Functional connectivity patterns predict naturalistic viewing versus rest across development.

Cognitive states, such as rest and task engagement, share an 'intrinsic' functional network organization that is subject to minimal variation over time and yields stable signatures within an individual. Importantly, there are also transient state-specific functional connectivity (FC) patterns that vary across neural states. Here, we examine functional brain organization differences that underlie distinct states in a cross-sectional developmental sample. We compare FC fMRI data acquired during naturalistic viewing (i.e., movie-watching) and resting-state paradigms in a large cohort of 157 children and young adults aged 6-20. Naturalistic paradigms are commonly implemented in pediatric research because they maintain the child's attention and contribute to reduced head motion. It remains unknown, however, to what extent the brain-wide functional network organization is comparable during movie-watching and rest across development. Here, we identify a widespread FC pattern that predicts whether individuals are watching a movie or resting. Specifically, we develop a model for prediction of multilevel neural effects (termed PrimeNet), which can with high reliability distinguish between movie-watching and rest irrespective of age and that generalizes across movies. In turn, we characterize FC patterns in the most predictive functional networks for movie-watching versus rest and show that these patterns can indeed vary as a function of development. Collectively, these effects highlight a 'core' FC pattern that is robustly associated with naturalistic viewing, which also exhibits change across age. These results, focused here on naturalistic viewing, provide a roadmap for quantifying state-specific functional neural organization across development, which may reveal key variation in neurodevelopmental trajectories associated with behavioral phenotypes.

Tobacco and tobacco branding in films most popular in the UK from 2009 to 2017.

BACKGROUND: Exposure to tobacco content in films is a cause of smoking uptake in young people. In an earlier study, we reported that tobacco content occurred in 70% of UK box office films popular between 1989 and 2008. We now report an analysis of tobacco content in a sample of the top grossing UK box office films between 2009 and 2017, and of population exposure resulting from audience exposure to the 2017 films. METHODS: Occurrence of tobacco intervals (actual tobacco use, implied use, appearance of smoking paraphernalia or branding) was measured by 5 min interval coding in the 15 most commercially successful films in the UK in each year from 2009 to 2017. A nationally representative survey was used to estimate population exposure to the top 15 films from 2017. RESULTS: We coded 3248 intervals from the 135 films. Tobacco content appeared in 245 intervals (8%, 95% CI 7% to 9%) across 56 (41%, 95% CI 33% to 49%) films. Tobacco content occurred in films in all BBFC age ratings, and 36 (64%, 95% CI 51% to 77%) of films containing tobacco imagery were classified as suitable for viewing by people aged under 15 years. Although less prevalent than in our earlier study, there was no evidence of a secular decline in tobacco content during this study period. The top 15 films from 2017 delivered approximately 21.6 (95% CI 21.06-22.14) million tobacco impressions to young people aged 10-18 years in the UK. CONCLUSIONS: Tobacco content continues to appear in UK Box Office films and is widely seen by young people, representing a major driver of smoking uptake.

Illuminating nursing's shadow side through a Jungian analysis of the film Fog in August.

Fog in August is a German film based on Robert Domes' historical novel of the same name. The film provides a fictionalized account of the institutionalization and eventual killing of children and adults labelled as a burden on the State and unworthy of life. On one level, this is a story of good versus evil, where innocent patients are manipulated by callous doctors and nurses. At a deeper level, however, it is possible to read the characters as more complex and such a reading gives an insight into the paradox of how a genocidal policy was able to be systematically implemented by health care professionals who had previously taken an oath to provide care to all people. Carl Jung argued that powerful stories, told across generations, contain mythical archetypes that help drive the plot and convey beliefs about humanity. The aims of this paper are to explore Jungian ideas within Fog in August that help the historical story it is based on resonate with viewers today, and demonstrate how the application of these insights can help health care professionals more fully understand morally distressing events and, as a result, support and improve the safety of patients.

"You took an Oath!": Engaging Medical Students About the Importance of Oaths and Codes Through Film and Television.

In this paper, we will consider the role of oaths and codes of ethics in undergraduate medical education. Studies of ethics syllabi suggest that ethics educators typically use well-known bioethics texts such as Beauchamp and Childress (Principles of biomedical ethics, 8th ed. Oxford University Press, Oxford, 2019). Yet, many issues that medical students will face (as students and as physicians) are addressed by codes of ethics and oaths. We will first provide a historical survey of oaths and codes and then address how these sources of ethical guidance can be effectively used in ethics education of medical students. Oaths and codes can be engagingly taught using a range of techniques including visual narrative. Excerpts from television and film can be used to highlight challenging ethical dilemmas in a variety of settings, taking the learning from the theoretical to the more applied while offering context.

Exposure to Alcohol Content in Movies and Initiation of Early Drinking Milestones.

BACKGROUND: Exposure to alcohol content in movies has been shown to be associated with adolescent use of alcohol, including earlier onset. This study examined the influence of movie alcohol exposure on subsequent alcohol onset, considering the social context (whether the movie was viewed with a friend or parent). We examined whether media's influence holds across a spectrum of early drinking milestones: sipping (but not consuming a full drink of) alcohol, consuming a full drink of alcohol, and engaging in heavy episodic drinking (HED). METHODS: Data were taken from a sample of 882 middle school youth (52% female; 24% non-White) enrolled in an ongoing study on alcohol initiation and progression. Exposure to alcohol content in films was measured using a method that combines content analysis and random assignment of movie titles to youth surveys. The hazard of initiating alcohol use (sip, full drink, HED) as a function of exposure was estimated using survival analysis. Associations were adjusted for demographic, personality, and social influence factors known to be associated with both movie exposure and alcohol use. RESULTS: Exposure to alcohol content was common. Hours of exposure prospectively predicted earlier onset of alcohol involvement across all outcomes. Viewing movies with friends appeared to augment the media exposure effect, in contrast to viewing movies with parents, which was not a significant predictor of initiation. CONCLUSIONS: Exposure to alcohol in films is involved in the entry into early stages of alcohol involvement. Findings support further investigation into the role of the media in underage drinking, especially in the context of consuming media with friends and peers. Limiting media exposure and/or stronger Federal Trade Commission oversight of movie ratings should be a priority for preventing underage drinking.

On the shoulders of giants. The story behind the 'Pioneers of Nephrology' project.

This editorial introduces a series of interviews with the pioneers of Nephrology. It's a story that speaks by itself, given the thousands of people that are now alive thanks to the remarkable advances in renal replacement therapies such as dialysis, and kidney transplantation but also the many scientific advances in our understanding of the pathophysiology and treatment of kidney diseases worldwide.The interviews that we have selected for this series are, however, not dealing with their achievements, and their success; they try to pass on to future generations the idea of how they were, why they were passionate, what they loved, and, not last, where they found poetry in our profession.At a time in which narrative medicine points out the importance of the different life experiences in understanding diseases, we would invite you to discover a narrative portrait of the men and women who made our discipline what it is now.

Using Hawkeye from the Avengers to communicate on the eye.

Superheroes, such as Iron Man, Captain America, Wonder Woman, Batman, and Hawkeye, have appeared in numerous films, displaying their range of incredible superpowers and abilities. Therefore, it is unsurprising that many people would not only wish to attain these powers, but also to learn about scientific accessibility to these powers. Popular culture characters such as superheroes can provide a unique platform for the communication of difficult scientific concepts. In the classroom, these characters can be used to communicate learning objectives to students in an interesting, fun, and accessible manner by taking advantage of student familiarity with the characters. Hawkeye, a member of the Avengers, is one such superhero who can be utilized by educators. His powers can be attributed in part to his advanced eyesight, which has physiological aspects in common with many birds of prey. Hence, Hawkeye can instigate discussion on the physiology of the human eye, while also allowing for comparison with other species, such as birds of prey, and reflection on advancements related to genetic engineering and wearable technologies. In addition, in my experience, Hawkeye has proven to be a highly suitable popular culture character for use in scientific communication and outreach.

Tobacco advertising, promotion and sponsorship in entertainment media: a phenomenon requiring stronger controls in the Eastern Mediterranean Region.

Tobacco use and placement of tobacco products in television (TV) productions and movies is a way to promote tobacco use while avoiding tobacco advertising bans that exist in most countries. The fact that such productions are broadcast widely and viewed by millions, including children and young people, is of concern. This paper reviews the evidence on the use of tobacco advertising, promotion and sponsorship (TAPS) in TV and films in the Eastern Mediterranean Region and the ways to combat it. Evidence from Egypt shows considerable and increasing use of tobacco products by actors on screen, including female actors, in programmes aired during Ramadan in 2015-2017. A study of Iranian movies in 2015 showed that tobacco scenes in Iranian movies were increasing. In 2014, the WHO Regional Office for the Eastern Mediterranean held a consultative meeting on TAPS in drama. The consultation recommended regulating the tobacco presence in movies and TV through complete implementation of Article 13 of the WHO FCTC, and raising the issue to the WHO FCTC Conference of the Parties. In 2016, the Conference of the Parties called on parties to consider scaling up the implementation of WHO FCTC Article 13 and monitoring the use of TAPS in entertainment media in accordance with national legislation. A comprehensive approach is essential to end the tobacco industry's use of TV productions and movies to promote their products.

Did limits on payments for tobacco placements in US movies affect how movies are made?

OBJECTIVE: To compare how smoking was depicted in Hollywood movies before and after an intervention limiting paid product placement for cigarette brands. DESIGN: Correlational analysis. SETTING/PARTICIPANTS: Top box office hits released in the USA primarily between 1988 and 2011 (n=2134). INTERVENTION: The Master Settlement Agreement (MSA), implemented in 1998. MAIN OUTCOME MEASURES: This study analyses trends for whether or not movies depicted smoking, and among movies with smoking, counts for character smoking scenes and average smoking scene duration. RESULTS: There was no detectable trend for any measure prior to the MSA. In 1999, 79% of movies contained smoking, and movies with smoking contained 8 scenes of character smoking, with the average duration of a character smoking scene being 81 s. After the MSA, there were significant negative post-MSA changes (p<0.05) for linear trends in proportion of movies with any smoking (which declined to 41% by 2011) and, in movies with smoking, counts of character smoking scenes (which declined to 4 by 2011). Between 1999 and 2000, there was an immediate and dramatic drop in average length of a character smoking scene, which decreased to 19 s, and remained there for the duration of the study. The probability that the drop of -62.5 (95% CI -55.1 to -70.0) seconds was due to chance was p<10-16. CONCLUSIONS: This study's correlational data suggest that restricting payments for tobacco product placement coincided with profound changes in the duration of smoking depictions in movies.

Time trends for tobacco and alcohol use in youth-rated films popular in Mexico and Argentina, from 2004-2012.

OBJECTIVE:: To examine and compare overall prevalence and time trends in tobacco and alcohol portrayals and brand appearances in youth-rated US and nationally-produced films that were the most successful in Argentina and Mexico from 2004-2012. MATERIALS AND METHODS:: Top-grossing nationally produced films from Argentina (n=73), Mexico (n=85) and the US (n=643) were content analyzed. Logistic regression was used to determine differences between Mexican, Argentine and US produced films. Linear regression models assessed significant cross-country differences in the mean number of tobacco and alcohol seconds. RESULTS:: Films from Mexico and Argentina were more likely than US films to contain tobacco, (OR=4.2; p<0.001) and (OR=7.2; p<0.001). Alcohol was present in 93% of Argentine, 83% in Mexican and 83% US films. CONCLUSIONS:: Smoking and alcohol were highly prevalent in nationally produced films. They may have a significant impact and should be targeted by policies to reduce youth exposure to portrayals of risk behaviors.

Exposure to Alcohol Use in Motion Pictures and Teen Drinking in Latin America.

BACKGROUND: Our objective was to assess whether exposure to alcohol use in films (AUF) is associated with alcohol use susceptibility, current alcohol use, and binge drinking in adolescents from 2 Latin American countries. METHODS: We performed a cross-sectional study with 13,295 middle school students from public and private schools in Mexico and Argentina. Exposure to alcohol use in over 400 contemporary top box office films in each country was estimated using previously validated methods. Outcome measures included current drinking (i.e., any drink in the last 30 days), ever binge drinking (i.e., more than 4 or 5 drinks in a row for females and males, respectively) and, among never drinkers, alcohol susceptibility (i.e., might drink in the next year or accept a drink from a friend). Multivariate models were adjusted for age, sex, parental education, peer drinking, sensation seeking, parenting style, and media access. RESULTS: Mean age was 12.5 years (SD = 0.7), and the prevalence of alcohol consumption and binge drinking was 19.8 and 10.9%, respectively. Mean exposure to alcohol from the film sample was about 7 hours in both countries. Adjusted models indicated independent dose-response associations between higher levels of exposure to AUF and all outcomes; the adjusted odds ratios (aORs) comparing quartiles 4 and 1, 1.99 (95% confidence interval [CI] 1.73 to 2.30) for current drinking, aOR 1.68 (CI 1.39 to 2.02) for binge drinking, and aOR 1.80 (1.52 to 2.12) for alcohol susceptibility. Compared to Mexican adolescents, Argentine adolescents were significantly more likely to have engaged in binge drinking (aOR 1.40, 95% CI 1.12 to 1.76) and, among never drinkers, were more susceptible to try drinking (aOR 1.40, 95% CI 1.20 to 1.64). CONCLUSIONS: Higher levels of exposure to AUF were associated with higher likelihood of alcohol use, binge drinking, and alcohol susceptibility in Latin American adolescents.

Portrayals of character smoking and drinking in Argentine-, Mexican- and US-produced films.

The aim of this study was to assess film character portrayals of tobacco and alcohol use in US and nationally-produced films that were popular in Argentina and Mexico from 2004-2012. We performed a content analysis of these films (n=82 Argentine, 91 Mexican, and 908 US films, respectively). Chi-squares and t-tests were used to compare characteristics of characters who smoked or drank by country of movie production. Then data from all countries were pooled, and generalized estimating equation (GEE) models were used to determine independent correlates of character smoking or drinking. There were 480 major characters for Argentine-, 364 for Mexican-, and 4962 for US-produced films. Smoking prevalence among movie characters was similar to population smoking prevalence in Mexico (21%) and Argentina (26%), but about half in the US (11%), where movie product placements are restricted. Movie smoking declined over the period in all three countries. Movie alcohol prevalence was 40-50% across all countries and did not change with time. Demographic predictors of character smoking included: being male, 18 and older, having negative character valence. Movie smoking was not associated with lower SES. Predictors of character drinking included: being age 18 and older and positive character valence. Smoking and drinking predicted each other, illicit drug use, and higher scores for other risk behaviors. This suggests that policy development in Mexico and Argentina may be necessary to reduce the amount of character tobacco and alcohol use in films.

Time trend of smoking scenes in Iranian movies during the past three decades (1982-2011): a historical analysis.

BACKGROUND: Evidence from the USA and elsewhere has linked smoking depictions in movies with youth smoking initiation. Prior research has not focused on depictions in films produced in the Middle East, however. OBJECTIVE: We reviewed the 10 most commercially successful Iranian films released each year over three decades (1982-2011) to determine trends in depictions of tobacco use over time. METHODS: Each movie was reviewed in its entirety, and depictions of smoking were recorded and classified as direct (characters holding or using tobacco products) and indirect (tobacco products appearing in the frame, but not being used). Time trends in average duration of direct, indirect and total smoking depictions were analysed using linear regression and Cohen's κ coefficient. RESULTS: The mean duration of tobacco depictions in the most commercially successful Iranian films fluctuated yearly over the 3 decades, but with an overall significant upward trend (p<0.005). The proportion of movies depicting tobacco consumption during the three decades was 36% (1982-1991), 60% (1992-2001) and 74% (2002-2011), respectively. The average proportion of total movie time for these depictions (0.75%, 1.41%, 2.08%) increased significantly (p<0.005) over the 3 decades as did the average duration of smoking depictions,(39.1, 67 and 99.3 s, respectively, p<0.005). CONCLUSIONS: The significant increase in the proportion of movies depicting tobacco consumption and in the duration of smoking depictions over the past 30 years underscores the need for increased regulation of the Iranian film industry to minimise this important source of influence on tobacco initiation in young people.

Giving the wrong impression: food and beverage brand impressions delivered to youth through popular movies.

BACKGROUND: Marketing on television showcases less-healthful options, with emerging research suggesting movies promote similar products. Given the obesity epidemic, understanding advertising to youth should be a public health imperative. The objective of this study was to estimate youth impressions to food and beverages delivered through movies. METHODS: Impressions were calculated by dividing US receipts annually into average movie ticket prices, then multiplying this by the number of brand appearances. Examination by ratings, product types and ages were conducted by Spearman rank correlation coefficient tests. RESULTS: Youth in the USA saw over 3 billion food, beverage or food-retail establishment (FRE) impressions on average, annually from 1996 to 2005. Those aged 12-18 viewed over half of all impressions, with PG-13-rated movies containing 61.5% of impressions. There were no significant trends in brand appearances by food, beverage or FRE impressions over the decade, although there was a decreasing trend in R-rated impressions for both foods (P< 0.01) and beverages (P< 0.01), but not FREs (P= 0.08). CONCLUSIONS: Movies promote billions of food and beverage impressions annually to youth. Given the public health crisis of obesity, future research should further investigate these trends, as well as the potential association of these unhealthy exposures in youth.

Smoking in top-grossing US movies, 2011.

We reviewed the number of incidents of tobacco use (almost exclusively smoking) depicted in movies in the United States in 2011 to compare that with previously reported trends. We counted use or implied use of a tobacco product by an actor in all movies whose box office gross ranked in the top 10 for at least 1 week. Total tobacco incidents per movie rose 7% from 2010 to 2011, ending 5 years of decline; incidents rose 34% per movie rated G, PG, or PG-13 and 7% per R-rated movie. The reversal of progress toward less onscreen smoking in youth-rated movies underscores the need to rate movies with tobacco imagery as R, establishing an industry-wide market incentive to keep youth-marketed movies tobacco-free.

Aspects of the structure of film expression and anthropological paradigm of films reception in Croatian cinema and TV distribution.

This research paper deals with one part of a comprehensive study called "Causality of narratological-semiotic aspects of the structure of film expression and paradigms of reception of Croatian feature film". It is conceived as a response to the hypothesis that the expression of narrative-semiotic terms correlate with the reception of the Croatian feature film audience and all them leads into a broader holistic i.e. anthropological context.The basic idea of scientific research is to analyze the complete feature productions since Croatian independence 1991 to date, presented at the National Film Festival (film festival in Pula), identify, define and isolate positive social narrative-semiotic stereotypes, which can then serve as a paradigm of better ratings and increase of the currently very low rating of domestic films in Croatian cinemas, as well as TV distribution. In other words, the paper will be analyzed and processed by a range of different effects based on narrative-semiotic, set design and mise-en-scène motives, used in the Croatian feature films since independence to date, that we assume to positively influence the mood of the viewer, and thus increase the rating of the film.

Teen lesbian desires and identities in international cinema: 1931-2007.

This article provides an overview of representations of teenage lesbian desires and/or identity in a global cinematic context, addressing twenty-seven films from fourteen nations released between 1931 and 2007. Despite temporal and geographical differences, three main forms of film texts emerged: those that engaged in sub or somewhat textual depictions of teen lesbian desires and relationships; others that offered a tragic take on lesbian desire; and the dominant form, engaging with a coming of age narrative structure.