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Jessica L Bourdon,1 Sidney Judson,1 Gabriella Caporaso,1 Monica F Wright,2 Taylor Fields,1 Nehal P Vadhan,3 Jon Morgenstern4 1Center for Addiction Science, Wellbridge Addiction Treatment and Research, Calverton, NY, USA; 2Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; 3Institute of Behavioral Science, Feinstein Institutes for Medical Research, Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempsted, NY, USA; 4Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempsted, NY, USACorrespondence: Jessica L Bourdon, Center for Addiction Science, Wellbridge Addiction Treatment and Research, 525 Jan Way, Calverton, NY, 11933, USA, Email jbourdon@wellbridge.orgBackground: Quality training is an oft-cited barrier to effective implementation and ongoing delivery of high-quality evidence-based practice (EBP) across fields. This is especially true in the addiction field, but there is little cited evidence for optimal methods to improve EBP in inpatient addiction facilities with minimal resources.Objective: The current paper focuses on evaluating the state of our facility’s group CBT manual and clinical training on the manual in a “realistic” (ie, non-RCT, non-grant-funded) inpatient addiction treatment setting.Methods: Five full-time clinicians volunteered to take part in the study (woman = 60%; Mage = 36.20 years). The study involved a mix of semi-structured interviews and surveys designed to measure seven outcomes (barriers, feasibility, useability, appropriateness, acceptability, burden, trialability).Results: Three themes emerged from the data that impacted the group CBT manual: training, timing, and functionality. Addressing these themes allowed for a new, optimal manual and training procedure to be put into place.Conclusion: The current study highlights that under-resourced inpatient addiction facilities can still methodically utilize implementation approaches to study their EBP, namely CBT. Such an approach will ensure that the highest quality care is being delivered to patients and actively addresses known training barriers that prevent proper EBP delivery.Plain Language Summary: Quality training is a barrier when implementing evidenced-based practice to treat substance use disorders.CBT is a manualized evidence-based practice that is performed at inpatient addiction facilities.An evaluation of the CBT manual was made by an inpatient addiction facility to identify barriers of implementation of EBPs.Identified barriers included training, timing, and functionality.Keywords: cognitive behavioral therapy, addiction, evidence-based practice, inpatient, substance use disorders

This study compares the use of evidence in two 18-month Canadian projects with a similar goal: improved prevention of type II diabetes in women from ethno-cultural communities with a gestational diabetes diagnosis. Evidence used for both projects included epidemiological data and research literature, needs assessments with the target population, and project evaluations. Contexts for the use of evidence differed between the two projects in terms of the innovation and its level of complexity; organizational context and system readiness for change; and partnership characteristics. This study showed that while evidence played some role in determining project success, it was but one factor in deciding how project activities were (or were not) sustained. [ABSTRACT FROM AUTHOR]

Researchers have focused on identifying factors that may mitigate the negative consequences associated with cyberbullying victimization. A significant factor that has received considerable attention is perceived social support from parents and friends and its potential to reduce the risk of cyberbullying victimization and the associated negative mental health issues. However, the buffering effects of perceived social support from parents and friends on the longitudinal relationships among cyberbullying victimization, depression, subjective health complaints, and self-harm have been less explored, particularly in cross-cultural contexts. To address this gap, the present study examined the role of perceived social support from parents and friends in buffering against depression, subjective health complaints, and self-harm, measured one year later, associated with cyberbullying victimization among 463 Chinese (49% female) and 445 American (52% female) eighth graders (ages 13-15). They completed self-report questionnaires on cyberbullying victimization, perceived social support from parents and friends, and mental health (i.e., depression, subjective health complaints, self-harm). One year later, they completed the same mental health questionnaires. The findings revealed no differences in reports of perceived support from parents, but greater reports of social support from friends for American adolescents when compared to Chinese adolescents. High levels of perceived social support from parents were associated with a stronger negative relationship between cyberbullying victimization, depression, subjective health complaints, and self-harm for both Chinese and American adolescents, with these effects being more pronounced for Chinese adolescents, while opposite patterns were found for American adolescents and perceived social support from friends. These results are discussed in the context of cultural values and how these values shape the role of adults in adolescents' lives.

Background/objectives: The primary objective of this research was to assess age differences in the associations between cyberbullying victimization and bystanding and depression among 234 elementary school students (4th and 5th graders; 51% female), 363 middle school students (6th to 8th grades; 53% female), and 341 high school students (9th to 12th grades; 51% female) as well as the moderating effect of parental mediation in these relationships., Methods: Participants completed self-report questionnaires on their cyberbullying victimization and bystanding, as well as depressive symptoms., Results: The findings revealed that high levels of instructive mediation buffered against depression associated with cyberbullying victimization and bystanding across all age groups, with the strongest effects found for middle school students. Lower levels of instructive mediation and higher levels of restrictive mediation increased the positive relationships between cyberbullying victimization and bystanding and depression. Co-viewing mediation did not moderate any of the associations., Conclusions: Parental mediation of technology use has the potential to alleviate the negative consequences associated with cyberbullying victimization and bystanding. The findings highlight the importance of tailoring prevention and intervention strategies to specific age groups and to parents.

Prior research into bystander responses to hate speech has utilized variable-centered analyses - such approaches risk simplifying the complex nature of bystander behaviors. Hence, the present study used a person-centered analysis to investigate latent hate speech bystander profiles. In addition, individual and classroom-level correlates associated with the various profiles were studied. The sample included 3225 students in grades 7-9 (51.7% self-identified as female; 37.2% with immigrant background) from 215 classrooms in Germany and Switzerland. The latent profile analysis revealed that four distinct profiles could be distinguished: Passive Bystanders (34.2%), Defenders (47.3%), Revengers (9.8%), and Contributors (8.6%). Multilevel logistic regression models showed common and distinct correlates. For example, students who believed that certain social groups are superior were more likely to be Revengers and Contributors than Passive Bystanders, students who felt more connected with teachers were more likely to be Defenders, and students who were more open to diversity were less likely to be Contributors than Passive Bystanders. Students were less likely Defenders and more likely Revengers and Contributors than Passive Bystanders in classrooms with high rates of hate speech perpetration. Further, in classrooms with high hate speech intervention, students were more likely to be Defenders and less likely to be Contributors than Passive Bystanders. In classrooms with stronger cohesion, students were more likely to be Defenders and less likely to be Contributors than Passive Bystanders. In conclusion, the findings add to our understanding of bystander profiles concerning racist hate speech and the relevance of individual and classroom-level factors in explaining various profiles of bystander behavior., (© 2024. The Author(s).)

The present study investigated the moderating effect of adolescent demographic variables in the longitudinal associations among different types of sexting, mental health (i.e., depression, self-harm, subjective health complaints), and sexual risk behaviors. There were 1113 adolescents (ages 14-17 years; Mage = 16.36; SD age  = .81; 50% female) from six high schools located in the United States included in this study. Adolescents completed questionnaires on their sexting behaviors, mental health, and sexual risk behaviors during the ninth grade; in tenth grade, they completed questionnaires on mental health and sexual risk behaviors. Non-consensual sexting and pressured sexting were both related positively to each of the mental health variables and sexual risk behaviors. The relationship between non-consensual sexting and depressive symptoms was stronger for girls, ethnic minorities, those adolescents with disabilities, and sexual minorities. Similar patterns were found for pressured sexting, non-suicidal self-harm, and subjective health complaints. The relationships between pressured sexting and sexual risk behaviors were stronger for girls, ethnic minorities, those adolescents with disabilities, and those who identified as sexual minorities. Research focused on the relationships among different types of sexting, mental health, and sexual risk behaviors is important as such research facilitates the development of evidence-based recommendations for sexting harm prevention and sexual education programs., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Problematic Use of the Internet (PUI) is characterized as the inability to control one's internet use or as an excessive use of the internet that may result in social, psychological, and emotional difficulties (Fernandes et al., 2019). It is regarded nowadays as an increasingly worrisome public heath issue, especially among youth. This study explored the contexts in which youth PUI occurs and its associations with socio-emotional functioning that may lead to a decrease in one's sense of well-being. We conducted this exploration among 783 middle school students from the US (425 students; 54.27%) and Israel (358 students; 45.73%). The overall age of both samples ranged between 12 and 16 ( M  = 13.94, SD = 1.59). In the Israeli sample, 49.1% of the students were girls and 50.9% were boys, whereas in the US sample, 48.8% were girls and 51.2% were boys. The study examined the role of depressive mood, loneliness, resilience, self-control, and school engagement in mediating the relationship between PUI and well-being, and how country of origin might moderate these relationships. Results indicate PUI was related to lower well-being only for the US sample. Yet, for both samples, higher loneliness was related to lower well-being, and higher school engagement was related to higher well-being. A moderated mediation analysis revealed the socio-emotional variables were all mediators in these associations, but differently for each country sample. The study results are discussed according to key factors required for developing intervention programs for coping with youth PUI behaviors.

Background: Birth prevalence of Robin sequence (RS) is commonly reported as 1 case per 8000-14 000 live births. These estimates are based on single-source case ascertainment and may miss infants who did not require hospital admission or those without overt upper airway obstruction at birth., Objectives: To identify the true birth prevalence of RS with cleft palate in the UK and Ireland from a population-based birth cohort with high case ascertainment., Methods: Active surveillance of RS with cleft palate was carried out in the UK/Ireland using dual sources of case ascertainment: British Paediatric Surveillance Unit (BPSU) reporting card and nationally commissioned cleft services. Clinical data were collected from notifying clinicians at two time points., Results: 173 live-born infants met the surveillance case definition, giving a birth prevalence of 1 case per 5250 live births (19.1 per 100 000 (95% CI 16.2 to 21.9)), and 1:2690 in Scotland. 47% had non-isolated RS, with Stickler syndrome the most common genetic diagnosis (12% RS cases). Birth prevalence derived from the combined data sources was significantly higher than from BPSU surveillance alone., Conclusions: Birth prevalence of RS in the UK/Ireland derived from active surveillance is higher than reported by epidemiological studies from several other countries, and from UK-based anomaly registries, but consistent with published retrospective data from Scotland. Dual case ascertainment sources enabled identification of cases with mild or late-onset airway obstruction that were managed without hospital admission. Studies of aetiology and equivalent well-designed epidemiological studies from other populations are needed to investigate the identified geographical variability in birth prevalence., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

The aim of the present study was to examine cyberbullies' attributions pertaining to their perpetration of cyberbullying, and how such attributions relate to their cyberbullying behaviors six months later. Participants were 216 adolescents ( M = 13.46, SD = 0.62 years; 55% female) from the suburbs of a large Midwestern city in the United States. They were interviewed face-to-face in the fall of 2018 concerning why they acted in negative ways toward peers online or through text messages. They also answered questionnaires regarding how often they perpetrated face-to-face bullying and cyberbullying during the fall of 2018 and spring of 2019. The attributions of revenge, convenience, anger, and anonymity each predicted cyberbullying at the second time point while controlling for face-to-face bullying perpetration. Results from this study provide important information to the literature regarding cyberbullies' attributions for perpetrating cyberbullying, and how such attributions predict future cyberbullying perpetration. These findings are important for the development of antibullying programs that might aim to change adolescents' attributions for cyberbullying perpetration to reduce continued engagement in these behaviors.

Currently, there is a lack of empirically evaluated prevention programs targeting hate speech among adolescents. This is problematic because hate speech jeopardizes adolescents' well-being and social integration. To this end, this study aims to evaluate the short-term effects of the newly developed anti-hate speech prevention program, "HateLess. Together against Hatred", on adolescents' empathy, self-efficacy, and counter-speech. Eight hundred and twenty adolescents between 12 and 16 (M = 13.27, SD = 1.04) from 11 German schools participated in this study. More specifically, 567 adolescents participated in the one-week prevention program, and 253 participants were assigned to the control group. Repeated measures ANOVAs showed that HateLess was successful, as there was a significant increase in empathy, self-efficacy, and counter-speech in the intervention group from the pretest (T1) to the posttest (T2) one month after the intervention. In contrast, no changes were found among adolescents in the control group. A multilevel mediation model revealed that the effect of being a member of the intervention group on counter-speech was partially mediated via empathy and self-efficacy. The findings indicate that HateLess is an effective, cost-efficient approach to enhance adolescents' counter-speech directly and indirectly by altering the skills they need to become informed citizens in democratic societies., (© 2023. The Author(s).)

One aim of this study was to investigate differences in cyberbullying involvement (i.e., victimization, bystanding, perpetration) across four age groups, including 234 elementary school students (4th and 5th grades; 51% female), 363 middle school students (6th through 8th grades; 53% female), 341 high school students (9th through 12th grade; 51% female), and 371 university students (all four years; 60% female). Another aim was to examine the age group differences in the associations between cyberbullying involvement and depression, as well as the moderating effect of social support from parents and friends. Participants completed questionnaires on cyberbullying involvement, depression, and social support from parents and friends. Findings revealed that middle school students were more often involved in cyberbullying as victims, bystanders, and perpetrators, followed by high school and university students, and elementary school students. High school and university students did not differ on their cyberbullying involvement. Gender moderated these relationships for elementary school students, with boys more often involved in cyberbullying perpetration and victimization than girls. In addition, female university students witnessed cyberbullying more so than males. Social support from parents buffered against the negative effects of cyberbullying involvement on depression across all age groups. Results were similar for social support from friends, but only for middle school and high school students. Gender did not influence the associations among age groups, cyberbullying involvement, and depression. The results have implications for designing prevention and intervention programs and ensuring that such programs consider age.

This study investigated the role of medium (face-to-face, cyber) and publicity (public, private) in adolescents' perceptions of severity and coping strategies (i.e., avoidant, ignoring, helplessness, social support seeking, retaliation) for victimization, while accounting for gender and cultural values. There were 3432 adolescents (ages 11-15, 49% girls) in this study; they were from China, Cyprus, the Czech Republic, India, Japan, and the United States. Adolescents completed questionnaires on individualism and collectivism, and ratings of coping strategies and severity for public face-to-face victimization, private face-to-face victimization, public cyber victimization, and private cyber victimization. Findings revealed similarities in adolescents' coping strategies based on perceptions of severity, publicity, and medium for some coping strategies (i.e., social support seeking, retaliation) but differential associations for other coping strategies (i.e., avoidance, helplessness, ignoring). The results of this study are important for prevention and intervention efforts because they underscore the importance of teaching effective coping strategies to adolescents, and to consider how perceptions of severity, publicity, and medium might influence the implementation of these coping strategies.

Hate speech is often discussed and investigated as an online phenomenon, while hate speech among adolescents in the real world (e.g., in schools) has rarely been researched. Consequently, not much is known about potential interpersonal correlates and theoretical frameworks that might help us better understand why adolescents engage in hate speech in offline environments. To add to the literature, this study investigates hate speech perpetration among young people by utilizing the Social Cognitive Theory; more specifically, the association between witnessing and perpetrating hate speech in schools, and whether this relation is weakened or strengthened by anti-hate speech injunctive norms and deviant peer pressure. The sample consists of 1719 young people (45.1% boys, 53.6% girls, 1.3% gender diverse) between 11 and 18 years old ( M age = 13.96; SD = .98) from 22 schools in Switzerland. Self-report questionnaires were administered to measure hate speech involvement and adolescents' perception of social norms (i.e., anti-hate speech injunctive norms and deviant peer pressure). Multilevel regression analyses revealed that witnessing and perpetrating hate speech were positively associated. Moreover, injunctive anti-hate speech norms were negatively related and deviant peer pressure positively related to hate speech perpetration. Finally, increasing levels of injunctive anti-hate speech norms weakened the relation between witnessing and perpetrating hate speech, whereas higher levels of deviant peer pressure strengthened this association. The findings demonstrate that the Social Cognitive Theory is a useful framework for understanding hate speech perpetration in schools. The results also highlight the importance of taking into account social norms and interpersonal relationships (e.g., within the class) when designing anti-hate speech prevention programs and not focusing solely on intrapersonal factors.

Drawing on the social-ecological perspective, this longitudinal study investigated the potential moderating effect of gender in the relationships among Machiavellianism, popularity goals, and cyberbullying involvement (i.e. victimization, perpetration) among adolescents from China, Cyprus, India, and the United States. There were 2,452 adolescents ( M age = 14.85; SD = .53; 13-16 years old; 49.1% girls) from China, Cyprus, India, and the United States included in this study. They completed surveys on Machiavellianism, popularity goals, and cyberbullying victimization and perpetration during the fall of 2014 (Time 1). One year later, during the fall of 2015, adolescents completed surveys on cyberbullying victimization and perpetration. Findings revealed that Machiavellianism and popularity goals were both associated positively with Time 2 cyberbullying victimization and perpetration for all adolescents. The associations between Machiavellianism and Time 2 cyberbullying perpetration and between popularity goals and Time 2 cyberbullying perpetration were stronger for Chinese and Indian boys than girls. Opposite patterns were found for popularity goals and Time 2 cyberbullying perpetration for adolescents from the United States. Gender did not moderate any of the associations for Cypriot adolescents or for Time 2 cyberbullying victimization. The social-ecological perspective provides a useful understanding of how various contexts influence bullying.

Introduction: Unintentional home injuries are common and costly, with over 1.6 million occurring among U.S. children ages 0-4 in 2018. Home visitors and other early childhood professionals can provide valuable prevention education and intervention to reduce unintentional injury risk for children. This proof-of-concept study aimed to test the feasibility of the first phase of Home Safety Hero, a software-based serious game simulation that trains users in identification of home safety risks, as a capacity building tool for early childhood professionals., Methods: The game simulation's potential for knowledge promotion and engagement in a sample of home visitors was explored based on play of the first phase. Repeated measures ANOVAs were used to assess learning via reaction time, and engagement was measured via the User Engagement Scale (UES)., Results: Reaction time (i.e., average time to identify hazards) improved from the first to last levels in both single and mixed category levels in this trial. Participant indicated agreement with four subscales of engagement measured by the UES, and neutral to agree on a fifth subscale, focused attention., Conclusions: We propose that this game simulation can meet the unique training needs of early childhood professionals while promoting home safety knowledge that can improve prevention work with families. Participant feedback was largely positive, and results suggest that the game simulation is engaging and contributes to knowledge., Practical Applications: The Home Safety Hero serious game simulation is a flexible training option that appeared to be feasible for reducing time to hazard identification among home visitors in this proof-of-concept study. The design of the game simulation has utility in meeting the specialized training needs of early childhood professionals and potential to build their capacity to provide direct intervention around home safety, reducing risk for unintentional injury among children., Competing Interests: Declarations of interest None., (Copyright © 2022 National Safety Council and Elsevier Ltd. All rights reserved.)

There has been little research attention given to how Gay-Straight Alliances might mitigate mental health consequences associated with experiencing homophobic cyberbullying. To address this gap in knowledge, the purpose of this one-year longitudinal study was to investigate the moderating effect of perceived social support from Gay-Straight Alliances in the relationships among homophobic cyberbullying victimization and bystanding and depressive and anxiety symptoms among 466 LGBTQIA adolescents (M age  = 15.76; 52% female). The findings revealed that perceived social support was related negatively to homophobic cyberbullying involvement and depressive and anxiety symptoms. Homophobic cyberbullying involvement was related positively to depressive and anxiety symptoms. High perceived social support buffered against the depressive and anxiety symptoms resulting from homophobic victimization and bystanding among LGBTQIA adolescents but low levels and average levels did not moderate these associations. These findings highlight the importance of expanding Gay-Straight Alliances in schools., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Online hate speech has become a widespread problem in the daily life of adolescents. Despite growing societal and academic interest in this online risk, not much is known about the relationship between online hate speech victimization (OHSV) and adolescents' mental well-being. In addition, potential factors influencing the magnitude of this relationship remain unclear. To address these gaps in the literature, this study investigated the relationship between OHSV and depressive symptoms and the buffering effects of resilience in this relationship. The sample consists of 1,632 adolescents (49.1% girls) between 12 and 18 years old ( M age  = 13.83, SD age  = 1.23), recruited from nine schools across Spain. Self-report questionnaires were administered to assess OHSV, depressive symptoms, and resilience. Regression analyses revealed that OHSV was positively linked to depressive symptoms. In addition, victims of online hate speech were less likely to report depressive symptoms when they reported average or high levels of resilience (i.e., social competence, personal competence, structured style, social resources, and family cohesion) compared with those with low levels of resilience. Our findings highlight the need for the development of intervention programs and the relevance of focusing on internal and external developmental assets to mitigate negative outcomes for victims of online hate speech.

The present study proposes and tests pathways by which racial discrimination might be positively related to bullying victimization among Black and White adolescents. Data were derived from the 2016 National Survey of Children's Health, a national survey that provides data on children's physical and mental health and their families. Data were collected from households with one or more children between June 2016 to February 2017. A letter was sent to randomly selected households, who were invited to participate in the survey. The caregivers consisted of 66.9% females and 33.1% males for the White sample, whose mean age was 47.51 ( SD = 7.26), and 76.8% females and 23.2% males for the Black sample, whose mean age was 47.61 ( SD = 9.71). In terms of the adolescents, 49.0% were females among the White sample, whose mean age was 14.73 ( SD = 1.69). For Black adolescents, 47.9% were females and the mean age was 14.67( SD = 1.66). Measures for the study included bullying perpetration, racial discrimination, academic disengagement, and socio-demographic variables of the parent and child. Analyses included descriptive statistics, bivariate correlations, and structural path analyses. For adolescents in both racial groups, racial discrimination appears to be positively associated with depression, which was positively associated with bullying perpetration. For White adolescents, racial discrimination was positively associated with academic disengagement, which was also positively associated with bullying perpetration. For Black adolescents, although racial discrimination was not significantly associated with academic disengagement, academic disengagement was positively associated with bullying perpetration.

Cyberhate represents a risk to adolescents' development and peaceful coexistence in democratic societies. Yet, not much is known about the relationship between adolescents' ability to cope with cyberhate and their cyberhate involvement. To fill current gaps in the literature and inform the development of media education programs, the present study investigated various coping strategies in a hypothetical cyberhate scenario as correlates for being cyberhate victims, perpetrators, and both victim-perpetrators. The sample consisted of 6829 adolescents aged 12-18 years old ( M age = 14.93, SD = 1.64; girls: 50.4%, boys: 48.9%, and 0.7% did not indicate their gender) from Asia, Europe, and North America. Results showed that adolescents who endorsed distal advice or endorsed technical coping showed a lower likelihood to be victims, perpetrators, or victim-perpetrators. In contrast, if adolescents felt helpless or endorsed retaliation to cope with cyberhate, they showed higher odds of being involved in cyberhate as victims, perpetrators, or victim-perpetrators. Finally, adolescents who endorsed close support as a coping strategy showed a lower likelihood to be victim-perpetrators, and adolescents who endorsed assertive coping showed higher odds of being victims. In conclusion, the results confirm the importance of addressing adolescents' ability to deal with cyberhate to develop more tailored prevention approaches. More specifically, such initiatives should focus on adolescents who feel helpless or feel inclined to retaliate. In addition, adolescents should be educated to practice distal advice and technical coping when experiencing cyberhate. Implications for the design and instruction of evidence-based cyberhate prevention (e.g., online educational games, virtual learning environments) will be discussed.

Adolescents around the globe are increasingly exposed to online hate speech (OHS). And yet little is known about the varying roles of involvement and the determinants of adolescents' hate speech perpetration. Building on previous research, this study aims to test the cycle of violence hypothesis for OHS and to analyze whether moral disengagement (MD) and empathy moderate the victim-to-perpetrator relationship. The sample consists of 3,560 seventh to ninth graders (52.1 percent girls), recruited from 40 schools across Germany and Switzerland. Self-report questionnaires were administered to assess OHS involvement, MD, and empathy. Multilevel analyses revealed that victims of OHS were more likely to report OHS perpetration. In addition, victims of OHS were more likely to report OHS perpetration when they reported higher levels of MD than those with lower levels of MD. Finally, victims of OHS were less likely to report OHS perpetration when they reported higher levels of empathy than those with lower levels of empathy. The findings extend the cycle of violence hypothesis to OHS and highlight the need to address MD and empathy in hate speech prevention. Implications for future research will be discussed.

With the nationwide closures of educational institutions in the United States due to the novel coronavirus disease 2019 (COVID-19), many schools transitioned from face-to-face instruction to eLearning formats at the beginning of the pandemic, while many students and their families self-isolated at home. The literature has revealed that self-isolation has a negative effect on adolescents' psychological outcomes, and high social support buffers against these outcomes. The purpose of the present research was to examine the moderating effect of perceived teacher support in the relationships between self-isolation during the beginning of the pandemic and negative health outcomes. Teacher support, self-isolation during the beginning of the COVID-19 pandemic, and health outcomes (i.e., suicidal ideation, nonsuicidal self-harm, subjective health complaints, depression) were measured in mid-April 2020 and health outcomes were measured again in late-May 2020. Participants were 467 7th and 8th graders (51% female; M age = 13.47; ages range from 12 to 15 years old) from the suburbs of a large Midwestern city in the United States. The findings revealed that greater perceived teacher support buffered against the negative outcomes associated with self-isolation during the beginning of the COVID-19 pandemic and lower perceived teacher support strengthened these relationships. The results might inform policy development regarding strategies to improve health outcomes for adolescents during the COVID-19 crisis and future pandemics. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Child sexual abuse (CSA) is associated with revictimization and sexual risk-taking behaviours. The Internet has increased the opportunities for teens to access sexually explicit imagery and has provided new avenues for victimization and exploitation. Online URL activity and offline psychosocial factors were assessed for 460 females aged 12-16 (CSA = 156; comparisons = 304) with sexual behaviours and Internet-initiated victimization assessed 2 years later. Females who experienced CSA did not use more pornography than comparisons but were at increased odds of being cyberbullied (odds ratio = 2.84, 95% confidence interval = 1.67-4.81). These females were also more likely to be represented in a high-risk latent profile characterized by heightened URL activity coupled with problematic psychosocial factors, which showed increased odds of being cyberbullied, receiving online sexual solicitations and heightened sexual activity. While Internet activity alone may not confer risk, results indicate a subset of teens who have experienced CSA for whom both online and offline factors contribute to problematic outcomes., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Due to the COVID-19 pandemic, higher educational institutions worldwide switched to emergency distance learning in early 2020. The less structured environment of distance learning forced students to regulate their learning and motivation more independently. According to self-determination theory (SDT), satisfaction of the three basic psychological needs for autonomy, competence and social relatedness affects intrinsic motivation, which in turn relates to more active or passive learning behavior. As the social context plays a major role for basic need satisfaction, distance learning may impair basic need satisfaction and thus intrinsic motivation and learning behavior. The aim of this study was to investigate the relationship between basic need satisfaction and procrastination and persistence in the context of emergency distance learning during the COVID-19 pandemic in a cross-sectional study. We also investigated the mediating role of intrinsic motivation in this relationship. Furthermore, to test the universal importance of SDT for intrinsic motivation and learning behavior under these circumstances in different countries, we collected data in Europe, Asia and North America. A total of N = 15,462 participants from Albania, Austria, China, Croatia, Estonia, Finland, Germany, Iceland, Japan, Kosovo, Lithuania, Poland, Malta, North Macedonia, Romania, Sweden, and the US answered questions regarding perceived competence, autonomy, social relatedness, intrinsic motivation, procrastination, persistence, and sociodemographic background. Our results support SDT's claim of universality regarding the relation between basic psychological need fulfilment, intrinsic motivation, procrastination, and persistence. However, whereas perceived competence had the highest direct effect on procrastination and persistence, social relatedness was mainly influential via intrinsic motivation., Competing Interests: The authors have declared that no competing interests exist.

The purpose of this study was to examine the moderating effects of technology use for relationship maintenance on the longitudinal associations among self-isolation during the coronavirus-19 (COVID-19) pandemic and romantic relationship quality among adolescents. Participants were 239 (120 female; M age = 16.69, standard deviation [ SD ] = 0.61; 60 percent Caucasian) 11th and 12th graders from three midwestern high schools. To qualify for this study, adolescents had to be in the same romantic relationship for the duration of the study, ∼7 months ( M length of relationship = 10.03 months). Data were collected in October of 2019 (Time 1) and again 7 months later in May of 2020 (Time 2). Adolescents completed a romantic relationship questionnaire at Time 1 and again at Time 2, along with questionnaires on frequency of self-isolation during the COVID-19 pandemic and use of technology for romantic relationship maintenance. Findings revealed that increases in self-isolation during the COVID-19 pandemic related positively to the use of technology for romantic relationship maintenance and negatively to Time 2 romantic relationship quality. High use of technology for romantic relationship maintenance buffered against the negative effects of self-isolation during the COVID-19 pandemic on adolescents' romantic relationship quality 7 months later, whereas low use strengthened the negative relationship between self-isolation during the COVID-19 pandemic and romantic relationship quality. These findings suggest the importance of considering the implications of societal crisis or pandemics on adolescents' close relationships, particularly their romantic relationships.

The sudden switch to distance education to contain the outbreak of the COVID-19 pandemic has fundamentally altered adolescents' lives around the globe. The present research aims to identify psychological characteristics that relate to adolescents' well-being in terms of positive emotion and intrinsic learning motivation, and key characteristics of their learning behavior in a situation of unplanned, involuntary distance education. Following Self-Determination Theory, experienced competence, autonomy, and relatedness were assumed to relate to active learning behavior (i.e., engagement and persistence), and negatively relate to passive learning behavior (i.e., procrastination), mediated via positive emotion and intrinsic learning motivation. Data were collected via online questionnaires in altogether eight countries from Europe, Asia, and North America (N = 25,305) and comparable results across countries were expected. Experienced competence was consistently found to relate to positive emotion and intrinsic learning motivation, and, in turn, active learning behavior in terms of engagement and persistence. The study results further highlight the role of perceived relatedness for positive emotion. The high proportions of explained variance speak in favor of taking these central results into account when designing distance education in times of COVID-19., Competing Interests: The authors have declared that no competing interests exist.

Beta-catenin (BC) mutations are associated with a high risk of recurrence in otherwise low-grade, early-stage uterine endometrioid adenocarcinomas. Recent literature suggests nuclear BC expression by immunohistochemistry is highly sensitive and specific for BC mutations. The significance of BC expression in endometrioid intraepithelial neoplasia (EIN/atypical hyperplasia) and its relationship to altered differentiation patterns in EIN has yet to be fully explored. Cases meeting current diagnostic criteria for EIN based on H&E examination were obtained from 2 institutions (years 1999-2014). Patterns of altered differentiation (eg, tubal, squamous morular metaplasia, mucinous, secretory) were noted. Representative blocks were stained for BC, and expression patterns recorded. Follow-up and demographic data was obtained from the electronic medical record. Ninety-six cases were included (84 biopsies, 12 hysterectomies). BC nuclear expression was identified in 41 cases (42.7%), with 33 of 41 demonstrating foci of nonmorular BC staining. BC staining in any component of EIN was not significantly associated with the presence of carcinoma on subsequent hysterectomy (P=0.79). When restricting to nonmorular BC, the results were the same (P=0.56). Cases with tubal differentiation were significantly less likely to demonstrate nonmorular BC than cases with no specific pattern of differentiation (P<0.01). EIN frequently demonstrates BC nuclear positivity, especially in cases without tubal differentiation. BC nuclear expression in EIN does not appear to be associated with an increased likelihood of carcinoma on subsequent hysterectomy. Our results do not support routine use of BC immunohistochemistry as a prognostic biomarker in cases of EIN., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 by the International Society of Gynecological Pathologists.)

Sexting among adolescents has triggered controversial debates among scholars and the general public. However, questions regarding the associations between different types of sexting, namely consensual, non-consensual, and pressured sexting, depressive symptoms, and non-suicidal self-harm remain. In addition, little attention has been given to whether demographic variables (i.e., gender, ethnicity, disability, sexual minority) might influence these associations. To fill these gaps in the literature, the present study was conducted. Participants were 2506 adolescents (ages 13-16 years old; M age = 15.17; SD age = 0.89) from eight high schools located in the suburbs of a large Midwestern city in the United States. Adolescents self-identified as female (50%), Caucasian (57%), approximately 15% reported that they had a disability they received school accommodation for, and 18% self-identified as a sexual minority. They completed self-report questionnaires on their sexting behaviors, depressive symptoms, and non-suicidal self-harm. Findings revealed that non-consensual and pressured sexting were positively related to depressive symptoms and non-suicidal self-harm, whereas consensual sexting was unrelated to these outcomes. Boys engaged in more non-consensual sexting compared with girls, girls were more pressured to send sexts compared with boys, and sexual minority adolescents reported greater consensual sexting compared with non-sexual minority adolescents. Moderating effects revealed that girls, non-minority adolescents, and non-sexual minority adolescents experienced greater depressive symptoms and non-suicidal self-harm when they experienced pressured sexting. These findings underscore the importance of considering various types of sexting and adolescents' demographic variables when examining the negative outcomes of sexting. Disentangling the relationships among different types of sexting, depressive symptoms, and self-harm aids in the development of evidence-based recommendations for sexting harm prevention and sexual education programs.

As competition over peer status becomes intense during adolescence, some adolescents develop insecure feelings regarding their social standing among their peers (i.e., social status insecurity). These adolescents sometimes use aggression to defend or promote their status. The aim of this study was to examine the relationships among social status insecurity, callous-unemotional (CU) traits, and popularity-motivated aggression and prosocial behaviors among adolescents, while controlling for gender. Another purpose was to examine the potential moderating role of CU traits in these relationships. Participants were 1,047 (49.2% girls; M age = 12.44 years; age range from 11 to 14 years) in the 7th or 8th grades from a large Midwestern city. They completed questionnaires on social status insecurity, CU traits, and popularity-motivated relational aggression, physical aggression, cyberaggression, and prosocial behaviors. A structural regression model was conducted, with gender as a covariate. The model had adequate fit. Social status insecurity was associated positively with callousness, unemotional, and popularity-motivated aggression and related negatively to popularity-motivated prosocial behaviors. High social status insecurity was related to greater popularity-motivated aggression when adolescents had high callousness traits. The findings have implications for understanding the individual characteristics associated with social status insecurity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wright, Wachs and Huang.)

Background: High-risk human papillomavirus-positive (hrHPV+) oropharyngeal squamous cell carcinomas comprise a subset of head and neck squamous cell carcinomas (HNSCCs) with a distinct biology and prognosis. Commonly, the diagnosis of HNSCC is rendered on fine-needle aspiration (FNA). Because cell blocks may be insufficient for determining HPV status using microscopy-based techniques, the ability of liquid-based assays was examined in the current study., Methods: The performance of the Roche cobas 4800 platform was evaluated on the FNA material from the cell pellet and corresponding cell-free supernatant fluid specimens of primary and metastatic HNSCCs. These results were compared with the p16 immunostain result from the histologic material obtained from the same patient. Discrepant cases were adjudicated using hrHPV RNA in situ hybridization., Results: A total of 41 samples (23 primary tumors and 18 lymph node metastases) were acquired from 34 patients with HNSCC. Primary tumors included the oropharynx (20 samples), oral cavity (13 samples), larynx (3 samples), and skin (3 samples). In 2 cases, a primary tumor could not be identified. Twenty-three samples (56%) were found to be p16 positive by immunohistochemistry. Twenty-two samples were found to be positive on cobas hrHPV testing from both cell pellet and cell-free supernatant fluid. Two cell-free supernatant fluid specimens yielded indeterminate cobas results. At the time additional hrHPV RNA in situ hybridization analysis was performed, one cobas-positive cell pellet was deemed to be a false-positive result. The sensitivity of the cobas assay was 100% for pellet material and cell-free supernatant fluid, with specificities of 94.7% and 100%, respectively., Conclusions: cobas hrHPV testing of HNSCC specimens demonstrated high concordance with p16 immunohistochemistry on the corresponding cell block and/or tissue specimen. Using the cell-free supernatant fluid in this platform could provide accurate HPV results while conserving material for cytomorphologic analyses., (© 2020 American Cancer Society.)

The relationship among cyberbullying victimization, lower self-esteem, and internet addiction has been well-established. Yet, little research exists that explains the nature of these associations, and no previous work has considered the inability to identify or describe one's emotions, namely, alexithymia, as a potential mediator of these links. The present study sought to investigate the indirect effects of cyberbullying victimization on self-esteem and internet addiction, mediated by alexithymia. The sample consisted of 1,442 participants between 12 and 17 years ( M age = 14.17, SD = 1.38, 51.5% male) from Germany, the Netherlands, and the United States. Results showed a direct relationship between cyberbullying victimization and self-esteem and an indirect association mediated by alexithymia in the Dutch sample. However, in the German and U.S. samples, only an indirect relationship via alexithymia, but not a direct effect of cyberbullying victimization on self-esteem, was found. Consistent across the three country samples, cyberbullying victimization and internet addiction were directly and also indirectly associated via alexithymia. In sum, findings indicate that alexithymia might help better understand which detrimental effects cyberbullying victimization has on adolescent psychological health. Thus, cyberbullying prevention programs should consider implementing elements that educate adolescents on the ability to identify and describe their own emotions., (Copyright © 2020 Wachs, Vazsonyi, Wright and Ksinan Jiskrova.)

The present study focused on the impact of gender and gender stereotype traits (i.e., masculinity, femininity) on cyber aggression perpetration utilizing different technologies (i.e., social-networking sites, gaming consoles, mobile phones) and behaviors (i.e., cyber relational aggression, cyber verbal aggression, hacking). Participants included 233 eighth graders (108 female; M age = 13.26, SD = 0.36) from two middle schools in the Midwestern United States. Adolescents completed questionnaires on their endorsement of masculinity and femininity traits as well as how often they engaged in cyber aggression perpetration (i.e., cyber relational aggression, cyber verbal aggression, hacking) through mobile phones, social-networking sites, and gaming consoles. Findings indicated that boys and girls with more feminine traits engaged in more cyber relational aggression through social-networking sites and mobile phones, while boys and girls who endorsed more masculine traits perpetrated this behavior and cyber verbal aggression more often through online gaming. In addition, these boys and girls engaged in more hacking through all technologies when compared with girls and boys who reported more feminine traits. Results of this study indicate the importance of delineating gender stereotype traits, behaviors, and technologies when examining cyber aggression perpetration.

Little attention has been given academically to empirically tested theoretical frameworks that aim at measuring the risk of adolescents falling victim to cybergrooming. To this end, we have applied the routine activity theory (RAT) to investigate whether exposure to motivated offenders (PC/laptop ownership and Internet access in one's own bedroom), capable guardianship (parental mediation strategies of Internet use), and target suitability (adolescents' online disclosure of private information) might predict cybergrooming victimization among adolescents. Using data from a cross-sectional survey of 5,938 adolescents from Germany, India, South Korea, Spain, Thailand, and the United States, ranging in age from 12 to 18 ( M  = 14.77, SD  = 1.60), we found that PC/laptop ownership and Internet access in one's own bedroom, parental mediation, and online disclosure are all directly associated with cybergrooming victimization. Although instructive parental mediation is negatively related to online disclosure and cybergrooming victimization, restrictive mediation is positively related to both. In addition, online disclosure partially mediated the relationship between parental mediation and cybergrooming victimization. The analyses confirm the effectiveness of applying RAT to cybergrooming. Moreover, this study highlights the need for prevention programs, including lessons on age-appropriate information and communication technology usage and access, to educate parents on using instructive strategies of Internet mediation, and inform adolescents about how to avoid disclosing too much private information online. RAT could function as a theoretical framework for these programs.

The purpose of the present study was to investigate the role of gender and gender stereotype traits (masculinity, femininity) in cyber victimization behaviors (cyber relational victimization, cyber verbal victimization, hacking) through different technologies (mobile phones, gaming consoles, social networking sites). There were 456 8th graders (226 females; M age = 13.66, SD = 0.41) from two midwestern middle schools in the United States included in this study. They completed questionnaires on their endorsement of masculine and feminine traits, and self-reported cyber victimization through different technologies. The findings revealed main effects of types of cyber victimization for boys and of technology for girls. In particular, boys with feminine traits experienced the most victimization by cyber verbal aggression, cyber relational aggression, and hacking when compared to the other groups of boys. Girls with feminine traits experienced the most cyber victimization through social networking sites, gaming consoles, and mobile phones in comparison to the other groups of girls. For girls with feminine traits, they reported more cyber relational victimization and cyber verbal victimization through mobile phones and social networking sites, as well as more hacking via social networking sites. Such findings underscore the importance of considering gender stereotype traits, types of victimization, and technologies when examining cyber victimization., Competing Interests: The authors declare no conflict of interest.

Despite a well-established manufacturing-process understanding, tablet quality issues are frequently encountered during various stages of drug-product development. Compact breaking force (tensile strength), capping and friability are among the commonly observed characteristics that determine the integrity, quality and manufacturability of tablets. In current study, a design space of the compaction pressure, compaction speed and head flat types is introduced for solid dosage compacts prepared from pure silicified microcrystalline cellulose, a popular tableting excipient. In the reported experiments, five types of head flat types at six compaction pressure levels and two compaction speeds were employed and their effects on compact mechanical properties evaluated. The mechanical properties of the tablets were obtained non-destructively. It is demonstrated these properties correlate well with compact porosity and tensile strength, thus their availability is of practical value. The reported mechanical properties are observed to be linearly sensitive to the tableting speed and compaction pressure, and their dependency on the head-flat profile, while clearly visible in the presented waveforms, was found to be nonlinear in the range of the parameter space. In this study, we detail a non-destructive, easy-to-use approach for characterizing the porosity and tensile strength of pharmaceutical tablets., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier B.V. All rights reserved.)

We applied the Social Cognitive Theory to investigate whether parent-child relationships, bullying victimization, and teacher-student relationships are directly as well as indirectly via self-efficacy in social conflicts associated with adolescents' willingness to intervene in a bullying incident. There were 2071 (51.3% male) adolescents between the ages of 12 and 17 from 24 schools in Germany who participated in this study. A mediation test using structural equation modeling revealed that parent-child relationships, bullying victimization, and teacher-student relationships were directly related to adolescents' self-efficacy in social conflicts. Further, teacher-student relationships and bullying victimization were directly associated with adolescents' willingness to intervene in bullying. Finally, relationships with parents, peers and teachers were indirectly related to higher levels of students' willingness to intervene in bullying situations due to self-efficacy in social conflicts. Thus, our analysis confirms the general assumptions of Social Cognitive Theory and the usefulness of applying its approach to social conflicts such as bullying situations.

Background: Plasminogen activator inhibitor-1 (PAI-1) expression increases extracellular matrix deposition and contributes to interstitial fibrosis in the kidney after injury. While PAI-1 is ubiquitously expressed in the kidney, we hypothesized that interstitial fibrosis is strongly dependent on fibroblast-specific PAI-1 (fbPAI-1)., Methods: Tenascin C Cre (TNC Cre) and fbPAI-1 knockdown (KD) mice with green fluorescent protein (GFP) expressed within the TNC construct underwent unilateral ureteral obstruction and were sacrificed 10 days later., Results: GFP+ cells in fbPAI-1 KD mice showed significantly reduced PAI-1 expression. Interstitial fibrosis, measured by Sirius red staining and collagen I western blot, was significantly decreased in fbPAI-1 KD compared with TNC Cre mice. There was no significant difference in transforming growth factor β (TGF-β) expression or its activation between the two groups. However, GFP+ cells from fbPAI-1 KD mice had lower TGF β and connective tissue growth factor (CTGF) expression. The number of fibroblasts was decreased in fbPAI-1 KD compared with TNC Cre mice, correlating with decreased alpha smooth muscle actin (α-SMA) expression and less fibroblast cell proliferation. TNC Cre mice had decreased E-cadherin, a marker of differentiated tubular epithelium, in contrast to preserved expression in fbPAI-1 KD. F4/80-expressing cells, mostly CD11c+/F4/80+ cells, were increased while M1 macrophage markers were decreased in fbPAI-1 KD compared with TNC Cre mice., Conclusion: These findings indicate that fbPAI-1 depletion ameliorates interstitial fibrosis by decreasing fibroblast proliferation in the renal interstitium, with resulting decreased collagen I. This is linked to decreased M1 macrophages and preserved tubular epithelium., (© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Online hate is a topic that has received considerable interest lately, as online hate represents a risk to self-determination and peaceful coexistence in societies around the globe. However, not much is known about the explanations for adolescents posting or forwarding hateful online material or how adolescents cope with this newly emerging online risk. Thus, we sought to better understand the relationship between a bystander to and perpetrator of online hate, and the moderating effects of problem-focused coping strategies (e.g., assertive, technical coping) within this relationship. Self-report questionnaires on witnessing and committing online hate and assertive and technical coping were completed by 6829 adolescents between 12 and 18 years of age from eight countries. The results showed that increases in witnessing online hate were positively related to being a perpetrator of online hate. Assertive and technical coping strategies were negatively related with perpetrating online hate. Bystanders of online hate reported fewer instances of perpetrating online hate when they reported higher levels of assertive and technical coping strategies, and more frequent instances of perpetrating online hate when they reported lower levels of assertive and technical coping strategies. In conclusion, our findings suggest that, if effective, prevention and intervention programs that target online hate should consider educating young people about problem-focused coping strategies, self-assertiveness, and media skills. Implications for future research are discussed.

Cyber victimization research reveals various personal and contextual correlations and negative consequences associated with this experience. Despite increasing attention on cyber victimization, few studies have examined such experiences among ethnic minority adolescents. The purpose of the present study was to examine the moderating effect of ethnicity in the longitudinal associations among cyber victimization, school-belongingness, and psychological consequences (i.e., depression, loneliness, anxiety). These associations were investigated among 416 Latinx and white adolescents (46% female; M age = 13.89, SD = 0.41) from one middle school in the United States. They answered questionnaires on cyber victimization, school belongingness, depression, loneliness, and anxiety in the 7th grade (Time 1). One year later, in the 8th grade (Time 2), they completed questionnaires on depression, loneliness, and anxiety. Low levels of school-belongingness strengthened the positive relationships between cyber victimization and Time 2 depression and anxiety, especially among Latinx adolescents. The positive association between cyber victimization and Time 2 loneliness was strengthened for low levels of school-belongingness for all adolescents. These findings may indicate that cyber victimization threatens adolescents' school-belongingness, which has implications for their emotional adjustment. Such findings underscore the importance of considering diverse populations when examining cyber victimization.

The goal of this three-year longitudinal study was to examine the buffering effect of parental mediation of adolescents' technology use (i.e., restrictive, co-viewing, and instructive) on the relationships among cyber aggression involvement and substance use (i.e., alcohol use, marijuana use, cigarette smoking, and non-marijuana illicit drug use). Overall, 867 ( M age = 13.67, age range from 13-15 years, 51% female, 49% White) 8th grade adolescents from the Midwestern United States participated in this study during the 6th grade (Wave 1), 7th grade (Wave 2), and 8th grade (Wave 3). Results revealed that higher levels of Wave 2 instructive mediation weakened the association between Wave 1 cyber victimization and Wave 3 alcohol use and Wave 3 non-marijuana illicit drug use. The relationship was stronger between Wave 1 cyber victimization and Wave 3 alcohol use and Wave 3 non-marijuana illicit drug use when adolescents reported lower levels of Wave 2 instructive mediation. At lower levels of Wave 2 instructive mediation, the association between Wave 1 cyber aggression perpetration and Wave 3 non-marijuana illicit drug use was stronger. Implications of these findings are discussed in the context of parents recognizing their role in helping to mitigate the negative consequences associated with adolescents' cyber aggression involvement.

Background: Problem behaviour theory postulates that different forms of norm violations cluster and can be explained by similar antecedents. One such cluster may include cyberbullying and cyberhate perpetration. A potential explanatory mechanism includes toxic online disinhibition, characterised by anonymity, an inability to empathise and to recognise and interpret social cues. The current study to develop a better understanding of the relationship between cyberhate and cyberbullying to inform effective intervention and prevention efforts., Aims: To test the link between cyberbullying and cyberhate and whether this relationship was moderated by toxic online disinhibition., Methods: Self-report questionnaires on cyberbullying, cyberhate, and toxic online disinhibition were completed by 1,480 adolescents between 12 and 17 years old (M = 14.21 years; SD = 1.68)., Results: Increases in cyberbullying perpetration and toxic online disinhibition were positively related to cyberhate perpetration. Furthermore, cyberbullies reported more cyberhate perpetration when they reported higher levels of toxic online disinhibition and less frequent cyberhate perpetration when they reported lower levels of toxic online disinhibition., Conclusion: The current study provides evidence of a possible link between cyberbullying and cyberhate perpetration, moderated by toxic online disinhibition. This suggests that, to be effective, prevention and intervention programmes should (i) consider the co-occurrence of varying forms of cyberaggression and (ii) consider potential effects of the online environment on aggressive online behaviour among young people., (© 2019 John Wiley & Sons, Ltd.)

Introduction: This study examined the relationship between racial discrimination by peers and aggression (i.e., self-reported and peer-nominated relational aggression and physical aggression) across one year through the moderation of social support from parents, friends, and teachers., Methods: Participants were 606 Latinx adolescents from the United States (60% girls; M = 14.36, SD = 0.46). They completed self-report questionnaires on their perceived racial discrimination by peers, and self-reported and peer-nominated relational and physical aggression., Results & Conclusions: Racial discrimination by peers was negatively associated with social support from parents, friends, and teachers, as well as positively related to all forms of Time 2 (1 year) self-reported and peer-nominated relational aggression and physical aggression. Social support from parents, friends, and teachers were negatively related to all forms of Time 2 aggressive behaviors. Increases in social support from parents, friends, and teachers weakened the positive association between racial discrimination by peers and Time 2 self-reported and peer-nominated relational aggression, while lower levels of social support strengthened this association. There were no significant moderating effects of social support from parents, social support, and close friends found for Time 2 self-reported and peer-nominated physical aggression. These findings indicate that high social support from parents, friends, and teachers impacts Latinx adolescents reduces the impact of racial discrimination by peers on adolescents' relational aggression., (Copyright © 2019 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Online hatred based on attributes, such as origin, race, gender, religion, or sexual orientation, has become a rising public concern across the world. Past research on aggressive behavior suggests strong associations between victimization and perpetration and that toxic online disinhibition and sex might influence this relationship. However, no study investigated both the relationship between online hate victimization and perpetration and the potential moderation effects of toxic online disinhibition on this relationship. To this end, the present study was conducted. The sample consists of 1,480 7th to 10th graders from Germany. Results revealed positive associations between online hate victimization and perpetration. Furthermore, the results support the idea that toxic online disinhibition and sex, by way of moderator effects, affect the relationship between online hate victimization and perpetration. Victims of online hate reported more online hate perpetration when they reported higher levels of online disinhibition and less frequent online hate perpetration when they reported lower levels of toxic online disinhibition. Additionally, the relationship between online hate victimization and perpetration was significantly greater among boys than among girls. Taken together, our results extend previous findings to online hate involvement among adolescents and substantiate the importance to conduct more research on online hate. In addition, our findings highlight the need for prevention and intervention programs that help adolescents deal with the emerging issue of online hate.

The liver and peritoneum are the 2 most common distant metastatic sites for small intestinal neuroendocrine tumors (SI-NET). In this study, we evaluated the differential impact of hepatic and/or peritoneal metastasis on prognosis of SI-NET patients. Surgical Pathology archives were searched for SI-NET resections performed between January 1, 1994 and August 31, 2017. Two hundred nineteen cases with clinical follow-up data were identified. Pathology reports and electronic medical records were reviewed. The 219 patients included 104 females and 115 males with a median age of 59 years (range, 19 to 85 y). There were 71 (33%) cases without hepatic or peritoneal metastasis, 80 (37%) with hepatic metastasis only, 14 (6%) with peritoneal metastasis only, and 53 (24%) with both hepatic and peritoneal metastasis at the time of surgery or during follow-up. The number of primary tumors, largest tumor size, lymph node metastasis, pT category, and sex were not significant independent prognostic factors in multivariate Cox proportional hazard regression. Age was the only variable other than presence of metastatic disease that was associated with worse prognosis (5% increase in risk/year of age; 95% confidence interval, 1.7%-8.2%; P=0.003). After controlling for patient age, pairwise comparisons of marginal linear predictions showed increased risk with peritoneal metastasis, with or without associated hepatic metastasis, compared to hepatic metastasis only. In conclusion, although limited by the number of patients with peritoneal metastasis only, these results support substratifying patients with metastatic SI-NET by anatomic site of metastasis.

While the consequences of cyberbullying victimization have received some attention in the literature, to date, little is known about the multiple types of strains in adolescents' lives, such as whether cyberbullying victimization and peer rejection increase their vulnerability to depression and anxiety. Even though some research found that adolescents with disabilities show higher risk for cyberbullying victimization, most research has focused on typically developing adolescents. Thus, the present study focused on examining the moderating effect of peer rejection in the relationships between cyberbullying victimization, depression, and anxiety among adolescents with autism spectrum disorder. There were 128 participants (89% male; ages ranging from 11⁻16 years old) with autism spectrum disorder in the sixth, seventh, or eighth grade at 16 middle schools in the United States. Participants completed questionnaires on cyberbullying victimization, peer rejection, depression, and anxiety. Results revealed that cyberbullying victimization was associated positively with peer rejection, anxiety, and depression among adolescents with autism spectrum disorder. Further, peer rejection was linked positively with depression and anxiety. Peer rejection moderated the positive relationship between cyberbullying victimization and depression, but not anxiety. Implications for prevention programs and future research are discussed.

Objectives: Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT., Methods: Data collection included demographics, preoperative and intraoperative data, blood utilization, and cost data. Statistical analysis was performed using R software., Results: Total blood product utilization was reduced by approximately 50%. Statistically significant decreases were noted in blood product usage in the intraoperative and first 48-hour postoperative utilization, the number of OLTs using fewer than five RBC units, length of hospital stay, and cost., Conclusions: This study showed successful implementation of quality improvement team interventions to reduce blood utilization during OLT. Reduced transfusion significantly correlated with decreased length of hospital stay and cost., (© American Society for Clinical Pathology, 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)