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OBJECTIVES The objective of this study was to evaluate the influence of music versus speech on a listener's signal-to-noise ratio (SNR) preferences when listening in a noise background. SNR preferences were quantified using acceptable noise level (ANL) and preferred SNR metrics. The measurement paradigm for ANL allows the listener to adjust the level of background noise while listening to the target at their most comfortable loudness level. A higher ANL indicates less tolerance for noise and a lower ANL indicates high tolerance for noise. The preferred SNR is simply the SNR the listener prefers when attending to a target in a fixed-amount (level) of background noise. In contrast to the ANL, the listener does not have control over the noise. Rather, they are only able to manipulate the target level. The first aim of the study was to determine if listeners' tolerances for noise, quantified using the ANL, when listening to music is different from that when listening to speech. The second aim of the study was to determine if listeners' tolerances for noise, quantified using their preferred SNR, when listening to music is different from that when listening to speech. The third aim of the study was to quantify the relationship between ANL and preferred SNR. DESIGN Ninety-nine normal-hearing, native-English speakers participated in this study. The ANL and preferred SNR were measured for speech and music targets. Music targets included two variations (with lyrics and without lyrics) of the song "Rocky Top." Measurements were made in the sound field at 0° azimuth, 1.5 m from a loud speaker. For both ANL and preferred SNR, targets were presented in 12-talker babble noise. The level of the noise was adjusted by the listener during ANL measurement but was fixed in level during the preferred SNR measurement (75 dB A). Repeated-measures analysis of variance was performed to identify any significant effect of target on the ANL and preferred SNR. Correlation analysis was performed to evaluate the relationship between ANL and preferred SNR. RESULTS Findings demonstrate a significant effect of target on ANL and preferred SNR. ANLs were highest for speech (mean = 7.2 dB), followed by music with lyrics (6.1 dB), and music without lyrics (2.5 dB). Preferred SNRs were highest for music with lyrics (mean = 2.3 dB), followed by speech (1.2 dB), and music without lyrics (-0.1 dB). A listener's ANL for a given target was strongly correlated with their ANL for a different target (the same was true for preferred SNR); however, ANL for a given target was not a statistically significant predictor of preferred SNR for the same target. CONCLUSIONS When listening in a background of noise, the listener's tolerance for noise depends on the target to which they are attending, whether music or speech. This dependence is especially evident for ANL measures, and less so for preferred SNR measures. Despite differences in ANL and preferred SNR across targets, a listener's ANL and preferred SNR for one target predicts their ANL and preferred SNR, respectively, for a different target. The lack of correlation between ANL and preferred SNR suggests different mechanisms underly these listener-preference metrics.

The effect of social media use on well-being is among the hottest debates in academia and society at large. Adults and adolescents alike spend around 2-3 hours per day on social media, and they typically use five to seven different platforms in a complementary way, to chat with their friends, to browse others’ posts, and present themselves to their friends and followers. In parallel with this surging social media use, research into its impact on well-being has accumulated rapidly. The aim of this special issue of Current Opinion in Psychology is to inform researchers about the rapidly expanding volume of studies into social media use and well-being. Each of the 26 invited reviews in this issue provides an indispensable overview of the uses and effects of social media use on well-being. A first section of this issue includes reviews that provide theoretical and/or methodological meta-perspectives. A second section focuses on different types of social media use, such as online dating, social gaming, and cyberbullying. A third section reviews the effects of social media use on risk and resilience factors of well-being, such as self-esteem, social comparison, and body image. And a final section pays attention to the uses and effects of social media among special audiences (older people, youth) and in different contexts (the workplace, the Global South). Together, this collection of accessible and inclusive reviews provides interested readers—researchers and practitioners alike—with the conceptual tools and empirical knowledge to assess the state of research into social media use and well-being.

Contains fulltext : 239445.pdf (Publisher’s version ) (Closed access) The formation and maintenance of friendship closeness is an important developmental task in adolescence. To obtain insight in real-time processes that may underly the development of friendship closeness in middle adolescence, this preregistered experience sampling study [ESM] investigated the effects of social media use on friendship closeness. The study was conducted among 387 adolescents (54% girls; Mage = 14.11 years; 96% Dutch) from different educational tracks (44% lower prevocational secondary education, 31% intermediate general secondary education, 26% academic preparatory education). Adolescents reported six times per day for 3 weeks on their Instagram, WhatsApp, and Snapchat use in the previous hour and their momentary experiences of friendship closeness (126 assessments; 34,930 observations). Multilevel analyses revealed positive between-person associations of friendship closeness with general WhatsApp use and Instagram use with close friends. In contrast, at the within-person level, we found small negative overall associations of general WhatsApp use and Instagram use (with and without close friends) with friendship closeness. However, there was large heterogeneity in the person-specific effect sizes of the within-person associations of social media use with friendship closeness. For example, person-specific effect sizes of the association of Instagram use with close friends with friendship closeness ranged from ß = -.745 to ß = .697. These results underline the importance of acknowledging person-specific effects in developmental and media effect theories. 15 p.

Osteoporosis is highly prevalent but underdiagnosed and undertreated in Hong Kong. Fragility fractures associated with osteoporosis often result in loss of independence and increased mortality for home-dwelling patients, imposing a high socio-economic burden on society. This issue requires urgent attention given the rapid growth of the elderly population in Hong Kong by approximately 4.3% each year. To address this situation, a group of experts convened to discuss practical ways to reduce the burden of fractures and formulated three recommendations: first, all men (aged ≥70 years) and women (aged ≥65 years) should receive universal dual-energy X-ray absorptiometry assessment for osteoporosis. Second, all men (aged ≥70 years) and women (aged ≥65 years) with a fracture-risk assessment-derived 10-year risk (hip fracture with bone mineral density) ≥3% should receive ≥3 years of anti-osteoporotic treatment. Third, comprehensive structured assessment (including dual-energy X-ray absorptiometry) should be conducted in older patients with a history of falling. By implementing these recommendations, we estimate that we could prevent 5234 hip fractures in 10 years, an annual incidence reduction of approximately 7%, and save HK$425 million in direct medical costs plus substantial indirect savings. Ample clinical and cost-effectiveness data support these recommendations, and studies in Hong Kong and abroad could serve as models on how to implement them. We are confident that by applying these recommendations rigorously and systematically, a significant reduction in hip fractures in Hong Kong is achievable.

Contains fulltext : 249633.pdf (Publisher’s version ) (Open Access) Research agrees that self-reported measures of time spent with social media (TSM) show poor convergent validity, because they correlate modestly with equivalent objective digital trace measures. This experience sampling study among 159 adolescents (12,617 self-reports) extends this work by examining the comparative predictive validity of self-reported and digital trace measures of TSM, that is, the extent to which self-reported and digital trace measures of TSM correspond in their effects on self-esteem, well-being, and friendship closeness. Using an N = 1 method of analysis, we investigated the correspondence on a between-person, within-person, and person-specific level. Although our results confirmed the poor convergent validity of self-reported TSM reported earlier, we found that self-reports of TSM had comparable predictive validity to digital trace measures on all three levels. Because comparative predictive validity of self-reported TSM is crucial for investigating social media effects, our results have important implications for future research using self-reported TSM. 11 p.

Literature reviews on how social media use affects adolescent mental health have accumulated at an unprecedented rate of late. Yet, a higher-level integration of the evidence is still lacking. We fill this gap with an up-to-date umbrella review, a review of reviews published between 2019 and mid-2021. Our search yielded 25 reviews: seven meta-analyses, nine systematic, and nine narrative reviews. Results showed that most reviews interpreted the associations between social media use and mental health as ‘weak’ or ‘inconsistent,’ whereas a few qualified the same associations as ‘substantial’ and ‘deleterious.’ We summarize the gaps identified in the reviews, provide an explanation for their diverging interpretations, and suggest several avenues for future research.

Research into the impact of social media use (SMU) on well-being (e.g., happiness) and ill-being (e.g., depression) has exploded over the past few years. From 2019 to August 2021, 27 reviews have been published: nine meta-analyses, nine systematic reviews, and nine narrative reviews, which together included hundreds of empirical studies. The aim of this umbrella review is to synthesize the results of these meta-analyses and reviews. Even though the meta-analyses are supposed to rely on the same evidence base, they yielded disagreeing associations with well- and ill-being, especially for time spent on SM, active SMU, and passive SMU. This umbrella review explains why their results disagree, summarizes the gaps in the literature, and ends with recommendations for future research.

Contains fulltext : 239197.pdf (Publisher’s version ) (Open Access) Who benefits most from using social media is an important societal question that is centered around two opposing hypotheses: the rich-get-richer versus the poor-get-richer hypothesis. This study investigated the assumption that both hypotheses may be true, but only for some socially rich and some socially poor adolescents and across different time intervals. We employed a state-of-the-art measurement burst design, consisting of a three-week experience sampling study and seven biweekly follow-up surveys. Person-specific analyses of more than 70,000 observations from 383 adolescents revealed that 12% of the socially rich adolescents (high in friendship support or low in loneliness) felt closer to their friends after using social media, as opposed to about 25% of the socially poor adolescents (low in friendship support or high in loneliness). However, only 1 to 6% of all adolescents (socially rich and poor) felt closer both in the short- and longer-term. These results indicate that the rich-get-richer and the poor-get-richer hypotheses can hold both, but for different adolescents. 15 p.

Social competence refers to the ability to engage in meaningful interactions with others. It is a crucial skill potentially malleable to interventions. Nevertheless, it remains difficult to select which children, which periods in a child's life, and which underlying skills form optimal targets for interventions. Development of social competence is complex to characterize because (a) it is by nature context- dependent; (b) it is subserved by multiple relevant processes that develop at different times in a child's life; and (c) over the years multiple, possibly conflicting, ways have been coined to index a child's social competence. The current paper elaborates upon a theoretical model of social competence developed by Rose-Krasnor (Rose- Krasnor, 1997; Rose-Krasnor and Denham, 2009), and it makes concrete how underlying skills and the variety of contexts of social interaction are both relevant dimensions of social competence that might change over development. It then illustrates how the cohorts and work packages in the Consortium on Individual Development each provide empirical contributions necessary for testing this model on the development of social competence.

The question whether social media use benefits or undermines adolescents’ well-being is an important societal concern. Previous empirical studies have mostly established across-the-board effects among (sub)populations of adolescents. As a result, it is still an open question whether the effects are unique for each individual adolescent. We sampled adolescents’ experiences six times per day for one week to quantify differences in their susceptibility to the effects of social media on their momentary affective well-being. Rigorous analyses of 2,155 real-time assessments showed that the association between social media use and affective well-being differs strongly across adolescents: While 44% did not feel better or worse after passive social media use, 46% felt better, and 10% felt worse. Our results imply that person-specific effects can no longer be ignored in research, as well as in prevention and intervention programs.

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents has increased considerably over the past decades. Scholars and health professionals alike have expressed concern about the role of screen media in the rise in ADHD diagnosis. However, the extent to which screen media use and ADHD are linked remains a point of debate. To understand the current state of the field and, ultimately, move the field forward, we provide a systematic review of the literature on the relationship between children and adolescents' screen media use and ADHD-related behaviors (i.e., attention problems, hyperactivity, and impulsivity). Using the Differential Susceptibility to Media effects Model as a theoretical lens, we systematically organize the existing literature, identify potential shortcomings in this literature, and provide directions for future research. The available evidence suggests a statistically small relationship between media and ADHD-related behaviors. Evidence also suggests that individual child differences, such as gender and trait aggression, may moderate this relationship. There is a clear need for future research that investigates causality, underlying mechanisms, and differential susceptibility to the effects of screen media use on ADHD-related behaviors. It is only through a richer empirical body that we will be able to fully understand the media-ADHD relationship. ispartof: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA vol:115 issue:40 pages:9875-9881 ispartof: location:United States status: published

Bismuth is a well-known therapeutic agent that is used primarily for treatment against peptic ulcers. It has also had success in protecting against nephrotoxicity caused by the anticancer compound cisplatin by inducing the liver and kidney metalloprotein, metallothionein (MT) that then binds to the cisplatin. MT is a small, ubiquitous protein that binds monovalent, divalent, and trivalent metals using its abundant cysteine thiols (20 cysteines in the mammalian protein). It is important in the understanding of both these therapeutic applications to explore in detail the earliest stages of MT binding to bismuth salts. In this paper, we explored the binding of [Bi(cit)]

Background A digital cognitive test can be a useful and quick tool for the screening of cognitive impairment. Previous studies have shown that the diagnostic performance of digital cognitive tests is comparable with that of conventional paper-and-pencil tests. However, the use of commercially available digital cognitive tests is not common in Hong Kong, which may be due to the high cost of the tests and the language barrier. Thus, we developed a brief and user-friendly digital cognitive test called the Electronic Cognitive Screen (EC-Screen) for the detection of mild cognitive impairment (MCI) and dementia of older adults. Objective The aim of this study was to evaluate the performance of the EC-Screen for the detection of MCI and dementia in older adults. Methods The EC-Screen is a brief digital cognitive test that has been adapted from the Rapid Cognitive Screen test. The EC-Screen uses a cloud-based platform and runs on a tablet. Participants with MCI, dementia, and cognitively healthy controls were recruited from research clinics and the community. The outcomes were the performance of the EC-Screen in distinguishing participants with MCI and dementia from controls, and in distinguishing participants with dementia from those with MCI and controls. The cohort was randomly split into derivation and validation cohorts based on the participants’ disease group. In the derivation cohort, the regression-derived score of the EC-Screen was calculated using binomial logistic regression. Two predictive models were produced. The first model was used to distinguish participants with MCI and dementia from controls, and the second model was used to distinguish participants with dementia from those with MCI and controls. Receiver operating characteristic curves were constructed and the areas under the curves (AUCs) were calculated. The performances of the two predictive models were tested using the validation cohorts. The relationship between the EC-Screen and paper-and-pencil Montreal Cognitive Assessment-Hong Kong version (HK-MoCA) was evaluated by the Pearson correlation coefficient. Results A total of 126 controls, 54 participants with MCI, and 63 participants with dementia were included in the study. In differentiating participants with MCI and dementia from controls, the AUC of the EC-Screen in the derivation and validation cohorts was 0.87 and 0.84, respectively. The optimal sensitivity and specificity in the derivation cohorts were 0.81 and 0.80, respectively. In differentiating participants with dementia from those with MCI and controls, the AUC of the derivation and validation cohorts was 0.90 and 0.88, respectively. The optimal sensitivity and specificity in the derivation cohort were 0.83 and 0.83, respectively. There was a significant correlation between the EC-Screen and HK-MoCA (r=–0.67, P Conclusions The EC-Screen is suggested to be a promising tool for the detection of MCI and dementia. This test can be self-administered or assisted by a nonprofessional staff or family member. Therefore, the EC-Screen can be a useful tool for case finding in primary health care and community settings.

Inborn errors of metabolism (IEMs) are a large class of genetic disorders that result from defects in enzymes involved in energy production and metabolism of nutrients. For every metabolic pathway, there are defects that can occur and potentially result in an IEM. While some defects can go undetected in one's lifetime, some have moderate to severe clinical consequences. In the latter case, the biochemical defect leads to accumulation of metabolites and byproducts that are toxic or interfere with normal biological function. Disorders of amino acid metabolism, organic acid metabolism and the urea cycle comprise a large portion of IEMs. Two essential tools required for the diagnosis of these categories of disorders are amino acid and organic acid profiling. Most all clinical laboratories offering metabolic testing perform amino acid analysis, while organic acid profiling is restricted to more specialized pediatric hospitals and reference laboratories. In this chapter, we will provide an overview of various methodologies employed for amino acid and organic acid profiling as well as specific examples to demonstrate how these techniques are applied in clinical laboratories for the diagnosis of IEMs.

This review analyzes trends and commonalities among prominent theories of media effects. On the basis of exemplary meta-analyses of media effects and bibliometric studies of well-cited theories, we identify and discuss five features of media effects theories as well as their empirical support. Each of these features specifies the conditions under which media may produce effects on certain types of individuals. Our review ends with a discussion of media effects in newer media environments. This includes theories of computer-mediated communication, the development of which appears to share a similar pattern of reformulation from unidirectional, receiver-oriented views, to theories that recognize the transactional nature of communication. We conclude by outlining challenges and promising avenues for future research.

The goal of this review was to systematize empirical research that was published in peer-reviewed English-language journals between 1995 and 2015 on the prevalence, predictors, and implications of adolescents’ use of pornography. This research showed that adolescents use pornography, but prevalence rates varied greatly. Adolescents who used pornography more frequently were male, at a more advanced pubertal stage, sensation seekers, and had weak or troubled family relations. Pornography use was associated with more permissive sexual attitudes and tended to be linked with stronger gender-stereotypical sexual beliefs. It also seemed to be related to the occurrence of sexual intercourse, greater experience with casual sex behavior, and more sexual aggression, both in terms of perpetration and victimization. The findings of this review need to be seen against the background of various methodological and theoretical shortcomings, as well as several biases in the literature, which currently precludes internally valid causal conclusions about effects of pornography on adolescents.

This study aimed to measure and compare sound and light source localization ability in young children and adults who have normal hearing and normal/corrected vision in order to determine the extent to which age, type of stimuli, and stimulus order affects sound localization accuracy.Two experiments were conducted. The first involved a group of adults only. The second involved a group of 30 children aged 3 to 5 years. Testing occurred in a sound-treated booth containing a semi-circular array of 15 loudspeakers set at 10° intervals from -70° to 70° azimuth. Each loudspeaker had a tiny light bulb and a small picture fastened underneath. Seven of the loudspeakers were used to randomly test sound and light source identification. The sound stimulus was the word "baseball". The light stimulus was a flashing of a light bulb triggered by the digital signal of the word "baseball". Each participant was asked to face 0° azimuth, and identify the location of the test stimulus upon presentation. Adults used a computer mouse to click on an icon; children responded by verbally naming or walking toward the picture underneath the corresponding loudspeaker or light. A mixed experimental design using repeated measures was used to determine the effect of age and stimulus type on localization accuracy in children and adults. A mixed experimental design was used to compare the effect of stimulus order (light first/last) and varying or fixed intensity sound on localization accuracy in children and adults.Localization accuracy was significantly better for light stimuli than sound stimuli for children and adults. Children, compared to adults, showed significantly greater localization errors for audition. Three-year-old children had significantly greater sound localization errors compared to 4- and 5-year olds. Adults performed better on the sound localization task when the light localization task occurred first.Young children can understand and attend to localization tasks, but show poorer localization accuracy than adults in sound localization. This may be a reflection of differences in sensory modality development and/or central processes in young children, compared to adults.

Recently, the American Psychiatric Association included Internet gaming disorder (IGD) in the appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The main aim of the current study was to test the reliability and validity of 4 survey instruments to measure IGD on the basis of the 9 criteria from the DSM-5: a long (27-item) and short (9-item) polytomous scale and a long (27-item) and short (9-item) dichotomous scale. The psychometric properties of these scales were tested among a representative sample of 2,444 Dutch adolescents and adults, ages 13-40 years. Confirmatory factor analyses demonstrated that the structural validity (i.e., the dimensional structure) of all scales was satisfactory. Both types of assessment (polytomous and dichotomous) were also reliable (i.e., internally consistent) and showed good criterion-related validity, as indicated by positive correlations with time spent playing games, loneliness, and aggression and negative correlations with self-esteem, prosocial behavior, and life satisfaction. The dichotomous 9-item IGD scale showed solid psychometric properties and was the most practical scale for diagnostic purposes. Latent class analysis of this dichotomous scale indicated that 3 groups could be discerned: normal gamers, risky gamers, and disordered gamers. On the basis of the number of people in this last group, the prevalence of IGD among 13- through 40-year-olds in the Netherlands is approximately 4%. If the DSM-5 threshold for diagnosis (experiencing 5 or more criteria) is applied, the prevalence of disordered gamers is more than 5%.

The issue of whether pressure injuries are avoidable or preventable has been and continues to be an issue of great debate and discussion for many years, and it has significant legal and regulatory implications related to prevention of wounds due to pressure. The following position paper outlines the position of the Wound, Ostomy and Continence Nurses Society (WOCN) on avoidable versus unavoidable pressure injuries. It includes the following information: statement of position, purpose/rationale for the position, definitions of avoidable versus unavoidable pressure injuries, alternative definitions, historical overview, supportive statements from expert opinion and research in the literature, and recommendations for research.

This quantitative content analysis investigated the hookup culture in U.S. and Dutch teen girl magazines. Using Hofstede's cultural dimension of masculinity/femininity, the hookup culture (i.e., the relational context of sex, emotional context of sex, specific sexual activities, and contraceptives) was examined in 2,496 stories from all 2006 through 2008 issues of the three most popular U.S. (i.e., Seventeen, CosmoGirl! U.S. edition, and Teen) and Dutch teen girl magazines (i.e., Fancy, CosmoGirl! Netherlands edition, and Girlz!). Regarding the relational context of sex, stories about casual sex occurred more often in U.S. magazines, and Dutch magazines focused more on committed sex. Dutch magazines also emphasized sex within the emotional context of love more often than did U.S. magazines. In terms of sexual activities, coital sex was mentioned more often in U.S. coverage, while petting was mentioned more frequently in Dutch coverage. Condoms were covered more positively in U.S. magazines than in Dutch magazines. Overall, the hookup culture seems to be more visible in U.S. magazines for the occurrence of casual sex and lack of love stories, whereas it does not emerge in Dutch magazines due to the presence of committed sex and love-related articles.

Platelet transfusion-refractoriness is a challenging and expensive clinical scenario seen most often in patients with hematologic malignancies. Although the majority of platelet transfusion-refractory cases are due to nonimmune causes, a significant minority are caused by alloimmunization against Class I human leukocyte antigens (HLAs) or human platelet antigens (HPAs). Such platelet transfusion-refractory patients can be effectively managed with appropriate antigen-negative products.Our institution has developed a diagnostic and management algorithm for the platelet transfusion-refractory patient with an early focus on identifying those cases caused by immune-mediated factors. Using physical platelet cross-matches to initially classify platelet transfusion-refractory patients as immune-mediated or not, cross-match-compatible inventory is then provided to immune-mediated patients, whereas subsequent HLA (with or without HPA) testing is performed.Our blood donor program performs Class I HLA typing of all repeat platelet donors to facilitate the identification of antigen-negative platelet units (virtual cross-matching) as well as the recruitment of HLA-matched donors. The platelet transfusion-refractoriness algorithm realizes an initial net cost savings once two apheresis platelets are saved from use for each newly identified, immune-mediated platelet transfusion-refractory patient.An algorithm utilizing physical platelet cross-matches, Class I HLA and HPA antibody testing, and upfront Class I HLA typing of platelet donors leads to overall resource savings and improved clinical management for platelet transfusion-refractory patients.

OBJECTIVES: The aims of this study were (1) to investigate the prevalence and development of both online (OnSRB) and offline sexual risk behavior (OffSRB) in adolescence, (2) to establish whether OnSRBs and OffSRBs are related, and (3) to identify risk factors that determine problematic pathways of OnSRB and OffSRB. METHODS: A 4-wave longitudinal study with 1762 Dutch adolescents aged 12 to 18 was conducted (mean age, T1 = 14.52, 49% girls). By using group-based modeling, developmental pathways for OnSRB and OffSRB were identified and the relationship between both behaviors over time was examined. RESULTS: Substantial intraindividual differences in the development of OnSRB and OffSRB were found. The analysis revealed 3 developmental pathways of OnSRB: no risk (70.2%), moderate risk (23.7%), and high risk (6.1%). For OffSRB, we identified a no risk (90.6%) and an increasing pathway (9.4%). OnSRBs and OffSRBs were related and had common predictors (ie, sensation seeking, low educational level, gender). CONCLUSIONS: Only a minority of adolescents shows sustained high OnSRB. This group is likely to consist of low-educated, high-sensation-seeking adolescents who spend more time communicating on the Internet and come from less cohesive families. These same adolescents are also more likely to engage in OffSRB. Preventions should focus on these adolescents.

This study investigated whether unfamiliar characters are as effective as familiar characters in stimulating children's affective responses toward healthy foods. In particular, the authors investigated whether an unfamiliar character which is congruent with a product can be as effective as a familiar character. The authors tested 2 types of character-product congruence: conceptual congruence (on the basis of a familiar link), and perceptual congruence (on the basis of color similarity). In a repeated measures design, 166 children (4-6 years old) were exposed to a picture of a carrot combined randomly with 5 different types of character: an (incongruent) familiar character and four unfamiliar characters varying in character-product congruence (i.e., both conceptually and perceptually congruent, conceptual only, perceptual only, and incongruent). The authors measured children's automatic affective responses toward these character-product combinations using a time-constrained task, and elaborate affective responses using a nonconstrained task. Results revealed that the conceptually congruent unfamiliar characters were just as effective as the familiar character in increasing children's automatic affective responses. However, the familiar character triggered the most positive elaborate affective responses. Results are explained in light of processing fluency and parasocial relationship theories.

OBJECTIVE: Research among adults suggests that materialism and life satisfaction negatively influence each other, causing a downward spiral. So far, cross-sectional research among children has indicated that materialistic children are less happy, but causality remains uncertain. This study adds to the literature by investigating the longitudinal relation between materialism and life satisfaction. We also investigated whether their relation depended on children’s level of exposure to advertising. METHODS: A sample of 466 children (aged 8–11; 55% girls) participated in a 2-wave online survey with a 1-year interval. We asked children questions about material possessions, life satisfaction, and advertising. We used structural equation modeling to study the relationship between these variables. RESULTS: For the children in our sample, no effect of materialism on life satisfaction was observed. However, life satisfaction did have a negative effect on materialism. Exposure to advertising facilitated this effect: We only found an effect of life satisfaction on materialism for children who were frequently exposed to advertising. CONCLUSIONS: Among 8- to 11-year-old children, life satisfaction leads to decreased materialism and not the other way around. However, this effect only holds for children who are frequently exposed to television advertising. It is plausible that the material values portrayed in advertising teach children that material possessions are a way to cope with decreased life satisfaction. It is important to reduce this effect, because findings among adults suggest that materialistic children may become less happy later in life. Various intervention strategies are discussed.

There is little to no empirical data available on how data and safety monitoring boards (DSMBs) are structured and how they operate. The purpose of this study was to provide data on this. To accomplish this goal, we administered a random survey on current structure and management practices and opinions as reported by principal investigators (PIs) and biostatisticians. We also surveyed Institutional Review Board (IRB) community members, as proxies for the public, as to their opinions on how DSMBs should be structured and managed. A final purpose was to compare opinions about what should be taking place to what is actually happening.

The aim of this study was to investigate the influence of descriptive and injunctive peer norms on the engagement in risky sexual online behavior. A four-wave longitudinal study among a representative sample of 1,016 Dutch adolescents (12–17 years old) was conducted. Two autoregressive cross-lagged structural equation models were analyzed to investigate the relationship between perceptions of peer norms and risky sexual online behavior. The findings of this study indicate that both, descriptive and injunctive peer norms, predicted adolescents' engagement in risky sexual online behavior. The effect of descriptive peer norms was stronger and more consistent over the four waves. As expected, perceptions of peer norms were predictors, but not consequences, of risky sexual online behavior. The findings suggest that problematic behaviors on the Internet are influenced by perceptions of what peers do, or approve of, in ways similar to offline risk behaviors.

Studies have shown that pathological involvement with computer or video games is related to excessive gaming binges and aggressive behavior. Our aims for this study were to longitudinally examine if pathological gaming leads to increasingly excessive gaming habits, and how pathological gaming may cause an increase in physical aggression. For this purpose, we conducted a two-wave panel study among 851 Dutch adolescents (49% female) of which 540 played games (30% female). Our analyses indicated that higher levels of pathological gaming predicted an increase in time spent playing games 6 months later. Time spent playing violent games specifically, and not just games per se, increased physical aggression. Furthermore, higher levels of pathological gaming, regardless of violent content, predicted an increase in physical aggression among boys. That this effect only applies to boys does not diminish its importance, because adolescent boys are generally the heaviest players of violent games and most susceptible to pathological involvement.

Adolescents far outnumber adults in their use of e-communication technologies, such as instant messaging and social network sites. In this article, we present an integrative model that helps us to understand both the appeal of these technologies and their risks and opportunities for the psychosocial development of adolescents. We first outline how the three features (anonymity, asynchronicity, and accessibility) of online communication stimulate controllability of online self-presentation and self-disclosure among adolescents. We then review research on the risks and opportunities of online self-presentation and self-disclosure for the three components of adolescents' psychosocial development, including identity (self-unity, self-esteem), intimacy (relationship formation, friendship quality, cyberbullying), and sexuality (sexual self-exploration, unwanted sexual solicitation). Existing research suggests several opportunities of online communication, such as enhanced self-esteem, relationship formation, friendship quality, and sexual self-exploration. It also yields evidence of several risks, including cyberbullying and unwanted sexual solicitation. We discuss the shortcomings of existing research, the possibilities for future research, and the implications for educators and health care professionals.

Previous research on the influence of sexually explicit Internet material (SEIM) on adolescents' stereotypical beliefs about women's sexual roles has three shortcomings. First, the role of peers has been neglected; second, stereotypical beliefs have rarely been studied as causing the use of SEIM and the selection of specific peers; and third, it is unclear whether adolescents are more vulnerable to the effects of SEIM than adults. We used data from two nationally representative two-wave panel surveys among 1,445 Dutch adolescents and 833 Dutch adults, focusing on the stereotypical belief that women engage in token resistance to sex (i.e., the notion that women say 'no' when they actually intend to have sex). Structural equation modeling showed that peers who supported traditional gender roles elicited, both among adolescents and adults, stronger beliefs that women use token resistance to sex. Further, the belief that women engage in token resistance predicted adolescents' and adults' selection of gender-role traditional peers, but it did not predict adolescents' and adults' use of SEIM. Finally, adults, but not adolescents, were susceptible to the impact of SEIM on beliefs that women engage in token resistance to sex.

This study had three goals: first, to investigate whether sexually explicit Internet material (SEIM) affects sexual risk behavior; second, to study whether these effects differ between adolescents and adults; and third, to analyze, separately for adolescents and adults, whether gender and age moderate an influence of SEIM on sexual risk behavior. The authors conducted a 2-wave panel survey among nationally representative random samples of 1,445 Dutch adolescents and 833 Dutch adults. SEIM use increased sexual risk behavior among adults, but not among adolescents. More specifically, moderator analyses showed that SEIM use increased sexual risk behavior only among male adults, but not among female adults. In the adolescent sample, no moderating gender effect occurred. Neither among adolescents nor among adults did age moderate the effects. Our study shows that SEIM may influence outcomes related to people's sexual health. It also suggests that male adults may present a potential risk group for adverse effects of SEIM.

An implicit assumption in research on adolescents’ use of sexually explicit internet material (SEIM) is that they may feel more attracted to such material than adults, given the "forbidden" character of SEIM for minors. However, systematic comparisons between adolescents’ and adults’ SEIM use and of its antecedents are missing. We conducted a two-wave panel survey among a nationally representative sample of 1,445 Dutch adolescents and a nationally representative sample of 833 Dutch adults. Adolescents’ and adults’ SEIM use was similar. When significant differences in the SEIM use occurred, they indicated that adults used SEIM more often than adolescents. Male adults were the most frequent users of SEIM. No difference in the antecedent structure of SEIM use emerged between adolescents and adults. In both groups, males, sensation seekers, as well as people with a not exclusively heterosexual orientation used SEIM more often. Among adolescents and adults, lower life satisfaction increased SEIM use. Our findings suggest that the frequency of SEIM use and its antecedents are largely the same among adolescents and adults.

Background: Open canal hearing instruments differ in method of sound delivery to the ear canal, distance between the microphone and the receiver, and physical size of the devices. Moreover, RITA (receiver in the aid) and RITE (receiver in the ear) hearing instruments may also differ in terms of retention and comfort as well as ease of use and care for certain individuals. What remains unclear, however, is if any or all of the abovementioned factors contribute to hearing aid outcome. Purpose: To determine the effect of receiver location on performance and/or preference of listeners using open canal hearing instruments. Research Design: An experimental study in which subjects were exposed to a repeated measures design. Study Sample: Twenty-five adult listeners with mild sloping to moderately severe sensorineural hearing loss (mean age 67 yr). Data Collection and Analysis: Participants completed two six-week trial periods for each device type. Probe microphone, objective, and subjective measures (quiet, noise) were conducted unaided and aided at the end of each trial period. Results: Occlusion effect results were not significantly different between the RITA and RITE instruments; however, frequency range was extended in the RITE instruments, resulting in significantly greater maximum gain for the RITE instruments than the RITA instruments at 4000 and 6000 Hz. Objective performance in quiet or in noise was unaffected by receiver location. Subjective measures revealed significantly greater satisfaction ratings for the RITE than for the RITA instruments. Similarly, preference in quiet and overall preference were significantly greater for the RITE than for the RITA instruments. Conclusions: Although no occlusion differences were noted between instruments, the RITE did demonstrate a significant difference in reserve gain before feedback at 4000 and 6000 Hz. Objectively; no positive benefit was noted between unaided and aided conditions on speech recognition tests. These results suggest that such testing may not be sensitive enough to determine aided benefit with open canal instruments. However, the subjective measures (Abbreviated Profile of Hearing Aid Benefit [APHAB] and subjective ratings) did indicate aided benefit for both instruments when compared to unaided. This further suggests the clinical importance of subjective measures as a way to measure aided benefit of open-fit devices.

The main aim of this study was to investigate the causal nature of the relationship between adolescents' risky sexual behavior on the internet and their perceptions of this behavior. Engagement in the following online behaviors was assessed: searching online for someone to talk about sex, searching online for someone to have sex, sending intimate photos or videos to someone online, and sending one's telephone number and address to someone exclusively known online. The relationship between these behaviors and adolescents' perceptions of peer involvement, personal invulnerability, and risks and benefits was investigated. A two-wave longitudinal study among a representative sample of 1,445 Dutch adolescents aged 12-17 was conducted (49% females). Autoregressive cross-lagged structural equation models revealed that perceived peer involvement, perceived vulnerability, and perceived risks were all significant predictors of risky sexual online behavior 6 months later. No reverse causal paths were found. When the relationships between perceptions and risky sexual online behavior were modeled simultaneously, only perceived peer involvement was a determinant of risky sexual online behavior. Findings highlight the importance of addressing peer involvement in future interventions to reduce adolescents' risky sexual online behavior.

Calcific aortic stenosis (AS) is primarily a disease of the elderly, possessing features that are biomechanical as well as systemic and inflammatory in nature, with risk factors and histopathology similar to atherosclerosis. To date no medical therapy has been shown to conclusively alter the progression of the disease, and for those with symptomatic AS, aortic valve replacement (AVR) is advocated. Factors that may alert the physician to an accelerated progression of calcific aortic valvular disease toward severe symptomatic AS include moderate aortic valve calcification, chronically dialyzed patients, and patients 80 years and older. There remains significant morbidity and mortality associated with AVR, and new techniques and technologies for AVR are being developed. For those who undergo successful AVR the long-term prognosis is good. A substantial number of patients with symptomatic AS present for anesthesia care for a variety of procedures. A thorough, modern understanding of AS and its course are necessary for the anesthesiologist to guide the patient through the perioperative period.

The aims of this study were (a) to investigate the influence of computer-mediated communication (CMC) on interpersonal attraction and (b) to examine two underlying processes in the CMC-interpersonal attraction relationship. We identified two variables that may mediate the influence of CMC on interpersonal attraction: self-disclosure and direct questioning. Focusing on these potential mediating variables, we tested two explanatory hypotheses: the CMC-induced direct questioning hypothesis and the CMC-induced self-disclosure hypothesis. Eighty-one cross-sex dyads were randomly assigned to one of three experimental conditions: text-only CMC, visual CMC, and face-to-face communication. We did not find a direct effect of CMC on interpersonal attraction. However, we did find two positive indirect effects of text-only CMC on interpersonal attraction: text-only CMC stimulated both self-disclosure and direct questioning, both of which in turn enhanced interpersonal attraction. Results are discussed in light of uncertainty reduction theory and CMC theories.

The 1st goal of this study was to investigate how online communication is related to the closeness of existing friendships. Drawing from a sample of 794 preadolescents and adolescents, the authors found that online communication was positively related to the closeness of friendships. However, this effect held only for respondents who primarily communicated online with existing friends and not for those who mainly talked with strangers. The 2nd goal was to refine 2 opposing hypotheses, the rich-get-richer and the social compensation hypotheses. Consistent with the rich-get-richer hypothesis, socially anxious respondents communicated online less often than did nonsocially anxious respondents. However, socially anxious respondents perceived the Internet as more valuable for intimate self-disclosure than did nonsocially anxious respondents, and this perception in turn led to more online communication. This result is consistent with the social compensation hypothesis. Online communication and closeness to friends increased with age. There was a curvilinear relationship between age and perceived value of the Internet for intimate self-disclosure, such that 15-year-olds were at the epitome of online self-disclosure. Girls were closer to friends and more socially anxious than were boys.

The Integrative Themes in Physiology (ITIP) project was a National Science Foundation-funded collaboration between the American Physiological Society (APS) and the Human Anatomy and Physiology Society (HAPS). The project goal was to create instructional resources that emphasized active learning in undergraduate anatomy and physiology classrooms. The resources (activity modules and professional development) addressed two factors thought to be limiting science education reform: instructors' knowledge of how to implement active learning instruction and time to design innovative curricula. Volunteer instructors with a strong interest in using active learning in their classrooms were recruited to use the ITIP modules and provide ease-of-use feedback and student assessment data. As the study unfolded, instructor attrition was higher than had been anticipated, with 17 of 36 instructors withdrawing. More surprisingly, instructors remaining with the project failed to use the modules and reported specific obstacles that precluded module use, including lack of support from academic leadership, unplanned class size increases and heavy teaching loads, a union strike, insufficient time to develop a mindset for change, inadequate technology/funding, an adverse human subjects ruling, incompatibility of modules with instructors' established content and expectations, and personal factors. Despite the lack of module use and obstacles, 8 of 19 site testers began independently to introduce new active learning instruction into their classrooms. In the larger picture, however, it is important to note that only 8 of the initial 36 volunteers (22%) actually ended up changing their instruction to include opportunities for student active learning. These findings underscore the difficulty of implementing instructional change in college classrooms.

Speech recognition in noisy environments improves when the speech signal is spatially separated from the interfering sound. This effect, known as spatial release from masking (SRM), was recently shown in young children. The present study compared SRM in children of ages 5-7 with adults for interferers introducing energetic, informational, and/or linguistic components. Three types of interferers were used: speech, reversed speech, and modulated white noise. Two female voices with different long-term spectra were also used. Speech reception thresholds (SRTs) were compared for: Quiet (target 0 degrees front, no interferer), Front (target and interferer both 0 degrees front), and Right (interferer 90 degrees right, target 0 degrees front). Children had higher SRTs and greater masking than adults. When spatial cues were not available, adults, but not children, were able to use differences in interferer type to separate the target from the interferer. Both children and adults showed SRM. Children, unlike adults, demonstrated large amounts of SRM for a time-reversed speech interferer. In conclusion, masking and SRM vary with the type of interfering sound, and this variation interacts with age; SRM may not depend on the spectral peculiarities of a particular type of voice when the target speech and interfering speech are different sex talkers.

We evaluated the accuracy of an erythromycin-clindamycin double-disk test (D-zone test) and an erythromycin-telithromycin D-zone test for detection of inducible resistance in isolates of beta-hemolytic streptococci with erythromycin resistance. The results of these tests were compared to results of a broth microdilution (BMD) induction test using combinations of erythromycin and either clindamycin or telithromycin. Of 29 erythromycin-resistant, clindamycin-susceptible isolates, 16 were positive by the erythromycin-clindamycin D-zone test; all of these demonstrated inducible clindamycin resistance by BMD. Twelve isolates were D-zone test-negative, did not demonstrate inducible resistance by BMD, and were positive for a mef determinant. Of 39 erythromycin-resistant, telithromycin-susceptible isolates, 13 were erythromycin-telithromycin D-zone test-positive, 19 questionably positive (unclear blunting of the zone), and 7 were D-zone test-negative. The erythromycin-telithromycin D-zone test result did not correlate with inducible resistance by BMD or the presence of an erm or mef gene. These results demonstrate that the erythromycin-clindamycin D-zone and BMD induction tests accurately detect inducible clindamycin resistance, but the erythromycin-telithromycin D-zone test is not reliable for detecting inducible telithromycin resistance.

To evaluate sound localization acuity in a group of children who received bilateral (BI) cochlear implants in sequential procedures and to determine the extent to which BI auditory experience affects sound localization acuity. In addition, to investigate the extent to which a hearing aid in the nonimplanted ear can also provide benefits on this task.Two groups of children participated, 13 with BI cochlear implants (cochlear implant + cochlear implant), ranging in age from 3 to 16 yrs, and six with a hearing aid in the nonimplanted ear (cochlear implant + hearing aid), ages 4 to 14 yrs. Testing was conducted in large sound-treated booths with loudspeakers positioned on a horizontal arc with a radius of 1.5 m. Stimuli were spondaic words recorded with a male voice. Stimulus levels typically averaged 60 dB SPL and were randomly roved between 56 and 64 dB SPL (+/-4 dB rove); in a few instances, levels were held fixed (60 dB SPL). Testing was conducted by using a "listening game" platform via computerized interactive software, and the ability of each child to discriminate sounds presented to the right or left was measured for loudspeakers subtending various angular separations. Minimum audible angle thresholds were measured in the BI (cochlear implant + cochlear implant or cochlear implant + hearing aid) listening mode and under monaural conditions.Approximately 70% (9/13) of children in the cochlear implant + cochlear implant group discriminated left/right for source separations ofor=20 degrees , and, of those, 77% (7/9) performed better when listening bilaterally than with either cochlear implant alone. Several children were also able to perform the task when using a single cochlear implant, under some conditions. Minimum audible angle thresholds were better in the first cochlear implant than the second cochlear implant listening mode for nearly all (8/9) subjects. Repeated testing of a few individual subjects over a 2-yr period suggests that robust improvements in performance occurred with increased auditory experience. Children who wore hearing aids in the nonimplanted ear were at times also able to perform the task. Average group performance was worse than that of the children with BI cochlear implants when both ears were activated (cochlear implant + hearing aid versus cochlear implant + cochlear implant) but not significantly different when listening with a single cochlear implant.Children with sequential BI cochlear implants represent a unique population of individuals who have undergone variable amounts of auditory deprivation in each ear. Our findings suggest that many but not all of these children perform better on measures of localization acuity with two cochlear implants compared with one and are better at the task than children using the cochlear implant + hearing aid. These results must be interpreted with caution, because benefits on other tasks as well as the long-term benefits of BI cochlear implants are yet to be fully understood. The factors that might contribute to such benefits must be carefully evaluated in large populations of children using a variety of measures.

Rehabilitation centres provide therapeutic intervention to both patients with traumatic brain injury (TBI) and spinal cord injury (SCI). Patients with a dual diagnosis of TBI and SCI present a challenge to the rehabilitation professional. Previous studies indicate an incidence of concomitant TBI and SCI to be between 24-59%. Many research articles discuss how a diagnosis of TBI is often missed during the medical examination of a person with a suspected SCI. This article will focus on the implications of dual diagnosis encountered during the rehabilitation process. A case study is used to highlight the challenges presented by the cognitive impairments of a TBI in combination with the motoric deficits of SCI. Management strategies utilised by the rehabilitation team are discussed.

The hypothesis of this study was that broader patterns of physiological channel interactions in the local region of the cochlea are associated with poorer spectral resolution in the same region. Electrically evoked compound action potentials (ECAPs) were measured for three to six probe electrodes per subject to examine the channel interactions in different regions across the electrode array. To evaluate spectral resolution at a confined location within the cochlea, spectral-ripple discrimination (SRD) was measured using narrowband ripple stimuli with the bandwidth spanning five electrodes: Two electrodes apical and basal to the ECAP probe electrode. The relationship between the physiological channel interactions, spectral resolution in the local cochlear region, and vowel identification was evaluated. Results showed that (1) there was within- and across-subject variability in the widths of ECAP channel interaction functions and in narrowband SRD performance, (2) significant correlations were found between the widths of the ECAP functions and narrowband SRD thresholds, and between mean bandwidths of ECAP functions averaged across multiple probe electrodes and broadband SRD performance across subjects, and (3) the global spectral resolution reflecting the entire electrode array, not the local region, predicts vowel identification.

Conflicting data are reported on pro- or anti-inflammatory activity of bovine lactoferrin (bLf) in different cell models as phagocytes or epithelial cell lines infected by bacteria. Here we evaluated the bLf effect on epithelial models mimicking two human pathologies characterized by inflammation and infection with specific bacterial species. Primary bronchial epithelium from a cystic fibrosis (CF) patient and differentiated intestinal epithelial cells were infected with Pseudomonas aeruginosa LESB58 isolated from a CF patient and Adherent-Invasive Escherichia coli LF82 isolated from a Crohn's disease patient. Surprisingly, bLf significantly reduced the intracellular bacterial survival, but differently modulated the inflammatory response. These data lead us to hypothesize that bLf differentially acts depending on the epithelial model and infecting pathogen. To verify this hypothesis, we explored whether bLf could modulate ferroportin (Fpn), the only known cellular iron exporter from cells, that, by lowering the intracellular iron level, determines a non permissive environment for intracellular pathogens. Here, for the first time, we describe the bLf ability to up-regulate Fpn protein in infected epithelial models. Our data suggest that the mechanism underlying the bLf modulating activity on inflammatory response in epithelial cells is complex and the bLf involvement in modulating cellular iron homeostasis should be taken into account.

Recent reports of the transmission of hepatitis B, hepatitis C, and HIV from physicians to patients during invasive procedures have again raised the question of whether physicians infected with bloodborne pathogens should perform invasive procedures that place patients at risk, and if so, under what conditions. Attempts to formulate a national policy on this subject must consider the competing interests of the patient's welfare versus the physician's livelihood. A review of the legal aspects of this topic is provided to assist policy makers and to serve as a foundation for the recommended establishment of a multidisciplinary committee to develop a uniform national policy. Both legal and medical realities call for the formulation of a clear policy to guide those who must make the decisions on this issue.

There are several theoretical reasons to believe that media use might be related to attention-deficit/hyperactivity disorder (ADHD) or ADHD-related behaviors (i.e., attention problems, hyperactivity, and impulsivity). Although studies into the media-ADHD relationship have accumulated, they have yielded inconsistent results. Therefore, we still do not know whether children’s media use and ADHD-related behaviors are related and, if so, under which conditions. To fill this gap in the literature, we first identified 6 different hypotheses that may explain why media use in general and viewing fast-paced or violent media content might be related to 1 or more ADHD-related behaviors. Subsequently, we conducted a meta-analysis of 45 empirical studies investigating the relationship between media use and ADHD-related behaviors in children and adolescents. Our results indicated a small significant relationship between media use and ADHD-related behaviors (r+ = .12). Finally, we identified several specific gaps in the existing literature and presented 5 crucial directions for future research. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

The neural dys-synchrony associated with auditory neuropathy spectrum disorder (ANSD) causes a temporal impairment that could degrade spatial hearing, particularly sound localization accuracy (SLA) and spatial release from masking (SRM). Unilateral cochlear implantation has become an accepted treatment for ANSD but treatment options for the contralateral ear remain controversial. We report spatial hearing measures in a child with ANSD before and after receiving a second cochlear implant (CI).An 11-year-7-month old boy with ANSD and expressive and receptive language delay received a second CI eight years after his first implant.The SLA and SRM were measured four months before sequential bilateral CIs (with the contralateral ear plugged and unplugged), and after nine months using both CIs.Testing done before the second CI, with the first CI alone, suggested that residual hearing in the contralateral ear contributed to sound localization accuracy, but not word recognition in quiet or noise. Nine-months after receiving a second CI, SLA improved by 12.76° and SRM increased to 3.8-4.2 dB relative to pre-operative performance. Results were compared to published outcomes for children with bilateral CIs.The addition of a second CI in this child with ANSD improved spatial hearing.

Patients with suspected gastroesophageal reflux disease (GERD) should undergo a thorough preoperative workup. After establishing the diagnosis, the treatment should be individualized and a decision about an operation made jointly between surgeon and patient. The indications for surgery have changed in the last twenty years, as the minimally invasive approach to antireflux surgery has allowed good control of reflux with a short hospital stay, fast recovery and excellent long term results. This article reviews the current status on diagnosis and treatment of GERD in the United States.

Contains fulltext : 124168.pdf (Publisher’s version ) (Closed access) The present study investigated whether and how a picture book promoting carrots can increase young children's carrot consumption. One hundred and four children (aged 4-6 years) participated in shared reading sessions using the book on five consecutive days in school. These children were assigned randomly to one of four experimental conditions. In a 2 x 2 between-subjects design, the reading style and character in the book were manipulated. The reading style was either passive (listening to the story) or interactive (also answering questions about the story). The character in the book fitted either conceptually well with carrots (a rabbit) or not (a turtle). Compared to a baseline group of 56 children who were not exposed to the book, the children in the experimental groups consumed almost twice as much carrots (in proportion to other foods consumed), F(1,159) = 7.08, p < .01. Results suggest that picture books are particularly effective when children are actively involved, answering questions about the story. Young children seem to enjoy this interactive shared reading style, triggering positive feelings that increase children's liking and consumption of the healthy food promoted in the book.