This study assesses how perceptions of school climate and four mediating factors (school connectedness, peer attachment, assertiveness, and empathy) influence reports of bullying behaviors among 2,834 students in 14 middle schools. Results revealed that students in positive school climates reported experiencing fewer physical, emotional, and cyberbullying behaviors. They also reported greater levels of school connectedness, peer attachment, assertiveness, and empathy, which in turn helped explain the influence of perceived school climate on bullying. In addition, the greater levels of empathy that students reported, the more likely they were to report being bullied. These results highlight the role that perceptions of school climate can play in influencing bullying and underscore the importance of mediating factors as schools work to track and improve school climate.
This study fills a gap in research on multi-level school-based approaches to promoting positive youth development and reducing bullying, in particular cyberbullying, among middle school youth. The study evaluates the Restorative Practices Intervention, a novel whole-school intervention designed to build a supportive environment through the use of 11 restorative practices (e.g., communication approaches that aim to build stronger bonds among leadership, staff, and students such as using "I" statements, encouraging students to express their feelings) that had only quasi-experimental evidence prior to this study. Studying multilevel (e.g., individual, peer group, school) approaches like the Restorative Practices Intervention is important because they are hypothesized to address a more complex interaction of risk factors than single level efforts, which are more common. Baseline and two-year post survey data was collected from 2,771 students at 13 middle schools evenly split between grades 6 (48 percent) and 7 (52 percent), and primarily ages 11 (38 percent) or 12 (41 percent). Gender was evenly split (51 percent male), and 92 percent of students were white. The intervention did not yield significant changes in the treatment schools.
Key Points
Question
Has the number of vomiting-related emergency department visits increased after recreational cannabis legalization in Colorado?
Findings
In this cross-sectional study of 820 778 patients seeking care through Colorado emergency departments, cannabis legalization was associated with an increase in annual vomiting-related health care encounters. The highest increases were observed in counties without existing medical dispensaries.
Meaning
These findings suggest that health care clinicians in states that have legalized cannabis should be aware of symptoms associated with cannabis hyperemesis syndrome; documentation may help ensure accurate public health surveillance on consequences associated with cannabis legalization.
Clinical home visit programs for Medicare beneficiaries are a promising approach to supporting aging in place and avoiding high-cost institutional care. Such programs combine a comprehensive geriatric assessment by a clinician during a home visit with referrals to community providers and health plan resources to address uncovered issues. We evaluated UnitedHealth Group's HouseCalls program, which has been offered to Medicare Advantage plan members in Arkansas, Georgia, Missouri, South Carolina, and Texas since January 2008. We found that, compared to non-HouseCalls Medicare Advantage plan members and fee-for-service beneficiaries, HouseCalls participants had reductions in admissions to hospitals (1 percent and 14 percent, respectively) and lower risk of nursing home admission (0.67 percent and 1.3 percent, respectively). In addition, participants' numbers of office visits--chiefly to specialists--increased 2-6 percent (depending on the comparison group). The program's effects on emergency department use were mixed. These results indicate that a thorough home-based clinical assessment of a member's health and home environment combined with referral services can support aging in place, promote physician office visits, and preempt costly institutional care.
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