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The aim of the current study was to identify which subgroups of children with Attention Deficit Hyperactivity Disorder (ADHD) benefitted the most from playing a Serious Game (SG) intervention shown in a randomized trial to improve behavioral outcomes. Pre-intervention characteristics [i.e., gender, age, intellectual level of functioning, medication use, computer experience, ADHD subtype, severity of inattention problems, severity of hyperactivity/impulsivity problems, comorbid Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) symptoms] were explored as potential moderators in a Virtual Twins (VT) analysis to identify subgroups for whom the SG intervention was most effective. Primary outcome measures were parent-reported time management, planning/organizing and cooperation skills. Two subgroups were identified. Girls (n = 26) were identified as the subgroup that was most likely to show greater improvements in planning/organizing skills as compared to the estimated treatment effect of the total group of participants. Furthermore, among the boys, those (n = 47) with lower baseline levels of hyperactivity and higher levels of CD symptoms showed more improvements in their planning/organizing skills when they played the SG intervention as compared to the estimated treatment effect of the total group of participants. Using a VT analysis two subgroups of children with ADHD, girls, and boys with both higher levels of CD and lower levels of hyperactivity, were identified. These subgroups mostly benefit from playing the SG intervention developed to improve ADHD related behavioral problems. Our results imply that these subgroups have a higher chance of treatment success.

Background An acute bout of exercise elicits a beneficial effect on subsequent cognitive function in adolescents. The effect of games-based activity, an ecologically valid and attractive exercise model for young people, remains unknown; as does the moderating effect of fitness on the acute exercise-cognition relationship. Therefore, the aim of the present study was to examine the effect of games-based activity on subsequent cognition in adolescents, and the moderating effect of fitness on this relationship. Methods Following ethical approval, 39 adolescents (12.3 ± 0.7 year) completed an exercise and resting trial in a counterbalanced, randomised crossover design. During familiarisation, participants completed a multi-stage fitness test to predict VO 2 peak. The exercise trial consisted of 60-min games-based activity (basketball), during which heart rate was 158 ± 11 beats∙min − 1 . A battery of cognitive function tests (Stroop test, Sternberg paradigm, trail making and d2 tests) were completed 30-min before, immediately following and 45-min following the basketball. Results Response times on the complex level of the Stroop test were enhanced both immediately ( p  = 0.021) and 45-min ( p  = 0.035) post-exercise, and response times on the five item level of the Sternberg paradigm were enhanced immediately post-exercise ( p  = 0.023). There were no effects on the time taken to complete the trail making test or any outcome of the d2 test. In particular, response times were enhanced in the fitter adolescents 45-min post-exercise on both levels of the Stroop test (simple, p  = 0.005; complex, p  = 0.040) and on the three item level of the Sternberg paradigm immediately ( p  = 0.017) and 45-min ( p  = 0.008) post-exercise. Conclusions Games-based activity enhanced executive function and working memory scanning speed in adolescents, an effect particularly evident in fitter adolescents, whilst the high intensity intermittent nature of games-based activity may be too demanding for less fit children.

Although smoking cessation apps have become popular, few have been tested in randomized clinical trials or undergone formative evaluation with target users. We developed a cessation app targeting tobacco-dependent cancer patients. Game design and behavioral rehearsal principles were incorporated to help smokers identify, model, and practice coping strategies to avoid relapse to smoking. In this randomized pilot trial, we examined feasibility (recruitment and retention rates), acceptability (patient satisfaction), quitting self-confidence, and other cessation-related indices to guide the development of a larger trial. We randomized 42 English-speaking cancer patients scheduled for surgical treatment to either the Standard Care (SC; telecounseling and cessation pharmacotherapies) or the experimental QuitIT study arm (SC and QuitIT game). Gameplay parameters were captured in-game; satisfaction with the game was assessed at 1-month follow-up. We report study screening, exclusion, and refusal reasons; compare refusal and attrition by key demographic and clinical variables; and report tobacco-related outcomes. Follow-up data were collected from 65% (13/20) patients in the QuitIT and 61% (11/18) in SC arms. Study enrollees were 71% (27/38) females, 92% (35/38) white people, and 95% (36/38) non-Hispanic people. Most had either lung (12/38, 32%) or gastrointestinal (9/38, 24%) cancer. Those dropping out were less likely than completers to have used a tablet (P<.01) and have played the game at all (P=.02) and more likely to be older (P=.05). Of 20 patients in the QuitIT arm, 40% (8/20) played the game (system data). There were no differences between those who played and did not play by demographic, clinical, technology use, and tobacco-related variables. Users completed an average of 2.5 (SD 4.0) episodes out of 10. A nonsignificant trend was found for increased confidence to quit in the QuitIT arm (d=0.25, 95% CI -0.56 to 1.06), and more participants were abstinent in the QuitIT group than in the SC arm (4/13, 30%, vs 2/11, 18%). Satisfaction with gameplay was largely positive, with most respondents enjoying use, relating to the characters, and endorsing that gameplay helped them cope with actual smoking urges. Recruitment and retention difficulties suggest that the perihospitalization period may be a less than ideal time for delivering a smoking cessation app intervention. Framing of the app as a \"game\" may have decreased receptivity as participants may have been preoccupied with hospitalization demands and illness concerns. Less tablet experience and older age were associated with participant dropout. Although satisfaction with the gameplay was high, 60% (12/20) of QuitIT participants did not play the game. Paying more attention to patient engagement, changing the intervention delivery period, providing additional reward and support for use, and improving cessation app training may bolster feasibility for a larger trial. ClinicalTrials.gov NCT01915836; https://clinicaltrials.gov/ct2/show/NCT01915836 (Archived by WebCite at http://www.webcitation.org/73vGsjG0Y).

ObjectiveGamification is a non-evaluation and competition-based training methodology with high emotional involvement. The goal of this study was to evaluate gamification methodology as compared with other existing methodologies when teaching cardiopulmonary resuscitation (CPR) to secondary school students.Methods489 secondary school students from two high schools in Spain participated in this randomised-block quasi-experimental study in February 2018. The students were classified into different groups. Each group received CPR training with a different methodology: GAM (gamification-based training as a compulsory but non-tested academic activity to learn by playing in teams, with instructor and visual feedback); EVA (training based on subsequent evaluation as a motivational incentive, with instructor and visual feedback); VFC (visual feedback complementary, training based on a non-compulsory and non-tested academic activity, with instructor and visual feedback); TC (traditional complementary, training based on a non-compulsory and non-tested academic activity, with instructor feedback). After a week, each student performed a 2 min hands-only CPR test and quality of CPR was assessed. Visual feedback in training and CPR variables in test were provided by the QCPR Instructor App using a Little Anne manikin, both from Laerdal (Norway).ResultsGAM (89.56%; 95% CI 86.71 to 92.42) methodology resulted in significantly higher scores for CPR quality than VFC and TC (81.96%; 95% CI 78.04% to 85.88% and 64.11%; 95% CI 58.23 to 69.99). GAM (61.77%; 95% CI 56.09 to 67.45) methodology also resulted in significantly higher scores for correct rate than VFC and TC (48.41%; 95% CI 41.15% to 55.67% and 17.28%; 95% CI 10.94 to 23.62). 93.4% of GAM methodology participants obtained >50 mm of compression mean depth which was a significantly higher proportion than among students in VFC and TC (78.0% and 71.9%). No differences between GAM and EVA were found. A confidence level of 95% has been assigned to all values.ConclusionsGAM methodology resulted in higher CPR quality than non-tested methods of academic training with instructor feedback or visual feedback. Gamification should be considered as an alternative teaching method for Basic Life Support (BLS) in younger individuals.

Background Participation in recreational activities supports continuity of activity and psychological well-being in old age. Games are one of these recreational activities. This study aims to measure the influence of recreational games on somatisation, loneliness, happiness and life satisfaction among elderly individuals. Methods This non-randomized quasi-experimental study involved 80 individuals from two nursing homes, allocated to intervention ( n  = 40) and control ( n  = 40) groups. Participants, aged 65 or older, met cognitive eligibility criteria based on the Standardized Mini-Mental State Examination. The intervention group selected 4 games (hot-and-cold, word challenge, bingo, matching pairs) from a set of 15 and played twice weekly for two months in smaller groups. The control group maintained their usual leisure activities. Data were collected using the Oxford Happiness Questionnaire Short Form, Satisfaction with Life Scale, De Jong Gierveld Loneliness Scale, and Symptom Checklist-90-Revised Somatization Subscale at baseline, 1 week, and 1 month post-intervention. Results The intervention group (IG) showed significant improvements compared to the control group (CG). Happiness (η² = 0.93) and life satisfaction (η² = 0.92) increased significantly in the IG ( p  < 0.0001), with higher scores than the CG in both the post-test ( r ≈ -0.246 to -0.212, p  < 0.05) and follow-up ( r ≈ -0.273 to -0.309, p  < 0.01). Loneliness, including emotional and social loneliness, decreased significantly in the IG (η² = 0.94, p  < 0.0001), with greater reductions than the CG in the post-test and follow-up ( r ≈ -0.503 to -0.593, p  < 0.0001). Somatization did not change significantly within the IG but showed a reduction compared to the CG in the post-test and follow-up ( r ≈ -0.226 to -0.280, p  < 0.05). Conclusions Recreational games may give psychological benefits to older adults. Yet, results of the study need to be interpreted with caution and need to be replicated. Trial registration ClinicalTrials.gov identifier: NCT06505070 (retrospectively registered, Protocol ID: Duzce-U-merve0003, Last Update Posted: 2024-08-02). https://ctv.veeva.com/study/the-effect-of-recreational-games-on-happiness-life-satisfaction-loneliness-and-somatisation-in-el?comeFrom=study-search .

Relative to other racial/ethnic groups in the United States, Hispanic American (HA) youth have higher rates of overweight and obesity. Previous work suggests that low perceived social status (SS) promotes excess caloric intake and, thereby, development of obesity. Psychological resilience may play a role in reducing adverse eating behaviors and risk for obesity. The objective of this study was to investigate whether resilience (as measured by the Connor Davidson Resilience Scale) interacts with experimentally manipulated SS to affect dietary intake among HA adolescents ( = 132). Using a rigged game of Monopoly (Hasbro, Inc.), participants were randomized to a high or low SS condition. Following the Monopoly game, participants consumed an lunch and their dietary intake was assessed. There was a significant interaction between resilience and experimentally manipulated SS for total energy intake ( = 0.006), percent energy needs consumed ( = 0.005), and sugar intake ( = 0.004). For the high SS condition, for each increase in resilience score, total energy intake decreased by 7.165 ± 2.866 kcal ( 0.014) and percent energy needs consumed decreased by 0.394 ± 0.153 ( 0.011). In the low SS condition, sugar intake increased by 0.621 ± 0.240 g for each increase in resilience score ( 0.011). After correction for multiple comparisons, the aforementioned interactions, but not simple slopes, were statistically significant.

The objective of this pilot study was to investigate the effect of a specially developed serious game to improve food behavior in families with children aged 5–13 years using mixed methods. Fourteen families were randomized into a game-group and a non-game-group and divided into age groups (game-children (GC), game-parents (GP), non-game-children (nGC), and non-game-parents (nGP)). The families completed a baseline test, a three-week intervention period with or without a game element, and a follow-up test. Qualitative results showed a positive change in food behavior in all families. Quantitative results mainly showed an effect in food neophobia as a decrease was seen in all groups; however, it was only significant (p < 0.05) in three groups (GP, nGC, nGP). No changes were seen in willingness to taste, and only limited changes in liking and number of words used to describe the stimuli. In conclusion, qualitative results showed positive change in the children’s food behavior in most families, indicating a positive effect of performing tastings and tasks together as a family—regardless of the presence of a game element. However, this was not as clear in the quantitative data, indicating that current quantitative tools are less suited to measure complex concepts like willingness to taste.

To compare the effectiveness of an educational board game with interactive didactic instruction for teaching optometry students elements of the core optometric curriculum. Forty-two optometry students were divided into two GPA-matched groups and assigned to either 12 hours of game play (game group) or 12 hours of interactive didactic instruction (lecture group). The same material from the core optometric curriculum was delivered to both groups. Game play was accomplished via an original board game. Written examinations assessed change in knowledge level. A post-intervention opinion survey assessed student attitudes. There was no significant difference in pre- or post-intervention test scores between the lecture and game groups (Pre-test: p = 0.9; Post-test: p = 0.5). Post-intervention test scores increased significantly from baseline (Game group: 29.3% gain, Didactic group: 31.5% gain; p<0.001 for each). The score increase difference between groups was not statistically significant (p = 0.6). The post-intervention attitude survey did not reveal any significant between group differences (p = 0.5). Our results indicate that an educational game and interactive didactic instruction can be equally effective in teaching optometry students basic and applied science. Furthermore, both modes of instruction have the potential to be equally engaging and enjoyable experiences.

Little is known about how the age pattern in individual performance in cognitively demanding tasks changed over the past century. The main difficulty for measuring such life cycle performance patterns and their dynamics over time is related to the construction of a reliable measure that is comparable across individuals and over time and not affected by changes in technology or other environmental factors. This study presents evidence for the dynamics of life cycle patterns of cognitive performance over the past 125 y based on an analysis of data from professional chess tournaments. Individual move-by-move performance in more than 24,000 games is evaluated relative to an objective benchmark that is based on the respective optimal move suggested by a chess engine. This provides a precise and comparable measurement of individual performance for the same individual at different ages over long periods of time, exploiting the advantage of a strictly comparable task and a comparison with an identical performance benchmark. Repeated observations for the same individuals allow disentangling age patterns from idiosyncratic variation and analyzing how age patterns change over time and across birth cohorts. The findings document a hump-shaped performance profile over the life cycle and a long-run shift in the profile toward younger ages that is associated with cohort effects rather than period effects. This shift can be rationalized by greater experience, which is potentially a consequence of changes in education and training facilities related to digitization.

The field of technological behavioural addictions is moving towards specific problems (i.e., gaming disorder). However, more evidence of generalised versus specific Internet use-related addiction problems (generalised pathological Internet use (GPIU) vs. specific pathological Internet use (SPIU)) is still needed. This mixed methods study aimed to disentangle GPIU from SPIU. A partially mixed sequential equal status study design (QUAN→QUAL) was undertaken. First, through an online survey, which adapted the compulsive Internet use scale (CIUS) for three types of problems (i.e., generalised Internet use, and specific online gaming and social networking). Second, potential problem users’ perceptions of the evolution of these problems (aetiology, development, consequences, and factors) were ascertained, through semi-structured interviews, together with their opinion on present Internet gaming disorder (IGD) criteria adapted to each problem studied. Findings showed the CIUS remains valid and reliable for GPIU and SPIUs examined; a prevalence between 10.8% and 37.4% was estimated for potential at-risk problem gamers and Internet users, respectively, who reported their preference for maintaining their virtual lives. Half of the sample had a risk of a unique or mixed profile of these problems. Moreover, device patterns, gender, and age issues emerged, such as problem gamers being proportionally equal male and female young or middle-aged adults. GPIU was highly associated with problem social networking use, and weakly with problematic gaming, but both SPIUs were independent. Concerning addictive symptoms, salience, deception, and tolerance required redefinition, especially for SPIUs, while better-valued IGD criteria applied to GPIU and SPIUs were: Risk relationships or opportunities, give up other activities, withdrawal, and continue despite problems. Thus, although problems studied are present as risk behaviours, SPIUs seem to cover the addictive symptomatology in those categorised as potential problem users, online gaming being the most severe behavioural addiction problem.