No abstract

Many psychosomatic and psychosocial health problems follow an episode of bullying victimization. These findings stress the importance for doctors and health practitioners to establish whether bullying plays a contributing role in the etiology of such symptoms. Furthermore, our results indicate that children with depressive symptoms and anxiety are at increased risk of being victimized. Because victimization could have an adverse effect on children's attempts to cope with depression or anxiety, it is important to consider teaching these children skills that could make them less vulnerable to bullying behavior.

Bullying victimization is associated with several health issues. Prevention of bullying is therefore an important goal for health and education professionals. In the present study, 2766 children from 32 Dutch elementary schools participated by completing a questionnaire on bullying behavior, and the involvement of teachers, parents and classmates in bullying incidents. The results of this study show that bullying is still prevalent in Dutch schools. More than 16% of the children aged 9-11 years reported being bullied on a regular basis and 5.5% reported regular active bullying during the current school term. Almost half of the bullied children did not tell their teacher that they were being bullied. When teachers knew about the bullying, they often tried to stop it, but in many cases the bullying stayed the same or even got worse. With regard to active bullying, neither the majority of the teachers nor parents talked to the bullies about their behavior. Our results stress the importance of regular communication between children, parents, teachers and health care professionals with regard to bullying incidents. In addition, teachers need to learn effective ways to deal with bullying incidents. Schools need to adopt a whole-school approach with their anti-bullying interventions.

Waist circumferences can be used to screen for increased abdominal fat mass in children, whereby a cut-off point of 1.3 standard deviation score seems most suitable.

Health-related quality of life (HRQoL), conceptualized as patients' own evaluations of their health status, is an important criterion in evaluation health and health care and in the treatment of individual patients. Until now, few systematic attempts have been made to develop instruments to assess the HRQoL of children using such a conceptualization. This article describes the conceptualization and results of a study aiming to develop such an instrument for children aged 6-15 years using their parents as a proxy. The feasibility and psychometric performance of the instrument were evaluated in a study of 77 patients of the paediatric out-patient clinic of Leiden University Hospital. For each of the a priori-defined domains, a parent form scale could be constructed with satisfactory reliability and moderate correlations with the other scales. Only some of the parents indicating health status problems also signalled negative reactions to these problems. This is, in our view, a strong argument for the distinction between health status and quality of life (QoL). The correlation coefficients between the parent form and a children's questionnaire were low. Overall, the psychometric performance of the TACQOL parent form looks promising, which suggests that this instrument--with some modifications--can indeed be used to assess group differences in HRQoL in children. The results, however, should be replicated in larger samples, currently under study. The relation between parents' proxy reports on the HRQoL of their children and children's self-reports needs further investigation.