Control of a virtual vehicle influences postural activity and motion sickness in pre-adolescent children.

Among adults, persons in control of a vehicle (i.e., drivers) are less likely to experience motion sickness compared to persons in the same vehicle who do not control it (i.e., passengers). This "driver-passenger effect" is well-known in adults, but has not been evaluated in children. Using a yoked-control design with seated pre-adolescent children, we exposed dyads to a driving video game. In each dyad, one child (the driver) drove the virtual vehicle. Their performance was recorded, and later shown to the other child (the passenger). Thus, visual motion stimuli were identical for the members of each dyad. During exposure to the video game, we monitored the quantitative kinematics of head and torso movements. Participants were instructed to discontinue participation immediately if they experienced any symptoms of motion sickness, however mild. Accordingly, the movements that we recorded preceded the onset of motion sickness. Results revealed that Passengers (73.08%) were more likely than Drivers (42.31%) to state that they were motion sick. Drivers tended to move more than passengers, and with a greater degree of multifractality. The magnitude of movement was greater among participants who later reported motion sickness than among those who did not. In addition, for the multifractality of movement a statistically significant interaction revealed that postural precursors of motion sickness differed qualitatively between Drivers and Passengers. Overall, the results reveal that control of a virtual vehicle reduces the risk of motion sickness among pre-adolescent children.

Long-Term Trends and Predictors of Medical Resource Utilization and Medical Outcomes in Inguinal Hernia Repair: A Nationwide Cohort Study.

BACKGROUND: Few studies have comprehensively and systematically analyzed nationwide samples. This study purposed to explore temporal trends and predictors of medical resource utilization and medical outcomes in these patients to obtain data that can be used to improve healthcare policies and to support clinical and administrative decision-making. METHODS: This study used nationwide population data contained in the Longitudinal Health Insurance Database of Taiwan. The 14,970 inguinal hernia repair patients were enrolled in this study (age range, 18-100 years) from 1997 to 2013 in Taiwan. After temporal trends analysis of demographic characteristics, clinical characteristics, and institutional characteristics, predictors of postoperative medical resource utilization and medical outcomes were evaluated through multiple linear regression analysis and Cox regression analysis. RESULTS: The prevalence of inguinal hernia repair per 100,000 population significantly decreased from 195.38 in 1997 to 39.66 in 2013 (p < 0.05). Demographic characteristics, clinical characteristics, and institutional characteristics were significantly associated with postoperative medical resource utilization and medical outcomes (p < 0.05). Of these characteristics, both surgeon volume and hospital volume had the strongest association. CONCLUSIONS: The inguinal hernia repair prevalence rate gradually decreased during the study period. Demographic characteristics, clinical characteristics, and institutional characteristics had strong associations with postoperative medical resource utilization and medical outcomes. Furthermore, hospital volume and surgeon volume had the strongest associations with postoperative medical resource utilization and medical outcomes. Additionally, providing the education needed to make the most advantageous medical decisions would be a great service not only to patients and their families, but also to the general population.

Postural activity and motion sickness during video game play in children and adults.

Research has confirmed that console video games give rise to motion sickness in many adults. During exposure to console video games, there are differences in postural activity (movement of the head and torso) between participants who later experience motion sickness and those who do not, confirming a prediction of the postural instability theory of motion sickness. Previous research has not addressed relations between video games, movement and motion sickness in children. We evaluated the nauseogenic properties of a commercially available console video game in both adults and 10-year-old children. Individuals played the game for up to 50 min and were instructed to discontinue immediately if they experienced any symptoms of motion sickness, however mild. During game play, we monitored movement of the head and torso. Motion sickness was reported by 67% of adults and by 56% of children; these rates did not differ. As a group, children moved more than adults. Across age groups, the positional variability of the head and torso increased over time during game play. In addition, we found differences in movement between participants who later reported motion sickness and those who did not. Some of these differences were general across age groups but we also found significant differences between the movement of adults and children who later reported motion sickness. The results confirm that console video games can induce motion sickness in children and demonstrate that changes in postural activity precede the onset of subjective symptoms of motion sickness in children.