A cluster randomised controlled trial and evaluation and cost-effectiveness analysis of the Roots of Empathy schools-based programme for improving social and emotional well-being outcomes among 8- to 9-year-olds in Northern Ireland

Background:There is growing consensus regarding the importance of attending to children’s social and emotional well-being. There is now a substantial evidence base demonstrating the links between a child’s early social and emotional development and a range of key longer-term education, social and health outcomes. Universal school-based interventions provide a significant opportunity for early intervention in this area and yet the existing evidence base, particularly in relation to their long-term effects, is limited.Objectives and main outcomes:To determine the effectiveness and cost-effectiveness of Roots of Empathy (ROE), a universal school-based programme that, through attempting to enhance children’s empathy, seeks to achieve the following two main outcomes: improvement in prosocial behaviour and reduction in difficult behaviour.Design:A cluster randomised controlled trial and an economic evaluation. A total of 74 primary schools were randomly assigned to deliver ROE or to join a waiting list control group. Seven schools withdrew post randomisation and a further two withdrew before the immediate post-test time point. Children (n = 1278) were measured pre test and immediately post test, and then for 3 years following the end of the programme. Data were also collected from teachers and parents.Setting and participants:The intervention schools delivered ROE to their Year 5 children (aged 8–9 years) as a whole class.Intervention:ROE is delivered on a whole-class basis for one academic year (October–June). It consists of 27 lessons based around the monthly visit from a baby and parent who are usually recruited from the local community. Children learn about the baby’s growth and development and are encouraged to generalise from this to develop empathy towards others.Results:Although it was developed in Canada, the programme was very well received by schools, parents and children, and it was delivered effectively with high fidelity. ROE was also found to be effective in achieving small improvements in children’s prosocial behaviour (Hedges’ g = 0.20; p = 0.045) and reductions in their difficult behaviour (Hedges’ g = –0.16; p = 0.060) immediately post test. Although the gains in prosocial behaviour were not sustained after the immediately post-test time point, there was some tentative evidence that the effects associated with reductions in difficult behaviour may have remained up to 36 months from the end of the programme. These positive effects of ROE on children’s behaviour were not found to be associated with improvements in empathy or other social and emotional skills (such as emotional recognition and emotional regulation), on which the trial found no evidence of ROE having an effect. The study also found that ROE was likely to be cost-effective in line with national guidelines.Conclusions:These findings are consistent with those of other evaluations of ROE and suggest that it is an effective and cost-effective programme that can be delivered appropriately and effectively in regions such as Northern Ireland. A number of issues for further consideration are raised regarding opportunities to enhance the role of parents; how a time-limited programme such as ROE can form part of a wider and progressive curriculum in schools to build on and sustain children’s social and emotional development; and the need to develop a better theory of change for how ROE works.Trial registration:Current Controlled Trials ISRCTN07540423.Funding:This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 4. See the NIHR Journals Library website for further project information

Parental Expectations and Prosocial Behavior of Adolescents From Low-Income Backgrounds: A Cross-Cultural Comparison Between Three Countries¿Argentina, Colombia, and Spain

Parental expectations are influenced by cultural models, which in turn are subject to a great influence from historically fluctuating features of the socioeconomic background. Parental expectations seem to be linked to children¿s social and emotional development in terms of empathy and prosocial behavior. The current study aims to (a) compare low-income adolescents¿ perceptions of parental expectations of prosocial and antisocial behavior across three Latin countries (Argentina, Colombia, and Spain), (b) compare the empathy and prosocial behavior between the three countries, (c) compare the prosocial behavior between the three countries, and (d) study the effect of perceived parental expectations and empathy on the prosocial behavior of adolescents in all three of the countries studied in this research. The sample was made up of 446 Argentinean adolescents, 474 Colombian adolescents, and 632 Spanish adolescents. The Expected Parental Reactions Scale, Interpersonal Reactivity Index, and Prosocial Behavior Questionnaire were used to measure the variables included in this study. Results reveal considerable differences between children¿s perceptions of parental expectations in different countries. Results also show the existence of significant differences between male and female adolescents. In all three countries, girls score more highly than boys in prosocial behavior and empathy. Furthermore, we find that low-income Argentinean adolescents score more highly than Spanish and Colombian adolescents in prosocial behavior measures. Finally, expected parental reactions toward prosocial behavior and empathy seem to have an influence on the adolescents¿ development of prosocial behavior in all three countries

ICAR: endoscopic skull‐base surgery

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The Development and Validation of the Empathy Components Questionnaire (ECQ)

Key research suggests that empathy is a multidimensional construct comprising of both cognitive and affective components. More recent theories and research suggest even further factors within these components of empathy, including the ability to empathize with others versus the drive towards empathizing with others. While numerous self-report measures have been developed to examine empathy, none of them currently index all of these wider components together. The aim of the present research was to develop and validate the Empathy Components Questionnaire (ECQ) to measure cognitive and affective components, as well as ability and drive components within each. Study one utilized items measuring cognitive and affective empathy taken from various established questionnaires to create an initial version of the ECQ. Principal component analysis (PCA) was used to examine the underlying components of empathy within the ECQ in a sample of 101 typical adults. Results revealed a five-component model consisting of cognitive ability, cognitive drive, affective ability, affective drive, and a fifth factor assessing affective reactivity. This five-component structure was then validated and confirmed using confirmatory factor analysis (CFA) in an independent sample of 211 typical adults. Results also showed that females scored higher than males overall on the ECQ, and on specific components, which is consistent with previous findings of a female advantage on self-reported empathy. Findings also showed certain components predicted scores on an independent measure of social behavior, which provided good convergent validity of the ECQ. Together, these findings validate the newly developed ECQ as a multidimensional measure of empathy more in-line with current theories of empathy. The ECQ provides a useful new tool for quick and easy measurement of empathy and its components for research with both healthy and clinical populations

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

The structure and development of dispositional empathy during middle childhood and its relationship to prosocial behavior

Bibliography: p. 149-158

The Effects of peer influence and empathy on the altruism of young adolescents

Bibliography: p. 102-112.This study investigated the effects of peer influence and dispositional empathy on the altruism of young adolescents. The subjects, 203 junior high school students were divided into three treatment groups: peer exhortation, adult exhortation and no exhortation and into high and low empathy groups. The study was conducted in two sessions. In the first session, subjects completed a measure of dispositional empathy, the Interpersonal Reactivity Index (Davis, 1980) and viewed a film documentary about the plight of African famine victims and the relief efforts of the International Red Cross. Prior to viewing the films, two of the treatment groups were exposed to a brief charitable exhortation delivered by either a high-status peer or a teacher. Approximately one week later the subjects reassembled. The same speakers delivered a second brief exhortation to their respective groups and subjects completed an index of altruism and anti-utilitarianism. The subjects then received a $0.50 payment for their participation in the study and were told that they could donate up to$0.45 to famine relief. Multivariate analyses of variance were used to assess the relationships of exhortation and trait empathy with charitable donations, altruism and anti-utilitarianism. The multivariate analyses of variance revealed no significant exhortation effects for the overall group. Exhortation effects did, however, appear for those subjects who had scored in the top and bottom thirds (approximately) of the empathic concern subscale of the Interpersonal Reactivity Index (Davis, 1980). Stepdown-F tests and t-tests revealed that subjects in the peer-exhortation group scored significantly higher on the anti-utilitariansim measure than did subjects in the adult-exhortation group (p=.007). Analyses of variance and corresponding stepdown-F tests revealed that both overall empathy and empathic concern significantly and positively affected charitable donations and altruism scores (p=.001) but not to anti-utilitarianism