Effects of game-based physical education program on enjoyment in children and adolescents: a systematic review and meta-analysis.

OBJECTIVE: The objective of this study was to conduct a systematic review to summarize and assess the advancements lately made on the enjoyable impacts of game-based physical education interventions on children and adolescents. Additionally, it attempted to identify the effects and variables influencing the enjoyable outcomes of children and adolescents' engagement in physical education games, through meta-analysis. METHODS: This study involves a comprehensive search of different databases like Web of Science, PubMed, Embase, EBSCOhost, Cochrane, and Scopus. Specific criteria are established for the selection process to make sure the relevant literature included. The quality assessment of the included researches is conducted based on the guidelines outlined in the Cochrane 5.1 handbook. Review Manager 5.3 software is employed to synthesis the effect sizes. Additionally, bias is assessed using funnel plots, and to identify potential sources of heterogeneity, subgroup analyses are performed. RESULTS: A total of 1907 academic papers, out of which 2 articles were identified via other data sources. The present study examined the impact of a pedagogical intervention involving physical education games on the enjoyment experienced by children and adolescents. The results indicated a significant positive effect (MD = 0.53, 95%CI:[0.27,0.79], P < 0.05) of this intervention on enjoyment. Subgroup analyses further revealed that both boys (MD = 0.31, 95%CI:[0.13,0.50], P < 0.05) and girls (MD = 0.28, 95%CI:[0.05,0.51], P < 0.05) experienced increased pleasure compared to traditional physical education. Additionally, children under 12 years of age (MD = 0.41, 95%CI:[0.17,0.64], P < 0.05) benefited from sessions lasting at least 30 minutes or more per session (MD = 0.40, 95%CI:[0.19,0.60], P < 0.05), occurring 1 to 3 times per week (MD = 0.28, 95%CI:[0.16,0.40], P < 0.05), and lasting for more than 3 weeks (MD = 0.81, 95%CI:[0.29,1.34], P < 0.05). These findings suggest that the implementation of physical education games can be an effective approach to teaching this subject. CONCLUSIONS: 1) Interventions using physical games have been shown to yield beneficial outcomes in terms of enhancing the enjoyment experienced by children and adolescents. 2) The effectiveness of treatments aimed at promoting enjoyment among children and adolescents is influenced by several aspects, including gender, age, duration and frequency of physical activity, as well as the specific cycle of activity used.

Identifying barriers and facilitators to physical activity and perceptions of Traditional Indigenous Games among Aboriginal and Torres Strait Islander women: a qualitative study.

Aboriginal and Torres Strait Islander women are key members of the community who have specific roles within their families that may result in lower levels of physical activity (PA) undertaken. Clearly identifying barriers for women to engage with PA, and exploring culturally based activities (i.e. Traditional Indigenous Games), may help to improve long-term health benefits. Subsequently, the aim of this study was to identify the barriers and facilitators for Aboriginal and Torres Strait Islander women engaging in PA, and their interest in participating in Traditional Indigenous Games. Seventeen Aboriginal and Torres Strait Islander women (34.3 ±â€…10.2 years) participated in focus groups. Through thematic analysis, participants experienced a range of common barriers such as lack of time due to family commitments, limited finances, ageing and poor physical and/or mental health. Common facilitators were also identified such as fun, access and improving mental and/or physical health. Importantly, unique themes were identified for Aboriginal and Torres Strait Islander women including barriers (e.g. racism, shame) and facilitators (e.g. culture, interactions with other Aboriginal and Torres Strait Islander women) that influenced PA participation. Notably, Traditional Indigenous Games were considered as an appealing PA mode to engage with their culture, experience nostalgia and be around other Aboriginal and Torres Strait Islander women. These key findings will guide future PA programs including Traditional Indigenous Games to improve health outcomes of Aboriginal and Torres Strait Islander women, vital members of the community.

Paths from simple game-targeted pro-environmental behaviors to more diverse pro-environmental behaviors: Empirical evidence from the Ant Forest app.

Game interventions have drawn much attention for their playful features and "painless" promotion of simple game-targeted pro-environmental behaviors (GPEBs), which could spill over to more "costly" prosocial behaviors for pro-environmental causes (PSBPs). The literature places much emphasis on game-targeted mechanisms (e.g., enjoyment and competition) to explain the impacts of game interventions, but pays little attention to non-game-targeted mechanisms to explore their spillover effect. Using online survey data from 1246 Chinese residents, this paper first compares players' and nonplayers' levels of engagement with GPEBs and with two common PSBPs, finding a positive spillover effect from game-targeted simple behaviors to more diverse PSBPs. Based upon goal theory, self-perception theory, and learning theory, the paper then examines the underlying mediating mechanisms of the positive relationship between GPEBs and PSBPs for subsamples of players and nonplayers respectively. The results demonstrate that individual awareness of problem and self-efficacy could be enhanced through engaging in simple GPEBs, which could spill over to more challenging and "costly" PSBPs, including charitable giving and volunteering for pro-environmental causes. The study provides important insights on helping to encourage specific types of more challenging PSBPs not directly targeted by the game.

Life cycle patterns of cognitive performance over the long run.

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.

Piecing Together the Puzzle of Pictorial Representation: How Jigsaw Puzzles Index Metacognitive Development.

Jigsaw puzzles are ubiquitous developmental toys in Western societies, used here to examine the development of metarepresentation. For jigsaw puzzles this entails understanding that individual pieces, when assembled, produce a picture. In Experiment 1, 3- to 5-year-olds (N = 117) completed jigsaw puzzles that were normal, had no picture, or comprised noninterlocking rectangular pieces. Pictorial puzzle completion was associated with mental and graphical metarepresentational task performance. Guide pictures of completed pictorial puzzles were not useful. In Experiment 2, 3- to 4-year-olds (N = 52) completed a simplified task, to choose the correct final piece. Guide-use associated with age and specifically graphical metarepresentation performance. We conclude that the pragmatically natural measure of jigsaw puzzle completion ability demonstrates general and pictorial metarepresentational development at 4 years.

Preschoolers' Motivation to Over-Imitate Humans and Robots.

From preschool age, humans tend to imitate causally irrelevant actions-they over-imitate. This study investigated whether children over-imitate even when they know a more efficient task solution and whether they imitate irrelevant actions equally from a human compared to a robot model. Five-to-six-year-olds (N = 107) watched either a robot or human retrieve a reward from a puzzle box. First a model demonstrated an inefficient (Trial 1), then an efficient (Trial 2), then again the inefficient strategy (Trial 3). Subsequent to each demonstration, children copied whichever strategy had been demonstrated regardless of whether the model was a human or a robot. Results indicate that over-imitation can be socially motivated, and that humanoid robots and humans are equally likely to elicit this behavior.

Fostering early numerical competencies by playing conventional board games.

Recent evidence indicates that playing numerical board games is beneficial for the numerical development of preschoolers. However, board games used in these studies were often specifically developed for training numerical skills. Therefore, we examined whether similar beneficial effects could be observed for playing conventional board games such as Parcheesi. In an intervention study with seven 30-min training sessions over a period of 4 weeks, we observed that 4- to 6-year-old children (Mage = 4 years 11 months) who played conventional board games with traditional number dice (with dot faces numbered from one to six) benefitted more from the board games than children who played board games with color or non-numerical symbol dice. Pretest-posttest comparisons indicated differential effects on counting skills and the ability to recognize and use structures. Beyond these immediate training effects observed in posttest, the differential beneficial effects of playing board games using traditional dot dice on recognizing and using structures was still present in a follow-up test 1 year after the intervention. Thus, playing conventional board games using traditional number dice seems to be an effective low-threshold intervention to foster early numerical competencies.

Children can optimally integrate multisensory information after a short action-like mini game training.

Combining information across different sensory modalities is of critical importance for the animal's survival and a core feature of human's everyday life. In adulthood, sensory information is often integrated in a statistically optimal fashion, so that the combined estimates of two or more senses are more reliable than the best single one. Several studies have shown that young children use one sense to calibrate the others, which results in unisensory dominance and undermines their optimal multisensory integration abilities. In this study we trained children aged 4-5 years with action-like mini games, to determine whether it could improve their multisensory as well as their visuo-spatial skills. Multisensory integration abilities were assessed using a visuo-haptic size discrimination task, while visuo-spatial attention skills were investigated using a multiple object tracking task (MOT). We found that 2-weeks training were sufficient to observe both optimal multisensory integration and visuo-spatial enhancements selectively in the group trained with action-like mini games. This plastic change persisted up to 3 months, as assessed in a follow-up. Our novel findings reveal that abilities that are commonly known to emerge in late childhood can be promoted in younger children through action-like mini games and have long-lasting effects. Our data have clinical implications, in that they suggest that specific trainings could potentially help children with multisensory integration deficits.

Crossword puzzles improve learning of Palestinian nursing students about pharmacology of epilepsy: Results of a randomized controlled study.

OBJECTIVE: This study was conducted to investigate if crossword puzzles as active learning tools can improve the knowledge retention of nursing students in pharmacology of epilepsy and improve their performance in writing the correct spelling of antiepileptic drugs (AEDs). METHODS: The present study was a randomized controlled prospective parallel study in which a control group design with pretests and posttests were used among nursing students. Students were randomly allocated to either control group (n = 114) who received routine learning or intervention group (n = 110) who received crossword puzzles. Both control and intervention groups had to complete multiple-choice question (MCQs) and spelling pretests and posttests. RESULTS: Scores of the MCQs and spelling pretests were not statistically different (p-value > 0.05) for participants in all achievement categories in both control and intervention groups. In the intervention group, scores in the first and second MCQs and spelling posttests were significantly higher than their corresponding scores in the pretest scores for participants from the all achievement categories (p-value < 0.05) and scores of the first and second MCQs and spelling posttests were not significantly different (p-value > 0.05). Data analyses showed that there were significant normalized changes between scores of students in across all achievement categories. CONCLUSION: Findings of this study suggested that crossword puzzles were effective in improving the learning of nursing students about the pharmacology of epilepsy and writing correct spelling of AEDs. Educators should consider using crossword puzzles as active learning tools to improve knowledge of nursing students about the pharmacology of epilepsy.

Using a Virtual Reality Serious Game to Assess the Performance of Older Adults with Frailty.

OBJECTIVES: The comparison of cognitive performance of older adults with frailty and non-frail ones (according to Fried's criteria) was investigated. METHODS/DESIGN: The differences in performance between people with frailty and individuals without frailty according to Fried were tested using a Virtual Reality (VR) application. The Fried criteria for frailty were used to categorize users into study groups, while standardized batteries were used for a Comprehensive Geriatric Assessment, including Activities of Daily Living (ADL), lifestyle, cognition, and depression screening. A group of 80 elders (78.08 years old in average) played the VR game entitled Virtual Supermarket (VSM). From those, 39 were healthy controls and 30 were categorized as pre-frail and 11 as frail. The VSM application presented users with a virtual shopping experience where users had to locate and purchase items displayed in a shopping list. This application was designed to test player's ability to reproduce a typical customer behavior in a simulated environment which requires spatial orientation, short-term memory, selective attention, and cognition speed. The performance, duration, and error rate were used as measurements. RESULTS: The analysis showed that there was a statistically significant difference in game performance between the different user groups with X2 (2) = 9.929, p = 0.007. Moreover, the multinomial logistic regression model generated, which based on game performance metrics, was found to be statistically significant with X2 (4) = 15.662, p = 0.004. CONCLUSIONS: Results shed more light toward the possible use of VR for distant self-administered evaluation of the frail status.

Designed game situations enhance fundamental movement skills in children with Down syndrome.

BACKGROUND: This study aimed to compare the effects of a designed program based on games situations with those of a conventional one, the Adapted Physical Education (APE) program, on the fundamental movement skills (FMS) in children with Down Syndrome (DS), aged 6 to 10. METHODS: Twenty-eight children (13 girls and 15 boys; age 8.84 ± 1.06) with DS participated in this study. The participants were divided into two groups as the experimental group (EG) with 13 children (3 girls and 10 boys) and the control group (CG) composed with 15 children (10 girls and 5 boys). The EG participated in a conceived training program based on games situations along 10 weeks, while the CG took part in an APE conventional program based on football, long Jump and sprint adapted exercises. The FMS (locomotor and object control skills) were evaluated using the Gross Motor Development-2 Test at pretraining and posttraining for both groups. RESULTS: The results revealed that both programs improve significantly locomotor skills with significantly better improvement in the EG. However, a significant object control skills improvement was observed only among the EG. CONCLUSIONS: In light of our findings, a training program based on adapted games situations during 10 weeks may be recommended for FMS improvement, specifically object control skills.

Effectiveness of board game activities for reducing depression among older adults in adult day care centers of Taiwan: a quasi-experimental study.

Depression is common in older adults and is associated with an increased risk of cognitive impairment. To clarify the possible roles of board game use in psychosomatic health promotion, this study evaluated the effects of board game activities in reducing depression in older adults. This was a quasi-experimental study. Purposive sampling was used to select 150 participants aged 65 years and above with intact mental functions who were currently residing in adult day care centers. Seventy-five participants who participated in 12 sessions of selected board game activities were assigned to the experimental group, and 75 participants who adhered to their ordinary activities were allocated to the control group. Structured questionnaires were used for data collection. The board game activities showed promising effects on the depression levels of the investigated older adults living in adult day care centers. Therefore, one possible beneficial effect of board game activities may be reduced depression in older adults. The results of this study provide support for the mediating role of board game activities in the mental health of long-term care elders. Incorporating board game activities into social work may help to make it more diverse and innovative.

Within- and between-person variation in morning testosterone is associated with economic risk-related decisions in athletic women across the menstrual cycle.

Literature suggests that women experience ovulatory shifts in risk-taking behaviours across different domains, which might be partly attributed to changes in testosterone (T). Thus, we investigated associations between menstrual variability in T concentrations and economic risk-related decisions among athletic women. Thirty-five women were monitored across three consecutive menstrual cycles. Testing occurred on day seven (D7), 14 (D14) and 21 (D21) following the onset of menses. The morning (7 to 8 am) assessment of salivary T (sal-T) and cortisol (sal-C) was followed by the economic Hawk-Dove game (11 am to 12 pm) played in pairs, where hawk decisions were used to index risk. Morning sal-T concentration increased from D7 to D14, before decreasing on D21 (p < 0.001), representing moderate effect size (ES) changes of 0.6 to 0.8. Morning sal-C did not vary over time. Hawk choices paralleled the sal-T results, being elevated on D14 (p < 0.001) with large ES changes of 1.8. Regression analyses revealed that morning sal-T concentration was positively related (p ≤ 0.01) to the number of hawks chosen between- (beta = 0.47) and within-participants (beta = 0.10) when controlling for training hours and menstrual day. In summary, the risk-related choices of athletic women during a dyadic contest covaried with morning sal-T concentrations across the menstrual cycle. Both outcomes were positively correlated on a within- and between-person level. Confirming the major sources of T variation across the menstrual cycle, whilst discerning its relationship with other risk-related behaviours, would be worthwhile avenues for research.

Getting less than their fair share: Maltreated youth are hyper-cooperative yet vulnerable to exploitation in a public goods game.

Human cooperative behavior has long been thought to decline under adversity. However, studies have primarily examined perceived patterns of cooperation, with little eye to actual cooperative behavior embedded within social interaction. Game-theoretical paradigms can help close this gap by unpacking subtle differences in how cooperation unfolds during initial encounters. This study is the first to use a child-appropriate, virtual, public goods game to study actual cooperative behavior in 329 participants aged 9-16 years with histories of maltreatment (n = 99) and no maltreatment (n = 230) while controlling for psychiatric symptoms. Unlike work on perceived patterns of cooperation, we found that maltreated participants actually contribute more resources to a public good during peer interaction than their nonmaltreated counterparts. This effect was robust when controlling for psychiatric symptoms and peer problems as well as demographic variables. We conclude that maltreatment may engender a hyper-cooperative strategy to minimize the odds of hostility and preserve positive interaction during initial encounters. This, however, comes at the cost of potential exploitation by others.

Tobacco Industry Promotional Strategies Targeting American Indians/Alaska Natives and Exploiting Tribal Sovereignty.

BACKGROUND: American Indians/Alaska Natives have the highest commercial tobacco use in the United States, resulting in higher tobacco-caused deaths and diseases than the general population. Some American Indians/Alaska Natives use commercial tobacco for ceremonial as well as recreational uses. Because federally recognized Tribal lands are sovereign, they are not subject to state cigarette taxes and smoke-free laws. This study analyzes tobacco industry promotional efforts specifically targeting American Indians/Alaska Natives and exploiting Tribal lands to understand appropriate policy responses in light of American Indians'/Alaska Natives' unique sovereign status and culture. METHODS: We analyzed previously secret tobacco industry documents available at the Truth Tobacco Documents Library (https://industrydocuments.library.ucsf.edu/tobacco/). RESULTS: Tobacco companies used promotional strategies targeting American Indians/Alaska Natives and exploiting Tribal lands that leveraged the federally recognized Tribes' unique sovereign status exempting them from state cigarette taxes and smoke-free laws, and exploited some Tribes' existing traditional uses of ceremonial tobacco and poverty. Tactics included price reductions, coupons, giveaways, gaming promotions, charitable contributions, and sponsorships. In addition, tobacco companies built alliances with Tribal leaders to help improve their corporate image, advance ineffective Youth Smoking Prevention programs, and defeat tobacco control policies. CONCLUSIONS: The industry's promotional tactics likely contribute to disparities in smoking prevalence and smoking-related diseases among American Indians//Alaska Natives. Proven policy interventions to address these disparities including tobacco price increases, cigarette taxes, comprehensive smoke-free laws, and industry denormalization campaigns to reduce smoking prevalence and smoking-related disease could be considered by Tribal communities. The sovereign status of federally recognized Tribes does not prevent them from adopting these measures. IMPLICATIONS: American Indians/Alaska Natives suffer disparities in smoking prevalence and smoking-related diseases as compared with other groups. The tobacco industry has used promotional tactics including price reductions, coupons and giveaways, casino and bingo promotions, charitable contributions and sponsorships, and so-called Youth Smoking Prevention (YSP) programs to specifically target American Indians/Alaska Natives and exploit Tribal sovereignty, which likely contribute to disparities in tobacco use and related diseases and deaths among this population. Tribal and public health policy makers should consider rejecting ineffective YSP programs and instead consider adopting proven policy interventions including tobacco price increases, cigarette and casino taxes, comprehensive smokefree laws, and anti-industry denormalization campaigns to reduce smoking and smoking-related disease.

Incentive-Based Game for Allaying Preoperative Anxiety in Children: A Prospective, Randomized Trial.

BACKGROUND: Induction of anesthesia can be distressing both for children and their parents. Nonpharmacological behavioral interventions can reduce the anxiety of children without significant adverse effects as seen with sedative medications. We hypothesized that the use of incentive-based game therapy in conjunction with parental involvement would be a simple and cost-effective intervention in reducing the preoperative anxiety in children. METHODS: Eighty children between the age group of 4 and 8 years scheduled to undergo surgery were randomly assigned to a control group (n = 40) and intervention group (n = 40). Children in the intervention group participated in an incentive-based game in the preoperative room. Anesthesia was induced with parental presence in both the groups. The modified Yale Preoperative Anxiety Scale (mYPAS) score to measure the anxiety of the children during induction was taken as the primary outcome. Induction Compliance Checklist score and parental satisfaction were assessed as secondary outcomes. RESULTS: The mYPAS score of children in the intervention group was significantly less than the control group during anesthesia induction. The mean difference (95% confidence interval [CI]) of the mYPAS at induction between the 2 groups was 20 (95% CI, 16-24; P < .001). Fourteen (35%) children in the intervention group and 2 (5%) children in control group displayed no anxiety (mYPAS score <30) (difference of -30%; 95% CI, -11% to -49%; P < .001). Children in the intervention group were more compliant with mask induction and had a significantly less Induction Compliance Checklist score compared to the control (P < .001). Thirty (75%) parents in the intervention group were satisfied at the end of surgery compared to 6 (15%) in the control group (difference of -60%; 95% CI, -39% to -73%; P < .001). CONCLUSIONS: The use of incentive-based game therapy reduces the anxiety scores during induction of anesthesia and improves the compliance to facemask induction in children undergoing surgery. It can form a simple, cost-effective, and easy-to-administer technique that can be easily applied in low-income settings.

Cocaine use disorder in females is associated with altered social decision-making: a study with the prisoner's dilemma and the ultimatum game.

BACKGROUND: Chronic cocaine use is associated with cognitive deficits, including poor performance on neuropsychological tasks of memory, executive functions, theory of mind and decision-making. However, the relationship between cocaine use disorder and social decision-making remains unclear. This is particularly relevant given the fact that many cocaine abusers present impairments in social functioning. In this sense, game theory paradigms have been helping to comprehend the behavior of psychiatric patients when they directly engage in social situations, which may better approximate many of their real-life choices. METHODS: The present study investigated social decision-making in individuals with or without cocaine use disorder, examining their behavior in the Prisoner's Dilemma and in the Ultimatum Game. Thus, 129 females diagnosed with cocaine use disorder and 55 females with no history of substance abuse were recruited and performed both social decision-making tasks. Additional assessments included information about demographics, patterns of substance consumption and executive function performance. RESULTS: Females with cocaine use disorder opted more often to not defect in the Prisoner's Dilemma, while in the Ultimatum Game they frequently chose to accept the first and unfair offer as responders. These effects were more pronounced within females with long-term history of cocaine use. Associations between cocaine use disorder and altered social decision-making were independent from demographic and executive function variables. CONCLUSIONS: The influence of cocaine use disorder on social decision-making was detected in both game paradigms, resulting in more cooperative behavior in the Prisoner's Dilemma and higher acceptance rate of unfair offers in the Ultimatum Game. Further studies should focus on investigating these associations to shed light on the putative biopsychosocial factors underlying the observed effects.

Children engage in competitive altruism.

Humans cultivate their reputations as good cooperators, sometimes even competing with group mates, to appear most cooperative to individuals during the process of selecting partners. To investigate the ontogenetic origins of such "competitive altruism," we presented 5- and 8-year-old children with a dyadic sharing game in which both children simultaneously decided how many rewards to share with each other. The children were either observed by a third-person peer or not. In addition, the children either knew that one of them would be picked for a subsequent collaborative game or had no such knowledge. We found that by 8 years of age, children were more generous in the sharing game not only when their behavior was observed by a third party but also when it could affect their chances of being chosen for a subsequent game. This is the first demonstration of competitive altruism in young children, and as such it underscores the important role of partner choice (and individual awareness of the process) in encouraging human cooperation from an early age.

Children use rules to coordinate in a social dilemma.

Humans are frequently required to coordinate their actions in social dilemmas (e.g. when one of two drivers has to yield for the other at an intersection). This is commonly achieved by individuals following communally known rules that prescribe how people should behave. From relatively early in development, children swiftly pick up the rules of their culture and even start creating game rules among peers. Thus far, however, little is known about children's abilities create rules to regulate their own interactions in social dilemma situations in which individuals' interests are partially in conflict. Here, we repeatedly selected dyads of children (5- and 8-year-olds, N = 144) at random from a group and presented them with a chicken game - a social dilemma in which individuals have conflicting motives but coordination is required to avoid mutual failure. In game breaks, groups reconvened and had the opportunity to think of additional game rules. Eight- but not five-year-olds readily came up with and agreed upon impartial rules to guide their subsequent game behavior (but only after adult prompting). Moreover, when playing by the self-made rules, children achieved higher payoffs, had fewer conflicts, and coordinated with greater efficiency than when playing without a rule - which mimics the functional consequences of rules on a societal level. These findings suggest that by at least age 8, children are capable of using rules to independently self-regulate potential conflicts of interest with peers.