Background: Mental health problems frequently emerge during adolescence and young adulthood, yet many young people do not seek or receive timely support. Digital mental health interventions, including serious games and gamified tools, may improve accessibility and engagement, but evidence for their feasibility and preliminary efficacy across diverse European settings remains limited.
Objective: This protocol describes the evaluation and trial component of the SMILE (Supporting Mental Health in Young People: Integrated Methodology for Clinical Decisions and Evidence-Based Interventions) project, which aims to evaluate the acceptability, feasibility, reach, and preliminary efficacy of a cognitive behavioral therapy (CBT)–informed gamified mobile intervention for adolescents and young adults, and to explore mechanisms of change and the impact of its implementation contexts.
Methods: SMILE uses a cluster-randomized, multisite, multiarm adaptive proof-of-concept design across 7 European countries, complemented by semistructured stakeholder interviews. Adolescents and young adults aged 10‐24 years are recruited mainly through schools, universities, and community channels; the target sample is 1438 participants. Clusters are assigned to 1 of 3 sequences comprising a neutral baseline period followed by 2, 4, or 5 game modules, and are randomized to a feedback or no-feedback version of the intervention. The intervention consists of the SMILE Game App (Nurogames and DigitalTwin Technology) and Companion App (RDIUP), which deliver CBT-based gamified content, self-monitoring, experience sampling, and, in one of the study conditions, automated personalized feedback. Primary outcomes are anxiety and depression. Secondary outcomes include well-being, resilience, emotion regulation, self-efficacy, and social anxiety. Feasibility, acceptability, engagement, app usage, in-game metrics, and diary-based digital markers are also assessed. Quantitative data will be analyzed using linear mixed-effects models with adaptive interim analyses. Qualitative stakeholder interviews with young people, their legal guardians, school professionals, and clinicians will be analyzed using inductive thematic analysis within a mixed-methods realist evaluation framework.
Results: The proof-of-concept trial was prospectively registered on April 29, 2025 (ISRCTN32523126). Study rollout is taking place from September 2025 to June 2026. As of March 2026, recruitment is ongoing, 2 study sequences have been completed, and the third sequence began at the end of March 2026. Primary results are expected in September 2026.
Conclusions: SMILE is designed to generate evidence on the feasibility, acceptability, and preliminary efficacy of a scalable gamified mental health intervention for young people across diverse European contexts. The findings will inform intervention refinement, evaluation of the added value of personalized feedback, and the design of a future definitive randomized controlled trial and broader implementation in educational and clinical settings.
Background/Objectives: Multiple sclerosis (MS) is frequently accompanied by cognitive impairment, yet the neurobiological mechanisms underlying cognitive heterogeneity remain incompletely understood. The choroid plexus (CP), a blood–CSF barrier structure involved in cerebrospinal fluid production and neuroimmune signaling, has recently emerged as a potential MRI marker of inflammatory and neurodegenerative activity in MS. This scoping review mapped evidence on associations between CP features and cognitive functions in adults with MS.
Methods: A broad search of PubMed, Scopus, Web of Science Core Collection, and the Cochrane Library identified 1163 records; after deduplication, screening, and full-text assessment, seven studies were included.
Results: CP volume or normalized CP volume was assessed in all seven studies, and one study additionally examined the CP T1/T2 ratio. The Symbol Digit Modalities Test was used in six studies, while five applied multidomain cognitive assessment. Larger CP volume was associated in several studies with poorer baseline information-processing speed, visuospatial memory, or multidomain cognition, but longitudinal findings did not show consistent predictive value for CP volume. One study reported that a higher CP T1/T2 ratio predicted faster visuospatial-memory decline.
Conclusions: CP-related measures may reflect broader neuroinflammatory and neurodegenerative processes relevant to cognition in MS, but the evidence remains limited and methodologically heterogeneous. Standardized acquisition and segmentation, harmonized cognitive assessment, and adequately powered longitudinal studies are needed to establish their independent and predictive value.
While Western modernity saw the displacement of a myth-based worldview by reason, Asian cultures followed a different trajectory. There, myth retained the ethical and spiritual dimensions acquired during the Axial Age (800–200 BCE), continuing to serve as a foundational social force. The enduring power of this mythos is evident in the emergence of new religious movements (NRMs) in 19th and 20th century Korea and, moreover, it remains significant today, offering a necessary counterweight in a pragmatic world where logos alone is often insufficient and where the need for compassion is renewed. This study analyzes the mythology of Daesoon Jinrihoe’s The Canonical Scripture (Jeon-gyeong 典經) through the lens of Bronisław Malinowski’s functional theory of myth, demonstrating how it shapes lifestyles, reinforces beliefs, justifies rituals, and codifies social norms.
Prawo zamówień publicznych w ochronie zdrowia funkcjonuje na styku dwóch porządków wartości, które nie zawsze pozostają ze sobą w harmonii: transparentności i konkurencyjności wydatkowania środków publicznych oraz bezpieczeństwa pacjenta i jakości udzielanych świadczeń zdrowotnych. Szpitale publiczne, jako zamawiający w rozumieniu ustawy Pzp, są zobowiązane do stosowania rygorystycznych procedur, których zasadniczym celem jest zapewnienie równego dostępu wykonawców do rynku oraz ochrona przed arbitralnością decyzji zakupowych. Jednocześnie są one podmiotami leczniczymi, na których ciąży konstytucyjny i ustawowy obowiązek zapewnienia świadczeń zdrowotnych odpowiadających aktualnej wiedzy medycznej oraz standardom bezpieczeństwa pacjenta. Napięcie pomiędzy tymi dwoma porządkami szczególnie wyraźnie ujawnia się przy sporządzaniu opisu przedmiotu zamówienia, który w praktyce decyduje o tym, jaki sprzęt, wyroby medyczne lub usługi trafią do codziennej praktyki klinicznej.
Second-order understanding of mental states develops during middle childhood. However, due to the limited number of longitudinal studies on this topic, the timing of developmental changes and the stability of individual performance remain insufficiently explored. The current study examined the development of recursive theory of mind abilities, namely second-order ignorance and false-belief understanding, between the ages of 5 and 7. Using the Ice Cream Task and the Birthday Puppy Task, we longitudinally tested 166 Polish children at three time points (mean ages: MT1 = 5.64 years, SDT1 = 0.23; MT2 = 6.69, SDT2 = 0.11; and MT3 = 7.63, SDT3 = 0.13). Although we observed overall growth in second-order mental state understanding, understanding of ignorance emerged two years earlier, showing smaller gains between ages 5 and 7 compared to false-belief understanding. Moreover, most children demonstrated consistent developmental trajectories in individual performance. These findings provide a comprehensive developmental overview of second-order mental state attribution, suggesting that, alongside gradual improvement, the observed rank-order stability in rToM may reflect partially stable individual differences over time.
Pozostałe osiągnięcia naukoweArtykuły (zamknięty dostęp)Journal article
