Temporal asymmetries in inferring unobserved past and future events.

Unlike temporally symmetric inferences about simple sequences, inferences about our own lives are asymmetric: we are better able to infer the past than the future, since we remember our past but not our future. Here we explore whether there are asymmetries in inferences about the unobserved pasts and futures of other people's lives. In two experiments (analyses of the replication experiment were pre-registered), our participants view segments of two character-driven television dramas and write out what they think happens just before or after each just-watched segment. Participants are better at inferring unseen past (versus future) events. This asymmetry is driven by participants' reliance on characters' conversational references in the narrative, which tend to favor the past. This tendency is also replicated in a large-scale analysis of conversational references in natural conversations. Our work reveals a temporal asymmetry in how observations of other people's behaviors can inform inferences about the past and future.

Influence of eating while watching TV on food preference and overweight/obesity among adolescents in China: a longitudinal study.

Background: Eating while watching TV was found associated with unhealthy food preferences and obesity in adolescents in foreign studies, which is not clear in China. The study aims to explore the influence of eating while watching TV on food preferences and overweight/obesity in Chinese adolescents. Methods: Data from 1768 adolescents (aged 12-17 years) in the 2006, 2009, 2011, and 2015 China Health and Nutrition Survey (CHNS) was analyzed. The height and weight were measured. Mixed effect models were used to identify the associations between eating while watching TV and adolescents' food preferences and overweight/obesity. Results: Adolescents eating while watching TV ≥1 time/week were more likely to prefer fast food, salty snacks and soft drinks than those eating while watching TV <1 time/week. Adolescents eating meals while watching TV ≥1 time/week were less likely to prefer vegetables than those eating meals while watching TV <1 time/week. In addition, adolescents eating snacks while watching TV ≥1 time/week were more likely to be overweight/obesity than those eating meals while watching TV <1 time/week (odds ratio [OR] = 7.16; 95% confidence interval [CI] 1.39-36.93). Conclusion: Eating snacks while watching TV was positively associated with adolescents' unhealthy food preferences and overweight/obesity. Eating meals while watching TV was associated with adolescents' unhealthy food preferences. Implementing web-based Community-based participatory research (CBPR) about reducing eating while watching TV may be a practical strategy to develop healthy food preferences and prevent overweight/obesity in Chinese adolescents.

Media Usage and Adherence to the Mediterranean Diet in Children.

BACKGROUND: Increased screen time in children is significantly associated with lower adherence to the Mediterranean diet (MD). The purpose of this study was to explore the association between different types of media use and the adherence to the MD in children. METHODS: The study sample included 332 children aged 10-11 years attending the fifth year of primary school in Veneto, north-east Italy. The children's mothers were surveyed on their children's adherence to the MD, using the KidMed questionnaire, and on the time of media use, using the Media Activity Form-Parent (MAF-P). A multivariable backward stepwise linear regression was applied, adjusting the association for other potential confounding factors. RESULTS: Children's primary digital activities were watching TV or streaming platforms (5.0 h/week) and video content (2.5 h/week), followed by digital games (2.3 h/week). Lower adherence to the Mediterranean diet was associated with digital games (regression coefficient -0.65, SE 0.29, p = 0.026) and time spent watching TV or streaming platforms (regression coefficient -0.60, SE 0.29, p = 0.04). CONCLUSION: Interventions to promote healthier diets justify an approach that includes media education. Providing parents with recommendations on children's use of digital media devices can empower them to improve their children's well-being.

Father-child attachment on children's screen time: mediating role of ego resilience.

BACKGROUND: Children spend a significant amount of time engaging in sedentary behaviors, defined as activities that do not increase energy expenditure significantly above resting levels, such as watching TV and playing PC/video games. Increased screen time is a significant public health concern because children are in a developmental stage where lifestyle behaviors predict various health outcomes in adulthood and beyond. This study explores the links between parent-child attachment, ego resilience, and children's screen time. METHODS: This cross-sectional correlation study uses 1,163 parents and their children data from the 12th Panel Survey of Korean Children. The study instruments were a modified Armsden and Greenberg scale of parent-child attachment and modified the children's ego resilience scale of the Block and Kremen. Children's screen time was classified as more than 2 h per day spent watching television, playing on computers, or playing video games in their leisure time. RESULTS: Study results show a negative association between father-child attachment and children's screen time (ß = -0.43, p < .001) and a positive association between father-child attachment and ego resilience (ß = 0.24, p < .001). Ego resilience showed a negative link to children's screen time after adjusting for parental attachment (ß =- 0.03, p = .009). Father-child attachment link to children's screen time (ß = -0.36, p < .001) continued even though the association was slightly reduced in magnitude after adjusting for ego resilience. CONCLUSIONS: Our findings show the mediating role of ego resilience on a negative path of father-child attachment to children's screen time. This finding emphasizes the importance of fostering solid father-child relationships and enhancing children's psychological resilience as critical strategies for reducing excessive screen time. By addressing emotional support and resilience-building, interventions can more effectively promote healthier behavioral outcomes in children.

Leisure Screen Time and Food Consumption among Brazilian Adults.

BACKGROUND: Screen time, involving activities like watching television (TV), and using tablets, mobile phones, and computers (electronic devices), is associated with the consumption of unhealthy foods. This study aimed to analyze the association between prolonged leisure screen time and healthy and unhealthy food consumption indicators among Brazilian adults (≥18 years). METHODS: Data from the National Health Survey (NHS), conducted in 2019 (n = 88,531), were used. Prolonged leisure screen time (screen time ≥ 3 h/day) was analyzed in three dimensions: watching TV; use of electronic devices; and total screen time (TV and electronic devices). Food consumption was analyzed in two dimensions: healthy (in natura and minimally processed foods) and unhealthy (ultra-processed foods). Poisson regression models were used to calculate prevalence ratios (crude and adjusted (PRa)) by sociodemographic factors (sex, age, schooling, income, area of residence, and race/color) and health factors (weight status, self-rated health, and presence of noncommunicable disease), to assess the association between prolonged screen time and food consumption indicators. RESULTS: Among Brazilian adults, the prevalence of prolonged screen time was 21.8% for TV and 22.2% for other electronic devices for leisure. The highest frequency of watching TV for a prolonged time was observed among women, older adults, and those with a lower income and schooling. Prolonged use of electronic devices was more common among young adults and those with intermediate schooling and income. Prolonged screen time was associated with an unhealthy diet, due both to the higher consumption of unhealthy foods (PRa = 1.35 for TV, PRa = 1.21 for electronic devices, and PRa = 1.32 for both types) and the lower consumption of healthy foods (PRa = 0.88 for TV, PRa = 0.86 for electronic devices, and PRa = 0.86 for both). CONCLUSIONS: Prolonged screen time was negatively associated with the consumption of healthy foods and favored the consumption of unhealthy foods among Brazilian adults.

[Prolonged television exposure in children and adolescents: health effects and protection strategies]. / Exposición prolongada a la televisión en niños y adolescentes: efectos sobre la salud y estrategias de protección.

OBJECTIVE: Since COVID-19 pandemic, screen time (ST) seems to have increased among children and young people. There is controversy about its impact in the physical and mental well-being of children. The aim of this study was to analyse the possible influence of excessive ST on child health through a systematic review of the literature. METHODS: Systematic review was done by two independent reviewers. We analysed the medical literature (MEDLINE data base) from 2017 to 2022. Data related to the effects of ST on children´s health were analysed along with strategies that can mitigate those effects. RESULTS: The search identified 3,151 articles, 37 finally selected as they fulfilled the demanded methodological quality criteria. Negative effects on children's health such as obesity, linked to a sedentary lifestyle, sleep disorders or anxiety problems in adolescents were detected. However, a better development of language or memory functioning, when interactive media were used, have also been described. Educational measures have proven useful in controlling exposure time and reducing exposure-related negative effects. CONCLUSIONS: Although high levels of ST could affect children`s health, we have recorded some positive effects that are enhanced when parents get involved in TV watching (co-viewing). Exposure time should be customized according to every child's lifestyle.

OBJETIVO: Desde la pandemia de la COVID-19, el tiempo frente a la pantalla (TP) parece haber aumentado entre niños y jóvenes. Existe controversia sobre su impacto en el bienestar físico y mental de los niños. Este estudio tuvo el objetivo de analizar la posible influencia de un excesivo TP en la salud infantil mediante una revisión sistemática de la literatura. METODOS: Dos revisores independientes realizaron una revisión sistemática. Se analizó la literatura médica (base de datos MEDLINE) desde 2017 hasta 2022. Se analizaron los datos relacionados con los efectos del tiempo frente a la pantalla en la salud infantil junto con las estrategias que pueden mitigar dichos efectos. RESULTADOS: La búsqueda identificó 3.151 artículos, siendo 37 finalmente seleccionados por cumplir los criterios de calidad metodológica exigidos. Se detectaron efectos negativos sobre la salud infantil como la obesidad, ligada a un estilo de vida sedentario, trastornos del sueño o problemas de ansiedad en adolescentes. Sin embargo, también se ha descrito un mejor desarrollo del lenguaje o del funcionamiento de la memoria, cuando se utilizaban medios interactivos. Las medidas educativas han demostrado ser útiles para controlar el tiempo de exposición y reducir los efectos negativos relacionados con la exposición. CONCLUSIONES: Aunque unos niveles elevados de tiempo frente a la pantalla podrían afectar a la salud de los niños, se han registrado algunos efectos positivos que se potencian cuando los padres se implican en el visionado de la televisión (coviewing). El tiempo de exposición se debe personalizar según el estilo de vida de cada niño.

Factors Associated With Screen Time Among Preschool Children in Lima, Peru.

OBJECTIVE: This study aims to identify factors associated with excessive screen time among preschoolers in Lima, Peru. METHODS: Cross-sectional analysis from a 2019 panel study in Lima, Peru, was conducted focusing on women, aged 18 and above, who are mothers of 3- to 5-year-olds in mid-high and mid-low districts. There were two outcome variables: excessive TV and excessive electronic devices screen time, defined as ≥ 1 h of screen exposure for each one. Explored factors included the mother's age, education and wealth index and the children's age, sex, physical activity, day care attendance and ultra-processed food consumption. Crude (cPR) and adjusted prevalence ratios (aPR) were estimated for the association between associated factors and excessive screen time using the GLM Poisson of with a logarithmic link. RESULTS: Excessive TV screen time and electronic devices prevalence was 74% and 36.9%, respectively. For TV screen time, a high wealth index (aPR 1.13; 95%CI: 1.03-1.23) and children's age (aPR 1.18; 95%CI: 1.08-1.29 for 4 years, PR = 1.17; 95%CI: 1.07-1.28 for 5 years) were significant. For electronic devices, significant associations included mothers with more than 3 children (aPR 0.77; 95%CI: 0.62-0.96), being single (aPR 1.27; 95%CI: 1.01-1.58) and a high wealth index (aPR 1.38; 95%CI: 1.13-1.68). Furthermore, significant associations were found between excessive electronic device screen time and consumption of candies and chocolates (aPR 1.38; 95%CI: 1.08-1.77). CONCLUSIONS: Seven out of 10 preschool children exceeded the recommended television screen time. Certain characteristics of the children, their mothers and the family's socio-economic situation are related to excessive television screen time and excessive electronic device screen time.

Association of electronic screen exposure with depression among women in early pregnancy: a cross-sectional study.

BACKGROUND: Previous studies indicated that excessive engagement in digital devices could lead to negative psychological impacts in general population. We aimed to determine the association of electronic screen exposure with depression among women in early pregnancy. METHODS: A cross-sectional study was conducted from June 2021 to June 2022. A total of 665 women in early pregnancy were recruited and the information included socio-demographic characteristics, screen exposure and Patient Health Questionnaire - 9 depression scale. RESULTS: Among the women in early pregnancy, the total daily smartphone viewing time was the longest (median [P25-P75], 5 [3-6] hours/day) in the three types of electronic screen exposure. The total daily smartphone viewing time (P = 0.015, OR[95%CI] = 1.09[1.11-1.18]), smartphone (P = 0.016, OR[95%CI] = 1.24[1.04-1.47]) and television viewing time (P = 0.006, OR[95%CI] = 1.35[1.09-1.67]) before nocturnal sleep were significantly associated with depression among women in early pregnancy. The thresholds calculated by receiver operator characteristic curves were 7.5 h/day, 1.5 h/day and 1.5 h/day, respectively. In addition, women with higher scores of smartphone addiction were more susceptible to depression (P<0.001, OR[95%CI] = 1.11[1.07-1.16]). The top three smartphone usages in women with depression were watching videos (22.0%), listening to music (20.9%) and playing games (16.7%). CONCLUSIONS: In conclusion, electronic screen exposure, including screen viewing time, smartphone addiction and problematic smartphone use was associated with depression among women in early pregnancy. Further studies are warranted to verify the conclusions.

Sedentary and 21 gastrointestinal disorders: A Mendelian randomization study.

Sedentary behavior (SB) has been linked in the past by observational studies to gastrointestinal illnesses, although the exact cause of the link is still unknown. To deal with this problem, we carried out a Mendelian randomization (MR) study to thoroughly examine the connection between SB and common gastrointestinal illnesses. We selected instrumental variables representing the SB from the UK Biobank study, including watching television viewing, playing computer, and driving. In addition, we obtained genetic associations of 21 common gastrointestinal disorders from the FinnGen research. After adjusting for common risk factors associated with gastrointestinal diseases, we analyzed the independent association between genetic. Furthermore, we used the inverse-variance weighted (IVW) method in conjunction with complementing techniques like MR-Egger (Mendelian randomization based on Egger Regression) and weighted median to assure the accuracy and dependability of the results. Our findings suggest that genetic susceptibility to prolonged television viewing is significantly associated with an increased risk of 9 out of 21 gastrointestinal disorders. Specifically, these disorders include gastroesophageal reflux disease, chronic gastritis, cholelithiasis, acute pancreatitis, chronic pancreatitis, gastroduodenal ulcer, fatty liver, irritable bowel syndrome, and acute appendicitis. These associations remained significant even after correcting for potential confounding factors. The replication analysis confirms the same conclusion. The results of this study demonstrate a causal relationship between cachexia and genetically predicted SB. To further understand the underlying pathogenic mechanisms at play, more study is required.

Are the Relationships of Physical Activity and Television Viewing Time With Mortality Robust to Confounding? A Study, Utilizing E-Values, From the Melbourne Collaborative Cohort Study.

BACKGROUND: Physical activity and sedentary behavior are associated with health outcomes. However, evidence may be affected by confounding bias. This study aimed to examine the relationships of physical activity and television (TV) viewing time with all-cause, cardiovascular, and cancer mortality in a cohort of Australian adults, and determine the robustness of these relationships to residual and unmeasured confounding. METHODS: Data from 27,317 Melbourne Collaborative Cohort Study participants (mean age = 66) were used. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form and categorized as insufficient, sufficient, or more than sufficient. TV viewing time was categorized as low, moderate, or high. Multivariable Cox regression models were used to evaluate associations of interest. E-values were calculated to assess the strength of unmeasured confounders required to negate the observed results. RESULTS: For highest versus lowest physical activity category, the hazard ratio was 0.67 (95% confidence interval, 0.56-0.81) for all-cause mortality; E-values ranged between 1.79 and 2.44. Results were similar for cardiovascular mortality; however, hazard ratios were lower (0.72; 95% confidence interval, 0.51-1.01) and E-values much smaller (1.00-2.12) for cancer mortality. For highest versus lowest TV viewing time category, the hazard ratio was 1.08 (1.01-1.15) for all-cause mortality; E-values ranged between 1.00 and 1.37. Results were similar for cardiovascular and cancer mortality. CONCLUSIONS: Physical activity and TV viewing time were associated with mortality. The robustness to unmeasured/residual confounding was moderate for physical activity (all-cause and cardiovascular mortality), but weaker for physical activity (cancer mortality) and TV viewing time in this study of Australian adults.

Recreational screen time and obesity risk in Korean children: a 3-year prospective cohort study.

BACKGROUND: Studies have shown that prolonged television watching increases obesity risk among children. However, few studies examined the associations with other types of screen time, such as computer and smartphone use, using a prospective cohort study design. Further, little is known about the specific non-screen time activity that may yield the most benefits when reallocating screen time to other activities. METHODS: We conducted a prospective cohort analysis using 3-year follow-up data from the Korean Children and Youth Panel Survey 2018 (n = 2,023; 4th grade elementary students who were not obese at baseline). Average time spent watching television, using computer and smartphone, and other after-school activities were self-reported at baseline. Weight and height were also self-reported at baseline and follow-up surveys through 2021. We performed multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between screen time and obesity incidence, adjusting for potential confounders. We also performed isotemporal substitution models to examine the associations of reallocating screen time to other non-screen time activities (physical activity, sleeping, hanging out with friends, reading, studying, and chatting with parents) in an equal time-exchange manner. RESULTS: Longer combined screen time (≥ 240 vs. <120 m/d) was statistically significantly associated with an increased obesity risk (OR [95% CI] = 1.68 [1.03, 2.73]). The direction of associations with television watching (≥ 180 vs. <60 m/d: OR [95% CI] = 2.86 [1.58, 5.20]), computer use (≥ 120 vs. <60 m/d: 1.38 [0.52, 3.64]), and smartphone use (≥ 180 vs. <60 m/d: 1.42 [0.76, 2.65]) were all positive, although the association was most apparent and statistically significant for television watching only. The associations did not change after additional adjustment for other lifestyle factors, including physical activity, sleep, and breakfast skipping. In the isotemporal substitution models, reallocating 1-hour of screen time to reading (OR [95% CI] = 0.67 [0.48, 0.93]) was associated with a decreased obesity risk. Reallocating 1-hour of screen time to physical activity was only marginally significantly associated with obesity risk (0.79 [0.62, 1.01]). CONCLUSIONS: Our data suggest that more efforts should focus on reducing screen time and increasing time for other non-screen time activities, particularly reading, for obesity prevention in children.

2' Life-changing minutes: impact evaluation of a novel health promotion format on cancer prevention.

Cancer is one of the most important societal challenges in the world, with over 23 million new cases/year and 10 million deaths/year, that will only be properly tackled with a stronger focus on prevention. This calls for an informed population, aware of risk factors and willing to adopt preventive behaviors and early cancer screenings. For that purpose, 2' Life-changing minutes was created, the first ever televised Entertainment-Education series on cancer prevention. This study aims to evaluate the impact of 2' Life-changing minutes, a novel E-E format for cancer prevention, on knowledge gains and behavior changes. Two complementary studies were performed involving a total of 1314 participants: a test-screening (TS) study targeting potential viewers of the series, and a natural-screening (NS) study targeting those that spontaneously watched the series on television. We found (i) very high levels of appreciation and narrative engagement, and also willingness to see more episodes; (ii) statistically significant knowledge gains, ranging from 17% to 44%, on all four topics tested; (iii) evidence of effective behavior change. Regression analysis showed that narrative engagement was the best predictor of behavior change [NS: odds ratio (OR) = 3.38, 95% confidence interval (CI) = 1.70-6.74, p = 0.001; TS: OR = 2.05, 95% CI = 1.13-0.371, p = 0.018]. This study demonstrates the series' real impact and serves as a proof-of-concept for a novel strategy of cancer prevention that is based around compelling health narratives, rather than information or data, to engage viewers, increase knowledge and induce behavior change.

Trends in Children's Exposure to Food and Beverage Advertising on Television.

Importance: Reducing children's exposure to advertisements promoting unhealthy foods and beverages has been recognized by the World Health Organization as a key strategy to improve children's diets and reduce childhood obesity. Objective: To examine changes in children's exposure to food-related (food, beverage, and restaurant) television advertising, including for products high in nutrients to limit (NTL; ie, saturated fat, trans fat, total sugars, and sodium) based on federal Interagency Working Group guidelines, following changes in the voluntary industry self-regulatory Children's Food and Beverage Advertising Initiative (CFBAI). Design, Setting, and Participants: This repeated cross-sectional study used US television ratings data on advertising exposure from The Nielsen Company for 2013, 2014, 2015, 2018, and 2022. Food and beverage product advertisements were assessed for nutritional content. Participants included 2- to 5-year-old and 6-to 11-year-old children. Data analysis was performed from July 2023 to January 2024. Exposure: Changes in CFBAI standards in 2014 and 2020. Main Outcomes and Measures: The primary outcome was the number of food-related advertisements seen per year and percentage of food and beverage product advertisements high in NTL, on all programming and children's programming (defined as ≥35% child audience share). Results: From 2013 to 2022, total advertisements seen per year declined by 77.6% (from 4611 to 1035) for 2- to 5-year-olds and by 78.5% (from 4860 to 1046) for 6- to 11-year-olds. Advertisements seen on children's programming decreased by 95.1% (from 1703 to 84 per year) for 2- to 5-year-olds and by 97.0% (from 1745 to 52 per year) for 6- to 11-year-olds. The percentages of advertisements for products high in NTL decreased from 2013 to 2022 but were still high: 68.9% for all programming and 63.9% for children's programming for 2- to 5-year-olds, and 68.4% for all programming and 60.6% for children's programming for 6- to 11-year-olds. The majority (51%-52%) of CFBAI-member food and beverage advertisements on children's programming remained high in NTL. Black children saw more food-related television advertisements than White children (58% more for 2- to 5-year-olds and 72% more for 6- to 11-year-olds); however, the percentage of advertisements for food and beverage products high in NTL seen was similar by race. Conclusions and Relevance: In this repeated cross-sectional study of children's exposure to food-related television advertisements, exposure via children's programming decreased substantially. However, most advertisements seen were still for unhealthy products, and exposure from all programming remained substantial. Findings of more than 90% of advertising exposure not from children's programming and more than 1000 food-related advertisements seen per year suggest the need for government regulations based on time of day rather than programming.

Disparities in Exposure to Tobacco on Television or Streaming Platforms.

Importance: With the rise in popularity of streaming platforms concerns about exposure to tobacco advertising and promotion have emerged. While tobacco marketing and promotion through traditional television (TV) media channels has been extensively studied, less is known about exposure to tobacco through TV or streaming platforms and its associated factors. Objective: To examine the prevalence and factors associated with exposure to tobacco products advertised, marketed, or promoted on TV or streaming platforms among US adults. Design, Setting, and Participants: This cross-sectional study used data from the National Cancer Institute's Health Information National Trends Survey (HINTS 6), conducted from March 7 to November 8, 2022. The nationally representative survey included noninstitutionalized civilian US adults. Main Outcomes and Measures: The primary outcome was self-reported exposure to tobacco advertisements, marketing, or promotion on TV or streaming platforms in the past 3 months. Factors associated with exposure were explored using multivariable survey logistic regression. Results: The study included 5775 participants (3415 females [weighted percentage, 50.5%], 970 Hispanic individuals [weighted percentage, 16.9%], 872 non-Hispanic Black or African American individuals [11.1%], 3144 non-White individuals [61.5%], and 632 individuals who currently smoke [12.0%]). The estimated exposure to tobacco advertisements, marketing, or promotion on television or streaming platforms was 12.4% (95% CI, 10.8%-14.2%). Multivariable logistic regression analysis revealed that exposure odds were higher among those who had a level of education of high school or less (adjusted odds ratio [aOR], 1.60; 95% CI, 1.08-2.37), individuals who currently smoke (aOR, 1.85; 95% CI, 1.06-3.25), non-Hispanic Black or African American respondents (aOR, 2.20; 95% CI, 1.40-3.45) and Hispanic respondents (aOR, 1.58; 95% CI, 1.04-2.42). Conclusions and Relevance: In this study of the prevalence of exposure to tobacco advertisements on TV or streaming platforms among US adults, disparities in exposure by race or ethnicity, education level, and smoking status were identified. These findings underscore the need for targeted public health interventions and regulation to address these disparities and reduce the impact of tobacco advertisements on vulnerable populations.

Leisure television watching exerts a causal effect on gastroesophageal reflux disease: evidence from a two-step mendelian randomization study.

BACKGROUND: Previous studies have shown that physical activity (PA) and leisure sedentary behaviors (LSB, including leisure television watching) are linked to gastroesophageal reflux disease (GERD). However, the associations between PA/LSB and GERD remain controversial. In this study, we aimed to reveal whether these associations reflect causal relationships and reveal the potential mechanisms of these relationships using bidirectional and two-step Mendelian randomization (MR) analyses. METHODS: We obtained genome-wide association study (GWAS) summary statistics for PA/LSB, four common risk factors (including cigarettes smoked per day, alcoholic drinks per week, triglycerides, total cholesterol) and GERD from published GWASs. A bidirectional MR analysis was performed to identify causal relationships between PA/LSB and GERD. Then, a series of sensitivity analyses were performed to verify the robustness of the results. Finally, a mediation analysis via two-step MR was conducted to investigate any effects explained by common risk factors in these relationships. RESULTS: Genetically predicted per 1-SD increase in leisure time television watching significantly increased the risk of GERD in the bidirectional MR analysis (OR = 1.33; 95% CI: 1.14-1.56; P = 2.71 × 10- 4). Sensitivity analyses successfully verified the robustness of the causal relationship. Further mediation analysis showed that this effect was partly mediated by increasing cigarettes smoked per day, with mediated proportions of 18.37% (95% CI: 11.94-39.79%). CONCLUSION: Our findings revealed a causal relationship between leisure television watching and an increased risk of GERD, notably, the causal effect was partially mediated by cigarettes smoked per day. These findings may inform prevention and management strategies directed toward GERD.

TV medical dramas: assessing the portrayal of public health in primetime.

Introduction: The influence of medical dramas could extend beyond the realm of entertainment and potentially strengthen/orient the knowledge, attitudes and hopefully practice of health professionals and the public, despite often depicting unrealistic medical outcomes and scenarios. Methods: This study examined the portrayal of public health issues in two popular international medical series, "Grey's Anatomy" and "House, MD," selected for their awards and viewership ratings. Individual episodes were double-rated by clinicians for patient characteristics, public health issues, and infection risk management. Results: 94 episodes with 286 clinical cases were analyzed. A wide range of conditions and pathologies were depicted, with a focus on acute clinical events, trauma and mental disorders, which contrasts with real-life causes of hospitalization and highlight the dramatization in these series. Public health issues such as organ donation and substance abuse were frequently addressed, but prevention and health promotion received little attention. Proper use of personal protective equipment was mostly observed, although hand hygiene was underrepresented. Conclusion: The study highlights the dual role of medical dramas as an entertainment medium and a potential educational tool. While they can raise awareness and encourage healthier behavior, their portrayal of medical practices and patient care often deviates from reality and can create unrealistic expectations. The influence of these dramas also extends to viewers' perceptions of healthcare and medical professionals, underscoring the need for accurate and responsible portrayal of health issues in the media.