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Patient knowledge and interest on dialysis efficiency: a survey.

BACKGROUND: Therapeutic compliance is fundamental on dialysis; however following a therapy requires a prior understanding of it. Aim of the study was to assess the need and interest for information on dialysis efficiency and to prepare a dedicated teaching tool. METHODS: 72 patients, on hemodialysis in two limited-care satellite units, were given a questionnaire testing knowledge and interest on dialysis efficiency. In a subsequent second phase, following patients' suggestions, a cartoon book was prepared and opinions recorded. RESULTS: 63 patients' returned the questionnaire. 79.4% had basic knowledge on routine blood tests, 30.1% were aware of their specific meaning. All patients asked for further information, preferring books to other media. The book "Kt/V as cartoon" was distributed; 71.2% read it, 93% scored it as good-very good. In the Unit employing flexible dialysis schedules, 22/42 patients increased dialysis time. CONCLUSIONS: Despite insufficient knowledge on dialysis efficiency, patient interest is high. An educational program is feasible and may also give practical results, such as self-increase in dialysis time.

Adult↗

ThOMAs: the other means of assessment.

We describe a pilot study to investigate whether drawing "Thomas the Tank Engine" could be as effective a measure of developmental progress as the Goodenough-Harris Draw A Man test against the ThOMAs test (The Other Means of Assessment), with internal validation. The study included 95 children aged between 3 and 11 years of age, including a subgroup of 13 children with registered special needs from community and general pediatric clinics within Birmingham, UK, as a means of validation. There was no significant evidence that ThOMAS was either culturally or sex biased. Using regression analysis, nine items were found to correlate highly with actual age, and their total score gave a correlation of 0.563 with age. Adding further items did not increase this. After being converted into age-standardized scores, ThOMAS was as sensitive and specific as the Draw A Man test, and more so above a defined age-standardized threshold. This pilot study suggests that drawing Thomas the Tank Engine would appear to be as sensitive and specific a means of identifying children with special needs as the Goodenough-Harris Draw A Man test. The relatively small sample size means that further research is necessary to further define the age standardizations and to refine the ThOMAs test.

Age Factors↗

Formative research in the Meena Communication Initiative.

The governments of South Asia designed the 1990's as the Decade of the Girl Child, in order to confront the extreme discrimination faced by girls in the region. A range of research studies undertaken by UNICEF and other agencies leading up to the Decade had documented the aspects and degrees of discrimination against girls in the region-with the most severe conditions in India, Bangladesh, Nepal and Pakistan.

Adolescent↗

Methodological issues in the use of published cartoons as data.

When common understanding of a phenomenon is under investigation, mass media representation in general, and cartoon images in particular, are a useful source of data. Sample selection, data collection, and the analysis of constructed images differ from other kinds of data. Cartoonists may intend to stimulate multiple interpretations among readers. Uncovering these interpretations is essential to understanding public discourse of the phenomenon of interest. Semantic validation is used to assess the degree to which the meanings of text relative to their context are accurately represented. Analysis of the image and text of cartoons has the potential to yield important understanding of public discourse surrounding issues of the public's health and well-being.

Cartoons as Topic↗

Images of cloning and stem cell research in editorial cartoons in the United States.

Through semiotic analysis of manifest and latent meanings in editorial cartoons, the author uncovers how cloning and stem cell research are represented in a popular mass medium. She identified 86 editorial cartoons published in the United States between 2001 and 2004 that referred to cloning and 20 that referred to stem cell research. Cartoonists portrayed people individually 224 times and 4 times in groups of more than 10. Men were portrayed in 64% of cartoons. Stem cell research was depicted as having a potential positive value, and cloning was depicted negatively. Some major messages are that cloning will lead to the mass production of evil, cloning creates monsters, and politics will influence who or what will be cloned. Analyzing popular images can allow access to public understanding about genetic technology and evaluation of public beliefs, preconceptions, and expectations as the public is educated on the use and value of services.

Cartoons as Topic↗

A preliminary study of a cartoon measure for children's reactions to chronic trauma.

Preliminary psychometric properties of a new instrument, Angie/Andy Cartoon Trauma Scales (ACTS), are presented. Angie/Andy features a cartoon-based methodology, measuring trauma-related sequelae of prolonged, repeated abuse. A sample of 208 children comprised intrafamilial trauma, extrafamilial trauma, combined trauma, and nontrauma groups. Angie/Andy demonstrated high internal consistency, with coefficient alphas from 0.70 to 0.95. The three trauma groups scored significantly higher than the nontrauma group on all scales (p's < 0.0001). Generally, the most severely traumatized group scored significantly higher than the less severely traumatized groups. The number of types of violence exposures correlated with Angie/Andy scores from 0.55 to 0.74. The frequency and severity of trauma exposure correlated with Angie/Andy scores from 0.44 to 0.56. The Angie/Andy parent version correlated with a standardized parent scale from 0.71 to 0.81. Parent/child agreement was significant. Angie/Andy is a promising tool for clinical assessment of chronic childhood abuse.

Cartoons as Topic↗

Mediating social representations using a cartoon narrative in the context of HIV/AIDS: the AmaQhawe Family Project in South Africa.

Using findings from the formative evaluation of the adaptation of the Collaborative HIV/AIDS Adolescent Mental Health Programme (CHAMP) family-based intervention in South Africa, known as the 'AmaQhawe Family Project', the potential role of 'micro-media' using a cartoon narrative for promoting health-enhancing behaviour change is explored. In particular, the cartoon narrative was found to be a useful medium for informing the development and diffusion of health-enhancing social representations that shape the potential for health-related behaviour change.

Acquired Immunodeficiency Syndrome↗

Thought-bubbles help children with autism acquire an alternative to a theory of mind.

Children with autism have specific difficulties understanding complex mental states like thought, belief, and false belief and their effects on behaviour. Such children benefit from focused teaching, where beliefs are likened to photographs-in-the-head. Here two studies, one with seven participants and one with 10, tested a picturein-the-head strategy for dealing with thoughts and behaviour by teaching children with autism about cartoon thought-bubbles as a device for representing such mental states. This prosthetic device led children with autism to pass not only false belief tests, but also related theory of mind tests. These results confirm earlier findings of the efficacy of picture-in-the-head teaching about mental states, but go further in showing that thought-bubble training more easily extends to children's understanding of thoughts (not just behaviour) and to enhanced performance on several transfer tasks. Thought-bubbles provide a theoretically interesting as well as an especially easy and effective teaching technique.

Adolescent↗

Identification of the relapsing Class III face: Chernoff faces in orthodontics.

Thirty Class III patients, treated by a standard non-extraction technique, provided the material for this study. Records were examined at the beginning of treatment and a minimum of 2 years out of all retention. On the basis of their post-retention occlusions, children were sub-divided into three groups: stable, borderline, and relapsed. Using this classification, a four-variable discriminant model had been generated which correctly indicated the eventual outcome from the pretreatment data. A graphical technique not previously described in orthodontics and suitable for displaying multivariate data: 'Chernoff faces', provided a pictorial illustration of the discriminant values for each individual. These stylized, cartoon faces were examined to determine whether any common, characteristic facial patterns existed at the beginning of treatment in children of a single outcome group. Whilst the information given by the faces was easier to assimilate than tabulated data, no typical stable or relapsing face could be identified using the features chosen. The reason for this and further possible applications of Chernoff faces to orthodontics are discussed.

Adolescent↗

Facial aesthetics following edgewise and Fränkel appliance therapy: the application of Chernoff faces.

This study investigates an application of the graphical technique of multivariate data description, 'Chernoff faces', to orthodontics. This method of pictorial presentation allows the simultaneous examination of several measurements in a single figure. Each variable is represented by a scaled feature of the human face: the size and position of the ears, eyes, eyebrows, nose, and mouth, as well as the face itself, are used to display data in a diagrammatic form. Using this method, the individual post-treatment results of 62 severe Class II division 1 cases treated by either Fränkel or Edgewise appliance therapy were compared. Nine cephalometric variables were chosen, describing the profile and the antero-posterior positions of the lower jaw and teeth, and stylized cartoon faces drawn for each child. These were compared with a control face prepared from untreated children of the same sex and age. Overall, children treated with Fränkel appliances showed a more normal relationship of the lips to Ricketts' aesthetic line and a greater prominence of the lower face. This difference between the two groups was most marked in the soft tissues. In a few cases, however, the appearance of the Edgewise treated children was indistinguishable from that of the controls. It is concluded that Chernoff faces, by portraying several pertinent aspects of data simultaneously, may be a useful adjunct to the presentation of orthodontic findings.

Adolescent↗

Chernoff faces: an orthodontic application.

This retrospective study examined 21 children (12 males and nine females) with Class III malocclusions, who had been successfully treated by a non-extraction technique and for whom follow-up records were available at least 2 years after all treatment and retention had ceased. On the basis of their post-retention records, children were divided into two groups: those who remained stable (n = 10) and those whose treatment relapsed (n = 11). A graphical technique of data description, Chernoff faces, in which variables for each individual may be portrayed by appropriate scaling of selected facial features, was used to construct cartoon faces for each child. Seven variables, overjet, overbite, upper and lower incisor inclination, the numbers of anterior and posterior teeth in lingual occlusion and the angle ANB were chosen and diagrammatic faces drawn using data from both the start of treatment and post-retention stages. These were arranged according to relapse status and scrutinized to determine whether the groups possessed any common features which were related to the outcome of treatment. The faces showed a wide range of variation, especially at the pretreatment stage. Whilst the cartoons were easy to read, no typical features could be identified at the start of treatment which might indicate that therapy would later relapse.

Adolescent↗

A theory of mind investigation into the appreciation of visual jokes in schizophrenia.

BACKGROUND: There is evidence that groups of people with schizophrenia have deficits in Theory of Mind (ToM) capabilities. Previous studies have found these to be linked to psychotic symptoms (or psychotic symptom severity) particularly the presence of delusions and hallucinations. METHODS: A visual joke ToM paradigm was employed where subjects were asked to describe two types of cartoon images, those of a purely Physical nature and those requiring inferences of mental states for interpretation, and to grade them for humour and difficulty. Twenty individuals with a DSM-lV diagnosis of schizophrenia and 20 healthy matched controls were studied. Severity of current psychopathology was measured using the Krawiecka standardized scale of psychotic symptoms. IQ was estimated using the Ammons and Ammons quick test. RESULTS: Individuals with schizophrenia performed significantly worse than controls in both conditions, this difference being most marked in the ToM condition. No relationship was found for poor ToM performance and psychotic positive symptomatology, specifically delusions and hallucinations. CONCLUSION: There was evidence for a compromised ToM capability in the schizophrenia group on this visual joke task. In this instance this could not be linked to particular symptomatology.

Awareness↗

Humor and smiling: cortical regions selective for cognitive, affective, and volitional components.

BACKGROUND: The interrelationships among humor, smiling, and grinning have fascinated philosophers for millennia and neurologists for over a century. A functional dissociation between emotional facial expressions and those under voluntary control was suggested decades ago. Recent functional imaging studies, however, have been somewhat at odds with older studies with respect to the role of the right frontal cortex in the perception of humor. METHODS: Blood oxygen level-dependent (BOLD) activity was measured in 13 subjects during the presentation of "funny" vs "nonfunny" versions of essentially the same cartoons and compared with BOLD activity associated with "merely grinning" at similar nonfunny cartoons via fMRI. RESULTS: Humor perception was correlated with BOLD activity in the left temporo-occipitoparietal junction and left prefrontal cortex and humor-associated smiling (recorded with an MR-compatible video camera) with bilateral activity in the basal temporal lobes. Unexpectedly, both conditions were also accompanied by a decrease in BOLD activity in the right orbitofrontal cortex. Voluntary "grinning" in the absence of humorous stimuli was accompanied by bilateral activity in the facial motor regions. CONCLUSIONS: These results confirm the clinically derived hypothesis of separate cortical regions responsible for the production of emotionally driven vs voluntary facial expressions. The right orbitofrontal decrease reconciles inconsistencies between clinical and functional imaging findings and may reflect a disinhibition of facial emotional expression.

Adolescent↗

The Popeye principle: selling child health in the first nutrition crisis.

The cartoon character Popeye the Sailor was capable of superhuman feats of strength after eating a can of spinach. Popeye ate spinach because the association of spinach with strength was a product of the first national nutrition crisis in the United States: the 1920s fight against child malnutrition. Spanning the first three decades of the twentieth century, the malnutrition crisis arose from the confluence of many different events including the invention of nutrition science and new standards for height and weight; international food crises created by world war; the rise of consumerism, advertising, and new forms of mass media; and Progressive reformers' conviction that education was a key component of any solution. The history of the malnutrition crisis presented in this essay synthesizes disparate histories concerning advertising, public health, education, consumerism, philanthropy, and Progressive Era reform with original analysis of a major nutrition education program sponsored by the Commonwealth Fund in the 1920s. Because the character of Popeye came to embody one of the nutritional norms advocated in the 1920s, I refer to the influence of culturally constructed social norms on children's beliefs about health and nutrition as the Popeye Principle. The history of the malnutrition crisis demonstrates the importance of understanding the cultural and economic conditions surrounding childhood nutrition, the use and influence of numerical norms, and the mutually reinforcing influences on children's nutritional norms from their parents, peers, teachers, and culture.

Cartoons as Topic↗

Child molesters vs. rapists as reflected in their self-figure drawings: a pilot study.

This study explored whether child molesters can be differentiated from rapists in their self-figure drawings. To achieve this aim, the Machover Draw-A-Person test (Machover, 1949) was used. A sample of 41 male adult perpetrators of sexual assault, 19 rapists and 22 child molesters (all incarcerated in jail) participated in the study. Participants were given paper and pencil and were asked to draw themselves. Results indicated that self-figure drawings of rapists had more indicators of a violent aggressive behavior trait than drawings of child molesters, whereas exaggeration and emphasis of penis were more obvious in the self-figure drawings of child molesters. However, indicators of anxiety were not found to significantly differ between the groups.

Adult↗