Training nurses in an international emergency medical team using a serious role-playing game: a retrospective comparative analysis.

BACKGROUND: Although game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training these nurses in an IEMT setting. To address this need, we developed a serious computer game called the IEMTtraining game. In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options. METHODS: The design of this study is a retrospective comparative analysis. The research was conducted with 209 nurses in a hospital. The data collection process of this study was conducted at the 2019-2020 academic year. A retrospective comparative analysis was conducted on the pre-, post-, and final test scores of nurses in the IEMT. Additionally, a survey questionnaire was distributed to trainees to gather insights into teaching methods that were subsequently analyzed. RESULTS: There was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010). The survey results indicated that the game group exhibited higher learning motivation scores and lower cognitive load compared with the lecture group. CONCLUSIONS: The IEMT training game developed by the instructor team is a promising and effective method for training nurses in disaster rescue within IEMTs. The game equips the trainees with the necessary skills and knowledge to respond effectively to emergencies. It is easily comprehended, enhances knowledge retention and motivation to learn, and reduces cognitive load.

A Biofeedback Based Virtual Reality Game for Pediatric Population (BioVirtualPed): A Feasibility Trial.

OBJECTIVE: This trial aims to assess the acceptability, feasibility, and safety of BioVirtualPed, a biofeedback-based virtual reality (VR) game designed to reduce pain, anxiety, and fear in children undergoing medical procedures. METHODS: An Oculus Quest 2 headset was used in the VR experience, respiratory data was captured using an ADXL354 accelerometer, and these data were integrated into the game with ArdunioUno software. The sample of this study consisted of 15 pediatric oncology patients aged 6 to 12 years between July and August 2023. BioVirtualPed's acceptability, feasibility, and safety were evaluated through child and expert feedback, alongside metrics including the System Usability Scale, Wong-Baker Pain Rating Scale, Child Fear Scale, Child Anxiety Scale-Status, Satisfaction Scoring, and various feasibility and safety parameters. RESULTS: Regarding the acceptability, the expert evaluation showed a mean score of 122.5 ± 3.53, indicating high usability for the system. All children provided positive feedback, and both children and their mothers reported high satisfaction with using BioVirtualPed. The BioVirtualPed was feasible for reducing children's pain, fear, and anxiety levels. All the children complied with the game, and no one withdrew from the trial. BioVirtualPed did not cause symptoms of dizziness, vomiting, or nausea in children and was found to be safe for children. CONCLUSION: The findings showed that BioVirtualPed meets the following criteria: feasibility, user satisfaction, acceptability, and safety. It is a valuable tool to improve children's experience undergoing port catheter needle insertion procedures. IMPLICATION FOR NURSING PRACTICE: Integration of VR interventions with BioVirtualPed into routine nursing care practices has the potential to effectively manage the pain, anxiety, and fear experienced by children undergoing medical procedures. The safety, feasibility, and acceptability results are promising for further research and integration into pediatric healthcare practice.

Impact of Gaming (Gamification) on Diabetes Self-Care Behaviors and Glycemic Outcomes Among Adults With Type 2 Diabetes.

PURPOSE: The purpose of this systematic review was to determine if the use of gaming (gamification) among persons with type 2 diabetes improves diabetes self-management behaviors and diabetes outcomes. METHODS: A systematic review was conducted using electronic databases including MEDLINE, Embase, Web of Science, and CINAHL. Studies reporting on the impact of gaming on at least 1 of the Association of Diabetes Care and Education Specialists self-care behaviors (ADCES7) were included. RESULTS: The review included 9 studies, 8 of which were of strong/high quality. Five of the self-care behaviors were addressed in at least 1 of the included studies. However, taking medications and problem solving were not reported in any of the studies. Physical activity and self-efficacy or quality of life (healthy coping) were the most frequently reported ADCES7 behaviors. Six of the studies used A1C as an outcome measure, with a reduction reported in all the studies except 1. CONCLUSION: Type 2 diabetes affects a person holistically, necessitating a range of self-care behaviors to effectively manage the chronic condition. Novel gaming interventions may improve coping mechanisms, lifestyle behaviors, medication engagement, and monitoring of risks and problems, all of which are essential in facilitating optimal diabetes self-management.

Comparing the effects of 30 minutes exergaming versus brisk walking on physiological and psychological measurements of older adults.

BACKGROUND: Active video games can make physical activity more appealing and enjoyable for older people. This study compared the effects of 30 min of Exergaming versus walking on the physiological and psychological measures of asymptomatic older adults. METHODS: Forty eligible participants (mean age = 69.60 ± 4.16 y/o) were randomly divided into two groups of 20 in a crossover design, who either performed Brisk Walking or Exergaming, one week apart. Before each session, each participant's blood pressure was measured, and the subjects were encouraged to play/walk continuously for 30 min using a self-selected intensity. During both sessions, average and peak heart rate, time spent in each of the heart rate zones, blood pressure, and double product were assessed through a Polar H10 heart rate monitor. Participants also filled out the modified Physical Activity Enjoyment Scale (PACES) questionnaire and Rate of Perceived Exertion (RPE) scale. RESULTS: Findings indicated a significantly higher average (P = 0.003) and peak heart rate (P < 0.001) and double product (P = 0.002) during Exergaming compared to Brisk Walking. Also, the RPE score was significantly lower and PACES score was significantly higher (P < 0.001) during the Exergaming session. The analyses of blood pressure showed significant changes in systolic and diastolic blood pressures following each session, while no statistically significant difference was reported between the two exercise modalities (P = 0.012 and P < 0.001, respectively). CONCLUSION: This study showed that Exergaming can be a good alternative to traditional exercises like walking for older adults, providing physiological benefits while being less exhausting and more enjoyable.

Perspectives from gambling expert stakeholders in relation to electronic gaming machines in New Zealand.

Electronic gaming machines (EGMs) are one of the most addictive and harmful forms of gambling. Gaming machine characteristics, easy accessibility of EGMs and normalisation of gambling behaviour have exacerbated these effects. We conducted a pilot study investigating the perspectives of gambling expert stakeholders on gambling harm and effective harm-minimisation policies regarding EGMs. In-depth individual interviews were undertaken with 14 health professionals working in the addiction sector, academics in the field of gambling and individuals from a range of government and non-government organisations who have an impact on gambling policy making in New Zealand. Five major themes were identified: the need to shift focus from problematic people to the problematic product, the need for a holistic approach to gambling intervention, focus on creating an empowered population, and improving protective factors and refining public health initiatives to gambling harm. The results suggest the need to challenge current narratives of EGM-related gambling harm and have wide-ranging implications for EGM harm minimisation and health promotion policies.

The usefulness of an intervention with a serious video game as a complementary approach to cognitive behavioural therapy in eating disorders: A pilot randomized clinical trial for impulsivity management.

OBJECTIVE: The aim of the present study was to test the usefulness of an add-on serious video game approach (i.e., Playmancer) to treatment as usual (TAU) on reducing impulsive behaviours and psychopathology in individuals diagnosed with an eating disorder (ED). METHOD: Thirty-seven patients diagnosed with an ED according to the DSM-5 were included in the present randomized clinical trial (RCT; study record 35,405 in ClinicalTrials.gov) and were randomly assigned to either the TAU or TAU + Playmancer group. All participants completed a clinical interview. Impulsivity (UPPS-P self reported questionnaire and Stroop task) and general psychopathology (SCL-90-R) measures were assessed at: baseline, 4 weeks into treatment, at the end of TAU (after 16 weeks), and follow-up (2 years). In addition, patients in the experimental group underwent a total of nine sessions with Playmancer over the span of 3 weeks. RESULTS: Patients in both treatment groups (TAU + Playmancer or TAU) improved on Stroop task performance and psychological distress. Additionally, patients in TAU-Playmancer improved on the impulsive trait domain of lack of perseverance. No statistical differences were found regarding treatment outcomes (i.e., treatment adherence and remission of eating symptomatology) when comparing the two treatment groups. CONCLUSION: Our results suggest that the impulsivity associated with EDs should be addressed and could be modified, as some facets of trait impulsivity improved after Playmancer add-on treatment. Yet, there were no significant differences in treatment outcomes when comparing the two groups and further research needs to be conducted.

The Impact of Virtual Reality (VR) on Psychological and Physiological Variables in Children Receiving Chemotherapy: A Pilot Cross-Over Study.

BACKGROUND: Virtual reality (VR) is a novel technology which provides a great opportunity to reduce some of the adverse effects of chemotherapy. OBJECTIVE: Our study aims to investigate the effects of VR on the emotional states of paediatric oncology patients (n = 29, age: 10-18 years) receiving chemotherapy in a clinical setting with a crossover design. METHODS: Children played a VR game in the experimental, and a mobile game in the control condition. Psychological (happiness, joy, fear, nervousness, anxiety, alertness, patience) and physiological variables (heart rate, systolic blood pressure, electrodermal activity), as well as pain and nausea were measured before and after the sessions. Data were analysed with multiple 2-way repeated measures ANOVA. RESULTS: Joy (P = .003) and happiness (P < .001) increased significantly when using VR, while there was no change in the control condition. Anxiety decreased (P = .002) and patience increased (P = .015) in both conditions, implying no additional benefit of VR. Children were more fearful before the VR session (P = .005), which disappeared after it. In case of physiological parameters, electrodermal activity decreased (P = .01) significantly after playing the mobile game, but not after the VR one. CONCLUSIONS: Our investigation point to the positive effects of VR on mood in paediatric oncology inpatients, thus, it could be used as a new tool in improving patients' well-being during chemotherapeutical treatment. Our results indicate that VR is an effective tool in improving patients' well-being during chemotherapeutic treatment.

Effects of Dietary Supplementation of a Microalgae Extract Containing Fucoxanthin Combined with Guarana on Cognitive Function and Gaming Performance.

BACKGROUND: Esports competitive gaming requires selective visual attention, memory, quick judgment, and an ability to sustain psychomotor performance over time. Fucoxanthin is a carotenoid, found in specific microalgae varieties such as Phaeodactylum tricornutum (PT), that has been purported to possess nootropic and neuroprotective effects through its anti-inflammatory and antioxidant properties. This study evaluated whether acute and 30-day supplementation of an extract of PT from microalgae combined with guarana (a natural source of caffeine) affects cognitive function in gamers. MATERIALS AND METHODS: In a double-blind, placebo-controlled manner, 61 experienced gamers (21.7 ± 4.1 years, 73 ± 13 kg) were randomly assigned to ingest a placebo (PL), a low-dose (LD) supplement containing 440 mg of PT extract including 1% fucoxanthin +500 mg of guarana containing 40-44 mg caffeine (MicroPhyt™, Microphyt, Baillargues, FR), or a high-dose (HD) supplement containing 880 mg of PT extract +500 mg of guarana for 30 days. At baseline, cognitive function tests were administered before supplementation, 15 min post-supplementation, and after 60 min of competitive gameplay with participants' most played video game. Participants continued supplementation for 30 days and then repeated pre-supplementation and post-gaming cognitive function tests. General linear model univariate analyses with repeated measures and changes from baseline with 95% confidence intervals were used to analyze data. RESULTS: There was some evidence that acute and 30-day ingestion of the PT extract from microalgae with guarana improved reaction times, reasoning, learning, executive control, attention shifting (cognitive flexibility), and impulsiveness. While some effects were seen after acute ingestion, the greatest impact appeared after 30 days of supplementation, with some benefits seen in the LD and HD groups. Moreover, there was evidence that both doses of the PT extract from microalgae with guarana may support mood state after acute and 30-day supplementation. Registered clinical trial #NCT04851899.

Effectiveness of binocular therapy as a complementary treatment of part-time patching in older amblyopic children: a randomized clinical trial.

PURPOSE: To assess the effectiveness of combined use of stereoscopic 3D video movies and part-time patching in treating older amblyopic children with poor response or compliance to traditional patching treatments and comparing this combined treatment with patching alone. METHODS: Thirty-two children aged 5-12 years with amblyopia associated with anisometropia, strabismus, or both were recruited in a randomized clinical trial. Eligible participants were assigned randomly to the combined and patching groups. Here, binocular treatment refers to using the Bangerter filter to blur the fellow eye and subsequently watching a close-up 3D movie with large parallax. The primary outcome was amblyopic eye (AE) best-corrected visual acuity (BCVA) improvement at six weeks. In addition, secondary outcomes included BCVA of AE improvement at three weeks and change of stereoacuity. RESULTS: Of 32 participants, mean (SD) age was 6.63 (1.46) years, and 19 (59%) were female. At 6 weeks, mean (SD) amblyopic eye VA improved by 0.17 ± 0.08 logMAR (2-sided 95% CI, 0.13 to 0.22; F = 57.2, p < 0.01) and 0.05 ± 0.04 logMAR (2-sided 95% CI, 0.05 to 0.09; F = 8.73, p = 0.01) in the combined and patching groups, respectively. The difference was statistically significant (mean difference, 0.13 logMAR [1.3 line]; 95% CI, 0.08-0.17 logMAR [0.8-1.7 lines]; t25 = 5.65, p < 0 .01). After treatment, only the combined group had significantly improved stereoacuity, such as binocular function score (median [interquartile range], 2.30 [2.23 to 2.68] vs. 1.69 [1.60 to 2.30] log arcsec; paired, z = -3.53, p < 0.01), and mean stereoacuity gain was 0.47 log arcsec (± 0.22). Changes in other types of stereoacuity were similar. CONCLUSION: Our laboratory-based binocular treatment strategy engaged a high level of compliance that led to a substantial gain in visual function after a short period of treatment for older amblyopic children having poor response or compliance to traditional patching treatments. Notably, the improving stereoacuity showed a greater advantage.

Electromyographic biofeedback-driven gaming to alter calf muscle activation during gait in children with spastic cerebral palsy.

BACKGROUND: Children with cerebral palsy often show deviating calf muscle activation patterns during gait, with excess activation during early stance and insufficient activation during push-off. RESEARCH QUESTION: Can children with cerebral palsy improve their calf muscle activation patterns during gait using one session of biofeedback-driven gaming? METHODS: Eighteen children (6-17 y) with spastic cerebral palsy received implicit game-based biofeedback on electromyographic activity of the calf muscle (soleus or gastrocnemius medialis) while walking on a treadmill during one session. Biofeedback alternately aimed to reduce early stance activity, increase push-off activity, and both combined. Early stance and push-off activity and the double-bump-index (early stance divided by push-off activity) were determined during baseline and walking with feedback. Changes were assessed at group level using repeated measures ANOVA with simple contrast or Friedman test with post-hoc Wilcoxon signed rank test, as well as individually using independent t-tests or Wilcoxon rank sum tests. Perceived competence and interest-enjoyment were assessed through a questionnaire. RESULTS: Children successfully decreased their electromyographic activity during early stance feedback trials (relative decrease of 6.8 ± 12.2 %, P = 0.025), with a trend during the combined feedback trials (6.5 ± 13.9 %, P = 0.055), and increased their electromyographic activity during push-off feedback trials (8.1 ± 15.8 %, P = 0.038). Individual improvements were seen in twelve of eighteen participants. All children experienced high levels of interest-enjoyment (8.4/10) and perceived competence (8.1/10). SIGNIFICANCE: This exploratory study suggests that children with cerebral palsy can achieve small within-session improvements of their calf muscle activation pattern when provided with implicit biofeedback-driven gaming in an enjoyable manner. Follow-up gait training studies can incorporate this method to assess retention and long-term functional benefits of electromyographic biofeedback-driven gaming.

Facets of mindfulness among video game players: A latent profile analysis.

OBJECTIVE: This study explores the presence of different profiles of video game players across five mindfulness facets (i.e., describing, observing, nonreacting, nonjudging, and acting with awareness) and nonattachment (i.e., the ability to relate to experiences without clinging onto them). METHOD: Adults who play video games (N = 629) were recruited from Amazon's Mechanical Turk. Participants completed an online survey, assessing their dispositional mindfulness and nonattachment, problem video gaming, emotion-based impulsivity, psychological inflexibility, and mental health. RESULTS: The latent profile analysis identified four profiles, representing those who were highly mindful (n = 131; 20.8%), moderately mindful (n = 289; 46.0%), reactive and attached (n = 132; 21.0%), and judgmental and unaware (n = 77; 12.2%). Subsequent comparisons revealed that the judgmental and unaware profile reported the highest level of problem gaming, followed by the reactive and attached profile. The judgmental and unaware profile evidenced stronger general gaming motivations and higher emotion-based impulsivity; in contrast, the reactive and attached profile demonstrated greater psychological inflexibility and escapism motivation relative to the other profiles. Both the judgmental and unaware and the reactive and attached profiles had elevated levels of anxiety and depression. CONCLUSION: These findings provide a more nuanced assessment of the protective role of mindfulness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychological treatments for excessive gaming: a systematic review and meta-analysis.

Despite widespread public interest in problematic gaming interventions, questions regarding the empirical status of treatment efficacy persist. We conducted pairwise and network meta-analyses based on 17 psychological intervention studies on excessive gaming (n = 745 participants). The pairwise meta-analysis showed that psychological interventions reduce excessive gaming more than the inactive control (standardized mean difference [SMD] = 1.70, 95% confidence interval [CI] 1.27 to 2.12) and active control (SMD = 0.88, 95% CI 0.21 to 1.56). The network meta-analysis showed that a combined treatment of Cognitive Behavioral Therapy (CBT) and Mindfulness was the most effective intervention in reducing excessive gaming, followed by a combined CBT and Family intervention, Mindfulness, and then CBT as a standalone treatment. Due to the limited number of included studies and resulting identified methodological concerns, the current results should be interpreted as preliminary to help support future research focused on excessive gaming interventions. Recommendations for improving the methodological rigor are also discussed.

Digital joint action: Avatar-mediated social interaction in digital spaces.

This article proposes a framework to characterize joint action in digital spaces. "Digital joint action" maintains many known elements from physical, real-world joint action including representations relating to joint goals and individual subgoals, processes such as predicting and monitoring own and others' actions, and supporting coordination through signaling and direct communication. In contrast to social interaction in the real world, joint action performed online comes with a unique additional feature: Digital joint action is mediated through (more or less vividly visualized) avatars that are controlled by the individual users but also imply particular personas that come with their own skills and acting abilities. This makes digital joint action a highly interesting research field as it allows to investigate the cognitive principles of joint action that lie outside of the constraints of human physicality but are nevertheless embodied (i.e., in a virtual body). The aim of this article is two-fold: First, we introduce digital joint action as joint action between avatars in a digital environment, and we specify commonalities and differences between joint actions in the real world and in digital spaces to provide a framework for further research. Second, using a survey study among users of the popular massively multiplayer online role-playing game (MMORPG) Final Fantasy XIV, we provide empirical validation for our approach.

Predictors of Gaming Disorder or Protective from It, in a French Sample: A Symptomatic Approach to Self-Regulation and Pursued Rewards, Providing Insights for Clinical Practice.

Gaming disorder (GD) is a new health condition still requiring a lot of evidence established around its underlying and related psychological mechanisms. In our study we focused on Massively Multiplayer Online Role Playing Games (MMORPGs), a specific very popular and engaging game genre, to determine that benefit, motivation and control aspects could be predictive of a dysfunctional engagement in gaming. In total, 313 participants were recruited from private forums of gamers between May 2009 and March 2010. They filled out a questionnaire on their socio-demographic data and their weekly gaming time. They also completed different psychometric assessments such as the DSM IV-TR criteria for substance dependence adapted to gaming such as the Dependence Adapted Scale (DAS), the external rewards they expected from gaming (External Motives), the expected internal reward they expected from gaming (Internal Motives), the Zuckerman Sensation Seeking Scale (ZSSS), and the Barratt impulsiveness Scale (BIS-10). Results showed that some psychological factors related to online gaming represented risk factors for GD in participants (i.e., competition and advancement motives, reduced anxiety, solace, greater personal satisfaction, and sense of power), whereas some others were found to be protective factors from GD (i.e., recreation, enjoyment and experience seeking) in participants. Additionally, the study found that disinhibition, boredom susceptibility, thrill and adventure seeking, and high impulsivity were correlated to GD in participants. In conclusion, not only motives for gaming and impulsivity could be predictors for GD, but maladaptive coping strategies based on experienced relief in-game from negative feelings (anxiety and boredom) or experienced improvement in-game of self-perception (personal satisfaction, sense of power) could play as well a role of negative reinforcers for GD. Some benefits from gaming, typically entertainment and enjoyment, are shown to be protective factors from GD, playing the role of positive reinforcing factors. They are worthy of being identified and promoted as functional gaming habits. These findings can feed the clinical and health promotion fields, with a more in-depth understanding of diverse psychological factors in gamers, identifying those at risk for GD and those protective from it. The current work can foster a more balanced approach towards gaming activities, taking their opportunities for mankind and controlling for their adverse effects in some individuals.

Feasibility of a Novel Video Game-Based Electromyography Biofeedback System in Patients With Knee Osteoarthritis.

CONTEXT: A novel virtual game system Knee Biofeedback Rehabilitation Interface for game-based home therapy (KneeBright) was developed for strength training using integrated electromyography biofeedback of the quadriceps muscle to control the game. The study aimed to compare the KneeBright and electromyography biofeedback interface among patients with knee osteoarthritis. DESIGN: Controlled before and after design. METHODS: Nineteen patients with knee osteoarthritis took part in this laboratory-based study. Exercise sessions took place on 2 separate days. During session 1, participants used a conventional electromyography biofeedback system while performing 3 sets of lower body exercises with emphasis on maximal muscle activation, endurance, and precision. During session 2, participants used the KneeBright game to match the exercise sets in the first session. For both sessions, knee extension torque during the isometric muscle activation exercises and time to voluntary additional exercise were recorded. Patient engagement was assessed using the technology acceptance model and System Usability Score questionnaires. RESULTS: The peak knee extension torque produced during the control exercise session and the KneeBright exercise session were positively correlated. Knee extension torque generated during KneeBright game exercise sessions was increased by an average of 25% compared to the control sessions (2.14 vs 1.77 N·m/kg, P = .02). The mean technology acceptance model score for the KneeBright system was 3.4/5 and the mean System Usability Score was 79, both indicating positive patient engagement. CONCLUSIONS: Patients using the KneeBright game produced greater knee torque than patients using the conventional system, had positive levels of engagement, and exercised longer with the KneeBright game.

Video game-based exercise in children and adolescents with non-cystic fibrosis bronchiectasis: A randomized comparative study of aerobic and breathing exercises.

BACKGROUND: Video game-based systems have been proposed to improve effectiveness and compliance with exercise training in children and adolescents with noncystic fibrosis bronchiectasis (NCFB). This study aimed to investigate the effects of aerobic and breathing video game-based exercises (VGE) on pulmonary function, respiratory and peripheral muscle strength, functional capacity, and balance in children and adolescents with NCFB. METHOD: Thirty-nine children and adolescents aged between 8 and 18 years with NCFB were randomly allocated into three groups as "home-based chest physiotherapy group" (CP), "aerobic VGE given in addition to home-based chest physiotherapy group" (CP + aerobic VGE), and "breathing VGE given in addition to home-based chest physiotherapy group" (CP + breathing VGE). All three groups performed chest physiotherapy program twice a day for 7 days per week for 8 weeks. Pulmonary function, respiratory and peripheral muscle strength, functional capacity, and balance were assessed at baseline and after 8 weeks of training. RESULTS: The improvement in maximum expiratory pressure and balance scores were significantly higher in both CP + aerobic and CP + breathing VGE groups. The significant improvement in maximum inspiratory pressure was greater in the CP + breathing VGE group. The changes in peripheral muscle strength and functional capacity were significantly higher in the CP + aerobic VGE group. CONCLUSIONS: The present study showed that aerobic VGE provides additional benefits in improving peripheral muscle strength and functional capacity, while breathing VGE provides further increase in improving respiratory muscle strength. In addition, both aerobic and breathing VGE were effective in improving balance, but they were not superior to each other.

Sex Differences in Competitiveness in Massively Multiplayer Online Role-Playing Games (MMORPGs).

Sex differences in the use of competitive tactics have been well established. Although many factors may contribute to these sex differences, according to social role theory (SRT), stereotypes and expectations about men's and women's typical social roles are crucial. We addressed the potential impact of social roles by studying massively multiplayer online role-playing games (MMORPGs), a setting where individuals represent themselves with avatars and thus enjoy the opportunity to compete without regard to the typical expectations and behaviors associated with men's and women's roles. We surveyed players via MTurk (63 women, 191 men) and Reddit (166 women, 1,326 men) regarding their frequency of engaging in five competitive behaviors and the sex and role of their primary avatar. As expected, there were reliable sex differences in competitiveness: men were more likely than women to engage in player-versus-player duels (MTurk d = 0.19; Reddit d = 0.51), do solo runs of difficult content (0.30, 0.35), and work to acquire expensive items (0.32, 0.19); women were more likely than men to seek in-game awards (-0.38, -0.36) and spend real-world money on expensive microtransactions (-0.16, -0.27). Contrary to SRT, these sex differences in forms of competitive behavior were generally unrelated to players' chosen avatar sex or avatar role. These results instead indicate that sex differences in competitiveness largely reflect evolved predispositions.

Are there sex differences in energy expenditure and enjoyment in older adults playing active video games?

The aim of this study was to compare sex differences in energy expenditure and enjoyment in older adults during Active Video Game activities and sedentary behavior (watching television). In a within-subjects design, n = 32 older adults were included (15 men and 17 women). Energy expenditure was measured during each activity using indirect calorimetry. Energy expenditure was expressed in J.kg-1.min-1 and Metabolic Equivalents. Enjoyment was measured after each activity with the Physical Activity Enjoyment Scale. Energy expenditure was greater in Active Video Game activities compared to sedentary behavior in both men and women, but no differences were observed between sexes. The women reported greater enjoyment in Active Video Game activities compared to the men, and women reported greater enjoyment in Active Video Game activities compared to watching television, whereas the men did not report differences in enjoyment between Active Video Game vs. television watching. In conclusion, despite no difference in Energy expenditure, older women enjoy more than men playing Active Video Game, maybe they can be targeted for this intervention. (Clinical Trials Registration - NCT04352543).

Visualization, Self-Efficacy, and Locus of Control in a Virtual Reality Biofeedback Video Game for Anxiety Regulation.

The current study aimed to identify specific feedback mechanics and psychological processes that may contribute to positive outcomes in biofeedback applications for anxiety regulation. Specifically, using a dismantling study design, the unique impact of visualizations that directly mirror users' breathing was examined in relation to anxiety regulation as well as locus of control and self-efficacy. Following an anxiety induction, participants (N = 67) were randomly assigned to play one of two variations of a biofeedback video game. In both versions, players' in-game movement was contingent on their breathing; however, the experimental condition additionally included visualizations that directly mirrored players' breathing. Changes in self-reported state anxiety and physiological arousal were measured as well as the level of internal control and self-efficacy participants experienced while playing the game. Results showed that all participants were able to effectively reduce their anxiety and arousal, but no condition differences were found. Implementing mirroring visualizations did not contribute to individuals' ability to self-regulate nor their self-efficacy or locus of control above and beyond receiving feedback based on their in-game movement. Overall, individuals who experienced higher self-efficacy and a stronger internal locus of control were better able to regulate their anxiety, but no clear links were found with changes in self-reported physiological arousal. In light of these results, we recommend the continued exploration of the role of specific design choices and intervention components as well as underlying mechanisms of change in biofeedback interventions, especially pertaining to how individuals perceive themselves and their ability to change.

Video Games as a Complementary Therapy for Schizophrenia: A Systematic Review.

BACKGROUND: Schizophrenia is a prevalent and serious disorder. Video games have shown potential as an aid in health care for people who suffer from schizophrenia. Although video games may contribute benefit in the treatment of schizophrenia, reviews on this topic are scarce. In this article, we systematically review the evidence concerning video game-based therapeutic interventions for people diagnosed with schizophrenia. METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in the PROSPERO database. We searched 4 databases-PubMed, Web of Science, EMBASE, and clinicaltrials.gov-to identify original studies exploring video game-based therapeutic interventions for people with schizophrenia. RESULTS: After initial screening, full-text review, and study selection, 11 articles were included in the review. Most studies used video consoles as the platform, with a minority using a personal computer. Video game-based therapeutic interventions were well accepted and generally effective in improving cognitive areas. CONCLUSIONS: Cognitive training could be one of the main mechanisms underlying the usefulness and effectiveness of video game-based therapeutic interventions. Software optimization and greater collaboration between developers and health care professionals are some of the priorities for future research in this area.