Gaming expertise induces meso­scale brain plasticity and efficiency mechanisms as revealed by whole-brain modeling.

Video games are a valuable tool for studying the effects of training and neural plasticity on the brain. However, the underlying mechanisms related to plasticity-associated brain structural changes and their impact on brain dynamics are unknown. Here, we used a semi-empirical whole-brain model to study structural neural plasticity mechanisms linked to video game expertise. We hypothesized that video game expertise is associated with neural plasticity-mediated changes in structural connectivity that manifest at the meso­scale level, resulting in a more segregated functional network topology. To test this hypothesis, we combined structural connectivity data of StarCraft II video game players (VGPs, n = 31) and non-players (NVGPs, n = 31), with generic fMRI data from the Human Connectome Project and computational models, to generate simulated fMRI recordings. Graph theory analysis on simulated data was performed during both resting-state conditions and external stimulation. VGPs' simulated functional connectivity was characterized by a meso­scale integration, with increased local connectivity in frontal, parietal, and occipital brain regions. The same analyses at the level of structural connectivity showed no differences between VGPs and NVGPs. Regions that increased their connectivity strength in VGPs are known to be involved in cognitive processes crucial for task performance such as attention, reasoning, and inference. In-silico stimulation suggested that differences in FC between VGPs and NVGPs emerge in noisy contexts, specifically when the noisy level of stimulation is increased. This indicates that the connectomes of VGPs may facilitate the filtering of noise from stimuli. These structural alterations drive the meso­scale functional changes observed in individuals with gaming expertise. Overall, our work sheds light on the mechanisms underlying structural neural plasticity triggered by video game experiences.

Validation of the Gaming Skills Questionnaire in Adolescence: Effects of Gaming Skills on Cognitive and Affective Functioning.

Given the widespread popularity of videogames, research attempted to assess their effects on cognitive and affective abilities, especially in children and adolescents. Despite numerous correlational studies, robust evidence on the causal relationship between videogames and cognition remains scarce, hindered by the absence of a comprehensive assessment tool for gaming skills across various genres. In a sample of 347 adolescents, this study aimed to develop and validate the Gaming Skill Questionnaire (GSQ) and assess the impact of gaming skills in six different genres (sport, first-person shooters, role-playing games, action-adventure, strategy, and puzzle games) on cognitive and affective abilities of adolescents. The GSQ exhibited strong reliability and validity, highlighting its potential as a valuable tool. Gaming skills positively affected executive function, memory, overall cognition, cognitive flexibility, and emotion recognition, except for empathy. Various game genres had different effects on cognitive and affective abilities, with verbal fluency influenced mainly by sports, executive functions by action, strategy, and puzzle, and emotion recognition positively impacted by action and puzzle but negatively by sports and strategy games. Both age and gaming skills influenced cognitive flexibility, with gaming having a greater effect. These intriguing genre-specific effects on cognitive and affective functioning postulate further research with GSQ's contribution.

The Long and Winding Road to Real-Life Experiments: Remote Assessment of Executive Functions with Computerized Games-Results from 8 Years of Naturalistic Interventions.

Mate Marote is an open-access cognitive training software aimed at children between 4 and 8 years old. It consists of a set of computerized games specifically tailored to train and evaluate Executive Functions (EF), a class of processes critical for purposeful, goal-directed behavior, including working memory, planning, flexibility, and inhibitory control. Since 2008, several studies were performed with this software at children's own schools in interventions supervised in-person by cognitive scientists. After 2015, we incorporated naturalistic, yet controlled, interventions with children's own teachers' help. The platform includes a battery of standardized tests, disguised as games, to assess children's EF. The main question that emerges is whether the results, obtained with these traditional tasks but conducted without the presence of researchers, are comparable to those widely reported in the literature, that were obtained in more supervised settings. In this study, we were able to replicate the expected difficulty and age effects in at least one of the analyzed dependent variables of each employed test. We also report important discrepancies between the expected and the observed response time patterns, specifically for time-constrained tasks. We hereby discuss the benefits and setbacks of a new possible strategy for this type of assessment in naturalistic settings. We conclude that this battery of established EF tasks adapted for its remote usage is appropriate to measure the expected mental processes in naturalistic settings, enriching opportunities to upscale cognitive training interventions at schools. These types of tools can constitute a concerted strategy to bring together educational neuroscience research and real-life practice.

Non-Immersive Virtual Reality-Based Therapy Applied in Cardiac Rehabilitation: A Systematic Review with Meta-Analysis.

BACKGROUND: The aim of this systematic review with meta-analysis was to assess the effectiveness of non-immersive virtual reality (niVR) active videogames in patients who underwent cardiac rehabilitation (CR). METHODS: A systematic review with meta-analysis, according to the PRISMA guidelines and previously registered in PROSPERO (CRD42023485240), was performed through a literature search in PubMed (Medline), SCOPUS, WOS, and PEDro since inception to 21 November 2023. We included randomized controlled trials (RCTs) that assessed the effectiveness of an niVR intervention, in comparison with conventional CR and usual care, on aerobic capacity and cardiovascular endurance (physical function), anxiety, depression, and quality of life (QoL). The risk of bias in individual studies was assessed using the Cochrane risk of bias tool. Effect size was estimated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI) in a random-effects model. RESULTS: Nine RCT that met the inclusion criteria were included in the meta-analysis. The meta-analysis showed a moderate-to-large effect favoring niVR active videogames included in CR in increasing aerobic capacity and cardiovascular endurance (SMD = 0.74; 95% CI 0.11 to 1.37; p = 0.021) and reducing anxiety (SMD = -0.66; 95% CI -1.13 to -0.2; p = 0.006). Only 4.8% of patients reported adverse events while performing niVR active videogames. CONCLUSIONS: Inclusion of niVR active videogames in CR programs is more effective than conventional CR in improving aerobic capacity and cardiovascular endurance and in reducing anxiety.

Factorial structure of the Internet Gaming Disorder questionnaire in the Italian setting: a single-factored ailment or a multifaceted condition?

INTRODUCTION: Internet Gaming Disorder (IGD) according to DSM-5 is a behavioral addiction needing additional study. IGD in youth is correlated with anxiety, depression, attention problems, interpersonal problems, social phobia, behavior problems and low academic achievement. The aim of the present research is to contribute to the understanding of the disorder, by providing preliminary data on the factorial structure of the IGD Questionnaire in the Italian version. PARTICIPANTS: 612 Italian students (323 females), mean of age = 13.94 (SD = 2.44). Instruments: a survey comprising IGD Questionnaire, Internet Addiction Test (IAT), Children's Coping Strategies Checklist (CCSC-R1), Assessment of Interpersonal Relations (AIR), and Child Behavior Checklist (CBCL). RESULTS: 15.2% of participants showed a sub-clinical IGD and 2.1% met the full diagnostic criteria. Participants with IGD showed lower scores in interpersonal relationships, worse coping strategies and higher scores in externalization. The factorial structure of the IGD Questionnaire highlights 4 factors ("addiction", "gaming as coping", "impaired control" and "negative outcomes") that explain 52.14% of the variance. A single-factor solution was also tested and results seem to be coherent with the four-factor solution, explaining less variance. CONCLUSIONS: IGD is a complex clinical condition that can be thought both as a single-factored and as a multi-faceted condition.

A Video Game Intervention to Prevent Opioid Misuse Among Older Adolescents: Development and Preimplementation Study.

BACKGROUND: Opioid misuse and mental disorders are highly comorbid conditions. The ongoing substance misuse and mental health crises among adolescents in the United States underscores the importance of widely scalable substance misuse preventive interventions that also address mental health risks. Serious video games offer an engaging, widely scalable method for delivering and implementing preventive interventions. However, there are no video game interventions that focus on preventing opioid misuse among older adolescents, and there are limited existing video game interventions that address mental health. OBJECTIVE: This study aims to develop and conduct a formative evaluation of a video game intervention to prevent opioid misuse and promote mental health among adolescents aged 16-19 years (PlaySmart). We conducted formative work in preparation for a subsequent randomized controlled trial. METHODS: We conducted development and formative evaluation of PlaySmart in 3 phases (development, playtesting, and preimplementation) through individual interviews and focus groups with multiple stakeholders (adolescents: n=103; school-based health care providers: n=51; and addiction treatment providers: n=6). PlaySmart content development was informed by the health belief model, the theory of planned behavior, and social cognitive theory. User-centered design principles informed the approach to development and play testing. The Exploration, Preparation, Implementation, and Sustainability framework informed preimplementation activities. Thematic analysis was used to identify themes from interviews and focus groups that informed PlaySmart game content and approaches to future implementation of PlaySmart. RESULTS: We developed a novel video game PlaySmart for older adolescents that addresses the risk and protective factors for opioid misuse and mental health. Nine themes emerged from the focus groups that provided information regarding game content. Playtesting revealed areas of the game that required improvement, which were modified for the final game. Preimplementation focus groups identified potential barriers and facilitators for implementing PlaySmart in school settings. CONCLUSIONS: PlaySmart offers a promising digital intervention to address the current opioid and mental health crises among adolescents in a scalable manner.

Self-regulation, stress appraisal, and esport action performance.

Electronic sport has seen substantial growth in market value and popularity in the last 10 years. With this growth has come the pursuit of elite esports performance, especially from a psychological perspective. This study aimed to investigate potential variations in self-regulation levels among athletes of different levels (national vs. student), compare the self-regulation profiles of CS:GO players in the current study to an international sample of e'athletes and to assess the predictive capacity of self-regulation on performance outcomes. A total of 53 esports athletes (student competitors, n = 27 and national-level CS:GO competitors, n = 26), participated in an experiment exploring self-regulation, DRES, and action performance. Furthermore, analysis comparing our collective findings against a larger global sample of e'athletes (n = 993) was conducted. Results demonstrated that CS:GO players who displayed higher levels of self-regulation tended to perceive stressful situations as challenges, consequently showcasing superior accuracy and time trial performance. In contrast, individuals with lower self-regulation tended to perceive such situations as threats, which correlated with less favorable performance outcomes. On a broader scale, the study observed that CS:GO competitors generally exhibited lower levels of self-regulation when compared to the larger global sample. Furthermore, self-regulation was identified as a mediating variable in the relationship between stress appraisal and performance, suggesting that improved self-regulation skills can lead to enhanced accuracy and quicker time trial performance. This may imply that competitors with greater self-regulatory abilities perceive themselves as having more personal resources, enabling them to effectively assess challenging situations and employ problem-focused coping strategies. Overall, this research underscores the significance of self-regulation in optimizing esports performance, while providing valuable insights for player development, action performance, and overall outcomes in the field.

Influence of Pokémon Go Playing Style on Physical Activity and Its Effect on Kinanthropometry Variables and Body Composition in Adolescents.

BACKGROUND: Pokémon Go is a mobile app that offers both continuous and intermittent (gamified) gameplay, but no previous research in adolescents is known to have addressed changes in physical activity and body composition according to playing style. For this reason, the aims of the present investigation were (1) to establish the differences in the level of physical activity, and its influence on the kinanthropometric and body composition, of the adolescent population, considering their Pokémon Go playing style; and (2) to analyze whether the practice of previous physical activity has an influence on the effects of the use of Pokémon Go on the level of physical activity and changes in kinanthropometric and body composition variables. METHODS: A total of 94 adolescents (50 males and 44 females; mean age: 13.66 [1.17] years-old; mean body mass index: 20.82 [4.03] kg/m2) whose physical activity level and body composition were measured, participated in the investigation. Two groups of adolescents completed a 10-week intervention using Pokémon Go continuously (n = 30) or intermittently (n = 31), while the control group (n = 33) did not use any after-school app. A one-way analysis of variance (ANOVA), a multivariate analysis of variance, and 2 repeated-measures ANOVA were performed to analyze the data. RESULTS: Inactive adolescents in the continuous use group increased their physical activity between the pretest and posttest (P = .038), but this did not occur in the active group. Regarding body composition variables, the increase in body mass (P < .001) and body mass index (P = .006) in the control group was significantly higher than in the continuous use group of adolescents who were inactive, but not in the active group, while the decrease in fat mass (P < .001-.036) and sum of 3 skinfolds (P < .001-.003) was significantly higher in both Pokémon Go use groups as compared to the control group, regardless of the previous physical activity level. CONCLUSIONS: The continuous style of play seems to be more effective in increasing physical activity in adolescents, but the changes in body composition and kinanthropometric variables occur similarly with continuous and intermittent gameplay. Therefore, the playful use of Pokémon Go can be used in educational and health fields to produce changes in body composition in this population.

Exergames to Limit Weight Gain and to Fight Sedentarism in Children and Adolescents with Obesity.

Exergames are defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). The players interact with the game through whole-body movements improving energy expenditure. Exergames may be effective in improving physical and psychological aspects of children and adolescents with obesity. In this narrative review, we synthesized the current evidence regarding the role of exergames in modifying body composition and weight and in promoting changes in sedentary behavior to define the benefits of active video games as useful tools for fighting sedentarism and to outline the future directions of exergaming as a supplementation exercise rather than a replacement in educational programs for pediatric obesity. Data from the literature indicate that exergames may offer an interesting impact on childhood obesity and may be considered a potential strategy for controlling weight gain and body composition, promote PA, and decrease time spent on sedentary behavior in children and adolescents with obesity. However, exergame use also has some limits, such as children's poor self-regulation and poor structuring of exergame use. Therefore, a prudent approach should be maintained, and additional high-quality research is needed to determine if exergames can be effectively used in the treatment of childhood obesity and if new digital media, as a supplementation of exercise rather than a replacement, could be considered to combat sedentary behavior in educational programs for pediatric obesity prevention.

Resolución colaborativa de problemas de tríadas de niñas y niños de preescolar, mediada por un videojuego

Objetivo: Analizar cómo la interacción de tríadas de preescolar les permite resolver un problema de manera colaborativa, utilizando como mediador un videojuego de plataformas. Método: Investigación cuantitativa, observacional. Se validó un manual de categorías utilizando primero jueces expertos y posteriormente, se utilizaron el Kappa de Cohen (k) y el porcentaje de acuerdo o confiabilidad inter-observador, para establecer el porcentaje de acuerdo y validar las categorías (ver Paniagua, 2016). Se utilizó el programa Analizador secuencial de propósito general (GSEQ por sus siglas en inglés), para analizar los videos de estudiantes de preescolar mientras resolvían problemas de manera colaborativa. Resultados: Las 18 personas estudiantes de preescolar muestran capacidad de resolver problemas de manera colaborativa. Se utilizó la Q de Yule y la Razón de Momio para describir relación estadística entre las categorías de análisis. Todos los Q de Yule fueron superiores a 0,6 %, lo que indica anta relación entre categorías. Predomina la categoría Guía (34 y 31) en los niveles más difíciles y hay un aumento en la cantidad de categorías (42 en el primer nivel, 102 en el segundo). También disminuye el tiempo promedio de resolución (4,15 en escenario 1, 3,03 en el último, que es más difícil. Conclusiones: La población presenta un nivel de desarrollo social, reflejado en la cantidad de verbalizaciones y gestos, que le permite la resolución colaborativa de problemas. Además, se plantea el uso que se puede dar a los videojuegos, como herramienta de investigación en psicología social.

Objective: Analyze how the interaction of preschool triads allows them to solve a problem collaboratively, using a platform video game as a mediator. Method: Quantitative, observational research. A manual of categories was validated using expert judges first, and then Cohen's Kappa (k) and the percentage of agreement or inter-observer reliability were used to establish the percentage of agreement and validate the categories (see Paniagua, 2016). Videos of preschool students collaboratively solving problems were analyzed using rh The Generalized Sequential Querier (QSEQ) software. Results: The 18 preschool students show the ability to solve problems collaboratively. The Yule Q and the Odds Ratio were used to describe the statistical relationship between the analysis categories. All Yule Qs were greater than 0,6 % indicating a high relationship between categories. The Guide category predominates (34 and 31) in the most difficult levels and there is an increase in the number of categories (42 in the first level, 102 in the second). It also decreases the average resolution time (4,15 in scenario 1, 3,03 in the last one, which is more difficult. Discussions: The population shows a level of cognitive and social development, reflected in the number of verbalizations and gestures, which allows collaborative problem solving. In addition, the use that can be given to video games is considered as a research tool in social psychology.

Prevalence of internet gaming disorder and its psychological correlates / Prevalência do transtorno do jogo pela internet e seus correlatos psicológicos

ABSTRACT Objective To investigate the prevalence of internet gaming disorder (IGD) symptoms in a sample of Brazilian adults, and its association with personality, psychiatric symptoms and psychosocial measures. Methods We evaluated 219 adults online recruited using questionnaires and psychometric scales. We evaluated the behavior and pattern of internet games using the Game Addiction Scale (GAS). We tested the association of the previous measures with the GAS scores by spearman correlations and multiple regression analysis. Results Of our sample, 74% played games online. We found correlations between IGD symptoms and most symptoms of mental disorders, with small or moderate effect sizes, as well as correlations with the personality traits of agreeableness (r = -0.272; p < 0.001), conscientiousness (r = - 0.314; p < 0.001), and neuroticism (r = 0.299; p < 0.001). Additionally, we found a negative association with psychosocial outcomes such as quality of life (r = -0.339; p < 0.001) and life satisfaction (r = - 0.202; p < 0.003). The multivariate model included the personality traits of conscientiousness and agreeableness and symptoms of dissociation and somatization as predictors. The prevalence of IGD was 9% in those who played online games. Conclusion IGD is correlated with different areas of the individual's life, such as personality, quality of life, and several common symptoms of mental disorders. The prevalence can be considered high among players (9%). Conscientiousness, agreeability, somatic symptoms, and dissociative symptoms were associated with the symptoms of IGD.

RESUMO Objetivo Investigar a prevalência de sintomas do transtorno do jogo pela internet (TJI) em uma amostra de adultos brasileiros e sua associação com personalidade, sintomas psiquiátricos e medidas psicossociais. Métodos Avaliamos 219 adultos recrutados on-line por meio de questionários e escalas psicométricas. Avaliamos o comportamento e o padrão dos jogos na internet usando a Game Addiction Scale (GAS). Testamos a associação das medidas anteriores com as pontuações na GAS por meio de correlações de Spearman e análise de regressão múltipla. Resultados De nossa amostra, 74% jogavam jogos on-line. Encontramos correlações entre sintomas do TJI e a maioria dos sintomas de transtornos mentais, com tamanhos de efeito pequenos ou moderados, bem como correlações com os traços de personalidade de amabilidade (r = -0,272; p < 0,001), conscienciosidade (r = - 0,314; p < 0,001) e neuroticismo (r = 0,299; p < 0,001). Além disso, encontramos uma associação negativa com resultados psicossociais, como qualidade de vida (r = -0,339; p < 0,001) e satisfação com a vida (r = - 0,202; p < 0,003). O modelo multivariado incluiu os traços de personalidade de conscienciosidade e amabilidade e sintomas de dissociação e somatização como preditores. A prevalência de TJI foi de 9% entre os que jogavam jogos on-line. Conclusão O TJI está correlacionado com diferentes áreas da vida do indivíduo, como personalidade, qualidade de vida e vários sintomas comuns de transtornos mentais. A prevalência pode ser considerada alta entre os jogadores (9%). Conscienciosidade, amabilidade, sintomas somáticos e sintomas dissociativos estavam associados aos sintomas do TJI.

Biofeedback-Based Videogames: Fostering Emotion Regulation at a Diverse Community Summer Camp.

Implementing nonstigmatized mental health interventions and tools within community programs serving diverse populations may reduce inequities in access to mental health care and preventative emotional learning. One potentially impactful tool is Mightier, a heart rate biofeedback-based videogame that aims to foster emotion regulation skills and practice through game play. In a randomized controlled trial, the present study evaluated the efficacy of Mightier when utilized in a community setting. Seventy-two children (ages 7-12) from a low-cost community summer camp were randomly assigned to play Mightier for 6 weeks or continue camp activities as usual. All campers participated in biweekly social and emotional learning groups. Participants exhibited significantly greater levels of adaptive emotion regulation and lower levels of emotional dysregulation, internalizing symptoms, and externalizing behaviors after the intervention. Caregivers of participants in the intervention group also reported significantly less parenting-related stress after the intervention. When incorporated into community programs, biofeedback-based videogames can foster emotional intelligence competencies in children without access to traditional mental health services.

Immersive Virtual Reality Reaction Time Test and Relationship with the Risk of Falling in Parkinson's Disease.

Immersive virtual reality (IVR) uses customized and advanced software and hardware to create a digital 3D reality in which all of the user's senses are stimulated with computer-generated sensations and feedback. This technology is a promising tool that has already proven useful in Parkinson's disease (PD). The risk of falls is very high in people with PD, and reaction times and processing speed may be markers of postural instability and functionality, cognitive impairment and disease progression. An exploratory study was conducted to explore the feasibility of reaction time tests performed in IVR as predictors of falls. A total of 26 volunteers (79.2% male; 69.73 ± 6.32 years) diagnosed with PD (1.54 ± 0.90 H&Y stage; 26.92 ± 2.64 MMSE) took part in the study. IVR intervention was feasible, with no adverse effects (no Simulator Sickness Questionnaire symptoms). IVR reaction times were related (Spearman's rho) to functionality (timed up and go test (TUG) (rho = 0.537, p = 0.005); TUG-Cognitive (rho = 0.576, p = 0.020); cognitive impairment mini mental state exam (MMSE) (rho = -0.576, p = 0.002)) and the years of the patients (rho = 0.399, p = 0.043) but not with the first PD symptom or disease stage. IVR test is a complementary assessment tool that may contribute to preventing falls in the proposed sample. Additionally, based on the relationship between TUG and reaction times, a cut-off time is suggested that would be effective at predicting the risk of suffering a fall in PD patients using a simple and quick IVR test.

Realidad virtual semi-inmersiva en la rehabilitación de la extremidad superior en pacientes que han sufrido ictus. Revisión sistemática / Semi-immersive virtual reality in the rehabilitation of the upper extremity in patients who had suffered stroke. Systematic

Objetivos: el accidente cerebrovascular es una de las patologías que mayor dependencia generan en la población española. La rehabilitación basada en la evidencia, precoz e intensiva es la que ofrece unos mayores índices de recuperación, siendo la realidad virtual un abordaje que puede favorecer la mejora de la función de la extremidad superior. El objetivo de esta revisión sistemática es valorar la efectividad de los dispositivos de realidad virtual semi-inmersiva usados para la rehabilitación de la extremidad superior en pacientes que han sufrido un accidente cerebrovascular. Métodos: siguiendo las directrices PRISMA, se realizó una búsqueda bibliográfica en las bases de datos Pubmed, Cochrane Library, OTseeker y Scopus. Para evaluar la calidad metodológica de los estudios que cumplan los criterios de selección, se utilizó la escala Oxford y la escala PEDro. Resultados: Aplicando los criterios de inclusión y exclusión, se seleccionaron un total de 13 estudios. Conclusiones: De acuerdo a los resultados obtenidos, la realidad virtual es un abordaje eficaz para la rehabilitación del paciente con ictus, especialmente si se combina con terapia convencional. No existe un consenso claro acerca de los protocolos de tratamiento con mayor evidencia.(AU)

Objective: Cerebrovascular accident is one of the pathologies that generate the greatest dependency in the Spanish population. Evidence- based, early and intensive rehabilitation is the one that offers the highest recovery rates, with virtual reality being an approach that can favor the improvement of the function of the upper extremity. The objective of this systematic review is to assess the effectiveness of semi-immersive virtual reality devices used for the rehabilitation of upper extremity in patients who have suffered a stroke. Methods: Following the PRISMA guidelines, a bibliographic search was carried out in the Pubmed, Cochrane Library, OTseeker and Scopus databases. To assess the methodological quality of the studies that meet the selection criteria, the Oxford scale and the PEDro scale were used. Results: Applying the inclusion and exclusion criteria, a total of 13 studies were selected. Conclusions: According to the results obtained, virtual reality is an effective approach for the rehabilitation of stroke patients, especially if it is combined with conventional therapy. There is no clear consensus about the treatment protocols with the most evidence.(AU)

Therapeutic Interventions with Videogames in Treatments for Depression: A Systematic Review.

Introduction: Particularly in the last 2 years, due to the new coronavirus pandemic, people with depression have increasingly sought human connection and relief from depressive symptoms through playing in the world of videogames, and a small yet growing portion of researchers have been investigating the therapeutic potential of that kind of interaction. Objective: The objective of this review was to provide an exploration of the current panorama of scientific research with videogames used as therapeutic intervention tools for depression. Method: A systematic review was performed for that purpose, with a semantic field of 12 keywords around the terms "depression," "mental health," and "video games" narrowed down into a concise syntax-(games OR serious games) AND (depression) AND (treatment)-applied to relevant databases for health research; followed by the execution of a search and screening protocol based on one guiding question; and analysis of results based on four elaborative questions. Results: Twenty-six studies met the inclusion criteria and provided a set of both quantitative and qualitative data about demographics, kinds of therapeutic interventions, types of videogames used in the interventions, places, and forms of interaction. Conclusion: Important gaps were found in the review, such as a lack of research aimed at the age group most affected by the disorder, who is also the largest consumer of games; and fresh opportunities to expand the understanding of the subject as well as guide developments of game-based therapeutic interventions.

Action Video Gaming and Attention in Young Adults: A Systematic Review.

OBJECTIVE: Existing research in action video games has increased in recent years due to the expansion of their use all over the world. Specifically, there is growing evidence about the positive development of the cognitive functions associated with the use of this kind of video game. Therefore, this work aims to explore the relationship between playing action video games and the development of attention span as well as the impact at the brain level from a functional perspective. METHODS: Articles were searched in Scopus, Pubmed, and Web of Science. A total of 196 studies were retrieved, among which 13 studies were systematically reviewed. RESULTS: The review has shown that playing action video games can improve cognitive functions, including attention, with reaction time and processing speed being the aspects that would most benefit from such practice, as well as the development of focused, sustained, and divided attention. Also, there are functional brain changes. CONCLUSION: It is necessary to deepen the understanding of the association between playing action video games and the development of attention.

Habitual Videogame Playing Does Not Compromise Subjective Sleep Quality and Is Associated with Improved Daytime Functioning.

Research on the effects of videogames (VGs) on health has produced mixed results. Here, we assess the relationships of VG playing with sleep; chronotype; sleepiness; and levels of depression, anxiety, and stress; and how they are modulated by the level of exposure to VGs. Four hundred-and two adult participants (age = 26.2 ± 7.84; 227 F) completed an online survey including questions on VG use and a set of standardized questionnaires. The sample was divided into three groups: habitual gamers (HGs, 42.2%), nonhabitual gamers (NHGs, 36.5%), and non-gamers (NGs, 21.3%). No between-group differences emerged in sleepiness (Epworth Sleepiness Scale) or Pittsburgh Sleep Quality Index measures except the sleep disturbances subscore, which was higher in NHGs. HGs showed delayed bed- and risetimes and higher eveningness (reduced Morningness-Eveningness Questionnaire). HGs and NHGs showed higher depression subscores (Depression Anxiety Stress Scale) but remained in the subclinical range. Moreover, hours/week of VG playing predicted delayed sleep timing, lower daytime dysfunction, and lower sleepiness. Our data suggest that VG playing does not necessarily compromise sleep quality and may even benefit daytime functioning, underlining the need to reconsider the relationships between VG use and health by taking into account possible modulating factors such as habitual VG exposure.

The influence of Twitch and sustainability on the stock returns of video game companies: Before and after COVID-19.

The covid-19 pandemic has shocked society greatly, causing many changes in people's lives. One of these changes relates to leisure and how we relate to others. Videogames became one of the first entertainment options during the pandemic, making the video game industry and the pharmaceutical industry-one of the least affected by economic slowdown. This study analyzes how Twitch and sustainability jointly influence the stock returns of major videogame companies before and during Covid-19 using panel fsQCA analysis. The results show a positive relationship between Twitch, sustainability, and stock returns in video game companies, but this relationship differs yearly, being stronger during the Covid-19 period.

The Effects of Virtual Reality Physiotherapy Interventions on Cardiopulmonary Function and Breathing Control in Cystic Fibrosis: A Systematic Review.

Motivation and adherence are the main factors that limit participation in physiotherapy exercise sessions and airway clearance in cystic fibrosis (CF) population. One of the newly developed techniques is to use virtual reality (VR) games to increase motivation and adherence during exercise sessions for this population. However, this area is still poorly investigated. This review aims to evaluate, summarize, and review published literature regarding the effects of VR exercise on cardiopulmonary function and the use of VR games as a tool for airway clearance technique in CF population. A systematic search was conducted using PEDro, MEDLINE, AMED, CINAHL Plus, and relevant associated keywords. Seventy-three citations were identified from the search, of which 10 were included in this review. Overall, the use of VR was found to have positive effects on cardiac function and improved adherence and motivation during the exercise sessions in people with CF. Incorporating VR into exercise and airway clearance interventions may be beneficial for people with CF. However, further studies with larger sample size and wider range of disease severity are required to be conducted in future.

Testing the effects of the Strong Together self-advocacy serious game among women with advanced cancer: Protocol for the STRONG randomized clinical trial.

BACKGROUND: Women with advanced cancer experience significant barriers to achieving high-quality care and maximizing their physical and emotional health. Our novel serious game, Strong Together, aims to teach women with advanced cancer self-advocacy skills needed to improve their symptom burden, quality of life, and patient-centered care. METHODS: This is a single-center, multi-site randomized clinical trial of the Strong Together intervention among 336 women within three months of an advanced breast or gynecologic cancer diagnosis. Randomization occurs to the 3-month Strong Together serious game or enhanced care as usual group. The aims are to: (1) evaluate the effects of the intervention on patient self-advocacy (primary outcome); (2) evaluate the effects of the intervention on quality of life, symptom burden, and patient-centered care (secondary outcomes); and (3) evaluate the behavioral and game mechanisms that influence the efficacy of the intervention. ELIGIBILITY CRITERIA: female, age ≥ 18 years; diagnosis of advanced breast or gynecologic cancer within the past 3 months; Eastern Cooperative Oncology Group score of 0-2; English literacy; and ≥ 6-month life expectancy. Patient-reported outcome measures are collected at baseline, 3-months, and 6-months. CONCLUSION: This protocol is the first large-scale intervention aimed at promoting self-advocacy in women with advanced cancer. Understanding the ability of serious games to impact patient outcomes provides critical information for researchers, clinicians, and stakeholders aiming to improve patient-centered care. TRIAL REGISTRATION: NCT04813276.