Reading — 2026 Jan–Apr Recall Set 58

How can it be prevented? Peter Smith, Professor of Psychology at the University of Sheffield, directed the Sheffield Anti-Bullying Intervention Project, funded by the Department for Education. Here he reports on his findings. A. Bullying can take a variety of forms, from the verbal – being taunted or called hurtful names – to the physical – being kicked or shoved – as well as indirect forms, such as being excluded from social groups. A survey I conducted with Irene Whitney found that in British primary schools up to a quarter of pupils reported experience of bullying, which in about one in ten cases was persistent. There was less bullying in secondary schools, with about one in twenty-five suffering persistent bullying, but these cases may be particularly recalcitrant. B. Bullying is clearly unpleasant, and can make the child experiencing it feel unworthy and depressed. In extreme cases it can even lead to suicide, though this is thankfully rare. Victimised pupils are more likely to experience difficulties with interpersonal relationships as adults, while children who persistently bully are more likely to grow up to be physically violent, and convicted of anti-social offences. C. Until recently, not much was known about the topic, and little help was available to teachers to deal with bullying. Perhaps as a consequence, schools would often deny the problem. ‘There is no bullying at this school’ has been a common refrain, almost certainly untrue. Fortunately more schools are now saying: There is not much bullying here, but when it occurs we have a clear policy for dealing with it.’ D. Three factors are involved in this change. First is an awareness of the severity of the problem. Second, a number of resources to help tackle bullying have become available in Britain. For example, the Scottish Council for Research in Education produced a package of materials, Action Against Bullying, circulated to all schools in England and Wales as well as in Scotland in summer 1992, with a second pack, Supporting Schools Against Bullying, produced the following year. In Ireland, Guidelines on Countering Bullying Behaviour in Post-Primary Schools was published in 1993. Third, there is evidence that these materials work, and that schools can achieve something. This comes from carefully conducted ‘before and after’ evaluations of interventions in schools, monitored by a research team. In Norway, after an intervention campaign was introduced nationally, an evaluation of forty-two schools suggested that, over a two-year period, bullying was halved. The Sheffield investigation, which involved sixteen primary schools and seven secondary schools, found that most schools succeeded in reducing bullying. E. Evidence suggests that a key step is to develop a policy on bullying, saying clearly what is meant by bullying, and giving explicit guidelines on what will be done if it occurs, what records will be kept, who will be informed, what sanctions will be employed. The policy should be developed through consultation, over a period of time – not just imposed from the head teacher’s office! Pupils, parents and staff should feel they have been involved in the policy, which needs to be disseminated and implemented effectively. Other actions can be taken to back up the policy. There are ways of dealing with the topic through the curriculum, using video, drama and literature. These are useful for raising awareness, and can best be tied in to early phases of development, while the school is starting to discuss the issue of bullying. They are also useful in renewing the policy for new pupils, or revising it in the light of experience. But curriculum work alone may only have short-term effects; it should be an addition to policy work, not a substitute. There are also ways of working with individual pupils, or in small groups. Assertiveness training for pupils who are liable to be victims is worthwhile, and certain approaches to group bullying such as ‘no blame’, can be useful in changing the behaviour of bullying pupils without confronting them directly, although other sanctions may be needed for those who continue with persistent bullying. Work in the playground is important, too. One helpful step is to train lunchtime supervisors to distinguish bullying from playful fighting, and help them break up conflicts. Another possibility is to improve the playground environment, so that pupils are less likely to be led into bullying from boredom or frustration. F. With these developments, schools can expect that at least the most serious kinds of bullying can largely be prevented. The more effort put in and the wider the whole school involvement, the more substantial the results are likely to be. The reduction in bullying – and the consequent improvement in pupil happiness – is surely a worthwhile objective.

A An excellent definition was developed in the 1980s by Norwegian Prime Minister Gro Harlem Brundtland and used by the World Business Council for Sustainable Development: “Meeting the needs of the present without compromising the ability of future generations to meet their own needs.” Nowadays, governments and companies need to account for the social consequences of their actions. As a result, corporate social responsibility (CSR) has become a priority for business leaders around the world. When a well-run business applies its vast resources and expertise to social problems that it understands and in which it has a stake, it can have a greater impact than any other organisation. The notion of licence to operate derives from the fact that every company needs tacit or explicit permission from governments, communities, and numerous other stakeholders to justify CSR initiatives to improve a company’s image, strengthen its brand, enliven morale and even raise the value of its stock. B To advance CSR, we must root it in a broad understanding of the interrelationship between a corporation and society. Successful corporations need a healthy society. Education, health care, and equal opportunity are essential to a productive workforce. Safe products and working conditions not only attract customers but lower the internal costs of accidents. Efficient utilisation of land, water, energy, and other natural resources makes business more productive. Good government, the rule of law, and property rights are essential for efficiency and innovation. Strong regulatory standards protect both consumers and competitive companies from exploitation. Ultimately, a healthy society creates expanding demand for business, as more human needs are met and aspirations grow. Any business that pursues its ends at the expense of the society in which it operates will find its success to be illusory and ultimately temporary. At the same time, a healthy society needs successful companies. No social programme can rival the business sector when it comes to creating the jobs, wealth, and innovation that improve standards of living and social conditions over time. C A company’s impact on society also changes over time, as social standards evolve and science progresses. Asbestos, now understood as a serious health risk, was thought to be safe in the early 1900s, given the scientific knowledge then available. Evidence of its risks gradually mounted for more than 50 years before any company was held liable for the harms it can cause. Many firms that failed to anticipate the consequences of this evolving body of research have been bankrupted by the results. No longer can companies be content to monitor only the obvious social impacts of today. Without a careful process for identifying evolving social effects of tomorrow, firms may risk their very survival. D No business can solve all of society’s problems or bear the cost of doing so. Instead, each company must select issues that intersect with its particular business. Other social agendas are best left to those companies in other industries, NGOs, or government institutions that are better positioned to address them. The essential test that should guide CSR is not whether a cause is worthy but whether it presents an opportunity to create shared value – that is, a meaningful benefit for society that is also valuable to the business. Each company can identify the particular set of societal problems that it is best equipped to help resolve and from which it can gain the greatest competitive benefit. E The best corporate citizenship initiatives involve far more than writing a cheque: they specify clear, measurable goals and track results over time. A good example is General Electric’s programme to adopt underperforming public high schools near several of its major U.S. facilities. The company contributes between $250,000 and $1 million over a five-year period to each school and makes in-kind donations as well. GE managers and employees take an active role by working with school administrators to assess needs and mentor or tutor students. In an independent study of ten schools in the programme between 1989 and 1999, nearly all showed significant improvement, while the graduation rate in four of the five worst-performing schools doubled from an average of 30% to 60%. Effective corporate citizenship initiatives such as this one create goodwill and improve relations with local governments and other important constituencies. What’s more, GE’s employees feel great pride in their participation. Their effect is inherently limited, however. No matter how beneficial the programme is, it remains incidental to the company’s business, and the direct effect on GE’s recruiting and retention is modest. F Microsoft’s Working Connections partnership with the American Association of Community Colleges (AACC) is a good example of a shared-value opportunity arising from investments in context. The shortage of information-technology workers is a significant constraint on Microsoft’s growth; currently, there are more than 450,000 unfilled IT positions in the United States alone. Community colleges, with an enrolment of 11.6 million students, representing 45% of all U.S. undergraduates, could be a major solution. Microsoft recognises, however, that community colleges face special challenges: IT curricula are not standardised, technology used in classrooms is often outdated, and there are no systematic professional development programmes to keep faculty up to date. Microsoft’s $50 million five-year initiative was aimed at all three problems. In addition to contributing money and products, Microsoft sent employee volunteers to colleges to assess needs, contribute to curriculum development, and create faculty-development institutes. Microsoft has achieved results that have benefited many communities while having a direct and potentially significant impact on the company. G At the heart of any strategy is a unique value proposition: a set of needs a company can meet for its chosen customers that its competitors cannot. The most strategic CSR occurs when a company adds a social dimension to its value proposition, making social impact integral to the overall strategy. Consider Whole Foods Market, whose value proposition is to sell organic, natural, and healthy food products to customers who are passionate about food and the environment. The company’s sourcing emphasises purchases from local farmers through each store’s procurement process. Buyers screen out foods containing any of nearly 100 common ingredients that the company considers unhealthy or environmentally damaging. The same standards apply to products made internally. Whole Foods’ commitment to natural and environmentally friendly operating practices extends well beyond sourcing. Stores are constructed using a minimum of virgin raw materials. Recently, the company purchased renewable wind-energy credits equal to 100% of its electricity use in all of its stores and facilities, the only Fortune 500 company to offset its electricity consumption entirely. Spoiled produce and biodegradable waste are trucked to regional centres for composting. Whole Foods’ vehicles are being converted to run on biofuels. Even the cleaning products used in its stores are environmentally friendly. And through its philanthropy, the company has created the Animal Compassion Foundation to develop more natural and humane ways of raising farm animals. In short, nearly every aspect of the company’s value chain reinforces the social dimensions of its value proposition, distinguishing Whole Foods from its competitors.

Packaging One of the most prominent design issues in pharmacy is that of drug packaging and patient information leaflets (PILs). Many letters have appeared in The Journal’s letters pages over the years from pharmacists dismayed at the designs of packaging that are “accidents waiting to happen”. Packaging design in the pharmaceutical industry is handled by either in-house teams or design agencies. Designs for over-the-counter medicines, where characteristics such as attractiveness and distinguishability are regarded as significant, are usually commissioned from design agencies. A marketing team will prepare a brief and the designers will come up with perhaps six or seven designs. These are whittled down to two or three that might be tested on a consumer group. In contrast, most designs for prescription-only products are created in-house. In some cases, this may simply involve applying a company’s house design (i.e., logo, colour, font, etc). The chosen design is then handed over to design engineers who work out how the packaging will be produced. Design considerations The author of the recently published “Information design for patient safety,” Thea Swayne, tracked the journey of a medicine from manufacturing plant, through distribution warehouses, pharmacies and hospital wards, to patients’ homes. Her book highlights a multitude of design problems with current packaging, such as look-alikes and sound-alikes, small type sizes and glare on blister foils. Situations in which medicines are used include a parent giving a cough medicine to a child in the middle of the night and a busy pharmacist selecting one box from hundreds. It is argued that packaging should be designed for moments such as these. “Manufacturers are not aware of the complex situations into which products go. As designers, we are interested in not what is supposed to happen in hospital wards, but what happens in the real world,” Ms Swayne said. Incidents where vein has been injected intrathecally instead of spine are a classic example of how poor design can contribute to harm. Investigations following these tragedies have attributed some blame to poor typescript. Safety and compliance Child protection is another area that gives designers opportunities to improve safety. According to the Child Accident Prevention Trust, seven out of 10 children admitted to hospital with suspected poisoning have swallowed medicines. Although child-resistant closures have reduced the number of incidents, they are not fully child-proof. The definition of such a closure is one that not more than 15 percent of children aged between 42 and 51 months can open within five minutes. There is scope for improving what is currently available, according to Richard Mawle, a freelance product designer. “Many child-resistant packs are based on strength. They do not necessarily prevent a child from access, but may prevent people with a disability,” he told The Journal. “The legal requirements are there for a good reason, but they are not good enough in terms of the users,” he said. “Older people, especially those with arthritis, may have the same level of strength as a child,” he explained, and suggested that better designs could rely on cognitive skills (e.g., making the opening of a container a three-step process) or be based on the physical size of hands. Mr. Mawle worked with GlaxoSmithKline on a project to improve compliance through design, which involved applying his skills to packaging and PILs. Commenting on the information presented, he said: “There can be an awful lot of junk at the beginning of PILs. For example, why are company details listed towards the beginning of a leaflet when what might be more important for the patient is that the medicine should not be taken with alcohol?” Design principles and guidelines Look-alike boxes present a potential for picking errors and an obvious solution would be to use colours to highlight different strengths. However, according to Ms. Swayne, colour differentiation needs to be approached with care. Not only should strong colour contrasts be used, but designating a colour to a particular strength (colour coding) is not recommended because this could lead to the user not reading the text on a box. Design features can provide the basis for lengthy debates. For example, one argument is that if all packaging is white with black lettering, people would have no choice but to read every box carefully. The problem is that trials of drug packaging design are few—common studies of legibility and comprehensibility concern road traffic signs and visual display units. Although some designers take results from such studies into account, proving that a particular feature is beneficial can be difficult. For example, EU legislation requires that packaging must now include the name of the medicine in Braille but, according to Karel van der Waarde, a design consultant to the pharmaceutical industry, “it is not known how much visually impaired patients will benefit nor how much the reading of visually able patients will be impaired”. More evidence might, however, soon be available. EU legislation requires PILs to reflect consultations with target patient groups to ensure they are legible, clear and easy to use. This implies that industry will have to start conducting tests. Dr. van der Waarde has performed readability studies on boxes and PILs for industry. A typical study involves showing a leaflet or package to a small group and asking them questions to test understanding. Results and comments are used to modify the material, which is then tested on a larger group. A third group is used to show that any further changes made are an improvement. Dr. van der Waarde is, however, sceptical about the legal requirements and says that many regulatory authorities do not have the resources to handle packaging information properly. “They do not look at the use of packaging in a practical context—they only see one box at a time and not several together as pharmacists would do,” he said. Innovations The RCA innovation exhibition this year revealed designs for a number of innovative objects. “The popper”, by Hugo Glover, aims to help arthritis sufferers remove tablets from blister packs, and “pluspoint”, by James Cobb, is an adrenaline auto-injector that aims to overcome the fact that many patients do not carry their auto-injectors due to their prohibitive size. The aim of good design, according Roger Coleman, professor of inclusive design at the RCA, is to try to make things more user-friendly as well as safer. Surely, in a patient-centred health system, that can only be a good thing. “Information design for patient safety” is not intended to be mandatory. Rather, its purpose is to create a basic design standard and to stimulate innovation. The challenge for the pharmaceutical industry, as a whole, is to adopt such a standard.