Perceptions of Long-Term Community Adaptation of Delinquent Young Adults Who Graduated from Children’s Residential Mental Health Treatment

Purpose

This article presents results from one part of a longitudinal study into the post-discharge community adaptation of youth involved in residential mental health treatment. The focus is on young adults interviewed in Phase 3 of the research who have been identified as experiencing delinquent behaviour in their communities which brings them into contact with the law. This research is unique as young adult graduates of residential treatment were interviewed and they describe in detail how they are currently functioning in their lives.

Method

Qualitative interviews were completed with a convenience sample of 59 young adults between 18 and 25 years of age who had accessed children’s residential mental health treatment up to 10 years prior to data collection.

Results

The results demonstrate that delinquent behaviour post-discharge from residential treatment is a real concern and, for a sub-set of young adults, relates to negative outcomes in multiple domains of living, such as substance abuse, personal well-being, education and employment, and social networks and relationships.

Conclusions

The results indicate there is a need to improve long term community adaptation for this group, and that improving community living outcomes is much more a function of ongoing support and caring than short-term treatment and cure.

     

Barriers and facilitators to adherence to group exercise in institutionalized older people living with dementia: a systematic review

Objectives

Research suggests targeted exercise is important for people living with dementia, especially those living in residential care. The aim of this review was to collect and synthesize evidence on the known barriers and facilitators to adherence to group exercise of institutionalized older people living with dementia.

Methods

We searched all available electronic databases. Additionally, we searched trial registries (clinicaltrial.gov, and WHO ICTRP) for ongoing studies. We searched for and included papers from January 1990 until September 2017 in any language. We included randomized, non-randomized trials. Studies were not eligible if participants were either healthy older people or people suffering from dementia but not living in an institution. Studies were also excluded if they were not focused on barriers and facilitators to adherence to group exercise.

Results

Using narrative analysis, we identified the following themes for barriers: bio-medical reasons and mental wellbeing and physical ability, relationships dynamics, and socioeconomic reasons. The facilitators were grouped under the following thematic frames: bio-medical benefits and benefits related to physical ability, feelings and emotions and confidence improvements, therapist and group relationships dynamics and activity related reasons.

Conclusions

We conclude that institutionalized older people living with dementia, even those who are physically frail, incontinent and/or have mild dementia can demonstrate certain level of exercise adherence, and therefore can respond positively to exercise programs. Tailored, individually-adjusted and supported physical activity, led by a knowledgeable, engaging and well communicating therapist/facilitator improves the adherence to group exercise interventions of institutionalized older people living with dementia.

     

Subtyping Non-treatment-seeking Problem Gamblers Using the Pathways Model

This study examined whether distinct subgroups could be identified among a sample of non-treatment-seeking problem and pathological/disordered gamblers (PG) using Blaszczynski and Nower’s (Addiction 97:487–499, 2002) pathways model (N = 150, 50% female). We examined coping motives for gambling, childhood trauma, boredom proneness, risk-taking, impulsivity, attention-deficit/hyperactivity disorder (ADHD), and antisocial personality disorder as defining variables in a hierarchical cluster analysis to identify subgroups. Subgroup differences in gambling, psychiatric, and demographic variables were also assessed to establish concurrent validity. Consistent with the pathways model, our analyses identified three gambling subgroups: (1) behaviorally conditioned (BC), (2) emotionally vulnerable (EV), and (3) antisocial-impulsivist (AI) gamblers. BC gamblers (n = 47) reported the lowest levels of lifetime depression, anxiety, gambling severity, and interest in problem gambling treatment. EV gamblers (n = 53) reported the highest levels of childhood trauma, motivation to gamble to cope with negative emotions, gambling-related suicidal ideation, and family history of gambling problems. AI gamblers (n = 50) reported the highest levels of antisocial personality disorder and ADHD symptoms, as well as higher rates of impulsivity and risk-taking than EV gamblers. The findings provide evidence for the validity of the pathways model as a framework for conceptualizing PG subtypes in a non-treatment-seeking sample, and underscore the importance of tailoring treatment approaches to meet the respective clinical needs of these subtypes.     

Concerns About Identity and Services Among People with Autism and Asperger's Regarding DSM–5 Changes

The Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2012 American Psychiatric Association. (2012). DSM–5 development . Retrieved from www.dsm5.org  [Google Scholar]) now includes a new autism spectrum diagnosis (ASD) with previous separate diagnoses of autism removed. This study explores the concerns of people with Asperger's syndrome (AS) and autistic disorder (AD). Discussion forum data of people with AS and AD (N = 76) were analyzed using phenomenological, inductive-content analysis to gather qualitative data about the concerns of people with AS and AD regarding the changes in the DSM–5. People with AS and AD were concerned about identity, community, the cure movement, and services. They also discussed using advocacy and solidarity to address their concerns.     

Profiles of Systems Involvement in a Sample of High-Risk Urban Adolescents with Unmet Treatment Needs

This study examined profiles of involvement in four systems (education, child welfare, legal, and treatment) in a sample of 253 high-risk urban adolescents with unmet behavioral health needs. Self-report data were collected on multiple dimensions of involvement within each system, demographics, and DSM-IV diagnoses. Latent class analysis revealed four profiles: Education System: Academic and Disciplinary, Education System: Academic Only, Legal/Juvenile Justice Involved, and Multiple Systems/Child Welfare. Profiles differed based on gender and psychiatric diagnoses. Boys were overrepresented in Education System: Academic and Disciplinary and Legal/Juvenile Justice Involved, and girls were overrepresented in Multiple Systems/Child Welfare. The two education system focused classes were characterized by depressive disorders and ADHD. Youth in Legal/Juvenile Justice Involved and Multiple Systems/Child Welfare were characterized by conduct disorder and substance abuse. Implications for assessment and treatment planning for high-risk youth and for the organization of community-based behavioral health services are discussed.     

Mentors for adolescents in foster care

Significant numbers of adolescents in foster placement plan to live independently following discharge. Mentoring is increasingly being used as a support service to assist older foster youths to make the transition to adult living. A survey of 29 child welfare programs indicate that a variety of mentoring models are in use. The main models are transitional Life Skills Mentors, Cultural-Empowerment Mentors, and Corporate-Business Mentors. Mentoring connects foster wards with a cross-section of community citizens who provide a bridge to higher education and employment, and serve as a resource for transitional problem-solving. Information is needed on the impacts of mentor-mentee matches and efforts to sustain mentor-mentee relationships.Based on a paper presented at the Second National Child Welfare Conference, Division of Child Welfare Research, Arlington, Virginia, 1994. The research is supported by Research Grant #90CW1026 entitled Mentors as Resources for Preparing Foster Youths for Independent Living, from the Department of Health and Human Services, Administration for Children and Families, Washington, D.C.the Principal Investigator, Foster Youth Project and Adolescent Mentor Project.     

Implementing Cognitive Behavioral Intervention for Trauma in Schools (CBITS) with Latino Youth

Objective

Many Latino youth are often unable to access mental health services and support following exposure to traumatic and stressful events. This study assesses the benefits and effectiveness of utilizing Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a school based intervention, with Spanish speaking, Latino youth residing in New Orleans, Louisiana, in effort to address presenting symptoms of trauma and depression.

Method

Twenty three children and adolescents ages 10 to 14, in fifth, sixth and seventh grades, presenting with symptoms of trauma and depression, participated in a 10 week program of CBITS which was primarily conducted in Spanish.

Results

Children who participated in CBITS reported significantly fewer symptoms of trauma and depression following the intervention; however, no differences were noted between genders. Significant differences were observed between older boys and girls (12–14), as they were more likely to report higher levels of exposure to trauma than younger boys and girls (10–11). The effect sizes for the intervention were large.

Conclusions

Findings of this study suggest that CBITS is a practical and effective school based intervention available to mental health providers as a resource to be used with Spanish speaking, Latino youth who have been exposed to different forms of stress and trauma.

     

Examining the relationship between psychotropic medication use and testing positive for Chlamydia and Gonorrhea among detained adolescents

Objective

We examined whether psychotropic medication (PTM) use was related to testing positive for Chlamydia and Gonorrhea among detained adolescents.

Methods

A convenience sample of 550 detained adolescents ages 14-18 years were recruited from eight youth detention centers in Georgia. Using A-CASI technology, data was collected on demographic factors, use of PTM, and sexual risk behaviors. Chlamydia and Gonorrhea diagnoses were assessed by laboratory testing.

Results

Thirteen percent (13.1%) of adolescents not using PTMs tested positive for STIs compared to only 4.9% of those reporting PTM use. PTM users had a 62% smaller odds ratio for testing positive for Chlamydia or Gonorrhea.

Conclusion

Findings suggest that use of psychotropic medication, if deemed useful by detained youth, may be a protective factor against engaging in behaviors which may culminate in contracting some STDs. The practice implications are discussed within the context of these findings.     

The outcome of Solution-Focused Brief Therapy among foster care adolescents: The changes of behavior and perceived somatic and cognitive difficulties

Objective

To evaluate the outcome of Solution-Focused Brief Therapy as an individual intervention among foster care adolescents using “traditional” methods of between-group comparison as well as analysis at individual level by assessing reliable and clinically significant change.

Material and methods

The research was conducted at seven foster care homes in Lithuania. Treatment (age average 14.6) and control groups consisted of 46 adolescents each. Control group was similar to the treatment group considering gender, age and pre-treatment evaluation of behavior and perceived somatic and cognitive difficulties. Participants could attend a maximum of 5 sessions. Post-treatment evaluation was conducted 6 weeks after the pre-treatment evaluation. Behavior and perceived somatic and cognitive difficulties were assessed using Standardized Interview for the Evaluation of Adolescents' Problems. The outcome of Solution-Focused Brief Therapy was assessed using the following statistical methods: between group comparisons; effect size (Cohen d with Hedges adjustment), reliable and clinically significant change methods proposed by Jacobson and Truax (1991).

Results

Between-group comparisons revealed that Solution-Focused Brief Therapy is an effective method for reaching positive changes in the area of behavior difficulties among foster care adolescents. 31% of treatment group adolescents reached reliable and clinically significant change in the area of behavior and 29% in the area of perceived somatic and cognitive difficulties. Also, the issue of the necessity of the quantitative criteria allowing decision making about the effectiveness of the treatment at the individual level, when using reliable and clinically significant change method, was raised in the article.     

“SOCIOECONOMIC DIVERSITY IS OVERRATED”: WHITE ATTITUDES ON RACE AND CLASS IN A RACIALLY INTEGRATED NEIGHBORHOOD

This article investigates homeowners' perceptions of race and class within a racially integrated neighborhood in Baltimore, Maryland. Forty-two semi-structured interviews were completed with 59 white homeowners between September 2005 and September 2006. Adding a social class component to Bonilla-Silva's (2006 ——— . 2006 . Racism Without Racists: Color-Blind Racism and the Persistence of Racial Inequality in the United States, , 2nd edition . Lanham , MD : Rowman & Littlefield . [Google Scholar]) color-blind racism perspective, I ask if white homeowners in a racially-integrated neighborhood accept a color-blind worldview, or if they have an alternate framework for understanding race. Akin to O'Brien's antiracists (2001 Bonilla-Silva , Eduardo. 2001 . White Supremacy and Racism in the Post-Civil Rights Era . Boulder , CO : Lynne Rienner Publishers . [Google Scholar]), there was a range of rejection of color-blindness, from selective to reflexive race cognizance. Most homeowners recognized the institutional basis of racial inequality and their own white privilege. However, many conflated race and class and argued that it was really class differences that caused racial differences. While many supported more racial integration, most rejected class integration in the neighborhood. This paradoxical set of attitudes will most likely continue to be an obstacle to the maintenance of racially integrated neighborhoods.     

The Effects of Importance of Religion and Church Attendance on Adolescents' Moral Beliefs

Drawing on the work of Emile Durkheim ([1912] 1995) and Rodney Stark (2001 Stark, Rodney. 2001. Gods, Rituals, and the Moral Order. Journal for the Scientific Study of Religion, 40(4): 619–636. [Crossref], [Web of Science ®] , [Google Scholar]) as well as research on the anti-ascetic thesis and reference group theory, we formulate a series of hypotheses regarding the effects of church attendance and importance of religion on adolescents' moral beliefs about marijuana use, getting drunk, hitting, and property offenses. The results of our study suggest that moral beliefs are more consistently and strongly related to importance of religion than to church attendance. Furthermore, much of the effect of church attendance on moral beliefs is mediated by importance of religion. Finally, we find evidence that importance of religion moderates (interaction) the effect of church attendance on moral beliefs. When adolescents believe religion is important, frequent church attendance further strengthens their moral beliefs. On the other hand, when adolescents believe religion is not important, frequent church attendance may actually reduce moral beliefs.     

A Streetcar Named “Derousal”? A Psychophysiological Examination of the Desire–Arousal Distinction in Sexually Functional and Dysfunctional Women

Research indicates that desire and arousal problems are highly interrelated in women. Therefore, hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder (FSAD) were removed from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and a new diagnostic category, female sexual interest/arousal disorder (FSIAD), was created to include both arousal and desire difficulties. However, no research has tried to distinguish these problems based on psychosocial-physiological patterns to identify whether unique profiles exist. This study compared psychosocial-physiological patterns in a community sample of 84 women meeting DSM-IV (American Psychiatric Association, 2000 American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.[Crossref] , [Google Scholar]) criteria for HSDD (n = 22), FSAD (n = 18), both disorders (FSAD/HSDD; n = 25), and healthy controls (n = 19). Women completed self-report measures and watched neutral and erotic films while genital arousal (GA) and subjective arousal (SA) were measured. Results indicated that GA increased equally for all groups during the erotic condition, whereas women with HSDD and FSAD/HSDD reported less SA than controls or FSAD women. Women in the clinical groups also showed lower concordance and greater impairment on psychosocial variables as compared to controls, with women with FSAD/HSDD showing lowest functioning. Results have important implications for the classification and treatment of these difficulties.     

Kinect-based choice reaching and stepping reaction time tests for clinical and in-home assessment of fall risk in older people: a prospective study

Background

Quick protective reactions such as reaching or stepping are important to avoid a fall or minimize injuries. We developed Kinect-based choice reaching and stepping reaction time tests (Kinect-based CRTs) and evaluated their ability to differentiate between older fallers and non-fallers and the feasibility of administering them at home.

Methods

A total of 94 community-dwelling older people were assessed on the Kinect-based CRTs in the laboratory and were followed-up for falls for 6 months. Additionally, a subgroup (n?=?20) conducted the Kinect-based CRTs at home. Signal processing algorithms were developed to extract features for reaction, movement and the total time from the Kinect skeleton data.

Results

Nineteen participants (20.2 %) reported a fall in the 6 months following the assessment. The reaction time (fallers: 797?±?136 ms, non-fallers: 714?±?89 ms), movement time (fallers: 392?±?50 ms, non-fallers: 358?±?51 ms) and total time (fallers: 1189?±?170 ms, non-fallers: 1072?±?109 ms) of the reaching reaction time test differentiated well between the fallers and non-fallers. The stepping reaction time test did not significantly discriminate between the two groups in the prospective study. The correlations between the laboratory and in-home assessments were 0.689 for the reaching reaction time and 0.860 for stepping reaction time.

Conclusion

The study findings indicate that the Kinect-based CRT tests are feasible to administer in clinical and in-home settings, and thus represents an important step towards the development of sensor-based fall risk self-assessments. With further validation, the assessments may prove useful as a fall risk screen and home-based assessment measures for monitoring changes over time and effects of fall prevention interventions.

     

The effect of aging on pacing strategies of cross-country skiers and the role of performance level

Background

The participation of master cross-country (XC) skiers in training and competition has increased during the last decades; however, little is known yet about whether these athletes differ from their younger counterparts in aspects of performance such as pacing. Therefore, the aim of the present study was to examine the combined effect of age and performance (race time) on pacing in cross-country (XC) skiing. We analyzed all finishers (n?=?79,722) in ‘Vasaloppet’ from 2012 to 2017, the largest cross-country skiing race in the world, classified according to their race time into 10 groups: 3-4 h, 4-5 h, ..., 12-13 h.

Results

A trivial main effect of sex on total pace range was observed (p?<?0.001, η²?=?0.002), where women (44.1?±?10.2%) had larger total pace range than men (40.9?±?11.8%). A large main effect of performance group on total pace range was shown (p?<?0.001, η²?=?0.160), where the smallest total pace range was 21.8?±?1.9% (3-4 h group) and the largest 50.1?±?9.9% (10-11 h group). A trivial sex×performance group interaction on total pace range was found (p?<?0.001, η²?=?0.001) with the largest sex difference in pacing shown in 9-10 h group. A trivial and small main effect of age was found in women (p?<?0.001, η²?=?0.005) and men (p?<?0.001, η²?=?0.011), respectively, where the masters had smaller total pace range than their younger counterparts. A trivial age group×performance group interaction on total pace range was observed in both women (p?<?0.001, η²?=?0.008) and men (p?<?0.001, η²?=?0.006) with smaller differences among age groups in the faster performance groups.

Conclusions

In summary, master XC skiers adopted a relatively even pacing independently from their race time and the differences in pacing from the younger XC skiers were more pronounced in the slower masters. These findings suggest that exercise attenuates the decline of performance in master XC skiers as shown by the similar pacing strategies between fast master XC skiers and their younger counterparts.

     

Physical activity does not alter prolactin levels in post-menopausal women: results from a dose-response randomized controlled trial

Background

Increased circulating levels of prolactin have been associated with increased risk of both in situ and invasive breast cancer. We investigated whether or not physical activity had a dose–response effect in lowering plasma levels of prolactin in postmenopausal women.

Methods

Four hundred previously inactive but healthy postmenopausal women aged 50–74 years of age were randomized to 150 or 300 min per week of aerobic physical activity in a year-long intervention. Prolactin was measured from fasting samples with a custom-plex multiplex assay.

Results

A high compared to moderate volume of physical activity did not reduce plasma prolactin levels in intention-to-treat (Treatment Effect Ratio (TER) 1.00, 95% Confidence Interval (CI) 0.95 – 1.06) or per-protocol analyses (TER 1.02, 95% CI 0.93 – 1.13).

Conclusions

It is unlikely that changes in prolactin levels mediate the reduced risk of breast cancer development in post-menopausal women associated with increased levels of physical activity.

Trial registration

clinicaltrials.gov identifier: NCT01435005.

     

Development of low-volume,high-intensity,aerobic-type interval training for elderly Japanese men: a feasibility study

Background

The purposes of this study were to identify 1) the feasibility of a novel exercise protocol (elderly Japanese male version of high-intensity interval aerobic training: EJ-HIAT) and 2) its preliminary data (%V?O_2peak, rating of perceived exertion) in comparison with traditional moderate-intensity continuous aerobic training (MICT).

Results

Twenty-one sedentary elderly men, aged 60–69 years, performed two exercise protocols: EJ-HIAT, consisting of 3 sets of 2?3-min cycling at 75?85%V?O_2peak with 1??2-min active rests at 50%V?O_2peak between sets, and MICT, consisting of 40-min cycling at 65%V?O_2peak. The completion rate, defined as the rate of participants who 1) did not demand withdrawal, 2) were not interrupted by the tester, and 3) did not change the workload during either exercise protocol, of EJ-HIAT was similar to that of MICT (EJ-HIAT: 100%, MICT: 95.2%). Maximal perceived exertion ratings assessed by Borg scale were also similar between EJ-HIAT and MICT. However, objectively measured maximal intensity assessed by %V?O_2peak was higher for EJ-HIAT than for MICT (EJ-HIAT: 86.0 ± 5.6%, MICT: 67.1 ± 6.4%).

Conclusion

These results suggested that EJ-HIAT has good feasibility and perceived exertion similar to MICT despite having higher objectively measured intensity than MICT. An intervention aimed as identifying the effects of EJ-HIAT on exercise tolerance should be performed in the future.

Trial registration

UMIN000021185 (February 26, 2016).

     

Influence of socioeconomic status on changes in body size and physical activity in ageing black South African women

Background

The increasing prevalence of obesity in sub-Saharan African women is not well understood, and black South African women in the region are particularly vulnerable. This study aimed to examine whether the relationship of socioeconomic status (SES) with changes in body mass index (BMI) and waist circumference (WC) is mediated by physical activity in ageing African women.

Methods

In a longitudinal analysis of the 518 caregivers associated with the Birth to Twenty Plus study, the role of SES associated with 10-year changes in BMI and WC was tested using structural equation modelling (SEM). The degree of mediation of moderate-vigorous physical activity (MVPA) and sitting time in this association was also assessed.

Results

The prevalence of obesity increased significantly from baseline to follow-up (p?<?0.0001). In the SEM models, baseline SES had a direct positive effect on changes in BMI (β, 95% CI, 0.02 (0.005 to 0.04), and a direct negative effect on changes in MVPA (β, 95% CI, ??3.81 (??6.92 to ??0.70). Baseline MVPA had a direct negative effect (β, 95% CI, ??0.002 (??0.003 to ??0.0003) and indirect positive effect via change in MVPA (β, 95% CI, 0.01 (0.0001 to 0.001) on change in WC.

Conclusions

Our study demonstrates the role and interaction of sociodemographic and behavioural predictors of obesity, and suggests a multifaceted approach to management of the crisis in communities of ageing urban African women.