Are students with asthma at increased risk for being a victim of bullying in school or cyberspace? Findings from the 2011 Florida youth risk behavior survey

Examining the Risks of Multiple Types of Interpersonal Victimization for Transgender and Gender Non-Conforming College Students

Recent research has shown that transgender and gender non-conforming (TGNC) individuals are at risk of experiencing interpersonal violence, yet there may be differences within this group and across victimization types. The current study examined rates of seven types of interpersonal victimization based on six gender identities (cisgender women, cisgender men, trans women, trans men, nonbinary, and another identity) among a national study of college students. Data from the Spring 2021 American College Health Association's National College Health Assessment III (ACHA-NCHA III), a national-level study of U.S. college students, were used. We examined the association between gender identity and seven types of interpersonal violence victimization (violent victimization, sexual victimization, intimate partner violence victimization, stalking, bullying, microaggression, and discrimination) that occurred within the past 12 months. Logistic regression analyses were performed to examine if, when controlling for competing factors, gender identity was associated with an increase in the expected odds of victimization for each victimization type. Analyses revealed that TGNC college students reported experiencing a greater amount of all seven types of victimization compared to cisgender college students. These findings corroborate previous research indicating that rates of interpersonal violence are higher among TGNC college students compared to those who identify as cisgender, even after controlling for sexual orientation, related demographic factors, and substance use. Findings from the current study suggest that there are differences within individuals who identify as TGNC in terms of their risk for interpersonal victimization and that rates differ across victimization types. More work is needed to provide tailored prevention programming for TGNC college students.

Sex Differences in the Relationship Between Asthma and Bullying Victimization Among High School Students in the United States

BACKGROUND

Children with asthma are often marginalized at school, including bullying victimization. The purpose of this study is to estimate the association between asthma and school or electronic bullying victimization among US high school students, and test whether the association varies significantly by sex.

METHODS

Pooled data from five waves of the Youth Risk Behavior Survey (N = 73,074) were used. Additive interactions were estimated in R software as per STROBE guidelines.

RESULTS

Asthma increases the risk of bullying victimization among female and male adolescents. The risk of school bullying was significantly greater among female students with asthma (7.3%) compared to males (4.0%, p = .002). Similarly, the increased risk for electronic bullying victimization associated with asthma was significantly greater among female (7.2%) than among male students (3.4%, p < .001).

CONCLUSIONS

Targeted educational interventions to decrease bullying victimization among adolescents with asthma are needed to mitigate its negative impacts.

The Impact of Cybervictimization on the Self-Management of Chronic Conditions: Lived Experiences

BACKGROUND

Cybervictimization of people with long-term conditions is a disturbing phenomenon with a documented impact on health and well-being. These experiences are primarily examined using quantitative methods, focusing on children and young people. However, research centered on the cybervictimization of adults with chronic conditions is scarce, with limited qualitative input from the victims as experts in their own experiences.

OBJECTIVE

This study aims to understand the impact of cybervictimization on the self-management of long-term conditions among adults with chronic conditions and disabilities in the United Kingdom.

METHODS

This paper reports the findings from the qualitative phase of a phenomenologically informed mixed methods study. The biographical disruption concept was used to conceptualize the study. In-depth semistructured interviews were conducted with 13 participants with chronic conditions who experienced cybervictimization. A codebook was developed, and a zigzag approach to thematic analysis was used to define and refine themes. Ethical considerations and risk assessment were ongoing during the research process because of the sensitivity of the topic and cases of harassment.

RESULTS

Cybervictimization has direct and indirect impacts on the self-management of chronic conditions. This impact was verified across 6 overarching themes that emerged from this study. First, biomedical events included overall health deterioration because of existing conditions, new diagnoses, and subjective physical complaints. Second, the impact on mental health was perceived through psychological consequences and psychiatric disorders that developed after or during this traumatic experience. Third, the multilevel impact theme focused on disrupting the strategies for coping with health conditions and involved unplanned changes to victims' health management priorities. Fourth, the impact of complexity reflected the perceived uniqueness in each case, intersectionality, struggle to obtain formal support, and subsequent health complications. Fifth, social network involvement comprised the effects of social isolation, victim blaming, and deception. Finally, the disability discrimination theme focused on prejudice, issues on inclusion, and hostility in society, with subsequent effects on well-being.

CONCLUSIONS

People with long-term conditions experienced different forms of cybervictimization, all disruptive with various effects on health. Disability discrimination was a prominent finding to be further investigated. This paper reports the impact as themes to guide further research and practice, with the recognition that long-term conditions and impairments are not a homogeneous group. Despite the devastating consequences, there are positive points that strengthen potential interventions. Awareness-raising campaigns, training of support channels, and multidisciplinary research are recommended to tackle this issue and initiate change.

Asthma is associated with bullying victimization in rural adolescents

OBJECTIVE

We characterized bullying among rural adolescents and examined the association between asthma and bullying victimization.

METHODS

Participants (N = 1905; 44.5% Black) were students attending rural high schools who were screened for a randomized trial to address uncontrolled asthma. Screening questions asked students about asthma diagnosis and symptoms, bullying victimization, and demographic characteristics. Logistic regression analyses with school as a fixed effect were employed to examine the extent to which demographic factors, asthma diagnosis, asthma status (i.e. current asthma, no asthma, possible undiagnosed asthma), and among those with current asthma, asthma severity, were associated with bullying victimization. Sensitivity analyses using bullying frequency as the outcome were also conducted.

RESULTS

26.0% reported being bullied. Younger age and self-identifying as White were associated with increased risk of bullying victimization. Compared to those with no asthma, those with current asthma or possible undiagnosed asthma were at increased risk for bullying victimization (adjusted odds ratio [AOR] = 2.46; 95% confidence interval (CI) = 1.76-3.46 and AOR = 2.42; 95% CI = 1.87-3.14, respectively). Among those with current asthma, persistent symptoms increased the risk for bullying victimization (AOR = 2.59; 95% CI = 1.45-4.71). Similar results were obtained with sensitivity analyses.

CONCLUSIONS

In a large rural community cohort, asthma was associated with bullying victimization. Findings suggest that rural students with asthma, with or without diagnosis, could benefit from schools creating inclusive environments that reduce victimization based on this medical condition. School administrators should foster environments that are accepting of all students' abilities and statuses, and healthcare providers can provide proper asthma management education to these adolescents.

Associations Between Bullying and Condition Severity Among Youth With Chronic Health Conditions

PURPOSE

Children with chronic conditions are at increased risk of bullying involvement. In addition to examining associations between chronic health conditions and both victimization and perpetration, this study investigated whether condition severity is associated with bullying involvement.

METHODS

A secondary analysis of the 2018-2019 National Survey of Children's Health was performed. Children ages six-17 (n = 42,716) were classified as perpetrators (if bullied others ≥one-two times/month), victims-only (if victimized ≥one-two times/month and not a perpetrator) or uninvolved in bullying (neither perpetrator nor victim-only). Survey-weighted multinomial logistic regressions were used to investigate associations between bullying involvement and 13 chronic medical and developmental/mental health conditions. For children with conditions associated with being a victim and/or perpetrator, multinomial logistic regressions were used to further investigate associations between condition severity and victimization or perpetration.

RESULTS

All 13 conditions were associated with higher odds of victimization. Seven developmental/mental health conditions were associated with higher odds of perpetration. Condition severity was associated with at least one domain of bullying involvement for one chronic medical and six developmental/mental health conditions. Notably, among children with attention-deficit/hyperactivity disorder, learning disability, or anxiety, condition severity was associated with higher odds of being a victim or bully/bully-victim.

DISCUSSION

Condition severity may be a risk-factor for bullying involvement for many developmental/mental health conditions. Future condition-specific analyses are needed that directly examine bullying involvement among children with varying severity of individual conditions like attention-deficit/hyperactivity disorder, learning disability, and anxiety, using a clear operational definition for bullying, objective measures of condition severity, and multiple informants of bullying involvement.

Cybervictimization of Adults With Long-term Conditions: Cross-sectional Study

BACKGROUND

People living with chronic conditions and disabilities experience harassment both offline and on the web. Cybervictimization is an umbrella term for negative web-based experiences. It has distressing consequences on physical health, mental well-being, and social relationships. These experiences have mostly been documented among children and adolescents. However, the scope of such experiences is not well documented among adults with long-term conditions, and the potential impact has not been examined from a public health perspective.

OBJECTIVE

This study aimed to examine the scope of cybervictimization among adults living with long-term conditions in the United Kingdom and the perceived impact on self-management of chronic conditions.

METHODS

This paper reports the findings of the quantitative phase of a mixed methods study in the United Kingdom. This cross-sectional study targeted adults aged ≥18 years with long-term conditions. Using a web-based link, the survey was shared on the web via 55 victim support groups, health support organizations, and social media accounts of nongovernmental organizations and activists such as journalists and disability campaigners. People with long-term conditions were asked about their health conditions, comorbidities, self-management, negative web-based experiences, their impact on them, and support sought to mitigate the experiences. The perceived impact of cybervictimization was measured using a set of questions on a Likert scale, frequency tables, and the Stanford Self-Efficacy for Managing Chronic Diseases Scale. Demographic data and the impact on self-management were cross-tabulated to identify the demographic characteristics of the targeted individuals and potential conditions with complications and highlight directions for future research.

RESULTS

Data from 152 participants showed that almost 1 in every 2 adults with chronic conditions was cybervictimized (69/152, 45.4%). Most victims (53/69, 77%) had disabilities; the relationship between cybervictimization and disability was statistically significant (P=.03). The most common means of contacting the victims was Facebook (43/68, 63%), followed by personal email or SMS text messaging, each accounting for 40% (27/68). Some participants (9/68, 13%) were victimized in web-based health forums. Furthermore, 61% (33/54) of victims reported that experiencing cybervictimization had affected their health condition self-management plan. The highest impact was on lifestyle changes such as exercise, diet, avoiding triggers, and avoiding excessive smoking and alcohol consumption. This was followed by changes to medications and follow-ups with health care professionals. Most victims (38/55, 69%) perceived a worsened self-efficacy on the Self-Efficacy for Managing Chronic Diseases Scale. Formal support was generally rated as poor, with only 25% (13/53) of victims having disclosed this experience to their physicians.

CONCLUSIONS

Cybervictimization of people with chronic conditions is a public health issue with worrying consequences. This triggered considerable fear and negatively influenced the self-management of different health conditions. Further context- and condition-specific research is needed. Global collaborations to address inconsistencies in research are recommended.

Cyberbullying Among Adolescents with Chronic Illnesses in Thailand: Prevalence and Relationship with Health-Risk Behaviors

BACKGROUND

The use of social media may enhance the quality of life in adolescents living with chronic illnesses but may increase the risk of cyberbullying.

OBJECTIVE

The aim of this study was to estimate the prevalence of cyberbullying among adolescents with chronic illnesses and relationship with health-risk behaviors.

METHODS

This is an online survey of randomly recruited adolescents aged 11 to 18 years with chronic illness managed at Siriraj Hospital, Thailand, during 2019 to 2020. Participants were asked to respond anonymously to validated online questionnaires to evaluate health-risk behaviors, experience with cyberbullying, and depression-screening questions.

RESULTS

Three hundred forty-one participants with a mean age of 15.02 ± 2.17 years (interquartile range 12.8, 17.2) responded. Reported risk behaviors included sexual activity in 42 participants (12.3%) with almost half (47.6%) having practiced unsafe sex. Alcohol drinking and polysubstance use were also found in 8.5% and 1.2%, respectively. 38 (11.1%) felt depressed within the previous 2-week period. 56 (16.4%) had been a cyberbully victim. Among the victims, 25 (44.6%) were also cyberbullies themselves. Chronically ill adolescents were more likely to be a victim of cyberbullying if they knew someone who had also been a victim (adjusted odds ratio [aOR] 5.25 [95% confidence interval [CI] = 1.80-15.29], p < 0.001) or had a positive depression screening (aOR 6.182 [95% CI = 2.41-15.85], p < 0.001). Underlying diseases, age, sex, risky behaviors, and time spent online were not associated with being cyberbullied.

CONCLUSION

Thai adolescents with chronic illness were similar to their healthy peers regarding health-risk behaviors and the likelihood of being a victim of cyberbullying. Screening for risky behaviors, evidence of depression, and online activity during routine medical visits was an opportunity to prevent cyberbullying.

[Asthma and suicidal behavior in adolescents: a literature review]

INTRODUCTION

Adolescence is a difficult time in life and asthma has major psychological consequences for adolescents.

OBJECTIVES

This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population.

METHOD

Research on Medline for the 1980-2021 period. Objectives This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population.

RESULTS

An overwhelming majority of the studies taken into consideration demonstrated a significant positive association between asthma and suicidal behaviors. Among the 10 studies assessing SI (with or without SP), 9 of them found a significant positive association between asthma and SI. Eight studies assessed SA; five cross-sectional studies and one prospective study demonstrated a significant positive association between asthma and SA. Only one case-control study did not find a significant positive association between asthma and SA after hospitalization for asthma. The two cross-sectional studies assessing suicidal risk taken as a whole (SI, SP and SA) demonstrated a significant positive association between asthma and at least one suicidal behavior. (OR=1.71; P<0.001). However, several studies did not include depression as an adjustment factor.

CONCLUSION

It is important that healthcare professionals assess suicide risk in adolescent suffering from asthma, the objective being to avoid SA or death from SA.

Bullying and lifetime asthma among children and adolescents in the United States

PURPOSE

To examine the association of experiencing bullying within the past year with the prevalence of lifetime childhood asthma in US children and adolescents; and whether this associations vary with sex of the child and select socioeconomic indicators.

METHODS

We performed secondary analysis of data from the 2018 National Survey of Children's Health participants aged 6 to 17 years (n=19,766). We used log-binomial regression to examine the association between bullying and lifetime childhood asthma before and after controlling for select covariates. We also tested interactions of bullying with sex and select socioeconomic indicators.

RESULTS

Children who experience bullying have a significantly increased probability of having asthma in adjusted analyses. The probability of childhood asthma increased with the frequency of bullying with PRs starting at 1.28 (95%CI:1.06, 1.55) for children bullied 1-2 times per year to 1.59 (95%:1.22, 2.09) for those being bullied at least 4 times per month. This association did not differ with sex of the child and select socioeconomic indicators.

CONCLUSION

We found that children who experienced bullying had a greater probability of having asthma relative to those who never experienced bullying. These finding highlight the impact of psychosocial stressors on asthma as a nontraditional trigger in children with asthma.

A Comparison of Activity Participation between Children with and without Asthma

Background

Asthma affects approximately 6 million children in the United States and can greatly impact quality of life and occupational engagement. Although occupational therapists are well-equipped to address participation limitations, insufficient evidence exists to support the role of occupational therapists in asthma treatment.

Method

The purpose of this study was to further understand the occupational limitations experienced by children with asthma. We also explored a dual diagnosis of asthma and obesity. The participants included children with (n = 84) and without (n = 63) asthma living in New York City. The Child Behavior Checklist, Youth Self Report, Brief Respiratory Questionnaire, and accelerometer data were used to examine occupational participation.

Results

Although accelerometry data demonstrated that children with asthma were equally as active as their non-asthmatic peers, the participants with asthma perceived themselves as participating more in sedentary occupations and were less likely to be members of sports teams. They also had more missed school days and nights of troubled sleep. The children with both asthma and obesity reported the highest level of activity limitations.

Conclusion

This study illustrates specific limitations experienced by children with asthma and supports the need for occupational therapy intervention. Future studies are needed to design and assess interventions that will support the addition of occupational therapists to multidisciplinary asthma treatment teams.

Blockchain and IoMT against Physical Abuse: Bullying in Schools as a Case Study

By law, schools are required to protect the well-being of students against problems such as on-campus bullying and physical abuse. In the UK, a report by the Office for Education (OfE) showed 17% of young people had been bullied during 2017–2018. This problem continues to prevail with consequences including depression, anxiety, suicidal thoughts, and eating disorders. Additionally, recent evidence suggests this type of victimisation could intensify existing health complications. This study investigates the opportunities provided by Internet of Medical Things (IoMT) data towards next-generation safeguarding. A new model is developed based on blockchain technology to enable real-time intervention triggered by IoMT data that can be used to detect stressful events, e.g., when bullying takes place. The model utilises private permissioned blockchain to manage IoMT data to achieve quicker and better decision-making while revolutionising aspects related to compliance, double-entry, confidentiality, and privacy. The feasibility of the model and the interaction between the sensors and the blockchain was simulated. To facilitate a close approximation of an actual IoMT environment, we clustered and decomposed existing medical sensors to their attributes, including their function, for a variety of scenarios. Then, we demonstrated the performance and capabilities of the emulator under different loads of sensor-generated data. We argue to the suitability of this emulator for schools and medical centres to conduct feasibility studies to address sensor data with disruptive data processing and management technologies.

EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma

Adolescent and young adult (AYA) patients need additional support, while they experience the challenges associated with their age. They need specific training to learn the knowledge and skills required to confidently self-manage their allergies and/or asthma. Transitional care is a complex process, which should address the psychological, medical, educational and vocational needs of AYA in the developmentally appropriate way. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline to provide evidence-based recommendations for healthcare professionals to support the transitional care of AYA with allergy and/or asthma. This guideline was developed by a multidisciplinary working panel of experts and patient representatives based on two recent systematic reviews. It sets out a series of general recommendations on operating a clinical service for AYA, which include the following: (a) starting transition early (11-13 years), (b) using a structured, multidisciplinary approach, (c) ensuring AYA fully understand their condition and have resources they can access, (d) active monitoring of adherence and (e) discussing any implications for further education and work. Specific allergy and asthma transition recommendations include (a) simplifying medication regimes and using reminders; (b) focusing on areas where AYA are not confident and involving peers in training AYA patients; (c) identifying and managing psychological and socio-economic issues impacting disease control and quality of life; (d) enrolling the family in assisting AYA to undertake self-management; and (e) encouraging AYA to let their friends know about their allergies and asthma. These recommendations may need to be adapted to fit into national healthcare systems.

Risk Factors Associated With Bullying at School and Electronic Bullying in U.S. Adolescent Females With Asthma

Although adolescent females with asthma are at increased risk for bullying, relationships between bullying at school and electronic bullying and demographics, mental health issues, and substance use have not specifically been studied in these young women. The purpose of this research was to examine such relationships among adolescent females with asthma. Complex sampling software was used to extrapolate frequencies and χ² analyses to adolescent females with asthma. In this U.S. sample of adolescent females with asthma (n = 1,634), younger age, mental health issues, and substance use were significantly related to bullying at school and electronic bullying, while race/ethnicity and grade in school were significantly related only to bullying at school. In general, findings are consistent with previous research regarding relationships between bullying and risk factors among all U.S. adolescent females. Guidance by school nurses is needed to create effective supports for victimization reduction in this vulnerable group.

Understanding the challenges faced by adolescents and young adults with allergic conditions: A systematic review

BACKGROUND

Adolescence represents a vulnerable time for individuals with asthma and allergic conditions. They suffer an unexpected degree of morbidity. This systematic review aimed to understand the challenges faced by adolescents and young adults with these conditions.

METHODS

A systematic literature search was undertaken across eight databases. References were checked by two reviewers for inclusion. Study data were extracted, and their quality was assessed in duplicate. A narrative meta-synthesis was undertaken.

RESULTS

A total of 108 papers describing 106 studies were retrieved, most focused on asthma. Five themes were identified across studies: (a) Health-related quality of life-impairment was associated with poor disease control, psychosocial issues, adolescent-onset allergic disease and female sex; (b) Psychological factors-asthma and food allergy were associated with anxiety and depression, atopic dermatitis was associated with suicidal ideation, and that parental emotional support may be protective; (c) Adherence-suboptimal adherence was associated with older age, barriers to medication usage, poor symptom perception and failure to take responsibility, and positive factors were routines, simpler treatment regimes, better knowledge and perceptions about medications; (d) Self-management-facilitated by education, knowledge and a positive attitude; and (e) Supportive relationships-families could modify barriers to adherence and foster positive views about self-management, adolescents suggested that their peers should be more involved in supporting them, and adolescents also wished to have support from nonjudgemental healthcare professionals.

CONCLUSIONS

We have some understanding of the challenges faced by adolescents with asthma, less so for other allergic conditions. This knowledge will be used to support guidelines for managing adolescents.

Adolescents with asthma reported more peer victimization, more anger repression, and less anger expression

Objective: The aim of this study was to investigate the peer victimization and anger expression in adolescents with asthma. The relationship between asthma control and psychological features was also examined.Methods: The study was a cross-sectional study with a healthy control group. The sample of the study was composed of 61 adolescents who were previously diagnosed by a physician with asthma of various intensities. Sixty adolescents with no chronic disorders were enrolled as the control group. Peer victimization was examined using the Multidimensional Peer Victimization Scale (MPVS). The State-Trait Anger Expression Inventory (STAXI) was used to assess anger expression styles. Emotional and behavioral symptoms of the adolescents were measured using the Strengths and Difficulties Questionnaire (SDQ).Results: Adolescents with asthma reported more peer victimization in the subscales of physical, social, verbal, attacks on property, and frightening in the MPVS; and having more problems in emotional, social, and peer relations areas in the SDQ (p < .001 for all subscales) compared to the control group. The results were similar between the groups regarding the conduct problems and hyperactive behaviors. The adolescents with asthma reported more anger repression and less anger expression than the control group (p < .001 for both subscales).Conclusions: The results indicated that the adolescents with asthma were subjected to more peer victimization and experienced more difficulties in anger expression than the controls. Based on the findings of this study, we suggest that these psychological factors should be kept in mind during the management of asthma in adolescents.

A nationwide study of asthma correlates among adolescents in Saudi Arabia

Background

Asthma is a chronic airway inflammation disease that is frequently found in children and adolescents with an increasing prevalence. Several studies are linking its presence to many lifestyle and health correlates. The objective of this study was to explore these correlates and find characteristics of self-reported asthmatics among adolescents in Saudi Arabia.

Methods

This is a cross-sectional, school-based study carried out in all 13 regions of Saudi Arabia. Sampling was randomly done from intermediate and secondary school students. Data in our study consisted of demographic characteristics, health conditions and lifestyle patterns and were compared between the two groups: asthmatics versus non-asthmatics. Comparison between the two groups was done by analyzing our data using Statistical Analysis Software SURVEYFREQ procedure (SAS Version 9; SAS Institute, Cary, NC).

Results

Among a sample of 11,348 participants, the prevalence of self-reported asthma was found to be 8.2%. Various characteristics were found significantly different between the 2 groups including the gender, the weight, the family’s education, and dietary patterns. Self –reported asthmatic were more likely to be males, overweight or obese, with a lower father’s level of education and a higher consumption of milk and power drinks.

Conclusion

Asthma disease remains prevalent among adolescents in Saudi Arabia and requires higher awareness and better guidance for its prevention and treatment. Further efforts should focus on health promotion and lifestyle wellness to support preventive efforts of this chronic disease condition.

A Mixed-methods Study Examining Inhaler Carry and Use among Children at School

Objective: Asthma self-management depends partly on access to inhalers; for children, this includes independent inhaler carry and use at school ("self-carry"). Although laws and policies support self-carry, little is known about practices within schools. This study aimed to identify factors associated with inhaler self-carry among children and examine barriers and facilitators to self-carry.Methods: This mixed-methods observational study included child-parent dyads and nurses from four Chicago schools. Children and parents answered questions about asthma care and morbidity, confidence in self-carry skills, and facilitators and barriers to self-carry. Nurses reported asthma documentation on file and their confidence in children's self-carry skills. Analysis utilized logistic regression. Thematic analysis was performed for open-ended questions.Results: Of 65 children enrolled (mean = 10.66 years), 45 (69.2%) reported having quick-relief medication at school, primarily inhalers, and 35 (53.8%) reported self-carry. Inhaler self-carry was associated with controller medication use and parent confidence in child's self-carry skills. Children and parents identified several facilitators to self-carry: child's asthma knowledge, inhaler characteristics, and need for easy inhaler access. Barriers included child's limited understanding of asthma and inhalers, perception that inhaler is not needed, and limited inhaler access. Children also emphasized social relationships as facilitators and barriers, while parents described children's responsibility as a facilitator and inconsistent policy implementation as a barrier.Conclusions: Efforts to improve inhaler self-carry at school should focus on educating children about asthma and inhaler use, creating supportive environments for self-carry among peers and teachers, and fostering consistent implementation and communication about asthma policy among schools and families.

The Effects of Asthma and Bullying on Suicidal Behaviors Among US Adolescents

BACKGROUND

Positive associations between suicidal behaviors and asthma have been established in previous adolescent studies. Few studies consider social risk factors, such as bullying. This study involved an analysis of suicidal behaviors and asthma, but also includes an assessment of whether these relationships were modified by the co-occurrence of bullying.

METHODS

Data included 13,154 participants from the 2013 Youth Risk Behavior Survey (YRBS), collected by the US Centers for Disease Control and Prevention. Logistic regression models were constructed and summarized using odds ratios (ORs) and 95% confidence intervals (95% CIs).

RESULTS

When comparing adolescents with asthma who were bullied at school to those who were not bullied at school, the odds of contemplating suicide were increased by nearly 2-fold (OR = 1.8, 95% CI = 1.5-2.3), and the odds of creating a suicide plan were 2.3 times higher (OR = 2.3, 95% CI = 1.7-3.1). The odds of a suicide attempt and incurring an injury from a suicide attempt were also substantially increased. Similarly, increased odds of suicidal behaviors were observed for adolescents with asthma who were bullied electronically.

CONCLUSION

Having asthma and being bullied are both associated with increased odds of suicidal behaviors.

Knowledge on asthma, food allergies, and anaphylaxis: Assessment of elementary school teachers, parents/caregivers of asthmatic children, and university students in Uruguaiana, in the state of Rio Grande do Sul, Brazil

INTRODUCTION

Allergic diseases have become an increasingly common reality in the last years, extending beyond the family context.

OBJECTIVE

Assessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil.

METHOD

577 individuals (PC - N=111; EST - N=177; US - N=299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis.

RESULTS

Although PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students.

CONCLUSION

Despite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients.

Systematic Review: Bullying Involvement of Children With and Without Chronic Physical Illness and/or Physical/Sensory Disability-a Meta-Analytic Comparison With Healthy/Nondisabled Peers

Objective

To compare levels of victimization and perpetration associated with bullying among children and adolescents with and without chronic physical illnesses and/or physical or sensory disabilities.

Methods

In total, 107 studies were identified using a systematic search in electronic databases and cross-referencing. A random-effects meta-analysis was computed.

Results

Children and adolescents with chronic physical illness or disability were more likely to be victims of bullying in general (odds ratio [OR] = 1.65), particularly physical bullying (OR = 1.47), relational bullying (OR = 1.47), verbal bullying (OR = 1.67), cyberbullying (OR = 1.39), and illness-specific teasing (OR = 5.29). They were also more likely to be bullies in general (OR = 1.28), as well physical (OR = 1.38) and relational bullies (OR = 1.13). The effect sizes varied across different illnesses and disabilities and, in part, by visibility of the disease, school type, and year of assessment.

Conclusions

Although most between-group differences tend to be small, some form of intervention is needed to reduce bullying among children and adolescents with chronic physical illnesses and/or physical or sensory disabilities, and illness-specific weight- and appearance-related teasing in particular.

Gender and Geographic Predictors of Cyberbullying Victimization, Perpetration, and Coping Modalities Among Youth

Cyberbullying has become an important public health issue due to documented associations among victimization, perpetration, and greater likelihood of depression, substance abuse, anxiety, insomnia, and school-related problems for adolescents. Less is known, however, about how youth cope with cyberbullying and the types of services and supports they are likely to use based on relevant socioeconomic, demographic and geographic factors. The objective of this project was to determine whether gender and geography, in combination with mental health and socioeconomic status, predicted cyberbullying victimization, perpetration, and patterns of coping and help seeking in a sample of youth aged 16 to 19 years ( N = 289). An anonymous online survey was used to gather information on cyberbullying victimization, perpetration, and methods for coping from youth from New Brunswick, Canada. The results of this study suggest that the likelihood of becoming a cyberbullying victim or perpetrator, as well as the coping modalities used to respond to bullying, are highly gendered and intersect with existing social and health inequities. Interventions aimed at bolstering resiliency should be developed in the context of the urban and rural school environments where coping skills are developed and refined.

The Benefits and Challenges of Managing Asthma in Hispanic Families in South Texas: A Mixed-Methods Study

Background

Understanding the experience of Hispanic parents of children diagnosed with asthma can be useful in the delivery of effective and meaningful asthma education. In order to assess the needs of Hispanic families with asthmatic children in South Texas, investigators utilized a combination of qualitative and quantitative research methods.

Objectives

This study aimed (1) to assess the impact of asthma in the quality of life of Hispanic children and their families and (2) to identify barriers and challenges to asthma management as perceived by parents of children diagnosed with asthma.

Methods

A mixed-methods study included a quality-of-life survey and focus group discussions. The Children’s Health Survey for Asthma (CHSA) was completed by 90 parents of children with asthma. Three focus groups were conducted with 15 low-income, Hispanic parents of asthmatic children to assess their needs and experience in managing the disease.

Results

Results from the CHSA showed that asthma significantly affects the quality of life of children with asthma and their families, particularly the emotional dimensions and the child’s physical health. Fifty-three percent of the children had visited the emergency room, and 51% had been hospitalized due to asthma. One out of five parents had missed work, and 27% of children had missed school in the past 2 weeks due to the child’s asthma. In the focus group discussions, the key themes emerging included lack of asthma knowledge, the burden of disease for asthmatic children and their families, and the importance of asthma education and self-management behaviors for asthma control.

Conclusion

One of the main challenges faced by Hispanic families with asthmatic children is the lack of asthma-related knowledge to help understand and control their children’s disease. Lack of knowledge and self-management skills lead to significant stress and anxiety among children with asthma and their parents. Results highlight that while asthma has an effect on the quality of life of children and their families, particularly on the emotional health domain, a wide dissemination of asthma management education in different settings might help prevent asthma attacks and improve symptom control among those suffering from this disease along the US–Mexico border.

Asthma education for school staff

BACKGROUND

Teachers and school staff should be competent in managing asthma in schools. Demonstrated low levels of asthma knowledge mean that staff may not know how best to protect a child with asthma in their care, or may fail to take appropriate action in the event of a serious attack. Education about asthma could help to improve this knowledge and lead to better asthma outcomes for children.

OBJECTIVES

To assess the effectiveness and safety of asthma education programmes for school staff, and to identify content and attributes underpinning them.

SEARCH METHODS

We conducted the most recent searches on 29 November 2016.

SELECTION CRITERIA

We included randomised controlled trials comparing an intervention to educate school staff about asthma versus a control group. We included studies reported as full text, those published as abstract only and unpublished data.

DATA COLLECTION AND ANALYSIS

At least two review authors screened the searches, extracted outcome data and intervention characteristics from included studies and assessed risk of bias. Primary outcomes for the quantitative synthesis were emergency department (ED) or hospital visits, mortality and asthma control; we graded the main results and presented evidence in a 'Summary of findings' table. We planned a qualitative synthesis of intervention characteristics, but study authors were unable to provide the necessary information.We analysed dichotomous data as odds ratios, and continuous data as mean differences or standardised mean differences, all with a random-effects model. We assessed clinical, methodological and statistical heterogeneity when performing meta-analyses, and we narratively described skewed data.

MAIN RESULTS

Five cluster-RCTs of 111 schools met the review eligibility criteria. Investigators measured outcomes in participating staff and often in children or parents, most often at between 1 and 12 months.All interventions were educational programmes but duration, content and delivery varied; some involved elements of training for pupils or primary care providers. We noted risk of selection, performance, detection and attrition biases, although to a differing extent across studies and outcomes.Quanitative and qualitative analyses were limited. Only one study reported visits to the ED or hospital and provided data that were too skewed for analysis. No studies reported any deaths or adverse events. Studies did not report asthma control consistently, but results showed no difference between groups on the paediatric asthma quality of life questionnaire (mean difference (MD) 0.14, 95% confidence interval (CI) -0.03 to 0.31; 1005 participants; we downgraded the quality of evidence to low for risk of bias and indirectness). Data for symptom days, night-time awakenings, restricted activities of daily living and school absences were skewed or could not be analysed; some mean scores were better in the trained group, but most differences between groups were small and did not persist to 24 months.Schools that received asthma education were more adherent to asthma policies, and staff were better prepared; more schools that had received staff asthma training had written asthma policies compared with control schools, more intervention schools showed improvement in measures taken to prevent or manage exercise-induced asthma attacks and more staff at intervention schools reported that they felt able to administer salbutamol via a spacer. However, the quality of the evidence was low; results show imbalances at baseline, and confidence in the evidence was limited by risk of bias and imprecision. Staff knowledge was higher in groups that had received asthma education, although results were inconsistent and difficult to interpret owing to differences between scales (low quality).Available information about the interventions was insufficient for review authors to conduct a meaningful qualitative synthesis of the content that led to a successful intervention, or of the resources required to replicate results accurately.

AUTHORS' CONCLUSIONS

Asthma education for school staff increases asthma knowledge and preparedness, but studies vary and all available evidence is of low quality. Studies have not yet captured whether this improvement in knowledge has led to appreciable benefits over the short term or the longer term for the safety and health of children with asthma in school. Randomised evidence does not contribute to our knowledge of content or attributes of interventions that lead to the best outcomes, or of resources required for successful implementation.Complete reporting of the content and resources of educational interventions is essential for assessment of their effectiveness and feasibility for implementation. This applies to both randomised and non-randomised studies, although the latter may be better placed to observe important clinical outcomes such as exacerbations and mortality in the longer term.

Physical Conditions and Special Needs as Risk Factors of Peer Victimization Among School Children in Taiwan

Students with physical symptoms and diseases may be at an increased risk of peer victimization. This study examined the associations of several medical conditions (obesity, asthma, allergy, epilepsy, and diabetes) with experience of physical, verbal, and relational victimization among children. A sample of 6,233 fourth-grade students from 314 elementary schools in Taiwan was recruited for the analysis. The mean age of the sample was 10.5, with an even distribution of gender (50.3% male and 49.7% female). Children with asthma, allergy, and epilepsy reported higher frequencies of peer victimization. Those who took daily medications or received treatment were also at a higher risk of being victimized. Diabetes and obesity were not found to be associated with peer victimization. The findings highlighted that children with physical conditions suffer maltreatment from peers. Sensitivity training should be provided to school health professionals, so they can evaluate the risk of victimization among students with special needs during assessment.

Cyberbullying Prevalence Among US Middle and High School-Aged Adolescents: A Systematic Review and Quality Assessment

PURPOSE

Cyberbullying (CB) has established links to physical and mental health problems including depression, suicidality, substance use, and somatic symptoms. Quality reporting of CB prevalence is essential to guide evidence-based policy and prevention priorities. The purpose of this systematic review was to investigate study quality and reported prevalence among CB research studies conducted in populations of US adolescents of middle and high school age.

METHODS

Searches of peer-reviewed literature published through June 2015 for "CB" and related terms were conducted using PubMed, PsycINFO, CINAHL Plus, and Web of Science. Included manuscripts reported CB prevalence in general populations of US adolescents between the ages of 10 and 19 years. Using a review tool based on the Strengthening the Reporting of Observational Studies in Epidemiology statement, reviewers independently scored study quality on study methods, results reporting, and reported prevalence.

RESULTS

Search results yielded 1,447 manuscripts; 81 manuscripts representing 58 unique studies were identified as meeting inclusion criteria. Quality scores ranged between 12 and 37 total points of a possible 42 points (mean = 26.7, standard deviation = 4.6). Prevalence rates of CB ranged as follows: Perpetration, 1%-41%; victimization, 3%-72%; and overlapping perpetration and victimization, 2.3%-16.7%.

CONCLUSIONS

Literature on CB in US middle and high school-aged students is robust in quantity but inconsistent in quality and reported prevalence. Consistent definitions and evidence-based measurement tools are needed.