Exploring the Impact of a Persuasive Serious Video Game (Farmily) on Promoting Home Gardening Among Novices: Design and Randomized Controlled Trial.

BACKGROUND: Home gardens worldwide provide sustenance, economic support, and access to fresh produce and promote household well-being, health, self-sufficiency, and food security. However, they face significant challenges worldwide and necessitate innovative promotion approaches. Serious video games have proven effective in promoting agricultural knowledge. However, more research is needed on the persuasive potential of agriculture games to influence players' thoughts, attitudes, and behaviors. This provides an opportunity to examine the impact of persuasive games on promoting home gardening among novices. OBJECTIVE: This study aims to describe the design and development of Farmily, a persuasive video game promoting home gardening among novices. In addition, it evaluated the effectiveness of Farmily and compared its impact with that of a traditional home gardening workshop. Furthermore, the study explored how game enjoyment relates to the game's outcomes. METHODS: A randomized controlled trial with 50 novice gardening participants aged 20 to 50 years was carried out. Participants were randomly assigned to a control group (1.5-hour workshop) or an experimental group (1.5-hour Farmily session). Pre- and postintervention assessments were conducted. We evaluated Farmily's impact on knowledge, attitudes, perceived self-efficacy, and intentions regarding initiating home gardens. In addition, we investigated the user enjoyment and its relationship with the game's effect outcomes. RESULTS: The experimental group significantly improved their knowledge (t24=4.26; P<.001), attitude (z24=2.98; P=.003), self-efficacy (t24=2.6; P=.02), and intention to initiate home gardens (z24=4.15; P<.001). The experimental group showed similar effectiveness in knowledge transfer (t24=-1.71; P=.09) and a more significant impact on attitude (z24=2.73; P=.006), self-efficacy (t24=2.21; P=.03), and intention to start a home garden (t24=-5.33; P<.001) than the control group. Farmily was well received by the intervention group, generating high enjoyment. Furthermore, user enjoyment substantially correlated with user attitudes (r23=0.72; P<.001) and self-efficacy (r23=0.67; P<.001), yet no discernible association was observed among user enjoyment, knowledge (r23=0.26; P=.20), and intention (r23=0.06; P=.77). CONCLUSIONS: Evidence indicates that Farmily appears to be a viable tool for promoting home gardening among novices in the short term. Farmily demonstrated similar effects in knowledge improvement to those of a traditional workshop and had a more significant impact on the other variables. In addition, we found that the player's gaming experience positively relates to the player's attitudes and self-efficacy. A well-powered randomized controlled trial with more diverse samples and extended follow-up periods will be conducted to establish the long-term efficacy of Farmily and gain a deeper understanding of the influence of enjoyment on game outcomes.

The effect of transcranial direct current stimulation associated with video game training on the postural balance of older women in the community: A blind, randomized, clinical trial.

BACKGROUND: Falls are frequent in older adults and can cause trauma, injury, and death. Fall prevention with virtual reality presents good results in improving postural control. Transcranial Direct Current Stimulation (tDCS) has been used with the same aim; however, the combination of the two techniques has still been little studied. PURPOSE: To assess whether tDCS can enhance the effect of video game training (VGT) on improving the postural balance of healthy older women. METHOD: A blinded, randomized, controlled clinical trial was conducted with 57 older women who were randomized to three balance training groups: Control Group (VGT), Anodal Group (VGT combined with anodic tDCS-atDCS), and Sham Group (VGT combined with sham tDCS-stDCS). Balance training was performed twice a week for four weeks, totalizing eight 20-min sessions using VGT associated with tDCS. Postural balance was assessed pre-and post-training and 30 days after the end of the eight sessions using the Mini-Balance Evaluation Systems Test. RESULTS: Compared to pre-intervention the Mini BEST test increased similarly in the three groups in post-intervention (control: pre 23.7 ± 2.8 to post 27.0 ± 2.2; anodal: pre 24.4 ± 1 to post 27.7 ± 0.8 and sham: pre 24.2 ± 1.9 to post 26.5 ± 1.6; p < 0.001) and follow-up (control: pre 23.7 ± 2.8 to follow-up 26.8 ± 2.3; anodal: pre 24.4 ± 1 to follow-up 27.3 ± 1.4 and sham: pre 24.2 ± 1.9 to follow-up 26.8 ± 1.5; p < 0.001). CONCLUSION: There was an improvement in the postural balance of the three training groups that were independent of tDCS. DISCUSSION: Some studies have shown the positive tDCS effects associated with other tasks to improve balance. However, these results convey the effects of only anodic-tDCS compared to sham-tDCS. Possibly, the effect of VGT surpassed the tDCS effects, promoting a ceiling effect from the combination of these two therapies. However, studies with other therapies combined with tDCS for older adults deserve to be investigated, as well as in frail older people.

Impact of exergames on bmi and cardiovascular risk factors: a systematic review / Impacto de exergames sobre imc y los factores de riesgo cardiovascular: revisión sistemática / Impacto de exergames no imc e fatores de risco cardiovascular: uma revisão sistemática

ABSTRACT Introduction: Exergames or active video games are digital platforms with functionality associated with body movement, which dialogue with improving physical activity levels, stimulating pleasure in practice and adherence to change habits, physically active behavior, and better quality of life. Objective: This study aimed to synthesize the available evidence on the contribution of exergame to Body Mass Index, physical activity level, glycemic control, blood pressure, and cardiorespiratory fitness in adolescents. Methods: This is a systematic review, reported following the PRISMA writing recommendations, without language restrictions, for articles indexed in the following databases: MEDLINE / PubMed, Embase, Cochrane Library, and Lilacs. Data extraction was performed analogously in a spreadsheet previously tested and standardized. The assessment of the risk of bias in the included studies was carried out by the RoB 1.0 tool in all of its domains in duplicate of reviewers. Initially, 3.039 studies were found. Results: The studies cover a total of 526 adolescents aged ten to 19. The most used platform in the studies was the Nintendo Wii, followed by the PlayStation, Xbox 360, and Dance Dance Revolution. The results indicated that interventions using exergames were effective for changing BMI, but there was no evidence on cardiovascular outcomes, with no effective changes in glycemic control and blood pressure and a significant response (p <0.05) in cardiorespiratory fitness. Conclusion: The exergame points to satisfactory results in improving health and can be incorporated as a relevant public policy in the adolescent health promotion. (PROSPERO Registration CRD42020181772). Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMEN Introducción: Los Exergames o videojuegos activos son plataformas digitales con funcionalidad asociada al movimiento corporal, que dialogan con la mejora de los niveles de actividad física, estimulando el placer en la práctica y la adherencia a cambios de hábitos, conducta físicamente activa y mejor calidad de vida. Objetivo: Este estudio tuvo como objetivo sintetizar la evidencia disponible sobre la contribución del exergame al índice de masa corporal, nivel de actividad física, control glucémico, presión arterial y aptitud cardiorrespiratoria en adolescentes. Métodos: Se trata de una revisión sistemática, reportada siguiendo las recomendaciones de redacción de PRISMA, sin restricción de idioma, para artículos indexados en las siguientes bases de datos: MEDLINE / PubMed, Embase, Cochrane Library y Lilacs. La extracción de datos se realizó de manera similar en una hoja de cálculo estandarizada y probada previamente. La evaluación del riesgo de sesgo en los estudios incluidos se realizó mediante la herramienta RoB 1.0 en todos sus dominios por duplicado de revisores. Inicialmente, se encontraron 3.039 estudios. Resultados: Los estudios abarcaron un total de 526 adolescentes de 10 a 19 años. La plataforma más utilizada en estudios fue la Nintendo Wii, seguida de la PlayStation, Xbox 360 y Dance Dance Revolution. Los resultados indicaron que las intervenciones con exergames fueron efectivas para cambiar el IMC, pero no hubo evidencia sobre los resultados cardiovasculares, no hubo cambios efectivos en el control glucémico y la presión arterial, y una respuesta explicativa (p <0.05) en la aptitud cardiorrespiratoria. Conclusión: El exergame muestra resultados satisfactorios en la mejora de la salud y puede ser incorporado como una política pública relevante en la promoción de la salud de los adolescentes. (Registro PROSPERO CRD42020181772). Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

RESUMO Introdução: Exergames ou vídeo games ativos são plataformas digitais com funcionalidade associada ao movimento corporal, que dialogam com a melhora dos níveis de atividade física, estimulando o prazer na prática e a adesão à mudança de hábitos, comportamento ativo e melhor qualidade de vida. Objetivo: Este estudo teve como objetivo sintetizar as evidências disponíveis sobre a contribuição do exergame para o Índice de Massa Corporal, nível de atividade física, controle glicêmico, pressão arterial e aptidão cardiorrespiratória em adolescentes. Métodos: Trata-se de uma revisão sistemática, relatada seguindo as recomendações de redação do PRISMA, sem restrição de idioma, para artigos indexados nas seguintes bases de dados: MEDLINE / PubMed, Embase, Cochrane Library e Lilacs. A extração dos dados foi realizada de forma análoga em planilha previamente testada e padronizada. A avaliação do risco de viés nos estudos incluídos foi realizada pela ferramenta RoB 1.0 em todos os seus domínios em duplicata de revisores. Inicialmente, foram encontrados 3.039 estudos. Resultados: Os estudos abrangeram um total de 526 adolescentes de dez a 19 anos. A plataforma mais utilizada nos estudos foi o Nintendo Wii, seguido do PlayStation, Xbox 360 e Dance Dance Revolution. Os resultados indicaram que as intervenções com exergames foram eficazes para alterar o IMC, mas não houve evidências sobre os desfechos cardiovasculares, sem alterações eficazes no controle glicêmico e na pressão arterial e uma resposta significativa (p <0,05) na aptidão cardiorrespiratória. Conclusão: O exergame aponta resultados satisfatórios na melhoria da saúde e pode ser incorporado como uma política pública relevante na promoção da saúde do adolescente. (Registro PROSPERO CRD42020181772). Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

Gaming Disorder em Minorias Sexuais e de Gênero / Gaming Disorder in sexual and gender minorities / Trastorno de juego en minorías sexuales y de género

ntrodução: Os jogos eletrônicos são agora reconhecidos como um problema de saúde mental, especialmente entre a comunidade LGBTQIA+. Objetivo: explorar os efeitos do transtorno de jogo (gaming disorder) na população LGBTQIA+. Método: A revisão narrativa abordou hábitos de jogo e gaming disorder em minorias sexuais e de gênero, usando PubMed, Google Scholar, Embase e Web of Science. Das 1640 pesquisas, apenas 3 abordaram gaming disorder nessa população. Resultado: consumidores LGBTQ+ gastam mais em jogos digitais. Jogadores LGBTQIA+ consomem mais jogos de exploração de identidade, possivelmente relacionados ao estresse de minoria. Discussão: minorias sexuais têm maior risco de gaming disorder. Para indivíduos LGBTQIA+, os jogos podem servir como escape e plataforma de apoio, mas o uso problemático pode estar associado a desfechos psiquiátricos negativos. Conclusão: Os jogos online têm o potencial de serem ferramentas de apoio para minorias, no entanto, as evidências são limitadas. É necessária mais pesquisa para compreender melhor a relação entre o uso de jogos e a saúde mental da população LGBTQIA+.

ntroduction: Electronic games are now recognized as a mental health issue, especially within the LGBTQIA+ community. Objective: To explore the effects of gaming disorder in the LGBTQIA+ population. Method: The narrative review addressed gaming habits and gaming disorder in sexual and gender minorities, utilizing PubMed, Google Scholar, Embase, and Web of Science. Out of 1640 studies, only 3 focused on gaming disorder in this population. Result: LGBTQ+ consumers spend more on digital games. LGBTQIA+ players engage more in identity exploration games, possibly linked to minority stress. Discussion: Sexual minorities face a higher risk of gaming disorder. For LGBTQIA+ individuals, games can serve as an escape and support platform, but problematic use may be associated with negative psychiatric outcomes. Conclusion: Online games have the potential as support tools for minorities, but evidence is limited. Further research is needed to better understand the relationship between game use and mental health in the LGBTQIA+ population.

Introducción: Los videojuegos electrónicos son reconocidos actualmente como un problema de salud mental, especialmente dentro de la comunidad LGBTQIA+. Objetivo: Explorar los efectos del trastorno de juego (gaming disorder) en la población LGBTQIA+. Método: La revisión narrativa abordó los hábitos de juego y el gaming disorder en minorías sexuales y de género, utilizando PubMed, Google Scholar, Embase y Web of Science. De las 1640 investigaciones, solo 3 se centraron en el gaming disorder en esta población. Resultado: Los consumidores LGBTQ+ gastan más en juegos digitales. Los jugadores LGBTQIA+ consumen más juegos de exploración de identidad, posiblemente relacionados con el estrés de minoría. Discusión: Las minorías sexuales enfrentan un mayor riesgo de gaming disorder. Para los individuos LGBTQIA+, los juegos pueden servir como un escape y plataforma de apoyo, pero el uso problemático puede estar asociado con resultados psiquiátricos negativos. Conclusión: Los juegos en línea tienen el potencial como herramientas de apoyo para las minorías, pero la evidencia es limitada. Se requiere más investigación para comprender mejor la relación entre el uso de juegos y la salud mental en la población LGBTQIA+.

Escaping through virtual gaming-what is the association with emotional, social, and mental health? A systematic review.

Background: The realm of virtual games, video games, and e-sports has witnessed remarkable and substantial growth, captivating a diverse and global audience. However, some studies indicate that this surge is often linked to a desire to escape from real life, a phenomenon known as escapism. Much like substance abuse, escapism has been identified as a significant motivator, leading to adverse outcomes, including addiction. Therefore, it is crucial to comprehend the existing research on the connection between escapism and engagement in virtual gaming. This understanding can shed light on the reasons behind such practices and their potential impact on mental and public health. Purpose: The objective of this systematic review is investigate the findings pertaining to association between escapism and the practice of virtual games, such as video-games and e-sport. Methods: PUBMED and SCOPUS database were systematically searched. Six independent researchers screened articles for relevance. We extracted data regarding escapism-related measures, emotional/mental health-related measures and demographic information relevant to the review purpose. Results: The search yielded 357 articles, 36 were included. Results showed that: (i) Escapist motivation (EM) is one of the main motives for playing virtual games; (ii) EM is related to negative clinical traits; (iii) EM predicts negative psychological/emotional/mental health outcomes; (iv) EM is associated with impaired/negative perception of the real-world life; (v) EM predicts non-adaptive real social life; and (vi) EM is associated with dysfunctional gaming practices in some cases. However, EM can have beneficial effects, fostering confidence, determination, a sense of belonging in virtual communities, and representation through avatars. Furthermore, the reviewed findings suggest that EM was positively linked to mitigating loneliness in anxious individuals and promoting social activities that preserved mental health among typical individuals during the pandemic. Conclusion: Our review reinforces the evidence linking EM in the context of virtual games to poor mental health and non-adaptive social behavior. The ensuing discussion explores the intricate connection between escapism and mental health, alongside examining the broad implications of virtual gaming practices on underlying motivations for escapism in the realms of social cognition, health promotion, and public health.

A Video Game for Entrepreneurship Learning in Ecuador: Development Study.

BACKGROUND: Games have been a part of human life since ancient times and are taught to children and adults who want to simultaneously have fun and learn. Nevertheless, in the third decade of this century, technology invites us to consider using video games to learn topics such as entrepreneurship. However, developing a serious game (SG) is difficult because everyone who forms part of the game development team requires adequate learning resources to acquire the necessary information and improve their game development skills. OBJECTIVE: This work aimed to detail the experience gained in developing ATIC (Aprende, Trabaja, Innova, Conquista [learn, work, innovate, conquer]), an SG proposed for teaching and learning entrepreneurship. METHODS: To develop a videogame, first, we established a game development team formed by professors, professionals, and students who have different roles in this project. Scrum was adopted as a project management method. To create concept art for the video game, designers collected ideas from various games, known as "getting references." In contrast, narratology considers the life of a recent university graduate immersed in real life, considering locations, characteristics, and representative characters from an essential city of Ecuador. RESULTS: In a Unity 3D video game in ATIC, the life of a university student who graduates and ventures into a world full of opportunities, barriers, and risks, where the player needs to make decisions, is simulated. The art of this video game, including sounds and music, is based on the landscape and characteristics of and characters from Cuenca, Ecuador. The game aims to teach entrepreneurs the mechanisms and processes to form their businesses. Thus, we developed the following elements of an SG: (1) world, (2) objects, (3) agents, and (4) events. CONCLUSIONS: The narrative, mechanics, and art of video games are relevant. However, project management tools such as leaderboards and appointments are crucial to influencing individuals' decision to continue to play, or not play, an SG. Developing a serious video game is not an easy task. It was essential to consider many factors, such as the video game audience, needs of learning, context, similarities with the real world, narrative, game mechanics, game art, and game sounds. However, overall, the primary purpose of a serious video game is to transmit knowledge in a fun way and to give adequate and timely feedback to the gamer. Finally, nothing is possible if the members of game development team are not satisfied with the project and not clear about their roles.

A Systematic Review of Pharmacological Treatments for Internet Gaming Disorder.

OBJECTIVE: Internet gaming disorder (IGD) is an increasingly common behavioral addiction, with an estimated global prevalence of 3%. A variety of pharmacological treatments have been used to treat IGD, yet no review to date has synthesized clinical trials evaluating their efficacy. This systematic review therefore synthesized the literature reporting on clinical trials of pharmacological treatments for IGD. METHODS: We reviewed articles from MEDLINE, Embase, PubMed Central, CINAHL, and PsycINFO that were published as of March of 2022. A total of 828 articles were retrieved for review and 12 articles were included, reporting on a total of 724 participants. RESULTS: Most participants were male (98.6%), and all were currently living in South Korea. The most common drugs used to treat IGD were bupropion, methylphenidate, and a range of selective serotonin reuptake inhibitors. The Young Internet Addiction Scale was the most frequently used to measure gaming-related outcomes. All studies reported reduced symptoms of IGD from pre- to post-treatment. Across all clinical trials, IGD symptom reductions following the administration of pharmacological treatments ranged from 15.4% to 51.4%. A risk of bias assessment indicated that only four studies had a low risk of bias. CONCLUSION: Preliminary results suggest that a wide array of pharmacological interventions may be efficacious in the treatment of IGD. Future studies using double-blind randomized controlled trial designs, recruiting larger and more representative samples, and controlling for psychiatric comorbidities are needed to better inform understanding of pharmacological treatments for IGD.

Augmented reality in interventional radiology education: a systematic review of randomized controlled trials

ABSTRACT BACKGROUND: Augmented reality (AR) involves digitally overlapping virtual objects onto physical objects in real space so that individuals can interact with both at the same time. AR in medical education seeks to reduce surgical complications through high-quality education. There is uncertainty in the use of AR as a learning tool for interventional radiology procedures. OBJECTIVE: To compare AR with other learning methods in interventional radiology. DESIGN AND SETTING: Systematic review of comparative studies on teaching techniques. METHODS: We searched the Cochrane Library, MEDLINE, Embase, Tripdatabase, ERIC, CINAHL, SciELO and LILACS electronic databases for studies comparing AR simulation with other teaching methods in interventional radiology. This systematic review was performed in accordance with PRISMA and the BEME Collaboration. Eligible studies were evaluated using the quality indicators provided in the BEME Collaboration Guide no. 11, and the Kirkpatrick model. RESULTS: Four randomized clinical trials were included in this review. The level of educational evidence found among all the papers was 2B, according to the Kirkpatrick model. The Cochrane Collaboration tool was applied to assess the risk of bias for individual studies and across studies. Three studies showed an improvement in teaching of the proposed procedure through AR; one study showed that the participants took longer to perform the procedure through AR. CONCLUSION: AR, as a complementary teaching tool, can provide learners with additional skills, but there is still a lack of studies with a higher evidence level according to the Kirkpatrick model. SYSTEMATIC REVIEW REGISTRATION NUMBER: DOI 10.17605/OSF.IO/ACZBM in the Open Science Framework database.

Intervención neuropsicológica sobre entrenamiento de memoria de trabajo con videojuego "Recuérdalo Todo" / Neuropsychological intervention on working memory training with the video game "Recuérdalo Todo" / Intervenção neuropsicológica no treino da memória de trabalho com o videojogo "Recuérdalo Todo"

RESUMEN Introducción: La intervención desde un enfoque neuropsicológico permite conseguir mejoras, aportar estrategias y proponer cambios que impactan el aprendizaje y la salud cognitiva de los participantes. El empleo de videojuegos muestra mejoras en habilidades de dominio general como la memoria de trabajo y de dominio específico como el rendimiento. Objetivo: Determinar el efecto del entrenamiento de memoria de trabajo a través del videojuego "Recuérdalo Todo" en el rendimiento académico (matemático y lector), en niños de preescolar y segundo grado. Método: Se realizó un estudio cuasi-experimental en La Habana, Cuba, durante el curso 2018-2019. Participaron 29 niños de preescolar (14 niñas) y 27 niños de segundo grado (8 niñas) que fueron asignados aleatoriamente a un grupo experimental (recibe entrenamiento con el videojuego) y un grupo control (no recibe el entrenamiento hasta no concluir los pos-test). Fueron evaluados antes y después del entrenamiento con pruebas de procesos de dominio general y rendimiento académico. Resultados: El entrenamiento tuvo una influencia positiva en los procesos de dominio general más que en el rendimiento académico. El tamaño del efecto de intervención en los procesos de dominio general fue medio, lo cual avaló la efectividad. Conclusiones: "Recuérdalo todo" tiene un efecto favorable sobre procesos de dominio general y sobre procesos predictores de la adquisición de la lectura en preescolares, así como en el procesamiento numérico en niños de segundo grado. Esta intervención sobre memoria de trabajo aporta herramientas que pueden contribuir a la preparación de los maestros para optimizar el aprendizaje de los escolares, lo que tiene un impacto en su salud cognitiva.

ABSTRACT Introduction: Intervention method, from a neuropsychological point of view, helps for increasing, giving strategies, and to propose impact changing in learning process and cognitive health of participants. The uses of video games have demonstrated improvements in domain-general skills such as working memory and domain-specific skills as the performance. Objective: Determine the effect of working memory training through the video game "Recuérdalo Todo" on academic performance (mathematics and reading) in Pre-kindergarten and second grade children. Methods: A quasi-experimental study was conducted during the academic year 2018-2019 in Havana, Cuba. A total of 29 pre-kindergarten children (among them 14 girls) and 27 second graders (including 8 girls) were involved. They were randomly assigned to two groups, an experimental group which received the working memory training sessions through the video game "Recuérdalo Todo") and a control group which not received the training sessions during that period, but after the post-tests were concluded. They were evaluated before and after training with tests of domain-general processes and academic performance. Results: The training had a positive influence on domain-general processes rather than on academic performance. The effect of this intervention on domain-general processes was medium, which supported its effectiveness. Conclusions: The video game "Recuérdalo Todo" has a favorable effect on domain - general processes of reading in pre-kindergarten children, as well as in the numerical processing for children of second grade. This working memory intervention provides tools that can contribute to the preparation of teachers in order to optimize the schoolchildren learning process with an impact on their cognitive health.

RESUMO Introdução: A intervenção a partir de uma abordagem neuropsicológica permite alcançar melhorias, fornecer estratégias e propor mudanças que impactam na aprendizagem e na saúde cognitiva dos participantes. O uso de videogames mostra melhorias em habilidades de domínio geral, como memória de trabalho, e habilidades de domínio específico, como desempenho. Objetivo: Determinar o efeito do treinamento da memória de trabalho por meio do videogame "Recuérdalo Todo" no desempenho acadêmico (matemático e leitura), em crianças da pré-escola e da segunda série. Método: Um estudo quase experimental foi realizado em Havana, Cuba, durante o ano letivo 2018-2019. Os participantes foram 29 crianças pré-escolares (14 meninas) e 27 crianças da segunda série (8 meninas) que foram aleatoriamente designadas para um grupo experimental (recebe treinamento com o videogame) e um grupo controle (não recebe treinamento até que os pós-testes sejam concluídos). Eles foram avaliados antes e após o treinamento com testes de processos de domínio geral e desempenho acadêmico. Resultados: O treinamento influenciou positivamente nos processos de domínio geral mais do que no desempenho acadêmico. O tamanho do efeito da intervenção nos processos de domínio geral foi médio, o que apoiou a eficácia. Conclusões: "Recuérdalo Todo" tem um efeito favorável nos processos de domínio geral e nos processos preditivos de aquisição de leitura em pré-escolares, bem como no processamento numérico em crianças do segundo ano. Esta intervenção na memória de trabalho fornece ferramentas que podem contribuir para a preparação dos professores para otimizar a aprendizagem dos escolares, o que tem impacto na sua saúde cognitiva.

A Video Game for Brazilian T1D Children about Knowledge of Disease and Self-care: A Methodological Study.

BACKGROUND: Video games are interactive technologies able to support children in health promotion, behavior changes, and chronic disease self-management. The use of health behavior change determinants in video game design can increase its effectiveness. This study describes the process of designing a video game for Brazilian children with T1D clarifying the use of health behavior change determinants that may influence self-management behaviors. METHODS: This was a methodological study based on health behavior change theories and the user-centered design approach. The results of a qualitative study conducted with children aged 7 to 12 years identified learning needs about knowledge on diabetes and self-care tasks which contribute to inappropriate behaviors. A Behavioral Diagnosis presented health behavior change determinants, capable of influencing children's learning needs and behaviors, that were considered to design The Heroes of Diabetes-the power of knowledge. RESULTS: The results presented the process of designing 4 mini games with its description and theory foundation to reach children's lack of understanding about T1D, insulin's role, SMBG requirements, food groups and physical activity's role in glycemic control. Knowledge, goal settings, extrinsic and intrinsic motivation determinants were related with video games design features. CONCLUSIONS: The findings support the use of health behavior change determinants into video game design as a guide to achieve children learning needs and that might influence self-management behaviors.

Do estimated metabolic equivalent and energy expenditure verify the physical effort of type-1 diabetics in resting and exercise situations? A randomized crossover trial / O equivalente metabólico estimado e o gasto energético verificam o esforço físico de diabéticos tipo 1 em repouso e exercícios? Um ensaio cruzado randomizado / ¿El equivalente metabólico y el gasto energético estimados verifican el esfuerzo físico de los diabéticos tipo 1 en situaciones de reposo y ejercicio? Un ensayo cruzado aleatorio

ABSTRACT To compare measured and estimated metabolic equivalent (MET) and energy expenditure (EE) in different situations with Type-1 diabetes (T1DM) patients. Ten T1DM patients performed three 30-minute sessions (resting, running-RS, and exergame-VS) at moderate intensity. MET and EE were measured by direct gas analyzer and estimated using the formula applying heart rate and V̇02peak. MET values (measured vs. estimated) were statistically different during RS (4.58±1.11 vs.7.59±1.36) and VS (3.98± 0.84 vs. 5.77±0.84) (p<0.001). EE values were similar: RS (147±43 vs. 246±157) and VS (129±33 vs. 184±20) (p<0.001). The error between the methods: 0.41, 1.51, and 1.07 METs and 20.1, 51.5, and 32.5 Kcals for resting, RS, and VS. Estimation could be used in resting and with caution for RS and VS.

RESUMO Comparar o equivalente metabólico (MET) medido e estimado e o gasto energético (EE) em diferentes situações em pacientes com diabetes tipo 1 (DM1). Dez DM1 realizaram três sessões de 30 minutos (Repouso, Corrida-RS e Exergame-VS) em intensidade moderada. MET e EE foram medidos por um analisador direto de gases e estimados pela fórmula usando frequência cardíaca e V̇02pico. Valores MET (medidos vs. estimados) foram estatisticamente diferentes durante o RS (4,58±1,11 vs. 7,59±1,36) e o VS (3,98±0,84 vs. 5,77±0,84) (p<0,001). Semelhante em EE: RS (147±43 vs. 246±157) e VS (129±33 vs. 184±20) (p<0,001). O erro entre os métodos: 0,41, 1,51 e 1,07 MET e 20,1, 51,5 e 32,5 Kcal para Repouso, RS e VS. A estimativa pode ser usada em repouso e com cuidado durante RS e VS.

RESUMEN Comparar el equivalente metabólico (MET)y gasto energético (EE) medido y estimado en diferentes situaciones en diabeticos tipo-1 (T1DM). Diez T1DM realizaron tres sesiones de 30 minutos (Descanso, Running-RS y Exergame-VS) en intensidad moderada. El MET y EE se midieron con un analizador de gases y se calcularon con fórmula utilizando la frecuencia cardíaca y VO2pico. Valores MET (medidos frente a estimados) eran estadísticamente diferentes durante RS (4,58±1,11 vs 7,59±1,36) y VS (3,98±0,84 vs 5,77±0,84) (p<0,001). Similar en EE: RS (147±43 vs 246±157) y VS (129±33 vs 184±20) (p<0,001). El error entre los métodos: 0.41, 1.51 y 1.07 MET y 20.1, 51.5 y 32.5 Kcal para Reposo, RS y VS. La estimación podría usarse en reposo y con cuidado durante RS y VS.

State Anxiety after Exergame Beach Volleyball Did Not Differ between the Single and Multiplayer Modes in Adult Men.

This study compared the exergame beach volleyball's acute effects on state anxiety level in single vs. multiplayer mode in adult men. Sixty adult men (age: 21.98 [4.58] years, body mass: 75.40 [15.70] kg, height: 1.77 [0.09] m, and body mass index: 24.19 [5.44] kg/m2; data are expressed as median [interquartile range]) were assigned to play exergame of beach volleyball in single- or multiplayer mode for approximately 30 min using the Xbox 360 Kinect®. The state anxiety level was evaluated before and after the intervention. There was no significant difference in the state anxiety levels after an exergame session between the single and multiplayer modes (p-value = 0.407, effect size (rB) = -0.12, defined as small). Furthermore, there was no significant difference in the state anxiety levels before and after an exergame session in single-player mode (p-value = 0.516, effect size (d) = 0.14, defined as trivial) and multiplayer mode (p-value = 0.053, rB = 0.43, defined as medium). In conclusion, state anxiety level after exergame beach volleyball did not differ between the single and multiplayer modes in adult men.

Comment on: Problematic online gaming and the COVID-19 pandemic - The role of exergames.

Although significant increases in gaming may not always be beneficial, exergames (a new generation of video games also known as exergaming or active video games) appear as an alternative, feasible, attractive, and safe way to perform physical exercise for most clinical and nonclinical populations. Therefore, it is important to recognize that exergames can be considered a useful tool for coping with the COVID-19 outbreak and the recommended social distancing period.

Acute effects of 2D exergame on cognitive functions and frontal cortical activity / Efeitos agudos do exergame 2D nas funções cognitivas e na atividade do córtex frontal / Efectos agudos del exergame 2D sobre las funciones cognitivas y la actividad cortical frontal

ABSTRACT This study aims to evaluate the effect of an exercise with a 2D virtual reality session on the cognition and cortical activity of young males. This is a randomized controlled trial with ten men aged 18 to 23 years. They were randomly assigned under two conditions: 1) exercise session with 2D virtual reality games and 2) control, which consisted of watching a two-episode video of a comic TV show. Cognition and frontal cortical activity were assessed immediately before and after the intervention, using the Mindset, performing the Digit Span Test, semantic verbal fluency, and executive function. Executive function improved with the exergame session (p=0.025). Exergames partially promote an immediate increase in the executive function of young people.

RESUMO Este estudo tem como objetivo avaliar o efeito de um exercício com sessão de realidade virtual 2D na cognição e atividade cortical de jovens do sexo masculino. Trata-se de um ensaio controlado randomizado com dez homens de 18 a 23 anos. Os participantes foram distribuídos aleatoriamente em duas condições: 1) sessão de exercícios com jogos de realidade virtual 2D e 2) controle, que consistia em assistir a um vídeo de dois episódios de um programa de TV. A cognição e a atividade cortical frontal foram avaliadas imediatamente antes e após a intervenção, por meio do Mindset, realização do Digit Span Test, fluência verbal e função executiva. A função executiva melhorou com a sessão de exergame (p=0,025). Exergames promove parcialmente um aumento imediato na função executiva dos jovens.

RESUMEN Este estudio tiene como objetivo evaluar el efecto de un ejercicio con sesión de realidad virtual 2D sobre la cognición y la actividad cortical de varones jóvenes. Este es un ensayo controlado aleatorio con diez hombres de 18 a 23 años. Fueron asignados aleatoriamente bajo dos condiciones: 1) sesión de ejercicios con juegos de realidad virtual 2D y 2) control, que consistía en ver dos episodios de un programa de televisión. Se evaluó la cognición y la actividad cortical frontal inmediatamente antes y después de la intervención, utilizando el Mindset, realizando el Digit Span Test, la fluidez verbal y la función ejecutiva. La función ejecutiva mejoró con la sesión de exergame (p=0.025). Exergames promueven parcialmente un aumento de la función ejecutiva de los jóvenes.

Prevalence and risk factors for internet gaming disorder

Objectives: To estimate the prevalence of internet gaming disorder (IGD) and associated risk factors in a sample of secondary and postsecondary students from a public federal institution of higher education (Instituto Federal de Educação, Ciência e Tecnologia) in Southern Brazil. Methods: The study included a sociodemographic questionnaire, the Beck Depression Inventory (BDI), Self-Report Questionnaire (SRQ-20), Pittsburgh Sleep Quality Index (PSQI-BR), the Mini-Social Phobia Inventory (Mini-SPIN), and the Game Addiction Scale (GAS). Finally, IGD was measured with the Brazilian version of the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), which has been psychometrically validated in this population. Results: Overall, 38.2% (n=212) of the sample exhibited IGD symptoms, with 18.2% (n=101) being classed as at-risk gamers. Regression analysis found IGD to be associated with male gender, severe depressive symptoms, poor sleep quality, increased time spent gaming, and total free time spent gaming (p < 0.001). Conclusions: The prevalence of IGD in this sample was relatively high, and associated risk factors found were similar to those previously reported in the literature. Further studies investigating the epidemiology of IGD in Brazilian samples are warranted to better understand treatment needs and inform preventive measures in this population.

Serious games para educação em higiene bucal infantil: uma revisão integrativa e a busca de aplicativos / Serious games for childrens oral hygiene education: an integrative review and application search

Resumo O objetivo deste artigo é realizar uma revisão integrativa sobre as publicações que abordam o uso de serious games voltados para educação em higiene bucal infantil e uma busca dos aplicativos disponíveis com esse mesmo fim. Foi conduzida uma revisão integrativa pareada nas bases de dados IBECS, LILACS, SCIENCE DIRECT, SciELO, PUBMED, SCOPUS, MEDLINE e Google Acadêmico, de janeiro a novembro de 2017 e em paralelo uma busca de aplicativos disponíveis na plataforma Android® e em sítios eletrônicos das Ciências da Computação, como o IEEE Xplore. Na revisão integrativa, foram selecionados 12 artigos que atenderam aos critérios de inclusão. Nas buscas em sítios eletrônicos, 11 jogos foram classificados como serious games voltados para higiene bucal. Foram identificados 284 aplicativos na Play Store®, com predomínio para atividades intervencionistas em consultório, sendo dor, cárie dental e trauma os enredos principais. Poucos aplicativos voltados para educação em higiene bucal estão disponíveis. Quanto ao público-alvo, há predomínio do público infantil. Apesar da escassez de publicações sobre o assunto, explorar recursos tecnológicos como meios de educação em higiene bucal infantil sinaliza uma área do conhecimento com potencial acadêmico e com possíveis aplicações para a saúde pública.

Abstract This article aims to perform an integrative review on publications that discuss the use of serious games focused on education of children's oral hygiene and a search for available apps with this same purpose. An integrative peer review was conducted in the databases IBECS, LILACS, SCIENCE DIRECT, SciELO, PUBMED, SCOPUS, MEDLINE and Scholar Google, from January to November of 2017 and in parallel a search of available applications on the Android® platform, and websites of computer science, such as the IEEE Xplore. In the integrative review, 12 articles were selected that fulfilled the inclusion criteria. In searches on websites, 11 games were classified as serious games aimed for oral hygiene. A total of 284 apps were identified at Play Store®, with predominance for interventionist activity in dental offices, with pain, dental cavity and trauma being the main plots. Few applications focused on oral hygiene education are available. As for intended audience, there is the prevalence of children's public. Despite the scarcity of publications on the subject, exploring technological resources as educational options for children's oral hygiene indicate an area of knowledge with academic potential and possible applications for public health.

Protocol for a controlled, randomized, blind, clinical trial to assess the effects of anodal transcranial direct current stimulation dorsolateral prefrontal cortex associated with balance training using games in the postural balance of older people.

Aims: This study aims to evaluate the additional effect of anodal transcranial direct current stimulation (a-tDCS) applied on dorsolateral pré-frontal cortex on training postural balance with the use of video games in the aged. Methods: This is a blinded, randomized, controlled clinical trial protocol, with older people of both genders. Participants will be randomized into three training groups: Group 1 (videogame balance training), group 2 (videogame balance training associated with anodal tDCS), group 3 (videogame balance training associated with sham tDCS). The training will be carried out twice a week for four weeks, totaling eight sessions, and will be performed with the Nintendo Wii videogame console, using games that stimulate the postural balance associated with tDCS, with anode applied over the left dorsolateral prefrontal cortex and cathode on the contralateral supraorbital region at 2 mA for 20 minutes. The postural balance will be assessed using the Mini Test of the Balance Assessment System and posturography. Evaluations will be carried out before and after eight training sessions and 30 days after the end of treatment. Discussion: Some studies show favorable results from the use of video games in improving postural balance in older people; however, their effect does not remain long-term. TDCS associated with other therapies can potentiate and prolong the effects of these therapies owing to its ability to stimulate neurotrophins important for neurogenesis, facilitating tasks that require attention, and helping to consolidate learning and memory. The effect of the two associated techniques on balance has not yet been tested in this population. Registration: Brazilian Registry of Clinical Trials ID U1111-1213-4266; registered on 15 October 2018.

Effects of active video games on children and adolescents: A systematic review with meta-analysis.

OBJECTIVE: To investigate the effectiveness of active video games (AVGs) on obesity-related outcomes and physical activity levels in children and adolescents. DESIGN: Systematic review with meta-analysis. METHODS: Literature search was performed in five electronic databases and the main clinical trials registries. Randomized controlled trials investigating the effect of AVGs compared with no/minimal intervention on obesity-related outcomes (body mass index [BMI], body weight, body fat, and waist circumference) and physical activity levels of children and adolescents were eligible. Two independent reviewers extracted the data of each included study. PEDro scale was used to assess risk of bias and GRADE approach to evaluate overall quality of evidence. Pooled estimates were obtained using random effect models. RESULTS: Twelve studies were considered eligible for this review. Included studies mostly reported outcome data at short-term (less or equal than three months) and intermediate-term follow-up (more than 3 months, but <12 months). AVGs were more effective than no/minimal intervention in reducing BMI/zBMI at short-term (SMD = -0.34; 95% CI: -0.62 to -0.05) and intermediate-term follow-up (SMD = -0.36; 95% CI: -0.01 to -0.71). In addition, AVGs were more effective in reducing body weight compared with no/minimal intervention at intermediate-term follow-up (SMD = -0.25; 95% CI: -0.46 to -0.04). Regarding physical activity levels, AVGs were not more effective compared with minimal intervention at short-term and intermediate-term follow-up. CONCLUSIONS: Our review identified that AVGs were better than minimal intervention in reducing BMI and body weight, but not for increasing physical activity in young people.

Evaluation instruments for physical therapy using virtual reality in stroke patients: a systematic review.

BACKGROUND: Physiotherapeutic rehabilitation is essential to improve functional mobility, muscular strength, balance and quality of life of stroke patients, but conventional techniques using repeated physical activities can soon become monotonous. The use of virtual reality (VR) in rehabilitation offers a possible alternative to the traditional methods of promoting improvements in muscle strength and balance. However, there is not yet consensus about which instruments should be used to assess the effectiveness of VR in stroke rehabilitation. OBJECTIVE: To conduct a systematic review to identify the types of evaluation tools used for different VR interventions to rehabilitate stroke patients, considering balance, strength, function, quality of life, cognition and motivation. DATA SOURCES: A comprehensive literature search using MEDLINE-PubMed, Web of Science, Scopus, Lilacs and IEEE Xplore was undertaken. STUDY SELECTION: Studies on stroke patients who had undergone VR therapy and an assessment of its effectiveness using evaluative instruments. STUDY APPRAISAL AND SYNTHESIS METHODS: Data were extracted by a single reviewer using standardised forms, and were checked by a second reviewer. The extracted information included study design, number of participants, type of stroke, items that were evaluated (balance, muscle strength, functional evaluation), console used, number of rehabilitation sessions, results and conclusions. RESULTS: In total, 1836 articles were identified; of these, 29 were included in this review after consideration of the inclusion and exclusion criteria. The selected articles rated one or more of the following factors: balance (n=12), grip strength (with or without devices for direct measurement) (n=8), functionality (n=12) and quality of life (n=12). LIMITATIONS: The full text of one article was not available, despite a request to the authors to send it via email. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: The Berg Balance Scale, the Fugl-Meyer Assessment and the Stroke Impact Scale were the instruments used most frequently to assess balance, function and quality of life, respectively, in stroke patients who underwent rehabilitation using VR. Systematic review registration PROSPERO number: 87546.

Uso de videojuegos en alumnos de la escuela secundaria y factores asociados / Video game use among secondary school students and associated factors

Introducción: el avance de la tecnología e internet aumentaron la frecuencia con que los niños utilizan videojuegos. El objetivo fue determinar la frecuencia y patrones de uso y la adicción a videojuegos (AVJ) en alumnos de secundaria y la relación con factores sociodemográficos, familiares e individuales. Población y métodos: estudio descriptivo transversal en cuatro escuelas secundarias. Se realizó un cuestionario estructurado a los padres y la "Videogame Addiction Scale for Children (VASC)" a los alumnos jugadores de videojuegos. Resultados: se incluyó a 297 alumnos; 245 (82,5 %) jugaban a videojuegos. La tasa total de AVJ fue 1,6 % en toda la muestra. La tasa de AVJ fue 3,1 % entre los varones. La media geométrica para VASC (MG-VASC) fue mayor en varones y alumnos obesos (p < 0,001, p = 0,022, respectivamente). Los alumnos que utilizan redes sociales tuvieron puntajes más altos (p = 0,034). Las consolas, los juegos en línea y multijugador aumentan los puntajes de la MG-VASC (p = 0,028, p = 0,002, p = 0,016, respectivamente). Los juegos de guerra y estrategia tenían MG-VASC más elevadas (p < 0,001, p = 0,034, respectivamente). Los juegos de ingenio y casuales se relacionaron con puntajes menores (p = 0,006, p = 0,004, respectivamente).Conclusiones. Ser varón, ser obeso, usar redes sociales, tener consola, jugar a géneros específicos (guerra o estrategia), y los juegos en línea y multijugador están relacionados a mayores puntajes de la VASC en alumnos de secundaria. Los estudios prospectivos y las medidas preventivas deberían centrarse en esto.

Introduction: The rapid progress of technology and widespread use of internet has increased thefrequency of video gaming among children. The objective was to determine the frequency and patterns of video game use and video game addiction (VGA) in secondary school students and the relationship with socio-demographic, familial and individual factors. Population and methods: This cross-sectional descriptive study was conducted in four secondary schools in varied sociodemographic characteristics. A structured questionnaire was applied to the parents who agreed to participate. 'Videogame Addiction Scale for Children (VASC)' was performed to the video-gamer students. Results: 297 healthy students were included; 245 (82.5 %) reported as video game players. The rate of VGA was 1.6 % in our whole sample. The VGA rate was 3.1 % within the male students. VASC-Geometric Mean Score (VASC-GMS) was significantly higher in male and obese children (p < 0.001, p= 0.022, respectively). Students who use socialmedia also had higher scores (p= 0.034). Gaming consoles, online games or games with multiplayers increase the VASC-GMS scores (p= 0.028, p= 0.002, p= 0.016, respectively). War and strategy games lead higher VASC-GMS (p < 0.001, p= 0.034, respectively). In contrast, mind and casual games were related to lower VASC-GMS (p= 0.006, p= 0.004, respectively).Conclusions. It was observed that being male, being obese, use of social media, game console ownership, playing specific game genres (war or strategy games), online and multiplayer games are related to higher scores of video game addiction scale in secondary school students. Future prospective studies and preventive measures on VGA should focus on these factors.