Perceived consequences of hazing exposure during the first year of college: Associations with childhood victimization.

Objective: This study investigates the association between histories of childhood victimization and perceived consequences of college hazing. Participants: First-year college students at four US universities (N = 120). Method: Participants completed Web-based surveys asking about childhood victimization (eg, child maltreatment), peer victimization, and perceived consequences of hazing during college. Results: Results indicated that college students with childhood victimization histories perceived hazing to be negative. In particular, physical dating violence and a greater total number of childhood victimization exposures were related to a higher number of perceived negative consequences. Conclusion: Past victimization exposures confer risk on college students who experience hazing, in that these students are more likely to perceive negative consequences of hazing. Hazing-related policies and outreach efforts should consider these potential negative consequences, and counselors should be aware of the link between past victimization and how hazing might be experienced.

Using Research-Informed Pedagogical Practices to Maximize Learning in Youth Cognitive Behavioral Therapy.

Cognitive-behavioral therapy (CBT) for youth is an evidence-based treatment that typically starts with some form of psychoeducation, during which the patient is taught in a didactic manner about their presenting problems and strategies to ameliorate their symptoms. The learning process continues over the course of treatment as patients consolidate and attempt to utilize their aqcuired knowledge in their daily life. Manuals provide helpful structure and strategies to facilitate this learning process (e.g., using metaphors, personalized coping cards); however, there is variability across patients in terms of what presented content they will be able to access and understand, how they can most effectively transfer what they learn into their everyday life, and why they will become engaged in this learning process. The purpose of this paper is to connect CBT and pedagogy by outlining the research-informed pedagogical framework known as Universal Design for Learning (UDL) as it relates to the teaching and learning that takes place in CBT. First, we describe UDL as a lens through which clinicians can conceptualize evidence-based pedagogical principles that undergird common CBT teaching practices. Second, we recommend that clinicians use UDL as a guiding framework when they are faced with barriers to learning due to the variability that exists in how patients engage in, access and understand, and utilize the material. We posit that UDL can help clinicians ensure that more patients are able to successfully access and benefit from CBT.

School- and Classroom-Based Supports for Children Following the 2013 Boston Marathon Attack and Manhunt.

School staff provide key mental health services following mass crisis events and teachers, in particular, can provide important supports within their classrooms. This study examines Boston-area teachers' perception of classroom-wide psychiatric distress and the types of supports that schools and teachers provided following the 2013 Boston Marathon bombing and subsequent manhunt. Boston-area K-12 teachers (N = 147) in communities with varying levels of exposure to the bombing and manhunt completed an anonymous web-based survey 2-5 months after the attack. Teachers reported on students' exposure to the bombings and manhunt, classroom-wide psychiatric distress, and the types of supports they and their schools provided students. Teacher reports of student exposure to the bombings and manhunt were significantly associated with their perceptions of greater classroom-wide psychiatric distress. Almost half indicated that their school had no formal policy for responding to the crisis, half reported no training to address events, and even the most common classroom-based support strategy-reassuring students of their safety-was provided by only 76 % of teachers. Teacher perceptions of student exposure to the manhunt, but not the bombing, were significantly associated with greater provision of these supports. In the aftermath of the Boston Marathon bombings and manhunt, teachers and schools provided supports; however, the extent and types of supports varied considerably. Working with teachers to most effectively and consistently serve in this complex role has the potential to improve school-based crisis response plans, as well as student outcomes.

Bullying and suicidal ideation and behaviors: a meta-analysis.

BACKGROUND AND OBJECTIVES: Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. METHODS: We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. RESULTS: Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67-2.69] to 4.02 [95% CI, 2.39-6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study's country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. CONCLUSIONS: Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior.

Associations between past bullying experiences and psychosocial and academic functioning among college students.

OBJECTIVES: This study examined whether childhood bullying victimization was associated with psychosocial and academic functioning at college. PARTICIPANTS: The sample consisted of 413 first-year students from a large northeastern university. METHODS: Students completed an online survey in February 2012 that included items assessing past bullying involvement, current psychosocial and academic functioning, and victimization experiences since arriving at college. RESULTS: Regression analyses indicated that reports of past bullying and other peer victimization were associated with lower mental health functioning and perceptions of physical and mental health, but were not associated with perceptions of social life at college, overall college experience, or academic performance. CONCLUSIONS: Childhood bullying victimization is associated with poorer mental and physical health among first-year college students. Colleges should consider assessing histories of bullying victimization, along with other past victimization exposures, in their service provision to students.

Sexual risk taking and bullying among adolescents.

BACKGROUND: Psychological and educational correlates of bullying have been explored extensively. However, little information is available about the link between bullying and sexual risk-taking behaviors among adolescents, though for some youth it may be that sexual risk taking emerges in response to bullying involvement. Associations for both heterosexual youth and those who identify as gay, lesbian, bisexual, transgender, or questioning (GLBTQ) should be considered, as should the influence of victimization exposures in other domains. Accordingly, associations among bullying, other victimization forms, and sexual risk-taking behaviors were examined among adolescents with particular consideration to sexual orientation. METHODS: A sample of 8687 high school students completed the Dane County Youth Survey, a countywide survey administered high school students from 24 schools. Participants were asked questions about their bullying involvement and sexual risk-taking behaviors (ie, engaging in casual sex and having sex while under the influence of alcohol or drugs). RESULTS: Results indicated that bullies and bully-victims were more likely to engage in casual sex and sex under the influence. In multivariate analyses, these findings held even after controlling for demographic characteristics and victimization exposures in other domains, but primarily for heterosexual youth. CONCLUSIONS: Bullies and bully-victims engaged in more sexual risk-taking behaviors, although patterns of association varied by sexual orientation. Bullying prevention programs and programs aimed at reducing unhealthy sexual practices should consider a broader stress and coping perspective and address the possible link between the stress of bullying involvement and maladaptive coping responses.

Medication prescribing patterns in ambulatory haemodialysis patients: comparisons of USRDS to a large not-for-profit dialysis provider.

BACKGROUND: End-stage renal disease (ESRD) patients are prescribed numerous medications. The United States Renal Data System (USRDS) reported on medication prescribing patterns in 1998. Since then, several new medications, treatment guidelines and recommendations have been introduced. The objective was to analyse and compare haemodialysis (HD) patient medication prescribing patterns between the Dialysis Clinic, Inc. (DCI) database and the USRDS report. METHODS: Point-prevalent (01/01/03) medication use data from the DCI national database was obtained. Data collected included patient demographics, reason for and duration of ESRD, and medication listed on profile. All medications were classified similar to the USRDS and by where taken (clinic vs home). Medication prescribing patterns were compared between DCI and USRDS databases. Comparisons between age groups (<65 and >or=65 years) and diabetic status [diabetes mellitus (DM) vs non-DM] were made. RESULTS: There were 128 477 medication orders categorized in 10 474 patients. DCI patient demographics were similar to present USRDS patients except for fewer Hispanics (P<0.001). Patients were prescribed 12.3+/-5.0 (median 12) different medications (2.6+/-1.4 clinic medications and 10.0+/-4.5 home medications). This is higher than reported by USRDS (median 9 medications). Patient age did not influence number of medications used (P = 0.54). DM patients are prescribed more medications than non-DM (13.3+/-5.0 DM vs 11.6+/-4.8 non-DM; P<0.00001). All medication class prescribing patterns were markedly different. CONCLUSION: The data suggest that medication prescribing patterns in HD patients have changed. The audit identified appropriate and questionable prescribing patterns. Various prescribing patterns identified areas for improvement in care (e.g. increased use of aspirin, beta-blockers and hyperlipidaemia medications) and areas requiring further investigation (e.g. high use of anti-acid, benzodiazepine and non-aluminum/non-calcium phosphate-binding medications).

Factors associated with medication-related problems in ambulatory hemodialysis patients.

BACKGROUND: Hemodialysis (HD) patients are at risk for medication-related problems. Patient characteristics associated with the number of medication-related problems in HD patients have not been investigated. METHODS: Patient records were reviewed to identify medical problems, prescribed medications, medication indication(s), and medication-related problems. Medication classes and medication-related problems were compared between patients with and without diabetes mellitus (DM). Correlations were performed to determine whether associations exist between medication-related problems, number of medications, number of medication doses per day, number of comorbid conditions, patient age, and duration of end-stage renal disease while controlling for DM status. RESULTS: Medical records of 133 patients were evaluated. Patients were 60.5 +/- 15.2 years old, prescribed 11.0 +/- 4.2 medications, and had 6.0 +/- 2.3 comorbidities. Medication-related problems were identified in 97.7% of patients. Four hundred seventy-five medication-related problems were identified, averaging 3.6 +/- 1.8 medication-related problems per patient. Patients with DM had more medication-related problems identified than those without DM (303 versus 172 medication-related problems, respectively; P < 0.05). Medication-related problems correlated positively with number of patient comorbidities (P < 0.001). CONCLUSION: Medication-related problems are prevalent in virtually all HD patients. The number of medication-related problems in an individual patient increases as the number of comorbid conditions increases. The most frequent medication-related problems were drug without indication (30.9%), laboratory (27.6%), indication without drug use (17.5%), and dosing errors (15.4%). Patients with DM are at increased risk for medication-related problems. Health care providers taking care of HD patients should be aware of this problem, and efforts to avoid or resolve medication-related problems should be undertaken at all HD clinics.