Understanding and working with non‐compliant and aggressive young children

This study examines the association between type of child care arrangement at age 1, 1.5 and 3 years and late talking (LT). The data were from 19,919 children in the population-based prospective Norwegian Mother and Child Cohort Study (MoBa) and included information about child care arrangement, LT and a variety of covariates. Attendance at universally accessible child care at 1.5 and 3 years of age was related to a reduced risk for LT, even after controlling for covariates, including early social communication skills before entering child care. However, type of child care at one year of age did not predict LT. Children attending centre care full-time at age three years showed less LT than children attending centre care part-time, whereas no such relationship was found for children at age 1.5 years or for children attending family day care. The results indicate that high-quality universal child care protects children from LT.     

Do consumer-directed health benefits favor the young and healthy?

This paper demonstrates through a simulation and demographic analysis of consumers' out-of-pocket payments for premiums and medical care that the young and healthy are potential winners with consumer-directed health benefits (CDHBs), and the moderately sick are the losers. However, benefit design constraints and job tenure realities limit the savings opportunities for the young. As employee cost sharing continues unabated, one potential remedy is to cap expenses as a percentage of income, thereby placing a limit on the burden to the sick and ensuring that all Americans share the burden equally according to ability to pay.     

Where do teenagers and young adults receive treatment for cancer?

BACKGROUND: Little is known about where teenagers and young adults receive their first cancer treatment. METHOD: We extracted data on 2260 residents of southeast England diagnosed with a malignant neoplasm aged 10-24 between 1998 and 2002 from the Thames Cancer Registry database. We identified 11 cancer network areas of residence, and the hospital and network where each patient received their first chemotherapy treatment. We classified hospitals as those including paediatric oncology centres, cancer centres with a teenage cancer unit or adult cancer centres or units. We examined how many patients in each of the age groups 10-14, 15-19 and 20-24 travelled outside their network of residence for chemotherapy. RESULTS: Overall 45% (1018) received chemotherapy. Three networks had paediatric oncology centres, and one also had a teenage cancer unit. Most 10-14-year-olds were referred from their network of residence to networks with these services. However, there was an increasing tendency for patients aged 15-19 and 20-24 to be treated within their network of residence and to be referred less commonly. CONCLUSIONS: Many young people with cancer are not referred to services providing care tailored to the needs of their age group. The absence of any pattern to referral, despite the presence of a teenage cancer unit in the area, suggests a lack of coordinated referral practice within and between cancer networks.     

Violence prevention and young adolescents’ participation in community youth service

Purpose: To examine whether participation in a school-sponsored community youth service program reduces self-reported violent behaviors among young urban adolescents.Methods: A total of 972 seventh- and eighth-grade students at two large, urban, public middle schools were surveyed at baseline and at 6-month follow-up. One school was assigned to interventions and the other served as a control. All students at the intervention school received the Reach for Health classroom curriculum that included a 10-lesson unit focusing on violence prevention. In addition, approximately half the students were randomly assigned by classroom to participate in the Reach for Health Community Youth Service program (CYS). Under the guidance of teachers and community nurses, these students spent several hours each week providing service in local health care agencies. Regression analyses were used to assess the influence of treatment condition on violent behavior outcomes.Results: Comparing students in the curriculum-only and curriculum-plus-CYS interventions to the control group, there is a statistically significant interaction (p < .03) among grade, CYS participation, and violence at follow-up. Eighth-grade CYS students reported significantly less violence at follow-up than students in the control school, taking into account baseline level of risk behavior, gender, ethnicity, and social desirability (p < .04). There was no significant difference between controls and students in the curriculum-only condition. Comparing students in the CYS intervention to the curriculum-only condition within the intervention school, the grade by intervention interaction again is significant (p < .05). Eighth-grade CYS students—who received the broadest CYS experience—reported less violence at follow-up than their curriculum-only counterparts.Conclusion: When delivered with sufficient intensity, school programs which couple community service with classroom health instruction can have a measurable impact on violent behaviors of a population of young adolescents at high risk for being both the perpetrators and victims of peer violence. Community service programs may be an effective supplement to curricular interventions and a valuable part of multicomponent violence prevention programs.     

Lies, damned lies and statistics? Reliability and personal accounts of smoking among young people

Smoking remains a major problem among young people in Europe. However, within the research community examining the issue, debate continues about the best way of assessing the extent of that problem. Questions have been raised about the extent to which existing techniques for generating statistical representations of patterns of youth smoking can address a range of problems connected with identifying, accounting for and correcting unreliable self-report smoking data. Using empirical data from the UK Liverpool Longitudinal Smoking Study (LLSS), this paper argues that self-report measures of smoking, treated in isolation from participants' personal accounts, can disguise problems with the reliability and validity of a given study. Using longitudinal qualitative and quantitative data in dialogue, two main factors contributing to unreliable data are discussed: (a) participants' access to and familiarity with frameworks of everyday cultural knowledge about the practice of smoking, and (b) participants' retrospective revision of events in line with their current goals, aspirations and self-understandings. The conclusion drawn is that research has to employ multiple methods, minimally incorporating some personal contribution from participants, to explore the complex character of the problem of smoking and to avoid the difficulties posed by the models of smoking behaviour embodied within stand-alone statistical research.     

Sterilisations in girls and young women: is it still happening?

OBJECTIVE: To determine whether sterilising procedures - hysterectomies, endometrial ablations or tubal ligations - are being performed in minors for non-therapeutic reasons, without Family Law Court approval. METHODS: Victorian Admitted Episode Dataset 1996-99 was used to identify all young women < 18 who had a sterilising procedure. Associated codes for indications and pathology were reviewed to exclude malignancies, congenital anomalies, potential miscoding and misleading codes associated with endometriosis. RESULTS: Although 40 procedures were identified from the dataset, the majority of these can be excluded after review of the associated codes. In two cases sterilising procedures were performed without clear therapeutic indications and it is likely they were done in young women with disabilities. No Family Law Court applications were heard in this time period, thus it is likely they represent unlawful sterilisations. CONCLUSIONS: It would appear that sterilisations without Family Law Court approval are probably occurring at very low rates in Victoria.     

A comparison of homeless and high-risk young adults: Are they one and the same?

Although experiencing poor parenting has been linked to high-risk behaviors and negative outcomes among different populations, very little research has been conducted on whether inadequate parenting has the same detrimental consequences for homeless and high-risk young adults. As such, this article compares homeless and marginally housed young adults to see if the associations between poor parenting (e.g. lower monitoring, neglect and physical abuse) and negative outcomes including depressive symptoms, victimization, delinquency and substance use are similar for these two groups. The sample consisted of 199 homeless and high-risk young adults from the Midwestern United States. Multivariate results revealed that childhood sexual abuse was correlated with physical and sexual victimization and delinquency among marginally housed young adults. Among homeless individuals, neglect and physical abuse were associated with physical victimization and delinquency, respectively. Caretaker monitoring was linked with delinquency and substance use among both groups. Finally, caretaker substance misuse was related positively with higher levels of substance use, but only among marginally housed individuals. The results are discussed in terms of policy implications.     

Unemployment and psychosocial adjustment in young adults: causation or selection?

This study investigates the relationships between unemployment following school leaving and psychosocial adjustment problems (mental health, substance use, crime, suicidal behaviours and teenage pregnancy) in a birth cohort of over 1000 New Zealand born young people. The data were gathered during the course of the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal study of a birth cohort of 1265 children born in the Christchurch (NZ) urban region who have been studied from birth to age 21. Data were gathered by personal interview on: (a) exposure to unemployment and (b) personal adjustment over the period from age 16 to age 21. Measures of personal adjustment included mental health (depression, anxiety), substance use, crime, suicidal behaviours and (for females) teenage pregnancy. Data were analysed using a fixed effects regression model that took into account both observed and non-observed sources of confounding and the possibility of reverse causal associations between personal adjustment and unemployment. Before adjustment for confounding and reverse causality there were significant (p < 0.001) associations between exposure to unemployment and measures of mental health, substance use, crime, suicidal behaviours and teenage pregnancy. Adjustment for confounding factors and reverse causality reduced these associations quite substantially and after control for sources of confounding a number of associations became nonsignificant. Nonetheless, after such control, exposure to unemployment remained significantly (p < 0.05) associated with suicidal ideation, substance abuse and criminal behaviours. It is concluded that, in part, the associations between unemployment and personal adjustment are spurious and reflect the presence of confounding factors that are related to both unemployment and adjustment. Nonetheless, the findings suggest that exposure to unemployment may be associated with increased risks of suicidal thoughts, crime and substance use.     

Inhibition of nitric oxide in LPS-stimulated macrophages of young and senescent mice by δ-tocotrienol and quercetin

Background

Changes in immune function believed to contribute to a variety of age-related diseases have been associated with increased production of nitric oxide (NO). We have recently reported that proteasome inhibitors (dexamethasone, mevinolin, quercetin, δ-tocotrienol, and riboflavin) can inhibit lipopolysaccharide (LPS)-induced NO production in vitro by RAW 264.7 cells and by thioglycolate-elicited peritoneal macrophages derived from four strains of mice (C57BL/6, BALB/c, LMP7/MECL-1^-/- and PPAR-α^-/- knockout mice). The present study was carried out in order to further explore the potential effects of diet supplementation with naturally-occurring inhibitors (δ-tocotrienol and quercetin) on LPS-stimulated production of NO, TNF-α, and other pro-inflammatory cytokines involved in the ageing process. Young (4-week-old) and senescent mice (42-week old) were fed control diet with or without quercetin (100 ppm), δ-tocotrienol (100 ppm), or dexamethasone (10 ppm; included as positive control for suppression of inflammation) for 4 weeks. At the end of feeding period, thioglycolate-elicited peritoneal macrophages were collected, stimulated with LPS, LPS plus interferon-β (IFN-β), or LPS plus interferon-γ (IFN-γ), and inflammatory responses assessed as measured by production of NO and TNF-α, mRNA reduction for TNF-α, and iNOS genes, and microarray analysis.

Results

Thioglycolate-elicited peritoneal macrophages prepared after four weeks of feeding, and then challenged with LPS (10 ng or 100 ng) resulted in increases of 55% and 73%, respectively in the production of NO of 46-week-old compared to 8-week-old mice fed control diet alone (respective control groups), without affecting the secretion of TNF-α among these two groups. However, macrophages obtained after feeding with quercetin, δ-tocotrienol, and dexamethasone significantly inhibited (30% to 60%; P < 0.02) the LPS-stimulated NO production, compared to respective control groups. There was a 2-fold increase in the production of NO, when LPS-stimulated macrophages of quercetin, δ-tocotrienol, or dexamethasone were also treated with IFN-β or IFN-γ compared to respective control groups. We also demonstrated that NO levels and iNOS mRNA expression levels were significantly higher in LPS-stimulated macrophages from senescent (0.69 vs 0.41; P < 0.05), compared to young mice. In contrast, age did not appear to impact levels of TNF-α protein or mRNA expression levels (0.38 vs 0.35) in LPS-stimulated macrophages. The histological analyses of livers of control groups showed lesions of peliosis and microvesicular steatosis, and treated groups showed Councilman body, and small or large lymphoplasmacytic clusters.

Conclusions

The present results demonstrated that quercetin and δ-tocotrienols inhibit the LPS-induced NO production in vivo. The microarray DNA analyses, followed by pathway analyses indicated that quercetin or δ-tocotrienol inhibit several LPS-induced expression of several ageing and pro-inflammatory genes (IL-1β, IL-1α, IL-6, TNF-α, IL-12, iNOS, VCAM1, ICAM1, COX2, IL-1RA, TRAF1 and CD40). The NF-κB pathway regulates the production of NO and inhibits the pro-inflammatory cytokines involved in normal and ageing process. These ex vivo results confirmed the earlier in vitro findings. The present findings of inhibition of NO production by quercetin and δ-tocotrienol may be of clinical significance treating several inflammatory diseases, including ageing process.     

Are young adults appreciating the health promotion messages on diet and exercise?

Aim

This study aims to determine if current health promotion messages relating to diet and physical activity are sufficiently targeted towards young adults. In addition, we examine what elements of these messages might be improved to ensure they encourage improved diet and exercise behaviours within this underserved group.

Subject and methods

Using qualitative methods, five focus group discussions (FGDs) and two semi-structured in-depth interviews were conducted among 19 young adults in Aberdeen City. An appropriate topic guide was developed for this purpose. After obtaining consent, all FGDs and interviews were audio-recorded and transcribed verbatim. A thematic analysis was conducted that allowed for emerging themes to be identified from the data. Links between themes were established and key quotes identified.

Results

Five major themes emerged: (1) exposure to health messages over time; (2) chains of healthy or unhealthy behaviours; (3) perceptions and attitudes towards health messages; (4) facilitators and barriers; (5) improving the usability of health messages.

Conclusions

The results demonstrate that young adults did not find current health promotion messages engaging. These messages did not support them in overcoming their perceived barriers, nor were they suitably formatted or located for them. There were suggestions from young adults on how to improve these messages including using social media, presenting messages in more usable forms, and working with larger corporations to make these messages more effective. Tailoring these messages specifically for young adults could improve their diet and exercise behaviours, thereby helping to reduce future obesity levels and co-morbidities within Scotland.

     

Co-parental self-efficacy and young child developmental outcomes among rural–urban migrant families

ABSTRACT

China's fast-developing urbanization has promoted a great number of rural families migrating to urban areas. The objective of this study is to address the existing situation of urban migrant parents' parenting for infant and toddlers and the association between co-parental self-efficacy and child developmental outcomes. A sample of 387 parents of rural–urban migrant families in urban China was invited to complete the online questionnaires. Results showed that mothers have higher parenting self-efficacy (PSE) levels than fathers in all measured dimensions, and found an interdependence of their co-PSE predicting child development outcomes. This study revealed that rural–urban migrant families were still following Chinese traditional parenting and attributed mothers to the responsibility for early childcare, although the ensuing modernization and ingress of Western values have greatly influenced urban parents' understandings about parenting. Based on these results, this paper provides implications for intervention approaches to promote PSE among migrant parents with young children.     

Seroepidemiology of Epstein−Barr virus and cytomegalovirus among Israeli male young adults

PurposeTo assess the seroprevalence and seroconversion of Epstein?Barr virus (EBV) and cytomegalovirus (CMV) Immunoglobulin G (IgG) antibodies and identify associated socioeconomic and smoking variables among male young adults in Israel, to explore health disparities and aid prevention efforts.MethodsA population-based seroprevalence study of EBV and CMV IgG antibodies in a systematic sample of Israeli males upon recruitment to mandatory military service during 1994–2004. Associations between socioeconomic and smoking variables and the seroprevalence of EBV/CMV were evaluated, controlling for possible confounders. A subset of seronegative subjects was assessed for seroconversion upon discharge from military service.ResultsOverall seroprevalence rates were 87% for EBV and 59% for CMV. An association between the seroprevalence of EBV and CMV was observed. Seroconversion was 56% for EBV as compared with 31% for CMV. Lower paternal education was found to be associated with both EBV and CMV seroprevalence. Lower socioeconomic status, North African origin, and urban residence were found to be associated with CMV seropositivity, as was smoking for EBV seropositivity.ConclusionsSocioeconomic disparities exist in the seroprevalence rates of CMV and EBV among Israeli male young adults. The results of the study could aid public health efforts and determine target populations when a vaccine becomes available.     

Avoiding shame: young LGBT people,homophobia and self‐destructive behaviours

This paper reports on findings from qualitative research conducted in the UK that sought to explore the connections between sexual identities and self‐destructive behaviours in young people. International evidence demonstrates that there are elevated rates of suicide and alcohol abuse amongst lesbian, gay, bisexual and transgender (LGBT) youth. Rarely included in this body of research are investigations into young LGBT people's views and experiences of self‐destructive behaviours. Data from interviews and focus groups with young LGBT participants suggest a strong link between homophobia and self‐destructive behaviours. Utilising a discourse analytic approach, we argue that homophobia works to punish at a deep individual level and requires young LGBT people to manage being positioned, because of their sexual desire or gendered ways of being, as abnormal, dirty and disgusting. At the centre of the complex and multiple ways in which young LGBT people negotiate homophobia are ‘modalities of shame‐avoidance’ such as: the routinization and minimizing of homophobia; maintaining individual ‘adult’ responsibility; and constructing ‘proud’ identities. The paper argues that these strategies of shame‐avoidance suggest young LGBT people manage homophobia individually, without expectation of support and, as such, may make them vulnerable to self‐destructive behaviours.     

Friendship,sexual intimacy and young people’s negotiations of sexual health

Abstract

This paper examines how young people’s friendships influence safer sexual practices. Through a thematic discourse analysis, interviews with Sydney-based young people (aged 18–25 years) and Australian-based sexual health websites for young people are considered. Interview data illustrate how friendships can support young people's sexual experiences, concerns and safeties beyond the practice of ‘safe sex’ (condom use). This is evident in friends’ practices of sex and relationship advice, open dialogue, trust and sharing experiential knowledge, as well as friend-based sex. Meanwhile, friendship discourse from selected Australian sexual health websites fails to engage with the support offered by friendship, or its value to a sexual health agenda. Foucault’s account of friendship as a space of self-invention is considered in light of these data, along with his argument that friendship poses a threat to formal systems of knowing and regulating sex. Whether sexual or not, many close friendships are sexually intimate given the knowledge, support and influence these offer to one’s sexual practices and relations. This paper argues that greater attention to friendship among sexual health promoters and researchers would improve professional engagements with young people’s contemporary sexual cultures, and better inform their attempts to engage young people through social media.     

"Why does he wheeze?": wheezing and asthma in young children

Wheezing is common in young children and parents often worry that the child has asthma. The diagnosis of asthma in the under-fives is not always easy but assessing the severity of wheezing and whether it is transient, intermittent, persistent or associated with viral infection helps health professionals to rationalise treatment. This article outlines the different patterns of wheezing and some current approaches to management. Although wheezing and asthma are often associated, wheezing is commonly due to viral infection and more than 60% of children who wheeze during the first three years of life have ceased to do so by six years old. Parents of young children with wheeze and/or asthma need support and consistent advice from health professionals. Parents who smoke should be encouraged and helped to stop, as exposure to tobacco smoke increases the risk of a child developing recurrent wheeze, cough and breathlessness.     

‘Always between two cultures’: young British Bangladeshis and their mothers' views on sex and relationships

This paper presents data on the sexual health perspectives of young British Bangladeshis and their mothers. It discusses the implications of these data for the development of appropriate sexual health education. Between April and September 2006, 36 young people and 25 mothers of Bangladeshi young people were interviewed through seven focus group discussions. Groups were gender and age specific (16–18 years, 19–20 years and mothers). Recruitment took place in community‐based organisations in an inner city London borough. Mothers expressed concern about pre‐marital sex but felt unable to control out‐of‐home activity. Feelings of isolation, lack of control and communication difficulties were key issues for them. Young people had varied perspectives on pre‐marital sex. Some experienced emotional conflict between what was expected of them in terms of their faith and their engagement in intimate relationships. Both the young people and mothers highlighted the need for sex and relationship education to take account of cultural perspectives and the involvement of parents and the wider community. However, parents and community representatives require information and communication support to enable this involvement. Sex and relationships education content needs to be inclusive, have both secular and faith perspectives and engage where relevant with local communities.