. However, the question of whether these alterations are part of an adaptive process that leads to improved outcomes over time remains.Item Play value of digital play spaces: children’s voices(Elsevier, 2024) Loudoun, Fiona M.; Boyle, Bryan; Larsson-Lund, Maria; Horizon 2020Play for plays sake emphasises the significance of how children characterise play opposed to any secondary purposes or benefits it may generate. The concept of play value draws attention to how the space in which children play proffers the experiences that children want. Increasingly, digital play experiences are emerging as spaces for play. This inquiry aims to examine the play value of digital spaces, specifically how play is afforded by the digital space from the perspective of children. Eight children aged 11 years old participated in seven focus groups, creating comic strips which were used to elicit discussions. Focus group analysis generated three themes with associated sub-themes which were collectively explained by the overarching theme of endless possibilities in play in digital spaces. This study provides a new understanding of how digital spaces affords play value from the child's perspective.Item Making choices in digital play spaces: children’s experiences(Taylor and Francis, 2023) Loudoun, Fiona M.; Boyle, Bryan; Larsson-Lund, Maria; Horizon 2020Background: Digital spaces are rapidly emerging as a space for children to engage in autotelicplay.Aim: To explore and describe children’s experiences of choice-making in their play in digitalspaces from the perspective of children themselves.Methods: Focus groups were conducted with a total of eight children aged six years of agewithin their school, in a large city in Ireland. A Mosaic Approach with drawing, cutting, andcolouring in was used to elicit the children’s voices to ensure their active engagement throughoutthe data collection. Data was analyzed using focus group analysis.Results: Data analysis revealed three main themes; children enjoy the ability to make choices intheir play, that they are often constrained in their ability to make choices, and that they negotiateways in which they can select options for play in digital spaces.Conclusions: Findings indicate that children are agentic individuals who are capable of makingdecisions in their play in digital spaces. This knowledge provides implications for OccupationalTherapists to enhance play as an occupation in digital spaces.Item Children’s experiences of play in digital spaces: a scoping review(Public Library of Science, 2022) Loudoun, Fiona M.; Boyle, Bryan; Larsson-Lund, MariaThe United Nations Convention on the Rights of the Child has substantiated play for play’s sake, thus focusing on the doing or being of play rather than any potentially desired outcomes. Examining this type of play from the perspective of the child acknowledges children as meaning-makers. A scoping review was conducted to expose and map the extent of the evidence available in the emerging and diverse field of children’s experiences of play in digital spaces. Specifically, the literature was examined with regards to relevance to children’s everyday lives, the personal and ecological relevance, and the methods used. A systematic search of the literature over the past fifteen years found thirty-one articles appropriate for inclusion. The analysis of the literature revealed that the articles formed four categories of how play in digital spaces was approached: ‘Videogames, behaviours, and societal norms’, ‘Videogames for its own sake’, ‘Videogames for learning’, and ‘Active Videogames for health promotion’. This scoping review has identified a lack of articles focusing on children’s experiences of play in a digital space, and these perspectives are essential for parents, professionals, game designers, and policymakers alike to contribute to an enhanced understanding of the role of play in digital spaces.Item Using the theory of affordances to understand environment-play transactions: Environmental taxonomy of outdoor play space features—a scoping review(AOTA American Occupational Therapy Association, 2024-05-28) Morgenthaler, Thomas; Lynch, Helen; Loebach, Janet; Pentland, Duncan; Schulze, Christina; Horizon 2020; H2020 Marie Skłodowska-Curie ActionsImportance: The transactions between the physical environment and children’s play have not been well studied. The theory of affordances provides a way to better understand how environmental characteristics offer opportunities for play occupation. Objective: To investigate the relationship between environmental characteristics of outdoor play spaces and children’s outdoor play and to develop an environmental taxonomy to support the analysis of play affordances in community play spaces. Data Sources: Peer-reviewed literature (1974–2023) was sourced from a previously published scoping review (Morgenthaler, Schulze, et al., 2023). The Academic Search Complete, Avery Index to Architectural Periodicals, CINAHL, MEDLINE, PsycINFO, Scopus, and Web of Science databases were searched using the keywords and synonyms of playground, environmental qualities, and children with and without disabilities. Study Selection and Data Collection: A secondary analysis of the previously published scoping review was conducted. Included studies were those that provided descriptions of physical environment–play activity transactions. Findings: A qualitative content analysis of 45 articles was conducted and used to form an environmental taxonomy. This taxonomy consisted of 14 space and object categories defined by their functional qualities and linked to play affordances. An array of 284 play occupations were identified in different forms. Play affordances of spaces and object categories and their functional environmental qualities were subsequently identified. Conclusions and Relevance: This study provides evidence to support the understanding of how the physical environment shapes children’s outdoor play occupations. Plain-Language Summary: The study authors developed the Environmental Taxonomy of Outdoor Play Space Features as a tool that occupational therapists can use to better understand and describe how the physical environment shapes opportunities for play. The tool could also be useful to justify environmental intervention in schools and public playgrounds to create spaces that support more play for a diversity of children