Use of multimedia devices in pediatric age: risks or advantages? A survey in an Italian center.

BACKGROUND: Nowadays children live in a digital world, exposed to relevant risks for their health and safety. The aim of this study is to investigate the use of multimedia devices in a sample of children and adolescents. METHODS: The study was performed between November 2018 and June 2019 in a third-level University Hospital, recruiting children and adolescents during general or specialistic follow-up visits. Anonymous, age-specific, questionnaires were distributed to 500 children and adolescents and 370 parents. RESULTS: Among children, 25 (17.1%) had their own mobile device, of which 84% Italian. The 54.1% of them uses multimedia devices half an hour/an hour per day and many of them (37.5% of Italian and 40% of foreign) use it without their parents' control. Most of adolescents had a mobile phone since the age of 10-12 years old. WhatsApp (Meta Inc., Cambridge, MA, USA) is the most used social network, followed by Instagram and Facebook. The use of multimedia devices was widespread between teenagers during classroom hours, meals and before sleeping and they are an important mean for cyberbullying. In addition, in the 29.9% of cases there is no correspondence between information given by parents and respective sons/daughters. CONCLUSIONS: This study shows more risks than advantages derived from the use of multimedia devices in children and adolescents. Therefore, it is essential to educate them about their correct and responsible use.

Developing a multimedia patient-reported outcomes measure for low literacy patients with a human-centered design approach.

INTRODUCTION: Almost all patient-reported outcomes measures (PROMs) are text-based, which impedes accurate completion by low and limited literacy patients. Few PROMs are designed or validated to be self-administered, either in clinical or research settings, by patients of all literacy levels. We aimed to adapt the Patient Reported Outcomes Measurement Information System Upper Extremity Short Form (PROMIS-UE) to a multimedia version (mPROMIS-UE) that can be self-administered by hand and upper extremity patients of all literacy levels. METHODS: Our study in which we applied the Multimedia Adaptation Protocol included seven phases completed in a serial, iterative fashion: planning with our community advisory board; direct observation; discovery interviews with patients, caregivers, and clinic staff; ideation; prototyping; member-checking interviews; and feedback. Direct observations were documented in memos that underwent rapid thematic analysis. Interviews were audio-recorded and documented using analytic memos; a rapid, framework-guided thematic analysis with both inductive and deductive themes was performed. Themes were distilled into design challenges to guide ideation and prototyping that involved our multidisciplinary research team. To assess completeness, credibility, and acceptability we completed additional interviews with member-checking of initial findings and consulted our community advisory board. RESULTS: We conducted 12 hours of observations. We interviewed 17 adult English-speaking participants (12 patients, 3 caregivers, 2 staff) of mixed literacy. Our interviews revealed two distinct user personas and three distinct literacy personas; we developed the mPROMIS-UE with these personas in mind. Themes from interviews were distilled into four broad design challenges surrounding literacy, customizability, convenience, and shame. We identified features (audio, animations, icons, avatars, progress indicator, illustrated response scale) that addressed the design challenges. The last 6 interviews included member-checking; participants felt that the themes, design challenges, and corresponding features resonated with them. These features were synthesized into an mPROMIS-UE prototype that underwent rounds of iterative refinement, the last of which was guided by recommendations from our community advisory board. DISCUSSION: We successfully adapted the PROMIS-UE to an mPROMIS-UE that addresses the challenges identified by a mixed literacy hand and upper extremity patient cohort. This demonstrates the feasibility of adapting PROMs to multimedia versions. Future research will include back adaptation, usability testing via qualitative evaluation, and psychometric validation of the mPROMIS-UE. A validated mPROMIS-UE will expand clinicians' and investigators' ability to capture patient-reported outcomes in mixed literacy populations.

Designing multimedia patient education materials for adolescent idiopathic scoliosis: A protocol for a feasibility randomized controlled trial of patient education videos.

Triple-masked three-armed feasibility parallel randomized controlled trial. Multimedia patient education materials are increasingly used in healthcare. While much research focuses on optimising their scientific content, research is equally needed to optimise design and implementation. This study aims to determine the feasibility of a study examining how the implementation of scientific advice on design affects patient outcomes. Participants aged 10-18 with radiographically confirmed adolescent idiopathic scoliosis will be recruited from community settings in Ireland and randomized into usual care or receiving multimedia educational videos with or without evidence-informed design principles. Participants will be masked in the two video intervention arms, as will the therapist sending the educational videos. Outcomes will include the number of participants recruited and randomized, the number analysed post-intervention and at week eight, and the outcomes for baseline, post-intervention, and week 8. Adverse events will also be reported. This feasibility randomized controlled trial will offer insight into the feasibility of implementing advice from the literature in designing a trial of multimedia patient education materials for a population with adolescent idiopathic scoliosis. Trial registration: Clinical Trail: Trial is registered on ClinicalTrials.gov as NCT06090344.

Effectiveness of preoperative multimedia educational sessions on the levels of anxiety and satisfaction among women undergoing cesarean: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to explore the effectiveness of preoperative multimedia educational sessions on the levels of anxiety and satisfaction among women undergoing cesarean section (CS). The Scopus, PubMed, and Cochrane databases were searched without language limitations for eligible randomized controlled trials (RCTs) published from their inception up to October 15, 2023. A random-effect meta-analysis was conducted, and the quality of this meta-analysis was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Seven RCTs (n = 1006 women) met the inclusion criteria. Preoperative multimedia sessions were found to significantly reduce anxiety levels (n = 6 RCTs, weighted mean difference: -3.10; 95 percent confidence intervals (CI): -4.48, -1.73; I2 = 44.24 percent, moderate certainty of evidence) compared to the control group. However, there was no significant difference between the two groups regarding women's satisfaction after surgery (n = 5 RCTs, risk ratio: 1.37; 95 percent CI: 0.76, 2.50; I2 = 98.26 percent, moderate certainty of evidence). Leave-one-out sensitivity analysis showed robustness of the outcomes. The findings of this meta-analysis suggest that providing multimedia educational programs before surgery could potentially have a beneficial effect on the levels of anxiety experienced by women undergoing CS. However, it is imperative to validate these results through larger samples and multi-centered RCTs.

Effects and prediction of cognitive load on encoding model of brain response to auditory and linguistic stimuli in educational multimedia.

Multimedia is extensively used for educational purposes. However, certain types of multimedia lack proper design, which could impose a cognitive load on the user. Therefore, it is essential to predict cognitive load and understand how it impairs brain functioning. Participants watched a version of educational multimedia that applied Mayer's principles, followed by a version that did not. Meanwhile, their electroencephalography (EEG) was recorded. Subsequently, they participated in a post-test and completed a self-reported cognitive load questionnaire. The audio envelope and word frequency were extracted from the multimedia, and the temporal response functions (TRFs) were obtained using a linear encoding model. We observed that the behavioral data are different between the two groups and the TRFs of the two multimedia versions were different. We saw changes in the amplitude and latencies of both early and late components. In addition, correlations were found between behavioral data and the amplitude and latencies of TRF components. Cognitive load decreased participants' attention to the multimedia, and semantic processing of words also occurred with a delay and smaller amplitude. Hence, encoding models provide insights into the temporal and spatial mapping of the cognitive load activity, which could help us detect and reduce cognitive load in potential environments such as educational multimedia or simulators for different purposes.

Evaluating the impact of using storytelling and visual multimedia music intervention to improve knowledge of the Child Rights Act and reduce the propensity to engage in child marriage.

Child marriage has continued to rear its ugly head in Nigerian society. This study aimed to evaluate the impact of storytelling and multimedia music interventions in improving knowledge of the Child Rights Act and reducing the propensity to engage in child marriage. The researchers applied a quasi-experimental design and collected data using a structured questionnaire. The children were assigned into three groups (control, storytelling and multimedia music) of 173 participants. It was found that the interventions were effective. In particular, while storytelling contributed more to reducing the propensity to engage in child marriage, multimedia music contributed more to improving knowledge of the Child Rights Act. These results suggest that storytelling and multimedia music interventions can be effective approaches for addressing the lingering problem of child marriage in Nigeria.

Multimedia distribution, dynamics, and seasonal variation of PAHs in Songhua wetland: Implications for ice-influenced conditions.

The knowledge of polycyclic aromatic hydrocarbons (PAHs) in wetlands remains limited. There is a research need for the dynamics between interfaces of multimedia when ice is present in this fragile ecosystem. In this study, sediment, open-water, sub-ice water, and ice samples were collected from the Songhua wetland to study the behaviors of PAHs with and without influences from ice. The concentration of all individual PAHs in sub-ice water (370-1100 ng/L) were higher than the open-water collected from non-ice-covered seasons (50-250 ng/L). Enrichment of PAHs in the ice of wetland was found, particularly for high-molecular-weight PAHs (HMW). This could be attributed to the relatively lower polarity of hydrocarbons compounds, making them more likely to remain in the ice layer during freezing. Source assessments reveal common sources for sub-ice water and ice, which differ from those in the open water in non-ice-covered seasons. This difference is primarily attributed to heating activities in the Harbin during winter. The average percentage contributions were 79% for sub-ice water and 36% for ice related to vehicle exhausts and coal combustion. Additionally, wood burning contributed 25% to sub-ice water and 62% to ice. Sediment in the wetland was found to serve as a final deposit particularly for heavier PAHs, especially those with 6 rings. Sediment also has the potential to act as a source for the secondary emission of low-molecular-weight PAHs (LMW) congeners into the water. PAHs in wetland displayed low ecological risk, while HMW PAHs with relative higher ecological risk is recommended to be further monitored.

Onscreen presence of instructors in video lectures affects learners' neural synchrony and visual attention during multimedia learning.

COVID-19 forced students to rely on online learning using multimedia tools, and multimedia learning continues to impact education beyond the pandemic. In this study, we combined behavioral, eye-tracking, and neuroimaging paradigms to identify multimedia learning processes and outcomes. College students viewed four video lectures including slides with either an onscreen human instructor, an animated instructor, or no onscreen instructor. Brain activity was recorded via fMRI, visual attention was recorded via eye-tracking, and learning outcome was assessed via post-tests. Onscreen presence of instructor, compared with no instructor presence, resulted in superior post-test performance, less visual attention on the slide, more synchronized eye movements during learning, and higher neural synchronization in cortical networks associated with socio-emotional processing and working memory. Individual variation in cognitive and socio-emotional abilities and intersubject neural synchronization revealed different levels of cognitive and socio-emotional processing in different learning conditions. The instructor-present condition evoked increased synchronization, likely reflecting extra processing demands in attentional control, working memory engagement, and socio-emotional processing. Although human instructors and animated instructors led to comparable learning outcomes, the effects were due to the dynamic interplay of information processing vs. attentional distraction. These findings reflect a benefit-cost trade-off where multimedia learning outcome is enhanced only when the cognitive benefits motivated by the social presence of onscreen instructor outweigh the cognitive costs brought about by concurrent attentional distraction unrelated to learning.

Examination of medical students' opinions on multimedia learning materials according to social cues: focusing on sound principles.

PURPOSE: Although interest in various forms of learning media is increasing due to the coronavirus disease 2019 (COVID-19) pandemic there is relatively little research on influencing student motivation by intervening in cognitive processing. The purpose of this study was to present the optimal form of learning materials provided to medical students. METHODS: This study provided learning materials in class at a level according to social cues (script, video [artificial intelligence (AI) voice], video [professor voice]) based on the principle of voices among the principles of personalization, voices, image, and embodiment of social cues in multimedia learning, and surveyed students' opinions. RESULTS: There was no statistically significant difference according to social clues in satisfaction and learning help, but both appeared in the order of silent videos containing the professor's voice, followed by videos containing the AI voice. CONCLUSION: This study is significant in that there is no research on the impact of student motivation on the provision of learning materials for medical school education in Korea, and we hope that it will help provide learning materials for self-directed learning of medical students in the post-COVID-19.

The Effects of Animations and Multimedia Messages on Public Engagement in Precision Medicine: Assessment of Moderation and Mediation.

Public participation in precision medicine (PM) research is essential to achieving effective health care but has been impeded by a lack of awareness and basic knowledge. There is a critical need for educational materials that can clearly explain PM to foster involvement. This randomized controlled trial with a posttest-only control group design aims to assess the effects of educational messages delivered through animations relative to live-action videos and leaflets on intentions of involvement in PM research. Knowledge as the moderator and four mediators (engagement, vividness, trustworthiness, and cognitive value) of the intended effects were also evaluated. A total of 326 U.S. adults were sampled from Amazon Mechanical Turk. Among participants with less knowledge about PM, animations produced stronger information-seeking intentions and willingness to participate than leaflets. The effects of three message modalities were not significantly different among average and highly knowledgeable participants. Engagement and vividness mediated the effects of animations relative to two other message modalities. Trustworthiness and cognitive value mediated the effects of animations relative to live-action videos. Overall, animations can be an effective communication strategy to motivate involvement in PM but its effectiveness could decline as knowledge increases. The explanations and implications of the findings were discussed.

Application of multimedia technology to innovative vocational education on learning satisfaction in China.

Multimedia technology holds paramount importance in driving innovation within vocational education, significantly influencing learning satisfaction. Its integration facilitates dynamic and interactive learning environments, catering to diverse learning styles and preferences. Moreover, multimedia technology enables educators to simulate real-world scenarios, providing practical and hands-on training opportunities. This aspect is particularly valuable in vocational education, where practical skills and application are required. The paper investigates the impact of multimedia technology in enhancing learning satisfaction within innovative vocational education. It delves into the utilization of multimedia tools and their correlation with learner satisfaction, exploring how these technologies augment engagement and comprehension in vocational training. The primary data from 515 students of vocational colleges of China has been collected and regression analysis is applied for empirical analysis. The findings of the study highlight that multimedia technology has positive relationship with innovative vocational education and learning outcome. The findings contribute valuable insights for policymakers regarding significant role multimedia plays in fostering enhanced learning experiences and overall satisfaction among vocational learners.

Multimedia design for learner interest and achievement: a visual guide to pharmacology.

BACKGROUND: Medical education increasingly relies on digital learning materials. Despite recognition by the Association of American Medical Colleges Institute for Improving Medical Education, medical education design often fails to consider quality multimedia design principles. Further, the AAMC-IIME issued a call to study the role of design principles in medical education. Thus, the current study investigated the cognitive and affective effects of redesigning PowerPoint slides used to support pharmacology content during the preclinical years of medical school training. METHODS: Researchers implemented a quasi-experimental design, using traditionally-designed (original) slides with a Traditional group (n = 100) and slides redesigned to follow principles from the Cognitive Theory of Multimedia Learning with an Experimental group (n = 40). Participants in the Experimental group completed a post-survey incorporating the Situational Interest Survey for Multimedia to indicate motivational engagement with the media. Students in the Experimental group also responded to additional preference questions. Researchers analyzed survey responses and students' scores in pharmacology-related coursework across the preclinical Foundations Phase of training to determine the impact on achievement and motivation. RESULTS: Findings related to learner achievement showed a modest but significant increase in the Experimental group compared to the Traditional group in the Cardiac, Pulmonary, and Renal (CPR) educational block (105%, normalized to Traditional group, p = 0.013) and cumulative pharmacology grades (101%, normalized to Traditional group, p = 0.043). Additionally, participants in the Experimental group indicated a significantly higher average triggered situational interest in redesigned slides (M = 4.85, SD = 0.25) than the original slides (M = 3.23, SD = 1.40, t=-6.33, p < 0.001). Similarly, the interest rating of the redesigned slides (M = 4.87, SD = 0.24) was significantly greater than that of the original slides (M = 3.89, SD = 0.86, t=-6.824, p < 0.001). Moreover, results further indicated significant differences in the maintained-feeling and maintained-value constructs, and all participants in the Experimental group indicated a preference for the redesigned slides. CONCLUSIONS: The findings provide strong evidence in support of using the Cognitive Theory of Multimedia Learning design principles to intentionally design media in medical education. In addition to increased achievement scores, students in the Experimental group demonstrated significantly higher levels of situational interest in the redesigned slides, especially triggered interest and maintained-feeling interest. Medical education learning designers should seriously consider redesigning media to achieve similar results.

The effects of segmentation on cognitive load, vocabulary learning and retention, and reading comprehension in a multimedia learning environment.

BACKGROUND: Segmentation is a common pedagogical approach in multimedia learning, but its effects on cognitive processes and learning outcomes have yet to be comprehensively explored. Understanding the role of segmentation is crucial, as it has the potential to influence the way instructional materials are designed and delivered in digital learning environments. OBJECTIVES: This research aims to fill this gap by examining the impact of segmentation on cognitive load, vocabulary acquisition, retention, and reading comprehension in a multimedia learning context. METHODOLOGY: Participants were selected from two language schools in Zhengzhou through a multi-stage random sampling method. Ninety teenage students were randomly assigned to six experimental groups. The study utilized a 2 × 3 factorial design to examine segmentation and textual augmentation effects. Four assessment instruments were employed: a Reading Comprehension Test, a Vocabulary Assessment Test, a Cognitive Load Assessment Scale, and a Prior Knowledge Test. The experiment comprised four stages: pre-test, Instruction, post-test, and follow-up. Data analysis was performed using SPSS 22 software, involving descriptive statistics, one-way, and multi-way analysis of variance. RESULTS: Results indicated that high segmentation significantly impacts cognitive load, vocabulary learning, retention, and reading comprehension across various aspects of multimedia learning. In essence, segmentation reduces cognitive load, supports learning efficiency, and facilitates more profound understanding, vocabulary learning, and retention. CONCLUSIONS AND IMPLICATIONS: High segmentation in multimedia learning significantly impacts cognitive load, vocabulary learning, comprehension, and retention. Educators should prioritize segmentation for more effective and engaging e-learning experiences.

Cross-modality integration framework with prediction, perception and discrimination for video anomaly detection.

Video anomaly detection is an important task for public security in the multimedia field. It aims to distinguish events that deviate from normal patterns. As important semantic representation, the textual information can effectively perceive different contents for anomaly detection. However, most existing methods primarily rely on visual modality, with limited incorporation of textual modality in anomaly detection. In this paper, a cross-modality integration framework (CIForAD) is proposed for anomaly detection, which combines both textual and visual modalities for prediction, perception and discrimination. Firstly, a feature fusion prediction (FUP) module is designed to predict the target regions by fusing the visual features and textual features for prompting, which can amplify the discriminative distance. Then an image-text semantic perception (ISP) module is developed to judge semantic consistency by associating the fine-grained visual features with textual features, where a strategy of local training and global inference is introduced to perceive local details and global semantic correlation. Finally, a self-supervised time attention discrimination (TAD) module is built to explore the inter-frame relation and further distinguish abnormal sequences from normal sequences. Extensive experiments on the three challenging benchmarks indicate that our CIForAD obtains state-of-the-art anomaly detection performance.

Multimedia Mercury Recovery from Coal-Fired Power Plants Utilizing N-Containing Conjugated Polymer Functionalized Fly Ash.

To recover multimedia mercury from coal-fired power plants, a novel N-containing conjugated polymer (polyaniline and polypyrrole) functionalized fly ash was prepared, which could continuously adsorb 99.2% of gaseous Hg0 at a high space velocity of 368,500 h-1 and nearly 100% of aqueous Hg2+ in the solution pH range of 2-12. The adsorption capacities of Hg0 and Hg2+ reach 1.62 and 101.36 mg/g, respectively. Such a kind of adsorbent has good environmental applicability, i.e. good resistance to coexisting O2/NO/SO2 and coexisting Na+/K+/Ca2+/Mg2+/SO42-. This adsorbent has very low specific resistances (6 × 106-5 × 109 Ω·cm) and thus can be easily collected by an electrostatic precipitator under low-voltage (0.1-0.8 kV). The Hg-saturated adsorbent can desorb almost 100% Hg under relatively low temperature (<250 °C). Characterization and theoretical calculations reveal that conjugated-N is the critical site for adsorbing both Hg0 and Hg2+ as well as activating chlorine. Gaseous Hg0 is oxidized and adsorbed in the form of HgXClX(ad), while aqueous Hg2+ is adsorbed to form a complex with conjugated-N, and parts of Hg2+ are reduced to Hg+ by conjugated-N. This adsorbent can be easily large-scale manufactured; thus, this novel solid waste functionalization method is promising to be applied in coal-fired power plants and other Hg-involving industrial scenes.

Multimedia distribution, partitioning, sources, comprehensive toxicity risk and co-occurrence network characteristics of trace elements in a typical Chinese shallow lake with high antibiotic risk.

Although the combined pollution of trace elements and antibiotics has received extensive attention, the fate and toxicity risk of trace elements with high antibiotic risk are still unclear. The multimedia distributions, partitioning, sources, toxicity risks and co-occurrence network characteristics of trace elements in surface water (SW), overlying water (OW), pore water (PW) and sediment (Sedi) samples of 61 sites from Baiyangdian (BYD) Lake were investigated. The trace elements in the SW and OW are derived mainly from traffic and agricultural sources, and those in PW and Sedi samples are primarily from lithogenic and industrial sources. The total toxicity risk index (TRI) of nine trace elements (ΣTRI) in Sedi samples showed a very high toxicity risk (18.35 ± 8.84), and a high combined pollution toxicity risk (ΣΣTRI) was observed in PW (149.17 ± 97.52) and Sedi samples (46.37 ± 24.00). The co-occurrence network from SW to PW became more vulnerable. Generally, total antibiotics and TP may be keystones of trace elements in water and sediment. The high antibiotic risk significantly influenced ΣΣTRI in water samples but not in Sedi samples. The findings provide new implications for the monitoring and control of combined antibiotic-trace element pollution in shallow lakes.

Integrating digital literacies and scientific communication in a multimedia anatomy group assignment to advance contextual learning.

Anatomists are facing a new generation of learners who will study and work in a technology-rich environment. Indeed, digital technologies are tremendously changing how information and knowledge are communicated and retrieved. However, it remains unclear whether an anatomy assessment can be designed to promote contextual learning through integrating a digital communication strategy. To investigate this, assessment methods were diversified in the first-year neuroanatomy and third-year regional anatomy curricula through implementing a multimedia human anatomy group assignment integrating digital literacies and scientific communication. Through completing this multimedia assignment, students demonstrated their anatomy knowledge transfer using a range of approaches. The main mode of presentations chosen in the two anatomy units were non-animated video presentations (~50%), animated video presentations (~30%), storyboards (~10%), podcasts (~3%), and filmed videos (~3%). A 5-point Likert scale learning and teaching survey was conducted for a total of 195 undergraduate health science students to evaluate students' perception of this group assignment. The majority of students (70-80%) strongly agreed or agreed that the multimedia group assignment helped their teamwork skills. Students who produced animated videos significantly outperformed those who adopted the non-animated presentations during the end-of-semester theory examination (p < 0.05). This study demonstrates that an anatomy group assignment integrating digital literacy and scientific communication is an effective assessment strategy associated with a positive learning experience and outcome. This inquiry-based assignment promotes learning through assessment, allowing students to not only consolidate and extend anatomy knowledge but also developing effective digital communication skills, providing new insights into non-didactic anatomy assessments.

New insight into the bioaccumulation and trophic transfer of free and conjugated antibiotics in an estuarine food web based on multimedia fate and model simulation.

The substantial utilization of antibiotics causes their "pseudo-persistence" in offshore environments. Published studies on antibiotic surveillance in food webs have primarily emphasized on parent forms; however, the compositions and concentrations of conjugated antibiotics in aquatic organisms remain largely unexplored. This study systematically examined the distribution characteristics and trophodynamics of free antibiotics and their conjugated forms in an estuarine food web. Total antibiotic levels differed insignificantly between the surface and bottom waters. The total mean values of free antibiotics in crabs, fish, shrimps, sea cucumbers, and snails varied from 0.77 to 1.4 ng/g (wet weight). The numbers and values of antibiotics rose in these biological samples after enzymatic hydrolysis. Conjugated antibiotics accounted for 23.8-76.9% of the total antibiotics in the biological samples, revealing that conjugated forms play a non-negligible role in aquatic organisms. More number of antibiotics exhibited bioaccumulation capabilities after enzymatic hydrolysis. In the food web, the free forms of anhydroerythromycin and conjugated forms of trimethoprim and ciprofloxacin underwent trophic dilution, whereas the free forms of trimethoprim and conjugated forms of ofloxacin underwent trophic amplification. The present work provides new insights into the bioaccumulation and trophic transfer of free and conjugated antibiotics in food webs.