scholarly journals Incidencia de la práctica de actividad física y deportiva como reguladora de la violencia escolar (Incidence of the practice of physical and sporting activities as a regulator of school violence)

Retos ◽  
2018 ◽  
pp. 54-60
Author(s):  
José Ángel Medina Cascales ◽  
María Jose Reverte Prieto
Keyword(s):  
Physical Activity ◽  
School Violence ◽  
Physical Violence ◽  
Sampling Technique ◽  
Negative Consequences ◽  
Competitive Environments ◽  
Violent Behaviors ◽  
Sporting Activities ◽  
Educación Primaria ◽  
Violencia Escolar

La violencia escolar se ha convertido en un fenómeno de repercusión mundial, por las graves y duraderas consecuencias negativas que produce en las víctimas. La violencia escolar prevalece en la etapa de Educación Primaria mostrándose de manera física, verbal, por exclusión social o a través de las TIC. La práctica deportiva puede servir como estrategia de prevención contra la aparición de conductas violentas en las aulas, por lo que el objetivo del presente estudio, es analizar la relación entre esta práctica de actividad física y la victimización por violencia escolar en función del sexo. Mediante un muestreo no probabilístico por conveniencia o casual, un total de 113 sujetos (74 hombres; 39 mujeres; Medad = 10.66, DE = .74) completaron los cuestionarios PAQ-C y “Acoso y Violencia Escolar”. Los resultados indican la prevalencia de ciberviolencia y la violencia física indirecta para ambos sexos. Obteniéndose diferencias significativas entre ambos géneros para la violencia física directa. Una práctica deportiva moderada orientada a disciplinas como fútbol o atletismo conlleva a una mayor victimización en todas las dimensiones. Por el contrario, una alta práctica dirigida hacia artes marciales o juegos populares supone las menores tasas de percepción violencial. Concluyendo que la cantidad de actividad física desarrollada y el tipo de deporte practicado, actúan como reguladores en la victimización por violencia escolar, lo que requiere de la necesidad de promover estrategias que favorezcan la adherencia deportiva en los escolares en entornos menos competitivos y más enfocados en la educación deportiva.Abstract. School violence has become a phenomenon of global impact due to the severe and long-lasting negative consequences on victims. School violence is more evident in the primary education stage, being expressed physically, verbally, and through social exclusion or ICT. Sports can serve as a prevention strategy against the emergence of violent behaviors in the classroom. Therefore, the objective of the present study is to analyze the relationship between the practice of physical activity and victimization by school violence based on gender. After employing a non-probability, convenience-based sampling technique, a total of 113 subjects (74 men, 39 women; Mage = 10.66, E.D. =. 74) completed the questionnaires PAQ-C and “Harassment and School Violence”. The results indicate the prevalence of cyber-violence and indirect physical violence for both sexes. Significant differences are shown between genders for direct physical violence. A moderate sports practice oriented to disciplines such as football or athletics leads to greater victimization in all dimensions. On the contrary, a high practice directed towards martial arts or popular games appears to reduce the rates of perceived violence. The amount of physical activity carried out and the type of sport practiced act as regulators in the victimization of school violence, which indicates the need to promote strategies that favor sports adherence in school children in less competitive environments and more focused on sports education.

scholarly journals Acoso escolar en Educación Primaria y en Educación Secundaria en Badajoz. Análisis de los factores de riesgos

2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Manuel Fernández Guerrero ◽  
Miriam Suárez Ramírez ◽  
Jorge Rojo Ramos ◽  
Sebastián Feu Molina
Keyword(s):  
Secondary Education ◽  
School Violence ◽  
Physical Violence ◽  
Verbal Violence ◽  
Educación Primaria ◽  
Forms Of Violence ◽  
The City ◽  
Violencia Escolar

En el periodo de la transición de Ed. Primaria a Educación Secundaria Obligatoria es donde se producen la mayoría de los casos de acoso escolar a lo largo de toda la geografía española. Es muy importante detectar dicha problemática con premura para analizarla y erradicarla de los centros escolares. Con este estudio se ha pretendido identificar las formas de violencia que se producen en las aulas, y analizar la percepción del acoso escolar para cada una de las formas de violencia recibida y observada en función de las características de los alumnos de Ed. Primaria y ESO de la ciudad de Badajoz. Para ello han participado 1093 alumnos de 6º de Ed. Primaria y de 1º de Educación Secundaria Obligatoria de 19 centros educativos con edades entre 11 y 14 años. El instrumento utilizado ha sido el Cuestionario de Violencia Escolar Cotidiana (CUVECO). Entre las conclusiones más destacadas podemos reseñar que en Badajoz existen algunos casos de acoso escolar con puntuaciones elevadas, las chicas observan más el acoso escolar, los chicos reciben más violencia verbal, la violencia observada predomina en ESO y a medida que la edad aumenta el alumno cambia la violencia verbal por la violencia física. In the period of the transition from Primary to Compulsory Secondary Education is where most cases of bullying occur throughout the Spanish geography. It is very important to detect this problem quickly to analyse it and eradicate it from schools. This study has been aimed at identifying the forms of violence occurring in classrooms, and analyzing the perception of bullying for each of the forms of violence received and observed based on the characteristics of Primary Ed. and ESO students in the city of Badajoz. For this purpose, 1093 students from 6th Ed. Primary and 1st Compulsory Secondary Education of 19 schools between 11 and 14 years old participated. The instrument used has been the Daily School Violence Questionnaire (CUVECO). Among the most noteworthy conclusions we can say that in Badajoz there are some cases of bullying with high scores, girls see more bullying, boys receive more verbal violence, observed violence predominates in ESO and as age increases the student changes verbal violence by physical violence.

scholarly journals "Ella lo provocó": el enfoque de género en la comprensión de la violencia escolar

2019 ◽  
Vol 37 (2) ◽  
pp. 363-378 ◽  
Author(s):  
Berenice Pacheco-Salazar ◽  
Julián López-Yáñez
Keyword(s):  
School Violence ◽  
Gender Stereotypes ◽  
Physical Violence ◽  
Participant Observation ◽  
Female Students ◽  
Gender Violence ◽  
Creative Play ◽  
Desarrollo Profesional ◽  
Gender Based ◽  
Violencia Escolar

El objetivo de este trabajo es analizar la presencia de los estereotipos de género en las dinámicas de violencia escolar. Se realizó un estudio descriptivo con diseño cualitativo en dos centros educativos en República Dominicana, a partir de una muestra de 604 estudiantes entre 9 y 16 años. Las técnicas de levantamiento de información fueron talleres lúdicos-creativos, grupos focales y observación no participante. Los resultados evidencian que el arraigo a los roles estereotipados de género se constituye en un perpetuador de la violencia escolar. Esto se expresa en la violencia verbal y física y, de manera aún más dramática, en la violencia sexual, de la cual las alumnas siempre son las principales víctimas. Además, la socialización diferenciada produce que manifestaciones de violencia de género en la escuela sean invisibilizadas. Los hallazgos plantean la necesidad de formar a estudiantes en igualdad de género y educación afectivo-sexual, e integrar el enfoque de género y la coeducación en el desarrollo profesional docente a fin de que los centros educativos puedan desarrollar un abordaje preventivo y no reduccionista de la violencia escolar. The aim of this research is to analyze the presence of gender stereotypes in the dynamics of school violence. A descriptive study with qualitative design was carried out in two schools in the Dominican Republic, from a sample of 604 students between the ages 9 to 16 years old. The information-gathering techniques included creative play workshops, focus groups, and non-participant observation. The results demonstrate that the deeply-rooted gender stereotypes constitute a perpetuating support of school violence. This is expressed in verbal and physical violence and, even more severely, in sexual violence, of which female students are always the main victims. Furthermore, differentiated socialization renders manifestations of gender violence in school invisible. These findings raise the need to train students in gender equality and affective-sexual education, and to integrate a gender-based approach in the professional development of teachers in order to achieve a preventive approach to school violence.

scholarly journals VIOLENCIA ESCOLAR EN LA ADOLESCENCIA: DIFERENCIAS POR GÉNERO, EDAD Y TIPO DE CENTRO

2017 ◽  
Vol 2 (1) ◽  
pp. 179
Author(s):  
Begoña Nieto Campos ◽  
Margarita Pino Juste ◽  
Víctor Domínguez Rodríguez
Keyword(s):  
Secondary Education ◽  
Secondary School ◽  
School Violence ◽  
Secondary School Students ◽  
School Students ◽  
Student Violence ◽  
Violent Behaviors ◽  
Type Of School ◽  
Do So ◽  
Violencia Escolar

Abstract.SCHOOL VIOLENCE IN ADOLESCENCE: DIFFERENCES BY GENDER, AGE AND TYPE OF CENTERViolence in schools is one of the most worrisome reasons in educational communities and also in the rest of society. The objective of the study was to analyze whether gender, age and type of center have a significant impact on the type of school violence practiced by compulsory secondary school students. There were 1270 students (51.2% male and 48.8% female) aged 12 to 16 years (mean age: 13.79 ± 1.28). The revised school violence questionnaire (CUVE-R) was administered. The results showed that boys scored higher on student violence, teacher violence, and violence through ICT, while girls do so in disruption in the classroom. Also, an older age increases the exercise of violent behaviors, except in the disruption in the classroom that presents higher values at thirteen years. Finally, it is the publicly owned centers that have the highest probabilities of school violence. In general, the results have allowed confirm that gender, age and type of center can be variable to take into account for the regulation of coexistence in compulsory secondary education centers, on which the prevention and intervention actions to be developed should be centered.Key words: school violence, gender, age, educational center, secondary school.Resumen.La violencia en los centros escolares es uno de los motivos que más preocupaciones genera en las comunidades educativas y también en el resto de la sociedad. El objetivo del estudio fue analizar si el género, edad y tipo de centro inciden significativamente en el tipo de violencia escolar ejercida por el alumnado de educación secundaria obligatoria. Participaron 1270 alumnos (51.2% hombres y 48.8% mujeres) con edades comprendidas entre los 12 y 16 años (media de edad: 13.79±1.28). Se administró el cuestionario de violencia escolar revisado (CUVE-R). Los resultados mostraron que los chicos puntuaban más alto en violencia del alumnado, violencia del profesorado, y violencia a través de las TIC, mientras que las chicas lo hacen en la disrupción en el aula. Asimismo, una mayor edad incrementa el ejercer conductas violentas, excepto en la disrupción en el aula que presenta mayores valores a los trece años. Finalmente, son los centros de titularidad pública los que presentan probabilidades más elevadas de violencia escolar. En general, los resultados han permitido confirmar que género, edad y tipo de centro pueden ser variables a tener en cuenta para la regulación de la convivencia en los centros educativos de educación secundaria obligatoria, sobre las que se debería centrar las acciones de prevención e intervención a desarrollar.Palabras clave: violencia escolar, género, edad, centro educativo, educación secundaria obligatoria.

scholarly journals Mediación de conflictos y violencia escolar: Resultados de intervención a través de un estudio cuasi-experimental

2020 ◽  
Vol 31 (3) ◽  
pp. 45
Author(s):  
Edgar Guillermo Pulido Guerrero ◽  
Lorena Cudris Torres ◽  
María Margarita Tirado Vides ◽  
Luz Karine Jiménez Ruíz
Keyword(s):  
School Violence ◽  
Physical Violence ◽  
Peer Mediation ◽  
Educational Institution ◽  
Mediation Process ◽  
Control Group ◽  
Conflict Mediation ◽  
Student’S T ◽  
Student’S T Test ◽  
Violencia Escolar

RESUMENLa presente investigación buscó verificar el efecto en la percepción de violencia escolar tras la implementación de un proyecto de mediación de conflictos. Se llevó a cabo el entrenamiento de mediadores escolares mediante b-learning y el desarrollo de jornadas de mediación escolar de pares. Se desarrolla un cuasi-experimento, donde se compara la intervención de mediación del grupo beneficiado (54 participantes), con una segunda intervención mediante talleres lúdico-pedagógicos sobre resolución de conflictos (57 participantes), así como con un grupo control donde no se realizó intervención (53 participantes); todos los participantes pertenecen al nivel de educación secundaria de una institución educativa de Valledupar, Colombia. La prueba estadística t de Student para muestras relacionadas demuestra una reducción significativa de la percepción de violencia escolar solamente en el grupo donde se desarrolló el proceso de mediación escolar; así mismo, se encontró que la mediación tuvo efectos diferenciales en las dimensiones de violencia verbal entre pares, violencia física y amenaza, exclusión social y disrupción en el aula. Se discute sobre la pertinencia de la implementación masiva de la mediación de conflictos en escenarios escolares locales, dada la propensión a la violencia escolar relacionada con violencia social y estructural, así como la necesidad de evaluar objetivamente los resultados de este tipo de intervenciones, aspectos que son clave en la orientación educativa para la construcción de paz y ciudadanía.ABSTRACTThe present study purported to verify the effect on the perception of school violence after the implementation of a conflict mediation project. The training of school mediators was carried out through b-learning and the development of peer mediation sessions. A quasi-experiment was developed, comparing the mediation intervention of the group benefited (54 participants), with a second intervention through playful-pedagogical workshops about conflict resolution (57 participants), as well as with a control group where no intervention was performed (53 participants); all the participants belong to secondary school of an educational institution of Valledupar, Colombia. Student’s t-test for related samples demonstrates a significant reduction in the perception of school violence only in the group where the school mediation process was developed. Likewise, it was found that mediation had differential effects on the dimensions of verbal violence between peers, physical violence and threat, social exclusion and disruption in the classroom. The relevance of the massive implementation of conflict mediation in local school scenarios is discussed, given the propensity to school violence related to social and structural violence, as well as the need to objectively evaluate the results of this type of intervention, aspects that are key in school counseling for the construction of peace and citizenship.

scholarly journals Perceptions of Elementary School Teachers about Effect of Physical and Emotional Violence on Students' Performance

2020 ◽  
Vol 6 (2) ◽  
pp. 661-667
Author(s):  
Misbah Malik ◽  
Sumaira Munawar ◽  
Khadija Sittar
Keyword(s):  
Academic Performance ◽  
School Violence ◽  
Physical Violence ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Teachers Perceptions ◽  
Positive Effects ◽  
Validated Questionnaire

Physical and emotional violence has become a serious problem in schools. Teachers are important part of the whole education system, therefore, their insights into school violence are essential to understand the problem. This study aimed to investigate the teachers’ perceptions about the effect of physical and emotional violence on students’ academic performance. A causal-comparative research design based on a cross-sectional survey was used. A self-developed and validated questionnaire was used to measure the level of teachers’ perceptions about physical and emotional violence and its effect on students’ academic performance. The reliability index (Cronbach’s alpha) of the questionnaire was 0.92. All the teachers of the public high schools of Lahore city were the population of the study. A sample of 300 teachers was taken through simple random sampling technique. Data were analyzed by applying descriptive and inferential statistics. The results revealed that teachers thought that many practices related to emotional and physical violence had positive effects on students’ performance. Majority of the teachers responded that they had to use many of the practices in order to put students’ attention towards their learning which ultimately improved their performance. Result of correlation analysis also confirmed that teachers’ practices related to physical and emotional violence were positively associated with students’ academic performance. It was also found that the physical and emotional violence was a significant predictor of students’ academic performance. On the basis of these results, it is recommended that school education department should conduct seminars and training workshops to educate teachers about negative effects of violent practices they are using to improve students’ performance. Keywords: Emotional violence, physical violence, academic performance Physical and emotional violence has become a serious problem in schools. Teachers are important part of the whole education system, therefore, their insights into school violence are essential to understand the problem. This study aimed to investigate the teachers’ perceptions about the effect of physical and emotional violence on students’ academic performance. A causal-comparative research design based on a cross-sectional survey was used. A self-developed and validated questionnaire was used to measure the level of teachers’ perceptions about physical and emotional violence and its effect on students’ academic performance. The reliability index (Cronbach’s alpha) of the questionnaire was 0.92. All the teachers of the public high schools of Lahore city were the population of the study. A sample of 300 teachers was taken through simple random sampling technique. Data were analyzed by applying descriptive and inferential statistics. The results revealed that teachers thought that many practices related to emotional and physical violence had positive effects on students’ performance. Majority of the teachers responded that they had to use many of the practices in order to put students’ attention towards their learning which ultimately improved their performance. Result of correlation analysis also confirmed that teachers’ practices related to physical and emotional violence were positively associated with students’ academic performance. It was also found that the physical and emotional violence was a significant predictor of students’ academic performance. On the basis of these results, it is recommended that school education department should conduct seminars and training workshops to educate teachers about negative effects of violent practices they are using to improve students’ performance.

scholarly journals Percepciones del alumnado sobre diferentes tipos de violencia. Adaptación y validación del CUVE3 -ESO al contexto universitario

2020 ◽  
Vol 38 (2) ◽  
pp. 567-581 ◽  
Author(s):  
Sara Conde Vélez ◽  
Manuel Delgado-García
Keyword(s):  
School Violence ◽  
Different Types ◽  
University Level ◽  
University Of Huelva ◽  
The One ◽  
Educación Primaria ◽  
The University ◽  
Forms Of Violence ◽  
Point Of Departure ◽  
Violencia Escolar

La mayoría de los estudios sobre violencia escolar centran sus análisis en las etapas de la educación primaria y secundaria, siendo escasas las investigaciones de esta temática en el ámbito universitario. Partiendo de esta realidad y apoyándose en una metodología de tipo encuesta, se presenta un trabajo que indaga en la percepción del alumnado universitario en lo referente a la frecuencia con la que consideran que aparecen diferentes tipos de violencia escolar, protagonizada por los estudiantes o por el profesorado universitario. En concreto, los resultados tienen como punto de partida la adaptación del CUVE3-ESO al contexto universitario y su aplicación a una muestra constituida por 337 alumnos y alumnas de la Universidad de Huelva. Se han analizado sus propiedades psicométricas y se han efectuado análisis descriptivos de las variables estudiadas. A modo de discusión y conclusiones, por una parte cabe resaltar la identificación de determinadas conductas de tipo disruptivo en el aula, así como la violencia verbal entre el alumnado y la violencia del profesorado de tipo excluyente hacia el alumnado, en cuanto a tener preferencia por ciertos alumnos/as (M=2.56), manía a algunos alumnos/as (M=2.25) e ignorar a ciertos alumnos/as (M=2.06). Estas conductas se presentan como las formas más habituales de violencia en la universidad (factores igualmente detectados en otros niveles educativos). Por otra parte, se corrobora que la adaptación del instrumento utilizado también es fiable y válida para evaluar la violencia en el contexto universitario. Most studies about school violence focus their analysis on the stages of primary and secondary education with little research being available on this subject at the university level. Taking this reality as a point of departure and making use of a survey-type methodology, this study investigates the perception of students at the University of Huelva (Spain). This study is concerned with the frequency with which they consider that different types of school violence appear, whether carried out by other students or by professors of the University. Specifically, this study is based on the adaptation of the CUVE3-ESO to a university context and its application to a sample made up of 337 students at the University of Huelva. Their psychometric properties have been analyzed. Descriptive analyses of the studied variables have also been carried out. By way of discussion and conclusions, on the one hand, it is worth highlighting the identification of certain disruptive behaviors in the classroom, as well as verbal violence between students and exclusionary teacher violence towards certain students, in terms of having a preference for some students (M=2.56), disliking some (M=2.25) and ignoring others (M=2.06). These behaviors are presented as the most common forms of violence at the University (and have also been detected at other educational levels). On the other hand, this study corroborates that the adaptation of the instrument used is reliable and valid for evaluating violence in a university context.

PERCEIVED EFFECTS OF STREET HAWKING ON THE WELL-BEING OF CHILDREN IN ANYIGBA, DEKINA LOCAL GOVERNMENT AREA OF KOGI STATE, NIGERIA

2018 ◽  
Vol 8 (1) ◽  
pp. 01-07
Author(s):  
Alfred Eboh
Keyword(s):  
Local Government ◽  
Survey Design ◽  
Sampling Technique ◽  
Well Being ◽  
Local Government Area ◽  
Negative Consequences ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Perceived Effects ◽  
The Government

Background: The hawking of wares by children has been a serious issue confronting the Nigerian society. Children hawk in some of the most horrible conditions conceivable, where they face a serious risk of injury, chronic illness, kidnapping, rape or death. Objective: The focus of this study was to assess the perceived effects of street hawking on the well-being of children in Anyigba, Dekina Local Government Area of Kogi State. Methods: The population of this study consists of parents of the street hawkers in Anyigba while cross-sectional survey design was used through the purposive sampling technique to choose the sample size of one hundred and sixty-two (162) respondents. The validated structured questionnaire and In-Depth Interviews (IDIs) served as the instruments for the data collection respectively. The hypotheses were tested using Chi-Square at a predetermined 0.05 level of significance. The quantitative data were analysed with the aid of the SPSS (version 20). Results: The results indicated among others that street hawking had significant social implications and physical consequences on children's moral behaviour as well as health status in the study area. Conclusion: The study, therefore, concluded that the government of Kogi State should carry out an enlightenment campaign through the media and religious institutions on the negative consequences of street hawking are recommended as panacea. Also, the child right act instrument and its implementation should be strengthened in order to curb street hawking in the study area.

Fenny Roshayanti: A Biography of Science Educator for Our Time

2019 ◽  
Author(s):  
Adib Rifqi Setiawan
Keyword(s):  
Sampling Technique ◽  
Science Educator ◽  
Data Sources ◽  
Negative Consequences ◽  
Academic Advisor ◽  
External Audit ◽  
Narrative Approaches ◽  
The Past ◽  
Science Technology ◽  
And Mathematics

STEAM is an acronym for Science, Technology, Engineering, Art, Mathematics. STEAM defined as the integration of science, technology, engineering, art, and mathematics into a new cross-disciplinary subject in schools. The concept of integrating subjects in Indonesian schools, generally is not new and has not been very successful in the past. Some people consider STEAM as an opportunity while others view it as having problems. Fenny Roshayanti is science educator and researcher that consider STEAM as an opportunity. She has involved the study of STEAM, as an author, educator, academic advisor, and seminar speaker. This article examines what it has been and continues work from Fenny Roshayanti in the science education. Our exploration uses qualitative methods of narrative approaches in the form of biographical studies. Participants as data sources were selected using a purposive sampling technique which was collected based on retrospective interview and naturalistic observation. Data's validity, reliability, and objectivity checked by using external audit techniques. This work explores the powerful of female’s personal style in developing a form of social influence based on her forms of capital as well as address the positive and negative consequences that may follow while implement and research STEAM in teaching classroom.

Mental distress and its associations with behavioral outcomes during the COVID-19: A national survey of Chinese adults (Preprint)

2020 ◽  
Author(s):  
Lu Ma ◽  
Liwang Gao ◽  
Joseph Tak-Fai Lau ◽  
Rahman Atif ◽  
Blair T. Johnson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Educational Attainment ◽  
Structural Equation ◽  
Online Survey ◽  
Mental Distress ◽  
Structural Equation Models ◽  
Behavioral Outcomes ◽  
National Sample ◽  
Negative Consequences

BACKGROUND This study primarily aimed to evaluate the associations between mental distress and COVID-19-related changes in behavioral outcomes, and potential modifiers (age, gender, and educational attainment) of such associations. OBJECTIVE The COVID -19 pandemic has led to elevated levels of mental distress attributed to prolonged lockdowns, business closures, and social isolation. Its impact on behavioral outcomes is however less known. This study is designed to primarily evaluate the associations between mental distress and COVID-19-related changes in drinking, smoking, physical activity and body weight, and potential modifiers of such associations including age, gender, and educational attainment. METHODS An online survey using anonymous network sampling was conducted in China during April-May, 2020 using a 74-item questionnaire distributed through social media. A national sample of 10,545 adults in 31 provinces provided data on socio-demographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses. RESULTS About 13% of adults reported experiencing at least one symptom of mental distress. After adjusting for age, education, gender, ethnicity, marital status, residence, and number of chronic conditions, greater mental distress was associated with increased smoking and alcohol consumption (among current smokers and drinkers) and with both increased and decreased physical activity. Underweight adults were more likely to lose body weight (≥1 kg) whereas overweight adults were more likely to gain weight by the same amount. The association between mental distress and change in physical activity was stronger in adults aged 40 and above and those with high education. Mental distress was significantly associated with an increase in smoking in males but not females. CONCLUSIONS Mental distress was associated with increased smoking in males but not females. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.

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