Positive and negative effects of increased video game use- 4/17/13

Pro 1: Great educational tool

Educational video games are not as popular in our culture as other action games but when they are used they are a fun, interactive way for kids to learn. When I was growing up I learned to type using Mavis Beacon, learned how to be resourceful playing the Oregon Trail, and mastered words with Word Munchers. I remember those video games being my favorite way to learn, it added variety to school and provided a learning tool for the more visual learner.

Pro 2: Better performance on attention-demanding tasks

A study conducted by Mishra et al. described how players of action video games are able to quickly pick out important information in an over-stimulating situation, divide their attention between multiple tasks, and are able to avoid distraction better when compared to non video game players (2010). This has only been shown to be true with action video games but could be a benefit to children with shorter attention spans and could be particularly useful for increasing focus in school.


Con 1: Increased risk of aggressive behaviors

Each year hundreds of new video games are released, amongst the most popular titles such as Call of Duty, Mass Effect, Assassin’s Creed, Halo, Hitman, and World of WarCraft (IMBD, 2012). Though some are more popular than others they all have one thing in common, violence is a central theme. I am not a video-gamer myself but I have seen these games being played and typically the player carries a weapon is sets out to kill the enemy which ranges from anything from a solider to a mythical creature.  According to a meta-analysis, “A primary process in such socialization is observational learning taken in its broadest sense. Children and adolescents mimic what they see in the short run and acquire complicated scripts for behaviors, beliefs about the world, and moral precepts about how to behave in the long run from what they observe” (Huesmann, 2010). So if we are exposing children to constant violence there is a chance this will alter their perception of reality and eventually lead to behavior changes. This meta-analysis goes on to explain that there is a definite correlation between short term aggression and playing a violent video once but also long term aggression for those who regularly play violent games.

Con 2: More inactivity leads to higher rate of obesity

Our country is currently facing an obesity epidemic, according to the Center for Disease Control, 17% of children in this nation on considered obese (2012). This rate has been climbing throughout the last 20 years and high incidences can be contributed to unhealthy diets and lack of exercise. Also within the past few generations, the amount of time children spend playing video games has gradually increased as well. It is no secret that this correlation is a huge contributor to our current epidemic and is encouraging a sedentary lifestyle for many American children. The time spent in front of the TV takes away from time for active play, a healthy and necessary ingredient for development.  

References

Bo, S., Ciccone, G., Durazzo, M., Ghinamo, L., Villois, P., Canil, S., Gambino, R., Cassander,     M.,    Gentile, L., Cavallo-Perin, P. (2011). Contributors to the obesity and hyperglycemia     epidemics. A prospective study in a population-based cohort. International Journal of      Obesity 35(11); 1442-1449.

Center for Disease Control (2012). Overweight and obesity. Retrieved from             http://www.cdc.gov/obesity/data/facts.html.

Huesmann, R.L. (2010). Nailing the coffin shut on doubts that video games stimulate aggression:             Comment on Anderson et al. Psychological Bulletin 136(2).
 IMBD (2012). Most popular video games released in 2012. Retrieved from             http://www.imdb.com/search/title?sort=moviemeter&title_type=game&year=2012,2012.

Mishra, J., Zinni, M., Bavlier, D., Hillyard, S. (2011). Nueral basis of superior performance of       action videogame players  in an attention-demanding task. The Journal of Neuroscience         31(3), 992-998. 

Extra Credit Blog: Contagion

 I had originally seen this movie when it first came out several years ago; now having watched it with a new understanding of epidemiology and how public health organizations work, it was intriguing to see how “Contagion” could become a reality.  Just as we learned about the epidemiological triangle the 3 elements of this movie are the MEV-I virus, the host being people (however it originally came from bats), and the environment of being mostly in densely populated areas because it spreads easily via fomites and airborne. You certainly see in this movie how there is a web of causation and as things progress in the plot line how it all interrelates. I would believe this this movie to portray analytical epidemiology because they are trying to analyze the virus, draw hypotheses of where it came from, how it works, and how to fix this problem with experimentation.

 I really thought the movie had an interesting plot line and a lot of realistic information; therefore, I would give this movie a 4 star rating. I thought it a very realistic approach in the chain reaction of different agencies get involved starting with the Minnesota Department of Health,  progressing to the CDC and WHO  monitoring all the different incidence of new cases that started to occur. Finally it ended up to the point where there was involvement of FEMA and federal agencies of other countries. I think it had very accurate information regarding expertise of the public health workers and their struggles. For example Kate Winslet’s character, Dr. Erin Mears, was trying to describe the seriousness of the spread in regards to the virus’s incubation period. The agency was very skeptical, but for a good reason. They did not want to cause panic and chaos like in the case of the H1NI virus. They had been very cautious in the H1N1 case, however little really happened. However, as Dr. Ellis Cheever (Laurence Fishburne) brilliantly said it is better to be more prepared or expect the worst then have many people die because they did not take it seriously enough action. Although the reaction of the regular town’s people may have been overdramatized due the fact it being a film, I would expect something of this magnitude and pandemic to occur, there would most certainly be this type of fear and panic. Finally it did a great job of showing how it is the public health role of vaccines, inoculation, and even though not shown, air, water, and environmental testing.

Overall it was really enjoyable movie now having a grasp of the disease process and types of disaster planning with public health involvement. And if there is anything important we can get form this film, let us at least see the importance of WASHING OUR HANDS!!!!...for my sake and yours!!

Pro/Cons of Video Gaming- 4/17/2013

How many times have we heard from our parents and grandparents' generation how they had spent their time as children playing outside getting dirty, going to the community pool, working hard on a family-run farm, or playing with neighbors and friends all around town. Today it safe to say that "kids these days" have a somewhat different lifestyle and the concept of play that has greatly changed within the past 50 years. In a era where technology is available at the touch of our finger tips, kids have embraced the use of home gaming systems and travel size devices that have become an integral part of our culture.

Interestingly the creation of video games actually goes back to 1952 but it wasn't until the the late 1970's to 1980's that video games started to develop and gain popularity with the invention of arcade games (PBS, 2013).  Since then these games have provide hours of entertainment to thousands of people. However, with their popularity, parents and specialist have began to wonder if they are doing more harm than benefit for kids.

The advancement and technology available is incredible with these "toys". Not only are we able to implement these for recreational fun, but video games also can and have been used for educational purposes. According to the Utah Valley Pediatrics, "When video games have been used in the classroom, teachers see improved test scores. Games also allow students to learn and then apply what they have learned in a real-life situation" (2011). I think back when I there was a huge push for use of Leap Frog or Hooked on Phonics. These are great interacive games that children can use on hand held devices or on the computer to help learn to read. Other features help with early developmental stages they are in with identification, counting, letters, etc. Although a disadvantage is that children are not being active, with the creation of the Wii Nintendo Fit game children are actually able to use this this to stay fit and in some cases not even knowing they are. A 2010 survey by the American Heart Association and Nintendo of America " showed that games requiring active-play increased physical activity in the real world" (Utah Valley Pediatrics, 2011).

However, there are many disadvantages that people are quick to point out. One obvious one is that children are not being social and developing that human interaction and play needed at a young age. Games can become addictive to the point where children spend hours in front of the television. Playing video games releases certain neurotransmitters, like dopamine, which leave a feeling of wanting to  "do it again.” (Utah Valley Pediatrics, 2011). These video games are actually created to be addictive. Another aspect is that games can have extremely violent content that many parents do not closely monitor. Some studies have even shown that this violence seen can lead  to fighting, delinquency, and violent criminal behavior because of its desensitizing nature. (Utah Valley Pediatrics, 2011)

Some things we as nurses can do is to tell parents what adverse affects these games can have. Like anythingm  they are fine in moderation and monitoring. We should inform them that some games are inappropriate for certain ages and to be aware of ratings on games. A interesting web site for kids shows how gaming could be bad for them in a simplistic manor; this can even help parents.  http://fit.webmd.com/kids/recharge/article/screen-time

References





PBS. (2013). The video game revolution . Retrieved from http://www.pbs.org/kcts/videogamerevolution/index.html

Web MD. (2013). Are tv and video games that bad?. Retrieved from http://fit.webmd.com/kids/recharge/article/screen-time

Utah Valley Pediatrics (2011). Video games: Pros and cons. Retrieved from    http://www.uvpediatrics.com/news/2012/02/video-games-pros-and-cons/

Extra Credit: Culture Shock in Iraq - 04/11/13

Culture shock is the "state of disorientation or inability to respond to the behavior of a different cultural group because it holds sudden strangeness, unfamiliarity, and incompatibility to the newcomer's perceptions and expectations" (Nies & McEwen, 2011, p. 227).  Culture shock can occur in any transition to a new environment.  It can be as simple as visiting a new place, such as a hospital, or as radical as visiting or moving to a new country.  CPT Rene De La Rosa and CPT Kevin Goke, registered nurses of the United States Army, describe the themes of suffering and healing while serving at Abu Ghraib Internment Facility in Iraq and the mutual cultural shock experienced by both sides of the war effort. 

From the perspective of the nurses, there were many cultural differences from that of the United States culture.  First, the Hospital at Abu Ghriab was assigned to take care of detainees with acute and chronic conditions, a finite number of beds, and limited supplies.  Because the hospital risked attacks, the hospital personnel "had to wear a flak vest, Kevlar helmet, and carry a weapon at all times during times of increased danger level in the area" (p. 54).  The healthcare of the Iraqi people is also as poor. 

In 2005, the infant mortality rate was reported to be 48.64 deaths per 1,000 live births, as compared to 6.43 deaths in the United States.  Additionally, 30% of the children were affected with diarrhea, measles, respiratory infections, or malaria due to lack of immunizations, healthcare centers, and hospitals.  With death and illness of infants and children, mental illness such as depression is bound to occur.  25% of the Iraqi people suffer from mental illness, however "a large stigma exists for the whole family of psychiatric patients" as Saddam Hussein believes that "depression doesn't exist in Iraq, depression is a sickness derivative of western societies, we are all happy here" (p. 54).  The long years of war and torture have affected individuals mentally and physically.  Iraqi citizens who refused to serve in the army had their ears cut off. 

Secondly, it was a shock to the nurses was the lack of record keeping when individuals did seek healthcare.  American patients have a chart that notes the visit, history, recommendations, diagnoses, and treatment.  The Iraqi physicians keep a record of the care, however it is takes place in their own record books.  If the individual sees a different provider, there is no record of their prior care.  This lack of record keeping has caused an increase in self-medicating and drug abuse.  It was "common for prisoners under Saddam's regime to receive all the Artane and Valium along with all the cigarettes they could handle" during their 7 day punishment period (p. 55).  Overall, the nurses found that the medical system was not set up for the modern medications available to the rest of the world.

The Iraqi detainees also experienced a culture shock.  Because they were detained for suspicious activity, they had to learn the ways of the camp.  Many did not know how to react to receiving superior healthcare while in the prison.  The Iraqi people do not go to their local provider for an evaluation and for most of them, it was the first time they received a thorough checkup (p. 57). 
Many were astounded that males could be nurses and how smooth their skin was as the "skin on the men's faces could be considered like shoe leather" (p. 54, 57).  The men also joked with the American nurses about how many wives they had.  When they would respond one, they would press as to why and they would respond that "the first wife spent all of our money" (p. 57). 

Overall, although the American nurses were shocked to find so many cultural differences, they were able to assist in completing their mission and "use the most disarming tactic known to mankind: the human smile" (p. 58).  It didn't matter that they had a different culture or language; they were still able to provide care. 

Reading the account of the nurses opened my eyes to the differences of other cultures.  Even though I have experienced culture shock, I have never experienced it to this extent.  Working in healthcare, we will come across individuals of different cultures who have different values, beliefs, and attitudes than us, like the Iraqi people.  In some cases, it may not alter the approach to their healthcare needs but in other situations an alternate approach needs to be taken to accommodate.  As nurses, it is important to be aware and educated of the cultural differences in the area we are providing care.  Doing so will make the patient and their family comfortable and allow you to provide optimal care.

So I ask you: Have you ever experienced a culture shock?  How did it make you feel?  Did you gain a valuable insight from the experience?  How can you apply the experience to your future career as a nurse?

Link to article:  Reflections on Suffering and Culture in Iraq: An Army Nurse's Perspective

References:

 

De La Rosa, R. , & Goke, K. (2007). Reflections on suffering and culture in iraq: An army nurse perspective. International Journal for Human Caring, 11(2), 53-58.

Nies, M.A. & McEwen, M. (2011). Community/public health nursing: Promotion the health of
populations (5^th ed.) St. Louis, MO: Saunders/Elsevier.

School-Age Child Fear - 04/03/13

The lifespan from age 6 years to approximately 12 years is often referred to as the school-age years.  During this timeframe, children are impacted significantly developmentally and physiologically.  Children become more mature physically as their bodies grow into adolescents.  They also begin to mature mentally, spiritually, and socially.  School-aged child are becoming increasingly independent, however fears still exist. 

An online dictionary (2013) defines fear as the distressing emotion aroused by impending danger, evil, or pain, whether the threat is real or imagined.  During the maturation, the child begins to loose some of the preschooler fears and develop new fears.  During this stage, normal development events include a variety of anxiety symptoms.  These include a fear of the dark, excessive worry about past behavior, self-consciousness, social withdrawal, and an excessive need for reassurance (2011). 

Many children have fears relating to school and families and fear failing and being bullied.  Because of these fears, body image becomes important during the school age years.  Children “evaluate how their physical appearance, body configuration, and coordination compare with those of their peers” and emulate others, especially those in the media (2011).

The image is a demonstration of a child’s altered perception of their body image.  Hockenberry and Wilson state that “children are aware of physical disabilities in others, and it is not unusual for them to believe that their own bodies are not the right size or the right shape or are in some way defective” (2011).  In the image, the syringe is symbolic of a child looking at themselves.  Although the syringe is looking into the mirror, the perception is altered.  Therefore, the reflection displays a larger syringe looking back. 

Hockenberry and Wilson (2011) suggests that adults involved with the children should discuss their fears individually or through group activities.  Although the fears may seem simple and silly, child need to know that their concerns are heard, understood, and respected.  Being ridiculed may only incline the child to hide their fears for the fear of being labeled a "baby" or "chicken".  By hiding their fears, it only develops displaced  fears and even phobias.  

References 

Fear. (2013). In Dictionary.com.  Retrieved from http://dictionary.reference.com/browse/fear

Hockenberry, M. J., & Wilson, D. (2011). Wong's nursing care of infants and children. St. Louis, MO:

        Mosby/Elsevier.

Childhood Fear

This model represents the preschooler age group; which are children between the ages three and five. At this age children are socializing with other children while slowly being introduced to attending school. The are learning to control their body and bodily functions and also be able to be away from their parents for brief or prolonged periods of time. They are increasing their vocabulary, their attention span is getting longer, and they have a better memory. This time period is spent refining many of the tasks that they achieved as a toddler.

According to Hockenberry and Wilson the greatest number and variety of real and imagined fears are present during the preschool years. Fear is an unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or is a threat (2011).

This picture is a model of the preschool age fear of monsters that they may see coming out of things or hiding under things. If a preschool aged child sees a commercial of the scum monsters coming out of a toilet or dust monsters under a bed they might be fearful of their own toilet or bed which makes going to the bathroom or sleeping more difficult. They don’t quite understand that it isn’t real as this age and they can't differentiate between what is an animation and what is actually real.

References

Hockenberry, M. J., & Wilson, D. (2011). Wong's nursing care of infants and children. St. Louis, MO: Mosby/Elsevier.

Current Event- Anthrax Vaccination in Children 3/27/13

          Childhood vaccination usually consists of the typical measles, mumps, rubella, tetanus, influenza and the list goes on. A story that has reached national news recently is the controversy about testing anthrax vaccination in children. When I came across this article on the NBC News webpage, I honestly never even knew people got vaccinated for anthrax exposure. Caplan (2013), the head of the Division of Medical Ethics at NYU, talks about the controversy of this topic and why it is risky to approve studying the safety of anthrax vaccines in children. The reason that one may be interested in vaccinating their child in the first place is in sight of a terror attack. The U.S. government conducted a bioterrorism preparedness exercise in 2011 studying the results of anthrax spores on a major city. Results demonstrated that “nearly 8 million citizens would be affected, nearly a quarter of them children” (Caplan, 2013). The National Biodefense Science Board and other commissioners are recommending that the government start conducting studies in pediatric patients but Caplan revokes, “there is not a chance that a sufficient number of American parents are going to sign up their kids” (2013). Anthrax vaccines are given to millions of adults in the military, however no one knows what effect using this vaccine would cause in children (Caplan, 2013). Also, if a child has any other medical diagnoses such as allergies, asthma, diabetes, or cancer, the risk for testing increases greatly.

            This controversy about testing in children or not leads to a great mess of ethical and legal issues. According to Caplan’s article, “the commissioners have found a small ethical opening through which a study might pass” (2013). To me, this type of research has ethical issues written all over it. First of all, parents would need to voluntarily sign up to be part of this study. As mentioned above, I’m not so sure how many parents would be willing to jump on this band wagon. The vaccine itself is a series of five- yes I said five-shots (Caplan, 2013). Military participants find this vaccination helpful and the side effects of burning, headaches, joint and muscle aches, and rashes are nothing compared to being bombarded with an anthrax-loaded shell. In children, however, these simple side effects can be exacerbated by any other medical diagnoses or their physical immaturity in general. From a community health standpoint, I can see why commissioners would want to study this in children. If a community were to experience a bioterrorism attack, a disaster plan could be implemented and the population may see less complications if anthrax vaccines were offered to all ages. Overall, I do not see studying the safety of anthrax in a pediatric population as ethical. Parents may inquire about this vaccine for their children, and it is our duty to understand and give the best recommendation for the health of their child. According to Hockenberry and Wilson (2011), “ nurses are at the forefront in providing parents with appropriate information regarding childhood immunization benefits, contraindications, and side effects on the child’s health” (p. 506). The parents that would volunteer children may only do so because they have a healthy child. The study population may be skewed and could affect results. Overall, there are too many unknowns and preventable harm could be caused to young, innocent children.

References

Caplan, A. (2013, March 19). Bioethicist: No chance of anthrax trials in kids. NBC News. Retrieved from http://vitals.nbcnews.com/_news/2013/03/18/17361790-bioethicist-no-chance-of-anthrax-vaccine-trials-in-kids?lite

Hockenberry, M. J., & Wilson, D. (2011). Wong's nursing care of infants and children. St. Louis, MO: Mosby/Elsevier.