The effectiveness of the use of video games and software-based programs for asthma education and self-management for children and teenagers

Abstract Introduction: Asthma is a chronic disease of the lower airways characterized by usually reversible airflow obstruction, inflammation, and hyperreactivity to various types of stimuli. It is one of the most common chronic respiratory diseases among children and adults, with an incidence of 300 million people worldwide. Objective: To evaluate the quality of the existent evidence in the literature in order to support the use of videogames and software-based programson asthmatic children and teenager’s knowledge capacity and self-management compared with standard education. Methods: Search, selection and analysis (starting March 2016) of all the original articles on virtual reality (VR) concerning asthmatic children and adolescents (ages 3 to 18), published up to October 2017, in Portuguese, English and Spanish, at the electronic databases Pubmed, Web of Science, MedlLine and LILACS, obtained by using the descriptors: asthma, video game, virtual reality, pulmonary rehabilitation, physical training. Results: Only six original articles were obtained. Of these, five (80%) presented level of evidence A, and one (20%) presented level of evidence B. All authors point out the treatment of asthma from VR as a safe and innovative therapy considering that the motivation and intensity of treatment from the use of VR improves the self-management capacity and aerobic capacity of asthmatic patients. Conclusion: The present study seeks to contribute to the literature by demonstrating that videogames and other software-based systemscan be used to improve knowledge capacity and self-management skills in children and teenagers with asthma diagnosis.

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The Potential Role of The Long non-coding RNA MEG3 in Bronchial Asthma in children

QJM ◽

10.1093/qjmed/hcab088.002 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Basma Tarek Rezk ◽

Fayda Ibrahim Abdel Motaleb ◽

Terez Boshra Kamel ◽

Enas Samir Nabih ◽

Marwa Ali Abd El-Khalek

Keyword(s):

Bronchial Asthma ◽

Airflow Obstruction ◽

Response To Therapy ◽

Control Group ◽

Healthy Children ◽

Asthmatic Children ◽

Clinical Biomarkers ◽

Asthma In Children ◽

Reversible Airflow Obstruction

Abstract Aim and Background Asthma is an inflammatory disease affecting the airways of the lungs being characterized by reversible airflow obstruction and bronchospasm. Environmental and genetic factors play a role in the pathogenesis of the disease; these factors are controlled by epigenetic mechanisms. There is a demand of clinical biomarkers for diagnosis of asthma and monitoring the response to therapy. In this study, we aimed to evaluate the role of lnc-MEG3 expression and its downstream effector in the pathogenesis of bronchial asthma disease. Methods Based on bioinformatics analysis using online databases, the current work has been designed to study the expression status of lnc-MEG3 and GDF15 mRNA in serum and sputum of asthmatic children aiming to find its clinical significance. This study was conducted on 30 children, 15 children newly diagnosed with bronchial asthma as patient group (A) and 15 age and sex matched healthy children as control group (B). Quantitative PCR was carried out to evaluate the expression pattern of selected biomarkers in serum and sputum of asthmatic children. Results The expression of circulating lnc-MEG3 was highly significantly up-regulated in asthmatic children than in control group (p ≤ 0.01), while the expression of circulating GDF15 mRNA was highly significantly down-regulated in asthmatic children than in control group (p ≤ 0.01). The findings showed a negative significant correlation between both investigated biomarkers. Conclusion This study supports the role of lnc-MEG3 and GDF15 protein as potential biomarkers in diagnosis of bronchial asthma in children.

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SELF-PERCEPTION OF ASTHMATIC CHILDREN AND MODIFICATION THROUGH SELF-MANAGEMENT PROGRAMMES

Psychological Reports ◽

10.2466/pr0.71.7.903-913 ◽

1992 ◽

Vol 71 (7) ◽

pp. 903 ◽

Cited By ~ 1

Author(s):

M. I. VAZQUE

Keyword(s):

Self Management ◽

Self Perception ◽

Asthmatic Children

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Virtual reality video game improves high-fidelity memory in older adults

Scientific Reports ◽

10.1038/s41598-021-82109-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Peter E. Wais ◽

Melissa Arioli ◽

Roger Anguera-Singla ◽

Adam Gazzaley

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Video Game ◽

Cognitive Abilities ◽

Environmental Enrichment ◽

Cognitive Intervention ◽

Therapeutic Interventions ◽

Placebo Control ◽

Long Term Memory ◽

High Fidelity

AbstractTherapeutic interventions have not yet been shown to demonstrate restorative effects for declining long-term memory (LTM) that affects many healthy older adults. We developed a virtual reality (VR) spatial wayfinding game (Labyrinth-VR) as a cognitive intervention with the hypothesis that it could improve detailed, high-fidelity LTM capability. Spatial navigation tasks have been used as a means to achieve environmental enrichment via exposure to and learning about novel and complex information. Engagement has been shown to enhance learning and has been linked to the vitality of the LTM system in the brain. In the current study, 48 older adults (mean age 68.7 ± 6.4 years) with average cognitive abilities for their age were randomly assigned to 12 h of computer game play over four weeks in either the Labyrinth-VR or placebo control game arms. Promptly before and after each participant’s treatment regimen, high-fidelity LTM outcome measures were tested to assess mnemonic discrimination and other memory measures. The results showed a post-treatment gain in high-fidelity LTM capability for the Labyrinth-VR arm, relative to placebo, which reached the levels attained by younger adults in another experiment. This novel finding demonstrates generalization of benefits from the VR wayfinding game to important, and untrained, LTM capabilities. These cognitive results are discussed in the light of relevant research for hippocampal-dependent memory functions.

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

Journal of Diabetes Science and Technology ◽

10.1177/19322968211017555 ◽

2021 ◽

pp. 193229682110175

Author(s):

Valéria de Cássia Sparapani ◽

Sidney Fels ◽

Noreen Kamal ◽

Rebecca Ortiz La Banca ◽

Lucila Castanheira Nascimento

Keyword(s):

Health Behavior ◽

Behavior Change ◽

Video Game ◽

Game Design ◽

Health Behavior Change ◽

Self Management ◽

Learning Needs ◽

Methodological Study ◽

Video Game Design ◽

Management Behaviors

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.

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Effects of Obesity on Airway and Systemic Inflammation in Asthmatic Children

International Archives of Allergy and Immunology ◽

10.1159/000513809 ◽

2021 ◽

pp. 1-11

Author(s):

Emine Vezir ◽

Ersoy Civelek ◽

Emine Dibek Misirlioglu ◽

Muge Toyran ◽

Murat Capanoglu ◽

...

Keyword(s):

Airway Inflammation ◽

Systemic Inflammation ◽

Adiponectin Level ◽

Inflammatory Cells ◽

Prick Test ◽

Asthmatic Children ◽

Asthmatic Patients ◽

Reactive Protein ◽

Type 2 Cytokines ◽

Asthma In Children

Background: Obese asthma is a complex syndrome with certain phenotypes that differ in children and adults. There is no clear evidence regarding the presence of additive or synergistic pathological interaction between obesity and asthma in children. Objectives: Our aim was to demonstrate the interaction of obesity and asthma in children in terms of airway and systemic inflammation by a controlled observational study. Methods: Four groups were formed: asthma obese (AO), asthma nonobese (ANO), non-AO (NAO), nonasthma nonobese (NANO). Spirometry test, fractional exhaled nitric oxide (FeNO) test, skin prick test, serum inflammatory biomarkers (C-reactive protein, C3, C4, adiponectin, leptin, resistin, periostin, YKL-40, Type 1, and Type 2 cytokines) were conducted and evaluated in all participants. Sputum inflammatory cells (sputum eosinophils and neutrophils) were evaluated in patients who could produce induced sputum and obesity-asthma interactions were determined. Results: A total of 153 participants aged 6–18 years were included in the study, including the AO group (n = 46), the ANO group (n = 45), the NAO group (n = 30), and the NANO group (n = 32). IL-4 (p < 0.001), IL-5 (p < 0.001), IL-13 (p < 0.001), resistin (p < 0.001), and YKL-40 (p < 0.001) levels were higher in patients with asthma independent of obesity. The lowest adiponectin level was found in the AO group and obesity-asthma interaction was detected (p < 0.001). Sputum eosinophilia (p < 0.01), sputum neutrophilia (p < 0.01), and FeNO levels (p = 0.07) were higher in asthmatic patients independent of obesity. In the group with paucigranulocytic inflammation, resistin and YKL-40 levels were significantly lower than in the group without paucigranulocytic inflammation (p < 0.01). Conclusion: No interaction was found between obesity and asthma in terms of airway inflammation. Interaction between obesity and asthma was shown in terms of adiponectin level and resistin/adiponectin and leptin/adiponectin ratios. It was found that serum YKL-40 and resistin levels could be associated with airway inflammation.

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Regulation of Eosinophilia in Asthma—New Therapeutic Approaches for Asthma Treatment

Cells ◽

10.3390/cells10040817 ◽

2021 ◽

Vol 10 (4) ◽

pp. 817

Author(s):

Ruth P. Cusack ◽

Christiane E. Whetstone ◽

Yanqing Xie ◽

Maral Ranjbar ◽

Gail M. Gauvreau

Keyword(s):

Drug Targets ◽

Airflow Obstruction ◽

Chronic Inflammatory Disease ◽

Therapeutic Approaches ◽

Eosinophilic Asthma ◽

Airway Eosinophilia ◽

Gm Csf ◽

New Therapeutic Approaches ◽

Cellular Apoptosis ◽

Reversible Airflow Obstruction

Asthma is a complex and chronic inflammatory disease of the airways, characterized by variable and recurring symptoms, reversible airflow obstruction, bronchospasm, and airway eosinophilia. As the pathophysiology of asthma is becoming clearer, the identification of new valuable drug targets is emerging. IL-5 is one of these such targets because it is the major cytokine supporting eosinophilia and is responsible for terminal differentiation of human eosinophils, regulating eosinophil proliferation, differentiation, maturation, migration, and prevention of cellular apoptosis. Blockade of the IL-5 pathway has been shown to be efficacious for the treatment of eosinophilic asthma. However, several other inflammatory pathways have been shown to support eosinophilia, including IL-13, the alarmin cytokines TSLP and IL-33, and the IL-3/5/GM-CSF axis. These and other alternate pathways leading to airway eosinophilia will be described, and the efficacy of therapeutics that have been developed to block these pathways will be evaluated.

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Developing a scenario-based video game generation framework for computer and virtual reality environments: a comparative usability study

Journal on Multimodal User Interfaces ◽

10.1007/s12193-020-00348-6 ◽

2020 ◽

Author(s):

Elif Surer ◽

Mustafa Erkayaoğlu ◽

Zeynep Nur Öztürk ◽

Furkan Yücel ◽

Emin Alp Bıyık ◽

...

Keyword(s):

Virtual Reality ◽

Video Game ◽

Usability Study ◽

Game Generation

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Ventilation Heterogeneity in Asthma and COPD: The Value of the Poorly Communicating Fraction as the Ratio of Total Lung Capacity to Alveolar Volume

Respiration ◽

10.1159/000513954 ◽

2021 ◽

pp. 1-7

Author(s):

Roberta Pisi ◽

Marina Aiello ◽

Luigino Calzetta ◽

Annalisa Frizzelli ◽

Veronica Alfieri ◽

...

Keyword(s):

Total Lung Capacity ◽

Airflow Obstruction ◽

Diffusing Capacity ◽

Body Plethysmography ◽

Alveolar Volume ◽

Asthmatic Patients ◽

Lung Capacity ◽

Copd Patients ◽

Ventilation Heterogeneity ◽

Patient Groups

Background: The ventilation heterogeneity (VH) is reliably assessed by the multiple-breath nitrogen washout (MBNW), which provides indices of conductive (Scond) and acinar (Sacin) VH as well as the lung clearance index (LCI), an index of global VH. VH can be alternatively measured by the poorly communicating fraction (PCF), that is, the ratio of total lung capacity by body plethysmography to alveolar volume from the single-breath lung diffusing capacity measurement. Objectives: Our objective was to assess VH by PCF and MBNW in patients with asthma and with COPD and to compare PCF and MBNW parameters in both patient groups. Method: We studied 35 asthmatic patients and 45 patients with COPD. Each patient performed spirometry, body plethysmography, diffusing capacity, and MBNW test. Results: Compared to COPD patients, asthmatics showed a significantly lesser degree of airflow obstruction and lung hyperinflation. In asthmatic patients, both PCF and LCI and Sacin values were significantly lower than the corresponding ones of COPD patients. In addition, in both patient groups, PCF showed a positive correlation with LCI (p < 0.05) and Sacin (p < 0.05), but not with Scond. Lastly, COPD patients with PCF >30% were highly likely to have a value ≥2 of the mMRC dyspnea scale. Conclusions: These results showed that PCF, a readily measure derived from routine pulmonary function testing, can provide a comprehensive measure of both global and acinar VH in asthma and in COPD patients and can be considered as a comparable tool to the well-established MBNW technique.

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Adapting game’s evaluation metrics to virtual reality serious games and its validation on “Hellblade: Senu’s Sacrifice” (Preprint)

10.2196/preprints.29677 ◽

2021 ◽

Author(s):

Kim Martinez ◽

Maria Isabel Menéndez-Menéndez ◽

David Checa ◽

Andres Bustillo

Keyword(s):

Virtual Reality ◽

Video Game ◽

Game Design ◽

Serious Games ◽

Research Field ◽

Raising Awareness ◽

Quantitative Rating ◽

Study Case ◽

Definition Of

BACKGROUND The design of Virtual Reality Serious Games (VR-SG) is a subject still developing. One of its open developments is the definition of metrics to evaluate the fun and learning result. In this way, weaknesses and strengths in the design of serious games can be found for future works in this research field. OBJECTIVE This paper aims to create a metric that can be used to rate the gameplay of VR-SG. This metric’s novelty allows to evaluate the different fun and learning features and give them a quantitative rating. A study case shows the capability of implementing this evaluation to identify strengths and weaknesses of VR-SGs. METHODS The new VR-SG metric is developed on the basis of the Mechanics, Dynamics and Aesthetic (MDA) framework but including User Experience (UX) elements and adapting them to VR-SG. This metric includes 1) UX aspects: VR-headsets, training tutorials and interactive adaptions to avoid VR inconveniences; and 2) MDA aspects: exclusive VR audiovisual elements and its aesthetics interactions. RESULTS The selected indie serious game is Hellblade, developed to raise awareness about the difficulties of people suffering from psychosis with two versions: one for 2D-screens and the other for VR devices. The comparison of metric´s scores for both versions shows: 1) some VR dynamics increase the gameplay impact and therefore, the educational capacity; and 2) flaws in game design where the scores drop down. Some of these flaws are: reduced number of levels, missions and items, lack of a tutorial to enhance usability and lack of strategies and rewards in the long-term to increase motivation. CONCLUSIONS This metric allows to identify the elements of the gameplay and UX that are necessary to learn in VR experiences. The study case shows this research is useful to evaluate the educational utility of VR-SG. Further works will analyze VR applications to synthetize every game element influencing its intrinsic sensations. CLINICALTRIAL The trials have not been registered, as testing for this metric has not involved people with mental conditions or addressed other medical applications. Hellblade is a commercial video game that anyone can purchase and play. The trials have been carried out to obtain results on the gaming experience of different people in relation to the educational purpose of raising awareness of psychosis.

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