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OBJECTIVE The aim of the study was to evaluate the effectiveness of an audio and animated cartoon questionnaire (AACQ) at improving consent process in child for biospecimen donation. METHODS A multi-center randomized and controlled survey was performed at two pediatric hospitals in China from 2019 to 2020. Children aged from 7 to 18 years in the pediatric surgery wards were invited to investigate the participants' willingness and attitudes for donating biospecimens. A total of 264 children, including 119 in the AACQ group and 145 in the TQ group, and 67 parents of children were analyzed. A separate knowledge test was acquired in the questionnaires. RESULTS Our findings showed that the response rate of the AACQ group (89.85%) was significantly higher than that of the TQ group (68.44%; p

Comics are complex documents whose reception engages cognitive processes such as scene perception, language processing, and narrative understanding. Possibly because of their complexity, they have rarely been studied in cognitive science. Modeling the stimulus ideally requires a formal description, which can be provided by feature descriptors from computer vision and computational linguistics. With a focus on document analysis, here we review work on the computational modeling of comics. We argue that the development of modern feature descriptors based on deep learning techniques has made sufficient progress to allow the investigation of complex material such as comics for reception studies, including experimentation and computational modeling of cognitive processes.

Comics have always responded to pandemics/catastrophes, documenting the way we deal with such crises. Recently, graphic medicine, an interdisciplinary field of comics and medicine, has been curating comics, editorial cartoons, autobiographical cartoons, and social media posts under the heading "COVID-19 Comics" on their websites. These collected comics express what we propose to call covidity, a neologism that captures both individual and collective philosophical, material, and wide-ranging emotional responses to the COVID-19 pandemic. Treating such comics as the source material and drawing insights from theorists Ian Williams, Alan Bleakley, Susan Sontag, and others, this article examines graphic medicine's representation of the COVID-19 pandemic. The conceptual metaphors of war, anthropomorphism, and superheroism are used to represent and illustrate the lived experience of the pandemic, and the article investigates metaphor types, their utility, and motivational triggers for such representations. In doing so, the essay situates graphic medicine as a productive site that presents the pandemic's multifarious impact.

Laboratory testing for SARS-CoV-2 has been delayed in some laboratories due to high demand for testing and supply shortages. This has led to proposals and plans that reimbursement for delayed results be reduced or not paid at all (1, 2). Read the comic strip to find out more.

The Exhibition Program, part of the History of Medicine Division of the National Library of Medicine, spotlights the collection of the library by creating exhibitions and educational resources that explore the social and cultural history of medicine. Our goal is to stimulate people’s enthusiasm for history and encourage visitors of all ages to learn more about themselves and their communities. We do what we do because we believe that health and well-being are fundamental human rights and are essential to our American way of life. And we believe exhibitions are a logical expression of that commitment.Oftentimes, exhibitions focus on underrepresented subjects or lesser-known types of literature, which helps to inform the library’s collection development activity. Collection development staff take a keen interest in viewing exhibitions, attending related lectures, and performing bibliographic research on topics that are unlikely to be captured in conventional scientific and professional literature. This heightened awareness leads staff to discover niche publishers, significant authors, and unique titles, thereby enriching the collection for future generations.Following the decision to embark on an exhibition about graphic medicine, collections staff more closely investigated this class of literature. This column explores how wider social and cultural influences can change the medical literature and inform and enrich the collections policies of an institution.

This was to evaluate the effect of visual distraction on anxiety of children during dental treatment. This randomized, crossover clinical trial study was conducted on 28 children (aged 4–5 years) randomly divided into two groups of 14 each. Group 1, treatment procedure in the first visit was completed while the patients were watching a cartoon as a visual distraction tool, at the second visit, the procedure was carried out with conventional tell-show-do. Group 2, had visual distraction in their second visit and conventional tell-show-do during the first visit. Treatment procedures were similar in both groups during two sessions. The anxiety level was determined using Venham picture test and pulse rate (PR) at the beginning and the end of each appointment. Patient behaviour was also scored using Frankl behaviour rating scale (FBRS). Self-reported dental anxiety was reduced significantly by visual distraction (p-value

BACKGROUND AND OBJECTIVES Primary skin cancer prevention campaigns are essential and more effective among children, not only because of the importance of sun exposure effects during this period, but also because this age is when individuals are developing behaviours. The Brazilian Society of Dermatology - Regional State of Sao Paulo developed and conducted the programme named 'The Sun, Friend of Childhood', a school health education and disease prevention project for children and parents. Our objective was to evaluate the cognitive and behavioural effects of the children and parents before and after an education model-based intervention of sun protection. METHODS We carried out a study on a school population of Social Service of Industry - Regional State of Sao Paulo, from the first to the fifth years of the regular course (6-10 years). Our educational project was planned to be based on two children's learning tools (comic magazine and a DVD cartoon). Questionnaires in relation to habits and knowledge in sun exposure were applied to the children (3776) before and (2748) after the intervention. A questionnaire was applied to 3663 parents regarding personal details and habits of their children. RESULTS According to the McNemar's statistical test, all changes in the children in acquiring new knowledge about good practices for sun exposure were statistically significant. CONCLUSIONS Educative sun exposure programmes in childhood are a relevant tool to modify the history of life for next generations, to concern the skin cancer and good health practices.

This study compared the following effects of two vaccine information flyers-one developed by the Centers for Disease Control and Prevention (CDC) versus one adapted from this information to a comic medium (comic)-on adults: (a) attitude toward the flyer; (b) perceived informativeness of the flyer; (c) intention to seek more information about adult immunizations after viewing the flyer; and (d) intention to get immunized after viewing the flyer. A between-group, randomized trial was used to randomly assign adults (age 18 years or older) at an ambulatory care center to review the CDC or comic flyer. Participants were asked to complete a survey to measure several outcome variables. Items were measured using a 7-point semantic differential scale. Independent-samples t-test was used for comparisons. A total of 265 surveys (CDC n = 132 vs comic n = 133) were analyzed. The comic flyer had a statistically significant effect on participants' attitudes and their perception of the flyer's informativeness compared to the CDC flyer. Flyer type did not have a statistically significant effect on intention-related variables. The study findings showed that the comic flyer was positively evaluated compared to the CDC flyer. These findings could provide a new direction for developing adult educational materials.

There are unaesthetic aspects in teaching people about the early detection of colorectal cancer using the fecal immunochemical test. Comics were seen as a way to overcome those unaesthetic aspects. This study used the Asian grocery store-based cancer education venue to pilot-test the clarity, cultural acceptability, and alignment of five colorectal cancer education comics intended for publication in Asian American and Pacific Islander (API) community newspapers. After developing the colorectal cancer education comics, API students asked shoppers to review a comic from their collection and provide feedback on how to make the comic clearer and more culturally pertinent to API readers. To evaluate viewers' responses, the students gathered such unobtrusive data as: (1) how many of the predetermined salient information points were discussed as the student educators interacted with shoppers and (2) how many comics the shoppers were willing to review. Shoppers were also asked to evaluate how effective the comics would be at motivating colorectal cancer screening among APIs. The students were able to cover all of the salient information points with the first comic. As evidence of the comics' capacity to engage shoppers' interest, shoppers willingly evaluated all five comics. Using multiple comics enabled the educators to repeatedly address the four salient colorectal cancer information points. Thus, the comics helped student educators to overcome the unesthetic elements of colorectal cancer discussions, while enabling them to engage shoppers in animated discussions, for far more time than with their conventional didactic educational methods.

School-based intervention would be promising to spread stroke knowledge widely. This study aimed to clarify the effectiveness of our new educational aids that were developed for elementary school children to impart information about stroke to children and their parents in 2 different ways: with or without stroke lessons by a neurologist.We enrolled 562 children (aged 11 to 12 years) and their parents (n = 485). The students were divided into 2 groups: 323 received a lesson on stroke by a stroke neurologist without watching an animated cartoon (Group I), and 239 watched an animated cartoon without the lesson (Group II). All of the children took the manga home, and talked about stroke with their parents. Questionnaires on stroke knowledge were administered at baseline (BL), immediately after the lesson (IL), and 3 months (3M) after the lesson.There were significant increases in the adjusted mean scores for risk factors as well as stroke symptoms at 3M in both groups compared with BL scores, although the children in Group I scored significantly better than those in Group II at IL and 3M (P .05). In both children and parents, the correct answer rates of the FAST mnemonic at 3M were around 90%, with no significant differences between groups.Stroke education for elementary school children using our educational aids provided knowledge of stroke symptoms to the children as well as their parents even without lessons on stroke, although a better understanding of stroke was obtained from lessons led by stroke neurologists.

Objective: To evaluate the impact of positive images versus neutral images on child behavior during dental treatment and their dental anxiety after dental treatment. Study design: Sixty, 4 to 6 year old healthy pediatric dental patients, indicated for pulpotomy and stainless steel crown restorations, were divided randomly into two equal groups. Group I (experimental group viewed positive dental images and group II (control group) viewed neutral cartoon images prior to treatment. Behavior was assessed using Frankl rating scale in all four treatment phases: seating, local anesthesia administration, pulpotomy and overall rating. Patient's anxiety was determined according to Venham Picture Test (VPT) before and after dental procedure. Results: Behavior rating using the Frankl scale showed a statistically significant difference in the two groups in the overall rating (P= 0.003, 0.001 respectively). No statistically significant difference was found between both groups in any of the treatment phases (P= 0.288, 0.060, 0.719 respectively) and between the mean VPT scores before and after procedures (P=0.95, 0.93 respectively. Conclusion: Viewing neutral or positive dental images did not have an effect on child's anticipatory anxiety level. However, it is an effective method of improving the behavior in children.

Background Cartoon characters on processed food packaging increase the perception of product preference among children, but their effect among adults has rarely been examined. We evaluated the effect of a cartoon character on breakfast cereals on beliefs about buying them for children, as well as whether demographic characteristics modified this effect. Methods An experimental study was conducted with adults from online consumer panels in Mexico (n = 3755). Participants were randomly assigned to a “cartoon” condition (n = 1789), in which they viewed a breakfast cereal box with a Minion character on the front of the package, or the “control” condition (n = 1966), in which the same cereal box was displayed with no character on the package. Participants were asked: “Is this a good cereal to buy children?” with the response options “Yes”, “No”, or “Don’t know”. Multinomial adjusted logistic models regressed responses to this question (Yes = 0, No = 1, 2 = Don’t know) on experimental condition. Differences in the effect of the cartoon character across demographic characteristics were tested by introducing multiplicative interaction terms. Results The adjusted model showed that participants in the “cartoon character” condition were 1.67 (1.45–1.94) times more likely to consider the cereal as being “Not good to buy for children” than those in the control condition (p Conclusion Among this sample of Mexican adults, a cereal with a cartoon character on the packaging was more often perceived as “not good to buy for children” compared to a cereal without it. This effect was smaller among parents, potentially due to children influences of parental decisions during food purchasing.

BACKGROUND: During cancer treatment, children undergo potentially stressful hospitalizations and procedures. Animatronic devices are a promising means of distraction intervention. This study aimed to assess acceptability and feasibility of the My Special Aflac Duck® (MSAD) intervention among pediatric oncology patients and parents. We hypothesized that MSAD would be feasible to implement, have greater than 50% acceptance, and be useful distraction. PROCEDURES: This feasibility study enrolled oncology patients aged 3–11 years admitted to Children’s Healthcare of Atlanta between May and August 2018. Patients were exposed to MSAD for 3 days and completed quantitative and qualitative assessments of acceptability. Patient and hospital data were abstracted. RESULTS: Seventeen (80.9%) of 21 eligible patients enrolled; 64.7% were

CMAJ will soon begin publishing graphic medicine articles in its Humanities section. Graphic medicine is a form of visual storytelling that explores narratives of the body, health care, healing and disability. This burgeoning area of medical humanities is part of growing popular interest in graphic

For microbiologists, the importance of microorganisms in our daily lives and their impact on our well-being is evident. However, microbiology literacy in our society is far from being enough for individuals to make informed choices and to demand actions based on that information. The vaccine hesitation movement and the alarming increase in antimicrobial resistance due to overuse and misuse of antibiotics are just two examples of how much work is needed to make our society literate in topics related to microbiology. Considering the challenges of communicating a discipline surrounded by misconceptions, which studies the role of living organisms that cannot be seen in plain sight, we need to explore different strategies to effectively contribute to microbiology literacy in our society. Here, we will comment on the use of comics for such a task.

PURPOSE This study aimed to develop and examine the effects of a prenatal program on environmental health behavior using cartoon comics among Korean pregnant women. METHODS This study used a non-equivalent control group pre-test/post-test design. The program used cartoon comics to explore environmental health behaviors during pregnancy. The program consisted of the following four components: environmental toxicants during pregnancy, avoiding particulate matter during pregnancy, environmental toxicants during baby care, and making a healthy environment for children. In total, 35 pregnant women participated in the study: 18 in the experimental group and 17 in the control group. Data collection and program adaptation were conducted between November 3, 2020 and January 19, 2021. The effect of the prenatal education program was evaluated by t-test and repeated measures ANOVA. RESULTS Learning experience (t = - 2.35, p = .025), feasibility (t = - 2.46, p = .019), satisfaction (t = - 2.23, p = .032) were higher in the experimental group than in the control group in the first post-test. Feasibility (t = - 2.40, p = .022) was higher in the experimental group than in the control group in the second post-test. Repeated-measures ANOVA showed significant interactions between time and group in environmental susceptibility (F = 9.31, p < .001), self-efficacy (F = 3.60, p = .033), and community behavior (F = 5.41, p = .007). CONCLUSION This study demonstrates the need for a prenatal education program to promote environmental health perceptions and behavior during pregnancy. We suggest a prenatal class adopting the creative cartoon comics to promote the maternal environmental health behaviors.

The objective of this study was to determine the feasibility of a comic education module in the Emergency Department setting. A convenience sample of 50 injured children and their caregivers were enrolled. The comic was found to be likeable, easy to read, and provided important information to both children and their caregivers. Total time to read the comic was three minutes (SD 1.4, range 1.4-7.1). Most children (60%) read the comic independently, including all children over age 14 years. At 72-hour phone follow-up, 86% of caregivers had accurate recall of all three comic teaching points. This innovative comic educational module is feasible for use for children ages 4-18 years in the Emergency Department. Though this comic was intended to educate children, caregivers recalled all three teaching points 72 hours after discharge.

As the interest in graphic medicine grows, health communicators have started engaging readers with compelling visual and textual accounts of health and illness, including via comic books. One context where comics have shown promise is cancer communication. This brief report presents an early example of graphic medicine developed by the American Cancer Society. "Ladies … Wouldn't It Be Better to Know?" is a comic book produced in the 1960s to provide the public with lay information about the Pap test for cervical cancer prevention and detection. An analysis of a key narrative attribute, plot development, illustrates the central role that perceived barriers played in this midcentury public health message, a component that remains a consideration of cancer communication design today. This case study of an early graphic narrative identifies promising cancer message features that can be used to address and refute barriers to cervical cancer screening and connects contemporary research with historical efforts in public health communication.

Illness related to the novel coronavirus has driven a global crisis, and many clinicians are facing unexpected and challenging conversations. This guide is a graphic medicine adaptation of text that was created to provide a practical introduction on how to talk about difficult topics related to covid-19. During early spread of the …

Locomotion studies, biomechanics, and particularly vertebrate paleontology have had a deep influence on the development of motion pictures, animation, and computer generated visual effects. Biologically straightforward concepts such as morphological correlates of diet, sexual dimorphism, and ontogenetic change are powerful tools for animators and visual effects artists. Despite this deep debt to the ever-increasing role of science and technology in film making, scientists often forget to mine the communication strategies of their science-savvy entertainment industry kin. Further, many of the tools of the film industry are making a direct impact on basic research or have the potential to do so. It is becoming increasingly clear as part of the overall outreach for science, technology, engineering, and mathematics ("STEM"), scientists must inform and engage with the public. Significantly, many of the concepts and stories we offer as useful to film makers are compelling stories to offer to our own students. And these can be as compelling to the public as the entertainment they often facilitate. Whereas STEM is critically important, adding "A"-art-as in the artistic strategies from the fields of animation and visual effects to produce "STEAM" helps to build a potentially unstoppable tool for science communication and the public good.

PubMedID: 30306252 Treating the patient—not only the disease itself—is important in daily clinical practice. Herein, a short text and a related cartoon on patient care are provided. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Background The number of active opioid analgesic prescriptions has risen steadily, causing increases in nonmedical opioid use, addiction, and overdose. Insufficient focus on patient discharge instructions has contributed to lack of patient awareness regarding dangers of opioids. This study examines whether an educational Khan Academy–style animation discharge instruction on the dangers and safe usage of opioid analgesics elicits higher knowledge acquisition than current standard of care. Additionally, it measures the feasibility of implementing this video discharge instruction in the emergency department (ED). Methods Fifty-two English-speaking patients aged 18 years or older receiving an opioid prescription were enrolled in this study. Patients were randomized into 2 groups. The standard of care group received verbal instruction and an informational sheet, whereas the video animation group received a 6-minute video on proper usage of opioids in addition to standard of care. Video content was sourced from samhsa.gov and administered within the ED prior to discharge. Both groups received a 26-question test regarding the dangers and safe usage of opioids immediately after education. An unpaired t test compared knowledge acquisition between the 2 groups. Results Fifty-four patients were approached, 52 patients enrolled; 27 in the standard group and 25 in the animation group. The standard of care group averaged 65% knowledge acquisition (16.8/26 correct), whereas the animation group averaged 82% acquisition (21.2/26 correct). The video animation significantly increased patient knowledge acquisition about opioid medications’ risks and proper usage and disposal ( P = .001). Conclusion It can be concluded that medical knowledge acquisition is improved in the video animation group compared with the current standard of care ( P = .001). It can also be concluded that it is feasible to implement a novel media platform to educate patients receiving opioid analgesics in the ED (96.1%).

PubMedID: 30810781 [No abstract available]

This essay considers the ways in which graphic caregiving memoirs complicate the idealizing tendencies of ethics of care philosophy. The medium's "capacious" layering of words, images, temporalities, and perspectives produces "productive tensions. . . The words and images entwine, but never synthesize" (Chute 2010, 5). In graphic memoirs about care, this "capaciousness" allows for quick oscillation between the rewards and struggles of care work, representing ambiguous, even ambivalent attitudes toward care. Graphic memoirs effectively represent multiple perspectives without synthesis, part of a structural and thematic ambivalence that provides a provocative counterpart to the abstract idealism of ethics of care philosophy.

The spring I first offered a graphic medicine graduate seminar, I wasn't sure what to expect. Every class meeting included one hour in which the students, from fields that stress rigorous verbal and written achievement, were required to embrace the position of the amateur by learning to create comics. They experimented with putting images and words together in sequential drawn panels in order to tell a story of their own devising. Of course, they did more than draw; the other two hours of the seminar introduced them both to the medium of comics and to graphic medicine in particular. What happened surprised me. Not only did the students, none of whom were medical students, explore illness, disability, and medical treatment in their comics, but they also often articulated bioethics issues as well.

Visual approaches to health information reduce complexity and may bridge challenges in health literacy. But the mechanisms and meanings of using animated video in communication with patients undergoing surgery are not well described. By comparing two versions of a two-dimensional animated video on spinal anesthesia, this study tested the patient–avatar identification within two different narrative models. To explore the perspectives of total hip arthroplasty, we employed qualitative methods of interviews and ethnographic observation. The animated presentation of the spinal anesthesia procedure was immediately recognized by all participants as reflecting their experience of the procedure independent of the narrative form. The avatar gender did not affect this identification. We found no preference for either narrative form. This study supports the potential of animation video in health informatics as a didactic model for qualifying patient behavior. Animation video creates a high degree of identification that may work to reduce pre-surgical anxiety.

Reducing the extent and persuasive power of marketing unhealthy foods to children worldwide are important obesity prevention goals. Research is limited to understand how brand mascots and cartoon media characters influence children's diet. We conducted a systematic review of five electronic databases (2000-2014) to identify experimental studies that measured how food companies' mascots and entertainment companies' media characters influence up to 12 diet-related cognitive, behavioural and health outcomes for children under 12 years. Eleven studies met the inclusion criteria. Studies used 21 unique popular media characters, but no brand mascots. Results suggest that cartoon media character branding can positively increase children's fruit or vegetable intake compared with no character branding. However, familiar media character branding is a more powerful influence on children's food preferences, choices and intake, especially for energy-dense and nutrient-poor foods (e.g. cookies, candy or chocolate) compared with fruits or vegetables. Future research should use a theoretically grounded conceptual model and larger and more diverse samples across settings to produce stronger findings for mediating and moderating factors. Future research can be used to inform the deliberations of policymakers, practitioners and advocates regarding how media character marketing should be used to support healthy food environments for children.

During World War II, the French Resistance used political cartoons while fighting for France's freedom from Nazi domination. Reprinting Jean de Preissac's 1945 political cartoon of Allied leaders operating as Hitler's anesthetist and surgeons, a commemorative postcard was issued on the 20th anniversary of the radio broadcast credited with founding the French Resistance, General Charles de Gaulle's "Appeal of 18 June 1940."

Background Integrated control programs, emphasizing preventive chemotherapy along with health education, can reduce the incidence of soil-transmitted helminthiasis and schistosomiasis. The aim of this study was to develop an educational animated cartoon to improve school children’s awareness regarding soil-transmitted helminthiasis, diarrheal diseases, and related hygiene practices in Côte d’Ivoire. The key messages included in the cartoon were identified through prior formative research to specifically address local knowledge gaps. Methodology In a first step, preliminary research was conducted to assess the knowledge, attitudes, practices, and beliefs of school-aged children regarding parasitic worm infections and hygiene, to identify key health messages to be included in an animated cartoon. Second, an animated cartoon was produced, which included the drafting of the script and story board, and the production of the cartoon’s initial version. Finally, the animated cartoon was pilot tested in eight selected schools and further fine-tuned. Principal findings According to the questionnaire results, children believed that the consumption of sweet food, eating without washing their hands, sitting on the floor, and eating spoiled food were the main causes of parasitic worm infections. Abdominal pain, diarrhea, lack of appetite, failure to grow, and general fatigue were mentioned as symptoms of parasitic worm infections. Most of the children knew that they should go to the hospital for treatment if they experienced symptoms of parasitic worm diseases. The animated cartoon titled “Koko et les lunettes magiques” was produced by Afrika Toon, in collaboration with a scientific team composed of epidemiologists, civil engineers, and social scientists, and the local school children and teachers. Pilot testing of the animated cartoon revealed that, in the short term, children grasped and kept key messages. Most of the children who were shown the cartoon reported to like it. Acceptance of the animated cartoon was high among children and teachers alike. The messaging was tailored to improve knowledge and practices for prevention of helminthiases and diarrheal diseases through prior identification of knowledge gaps. Integration of such education tools into the school curriculum, along with deworming campaigns, might improve sustainability of control and elimination efforts against helminthiases and diarrheal diseases., Author summary Soil-transmitted helminthiases, schistosomiasis, and diarrhea remain important public health issues in sub-Saharan Africa. Health educational animated cartoons can help raise awareness and improve hygiene practices, and thus contribute to the control and elimination of these diseases. For the development of an educational animated cartoon, we first evaluated the knowledge, attitudes, practices, and beliefs of school-aged children in Côte d’Ivoire regarding soil-transmitted helminthiases, diarrhea, and schistosomiasis in order to identify setting-specific health messages for our animated cartoon. We found that children believed that the consumption of sweet food, eating without washing their hands, sitting on the floor, and eating spoiled food were the main causes of parasitic worm infections. As a next step, the alpha version of the animated cartoon was produced and given the title: “Koko et les lunettes magiques”. The animated cartoon was pre-tested in eight schools and further developed. Our study found that children could retain most of the information provided by the animated cartoon. It is suggested that such a tool, integrated into the school curriculum, together with deworming campaigns in Côte d’Ivoire, might improve the sustainability of control and elimination efforts against soil-transmitted helminthiases, diarrhea, and schistosomiasis.

Osteoporosis is a degenerative bone disorder that disproportionately affects older women worldwide. Raising awareness regarding osteoporosis within this demographic is significant for health promotion. Initial evidence suggests that visualisations of illness and treatment can improve illness perceptions, increase treatment motivations and even promote health behaviours. We are yet to understand whether different visualisation mediums vary in their impact on perceptions and motivations. We investigated whether physical models or virtual animations had a greater impact on changing perceptions of osteoporosis and treatment motivation in an at-risk population of older women. A total of 128 women aged 50 and over were randomly assigned to view a brief presentation about osteoporosis using either 3-D printed bone models or electronic tablet animations. Illness perceptions, medication beliefs and motivations were measured at baseline and post-presentation. Mixed ANOVAs were used to identify significant changes over time between groups. There were no significant interaction effects, revealing that neither medium had a greater impact on beliefs over time. Significant main effects of time revealed that from baseline to post-presentation, both mediums increased consequence beliefs, personal and treatment control, understanding of osteoporosis, motivations to take treatment if needed and medication necessity beliefs. Timeline beliefs and medication concerns decreased over time for both groups. Both 3-D models and animations of osteoporosis are equally effective in changing beliefs and treatment motivation in an at-risk population. Visualisation devices are brief, cost-effective, have high acceptability and have considerable clinical applicability to promote awareness and prevention.

Context The push for knowledge translation on the part of health research funding agencies is significant in Canada, and many strategies have been adopted to promote the conversion of knowledge into action. In recent years, an increasing number of health researchers have been studying arts-based interventions to transform knowledge into action. This article reports on the results of an online questionnaire aimed at evaluating the effectiveness of a knowledge dissemination intervention (KDI) conveying findings from a study on the scientific and ethical challenges raised by nutrigenomics-nutrigenetics (NGx) research. The KDI was based on the use of four Web pages combining original, interactive cartoon-like illustrations accompanied by text to disseminate findings to Canadian Research Ethics Boards members, as well as to NGx researchers and researchers in ethics worldwide. Methods Between May and October 2012, the links to the Web pages were sent in a personal email to target audience members, one thematic Web page at a time. On each thematic Web page, members of the target audience were invited to answer nine evaluation questions assessing the effectiveness of the KDI on four criteria, (i) acquisition of knowledge; (ii) change in initial understanding; (iii) generation of questions from the findings; and (iv) intent to change own practice. Findings Response rate was low; results indicate that: (i) content of the four Web pages did not bring new knowledge to a majority of the respondents, (ii) initial understanding of the findings did not change for a majority of NGx researchers and a minority of ethics respondents, (iii) although the KDI did raise questions for respondents, it did not move them to change their practice. Conclusions While target end-users may not feel that they actually learned from the KDI, it seems that the findings conveyed encouraged reflection and raised useful and valuable questions for them. Moreover, the evaluation of the KDI proved to be useful to gain knowledge about our target audiences’ views since respondents’ comments allowed us to improve our understanding of the disseminated knowledge as well as to modify (and hopefully improve) the content of the Web pages used for dissemination.

Background We investigated whether junior high school students could be educated regarding stroke with an animated cartoon and a Manga that we produced for the purpose of dissemination of this knowledge. Methods We produced a 10-minute animated cartoon and a Manga that provided information regarding stroke risk factors, stroke signs and symptoms, and awareness to immediately contact emergent medical service (EMS) on identification of stroke signs and symptoms. From December 2011 to March 2012, 493 students in 15 classes of the first grade (age 12-13 years) of 3 junior high schools were enrolled in the study. Each subject watched the animated cartoon and read the Manga; this was referred to as “training.” Lessons about stroke were not given. Questionnaires on stroke knowledge were evaluated at baseline, immediately after the training, and 3 months after the training. Results The proportion of correct answers given immediately after the training was higher for all questions, except those related to arrhythmia, compared with baseline. Percentage of correct answers given at 3 months was higher than that at baseline in questions related to facial palsy (75% versus 33%), speech disturbance (91% versus 60%), hemiplegia (79% versus 52%), numbness of 1 side (58% versus 51%), calling for EMS (90% versus 85%), alcohol intake (96% versus 72%), and smoking (69% versus 54%). At 3 months after the training, 56% of students answered the FAST (facial droop, arm weakness, speech disturbance, time to call for EMS) mnemonic correctly. Conclusions Stroke education using these teaching aids of the animated cartoon and the Manga improved stroke knowledge in junior high school students.

Few direct comparisons have been made between the responsiveness of children with autism to computer-generated or animated characters and their responsiveness to humans. Twelve 4- to 8-year-old children with autism interacted with a human therapist; a human-controlled, interactive avatar in a theme park; a human actor speaking like the avatar; and cartoon characters who sought social responses. We found superior gestural and verbal responses to the therapist; intermediate response levels to the avatar and the actor; and poorest responses to the cartoon characters, although attention was equivalent across conditions. These results suggest that even avatars that provide live, responsive interactions are not superior to human therapists in eliciting verbal and non-verbal communication from children with autism in this age range.

Background We produced a stroke education program using the FAST (facial droop, arm weakness, speech disturbance, time to call an ambulance) mnemonic. Aims The aim of this study is to examine efficacy of our education program for junior high school students and their parents. Methods One hundred ninety students of 3 junior high schools (aged 12-13 years) and their parents were enrolled. Students received a 45-minute lesson of stroke enlightenment using the FAST mnemonic. Enlightenment items, such as a magnet poster, were distributed. Parents were educated indirectly from their child. Surveys of stroke knowledge were examined at baseline, immediately after the lesson, and at 3 months after the lesson. Results For the students, correct answers at 3 months were significantly higher than those at baseline in questions of facial palsy (98% versus 33%), speech disturbance (98% versus 54%), numbness on one side (64% versus 42%), weakness on one side (80% versus 51%), calling an ambulance (88% versus 60%), alcohol drinking (85% versus 65%), smoking (70% versus 43%), dyslipidemia (58% versus 46%), hyperglycemia (59% versus 48%), and obesity (47% versus 23%). At 3 months, the parents answered more correctly questions of facial palsy (93% versus 66%), calling an ambulance (95% versus 88%), and alcohol drinking (65% versus 51%) than at baseline. At 3 months, 96% of students and 78% of parents answered the FAST mnemonic correctly. Conclusions Our stroke education program improved stroke knowledge, especially the FAST message, for junior high school students and their parents.

Background Previous reports suggest that adherence to patching is a major issue in amblyopia treatment. We tested with an unmasked randomised controlled clinical trial whether an intense educational/motivational intervention improves adherence when a high-dose regime is prescribed. Methods 62 children with newly diagnosed amblyopia were randomly allocated into two treatment arms with and without educational/motivational intervention material. Both were prescribed patching 10 h/day, 6 days/week for a fixed period of 12 weeks. The intervention arm received an educational/motivational intervention before patching which included information booklets, video, a cartoon story book, sticker charts and a dedicated session with a researcher. The control arm received the usual clinical information. The primary outcome measure was adherence measured using electronic occlusion dose monitors where a success/failure binary outcome was used to account for participants who dropped out of the study defined as patching >4 h/day. Visual outcome, expressed as percentage visual deficit, was measured as secondary outcome. Results The intervention increased adherence success rate from 45.2% in the control group to 80.6% in the intervention group (p=0.0027). However, visual outcome was not significantly better in the intervention group (p=0.190). Conclusions Our study shows that an intense educational/motivational intervention can improve adherence to patching to high prescribed doses although no significant improvement in visual outcome was observed. Trials registration number: ISRCTN05346737 (International Standard Randomised Controlled Trial Number Register).

Marketing of high-energy, low-nutrient foods is one of the contributing factors to the obesity-promoting environment. Licensed characters are typically used to market these foods to children because they increase brand recognition and sales, and data suggest that they affect the taste and snack preferences of children in high-income countries, but it has not yet been explored in low/middle income countries (LMICs). We sought to examine how licensed characters on food packaging influence children's taste and snack preferences in Guatemala, a LMIC.One hundred twenty-one children (mean ± s.d. age, 7.4 ± 1.9 years) from four (two preschool and two elementary) public schools in Guatemala tasted three food types: potato chips, crackers and carrots. Each was presented in two identical packages, except that one had a licensed character and the other did not. Children tasted the foods (six total) in each package and answered whether they tasted the same or one tasted better. Snack preference was also evaluated.Children were significantly (P0.001) more likely to prefer the taste of the foods inside the package with the licensed character compared with the one with no character (mean ± s.d., 0.24 ± 0.54). Most (66%) chose the food in the package with the character for a snack. Younger children (P0.001) were more likely to prefer the taste of the food inside the package with the character.Licensed characters on food packaging influence Guatemalan children's taste and snack preferences. Given that these characters are typically used to promote high-energy, low-nutrient foods, their influence could contribute toward overconsumption of these foods and consequently increased risk of obesity in Guatemalan children. Therefore, public health advocates, in Guatemala and elsewhere, might explore restricting the use of licensed characters on food packaging as a public health strategy.

The ubiquitous marketing of energy-dense, nutrient-poor food and beverages is a key modifiable influence on childhood dietary patterns and obesity. Much of the research on television food advertising is focused on identifying and quantifying unhealthy food marketing with comparatively few studies examining persuasive marketing techniques to promote unhealthy food to children. This review identifies the most frequently documented persuasive marketing techniques to promote food to children via television. A systematic search of eight online databases using key search terms identified 267 unique articles. Thirty-eight articles met the inclusion criteria. A narrative synthesis of the reviewed studies revealed the most commonly reported persuasive techniques used on television to promote food to children. These were the use of premium offers, promotional characters, nutrition and health-related claims, the theme of taste, and the emotional appeal of fun. Identifying and documenting these commonly reported persuasive marketing techniques to promote food to children on television is critical for the monitoring and evaluation of advertising codes and industry pledges and the development of further regulation in this area. This has a strong potential to curbing the international obesity epidemic besieging children throughout the world.