Impact of COVID-19 lockdown on physical activity, insomnia, and loneliness among Spanish women and men.

During COVID-19 pandemic, quality of living was impacted by social isolation, loneliness, and altered sleep habits. The aims of this study were (1) to examine the relationship between physical activity (PA) levels with insomnia and loneliness among adults during Spain's first COVID-19 wave of lockdown and its impact on women and (2) to examine the digital technologic resources used to support both PA and other recreational activities in women. A cross-sectional design was used. An anonymous 15-min online survey was conducted in Spain to adults (≥ 18 years old) during the first COVID-19 lockdown, a 40-day period. A snowball distribution method was employed using personal email and social networks (Facebook, Whatsapp, Linkedin, Twitter). Variables studied included: socio-demographic items, insomnia, loneliness, PA, and digital technologic resources. A total of 996 adults (females = 663, 66.6%) completed the survey. Higher education levels were associated with greater PA levels (p-value < 0.001). Women presented with higher insomnia risk than men with low PA levels (OR = 1.9, CI = 1.25; 2.95). Living with family members or other individuals was related to lower insomnia risk. A strong correlation between medium-high PA levels was found with greater digital technology resources (DTS) than individuals with low PA levels. Females used significantly more DTS than males (p-value < 0.001). No significant associations between DTS were found with age or academic education level. PA levels, sex, and loneliness were related to insomnia risk. A strong correlation between PA and DTS use was observed. Participants with medium-high PA levels and females use them more than those with low PA levels and males. We recommend promoting the PA through digital technologies for women. This recommendation would also improve sleep disorders in women who present higher insomnia risks than men.

Personalized Gamification for Learning: A Reactive Chatbot Architecture Proposal.

A key factor for successfully implementing gamified learning platforms is making students interact with the system from multiple digital platforms. Learning platforms that try to accomplish all their objectives by concentrating all the interactions from users with them are less effective than initially believed. Conversational bots are ideal solutions for cross-platform user interaction. In this paper, an open student-player model is presented. The model includes the use of machine learning techniques for online adaptation. Then, an architecture for the solution is described, including the open model. Finally, the chatbot design is addressed. The chatbot architecture ensures that its reactive nature fits into our defined architecture. The approach's implementation and validation aim to create a tool to encourage kids to practice multiplication tables playfully.

Gender and Age Differences in Preferences on Game Elements and Platforms.

This paper analyzes different player type models and game elements in the literature, particularly focusing on the case of online games. Research based on an exploratory study is presented; it aims to explore the different types of interaction with gameful digital applications. The study is based on a survey and provides findings from the literature review and empirical insights about users' differences and preferences regarding game elements. The results reveal demographics regarding player profiles and the relationships between gender, age, culture, and the influence of different game design elements and platforms. The main contribution of this study fulfills the need for knowledge about the relationship between game element design, platforms/devices, and players (types and preferences).

Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women.

BACKGROUND: Digital health literacy (DHL) increases the self-efficacy and empowerment of pregnant and lactating women (PLW) in using the Internet for health issues. The European project IC-Health aimed to improve DHL among PLW, through the co-creation of Massive Open Online Courses (MOOCs). METHODS: The co-creation of the MOOCs included focus groups and the creation of communities of practice (CoPs) with PLW and healthcare professionals aimed to co-design the MOOCs. The quantitative measures of MOOCs' acceptability, experience in the co-creation process and increase in DHL (dimensions of finding, understanding and appraisal) were assessed. RESULTS: 17 PLW participated in focus groups, 113 participants were included in CoPs and 68 participants evaluated the acceptability of MOOCs. A total of 6 MOOCs aimed at improving PLW's DHL were co-designed. There was a significant improvement in self-perceived DHL after using MOOCs (p-value < 0.001). The acceptability of MOOCs and co-creation experience were positively valued. CONCLUSIONS: The preliminary results of the quantitative assessment showed a higher self-perceived DHL after the IC-Health MOOCs. These results suggest that IC-Health MOOCs and the co-creation methodology appear to be a viable process to carry out an intervention aimed to improve DHL levels in European PLW.

Cocreation of Massive Open Online Courses to Improve Digital Health Literacy in Diabetes: Pilot Mixed Methods Study.

BACKGROUND: Self-management education is a fundamental aspect in the health care of people with diabetes to develop the necessary skills for the improvement of health outcomes. Patients are required to have the competencies to manage electronic information resources-that is, an appropriate level of digital health literacy. The European project IC-Health aimed to improve digital health literacy among people with diabetes through the cocreation of massive open online courses (MOOCs). OBJECTIVE: We report the preliminary results obtained in 3 participating countries in the IC-Health project (Italy, Spain, and Sweden) regarding (1) experience of the participants during the cocreation process of MOOCs, (2) perceived changes in their digital health literacy level after using MOOCs, and (3) a preliminary assessment of the acceptability of MOOCs. METHODS: The cocreation of the MOOCs included focus groups with adults and adolescents with diabetes and the creation of independent communities of practice for type 1 diabetes and type 2 diabetes participants aimed to co-design the MOOCs. Quantitative measures of the acceptability of MOOCs, experience in the cocreation process, and increase in digital health literacy (dimensions of finding, understanding, and appraisal) were assessed. RESULTS: A total of 28 participants with diabetes participated in focus groups. Adults and adolescents agreed that the internet is a secondary source of health-related information. A total of 149 participants comprised the diabetes communities of practice. A total of 9 MOOCs were developed. Acceptability of the MOOCs and the cocreation experience were positively valued. There was a significant improvement in digital health literacy in both adults and adolescents after using MOOCs (P<.001). CONCLUSIONS: Although the results presented on self-perceived digital health literacy are preliminary and exploratory, this pilot study suggests that IC-Health MOOCs represent a promising tool for the medical care of diabetes, being able to help reduce the limitations associated with low digital health literacy and other communication barriers in the diabetes population.

Business Simulation Games Analysis Supported by Human-Computer Interfaces: A Systematic Review.

This article performs a Systematic Review of studies to answer the question: What are the researches related to the learning process with (Serious) Business Games using data collection techniques with Electroencephalogram or Eye tracking signals? The PRISMA declaration method was used to guide the search and inclusion of works related to the elaboration of this study. The 19 references resulting from the critical evaluation initially point to a gap in investigations into using these devices to monitor serious games for learning in organizational environments. An approximation with equivalent sensing studies in serious games for the contribution of skills and competencies indicates that continuous monitoring measures, such as mental state and eye fixation, proved to identify the players' attention levels effectively. Also, these studies showed effectiveness in the flow at different moments of the task, motivating and justifying the replication of these studies as a source of insights for the optimized design of business learning tools. This study is the first systematic review and consolidates the existing literature on user experience analysis of business simulation games supported by human-computer interfaces.

Active Game-Based Solutions for the Treatment of Childhood Obesity.

Obesity is one of the biggest health problems globally that, together with sedentarism, requires solutions that increase the enthusiasm towards physical activity. Therefore, this paper describes two solutions based on active games using the Kinect sensor and biometric sensors, designed for the outpatient treatment of childhood obesity. The solutions were applied in an intervention program based on active video games and motor games, developed with children in treatment for childhood obesity. An ad hoc questionnaire was used to assess the level of satisfaction, fun, learning, and behavior changes in the children of the experimental group that developed the intervention. The results showed a high index of satisfaction with the intervention program, as well as with the games developed. It is concluded that active video games and group games are highly motivating and can promote behavior change towards healthier life habits in children.

Psychological Health and Physical Activity Levels during the COVID-19 Pandemic: A Systematic Review.

The coronavirus disease (COVID-19) pandemic has been devastating in all senses, particularly psychologically. Physical activity (PA) is known to aid psychological well-being, and it is worth investigating whether PA has been a coping strategy during this pandemic. The objective of this literature review is to analyze the extent to which engaging in PA during the COVID-19 pandemic impacts psychological health in the adult population. The literature was searched in all databases from the EBSCOhost Research Database-MEDLINE, APA PsycArticles, between others-published between 1 January 2019 and 15 July 2020. From 180 articles found, 15 were eligible. The reviewed articles showed an association between mental health distress-e.g., stress, anxiety, depressive symptoms, social isolation, psychological distress-and PA. This research concludes that the COVID-19 pandemic and the lockdown measures caused psychological distress. Those studies that analyzed PA showed that, during quarantine, adults increased their sedentary time and reduced their PA levels, showing controversial psychological outcomes. This review discusses whether PA is an effective strategy to face the COVID-19 pandemic psychological effects contributing to a further putative increase in the prevalence of psychiatric disorders.

Health Promotion for Childhood Obesity: An Approach Based on Self-Tracking of Data.

At present, obesity and overweight are a global health epidemic. Traditional interventions for promoting healthy habits do not appear to be effective. However, emerging technological solutions based on wearables and mobile devices can be useful in promoting healthy habits. These applications generate a considerable amount of tracked activity data. Consequently, our approach is based on the quantified-self model for recommending healthy activities. Gamification can also be used as a mechanism to enhance personalization, increasing user motivation. This paper describes the quantified-self model and its data sources, the activity recommender system, and the PROVITAO App user experience model. Furthermore, it presents the results of a gamified program applied for three years in children with obesity and the process of evaluating the quantified-self model with experts. Positive outcomes were obtained in children's medical parameters and health habits.

Human-Robot Interaction and Sexbots: A Systematic Literature Review.

At present, sexual robots have become a new paradigm of social robots. In this paper, we developed a systematic literature review about sexual robots (sexbots). To do this, we used the Scopus and WoS databases to answer different research questions regarding the design, interaction, and gender and ethical approaches from 1980 until 2020. In our review, we found a male bias in this discipline, and in recent years, articles have shown that user opinion has become more relevant. Some insights and recommendations on gender and ethics in designing sexual robots were also made.

Improving Cognitive Visual-Motor Abilities in Individuals with Down Syndrome.

Down syndrome causes a reduction in cognitive abilities, with visual-motor skills being particularly affected. In this work, we have focused on this skill in order to stimulate better learning. The proposal relies on stimulating the cognitive visual-motor skills of individuals with Down Syndrome (DS) using exercises with a gestural interaction platform based on the KINECT sensor named TANGO:H, the goal being to improve them. To validate the proposal, an experimental single-case study method was designed using two groups: a control group and an experimental one, with similar cognitive ages. Didactic exercises were provided to the experimental group using visual cognitive stimulation. These exercises were created on the TANGO:H Designer, a platform that was designed for gestural interaction using the KINECT sensor. As a result, TANGO:H allows for visual-motor cognitive stimulation through the movement of hands, arms, feet and head. The "Illinois Test of Psycholinguistic Abilities (ITPA)" was applied to both groups as a pre-test and post-test in its four reference sections: visual comprehension, visual-motor sequential memory, visual association, and visual integration. Two checks were made, one using the longitudinal comparison of the pre-test/post-test of the experimental group, and another that relied on comparing the difference of the means of the pre-test/post-test. We also used an observational methodology for the working sessions from the experimental group. Although the statistical results do not show significant differences between the two groups, the results of the observations exhibited an improvement in visual-motor cognitive skills.

Serious games for rehabilitation: Gestural interaction in personalized gamified exercises through a recommender system.

One of the principal problems of rehabilitation is that therapy sessions can be boring due the repetition of exercises. Serious games, and in particular exergames in rehabilitation, can motivate, engage and increase patients' adherence to their treatment. Also, the automatic personalization of exercises to each patient can help therapists. Thus, the main objective of this work is to build an intelligent exergame-based rehabilitation system consisting of a platform with an exergame player and a designer tool. The intelligent platform includes a recommender system which analyzes user interactions, along with the user's history, to select new gamified exercises for the user. The main contributions of this paper focus, first, on defining a recommender system based on different difficulty levels and user skills. The recommender system offers the ability to provide the user with a personalized game mode based on his own history and preferences. The results of a triple validation with experts, users and rehabilitation center professionals reveal a positive impact on gestural interaction and rehabilitation uses. Also, different methods are presented for testing the rehabilitation recommender system.

Effects of a Gamified Educational Program in the Nutrition of Children with Obesity.

Obesity is considered a global epidemic of the twenty-first century by the World Health Organization (WHO). Specifically, the Canary Islands has the highest level of this disease in Europe and 40% of children in Spain are overweight or obese. This increase is a direct result of changes in the lifestyles of the population and its nutrition. Because of this, we have designed an educational program based on motor games, active videogames and virtual learning environments to improve the long-term health of children. This article presents and analyzes the results of a study on the nutritional knowledge and adherence to the Mediterranean diet of 46 obese children aged 6 to 12 years in the Canary Islands who participated in an educational program. The study design was quasi-experimental, with two groups (experimental and control). A long-term longitudinal study (3 years) was carried out. A set of evaluation instruments was used for the different phases. The results show significant improvements between the experimental and control groups in terms of their knowledge of healthy nutrition and their adherence to the Mediterranean diet. As a main conclusion, we emphasize that a gamified educational intervention program supported by ICT helps to motivate and promote improvements in the nutrition of children.