Between diverging discourses of the child: juveniles’ self-construction in coercive residential care

Based on a qualitative study, this article explores how Norwegian juveniles construct themselves through stories of everyday life in coercive residential care and how this is related to diverging discourses of the child’s status in society. The findings reveal two dominant positions of identification—the autonomy position and the responsibility position—which are discussed as made possible by the child-as-citizen discourse. The article argues that juveniles self-constructions primarily contrast but also are intervened with the dominant discourse of the vulnerable child in social work. The article concludes that recognising juveniles’ in residential care as citizens implies a critical evaluation of practices inherent in the discourse of the vulnerable child.     

Community action for health in socioeconomically deprived neighbourhoods in Barcelona: Evaluating its effects on health and social class health inequalities

BackgroundThe aim of this study was to analyse trends in several health-related indicators in socioeconomically deprived neighbourhoods in Barcelona with strong community action for health (CA), and compare them to neighbourhoods without such community action. A secondary goal was to analyse trends in socioeconomic inequalities in health in both types of neighbourhood.MethodsWe performed a quasi-experimental pre-post study using data from the Barcelona Health Surveys of 2001 and 2011. Our dependent variables were self-perceived health, mental health, previous drug use, and smoking cessation. We used Poisson regression with robust variance to calculate prevalence ratios (PR) and 95% Confidence Intervals (95% CI).ResultsThe percentage of men who had ever used drugs decreased over time in neighbourhoods with strong CA (PR = 0.48; 95% CI:0.25–0.92, from 2001 to 2011), but not in neighbourhoods without CA (PR = 1.02; 95% CI:0.74–1.40). However, the prevalence of poor mental health among men increased more in neighbourhoods with strong CA than in neighbourhoods without CA (p-value = 0.025). Among women, social class inequalities in poor mental health and smoking cessation decreased over time in neighbourhoods with strong CA but not in neighbourhoods without CA.ConclusionsOur study shows promising results regarding the effect of community action on health, particularly in terms of inequalities. Our results highlight the importance of allocating resources to implement and continuously evaluate CA initiatives.     

An overview of problematic Internet use

Problematic Internet use (PIU), which has become a global social issue, can be broadly conceptualized as an inability to control one's use of the Internet which leads to negative consequences in daily life. The aim of this paper is to give a brief overview of the gradually evolving body of literature on PIU. This shows that the definitions and diagnostic criteria that have been proposed, and the assessment tools that have been developed, stress similarities between PIU, addictive behaviours and impulse-control disorders. Disagreements regarding diagnostic criteria and the lack of large epidemiological studies have resulted in difficulties in establishing the prevalence of PIU in the general population. Studies suggest high comorbidity rates between PIU and numerous psychiatric disorders highlighting the importance of focusing on comorbidity in treatment. There is growing evidence that genetic, personality and individual differences in automatic and controlled aspects of self-regulation may promote the development of PIU. Pharmacological and psychotherapeutic treatments specific to PIU have received limited testing in large, rigorous studies however preliminary evidence suggests that both psychotropic medications (Escitalopram, Naltrexone and Methylphenidate) and cognitive behaviour therapy may have some utility in the treatment of PIU. More research is needed on areas which remain unclear and contribute to the prognosis of PIU, in particular the temporal relationships between psychiatric disorder and PIU, mechanisms of comorbidity and the more subtle psychological changes that occur through Internet use.     

Incorporating Peer Assessments within a Clinical Practicum Course: Insights from a Clinical Faculty Initiative

IntroductionPeer assessments have been used within health professional programs to provide some degree of judgment of professional behavior and to facilitate feedback among peers. In an attempt to further support the clinical learning of our students, the clinical education team at the Odette Cancer Centre initiated a pilot to introduce peer assessments as a part of strategies for learning and engagement within laboratory sessions. The aim of our work was to retrospectively review peer assessments completed during these sessions in an attempt to identify professional behaviors, both positive and negative, and subsequently correlate the assessments with observed behaviors noted, both formally and anecdotally, within clinical faculty assessments. Further to this, our team attempted to explore student perceptions on the impact of peer assessments to their own learning.MethodsStudents in the final year of a 3-year undergraduate medical radiation sciences program were asked to assess their peers during laboratory sessions using a modified version of an assessment tool previously known to the students, the Assessment of Readiness for Clinical tool. Students (N = 14) were required to evaluate each of their peers who participated in the same session and provide supporting comments for their rating. For each student, responses from peer assessors were anonymized and collated. Comments and numerical ratings on the peer assessments were compared. The student assessments were subsequently compared with similar measures extracted from faculty assessments. Students also participated in a debriefing session to provide feedback regarding the integration of these assessments within the learning sessions and the potential impact they had on their own professional behaviors.ResultsThe majority of students rated their peers in all criteria at a score of 2 (performed or surpassed expectations). There was some correlation between numerical ratings and comments written in the assessments. Comments on peer assessments were in concordance with observations extracted from previous assessments by clinical faculty and teachers for 71% of the students. Students expressed a favorable attitude toward the use of the peer assessments but did not find the numerical ratings useful and instead valued supporting constructive comments that cited specific examples for improvement.ConclusionsPeer assessments were found to be of some benefit to the learning of our students, particularly the anecdotal supporting comments that accompanied the ratings. However, their use must be accompanied by formalized training and guidelines to teachers and learners as well as a careful consideration of the tool chosen to ensure the most purposeful impact on behavior change.     

Media Review

Objective: To examine “college drinking culture” and explore alcohol use and other variables among a sample of US college students.

Methods: Bivariate crosstabulation and logistic regression analyses were used to examine associations between alcohol use, gender, Greek membership and risk behaviours among a random sample of 823 undergraduates who completed a health behaviour survey.

Results: Respondents who binged were significantly more likely to be male and belong to a fraternity/sorority. Fraternity bingers were significantly more likely to engage in physical fights (p < 0.05) than non-Greek male bingers. Sorority bingers were significantly more likely to be injured (p < 0.01), drive under the influence of alcohol (DUI) (p < 0.001), be sexually victimised (p < 0.01) and engage in unwanted sex (p < 0.05) than non-Greek female bingers. Fraternity members who binged frequently (≥3 times in 2 weeks) were significantly more likely to DUI (p < 0.01) and engage in unprotected sex (p < 0.05) than were those who binged intermittently. Sorority members who binged frequently were significantly more likely to DUI (p < 0.05) than were those who binged intermittently.

Conclusion: Prevention efforts likely to be effective in changing binge drinking among college students should be gender specific, consider peer drinking norms, target “windows of risk” and be tailored to the campus’ culture of drinking.     

Mumbai disease in far western Nepal: HIV infection and syphilis among male migrant-returnees and non-migrants

OBJECTIVE: To measure the seroprevalence of human immunodeficiency virus (HIV) infection and syphilis, and to assess the behavioural risk factors for these infections among migrant-returnees and non-migrants in far western Nepal. METHODS: In April 2001, we recruited 97 male migrant-returnees and 40 non-migrants from five rural villages in Doti district where migration to Mumbai is common. For data collection, we conducted a serological examination for HIV and syphilis, and a perception and behaviour survey on HIV and other sexually transmitted infections. RESULTS: We found that 11 of 137 men (8%) were positive for HIV infection and 30 men (22%) for syphilis. The respondents, especially the migrant-returnees from Mumbai, were engaging in risky behaviours such as pre- or extramarital sex, and sex with multiple partners, including sex workers. CONCLUSIONS: This study revealed high HIV and syphilis prevalence among the male migrant-returnees and non-migrants in far western Nepal where migration to Mumbai is common. The prevalent behaviours, particularly among the migrant-returnees, imply urgent needs of the behavioural modification programme in this area to prevent the spread of HIV infection to general population.