Daeun Hwang

Teen participation in esports is rapidly expanding, raising concerns about how competitive gaming shapes adolescent mental well-being. Existing mental well-being initiatives often adopt adult-centered approaches that overlook teenagers’ lived realities. This study explores mental well-being from the perspective of teen esports players. Through nine participatory design sessions with 34 participants, including adolescent players, coaches, and program coordinators, we examined how teens conceptualize a “healthy player” and sustain mental well-being in gaming. Findings emphasize three key insights: (1) for teens, being “healthy” means winning together, where well-being is tied to collective outcomes and social responsibility; (2) most stressors stem from esports environments beyond their control, underscoring the need for emotional resilience; and (3) teens favor simple, everyday coping strategies, such as taking breaks, reframing losses, adjusting play environments, and drawing on peer encouragement, over formal programs. These patterns resonate with Cognitive Behavioral Theory, suggesting that cycles of thought, emotion, and behavior underpin resilience. We argue for youth-centered, culturally relevant mental well-being strategies and micro-interventions embedded in the daily practices of adolescent esports.

The importance of coping with stress for adolescents is well documented. Various approaches to providing stress-coping strategies have been proposed, and mindfulness has been one of the commonly introduced techniques. It has shown clinical evidence of effectiveness, and questionnaires measuring its efficiency have been developed as well. However, the majority of current methods take a conventional approach of involving verbal or text-based explanations of mindfulness practices, which suffer from a distinct lack of engagement and long-term adherence. However, there are still limited methods for introducing mindfulness to adolescents. In order to make mindfulness not only more accessible for teens but also more engaging and effective, we introduce Mindful Fido, an interactive narrative empathy game that involves players in three different mindfulness techniques, making the learning process more enjoyable and relatable to their daily experiences. In Mindful Fido, players follow the story of a teenage student who faces common stress factors of adolescence. The game is designed to keep players engaged and present mindfulness techniques as game mechanics that naturally allow players to practice mindfulness.

Background: Sleep games are an emerging topic in the realm of serious health game research. However, designing features that are both enjoyable and effective at engaging users, particularly university students, to develop healthy sleep habits remains a challenge. Objective: This study aims to investigate user preferences for 3 sleep game prototypes, that is, Hero’s Sleep Journey, Sleep Tamagotchi, and Sleepland, and to explore their popularity and perceived utility in promoting sleep health. Methods: A mixed methods approach was used in this study. Quantitative and qualitative data were collected through a co-design workshop involving 47 university students. Participants were presented with storyboard cards of game features and were asked to provide an overall rating on each game, as well as ratings for individual features. They were also encouraged to provide free-form comments on the features and suggest improvements. In addition, participants were asked to express their preferences among the 3 games regarding which game they would most like to play and which one they found most useful for promoting sleep health. Results: Surprisingly, while Hero’s Sleep Journey was the most popular choice among participants, Sleep Tamagotchi was perceived as the most beneficial for improving sleep health. Relevance emerged as an overarching theme in the qualitative data analysis, with 3 interconnected dimensions: psychological relevance to users’ personal lives, logical relevance to sleep health, and situational relevance to users’ circumstantial context. We discussed how the 3 dimensions of relevance address the autonomy and relatedness constructs outlined in the self-determination theory and proposed 3 design recommendations. Conclusions: Our serious sleep game prototypes demonstrated the potential to engage university students to develop healthy sleep hygiene. Future sleep game designs should aim to create a sense of relevance to users’ personal lives, sleep health goals, and situational contexts. Rather than a one-size-fits-all approach, it is essential to develop a wide range of game genres and features to cater to diverse users. Aligning game features with sleep health goals and educating users on the design rationale through sleep knowledge are also important aspects. Furthermore, allowing users to customize their game experience and manage technology boundaries is necessary to nurture a sense of control and autonomy in the process of forming good sleep hygiene.

BACKGROUND Sleep games are an emerging topic in the realm of serious health game research. However, designing features that are both enjoyable and effective at engaging users, particularly university students, to develop healthy sleep habits remains a challenge. OBJECTIVE This study aims to investigate user preferences for 3 sleep game prototypes, that is, Hero’s Sleep Journey, Sleep Tamagotchi, and Sleepland, and to explore their popularity and perceived utility in promoting sleep health. METHODS A mixed methods approach was used in this study. Quantitative and qualitative data were collected through a co-design workshop involving 47 university students. Participants were presented with storyboard cards of game features and were asked to provide an overall rating on each game, as well as ratings for individual features. They were also encouraged to provide free-form comments on the features and suggest improvements. In addition, participants were asked to express their preferences among the 3 games regarding which game they would most like to play and which one they found most useful for promoting sleep health. RESULTS Surprisingly, while Hero’s Sleep Journey was the most popular choice among participants, Sleep Tamagotchi was perceived as the most beneficial for improving sleep health. Relevance emerged as an overarching theme in the qualitative data analysis, with 3 interconnected dimensions: psychological relevance to users’ personal lives, logical relevance to sleep health, and situational relevance to users’ circumstantial context. We discussed how the 3 dimensions of relevance address the autonomy and relatedness constructs outlined in the self-determination theory and proposed 3 design recommendations. CONCLUSIONS Our serious sleep game prototypes demonstrated the potential to engage university students to develop healthy sleep hygiene. Future sleep game designs should aim to create a sense of relevance to users’ personal lives, sleep health goals, and situational contexts. Rather than a one-size-fits-all approach, it is essential to develop a wide range of game genres and features to cater to diverse users. Aligning game features with sleep health goals and educating users on the design rationale through sleep knowledge are also important aspects. Furthermore, allowing users to customize their game experience and manage technology boundaries is necessary to nurture a sense of control and autonomy in the process of forming good sleep hygiene.

Background: Accurate classification of lung cancer subtypes has become critical in tailoring lung cancer treatment. Our study aimed to evaluate changes in diagnostic testing and pathologic subtyping of advanced non-small-cell lung cancer (NSCLC) over time at a major cancer centre. Methods: In a review of patients diagnosed with advanced NSCLC at Princess Margaret Cancer Centre between 2007–2009 and 2013–2015, diagnostic method, sample type and site, pathologic subtype, and use of immunohistochemistry (IHC) staining and molecular testing were abstracted. Results: The review identified 238 patients in 2007–2009 and 283 patients in 2013–2015. Over time, the proportion of patients diagnosed with adenocarcinoma increased to 73.1% from 60.9%, and diagnoses of NSCLC not otherwise specified (NOS) decreased to 6.4% from 18.9%, p < 0.0001. Use of diagnostic bronchoscopy decreased (26.9% vs. 18.4%), and mediastinal sampling procedures, including endobronchial ultrasonography, increased (9.2% vs. 20.5%, p = 0.0001). Use of IHC increased over time to 76.3% from 41.6% (p < 0.0001). Larger surgical or core biopsy samples and those for which IHC was performed were more likely to undergo biomarker testing (both p < 0.01). Conclusions: Customizing treatment based on pathologic subtype and molecular genotype has become key in treating patients with advanced lung cancer. Greater accuracy of pathology diagnosis is being achieved, including through the routine use of IHC.