Responding to Bullying

Children who are bullied are often told to `solve the problems themselves'; however, when bullying is repeated over time, it becomes increasingly difficult for victimized children to stop the torment because of their relative lack of power. We examine the ways in which children respond to bullying and their evaluations of the effectiveness of various strategies in reducing their bullying problems. One thousand eight hundred and fifty-two Canadian children and youth, ranging in age from 4- to 19-years-old (mean 12.6, SD 2.4) responded to a web-based questionnaire. Few respondents indicated that they were motivated by public education campaigns or information about bullying. Participants indicated they were motivated to do something to stop bullying by their own need to exert control and be assertive and by their emotional reactions to bullying. A significant group of youth responded that they did nothing to stop bullying. Finally, the longer the bullying had been ongoing, the less effective students perceived their own strategies. The results highlight the importance of adults supporting students. Similarly, it is important to provide children and youth with strategies that are effective, as they are most likely to implement strategies that are only going to increase the victimization over time.

Prevalence, Motivations, and Social, Mental Health and Health Consequences of Cyberbullying Among School-Aged Children and Youth: Protocol of a Longitudinal and Multi-Perspective Mixed Method Study

BACKGROUND

While the online environment may promote important developmental and social benefits, it also enables the serious and rapidly growing issue of cyberbullying. Cyberbullying constitutes an increasing public health problem - victimized children and youth experience a range of health and mental health concerns, including emotional and psychosomatic problems, maladaptive behaviors, and increased suicidality. Perpetrators demonstrate a lack of empathy, and may also struggle with health and mental health issues.

OBJECTIVE

This paper describes the protocols applied in a longitudinal and multi-perspective mixed-methods study with five objectives: (1) to explore children/youth's experiences, and children/youth's, parents', and teachers' conceptions, definitions, and understanding of cyberbullying; (2) to explore how children/youth view the underlying motivations for cyberbullying; (3) to document the shifting prevalence rates of cyberbullying victimization, witnessing, and perpetration; (4) to identify risk and protective factors for cyberbullying involvement; and (5) to explore social, mental health, and health consequences of cyberbullying.

METHODS

Quantitative survey data were collected over three years (2012-2014) from a stratified random baseline sample of fourth (n=160), seventh (n=243), and tenth (n=267) grade children/youth, their parents (n=246), and their teachers (n=103). Quantitative data were collected from students and teachers during in-person school visits, and from parents via mail-in surveys. Student, parent, and teacher surveys included questions regarding: student experiences with bullying/cyberbullying; student health, mental health, and social and behavioral issues; socio-demographics; and information and communication technology use. In-depth semi-structured qualitative interviews were conducted twice with a sub-sample of students (n=57), purposively selected based on socio-demographics and cyberbullying experience, twice with their parents (n=50), and once with their teachers (n=30).

RESULTS

Data collection for this study is complete. Planned analyses include transition probabilities and repeated measures analyses to determine involvement in cyberbullying. Repeated measures analyses, including between-subject factors (eg, socio-demographics), will be utilized to determine factors that protect or increase risk of involvement in cyberbullying. Qualitative analysis utilizing grounded theory is planned, to permit rich understanding of participant experiences and perspectives. Results will be reported in 2016 and 2017.

CONCLUSIONS

This study will offer insight into the contemporary phenomenon of cyberbullying while also informing interventions to curb cyberbullying and address its pervasive social, mental health, and health consequences. Knowledge mobilization strategies and implications for research and practice are discussed.

Cross-national time trends in bullying victimization in 33 countries among children aged 11, 13 and 15 from 2002 to 2010

BACKGROUND

Bullying among children and adolescents is a public health concern; victimization is associated with psychological and physical health problems. The purpose of this study is to examine temporal trends in bullying victimization among school-aged children in Europe and North America.

METHODS

Data were obtained from cross-sectional self-report surveys collected as part of the Health Behaviour in School-aged Children (HBSC) study from nationally representative samples of 11-, 13- and 15-year-olds, from 33 countries and regions which participated in the 2001-02, 2005-06 and 2009-10 surveys. Responses from 581 838 children were included in the analyses. Binary logistic regression was used for the data analyses.

RESULTS

The binary logistic regression models showed significant decreasing trends in occasional and chronic victimization between 2001-02 and 2009-10 across both genders in a third of participating countries. One country reported significant increasing trends for both occasional and chronic victimization. Gender differences in trends were evident across many countries.

CONCLUSION

Overall, while still common in many countries, bullying victimization is decreasing. The differences between countries highlight the need to further investigate measures undertaken in countries demonstrating a downward trend.

Active transportation and bullying in Canadian schoolchildren: a cross-sectional study

Background

Bullying is a recognized social problem within child populations. Engagement in childhood bullying often occurs in settings that are away from adult supervision, such as en route to and from school. Bullying episodes may also have a negative impact on school childrens’ decisions to engage in active transportation.

Methods

Using a cross-sectional design, we analyzed reports from the 2009/10 cycle of the Canadian Health Behaviour in School-Aged Children (HBSC) study. Records from this general health survey were obtained for 3,997 urban students in grades 6–10 who lived in close proximity of their school and were hence ineligible for school bussing. Students who indicated walking or bicycling to school were classified as engaged in active transportation. Victims and perpetrators of bullying were defined using standard measures and a frequency cut-off of at least 2–3 times per month. Analyses focused on relations between bullying and active transportation, as well as barriers to active transportation as perceived by young people.

Results

27% of young people indicated being victimized, and 12% indicated that they engaged in bullying. Girls were more likely to be victimized than boys, and younger students were more likely to be victimized than older students. Engagement in active transportation was reported by 63% of respondents, of these, 68% indicated that worrying about bullying on the way to school was an impediment to such transportation methods. Victimization by bullying (adjusted OR = 1.26, 95% CI: 1.00 – 1.59) was reported more frequently by children who used active transportation.

Conclusions

Health promotion efforts to promote engagement in active transportation of students to school have obvious value. The potential for modest increases in exposure to bullying should be considered in the planning of such initiatives.

Heterogeneity of sex-stratified BMI trajectories in children from 8 to 14 years old

OBJECTIVE

Describe and predict sex-stratified trajectories of weight change in youths transitioning from childhood to adolescence.

METHODS

Using an accelerated longitudinal design, 461 children between 8 and 12 years old at baseline were followed over three years. Body mass index was calculated from self-reported height and weight. Latent class growth analysis was used to identify BMI trajectories and multinomial logistic regressions, to predict group membership.

RESULTS

A four-group heterogeneous trajectory model emerged for boys and girls alike. Characteristics of the trajectories differed between sexes and no obesity group was found for boys. Sociocultural factors, such as media influence, body dissatisfaction, weight victimization, awareness of thin-ideal standards and related pressures were important correlates of trajectory membership.

CONCLUSION

BMI trajectories during preadolescence are stable over time for heavier children. Body image concerns and weight stigmatization stand out as important factors in the prediction of developmental weight trajectories and could therefore be integrated in weight gain prevention programs for children of all weights as well as in weight management interventions for overweight and obese children.

Supportive communication with parents moderates the negative effects of electronic media use on life satisfaction during adolescence

OBJECTIVES

To examine the impact of electronic media (EM) use on teenagers' life satisfaction (LS) and to assess the potential moderating effect of supportive communication with parents (SCP).

METHODS

Data were drawn from the cross-national Health Behaviour in School-aged Children (HBSC) study (2009/2010) in Canada, England, Germany, Hungary, Italy, Israel, The Netherlands, Poland and Scotland. Sample size: 53,973 students aged 11-15 years.

RESULTS

More hours per day spent on the computer were associated with lower LS; more EM communication with friends with higher LS. This relationship became negative if EM use reached and exceeded a certain threshold. SCP moderated the effect of EM communication with friends, but not computer use for the total sample. SCP seems to be more important than computer use or EM communication with friends for LS and it seems to buffer negative effects of EM use.

CONCLUSIONS

Communication with parents seems to buffer the negative effects of EM use on LS during adolescence. Higher computer use was related to lower LS, but "optimal" frequency of EM communication with friends was country specific.

Cyberbullying victimization and mental health in adolescents and the moderating role of family dinners

IMPORTANCE

This study presents evidence that cyberbullying victimization relates to internalizing, externalizing, and substance use problems in adolescents and that the frequency of family dinners attenuate these associations.

OBJECTIVES

To examine the unique association between cyberbullying victimization and adolescent mental health (after controlling differences in involvement in traditional, face-to-face bullying) and to explore the potential moderating role of family contact in this association.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional, observational study used survey data on 18,834 students (aged 12-18 years) from 49 schools in a Midwestern US state. Logistic regression analysis tested associations between cyberbullying victimization and the likelihood of mental health and substance use problems. Negative binomial regression analysis tested direct and synergistic contributions of cyberbullying victimization and family dinners on the rates of mental health and substance use problems.

EXPOSURES

Frequency of cyberbullying victimization during the previous 12 months; victimization by traditional (face-to-face) bullying; and perpetration of traditional bullying.

MAIN OUTCOMES AND MEASURES

Five internalizing mental health problems (anxiety, depression, self-harm, suicide ideation, and suicide attempt), 2 externalizing problems (fighting and vandalism), and 4 substance use problems (frequent alcohol use, frequent binge drinking, prescription drug misuse, and over-the-counter drug misuse).

RESULTS

About one-fifth (18.6%) of the sample experienced cyberbullying during the previous 12 months. The frequency of cyberbullying positively related to all 11 internalizing, externalizing, and substance use problems (odds ratios from 2.6 [95% CI, 1.7-3.8] to 4.5 [95% CI, 3.0-6.6]). However, victimization related more closely to rates of problems in adolescents that had fewer family dinners.

CONCLUSIONS AND RELEVANCE

Cyberbullying relates to mental health and substance use problems in adolescents, even after their involvement in face-to-face bullying is taken into account. Although correlational, these results suggest that family dinners (ie, family contact and communication) are beneficial to adolescent mental health and may help protect adolescents from the harmful consequences of cyberbullying.

Acute stressor exposure modifies plasma exosome-associated heat shock protein 72 (Hsp72) and microRNA (miR-142-5p and miR-203)

Exosomes, biologically active nanoparticles (40-100 nm) released by hematopoietic and non-hematopoietic cells, contain a variety of proteins and small, non-coding RNA known as microRNA (miRNA). Exposure to various pathogens and disease states modifies the composition and function of exosomes, but there are no studies examining in vivo exosomal changes evoked by the acute stress response. The present study reveals that exposing male Fisher 344 rats to an acute stressor modulates the protein and miRNA profile of circulating plasma exosomes, specifically increasing surface heat shock protein 72 (Hsp72) and decreasing miR-142-5p and -203. The selected miRNAs and Hsp72 are associated with immunomodulatory functions and are likely a critical component of stress-evoked modulation of immunity. Further, we demonstrate that some of these stress-induced modifications in plasma exosomes are mediated by sympathetic nervous system (SNS) activation of alpha-1 adrenergic receptors (ADRs), since drug-mediated blockade of the receptors significantly attenuates the stress-induced modifications of exosomal Hsp72 and miR-142-5p. Together, these findings demonstrate that activation of the acute stress response modifies the proteomic and miRNA profile of exosomes released into the circulation.

Power differentials in bullying: individuals in a community context

Central to the definition of bullying is the abuse of power. Power relationships are inherent in social groups, by virtue of differing size, strength, age, socioeconomic status (SES), or social connectedness of individuals. Beyond the influence of these individual characteristics, environmental factors have the potential to affect the power dynamic in bullying and victimization, but are a relatively unexplored research area. In particular, we know little about how the community-level factors relate to bullying in the adolescent population. The present study is guided by a social ecological perspective to gain a deeper understanding of the individual and built community characteristics (e.g., parks, recreational spaces, buildings that facilitate social interaction and community connectedness) that contribute to the power dynamics related to victimization or bullying in traditional and electronic contexts. Data were collected from 17,777 students in Grades 6 to 10 as part of the 2009/2010 Health Behavior in School-aged Children (HBSC) Survey, from Geographical Information Systems (GIS) data, and from 2006 Canadian Census data. Two nested models were run using HLM with age, gender, ethnicity, SES, social inclusion factors (e.g., collective efficacy), and community resource factors (e.g., access to recreation) as predictors. Characteristics of individuals that placed them at a power disadvantage (being younger, female, and having low SES) were linked to higher rates of victimization. Lower individual collective efficacy was also associated with higher rates of traditional and electronic victimization. Community recreational opportunities were associated with decreased victimization in both contexts. The relative importance of individual and built environmental factors and conceptualization of bullying interactions within a social ecology model are discussed.

Developmental trajectories of romantic stages and associations with problem behaviours during adolescence

Normative romantic development is theorized to progress through a series of stages: affiliative activities, group-based dating, and romantic relationships. The objectives of this research were threefold: empirically examine this progression of romantic stages during adolescence, determine normative and atypical trajectories, and examine links with internalizing and externalizing symptoms. An eight-wave longitudinal study was conducted with 698 adolescents (53.6% female; M(age) = 11.8 years at start of study). A group-based trajectory approach was employed to identify prototypical trajectories of romantic development and a model with three distinct romantic trajectories (i.e., On-time, Early Starters and Late Bloomers) was identified. Both timing and sequencing of romantic activity differed among trajectory groups. Analysis of Variance (ANOVAs) identified associations between Early Starters and externalizing behaviours in early, middle and later adolescence. The findings support progression through theorized stages of romantic activity and highlight the problems that are linked to early-starting and non-sequenced romantic development.

Exposure to public natural space as a protective factor for emotional well-being among young people in Canada

Background

Positive emotional well-being is fundamentally important to general health status, and is linked to many favorable health outcomes. There is societal interest in understanding determinants of emotional well-being in adolescence, and the natural environment represents one potential determinant. Psychological and experimental research have each shown links between exposure to nature and both stress reduction and attention restoration. Some population studies have suggested positive effects of green space on various indicators of health. However, there are limited large-scale epidemiological studies assessing this relationship, specifically for populations of young people and in the Canadian context. The objective of this study was to examine the relationship between exposure to public natural space and positive emotional well-being among young adolescent Canadians.

Methods

This cross-sectional study was based upon the Canadian 2009/10 Health Behaviour in School-aged Children Survey with linked geographic information system (GIS) data. Following exclusions, the sample included 17 249 (grades 6 to 10, mostly ages 11 to 16) students from 317 schools. Features of the natural environment were extracted using GIS within a 5 km radius circular buffer surrounding each school. Multilevel logistic regression was used to examine the relationship between the presence of public natural space (features include green and blue spaces such as parks, wooded areas, and water bodies) and students’ reports of positive emotional well-being, while controlling for salient covariates and the clustered nature of the data.

Results

Over half of Canadian youth reported positive emotional well-being (58.5% among boys and 51.6% among girls). Relationships between measures of natural space and positive emotional well-being were weak and lacked consistency overall, but modest protective effects were observed in small cities. Positive emotional well-being was more strongly associated with other factors including demographic characteristics, family affluence, and perceptions of neighbourhood surroundings.

Conclusion

Exposure to natural space in youth’s immediate living environment may not be a leading determinant of their emotional well-being. The relationship between natural space and positive emotional well-being may be context specific, and thus different for Canadian youth compared to adult populations and those studied in other nations. Factors of the individual context were stronger potential determinants.

Family dinners, communication, and mental health in Canadian adolescents

PURPOSE

To examine the association between the frequency of family dinners and positive and negative dimensions of mental health in adolescents and to determine whether this association is explained by the quality of communication between adolescents and parents.

METHODS

A community sample of 26,069 adolescents (aged 11 to 15 years) participated in the 2010 Canadian Health Behaviour of School-aged Children study. Adolescents gave self-report data on the weekly frequency of family dinners, ease of parent-adolescent communication, and five dimensions of mental health (internalizing and externalizing problems, emotional well-being, prosocial behavior, and life satisfaction). Regression analyses tested relations between family dinners, parent-adolescent communication, and mental health.

RESULTS

The frequency of family dinners negatively related to internalizing and externalizing symptoms and positively related to emotional well-being, prosocial behavior, and life satisfaction. These associations did not interact with differences in gender, grade level, or family affluence. However, hierarchical regression analyses found that these associations were partially mediated by differences in parent-adolescent communication, which explained 13% to 30% of the effect of family dinners on mental health, depending on the outcome.

CONCLUSIONS

These findings, though correlational, revealed a dose-response association between the frequency of family dinners and positive and negative dimensions of adolescent mental health. The ease of communication between parents and adolescents accounted for some of this association.

Physical and emotional health problems experienced by youth engaged in physical fighting and weapon carrying

Then aims of the current study were 1) to provide cross-national estimates of the prevalence of physical fighting and weapon carrying among adolescents aged 11–15 years; (2) To examine the possible effects of physical fighting and weapon carrying on the occurrence of physical (medically treated injuries) and emotional health outcomes (multiple health complaints) among adolescents within the theoretical framework of Problem Behaviour Theory. 20,125 adolescents aged 11–15 in five countries (Belgium, Israel, USA, Canada, FYR Macedonia) were surveyed via the 2006 Health Behaviour in School Aged Children survey. Prevalence was calculated for physical fighting and weapon carrying along with physical and emotional measures that potentially result from violence. Regression analyses were used to quantify associations between violence/weapon carrying and the potential health consequences within each country. Large variations in fighting and weapon carrying were observed across countries. Boys reported more frequent episodes of fighting/weapon carrying and medically attended injuries in every country, while girls reported more emotional symptoms. Although there were some notable variations in findings between different participating countries, increased weapon carrying and physical fighting were both independently and consistently associated with more frequent reports of the potential health outcomes. Adolescents engaging in fighting and weapon carrying are also at risk for physical and emotional health outcomes. Involvement in fighting and weapon carrying can be seen as part of a constellation of risk behaviours with obvious health implications. Our findings also highlight the importance of the cultural context when examining the nature of violent behaviour for adolescents.

Trends and socioeconomic correlates of adolescent physical fighting in 30 countries

BACKGROUND AND OBJECTIVES

No recent international studies provide evidence about its prevalence, trends, or social determinants of physical fighting in adolescents. We studied cross-national epidemiologic trends over time in the occurrence of frequent physical fighting, demographic variations in reported trends, and national wealth and income inequality as correlates.

METHODS

Cross-sectional surveys were administered in school settings in 2002, 2006, and 2010. Participants (N = 493874) included eligible and consenting students aged 11, 13, and 15 years in sampled schools from 30 mainly European and North American countries. Individual measures included engagement in frequent physical fighting, age, gender, participation in multiple risk behaviors, victimization by bullying, and family affluence. Contextual measures included national income inequality, absolute wealth and homicide rates. Temporal measure was survey cycle (year).

RESULTS

Frequent physical fighting declined over time in 19 (63%) of 30 countries (from descriptive then multiple Poisson regression analyses). Contextual measures of absolute wealth (relative risk 0.96, 95% confidence interval 0.93-0.99 per 1 SD increase in gross domestic product per capita) but not income inequality (relative risk 1.01, 95% confidence interval 0.98-1.05 per 1 SD increase) related to lower levels of engagement in fighting. Other risk factors identified were male gender, younger age (11 years), multiple risk behaviors, victimization by bullying, and national homicide rates.

CONCLUSIONS

Between 2002 and 2010, adolescent physical fighting declined in most countries. Specific groups of adolescents require targeted violence reduction programs. Possible determinants responsible for the observed declines are discussed.

Putting problem formulation at the forefront of GMO risk analysis

When applying risk assessment and the broader process of risk analysis to decisions regarding the dissemination of genetically modified organisms (GMOs), the process has a tendency to become remarkably complex. Further, as greater numbers of countries consider authorising the large-scale dissemination of GMOs, and as GMOs with more complex traits reach late stages of development, there has been increasing concern about the burden posed by the complexity of risk analysis. We present here an improved approach for GMO risk analysis that gives a central role to problem formulation. Further, the risk analysis strategy has been clarified and simplified in order to make rigorously scientific risk assessment and risk analysis more broadly accessible to diverse stakeholder groups.

Individual Motivations and Characteristics Associated With Bystander Intervention During Bullying Episodes Among Children and Youth

The aim of the current study was to explore bystander experiences during bullying episodes among children and youth attending a residential summer camp by investigating rates of witnessing and intervention, as well as individual motivations and characteristics associated with bystander intervention. The majority of children had witnessed bullying at least once in the past 3 weeks and reported intervening in some way. Among children who reported intervening, the strongest motivation appeared to be a sense of social justice. Among children who reported not intervening, the strongest motivation appeared to be the feeling that it was not their place to intervene because the bullying situation did not directly involve them and/or was not extremely severe. The determining factors for bystander intervention during bullying episodes differed between genders. Social self-efficacy predicted bystander intervention among girls, while empathy and attitudes about bullying predicted bystander intervention among boys. Implications for bullying prevention are discussed.

Quality of life after surgery for Graves' disease: comparison of those having surgery intended to preserve thyroid function with those having ablative surgery

BACKGROUND

Postoperative quality of life (QoL) after surgery for Graves' disease is not well documented, and the effect of different surgical operations has not been compared. This study examines the impact on QoL of a shift in policy from operations intended to preserve thyroid function (PF) to those ablating thyroid function (AF).

METHODS

A cross-sectional assessment was performed on patients who underwent surgery for Graves' disease between 1986 and 2008 in a tertiary endocrine surgical unit. Patients completed the Short Form 36 (SF-36) questionnaire by post. SF-36 scores, including the physical and mental component summaries, were compared with the general population and by operative intent (AF vs. PF). Statistical analyses were performed using SPSS 16.0.

RESULTS

Of 150 patients, 3 had died of unrelated causes and 14 were not contactable. In the remaining 133 patients, the median age at time of assessment was 46 years (interquartile range 42-50) and 43 years (interquartile range 33-47) in the PF and AF groups, respectively. From these patients, 87 questionnaires (65.4% response rate) were completed with an item completion rate of 99.3%. The median follow-up was 18.4 years for PF and 7.9 years for AF surgery. Of 87 respondents, 38 (43.7%) underwent PF and 49 (56.3%) AF surgery. Study participants reported lower scores across all SF-36 subscales than British norms (p<0.05). Comparisons on operative intent showed no significant difference in long-term QoL (p>0.05).

CONCLUSION

The shift to ablative surgery simplifies postoperative management with no adverse effect on QoL, justifying this practice from a patient perspective.

Self-expanding metallic stents for large bowel obstruction

BACKGROUND

Self-expanding metallic stents (SEMS) may relieve colonic obstruction as definitive therapy or as a bridge to elective surgery.

METHODS

This was a retrospective longitudinal cohort study of patients undergoing insertion of SEMS for large bowel obstruction at one institution. Scrutiny of the radiology department's coding system allowed identification of all patients undergoing colonic stent insertion between 2002 and 2008. Data were extracted from patient case notes and investigation reports.

RESULTS

Eighty-two patients with a median age of 75 (interquartile range (i.q.r.) 43-94) years underwent stent insertion, 71 for palliation and 11 as a bridge to surgery. Obstruction was due to malignant disease in 67 patients and had a benign cause in 15. Median survival in the palliative setting was 103 (i.q.r. 44-317) days. Complications occurred in 43 patients, of whom 22 underwent unplanned surgery. High-grade obstruction (relative risk (RR) 2·05; P = 0·055) and benign disease (RR 3·45; P < 0·001) were associated with risk of adverse events.

CONCLUSION

SEMS should not be used for large bowel obstruction with benign pathology.

Promoting relationships and eliminating violence in Canada

The Promoting Relationships and Eliminating Violence Network (PREVNet) involves Canadian researchers and national organizations working to promote healthy relationships and prevent bullying. In this paper, we provide the rationale for establishing PREVNet, a description of the work of the network, and an assessment of the success of PREVNet. PREVNet’s strategic plan focuses on enhancing the practice of those who work with children and youth through knowledge mobilization under four strategy pillars: education and training, assessment and evaluation, prevention and intervention, and policy and advocacy. For this paper, we focus on proximal indicators of PREVNet’s success: growth of the network, participation in network activities, and development of knowledge mobilization resources. We illustrate that building partnerships with national organizations has been highly effective in the generation and dissemination of knowledge relating to children’s healthy development and healthy relationships.