Evaluating the Effectiveness of Bite-Sized Animations in Teaching Palliative Care to Medical Students

BACKGROUND

Current palliative care training in medical school is inadequate in preparing doctors to provide quality palliative care. Little attention is paid to determining effective methods of training.

OBJECTIVE

To assess the use of bite-sized animations in improving the confidence, knowledge and attitudes of medical students towards palliative care.

METHODS

A mixed methods cohort study was adopted for the study. 50 medical students without prior palliative training completed questionnaires before and after watching a 12-part animated palliative care video series called PowerFacts. Of these participants, 18 underwent semi-structured interviews.

RESULTS

The quantitative results showed that animations are effective in improving the confidence (P < .001) and knowledge (P < .001), but not the attitudes (P = .183) of medical students. Confidence, knowledge and attitudes were not correlated. Analysis of follow-up interviews of a convenience sample of participants showed that animations can be effective in teaching knowledge and does fill some gaps in palliative education for medical undergraduates. However, the content delivered as a sole learning tool is inadequate in preparing medical students for clinical practice.

CONCLUSION

All participants achieved level 1 (reaction), some achieved level 2 (learning) but most did not achieve level 3 (behaviour) of the Kirkpatrick's model. There is a need for a multimodal approach in the comprehensive teaching of palliative care in undergraduate medical training to achieve all four levels of the Kirkpatrick Model.

Evidence of Language Development Using Brief Animated Stimuli: A Systematic Review

There is limited evidence regarding the effect of animation compared to static pictures on children's language development. The aim was to systematically review the available literature for evidence concerning the effect of brief animation on spoken language responses (receptive-listening or expressive-speaking) in typically developing (TD) children aged 3 to 9 years. Five databases were searched, resulting in seven included studies. The characteristics of animated stimuli, the manner of presentation, and the language-related tasks were recorded, and questions were posed about the effect of brief animation on children's receptive and expressive language abilities. The evidence suggests that animation may have a positive effect on expressive language abilities of children compared to static pictures. As far as the effect of animation on receptive language performance is concerned, the evidence is less concrete. Future directions regarding the potential of animation on language development are discussed.

Effects of Delivering an Animation-Based Inclusive Sex Education Curriculum for Adolescents in China

Evidence suggests that tailored inclusive sex education can be an effective response to prevent gender-based violence and promote an inclusive educational environment. This study examined the effects of an age-appropriate and animation-based inclusive sex education curriculum among Chinese adolescents. A total of 243 students from one comprehensive vocational high school participated in the study. Attitudes toward homosexuality and relevant knowledge were assessed using Attitudes Toward Lesbians and Gays Scale and researcher-made questionnaires at the preintervention and postintervention. Results indicated that adolescents' attitudes and knowledge showed improvement after intervention; female students showed more positive attitudes toward homosexuals; and the animation-based inclusive sex education was welcomed by most participants. Implications of the findings and directions for future research were also discussed.

The effect of an educational animation on knowledge of testicular health and fertility of adolescents

STUDY QUESTION

Does the provision of an educational animation, developed with young people, about testicular health and fertility impact the knowledge of these topics among adolescents?

SUMMARY ANSWER

The development and provision of education on testicular health and fertility were welcomed by adolescents and associated with a significant increase in knowledge.

WHAT IS KNOWN ALREADY

Young people may know less than they should about testicular health and male fertility topics. Lack of knowledge can have implications for health including late medical help-seeking for signs and symptoms of scrotal disorders, such as torsion, for which late presentation frequently results in testicular damage.

STUDY DESIGN, SIZE, DURATION

A mixed methods experimental pre- and post-design was used with embedded qualitative data collection. High school students completed a pre-animation questionnaire, watched four animations on testicular health and fertility, and completed a post-animation questionnaire. Data were collected during Personal Social and Health Education lessons across a 2-week period.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Four animations on testicular health and fertility, informed by andrologists, academics, designers, boys, and young men, were developed. Eligible participants were boys and girls in the UK school years 8 and 9 (age 13-14 years). Participants completed a Time 1 (T1) survey (fertility knowledge, demographics) prior to watching the animations and a Time 2 (T2) survey (fertility knowledge, perceptions of the animations) immediately after the animations. Perceptions were rated on 10-point response scales (higher scores better). Participants additionally expressed in their own words positive and negative aspects of the animations. ANOVA was used to examine the effects of the animations using a 2 (time: T1, T2)×2 (gender: male, female) design on topic knowledge, perceived importance, usefulness, and style of the animations according to gender. Regression analysis examined the associations between gender, disability, class year, and knowledge at T2 while controlling for knowledge at T1. Qualitative data on perceptions of the animations were analyzed using inductive thematic analysis.

MAIN RESULTS AND THE ROLE OF CHANCE

Results showed that the animations significantly increased testicular health and fertility-related knowledge from T1 (x̄=41.84 ± 24.72) to T2 (x̄=79.15, ±15.04). Boys had significantly higher levels of knowledge compared to girls at T1 (x̄=44.74, SD = 25.16 versus x̄=37.79 ± 23.49, respectively) and T2 (x̄=80.07, SD = 15.68 versus x̄=77.89 ± 14.30, respectively) but knowledge gain from T1 to T2 was not significantly different according to gender (P = 0.11) as shown by non-significant gender×time interaction. There were no significant gender differences in the perceived usefulness and importance of the animations or liking of the style of the animations, with both genders considering the animations as useful, important, and likable. Regression analysis showed only knowledge at T1 to be significantly associated with knowledge at T2. Qualitative data showed three main themes: accessibility of important and useful information; information engagement and help-seeking behaviour; and inclusivity of information.

LIMITATIONS, REASONS FOR CAUTION

This was a pre- and post-study with a sample of young people from a selected educational institution without a control group. Only short-term effects of the animations were recorded.

WIDER IMPLICATIONS OF THE FINDINGS

Adolescents are interested in and learn from the provision of engaging fertility-related information. Boys and men should be considered as being a relevant target population for fertility education, not just girls and women.

STUDY FUNDING/COMPETING INTEREST(S)

This research was carried out in partnership with the British Fertility Society, was financially supported by an Economic and Social Research Council Impact Acceleration Award (520792) and commercial sponsorship from iMediCare Ltd, Bayer AG, Merck Group, Cryos International given to the British Fertility Society, and a financial contribution from Orchid Cancer Appeal. The authors are fully responsible for the content of the animations and this manuscript, and the views and opinions described in the publication reflect solely those of the authors. J.B. reports a grant from Merck Serono Ltd outside the submitted work. C.H., G.G., A.D., E.B., U.G., M.L, B.W., and M.H. declare no conflict of interest. K.M. reports honoraria from Bayer and Merck. A.P. reports paid consultancy for Cryos International, Cytoswim Ltd, Exceed Health, and Merck Serono in the last 2 years, but all monies have been paid to the University of Sheffield.

TRIAL REGISTRATION NUMBER

N/A.

Three-Dimensional Virtual Reconstructions of Shoulder Movements Using Computed Tomography Images: Model Development

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The Ashes of Tragedy: Parental Death and Child Character Development in Bambi and The Lion King

The Walt Disney company has been the topic of extensive research for decades; among the explored subjects and identified themes is Disney's fixation on death. Disney has capitalized on the incredibly traumatic childhood experience of the death of a parent by featuring parental death as a major narrative component. Speculation remains regarding the accuracy of not only death presentations in media, but death influence on characters. Using textual analysis, this paper explores the role of parental death on child character development within two Disney animated films. Analysis demonstrates an inaccurate depiction of parental death influence on children in a positive light - essentially overlooking the trauma associated with loss during childhood and the mediating factors of long-term bereavement outcomes. Conversations remain to be had regarding how these inaccurate depictions of death and dying in popular culture influence the children consuming them.

Effects of Animated Movies on the Aggression and Behavior Performance of Primary School Students and Their Control Using a Cognitive Behavioral Anger-Control Training (CBACT) Program

This work is a combination of two studies, Study I and Study II, which aimed to examine the impact of animated movies on the aggression and behavioral performance of primary school students, as well as their control using the CBACT program. In Study I, the influence of animated movies on 300 students from ten primary schools in Pakistan with gender differences (50% male), family systems, and viewing time duration was examined. This study was performed on 7- to 9-year-old children on four subscales of the Buss-Perry aggression questionnaire (BPAQ), three subscales of the child behavior questionnaire (CBQ), and toy selection. Following that, in Study II the CBACT intervention was applied to aggressive students (n = 46) selected from Study I. Students were randomly divided into CBACT treatment (50%) and control groups. The results of Study I indicated that violent animated movies had a greater impact on the aggressive behavior of male students than on that of females, while girls were more affected by watching nonviolent movies. Furthermore, male viewers from nuclear families and females from joint families showed more aggressive problems. It was also observed that aggression in students significantly increased (p < 0.001) with increasing viewing animation time duration (10 to 30 min). The results of Study II showed that aggression in the treatment group was significantly reduced (p = 0.000) with the CBACT program but remained constant for the control group. The findings of Study I showed that violent animation is strongly linked with aggression and behavioral performance in primary school students. The CBACT program in Study II indicates that students may not be completely eliminated from watching violent movies, but their aggression levels were reduced when they watched animated movies. Therefore, the CBACT program opens a new window into behavioral problem treatment, which is casually influenced by violent media.

Animation in AAC: Previous research, a sample of current availability in the United States, and future research potential

Animation has been studied in the augmentative and alternative communication (AAC) literature regarding increasing transparency of symbols and decreasing operational demands of the interface design. This study investigated a sample of AAC devices to determine the presence and purpose of animation in the systems. We found that the majority of the animation found on AAC devices serve the function of providing feedback to the user. Future exploration of the use of animation in AAC through capitalizing on previous research, new technology, and as a method to foster linguistic and operational competence are considered. Clinical and research implications of these findings are discussed.

Bemoaning Bambi: Visual Communication of Trauma From Witnessing One of Disney's Saddest Character Deaths

Disney's collection of character deaths has been described by both consumers and academics as traumatic. Among the most often cited traumatic Disney deaths is that of Bambi's mother. Audiences engage in discussion online about the ways in which the film showcased a traumatic character death that left a lasting impression into adulthood, but the image referenced in these discussions offers more to researchers than mere words. Using a widely circulated audience-produced image of Bambi's mother's death, the following paper connects the symbolic elements within the image to larger cultural ideologies and assumptions about death and trauma. In doing so, it demonstrates how audiences communicate through visual medium the trauma of viewing animated death.

Drawing Disney: Analyzing Artistic Reinterpretations of Disney Deaths

Disney's notably traumatic character deaths have been the focus of several academic studies that identify the potential harm of witnessing animated deaths during childhood; however, these studies have almost exclusively examined death images within film without looking to images that exist external to the media texts themselves. This paper addresses such limitations by uniquely examining how audiences use/produce images to offer reinterpretations of popular death scenes in Disney films. The components of user-generated images, descriptions, and comments on deviantart.com indicate that audiences utilize creative expression to communicate the traumatic experience of viewing character deaths during childhood, change elements that are frustratingly inaccurate, and re-write narratives to challenge assumptions of sympathy. Such an analysis considers what these artistic expressions might suggest about the decoding of animated death by consumers and encourages new ways of thinking about the consumption and interpretation of death narratives.

Using Community-Based Participatory Research to Create Animated Videos to Attenuate Disparities in Access to Kidney Transplant Information

Introduction: Community-based participatory research and animated video offer promising approaches to attenuate disparities in access to kidney transplant information. Project Aims: We refined an evidence-based animated video curriculum (Kidney Transplant and Donation Information Made Easy) designed for diverse individuals, that is currently being trialed to advance kidney transplant access among referred patients at a single transplant center, to further accommodate information needs in earlier stages of the path to transplant (pre-referral) and to enhance fit for Black and Hispanic people. Design: We describe formation of an academic-community partnership and the application of qualitative research methods and partnership discussions to refine the Kidney Transplant and Donation Information Made Easy videos. A simple content analysis was undertaken of intervention refinement transcriptions, minutes, and meeting notes. Results: We formed a community steering committee and advisory board of local members predominantly of minoritized race or ethnicity. Full engagement with community members is evident in the program's adaptation process. Essential refinement elements were adaptation of 17 original videos and iterative development of 8 new videos with the community, conducting parallel cognitive interviews of an expanded sample of stakeholders, maintaining the theoretical grounding of Elaboration Theory, communication/multimedia learning best practices, and self-efficacy framework, and doing Spanish-language translation. Conclusions: Applying community-based participatory research principles and qualitative methods, we produced a culturally grounded adaptation of the Kidney Transplant and Donation Information Made Easy videos that provides information about kidney transplantation from primary care to transplantation. This approach is likely to strengthen our community partnership and eventual community acceptance of the intervention during the implementation phase. Challenges were achieving consensus and adding Spanish-language translation.

Development of a Method for Peeling Off Paper from Celluloid Pictures for Animation Films

During the storage of celluloid pictures for animation films over half a century, an interleave paper adhered to acrylic paint. The purpose of this study is to establish a methodology to cleanly remove the paper from the paint. A layered film, a replica of the celluloid pictures, adhered with paper was prepared and immersed in water or ethanol. The effect of these solvents on the peeling behavior was investigated using a peel test. The maximum peel force for the dry layered film in was distributed at ~0.5 N, independently of the peel speed. The peel force was significantly reduced after the layered film was immersed in pure water or ethanol. A morphological observation revealed that the dry paper was peeled off via the cohesive failure of the paper. After the layered film was immersed in pure water, the paper was also peeled off via cohesive failure. The layered film immersed in ethanol was peeled off at the paper/paint interface. To clear the effect of the volume change in the paint on peel behavior, the relative volume was determined via image analysis. The relative volume of paint was 1.56 in pure water and 1.37 in ethanol. It can be considered that the large difference in the volume of paint induces a large shear stress at the paint/paper interface.

Development of a video-based evidence synthesis knowledge translation resource: Drawing on a user-centred design approach

Objectives

We aimed to develop a video animation knowledge translation (KT) resource to explain the purpose, use and importance of evidence synthesis to the public regarding healthcare decision-making.

Methods

We drew on a user-centred design approach to develop a spoken animated video (SAV) by conducting two cycles of idea generation, prototyping, user testing, analysis, and refinement. Six researchers identified the initial key messages of the SAV and informed the first draft of the storyboard and script. Seven members of the public provided input on this draft and the key messages through think-aloud interviews, which we used to develop an SAV prototype. Seven additional members of the public participated in think-aloud interviews while watching the video prototype. All members of the public also completed a questionnaire on perceived usefulness, desirability, clarity and credibility. We subsequently synthesised all data to develop the final SAV.

Results

Researchers identified the initial key messages as 1) the importance of evidence synthesis, 2) what an evidence synthesis is and 3) how evidence synthesis can impact healthcare decision-making. Members of the public rated the initial video prototype as 9/10 for usefulness, 8/10 for desirability, 8/10 for clarity and 9/10 for credibility. Using their guidance and feedback, we produced a three-and-a-half-minute video animation. The video was uploaded on YouTube, has since been translated into two languages, and viewed over 12,000 times to date.

Conclusions

Drawing on user-centred design methods provided a structured and transparent approach to the development of our SAV. Involving members of the public enhanced the credibility and usefulness of the resource. Future work could explore involving the public from the outset to identify key messages in developing KT resources explaining methodological topics. This study describes the systematic development of a KT resource with limited resources and provides transferrable learnings for others wishing to do similar.

Preliminary feasibility of animated video education designed to empower patients' referral to kidney transplantation

BACKGROUND

Referral for kidney transplantation is influenced by patient education; digital technologies can enhance broad information accessibility. This single-group study tested the feasibility and acceptability of patient-centered self-directed educational animated videos to improve mediators of kidney transplant referral.

METHODS

Community-based adults with chronic kidney disease stage ≥4 invited from a clinical registry or self-responding to flyers viewed eight sequential videos (19:36 min total duration) remotely on their own device. Change in kidney transplant knowledge, concerns, and confidence talking about kidney transplantation to doctors was assessed with self-report surveys before and immediately after viewing. Program feedback was assessed by survey and self-selected exit interview.

RESULTS

Viewers of the video set (n = 50) demonstrated increases in mean kidney transplantation knowledge by +22%, confidence discussing with their doctor by +6%, and reductions in concerns by -2%. Knowledge results were consistent across age, race, and literacy level. Over 90% indicated positive ratings on understanding, engaging, and helpfulness. In post-study interviews viewers indicated the videos promoted confidence in obtaining a kidney transplant and none reported that the 19-min duration of the home education was too long.

CONCLUSION

The animated video education is promising to improve diverse individuals' knowledge, concerns, and communication confidence about kidney transplantation and is highly acceptable.

Animation Education Program Applied to Laparoscopic Sleeve Gastrectomy Patients Effect on Patient Care Results: A Randomized Controlled Trial

Laparoscopic sleeve gastrectomy is one of the most common bariatric surgical methods used in obesity treatment. As in every surgical operation, patients may face problems after the laparoscopic sleeve gastrectomy surgery. No study has been found in our country to investigate the effect of animation education applied to laparoscopic sleeve gastrectomy patients on patient care results. This study investigated the effect of animation education developed for respiratory rehabilitation among sleeve gastrectomy patients on patient care results. This is a randomized controlled study. A total of 66 patients who were going to have sleeve gastrectomy were randomly divided into two groups each including 33 participants. The intervention group was provided with animation education. The control group received routine face-to-face education. Postoperative risk of respiratory complications, presence of dyspnea, nausea, and vomiting, frequency of postoperative respiratory exercises, and satisfaction with postoperative respiratory education were examined. Patients' pain and sleep quality were examined 1 day before the surgery and on the postoperative first and fifth days. The mean postoperative fifth-day pain score of the experimental group was lower than that of the control group. The mean sleep score of the experimental group was higher than that of the control group. The early postoperative problems were less in the experimental group and all patients were satisfied with the animated respiratory education. The animation education developed for respiratory rehabilitation among sleeve gastrectomy patients promoted patient care results. Bariatric surgery nurses can use animation as an innovative education method to increase participation of patients who undergo sleeve gastrectomy surgery in health education and to improve patient care results.

Multimedia Instructions for Motor Control Exercises in Patients With Chronic Nonspecific Low Back Pain

BACKGROUND

Low back pain (LBP) is one of the top 3 diseases that may lead to disability. Current treatment guidelines define exercise as a first-line treatment for nonspecific LBP (NSLBP). There are various evidence-based exercise approaches for treating NSLBP, and many of them include motor control principles. Motor control exercises (MCEs) are better than general exercises that do not include motor control principles. Many patients find learning these exercises complex and challenging, in that MCE exercises have no standard teaching method. The researchers of this study developed multimedia instructions for an MCE program to make teaching MCE easier; thus, more effective.

METHODS

The participants were randomized into multimedia or standard (face-to-face) instruction groups. We applied the same treatments to both groups at the same dosage. The only differences between groups were the exercise instruction methods. The multimedia group learned MCE from multimedia videos; the control group learned MCE from a physiotherapist with face-to-face instructions. Treatment lasted 8 weeks. We evaluated patients' exercise adherence with Exercise Adherence Rating Scale (EARS), pain with the Visual Analog Scale, and disability with Oswestry Disability Index. Evaluations were made before and after treatment. Follow-up evaluations were carried out 4 weeks after the end of treatment.

RESULTS

There was no statistically significant interaction between the group and time on pain, F2,56 = 0.068, P = .935, partial η2 = .002 and Oswestry Disability Index scores, F2,56 = 0.951, P = .393, partial η2 = .033. Also, there was no statistically significant interaction between the group and time on Exercise Adherence Rating Scale total scores F1,20 = 2.343, P = .142, partial η2 = .105.

CONCLUSIONS

This study showed that multimedia instructions for MCE have similar effects to standard (face-to-face) instructions on pain, disability, and exercise adherence in patients with NSLBP. To our knowledge, with these results, the developed multimedia instructions became the first free, evidence-based instructions that have objective progression criteria and a Creative Commons license.

Improving the lives of ethnically diverse family carers and people living with dementia using digital media resources - Protocol for the Draw-Care randomised controlled trial

Objectives

Ethnically diverse family carers of people living with dementia (hereafter carers and people with dementia) experience more psychological distress than other carers. To reduce this inequality, culturally adapted, multilingual, evidence-based practical assistance is needed. This paper details the Draw-Care study protocol including a randomised control trial (RCT) to test the effectiveness of a digital intervention comprising a multilingual website, virtual assistant, animated films, and information, on the lives of carers and people with dementia in Australia.

Methods

The Draw-Care intervention will be evaluated in a 12-week active waitlist parallel design RCT with 194 carers from Arabic, Cantonese, Greek, Hindi, Italian, Mandarin, Spanish, Tamil, and Vietnamese-speaking language groups. Our intervention was based on the World Health Organization's (WHO) iSupport Lite online carer support messages and was co-designed with carers, people with dementia, service providers, and clinicians. Culturally adapted multilingual digital resources were created in nine languages and English.

Results

In Phase I (2022), six co-design workshops with stakeholders and interviews with people with dementia informed the development of the intervention which will be trialled and evaluated in Phases II and III (2023 and 2024).

Conclusions

Digital media content is a novel approach to providing cost-effective access to health care information. This study protocol details the three study phases including the RCT of a co-designed, culturally adapted, multilingual, digital intervention for carers and people with dementia to advance the evidence in dementia and digital healthcare research and help meet the needs of carers and people with dementia in Australia and globally.

From Entombment to Entertainment: Death Ritual in Disney Animation

The presentation of death in popular culture via media texts can not only serve as a reflection of death's religious and cultural nuances, but also occupies the potential to influence specific audiences. As developing social beings, children witness ample death-related messaging, including how to deal with death through ritualistic practices. The following article considers the observation of character behavior as an important element to message dissemination and uses 15 animated Disney films to analyze death ritual. Through various themes rooted in symbolism and mythos, Disney demonstrates within these films how death rituals in children's media remain imbedded with cultural and religious ideology.

A Creative Approach to Knowledge Translation: The Use of Short Animated Film to Share Stories of Refugees and Mental Health

This study used animated film to translate narratives of refugees and mental health into accessible material aimed at enhancing empathy and understanding. It focuses on the use of short animated films in series one and two of the Woven Threads catalogue. Series one shared moments of hope in a refugee's journey, whilst series two focused on people living with mental health challenges. This research was designed to understand the responses to viewing for people who watch these animations. A mixed-method design was used via an online Qualtrics platform that asked respondents to view two short animated films, one from the refugee series and one from the mental health series. 364 members of the general public viewed and responded to the refugee film and 275 responded to the mental health film. The platform collected both quantitative and qualitative data. Survey responses indicated that the majority of viewers found the films challenged public misconceptions about refugees and individuals with mental health challenges and left them with a feeling of hopefulness. Qualitative narratives were organised into one superordinate theme: the power of film as a knowledge translation strategy, with four subthemes: (i) changing perceptions and inspiring empathy, (ii) enhancing literacy, (iii) highlighting the power of storytelling, and (iv) encouraging hope and a sense of belonging. The use of short animated film as a knowledge translation strategy can enhance our understanding, promote deep reflection, increase empathy and has the potential to lead to social change.

["The association proposes animations and moments of distraction to the hospitalized children"]

The association Les Blouses roses intervenes in many hospitals in France, especially at the bedside of hospitalized children. It tries to bring them various animations, fantasy and gaiety in the dark universe of the disease. This is not always an easy task, but it is supported by the will to accompany the young patient and his family against all odds. Chantal Leroy, president of the Les Blouses roses committee in Grenoble (38) for two years, explains how it works.

["The association proposes animations and moments of distraction to the hospitalized children"]

Today, Le Rire médecin has thirty years of experience. It has 120 trained professional clowns who make more than 85,000 individualized visits to 58 pediatric wards in France. Caroline Simonds, the association's founding clown, and Dominique Valteau-Couanet, a pediatrician and former head of department at the Gustave-Roussy Institute in Villejuif (94), met for a two-voice, two-hearted discussion.

Testing the Effectiveness of an Animated Decision Aid to Improve Recruitment of Control Participants in a Case-Control Study: Web-Based Experiment

BACKGROUND

Participation in case-control studies is crucial in epidemiological research. The self-sampling bias, low response rate, and poor recruitment of population representative controls are often reported as limitations of case-control studies with limited strategies to improve participation. With greater use of web-based methods in health research, there is a further need to understand the effectiveness of different tools to enhance informed decision-making and willingness to take part in research.

OBJECTIVE

This study tests whether the inclusion of an animated decision aid in the recruitment page of a study website can increase participants' intentions to volunteer as controls.

METHODS

A total of 1425 women were included in a web-based experiment and randomized to one of two experimental conditions: one in which they were exposed to a simulated website that included the animation (animation; n=693, 48.6%), and one in which they were exposed to the simulated website without the animation (control; n=732, 51.4%). The simulated website was adapted from a real website for a case-control study, which invites people to consider taking part in a study that investigates differences in purchasing behaviors between women with and without ovarian cancer and share their loyalty card data collected through 2 high street retailers with the researchers. After exposure to the experimental manipulation, participants were asked to state (1) their intention to take part in the case-control study, (2) whether they would be willing to share their loyalty card for research, and (3) their willingness to be redirected to the real website after completing the survey. Data were assessed using ordinal and binary logistic regression, reported in percentages (%), adjusted odds ratio (AOR), and 95% confidence intervals.

RESULTS

Including the animation in the simulated website did not increase intentions to participate in the study (AOR 1.09; 95% CI 0.88-1.35) or willingness to visit the real study website after the survey (control 50.5% vs animation 52.6%, AOR 1.08; 95% CI 0.85-1.37). The animation, however, increased the participants' intentions to share the data from their loyalty cards for research in general (control 17.9% vs animation 26%; AOR 1.64; 95% CI 1.23-2.18).

CONCLUSIONS

While the results of this study indicate that the animated decision aid did not lead to greater intention to take part in our web-based case-control study, they show that they can be effective in increasing people's willingness to share sensitive data for health research.

Comparison of textbook versus three-dimensional animation versus cadaveric training videos in teaching laparoscopic rectal surgery: a prospective randomized trial

AIM

The aim of this prospective randomized study was to compare the effectiveness of various educational tools in laparoscopic rectal surgery, including surgical textbooks, animation and cadaveric videos.

METHOD

Initially, an electronic assessment test assessing knowledge of laparoscopic rectal surgery was created and validated. The test was sent to graduates completing a general surgery residency programme in Turkey, who were then randomized into four groups based on the type of study material. After a 4 week study period, the volunteers were asked to answer the same electronic assessment test imported into an edited live laparoscopic rectal surgery video. Pre- and posteducation assessment tests among the groups were compared.

RESULTS

A total of 168 volunteers completed the pre-education assessment test and were randomized into four groups. Pre-education assessment test scores were similar among the groups (p > 0.05). Of 168 volunteers, 130 (77.3%) completed the posteducation assessment test. Posteducation assessment test scores were significantly higher in the three-dimensional (3D) animation + cadaveric video group (p < 0.01), the 3D animation group (p < 0.01) and the cadaveric group (p < 0.01) compared with the textbook group. Moreover, posteducation assessment test scores were significantly higher in the 3D animation + cadaveric video group than the 3D animation group (p < 0.01). Each group's posteducation assessment test scores were significantly higher than the pre-education assessment test scores, with the exception of the textbook group.

CONCLUSION

Our study demonstrates that 3D animation + cadaveric videos, 3D animation alone and cadaveric videos are all superior to a surgical textbook when teaching laparoscopic rectal cancer surgery. Finally, our results show that 3D animation and cadaveric videos are also superior to textbooks in enabling an understanding of rectal surgery.

Anthropomorphic Character Animations Versus Digital Chalk Talks in a Resident Diabetes Pharmacotherapy Curriculum: a Randomized Controlled Trial

BACKGROUND

Animation in medical education has boomed over the past two decades, and demand for distance learning technologies will likely continue in the context of the COVID-19 pandemic. However, experimental data guiding best practices for animation in medical education are scarce.

OBJECTIVE

To compare the efficacy of two animated video styles in a diabetes pharmacotherapy curriculum for internal medicine residents.

DESIGN

Learners were randomized to receive one of two versions of the same multimodal didactic curriculum. They received identical lectures, group activities, and quizzes, but were randomized to either digital chalk talk (DCT) videos or Sugar-Coated Science (SCS). SCS is an animated series using anthropomorphic characters, stories, and mnemonics to communicate knowledge.

PARTICIPANTS

Ninety-two internal medicine residents at a single academic medical center received the curriculum within ambulatory medicine didactics.

MAIN MEASURES

Knowledge was measured at multiple time points, as was residents' self-reported comfort using each medication class covered. Surveys assessed video acceptability and telepresence. Key themes were identified from open-ended feedback.

KEY RESULTS

Baseline knowledge was low, consistent with prior needs assessments. On immediate posttest, mean scores were higher with SCS than DCT (74.8% versus 68.4%), but the difference was not statistically significant, p = 0.10. Subgroup analyses revealed increased knowledge in the SCS group for specific medication classes. Delayed posttest showed significant knowledge gains averaging 17.6% across all participants (p < 0.05); these gains were similar between animation types. SCS achieved significantly higher telepresence, entertainment, and acceptability scores than DCT. Qualitative data suggested that residents prioritize well-designed, multimodal curricula over specific animation characteristics.

CONCLUSION

SCS and DCTs both led to learning within a multimodal curriculum, but SCS significantly enhanced learner experience. Animation techniques exemplified by both SCS and DCTs have roles in the medical educator toolkit. Selection between them should incorporate context, learner factors, and production resources.

What's Up With Everyone? A qualitative study on young people's perceptions of cocreated online animations to promote mental health literacy

INTRODUCTION

Adolescence and young adulthood are especially critical times to learn about mental health, given that 75% of mental health issues are developed by the age of 24. Animations have great potential to effectively deliver mental health information to young people. A series of five short animated films to promote mental health literacy were created with and for young people in partnership with the multi-award-winning independent animation studio, Aardman Animations. The aim of this study was to explore young people's perceptions of the cocreated animated films.

METHODS

Seven Youth Juries were conducted to capture young people's opinions and recommendations about the content related to mental health literacy and presentation style of the cocreated animated films. Thematic analysis was used to analyse the audio transcripts.

RESULTS

Many participants reported a view that the animated films had the potential to promote mental health literacy, especially for understanding mental health and reducing stigma. Some recommendations were provided to improve the films, such as including subtitles and having a better transition to the companion website.

CONCLUSION

Cocreated animations have great potential to promote the mental health literacy of young people. We hope that the findings from the present study will inform future media development to make them as effective as possible.

PATIENT OR PUBLIC CONTRIBUTION

Young people were actively involved in the development, production, implementation and evaluation (up to the time before data analysis) of the animated films.

Effectiveness of the Use of Animation and Gamification in Online Distance Education During Pandemic

The study aimed to determine the effects on knowledge and motivation of animation and gamification in online distance education for a diabetes nursing course. This study was a randomized, controlled, prospective study implemented with 70 nursing students. The animation and gamification were applied to the experimental group. Data were collected using the "Diabetes Nursing Knowledge Test," "Instructional Materials Motivation Survey," and "Opinion Form on Diabetes Education Supported by Digital Instruments." There was a statistical difference between the Diabetes Nursing knowledge scores of the groups after the course (P < .05). The students in the experimental group had significantly higher attention and satisfaction and total scores from the Motivation Scale for Teaching Material sub-dimensions compared with the control group (P < .001). The results of our study in generation Z nursing students demonstrated that the use of animation and gamification in online distance learning in nursing students increased their knowledge as well as motivation.

Helping Children to Participate in Human Papillomavirus-Related Discussions: Mixed Methods Study of Multimedia Messages

BACKGROUND

Human papillomavirus (HPV) can cause several types of cancers and genital warts. A vaccine is available to prevent HPV infections, and several efforts have been made to increase HPV education and, eventually, vaccination. Although previous studies have focused on the development of messages to educate children about HPV and the existence of the HPV vaccine, limited research is available on how to help children better communicate with their parents and health care professionals about the HPV vaccination. In addition, limited research is available on the target audience of this study (Italian children).

OBJECTIVE

This manuscript describes a study assessing the feasibility of using an evidence-based animated video and a web-based game to help children (aged 11-12 years) participate in discussions about their health-in particular when such conversations center around the HPV vaccination-and improve several HPV-related outcomes. The study also compares the effects of these 2 educational multimedia materials on children's knowledge and perceptions of HPV prevention.

METHODS

A mixed methods approach consisting of focus group discussions and an experiment with children (N=35) was used to understand children's experiences with, and perceptions of, the animated video and the game and to measure possible improvements resulting from their interaction with these materials.

RESULTS

Both the animated video and a web-based game increased children's knowledge and positive perceptions about HPV and HPV vaccination. Any single message was not more effective than the others. The children discussed aspects of the features and characters they liked and those that need improvements.

CONCLUSIONS

This study shows that both materials were effective for improving children's education about the HPV vaccine and for helping them to feel more comfortable and willing to communicate with their parents and health care professionals about their health. Several elements emerged that will allow further improvements in the design and development of the messages used in this study as well as the creation of future campaigns.

Effectiveness of a Digital Intervention in Increasing Flu Vaccination-Related Risk Appraisal, Intention to Vaccinate and Vaccination Behaviour Among Pregnant Women

Background

Pregnant women are at increased risk of complications from flu, but uptake of flu vaccination is below 75% targets. Evidence suggests that changing illness risk appraisals may increase vaccination behaviour. In 2018–2019, researchers, public health specialists, and pregnant women co-designed a short animation targeting (unhelpful) beliefs underlying pregnant women’s flu risk appraisals aiming to promote vaccination uptake.

Aims

This study aimed to examine effectiveness of a digital intervention (animation) in increasing flu vaccination among pregnant women through changing illness risk appraisals.

Method

A prospective study design was used, involving convenience sampling of unvaccinated pregnant women recruited via a Qualtrics Online Panel. Participants received small payments via the panel for survey completion. Risk appraisals and intention to vaccinate were measured at baseline and immediately after intervention presentation (follow-up one). Six months later, a further survey (follow-up two) was administered measuring vaccination behaviour.

Results

Baseline and first follow-up surveys were completed by 411 participants. Watching the animation led to increased appraisals of likelihood of getting flu while pregnant and severity of flu during pregnancy, and increased intentions to accept flu vaccination during pregnancy. Of the 67 respondents who completed follow-up survey two, 38 reported having the vaccination while pregnant.

Conclusions

This study provides evidence supporting the promise of the intervention. Randomized controlled trials are required to produce definitive efficacy evidence. Should such a study prove intervention effectiveness, it could be readily embedded within existing campaigns at national and local levels by public health organizations.

The Effects of Designing an Educational Animation Movie in Virtual Reality on Preoperative Fear and Postoperative Pain in Pediatric Patients: A Randomized Controlled Trial

PURPOSE

The purpose of the study was to investigate the effects of watching an educational animated movie on fear and pain in children aged 6 to 12 years old.

DESIGN

A randomized controlled trial.

METHODS

In this study, the CONSORT checklist was used as a guide. The sample of participants (n = 132) was allocated to the Educational Animation Group (n = 44), Documentary Group (n = 44), and Control Group (n = 44) using block randomization. During the data collection, an information form, the Children's Fear Scale and Wong-Baker Faces Pain Rating Scale were used.

FINDINGS

Preoperative fear and postoperative pain scores were significantly lower in the Educational Animation group than in the other groups.

CONCLUSIONS

The educational animated movie was found to be an effective method in reducing preoperative fear and postoperative pain. Educational animated movies, which were effective in reducing the fear and pain of the child in the preparatory operations, increased the educational effectiveness and cooperation of the child.

Usefulness and acceptability of an animation to raise awareness to grief experienced by carers of individuals with dementia

AIM

Many carers of individuals with dementia experience high levels of grief before and after the death of the person with dementia. This study aimed to determine the usefulness, acceptability, and relevance of an animation developed to raise awareness to grief experienced by carers of people with dementia.

METHODS

This research had a cross-sectional survey design. We contacted carers of people with dementia over the phone or email. Participants evaluated the animation through an online or paper-based survey. We used descriptive statistics and analysed qualitative data using thematic analysis. We required a sample of 40 carers to adequately power the study with a target of 75% of carers finding the animation useful, acceptable, and relevant.

RESULTS

31/78 carers approached evaluated the animation. Ninety-four percent of participants found the animation relevant to their situation, meeting our target. However, we fell short of this target for usefulness (68%) and acceptability (73%). The qualitative responses suggested that participants felt the animation could help improve the understanding of grief among carers, family, friends, and healthcare professionals. Carers also shared that the animation would be most useful for carers of newly diagnosed people with dementia.

CONCLUSION

Most carers of people with dementia in this study reported that the animation was useful, acceptable, and relevant. Dissemination of the resource may be useful for the majority of carers, with the caveat that a few carers may find it distressing and need to be referred for further support.

The Application of Quaternions to Strap-Down MEMS Sensor Data

We describe the mathematical transformations required to convert the data recorded using typical 6-axis microelectromechanical systems (MEMS) sensor packages (3-axis rate gyroscopes and 3-axis accelerometers) when attached to an object undergoing a short duration loading event, such as blast loading, where inertial data alone are sufficient to track the object motion. By using the quaternion description, the complex object rotations and displacements that typically occur are translated into the more convenient earth frame of reference. An illustrative example is presented where a large and heavy object was thrown by the action of a very strong air blast in a complex manner. The data conversion process yielded an accurate animation of the object’s subsequent motion.

Learning Through Digital Stories for Safe School Environment

This study aimed to evaluate the impact of digital stories in the learning-based themes of safe schools and to examine the perceptions of special educational needs in safe school environments. Training were carried out with informative videos created through the Distance Education and Information Technology Center (UZEBIM) for principals and teachers-in-charge, and the effectiveness of this process was evaluated through reflective opinion forms. In addition to this, an evaluation form was presented to the prospective special education teachers to obtain their opinions and evaluate the effectiveness of digital stories at safe schools. A total of 100 prospective teachers participated in the evaluation of the impact of digital stories on their learning about safe school environments. Digital stories regarding safe schools become an important source of information in creating a safe school environment more rapidly and efficiently. In line with the interviews, it was observed that the awareness of safe school environments was increased and the digital dimensions of safe school environments were internalized through digital stories. Due to the raising awareness in the COVID-19 process, it was revealed that the schools did not have sufficient safe school characteristics and all stakeholders should take preventive measures in coordination to establish a safe school environment.

An Animation- Versus Text-Based Computer-Tailored Game Intervention to Prevent Alcohol Consumption and Binge Drinking in Adolescents: Study Protocol

The purpose of this paper is to describe the protocol for the design, implementation, and evaluation of an animation- versus text-based computer tailoring game intervention aimed at preventing alcohol consumption and binge drinking (BD) in adolescents. A cluster-randomized controlled trial (CRCT) is carried out in students aged 14-19 enrolled in 24 high schools from Andalusia (Spain), which are randomized either to experimental (EC-1, EC-2) or waiting-list control conditions (CC). EC-1 receives an online intervention (Alerta Alcohol) with personalized health advice, using textual feedback and several gamification techniques. EC-2 receives an improved version (Alerta Alcohol 2.0) using animated videos and new gamification strategies. Both programs consist of nine sessions (seven taking place at high school and two at home): session 1 or baseline, sessions 2 and 3 that provide tailored advice based on the I-Change Model; sessions 4, 5, 7, and 8 are booster sessions, and sessions 6 and 9 are follow-up questionnaires at six and twelve months. The CC completes the baseline and the evaluation questionnaires. The primary outcome is BD within 30 days before post-test evaluations, and as secondary outcomes we assess other patterns of alcohol use. The findings should help the development of future alcohol drinking prevention interventions in adolescents.

Video education to facilitate patient outreach about living kidney donation: A proof of concept

BACKGROUND

Increasing living-donor kidney transplantation (LDKT) requires education of transplant candidates and their social network. This pre-post study tested the feasibility and acceptability of KidneyTIME, an intervention which leverages LDKT video-based educational content designed for sharing.

METHODS

Adult kidney candidates undergoing transplant evaluation/re-evaluation and their caregivers at a single transplant center viewed different sets of KidneyTIME videos prior to evaluation. Change in LDKT knowledge, self-efficacy, and concerns was assessed before and immediately after exposure and 3 weeks later. Also assessed were post-exposure program feedback, online use, and living donor (LD) inquiry.

RESULTS

A total of 82 candidates and 79 caregivers participated. Viewers of KidneyTIME demonstrated increases in mean LDKT knowledge by +71% and communication self-efficacy by +48%, and reductions in concerns by -21%. The intervention was received positively, with over 95% of participants agreeing that the videos were understandable, credible, and engaging. By 3 weeks follow-up, 58% had viewed it again, 63% of family clusters had shared it, and 100% would recommend the program to a friend. Time to LD inquiry was similar to historic controls.

CONCLUSION

KidneyTime improved facilitators of LDKT, was rated as highly acceptable, and was highly shared, but did not impact LD inquiry during the COVID-19 pandemic.

For 19-Month-Olds, What Happens On-Screen Stays On-Screen

Humans rely extensively on external representations such as drawings, maps, and animations. While animations are widely used in infancy research, little is known about how infants interpret them. In this study, we asked whether 19-month-olds take what they see on a screen to be happening here and now, or whether they think that on-screen events are decoupled from the immediate environment. In Experiments 1-3, we found that infants did not expect a falling animated ball to end up in boxes below the screen, even though they could track the ball (i) when the ball was real or (ii) when the boxes were also part of the animation. In Experiment 4, we tested whether infants think of screens as spatially bounded physical containers that do not allow objects to pass through. When two location cues were pitted against each other, infants individuated the protagonist of an animation by its virtual location (the animation to which it belonged), not by its physical location (the screen on which the animation was presented). Thus, 19-month-olds reject animation-reality crossovers but accept the depiction of the same animated environment on multiple screens. These results are consistent with the possibility that 19-month-olds interpret animations as external representations.

The Short-Term Impact of Animation on the Executive Function of Children Aged 4 to 7

Research has shown that animation plays an important role in the development of children's executive function (EF), and the development of EF components, inhibitory control, working memory, and cognitive flexibility, is asynchronous. Thus, this study explores the developmental trajectories and animation features (fantasy and pacing) that influence each EF component, by examining 218 children aged 4-7. Pretest information, mainly the childhood EF inventory, was provided by parents: child's age, age of first exposure to animation, animation viewing time on weekdays and weekends, family income, and parents' education. The children in each age group were randomly divided into four groups to watch animations comprised of different animation features. After watching, their EF were measured by a day-night task, backward digit-span task, and flexible item-selection task. The results showed that the children's inhibitory control, working memory and cognitive flexibility levels all improved with age. Highly fantastical animations weakened children's performance on each subsequent EF task. Pacing had no effect on any of the components of children's EF. An interactive effect on inhibitory control was only found with fantasy in younger children; specifically, high-fantastical animations had a more pronounced short-lived weakening effect on inhibitory control in younger children (4-6 years) compared with low-fantastical animations. Future research should explore the long-term impact of content rather than the form of animation on younger children's EF.

Stakeholder-Guided Development of Dialysis Vascular Access Education Materials

Background

Initiating hemodialysis via an arteriovenous (AV) access is considered best practice for most patients. Despite the well-recognized advantages of AV access, 80% of US patients start hemodialysis with a catheter. Limited patient knowledge about vascular access, among other factors, may play a role in this high rate. We used iterative stakeholder input to develop novel, mixed media vascular access education materials and evaluated their preliminary acceptability.

Methods

We conducted preliminary focus groups and interviews with key stakeholders to assess patient vascular access understanding and elicit perspectives on existing education materials. We then used stakeholder input to inform initial development and iterative updates to the content and design of an animated video and complementary brochure. Video development (scripting, storyboarding, animation) was guided by an evidence-based framework and two health behavior change models. We assessed acceptability of the completed materials with patients and medical providers/personnel via interviews.

Results

Overall, 105 stakeholders participated in education materials development and review (80 patients/care partners, 25 medical providers/personnel). Preliminary qualitative work included 52 patients/care partners and 16 providers/personnel; video development included 28 patients/care partners and nine providers/personnel. The video script, storyboards, and animation underwent 14, four, and nine stakeholder-guided iterations, respectively. Responsive changes included aesthetic modifications, technical updates, and content additions (e.g., HD circuit, access self-monitoring, enhanced patient testimonials). The final 18-minute video and complementary brochure define vascular access types, describe care processes, outline potential complications, and address common patient concerns. Interviews with 28 patients/care partners and nine providers/personnel from diverse geographic regions revealed preliminary acceptability of, and enthusiasm for, the materials by patients and providers.

Conclusions

In collaboration with key stakeholders, we developed mixed media vascular access education materials that were well-received by patients and providers. Preliminary findings suggest that the materials are promising to improve vascular access understanding among patients.

What Type of Body Shape Moves Children? An Experimental Exploration of the Impact of Narrative Cartoon Character Body Shape on Children's Narrative Engagement, Wishful Identification, and Exercise Motivation

Background

The incorporation of narratives helps to enhance children’s engagement in active video games (AVGs), thus increasing moderate-to-vigorous physical activity (MVPA). Specific narrative elements, such as the visual representation of the characters’ body shape, have been rarely manipulated to explore their role in modulating children’s narrative engagement (NE) and exercise motivation.

Objective

To investigate the effects of character body shape manipulation (overweight/obese, average, or athletic slim) on children’s narrative immersion (NI), NE, wishful identification (WI), as well as their mediating effect on AVG and PA motivation.

Methods

Children ages 8–12 years old (N = 87) were randomly assigned to watch a 15-min animated video (designed for an existing AVG) in which the main characters had an overweight/obese, or average^∗, or athletic slim body shape (all other elements were identical). Children’s NI, NE, WI, and AVG and physical activity (PA) motivation were then assessed.

Results

Controlling for social desirability, the analysis indicated that participants with a BMI of greater than the 75th percentile had a significantly higher NI, NE, WI, and PA motivation when video characters were set to the overweight/obese condition, than they did for video characters set to the average or athletic slim conditions. On the other hand, children of equal or less than the 75th percentile exposed to the average character body condition had a greater NE, WI, and PA motivation than overweight/obese or athletic slim conditions. A mediation analysis with structural equation modeling indicated that NE mediated the effect between character body shape and AVG and PA motivation.

Conclusion

Narrative cartoon characters that mirror the target participant’s body shape can increase NE, which in turn mediates AVG and PA motivation. Content producers should identify optimal strategies in character body shape design to encourage children of different weight status to participate in PA with engaging stories to maximize health narratives’ persuasive potentials.

^∗The term average in this sense is not in reference to the national average body weight, but rather an average of the body weights represented in conditions A and C.

Sex, Bugs and Rock 'n' Roll: Insects in Music Videos

The appearance of insects in music videos was examined. The most common taxa observed were Lepidoptera, then Hymenoptera, with Coleoptera, Araneae, Diptera, and Orthoptera essentially tied for third most represented. Insect music videos have increased in frequency over time, probably as an artifact of industry growth. Swarms and infestations were common in insect videos (appearing in 26%), as were chimeric insectoid humans (19%), and, to a lesser extent, giant insects (5%), but not all of these representations were used to induce horror. Some insect music videos have garnered awards, and many of the songs associated with them have been very successful. There were many animated insect sequences, but also images of specimens that were sufficiently detailed to allow identification of the species. The insect groups observed reflect both positive and negative values. There is some indication that insects are not viewed in such a negative light as they once were, providing hope for improving attitudes of humans toward insects.

The Effect of Spatial Ability in Learning From Static and Dynamic Visualizations: A Moderation Analysis in 6-Year-Old Children

Previous studies with adult human participants revealed mixed effects regarding the relation between spatial ability and visual instructions. In this study, we investigated this question in primary young children, and particularly we explored how young children with varying levels of spatial abilities integrate information from both static and dynamic visualizations. Children (M = 6.5 years) were instructed to rate their invested mental effort and reproduce the motor actions presented from static and dynamic 3D visualizations. The results indicated an interaction of spatial ability and type of visualization: high spatial ability children benefited particularly from the animation, while low spatial ability learners did not, confirming therefore the ability-as-enhancer hypothesis. The study suggests that an understanding of children spatial ability is essential to enhance learning from external visualizations.

Cortical Activity Linked to Clocking in Deaf Adults: fNIRS Insights with Static and Animated Stimuli Presentation

The question of the possible impact of deafness on temporal processing remains unanswered. Different findings, based on behavioral measures, show contradictory results. The goal of the present study is to analyze the brain activity underlying time estimation by using functional near infrared spectroscopy (fNIRS) techniques, which allow examination of the frontal, central and occipital cortical areas. A total of 37 participants (19 deaf) were recruited. The experimental task involved processing a road scene to determine whether the driver had time to safely execute a driving task, such as overtaking. The road scenes were presented in animated format, or in sequences of 3 static images showing the beginning, mid-point, and end of a situation. The latter presentation required a clocking mechanism to estimate the time between the samples to evaluate vehicle speed. The results show greater frontal region activity in deaf people, which suggests that more cognitive effort is needed to process these scenes. The central region, which is involved in clocking according to several studies, is particularly activated by the static presentation in deaf people during the estimation of time lapses. Exploration of the occipital region yielded no conclusive results. Our results on the frontal and central regions encourage further study of the neural basis of time processing and its links with auditory capacity.

Can Motion Graphic Animation About Snakes Improve Preschoolers' Detection on Snakes? A Study of Inattentional Blindness

This study created a motion graphic (MG) animation about the danger of snakes within a story telling structure, which is different from a traditional science animation that relies on explanatory language to explain the scientific concept. The effects of the two types of animations on children's attentional perception on snakes were compared by an inattentional blindness (IB) task. Three groups of children undertook the IB task with one control group who did not watch the animation and the other two groups who watched the MG and the traditional styled animation, respectively in advance. The results showed that: (1) Children who watched the animation were significantly more likely to detect the unexpected snake images in the IB task than those who did not watch the animation; (2) Children who watched the MG animation showed a higher detection rate on the snake images than those who watched the traditional animation. The findings indicate that the intervention of animation would increase children's attentional perception on the key concepts significantly. The MG animation has more impact than the traditional animation on children's attentional perception on the key information. This study demonstrates that MG animation may have a significant value in promoting science education for young children that merits further explorations in depth.

[Entertainment committee in accommodation facilities for dependent elderly, functional importance and psychic stakes]

In accommodation facilities for dependent elderly, entertainment is found in various forms. It is the place that promotes the stability and development of the relational, social and cultural life of the residents. Listening to what is said and experienced during the sessions allows a useful representation of the movements within the establishment. If daily difficulties may be encountered, the creation of an entertainment committee offers the opportunity to combine them and make them an added value.

Development of an animated infographic on Permanent Health Education

OBJECTIVE

to create an animated infographic on the concept of Permanent Health Education according to the National Policy and its main differences compared to continuing education and health education.

METHOD

a methodological study that analyzed context and knowledge gaps with a literature review and brainstorming; synthesized knowledge into a concept map; built and validated a script; created a didactic design; and produced infographic media. 18 representatives from the Center for Permanent Education and Humanization participated in the stages of context analysis and synthesis of knowledge, and six specialists participated in the validation of the script.

RESULTS

through the combination of texts, images, audios, animations and transitions, the concepts, principles and legal journey of the Permanent Education policy were presented with examples from daily work and, at the end, the difference compared to continuing education and health education is presented. The specialist on the theme evaluated the infographic positively as it has clear information that meet the needs of the target audience; favors learning; and is able to circulate in the scientific environment.

CONCLUSION

the infographic includes content on Permanent Health Education as it represents the daily work scenario and encourages reflection by the health care workers.

Learning the Concept of Function With Dynamic Visualizations

In this paper we present a laboratory experiment in which 157 secondary-school students learned the concept of function with either static representations or dynamic visualizations. We used two different versions of dynamic visualization in order to evaluate whether interactivity had an impact on learning outcome. In the group learning with a linear dynamic visualization, the students could only start an animation and run it from the beginning to the end. In the group using an interactive dynamic visualization, the students controlled the flow of the dynamic visualization with their mouse. This resulted in students learning significantly better with dynamic visualizations than with static representations. However, there was no significant difference in learning with linear or interactive dynamic visualizations. Nor did we observe an aptitude–treatment interaction between visual-spatial ability and learning with either dynamic visualizations or static representations.

Raising awareness of antimicrobial resistance in rural aquaculture practice in Bangladesh through digital communications: a pilot study

One of the key strategic objectives of the World Health Organisation’s global antimicrobial resistance (AMR) action plan is to improve public awareness and understanding of this issue. Very few AMR awareness campaigns have targeted the animal production sector, particularly in low- and middle-income countries (LMICs) where rural communities can be geographically difficult to access via traditional face-to-face community engagement methods. Aquaculture is a major food production industry in Bangladesh and across Asia, an area which poses a significant risk to global AMR dissemination. In this pilot study, we sought to investigate the potential for digital communication materials to rapidly and effectively communicate AMR messages to rural aquaculture farmers in Bangladesh. Working with stakeholders from the Bangladesh aquaculture industry, we developed a 4-minute digital animation designed specifically for this audience and assessed its capacity to engage and communicate AMR messages to farmers. We then conducted a small-scale social media campaign, to determine the potential for rapidly disseminating AMR awareness materials to a large audience across Bangladesh, where there is an extensive 4 G internet network and an ever-increasing proportion of the population (57% as of December 2019) have mobile internet access. Thirty-six farmers were surveyed: all of them liked this method of communication and 97% said it would change the way they use antibiotics in the future. Through the social media campaign, the animation received 9,100 views in the first 2 weeks alone. Although preliminary, these results demonstrate the huge potential for digital communication methods for the rapid and widespread communication of AMR awareness materials to rural aquaculture communities in Bangladesh and across Asia. Our results support the need for more research into the most appropriate and effective content of AMR awareness campaigns for aquaculture communities and question the need for explaining the science underlying AMR in such communication materials.

Spoken Animated Self-Management Video Messages Aimed at Improving Physical Activity in People With Type 2 Diabetes: Development and Interview Study

Background

Web-based tailored interventions are a promising approach to help people with type 2 diabetes successfully adopt regular physical activity. Spoken animation seems to be effective regardless of the characteristics of the user and may be a relevant strategy to communicate complex health information

Objective

The objectives of our study were to evaluate (1) pretesting communication elements and user appreciation, and (2) the applied behavior change techniques of the previously designed spoken animated video messages in a tailored self-management program for people with type 2 diabetes.

Methods

We conducted semistructured interviews with patients with type 2 diabetes recruited from general practices located in different socioeconomic status urban neighborhoods. Based on the pretesting key communication elements of Salazar’s model, we asked participants about the spoken animated video messages’ attractiveness, comprehensibility, acceptance, believability, involvement, and relevance and to what extent the video messages motivated them to become more physically active. We also assessed participants’ intention to use the spoken animated video messages and to recommend them to others. To evaluate participants’ appreciation of the different applied behavior change techniques, we conducted a post hoc analysis of the qualitative data using the MAXQDA program. Transcripts were coded by 2 coders using iterative qualitative content analysis methods to uncover key health communication issues.

Results

Of 23 patients who expressed an interest in participating, 17 met the inclusion criteria and 15 took part in the interviews. The positive appreciation of the comprehensibility, believability, and personalization was supported by participants’ statements on behavior change techniques and other communication elements. Reinforcement of and feedback on participants’ answers were positively evaluated as was the simplicity and concreteness of the spoken animated video messages. Most participants indicated reasons for not feeling motivated to increase their physical activity level, including being already sufficiently physically active and the presence of other impeding health factors.

Conclusions

Spoken animated video messages should be simple, short, concrete, and without the use of medical terminology. Providing positive reinforcement, feedback on participants’ answers, examples that match user characteristics, and the possibility to identify with the animation figures will enhance involvement in the health message. To connect more with patients’ needs and thereby increase the perceived relevance of and motivation to use an animated video program, we suggest offering the program soon after diabetes mellitus is diagnosed. We recommend piloting behavior change techniques to identify potential resistance.

Animation-supported consent for urgent angiography and angioplasty: a service improvement initiative

Objective

Patient understanding of angiography and angioplasty is often incomplete at the time of consent. Language barriers and time constraints are significant obstacles, particularly in the urgent setting. We introduced digital animations to support consent and assessed the effect on patient understanding.

Methods

Multi-language animations explaining angiography and angioplasty (www.explainmyprocedure.com/heart) were introduced at nine district hospitals for patients with acute coronary syndrome before urgent transfer to a cardiac centre for their procedure. Reported understanding of the reason for transfer, the procedure, its benefits and risks in 100 consecutive patients were recorded before introduction of the animations into practice (no animation group) and in 100 consecutive patients after their introduction (animation group). Patient understanding in the two groups was compared.

Results

Following introduction, 83/100 patients reported they had watched the animation before inter-hospital transfer (3 declined and 14 were overlooked). The proportions of patients who understood the reason for transfer, the procedure, its benefits and risks in the no animation group were 58%, 38%, 25% and 7% and in the animation group, 85%, 81%, 73% and 61%, respectively. The relative improvement (ratio of proportions) was 1.5 (95% CI 1.2 to 1.8), 2.1 (1.6 to 2.8), 2.9 (2.0 to 4.2) and 8.7 (4.2 to 18.1), respectively (p<0.001 for all comparisons).

Conclusion

Use of animations explaining angiography and angioplasty is feasible before urgent inter-hospital transfer and was associated with substantial improvement in reported understanding of the procedure, its risks and its benefits. The approach is not limited to cardiology and has the potential to be applied to all specialties in medicine.

Visualized pre- and subpectoral implant placement for immediate breast reconstruction

The use of mesh for immediate breast reconstruction was introduced almost two decades ago. Lately, the number of prepectoral direct to implant breast reconstructions has increased as this technique seems to leave an unimpaired muscle function and may lead to less or no breast animation deformity (BAD) and quicker recovery. However, challenges still remain as there is a risk of thin tissue coverage, visible implant edges and secondary ptosis. In this visualized surgery paper, we visualize the technical disparities between the sub- and prepectoral direct to implant breast reconstruction.