JMIR Serious Games
A multidisciplinary journal on gaming and gamification for health education/promotion, teaching and social change.
JMIR Serious Games (JSG, ISSN 2291-9279) is a sister journal of the Journal of Medical Internet Research (JMIR), one of the most cited journals in health informatics (Impact Factor 2015: 4.532). JSG is a multidisciplinary journal devoted to computer/web/mobile applications that incorporate elements of gaming to solve serious problems such as health education/promotion, teaching and education, or social change.
The journal also considers commentary and research in the fields of video games violence and video games addiction.
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The Rise Of New Alcoholic Games Among Adolescents: The Consequences At The Emergency Department
Date Submitted: Aug 30, 2016
Open Peer Review Period: Sep 9, 2016 - Nov 4, 2016
Background: This article can be considered as a result of three different works. The first one consists on a questionnaire regarding the behaviors about alcohol consumption among young people; the sec...
Background: This article can be considered as a result of three different works. The first one consists on a questionnaire regarding the behaviors about alcohol consumption among young people; the second one consists on an analysis of the scientific literature about this topic and finally the third one is the analysis of the shelters at the Emergency Department of acute alcoholic intoxication. The link between all these works is the existence of an abuse of alcohol by young people, the spread documented in the literature and the questionnaire on new practices of alcohol consumption and therefore a prevalence of young people in shelters at Emergency Department for reasons attributable to alcoholic behaviors. In scientific literature, there are many papers on the abuse of alcohol and binge drinking, but those are not describing enough how alcohol consumption happens in adolescence and there are no sufficient data about new drinking modes such as Neknomination or Vodka Eyeballing. 1. Today, analyzing scientific journals in PubMed Embase databases, there are no significant publications referring to the relationship between clinical sequelae for Neknomination and access to the emergency room as a result of the various alcoholic games. There are many projects and protocols relating to the Italian and European generic problem of alcohol consumption in adolescents (1) but despite some methodological differences, which can make it difficult to compare data among surveys, in general there are no discrepancies in the consumption trends among young Italians. 2. It is important to inform and educate parents and clinicians about the spread of new alcohol consumption modalities in adolescents, their risk and impact for Emergency Medicine. 3. The quantification of the cases, the knowledge of the clinical significance of the different modes of abuse chronic or acute intoxication of alcohol among teenagers, represent the central point for the development of a control system being aware not only of the distribution of the most dangerous alcohol consumption, but also of their evolution, focusing on Neknomination and new methods of recruitment (games alcohol, "binge roulette" etc.), and the increase of occasional consumption. The new trends related to consumption patterns found among teenagers are leading to a very high number of episodes of drunkenness. There are many risk factors related to alcohol abuse by young people and often the conclusions found in literature are conflicting: the age at which the first taste of alcohol occurs and the context in which this happens, seem to be related to the influence of the Web and "alcohol socialization" social networks with different methods and rules. Another risk factor in the relationship between adolescents and alcohol is the marketing of alcoholic beverages in the web not only throughout advertising but also by social influence model, which is characterized as "social norm and" life skills ". 4. The phenomenon of Neknomination can be seen as the translation on the web of the association between binge drinking (intake of large amounts of alcohol in a short period of time) and happy hour: video publishing on the web seems to be a way to get in a group or to be socially accepted by schoolmates. The amount of alcohol taken in these events is high and since the "game" lasts a few minutes, the boys get the same effects of binge drinking. (2). Other social consequences caused by alcohol can be road and domestic accidents, legal problems, financial problems and gambling. As for young people, alcohol abuse can lead to develop dangerous behaviors such as multiple consumption, unprotected sex, which can cause diseases and unwanted pregnancies, and driving while intoxicated. 5. The strategic role of Emergency Services is to identify and monitor a problem since its debut, to support the planning and to coordinate the implementation of interventions, ensuring operator training. At this stage, considering the literature data and previous experience in Veneto region and Padua, we have assessed the characteristics and extent of the phenomenon of alcohol consumption in young people and adolescents (risk analysis, definition scenarios), in order to identify the best methods to track trends over time; to define in detail the operations to be performed in the Emergency Department, the organization of interventions in the hospital acceptance phase, the alarm mode, the training of the operators involved, the communication between operators and the population (planning). 6. The communication with the public, with the media, and with schools plays a decisive role in this situation to gain timely and reliable information and to obtain cooperation by limiting the effects of the problem in place. It becomes necessary to invest in developing strategies of specific routes that meet the new styles of consumption of alcohol in adolescents, promoting healthy lifestyles, with specific interventions and coordinated between the different health care specialists enabling differentiated access to care pathways, and developing closer collaboration with general practitioners). The excessive and sometimes pathological use of Internet is currently rising among young people in many industrialized countries in Asia, North America and Europe. Recently, the use of internet has spread so rapidly among adolescents to become a serious public health problem, and many authors have started writing about "Internet addiction." It is estimated that 95% of adolescents connects on-line every day in different places and with different devices: computers, cell phones, smartphones, tablets or e-book readers. The effect of social networks on the health of adolescents and in general the influence of this lifestyle today remains controversial, especially when teens become more independent in their decisions (academic, educational and social / recreational) and are increasingly exposed to the trends of social media. While this may seem apparently harmless, it can actually profoundly affect the behaviors of teenagers and young adults. A study analyzed the profiles of MySpace of 400 adolescents and found that 56% contained references to alcohol and among them 49% spoke explicitly of alcohol use (5). Today's teenagers are increasingly inclined to take and share regularly "selfies" on social networking sites like Twitter, Youtube, Facebook, Instagram, snapchat etc., where each user is represented by its profile. Internet sites such as video-sharing platforms can significantly influence the behavior of adolescents and forms of communication between peers. For example, YouTube, which has become property of Google since 2006, is currently the most popular video sharing site in the world, with over one billion users per month. Some of the most popular videos on YouTube are music videos, each of which generates millions of views and comments. However, YouTube also has self-produced material that can be highly subject to interpretation by the users. While some viewers may be savvy enough to display the various video or advertising with detachment and critical spirit, others may be deeply influenced by the spirit of escape, fun and thrill described in some video. (6) The ease of communication between the various teenagers, that is the true success of social networks, not only affects the school environment, family or friends, but, thanks to the virtual network, it also extends globally, allowing one to share instantly a photo, a video or a simple "state". This attitude of ostentation can unfortunately also lead to pressures from peers and pathological conditioning that could adversely affect the behavior of the boy, pushing him toward a potentially reckless behavior (7). It is fast becoming clear that the widespread use of social networks can lead to a "viral phenomenon", where the emulation of dangerous acts spreads very rapidly throughout the world. The importance of these sources of influence becomes evident when looking at the various psychophysical changes typical of adolescence and it is therefore necessary for them to be taken into consideration by medical professionals, given their significant impact on the health not only of the same teenagers but also on that of society as a whole. Previous studies report that many factors can contribute to substance abuse and its evolution during adolescence, including a greater emphasis on independence, the presence of established habits in the family and peer influence. In a descriptive longitudinal study, D'Amico et al. They analyzed the various habits of adolescents, identifying a strong connection between alcohol abuse and other substances consumption such as tobacco and marijuana, demonstrating also a greater propensity to alcohol abuse in people of Hispanic and African American descendence(8). It was then considered that the general assumption of most descriptive models of peer pressure is based on the perception that adolescents have about the consumption of alcoholic beverages by friends, identified as predictor of long-term substance abuse in adolescents and youth in pre-adolescent(9-10) In relation to sexual maturity as it applies to teenagers, it is worth mentioning that the early use of alcohol is an important risk factor in relation to risky sexual activity among young people, whose health and well-being are so compromised by potential exposure to HIV and other sexually transmitted infectious diseases, as well as other potential negative consequences, including unwanted pregnancies. (12). Objective: This study encourages health care providers to pay attention to these new behavioral trends of substance abuse, especially alcohol, related to the use of internet and future surveys should identify potential markers of a problematic use of social networks, including the identification of groups at risk of abuse and should aim to establish a potential prevention strategy in terms of awareness and education that could help to avoid potentially fatal episodes. Methods: METHODS AND MATERIALS Purpose and design of the study This research is an observational study, retrospective longitudinal type single-center study conducted at the Hospital-University of Padua. The study aims to evaluate the influence of the web and social networks in the daily life of adolescents, who access to the Emergency Department of the main hospital of Padua, by questionnaires about the consumption of alcohol. The processing of the answers to these questionnaires allowed us to better understand the most problematic aspects that interfere in the mode of alcohol intake in young people. Admissions for acute alcohol intoxication of adolescents aged between 15 and 20 years old to the Emergency Department. The data obtained were compared with the meta-analysis, the review and the case studies reported in the literature when present. Organizational chart of the study The survey presented in this work let focus the attention of medical professionals, teachers and parents on a rapidly growing phenomenon among adolescents: the rapid development of Internet and with it the social networks. The survey was conducted according to the procedures listed below and then described in detail. 1. In the first part of the study 70 (Attachments) questionnaires were distributed at the entrance of the hospital while attending the emergency department in the period 2013-2015 to the sample of subjects in this study. Data obtained in this way were added to the questionnaires distributed in secondary schools and in health education classes. 2. The estimate of the impact of social networks on the health and daily lives of adolescents was assessed with 50 questionnaires (Attachments). The tool used to gather information is a questionnaire drawn up by a group of multidisciplinary research with Spanish colleagues, partially supplemented by a few questions about smoking and alcohol, placed on the initiative of the national coordinating corpse. To enable a better sharing of these tools, web pages have been created. If accepted, the guy with the consent of the parents, depending on age, will fill out a questionnaire validated for individual pediatric age groups (PedsQL Measurement Model). The questionnaires were processed by the principal investigator and collaborators in compliance with privacy laws. The anonymous questionnaires The information was gathered by analyzing the behavior described in the questionnaire (Attachment). They were alcohol consumption, considering various types of drinks such as spirits, liqueurs, aperitifs, wine or beer, and the use of cigarettes. The age of first use and its frequency were evaluated for each drug of abuse. In order to understand just how dominant the role of social media is in the daily lives of adolescents, they were asked to express an opinion on the importance of the influence of the web among their peers. To increase the validity of the responses, the questions about the use of substances were laid whereas the boy / girl has consumed the substance previously, for example, "How old were you when you..?" with the option "Never drank ..." and "How many times have you made use of...?" with the option to choose how to answer "one time", "2x", "3 or 5 times", "5 or more times, " and never". The questions refer to the last 30 days and events or places such as parties, clubs, bars where there is an increased risk of drinking alcohol in large quantities. In particular, to investigate the spread of binge drinking, he was asked respondents how many times they had consumed five or more drinks within 2 hours during the last 30 days, offering as an option to answer "Never, Once, 2 times , 3-5 times More than 5 times "and inviting to quantify the number of drinks consumed. To try to identify the best luxuries habits of adolescents surveyed, they were asked if they were aware of similar behavior present in their circle of friends or family members ("No member of the family makes use of alcohol, at least one component / both components make routine use of more than one alcoholic drink during or outside meals "). To assess the consequences of substance abuse from a clinical point of view, it was asked if the subjects were aware of the new games as NekNomination alcohol, Vodka Eyeballing etc., if they had ever attended and whether they had ever repented. Symptoms assessed were the most frequent associated to drunkenness or "tremors and incoordination, Altered behavior, increased talkativeness and sociability, language vague, uncertain gait, Abnormal reflexes, Altered perception of reality, Absence of perceptions, sense of death. " Other symptoms evaluated were: "I had a headache and chills, I threw up, I passed out / I had memory lapses" and eventual access to the emergency department. To correlate the recent tendency to alcohol abuse among adolescents and traffic accidents of persons testing positive blood alcohol, it asked respondents whether conducessero motorized vehicles, if they were aware of the alcohol limit foreseen by the Highway Code in Italy, if they had never taken alcohol for two hours prior to taking the lead and if they had never driven in conditions considered by them to little clarity. In the event that they had traffic accidents related to alcohol consumption, we were assessed the following clinical signs reported: "Bruises and minor trauma, Head injuries, fractures, hemorrhages, Abnormal breathing, loss of consciousness." From the standpoint of psycho-sociological was asked the boys surveyed what were the reasons that pushed them to the consumption of alcoholic beverages (To please myself, to please others, I think that alcohol makes me more fun, To not to feel excluded from the group) and what would change in their daily lives if they stopped drinking alcohol (Nothing, I divertirei less, I would not see the same people, I would try other busts). Finally, it was considered, in the same manner as the consumption of alcohol, smoking habits, invited the parties to express themselves about the age at which they started smoking, the frequency and amount of consumption of cigarettes and the duration of exposure to secondhand smoke daily allowance (Never, Occasionally, less than an hour a day, 1-5 hours a day). Evaluation of the phenomenon in a hospital: the Emergency Department Inclusion criteria of patients, data collection Among the 1,224,768 arrived at the emergency room of the Hospital of Padua since 2006, I have been examined 473,531 accesses in the years 2013-2015, selected retrospectively through the computer system Qlik. Including access to the emergency department, through Qlik, they were selected 3742 patients aged between 15 and 30 years old came to the emergency room of the Hospital of Padua hospitalized for acute alcohol intoxication associated with illness or trauma from 2006 to 2015. They were analyzed folders SDO and the database contains the access mode in the emergency department (only, ambulance, etc.), the diagnosis entry, the characteristics (sex, age, nationality), the circumstances of the fact, and the surveys required by ER doctors and in-hospital monitoring (monitoring PS, OBI, hospitalization, operating room, intensive care) and between tests was particularly considered the value of blood alcohol. It was therefore not possible to record the total complexity of emergencies ULSS 16, since the subjects under the age of 15 years have access to the Pediatric Emergency Department and a proportion of patients> 15 years comes to the emergency room of the nearby St. Anthony Hospital. Of these patients were analyzed folders DEA. Comparing the missing data with the computer program Galileo 22.214.171.124, DB 41, considering the anamnesis (directly or by friends) and symptoms attributable to alcohol consumption (consistent with the history of alcohol- positive: vomiting, altered reflexes , impaired vision, perception of shapes, colors, sizes, serious impairment of physical or mental condition, marked difficulty in standing or walking, hallucinations, cessation of reflexes, incontinence and coma). Data entered in spreadsheets Office Excel 2007 were analyzed using SAS 9.2 (SAS Institute Inc., Cary, NC, USA) for Windows. For categorical variables (gender, diagnosis closing observation period, days of the week, BAC and age) we have been reported the number of patients per category and the percentage of the variable considered. The variable age was reported in classifying subgroups (15-20 years, 20-25 years and 25-30 years). The variable "blood alcohol" has been divided into classes according to the classification scheme in art. 5 of Decree-Law no. 151/2003, conv. with Law no. 214 of 1 August 2003 (<0.5 g / L, 0.5g / L-0.8g / L, 0.8g / L-1.5g / L,> 1.5g / L). The association between categorical variables was evaluated using the chi-square test or the Fisher exact test. Considering significant p values less than or equal to 0.05. For continuous asymmetric (Duration of hospital stay, weight standard DGR) they were calculated Minimum, Maximum, Median and Quantiles; They were then compared between the sexes with the nonparametric Wilcoxon. Economic evaluation Based on the questionnaires, it was decided to select 225 belonging to the age group 15-20 years, because they were considered the main beneficiaries of the new trends about alcohol consumption. Of the 225 patients aged 15-20 years examined in 2013-2015, using the computer program Galileo 126.96.36.199, DB 41, were considered treatment programs care of a sample of 38 patients, hospitalized in OBI (Observation short intensive ) of which is considered the type of transport by which have come to the emergency department (118 - Ambulance 118 - other means, ambulatory), the access time (from 20 to 24, 24 to 8, from 8 to 20), recovery time. They were then evaluated clinical care processes of samples of patients: 1. inpatient OBI with its performance laboratoristiche and hospital. 2. Patients traumatized (DRG-486 other surgeries for multiple significant trauma, DRG 487-multiple other injuries relevant) and hospitalized with at least 5 days in hospital who had attended the neknomination or other games under the influence of alcohol content. Folders via SDO and the analysis of the therapy welfare of patients have been completed not only the provision of medical and surgical but also all related activities and diagnostic and laboratory allowing to outline the economic value of some cases more or less complex. The path of hospital inpatients or undergoing observation short, allowed the identification of categories or types of patients similar in intensity of consumption of resources and clinically significant in relation to the extent of the trauma or the type of cause of hospitalization associated to ' acute alcohol intoxication. Results: The extent of the phenomenon "Alcohol abuse and alcohol new games" The results for the 120 questionnaires (70 PS and 50 in schools) administered to young teenagers in the province of Padua (Attachments) show that the average respondent’s age is 17 years, 38% of respondents were male while 62% female. The questionnaires refer mainly to people attending secondary schools, especially high schools and technical institutes. 66 respondents (55%) claim to have been 13-14 years old when consumed (and not only tasted) in full his first alcoholic drink, while 41 (34%) say they have started to 15-16 years.Respondents were asked to indicate what was the type of alcoholic beverage consumed by them most: most drinking beer (42 subjects, 35%), 47 respondents (39%) consume aperitifs and digestives (Spritz Aperol, Campari, Amari ), 16 (13%) wine and 10 (8%) makes use of spirits and liquors (Vodka, Gin, Rum, Scotch, Wisky ..). The teens surveyed were then invited to express themselves about the habitual consumption of alcoholic beverages: 100 (83%) do not disapprove drinking one or two glasses regularly while 20 (17%) do not disapprove getting drunk once a week. Referring to the practices of extreme intoxication described in the questionnaire (in the eyes -vodka eyeballing- vodka, drink upside down, strong sucking from a straw, make a cocktail with mouthwash and hand sanitizer-drink hand sanitizer) 109 subjects (91% ) deny having ever participated and 11 (9%) say they have sucked strong from a straw. Despite the denial, 55 respondents (46%) admit to have seen video of guys getting drunk with extreme ways in social media like Youtube, Facebook and Instagram. As regards the NekNomination, 95 respondents (79%) are aware of this practice. Almost all, 112 (93%), denies having ever taken part, although 52 subjects (43%) know of at least one friend who took part in the past (figure 1). In the period from January 2006 to April 2015 a total of 1,224,768 accesses to the Emergency Department (ED) of the main hospital in Padua (Azienda Ospedaliera di Padova) have been recorded, of which 473,531 from January 2012 to April 2015. Of these recent data triage code was assigned as follow: white, 51%; yellow, 26%; red (critical), 4%; green, 18%. (figure 2)By analyzing these patients we considered 3 ages: 1) from 15 to 20 2) from 20 to 25 3) from 25 to 30. The data were further analyzed on the basis of sex. The categorizations by sex and age group are described in (FIGURE 3) for the period 2006-2012, (FIGURE 4) for 2013-2015. The age group between 15 and 30 years is a demographic group with a high incidence of requests for blood alcohol tests (BAC) at the Emergency Department. This age group is responsible for 37% of the total requests, while it represents only 14% of the resident population. (P <0.001). For comparison the report was for the age group 30 to 45: 29 % of BAC compared with 21 % of the population; for the age group from 45 to 60 years: 23 % of BAC compared with 22 % of the population(FIGURE 5).It was ascertained that the number increases considerably over the weekend and that the percentage difference between the sexes is minimal: on Saturday the admission for acute alcohol are 21% of the full week for both females (60) than for males (113). On Sunday the females are 73 (23%) and 132 Males (24%). Interestingly on Thursday the female patients admitted to the Emergency Department for acute alcohol intoxication are as many those admitted on Saturday, i.e. 56 (19%)(FIGURE 6)Subdividing the same patients by age, we note that: -15-20 Years: patients with acute alcohol intoxication accessing ED mainly on weekends with a peak abundance of 50 (22%) on Saturday, and 65 (29%) on Sunday. A certain proportion also focuses in correspondence of Thursday (29 subjects, 13%). -20-25 Years: the large number of such patients is distributed over the week. Wednesday and Thursday is the large number of 43 (14%) and 60 (19%) respectively. Over the weekend we do not have concentrations as high as for the youngest group, registering peaks of 62 patients (20%) on Saturday and 78 patients (25%) on Sunday. (FIGURE 7).Discharge diagnosis patients 15-20 years Among the 830 patients analyzed in the period from 2013 to 2015, of special interest are the 225 belonging to the age group 15-20 years, because they are believed to be those mainly exposed to new mode of intake of drinks with a high alcohol content. Table I summarises the diagnosis at discharge in this sub-group. In the years 2013-2015 blood alcohol content has been tested for 830 patients aged 15 to 30 years (TABLE II).In all the bands of age considered, the majority of patients had levels of ethyl alcohol in the blood greater than 1.5 g / L: 172 (21%) in the age 15-20, 262 (42%) aged 20- 25 and 232 (4%) in range aged 25-30. As shown in Figure 8, the other classes of blood alcohol levels are poorly represented in the age groups 20-25 and 25-30, while a significant percentage of patients aged 15-20 years (36, 10%) is admitted to Emergency Department for acute intoxication of alcohol, with values of ethyl alcohol of blood comprised between 0.8 g / L and 1.5 g / L. Of the 225 patients (135 males and 90 females) aged between 15 and 20 years, admitted to the Emergency Department of the Hospital of Padua for acute alcohol intoxication in the years 2013 to 2015 were analyzed blood alcohol levels obtained from Central Laboratory of the Hospital of Padua. Of these patients, 70 (31%) admitted that they have participated in new alcohol consumption based games. In particular, 14 (19%) reported having taken part in NekNomination, 53 (76%) to "other alcohol games" (among which beer pong, alcohol enema, flip cup were included) and 4 (5%) to VodkaEyeballing. table III. Of all 225 patients the blood alcohol concentration was analyzed and the data was then examined by individual years and by age. Blood concentration of ethanol (BAC Blood Alcohol Concentration) was grouped following the classification scheme outlined by Italian legislation (art. 5 of Decree no. 151/2003, converted in Law no. 214 of August 1, 2003), as described in Table IV. All values are > 0 g/L.Statistical analysis performed with the Chi Square test (Z2) does not identify significant changes over the years analyzed (p> 0.05). In all years 2013, 2014 and 2015 there is a high prevalence of patients whose values fall into the category of BAC> 1.5 g / L: 61 (75%) in 2013, 78 (76%) in 2014 and 33 (81% ) in 2015. The second value range blood alcohol most represented in the studied years is 0.8-1.5 g / L: 12 (13%) in 2013, 16 (15%) in 2014, and 8 (19%) in 2015. In 2015 (the data refer to the months from January to April), all the examined patients 15-20 years have blood alcohol values> 0.8 g / L. These levels are very dangerous for the life of those subjects. (Figure 9) Admissions for trauma. Of the 30 patients admitted for trauma, 24 were male (80%) and 6 women (20%). The median length of stay (one cannot have statistical average as the variables are asymmetrical) was 11 days, with a minimum of 3 and a maximum of 44 days. Overall, males have a median hospital stay which is double than that of females (12 days and 6 respectively). The average number of surgical operations, especially "Exploratory laparotomy, total Splenectomy and Surgical closure of lacerations of internal organs (liver and kidney), was 2 (Min: 0, Max: 4). Finally, the median value of the average weight of the DRG relative to interventions provided by the Hospital, is the same for both sexes and is equal to 46091 Euros, with a minimum of 17,349 euros and a maximum of 46091 Euro(Table 5). Conclusions: The normalization of the use of alcohol, in the light of cultural changes prompted by millions of Euros of investments in marketing, advertising and sponsorship of alcohol aimed at creating a value system for use of licit psychoactive substance and more available, which aims to encourage more However considerations and individual and collective well-being, pleasure, seduction, of leadership, has led and continues to lead the phenomena that go beyond the binge drinking and now come to decline it in various forms of hazardous and harmful alcohol consumption, boosted by 'use of technology and social media, as virtual stages, facilitate anyone in need to homologate and make an impact through risk taking and the violation of laws on the legal minimum, fitting in circles nomination and chains on which alcoholic there can be no control. It is a phenomenon which changes, culturally, more and more toward how their dependency on illegal substances, often integrating with other addictions. Virtual reality supplants, in other words, the concrete everyday: the popularity obtained the web is mirrored in the everyday, at school or in sports for many teens. This results in a spirit of idolatry if it is popular, a sense of marginalization and challenge to be "cool" if, on the contrary, you do not have an appropriate retinue in Social. And technology companies, well aware of the results of prorpi products on kids, continue to bring to market applications for smartphones, tablets and so on pushing more and more behaviors emulators on the web. The Klout Score, for example, is a tangible proof: it is a social networking service that offers customized statistical analysis on social media. In particular, it estimates the influence of the user through a score (from 0 to 100) obtained the degree of interaction in the user profiles of popular social networking sites, including Twitter, Facebook, Google+, LinkedIn and Foursquare. This influence is obtained from the amplitude of the network user, the generated content, and the feedback level obtained (https://klout.com/corp/score). The birth of NekNomination, Vodka Eyeballing, Butt Chugging and others is relatively recent. Initially concerned mainly beer but the need to dare and to be more popular soon brought teenagers from around the world to compete in these games with any alcoholic beverage they had available, also according to the culture of the country of alcohol: if in Italy and Western Europe consumes more wine, in the countries of Central alcoholic drink is beer cheaper in Eastern Europe you will also have easier access to hard liquor like vodka, which therefore give more effects serious in terms of health. Belts alcoholic Europe are European regions that are considered to be divided by consumption of beer, wine or liquor. Interestingly belts alcoholic beverages refer to traditional countries rather than in what is commonly drunk by the population; Today, in terms of beer consumption has become the most popular alcoholic beverage in the world. By anonymous questionnaires, it follows that 35% of respondents who habitually consume beer and 39% drink normally aperitifs and digestives (Aperol, Campari etc.). Aperitifs alcohol are consumed in 2012 from 31.5% of the population older than 11 years (M: 41.9%; F: 21.7%) The proportion of men aged over 11 years has remained stable compared the previous survey, but by focusing on older age group there was a significant increase in consumer amounting to 2.9 percentage points.The data collected through the study in question do reflect on the importance of dealing with behavior and health of young people who are tomorrow's adults. It is therefore necessary among adolescents to improve the living environment with an integrated approach and policies to prevent large-scale, combating tobacco consumption, obesity, physical inactivity, alcohol abuse and substance. The new games Alcohol encourage young people to consume large amounts of alcohol in a short period of time, putting them at risk of alcohol poisoning, which can potentially cause accidental injuries, unprotected sex, suicide, sexual violence and traffic accidents. This study showed that the frequency of these events is on the rise thanks to the widespread use and often indiscriminate "social media", and for this reason there may be an increase in the number of acute alcohol intoxication, severe trauma. Using the Internet it can be negatively associated with behavioral and social maladjustment among adolescents, and combining this with the fact that it can be a powerful source of pressure among peers with almost no direct link with the person concerned, may represent a potentially dangerous. It is, therefore, a need for greater awareness in order to prevent future incidents and also a deeper understanding of which population subgroups are most at risk, in order to establish a defensive and preventive education strategy. Emergency Physicians (as well as educators and in general all those who work in health care) that assist in these situations, have a responsibility to help identify and prevent the spread of these patterns of behavior, especially when there is a risk that they become hazardous to the health of an individual or of other persons. The alarming increase in the number of hospitalizations due to intoxication by alcohol unintentional adolescence, for neknomination, vodka eyeballing, butt chugging etc., And consequences of the absence of relevant interventions and adults, in all these cases, register exclusively on subjects defined as "disadvantaged" but more and more often in boys and girls around the world coming to characterize a social failure of education that swept reality increasingly heterogeneous and wide of too many young teens, as evidenced by the use of the services health care for the effects and consequences of drinking and alcohol-related mortality data they see alcohol as a leading cause of premature and avoidable death among young people. The questionnaires described in this work, while not constituting a survey of epidemiological, represented a pause for thought about the cescente impact of technology on adolescents. Future studies, conducted with epidemiological criteria and extended not only to the country but also the European, allow you to analyze and understand the true extent of the problem, developing prevention campaigns and education that is not only healthy regard to persons directly concerned but also the teaching staff and parents. The knowledge of the events described in quesa investigation would, in terms of medical and hospital, a better management of critically ill patients, with optimization of time and resources.
Planking: The “Lying Down Game” News In “Accidental Falls”
Date Submitted: Aug 28, 2016
Open Peer Review Period: Aug 30, 2016 - Oct 25, 2016
The monitoring and management of risks regarding children and young people admitted to Emergency as a result of dangerous behaviour “distributed via the internet”, should be based on clinical reas...
The monitoring and management of risks regarding children and young people admitted to Emergency as a result of dangerous behaviour “distributed via the internet”, should be based on clinical reasoning. Some data now available describe a relatively new game: planking, also known as the "lying-down game". A key element of this research study is to report physicians’ misperceptions concerning planking and, with these cases, used for teaching purposes, to improve knowledge of the clinical and forensic aspects of this emerging problem. Adolescents often choose unusual and sometimes dangerous places to increase the number of their "likes" in social media, often with some new "game" like planking,. The poses of the people photographed while planking are unusual. Analysis of published data shows that traumatic lesions may occur as a result of planking, which has probably had little effect on the number of immediate fatalities, but these results can be projected to other trauma centres and processed to create injury surveillance data. Previous studies have shown how much trauma costs. Reporting these cases may potentially prevent future traumatic events occurring in similar circumstances: the scientific community cannot leave this problem unaddressed.