Myths and Reality About Confronting Anti-Gay Prejudice: Who Confronts and Why (Not)?

There are lay theories about who would confront heterosexist prejudice, with people often citing women, educated, and liberals as being more likely to speak up. However, prior work is inconclusive about such predictors of confrontation. We tested which individual-level characteristics predict bystander confrontation, and what motivates or prevents straight individuals from confronting-focusing on socio-political ideology and gender. We conducted our study among Eastern-Southeastern Europeans (N = 132), and we employed a behavioral paradigm, where participants believed they witnessed and had an opportunity to confront anti-gay discrimination. We found 24% confrontation rate, which was not predicted by age, socioeconomic status, education level, or heterosexism. Moreover, we found that women or liberals were as likely to confront as men or conservatives were, respectively, however, their motivations and obstacles differed. Opposed to our prediction, men were not discouraged from confronting because of fear of being misidentified as gay, while as predicted, women were discouraged due to concerns about their assertiveness and efficacy. We also found that as predicted, liberals were encouraged to confront for equality/intergroup-oriented reasons, and conservatives were encouraged by individual/merit-oriented reasons. We suggest that intervention programs relying on personalized messages can be utilized to motivate confronting heterosexist prejudice along ideological lines.

The sound of silence: The importance of bystander support for confronters in the prevention of norm erosion

Observing deviant behaviour can lead to 'norm erosion', where a norm is no longer seen as relevant and compliance with it is reduced. Previous research argues that social confrontations can mitigate norm erosion. However, this work has not considered the impact of bystanders to confrontations, who might influence the outcome by supporting-or failing to support-the person confronting a social rule breaker. We examine the effect of bystanders' reactions on preventing norm erosion across three experimental studies. We examined how supportive and non-supportive bystander reactions to a confronter impacted the perceived strength of a prosocial norm among participants and their behavioural intentions. We find that when bystanders explicitly supported the confronter against the rule breaker, the norm was perceived as stronger-and sometimes, compliance intentions were higher-than when bystanders did not respond to the confronter. A mini meta-analysis across the three studies reveals that the effect of bystander support on perceived norm strength is large and robust. Our work demonstrates that for the prevention of norm erosion, confrontations benefit greatly from being explicitly supported by bystanders.

Examining the role of alcohol and cannabis use patterns in bystander opportunity and behavior for sexual and relationship aggression

OBJECTIVE

This study aimed to investigate the association between alcohol and cannabis use patterns and bystander intervention for sexual and relationship violence risk among college students who have used cannabis in the past year. The study tested two hypotheses: (1) reports of bystander opportunities will differ based on participants' alcohol and cannabis use patterns, and (2) among those who report bystander opportunities, reports of bystander behaviors will differ based on their alcohol and cannabis use patterns.

METHOD

Participants were 870 students recruited from two large, minority-serving universities in the United States who reported past year cannabis use. Participants reported about their typical alcohol and cannabis use patterns and bystander opportunities and behaviors. Students were grouped for analysis based on their reported average substance use into four groups: alcohol and cannabis use on the same day, alcohol use only, cannabis use only, or no use.

RESULTS

Students who reported alcohol and cannabis use on the same day, compared with those who reported alcohol use only, reported more bystander opportunities and behaviors in situations at risk for sexual and relationship violence. Compared with alcohol use only, students who reported only using cannabis or no use reported fewer bystander opportunities and behavior related to keeping others safe in party settings.

CONCLUSIONS

Alcohol and cannabis use patterns are associated with bystander intervention, emphasizing the need to include knowledge about cannabis and co-use in bystander programming that aims to reduce sexual and relationship violence.

Untrained Bystanders Administering Drone-Delivered Naloxone: An Exploratory Study

Introduction

Opioid overdose deaths continue to climb in the United States. Administering naloxone to an overdose victim can save their life, but rapid access to naloxone remains a barrier. Delivering naloxone to a bystander using a drone has potential to increase naloxone availability but there are still many uncertainties about this mode of delivery. Can an untrained bystander to an opioid overdose successfully administer drone delivered naloxone after viewing video instructions on the drone and how long does it take?

Methods

This mixed-methods observational study, conducted in a controlled outdoor environment, simulated an opioid overdose using a mannequin (overdose victim) and panicked bystander. Untrained and medically naïve participants were instructed to call for help, move the drone from the landing spot to the mannequin, and follow the instructions provided by the drone to administer naloxone. Data was collected using video recordings, interviews, and an online survey. Time stamp data was extracted from the video for 2 time points: time for removing the naloxone from the drone and time to administer the naloxone. Interviews were audio recorded and analyzed using an inductive concept analysis approach. One interview question was coded as a binary response of anxiety/no anxiety and added to the demographic data.

Results

The average time to remove and administer naloxone was 62 seconds. Anxiety during the activity was reported by 59% of the participants but there was no correlation between anxiety and time. The design of our drone and instructional video can be improved.

Conclusions

We have established baseline times for completing steps in administering naloxone delivered by drone. We were able to successfully induce anxiety and have a baseline measure for what percentage of untrained bystanders may experience anxiety when involved with an emergency situation. Design of instructional materials and drone construction can contribute to anxiety and successful administration of naloxone.

Anti-Bullying Interventions With an Emphasis on Bystanders: A Scoping Review

BACKGROUND

Bystanders' role in bullying situations is important, and may exacerbate or minimize the problem. Thus, this article aims to identify the characteristics of anti-bullying programs with an emphasis on bystanders.

METHODS

This is a scoping review. We included studies that addressed interventions with an emphasis on bystanders, carried out with school children and adolescents, aimed at reducing bullying/cyberbullying and/or increasing defending behavior. Fifteen portals/databases were searched. The selection and extraction processes were carried out through the blind review strategy. The synthesis took place descriptively.

RESULTS

We found 12 interventions. The most investigated were KiVa (n = 9), STAC (n = 3), and Curriculum-Based Anti-Bullying (n = 2).

CONCLUSIONS

There are few anti-bullying programs with an emphasis on bystanders, and the majority are universal programs with strategies applied by teachers, giving little attention to parents. Moreover, most of these programs lack a broader mix of anti-bullying strategies. Therefore, we suggest developing anti-bullying programs with multiple components that contain universal, selective, and indicated strategies.

Exposing the Role of Labor and Delivery Nurses as Active Bystanders in Preventing or Perpetuating Obstetric Violence

Obstetric violence is an issue of global scope and magnitude. Its widespread and continued presence indicates cultural tolerance enabled by policies and procedures that uphold paternalism. Labor and delivery nurses are the health care professionals who spend the most time at the point of care during birth, and their role must be examined. As active bystanders, labor and delivery nurses are uniquely positioned to prevent or perpetuate obstetric violence during labor and birth. Reflection on the nurse role is necessary to provide optimal care, enhance relationships with patients, and continue to evolve as a professional discipline. Perinatal nurses must lead the change to trauma-informed care practices to mitigate obstetric violence and reduce birth trauma.

Workplace Bullying Seen from the Perspective of Bystanders: Effects on Engagement and Burnout, Mediating Role of Positive and Negative Affects

The first and original aim of this study was to measure the impact of workplace bullying (WB) seen from the perspective of the witnesses (bystanders) on the work engagement and the burnout of these bystanders. The second aim was to test the mediating roles of affects between WB seen from the perspective of bystanders and two resulting variables, bystanders' work engagement and bystanders' burnout. This study was conducted using self-administered questionnaires with WB bystanders (n = 222) from the Cameroonian health sector. The results indicated that positive and negative affects played mediating roles between WB as seen by witnesses and the two resulting variables, burnout and work engagement. This study offers new avenues for intervention on the issue of WB bystanders. In addition to prevention for victims, witnesses experiencing bullying as bystanders in Cameroon must be supported and accompanied by occupational health services, occupational and psychosocial risk prevention workers, psychologists, as well as human resources.

Bystander Behavior and Sexual Harassment: The Case of the Fashion Industry

This study examines the role of bystander behavior in cases of sexual harassment within the cultural economy's fashion industry. Using grounded theory to explore 34 sexual harassment narratives posted on Instagram, this analysis revealed that while some bystander victim-alliance behavior occurred in the forms of verbal objections and a strong physical presence to thwart perpetrators, bystander facilitation of perpetrator abuse was much more common. Types of facilitation included active bystander complicity, bystander inaction, and what is termed automatic industry bystander deference, whereby seemingly widespread acceptance of certain norms in the business prevented intervention. Implications for victim counseling, bystander intervention training, and public policy reforms are discussed.

Nurse´ profiles in evaluating incivility: Even a slight sexism in employment affects the evaluation

BACKGROUND

Workplace incivility is a serious concern in the healthcare setting worldwide. Creating nurse profiles related to perceiving and tolerating an uncivil episode and addressing how sexism impacts this evaluation may help administrators take action to reduce this work health problem and to increase safety at work.

METHODS

A total of 557 nurses (63% women) were asked to read a hospital scene describing an episode of incivility from a nurse leader towards a nurse employee. They then completed a self-report questionnaire that measured how they evaluate the situation regarding their awareness, tolerance, and their beliefs toward sexism.

FINDINGS

Two clusters emerged showing two distinct nurse profiles: high-sensitivity (higher in awareness and lower in tolerance for incivility) and medium-sensitivity (lower in awareness and more tolerance for incivility). Medium-sensitivity nurses were significantly higher in sexism in employment, and thus, their evaluation of workplace incivility was different from that of highly sensitive nurses.

CONCLUSIONS

The majority of nurses are sensitive to workplace incivility, but those with sexist tendencies in employment are less aware and tolerate uncivil episodes to a greater extent. In fact, sexists belong to the second profile, which could affect their relationships and health.

APPLICATION TO PRACTICE

Although most nurses are sensitive to uncivility, it is still necessary to train nurses to be aware of workplace incivility, especially in those demonstrating sexism.

Imagined and extended contact experiences and adolescent bystanders' behavioral intentions in homophobic bullying episodes

Bystanders' helping interventions in bias-based bullying are rare, although they have the potential to intervene on behalf of the victim and quickly stop the aggression. Two studies tested, experimentally, the impact of adolescents' imagined (Study 1, N = 113, M_age  = 16.17) and extended contact experiences (Study 2, N = 174, M_age  = 15.79) on assertive bystanders' behavioral intentions in the context of homophobic bullying, an under-researched but highly detrimental behavior that emerges mainly during early adolescence. Potential mediators (empathic concern, social contagion concerns, and masculinity/femininity threat) were also examined. Results showed that female younger participants revealed more behavioral intentions to help victims of homophobic bullying when asked to imagine an interaction with an outgroup member (Study 1). Younger participants revealed less masculinity/femininity threat in the positive extended contact condition, and female participants revealed less empathic concern in the negative extended contact condition (Study 2). Overall, these findings identify specific conditions (e.g., younger females) where indirect contact interventions (i.e., extended and imagined) are likely to have a stronger impact. Age and sex differences were found to illustrate how adolescents vary in their behavioral intentions, empathic concern, and threat; and also highlight the need to further examine age and sex differences regarding responses to homophobic bullying episodes.

Pediatric Ventilation Skills by Non-Healthcare Students: Effectiveness, Self-Perception, and Preference

Since a great number of infant cardiopulmonary arrests occur outside of the hospital, it is crucial to train laypersons in cardiopulmonary resuscitation techniques, especially those professionals that will work with infants and children. The main objective of this study was to evaluate the efectiveness of ventilations performed by professional training students. The secondary objective was to analyze the preference between different ventilation and chest-compression methods. The sample consisted of 32 professional training students, 15 preschool students, and 17 physical education students. The activity was conducted separately for each group, and we provided a 10 min theoretical training about infant basic life support followed by a 45 min practical training using a Laerdal Little Anne QCPR CPR manikin. A practical test in pairs was organized to record the ventilation as performed by the participants, establishing the difference between the efficacious and the non-efficacious ones. Furthermore, we handed out a survey before and after training to evaluate their knowledge. More than 90% of the students completely agreed with the importance of learning cardiopulmonary resuscitation techniques for their professional future. More than half of the sample considered that they perform the rescue breathings with the mouth-to-mouth method better. We observed that through mouth-to-mouth-nose ventilations, the number of effective ventilations was significantly higher than the effective ventilations provided by a self-inflating bag and mask (EffectiveMtoMN 6.42 ± 4.27 vs. EffectiveMask 4.75 ± 3.63 (p = 0.007)), which was the preferred method. In terms of the compression method, hands encircling the chest was preferred by more than 85% of students. Mouth-to-mouth nose ventilation is more efficient than bag-face-mask ventilation in CPR as performed by professional training and physical activity students. This fact must be considered to provide higher-quality training sessions to professional training students.

Bystanders' Willingness to Perform Basic Life Support and Its Relationship with Facilitative and Obstructive Factors: A Nationwide Survey in Japan

Background

The administration of basic life support (BLS) by bystanders is essential to improve the survival rates of patients who have experienced out-of-hospital cardiac arrest (OHCA). Although providing BLS to individuals who experience OHCA greatly improves their chances of survival, the actual implementation rate is low. Therefore, we investigated the association between bystanders' willingness to perform BLS and facilitative/obstructive factors with the objective of identifying educational methods that would improve the likelihood of bystanders performing BLS should they encounter a patient with OHCA.

Methods

The study participants included 502 male and 498 female Japanese residents (total, 1000 participants) with no experience in performing BLS and 42 male and 59 female Japanese residents (total 101 participants) with experience in performing BLS. The participants were aged 15-65 years. Both groups graded the strength of their willingness to perform BLS in the future on a 4-point scale, as well as their level of agreement with factors facilitating or obstructing their willingness to perform BLS. These factors were established based on the theory of helping behavior, which defines psychological states when helping others in social psychology.We then analyzed the associations between willingness to perform BLS in the future and their level of agreement with factors facilitating or obstructing their willingness to perform BLS.

Results

The willingness to perform BLS decreased in accordance with the increase in the level of intervention required for patients who experienced OHCA , and was significantly associated with four facilitating factors: sufficient ability and experience to perform BLS, personal advantage, high personal norms, and psychological closeness to the patient.

Conclusion

Our results suggested that workshops and other educational activities focused on these facilitative factors may be helpful in increasing the rate at which bystanders perform BLS.

Science Mapping: A Bibliometric Analysis on Cyberbullying and the Psychological Dimensions of the Self

Cyberbullying prevalence is increasing in the world, being a form of abuse that follows victims into their most intimate settings. Cyberbullying affects victims' mental health, self-esteem, emotions, and academic performance. Cyberbullies present low levels of self-control and empathy. This research aimed to map scientific research on Cyberbullying and the Psychological Dimensions of the Self. A bibliometric analysis of scientific documents published in journals indexed in the Web of Science (WoS) was performed. Traditional bibliometric laws were applied and VOSviewer was used to generate visualizations. The annual publications followed exponential growth. Computers in Human Behaviour was the journal with the most publications. Researchers from the USA and Spain were the most prolific. Sameer Hinduja and Justin Patchin were the most cited authors. Hence, there is a growing interest among researchers in Cyberbullying and the emotional aspects of children and adolescents. The USA and Spain were the leading countries in research on this subject. Rosario Ortega-Ruiz, Sameer Hinduja and Justin Patchin were the most prolific and influential authors.

Cyberbullying: Common Predictors to Cyber-Victimisation and Bystanding

Cyberbullying has increased worryingly in the last decade, becoming a mental health problem in adolescence. Research usually focuses on cyber-bullies or cyber-victims, overlooking that these roles may overlap (e.g., cyber-victim-bystander).

AIM

To identify possible common predictors to cyber-victimisation and bystanding.

SAMPLE

The study sample consisted in 560 students, 12-15 years old, 47.5% female.

METHOD

Canonical correlation, examining linear relationship between a group of X variables, and a group of Y variables.

MAIN RESULTS AND CONCLUSIONS

Two canonical varieties were built (Cor (U₁,V₁) = 0.442; Cor (U₂,V₂) = 0.270). Minors with high scores in cyber-victimisation (r = -0.888) and bystanding (r = -0.902) would have more favourable attitude towards violence, greater number of contacts on social networks/messaging and greater attention to emotions. The second variety discriminates minors with high cyber-victimisation score, but low observation and would relate to low attitudes towards violence and contacts on social networks/messaging, together with high scores in parental monitoring. Results suggest the possible overlapping of roles and how cyber-victimisation and bystanding share predictive factors.

Exploring Multivariate Profiles of Psychological Distress and Empathy in Early Adolescent Victims, Bullies, and Bystanders Involved in Cyberbullying Episodes

(1) Background: Adolescents may be involved in cyberbullying as victims, perpetrators, or to a lesser extent, victim-perpetrators simultaneously. The present research investigated differences between participants acting in different bullying roles-namely, bully, victim, or bully/victim-and bystander roles-namely, defending, passive bystander, and passive/defending; (2) Methods: We used multivariate analysis of covariance to determine how, in the same individuals, direct involvement in cyberbullying episodes compares to participating in them as by-standers in relation to both psychological distress and empathy; (3) Results: Both victims and bully/victims were found to be at increased risk for suicidal ideation, internalizing and externalizing symptoms, and emotional dysregulation compared with students who were neither victims nor perpetrators of cyberbullying episodes. Additionally, victims showed higher empathy scores when compared with bullies and bully/victims. All bystander roles showed increased emotional dysregulation compared with uninvolved students, but no differences emerged on other psychological distress measures. Finally, defending bystanders showed increased cognitive empathy. (4) Conclusions: During early adolescence, the direct experience of cyberbullying, as a bully or a victim (or both), show a stronger association with psychological distress than the mere participation in cyberbullying as a witness, regardless of the witness acting defensive toward the victim, or passive. However, both cyberbullying and bystanding roles provide a similar (small) explicative power over empathy variables.

Psychological Predictors of Bystanders' Intention to Help Cyberbullying Victims Among College Students: An Application of Theory of Planned Behavior

The goal of the present study was to evaluate the Theory of Planned Behavior (TPB) as an explanation for bystanders' intention to help cyberbullying victims among college students. Participants completed an online survey in which their intention, attitude, subjective norm, and perceived behavioral control toward helping cyberbullying victims were assessed. In addition to these traditional TPB variables, empathy toward cyberbullying victims and anticipated regret from not helping victims were included in the model. Results showed that empathy and anticipated regret significantly predicted intention to help cyberbullying victims over and above the traditional TPB variables. Results also showed that gender altered how traditional TPB variables, empathy, and anticipated regret predict bystander's intention to help cyberbullying victims: Empathy and anticipated regret were most robust predictors for males and females, respectively. These results suggest that the TPB is a useful theoretical framework for understanding bystanders' intention to help cyberbullying victims. Implications for developing effective prevention and intervention strategies are discussed.

From pity to numbness: Social exclusion moderates the relationship between trait empathy and bystanders' aggressive tendencies in cyberbullying

Studies on cyberbullying have revealed an inconsistent relationship between trait empathy and bystanders' aggressive tendencies towards victims. We believe that these studies have overlooked the role of social exclusion. We infer that high-severity social exclusion suppresses the negative relationship between trait empathy and bystanders' aggressive tendencies. In Study 1, 226 participants read a news report concerning a singer's humiliation by netizens due to lack of talent. The results revealed that trait empathy predicted lower aggressive tendencies towards the singer for participants with fewer experiences of social exclusion. However, trait empathy was unrelated to aggressive tendencies for participants with more experiences of social exclusion. In Study 2, 146 participants were randomly assigned to a low-severity or a high-severity social exclusion condition and were required to recall their experiences of low- or high-severity social exclusion, respectively. The results demonstrated that in the low-severity condition, trait empathy was negatively associated with participants' aggressive tendencies towards the singer and this relationship was mediated by state empathy. However, there was no evidence that the process was at work in the high-severity condition. This study further presents implications and directions for future research.

Promoting an Emergency Action Plan for Sudden Cardiac Arrest in Youth Sports During a Pandemic

INTRODUCTION

Pandemic-related restrictions increased the risk of delayed emergency response of bystanders to sudden cardiac arrest among youth athletes. Education and SCA emergency preparedness, implemented by nurse leaders and adapted to environmental changes, can greatly reduce the risks associated with an SCA episode.

METHOD

A nurse-led, quality improvement pilot project was implemented in a recreational youth soccer league. The project included the implementation of an emergency action plan (EAP; with or without the pandemic and social-distancing restrictions) for bystanders responding to SCA.

RESULTS

Participants showed significant improvement in knowledge and perceptions of SCA and emergency response (p < .001). Willingness to initiate cardiopulmonary resuscitation (CPR) improved (p = .127), and fear to engage in EAP decreased (p = .119) following an educational intervention on SCA.

DISCUSSION

Nurse-led SCA education and implementation of youth league EAP successfully demonstrated safety in SCA preparedness and best practice recommendations for youth sports from the Interassociation Task Force.

At the core of cyberaggression: A group-based explanation

In this study, prototypicality of the aggressor was tested as a group‐level factor predicting social media users’ active participation in cyberaggression. Participants were exposed to a fictitious conversation, in which either a prototypical versus non‐prototypical user posted an aggressive comment as a reply to a provocative comment. In line with self‐categorization theory, we hypothesized that bystander participants would post an aggressive comment and rate the aggression as acceptable to a greater extent in the prototypical than in the non‐prototypical condition. Furthermore, we predicted that perceived normativity of aggression would mediate the effect of prototypicality. Results supported these predictions and showed that prototypical members affect the extent to which collective aggressive behaviors in online interactions are approved and enacted. These findings highlight the importance of group‐level factors in the study of cyberaggression and provide important information for understanding the psychological underpinnings of collective forms of online aggression.

Using photovoice to understand and amplify youth voices to prevent sexual and relationship violence

AIMS

Efforts to improve prevention of sexual and relationship violence (SRV) among adolescents call for more centering of youth voices, experiences, and skills to design prevention programs that incorporate youth engagement rather than those that are designed by adults for youth. Amplifying the voices of historically marginalized youth are especially needed. Photovoice (PV) is a participatory action method that can empower youth and generate prevention knowledge.

METHODS

The current project used PV to engage youth in late middle and early high school to discuss how they could work to prevent SRV in their community. A convenience sample of nine youth (predominately Native American) participated over seven sessions.

RESULTS

A key theme they generated is that SRV prevention needs to be viewed as relational. Participants described the complexity of prevention, including how youth need social support to thrive and prevent SRV and that asking for help can be challenging. Results also highlighted that youth can provide help and support, but it is not always welcome in addition to underscoring that youth are resilient and can be prevention leaders.

CONCLUSION

Innovations in SRV prevention, especially for older adolescents, should work to engage youth as prevention partners. Participatory research methods like photovoice can be an important part of that process.

The Role of Bystanders in the Prevention of Railway Suicides in New South Wales, Australia

Abstract.Background: Bystanders can play a key role in preventing railway suicides by taking direct action or by raising an alarm. Aims: The study investigated in this context: (1) the prevalence of preventative actions by bystanders; (2) the relationship, if any, between first-hand preventions by bystanders and the degree of ambiguity around the imminence of danger; and (3) the nature of first-hand preventions by bystanders. Method: Data were obtained from a security reporting database at Sydney Trains for 2011–2019 for accident and suicide-related incidents (N = 1,278). Results: In 635 cases of suicide prevention, bystanders were identified as first responders in 11% of cases and as raising the alarm in 11% of cases. Bystanders as first responders intervened proportionally more where the ambiguity of danger is low (jumping) compared with high (sitting, standing, wandering). Of the 69 cases of bystander preventions, 77% involved physical interaction (e.g., holding back) and 49% involved more than one bystander. Limitations: The data source could be biased because of incompleteness or nonstandard reporting. Conclusion: Rail policy-makers should consider education and support for bystanders and staff: for example, by making known the prevalence of helping, the importance of intervening, and what types of intervention are most helpful.

Exposure to Self-Directed Violence: Understanding Intention to Help and Helping Behaviors among Adolescents and Emerging Adults

Exposure to self-directed violence (SDV) is a public health issue. Prevention trains third parties to identify SDV risk and provide help. However, we know little about the range of help provided to those who engage in SDV. The current study used a cross-sectional online survey of 1031 adolescents and emerging adults to learn about their SDV exposure, intent and attempts to help, and barriers to helping. Most participants reported SDV exposure, commonly by a peer, and provided help. Regression analyses showed that intent to help was predicted by social norms and having knowledge of resources, and such knowledge (but not social norms) was also related to actual helping behaviors. Qualitative analysis of short open-ended questions on the survey documented a range of barriers to helping. Findings support but also encourage revision of theoretical models of helping upon which prevention programs are based.

Bystander Roles in Cyberbullying: A Mini-Review of Who, How Many, and Why

Cyberbullying has progressively increased due to the massive use of the internet and social networks. Bystanders constitute the largest group, occupying a key role in the evolution of the cyberbullying situation and its consequences for the victim. Research shows different ways in which bystanders behave, suggesting different types of sub-roles associated with different study variables. The objective of this literature review is to identify and characterize the roles of bystanders in cyberbullying situations that involve adolescent students. To achieve this objective, a systematic search was carried out in the Web of Science, PubMed, and Scopus databases for articles published between 2015 and 2020, resulting in 233 articles. Articles were then selected by relevant title and summary. Subsequently, the inclusion and exclusion criteria were applied, resulting in a total of nine articles. The findings of this review allowed us to identify two to five types of bystanders, the largest type representing outsiders and the smallest type representing assistants of the aggressor. The identified types of bystanders are characterized for variables such as sex, age, previous experience, and empathy. The results are discussed considering the available theoretical and empirical evidence.

Direct Bullying and Cyberbullying: Experimental Study of Bystanders' Motivation to Defend Victims and the Role of Anxiety and Identification With the Bully

School bullying among young adolescents is a globally pervasive problem, but is less common when bystanders are motivated to defend victims. Thus, the focus of this experimental study is on motivation to defend victims of bullying.

Methods: A total of 388 students (M_age = 12.22 years, 49.7% girls) from two Turkish public schools (5th–8th grade) participated in a vignette experiment. Students were randomized to one of two vignettes (direct vs. cyberbullying). Self-report measures of motivation to defend, trait anxiety, depression, and identification with the victim or bully were used.

Results: Participants reported more autonomous motivation in the cyberbullying condition, while those who witnessed direct bullying reported higher anxiety and depression.

Results also revealed that this type of condition was associated with anxiety and depression, while anxiety was associated with autonomous motivation to defend. Finally, participants in the direct bullying condition were more likely to identify with the bully.

Conclusion: Findings advance our understanding of when and why adolescents are motivated to help victims of bullying because they give a richer picture of what they assess when deciding whether or not they should intervene.

Who, When, How, and Why Bystanders Intervene in Physical and Psychological Teen Dating Violence

Teen dating violence victimization is associated with a host of adverse mental and physical health problems. A number of bystander-focused interventions have been developed to mitigate the occurrence of abuse but with varying effectiveness. There remains a need to understand more about bystander behaviors used by adolescents to ensure that existing intervention components match with bystanders' attitudes and behaviors about intervening. The current study is a scoping review of existing literature on adolescents' use of bystander behaviors to determine who, when, how, and why adolescents intervene. Seventeen articles met inclusion criteria, the majority of which used qualitative or observational survey designs. Adolescents who either feel a sense of responsibility and confidence to intervene or are directly involved with or know the individuals involved in the dating violence are more likely to intervene. Adolescents intervene when they are able to define an act as dating violence and tend to intervene when the victim is female and when they have a supportive relationship with at least one teacher in their school. The various ways how bystander intervention is engaged in ranges from verbally or physically confronting the abuser, distracting the abuser, seeking support from an adult, to passively accepting the abuse. Reasons why adolescents intervene include believing the abuse is wrong and that intervening will diffuse the situation and help the victim. A number of barriers to bystander intervention emerged from analysis including individual attitudes and school climate factors. Implications for strengthening bystander intervention programs are discussed.

Risky research and bystander consent

There is no quick and easy answer to the question whether research activities that endanger bystanders without their consent ever thereby violate those bystanders' rights. We cannot dismiss the idea that bystanders possess strong rights against researchers simply on the grounds that they are, after all, merely bystanders. Indeed, it is easy to imagine scenarios in which researchers would be morally required to gain the informed consent of bystanders whom they risk harming. Whether bystander consent is required in any particular real-world case will depend, in part, upon exactly how the research activity endangers them.

Why IRBs should protect bystanders in human research

Many types of human research activities present risks and burdens to third parties (e.g., bystanders). Few human protection policies directly address the protection of research bystanders, though some address it in passing. In what follows, I re-iterate reasons why bystanders are entitled to protections. I also argue that Institutional Review Boards (IRBs) are in the best position to signal to researchers and sponsors that bystanders should be protected in research. In some cases, IRB review would consist of evaluating bystander protection strategies directly; in other cases, this might entail merely certifying that another institutions, like a drug regulator, has taken adequate measures to protect the welfare of research bystanders.

Bystanders, risks, and consent

This paper considers the moral status of bystanders affected by medical research trials. Recent proposals advocate a very low threshold of permissible risk imposition upon bystanders that is insensitive to the prospective benefits of the trial, in part because we typically lack bystanders' consent. I argue that the correct threshold of permissible risk will be sensitive to the prospective gains of the trial. I further argue that one does not always need a person's consent to expose her to significant risks of even serious harm for the sake of others. That we typically need the consent of participants is explained by the fact that trials risk harmfully using participants, which is very hard to justify without consent. Bystanders, in contrast, are harmed as a side-effect, which is easier to justify. I then consider whether the degree of risk that a trial may impose on a bystander is sensitive to whether she is a prospective beneficiary of that trial.

Minimal or reasonable? Considering the ethical threshold for research risks to nonconsenting bystanders and implications for nonconsenting participants

When research poses risks to non-participant bystanders, it is not always practicable to obtain their consent. One approach to assessing how much research risk may be imposed on nonconsenting bystanders is to examine analogous circumstances, including risk thresholds deemed acceptable for nonconsenting research participants and for nonconsensual risks imposed outside the research setting. For nonconsenting participants, US research regulations typically limit risks to those deemed to be "minimal." Outside the research context, US tort law tolerates a more flexible "reasonable" risk threshold. This article advances a preliminary case that nonconsenting participants and nonconsenting bystanders exposed to similar research risks may be entitled to the same level of protection, but that risks generated by research may not be special in kind. Thus, limiting research risks to those that are "reasonable," rather than demanding that they be held to the "minimal" standard, may be the best approach for both nonconsenting participants and nonconsenting bystanders. Further work is needed to establish whether the descriptive standards used to support the analogies relied on here are normatively justifiable, as well as the extent to which the minimal risk standard and the reasonable risk standard would lead to meaningfully different outcomes in practice.

Bystanders and ethical review of research: Proceed with caution

Scientists seeking to conduct research with human subjects must first submit their proposals to research ethics committees (Institutional Review Boards [IRBs], in the United States). Some of these studies pose risks to "bystanders," i.e., people who may be affected by the research but who are not enrolled as study subjects. Should IRBs expand their scope to include oversight over possible harms to bystanders as well as research subjects? This paper presents arguments against this step. Prior review of research with human subjects, despite its evident burden on the research enterprise, is a necessary caution, because the tension between the objectives of humane treatment of research subjects and sound scientific design and procedure has in the past led to serious abuses. This rationale is inapplicable in the case of bystanders. Moreover, in view of the many and varied effects of both research practices and scientific advances on the broader public over time, those who may be considered to be "bystanders" may potentially expand without limit; requiring IRBs to anticipate these distant and long-term effects as part of prior ethical review could greatly increase its burden and its deterrent effect on research. While conducting research without concern for serious potential harm to bystanders may be irresponsible and unethical, expanding the scope of prior review by IRBs to include risks to bystanders is not required by the principles governing human subjects research, and the costs and burdens of this expansion may outweigh any expected gains.

The role of community engagement in addressing bystander risks in research: The case of a Zika virus controlled human infection study

There is limited guidance on how to assess the ethical acceptability of research risks that extend beyond research participants to third parties (or "research bystanders"). Community or stakeholder engagement has been proposed as one way to address potential harms to community members, including bystanders. Despite widespread agreement on the importance of community engagement in biomedical research, this umbrella term includes many different goals and approaches, agreement on which is ethically required or recommended for a particular context. We analyse the case of a potential Zika virus human challenge trial to assess whether and how community engagement can help promote the ethical acceptability of research posing risks to bystanders. We conclude that, in addition to having intrinsic value, community engagement can improve the identification of bystander risks, effective approaches to minimizing them, and transparency about bystander risks for host communities.

Compensation and reparations for victims and bystanders of the U.S. Public Health Service research studies in Tuskegee and Guatemala: Who do we owe what?

Using the infamous research studies in Tuskegee and Guatemala, the article examines the difference between victims and bystanders. The victims can include families, sexual partners, and children not just the participants. There are also the bystanders in the populations who are affected, even vaguely, decades after the initial studies took place. Differing reparations for victims and bystanders through lawsuits and historical acknowledgments has to be part of broader discussions of historical justice, and the weighing of the impact of racism and imperial research endeavors.

Using, risking, and consent: Why risking harm to bystanders is morally different from risking harm to research subjects

Subjects in studies on humans are used as a means of conducting the research and achieving whatever good would justify putting them at risk. Accordingly, consent must normally be obtained before subjects are exposed to any substantial risks to their welfare. Bystanders are also often put at risk, but they are not used as a means. Accordingly-or so I argue-consent is more often unnecessary before bystanders are exposed to similar substantial risks to their welfare.

Online Celebrity Bashing: Purely Relaxation or Stressful Confrontation? An Experimental Study on the Effects of Exposure to Online Celebrity Bashing on the Emotional Responses and Physiological Arousal Among Adolescent Bystanders

Adolescents regularly observe practices of online celebrity bashing. Existing research pointed to adolescent bystanders' approving attitudes toward this practice. However, knowledge is lacking on how adolescent bystanders respond emotionally and physiologically to cases of celebrity bashing. An experimental study with two conditions (bashing/neutral) was conducted to investigate the influence of exposure to online celebrity bashing on the emotional responses and physiological arousal among adolescent bystanders (n = 67). Self-reported questionnaires before and after exposure to celebrity bashing were used to measure participants' emotional state. Their physiological activation (heart rate and skin conductance) was recorded using the E4 Empatica Wristlet. The results indicated that adolescents responded quite negatively to the cases of celebrity bashing, expressing increased feelings of anger, sadness, frustration and powerlessness, and decreased feelings of amusement. Moreover, adolescent bystanders experienced celebrity bashing as stressful, as both the heart rate and phasic skin conductance significantly increased after exposure to bashing.

"Involved in something (involucrado en algo)": Denial and stigmatization in Mexico's "war on drugs"

This article responds empirically to the question posed by Stan Cohen about "why, when faced by knowledge of others' suffering and pain-particularly the suffering and pain resulting from what are called 'human rights violations'-does 'reaction' so often take the form of denial, avoidance, passivity, indifference, rationalisation or collusion?". Our context is Mexico's "war on drugs." Since 2006 this "war" has claimed the lives of around 240,000 Mexican citizens and disappeared around 60,000 others. Perpetrators include organized criminal gangs and state security services. Violence is pervasive and widely reported. Most people are at risk. Our study is based on qualitative interviews and focus groups involving 68 "ordinary Mexicans" living in five different Mexican cities which have varying levels of violence. It investigates participant proximity to the victims and the psychological defense mechanisms they deploy to cope with proximity to the violence. We found that 62 of our participants knew, directly or indirectly, one or more people who had been affected. We also found one dominant rationalization (defense mechanism) for the violence: that the victims were "involved in something" (drugs or organized crime) and therefore "deserved their fate." This echoes prevailing state discourses about the violence. We argue that the discourse of "involved" is a discourse of denial that plays three prominent roles in a highly violent society in which almost no-one is immune: it masks state violence, stigmatizes the victims, and sanctions bystander passivity. As such, we show how official and individual denial converge, live, and reproduce, and play a powerful role in the perpetuation of violence.

You're It-You've Got to Save Someone: Immediate Responders, Not Bystanders

Recurring disasters and life-threatening emergencies mandate that communities across the world be adequately prepared to prevent, respond, and recover from these events. Experiences throughout the world with mass casualty incidents and other disasters have increasingly highlighted the vital role that “active bystanders”—persons at the scene of an event who step forward to help—can play in preventing, containing, reporting, saving lives, decreasing morbidity, and increasing resilience. This paper seeks to emphasize the importance of the public in response to emergencies. No longer should we use the passive word “bystanders.” Rather immediate responders fill a critical silent gap before trained professionals arrive. In support of immediate responders this paper will identify the barriers to bystander action, and provide next steps to increase the number of individuals who take action at times of emergency. Immediate responders can and do play a valuable and unique role in reducing mortality, morbidity, and suffering from emergency events. While some cultures and countries have a long history of engaging the public as critical in an emergency response, others do not. The challenge is how best to increase the number of individuals who are motivated, prepared and ready to respond appropriately when they find themselves at the scene of an active shooter, bombing, hurricane, earthquake, tornado, fire, vehicle crash, or other life-threatening emergency.

Dating CAFE Ambassador Programme: Chinese College Students to Help Peers in Dating Violence

Dating violence prevention programs have been understudied in Asia, including China. The current study sought to evaluate the feasibility of the Dating Compassion, Assessment, reFerral, and Education (CAFE) Ambassador Programme in China. This program is designed to enhance the behavioral intentions of Chinese students to help peers who are experiencing dating violence and to compare students' attitudes toward dating violence, students' subjective norms about helping peers, and students' perceived behavioral control in helping peers before and after attending the 7.5 hour program. A quasi-experimental design was used, including two student groups (n = 85) assessed at baseline and 3-month follow-up. Quantitative pre- and postintervention measurements, in conjunction with qualitative focus group interviews, were used to evaluate the program's effectiveness. The findings indicated a significant enhancement in the behavioral intentions of participants in the intervention group to help peers experiencing dating violence, a stronger subjective norm regarding helping others, and an enhanced sense of perceived behavioral control to help, compared with the control group, over time. Focus group data revealed that students who participated in the program developed a more comprehensive definition of dating violence, increased awareness of dating violence in peers, a shift in their focus concerning the role of intention in dating violence and felt more responsible for helping their peers. The findings support the effectiveness of the Dating CAFE Ambassador Programme.

Sex partners as bystanders in HIV prevention trials: Two test cases for research ethics

Research involving human subjects can impose risk on some 'bystanders'- people who are not themselves research subjects but whom the study may affect. We examine the consequences of research for a particular category of bystanders - research subjects' sex partners - in trials testing interventions to reduce (1) HIV transmission (HIV treatment-as-prevention trials) and (2) HIV acquisition (HIV pre-exposure prophylaxis trials). Both types of trials provide useful test cases for assessing whether bystanders to research deserve special consideration in ethics reviews, and potentially some of the benefits and protections that research subjects receive. In HIV treatment-as-prevention trials, there are two groups of people who are alike in many important respects but treated very differently by research ethics: research subjects who contribute data on the primary endpoint of the trial (because some of them have sex with the people receiving the treatment conditions of the trials) - and bystanders who are not enrolled in the trials but who could have contributed primary endpoint data in the same way as the first group. In pre-exposure trials, the sex partners of people participating in pre-exposure prophylaxis trials are bystanders, even though they are necessary for the success of the trial. Research subjects' autonomy is fiercely protected by trial enrolment processes. Bystanders, by contrast, often have no choice but to be affected by the study, because of their relationship to a research subject. In HIV prevention trials, standing by can come with important risks, including the same ones on which the success of the research hinges. It is thus important to consider the ethical obligations to protect bystanders, and the related procedural responsibilities.

The ethical relevance of two types of adverse health effects on research bystanders as applied to HIV, mosquito bednet and organ transplant trials

Using cases from this symposium, I illustrate a distinction between clinical trials that harm research non-participants' health and clinical trials that reduce a distinct health benefit to research non-participants. This distinction is ethically relevant for the design and justification of clinical trials. The relative stringency of the ethical duty to avoid harm makes it more important, all other things being equal, to avoid harms rather than avoid reduction of benefits. This is especially ethically important as it is often difficult to identify research non-participants who will suffer health harms due to research, let alone obtain their informed consent. In these difficult cases, all other things being equal, we have ethical reason to prefer clinical trials that only reduce non-participants' health benefits to those that only involve harms to non-participants' health. When such trials are not feasible and we are unable to get consent for the significant harms to research non-participants, these (and other) countervailing considerations must be outweighed by substantial social benefits in order for the trial to be ethically justified. Ethical research design must not just be concerned with the magnitude of adverse health effects on research non-participants but also the types of those effects.

A meta-analysis of the relationship between moral disengagement and bullying roles in youth

Over the last several years, researchers have become increasingly interested in the influence of moral factors on bullying behaviors. This is the first meta-analytic review to exclusively examine the relationship between moral disengagement (MD) and the key bullying roles of bully, victim, defender, and bystander. Forty-seven independent samples examining a total of 43,809 children/adolescents (aged 7-19) were included in this meta-analysis. Results indicated a positive relationship between MD and bullying (r = 0.31; 95% CI [0.27, 0.34]), MD and victimization (r = 0.08; 95% CI [0.05, 0.12]), and a negative relationship between MD and defending (r = -0.11; 95% CI [-0.17, -0.04]). No significant relationship was found for MD and bystanding behavior. Moderators of bullying type (traditional vs. cyberbullying), reporting type (self vs. peer report), age, and gender were included in the analyses. The results are discussed in the context of relevant literature with particular emphasis on the importance of distinguishing between guilty and unconcerned bystanders, and the significant overlap between bullying and victimization in the cyber context.

The Health Risks of Electronic Cigarette Use to Bystanders

This works aimed to assess the health risks of e-cigarette use to bystanders. The exhaled breath of 17 volunteers was collected while they were vaping, and the levels of nicotine, propylene glycol, glycerol, formaldehyde, acetaldehyde, acrolein, tobacco-specific nitrosamines (TSNAs), and heavy metals were analyzed. Increased levels of nicotine, propylene glycol, TSNAs and copper were found in the exhaled breath of the volunteers. From these measurements, bystander exposure was estimated for two different scenarios: (1) A non-ventilated car with two e-cigarette users and (2) a ventilated office with one e-cigarette user. Our results show that bystanders may experience irritation of the respiratory tract as a result of exposure to propylene glycol and glycerol. Systemic effects of nicotine should also be expected if nicotine-containing e-liquid is used, including palpitations, and an increase of the systolic blood pressure. Furthermore, due to the presence of TSNAs in some e-liquids, an increased risk of tumors could not be excluded for the ‘car’ scenario. While e-cigarette use can clearly have effects on the health of bystanders, the risks depend on the rate of ventilation, dimensions of the room, and vaping behavior of the e-cigarette user. The presence of TSNAs in e-liquids can be avoided, which will prevent the most serious effect identified (increased risk of tumors).

Cyberbullying across the Lifespan of Education: Issues and Interventions from School to University

Research on cyberbullying amongst students has tended to be conducted separately within specific education institutional contexts, schools, further education (FE) and higher education (HE), neglecting a view that takes account of the entire educational lifespan. The present article addresses this gap in the literature, providing a novel take on examining its nature, social environments, legal consequences and potentially helpful interventions. To facilitate this, the article conceptualises cyberbullying in broad terms, recognising that it can take multiple forms of online and digital practice including: spreading rumours, ridiculing and/or demeaning another person, casting aspirations on the grounds of race, disability, gender, religion or sexual orientation; seeking revenge or deliberately embarrassing a person by posting intimate photos or videos about them without their consent; accessing another's social networking profiles with malicious intent and socially excluding a person from a social network or gaming site. This article demonstrates that harm from cyberbullying is a cause for concern for students at each developmental stage and that there are continuities in its appearance that need to be challenged at each point in the educational lifespan. And inaccurately, by university, the idea that 'nothing can be done' still is one of the main concerns for the victims. The article concludes with five key recommendations for future research and practice across the educational lifespan.

Implementation of Online Opioid Prevention, Recognition and Response Trainings for Laypeople: Year 1 Survey Results

BACKGROUND

This article reports on the first implementation of an online opioid-overdose prevention, recognition and response training for laypeople. The training was disseminated nationally in November 2014. Between 2000 and 2014, U.S. opioid deaths increased by 200%. The importance of complementary approaches to reduce opioid overdose deaths, such as online training, cannot be overstated.

OBJECTIVES

A retrospective evaluation was conducted to assess perceived knowledge, skills to intervene in an overdose, confidence to intervene, and satisfaction with the training.

MEASUREMENTS

Descriptive statistics were used to report sample characteristics, compare experiences with overdose and/or naloxone between subgroups, and describe participants' satisfaction with the trainings. Z-ratios were used to compare independent proportions, and paired t-tests were used to compare participant responses to items pre- and posttraining, including perceived confidence to intervene and perceived knowledge and skills to intervene successfully.

RESULTS

Between January and October 2015, 2,450 laypeople took the online training; 1,464 (59.8%) agreed to be contacted. Of these, 311 (21.2% of those contacted) completed the survey. Over 80% reported high satisfaction with content, format and mode of delivery and high satisfaction with items related to confidence and overdose reversal preparedness. Notably, 89.0% of participants felt they had the knowledge and skills to intervene successfully posttraining compared to 20.3% pretraining (z = -17.2, p <.001). Similarly, posttraining, 87.8% of participants felt confident they could successfully intervene compared to 24.4% pretraining (z = -15.9, p <.001).

CONCLUSIONS

This study demonstrates the effectiveness of the GetNaloxoneNow.org online training for laypeople.

Flexible decision-making in grooming partner choice in sooty mangabeys and chimpanzees

Living in permanent social groups forces animals to make decisions about when, how and with whom to interact, requiring decisions to be made that integrate multiple sources of information. Changing social environments can influence this decision-making process by constraining choice or altering the likelihood of a positive outcome. Here, we conceptualized grooming as a choice situation where an individual chooses one of a number of potential partners. Studying two wild populations of sympatric primate species, sooty mangabeys (Cercocebus atys atys) and western chimpanzees (Pan troglodytes verus), we tested what properties of potential partners influenced grooming decisions, including their relative value based on available alternatives and the social relationships of potential partners with bystanders who could observe the outcome of the decision. Across 1529 decision events, multiple partner attributes (e.g. dominance ranks, social relationship quality, reproductive state, partner sex) influenced choice. Individuals preferred to initiate grooming with partners of similar global rank, but this effect was driven by a bias towards partners with a high rank compared to other locally available options. Individuals also avoided grooming partners who had strong social relationships with at least one bystander. Results indicated flexible decision-making in grooming interactions in both species, based on a partner's value given the local social environment. Viewing partner choice as a value-based decision-making process allows researchers to compare how different species solve similar social problems.

Meeting the Needs of Young Adolescents: ABBL Anti-Bullying Program During Middle School Transition

This article introduces ABBL, the anti-bullying program for the transition to middle school, which was designed as a free, feasible, and easily applicable solution for teachers who, for any reason, cannot take advantage of comprehensive anti-bullying school-based programs. The ABBL, based on the identification of the causal risk factors and mechanisms that lead to bullying, aims to influence the peer group in such a way that students do not reward antisocial behaviors and are, instead, able to create supportive class atmospheres and strong networks of personal attachments. The evaluation of the program effectiveness showed that it reduced bullying in the classroom. Indications for wider implementations are presented together with the ready-to-use ABBL anti-bullying program (see http://blizej.org/abbl-antibullying-program/ ).

Variations in Involvement: Motivating Bystanders to Care for Senior Citizens

PURPOSE

The purpose of this study was to determine the impact of a senior service advertising campaign designed to increase volunteerism and financial donations among bystanders.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional mail survey was administered to 2,500 adults; 384 usable responses were obtained. Survey responses were analyzed by level of exposure and involvement in senior care.

FINDINGS

High involvement individuals viewed the ads more favorably and exhibited stronger senior caretaking intentions. Low-involvement consumers were less likely to see their own potential contributions to senior care services as effective.

RESULTS/IMPLICATIONS

It is argued that nonparticipants in prosocial helping may fail to notice the need (low awareness), fail to view the cause as urgent (low perceived susceptibility), or have low prior experience with the issue.

PRACTICAL IMPLICATIONS

A typology of involvement could be developed that can be used for audience segmentation in marketing health behaviors to bystanders.

ORIGINALITY

With limited theoretical and practical guidance on how to motivate bystanders to engage in prosocial behaviors, health communicators and marketers are challenged to tap into the vital resource that bystanders potentially could provide. The research reviewed and presented here indicates hope for engaging the public to become active players in making the nation a safer and healthier place.

Bystanders' responses to offline bullying and cyberbullying: The role of empathy and normative beliefs about aggression

Cyberbullying often takes place with the virtual presence or knowledge of bystanders. While we have some evidence about the determinants of bystanders' responses to offline bullying, we lack empirical studies concerning the variables that influence bystanders' responses to cyberbullying. The current study examines bystanders' responses to offline bullying and cyberbullying incidents. Two types of responses were captured: support toward the victims and the reinforcement of bullies' actions. Using data from 321 German adolescents (ages 12-18; M = 14.99; 44% girls), the association between bystanders' responses and normative beliefs about verbal aggression and cyberaggression, and affective and cognitive empathy, were tested in a path model. Both types of normative beliefs positively predicted the reinforcement of bullies, and normative belief about verbal aggression also predicted support for the victims of offline bullying. Both types of empathy predicted support in offline bullying, but only affective empathy predicted support in cyberbullying. There was no link between affective or cognitive empathy to the reinforcement of bullies. Moreover, bystanders' tendencies to respond supportively to the victim or to reinforce the bully were rather consistent in both cyber- and offline bullying, but there was no link between support and reinforcement. The findings are discussed with regard to implications for prevention and intervention efforts.

Primary Trauma Triage Performed by Bystanders: An Observation Study

OBJECTIVE

The aim of this study was to evaluate whether bystanders with no training in triage can correctly prioritize three injured patients by using a triage instrument.

METHOD

An observational study was conducted. Participants performed a primary triage on three paper-based patient cases and answered 11 questions during a public event in the center of Stockholm, Sweden.

RESULTS

A total of 69 persons participated in the study. The success rate among all the participants for correct triage of the three patient cases was 52 percent. The female participants and younger participants (<55 years of age) performed correct triage to a greater extent. The over-triage was 12.5 percent and under-triage was 6.3 percent.

CONCLUSION

Participants with no prior knowledge of triage instruments may be capable of triaging injured patients with the help of an easy triage instrument. The over- and under-triage percentages were low, and this may indicate that the developed triage instrument is relatively easy to use. It may also indicate that bystanders can identify a severely injured patient. Nordberg M , Castrén M , Lindström V . Primary trauma triage performed by bystanders: an observation study. Prehosp Disaster Med. 2016;31(4):353-357.

Childhood bullying and social dilemmas

Children who witness bullying often do not defend victims. Bystanders might be reticent to intervene because they are stuck in "social dilemmas." Social dilemmas are situations in which individuals make decisions based on self-interest due to their lack of confidence that others will join with them in decisions that benefit the collective. In this study, the social dilemmas concept, which comes from game theory and social psychology, was applied to bullying for the first time. A total of 292 middle school students at a private residential school in the United States completed surveys about their bullying-related experiences within their residences of 10 to 12 students of the same gender. Multilevel modeling was employed to assess if and how attitudes, group norms, and social dilemmas predict behavior in bullying situations. The findings suggested that both individual and group factors were associated with behavior in bullying situations and that attitudes, group norms, and social dilemmas each made a unique contribution to predicting behavior in bullying situations. Aggr. Behav. 42:97-108, 2015. © 2015 Wiley Periodicals, Inc.