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Different patterns of sexting behaviors were examined to provide a more nuanced understanding of the context in which sexting occurs among adolescents. Participants were 1,000 Canadian adolescents (50.2% girls) between 12 and 18 years (M age = 15.21, SD = 2.00) who completed measures of sexting, cyber bullying and victimization, problematic social media use, self-regulation, and demographics. Contrary to our hypotheses, three latent profiles of sexting represented the frequency of sexting rather than whether the sexting was consensual versus non-consensual or with a partner versus non-partner. Participants in the moderate and high sexting profiles representing one fifth of youth, reported less self-regulation, experienced more cyber victimization, and engaged in more cyber bullying and problematic social media use than those in the no/low sexting profile. Our findings support the normalcy approach to education, which considers some sexting among healthy developmental behaviors. [ABSTRACT FROM AUTHOR]

This preliminary study explored a person-group dissimilarity hypothesis in the context of adolescent sexual harassment. Theory suggests that victimized youth are expected to experience worse outcomes if they perceive victimization to be a rare experience among their peers. This study comprised 435 middle school students who reported on their experiences of sexual harassment (victimization and witnessing), shame, and depressive symptoms. We tested a cross-sectional conditional indirect-effects model, with shame mediating the relationship between victimization and depressive symptoms (the indirect effect) and with witnessing as a moderator of the indirect effect. For all students, shame mediated the relationship between victimization and depressive symptoms. For female students, there was a buffering effect of witnessing, whereby the indirect effect was weaker at high levels of witnessing. These findings have potential implications for theory and intervention, suggesting the importance of examining young people's social contexts to better understand their responses to sexual harassment. [ABSTRACT FROM AUTHOR]

A substantial minority of adolescents experience and use dating violence in their sexual and/or romantic relationships. Limited attention has been paid to exploring theory-driven questions about use and experience of adolescent dating violence (ADV), restricting knowledge about promising prevention targets for diverse groups of youth. To address this gap, this paper investigates whether factors tied to power imbalances (bullying, risk of social marginalization) are associated with patterns of ADV victimization and perpetration in a large sample of Canadian mid-adolescents. We used data from the 2017/2018 Health-Behavior in School-Aged Children (HBSC) study, a nationally representative sample of Canadian youth. Our study was comprised of adolescents who were in grades 9 or 10, and who had dated in the past 12 months (N = 3779). We assessed multiple forms of ADV and bullying victimization and perpetration. We also included six variables assessing adolescents' risk of social marginalization: gender, race/ethnicity, immigration status, family structure, food insecurity, and family affluence. We used latent class analysis to explore the ways adolescents experience and use different forms of ADV, and then examined whether factors tied to power imbalances (bullying, social marginalization) were associated with classes of ADV. Three ADV classes emerged in our sample: uninvolved (65.7%), psychological and cyber victimization only (28.9%), and mutual violence (5.4%). Bullying was most strongly associated with the mutual violence class, suggesting a transformation of power from peer to romantic contexts. Social marginalization variables were associated with ADV patterns in different ways, highlighting the need to use a critical and anti-oppressive lens in ADV research and prevention initiatives. [ABSTRACT FROM AUTHOR]

The Promoting Relationships and Eliminating Violence Network (PREVNet) involves Canadian researchers and national organizations working to promote healthy relationships and prevent bullying. In this paper, we provide the rationale for establishing PREVNet, a description of the work of the network, and an assessment of the success of PREVNet. PREVNet’s strategic plan focuses on enhancing the practice of those who work with children and youth through knowledge mobilization under four strategy pillars: education and training, assessment and evaluation, prevention and intervention, and policy and advocacy. For this paper, we focus on proximal indicators of PREVNet’s success: growth of the network, participation in network activities, and development of knowledge mobilization resources. We illustrate that building partnerships with national organizations has been highly effective in the generation and dissemination of knowledge relating to children’s healthy development and healthy relationships. [ABSTRACT FROM PUBLISHER]

Bullying is a relationship problem in which power and aggression are used to cause distress to a vulnerable person. To assess and address bullying and victimization, we need to understand the nature of the problem, how the problem changes with age and differs for boys and girls, the relevant risk factors (those individual or environmental indicators that may lead to bullying and victimization), and the protective factors that buffer the impact of risk. For children involved in bullying, we need to assess its extent and the associated social, emotional, psychological, educational, and physical problems. Bullying is a systemic problem; therefore, assessments of bullying need to extend beyond the individual child to encompass the family, peer group, school, and community. We recommend that assessments at each of these levels reflect the scientific research on bullying and victimization. With attention to the problems associated with bullying, we can work collectively to make schools and communities safer for children and youth. [ABSTRACT FROM AUTHOR]

Youth who experience peer victimization are at risk of developing mental health problems. However, little is known about the emotional causal mechanisms linking peer victimization with these negative outcomes. This study investigated whether shame mediated this relationship. At three time points (T1-T3), 396 10- to 13-year-olds completed measures of peer victimization, shame (characterological, bodily, and behavioral; shame proneness), and mental health (depression, social anxiety, and externalizing behavior). Three multiple mediation models tested the indirect effects of T1 victimization on T3 mental health through the four T2 shame-related variables. Analyses revealed indirect effects for the shame-related mediators on depression, social anxiety, and externalizing behaviors. Specifically, indirect positive effects for characterological and bodily shame on depression and social anxiety were found, with greater bodily shame linked to higher levels of social anxiety in girls but not boys. In addition, an indirect negative effect for behavioral shame on externalizing problems was found, with higher levels of externalizing problems in victimized boys but not in girls. Finally, an indirect positive effect for shame proneness and externalizing problems was found. To clarify the directionality, three additional mediation models were run with mental health symptoms as predictors of shame and subsequent victimization. Indirect effects for the shame-related mediators were found for all outcomes, specifically bodily shame and shame proneness as mediators between internalizing and externalizing symptoms and victimization. These three models were compared and contrasted with the hypothesized models. In sum, findings support the role of shame as an underlying emotional mechanism of peer victimization, and may guide intervention programs to address the mental health concerns of victimized youth. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol is the most common substance use disorder in the United States. Despite this prevalence, there remains significant heterogeneity in medical management of alcohol withdrawal syndrome (AWS). While the 2020 American Society of Addition Medicine continues to recommend the use of benzodiazepines as first-line therapy for AWS, there is increasing use of phenobarbital in patients at high risk of severe AWS. Despite phenobarbital’s favorable pharmacologic profile, historically, clinical utilization on general medicine services has been low and often restricted. In this project, we have examined practice patterns and associated clinical outcomes in adult patients experiencing AWS on the general medicine service pre and post implementation of a phenobarbital-based protocol for the treatment of severe AWS at our institution. Methods: This quality improvement study evaluated changes in management of AWS on general medicine units associated with implementation of a phenobarbital-based protocol and order set in the electronic medical record (EMR). Our primary outcome measures were receipt of a phenobarbital loading dose, concomitant benzodiazepine administration, and total benzodiazepine dose. Safety outcomes were also explored to assess clinical impacts of this protocol implementation. The project was determined “not research” by our Institutional Review Board. Results: Phenobarbital-protocol implementation was associated with increased frequency of receiving a phenobarbital loading dose (49.5% vs 9.4%; P < .001), decreased use of concomitant benzodiazepine/phenobarbital (4.3% vs 28.9%; P < .001), and decreased total benzodiazepine dose (7.8 vs 15.5 mg; P < .001). Regarding safety, there was no significant pre/post difference in the rate of ICU transfer, but among those transferred there was a trend toward decreased mechanical ventilation rate (100% vs 28.6%; P = .051), and a significantly reduced ICU length of stay (median 11 vs 3 days; P = .04). There were no pre/post differences in seizures, delirium or use of adjunct medications. Conclusions: This quality improvement study demonstrates a marked change in provider prescribing practices for treating AWS after implementation of an institutional phenobarbital-based protocol. We observed no difference in overall clinical outcomes after protocol implementation, although a larger follow-up study is needed to confirm this and to further explore the shorter ICU length of stay for patients with AWS postimplementation. [ABSTRACT FROM AUTHOR]

Background: Surgery for Graves' disease may be performed with the intent of preserving thyroid function (subtotal thyroidectomy) or ablating thyroid function (total thyroidectomy). This study examines the evolving practice in a specialist endocrine surgical unit. Method: Longitudinal cohort study of patients undergoing surgery for Graves' disease between 1986 and 2008. Outcome measures were thyroid failure, recurrent toxicity, recurrent laryngeal nerve (RLN) palsy, early reoperation and hypocalcaemia. Time to thyroid failure was analysed by potential predictors. Results: Of 149 patients (129 female), 78 (52.3 percent) underwent subtotal thyroidectomy with the intention to preserve function (PF) and 71 (47.6 percent) total thyroidectomy with the intention to ablate thyroid function (AF). Mean duration of follow-up was 11.1 years; 14.8 years and 7.0 years respectively. Of 78 PF procedures: six (7.7 percent) patients suffered recurrent toxicity; 68 (87.2 percent) developed thyroid failure (four after treatment for recurrent toxicity); and eight (10 percent) remained euthyroid without replacement. Male gender and remnant gland weight were significant predictors of failure (P = 0.021 and 0.022 respectively). One patient developed permanent RLN palsy and one permanent hypocalcaemia. Of 71 AF procedures: one developed acute airway obstruction; one permanent RLN palsy; four permanent hypocalcaemia; and none developed recurrent toxicity. There were no deaths within a year of surgery. There was no statistically significant difference in complication rates. Conclusion: Most PF resections resulted in eventual thyroid failure. The shift to ablative surgery virtually eliminated the need for lifelong specialist follow-up, albeit with an insignificant rise in permanent hypocalcaemia. [ABSTRACT FROM AUTHOR]

In this study, 196 young adolescents who reported that they bullied their peers were identified out of a sample of 1, 758 students in Grades 5 through 8. After selecting from the total sample a group of nonbullying youth who were matched on gender, school, and grade, a comparison was made of the groups ' dating experiences, quality of friend and boyfriend or girlfriend relationships, and acts of physical and social aggression. The results indicated that bullies started dating earlier and engaged in more advanced dyadic dating than comparison adolescents. Bullies were highly relationship oriented, yet their views of their friends and boyfriends or girlfriends were less positive and less equitable than the comparison adolescents. Finally, bullies were more likely to report physical and social aggression with their boyfriends or girlfriends. Although the bullies reported more advanced pubertal development, this factor did not fully account for their dating precocity and negative romantic relationships. The results confirmed our hypotheses that adolescents whose peer relationships are characterized by bullying are at risk in their development of healthy romantic relationships. [ABSTRACT FROM AUTHOR]

Exposure to violence is recognized as a major health concern among adolescent populations. The evidence base that links religious involvement with risks for child violence is inconsistent. In a national analysis involving a weighted sample of 24,307 young people, we studied the perpetration of violence (fighting and bullying), as well as victimization by violence (bullying only), among young people who were affiliated with religious groups. One in four young Canadians reported involvement in such groups. Study findings confirmed some unique patterns among this group. First, these religiously involved children reported the same or greater levels of perpetration of violence than other children. Second, religiously involved children reported the same or greater levels of experiencing victimization from violence. Third, religious involvement appeared to protect against engagement in certain overt risk-taking behaviors, but not violence. These patterns were consistent even after adjustment for family, community, socioeconomic, and school-related determinants. If religious communities are to fulfill mandates that foster the protection and nurturing of children into healthy relationships, violence is best addressed using evidence-based strategies. Development of such effective preventive strategies requires the incorporation of contemporary evidence about the distribution, determinants, and possible effects of violence in such groups. Findings from our study suggest that a silence around the issue of violence may in fact be true in the context of some Canadian religious communities. Yet, if these communities make an intentional commitment to protecting children from violence and promoting healthy relationships, and are willing to learn from evidence-based practices that have shown to protect children from participating in and experiencing violent and victim behaviors, perhaps these disturbing trends could be reversed. This message is germane for all levels of leadership in Canadian religious communities. [ABSTRACT FROM AUTHOR]

We investigated the relation between relative deprivation (RD)—disparity in affluence between adolescents and their more affluent schoolmates—and involvement in bullying among 23,383 students (aged 9-19) in 413 schools that participated in the 2010 Canadian Health Behavior in School-Aged Children survey. Students reported family affluence and frequency of bullying victimization and perpetration during the previous 2 months. Using the Yitzhaki index of RD and multinomial logistic regression analysis, we found that RD positively related to three types of bullying victimization (physical, relational, and cyberbullying) and to two types of perpetration (relational and cyberbullying) after differences in absolute affluence were held constant. These findings suggest that RD uniquely contributes to risk of bullying involvement. [ABSTRACT FROM AUTHOR]

This study compared the romantic involvements of Canadian and Chinese adolescents as well as linkages with friend and parental relationships. Participants were 496 Chinese adolescents and 395 Canadian adolescents, aged 16-17 years. Chinese adolescents were less likely to have any form of romantic involvement, including a romantic relationship, displayed lower levels of romantic experience, and had fewer close romantic relationships. Gender moderated cultural differences, with Chinese girls least involved in romantic experiences. Although friendships were more intimate in Canada and parent relationships were closer in China, the linkages of parental and friend relationships with romantic experience were quite consistent across the two cultures, with friends being positively linked to romantic experiences and parents indirectly linked through their connection to friends. Among Chinese adolescents, parents also directly connected with romantic experiences in a negative direction. Implications of the findings for understanding the interface between individual growth and cultural context are discussed. [ABSTRACT FROM AUTHOR]

This study compared rates of dating aggression among 16-year-old adolescents in Canada and Italy, as well as differential associations with dyadic risk factors. 664 Canadians (297 boys, 367 girls) and 578 Italians (315 boys, 263 girls) indicated the frequency of physical aggression towards a romantic partner. They also rated the level of conflict and power imbalance in their romantic relationship. The results revealed comparable rates of physical dating aggression in the two countries for both boys and girls. Dyadic risk factors were also significant, with levels of conflict associated with dating aggression in both countries, and power imbalance uniquely linked in Italy. Overall, the results point to dating aggression as a global problem among youth. [ABSTRACT FROM AUTHOR]