Julie N. Germann

Rating Electronic Games: Violence Is in the Eye of the Beholder.

Commercial ratings assist parents in monitoring their childrens media experiences. Exposure to media violence may affect attitudes and behavior, and rating systems should accurately reflect the presence of violent content. Validity indicators for commercial rating systems are examined, including consistency with consumer perceptions. Violent electronic games are a contemporary media phenomenon. A comparison of commercial ratings for popular electronic games with consumer perceptions of game content indicates that, for games with obviously nonviolent or very violent content, there is agreement between consumers and the commercial system. However, there is considerable disagreement about notable violent content in games with cartoon-type violence. Recommendations include incorporating consumer perceptions into a comprehensive, content-based, informational rating system for all entertainment media.

Use of an Orientation Session May Help Decrease Attrition in a Pediatric Weight Management Program for Low-Income Minority Adolescents

This study examined predictors of attrition from a pediatric weight-control program in a low-income minority community and the potential usefulness of an orientation session to increase length of treatment. Participants were 342 children and adolescents (M age=13.0 years old; 54% female; 89% African American; M BMI=44.2, M BMI z-score=6.0) and their caregivers who attended FitMatters, a multidisciplinary cognitive-behavioral program focused on long-term participation. Those who attended an orientation session stayed in treatment significantly longer, but attrition was not affected by demographic factors, weight status, or psychological functioning. These results indicate that an orientation session that clearly delineates the structure of a program and expected attitudinal and behavioral requirements for the families may help align expectations, as well as more effectively identify families who are ready to make concerted efforts to change the family lifestyle in support of their obese childrens efforts.

Hoping Is Coping: A Guiding Theoretical Framework for Promoting Coping and Adjustment Following Pediatric Cancer Diagnosis

OBJECTIVE To determine the pattern of resilience and adjustment following pediatric cancer diagnosis and to evaluate hope as a mediator of adjustment. METHODS 61 participants with pediatric cancer completed measures of hope, depression, anxiety, and quality of life (QoL) within 4 weeks of cancer diagnosis and every 3 months for 1 year. RESULTS Participants showed high and increasing levels of hope and QoL, as well as low and decreasing levels of depression and anxiety. Linear mixed-effects regression analyses revealed changes in depression, anxiety, and hope to be significant predictors of changes in QoL. Changes in hope were found to partially mediate the effects of depression and anxiety on QoL. CONCLUSIONS While a variety of interventions are efficacious for treating anxiety and depression, hope theory provides a framework for choosing interventions that may more globally promote childrens ability to maintain good functioning, adjustment, well-being, and QoL following cancer diagnosis.

Efficacy of a Screening Procedure to Identify Potentially Disruptive Participants in an Immersion Program for the Treatment of Adolescent Obesity

Background: This study examined the efficacy of the red flag screening procedure, an approach used in a largescale immersion program for the treatment of adolescent obesity (Wellspring Camps). The intention of the red flag screening was to screen out potentially highly disruptive applicants, provide an impetus for additional support when high-risk campers were admitted, and help parents develop appropriate expectations. When compared to non-flagged peers, red-flagged campers who attended camp were expected to be sent home early more frequently. Methods: Wellspring’s admissions coordinators ‘red-flagged’ potential campers whose enrollment forms showed evidence of a history of psychological distress, major medical challenges, and/or developmental delays; a licensed psychologist then determined whether or not to admit the child after talking with the identified applicant, parents, and health care providers. 554 overweight young people attended three Wellspring Camps in the summer of 2007 (445 females, 109 males, mean age = 15.8 years, mean BMI = 35.6 kg/m2, mean % overweight = 66.7%). Results: 8.7% of applicants were red-flagged (n = 48), and 8% of all of the campers (n = 44) were dismissed prematurely. As expected, a much higher percentage of red-flagged campers who were admitted to camp were dismissed prematurely (31,3% of the red-flagged campers) than were non-flagged campers (5,1%; p < 0.0005). Conclusion: These findings support the efficacy of Wellspring’s red flag screening procedure. While further improvements can be made, such a tool may be useful to other immersion programs.

Ya gotta have friends: Social support and self-efficacy predict success following immersion treatment

This study examined the impact of perceived social support and self‐efficacy on predicting success in weight management following immersion treatment of adolescent obesity.

Back pain among long-term survivors of childhood Leukemia

Background: The objectives of this study are to determine the prevalence and relative risk (RR) of back pain and identify possible mechanisms of back pain among childhood acute lymphoblastic leukemia (ALL) survivors. Methods: Surveys were mailed to 5+-year survivors of childhood ALL aged 13 to 25 years. Survivors’ siblings were also invited to participate in the study. Prevalence of back pain and hip pain among ALL survivors was determined and compared with siblings. Sex, treatment with radiation therapy, obesity, and physical activity were examined for an association with back pain and hip pain. Results: Forty-four of 99 (44.4%) ALL survivors reported back pain compared with 11 of 52 (21.2%) their siblings (P=0.007; RR: 2.01; 95% confidence interval=1.15-3.56). In contrast, 10 of 99 (10.1%) ALL survivors reported experiencing hip pain compared with 1 of 52 (2.0%) siblings experiencing hip pain [P=0.07; RR: 4.95 (0.65 to 37.57)]. Twenty-six of 43 female survivors reported back pain compared with 18 of 56 male survivors who reported back pain (P=0.005). Obesity, physical activity, and treatment with radiation therapy were not associated with back pain or hip pain. Conclusions: This is the first study demonstrating an increased frequency of back pain among survivors of childhood ALL. Future studies are needed to better define the causes of back pain among childhood ALL survivors.

Hope as a Predictor of Anxiety and Depressive Symptoms Following Pediatric Cancer Diagnosis

Objective To examine hope and its components of agency and pathways as predictors of anxiety and depressive symptoms in children receiving cancer treatment. Methods Sixty patients (mean standard deviation age = 13.3 (2.7); 57% male) completed Snyders Hope Scales, the Childrens Depression Inventory, and the State-Trait Anxiety Inventory at diagnosis and 3 month intervals for 1 year following pediatric cancer diagnosis. Parents also completed Snyders Hope Scales. Linear mixed-effect regression was used to assess hopes role in longitudinal models of symptoms of depression and anxiety. Results Agency was a significant predictor of between-patient differences and within-patient changes in symptoms of depression and anxiety. Neither patient pathways nor either component of parent hope was predictive of symptoms of depression or anxiety. Patients who were more likely to have depressive symptoms at baseline were older, diagnosed with leukemia, and non-Hispanic White as opposed to Hispanic. Patient demographics were not predictive of anxiety. Conclusions Patient agency is a potential target for intervention to prevent or reduce anxiety and depressive symptoms following pediatric cancer diagnosis.