When life is “difficult”: A comparison of street children's and non-street children's priorities

Research on street children has typically described the phenomenon and examined the risks of street life to healthy development. Thus far, research has not contextualized street children's psychosocial lives by comparing them with non-street children or street children undergoing rehabilitation. The purpose of this study was to assess how the life priorities of Tanzanian street children, former street children and school-going children (n?=?183) differ according to their living environment. The “Importance scale” was designed and validated for this study. It includes 29 four-level Likert items about relationships, activities and family, encompassing two subscales: current well-being (Cronbach's α?=?0.65) and preparing for the future (Cronbach's α?=?0.72). Data were analyzed using analysis of variance and contingency tables to determine group-level differences. Post-hoc Bonferroni tests determined pairwise differences. The analyses demonstrate significant differences in 14 of 29 priorities according to living context. With only three differences, former street children were more similar to school-going children than they were to street children. Street children and school-going children differed on 12 items, while street children and former street children differed on nine items. Street children considered that obtaining good advice from adults, having a dependable place to sleep and having time for enjoyable activities are most important, while former street children and school-going children pointed to education-related ambitions as most important. Findings show that after just 1 year of rehabilitative care, former street children's priorities are more similar to school-going children's, and thus rehabilitative care may be instrumental in enabling children to prioritize preparing for the future. Street children's emphasis on a safe place to sleep and adult support may reflect unmet basic needs. Former street children's high priorities on education and protecting themselves may represent healthy adaptation and a hopeful orientation to the future. High-quality rehabilitation for homeless youth can fulfill essential needs that may promote positive shifts in street children's priorities.     

The challenge of low literacy in health promotion: Using empowerment methods with out-of-school adolescents in North India

This article reports on a series of three-month projects undertaken among out-of-school adolescents in North India that used photographs and charts to elicit critical analysis of health in small groups led by peer educators. This method of “problematization” is a component of the empowerment model. The study found that the methodology of problematization through pictures was very effective in identifying the local knowledge level of semi-literate adolescents and bringing out relevant barriers to health. Knowledge of health topics improved and many participants began to attend school after the project; however, behaviour changes were limited by obstacles and challenges beyond the control of the adolescents. The methodology allowed for flexibility in order that the social and cultural contexts of this project, namely caste divisions, gender divisions, poor literacy and parental desire to “listen in”, could be incorporated into the design. It also allowed the unique social and cultural problems of the area regarding relationships, crime and alcohol to emerge as part of the discussions. Recommendations are that health promotion projects using empowering methods need to be long term and involve the entire community in order to be sustainable.     

Silence: a strategy used to deal with psychological distress by young people in the Eastern Cape,South Africa

Reported high levels of distress in South African youth are worrying. This article presents an analysis of expression of distress from narratives of young people in Butterworth, Eastern Cape Province, in South Africa. Twenty-four females and 16 males aged 16–22 volunteered. Self-reported data were obtained through one-on-one audio-recorded in-depth interviews conducted in IsiXhosa, transcribed verbatim and translated into English. Constant comparison analysis discovered underlying meanings for non-expression of distress related to fulfilling distinct but related purposes. First, silence was a strategy for containing a potentially explosive or hurtful situation. Second, silence showed gratitude for accrued benefits often constructed as parents’ or guardians’ generosity. Third, silence was maintained as a sign of deference; it was not a choice that participants made but rather they were conforming to standards of respect as set by their society. Lastly, silence was used to protect, in particular, the mother from distress. This study suggests that young people need to be empowered with appropriate and effective ways of handling distress not based on avoidance because silence as a strategy can only delay dealing with distressing issues.     

Insomnia,Sleepiness, and Depression in Adolescents Living in Residential Care Facilities

The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration, frequency, and consequences of sleep difficulties, the Beck Depression Inventory-2, and the Epworth Sleepiness Scale were administered to a sample of 66 adolescents. Results suggest a high rate of sleep disturbances in this sample, with 41% reporting insomnia symptoms and 21% meeting diagnostic criteria for an insomnia syndrome. Those with more severe insomnia syndrome showed more severe depressive symptoms and daytime consequences.     

Leaping in the Dark

The paper describes some of the pathology of seriously disturbed young people. It implies that the residential setting can be designed to accomplish psychotherapy, to which those people would usually be too resistant. Its primary discussion concerns the problem of how changes to the comrnunity-especially changes of leadership-affect the youngsters once they have become necessarily dependent on it. It suggests that the staff group has an essential transitional task, which is to maintain contact wth the residents' emotional world and to withstand the youngsters' increased testing out of the staff's reliability. It describes how dificult it is for staff not to get emotionally embroiled in the residents' issues and how essential good consultancy is to help the staff maintain their professional focus. The paper is optimistic though it emphasises how stessful such changes are.     

A new concept for the non-invasive treatment of Adolescent Idiopathic Scoliosis: The Corrective Movement© principle integrated in the SpineCor System

Purpose. To evaluate the change in spinal curvature and posture of Idiopathic Scoliosis patients when a curve specific ‘Corrective Movement^© Principle’ (CMP) is applied.

Methods. This prospective interventional study was carried out on a group of 639 patients (92.3% females) having idiopathic scoliosis treated with the SpineCor brace. All girls were premenarchal or less than 1 year postmenarchal. Assessment of brace effectiveness followed the SRS outcome criteria for bracing. The clinical, radiological and postural evaluations assisted to define the patient classification, which guided the unique application of the CMP to each type of curvature.

Results. A total of 583 patients met the outcome criteria. Overall, 349 patients have a definitive outcome. Successful treatment was achieved in 259 (74.2%) of the 349 patients from the fitting to the weaning of the brace. Some 51 immature patients (14.6%) required surgical fusion while receiving treatment. Eight mature patients out of 298 (2.7%) required surgery within 2 years of follow-up beyond skeletal maturity.

Conclusion. The SpineCor brace is effective for the treatment of adolescent idiopathic scoliosis. Moreover, positive outcomes are maintained after 2 years because 151 (93.2%) of 162 patients stabilized or corrected their end of bracing Cobb angle up to 2 years after bracing.     

青少年特发性胸椎侧凸患者的脊髓偏移及临床意义

[目的]揭示青少年胸椎特发性侧凸患者椎管内脊髓的偏移，明确其变化趋势，并探讨其可能的发生机制和临床意义。[方法]本研究包括39名以右胸弯为主弯的青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）患者。测量主胸弯节段内（T5-12）椎管内脊髓与凸凹侧椎弓根之间的距离，计算脊髓的偏移，揭示其变化趋势，并分析顶椎区脊髓偏移与主胸弯Cobb＇s角和顶椎相对偏移之间的相关性。[结果]在T5-12节段椎管内，脊髓与凸侧椎弓根之间的距离显著大于与凹侧椎弓根之间的距离（P〈0．05），即脊髓向凹侧椎弓根偏移，且以顶椎区最为显著，而逐渐向两侧端椎区递减。顶椎区脊髓偏移与主胸弯Cobb’s角和顶椎相对偏移存在显著的正相关（相关系数分别为0．631和0．546）。[结论]胸椎特发性脊柱侧凸患者存在侧凸节段椎管内脊髓偏移的现象，且以顶椎区最显著。研究结果提示脊髓偏移可能与脊椎偏移后凹侧脊神经的牵拉有关，而且凹侧置钉的风险高于凸侧。