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The school-based mental health promotion and suicide prevention universal program Youth Aware of Mental Health (YAM) significantly reduces incident suicide attempts and severe suicidal ideation. This paper aims at elucidating psychological mechanisms underlying YAM's efficacy. Our hypothesis is that YAM operates through interactions with coping strategies (CS) on the reduction of suicidal ideation (SI). In the Saving and Empowering Young Lives in Europe (SEYLE) study, five coping strategies were assessed at baseline (T0) and 12-month follow-up (T12): "learning", "help-seeking", "arts", "sports" and "fight". We analyzed interactions between the YAM intervention, coping strategies and SI in the YAM group (N = 1693) and the minimal intervention group (N = 1909), after excluding prevalent cases with SI and previous suicide attempts from our total sample (N = 5654). General Linear Mixed Model regressions were performed. The present study confirms that coping strategies play an influential role on suicidal ideation. Our results showed that YAM acts whatever the prevailing coping strategies used. It is particularly efficient for pupils insufficiently using adaptive coping strategies such as LEARN and HELP-SEEKING or using maladaptive coping strategies, such as ARTS and FIGHT. The socialization induced by the YAM intervention seems to be a strong component of its efficiency.

Background: Predictions of two different models for suicide attempts (SA) over 12 months, as differentially impacted by specific school-based suicide prevention interventions, were compared. These were as follows: (a) interpersonal theory (IPTS) and (b) a two-pathway model, one path associated with externalizing symptoms and continuum of self-harm behaviors, and the other with internalizing symptoms., Methods: Self-report questionnaires were completed by 11,110 high school students from ten EU countries enrolled in the Saving and Empowering Young Lives in Europe (SEYLE) study. Baseline measures included perceived burdensomeness, thwarted belongingness from parents and peers, health risk behaviors, self-injury, suicide ideation (SI), and attempts (SA). SI and SA were reassessed at 12-month follow-up. Each model's predictions of SI and SA groups over time (i.e., repeated SA, remitted SA, SA onset, and no SA) were estimated in the no intervention/control group. The superior model was estimated across intervention groups., Results: Interpersonal theory showed better fit compared to the two-pathway model. In partial agreement with IPTS predictions, parental low belongingness but not peer belongingness or burdensomeness predicted greater likelihood of SI. The likelihood of repeated SA versus no SA was higher among adolescents who reported SI, self-injury, risk behaviors, and particularly both SI and self-injury. All three interventions attenuated the combined effect of SI and self-injury. Youth Aware of Mental Health Program (YAM) additionally decreased the effect of risk behaviors on the likelihood of repeated SA., Conclusions: Interpersonal theory assumptions were partially supported. Perceived interpersonal difficulties with parents were primarily related with SI, and risk behaviors and self-injury were important predictors of SA. Suicide prevention interventions may be effective by mitigating the hazardous effect of varying self-harm behaviors and may be further advanced by increasing parental involvement., (© 2019 Association for Child and Adolescent Mental Health.)

Background: This study investigated the trajectories of interpersonal stress and psychological pain and their effects on self-harm behaviors in adolescents and explored the reciprocal associations between interpersonal stress and NSSI/SA., Methods: The participants included 1149 adolescents (50.3% women; M age  = 12.86, SD = 0.69) who participated in three waves of data collection. Latent class growth models and cross-lagged panel models were used to identify subgroups of individuals and interactions between interpersonal stress and NSSI/SA., Results: Controlling for sex and age, compared to the low interpersonal stress class, the moderate to high and increasing classes have higher risks of NSSI and SA. Compared to adolescents in the low increasing feelings with high increasing avoidance class, those in the low increasing feelings with low decreasing avoidance class reported lower probabilities of NSSI and SA. Pain avoidance and painful feelings mediated the pathway from interpersonal stress to NSSI/SA, whereas pain arousal mediated the pathway from NSSI/SA to interpersonal stress., Conclusions: Shared impact of interpersonal stress and distinct effects of psychological pain over time on maintaining and distinguishing self-harm behaviors were found. Adolescent crisis interventions should simultaneously focus on building social networks within the school context and regulating maladaptive minds., (© 2024 American Association of Suicidology.)

Background: The association between bullying victimization and depression, suicide ideation and suicide attempts has been studied mainly in cross-sectional studies. This study aims to test the bidirectional effect and the chronicity versus sporadic effect of physical, verbal, and relational bullying victimization on suicidal ideation/attempts and depression., Methods: Longitudinal assessments with an interval of 3- and 12-months were performed within a sample of 2,933 adolescents (56.1% females; mean age 14.78, SD = .89) from 10 European countries, participating in the Saving and Empowering Young Lives in Europe (SEYLE) school-based multicenter control sample. Multilevel Structural Equation Models were used, controlling for sociodemographic variables. Victimization was considered chronic when a student was victimized in the first two time points and sporadic when it was reported only at one point but not in another., Results: Bidirectional prospective association between all types of victimization and depression were found. Among participants, who reported victimization once (but not twice), physical victimization, but not verbal and relational, was associated with later suicidal ideation and attempts. Chronic victimization of any type increased likelihood for later depression compared with sporadic and no-victimization. Chronic relational victimization increased the likelihood of later suicidal ideation, and chronic physical victimization increased the likelihood for suicidal attempts., Conclusions: The results support the bidirectional effect of victimization and depression and indicate that there are complex longitudinal associations between victimization and suicidal ideation/attempts. Physical victimization may especially carry effect on suicidal risk over time. Interventions should focus on victimization as a cause of distress but also aim to prevent vulnerable adolescents from becoming targets of victimization., (© 2018 Association for Child and Adolescent Mental Health.)

Suicide is one of the leading causes of death among young people globally. In light of emerging evidence supporting the effectiveness of school-based suicide prevention programmes, an analysis of cost-effectiveness is required. We aimed to conduct a full cost-effectiveness analysis (CEA) of the large pan-European school-based RCT, Saving and Empowering Young Lives in Europe (SEYLE). The health outcomes of interest were suicide attempt and severe suicidal ideation with suicide plans. Adopting a payer's perspective, three suicide prevention interventions were modelled with a Control over a 12-month time period. Incremental cost-effectiveness ratios (ICERs) indicate that the Youth Aware of Mental Health (YAM) programme has the lowest incremental cost per 1% point reduction in incident for both outcomes and per quality adjusted life year (QALY) gained versus the Control. The ICERs reported for YAM were €34.83 and €45.42 per 1% point reduction in incident suicide attempt and incident severe suicidal ideation, respectively, and a cost per QALY gained of €47,017 for suicide attempt and €48,216 for severe suicidal ideation. Cost-effectiveness acceptability curves were used to examine uncertainty in the QALY analysis, where cost-effectiveness probabilities were calculated using net monetary benefit analysis incorporating a two-stage bootstrapping technique. For suicide attempt, the probability that YAM was cost-effective at a willingness to pay of €47,000 was 39%. For severe suicidal ideation, the probability that YAM was cost-effective at a willingness to pay of €48,000 was 43%. This CEA supports YAM as the most cost-effective of the SEYLE interventions in preventing both a suicide attempt and severe suicidal ideation.Trial registration number DRKS00000214.

Background: Sexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of sexual initiation in a large multinational cohort of European adolescents., Methods: A questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use., Results: Baseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14-15; females 59.6%). This was significantly more frequent among pupils older than 15 (41%) and males (20.8%). Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%), 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio [aOR] 3.63), alcohol use (aOR 2.95), illegal drugs use (aOR 2.72), and poor sleep (aOR 1.71) predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity) symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems) were negatively associated with early and risky sexual initiation among boys. Significant predictors included also being bullied, fighting, truancy, and low parental involvement., Conclusions: Adolescent sexual behaviours are related to non-sexual risk behaviours, psychological difficulties and contextual vulnerabilities. While gateway effects explain some associations, a comprehensive model is needed to understand adolescent sexual behaviours, their physical, mental, and social health outcomes, and their potential positive effects on wellbeing. Tailored interventions may need to consider younger girls as a particularly vulnerable group in view of a strong association between non-sexual and sexual behaviors.

Background: Migration has been reported to be associated with higher prevalence of mental disorders and suicidal behaviour., Aims: To examine the prevalence of emotional and behavioural difficulties, suicidal ideation and suicide attempts among migrant adolescents and their non-migrant peers., Method: A school-based survey was completed by 11 057 European adolescents as part of the Saving and Empowering Young Lives in Europe (SEYLE) study., Results: A previous suicide attempt was reported by 386 (3.6%) adolescents. Compared with non-migrants, first-generation migrants had an elevated prevalence of suicide attempts (odds ratio (OR) 2.08; 95% CI 1.32-3.26; P =0.001 for European migrants and OR 1.86; 95% CI 1.06-3.27; P =0.031 for non-European migrants) and significantly higher levels of peer difficulties. Highest levels of conduct and hyperactivity problems were found among migrants of non-European origin., Conclusions: Appropriate mental health services and school-based supports are required to meet the complex needs of migrant adolescents., Declaration of Interest: None., Copyright and Usage: © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Early onset and long-term smoking are associated with physical and psychological health problems. The aim of the presented analysis was to investigate risk and influencing factors for different smoking status in a big sample of European adolescents. In the context of the "saving and empowering young lives in Europe" (SEYLE) study we surveyed 12,328 adolescents at the age of 13-17 from 11 countries. The survey took place in a school-based context using a questionnaire. Overall 58% reported the onset of ever-smoking under the age of 14 and 30.9% smoke on a daily basis. Multinomial logistic regression model showed significant positive associations between adolescent smoking and internalizing problems (suicidal behavior, direct self-injurious behavior, anxiety), externalizing problems (conduct problems, hyperactivity, substance consumption) and family problems (parental substance consumption, broken home). Our data show that smoking among adolescents is still a major public health problem and adolescents who smoke are at higher risk for mental problems. Further, adolescent smoking is associated with broken home families and parental behaviors. Therefore, early preventive measures are necessary not only for adolescents, but also for their parents.

Purpose: To examine risk and protective factors moderating the associations between three types of bullying victimization (physical, verbal, and relational bullying) with suicide ideation/attempts in a large representative sample of European adolescents., Methods: We analyzed cross-sectional data on 11,110 students (mean age = 14.9, standard deviation = .89) recruited from 168 schools in 10 European Union countries involved in the Saving and Empowering Young Lives in Europe study. A self-report questionnaire was used to measure victimization types, depression, anxiety, parental and peer support, and suicide ideation and attempts. For each outcome, we applied hierarchical nonlinear models controlling for sociodemographics., Results: Prevalence of victimization was 9.4% physical, 36.1% verbal, and 33.0% relational. Boys were more likely to be physically and verbally victimized, whereas girls were more prone to relational victimization. Physical victimization was associated with suicide ideation, and relational victimization was associated with suicide attempts. Other associations between victimization and suicidality (ideation/attempts) were identified through analysis of interactions with additional risk and protective factors. Specifically, verbal victimization was associated with suicide ideation among adolescents with depression who perceived low parental support. Similarly, low peer support increased the associations between verbal victimization and suicide ideation. Verbal victimization was associated with suicide attempts among adolescents with anxiety who perceived low parental support., Conclusions: Findings support the development of prevention strategies for adolescent victims of bullying who may be at elevated risk for suicide ideation/behavior, by taking into account gender, the type of bullying, symptomatology, and availability of interpersonal support., (Copyright © 2017. Published by Elsevier Inc.)

One approach to minimizing the negative consequences of excessive gambling is staff training to reduce the rate of the development of new cases of harm or disorder within their customers. The primary goal of the present study was to assess suitable benchmark criteria for the training of gambling employees at casinos and lottery retailers. The study utilised the Delphi Method, a survey with one qualitative and two quantitative phases. A total of 21 invited international experts in the responsible gambling field participated in all three phases. A total of 75 performance indicators were outlined and assigned to six categories: (1) criteria of content, (2) modelling, (3) qualification of trainer, (4) framework conditions, (5) sustainability and (6) statistical indicators. Nine of the 75 indicators were rated as very important by 90 % or more of the experts. Unanimous support for importance was given to indicators such as (1) comprehensibility and (2) concrete action-guidance for handling with problem gamblers, Additionally, the study examined the implementation of benchmarking, when it should be conducted, and who should be responsible. Results indicated that benchmarking should be conducted every 1-2 years regularly and that one institution should be clearly defined and primarily responsible for benchmarking. The results of the present study provide the basis for developing a benchmarking for staff training in responsible gambling.

The present study aimed to identify gender and age differences in motivation toward physical education (PE) and to explore the relationship between bullying roles, in PE and in the educational context in general, and motivation toward PE. A total of 1352 schoolchildren (49.7% girls) from 5th year of Compulsory Primary Education to 1st year of Baccalaureate, completed 3 questionnaires to determine their attitude toward bullying and their motivation toward PE. The findings showed that being a girl and being older provoked a lower self-determined motivation toward PE. Regarding the attitude toward bullying, active defense behavior was a significant predictor of higher self-determined motivation. Conversely, victimization predicted lower self-determined motivation and increased demotivation toward PE. Motivation toward PE is influenced by gender, age, and bullying behavior, underscoring the need to implement programs that promote active defense behaviors and reduce victimization in the educational setting through PE. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents who experience prior victimization such as child abuse within the home and experience low self-esteem/depression are at higher risk of repetitive bullying victimization when compared to those without such experiences. Recent scholarship has explored growth trajectories of bullying during adolescent development; however, relatively little is known about distinct trajectory patterns of bullying victimization across adolescent development. The current study identifies unobserved subgroups thus capturing the heterogeneity in developmental pathways in bullying victimization., Method: The current study uniquely utilized a multitheoretical approach to help explain the phenomenon of bullying victimization among a national sample of 2,190 youth in South Korea from 2010 to 2016. Theories tested include the integrated approach of target congruence, lifestyle and routine activities theories (LRAT), and the state dependence and population heterogeneity perspectives. To conduct this analysis, we performed a three-step latent class growth analysis., Results: The study revealed three distinct trajectory groups. Korean adolescents who had higher levels of low self-esteem demonstrated greater odds of belonging to both the early-onset and decreasing and increasing and late peak groups. Those who had low-self-esteem and were depressed demonstrated greater odds of belonging to the early-onset and decreasing group. Prior experience of child abuse for the early-onset and decreasing group was fully mediated by the measures of target congruence and lifestyles., Conclusion: The current study contributes to research on developmental victimization by demonstrating the utility of integrating target congruence variables with lifestyle-routine activity concepts in explaining heterogeneity., (© 2023 Foundation for Professionals in Services to Adolescents.)

Objective: Despite decades of research, relatively little is known about short-term predictors of suicidal thoughts and behavior. Intensive longitudinal methods are increasingly applied to investigate near-term risk factors of suicidal thoughts in daily life. The aim of this study was to examine short-term predictors of daily-level suicidal thoughts in a high-risk adolescent sample using the interpersonal-psychological theory of suicidal behavior (IPTS) as a guiding framework; the theory proposes that interpersonal experiences of thwarted belongingness in combination with perceived burdensomeness lead to suicidal desire. Methods: Seventy-eight adolescents hospitalized due to suicide risk responded to one survey/day for 28 days after discharge (n = 1621 unique observations). Multilevel models examined IPTS-informed predictors of same- and next-day suicidal urge intensity. Results: Partial and time-dependent support for the theory was found. The hypothesized two-way interaction between burdensomeness and thwarted belongingness (either family or peer) was significantly associated with increasing same-day, but not next-day, suicidal ideation; specifically, greater belongingness attenuated adverse impact of burdensomeness. The only significant predictor of next-day ideation was higher previous-day burdensomeness. Baseline burdensomeness also emerged as a predictor of day-to-day suicidal ideation. Conclusion: Using a theoretically informed model, this study offers an in-depth examination of short-term predictors of suicidal ideation among high-risk adolescents. Findings underscore the importance of fostering peer and family relationships in reducing suicidal thoughts in the post-discharge period. Results additionally suggest that both state- and trait-level burdensomeness have lasting influence on suicidal thoughts during this high-risk period. These findings could inform intervention efforts for high-risk youth. [ABSTRACT FROM AUTHOR]

Despite increasing interest in country differences and the identification of macro-societal circumstances that shape children's well-being, cross-national comparisons of children's subjective well-being are still rare. This study investigates the effect of family relations on children's life satisfaction in 39 countries from multiple world regions, with the aims of unveiling differences in average life satisfaction, comparing the effect of family relations on life satisfaction and testing the moderating effect of cultural values, emphasizing differences between collectivist and individualistic countries. Single-country regressions and multilevel modelling are used to analyse data from 129,018 children from two-parent families who participated in the first, second or third wave of the International Survey of Children's Lives and Well-Being. The results reveal that average life satisfaction is slightly higher in individualistic societies, but that the association between the Individualism Index and life satisfaction is not linear. Good family relations are shown to improve life satisfaction in all countries, but the effect strength differs considerably. The life satisfaction of children from individualistic countries, compared to that of children from collectivist countries, suffers considerably more from the experience of bad family relations. These findings highlight the necessity of considering children's cultural environment when examining their life satisfaction. [ABSTRACT FROM AUTHOR]

Bullying is one of the important global health issues affecting both health and educational outcomes of adolescents. The aim of this study was to examine gender differences and correlates of bullying victimisation among in-school adolescents in Benin, West Africa. A secondary analysis was conducted with Benin's national dataset among 2496 school-going adolescents aged 13 years and above from the 2016 Global School-Based Student Health Survey. The overall prevalence of bullying victimisation among in-school adolescents was 42.1%, with varying rates across males (40.1%) and females (44.6%), respectively. The odds of bullying victimisation were 56% significantly higher among males in lower grades than those in higher grades (AOR = 1.56, 95% CI 1.20–2.03). Also, there was a 32% increased odds of bullying victimisation among males who currently use alcohol compared to those who do not use alcohol (AOR = 1.32, CI 1.02–1.70). Males who were physically attacked (AOR = 1.78, 95% CI 1.32–2.40) and those who were seriously injured (AOR = 1.80, 95% CI 1.41–2.30), respectively, had 78% and 80% increased odds of bullying victimisation compared to males who were not physically attacked or seriously injured. Males who engaged in physical fights had 2.03 higher odds of bullying victimisation compared to those who did not engage in physical fights (AOR = 2.03, 95% CI 1.51–2.72). For females, there were 73%, and 90% increased odds of bullying victimisation among those who were physically attacked (AOR = 1.73, CI 1.21–2.46) and those who engaged in physical fights (AOR = 1.90, CI 1.36–2.66), respectively, compared to those who were not physically attacked or involved in physical fights. The odds of bullying victimisation were 60% higher among females who were seriously injured compared to those who were not injured (AOR = 1.60, CI 1.23–2.09). Also, females who ideated suicide had 2.04 higher odds of bullying victimisation compared to those who did not ideate suicide. Gender-specific variations of bullying victimisation exist among in-adolescents in Benin. Major stakeholders (teachers, school healthcare providers, and other school authorities) should be mindful of the identified risk differentials and develop effective anti-bullying intervention strategies aimed at promoting the mental health and well-being of school-going adolescents in Benin. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco use is the major preventable cause of premature death worldwide, responsible for about 8 million deaths per year, mostly in low- and middle-income countries, such as Morocco. Adolescents' tobacco use is a matter of concern, because early initiation increases the risk of becoming a lifelong user. There exists a notable gap in the synthesis of evidence concerning tobacco use among Moroccan adolescents. Thus, the purpose of this study was to provide a comprehensive view of the prevalence of tobacco products' use and associated factors among adolescents in Morocco. Methods: We systematically searched PubMed, Scopus, Web of Science and ScienceDirect for relevant studies reporting prevalence rates of tobacco products' use among Moroccan adolescents, published until June 2024, using inclusion and exclusion criteria in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Additional searches were completed on other sources to reach unpublished reports. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of included studies. Results: After the final screening, 22 papers met the inclusion criteria. Life-time prevalence of tobacco use ranged from 7.8% to 20.4% for cigarettes smoking, from 10.6% to 21.9% for waterpipe, from 7.9% to 9.1% for chewing tobacco and from 9.2% to 12.4% for snuff. The last 12-month prevalence of cigarette smoking was comprised between 6.9% and 10.8%. As for the prevalence of current use, ranges of (1.8%-16.4%) and (4.9%-8.4%) were noted for cigarettes and waterpipe, respectively. The most commonly highlighted risk factors for tobacco use included male sex, older age, having friends or family members who use tobacco and low perception of risk associated with tobacco use. Conclusion: Our findings reveal an alarming situation of tobacco use among Moroccan adolescents. Therefore, it is crucial that all stakeholders engage in concerted efforts to develop and implement evidence-based preventive interventions among early adolescents. [ABSTRACT FROM AUTHOR]

This study examined how normative beliefs, identification scores, perceived severity, self-efficacy in intervention, and victim-blaming tendencies impact teachers' willingness to intervene in relational bullying. Two groups of Taiwanese teachers (145 and 541 participants) completed self-developed questionnaires. Reliability and validity were assessed using Rasch analysis for the first group, while the second group's data were analyzed through hierarchical multiple regression. The results indicated that normative beliefs, perceived severity, victim-blaming tendencies, and self-efficacy significantly predicted teachers' willingness to intervene. Additionally, victim-blaming tendencies moderated the relationship between intervention efficacy and willingness. Specifically, under conditions of low self-efficacy, a high victim-blaming tendency led to a significantly reduced willingness to intervene. This study underscores the importance of improving teachers' awareness and skills in addressing relational bullying. [ABSTRACT FROM AUTHOR]

The Interpersonal Theory of Suicide (IPTS) has received support for its role in understanding suicidal thoughts and behaviors. However, few longitudinal studies have focused on testing this theory in university students. The present study aimed to confirm the theoretical model of the IPTS in a sample of 225 Spanish university students, using path analysis in a longitudinal study. We assessed thwarted belongingness and perceived burdensomeness at T1 and hopelessness and suicidal ideation at T2, 12-14 weeks later. Moreover, we assessed suicidal ideation weekly for 14 weeks. Path analyses confirmed the Interpersonal Theory of Suicide model, with thwarted belongingness and perceived burdensomeness as direct and indirect predictors of suicidal ideation through hopelessness. Providers of guidance and clinical services in university settings should be trained to identify perceived burdensomeness, social belongingness, hopelessness, and suicidal ideation when screening for suicide prevention. [ABSTRACT FROM AUTHOR]

Background: Unhealthy lifestyle behaviors among adolescents have emerged as a significant public health concern worldwide, however, there is little investigation on the impact of unhealthy behaviors on non-suicidal self-injury (NSSI), suicidal ideation (SI) and suicide attempt (SA). This study aimed to investigate the prevalence of seven unhealthy behaviors as well as their associations with NSSI, SI and SA, and to explore whether the aforementioned associations differ across sex. Methods: A total of 74,152 adolescents were included in this study via a multi-stage, stratified cluster, random sampling method in 2021. Information about unhealthy behaviors (insufficient physical activity, current smoking, current drinking, excessive screen time, long homework time, insufficient sleep and unhealthy BMI), NSSI, SI, SA and other demographics was collected. Sampling weights were used to estimate the prevalence, and the weighted logistic regression models were performed. Stratified analyses by sex and sensitive analyses were conducted. Results: Overview, the weighted prevalence of adolescents had more than five unhealthy behaviors were 5.2%, with boys showing a higher prevalence than girls (6.5% vs.3.8%). Current smoking, current drinking, excessive screen use, long homework time, insufficient sleep, and unhealthy BMI were significantly associated with NSSI, SI and SA. Moreover, adolescents with high lifestyle risk scores were associated with an increased risk of NSSI (5–7 vs. 0: OR 6.38, 95% CI 5.24–7.77), SI (5–7 vs. 0: OR 7.67, 95% CI 6.35–9.25), and SA (5–7 vs. 0: OR 9.57, 95% CI 6.95–13.17). Significant sex differences were found in the associations of unhealthy behaviors with NSSI, SI and SA. Conclusion: Unhealthy behaviors are quite common among Chinese adolescents. Adolescents with multiple unhealthy behaviors are associated with increased risks of NSSI, SI, and SA. The implementation of school and family-based interventions to promote healthy lifestyles is recommended as a preventive measure against self-injurious behavior and suicidality in adolescents. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic's overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania. [ABSTRACT FROM AUTHOR]

Suicidal behaviour among young people is a serious public health concern. Each suicide attempt is related to further suicide attempts and completed suicide. This study aims to explore risk factors associated with repeated suicide attempt among adolescents and young adults. The cohort included 510 patients aged 12–29 years residing in Piedmont Region in North-Western Italy, who had been admitted to hospital or emergency department with a diagnosis of suicide attempt between 2010 and 2020. Cox regression models were used to evaluate potential risk factors for repeated suicide attempt. During the 11-years follow-up, 20.6% of adolescents and young adults repeated suicide attempt, 24.8% of females and 12.3% of males. Nearly 90% of youth who attempted suicide had a diagnosis of psychiatric disorder. After adjustment, younger age of onset of suicidal behaviour, and diagnosis of schizophrenia, bipolar disorder, depressive disorder, anorexia nervosa and personality disorder were significantly associated with repeated suicide attempt. The early identification of patients at higher risk of repetition of suicidal behaviour is of crucial importance. Better understanding of risk factors and effective treatment of mental disorders could help suicide prevention to reduce the burden of the problem among young people. Special attention should be paid during the initial months following discharge from hospital or emergency department, when suicide reattempt risk is very high. [ABSTRACT FROM AUTHOR]

Both adverse childhood experiences (ACEs) and bullying victimization are linked with mental health problems in adolescents. However, little is known about the overlap between the two factors and how this impacts adolescent mental health problems (i.e., internalizing and externalizing problems). The current study analyzed data from 8,085 participants (47.7% female; 44.1% racial/ethnic minority) in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016–2018, ages 9–10 years) to Year 2. Regression analyses were used to estimate associations between ACEs, bullying victimization and mental health problems, respectively, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site. The findings showed that both ACEs and bullying victimization were independently associated with higher internalizing and higher externalizing problems. However, no significant interaction was found between ACEs and bullying victimization. Overall, the results align with the cumulative risk model of adversity, linking cumulative ACEs and bullying victimization to internalizing and externalizing problems in early adolescents. [ABSTRACT FROM AUTHOR]

Adolescent violent behavior is often explained through direct relationships between variables rather than the underlying process. However, research has found a correlation between injustice and aggression, although studies tend to focus solely on this link and fail to explain how violent behavior is developed in adolescents. To explore this relationship further, we conducted a study testing two hypotheses: firstly, that injustice leads to revengeful behavior, and secondly, that frustration and aggression mediate between injustice and revenge. We gathered data from 444 participants in study 1 to validate scales and used convenient sampling to select 427 university undergraduates for study 2 to test the revenge model. Our findings suggest that injustice fuels frustration and aggression, increasing the tendency towards revengeful behavior. Consequently, communities with a prevalence of injustice may foster aggression and violent tendencies in adolescents. This research has practical implications for organizations and institutions, providing insights to help develop interventions that steer young people toward positive pursuits. [ABSTRACT FROM AUTHOR]

Introduction: This study uses Bronfenbrenner’s bioecological model as its theoretical framework to consider the findings of an investigation of the emotional, social, and physical wellbeing of Chinese migrant children and lessons learned from the COVID-19 pandemic in urban areas. This study expands our perspective by combining the views of students, parents, and teachers to explore the emotional, social and physical wellbeing of migrant children in Shanghai who were participating in online learning during the COVID-19. Methods: Observation and semi-structured interviews were carried out to collect data for this case study. Thirty-one migrant children, nine parents, 10 teachers and a school principal from a Shanghai junior high school participated in this research. Qualitative data were analyzed using thematic analysis. Results and Discussion: The findings indicated that although video-recorded lessons were high quality, it put pressure on migrant children due to the lessons containing only new material with no reviews and reduced opportunities for them to interact with their own teachers. In addition, the differences in study progress between the migrant children and the local children that showed up during the online learning, and neglect from teachers and policymakers, made the migrant children anxious, angry and confused about their future. Besides, parents install monitors at home to support their children’s online learning, but it had the opposite effect and simply provoked increased conflicts between children and their parents. Finally, although the online lessons have affected the optical health of students, the subsequent additional cooking lessons have mitigated the optical health problem and strengthened the connections between home and school. Conclusion: The inequalities of education encountered by migrant children during the COVID-19 period have made them realize the disparities they have suffered in Shanghai. The exposure of this problem raises the prospect of a reform of educational policies for migrant children in the future. [ABSTRACT FROM AUTHOR]

Suicide is one of the leading causes of death among adolescents and repetitional suicidal ideations (SI) and non-suicidal self-injury (NSSI) often precede it. In order to improve recognition of youth who are at high risk of suicide, current study aims to identify which individual variables (personality, self-concept and adverse childhood experiences – ACE) predict prolonged NSSI and SI from middle to late adolescence. A 3-year longitudinal study was conducted with 1101 Croatian adolescents (aged 15–17). 181 students (72.4% females) reported either NSSI or SI or both in T1 and were included in all waves of the study. Analyses are focused on differentiation between adolescents who continue with NSSI/SI and those who stop with it in a 3-year period. Results showed that adolescents with prolonged NSSI/SI had more ACE, especially domestic violence, worse family financial status, higher neuroticism and lower results on self-concept variables. The prediction model of classification of those who have prolonged NSSI or SI was better for SI than NSSI, with predictors explaining 31% of variation in SI. Adolescents who experienced more ACE and report more neuroticism have a higher chance of prolonged SI, while youth who perceive better family financial status and have better relationships with parents have a greater chance to stop with it. For NSSI only neuroticism was a significant predictor. Considering significant variables which could predict prolonged NSSI and/or SI, data presented in this paper have both scientific and practical contribution in understanding, treating and preventing adolescents' mental health problems. [ABSTRACT FROM AUTHOR]

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We examine the heterogeneous effects of childhood bullying victimization and chronic bullying victimization on a wide range of outcomes using data from the National Longitudinal Survey of Youth in the United States. Bullying victimization is categorized as childhood or chronic depending on the duration of victimization. We find that bullying victimization negatively affects the physical and mental health of youths, and increases the likelihood of engaging in risky behaviors, such as, smoking and marijuana use. The adverse effects tend to increase in magnitude with chronic bullying victimization. In addition, chronic bullying victimization increases the likelihood of utilizing mental health services and experiencing life-disrupting emotional problems in adulthood. [ABSTRACT FROM AUTHOR]

The interaction between light and matter, particularly chirality, plays a pivotal role in modern science and technology. Typically, metasurfaces achieve chiro-optical effects by coupling electric and magnetic dipoles in specific orientations. In this work, the design and optimization of an asymmetric H-shaped metasurface is explored to induce hybrid anapole (HA) for optical activity. When the symmetry of the metasurface structure is disrupted, the design can simultaneously excite first-order and pseudo high-order HA under illumination with a specific circular polarization, both occurring within the same spectral regime. This results in high reflection for one circular polarization and a significant reduction in reflection for the orthogonal polarization, thereby exhibiting exceptional chiro-optical activity. Moreover, the HA-based chiral metasurface demonstrates strong polarization control capabilities, as verified by Stokes parameter analysis, revealing high birefringence and a pronounced dependence on the incident polarization angle. These results provide valuable insights for the design and optimization of HA metasurfaces for advanced optical applications and polarization control, paving the way for new developments in chiral nanophotonics., (© 2024 Wiley‐VCH GmbH.)

Introduction: Suicide is a global mental health problem for people of all ages. While rates of suicide in children and adolescents are reported as lower than those in older populations worldwide, they represent the third leading cause of death in 15-19-year-olds. The rates are higher among boys than girls worldwide, though the death rates for girls exceed those for boys in Bangladesh, China, India, and Nepal. There has been a general decrease in adolescent suicide rates over recent decades. However, increases are reported in South East Asia as well as South America over the same time period., Methods: A narrative review method has been used to summarize current knowledge about risk and protective factors for suicide among children and adolescents and to discuss evidence-based strategy for suicide prevention in this age group., Results: Identified suicide risk and protective factors for children and adolescents largely overlap with those for adults. Nevertheless, developmental characteristics may strengthen the impact of some factors, such as decision-making style, coping strategies, family and peer relationships, and victimization. The implementation of evidence-based suicide preventive strategies is needed. Restricting access to lethal means, school-based awareness and skill training programs, and interventions delivered in clinical and community settings have been proven effective. The effectiveness of gatekeeper training and screening programs in reducing suicidal ideation and behavior is unproven but widely examined in selected settings., Discussion: Since most studies have been conducted in western countries, future research should assess the effectiveness of these promising strategies in different cultural contexts. The use of more rigorous study designs, the use of both short- and long-term follow-up evaluations, the larger inclusion of individuals belonging to vulnerable groups, the evaluation of online intervention, and the analysis of programs' cost-effectiveness are also required., (© 2020 The Authors. Asia-Pacific Psychiatry published by John Wiley & Sons Australia, Ltd.)

With healthcare systems facing growing pressure from ageing populations and associated complex care needs, attention is increasingly being focused on sustainable strategies to improve health outcomes across populations. Encouraging access to natural environments is one form of preventative public health strategy that has been shown to lead to improved physical and mental health outcomes at the population level. A significant body of research has documented the health benefits of accessing a wide range of natural environments, including green space and coastal areas. However, freshwater resources, or inland blue spaces, have received less attention in the field of human–environment interactions. This critical review highlights current research opportunities for developing rich and nuanced insight into inland blue space experiences. Future research must take steps to account for the dynamic and unique nature of inland blue spaces through the application of a wide range of flexible and sensitive research methodologies alongside the application of broader mixed methods research approaches. To effectively utilise inland blue spaces as public health resources, it is vital that research captures the influence of temporal changes on blue space interactions and considers the overarching impact of context-specific factors. Addressing current research gaps in combination with advancing research methodologies offers the potential to consolidate inland blue space findings and create a robust evidence base for the implementation of effective public health policies. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between youth violence exposures (i.e., peer and neighborhood) and early sexual initiation. It also explored whether caring relationships with teachers might moderate this relationship and whether results differed for heterosexual versus non-heterosexual African American youth. The study sample (N = 580) comprised 475 heterosexual and 105 non-heterosexual youths, 319 female and 261 male, ages 13 to 24 years (M age = 15.8). Students were assessed for peer and neighborhood violence, relationship with teachers, early sexual initiation, sexual orientation, and socioeconomic status. Major results indicated a positive relationship between exposure to peer and neighborhood violence and early sexual initiation for heterosexual youth but not those who identified as non-heterosexual. Further, identifying as female (vs. male) was significantly associated with later sexual initiation for both heterosexual and non-heterosexual youth. In addition, caring teachers moderated the relationship between exposure to peer violence and age of sexual initiation among non-heterosexual youth. Programs and interventions to curtail violence sequelae would need to consider the unique effects of various types of youth violence exposures and the significance of sexual orientation. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Educational Psychology is the property of International Journal of Educational Psychology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study explored the associations between bullying perpetration and victimization at 8 years of age and violent offenses by the age of 31. Data were obtained for subjects enrolled in a population-based longitudinal birth cohort study. In 1989, 5813 8-year-old children (attrition 3.4%), and their parents and teachers, were surveyed about bullying. When 5405 subjects (attrition 10.2%) were 15–31 years of age, violent offenses were extracted from the Finnish National Police Register. We analyzed the data by sex and categorized bullying perpetration and victimization by frequency. Violent offenses were categorized by severity. Cox regression analyses estimated the hazard ratios (HRs) and 95% confidence intervals (95% CIs). When they were compared to males who had not been bullies at 8 years of age, frequent male bullies had an increased hazard for violent offenses (adjusted HR 3.01, 95% CI 2.11–4.33) and severe violent offenses (adjusted HR 2.86, 95% CI 1.07–7.59) as adults, even when the data were controlled for them being victims, parental education level, family structure and child psychopathology. Frequent female bullies also had an increased hazard for violent offenses, compared to those who had not bullied others (adjusted HR 5.27, 95% CI 1.51–18.40). Frequent male bullying was associated with higher odds for violent offenses compared to only bullying sometimes. Being a victim was not associated with violent offenses. Preventing childhood bullying could reduce violent offenses by both sexes. [ABSTRACT FROM AUTHOR]

Over the years, researchers have been exploring ways to artificially design chiral structures and materials, namely metamaterials and metasurfaces. They exhibit unique optical properties that can be used for various applications. However, metasurfaces comprise symmetry‐breaking structures that provide a more convenient solution for planar chiral optics regardless of whether they are plasmonic or dielectric. In general, plasmonic chiral metasurfaces are more suitable for applications requiring a high confinement level and substantial optical near‐field enhancement. In contrast, dielectric chiral metasurfaces are ideal for wide operating wavelength ranges and low losses. This review summarizes the recent progress on plasmonic and dielectric chiral metasurfaces. It includes the fundamental concepts, design strategies, and their implementation for applications in holographic displays, imaging and sensing, and detection. Moreover, an overview of chiral metasurfaces to generate the nonlinear effects, hosting bound states in the continuum, and the significant role of machine‐learning‐based design approaches are also discussed. Finally, some future developments are highlighted where chiral metasurfaces are expected to play a vital role. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the longitudinal mediationa(l pathways on the link between various straining experiences and suicidal ideation and to test whether its relationship was mediated by the role of negative emotions, constraints, and motivations. Data for this study were collected as part of the Korean Welfare Panel Study, which was a longitudinal study conducted among 7,027 Korean households, surveyed annually from 2006 to 2012. The results indicated that bullying victimization had important effects on negative emotions, although bullying victimization was not significant for later suicidal ideation. Peer delinquency was significantly correlated with negative emotions and positively predicted later suicidal ideation. Also, the significant impact of bullying victimization was transmitted to suicidal ideation through negative emotions. It implies that individuals' negative life events predicted strain or stressors generating negative emotions that, in turn, led to a high risk of suicidal ideation as a possible coping skill. [ABSTRACT FROM AUTHOR]

This study examines three family therapy cases of adolescents bullying victims in South Korea. We explored factors related to the onset of bullying victimization, family factors, intervention, and therapy outcome. Findings are as follows. First, the onset-related factors included hygiene issues and hostile teachers. Second, family factors were prenatal stressors, lack of affection, communication patterns, parenting practices, and transference. Third, interventions included promoting insight and coaching communication styles. Fourth, families showed cognitive and behavioral changes. Fifth, adolescents better adjusted to school. Findings suggest therapists counseling bullying victims explore family factors and help initiate changes in communication and parenting. [ABSTRACT FROM AUTHOR]

The high prevalence of bullying is accompanied by research suggesting that bullying victimization predicts depressive symptoms during late adolescence. However, the processes through which bullying may lead to depression are not fully understood. This study used structural equation modeling to examine future orientation and self-mastery in the relationship between bullying and depression. Researchers used three waves of data (N = 448; M age = 14.83; 52% female) in the Youth Development Study. The indirect pathway from bullying victimization to depressive symptoms through self-mastery was significant, suggesting that self-mastery may mediate the relationship. Results demonstrate that bullying victimization has long-term effects on adolescents' mental health, and self-mastery can serve as a potential target for intervention and prevention. [ABSTRACT FROM AUTHOR]

Objective: The Interpersonal Theory of Suicide (ITS) could help identify differences in groups of suicidal adolescents and inform treatment., Method: Latent Profile Analysis (LPA) using thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, and capability was conducted on data from an at-risk clinical sample (N = 500). The ITS prediction that changes in TB and PB are associated with changes in suicidal ideation was tested using admission and discharge data., Results: Latent Profile Analysis identified three profiles with increasing complexity and severity on ITS factors. The profiles were labelled low-severity (7.6% of participants), moderate-severity (45.2%), and high-severity (47.2%). ITS predictions were partially supported for the full sample and only for the high-severity and moderate-severity subgroups, whereby changes in TB were significantly associated with changes in suicidal ideation over the course of treatment. However, changes in PB were only significant in the moderate-severity subgroup, and none of the ITS predictions were supported in the low-severity subgroup. Additionally, effect sizes for changes in TB and PB were modest in all analyses., Conclusions: Our findings highlight the importance reducing low belongingness in youth, which is a component of all supported interventions of youth suicide prevention. However, given the modest association of changes in ITS variables had with changes in suicidal ideation, it may be fruitful to elaborate on the relative importance on types of low belongingness or include other non-ITS variables., (© 2023 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

In the USA, suicide is a leading cause of death for adolescents ages 12 to 18 (National Institute of Mental Health (NIMH), 2019). Given the urgency of this public health crisis, this paper aims to explore the impact of a sense of school belonging and teacher-based discrimination and peer-based prejudice on suicidal ideation and attempts among Black youth. This secondary analysis used a sample of Black youth (N = 4229; M age  = 16) from the National Longitudinal Study of Adolescents to Adult Health data. Independent variables included a sense of school belonging, school-based teacher discrimination, and school-based peer prejudice; the dependent variable was suicidal thoughts and behaviors. The results of multinomial regression analyses revealed that as Black adolescents' sense of school belonging decreased, they were 35% more likely to be at risk for suicidal ideation and attempts. Findings from our study support the assertion that the school microsystem plays a substantial role in modifying the risk of suicidal behavior among Black youth., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

The chiroptical response occurring in the chiral metamaterials (MMs) has crucial and extensive applications for stereochemistry, polarization optics, and spintronics. Yet, such intrinsically chiral metamaterials are restricted to a complicated subwavelength chiral profile, causing pronounced fabrication challenges, particularly at the near‐infrared (N‐IR) spectral regime. Instead, extrinsic chirality can also be observed in the nonchiral MMs under an oblique incidence, indicating that the chiroptical response can be achieved with simple structures. The development of photon‐spin selective integrated devices needs an actively reversible tuning of chirality in MMs. Herein, a reversible switching of the extrinsic chirality at the N‐IR region is demonstrated by integrating a nonvolatile chalcogenide semiconductor, Ge2Sb2Te5, into the nonchiral MMs design. It provides an ultrafast and reconfigurable tuning of transmittance circular dichroism (TCD) between amorphous and crystalline states under a stimulus of a nanosecond pulsed laser at a wavelength of 532 nm. Meanwhile, it also effectively manipulates the TCD by titling both rotation and incident angles while fixing geometrical parameters. Utilizing ellipsometry and analytical inversion, it can obtain not only linear but circular birefringence‐dichroism pairs from a single general ellipsometry measurement, which gives a comprehensive description of the polarization characteristics of the non‐chiral MMs, having an advantage over the typical circular dichroism measurements. [ABSTRACT FROM AUTHOR]

Previous studies have found that different types of bullying have different effects on individuals. However, few studies have investigated the types of bullying victimization among primary school students using latent profile analysis (LPA), and considered both the frequency and form of bullying victimization when naming these types. This study explored bullying victimization types with a sample of 1748 primary school students. Participants were 52.1% (911) male, and 47.7% (833) female. Four (0.2%) students didn't report their sex. Results show that school bullying victimization can be classified as "never bullied" (66.3%), "often oppressed" (18.2%), "often threatened" (8.0%), and "always bullied in all forms" (7.5%). There is a significant difference in sex and grade for victimization types. Specifically, the risk of being "often threatened" and "always bullied in all forms" types is higher for males than for females. Grade 4 students are at higher risk of being "often oppressed", "often threatened", and "always bullied in all forms" types than Grade 6. Students with different types of victimization show significant differences in school adaptation. Students in bullying victimization are more likely to experience lower school belonging and prosocial behavior, and higher aggressive behavior and withdrawal behavior. These results reveal that schools, teachers, and parents should pay close attention to bullying victimization types among primary students and help them deal with bullying victimization according to clear guidelines. [ABSTRACT FROM AUTHOR]

Chiral lattice modes are hybrid states arising from the chiral plasmonic particles assembled in ordered arrays with opportune periodicity. These resonances exhibit dependence on excitation handedness, and their observation in plasmonic lattices is strictly related to the chiroptical features of the fundamental plasmonic unit. Here, the emergence of chiral surface lattice resonances (c‐SLRs) is shown in properly engineered arrays of nanohelices (NHs), fully three dimensional (3D) chiral nano‐objects fabricated by focused ion beam processing. By tuning the relative weight of plasmonic and photonic components in the hybrid mode, the physical mechanism of strong diffractive coupling leading to the emergence of the lattice modes is analyzed, opening the way to the engineering of chiral plasmonic systems for sensing applications. In particular, a coupling regime is identified where the combination of a large intrinsic circular dichroism (CD) of the plasmonic resonance with a well‐defined balance between the photonic quality factor (Q factor) and the plasmonic field enhancement (M) maximizes the capability of the system to discriminate refractive index (RI) changes in the surrounding medium. The results lay the foundation for exploiting CD in plasmonic lattices to high performance refractometric sensing. [ABSTRACT FROM AUTHOR]

Aims. Preventing the occurrence of depression/anxiety and suicide during adolescence can lead to substantive health gains over the course of an individual person's life. This study set out to identify the expected population-level costs and health impacts of implementing universal and indicated school-based socio-emotional learning (SEL) programs in different country contexts. Methods. A Markov model was developed to examine the effectiveness of delivering universal and indicated school-based SEL programs to prevent the onset of depression/anxiety and suicide deaths among adolescents. Intervention health impacts were measured in healthy life years gained (HLYGs) over a 100-year time horizon. Country-specific intervention costs were calculated and denominated in 2017 international dollars (2017 I$) under a health systems perspective. Cost-effectiveness findings were subsequently expressed in terms of I$ per HLYG. Analyses were conducted on a group of 20 countries from different regions and income levels, with final results aggregated and presented by country income group - that is, low and lower middle income countries (LLMICs) and upper middle and high-income countries (UMHICs). Uncertainty and sensitivity analyses were conducted to test model assumptions. Results. Implementation costs ranged from an annual per capita investment of I$0.10 in LLMICs to I$0.16 in UMHICs for the universal SEL program and I$0.06 in LLMICs to I$0.09 in UMHICs for the indicated SEL program. The universal SEL program generated 100 HLYGs per 1 million population compared to 5 for the indicated SEL program in LLMICs. The cost per HLYG was I$958 in LLMICS and I$2,006 in UMHICs for the universal SEL program and I$11,123 in LLMICs and I$18,473 in UMHICs for the indicated SEL program. Cost-effectiveness findings were highly sensitive to variations around input parameter values involving the intervention effect sizes and the disability weight used to estimate HLYGs. Conclusions. The results of this analysis suggest that universal and indicated SEL programs require a low level of investment (in the range of I$0.05 to I$0.20 per head of population) but that universal SEL programs produce significantly greater health benefits at a population level and therefore better value for money (e.g., less than I$1,000 per HLYG in LLMICs). Despite producing fewer population-level health benefits, the implementation of indicated SEL programs may be justified as a means of reducing population inequalities that affect high-risk populations who would benefit from a more tailored intervention approach. [ABSTRACT FROM AUTHOR]

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The study's objective was to develop and validate the psychometric properties of two brief pictorial scales to evaluate the roles of bystanders and victims of bullying. A sample of 910 students was considered (49.6%, boys; 50.4%, girls) between the ages of 7 and 13 (M = 10, SD = 1.4). Both instruments present nine pictorial items representing two dimensions: physical bullying (items 1 to 4) and psychological bullying (items 5 to 9). An additional measure of anxiety was used to assess convergent validity. The Confirmatory Factorial Analysis shows that the two-dimensional oblique model, physical bullying and psychological bullying, presents a better fit to the bystander scale data (RMSEA =.040; CFI =.984; SRMR =.033) and in the victim scale (RMSEA =.051; CFI =.978; SRMR =.040) in comparison to other competitor models. From the perspective of the Item Response Theory (IRT), it was found that the items adequately discriminate the levels of the latent variable; therefore, items 1 (physical bullying) and 7 (psychological bullying) are the most accurate on the bystander scale, and items 3 (physical bullying) and 7 (psychological bullying), on the victim scale. It was also found that the degree of difficulty on both scales is lower for the psychological bullying dimension than for the physical bullying dimension. Both instruments demonstrated good psychometric properties; therefore, they can detect school bullying in classrooms. [ABSTRACT FROM AUTHOR]