Screens for infants and preschool children: Assessment of medical prevention with parents and assessment of exposure.

BACKGROUND: Regarding the massive increase of interactive mobile screen household equipment and the omnipresence of television, many recommendations are in favor of a limitation of use, especially among the youngest. OBJECTIVE: We aimed to evaluate the proportion of parents who report having discussed the subject of their child's exposure to screens during a consultation with a health professional. We also aimed to assess preschool exposure to television and mobile media devices, and to explore parents' views on the benefits and risks of exposing their children under 3 years old. METHODS: A questionnaire was administered to parents of children aged 6 months to 3 years in a pediatric emergency ward and several nurseries. This observational, cross-sectional and multicenter study was conducted from January to May 2019. RESULTS: We included 451 responses in the analyses. Only 99 (22.7%; 95% CI: 18.7-26.6) parents reported having discussed their child's exposure to screens with a doctor, on the initiative of the parents themselves for 52 households (53.1%; 95% CI: 43.2-62.9). Feelings of a benefit of screens on child learning concerned 134 (34.5%; 95% CI: 29.8-39.3) parents; 300 (68.5%; 95% CI: 64.1-72.8) said they were sufficiently informed about benefits and risks. In a typical week, 240 (53.7%; 95% CI: 49.1-58.3), 160 (35.8%; 95% CI: 31.3-40.2), and 58 (13.0%; 95% CI: 9.9-16.1) children were exposed at least once a week to television, smartphones, and tablets, respectively. CONCLUSIONS: Our study showed that the theme of exposure to screens was hardly addressed by physicians in consultation. Our findings help target prevention messages, including fighting the widespread belief that media are beneficial to child development, emphasizing the importance of screen-free time (eating, going to bed, after waking up) and encouraging support and interaction during exposure in families who choose to expose their children.

Popular media as a double-edged sword: An entertainment narrative analysis of the controversial Netflix series 13 Reasons Why.

13 Reasons Why is a Netflix original series adapted from Jay Asher's 2007 young adult novel with the same title. Season 1 premiered on March 31, 2017 and featured the sensitive issue of teen suicide along with bullying, substance use, depression, and sexual assault. Unlike the typical teen dramas on popular streaming platforms, this show was created not only for entertainment, but also to stimulate conversations about taboo topics that people often shy away from. However, it also caused significant controversy, especially criticism around the main character Hannah's suicide scene. More than three years into the initial controversy and at least two dozen scholarly publications later, this study is the first to examine the entertainment narrative content of 13 Reasons Why Season 1 to better understand how these health and social issues were portrayed in the show, what specific examples we could identify as potential behavioral modeling, and to what degree it complied with the 2017 WHO guidelines for media professionals. We used the framing theory and social cognitive theory in communication research and media studies as our guiding conceptual frameworks and a narrative analysis approach to investigate a total of 660 cut scenes in all 13 episodes. Our findings provided empirical evidence, along with contextual information and detailed examples, to demonstrate that a popular entertainment program like the Netflix series 13 Reasons Why serves as a double-edged sword. The production team's good will and due diligence are commendable. Yet, additional steps can be taken in the future to effectively promote professional resources and reduce viewers' risks, especially the most vulnerable groups.

Television Viewing Time and the Risk of Colorectal Cancer Mortality among Japanese Population: The JACC Study.

PURPOSE: Sedentary behavior attributes to the increased risk of some cancers and all-cause mortality. The evidence is limited for the association between television (TV) viewing time, a major sedentary behavior, and risk of colorectal cancer death. We aimed to examine this association in Japanese population. MATERIALS AND METHODS: A prospective cohort study encompassed of 90,834 men and women aged 40-79 years with no prior history of colorectal cancer who completed a self-administered food frequency questionnaire, and provided their TV viewing information. The participants were followed-up from 1988-1990 to the end of 2009. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazard regression for risk of colorectal cancer mortality according to TV viewing time. RESULTS: During the median 19.1-year follow-up period, we documented 749 (385 men and 364 women) colorectal cancer deaths. The multivariable-adjusted HRs for mortality from colorectal cancer were 1.11 (0.88-1.41) for 1.5 to < 3 hr/day, 1.14 (0.91-1.42) for 3 to < 4.5 hr/day and 1.33 (1.02-1.73) for ≥ 4.5 hr/day in comparison to < 1.5 hr/day TV watching; p-trend=0.038, and that for 1-hour increment in TV viewing time was 1.06 (1.01-1.11). Moreover, the multivariable-adjusted HR (95%CI) of colon cancer for 1-hour increment in TV viewing time was 1.07 (1.02-1.13). Age, body mass index, and level of leisure-physical activity did not show significant effect modifications on the observed associations. CONCLUSION: TV viewing time is associated with the increased risk of colorectal cancer mortality among Japanese population, more specifically colon rather than rectal cancer.

Midwifery students' views and experiences of birth on mainstream factual television.

OBJECTIVES: To investigate midwifery students' experiences of viewing childbirth on mainstream factual television and to explore implications for student career intentions and potential pedagogical uses of television excerpts in midwifery education. DESIGN: Twenty-two undergraduate midwifery students at one of two universities took place in focus groups between February and June 2019. Ethical approval was obtained at both sites. Thematic analysis was employed to generate key themes from the data. SETTING: Two UK universities based in the East Midlands and East Yorkshire regions of England. PARTICIPANTS: Twenty-two midwifery students at any stage of their studies. FINDINGS: Researchers generated four key themes from the data a) Changed Perspectives on Televised Childbirth, b) Representations of Midwives and Social Implications, c) Representation of Childbirth and Social Implications and d) The Role of Televising Childbirth in Midwifery Education. KEY CONCLUSIONS: Midwifery students often experience a change of perspective on birth on television as they acquire new knowledge and skills. They recognise the potential social implications of how childbirth and midwifery are represented on television. Pedagogical use of televised birth has potential benefits but needs further investigation in the context of midwifery education. IMPLICATIONS FOR PRACTICE: Midwifery students are likely to begin their studies with pre-existing views and experiences around how birth is represented on mainstream factual television. They may need support to reflect on these to consider their expectations of the profession, to effectively support childbearing women and to potentially influence future production of media images of childbirth.

Real-time gun detection in CCTV: An open problem.

Object detectors have improved in recent years, obtaining better results and faster inference time. However, small object detection is still a problem that has not yet a definitive solution. The autonomous weapons detection on Closed-circuit television (CCTV) has been studied recently, being extremely useful in the field of security, counter-terrorism, and risk mitigation. This article presents a new dataset obtained from a real CCTV installed in a university and the generation of synthetic images, to which Faster R-CNN was applied using Feature Pyramid Network with ResNet-50 resulting in a weapon detection model able to be used in quasi real-time CCTV (90 ms of inference time with an NVIDIA GeForce GTX-1080Ti card) improving the state of the art on weapon detection in a two stages training. In this work, an exhaustive experimental study of the detector with these datasets was performed, showing the impact of synthetic datasets on the training of weapons detection systems, as well as the main limitations that these systems present nowadays. The generated synthetic dataset and the real CCTV dataset are available to the whole research community.

Depictions of Alcohol in Australian TV 'Bachelor In Paradise': A Content Analysis.

AIMS: To quantify the depictions of alcohol in the popular Australian reality TV show-Bachelor in Paradise (season 1: 2018). METHODS: All 16 episodes were coded in 1-min intervals for the presence of alcoholic beverage related content and non-alcoholic beverage content, and the categories of actual use, implied use and other references. RESULTS: Alcohol was highly prevalent in all episodes. Alcohol content occurred frequently, with 70.7% of intervals having any alcohol content. Actual alcohol use occurred in 31.9% of 1-min intervals, implied alcohol use occurred in 63.4% of intervals and other alcohol references occurred in 14.0% of intervals. Alcohol content was present in the first or second 1-min interval of all 16 episodes. Alcohol content was more than twice as prevalent as non-alcoholic content (34.0%). CONCLUSIONS: The high volume of alcohol content depicted in the show is of concern, due to the important influence it may have on the audience. Vulnerable viewers, especially minors and young adults, are being exposed to ubiquitous alcohol references. This may influence their perceptions of normal alcohol use, their attitudes toward alcohol and their own consumption of alcohol. A stronger regulatory regime is required in Australia to protect young people more effectively from depictions in television programs.

Evaluating the fake news problem at the scale of the information ecosystem.

"Fake news," broadly defined as false or misleading information masquerading as legitimate news, is frequently asserted to be pervasive online with serious consequences for democracy. Using a unique multimode dataset that comprises a nationally representative sample of mobile, desktop, and television consumption, we refute this conventional wisdom on three levels. First, news consumption of any sort is heavily outweighed by other forms of media consumption, comprising at most 14.2% of Americans' daily media diets. Second, to the extent that Americans do consume news, it is overwhelmingly from television, which accounts for roughly five times as much as news consumption as online. Third, fake news comprises only 0.15% of Americans' daily media diet. Our results suggest that the origins of public misinformedness and polarization are more likely to lie in the content of ordinary news or the avoidance of news altogether as they are in overt fakery.

Does Adolescent Media Use Predict Sexual Stereotypes in Adolescence and Emerging Adulthood? Associations with Music Television and Online Pornography Exposure.

Entertainment media consumed by adolescents have been criticized for their stereotyped depictions of sexual relationships. This longitudinal study among 182 boys and 218 girls from Belgium tests reciprocal relationships between adolescents' acceptance of gendered sexual roles and their exposure to music television and online pornography over three waves. The study innovates by including a fourth wave, approximately 5 years after Wave 3, when the participants had reached emerging adulthood, allowing to study long-term associations across the two developmental stages. Results first showed that adolescents who watched more music television than their same-aged peers reported a stronger acceptance of rape myths in emerging adulthood. Second, the link between adolescents' music television viewing and acceptance of rape myths in emerging adulthood was an indirect relationship through adolescents' acceptance of gendered sexual roles during adolescence. Third, adolescents' exposure to online pornography relative to their same-aged peers did not predict their acceptance of gendered sexual roles or rape myths in emerging adulthood. Fourth, gender and age differences could not be investigated due to model fit problems and are suggested to be examined in future research. Implications of the long-term consequences of adolescents' media use are discussed.

Youth Exposure to Alcohol Advertising in the United States: Assessment of Two Types of Television Ratings and Implications for Voluntary Advertising Guidelines.

OBJECTIVE: Do youth switch channels during alcohol advertisements at different rates than adults? This question has implications for the alcohol industry's self-regulation of its advertising placements. People may avoid television advertisements by switching channels, which can be measured by comparing two television audience metrics: commercial ratings (which measure the audience during the advertisement) and program ratings (which measure the audience during the television program). We assessed changes in youth and adult audiences during alcohol advertisements with implications for alcohol industry self-regulatory compliance. METHOD: A census of alcohol advertisements for 2010-2014 was licensed from Nielsen (New York, NY). We compared noncompliant advertisements (with youth making up >28.4% of the audience) and the percentage decline in per capita advertising exposure for youth and adult age groups using both commercial and program ratings. RESULTS: The audience during the alcohol advertisement declined by 8.48% among underage viewers ages 12-17 years and by 7.04% for viewers ages 18-20 years, compared with 8.20% for adults ages 21-24, 10.43% for ages 25-34, and 9.74% for ages 35 and older. These declines exceeded the margin of error (±2.6%), indicating a decline in viewership across all age groups, but we could not draw conclusions about differences between age groups. Compared with audience estimates using commercial ratings, program ratings underestimated the number of noncompliant advertisements by 8,800, leading to an underestimate of noncompliant exposure by 140 million impressions. CONCLUSIONS: Both underage viewers and young adults switched channels during alcohol advertisements. Using commercial ratings rather than program ratings may more accurately measure compliance with alcohol industry advertising guidelines.

Active Shooter and Terrorist Event-Related Posttraumatic Stress and Depression: Television Viewing and Perceived Safety.

OBJECTIVE: This study examined the relationship of sniper-related television viewing (TV) and perceived safety to posttraumatic stress (PTS) and depressive symptoms during the Washington, DC sniper attacks. METHODS: Participants were 1238 Washington, DC area residents assessed using an internet survey including the Impact of Event Scale-Revised, Patient Health Questionnaire-9, hours of TV, and perceived safety. RESULTS: Almost 40% (n = 459) of participants watched at least 2 hours of sniper-related TV daily. TV viewing was associated with lower total perceived safety. After adjusting for demographics, more TV viewing and decreased perceived safety were related to increased PTS and depressive symptoms. TV viewing modified the effect of safety on PTS and depressive symptoms. Among participants with low and high perceived safety, hours of TV were positively associated with PTS; however, the effect was stronger among those with low perceived safety. The relationship of TV to increased depressive symptoms was identified only in participants who reported low perceived safety. CONCLUSIONS: The influence of media exposure and perceived safety have implications for intervention by community leaders and mental health care providers. Recommendations include limiting media exposure during a terrorist event, particularly among those who perceive that their safety is at risk, and targeting safety in communication strategies. (Disaster Med Public Health Preparedness. 2019;13:570-576).

Why Thirteen Reasons Why may elicit suicidal ideation in some viewers, but help others.

When the popular Netflix series 13 Reasons Why (13RW) debuted, scholars were quick to raise concerns that the show may encourage suicide as an option, particularly for vulnerable audience members; nonetheless, others pushed back, noting that the evidence used to draw a link between exposure to media and actual suicide risk suffers from methodological weaknesses and that censoring mental health topics may do more harm than good. The problem highlighted by the debate is that researchers generally lack the kinds of studies that would truly help us understand if a show like 13RW is problematic, and if it is, which specific storylines carry risk. Indeed, this general lack of the empirical evidence is precisely why the study by Arendt and his colleagues (2019) in this issue makes such an important contribution to the literature. With this commentary, I (1) review what we know and what we don't about the media, 13RW, and suicide, (2) discuss Arendt et al.'s unique insights, and (3) outline an agenda for future research that will allow us to better answer how, when, and for whom exposure to media stories like 13RW harms - or helps - youth.

Investigating harmful and helpful effects of watching season 2 of 13 Reasons Why: Results of a two-wave U.S. panel survey.

RATIONALE: The Netflix show 13 Reasons Why (2017) aroused widespread concern regarding potential contagious effects of its graphic depiction of an adolescent girl's suicide and the events that led to her death. OBJECTIVE: To explore the effects of the second season of the show in 2018. METHOD: We recruited a sample of young adults (ages 18-29; N = 729) with access to Netflix who completed surveys shortly before and one month after the release of the show's second season. Based on theories of narrative empathy, we hypothesized that those who discontinued watching the show would be most vulnerable to its adverse effects on suicide-relevant outcomes. We further identified a higher risk subset of viewers who were more likely to have stopped watching the first season (those currently enrolled in school) in order to observe if the show had more adverse effects on this audience. Finally, we examined effects of the show on all viewers' intentions to help a suicidal person as a prosocial consequence of viewing the entire second season. We used both covariance and "genetic" matching to control for selection effects. RESULTS: In support of predictions, viewers who stopped watching the second season exhibited greater suicide risk and less optimism about the future than those who continued to the end. However, unexpectedly, current students who watched the entire second season reported declines in suicide ideation and self-harm relative to those who did not watch the show at all (ps < .01). Moreover, those who watched the entire second season were also more likely to express interest in helping a suicidal person, especially compared to those who stopped watching. CONCLUSION: The results suggest that a fictional story with a focus on suicidal content can have both harmful and helpful effects.

Content analysis of tobacco content in UK television.

AIMS: Exposure to audiovisual tobacco content in media is a risk factor for smoking in young people. While tobacco content in films has been extensively documented, content in mainstream television has received relatively little attention. We report an analysis of tobacco content in a sample of UK free-to-air prime-time television broadcasts in 2015, and compare this with a similar analysis from 2010. DESIGN: Content analysis of all programmes and advertisements or trailers broadcast on the five national UK free-to-air channels in the UK between 18:00 and 22:00 during three separate weeks in September, October and November 2015. SETTING: Great Britain. PARTICIPANTS: None (media analysis only). MEASUREMENTS: Occurrence of any tobacco, tobacco use, implied use, other tobacco reference/related objects and branding in every 1 min coding interval. FINDINGS: Tobacco content occurred in 33% of all programmes and 8% of all adverts or programme trailer breaks. Actual tobacco use occurred in 12% of all programmes broadcast. Tobacco-related objects, primarily no smoking signs, occurred in 2% of broadcasts; implied tobacco use and tobacco branding were also rare. The majority of tobacco content occurred after the 21:00 watershed. CONCLUSIONS: These findings are virtually unchanged from our earlier analysis of programme content from 2010. Audiovisual tobacco content remains common in UK television programmes.

Television Advertising and Health Insurance Marketplace Consumer Engagement in Kentucky: A Natural Experiment.

BACKGROUND: Reductions in health insurance enrollment outreach could have negative effects on the individual health insurance market. Specifically, consumers may not be informed about the availability of coverage, and if some healthier consumers fail to enroll, there could be a worse risk pool for insurers. Kentucky created its own Marketplace, known as kynect, and adopted Medicaid expansion under the Affordable Care Act, which yielded the largest decline in adult uninsured rate in the United States from 2013 to 2016. The state sponsored an award-winning media campaign, yet after the election of a new governor in 2015, it declined to renew the television advertising contract for kynect and canceled all pending television ads with over a month remaining in the 2016 open enrollment period. OBJECTIVE: The objective of this study is to examine the stark variation in television advertising across multiple open enrollment periods in Kentucky and use this variation to estimate the dose-response effect of state-sponsored television advertising on consumer engagement with the Marketplace. In addition, we assess to what extent private insurers can potentially help fill the void when governments reduce or eliminate television advertising. METHODS: We obtained television advertising (Kantar Media/Campaign Media Analysis Group) and Marketplace data (Kentucky Health Benefit Exchange) for the period of October 1, 2013, through January 31, 2016, for Kentucky. Advertising data at the spot level were collapsed to state-week counts by sponsor type. Similarly, a state-week series of Marketplace engagement and enrollment measures were derived from state reports to Centers for Medicare and Medicaid Services. We used linear regression models to estimate associations between health insurance television advertising volume and measures of information-seeking (calls to call center; page views, visits, and unique visitors to the website) and enrollment (Web-based and total applications, Marketplace enrollment). RESULTS: We found significant dose-response effects of weekly state-sponsored television advertising volume during open enrollment on information-seeking behavior (marginal effects of an additional ad airing per week for website page views: 7973, visits: 390, and unique visitors: 388) and enrollment activity (applications, Web-based: 61 and total: 56). CONCLUSIONS: State-sponsored television advertising was associated with nearly 40% of unique visitors and Web-based applications. Insurance company television advertising was not a significant driver of engagement, an important consideration if cuts to government-sponsored advertising persist.

Discordance Between Patient Reported Motivations to Seek Treatment for Psoriasis Compared to Television Advertisements.

INTRODUCTION: Despite a growing arsenal of therapies for psoriasis and, consequently, an increasing number of advertisements for these treatments, many psoriasis patients still remain untreated. While the primary treatment seeking motivations for these patients have been identified, it is unknown if the commercials for the medications designed to encourage patient engagement in treatment are relevant to these concerns. METHODS: Online databases for national television advertisements were searched for psoriasis treatment commercials broadcast between 2000 and 2018. Each advertisement video was viewed 3 times and separately assessed for the content displayed or information conveyed in images, text, and voice-over speech. Additionally, references to known patient motivations for seeking treatment, including concerns about skin symptoms or appearance (embarrassment, scaling/flaking, pain, discomfort, itch, etc.) were recorded. RESULTS: A total of 20 commercials were assessed. Of those, 100% emphasized "clear skin" as the result of the treatment that was being marketed. Bothersome skin symptoms, however, were less frequently displayed; scaling/flaking, pain/discomfort, and itch were present in 15%, 5%, and 0% of commercials, respectively. Similarly, text or images displaying sadness, shame or covering of skin were in 40%, 45% and 30% the advertisements, respectively. None (0%) of the commercials evaluated displayed images of people scratching or verbally addressed skin itching as a bothersome symptom of psoriasis. CONCLUSIONS AND RELEVANCE: While the advertisements assessed in this study did exhibit patient concerns regarding skin appearance, skin symptoms including skin itching, flaking, pain and discomfort were not equally addressed. As these are known factors that motivate psoriasis patients to actively engage in treatment, targeted ads that better demonstrate these concerns may help prompt under-treated patients to seek care. J Drugs Dermatol. 2018;17(8):886-887.

Sports Sponsorships of Food and Nonalcoholic Beverages.

BACKGROUND: Food and nonalcoholic beverage companies spend millions of dollars on professional sports sponsorships, yet this form of marketing is understudied. These sponsorships are valuable marketing tools but prompt concerns when unhealthy products are associated with popular sports organizations, especially those viewed by youth. METHODS: This descriptive study used Nielsen audience data to select 10 sports organizations with the most 2-17 year old viewers of 2015 televised events. Sponsors of these organizations were identified and assigned to product categories. We identified advertisements promoting food and/or nonalcoholic beverage sponsorships on television, YouTube, and sports organization Web sites from 2006 to 2016, and the number of YouTube advertisement views. The nutritional quality of advertised products was assessed. RESULTS: Youth watched telecasts associated with these sports organizations over 412 million times. These organizations had 44 food and/or nonalcoholic beverage sponsors (18.8% of sponsors), second to automotive sponsors (n = 46). The National Football League had the most food and/or nonalcoholic beverage sponsors (n = 10), followed by the National Hockey League (n = 7) and Little League (n = 7). We identified 273 advertisements that featured food and/or nonalcoholic beverage products 328 times and product logos 83 times (some advertisements showed multiple products). Seventy-six percent (n = 132) of foods had unhealthy nutrition scores, and 52.4% (n = 111) of nonalcoholic beverages were sugar-sweetened. YouTube sponsorship advertisements totaled 195.6 million views. CONCLUSIONS: Sports sponsorships are commonly used to market unhealthy food and nonalcoholic beverages, exposing millions of consumers to these advertisements.

The Outcome and Patterns of Traumatic Brain Injury in the Paediatric Population of a Developing Country Secondary to TV Trolley Tip-Over.

BACKGROUND: Television (TV) trolley tip-over incidences are common and can cause significant morbidity and mortality in children. This study was aimed at analyzing the pattern and outcomes of head injuries resulting from TV trolley tip-over. METHOD: We conducted a medical chart review of children with TV trolley tip-over head injuries from January 2009 to April 2016. We collected data on demographics, the mechanism of injury, clinical and radiological features of the injury, and outcomes. Outcomes were measured by means of the Glasgow Outcome Scale (GOS) at 6 months (except in 1 case). A descriptive analysis was carried out using SPSS v19. RESULT: Twenty-two children were included in the study (median age 23.5 months). Sixteen children were male. Most of the children (n = 16) were aged 12-35 months. The median Glasgow Coma Scale score on admission was 15. The median Rotterdam Score for the patients was 2.0. Common symptoms upon admission were vomiting, irritability, scalp laceration, and bruises. Median length of hospital stay was 3 days. Skull bone fractures were present in 12 children. Other CT findings included contusions, extradural and subdural haematomas, intraventricular haemorrhage, and pneumocranium. Surgical intervention was required in 4 cases. Although most of the patients made a good recovery (GOS = 5), 1 patient developed a mild disability and another died in hospital. CONCLUSION: TV trolley tip-over is most common in toddlers and can lead to significant head injury and mortality. This can be avoided by parental supervision and adjustments in the household.

Getting Your Grumble Back.

PURPOSE OF STUDY: Viewing the surgical patient holistically within their environment of care, the bedside nurse is aware of the possible complication of postoperative paralytic ileus that can lead to patient discomfort and increased medical costs. Acute care nurses observed postoperative patients watching televised cooking shows on a consistent basis and questioned if there was a mind-body link between bowel function and watching cooking shows. DESIGN OF STUDY: The study used an observational approach to examine the return of bowel sounds for postoperative patients. METHOD: Ninety-four patients that underwent abdominal surgery participated. A questionnaire was administered to capture total hours postsurgery of patient viewing cooking shows followed by chart review for age, height, weight, information specific to surgery, and documented first postsurgical flatus. FINDINGS: This study found that non-bariatric general surgery patients who watch cooking shows during hospitalization are significantly more likely to experience return of appetite and stomach sounds within 1 day postsurgery than patients who do not watch cooking shows. CONCLUSIONS: Based on the results of this study, the authors suggest that, when possible, patients who receive non-bariatric abdominal surgery be encouraged to watch cooking shows to experience the potential benefits such as early return of bowel functioning.