TELEVISED AGGRESSION AND CHILDREN\u27S SOCIAL BEHAVIOR: RELATIONSHIP OF AUTHENTICITY AND ADULT APPROVAL OF VIEWED BEHAVIOR TO CHILDREN\u27S AGGRESSION.

Television is nearly universal and young children are among the prime viewers. Citizens are concerned that television with its high rate of violence may be a more important guide to behavior than parents or teachers. This study investigates the effects on children\u27s behavior of viewed aggression varying both the level to which viewed actions are represented as authentic portrayals of real-life aggressive behavior and the level of approval for the portrayed behavior that is provided by an adult co-viewer. A critical review of the literature resulted in three hypotheses: increasing levels of authenticity and adult co-viewer approval associated with a portrayal of aggressive behavior interact to increase levels of children\u27s aggression as a result of the viewed presentation (Hypothesis I); levels of children\u27s aggressive behavior will decrease directly with decreasing levels of authenticity associated with viewed aggression (Hypothesis II); and levels of children\u27s aggressive behavior will decrease directly with decreasing levels of adult co-viewer approval expressed towards portrayals of aggression (Hypothesis III). A 3 x 2 factorial design was used. The first factor represents three levels of increasing adult co-viewer approval and the second represents two levels of authenticity of the scene. The subjects, 84 public school boys ranging in age from 10 to 13 years, were randomly assigned in equal numbers to one of the six experimental conditions. Each subject observed an aggressive scene on television while an adult co-viewer expressed either verbal approval, no comment, or verbal disapproval. These three conditions were combined with presentation of the scene with either a high or low level of authenticity (i.e., real or simulated aggression). Pre- and post-tests were conducted before and after the manipulation of the independent variables to obtain measures of each subject\u27s aggressiveness. Duration and frequency of button-pressing responses, through which a subject ostensibly could anonymously either help or interfere with a peer\u27s behavior were recorded. The procedure concluded with a post-experimental questionnaire which in part tested the validity of the experimental procedure and the impact of the independent variables. The data from the pre- and post-tests supported Hypothesis III. While the trends for Hypothesis I and Hypothesis II were in the predicted direction they were non-significant. It appears that the impact of televised aggression upon children\u27s behavior is highly dependent on adult co-viewer comments. Disapproving comments or approving comments tend to respectively decrease or increase children\u27s subsequent levels of aggression. Varying levels of authenticity had a marginal impact upon children\u27s reaction to the presentation but did not significantly interact with the approval variable. Previous studies which showed that varying the levels of authenticity of the viewed material affect children\u27s subsequent behavior, involved more salient modes of specifying authenticity and unlike the present study tested the impact of the presentation with obvious adult surveillance during testing. The present manipulation of the level of authenticity showed no significant effect and no interaction with the approval variable. This study suggests that televised violence should not be viewed as a threat to parental authority. When adults, perhaps unknowingly, indicate approval of violence, television may stimulate aggression. Adults who ignore television or see it as a baby-sitter, may be permitting haphazard factors to influence their children\u27s learning of social standards. Television, however, can be used by adults as an effective teaching tool. Parents can teach and reinforce their standards of behavior even with programming presenting contrary messages by showing their approval or disapproval of the programs.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis1980 .G643. Source: Dissertation Abstracts International, Volume: 42-03, Section: B, page: 1231. Thesis (Ph.D.)--University of Windsor (Canada), 1981

Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial.

BACKGROUND: Child stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe. METHODS: We did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Ministry of Health and Child Care. Women were eligible for inclusion if they permanently lived in clusters and were confirmed pregnant. Clusters were randomly assigned (1:1:1:1) to standard of care (52 clusters), IYCF (20 g of a small-quantity lipid-based nutrient supplement per day from age 6 to 18 months plus complementary feeding counselling; 53 clusters), WASH (construction of a ventilated improved pit latrine, provision of two handwashing stations, liquid soap, chlorine, and play space plus hygiene counselling; 53 clusters), or IYCF plus WASH (53 clusters). A constrained randomisation technique was used to achieve balance across the groups for 14 variables related to geography, demography, water access, and community-level sanitation coverage. Masking of participants and fieldworkers was not possible. The primary outcomes were infant length-for-age Z score and haemoglobin concentrations at 18 months of age among children born to mothers who were HIV negative during pregnancy. These outcomes were analysed in the intention-to-treat population. We estimated the effects of the interventions by comparing the two IYCF groups with the two non-IYCF groups and the two WASH groups with the two non-WASH groups, except for outcomes that had an important statistical interaction between the interventions. This trial is registered with ClinicalTrials.gov, number NCT01824940. FINDINGS: Between Nov 22, 2012, and March 27, 2015, 5280 pregnant women were enrolled from 211 clusters. 3686 children born to HIV-negative mothers were assessed at age 18 months (884 in the standard of care group from 52 clusters, 893 in the IYCF group from 53 clusters, 918 in the WASH group from 53 clusters, and 991 in the IYCF plus WASH group from 51 clusters). In the IYCF intervention groups, the mean length-for-age Z score was 0·16 (95% CI 0·08-0·23) higher and the mean haemoglobin concentration was 2·03 g/L (1·28-2·79) higher than those in the non-IYCF intervention groups. The IYCF intervention reduced the number of stunted children from 620 (35%) of 1792 to 514 (27%) of 1879, and the number of children with anaemia from 245 (13·9%) of 1759 to 193 (10·5%) of 1845. The WASH intervention had no effect on either primary outcome. Neither intervention reduced the prevalence of diarrhoea at 12 or 18 months. No trial-related serious adverse events, and only three trial-related adverse events, were reported. INTERPRETATION: Household-level elementary WASH interventions implemented in rural areas in low-income countries are unlikely to reduce stunting or anaemia and might not reduce diarrhoea. Implementation of these WASH interventions in combination with IYCF interventions is unlikely to reduce stunting or anaemia more than implementation of IYCF alone. FUNDING: Bill & Melinda Gates Foundation, UK Department for International Development, Wellcome Trust, Swiss Development Cooperation, UNICEF, and US National Institutes of Health.The SHINE trial is funded by the Bill & Melinda Gates Foundation (OPP1021542 and OPP113707); UK Department for International Development; Wellcome Trust, UK (093768/Z/10/Z, 108065/Z/15/Z and 203905/Z/16/Z); Swiss Agency for Development and Cooperation; US National Institutes of Health (2R01HD060338-06); and UNICEF (PCA-2017-0002)

Quality measures in pre-liver transplant care by the Practice Metrics Committee of the American Association for the Study of Liver Diseases

The LT evaluation and waitlisting process is subject to variations in care that can impede quality. The American Association for the Study of Liver Diseases (AASLD) Practice Metrics Committee (PMC) developed quality measures and patient-reported experience measures (PREMs) along the continuum of pre-LT care to reduce care variation and guide patient-centered care. Following a systematic literature review, candidate pre-LT measures were grouped into four phases of care: referral, evaluation and waitlisting, waitlist management, and organ acceptance. A modified Delphi panel with content expertise in hepatology, transplant surgery, psychiatry, transplant infectious disease, palliative care and social work selected the final set. Candidate PREMs spanned domains of cognitive health, emotional health, social well-being, and understanding the LT process. Of the 71 candidate measures, 41 were selected: 9 for referral; 20 for evaluation and waitlisting; 7 for waitlist management; and 5 for organ acceptance. A total of 14 were related to structure, 17 were process measures and 10 were outcome measures that focused on elements not typically measured in routine care. Among the PREMs, LT candidates rated items from understanding the LT process domain as the most important. The proposed pre-LT measures provide a framework for quality improvement and care standardization among LT candidates. Select measures apply to various stakeholders such as referring practitioners in the community and LT centers. Clinically meaningful measures that are distinct from those used for regulatory transplant reporting may facilitate local QI initiatives to improve access and quality of care