A preliminary validation of PMQ-A four-factor questionnaire measuring parental mentalizing.

The present study describes the construction and preliminary validation of a new parental mentalizing scale, PMQ. Based on theory, we hypothesized that one higher-order parental mentalizing factor would comprise four dimensions of parental mentalizing: (1) Parental self-mentalizing (SELF), (2) Parental child-mentalizing (CHILD), (3) Effort (E), and (4) Curiosity (C). After modifying the content of one factor (Effort > Lack of Effort, LE), four-factor structure with one higher-order factor was confirmed in data collected from parents of children aged two to 6 years through social media and email lists (N = 321, 10% male). All factors loaded significantly on the higher-order factor, with acceptable internal consistencies. Next, PMQ factors were compared with the factors of a previously validated questionnaire, parental reflective functioning questionnaire (PRFQ). The PMQ and PRFQ factors were consistently and significantly correlated, indicating the validity of the PMQ as a measure of parental mentalization ability. The continuation of PMQ validation is discussed.

Heterogeneity of adolescent bullying perpetrators: Subtypes based on victimization and peer status.

We identified different types of adolescent bullying perpetrators and nonbullies based on peer-reported bullying, victimization, and peer status (popularity, likeability, and rejection) and examined differences between bully subtypes in typical forms of bullying perpetrated. Moreover, we studied how bully subtypes differed from nonbullies with varying levels of victimization and peer status in academic and psychosocial adjustment. The study utilizes data from 10,689 adolescents (48.3% boys, mean age 14.7 years). Latent profile analysis identified three distinct subgroups of bullies: popular-liked bullies (13.5%), popular-rejected bully-victims (5.8%), and bully-victims (6.9%), and four groups on nonbullies. High-status bullies (popular-liked and popular-rejected) resembled nonbullies in many ways and had even lower social anxiety, whereas bully-victims were the most maladjusted group. Overall, popularity seems to protect adolescents from social anxiety, and victimization is related to internalizing problems. Results suggest that bullying, victimization, and peer status can be used to identify distinct subtypes of bullies.

Effects of the KiVa anti-bullying program on defending behavior: Investigating individual-level mechanisms of change.

Given that defending victimized peers might help discourage bullying behavior and prevent its harmful consequences, various anti-bullying programs have attempted to increase defending behavior among participating children. However, the cognitions that underlie the effectiveness of interventions in increasing defending remain unknown. Data for this randomized controlled trial (RCT) of the KiVa anti-bullying program were collected in Finnish primary schools at baseline, after 5 months of implementation, and after 9 months of implementation and were used to examine the possible mediating role of seven psychological factors (empathy for the victim, feelings of responsibility to intervene, self-efficacy for defending, negative attitudes towards victims, and outcome expectations that defending would decrease or stop the bullying, be beneficial for one's status, and not increase one's risk of being victimized). Analyses conducted on a sample of 5731 children (baseline Mage = 11 years; 51% girls) revealed that the positive effects of KiVa on defending behavior after 9 months of implementation could partly be explained by the positive effects of the program on two factors (i.e., feelings of responsibility to intervene and expectations that the defending would make the bullying decrease or stop) after 5 months of implementation. This study provides information regarding the individual-level factors that anti-bullying interventions can target to successfully promote defending of victimized peers in primary schools.

Tailoring surface properties of liposomes for dexamethasone intraocular administration.

Diseases of the posterior eye segment are often characterized by intraocular inflammation, which causes, in the long term, severe impairment of eye functions and, ultimately, vision loss. Aimed at enhancing the delivery of anti-inflammatory drugs to the posterior eye segment upon intravitreal administration, we developed liposomes with an engineered surface to control their diffusivity in the vitreous and retina association. Hydrogenated soybean phosphatidylcholine (HSPC)/cholesterol liposomes were coated with (agmatinyl)6-maltotriosyl-acetamido-N-(octadec-9-en-1-yl)hexanamide (Agm6-M-Oleate), a synthetic non-peptidic cell penetration enhancer (CPE), and/or 5% of mPEG2kDa-DSPE. The zeta potential of liposomes increased, and the mobility in bovine vitreous and colloidal stability decreased with the Agm6-M-Oleate coating concentration. Oppositely, mPEG2kDa-DSPE decreased the zeta potential of liposomes and restored both the diffusivity and the stability in vitreous. Liposomes with 5 mol% Agm6-M-Oleate coating were well tolerated by ARPE-19 retina cells either with or without mPEG2kDa-DSPE, while 10 mol% Agm6-M-Oleate showed cytotoxicity. Agm6-M-Oleate promoted the association of liposomes to ARPE-19 cells with respect to plain liposomes, while mPEG2kDa-DSPE slightly reduced the cell interaction. Dexamethasone hemisuccinate (DH) was remotely loaded into liposomes with a loading capacity of ∼10 wt/wt%. Interestingly, mPEG2kDa-DSPE coating reduced the rate of DH release and enhanced the disposition of Agm6-M-Oleate coated liposomes in the ARPE-19 cell cytosol resulting in a more efficient anti-inflammatory effect. Finally, mPEG2kDa-DSPE enhanced the association of DH-loaded Agm6-M-Oleate coated liposomes to explanted rat retina, which reflected in higher viability of inner and outer nuclear layer cells.

Effectiveness of the KiVa Antibullying Program with and without the Online Game in Chile: a Three-Arm Cluster Randomized Controlled Trial.

Bullying is a major health problem. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on self-reported bullying victimization and perpetration. No evaluations of this program have been conducted in Latin America. A cluster randomized controlled trial was conducted at socially vulnerable schools in Santiago, Chile, to assess the effectiveness of the KiVa antibullying program in grades 5 and 6 (aged 10-12 years). Schools were randomly assigned (1:1:1) to three groups: the full KiVa group (including the online game), the partial KiVa group (did not include the online game), and the control group in which the regular school curriculum was implemented. The primary outcome was self-reported bullying victimization, assessed before the intervention (baseline) at the end of the academic year (November 2016) and post-intervention, 12 months after the baseline assessment (November 2017). This trial is registered with ClinicalTrials.gov, number NCT02898324. A total of 39 schools (13 in each group) were included; no schools withdrew. The baseline survey included 5923 participants, and the endpoint survey included 3968 participants. Participants in the partial KiVa group had lower bullying victimization at the endpoint survey than those in the control group (OBVQ-R adjusted mean difference - 0.14; 95% CI, - 0.26 to - 0.01; effect size - 0.13, 95% CI - 0.24 to - 0.01, p = 0.035). There was no effect of the full KiVa group for bullying victimization compared with the control and partial KiVa groups. Compared to the control group, participants in the partial KiVa group had lower witnessing bullying at school (adjusted mean difference = - 0.25; 95% CI - 0.45 to - 0.05; effect size - 0.18, 95% CI, - 0.32 to - 0.04, p = 0.013). No effects were found for other secondary outcomes, including bullying perpetration in any comparisons between arms. The implementation of the KiVa antibullying program had mixed results in Chile. There was only a small effect on bullying victimization and witnessing when KiVa was delivered without the online game.

Intention to Stop Bullying following a Condemning, Empathy-Raising, or Combined Message from a Teacher - Do Students' Empathy and Callous-Unemotional Traits Matter?

Knowing which intervention strategies work best and for which student is essential for teachers when they intervene in cases of bullying. The effects of teachers' (1) condemning, (2) empathy-raising, and (3) combined (including elements of both) messages on students' intention to stop bullying were tested in a between-subject experimental design. A total of 277 seventh grade students (Mage = 12.93, SD = 0.49; 47% female) were asked to imagine they had bullied a peer and were invited to a discussion with a teacher. They saw a video vignette with one of the above messages. Hierarchical regression analyses indicated that students' intention to stop bullying was highest among those who saw the combined message. Callous-unemotional traits were negatively, and affective and cognitive empathy positively associated with intention to stop bullying. Students' level of cognitive empathy moderated the relative effect of the condemning message on intention to stop bullying. At low levels of cognitive empathy, the condemning message was the least effective, whereas among those with high cognitive empathy, all messages were equally likely to lead to intention to stop bullying. Together, the findings suggest that for educators intervening in bullying among adolescents, an approach involving both condemning and empathy-raising messages is the 'best bet', most likely to lead to intention to stop bullying.

Facilitators and Barriers to the Sustainability of a School-Based Bullying Prevention Program.

The long-term sustainment of bullying prevention programs has rarely been investigated. This study addresses this gap by identifying facilitators and barriers to the systematic implementation of KiVa antibullying program in real-life conditions, after an evaluation trial. The study is based on focus group interviews with teachers from 15 Finnish primary schools implementing the KiVa program. The schools were selected based on the annual KiVa survey data, with the criteria of long-term involvement in delivering the program and reaching successful outcomes in terms of decreasing trends in bullying and victimization. By utilizing thematic analysis, we identified program-related, organizational, and contextual facilitators and barriers to sustainability. The results stress the importance of organizational factors in promoting program sustainability.

Rumination Mediates the Longitudinal Associations Between Elementary-School Victimization and Adolescents' Internalizing Problems.

Identifying potential mechanisms responsible for victimized children's maladjustment over time is a crucial step in our efforts to alleviate negative consequences of victimization. In this study, we examined whether rumination would serve as a potential mediator of the prospective links between victimization in late childhood and symptoms of depression and anxiety in adolescence. The sample included 552 Finnish students (238 boys; Mage in third grade = 9.85 years, SD = .71) who participated in a longitudinal study. Participants filled out several measures where they were asked about the frequency of different forms of victimization (in third and fourth grade), how much they ruminated about their past victimization and whether it elicited sadness and anger (in seventh grade), and the degree to which they experienced depressive and anxiety symptoms (in third and seventh grade). We found that greater frequency of victimization in elementary school led to increases in symptoms of depression and anxiety through rumination. These findings suggest that at least some victimization-related negative consequences can be minimized if we are able to help young people to stop reliving their painful memories.

Longitudinal associations between poor reading skills, bullying and victimization across the transition from elementary to middle school.

Students with poor reading skills and reading difficulties (RDs) are at elevated risk for bullying involvement in elementary school, but it is not known whether they are at risk also later in adolescence. This study investigated the longitudinal interplay between reading skills (fluency and comprehension), victimization, and bullying across the transition from elementary to middle school, controlling for externalizing and internalizing problems. The sample consists of 1,824 students (47.3% girls, T1 mean age was 12 years 9 months) from 150 Grade 6 classrooms, whose reading fluency and comprehension, self-reported victimization and bullying, and self-reported externalizing and internalizing problems were measured in Grades 6, 7, and 9. Two cross-lagged panel models with three time-points were fitted to the data separately for reading fluency and comprehension. The results indicated that poorer fluency and comprehension skills in Grade 6 predicted bullying perpetration in Grade 7, and poorer fluency and comprehension skills in Grade 7 predicted bullying perpetration in Grade 9. Neither fluency nor comprehension were longitudinally associated with victimization. The effects of reading skills on bullying perpetration were relatively small and externalizing problems increased the risk for bullying others more than poor reading skills did. However, it is important that those who struggle with reading get academic support in school throughout their school years, and social support when needed.

Diffusion and Protein Corona Formation of Lipid-Based Nanoparticles in the Vitreous Humor: Profiling and Pharmacokinetic Considerations.

The vitreous humor is the first barrier encountered by intravitreally injected nanoparticles. Lipid-based nanoparticles in the vitreous are studied by evaluating their diffusion with single-particle tracking technology and by characterizing their protein coronae with surface plasmon resonance and high-resolution proteomics. Single-particle tracking results indicate that the vitreal mobility of the formulations is dependent on their charge. Anionic and neutral formulations are mobile, whereas larger (>200 nm) neutral particles have restricted diffusion, and cationic particles are immobilized in the vitreous. PEGylation increases the mobility of cationic and larger neutral formulations but does not affect anionic and smaller neutral particles. Convection has a significant role in the pharmacokinetics of nanoparticles, whereas diffusion drives the transport of antibodies. Surface plasmon resonance studies determine that the vitreal corona of anionic formulations is sparse. Proteomics data reveals 76 differentially abundant proteins, whose enrichment is specific to either the hard or the soft corona. PEGylation does not affect protein enrichment. This suggests that protein-specific rather than formulation-specific factors are drivers of protein adsorption on nanoparticles in the vitreous. In summary, our findings contribute to understanding the pharmacokinetics of nanoparticles in the vitreous and help advance the development of nanoparticle-based treatments for eye diseases.

Different Approaches to Address Bullying in KiVa Schools: Adherence to Guidelines, Strategies Implemented, and Outcomes Obtained.

We examined the extent to which school personnel implementing the KiVa® antibullying program in Finland during 2009-2015 systematically employed the program-recommended approaches (confronting or non-confronting), used one or the other depending on the bullying case (case-specific approach), or used their own adaptation when talking to perpetrators of bullying, and whether they organized follow-up meetings after such discussions. In addition to investigating adherence to program guidelines, we tested how effective these different approaches were in stopping bullying. Finally, we tested the contribution of follow-up meetings and the number of years KiVa had been implemented in a school to the effectiveness of the interventions, using reports from both school personnel and victimized students. The data were collected annually across 6 years via online questionnaires and included responses from 1221 primary and secondary schools. The school personnel were more likely to use the confronting approach than the non-confronting approach. Over time, rather than sticking to the two program-recommended approaches, they made adaptations (e.g., combining the two; using their own approach). Two-level regression analyses indicated that the discussions were equally effective, according to both personnel and victimized students, when the confronting, non-confronting, or a case-specific approach had been used. The discussions were less effective when the personnel used their own adaptation or could not specify the method used. Perceived effectiveness was higher in primary school and when follow-up meetings were organized systematically after each intervention, but unrelated to the number of years KiVa had been implemented.

Sustainable antibullying program implementation: School profiles and predictors.

We examined the sustainability of the KiVa antibullying program in Finland from its nationwide roll-out in 2009 to 2016. Using latent class analyses, we identified four different patterns of implementation. The persistent schools (43%) maintained a high likelihood of participation throughout the study period. The awakened (14%) had a decreasing trend during the first years, but then increased the likelihood of program participation. The tail-offs (20%) decreased in the likelihood of participating after the third year, and the drop-offs (23%) already after the first year. The findings suggest that many schools need support during the initial years to launch and maintain the implementation of evidence-based programs; yet a large proportion of schools manage to sustain the program implementation for several years. The logistic regression analyses showed that large schools persisted more likely than small schools. Lower initial level of victimization was also related to the sustainability of the program. Finally, persistent program participation was predicted by several school-level actions during the initial years of implementing the program. These results imply that the sustainability of evidence-based programs could be enhanced by supporting and guiding schools when setting up the program during the initial implementation.

Two is more valid than one, but is six even better? The factor structure of the Self-Compassion Scale (SCS).

INTRODUCTION: Self-compassion refers to a non-evaluative, interconnected and mindful attitude towards oneself especially when facing difficulties or feelings of personal inadequacies. The Self-Compassion Scale (SCS) is a frequently used instrument designed to measure self-compassion either by using the six subscale scores, or by calculating a total score, averaged across all 26 items. PURPOSE: The purpose of this study is to examine the factor structure of the Self-Compassion Scale, and in particular, whether the widely used six-factor model and the unidimensional model can be confirmed. METHODS: The internal structure of the SCS was examined using confirmatory factor analysis (CFA). Six different models (a one-factor model, an oblique six-factor model, a higher-order model, an oblique two-factor model, a bi-factor model with one general factor (bifactor model) and a bi-factor model with two general factors, i.e. two-bifactor model) were tested in a sample of adolescents (n = 1725; 50.3% female; mean age = 16.56, SD = 1.95). All models were replicated using responses collected five months after the first data collection from 1497 students (W2), who were largely, but not completely, the same students involved in W1 data collection. RESULTS: Fit indices for the two-factor model implied an acceptable fit, but none of the remaining models tested met the criteria for an adequate solution. Although the fit indices for the six-factor model suggested an acceptable fit to the data, in this model the negative components of the SCS were highly correlated with each other, especially with the over-identification factor. CONCLUSION: The results of this study provide evidence to support the use of the separate self-compassion- and self-coldness -scores rather than the overall score of the SCS. Although the fit indices supported the six-factor model, the use of six subscale scores cannot be recommended on the basis of our results given the extremely high correlations within this model between some factors.

Pharmacokinetic aspects of retinal drug delivery.

Drug delivery to the posterior eye segment is an important challenge in ophthalmology, because many diseases affect the retina and choroid leading to impaired vision or blindness. Currently, intravitreal injections are the method of choice to administer drugs to the retina, but this approach is applicable only in selected cases (e.g. anti-VEGF antibodies and soluble receptors). There are two basic approaches that can be adopted to improve retinal drug delivery: prolonged and/or retina targeted delivery of intravitreal drugs and use of other routes of drug administration, such as periocular, suprachoroidal, sub-retinal, systemic, or topical. Properties of the administration route, drug and delivery system determine the efficacy and safety of these approaches. Pharmacokinetic and pharmacodynamic factors determine the required dosing rates and doses that are needed for drug action. In addition, tolerability factors limit the use of many materials in ocular drug delivery. This review article provides a critical discussion of retinal drug delivery, particularly from the pharmacokinetic point of view. This article does not include an extensive review of drug delivery technologies, because they have already been reviewed several times recently. Instead, we aim to provide a systematic and quantitative view on the pharmacokinetic factors in drug delivery to the posterior eye segment. This review is based on the literature and unpublished data from the authors' laboratory.