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ABSTRACT. Objectives. The goal of this study was to evaluate awareness of, agreement with, and implementation of the American Academy of Pediatrics (AAP) media use guidelines among pediatricians. Pediatricians' beliefs about several media effects were also measured, as was their own media use. Pediatricians were also asked about how often they make media recommendations as part of anticipatory guidance during well-child visits, as well as the perceived efficacy of and barriers to making such recommendations. Design. A cross-sectional survey mailed to all members of the Minnesota chapter of the AAP. Participants. A total of 365 pediatricians completed the survey. Measures. The 58-item survey assessed familiarity with, agreement with, and implementation of each of 3 AAP recommendations, to limit children's media time, to discourage television (TV) viewing among children Results. Most pediatricians were familiar with and also agreed with the 3 AAP recommendations. Their agreement may stem from the fact that pediatricians almost universally believe that children's media use negatively affects children in many different areas, including children's aggressive behavior, eating habits, physical activity levels, risk for obesity, high-risk behaviors, and school performance. Pediatricians were most likely to have encouraged alternative entertainment and were least likely to have discouraged TV viewing for children Conclusions. Results suggest that the efforts of the AAP in reaching pediatricians have been largely successful, with the majority of pediatricians in Minnesota being aware of and agreeing with the 3 major recommendations suggested by the AAP policy statement on children, adolescents, and television. However, implementation of the recommendations could be improved, especially because pediatricians usually think that the recommendations are at least a little effective when made. Strategies for overcoming barriers to making recommendations need to be addressed, including the sense of futility in affecting media use that some pediatricians may feel. Pediatrics 2004; 114-1235-1241; media effects, television, recommendations, medical training., ABBREVIATIONS. AAP, American Academy of Pediatrics; TV, television. For 20 years, the American Academy of Pediatrics (AAP) has expressed concerns about the amount of time children and adolescents spend watching [...]

In the past, wilderness travel chiefly attracted adventurers or eccentrics. However, a wide range of people currently enjoy wilderness travel in the US and in developing countries. Many parents bring along their children; over 2 million children backpacked or wilderness-camped in 1987. It is important to recognize the innate risks of exposing children to these environments and to prevent or prepare for potential illnesses or injuries. Many parents consult physicians about these risks, but few doctors are trained in this area. The aspects of 'wilderness medicine' that are particularly significant for children are reviewed. Wilderness travel with children should be kept simple. Hiking and other activities should keep to children's paces and appropriate equipment is essential. Wilderness injuries can be controlled by prevention; minimizing the chances that injury will result, should an event occur; and by prompt medical intervention, if necessary. Children are particularly prone to soft tissue injuries, and prevention and treatment of these are discussed. High-altitude related medical problems are described, along with effective ways of preventing and treating them. Families who travel in hot climates must be aware that children are more susceptible to some problems than adults, and appropriate planning, including encouragement of fluid intake and gradual acclimatization, is important. For families who travel during cold weather, appropriate clothing, awareness of signs of frostbite and hypothermia, and knowledge of treatment is necessary. Traveler's diarrhea is a frequent problem, whether travel is in the US wilderness or in developing countries, and children may become debilitated. Bites and stings by snakes, wasps, mosquitoes, ticks, and scorpions, are common; prevention and treatment are discussed. Wilderness travelers with children should carry fully equipped medical kits. When well prepared, wilderness travel can be a unique and positive experience for both children and parents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Context. Numerous studies have documented the potential effects on young audiences of violent content in media products, including movies, television programs, and computer and video games. Similar studies have evaluated the effects associated with sexual content and messages. Cumulatively, these effects represent a significant public health risk for increased aggressive and violent behavior, spread of sexually transmitted diseases, and pediatric pregnancy. In partial response to these risks and to public and legislative pressure, the movie, television, and gaming industries have implemented ratings systems intended to provide information about the content and appropriate audiences for different films, shows, and games. Objective. To test the validity of the current movie-, television-, and video game-rating systems. Design. Panel study. Measure. Participants used the KidScore media evaluation tool, which evaluates films, television shows, and video games on 10 aspects, including the appropriateness of the media product for children based on age. Results. When an entertainment industry rates a product as inappropriate for children, parent raters agree that it is inappropriate for children. However, parent raters disagree with industry usage of many of the ratings designating material suitable for children of different ages. Products rated as appropriate for adolescents are of the greatest concern. The level of disagreement varies from industry to industry and even from rating to rating. Analysis indicates that the amount of violent content and portrayals of violence are the primary markers for disagreement between parent raters and industry ratings. Conclusions. As 1 part of a solution to the complex public health problems posed by violent and sexually explicit media products, ratings can have value if used with caution. Parents and caregivers relying on the ratings systems to guide their children's use of media products should continue to monitor content independently. Industry ratings systems should be revised with input from the medical and scientific communities to improve their reliability and validity. A single ratings system, applied universally across industries, would greatly simplify the efforts of parents and caregivers to use the system as well as the efforts of outside parties to monitor the use and validity of the system. Pediatrics 2001;107: 1302-1308; television, ratings, video games, movies., ABBREVIATIONS. MPAA, Motion Picture Association of America; G, general audience; PG, parental guidance suggested; PG-13, parents stongly cautioned; R, restricted; NC-17, no one under 18 admitted; TV-Y, for all children; [...]

The American Psychiatric Association recently included Internet gaming disorder (IGD) as a potential diagnosis, recommending that further study be conducted to help illuminate it more clearly. This paper is a summary of the review undertaken by the IGD Working Group as part of the 2015 National Academy of Sciences Sackler Colloquium on Digital Media and Developing Minds. By using measures based on or similar to the IGD definition, we found that prevalence rates range between ~1% and 9%, depending on age, country, and other sample characteristics. The etiology of IGD is not well-understood at this time, although it appears that impulsiveness and high amounts of time gaming may be risk factors. Estimates for the length of time the disorder can last vary widely, but it is unclear why. Although the authors of several studies have demonstrated that IGD can be treated, no randomized controlled trials have yet been published, making any definitive statements about treatment impossible. IGD does, therefore, appear to be an area in which additional research is clearly needed. We discuss several of the critical questions that future research should address and provide recommendations for clinicians, policy makers, and educators on the basis of what we know at this time. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The 3 national studies reported here were designed to find out how satisfied parents are with media rating systems, how regularly they use them, and what types of information they ideally would like to have. METHODS: Parents (n = 745, study 1; n = 768, study 2; n = 769, study 3) were surveyed nationally by independent research firms. Studies 1 and 2 were conducted by Harris Interactive, and study 3 was conducted by Research Now. All of them were cross-sectional national surveys. RESULTS: Parents desire ratings for many types of media, but they do not think the existing ratings accurately provide the information they want. They would prefer ratings to provide detailed content information. In general, parents tend to agree on the types and descriptors of content about which they would like to know. They do not, however, agree on the ages for which different content aspects are appropriate. Parents would support the creation of a universal rating system that could be applied to multiple types of media. CONCLUSIONS: Ratings can be effective only if they are useful for parents. This set of studies reveals that improvements in media ratings are needed to make them valuable for parents. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to measure the prevalence and length of the problem of pathological video gaming or Internet use, to identify risk and protective factors, to determine whether pathological gaming is a primary or secondary problem, and to identify outcomes for individuals who become or stop being pathological gamers., Methods: A 2-year, longitudinal, panel study was performed with a general elementary and secondary school population in Singapore, including 3034 children in grades 3 (N = 743), 4 (N = 711), 7 (N = 916), and 8 (N = 664). Several hypothesized risk and protective factors for developing or overcoming pathological gaming were measured, including weekly amount of game play, impulsivity, social competence, depression, social phobia, anxiety, and school performance., Results: The prevalence of pathological gaming was similar to that in other countries (∼9%). Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming., Conclusion: This study adds important information to the discussion about whether video game "addiction" is similar to other addictive behaviors, demonstrating that it can last for years and is not solely a symptom of comorbid disorders.

Context: Youth worldwide play violent video games many hours per week. Previous research suggests that such exposure can increase physical aggression., Objective: We tested whether high exposure to violent video games increases physical aggression over time in both high- (United States) and low- (Japan) violence cultures. We hypothesized that the amount of exposure to violent video games early in a school year would predict changes in physical aggressiveness assessed later in the school year, even after statistically controlling for gender and previous physical aggressiveness., Design: In 3 independent samples, participants' video game habits and physically aggressive behavior tendencies were assessed at 2 points in time, separated by 3 to 6 months., Participants: One sample consisted of 181 Japanese junior high students ranging in age from 12 to 15 years. A second Japanese sample consisted of 1050 students ranging in age from 13 to 18 years. The third sample consisted of 364 United States 3rd-, 4th-, and 5th-graders ranging in age from 9 to 12 years. RESULTS. Habitual violent video game play early in the school year predicted later aggression, even after controlling for gender and previous aggressiveness in each sample. Those who played a lot of violent video games became relatively more physically aggressive. Multisample structure equation modeling revealed that this longitudinal effect was of a similar magnitude in the United States and Japan for similar-aged youth and was smaller (but still significant) in the sample that included older youth., Conclusions: These longitudinal results confirm earlier experimental and cross-sectional studies that had suggested that playing violent video games is a significant risk factor for later physically aggressive behavior and that this violent video game effect on youth generalizes across very different cultures. As a whole, the research strongly suggests reducing the exposure of youth to this risk factor.