Sexual intercourse, age of initiation and contraception among adolescents in Ireland: findings from the Health Behaviour in School-aged Children (HBSC) Ireland study

Background

The need to tackle sexual health problems and promote positive sexual health has been acknowledged in Irish health policy. Young people’s sexual behaviour however remains under-researched with limited national data available.

Methods

This study presents the first nationally representative and internationally comparable data on young people’s sexual health behaviours in Ireland. Self-complete questionnaire data were collected from 4494 schoolchildren aged 15–18 years as part of a broader examination of health behaviour and their context. The prevalence of sexual initiation, very early sexual initiation (< 14 years) and non-condom use at last intercourse are reported and used as outcomes in separate multilevel logistic regression models examining associations between sociodemographic characteristics, lifestyle characteristics and young people’s sexual behaviours.

Results

Overall, 25.7% of boys and 21.2% of girls were sexually initiated. Older age was consistently predictive of initiation for both boys and girls, as were alcohol, tobacco and cannabis involvement, living in poorer neighbourhoods and having good communication with friends. Involvement in music and drama was protective. Very early sexual initiation (< 14 years) was reported by 22.8% of sexually initiated boys and 13.4% of sexually initiated girls, and was consistently associated with rural living, cannabis involvement and bullying others for both. Boys’ very early initiation was predicted by alcohol involvement, receiving unhealthy food from parents and taking medication for psychological symptoms, whereas better communication with friends and more experience of negative health symptoms were protective. Girls’ very early initiation was predicted by being bullied and belonging to a non-Traveller community, whereas taking medication for physical symptoms and attending regular health checks was protective. Condom use was reported by 80% of sexually initiated students at last intercourse. Boys’ condom use was associated with older age, higher family affluence, bullying others, more frequent physical activity and health protective behaviours. For girls, condom use was predicted by belonging to a non-Traveller community, healthy food consumption, higher quality of life and being bullied, whereas taking medication for physical and psychological symptoms was associated with non-condom use.

Conclusions

These nationally representative research findings highlight the importance of focusing on young people as a distinct population subgroup with unique influences on their sexual health requiring targeted interventions and policy.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5217-z) contains supplementary material, which is available to authorized users.

[Transition from child and adolescent to adult mental health care]

Adolescents and young adults are at particularly at-risk population in mental health. For a large majority of patients suffering from chronic psychiatric condition, the age of onset of psychiatric symptoms is less than 24 years, while the coverage in psychiatric care is the lowest between 16 and 24. Presenting a psychiatric pathology during childhood and adolescence constitutes an independent risk factor for the occurrence of adverse life events in adulthood. Furthermore, that population is at the edge between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). Transition is the deliberate and planned movement from CAMHS to AMHS. CAMHS and AMHS struggle to achieve optimal transitions between them. Many barriers exist at the interface of the two types of structure and some young people who require continuous care during this period do not have access to it. There are also too few specific psychiatric services for the population of adolescents and young adults. Some recommendations emerge to intend to guide practices, but the literature lacks data to better define this population and build guidelines about the transition between CAMHS and AMHS and about specific services for adolescents and young adults in psychiatry.

Effectiveness and cost-effectiveness of humanistic counselling in schools for young people with emotional distress (ETHOS): study protocol for a randomised controlled trial

Background

One in ten children in Britain have been identified as experiencing a diagnosable mental health disorder. School-based humanistic counselling (SBHC) may help young people identify, address, and overcome psychological distress. Data from four pilot trials suggest that SBHC may be clinically effective. However, a fully powered randomised controlled trial (RCT) is needed to provide a robust test of its effectiveness, to assess its cost-effectiveness, and to determine the process of change.

Methods/design

The Effectiveness and Cost-effectiveness Trial of Humanistic Counselling in Schools (ETHOS) is a two-arm, parallel-group RCT comparing the clinical and cost-effectiveness of SBHC with Pastoral Care as Usual (PCAU) in school settings. Eligibility criteria for young people include being between 13 and 16 years of age and experiencing moderate to severe levels of emotional distress. Participants are randomised to receive either SBHC or PCAU. SBHC is delivered in up to 10 weekly, individual sessions in their school with a qualified, experienced counsellor who has also received training using a clinical practice manual. Adherence to the SBHC model is assessed by a sub-team of auditors and in clinical supervision. PCAU consists of the schools’ pre-existing systems for supporting the emotional health and well-being of students. The primary outcomes are psychological distress measured using the Young Person’s Clinical Outcomes in Routine Evaluation (YP-CORE) and costs evaluated using the Client Service Receipt Inventory (CSRI). Secondary outcomes include psychological difficulties, levels of depression, anxiety and self-esteem, well-being, school engagement, educational outcomes and achievement of personal goals. Qualitative interviews with participants, parents and school staff will look to identify the mechanisms of change in SBHC. Researchers administering the measures are blind to allocation. The trial requires n = 306 participants (n = 153 in each group), with 90% power to detect a standardised mean difference (SMD) of 0.5. An intention-to-treat analysis will be undertaken.

Discussion

This RCT is powered to detect clinically meaningful differences, and will make a major contribution to the evidence base for mental health provision for adolescents. It will have implications for all stakeholders, including policy-makers, statutory advisory bodies for child welfare, head teachers, children and young people practitioners, child welfare and parenting organisations, and young people.

Trial registration

Controlled Trials International Standard Randomised Controlled Trial Number (ISRCTN) Registry, ID: ISRCTN10460622. Registered on 11 May 2016.

Electronic supplementary material

The online version of this article (10.1186/s13063-018-2538-2) contains supplementary material, which is available to authorized users.

Psychological distress and risk for suicidal behavior among university students in contemporary China

BACKGROUND

Psychological distress and suicidal behavior are important mental health problems among university students and warrant research to inform strategies for effective prevention in this young population. The present study aimed to assess psychological distress and suicidal behavior and to unravel their associations among university students.

METHODS

A total of 5972 undergraduate students, randomly selected from six universities in central China, comprised the sample. The Chinese version of the Symptom Checklist-90-revised (SCL-90-R) was used to assess various psychological symptoms. Logistic regression analysis was used to examine the relationship between psychological distress and risk for suicidal behavior.

RESULTS

40.7% of the university students reported positive in a least one of the 9 psychological symptom dimensions assessed by the SCL-90-R. 7.6% of the students reported suicidal behavior in the previous twelve months. The risk of suicidal behavior was significantly associated with psychological symptoms of all types, but there were notable differences by sex. For male students, depression and phobic anxiety increased the risk of suicidal behavior. Meanwhile, depression and obsessive-compulsiveness were positively associated with suicidal behavior in female students. Furthermore, increasing risk of suicidal behavior was associated with increasing positive symptom total (PST) score and a statistically significant trend was observed.

LIMITATIONS

Data collected from a cross-sectional survey does not allow any examination of causal inference.

CONCLUSIONS

Psychological distress and suicidal behavior were both common among university students; and psychological distress was highly associated with suicidal behavior. The findings underscore the importance of mental health care for university students.

Ethical implications of digital communication for the patient-clinician relationship: analysis of interviews with clinicians and young adults with long term conditions (the LYNC study)

BACKGROUND

Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions.

METHODS

A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom (UK)-based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites (cancer, liver, renal, cystic fibrosis and mental health) were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms.

RESULTS

Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician's duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical digital communication.

CONCLUSIONS

The ethical implications of clinical digital communication are complex and go beyond concerns about confidentiality and consent. Any development of this form of communication should consider its impact on the patient-clinician-relationship, and include appropriate safeguards to ensure that professional ethical obligations are adhered to.

School and class-level variations and patterns of physical activity: a multilevel analysis of Danish high school students

Background

There is limited knowledge of physical activity (PA) patterns among high school students. High schools plays an important role as context for the students, but it is uncertain to what extent schools influence student participation in PA during leisure time. The purpose of this study is to describe patterns of PA and assess variations between schools and classes in PA, in a large cohort of Danish high school students.

Methods

Self-reported cross-sectional data came from The Danish National Youth Study, comprising a total of 70,674 students attending 119 different schools and 3213 classes. Multilevel logistic regressions were applied to evaluate the association between socio-demographic variables and patterns of PA, and to assess the impact of schools and classes on PA measures.

Results

Students whose parents have achieved a lower level of education, older students and girls of perceived ethnic minority generally participated less in several forms of PA during leisure time. Substantial variations between schools were observed in terms of participation in PA at school during leisure time and in terms of use of active transportation to and from school. The school-level accounted for 9% (intra-class correlation coefficient (ICC) = 0.09 (95% CI: 0.06–0.11)) and 8% (ICC = 0.08 (95% CI: 0.07–0.11)) of the variation for participation in PA during leisure time and active transportation.

Conclusion

Overall, students whose parents achieved a lower level of education, older students and girls of perceived ethnic minority represent vulnerable groups in relation to participation in several forms of PA during leisure time. The ICCs indicate that schools, in particular, have the potential to influence participation in PA at school during leisure time and active transportation to and from school. Thus, high schools should encourage and facilitate activities aimed at engaging students in PA during leisure time as well as encourage active transportation.

Mortality of young people with cancer: clinical-epidemiological characteristics of death and emerging ethical aspects

Objective

To describe the epidemiological, clinical, and ethical aspects of the mortality of young people with cancer in Mexico.

Methods

63 medical records from 14 to 18-year-old patients, with cancer, who died between 2011 and 2014, were reviewed to obtain epidemiological and clinical characteristics of their death. The study sites were three tertiary referral hospitals in Mexico City.

Results

Of 40 young people in terminal phase, 16 (40%) continued to receive curative treatment; of the 51 whose place of death was known, 45 (88%) died in hospital. Of the 41 who died within 30 days of their last hospitalization, deaths were due to complications (51%), progression of the disease (41%), and deaths of those in palliative care (7%).

Conclusions

Oncological practice rests on what is known as a biomedical model. The results of this study suggest the urgent need for, and support the implementation of, true palliative-care services. More importantly, these findings underscore the necessity of putting the ethics of clinical practice into action, such that best practice in medicine is reinforced.

Individual- and Family-Level Determinants of Risky Sexual Behavior Among Swedish- and Foreign-Born Young Adults 18-30 Years of Age, Residing in Skåne, Sweden

In Sweden, various public health interventions have been performed to reduce risky sexual behaviors among young people and promote safer and positive approaches to sexuality, while attempting to bridge the gap between the less privileged or more vulnerable young people and their more privileged peers. This study aimed to compare the individual- and familial-level determinants of risky sexual behavior among foreign-born and Swedish-born young adults 18-30 years of age residing in Skåne, the south of Sweden. This was a cross-sectional study that used a questionnaire to collect data from 2968 randomly selected respondents between 18 and 30 years between January and March 2013. The associations were analyzed using chi-square tests, and simple and multiple logistic regression analyses. Younger age, i.e., individual-level factor, and living with only one parent or another person while growing up, i.e., familial-level factor, increased the risk of engaging in sexual risk taking for both Swedish- and foreign-born youth. Male gender was related to a higher risk of engaging in sexual risk-taking behaviors among foreign-born youth but was not as important as influence on sexual risk taking among Swedish-born youth. Parental education level, on the other hand, was significantly associated with sexual intercourse on the "first night" and early sexual debut solely among Swedish-born youth. Condom use was not associated with any family-level factor among both Swedish-born and foreign-born youth. The design of sexual reproductive health and rights messages and interventions to target risky sexual behavior among Swedish youth should take into consideration immigration status (for example, being Swedish-born or foreign-born), individual- and family-level characteristics, as well as the type of behavioral change or outcome desired.

Efficacy and outcomes of a mobile app targeting alcohol use in young people

Mobile apps provide a highly accessible way of reducing alcohol use in young people. This paper determines the 1-month efficacy and 2, 3 and 6month outcomes of the Ray's Night Out app, which aims to increase alcohol knowledge and reduce alcohol use in young people. User-experience design and agile development processes, informed by the Information-Motivation-Behavioral skills model and evidence-based motivational interviewing treatment approaches guided app development. A randomized controlled trial comparing immediate versus 1-month delayed access to the app was conducted in 197 young people (16 to 25years) who drank alcohol in the previous month. Participants were assessed at baseline, 1, 2, 3 and 6months. Alcohol knowledge, alcohol use and related harms and the severity of problematic drinking were assessed. App quality was evaluated after 1-month of app use. Participants in the immediate access group achieved a significantly greater increase in alcohol knowledge than the delayed access group at 1-month, but no differences in alcohol use or related problems were found. Both groups achieved significant reductions in the typical number of drinks on a drinking occasion over time. A reduction in maximum drinks consumed was also found at 1month. These reductions were most likely to occur in males and problem drinkers. Reductions in alcohol-related harm were also found. The app received a high mean quality (M=3.82/5, SD=0.51). The Ray app provides a youth-friendly and easily-accessible way of increasing young people's alcohol knowledge but further testing is required to determine its impact on alcohol use and related problems.

What influences university students to seek sexually transmitted infection testing?: A qualitative study in New Zealand

OBJECTIVE

Untreated sexually transmitted infections (STIs) can lead to serious health complications, increase susceptibility to contracting further STIs including human immunodefiniceny virus (HIV), and can be transmitted to others. The early diagnosis and treatment of STIs is therefore central to comprehensive STI management and prevention, but this relies on those at risk of STIs presenting for testing. In order to understand STI testing behaviours in view of their improvement, this study aimed to elucidate why people seek STI testing.

METHODS

Qualitative semi-structured interviews were conducted with 24 university students who had recently had an STI test. Resulting data were analysed employing a qualitative thematic analysis method to produce a final set of themes.

RESULTS

Five drivers for STI testing were identified from the data: crisis, partners, clinicians, routines, and previous knowledge. The final driver, previous knowledge, intersected with the previous four, particularly in relation to routines. Many participants acknowledged that the more they knew about STIs the more likely they were to undertake routine tests. However, at the same time, many participants felt they did not have a good knowledge base and that their school-based sex education had been lacking.

CONCLUSION

This study highlights important drivers for STI testing, which may aid the design of public health campaigns. It also underlines that school-based education could provide stronger foundations with regards to STIs and their prevention.

An examination of sex differences in neurocognition and social cognition in first-episode psychosis

Due to the dearth and conflicting findings of previous research, it is unclear whether males and females with first-episode psychosis (FEP) differ in their neurocognitive and social cognitive abilities. The aims of the current study were to investigate whether: (i) there are sex differences in neurocognition and social cognition among young people with FEP; and (ii) they resemble those observed in age-matched healthy controls. The current study involved secondary analysis of data from a previous study in which a large neurocognitive and social cognitive battery was administered to 146 individuals with FEP and 46 healthy controls aged 15-25 years. Seven two-way between-groups multivariate analysis of variances revealed that FEP participants were impaired relative to controls on all cognitive domains. Only one main effect of sex was found with males, regardless of group, outperforming females on verbal comprehension. A significant interaction effect was found for information processing speed with FEP females outperforming FEP males on the Symbol Digit Modalities Test; however, post-hoc analysis of the mean difference was not significant. Despite few sex differences, the current study highlights that cognitive impairment is a key feature of FEP that should be a treatment target in early intervention.

Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): A systematic review

INTRODUCTION

A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age.

OBJECTIVE

To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed.

METHOD

A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used.

RESULTS

Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration.

CONCLUSIONS

Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem.

Becoming independent: political participation and youth transitions in the Scottish referendum

Sociological debates on youth engagement with electoral politics play out against a backdrop of supposed 'decline' in civic participation (e.g. Putnam , Norris, ), in turn contextualized by theories of individualization in 'late' or 'reflexive' modernity (Beck, Giddens). However, the enfranchisement of 16 and 17 year olds in the 2014 Scottish Independence Referendum catalysed remarkably high levels of voter turnout among this youngest group, and was accompanied by apparently ongoing political engagement. We explored this engagement among a strategic sample of young 'Yes' voters, in the immediate aftermath of this exceptional political event. Analysis of qualitative interview data generated an unanticipated finding; that interviewees narrated their political engagement biographically, articulated their referendum participation reflexively, and located their new political ideas, allegiances and actions in the context of their own transitions to 'independent' adulthood. This inspired us to rethink young people's political engagement in relation to youth transitions. Doing so enables a synthesis of divergent strands in the sociology of youth, and offers new insights into the combinations of 'personal' agentic and 'political' structural factors involved in young people's politicization.

Children and young people's views on institutional safety: It's not just because we're little

The Australian Royal Commission into Institutional Responses to Child Sexual Abuse has set in motion a number of systemic and organizational approaches to identify and respond to child sexual abuse. These include increased child abuse awareness, developing and enhancing child-safe organizational cultures and policies and more thorough screening and supervision of staff in child and youth serving organizations. Although these advances should be applauded, many of the concerns that children and young people have raised about interpersonal safety have not been fully addressed. There is therefore a risk that children's physical, relational, generational, and organizational powerlessness are reinforced through child-safe practices that restrict their meaningful participation, ignore their agency and capacity and fail to respond to their felt safety needs or wishes. This paper presents the findings of a qualitative research project conducted with 121 Australian children and young people and presents their perspectives on issues of vulnerability and the ways that they would like adults and institutions to respond to their safety concerns. The value of adult-child alliances, of formal mechanisms that are child-friendly and accessible and having external agencies monitor and review institutional strategies to preventing harm are discussed.

Heterosexual Practices Among Young People in Britain: Evidence From Three National Surveys of Sexual Attitudes and Lifestyles

PURPOSE

To describe time trends and current patterns in sexual practices with opposite-sex partners among men and women aged 16-24 years in Britain.

METHODS

Complex survey analyses of cross-sectional probability survey data from three British National Surveys of Sexual Attitudes and Lifestyles (Natsal), conducted approximately decennially 1990-2012, involving interviews with 45,199 people in total.

RESULTS

Birth cohort analysis showed a decline in the median age at first sexual experience and first intercourse since the midtwentieth century and a narrowing of the interval between these events. Comparison of data from Natsals 1, 2, and 3 showed increases in the prevalence of ever experience of oral and anal sex among 16- to 24-year-olds, which were more marked among older respondents in this age group between Natsals 1 and 2, and among younger respondents between Natsals 2 and 3. Among the sexually active, vaginal and oral sex remained the most common combination of practices reported in the past year. The proportion reporting a past-year repertoire of vaginal, oral, and anal sex rose from approximately one in 10 in 1990-1991 to approximately one in four men and one in five women in 2010-2012. In the latest survey, heterosexual experience of practices was positively associated with bisexual attraction among women.

CONCLUSIONS

Recent decades have seen an earlier age at initiation of partnered sexual experiences and increased diversity in heterosexual practices among young people. Keeping pace with trends in sexual practices is necessary to safeguard young people's health and to support them in increasing their sexual well-being.

Improving metabolic monitoring rate for young people aged 35 and younger taking antipsychotic medications to treat a psychosis: A literature review

Young people aged 35 and younger who are taking antipsychotic medications to treat a psychosis are a high risk for developing metabolic syndrome due to the adverse effects of the medications. This paper reports the finding of a review of literature to identify interventions to improve metabolic monitoring rates in this group. A review of 478 studies identified 15 articles which met the inclusion criteria. Five articles reported single-intervention studies and the remaining integrated two or more interventions to improve uptake level of metabolic monitoring. As metabolic syndrome can be detected early through metabolic monitoring in young people taking antipsychotics, early intervention is important to improve their physical health trajectory.

Core Health Outcomes In Childhood Epilepsy (CHOICE): protocol for the selection of a core outcome set

BACKGROUND

There is increasing recognition that establishing a core set of outcomes to be evaluated and reported in trials of interventions for particular conditions will improve the usefulness of health research. There is no established core outcome set for childhood epilepsy. The aim of this work is to select a core outcome set to be used in evaluative research of interventions for children with rolandic epilepsy, as an exemplar of common childhood epilepsy syndromes.

METHODS

First we will identify what outcomes should be measured; then we will decide how to measure those outcomes. We will engage relevant UK charities and health professional societies as partners, and convene advisory panels for young people with epilepsy and parents of children with epilepsy. We will identify candidate outcomes from a search for trials of interventions for childhood epilepsy, statutory guidance and consultation with our advisory panels. Families, charities and health, education and neuropsychology professionals will be invited to participate in a Delphi survey following recommended practices in the development of core outcome sets. Participants will be able to recommend additional outcome domains. Over three rounds of Delphi survey participants will rate the importance of candidate outcome domains and state the rationale for their decisions. Over the three rounds we will seek consensus across and between families and health professionals on the more important outcomes. A face-to-face meeting will be convened to ratify the core outcome set. We will then review and recommend ways to measure the shortlisted outcomes using clinical assessment and/or patient-reported outcome measures.

DISCUSSION

Our methodology is a proportionate and pragmatic approach to expediently produce a core outcome set for evaluative research of interventions aiming to improve the health of children with epilepsy. A number of decisions have to be made when designing a study to develop a core outcome set including defining the scope, choosing which stakeholders to engage, most effective ways to elicit their views, especially children and a potential role for qualitative research.

Health and wellbeing during transition to adulthood for young people with intellectual disabilities: A qualitative study

BACKGROUND

Transition to adulthood may have negative consequences for health and wellbeing in individuals with intellectual disabilities (ID), but this aspect of transition has received little investigation. This qualitative study aimed to explore the transition experiences of individuals with ID from their own perspectives, and from that of their parents, in order to identify health or wellbeing implications of transition.

METHOD

Semi-structured interviews were conducted with 17 young people with mild, moderate and severe ID aged 16-27 years and with 23 parents of young people with mild, moderate, severe and profound ID aged 16-26 years. Interviews were analysed using thematic analysis, deploying both emic and etic coding categories.

RESULTS

This study provides direct insights into the issues on health and wellbeing that young people with ID and their parents find important during transition. The primary health implication of transition centred on mental health and wellbeing; young people experienced heightened anxiety during transition, and themes identified as contributing to anxiety included: a lack of meaningful activity following school exit; inadequate support during transition; and difficulties associated with 'growing up'. Problem behaviours and obesity were also implicated.

CONCLUSION

The transition from school needs to be better supported in order to ease anxiety for young people during this difficult period.

Development and validation of the cannabis experiences questionnaire - Intoxication effects checklist (CEQ-I) short form

OBJECTIVE

To develop and validate a short form of the Cannabis Experiences Questionnaire - Intoxication Effects (CEQ-I), a 42-item scale which measures the euphoric and paranoid-dysphoric effects of cannabis intoxication.

METHOD

Exploratory and confirmatory factor analyses were conducted among 604 past-month cannabis users to develop the short form. The factor structure was replicated in a second sample of 146 past-month cannabis users. The concurrent validity of the scale was also examined.

RESULTS

Consistent with previous research, two factors were identified (paranoid-dysphoric; euphoric), and were replicated with confirmatory factor analyses. The most parsimonious scale consisted of 13 items. Correlations of short-form subscales with corresponding original subscales were high. The paranoid-dysphoric subscale was also moderately positively correlated with measures of psychotic-like experiences (PLEs) and psychological distress.

CONCLUSIONS

The revised and validated CEQ-I short form can be used to explore the euphoric and paranoid-dysphoric effects of cannabis intoxication in young cannabis users, and whether these experiences increase their risk of developing cannabis use and psychotic disorders. The CEQ-I short form has the potential to aid in the identification of young cannabis users at risk of the paranoid-dysphoric effects of cannabis intoxication and may assist in the development of early intervention strategies targeting cannabis users with PLEs.

Mindfulness-Based Cognitive Therapy for Young People and Their Carers: a Mixed-Method Feasibility Study

We aimed to evaluate whether mindfulness-based cognitive therapy (MBCT) was feasible and acceptable for young people, their parents and the clinicians working with them; whether a parallel course for parents was a useful addition; and whether attendance at MBCT was associated with improved outcomes. The design was a mixed-method service evaluation of an eight-session MBCT programme for young people who were recovering from depression. The course was a manualised eight-session group intervention. Both young people (n = 18) and parents (n = 21) completed validated measures before and after the course. Semi-structured interviews were completed with some group participants and clinical staff working in the service. Care records were searched for additional contact following the intervention. Qualitative data from young people, parents and clinicians suggested that MBCT was acceptable and feasible and provided strategies to cope. The parent course was reported to provide personal support to parents and helped them cope with their child's depression whilst also impacting the family, promoted shared understanding of depression and strategies to combat it and addressed intergenerational aspects of depression. Eighty-four per cent of participants attended at least 6/8 sessions, and 48% required no further intervention within the following year. Young people had statistically significant improvements across all outcome measures, whilst parents had statistically significant improvements in rumination, self-compassion and decentring.

Young peoples' perceptions of the nursing profession: An integrative review

OBJECTIVES

The purpose of this integrative review was to describe young people's perceptions of the nursing profession and to identify factors influencing the perception.

DESIGN

Integrative literature review.

DATA SOURCES

The CINAHL, PubMed and Medic electronic databases were searched for research publications between 2006 and 2016. The keywords used were: perception, attitude, belief, view, knowledge, image, nurse, nursing care, career, profession, role, teen, middle school student, high school student, adolescent and pupil. A manual search was conducted of the reference lists of the identified articles.

REVIEW METHODS

Whittemore and Knafl's method for conducting an integrative review was utilized. The quality of the chosen articles was assessed with Joanna Briggs Institute's quality appraisal tools.

FINDINGS

The search resulted in eight articles. Young people described the nature of nursing work with poor working conditions, shift work and a limited level of autonomy. Nursing work was mainly seen as caring for and helping patients which was considered inferior to doctors' work. Young people did not recognize the educational requirements or the career pathways in nursing and described the status of nursing as low in society. Nurses were considered as kind and caring people who work hard and are less intellectual. The factors influencing the perception were family and relatives, friends, media, significant others and personal factors.

CONCLUSIONS

Perceptions of young people do not reflect the reality of the nursing profession and the perceived image of nursing has not changed in the last ten years. Young people and the public need realistic information of the nursing profession and the actions to change the image should take place at all levels of the society. Further research is needed to understand how the perceptions of the young people can be influenced and changed to reflect a more realistic image of a contemporary nurse.

Drinking motives and alcohol consumption behaviors among young French people

INTRODUCTION

Numerous studies suggest that social, enhancement, conformity and coping drinking motives each lead to unique behavioral patterns related to alcohol consumption. Recently it has been suggested to study specific coping motives that distinguish feelings of anxiety and depression. This study aims primarily to 1) psychometrically validate the recent five factor questionnaire of drinking motives among young French people, 2) explore differences in mean endorsements of motives across age and sex and 3) explore the concurrent validity of drinking motives by studying their associations with alcohol consumption behaviors.

METHODS

The French Modified Drinking Motives Questionnaire Revised and the Alcohol Use Disorders Identification Test were administered to 314 university students and 193 high school students.

RESULTS

The 5-factor model of drinking motives provided a good fit to the data and a better fit than the 4-factor model. Conformity motives were more strongly endorsed among high school students than among university students (d=0.26). Social motives were more endorsed by men than by women (d=0.47), as were enhancement motives (d=0.48). Our study suggests that each of the studied motives transcribes a specific set of drinking behaviors.

CONCLUSIONS

Researchers and practitioners could effectively use this conception of drinking motives in order to better understand and prevent problematic alcohol use among young people.

Using the nominal group technique to involve young people in an evidence synthesis which explored 'risk' in inpatient mental healthcare

PLAIN LANGUAGE SUMMARY

We conducted a review of research on the topic of 'risk' in hospital based mental health care for young people aged 11-18. We wanted to include a contribution from young people alongside other stakeholders with expertise to guide the research team in decisions made setting parameters for the review. To achieve this, we held a stakeholder group meeting. We used the nominal group technique, a method designed to create a structure and a process for getting feedback from a group of people in a way that allows everyone to have an equal say. In this study, we show how our use of this approach enabled our stakeholder group to shape the focus of our study towards an area of more importance and relevance to them.

BACKGROUND

In this paper we demonstrate how our application of the nominal group technique was used as a method of involving young people with previous experience of using inpatient mental health services in an evidence synthesis.

METHODS

Nominal group technique is an approach to group decision-making that places weight on all participants having an equal opportunity to express a view, and to influence decisions which are made. It is an effective way to enable people who might otherwise be excluded from decision-making to contribute.

RESULTS

In this study, the focus of the evidence synthesis was significantly shaped following using the nominal group technique in our stakeholder advisory group meeting. The young people present in the group invited the research group to think differently about which 'risks' were important, to consider how young people conceptualised risk differently, focussing on risks with long term impact and quality of life implications, rather than immediate clinical risks.

CONCLUSIONS

Using the nominal group technique with young people did offer a method of promoting the equality of decision making within a stakeholder advisory group to an evidence synthesis project, but care needs to be taken to invite sufficient young people to attend so they can be proportionally represented.

Training General Practitioners to Detect Probable Mental Disorders in Young People During Health Risk Screening

PURPOSE

The purpose of the study is to investigate whether a training intervention increases general practitioners' (GPs) detection sensitivity for probable mental disorders in young people.

METHODS

Forty general practices were randomized to an intervention (29 GPs) or comparison arm (49 GPs). Intervention GPs participated in 9 hours of interactive training on youth-friendly care, psychosocial health risk screening, and responding to risk-taking behavior with motivational interviewing approaches, followed by practice visits assisting with integration of screening processes and tools. Youth aged 14-24 years attending GPs underwent a computer-assisted telephone interview about their consultation and psychosocial health risks. Having a "probable mental disorder" was defined as either scoring high on Kessler's scale of psychological distress (K10) or self-perceived mental illness. Other definitions tested were high K10; self-perceived mental illness; and high K10 and self-perceived mental illness. Psychosocial health risk screening rates, detection sensitivity, and other accuracy parameters (specificity, positive predictive value, and negative predictive value) were estimated.

RESULTS

GPs' detection sensitivity improved after the intervention if having probable mental disorder was defined as high K10 score and self-perceived mental illness (odds ratio: 2.81; 95% confidence interval: 1.23-6.42). There was no significant difference in sensitivity of GPs' detection for our preferred definition, high K10 or self-perceived mental illness (.37 in both; odds ratio: .93; 95% confidence interval: .47-1.83), and detection accuracy was comparable (specificity: .84 vs. .87, positive predictive values: .54 vs. .60, and negative predictive values: .72 vs. .72).

CONCLUSIONS

Improving recognition of mental disorder among young people attending primary care is likely to require a multifaceted approach targeting young people and GPs.

A next-generation social media-based relapse prevention intervention for youth depression: Qualitative data on user experience outcomes for social networking, safety, and clinical benefit

Major depressive disorder (MDD) has a high prevalence and relapse rate among young people. For many individuals depression exhibits a severe course, and it is therefore critical to invest in innovative online interventions for depression that are cost-effective, acceptable and feasible. At present, there is a scarcity of research reporting on qualitative data regarding the subjective user experience of young people using social networking-based interventions for depression. This study provides in-depth qualitative insights generated from 38 semi-structured interviews, and a follow-up focus group, with young people (15-25 years) after the implementation of a moderated online social therapy intervention for depression relapse prevention ("Rebound"). Exploratory analysis identified patterns of content from interview data related to three main themes: 1) preferred content compared to perceived helpfulness of the online platform, 2) interest in social networking, and 3) protective environment. Two clear groups emerged; those who perceived the social networking component of the intervention as the most helpful component; and those who preferred to engage in therapy content, receiving individualized content suggested by moderators. The Rebound intervention was shown to be acceptable for young people with major depression. Integration of social networking features appears to enhance intervention engagement for some young people recovering from depression.