Bullying, victimization, and bystander behavior: Risk factors across elementary-middle school transition.

Students with mental health difficulties are at increased risk for victimization, and this risk may be exacerbated during the transition to middle school, when there is an increase in bullying behaviors. Through a social-ecological lens, the present study investigated how internalizing and externalizing problems in the fall of fifth grade were associated with bullying role behaviors in the fall of sixth grade and whether these associations differed by gender. This study expanded prior research by examining not only bullying and victimization, but also bystander behaviors (i.e., assisting, defending, or outsider behavior). Participants were students attending fifth grade at one of 13 elementary schools at Time 1, and later attending sixth grade at one of five middle schools at Time 2 (N = 1,139). Structural equation modeling results indicated that externalizing problems in fifth grade were positively associated with bullying (B = .25, p < .001), assisting (B = .08, p = .024), and victimization (B = .30, p = .010) in sixth grade; further, internalizing problems in fifth grade were significantly positively associated with victimization (B = .43, p < .001) and defending (B = .33, p = .002) in sixth grade. There were no significant gender differences in these associations. Implications for social-emotional screening and intervention are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

In vivo assessment of the safety of standard fractionation Temporally Feathered Radiation Therapy (TFRT) for head and neck squamous cell carcinoma: An R-IDEAL Stage 1/2a first-in-humans/feasibility demonstration of new technology implementation.

INTRODUCTION: Prior in silico simulations of studies of Temporally Feathered Radiation Therapy (TFRT) have demonstrated potential reduction in normal tissue toxicity. This R-IDEAL Stage 1/2A study seeks to demonstrate the first-in-human implementation of TFRT in treating patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: Patients with HNSCC treated with definitive radiation therapy were eligible (70 Gy in 35 fractions) were eligible. The primary endpoint was feasibility of TFRT planning as defined by radiation start within 15 business days of CT simulation. Secondary endpoints included estimates of acute grade 3-5 toxicity. RESULTS: The study met its accrual goal of 5 patients. TFRT plans were generated in four of the five patients within 15 business days of CT simulation, therefore meeting the primary endpoint. One patient was not treated with TFRT at the physician's discretion, though the TFRT plan had been generated within sufficient time from the CT simulation. For patients who received TFRT, the median time from CT simulation to radiation start was 10 business days (range 8-15). The average time required for radiation planning was 6 business days. In all patients receiving TFRT, each subplan and every daily fraction was delivered in the correct sequence without error. The OARs feathered included: oral cavity, each submandibular gland, each parotid gland, supraglottis, and posterior pharyngeal wall (OAR pharynx). Prescription dose PTV coverage (>95%) was ensured in each TFRT subplan and the composite TFRT plan. One of five patients developed an acute grade 3 toxicity. CONCLUSIONS: This study demonstrates the first-in-human implementation of TFRT (R-IDEAL Stage 1), proving its feasibility in the modern clinical workflow. Additionally, assessments of acute toxicities and dosimetric comparisons to a standard radiotherapy plan were described (R-IDEAL Stage 2a).

Technical Note: A step-by-step guide to Temporally Feathered Radiation Therapy planning for head and neck cancer.

PURPOSE: Prior in silico simulations propose that Temporally Feathered Radiation Therapy (TFRT) may reduce toxicity related to head and neck radiation therapy. In this study we demonstrate a step-by-step guide to TFRT planning with modern treatment planning systems. METHODS: One patient with oropharyngeal cancer planned for definitive radiation therapy using intensity-modulated radiation therapy (IMRT) techniques was replanned using the TFRT technique. Five organs at risk (OAR) were identified to be feathered. A "base plan" was first created based on desired planning target volumes (PTV) coverage, plan conformality, and OAR constraints. The base plan was then re-optimized by modifying planning objectives, to generate five subplans. All beams from each subplan were imported onto one trial to create the composite TFRT plan. The composite TFRT plan was directly compared with the non-TFRT IMRT plan. During plan assessment, the composite TFRT was first evaluated followed by each subplan to meet preset compliance criteria. RESULTS: The following organs were feathered: oral cavity, right submandibular gland, left submandibular gland, supraglottis, and OAR Pharynx. Prescription dose PTV coverage (>95%) was met in each subplan and the composite TFRT plan. Expected small variations in dose were observed among the plans. The percent variation between the high fractional dose and average low fractional dose was 29%, 28%, 24%, 19%, and 10% for the oral cavity, right submandibular, left submandibular, supraglottis, and OAR pharynx nonoverlapping with the PTV. CONCLUSIONS: Temporally Feathered Radiation Therapy planning is possible with modern treatment planning systems. Modest dosimetric changes are observed with TFRT planning compared with non-TFRT IMRT planning. We await the results of the current prospective trial to seeking to demonstrate the feasibility of TFRT in the modern clinical workflow (NCT03768856). Further studies will be required to demonstrate the potential benefit of TFRT over non-TFRT IMRT Planning.

Nonemergency Involuntary Antipsychotic Medication in Prison: Effects on Prison Inpatient Days and Disciplinary Charges.

We hypothesized that treating mentally ill inmates involuntarily with antipsychotic medication would reduce the number of prison inpatient days and the number of inmates who receive disciplinary charges. The subjects were 133 mentally ill inmates who were placed on the New Jersey Department of Corrections (NJ DOC) nonemergency involuntary medication protocol and received antipsychotic medication for at least one year. No difference was noted in an inmate's mean number of prison inpatient days in the year before versus the year during involuntary medication. Fewer inmates received serious disciplinary charges during the year of involuntary medication relative to the year before, when they were not medicated. In addition, there were decreases in mean instances and mean total number of charges during involuntary medication versus before. Neither an increased number of inpatient days nor depot medication accounted for the inmates who incurred no charges while receiving involuntary medication.