It matters what you see: Graphic media images of war and terror may amplify distress.

Media exposure to graphic images of violence has proliferated in contemporary society, particularly with the advent of social media. Extensive exposure to media coverage immediately after the 9/11 attacks and the Boston Marathon bombings (BMB) was associated with more early traumatic stress symptoms; in fact, several hours of BMB-related daily media exposure was a stronger correlate of distress than being directly exposed to the bombings themselves. Researchers have replicated these findings across different traumatic events, extending this work to document that exposure to graphic images is independently and significantly associated with stress symptoms and poorer functioning. The media exposure-distress association also appears to be cyclical over time, with increased exposure predicting greater distress and greater distress predicting more media exposure following subsequent tragedies. The war in Israel and Gaza, which began on October 7, 2023, provides a current, real-time context to further explore these issues as journalists often share graphic images of death and destruction, making media-based graphic images once again ubiquitous and potentially challenging public well-being. For individuals sharing an identity with the victims or otherwise feeling emotionally connected to the Middle East, it may be difficult to avoid viewing these images. Through a review of research on the association between exposure to graphic images and public health, we discuss differing views on the societal implications of viewing such images and advocate for media literacy campaigns to educate the public to identify mis/disinformation and understand the risks of viewing and sharing graphic images with others.

Communication and Social Determinants of Cancer Preventive Behaviors in Adolescents From Low Socio-Economic Backgrounds in India: A Cross-Sectional Study.

PURPOSE: Promoting cancer preventive behaviors among adolescents, especially those from lower socioeconomic backgrounds, is crucial due to the significant impact of health behaviors in adolescence on disease risk in adulthood. With India witnessing a rise in cancer incidence and mortality, adolescence becomes a pivotal stage for establishing healthy habits, emphasizing the need for early cancer prevention efforts. METHODS: This cross-sectional study used survey data from 2242 adolescents attending public schools of Mumbai, India. Multiple logistic regression was conducted to determine the associations between cancer preventive behaviors and: (1) the individual and social determinants of health, and (2) media exposure. FINDINGS: Merely 21.5% of the adolescents ate fruits and vegetables daily, 50% of the adolescents exercised 3 or more times a week, and 20% of the adolescents admitted having used tobacco and/or supari. Girls were found to have lower odds of exercising, as well as using tobacco and/or supari. Wealth and father's education were positively associated with all 3 cancer preventive behaviors. Media exposure was negatively associated, with television exposure linked to reduced fruits and vegetables consumption, while movies and social media exposure were associated with increased tobacco and/or supari use. INTERPRETATION: Our findings suggest that individual and social determinants of health and media exposure can influence cancer preventive health behaviors in low socio-economic status (SES) adolescents. Efforts to increase awareness to promote cancer preventive behaviors among the adolescents, particularly low SES adolescents, a population more vulnerable to poor health outcomes, is critical.

This study investigates factors that can influence cancer preventive behaviors among low socioeconomic status (SES) adolescents, focusing on dietary habits, physical activity, and avoidance of tobacco and areca nut. Our study gathered data from an underrepresented population of India, which is more vulnerable to poor health outcomes and have less access to health care. Our findings can alert public health officials, policy makers and non-governmental organizations to target this population and customize their intervention strategies to promote health and prevent cancer.

Multiple exposure pathways and health risk assessment of PAHs in Lanzhou city, a semi-arid region in northwest China.

In the sparse studies for multiple pathway exposure, attention has predominantly been directed towards developed regions, thereby overlooking the exposure level and health outcome for the inhabitants of the semi-arid regions in northwest China. However, cities within these regions grapple with myriad challenges, encompassing insufficient sanitation infrastructure and outdated heating. In this study, we analyzed the characteristics and sources of polycyclic aromatic hydrocarbons (PAHs) pollution in PM2.5, water, diet, and dust during different periods in Lanzhou, and estimated corresponding carcinogenic health risk through inhalation, ingestion, and dermal absorption. Our observations revealed the concentrations of PAHs in PM2.5, food, soil, and water are 200.11 ng m-3, 8.67 mg kg-1, 3.91 mg kg-1, and 14.5 ng L-1, respectively, indicating that the Lanzhou area was seriously polluted. Lifetime incremental cancer risk (ILCR) showed a heightened cancer risk to men compared to women, to the younger than the elderly, and during heating period as opposed to non-heating period. Notably, the inhalation was the primary route of PAHs exposure and the risk of exposure by inhalation cannot be ignored. The total environmental exposure assessment of PAHs can achieve accurate prevention and control of PAHs environmental exposure according to local conditions and targets.

Mediating effect of depression and acute stress between exposure to Israel-Gaza war media coverage and insomnia: a multinational study from five arab countries.

BACKGROUND: In the context of persistent wars and conflicts worldwide, the impact of acute, excessive and constant exposure to media coverage of such events on mental health outcomes becomes a serious problem for public health, and requires therefore urgent investigation to inform an effective prevention and management response. The objective of the present study was to test the hypothesis that war-related media exposure is directly and indirectly associated with insomnia through depression and perceived stress among adults from the general population of different Arab countries. METHODS: A cross-sectional study was carried-out two weeks after the beginning of Israel-Gaza war on the 7th of October 2023. An anonymous online survey and a snowball sampling method were adopted to collect data. A sample of 2635 general population adults (mean age of 23.98 ± 7.55 years, 73.1% females) took part of this study. RESULTS: The results of the mediation analysis showed that, after adjusting over potential confounders, depression and perceived stress fully mediated the association between war media exposure and insomnia; higher war media exposure was significantly associated with higher depression (Beta = 0.13; p < .001) and perceived stress (Beta = 0.07; p < .001), whereas higher depression (Beta = 0.43; p < .001) and perceived stress (Beta = 0.31; p < .001) were significantly associated with higher insomnia. It is of note that war media exposure was not significantly and directly associated with insomnia (Beta = - 0.01; p = .178 and Beta = 0.02; p = .098 respectively). CONCLUSION: The present study is the first to provide evidence that more time spent viewing the horrors of war is significantly associated with insomnia. In addition, symptoms of stress and depression were present as early as two weeks following the beginning of the war, and played a significant role in mediating the association between war media coverage and insomnia. These findings suggest that timely screening for, and management of depression and stress symptoms in clinical and preventive programs might be beneficial for community adults who have been heavily and indirectly exposed to war through media, and present with insomnia.

Impact of Concurrent Media Exposure on Professional Identity: Cross-Sectional Study of 1087 Medical Students During Long COVID.

BACKGROUND: Long COVID has widened the health gap across society and highlighted the vulnerabilities and risks faced by health care systems. For instance, the global trend of medical workers resigning has become a prominent topic on social media. In response to this severe social problem in global public health within the digital society, it is urgent to investigate how the professional identity of medical students, who are digital natives and the future workforce of medical practitioners, is affected by the media environment. OBJECTIVE: This study aims to examine how media exposure relates to medical students' perceptions of informational and emotional support, and how these perceptions further influence the development of their professional identity. METHODS: Building on the Stimulus-Organism-Response (SOR) framework, this study develops a theoretical model to illustrate how media exposure affects medical students' professional identity through the mediation of social support. Specifically, media exposure was assessed through online news media and social media exposure; social support was evaluated in terms of informational and emotional support; and professional identity was measured through medical students' sense of belonging and professional commitment. A survey was conducted at a medical school in China, yielding 1087 valid responses that were analyzed using SmartPLS 4.0. RESULTS: Consistent with our expectations, online news media exposure was positively associated with both informational support (ß=.163; P<.001) and emotional support (ß=.084; P=.007). Similarly, social media exposure showed positive associations with informational support (ß=.122; P<.001) and emotional support (ß=.235; P<.001). Thereafter, informational support (ß=.228; P<.001) and emotional support (ß=.344; P<.001) were positively associated with students' sense of belonging. Meanwhile, both informational support (ß=.245; P<.001) and emotional support (ß=.412; P<.001) positively impacted medical students' professional commitment. In addition, a mediation test was conducted. The results confirmed that informational support and emotional support partially mediated the effect of online news media, while fully mediating the effect of social media on medical students' sense of belonging and professional commitment. CONCLUSIONS: This study finds that exposure to online news media and social media can enhance medical students' sense of belonging and professional commitment through the formation of informational and emotional support. It expands the discussion on the role of media in providing social support and facilitating the development of medical students' professional identity. This is a valuable contribution to addressing complex public health crises through effective media governance in the network era.

Psychological Distress Trends and Effect of Media Exposure Among Community Residents After the Seoul Halloween Crowd Crush.

BACKGROUND: It is unclear how exposure to and perception of community trauma creates a mental health burden. This study aimed to examine the psychological distress trends among community residents in acute stress reaction, acute stress disorder, and post-traumatic stress disorder phases following the Seoul Halloween crowd crush. METHODS: A three-wave repeated cross-sectional survey was conducted with participants after the incident. Analysis of covariance (ANCOVA) with post hoc Bonferroni test was adopted to examine temporal changes in psychological distress and psychological outcomes resulting from media impacts. A two-way ANCOVA was adopted to examine the interaction effects of time and relevance to victims on psychological distress. RESULTS: A total of 807, 1,703, and 2,220 individuals participated in the three waves. Anxiety (estimated mean [standard error of the mean]: 2.28 [0.03] vs. 2.12 [0.02] vs. 2.03 [0.02]; P < 0.001), depression (2.22 [0.03] vs. 2.01 [0.02] vs. 1.90 [0.02]; P < 0.001), and anger (2.70 [0.03] vs. 2.66 [0.02] vs. 2.49 [0.02]; P < 0.001) gradually improved. However, sense of safety initially worsened and did not recover well (2.96 [0.03] vs. 2.75 [0.02] vs. 2.77 [0.02]; P < 0.001). The interaction effect of time and relevance to the victim were significant in depression (P for interaction = 0.049), anger (P for interaction = 0.016), and sense of safety (P for interaction = 0.004). Among participants unrelated to the victim, those exposed to graphics exhibited higher levels of anxiety (2.09 [0.02] vs. 1.87 [0.07]; P = 0.002), depression (1.99 [0.02] vs. 1.83 [0.07]; P = 0.020), and anger (2.71 [0.03] vs. 2.47 [0.08]; P = 0.003) at W2 and higher anger (2.49 [0.02] vs. 2.31 [0.06]; P = 0.005) at W3. CONCLUSION: Community residents indirectly exposed to trauma also experienced psychological distress in the early stages after the incident. A significant impact of media which might have served as a conduit for unfiltered graphics and rumors was also indicated.

The relationship between media exposure and mental health in children following Kahramanmaras earthquakes in Turkey.

PURPOSE: We aimed to explore the relationship between media exposure to the Kahramanmaras earthquakes and its impact on children's mental health difficulties. METHODS: This cross-sectional study was conducted with 409 parents between March and July 2023. Parents were invited to participate in an online survey through social media platforms. The data was collected using the 'Descriptive Characteristics Form', the 'Media Exposure Form Related to the Earthquake', and the 'Strengths and Difficulties Questionnaire'. RESULTS: The results indicated that exposure to images of earthquake-related events on the first day after the earthquake (p < 0.001), people rescued alive from the rubble on television (p < 0.001), earthquake victims staying on the streets/in tents on television (p = 0.006), and earthquake-related events while alone on the Internet (p = 0.02) were significantly associated with the impact of children's mental difficulties. Furthermore, exposure to images of people pulled deceased from the rubble (p < 0.001), exposure to images of demolished houses on the Internet (p = 0.007), and exposure to images of destroyed roads on the Internet (p = 0.01) were found to significantly predict the impact of children's mental difficulties (r2 = 0.29; p < 0.001). CONCLUSIONS: This study has shown that children who are exposed to screen media may experience difficulties in coping mentally, leading to emotional and behavioral problems. PRACTICE IMPLICATIONS: Children who have experienced natural disasters may be exposed to distressing images on screen, which can lead to difficulties and stress. To reduce the risk of mental health problems related to disasters, nurses may suggest that victims limit their exposure to television footage.

Mass Media Exposure Moderates the Association of Education and Wealth with Enrollment in Health Insurance Among Older Adults Aged 60 Years and Older in India.

Mass media exposure (MME) plays an important role in changing health-related behavior or decision-making. This study aimed to examine the association of MME with enrollment in health insurance and its moderating effect on the associations of education and wealth with enrollment in health insurance among older adults in India. The data of 29,935 older adults aged 60 years and older from the first wave (baseline) of the Longitudinal Ageing Study in India (LASI-2017/18) were utilized. Descriptive statistics, bivariate analysis, multivariable logistic regression models, and Fairlie decomposition were used. The findings revealed that 18.3% of older adults had MME and enrollment in health insurance in India. Older adults with MME were 1.42 times more likely to be enrolled in health insurance than those with no MME, and years of schooling increased the probability of enrolling in health insurance compared to those who did not have formal schooling. With increasing monthly per capita expenditure (MPCE), the probability of enrolling in health insurance is lower than the poorest. Further, MME moderates the effects of education and MPCE on enrollment in health insurance and increases the likelihood of enrollment in health insurance. The study's findings imply strategic communication plans to encourage health insurance enrollment in India should take into account the usage of these communication channels.

Intelligence-Dependent Differential Effects of Media Exposure on Executive Function Changes in Children: A Population-Based Cohort Study With a Longitudinal Design.

BACKGROUND: Excessive media use is known to be associated with executive dysfunction in children, but it's unclear whether this exposure can lead to long-term changes of executive function. This study aimed to investigate the association between media exposure and longitudinal changes in executive function within a population-based study, while considering the potential influence of intelligence. METHODS: This study used data from 1,209 participants in the Panel Korea Study for Children. The children's media exposure was measured at ages 7 and 8, and executive function was evaluated annually from ages 7 to 10 using the Executive Function Difficulty Screening Questionnaire. Participants were grouped by media exposure level (low, medium, or high), and longitudinal changes in executive function were analyzed using linear mixed effects models. Subgroup analysis was conducted to investigate how executive function changes varied based on intelligence within each media exposure group. RESULTS: Children with high media exposure (n = 97) had severer executive function difficulties than those with low (n = 141) or medium (n = 971) exposure in all waves. The high exposure group demonstrated persistent higher executive function difficulties up to age 10 after controlling for child gender, intelligence, parental education level and maternal depression. Children with intelligence quotient (IQ) ≤ 100 in the medium to high media exposure group had significantly more severe executive function difficulties than those with IQ > 100. CONCLUSION: This study provided evidence of a longitudinal negative association between media exposure and executive function. The findings suggest that excessive media exposure may lead to long-term changes in executive function in children and highlight the importance of implementing targeted interventions and educational strategies to mitigate the potential negative effects of excessive media use, particularly for children with lower cognitive abilities.

Media exposure, trustworthiness of sources and the health information literacy knowledge gap: a study in China.

Health information literacy (HIL), as an essential part of the wellbeing of citizens, is a crucial indicator used to measure a country's primary public health level. The present study collected 1051 samples in southern China to examine the factors predicting HIL. The results showed that males, those less educated, and older adults had lower HIL. Television exposure, unofficial Internet exposure, trust in government and trust in doctors and medical institutions were positively associated with HIL. In contrast, newspapers, radio exposure and trust in web celebrities were negatively associated with HIL. Official Internet media exposure helps to bridge the HIL knowledge gap generated by differences in education level, while trust in celebrities-especially web celebrities-could widen the HIL knowledge gap. This study extends the knowledge gap theory in health communication in the Chinese context and provides pathways for future health interventions.

Determinants of modern contraceptive use among married women and those living with a partner in Ghana.

The objective of the study was to ascertain the determinants of modern contraceptive use in Ghana among married women and those living with a partner. Secondary data from the Performance Monitoring and Accountability 2020 Ghana 2015 survey were used for the study. A multivariate logistic regression analysis was used. Modern contraceptive use was 25.5%. The significant predictors of modern contraceptive use were exposure to the media (AOR 2.07, 95% CI 1.20 - 3.55), residence in the Upper East region (AOR 0.26, 95% CI 0.10 - 0.71), final decision makers on contraceptive method either by themselves or jointly (AOR 0.26, 95% CI 0.14 -0.92), return to provider (AOR 6.96, 95% CI 3.59 - 13.49), refer relative or friend to provider (AOR 2.67, 95% CI 1.27 - 5.68), and parity of 5 or more (AOR 4.42, 95% CI 1.49 - 13.12). Media exposure on contraceptives and client satisfaction has the potential to improve modern contraceptive uptake in Ghana.

An extended health belief model for COVID-19: understanding the media-based processes leading to social distancing and panic buying.

Building on the health belief model (HBM), this research tests, over six months, how the exposure to COVID-related information in the media affects fear, which in turn conditions beliefs about the severity of the virus, susceptibility of getting the virus, and benefits of safety measures. These health beliefs ultimately lead to social distancing and panic buying. As a first contribution, we find that fear is not directly triggered by the objective severity of a crisis, but rather formed over time by the way individuals are exposed to media. Second, we show that fear affects behaviors through the components of the HBM which relate to the risks/benefits of a situation. Last, we find that critical thinking about media content amplifies the "adaptive" responses of our model (e.g., health beliefs, social distancing) and reduces its "maladaptive" responses (e.g., panic buying). Interestingly, we note that the beneficial effect of critical thinking about media content disappears as the level of fear increases over time. The implications of these findings for policymakers, media companies, and theory are further discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s11747-022-00865-8.

Association of mass media exposure with combustible and smokeless tobacco use among Indian population: findings from a panel survey.

BACKGROUND: Despite introducing different policies and initiatives, India is recognized as one of the global players in the tobacco epidemic race. Our study explores the association between tobacco consumption and mass media exposure among the Indian population, considering the contextual factors affecting the clustering at the community and state levels. METHODS: Using two waves of the India Human Development Survey (IHDS) conducted in 2005 and 2012 for 16,661 individuals, the present study explores the association of mass media exposure and tobacco consumption in the short-term and the long-term period of Cigarettes and Other Tobacco Products Act (COTPA) implementation, which came into existence in 2004. Bivariate analysis using the chi-square test for association showed the correlation of tobacco consumption with its respective predictors. Multivariable analysis using three-level random intercept logit models showed the adjusted association between tobacco consumption and its relevant covariates and the extent of clustering of tobacco consumption behaviour of persons in the communities and states. RESULTS: We found that watching television (TV) [(OR:1.03; CI:0.92-1.15) in 2004-05 and (OR:0.99; CI:0.88-1.12) in 2011-12], listening radio [(OR: 0.99; CI:0.90-1.10) in 2004-05 and (OR:1.04; CI:0.94-1.15) in 2011-12] and reading newspaper [(OR:1.02; CI:0.91-1.15) in 2004-05 and (OR:0.96; CI:0.87-1.06) in 2011-12] did not have any significant effect on consumption of combustible tobacco. Similarly, no effect of mass media was found on smokeless tobacco consumption. Further, the clustering of combustible and smokeless tobacco usage was higher at the community level than at the state level. In both rounds, smokeless tobacco consumption was found to be higher than combustible tobacco. DISCUSSION: The present study provides evidence that COTPA has achieved its aim of nullifying the significant effect of mass media on combustible and smokeless tobacco consumption among the Indian population. However, the influence of state- and community- level clustering had failed in curbing the increment of smokeless tobacco consumption. There is a need for policy reforms to curb the significant impact of factors that promotes smokeless tobacco consumption in India. Further, initiatives must focus on specific communities from high-risk states, reducing the time and cost required for implementation.

Information clarity about Covid-19 in Indonesia: does media exposure matter?

BACKGROUND: Confusion of information has also colored the course of the Covid-19 pandemic in Indonesia. The study analyzes the relationship between media exposure and information clarity about Covid-19 in Indonesia. METHODS: The study collected extensive data (n = 5,397). The study determines information clarity about Covid-19 based on respondents' admissions. There were four types of media exposure analyzed: frequency of reading a newspaper/magazine, frequency of listening to a radio, frequency of watching television, and frequency of internet use. The study carried out a binary logistic regression test in the final stage. RESULTS: The results show read a newspaper/magazine every day is 1.670 times more likely than reading a newspaper/magazine > five days a week to get precise information about Covid-19. Reading a newspaper/magazine 2-3 days a week is 1.386 times more likely than reading a newspaper/magazine > five days a week to get precise information about Covid-19. Reading a newspaper/magazine 4-5 days a week is 1.470 times more likely than reading a newspaper/magazine > five days a week to get precise information about Covid-19. Watching television 2 to 3 days a week is 1.601 times more likely than watching television > five days a week to get clear details about Covid-19. Watching television 4 to 5 days a week are 1.452 times more likely than watching television > five days a week to get precise information about Covid-19. CONCLUSION: The study concluded two types of media exposure related to information clarity about Covid-19 in Indonesia: the frequency of reading newspapers and watching television.

A gender-specific assessment of tobacco use risk factors: evidence from the latest Pakistan demographic and health survey.

BACKGROUND: The high prevalence of tobacco use in Pakistan poses a substantial health and economic burden to Pakistani individuals, families, and society. However, a comprehensive assessment of the key risk factors of tobacco use in Pakistan is very limited in the literature. A better understanding of the key risk factors of tobacco use is needed to identify and implement effective tobacco control measures. OBJECTIVES: To investigate the key socioeconomic, demographic, and psychosocial determinants of tobacco smoking in a recent large nationally representative sample of Pakistani adults. METHODS: N = 18,737 participants (15,057 females and 3680 males) from the 2017-18 Pakistan Demographic Health Survey, aged 15-49 years, with data on smoking use and related factors were included. Characteristics of male and female participants were compared using T-tests (for continuous variables) and χ2-tests (for categorical variables). Multivariable logistic regression models were used to identify gender-specific risk factors of tobacco use. The Receiver Operating Characteristic Curve test was used to evaluate the predictive power of models. RESULTS: We found that the probability of smoking for both males and females is significantly associated with factors such as their age, province/region of usual residence, education level, wealth, and marital status. For instance, the odds of smoking increased with age (from 1.00 [for ages 15-19 years] to 3.01 and 5.78 respectively for females and males aged 45-49 years) and decreased with increasing education (from 1.00 [for no education] to 0.47 and 0.50 for females and males with higher education) and wealth (from 1.00 [poorest] to 0.43 and 0.47 for richest females and males). Whilst the odd ratio of smoking for rural males (0.67) was significantly lower than that of urban males (1.00), the odds did not differ significantly between rural and urban females. Finally, factors such as occupation type, media influence, and domestic violence were associated with the probability of smoking for Pakistani females only. CONCLUSIONS: This study identified gender-specific factors contributing to the risk of tobacco usage in Pakistani adults, suggesting that policy interventions to curb tobacco consumption in Pakistan should be tailored to specific population sub-groups based on their sociodemographic and psychosocial features.

The Impact of COVID-19 Experiences on Adolescent Internalizing Problems and Substance Use Among a Predominantly Latinx Sample.

Given the salience of socialization factors on adolescence and their role in vulnerability to disasters and trauma, this study examined whether COVID-19-associated fears and impacted quality of life mediated associations between pandemic-focused family conversations and media exposure and subsequent youth mental health. A primarily Latinx sample of adolescents (N = 167; Mage = 16.2 years, 44.9% female) participated in a longitudinal (summer 2020-winter 2020) COVID-19 study. COVID-19 media exposure predicted engagement in relevant safety behaviors, which negatively impacted quality of life, which in turn predicted increased internalizing problems. COVID-19 family conversations predicted social distancing fears, which negatively impacted quality of life, which then in turn also predicted increased internalizing problems. Targeting key socialization factors may minimize negative consequences following major community trauma among adolescents.

Media and social factors influencing stigma towards eczema patients: A survey study in Singapore.

ISSUE ADDRESSED: Eczema is a common skin health issue in Singapore. A salient challenge eczema patients are facing is the stigma towards them, which has been relatively unacknowledged. It is critical to reducing stigma towards eczema patients, and an essential step is to identify factors influencing stigmatising behaviour. METHODS: With a general basis of the Integrative Model of Behavioral Prediction, we conducted a cross-sectional online survey (N = 293) in the context of Singapore. The sample was recruited via the online panel of a survey company, Rakuten Insights. Our sample's age and education level generally fit with the population in Singapore. RESULTS: Media exposure to eczema content did not influence stigmatising behaviour either directly or indirectly. However, personal connection with eczema patients reduced stigma indirectly, completely mediated by stigmatising attitude towards eczema patients and health literacy. That is, personal connection with eczema patients had a negative relationship with stigmatising attitude, which was positively associated with the intention of and actual stigmatising behaviour. However, personal connection increased health literacy, which in turn reduced stigmatising intention and behaviour. CONCLUSIONS: We call for more future initiatives to fight against health stigma. Health promotion can take advantage of eczema patients' social network to educate the general public about the eczema issue to lower stigma. Public policy responses to prevent discrimination on the basis of skin health are also needed. Media organisations should use news media and social media to speak out against stigma towards eczema patients, and avoid using stigmatising language.

Frequency of exposure to the media is associated with levels of HIV-related knowledge and stigmatising attitudes among adults in Ghana.

Studies show that increased knowledge of the human immunodeficiency virus (HIV) is achieved through exposure to mass media, which then contributes to positive attitudes and behaviours towards people living with HIV and acquired immune deficiency syndrome (AIDS). This study examined the relationship between the frequency of exposure to the media and the level of HIV-related knowledge and stigmatising attitudes towards HIV and AIDS among adults in Ghana. A weighted sample of 13 484 men and women 15 to 59 years old took part in the study. The main outcome variable was the HIV-related knowledge score, calculated based on responses to eight questions about general HIV concepts and HIV transmission modes. The frequency of exposure to the media was the primary explanatory variable. The relationship between the frequency of media exposure and the level of HIV-related knowledge was investigated using Poisson regression methods in Stata 13.0. Of the 13 484 respondents analysed, 25%, 88.2% and 79.7% reported reading print media, listening to the radio and watching TV at least once a week respectively. The average HIV-related knowledge score was 4.9 (SD 1.6), with 22.9% of respondents correctly answering five questions and about 2.0% correctly answering all eight questions. The frequency of exposure to the media, particularly print media and television, was associated with an increase in the level of HIV-related knowledge. When compared to having a low level of HIV-related knowledge, having a moderate and high level of HIV-related knowledge reduced the score of stigmatising attitude by 0.065 and 0.277 points, respectively. The adult population in Ghana has a very low level of HIV or AIDS knowledge, as well as a significant level of stigma associated with HIV or AIDS, which could stymie HIV prevention efforts. The media, on the other hand, provide a platform for these issues to be addressed.

Associations between screen time and cognitive development in preschoolers.

Objectives: To examine the cross-sectional associations between screen time and cognitive development in preschoolers. Methods: Participants were 97 preschoolers (36 to 60 months) in Alberta and Ontario, Canada in the supporting Healthy physical AcTive Childcare setting (HATCH) study. The time that children spent watching television, videos or DVDs (television time) or playing video or computer games (video game time) on a television, computer, or portable device was assessed using a parental questionnaire. Television time and video game time were summed to calculate total screen time. Adherence to the screen time recommendation (≤1 hour/day) of the Canadian 24-Hour Movement Guidelines was calculated. Expressive vocabulary and working memory were assessed using the Early Years Toolbox. Due to the distribution of working memory, it was categorized as a binary variable based on the median score. The associations between screen time and cognitive development were examined using mixed models (expressive vocabulary) or generalized mixed models (working memory). Results: Screen time was not associated with expressive vocabulary. Preschoolers who had higher total screen time were less likely to have better working memory (OR=0.52; 95%CI:0.31, 0.88), despite the null associations for television time (P=0.155) and video game time (P=0.079). Preschoolers who met the screen time recommendation were more likely to have higher working memory capacity (OR=3.48; 95%CI:1.06, 11.47), compared to those who did not meet the recommendation. Conclusion: Limiting total screen time to no more than one hour per day may facilitate working memory development in preschoolers. Screen time may be unrelated to expressive language development in this age group.

Differentiating the stress buffering functions of perceived versus received social support.

Drawing upon the stress buffering model of social support, this study investigated how perceived social support (PSS), defined as the amount of support individuals think they can mobilize from their network, and received social support (RSS), defined as the level of support individuals have received, moderated the direct and indirect relationships between COVID-19 news exposure (i.e., stressor) and stress via social trust. An online survey from six major cities in China (N = 636) revealed that PSS rather than RSS moderated the direct relationship between COVID-19 news exposure and stress such that this relationship was stronger at a low level of PSS than a high level. Additionally, RSS rather than PSS moderated the relationship between COVID-19 news exposure and social trust such that this relationship was stronger at a low level of RSS than a high level. These findings reveal the differential mechanisms by which PSS and RSS function to buffer against stress.