Do Classroom Relationships Moderate the Association Between Peer Defending in School Bullying and Social-Emotional Adjustment?

Peer defending has been shown to protect bullied peers from further victimization and so-cial-emotional problems. However, research on the effects of defending students demonstrated positive and negative social-emotional adjustment. To explain these mixed findings, researchers have suggested that associations between defending and social-emotional adjustment may be buffered by protective factors (i.e., defender protection hypothesis) or exacerbated by vulnerability factors (i.e., defender vulnerability hypothesis). In line with these hypotheses, the current study aimed to investigate whether relationships with teachers and peers moderate the association be-tween defending and social-emotional adjustment, i.e., depressive symptoms and self-esteem. This three-wave longitudinal study examined the association between peer-nominated defending, and later self-reported depressive symptoms and self-esteem in 848 fourth-to-sixth graders (53% girls; Mage = 10.61 years, SD = 0.90 at Wave 1). Peer-nominated positive and negative teacher-student relationships (closeness, conflict) and peer relationships (acceptance, rejection) were used. Clustered multiple linear regression analyses demonstrated that defending behavior did not predict later depressive symptoms or self-esteem. Contrary to our expectations, teacher-student closeness, peer acceptance and their combination did not play a protective role in the association between de-fending and social-emotional adjustment. In addition, teacher-student conflict, peer rejection and their combination did not put defending students at risk for social-emotional maladjustment. Thus, relationships with teachers and peers did not moderate the association between defending and later depressive symptoms and self-esteem

Speak up or stay silent: Can teacher responses towards bullying predict victimized students’ disclosure of victimization?

status: accepte

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London