The KiVa antibullying curriculum and outcome: Does fidelity matter?

Research on school-based prevention suggests that the success of prevention programs depends on whether they are implemented as intended. In antibullying program evaluations, however, limited attention has been paid to implementation fidelity. The present study fills in this gap by examining the link between the implementation of the KiVa antibullying program and outcome. With a large sample of 7413 students (7&ndash;12 years) from 417 classrooms within 76 elementary schools, we tested whether the degree of implementation of the student lessons in the KiVa curriculum was related to the effectiveness of the program in reducing bullying problems in classrooms. Results of multilevel structural equation modeling revealed that after nine months of implementation, lesson adherence as well as lesson preparation time (but not duration of lessons) were associated with reductions in victimization at the classroom level. No statistically significant effects, however, were found for classroom-level bullying. The different outcomes for victimization and bullying as well as the importance of documenting program fidelity are discussed.</p

Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials

An amendment to this paper has been published and can be accessed via the original article

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

The Effect of Bullying and Victimization on Cognitive Empathy Development During the Transition to Middle School.

Background Interventions aimed at reducing bullying behavior commonly target the development of empathy. Yet, few longitudinal studies have investigated how empathy levels vary with bullying and victimization over time, especially during the transition to middle school. Objective To that end, the purpose of the present study was to: (1) examine the naturally-occurring changes in cognitive empathy during the transition from elementary to middle school, and (2) explore the effect of bullying and victimization involvement on changes in cognitive empathy over time, and specifically during this school transition. Methods Latent growth curve modeling was used to examine growth trajectories in empathy over time and the effects of bullying involvement on this growth among a sample of 431 students (52 % female, 52 % Latino, 10.18 years old at baseline), using data collected during the spring semester of the 4th grade, the fall and spring semesters of 5th grade, and the spring semester of 6th grade. Results Cognitive empathy decreased over time, and a linear trajectory was the best fitting shape for these data. Bullying and victimization were both associated with lower levels of cognitive empathy throughout the study. However, the effect of victimization was small and it became non-significant when both were added to the model. Several notable participant-related differences were found

Physical Function Recovery Trajectories After Spinal Cord Injury

To explore trajectories of functional recovery that occur during the first 2 years after spinal cord injury (SCI). Observational cohort study. Eight SCI Model System sites. A total of 479 adults with SCI completed 4 Spinal Cord Injury–Functional Index (SCI-FI) item banks within 4 months of injury and again at 2 weeks, 3, 6, 12, and 24 months after baseline assessment (N=479). None. SCI-FI Basic Mobility/Capacity (C), Fine Motor Function/C, Self-care/C, and Wheelchair Mobility/Assistive Technology (AT) item banks. Growth mixture modeling was used to identify groups with similar trajectory patterns. For the Basic Mobility/C and Wheelchair Mobility/AT domains, models specifying 2 trajectory groups were selected. For both domains, a majority class exhibited average functional levels and gradual improvement, primarily in the first 6 months. A smaller group of individuals made gradual improvements but had greater initial functional limitations. The Self Care/C domain exhibited a similar pattern; however, a third, small class emerged that exhibited substantial improvement in the first 6 months. Finally, for individuals with tetraplegia, trajectories of Fine Motor Function/C scores followed 2 patterns, with individuals reporting generally low initial scores and then making either modest or large improvements. In individual growth curve models, injury/demographic factors predicted initial functional levels but less so regarding rates of recovery. Trajectories of functional recovery followed a small number of change patterns, although variation around these patterns emerged. During the first 2 years after initial hospitalization, SCI-FI scores showed modest improvements; however, substantial improvements were noted for a small number of individuals with severe limitations in fine motor and self-care function. Future studies should further explore the personal, medical, and environmental characteristics that influence functional trajectories during these first 2 years and beyond