Traditional and Race-based Bullying in Racial-Minority Majority and Racially Diverse Schools

Few studies in the U.S. have simultaneously examined general and race-based bullying with consideration of school-level racial composition. The current study examined victimization as a function of school racial composition, in minority-majority and diverse schools (N = 1911, Mage = 13.7 years) enrolled in 7th grade in 24 public schools (42.3% Hispanics, 9.0% non-Hispanic White, 28.9% non-Hispanic Black, and 19.7% non-Hispanic Asian). Multilevel regression analyses suggest student-level protective factors related to both forms of victimization, but, school racial composition was only significant in explaining race-based bullying. Specifically, minority-majority schools had lower levels of race-based victimization compared to racially diverse schools. Findings suggest that consideration of school contextual factors offers a more nuanced understanding of the relation between race and victimization.

Student-centered instruction can build social-emotional skills and peer relations: Findings from a cluster-randomized trial of technology-supported cooperative learning

Given the uneven track record of adjunctive social-emotional learning (SEL) programs and waning effects by middle and high school, we propose a more integrative approach to SEL through cooperative learning (CL). CL has demonstrated the ability to improve social-emotional, behavioral, academic, and mental health benefits, but CL lessons are complex and thus can be difficult to design and consistently deliver with fidelity. The present study attempted to address this barrier by examining the effects of technology-assisted CL on five social-emotional competencies, as well as social and behavioral outcomes. Participants were 813 students (50.2% female, N = 408, and 70.7% White, N = 575) from 12 middle and high schools in the Pacific Northwest in a cluster-randomized design where six intervention schools implemented technology-assisted CL and six control schools conducted business as usual. Using multilevel modeling, intervention effects on all outcomes after 1 year were significant, with moderate to large effect sizes, inviting further evaluation of integrative approaches to SEL that are developmentally aligned with the needs of students in secondary education. Although there remains a dearth of universal school-based interventions with demonstrated impacts on social outcomes in middle and high school, the present study builds support for the use of integrative, relationship-based instructional approaches, supported by technology, to promote positive peer relations, and social competencies for this age group. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Peer learning can modify the reciprocal relationship between peer support and victimization in middle school

INTRODUCTION

This research investigated how peer victimization and support are reciprocally related and how Cooperative Learning (CL) can reverse the progressive cascade that, unchecked, can culminate in youth mental health problems.

METHODS

The sample (N = 1890; 53% male) was derived from a randomized trial of CL in 15 middle schools in the United States. Students were recruited in the 7th grade. Structural Equation Modeling (SEM) was used to fit our cross-lag difference score model across four waves of data.

RESULTS

The results indicated a reciprocal relationship between peer support and victimization across time, suggesting the potential for negative experiences with peers to become amplified over time in a "vicious cycle," negatively impacting mental health. Students in intervention schools reported significantly higher levels of peer support and lower levels of victimization, suggesting that CL can intervene in this cycle, with salutary effects on mental health; CL also demonstrated direct effects on mental health.

CONCLUSIONS

The present study indicates that low peer support can be both a precursor to and an outcome of victimization, serving to maintain a vicious cycle that compounds negative effects on student mental health. Further, results demonstrate how CL can reverse this cycle. We conclude that CL can be of particular importance to the prevention field as a universal mental health program that does not require the associated stigma of identifying youth at elevated risk for referral to treatment programs.

Provision of eye care services and interventions in care homes: a narrative synthesis review

BACKGROUND

The prevalence of eye disease and visual impairment in care home residents is disproportionately higher compared to the general population. Access to eye care services and treatment can be variable for this vulnerable population.

OBJECTIVE

This paper reviews the available evidence of services and interventions for delivering eye care to care home residents. The key review questions are: (1) What is the existing evidence for eye care interventions or services (including service configuration) for care home residents? (2) Does the provision of these interventions or services improve outcomes?

METHODS

Literature search of EMBASE/MEDLINE for original papers published since 1995. Two reviewers independently reviewed abstracts/papers. Data were extracted and evaluated using narrative synthesis.

RESULTS

13 original papers met the inclusion criteria. Domiciliary optometrist services improved diagnosis and management of eye conditions, with one study showing 53% of residents benefited from direct ophthalmology intervention. Provision of interventions, such as cataract surgery, refractive error correction and low-vision rehabilitation, improved visual acuity and vision-related quality of life but did not improve cognitive or physical function, depression or health-related quality of life. There was little UK-based literature to inform eye service design or interventions to improve outcomes such as falls.

CONCLUSION

Care home-based eye assessments improve the management of eye conditions. Interventions improve visual acuity and vision-related quality of life. Further research is needed to better understand current UK services, access difficulties or examples of good practice as well as to identify and test cost-effective service models for this vulnerable group.

1210 PROVISION OF EYE CARE SERVICES AND INTERVENTIONS IN CARE HOMES - A NARRATIVE SYNTHESIS REVIEW

Introduction

The prevalence of eye disease and visual impairment in care home residents is disproportionately higher compared to the general population. Access to eye care services and treatment can be variable for this vulnerable population.

Objective

This narrative synthesis reviews the available evidence of services and interventions for delivering eye care to care home residents. The key review questions:

Methods

Literature search of EMBASE/MEDLINE for original papers published since 1995. Two reviewers independently reviewed abstracts/papers. Data was extracted and evaluated using narrative synthesis.

Results

13 original papers met the inclusion criteria. On-site optometrist-led services improved diagnosis and management of eye conditions, with one study showing 53% of residents benefited from direct ophthalmology intervention. Provision of interventions such as cataract surgery, refractive error correction and low vision rehabilitation improved visual acuity and vision-related quality of life but did not improve cognitive or physical function, depression or health-related quality of life. There was little UK-based literature to inform eye service design or interventions to improve outcomes.

Conclusion

Care home-based eye assessments improve the management of eye conditions. Interventions improve visual acuity and vision-related quality of life. Further research and/or clinical service scoping is needed to better understand current UK services, access difficulties or examples of good practice as well as to identify and test cost-effective service models for this vulnerable group.

1226 A MULTI-DISCIPLINARY APPROACH TO TRANSFORMING EYE CARE SERVICES FOR CARE HOME RESIDENTS

Introduction

Care home residents can have variable access to eye care services and treatments. We developed a collaborative approach between optometrists, care homes, and primary and secondary care to enable personalised patient-centred care.

Objective

To develop and evaluate an integrated model of eye care for care home residents.

Methods

Small scale plan-do-study-act (PDSA) service tests were completed in three care-homes in Southwark (2 residential, 1 nursing) between November 2021 to May 2022. Processes were compared to historical feedback and hospital-based ophthalmology clinic attendances (Mar 2019-2020). Hospital-like assessments were piloted at two care homes for feasibility and acceptability. Further piloting utilised usual domiciliary optometry-led assessment with multidisciplinary meeting access (including optometrist, GP, geriatrician, ophthalmologist and care home nurse) to reduce duplication of assessments and to evaluate MDM processes and referral rates.

Results

Examination was 100% successful at home (visual acuity and pressure measurement) compared to hospital outpatients (71.7% success visual acuity, 54.5% pressures). Examination was faster than in hospital settings (16 minutes vs 45 minutes-1 hour). Residents were away from usual activities for 32 minutes vs 6 hours for hospital visits including transport. Residents were less distressed with home-based assessments. Did-Not-Attend (DNA) rates reduced (26.7% to 0%), secondary care discharge rates improved (8.4% to 32%). Hospital eye service referral were indicated in 19% -23%, half of which were for consideration of cataract surgery. Alternative conservative plans were agreed at MDM for nursing home residents who were clinically too frail or would not have been able to comply with treatments avoiding 33% unnecessary referrals.

Conclusions

Home-based eye care assessments appear better tolerated and are more efficient for residents, health and care staff. Utilising an MDM for optometrists to discuss residents with ophthalmologists and wider MDT members enabled personalised patient-centred decision-making. Future work to test this borough wide is in progress.

Associations between partner violence, parenting, and children's adjustment: A dyadic framework

To date, our knowledge of the effects of exposure to intimate partner violence (IPV) on children's functioning via parenting have relied on individual approaches, effectively placing parents outside of a relationship context, and greatly neglecting to incorporate fathers. The present study addresses these gaps by utilizing a dyadic model to assess how mothers' and fathers' psychological and physical IPV perpetration in early childhood (age 5 years) predicts both their own and each other's parenting in midchildhood (age 7 years) and, in turn, children's social and scholastic competence in late childhood (ages 11-12 years). Such models reflect the current consensus that bidirectional IPV is the most common pattern among couples. The present study involved 175 children (87 females) of 105 mothers and 102 fathers who were originally in the Oregon Youth Study (OYS, N = 206). Simple mediation results suggest maternal involvement in parenting is an important mediational mechanism for the relation between maternal IPV as a perpetrator and victim and childhood competencies. Similarly, father's involvement with parenting served as a mediational mechanism for social competence but only for his own IPV perpetration. Dyadic actor-partner models with maternal and paternal parenting yielded few significant mediational pathways, which is likely partially due to strong shared variance across partners in both IPV and parenting, leaving little unique variance. Overall, results indicated that father's IPV perpetration adds valuable information in explaining child adjustment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Longitudinal Process Model Evaluating the Effects of Cooperative Learning on Victimization, Stress, Mental Health, and Academic Engagement in Middle School

Mental health is a significant concern among young people, particularly during the COVID-19 pandemic. Notably, mental health problems can significantly reduce student performance in school, including both engagement and achievement. Both mental health problems and reduced student performance often arise due to peer victimization, which can include teasing, racial- or gender-based discrimination, and/or physical assault. Stress has been proposed as one mechanism through which victimization influences mental health, and stress can also interfere with academic performance at school, including engagement and achievement. To date, however, no research has evaluated longitudinal associations between victimization and stress, and how these longitudinal patterns may impact adolescent behavior and mental health. In this study, we used data from a 2-year cluster randomized trial of cooperative learning to evaluate an etiological process model that includes (1) longitudinal reciprocal effects between victimization and stress, and (2) the effects of both victimization and stress on student mental health and academic engagement. We hypothesized that victimization and stress would have significant reciprocal effects, and that both would predict greater mental health problems and lower academic engagement. We further hypothesized that cooperative learning would have significant effects on all constructs. We found partial support for this model, whereby stress predicted greater victimization, but victimization did not predict increased stress. While both factors were linked to student outcomes, stress was a more powerful predictor. We also found significant salutary effects of cooperative learning on all constructs. The implications of these results for student behavioral and mental health are discussed.

Reciprocated Friendship as a Mediator of the Effects of Cooperative Learning on Peer Victimization in Middle School

Peer victimization represents a pervasive problem, particularly for students in middle school. Although curriculum-based prevention programs have generated small to moderate effects on victimization, these effects tend to weaken beginning with the transition to middle school. In this study, we evaluated cooperative learning (CL) as a mechanism to prevent victimization, and evaluated reciprocated friendships as a mediator of these effects. Using four waves of data from a cluster randomized trial of CL (7 intervention and 8 control middle schools; N=1,890 students, 47.1% female, 75.2% White), we found that CL significantly reduced victimization after two years, and these effects were mediated by growth in reciprocated friendship in the first year. We conclude that CL can reduce victimization by providing a means for students to engage in extended social interactions with a wider range of peers and thus creating opportunities for students to forge stronger (i.e., reciprocated) friendships.

POS0035 ONE IN TWENTY INFLAMMATORY BOWEL DISEASE PATIENTS WHO UNDERWENT ABDOMINOPELVIC COMPUTED TOMOGRAPHY HAVE UNDIAGNOSED AXIAL SPONDYLOARTHRITIS

Background:

The diagnosis of axial spondyloarthritis (axSpA) is challenging and hindered by delay. There may be an opportunity to identify sacroiliitis for further rheumatology review in inflammatory bowel disease (IBD) patients who undergo Computed Tomography (CT) for non-musculoskeletal (MSK) indications.

Objectives:

To identify what proportion of IBD patients who underwent abdominopelvic CT for non-MSK indications have axSpA and to explore the role of an imaging strategy for identifying axSpA.

Methods:

Abdominopelvic CT scans of verified IBD patients were identified retrospectively from eight years of imaging archive. Patients between 18-55 yrs. were selected as having the highest diagnostic yield for axSpA. CT review (using criteria from a validated CT screening tool developed by Chan1) was undertaken by a trained radiology team for presence of CT-defined sacroiliitis (CTSI). All CTSI patients were sent a screening questionnaire. Those with self-reported chronic back pain (CBP), duration > 3 months, onset < 45 years were invited for rheumatology review. This included a medical interview, physical examination (joint count, MASES, dactylitis count, BASMI), patient reported outcomes (BASDAI, BASFI, BASGI, Harvey-Bradshaw-Index, Partial-Mayo-Index), relevant laboratory tests (CRP, ESR, HLA-B27), axSpA protocol MRI, and remote review by a panel of experienced rheumatologists with a special interest in axSpA.

Results:

CTSI was identified in 60 of 301 patients. Thirty-two (53%) responded to the invitation to participate and 27 (84%) were enrolled. Of these, eight had a pre-existing axSpA diagnosis and five did not report chronic back pain. Fourteen patients underwent rheumatological assessment; three of 14 (21.4% [95% CI: 4.7%, 50.8%]) had undiagnosed axSpA. In total, 11 of 27 (40.7% [95% CI: 22.4%, 61.2%]) patients had a rheumatologist verified diagnosis of axSpA.

Conclusion:

One in five patients (60/301) with IBD who underwent abdominopelvic CT for non-MSK indications have CTSI and at least one in five (11/60) have axSpA. Five percent (3/60) were previously undiagnosed. This highlights a hidden disease burden and a potential strategy for identifying new cases.

References:

[1]Chan J, Sari I, Salonen D, Inman RD, Haroon N. Development of a Screening Tool for the Identification of Sacroiliitis in Computed Tomography Scans of the Abdomen. J Rheumatol 2016; 43(9); 1687-94.

Acknowledgements:

We are indebted to Baljeet Dhillon and Shin Azegami for their assistance in the scoring of the CTSI.

Disclosure of Interests:

Chong Seng Edwin Lim Grant/research support from: AbbVie, Louise Hamilton: None declared, Samantha Low: None declared, Andoni Toms: None declared, Alex MacGregor: None declared, Karl Gaffney Speakers bureau: AbbVie, Eli Lilly, Novartis, UCB Pharma, Consultant of: AbbVie, Eli Lilly, Novartis, UCB Pharma, Grant/research support from: AbbVie, Gilead, Eli Lilly, Novartis, UCB Pharma.

Zinc-α2-glycoprotein is associated with non-albuminuric chronic kidney disease progression in type 2 diabetes: a retrospective study with 4-year follow-up

AIM

To investigate the association between baseline plasma zinc-α2-glycoprotein and non-albuminuric chronic kidney disease progression in type 2 diabetes.

METHODS

Adults with normoalbuminuria at entry (n=341; age 57±10 years, 52% men) were analysed. Chronic kidney disease progression was defined as a decrease in chronic kidney disease stage and a decline of ≥25% in estimated GFR from baseline. Baseline plasma zinc-α2-glycoprotein levels were quantified by immunoassay, and analysed either as a continuous variable or by tertiles in Cox proportional hazards models. Model discrimination was assessed using Harrell's C-index. A sensitivity analysis was performed on a subset of individuals who maintained normoalbuminuria during follow-up.

RESULTS

Chronic kidney disease progression occurred in 54 participants (16%). Zinc-α2-glycoprotein levels were elevated in chronic kidney disease progressors (P = 0.011), and more progressors were assigned to the higher zinc-α2-glycoprotein tertile than non-progressors. In the unadjusted Cox model, zinc-α2-glycoprotein, both as a continuous variable (hazard ratio 1.72, 95% CI 1.08-2.75) and tertile 3 (vs tertile 1; hazard ratio 2.14, 95% CI 1.10-4.17), predicted chronic kidney disease progression. The association persisted after multivariable adjustment. The C-index of the Cox model increased significantly after incorporation of zinc-α2-glycoprotein into a base model comprising renin-angiotensin system antagonist usage. Sensitivity analysis showed that zinc-α2-glycoprotein independently predicted chronic kidney disease progression among individuals who maintained normoalbuminuria during follow-up.

CONCLUSIONS

Plasma zinc-α2-glycoprotein is associated with chronic kidney disease progression, and may serve as a useful early biomarker for predicting non-albuminuric chronic kidney disease progression in type 2 diabetes.

Associations of exposure to intimate partner violence and parent-to-child aggression with child competence and psychopathology symptoms in two generations

BACKGROUND

Associations of exposure to intimate partner violence (IPV) and parent-to-child aggression (PCA) with child adjustment have not been examined adequately for community samples.

OBJECTIVE

To examine main, cumulative, and interactive associations of IPV and PCA (separately for physical and psychological aggression) with four aspects of child adjustment (i.e., externalizing and internalizing behavior; social and scholastic competence). Associations were examined between (a) G1 parent behavior and the adjustment of G2 boys (N = 203) at ages 13-14 years and (b) G2 parent behavior and the adjustment of G3 children (N = 294) at ages 4-5 and 11-12 years.

PARTICIPANTS AND SETTING

Families in a prospective, multigenerational dataset.

METHODS

Measures included reports by caregivers, children, and teachers. Cross-sectional regression models (controlling for parent socioeconomic status and G3 child gender) examined: (a) main effects of IPV or PCA, (b) the simultaneous (i.e., cumulative) effects of both IPV and PCA, and (c) interactive effects of IPV and PCA (sample size permitting) on each of the child adjustment outcomes.

RESULTS

When considered simultaneously, PCA (but not IPV) was associated with each aspect of child adjustment. The interaction between PCA and IPV indicated lower G2 adolescent scholastic competence and greater G3 preschool externalizing behavior for children exposed to lower levels of IPV and higher levels of PCA.

CONCLUSION

Psychological and physical PCA were associated with child adjustment problems even when accounting for IPV. Findings support the use of evidence-based programs to prevent PCA and PCA-associated child adjustment problems.

CCM PILOT STUDY OVERVIEW: GEOMETRICAL MEASUREMENT OF THE ROCKWELL DIAMOND INDENTER

This paper describes an overview of the capability of the NMIs that participated on the CCM Pilot Study measurement systems, conducted by the CIPM/CCM/Working Group on Hardness, to characterize the Rockwell hardness diamond indenter geometry, by measuring the included cone angle, the straightness of the generatrix, the spherical tip radius, the deviation of the local radius and the tilt angle. Nine NMIs took part in this study: INMETRO (Brazil); INRiM (Italy); KRISS (South Korea); NIM/PR (China); NIMT (Thailand); NIST (USA); PTB (Germany); TUBITAK UME (Turkey); VNIIFTRI (Russia), where INMETRO (Brazil) served as pilot laboratory.

Evaluation of second step on early elementary students' academic outcomes: A randomized controlled trial

Research has consistently linked social-emotional learning to important educational and life outcomes. Early elementary represents an opportune developmental period to proactively support children to acquire social-emotional skills that enable academic success. Using data from a large scale randomized controlled trial, the purpose of this study was to investigate the impact of the 4th edition of Second Step on early elementary students' academic-related outcomes. Participants were Kindergarten to 2nd grade students in 61 schools (310 teachers; 7,419 students) across six school districts in Washington State and Arizona. Multilevel models (Time × Condition) indicated the program had no positive main effect impact on academic outcomes. However, moderator analyses revealed that quality of implementation, specifically a measure of student engagement and dosage, was found to be associated with significant, albeit small, reading and classroom behavior outcomes. Findings from this study provide support for Second Step when implemented in the context of high engagement and higher dosage to have small but potentially meaningful collateral impact on early academic-related outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Technique to reduce bending issues in Rockwell B scale hardness reference blocks: preliminary results

This paper describes a new design for HRBW scale reference blocks, that has the potential to greatly reduce the bending of brass blocks and thus improve short time stability of the block's apparent reference value. The experimental results given here are preliminary and only reflect short time period stability effects. The work was carried out in 2017 at the National Institute of Standards and Technology (NIST) in Gaithersburg, USA.

Determination of test cycle sensitivity coefficients for the Rockwell HRA hardness scale

This report describes investigations carried out to determine test cycle sensitivity coefficients for the Rockwell HRA hardness scale. Sensitivity coefficients were determined for the preliminary-force, total-force and recovery-force dwell times. The work was carried out in 2017 at the National Institute of Standards and Technology (NIST) in Gaithersburg, USA.

Health Information Management: Changing with Time

Objective: With the evolution of patient medical records from paper to electronic media and the changes to the way data is sourced, used, and managed, there is an opportunity for health information management (HIM) to learn and facilitate the increasing expanse of available patient data. Methods: This paper discusses the emerging trends and lessons learnt in relation with the following four areas: 1) data and information governance, 2) terminology standards certification, 3) International Classification of Diseases, 11th edition (ICD-11), and 4) data analytics and HIM. Results: The governance of patient data and information increasingly requires the HIM profession to incorporate the roles of data scientists and data stewards into its portfolio to ensure data analytics and digital transformation is appropriately managed. Not only are terminology standards required to facilitate the structure and primary use of this data, developments in Canada in relation with the standards, role descriptions, framework and curricula in the form of certification provide one prime example of ensuring the quality of the secondary use of patient data. The impending introduction of ICD-11 brings with it the need for the HIM profession to manage the transition between ICD versions and country modifications incorporating changes to standards and tools, and the availability and type of patient data available for secondary use. Conclusions: In summary, the health information management profession now requires abilities in leadership, data, and informatics in addition to health information science and coding skills to facilitate the expanding secondary use of patient data.

Family, Peer, and Pubertal Determinants of Dating Involvement Among Adolescents

This study examines the influence of family, peer, and biological contributors to dating involvement among early adolescents (11-14 years of age; n = 244). Further, we assess how parental monitoring may be modified by pubertal maturation and older sibling risky behavior. Data on delinquent peer affiliation, pubertal maturation, parental monitoring, older sibling risky behavior, and dating involvement were gathered through observations and surveys from adolescents, mothers, older siblings, and teachers. Results indicate that lower levels of parental monitoring and higher levels of older sibling risky behavior were related to adolescents' dating involvement through delinquent peer affiliation. Pubertal maturation was directly related to dating involvement for early daters. Findings emphasize the value of examining social and biological factors, in concert, over time.

Ethnic disparities in risk of cardiovascular disease, end-stage renal disease and all-cause mortality: a prospective study among Asian people with Type 2 diabetes

AIM

To study prospectively the ethnic-specific risks of cardiovascular disease, end-stage renal disease and all-cause mortality in patients with Type 2 diabetes mellitus among native Asian subpopulations.

METHODS

A total of 2337 subjects with Type 2 diabetes (70% Chinese, 17% Malay and 13% Asian Indian) were followed for a median of 4.0 years. Time-to-event analysis was used to study the association of ethnicity with adverse outcomes.

RESULTS

Age- and gender-adjusted hazard ratios for cardiovascular disease in ethnic Malay and Asian Indian subjects were 2.01 (1.40-2.88; P<0.0001) and 1.60 (1.07-2.41; P=0.022) as compared with Chinese subjects. Adjustment for conventional cardiovascular disease risk factors, including HbA1c , blood pressure and lipid profile, slightly attenuated the hazards in Malay (1.82, 1.23-2.71; P=0.003) and Asian Indian subjects (1.47, 0.95-2.30; P=0.086); However, further adjustment for baseline renal function (estimated GFR) and albuminuria weakened the cardiovascular disease risks in Malay (1.48, 0.98-2.26; P=0.065) but strengthened that in Asian Indian subjects (1.81, 1.14-2.87; P=0.012). Competing-risk regression showed that the age- and gender-adjusted sub-distribution hazard ratio for end-stage renal disease was 1.87 (1.27-2.73; P=0.001) in Malay and 0.39 (0.18-0.83; P=0.015) in Asian Indian subjects. Notably, the difference in end-stage renal disease risk among the three ethnic groups was abolished after further adjustment for baseline estimated GFR and albuminuria. There was no significant difference in risk of all-cause mortality among the three ethnic groups.

CONCLUSIONS

Risks of cardiovascular and end-stage renal diseases in native Asian subjects with Type 2 diabetes vary substantially among different ethnic groups. Differences in prevalence of diabetic kidney disease may partially explain the ethnic disparities.

Conduits from community violence exposure to peer aggression and victimization: contributions of parental monitoring, impulsivity, and deviancy

Community violence exposure results in heightened risk for engaging in and being a victim of interpersonal violence. Despite this robust literature, few studies have specifically examined how the relation between community violence exposure, peer aggression, and victimization is modified by individual, peer, and familial influences (considered jointly). In the current study, we used risk and resiliency theory to examine links between community violence exposure and peer aggression and victimization. Impulsivity and parental monitoring were examined as potential moderators of the link between community violence exposure and outcomes, both directly and indirectly via deviant behavior. Survey data on bullying involvement, fighting, deviancy, parental monitoring, and impulsivity were collected on 3 occasions over an 18-month period among a large cohort of adolescents (N = 1,232) in 5th-7th grades. Structural equation modeling suggests that for both male and female adolescents, impulsivity exacerbates the effects of community violence exposure by increasing involvement in deviant behavior. Parental monitoring buffered the effects of community violence exposure on perpetration and victimization (for males and female adolescents) via reduced involvement in deviant behavior. Findings suggest that impulsivity and parental monitoring are implicated in modifying the effects of community violence exposure on both victimization and perpetration through deviancy, although deviancy is not as potent of a predictor for victimization. Thus, prevention efforts would seem to be optimally targeted at multiple ecological levels, including parental involvement and peer networks.

Energy requirements for maintenance and growth of entire male Bali cattle in East Timor

The metabolisable energy (ME) requirements for maintenance and growth of entire male Bali cattle (Bos javanicus) were determined by regressing liveweight change on ME intake. Cattle were fed either a diet (DM basis) of 52.5% urea-treated rice straw plus 47.5% fresh leucaena forage (Expt 1), or fresh leucaena forage alone (Expt 2). In each experiment, liveweight change and feed intake were measured over 4 weeks, after a 1-week introductory period, and feed constituent digestibilities were measured during the final week. In Expt 1, 10 bulls between 1.5 and 3 years of age and weighing 123.7 ± 11.79 kg (mean ± s.d.) were allocated to DM intakes estimated to provide 0.75, 1.0, 1.25, 1.5, 1.75, or 2.0 times the estimated ME requirement for maintenance (based on calculations made from published CSIRO equations for tropical cattle species other than B. javanicus), with either one or two bulls per treatment. In Expt 2, the bulls were given treatments estimated to provide 0.85, 1.0, 1.4, 1.8, or 2.2 times the ME requirement for maintenance, with two bulls allocated to each treatment. The measured ME requirements for maintenance were 0.42 ± 0.369 and 0.40 ± 0.153 MJ/kg LW0.75.day (coefficient ± standard error, Expts 1 and 2, respectively). The ME requirement for ‘production’ (i.e. positive liveweight change of male Bali cattle under the specific conditions of the experiment) was calculated to be 39.2 MJ/kg liveweight gain in Expt 2. The calculated efficiency of use of dietary ME for production in Expt 2, was 0.34

The impact of a middle school program to reduce aggression, victimization, and sexual violence

PURPOSE

To evaluate the impact of the Second Step: Student Success Through Prevention (SS-SSTP) Middle School Program on reducing youth violence including peer aggression, peer victimization, homophobic name calling, and sexual violence perpetration and victimization among middle school sixth-grade students.

METHODS

The study design was a nested cohort (sixth graders) longitudinal study. We randomly assigned 18 matched pairs of 36 middle schools to the SS-SSTP or control condition. Teachers implemented 15 weekly lessons of the sixth-grade curriculum that focused on social emotional learning skills, including empathy, communication, bully prevention, and problem-solving skills. All sixth graders (n = 3,616) in intervention and control conditions completed self-report measures assessing verbal/relational bullying, physical aggression, homophobic name calling, and sexual violence victimization and perpetration before and after the implementation of the sixth-grade curriculum.

RESULTS

Multilevel analyses revealed significant intervention effects with regard to physical aggression. The adjusted odds ratio indicated that the intervention effect was substantial; individuals in intervention schools were 42% less likely to self-report physical aggression than students in control schools. We found no significant intervention effects for verbal/relational bully perpetration, peer victimization, homophobic teasing, and sexual violence.

CONCLUSIONS

Within a 1-year period, we noted significant reductions in self-reported physical aggression in the intervention schools. Results suggest that SS-SSTP holds promise as an efficacious prevention program to reduce physical aggression in adolescent youth.

Duration and mutual entrainment of changes in parenting practices engendered by behavioral parent training targeting recently separated mothers

Parent management training (PMT) has beneficial effects on child and parent adjustment that last for 5 to 10 years. Short-term changes in parenting practices have been shown to mediate these effects, but the manner in which changes in specific components of parenting are sequenced and become reciprocally reinforcing (or mutually entrained) to engender and sustain the cascade of long-term beneficial effects resulting from PMT has received modest empirical attention. Long-term changes in parenting resulting from the Oregon model of PMT (PMTO) over a 2-year period were examined using data from the Oregon Divorce Study-II in which 238 recently separated mothers and their 6- to 10-year-old sons were randomly assigned to PMTO or a no treatment control (NTC) group. Multiple indicators of observed parenting practices were used to define constructs for positive parenting, monitoring and discipline at baseline, and at 6-, 12-, 18- and 30-months postbaseline. PMTO relative to NTC resulted in increased positive parenting and prevented deterioration in discipline and monitoring over the 30-month period. There were reliable sequential, transactional relationships among parenting practices; positive parenting supported better subsequent monitoring, and positive parenting and better monitoring supported subsequent effective discipline. Small improvements in parenting resulting from PMTO and small deteriorations in parenting in the NTC group may be sustained and amplified by mutually entrained relationships among parenting practices. These data about the change processes engendered by PMTO may provide information needed to enhance the power, effectiveness, and efficiency of behavioral parent training interventions.

Engagement matters: lessons from assessing classroom implementation of steps to respect: a bullying prevention program over a one-year period

Steps to Respect: A Bullying Prevention Program (STR) relies on a social-ecological model of prevention to increase school staff awareness and responsiveness, foster socially responsible beliefs among students, and teach social-emotional skills to students to reduce bullying behavior. As part of a school-randomized controlled trial of STR, we examined predictors and outcomes associated with classroom curriculum implementation in intervention schools. Data on classroom implementation (adherence and engagement) were collected from a sample of teachers using a weekly on-line Teacher Implementation Checklist system. Pre-post data related to school bullying-related outcomes were collected from 1,424 students and archival school demographic data were obtained from the National Center for Education Statistics. Results of multilevel analyses indicated that higher levels of program engagement were influenced by school-level percentage of students receiving free/reduced lunch, as well as classroom-level climate indicators. Results also suggest that higher levels of program engagement were related to lower levels of school bullying problems, enhanced school climate and attitudes less supportive of bullying. Predictors and outcomes related to program fidelity (i.e., adherence) were largely nonsignificant. Results suggest that student engagement is a key element of program impact, though implementation is influenced by both school-level demographics and classroom contexts.

The role of economic strain on adolescent delinquency: a microsocial process model

The current study examines the role of economic strain as a moderator of the microsocial processes influencing younger siblings' delinquency (externalizing behavior and substance use) in a longitudinal design. The younger siblings (122 younger brothers and 122 younger sisters) were from 244 families with same-sex biological siblings. Structural equation modeling was utilized to examine a process model whereby mothers' harsh/inconsistent parenting and older sibling delinquency influence younger siblings' delinquent behavior via sibling aggression and delinquent peer affiliation. Findings suggest that indirect mechanisms vary as a function of economic strain, with sibling aggression having a stronger, more detrimental effect on adolescent delinquency in economically strained families. Data suggest that familial economic conditions contextualize the relative roles of parenting, sibling, and peer processes in the transmission of risk to adolescent delinquency.

The Drift toward Problem Behavior during the Transition to Adolescence: The Contributions of Youth Disclosure, Parenting, and Older Siblings

Prospective associations of mothers' parenting processes, youth disclosure and youth problem behavior were examined in a longitudinal design following 244 adolescent sibling dyads over a three year period. For both siblings, authoritative parenting was positively associated with youth disclosure and negatively related to problem behavior, and coercive parenting was negatively associated with youth disclosure and positively related to problem behavior. When the influence of older sibling problem behavior on younger sibling problem behavior was modeled, younger sibling disclosure accounted for the relationship of maternal parenting processes to problem behavior. Findings indicate the important role of sibling influence in the development of problem behavior, contextualizing the relative roles of maternal parenting and youth disclosure in the transmission of risk.

The Influence of Parents and Friends on Adolescent Substance Use: A Multidimensional Approach

The current study examined longitudinal associations between friend's substance use, friendship quality, parent-adolescent relationship quality and subsequent substance use. Participants were 166 adolescents, their parents and their close same-sex friends. Measures of relationship characteristics in the 10(th) grade were used to predict concurrent substance use and changes in substance use over a one-year period. The most consistent predictor of the use of different substances and changes in substance use over time was the friend's substance using behavior. Negative interactions with a friend were related only to tobacco use, and friendship support neither contributed to nor protected against substance use. Mother-adolescent relationship support was associated with lower levels of concurrent substance use, as well as lower levels of hard drug use over time. Findings highlight the need to examine parents and peers simultaneously and the importance of parental relationships and peer behavior on adolescent substance use. Limitations and future directions are discussed.

Effects of the Oregon model of Parent Management Training (PMTO) on marital adjustment in new stepfamilies: a randomized trial

Effects of intervention with the Oregon model of Parent Management Training (PMTO) on marital relationship processes and marital satisfaction in recently married biological mother and stepfather couples were examined. Sixty-seven of the 110 participating families were randomly assigned to PMTO, and 43 families to a non-intervention condition. Intervention had reliable positive indirect effects on marital relationship processes 24 months after baseline which in turn were associated with higher marital satisfaction. These indirect effects were mediated by the impact of PMTO on parenting practices 6 months after baseline. Enhanced parenting practices resulting from PMTO prevented escalation of subsequent child behavior problems at school. Consistent with a family systems perspective and research on challenges to marital quality in stepfamilies, improved co-parenting practices were associated with enhanced marital relationship skills and marital satisfaction as well as with prevention of child behavior problems.

Mortality among tuberculosis patients on treatment in Singapore

OBJECTIVE

To identify the risk factors associated with mortality among tuberculosis (TB) patients on treatment in Singapore.

DESIGN

A retrospective cohort study of 7433 TB patients notified and started on TB treatment from 2000 to 2006 was conducted. Cox regression analysis was used to determine independent risk factors for mortality.

RESULTS

Of 7433 patients who started TB treatment between 2000 and 2006, there were 884 deaths (11.9%) from any cause. Older age, male sex, being in a long-term care facility, having comorbidity, absence of cough, more than one site of TB, bacteriologically confirmed laboratory results, resistance to at least isoniazid (INH) and rifampicin (RMP) and absence of cavity were strongly associated with all-cause mortality among TB patients. A total of 203 patients (2.7%) died of TB. Risk factors for death due to TB were older age, male sex, Malay ethnicity, being in a long-term care facility, absence of cough, more than one site of TB, bacteriologically confirmed laboratory results and resistance to at least INH and RMP or to at least INH but not RMP.

CONCLUSION

It is important to identify TB patients with risk factors related to mortality so that appropriate and timely interventions can be instituted to prevent deaths among TB patients.

Is measurement of adult height useful in screening for primary angle closure?

BACKGROUND

Adult height is independently related to ocular dimensions and shorter people have shorter globes and shallower anterior chambers. We investigated the relationship between adult height and angle dimensions to explore measuring height as a possible screening test for angle closure.

METHODS

A population-based, cross-sectional survey of adult Chinese living in the Tanjong Pagar district, Singapore was conducted. Anterior chamber depth, gonioscopic angle width and height were assessed using standardized protocols.

RESULTS

Data were available for 996 persons. Shorter people had shallower anterior chamber depth (2.35 mm for persons <144 cm vs 2.72 mm for persons >170 cm, P=0.008) and smaller gonioscopic angles (22 degrees for <144 cm vs 30 degrees for >170 cm, P=0.079). After controlling for age and gender, adult height was significantly related to anterior chamber depth (P=0.008) but not significantly related to gonioscopic angle width (P=0.079). Female sex and age > or = 50 years used together correctly identified 45/66 (68.2%) individuals with an occludable angle (sensitivity 68.2%, specificity 61.3%). Fewer people, 41/66 (62.1%), were correctly identified when height <160 cm was added to female sex and age 50 > or = years (sensitivity was 62.1% and specificity was 64.7%).

CONCLUSIONS

Shorter adult height is significantly associated with a shallower anterior chamber depth, but the addition of height contributed little to demographics (age and gender) as the preliminary screening criteria to identify individuals at risk of an occludable angle.

A national study of the epidemiology of pneumococcal disease among hospitalised patients in Singapore: 1995 to 2004

INTRODUCTION

Infections with Streptococcus pneumoniae cause significant morbidity and mortality. In this study, we describe the epidemiology of pneumococcal disease based on hospitalisation rates for all age groups in Singapore. This is important for evaluating prevention and control strategies of pneumococcal disease.

METHODS

We conducted a retrospective study of hospitalisation cases admitted to all public and private hospitals from 1995 to 2004. 4,275 hospitalisation records were extracted, based on the International Classification of Diseases, Ninth Revision (ICD-9) codes for pneumococcal disease. We analysed the demographics, type of pneumococcal disease, length of stay and case fatality of these cases.

RESULTS

Our study showed that the mean annual hospitalisation rate for pneumococcal disease was 10.9 per 100,000 population from 1995 to 2004. The mean annual hospitalisation rate was highest in the young and the elderly.

CONCLUSION

Baseline information on the epidemiology of pneumococcal disease is important for the formulation and evaluation of a national prevention and control programme.