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A content analysis of safety behaviors of television characters: implications for children's safety and injury.

Examined frequency and characteristics of safety behaviors in television programs popular with child audiences. A sample of 52 programs was coded for safety event location, demographic characteristics of safety models, social and physical contexts of safety events, and successful or unsuccessful outcomes of safety behaviors. Results indicate an overall rate of 13 safety behaviors per hour, with hour half of all safety behaviors located in commercial advertisements. Most safety behaviors were performed by made adult characters, had limited relevance for children, and were not associated with either positive or negative outcomes. Findings are discussed in terms of their relevance for observational learning of safety behaviors by child viewers.

Adolescent↗

Nurse coaching and cartoon distraction: an effective and practical intervention to reduce child, parent, and nurse distress during immunizations.

Evaluated a low cost and practical intervention designed to decrease children's, parents', and nurses' distress during children's immunizations. The intervention consisted of children viewing a popular cartoon movie and being coached by nurses and parents to attend to the movie. Ninety-two children, 4-6 years of age, and their parents were alternatively assigned to either a nurse coach intervention, a nurse coach plus train parent and child intervention, or a standard medical care condition. Based on previous findings of generalization of adult behaviors during medical procedures, it was hypothesized that training only the nurses to coach the children would cost-effectively reduce all participants levels of distress. Observational measures and subjective ratings were used to assess the following dependent variables: children's coping, distress, pain, and need for restraint; nurses' and parents' coaching behavior; and parents' and nurses' distress. Results indicate that, in the two intervention conditions, children coped more and were less distressed, nurses and parents exhibited more coping promoting behavior and less distress promoting behavior, and parents and nurses were less distressed than in the control condition. Although neither intervention was superior on any of the variables assessed in the study, nurse coach was markedly more practical and cost-effective. Therefore, nurses' coaching of children to watch cartoon movies has great potential for dissemination in pediatric settings.

Adult↗

A pictorial sleepiness scale based on cartoon faces.

STUDY OBJECTIVES: To develop a sleepiness scale devoid of semantic or geometric elements. DESIGN: Subjects were asked to rank in order 7 cartoon faces representing degrees of sleepiness. We used Thurstone's scaling procedure to transform these rankings into an interval scale, which allowed us to eliminate 2 of the faces. The remaining 5 faces were ranked again using other subjects. In a validation study, subjects rated their perceived level of sleepiness using our scale and other sleepiness scales. Employed shiftworkers and school-going children used our scale to assess its practical applicability. SETTINGS: Research and diagnostic sleep laboratories, pre-primary to tertiary institutions, shift-working industry. PARTICIPANTS: Ethnically diverse healthy and sleep-disordered adults (n = 490), and school-going children (n = 345). MEASUREMENTS AND RESULTS: Our faces scale correlated with the Karolinska Sleepiness Scale (P < .05), the Stanford Sleepiness Scale (P < .04), and a visual analog scale measuring sleepiness (P < .0001). Shiftworkers showed a time-on-task effect on the evening shift (P < .0001) and a peak in sleepiness at 4:00 and 5:00 (P < .0001) on the night shift. Eight to 10 year old children appeared sleepier than older children throughout a school day (P < or = .02) and became sleepier as the day progressed (P < .0001). We confirmed that our scale measures sleepiness, uncontaminated by pain, anger, or happiness. CONCLUSIONS: We have devised a sleepiness scale suitable for people too young or insufficiently educated to employ more-conventional scales. We envisage the scale being used for diagnostic, therapeutic, and research purposes.

Adolescent↗

Does cartoon movie distraction decrease burned children's pain behavior?

The purpose of this study was to evaluate cartoon movie viewing as a practical and low-cost intervention to decrease burned children's pain behavior during dressing changes. Thirteen children, 4 to 12 years of age, with a mean TBSA burn of 7.9% were assessed using a reversal, single-subject experimental design. The experimental condition consisted of the presentation of a cartoon movie as a nonpharmacologic intervention in conjunction with a standardized analgesic medication. In the control condition children's pain was treated with the standardized analgesic medication only. Behavioral distress was measured during the first six dressing changes postburn with the Observational Scale of Behavioral Distress. No significant effect of cartoon movie distraction on observed behavioral distress in patients was found. Interrater reliability of the Observational Scale of Behavioral Distress was good (kappa =.87-.98). Wound debridement was found to be the most painful part of the dressing change. A simple, easily applicable, and low-cost distraction intervention such as presenting cartoon movies does not seem to be sufficiently powerful to measurably reduce burned children's distress during dressing changes. Findings are based on purely observational data. Inclusion of self-report measures in future studies might reveal intervention effects on anxiety and subjective pain perception.

Attention↗

Practical low-cost visual communication using binary images for deaf sign language.

Deaf sign language transmitted by video requires a temporal resolution of 8 to 10 frames/s for effective communication. Conventional videoconferencing applications, when operated over low bandwidth telephone lines, provide very low temporal resolution of pictures, of the order of less than a frame per second, resulting in jerky movement of objects. This paper presents a practical solution for sign language communication, offering adequate temporal resolution of images using moving binary sketches or cartoons, implemented on standard personal computer hardware with low-cost cameras and communicating over telephone lines. To extract cartoon points an efficient feature extraction algorithm adaptive to the global statistics of the image is proposed. To improve the subjective quality of the binary images, irreversible preprocessing techniques, such as isolated point removal and predictive filtering, are used. A simple, efficient and fast recursive temporal prefiltering scheme, using histograms of successive frames, reduces the additive and multiplicative noise from low-cost cameras. An efficient three-dimensional (3-D) compression scheme codes the binary sketches. Subjective tests performed on the system confirm that it can be used for sign language communication over telephone lines.

Algorithms↗

Ability to take an out-group's perspective in explaining positive and negative behaviors.

A total of 251 Latvian and Russian schoolteachers explained positive and negative behaviours from their own perspective and from the perspective of an ethnic out-group. The results were in line with the attributional pattern usually found in studies using Hewstone's direct perspective of judgement, when participants are asked to take the perspective of an ethnic out-group. That is, there was an outcome effect in causal attributions for in-group actors and a categorization effect for negative behaviour from the imagined (out-group's) perspective. The attributions from the direct perspective only partly replicated the commonly found pattern. The results support Montgomery's perspective theory.

Adult↗

Cardiac anatomy revisited.

In tomorrow's world of clinical medicine, students will increasingly be confronted by anatomic displays reconstructed from tomographically derived images. These images all display the structure of the various organs in anatomical orientation, this being determined in time-honoured fashion by describing the individual in the 'anatomical position', standing upright and facing the observer. It follows from this approach that all adjectives used to describe the organs should be related to the three orthogonal planes of the body. Unfortunately, at present this convention is not followed for the heart, even though most students are taught that the so-called 'right chambers' are, in reality, in front of their 'left' counterparts. Rigorous analysis of the tomographic images already available, along with comparison with dissected hearts displayed in attitudinally correct orientation, calls into question this continuing tendency to describe the heart in terms of its own orthogonal axes, but with the organ positioned on its apex, so that the chambers can artefactually be visualized with the right atrium and right ventricle in right-sided position. Although adequate for describing functional aspects, such as 'right-to-left' shunting across intracardiac communications, this convention falls short when used to describe the position of the artery that supplies the diaphragmatic surface of the heart. Currently known as the 'posterior descending artery', in reality it is positioned inferiorly, and its blockage produces inferior myocardial infarction. In this review, we extend the concept of describing cardiac structure in attitudinally correct orientation, showing also how access to tomographic images clarifies many aspects of cardiac structure previously considered mysterious and arcane. We use images prepared using new techniques such as magnetic resonance imaging and computerized tomography, and compare them with dissection of the heart made in time-honoured fashion, along with cartoons to illustrate contentious topics. We argue that there is much to gain by describing the components of the heart as seen in the anatomical position, along with all other organs and structures in the body. We recognize, nonetheless, that such changes will take many years to be put into practice, if at all.

Aorta↗

Clinical electroencephalographic study of nine pediatric patients with convulsion induced by the TV animation, Pocket Monster.

BACKGROUND: To determine the usefulness of a few types of photic stimulation in patients with photo-convulsive response. METHODS: A clinical electroencephalographic study was conducted in nine children who developed convulsions and other symptoms while they watched the TV animation and were subsequently treated at the hospital. Photic stimulation was applied with their eyes open or closed. Another photic stimulation was applied with the video tape of the animation. RESULTS: A photoparoxysmal response (PPR) was never seen in the electroencephalographs (EEG) in any of these patients when photic stimulation was applied with their eyes closed, while PPR was seen in three of seven patients when photic stimulation was applied with their eyes open. Two patients (siblings) showed no specific abnormality when photic stimulation was applied with their eyes either open or closed. However, myoclonus and PPR appeared when the EEG was conducted while they watched the video tape of the animation under supervised conditions. CONCLUSIONS: In a society where people are exposed to abundant TV games, TV animation or videos, self-restraint or regulations of frequent use of flickering scenes is thought to be necessary. However, it is also thought to be necessary to conduct EEG by applying photic stimulation, not only with the eyes closed, but also with the eyes opened or by applying flickering red light stimulation, which is emitted from a strong light source, or a combination of two colors, such as red and blue or red and green, in patients with suspected photosensitivity.

Adolescent↗

Patient background of the Pokemon phenomenon: questionnaire studies in multiple pediatric clinics.

Many children in Japan developed various neuropsychological problems, including seizures, while watching the program Pocket Monster, televised on 16 December 1997. To examine the basis for this incident, we have performed a survey of volunteering children and their parents who visited our pediatric clinics for other reasons from 8 January to 28 February 1998. Children and their parents filled out questionnaires. Among the total of 662 children surveyed, the great majority (603, 91.1%) was found to have watched the Pocket Monster program and 30 individuals (5.0% of viewers) complained of variable degrees of neuropsychological abnormalities. These included seizures (two cases), headache (nine cases), nausea (eight cases), blurred vision (four cases), vertigo (two cases), dysthymia (two cases) and vomiting (one case). Nearly half (14) of these children developed symptoms during or immediately after watching the program, while the remainder did so later. Representative cases are reported and other statistical aspects are discussed.

Adolescent↗

Photosensitive fits elicited by TV animation: an electroencephalographic study.

BACKGROUND: We carried out a clinical and electroencephalographic (EEG) study to reveal the pathophysiology of acute symptoms elicited by a TV animation program. METHODS: Clinical data and EEG were obtained from 20 patients ranging in age from 6 to 30 years. A pattern presentation and an intermittent photic stimulation were performed. RESULTS: Of 20 patients, 13 had a convulsion and seven had other symptoms, mainly nausea and/or vomiting. A photoparoxysmal response (PPR) was confirmed in 12 of 13 patients (92.3%) who had a convulsion. Only one of seven patients (14.3%) without a convulsion showed a PPR. The incidence of PPR was significantly higher in patients with convulsion than those without convulsion. There were no significant differences in the family history of convulsion, gender, parameters associated with TV watching and basic EEG between the two groups. All patients with PPR had a convulsion or consciousness disturbance. CONCLUSION: Acute symptoms, such as convulsion and impairment of consciousness, are supposed to be based on photosensitivity.

Adolescent↗

Pocket Monster incident and low luminance visual stimuli: special reference to deep red flicker stimulation.

On the evening of 16 December 1997 approximately 700 people around the nation (mostly children) were rushed to hospitals and treated for seizure symptoms. The youngsters had been watching the vastly popular TV animated cartoon series Pocket Monsters (Pokemon). We designated those individuals as a main group, who presumably had simultaneous occurrence of visually induced seizures. Follow-up studies revealed that 5-10.4% of Pokemon viewers had various minor symptoms not requiring hospital treatment. We designated those as a subgroup. Due to an official report regarding the problematic TV scene as a low luminance, 12 Hz alternating red/blue stimulus, we attempted an accounting of the Pokemon incident, with regard to the main group in particular, on the basis of electroencephalographic activation by use of low luminance 15 Hz deep red flicker stimulation. In order to explain the entire Pokemon incident, including symptoms experienced by individuals of the subgroup, we considered the possibility that some healthy youngsters may have latent photosensitivity and we thought that such a sensitivity might be disclosed by use of low luminance deep red flicker stimulation which is more provocative of photoparoxysmal response than ordinary high luminance stroboscopic intermittent photic stimulation. For prevention of visually induced seizures by TV viewing, we stress that care should be taken to test not only red flicker but also flickering geometric pattern stimuli.

Cartoons as Topic↗

Facilitating coping behavior in children prior to dental general anesthesia: a randomized controlled trial.

BACKGROUND: The aim of this study was to establish the efficacy of two different preparation packages, a paper-based cartoon and an interactive computer, at facilitating coping behavior in children undergoing dental general anesthetic (DGA) tooth extraction. METHOD: A total of 198 children were allocated randomly to computer, cartoon or control groups. A Visual Analog Scale (VAS) and Modified Child Dental Anxiety Scale (MCDAS) were used to compare preoperative anxiety levels between the three study groups. Blinded observers then scored behavior at both anesthesia induction and upon recovery using a VAS for each (0 = coped/no distress and 10 = no coping/high distress). RESULTS: The children's median age was 5 (range 3-10) years, 57% were boys, a median of seven teeth were extracted (range 1-20). Preoperative anxiety was similar for all preparation groups; with 24% of all children categorized 'phobic' using MCDAS. The median induction (coping) VAS level for both the computer and the cartoon groups was '1' (range 0-10), compared with the control group level of '3' (range 0-10). The median recovery (coping) VAS levels were: computer group: 0 (range 0-10), cartoon group: 4 (range 0-10) and control group: 2.5 (range 0-10). The Mann-Whitney U-test showed that the computer group coped significantly better than the control group at induction (P = 0.014) and significantly better than the cartoon group upon recovery (P = 0.016). The statistical power for detecting differences between groups (computer/cartoon versus control) was calculated to be 90%, based on pilot study data. CONCLUSIONS: The computer preparation package facilitated coping behavior in children undergoing DGA induction.

Adaptation, Psychological↗