UNASSIGNED: Defibrillation in the critical first minutes of out-of-hospital cardiac arrest (OHCA) can significantly improve survival. However, timely access to automated external defibrillators (AEDs) remains a barrier.
UNASSIGNED: The authors estimated the impact of a statewide program for drone-delivered AEDs in North Carolina integrated into emergency medical service and first responder (FR) response for OHCA.
UNASSIGNED: Using Cardiac Arrest Registry to Enhance Survival registry data, we included 28,292 OHCA patients ≥18 years of age between 1 January 2013 and 31 December 2019 in 48 North Carolina counties. We estimated the improvement in response times (time from 9-1-1 call to AED arrival) achieved by 2 sequential interventions: 1) AEDs for all FRs; and 2) optimized placement of drones to maximize 5-minute AED arrival within each county. Interventions were evaluated with logistic regression models to estimate changes in initial shockable rhythm and survival.
UNASSIGNED: Historical county-level median response times were 8.0 minutes (IQR: 7.0-9.0 minutes) with 16.5% of OHCAs having AED arrival times of <5 minutes (IQR: 11.2%-24.3%). Providing all FRs with AEDs improved median response to 7.0 minutes (IQR: 6.2-7.8 minutes) and increased OHCAs with <5-minute AED arrival to 22.3% (IQR: 16.4%-30.9%). Further incorporating optimized drone networks (326 drones across all 48 counties) improved median response to 4.8 minutes (IQR: 4.3-5.2 minutes) and OHCAs with <5-minute AED arrival to 56.3% (IQR: 46.9%-64.2%). Survival rates were estimated to increase by 34% for witnessed OHCAs with estimated drone arrival <5 minutes and ahead of FR and emergency medical service.
UNASSIGNED: Deployment of AEDs by FRs and optimized drone delivery can improve AED arrival times which may lead to improved clinical outcomes. Implementation studies are needed.

Recent studies have shown that bystander intervention involves moral engagement. However, the underlying internal mechanism is still poorly understood. Drawing on the norm activation model (NAM), Study 1 (questionnaire; n = 502) and Study 2 (experiment; n = 144) were conducted to investigate the influence of personal norms on defending through the mediating factors of anticipated pride and anticipated guilt. After controlling for age and gender, Study 1 revealed a significant positive association between personal norms and defending. This relationship was mediated by both anticipated pride and guilt, highlighting their parallel roles in explaining the influence of personal norms on defending. Study 2 investigated using writing tasks to manipulate personal norms from participants. The results revealed that the priming group had significantly higher levels of anticipated pride, guilt, and defending than the control group. Study 2 replicated the results of Study 1 in testing the mediated path, enhancing the reliability of research findings. This study expands the scope of the application of NAM by examining the interplay between personal norms, anticipated pride, anticipated guilt, and defending, as well as exploring the implications of these findings for interventions against bullying. Moral education should focus not only on the responsibility and obligation of bystanders to intervene in bullying incidents but also on the need to assist students in forming a moral compass within themselves that guides them to defend victims through moral emotions actively.

Harassment and abuse represent a pervasive and critical problem in sport with far-reaching consequences. Survivors\' testimonials underscore the profound and enduring impact of these experiences at individual, interpersonal, organizational and community level. Many of their stories reveal painful inaction from responsible adults in the sport organization, aggravating the harm. Other contributing factors to the harm inflicted include a culture of silence, lack of knowledge and understanding of what constitutes abuse, unawareness of reporting and supporting mechanisms, and fear of potential consequences. While effective bystander interventions have been developed outside the sport context, particularly targeting students in higher education, such initiatives have yet to be extensively adapted and assessed within the sport context. To address this gap, the Safe Sport Allies Erasmus+ collaborative partnership relied on the intervention mapping approach as a guiding framework to systematically develop a bystander training program (i.e., Safe Sport Allies) to train youth sport participants and youth sport coaches to act as effective bystanders. The current paper describes the comprehensive development process and provides an overview of implementation and evaluation possibilities. Throughout the paper, it is explained how each step of the Intervention Mapping approach shaped the Safe Sport Allies bystander training program. The program development, and the developed plans for implementation and evaluation are presented, shedding light on challenges encountered. The bystander training program developed in this paper and the implementation and evaluation plans can serve as an outline to build future interventions within this critical domain of safeguarding in sport.

BACKGROUND: Group-based situations are common settings for cyberbullying, making bystander responses crucial in combating this issue. This study investigated how adolescent bystanders respond to various victims, including family members, friends, teachers, and celebrities. This study also examined how different parenting styles influenced children\'s cyber bystander involvement.
METHODS: This study employed data from a cross-sectional school survey covering 1,716 adolescents aged 13-18 years from public and vocational schools in China collected in 2022. Logistic regression analyses were conducted to measure demographic characteristics, cyberbullying experiences, and parental rearing behaviors in predicting bystander reactions.
RESULTS: The findings showed that middle school students preferred to \"ask for help\" while high school students tended to choose \"call the police\" when witnessing cyberbullying incidents. Bystanders growing up with parental rejection and overprotection, having previous cyberbullying victimization experiences, where the victims were disliked by them, exhibited fewer defensive reactions.
CONCLUSIONS: This study has implications for future research and practices involving parental involvement in cyber bystander interventions, which could provide implications for future practice in designing specific intervention programs for cyberbullying bystander behavior. Future research and interventions against cyberbullying may provide individualized training including parents\' positive parenting skills and parent-child interactions.

First aid is a key factor in preventing further deterioration in an accident, saving lives, or improving treatment in emergencies. However, the reasons behind the willingness to provide first aid are still unclear. Therefore, this study aimed to investigate the role of social problem-solving and prosocial behavior in the dimension of first aid willingness. Self-administered questionnaires were used to evaluate the dimensions of first aid willingness (first aid willingness for peers, first aid willingness for strangers, knowledge, and negative emotions), social problem solving (positive problem orientation, negative problem orientation, rational problem solving, avoidance style, and impulsivity/carelessness) and prosocial behavior. A total of 497 school-aged students between the ages of 12 and 15 years (201 boys and 296 girls) participated in this study. Our results showed that positive problem orientation (p < 0.05) and rational problem solving (p < 0.001) are significant factors in determining first aid willingness for both peers and strangers. On the other hand, avoidance style orientation (p < 0.05) has a negative influence on the willingness to provide first aid to peers and strangers. Negative problem orientation (p < 0.001) only predicted negative emotions related to emergencies. Furthermore, prosocial behavior (p < 0.001) was more strongly associated with first aid willingness than social problem solving. Our study suggested that improving social competence could be a key factor in increasing first aid provision in real time, which could save lives in emergencies.

UNASSIGNED: The role of bystanders in cyberbullying situations is critical, with the potential to significantly influence outcomes. Bystanders who demonstrate positive behaviors-such as reporting incidents or supporting victims-can help to mitigate the damaging effects of cyberbullying. Based on the Social Cognitive Theory, this study seeks to address the psychosocial mechanisms that underlie positive cyber-bystander behaviors.
UNASSIGNED: A total of 1,716 students in Grades 8-12 from three secondary schools in China participated in this study. Path analysis was utilized to delineate the relationships between internet self-efficacy, empathy, teacher and parental support, and cyber-bystander behaviors.
UNASSIGNED: Adolescents who received greater support from teachers were more likely to demonstrate increased internet self-efficacy and empathy. In contrast, higher levels of parental warmth were associated with lower levels of internet self-efficacy. Teacher support and parental warmth exerted an indirect effect on positive bystander behaviors through empathy.
UNASSIGNED: The importance of parental warmth paired with Internet self-efficacy in preventing online interpersonal violence and motivate active bystander behaviors is considerable. We recommend adopting a nuanced approach that differentiates between empathy and internet self-efficacy in cyber-bystander research.

It is well documented that bullying victimization and perpetration are associated with mental health problems, including anxiety and depressive symptoms. Although the majority of students report witnessing bullying as bystanders, very few studies have investigated if negative consequences associated with bullying extend beyond targets and perpetrators to students who are bystanders. The present study examined the association between witnessing bullying and anxiety and depressive symptoms among middle school students. Middle school students (N = 130; grades 6th through 8th) completed questionnaires assessing experiences as a bystander, target, and perpetrator of bullying, as well as anxiety and depressive symptoms. Hierarchical regression analyses were conducted to determine if bystander status was associated with anxiety and depressive symptoms over and above the effects of victimization and perpetration and to examine bullying victimization and perpetration as moderators of these relationships. Analyses indicated being a bystander was associated with higher levels of anxiety (β = .40, p < .001) and depressive symptoms (β = .37, p < .001) even after controlling for frequency of being a target or perpetrator of bullying. Bystanders who were also targets of bullying reported the highest level of depressive symptoms; however, being a target of bullying did not moderate the relationship between being a bystander and anxiety. Furthermore, bullying perpetration did not moderate the relationship between being a bystander and anxiety or depressive symptoms. Findings indicate witnessing bullying uniquely contributes to anxiety and depressive symptoms for middle school students. For student bystanders who are also targets of bullying, depressive symptoms may be particularly high due to co-victimization or re-victimization experienced when witnessing bullying.

BACKGROUND: Cardiac arrest constitutes a critical medical emergency necessitating swift intervention to reinstate normal heart rhythm and prevent harm to vital organs. The pivotal role of bystander cardiopulmonary resuscitation (CPR) in influencing survival rates is well recognized. With older adults being the most common group to witness such events, it\'s curcial to understand their attitudes and knowledge about performing CPR. Additionally, understanding if health status has an influence can help in tailoring education for specific seniors needs.
METHODS: A cross-sectional survey was sent to University of the Third Age (UTA) students. The survey comprised sections focusing on demographic data, CPR knowledge, automated external defibrillator (AED) knowledge, first aid training, and readiness to perform CPR and use AEDs. Participants\' health conditions were also assessed through multiple-choice options.
RESULTS: We received 456 responses. Significant awareness of emergency numbers and cardiac arrest recognition was revealed. However, knowledge gaps persisted, particularly in compression rates. Most participants comprehended AED usage, yet training primarily relied on theoretical approaches. Health conditions notably affected CPR readiness, with associations between specific chronic diseases and willingness to perform CPR.
CONCLUSIONS: Addressing knowledge gaps and tailoring education for elderly needs are crucial for improving survival rates. Future research should explore barriers to bystander CPR during out-of-hospital cardiac arrests to further enhance survival prospects.

Social connections are fundamental to human well-being, yet ostracism can lead to mental and physical maladjustment. Ostracized individuals often attempt to reconnect, but their efforts can be hindered by feelings of helplessness and depression. This study examines factors that facilitate helping behavior toward ostracized individuals by third parties who witness the ostracism, that is, the mediating effects of guilt and shame on the effects of witnessing ostracism on subsequent helping behavior. Participants (n = 161) read scenarios depicting ostracism or inclusion situations and reported their likelihood to engage in helping behaviors and their feelings of guilt and shame after witnessing the events. Results indicated that guilt mediated a positive relationship between witnessing ostracism and subsequent helping behavior, whereas shame mediated a negative relationship. These findings are consistent with existing research on the prosocial motivation of guilt and the avoidance tendencies of shame. The results highlight the complex interplay of emotions in shaping bystander responses to ostracism and shed light on potential interventions to promote inclusive behaviors. By influencing the emotions of bystanders, prosocial actions based on guilt can be encouraged and avoidance based on shame can be discouraged, ultimately promoting a more inclusive society.

OBJECTIVE: Opioid use disorder is a cause of significant morbidity and mortality. In order to reverse opioid overdose as quickly as possible, many institutions and municipalities have encouraged people with no professional medical training to carry and administer naloxone. This study sought to provide preliminary data for research into the rates of adverse effects of naloxone when administered by bystanders compared to Emergency Medical Services (EMS) personnel, since this question has not been studied previously.
METHODS: This was a retrospective cohort study performed at an urban, tertiary, academic medical center that operates its own EMS service. A consecutive sample of patients presenting to EMS with opioid overdose requiring naloxone was separated into two groups based on whether naloxone was administered by bystanders or by EMS personnel. Each group was analyzed to determine the incidence of four pre-specified adverse events.
RESULTS: There was no significant difference in the rate of adverse events between the bystander (19%) and EMS (16%) groups (OR = 1.23; 95% CI, 0.63 - 2.32; P = .499) in this small sample. Based on these initial results, a study would need a sample size of 6,188 in order to reach this conclusion with 80% power. Similarly, there were no significant differences in the rates of any of the individual adverse events. Secondary analysis of patients\' demographics showed differences between the two groups which generate hypotheses for further investigation of disparities in naloxone administration.
CONCLUSIONS: This preliminary study provides foundational data for further investigation of naloxone administration by bystanders. Adverse events after the prehospital administration of naloxone are rare, and future studies will require large sample sizes. These preliminary data did not demonstrate a statistically significant difference in adverse event rates when comparing naloxone administration by bystanders and EMS clinicians. This study provides data that will be useful for conducting further research on multiple facets of this topic.