***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The main objective of our study was to assess the impact of a board game on smoking status and smoking-related variables in current smokers . To accomplish this objective , we conducted a r and omized controlled trial comparing the game group with a psychoeducation group and a waiting-list control group . Methods The following measures were performed at participant inclusion , as well as after a 2-week and a 3-month follow-up period : “ Attitudes Towards Smoking Scale ” ( ATS-18 ) , “ Smoking Self-Efficacy Question naire ” ( SEQ-12 ) , “ Attitudes Towards Nicotine Replacement Therapy ” scale ( ANRT-12 ) , number of cigarettes smoked per day , stages of change , quit attempts , and smoking status . Furthermore , participants were assessed for concurrent psychiatric disorders and for the severity of nicotine dependence with the Fagerström Test for Nicotine Dependence ( FTND ) . Results A time × group effect was observed for subscales of the ANRT-12 , ATS-18 and SEQ-12 , as well as for the number of cigarettes smoked per day . At three months follow-up , compared to the participants allocated to the waiting list group , those on Pick-Klop group were less likely to remain smoker . Outcomes at 3 months were not predicted by gender , age , FTND , stage of change , or psychiatric disorders at inclusion . Conclusions The board game seems to be a good option for smokers . The game led to improvements in variables known to predict quitting in smokers . Furthermore , it increased smoking-cessation rates at 3-months follow-up . The game is also an interesting alternative for smokers in the precontemplation stage This study investigated the effects of an intervention using the game “ GO ” on cognitive function in nursing home residents and evaluated the acquisition of GO according to each stage of dementia . Participants were r and omly assigned to either the GO intervention group or a control group , and the intervention was performed once weekly for 15 weeks . Cognitive tests were conducted before and after intervention , and 17 participants were included in the final analysis . Analysis of covariance demonstrated that in the intervention group , the digit span total score significantly improved and the digit span backward score was maintained , whereas these scores decreased in the control group . All participants , including those who had moderate dementia , acquired the rules of the game , and participants with mild cognitive impairment and mild dementia could play the game successfully . This study indicates that GO might improve the cognitive function of residents living in nursing homes A GO game can enhance mental health , but its effects on Alzheimer Disease ( AD ) remains unknown . To address the issue , 147 AD patients were r and omly assigned into control ( without GO-game intervention ) , Short-time GO-Game Intervention ( SGGI , 1 h daily ) and Long-time GO-game Intervention ( LGGI , 2 h daily ) groups . After 6-month follow-up , the game reduced the mean score of Montgomery-Asberg Depression Rating Scales ( MADRS ) of 4.72 ( 95 % CI , 0.69 to 9.12 ) and Hospital Anxiety and Depression Scale ( HADS ) of 1.75 ( 95 % CI , 0.17–3.68 ) , and increased the mean score of Global Assessment of Functioning ( GAF ) of 4.95 ( 95 % CI , −1.37–9.18 ) and R AND -36 of 4.61 ( 95 % CI , −2.75–11.32 ) ( P < 0.05 via controls ) . A GO-game intervention  improved 9 of 11 items of KICA-dep ( Kimberley Indigenous Cognitive Assessment of Depression ) . Meanwhile , serum levels of brain derived neurotrophic factor ( BDNF ) were higher in SGGI and LGGI groups ( 24.02 ± 7.16 and 28.88 ± 4.12 ng/ml respectively , P = 0.051 ) than those in controls ( 17.28 ± 7.75 ng/ml ) ( P < 0.001 ) . The serum levels of BDNF showed a negative relation with MADRS and a positive relation with R AND -36 ( P < 0.01 ) . A GO-game intervention ameliorates AD manifestations by up-regulating BDNF levels OBJECTIVE To examine the effectiveness of playing chess as a treatment option for children with ADHD . METHODS Parents of 44 children ages 6 to 17 with a primary diagnosis of ADHD consented to take part in the study . Parents completed the Spanish version of the Swanson , Nolan and Pelham Scale for parents ( SNAP-IV ) and the  Abbreviated Conner 's Rating Scales for parents ( CPRS-HI )  prior to an 11-week chess-training program . We used a paired t-test to compare pre- and post-intervention outcomes , and Cohen-d calculations to measure the magnitude of the effect . The statistical significance was set at P<.05 . RESULTS Children with ADHD improved in both the SNAP-IV ( t=6.23 ; degrees of freedom (df)=41 ; P<.001 ) and the CPRS-HI ( t=5.39 ; df=33 ; P<.001 ) . Our results suggest a large effect in decreasing the severity of ADHD as measured by the SNAP-IV ( d=0.85 ) and the CPRS-HI ( d=0.85 ) . Furthermore , we found a correlation between intelligence quotient and SNAP-IV improvement ( P<.05 ) . CONCLUSIONS The results of our pilot study should be interpreted with caution . This pilot project highlights the importance of carrying out larger studies with a case-control design . If our results are replicated in better design ed studies , playing chess could be included within the multimodal treatment of ADHD Introduction Prevention of obesity and overweight is an important target for health promotion . Early prevention requires an intervention during childhood and adolescence . At these stages , the game could be an appropriate means to teach nutrition knowledge and to influence dietary behaviour . To this end , the authors developed Kalèdo , a new board-game . Objective The aim of the present study was to test the efficacy of Kalèdo on changes in nutrition knowledge and dietary behaviour in a pilot study conducted in three middle schools in Naples , Italy . Material s and Methods A simple two-group design ( treatment and control ) with pre- and post- assessment was employed . The classroom was the unit of recruitment and r and om assignment to groups . All students ( 307 ) in the participating schools were invited to participate . Data analysis was performed on 241 subjects . During 24 weeks , a group of 153 children from 8 classrooms ( 11–14 year old Caucasian subjects ; 78 male , 75 female ) was involved in 15–30 minute-long play sessions once a week . A question naire was given to the participants at the beginning and at the end of the study to evaluate nutrition knowledge ( 31 questions ) , physical activity ( 8 questions ) and food intake ( 34 questions ) . Anthropometric measurements were also carried out . A second group of 88 children from 5 classrooms ( same age and ethnicity ; 55 male , 33 female ) was investigated at the same times with the same question naire and anthropometric measures but they did not receive any play sessions with Kalèdo . ObservationChildren playing Kalèdo showed a significant increase in nutrition knowledge ( p<0.05 ) and in weekly vegetable intake ( p<0.01 ) with respect to the control . Conclusion The results suggest that Kalèdo could be an effective instrument to teach children about healthy diet . More research is needed to study the long term effect of this intervention Abstract The board game Kaledo was proven to be effective in improving nutrition knowledge and in modifying dietary behavior in students attending middle and high school . The present pilot study aims to reproduce these results in younger students ( 7–11 years old ) attending primary school . A total of 1313 children from ten schools were recruited to participate in the present study . Participants were r and omized into two groups : ( 1 ) the treatment group which consisted of playing Kaledo over 20 sessions and ( 2 ) the no intervention group .  Anthropometric measures were carried out for both groups at baseline ( prior to any treatment ) and at two follow-up post- assessment s ( 8 and 18 months ) . All the participants completed a question naire concerning physical activity and a 1-week food diary at each assessment . The primary outcomes were ( i ) BMI z-score , ( ii ) scores on physical activity , and ( iii ) scores on a dietary question naire . BMI z-score was significantly lower in the treated group compared to the control group at 8 months . Frequency and duration of self-reported physical activity were also significantly augmented in the treated group compared to the control group at both post- assessment s. Moreover , a significant increase in the consumption of healthy food and a significant decrease in junk food intake were observed in the treated group . Conclusion : The present results confirm the efficacy of Kaledo in younger students in primary schools , and it can be used as a useful nutritional tool for obesity prevention programs in children . What is Known:• Kaledo is a new educational board game to improve nutrition knowledge and to promote a healthy lifestyle.• In two cluster r and omized trials conducted in Campania region ( Italy ) , we showed that Kaledo could improve nutrition knowledge and dietary behavior and have a positive effect on the BMI z-score in children with age ranging from 9 to 14 years old attending school.•  Kaledo may be used as an effective tool for obesity prevention programs in middle and high school students . What is New:• Investigating the effects of Kaledo on younger primary school children ( 7–11 year olds ) , Kaledo could be an effective tool in obesity prevention programs for children as young as 7 years old This study developed three types of educational preoperative material s and examined their efficacy in preparing children for surgery by analysing children 's preoperative  worries and  parental anxiety .  The sample was recruited from three hospitals in Lisbon and consisted of 125 children , aged 8 - 12 years , scheduled to undergo outpatient surgery . The participants were r and omly assigned to one of the seven independent conditions that were combined into the following three main groups : an experimental group , which received educational material s with information about surgery and hospitalization ( a board game , a video or a booklet ) ; a comparison group , which received entertaining material with the same format type ; and a control group , which did not receive any material .  Children 's preoperative worries and parental anxiety were evaluated after the experimental manipulation . Children who received educational material s were significantly less worried about surgery and hospital procedures than children in the comparison and the control groups , although no statistically differences were found between the type of material s within the experimental group , and no significant effect occurred on parental state anxiety . These results do however support the hypothesis that providing preoperative material s with educational information reduce children 's preoperative worries BACKGROUND Ska is a traditional board game in Thail and that involves high levels of cognition , planning , and decisionmaking . There have been no previous studies on the benefits of the Ska game as a cognitive function aid for older adults . OBJECTIVE To examine the effects of Ska game practice on improving cognitive functioning among older adults . MATERIAL AND METHOD Forty older adults living in the municipality of Phetchabun province , volunteered to take part in the present study . They were r and omly selected and arranged into two intervention groups , an experiment and a control group ( 20 participants each group ; 10 females and 10 males ) . Each group was repeatedly trained as planned for at least 50 minutes per day , three sessions per week for the continuous duration of 16 weeks . The cognitive function measured in term of memory , Verbal Pair Association I and II ( VPA I ; VPA II ) , Visual Reproduction I and II ( VR I ; VR II ) , the attention used of Trail Making Test part A ( TMT-A ) , and the executive function used by means of the Wisconsin Card Sorting Test ( WCST ) . The examination was done by a clinical psychologist and a medical technologist using neurotransmitter to measure Acetylcholinesterase ( AChE ) activity , before and after the intervention . The independent variables were measured with t-test to compare the mean scores of two different groups and between males and females of the Ska group . The level of significance considered was p < 0.05 . RESULTS The findings revealed that those who joined the Ska group reported statistically significant better scores of cognitive function in memory , attention , executive function from VPA I , VPA II , VR I , VR II , TMT-A , and WCST compared to those who were in the control group ( p < 0.05 ) . However , there was no significant difference of AChE activity between the Ska and the control group ( p > 0.05 ) . In addition , there was no significant difference mean in cognitive function between male and female Ska group ( p > or = 0.05 ) . CONCLUSION Finding shows that the Ska game could enhance the cognitive functioning in terms of memory , attention , and executive function in older adults Primary prevention and health promotion have become salient topics in Canadian society and in nursing during the past two decades . The noncommunicable chronic diseases , such as heart disease and cancer , have been linked to specific lifestyle behaviors or habits , which often develop early in life . The success of public health efforts to improve the health status of all Canadians depends substantially on the success of educationalprograms directedtowardchildren . Effective teaching strategies that seek to promote health and wellness in children need to be developed and empirically evaluated . Educational games may provide an efficient vehicle for carrying out developmentally specific nursing interventions in school setting s. This article begins with a brief overview of the historical origins of games , along with their advantages and disadvantages as educational strategies . The results ofa pretest-posttest control group design study that evaluated the effectiveness of a board game as a primary prevention teaching strategy with 23 sixth grade children in Winnipeg , Manitoba are presented . The experimental group had significant gains in knowledge related to anatomy and 
    Output:
    
The present findings showed that , as a tool , board games can be expected to improve the underst and ing of knowledge , enhance interpersonal interactions among participants , and increase the motivation of participants .