Leaving home in Slovenia: a quantitative exploration of residential independence among young adults

The present paper analyzes and contextualizes the phenomenon of prolonged co-residence of parents and young adult children in Slovenia. It analyzes the process of moving out or staying at home on the basis of a subsample of young people between 19 and 29 who are no longer at school included in the representative Slovenian field survey Youth 2010. Young people still living in the household of their parents or (legal) guardians are compared with those who have already left. The analysis considers factors associated with the status transitions from youth to adulthood; the demographic, social and economic background; and the perception of the parent-child relationship quality and parenting style by the children. Our findings point to the importance of possibilities for independent housing and the economic capacity of young people and their family. The most important factor behind moving out seems to be a stable partnership.

Younger children's nursing students are uniquely placed to provide emotional care for young people in hospital and promote for them a sense of normalcy

OBJECTIVES

To highlight the emotional impact of being in the hospital for young people and to explore the impact of the care by younger student nurses on promoting a sense of "normalcy" for them.

BACKGROUND

Adolescence is strongly influenced by peer relationships and is a unique period in life that requires the achievement of many developmental tasks. An important task of adolescent is developing relationships with peers and feeling part of a recognised peer group. Young people prefer engaging in conversation with people of their own age because they feel less likely to be judged by their peers.

DESIGN

Heideggerian hermeneutic phenomenological study.

METHOD

A Heideggerian phenomenological study was undertaken. Individual unstructured interviews were conducted with eleven younger student nurses (aged l7 years and 5 months-l8 years and 11 months) and nine young people with a chronic illness (aged 13 years and 7 months-18 years and 1 month). The data was collected in 2009.

RESULTS

Young people in the hospital with a chronic illness experienced moments in time when they had nothing to think about but the business of getting better. During unique caring interactions, younger children's nursing students were able to help them temporarily forget about their illness and promote for them a sense of normalcy.

CONCLUSIONS

Younger children's nursing students are in a unique position to engage in ontological caring interactions with the young people due to their similarity in age and stage of development. They are uniquely placed to help the young people reintegrate back into their known "lifeworlds" and promote for them a sense of "normalcy".

RELEVANCE TO CLINICAL PRACTICE

Clinical staff need to be alerted to the emotional distress caused to young people during long periods of time in the hospital. Practitioners and nurse educators should be facilitating younger student nurses to interact with the young people in a therapeutic way and the care delivered to young people in the hospital should promote a sense of normalcy for them.

Predictors of adolescent smoking cessation and smoking reduction

OBJECTIVE

To investigate the processes of change, demographic, health- and smoking-related predictors of both smoking cessation and smoking reduction in adolescents.

METHODS

Data were drawn from a sample of 755 adolescent smokers who participated in a study testing the efficacy of a text messaging-based intervention for smoking cessation. Demographic, health- and smoking-related variables were assessed at baseline. Five processes of smoking cessation, derived from the Transtheoretical Model and the Social Cognitive Theory, as well as outcome measures were assessed at 6-month follow up. Univariate and multivariate regression analyses were conducted to identify baseline and process variables to predict smoking abstinence and smoking reduction.

RESULTS

Male gender (OR=0.43, p<.01), lower alcohol consumption (OR=0.90, p=.05) and a lower number of cigarettes smoked per day at baseline (OR=0.87, p<.01) predicted smoking abstinence. Baseline physical activity predicted smoking reduction (OR=1.04, p=.03). None of the examined process variables significantly predicted smoking abstinence. The process variable "counter-conditioning" predicted smoking reduction (OR=1.46, p=.03).

CONCLUSIONS

Baseline predictors of smoking cessation differ from predictors of smoking reduction. Dynamic or modifiable variables play an important role in predicting adolescent smoking cessation.

PRACTICE IMPLICATIONS

Counter-conditioning might be an important element in adolescent smoking cessation interventions.

Assembling the dominant accounts of youth drug use in Australian harm reduction drug education

Education programs are a central element of Australian harm reduction drug policy. Considered less judgmental and more effective than the punitive policies of Australia's past, harm reduction drug education is premised on the goal of reducing 'risks' and harms associated with illicit drug use rather than an elimination of use per se. In this article I analyse two sets of key texts designed to reduce drug related harm in Australia: harm reduction teaching resources designed for classroom use and social marketing campaigns that are targeted to a more general audience. I identify two significant accounts of young people's drug use present in Australian harm reduction drug education: 'damaged mental health' and 'distress'. I then draw on some of Deleuze and Guattari's key concepts to consider the harm reducing potential these accounts may have for young people's drug using experiences. To demonstrate the potential limitations of current drug education, I refer to an established body of work examining young people's experiences of chroming. From here, I argue that the accounts of 'damaged mental health' and 'distress' may work to limit the capacity of young drug users to practice safer drug use. In sum, current Australian harm reduction drug education and social marketing may be producing rather than reducing drug related harm.

A review of self-rating instruments to identify young people at risk of bipolar spectrum disorders

BACKGROUND

Despite 15-25 years being the peak age at onset for bipolar disorder (BD), recognition and introduction of appropriate treatment are typically delayed by 6 or more years. A major reason for these delays is the failure to identify prior mood episodes or risk factors for bipolarity, suggesting that there may be a particular benefit in using screening tools in this age group.

METHODS

We identified papers published between 1980 and 2012 that assessed the validity of measures specifically used to screen for BD, risk factors for bipolarity, or a prior history of depressive, hypomanic or manic episodes. From these, we identified those studies that included sufficient information about participants aged 15-25 years.

RESULTS

Searches yielded only eleven independent studies with available data on the target age group. The studies employed seven separate scales that demonstrated quite different screening properties. The cut-off scores for optimal sensitivity and specificity often differed from those reported for adult samples and varied according to sample characteristics.

LIMITATIONS

Our findings may be undermined by the small sample sizes and low number of individuals in the specified age range included in the studies identified. Although we explored all available methods for detecting studies and data sets, we cannot exclude the likelihood that other relevant studies on this age range exist.

CONCLUSIONS

Available screening tools for BD have mainly been validated in middle-aged adult samples with established mood disorders, and the instruments reviewed show sub-optimal screening properties when applied to adolescents and young adults. Overall, those measures that examine personality traits or temperament appear to perform better than those assessing discrete symptoms or episodes. However, all the measures need further testing and/or modification. In the interim, to improve screening for BD in those in the peak age range for onset of this disorder, it may be appropriate to combine a measure with high sensitivity with one that demonstrates high specificity for a given sampling frame.

Assessment protocols of maximum oxygen consumption in young people with Down syndrome--a review

Maximum oxygen consumption is considered the gold standard measure of cardiorespiratory fitness. Young people with Down syndrome (DS) present low values of this indicator compared to their peers without disabilities and to young people with an intellectual disability but without DS. The use of reliable and valid assessment methods provides more reliable results for the diagnosis of cardiorespiratory fitness and the response of this variable to exercise. The aim of the present study was to review the literature on the assessment protocols used to measure maximum oxygen consumption in children and adolescents with Down syndrome giving emphasis to the protocols used, the validation process and their feasibility. The search was carried out in eight electronic databases--Scopus, Medline-Pubmed, Web of science, SportDiscus, Cinhal, Academic Search Premier, Scielo, and Lilacs. The inclusion criteria were: (a) articles which assessed VO2peak and/or VO2max (independent of the validation method), (b) samples composed of children and/or adolescents with Down syndrome, (c) participants of up to 20 years old, and (d) studies performed after 1990. Fifteen studies were selected and, of these, 11 measured the VO2peak using tests performed in a laboratory, 2 used field tests and the remaining 2 used both laboratory and field tests. The majority of the selected studies used maximal tests and conducted familiarization sessions. All the studies took into account the clinical conditions that could hamper testing or endanger the individuals. However, a large number of studies used tests which had not been specifically validated for the evaluated population. Finally, the search emphasized the small number of studies which use field tests to evaluate oxygen consumption.

"Every 'never' I ever said came true": transitions from opioid pills to heroin injecting

This qualitative study documents the pathways to injecting heroin by users in Philadelphia and San Francisco before and during a pharmaceutical opioid pill epidemic. Data was collected through in-depth, semi-structured interviews (conducted between 2010 and 2012) that were, conducted against a background of longer-term participant-observation, ethnographic studies of street-based drug users and dealers in Philadelphia (2007-12) and San Francisco (1994-2007, 2012). Philadelphia and San Francisco were selected for their contrasting political economies, immigration patterns and source type of heroin. In Philadelphia the ethnographers found heroin injectors, usually white users, who had started their opiate using careers with prescription opioids rather than transitioning from other drugs. In both Philadelphia and San Francisco, most of the young heroin injectors interviewed began, their drug-use trajectories with opioid pills--usually Percocet (oxycodone and acetaminophen), generic short acting oxycodone or, OxyContin (long-acting oxycodone)--before transitioning to heroin, usually by nasal inhalation (sniffing) or smoking at first, followed by injecting. While most of the Philadelphia users were born in the city or its suburbs and had started using both opioid pills and heroin there, many of the San Francisco users had initiated their pill and sometimes heroin use elsewhere and had migrated to the city from around the country. Nevertheless, patterns of transition of younger injectors were similar in both cities suggesting an evolving national pattern. In contrast, older users in both Philadelphia and San Francisco were more likely to have graduated to heroin injection from non-opiate drugs such as cannabis, methamphetamine and cocaine. Pharmaceutical opioid initiates typically reported switching to heroin for reasons of cost and ease-of-access to supply after becoming physically and emotionally dependent on opioid pills. Many expressed surprise and dismay at their progression to sniffing and subsequently to injecting heroin. Historically and structurally these users found themselves caught at the intersection of two major developments in the opiate supply: (1) an over 500% increase in opiate pill prescription from 1997 to 2005 resulting in easy access to diverted supplies of less stigmatized opiates than heroin and (2) a heroin supply glut, following the US entry of Colombian-sourced, heroin in the early 1990s, that decreased cost and increased purity at the retail level. A nationwide up-cycle of heroin use may be occurring among young inner city, suburban and rural youth fueled by widespread prescription opioid pill use.

Teaching age and discrimination: a life course perspective

Age discrimination in health and social care is a universal issue with significant potential ramifications for practice, and one which should be explicitly addressed in health and social care pre-registration education. However, developing teaching and learning strategies to effectively address this subject is complex given that implicit/indirect discrimination based upon tacit beliefs and assumptions, is problematic and difficult to tackle. This paper discusses the importance of teaching age and discrimination to student nurses in the context of the development of a novel approach to this aspect of education from a life course perspective. This discussion is based personal and professional reflections of the authors on the delivery of the teaching session over a number of years with approximately 500 student mental health nurses to date. The emerging themes of this are reported here and their implications for education and practice discussed. Exploring age and discrimination in relation to children and young people and older people in particular has enabled student nurses to explore the concept as one which requires critical reflection. This promotes awareness of usually unexamined personal attitudes in relation to age in order to enhance the potential for good experiences of health services for all people in need of them.

Stigma in school-based mental health: perceptions of young people and service providers

BACKGROUND

Mental health affects one in five young people, with the majority avoiding help due to stigma. In this study, young people's (n = 49) perception of stigma as a barrier to accessing school-based mental health services was compared with that of service providers (n = 63), along with the perceived extent of mental health problems and availability of school-based mental health resources.

METHOD

Participants completed a survey or interview. EBSCO and PubMed databases were used for the duration of this study, from August 2010 to September 2011.

RESULTS

A greater proportion of young people versus providers reported stigma as the largest barrier to accessing mental health services. In addition, most young people reported that school-based mental health resources were scarce.

CONCLUSIONS

These results emphasize the need for young people's involvement in mental health initiatives.

Attitudes of emergency care staff towards young people who self-harm: a scoping review

AIM

To determine whether reported attitudes towards patients who attend A&E following self-harm extend to young people.

BACKGROUND

Historically A&E staff have displayed negative attitudes towards patients who self-harm, although more recent research suggests that attitudes have shifted. There is retrospective evidence of low satisfaction with A&E services by individuals who self-harmed as adolescents, with comparatively little research which has specifically examined attitudes towards adolescent self-harm available.

METHOD

A scoping review of papers published from 2000 to 2012 was undertaken, papers accessed through the following databases, British Nursing Index, CINAHL, Medline, Psychology and Behavioural Science Collection, and PsychINFO. Hawker et al.'s (2002) methodology for critical appraisal was adopted.

RESULTS

Eleven papers derived from nine studies were located; three studies adopted qualitative methods, two mixed methods; the remainder were quantitative adopting a survey approach to measure attitudes. The studies revealed inconsistent findings, although the setting, patients' characteristics and education and training all appear to have a bearing on attitudes towards young people who self-harm.

CONCLUSION

Further research is required which considers attitudes of emergency care practitioners within the context of emergency care work, and which investigates whether being a young person per se has an influence on attitudes.

Correlates and Determinants of Reproductive Behavior among Female University Students in Tehran

BACKGROUND

This paper aims to examine the reproductive health and behaviors which might expose young people at risks of STIs/HIV and potential correlates of such behaviors among female college students in Tehran.

METHODS

This paper focuses on the study conducted on a sample of 1743 female undergraduate students in four multidisciplinary universities in Tehran during 2005- 2006 using a two-stage stratified cluster sampling. The main focus was to determine the predictors of premarital heterosexual reproductive behavior among female students.

RESULTS

The mean age of the unmarried students was 21.4 years. Low self-efficacy (OR=7.87, p <0.001), perceived peers' liberal attitude on virginity (OR= 4.33), perception of parents' liberal attitude towards relationship with the opposite sex and poor family atmosphere (OR=3.04 and 2.20, p <0.001, respectively) were predictors of ever having any type of sexual experience after controlling for other factors. The only predictors of penetrative sex remained in the logistic model were older age (OR=5.95), low self-efficacy (OR=10.86), poor family atmosphere (OR= 2.96), liberal parental attitude (OR=4.29) and liberal peer norms on virginity (OR= 4.90).

CONCLUSION

Interventional programs need to be designed at various levels such as enhancing self-efficacy, informing families of the protective role of a balanced control and monitoring over adolescents' behavior and choices of peer network against premarital sexual activity.

The GAMY Project: young people's attitudes to genetics in the South Wales valleys

This paper explores young people's attitudes to genetics. It describes a qualitative study involving a group of teenagers in a deprived South Wales valley town over a period of 18 months. The GAMY (Genetics and Merthyr Youth) Project involved a series of interactions with participants, including 2 interviews, 4 group days and 4 genetics tasks through which these young people learned about, and then reflected upon, issues relating to genetics and health. We have gathered data about the informed attitudes of teenagers to genetics based on deliberative learning and reflection over a long period of time, and as such this paper provides useful insights into the underlying values that are guiding young people's views and the factors that are shaping their responses to new genetic technologies. Attitudes to genetics are complex and not easily generalisable. There were low levels of familiarity with, and knowledge of, genetics from the outset. Most young people did not have pre-existing attitudes towards genetics and had given little or no thought to the topic before the project began. However, levels of awareness and general genetic literacy increased as the project progressed. This study suggests that over time young people can develop an awareness of genetics that makes sense to them; they demonstrate that they can think creatively about genetics, and they are able to engage in considering genetic and other risk factors when thinking about health and disease.

Alexithymia and acne vulgaris: a case control study

OBJECTIVE

To assess relationship between alexithymia and acne vulgaris in young people.

METHODS

A hundred and eleven subjects between 15 and 25 years of age referred to out-patient clinic of dermatology with acne and 78 subjects applied to family physician for complaints other than acne were included in patient and control groups of the study, respectively. A questionnaire to determine demographic characteristics, an acne classification to determine severity of acne and Toronto Alexithymic Scale (TAS) to assess alexithymia were used.

RESULTS

The mean scores of TAS were 52.7±10.8 and 51.7±10.7 in patient and control groups, respectively. Alexitymia was determined in 23.4% of the subjects in acne group and in 24.4% of control group. No significant differences were found between groups in terms of alexithymia, intermediate alexitymia and three-factors of TAS.

CONCLUSION

Alexithymia does not appear to be related to acne vulgaris.

The Effectiveness of a Community Intensive Therapy Team on Young People's Mental Health Outcomes

BACKGROUND

  UK-wide concerns about availability, cost, efficacy and inappropriate use of psychiatric inpatient provision for adolescents have led to the development of new models of intensive community based care.

METHOD

  This paper describes the Fife Intensive Therapy Team (FITT) model and provides an analysis of HoNOSCA (Health of the Nation Outcomes Scale for Children and Adolescents) data for 57 patients to evaluate the effectiveness of the service.

RESULTS

  Following intervention by the FITT, a substantial and significant reduction in HoNOSCA scores was recorded.

CONCLUSIONS

  The apparent success of the model has implications for the future development of acute mental health services for young people.

Group Work in Young People with Tourette Syndrome

Gilles de la Tourette Syndrome (TS) is characterised by motor and vocal tics, although it is often associated with learning, emotional or behavioural problems that tend to account for most of the impairment experienced. Recognising, naming and learning to cope with the range of difficulties arising in TS is an important part of treatment. Group working was used as a way of helping young people understand and deal with TS. Sessions focused on managing tics, building self-esteem, learning and bullying, anger management and obsessive-compulsive symptoms.