A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness

Introduction Poor medication adherence is common in children and adolescents with chronic illness, but there is uncertainty about the best way to enhance medication adherence in this group. The authors conducted a systematic review of controlled trials examining interventions that aim to improve medication adherence. Method A comprehensive literature search was undertaken to locate controlled trials that described specific interventions aiming to improve adherence to long-term medication, where participants were aged 18 years and under, medication adherence was reported as an outcome measure, and which could be implemented by individual health practitioners. Studies were reviewed for quality and outcome. Results 17 studies met inclusion criteria: seven studies examined educational strategies, seven studies examined behavioural interventions and three studies examined educational intervention combined with other forms of psychological therapies. Only two of seven studies reported a clear benefit for education on medication adherence, whereas four of seven trials indicated a benefit of behavioural approaches on medication adherence. One trial reported that combining education with behavioural management may be more effective than education alone. Studies which combined education with other non-medication specific psychological interventions failed to demonstrate a beneficial effect on medication adherence. Only two studies examined adherence-promoting interventions in young people with established adherence problems. Conclusion These findings suggest that education interventions alone are insufficient to promote adherence in children and adolescents, and that incorporating a behavioural component to adherence interventions may increase potential efficacy. Future research should examine interventions in high-risk groups.

Alternative education engaging Indigenous young people: Flexi schooling in Queensland

This article will discuss some of the findings from a qualitative research project that explored the connections between alternative education and Indigenous learners. This study investigated how flexi school leaders reported they were supporting Indigenous young people to remain engaged in education. The results of the survey provide demographic data focusing on Indigenous participation in this sample of flexi schools. The results revealed that a high number of Indigenous young people are participating in flexi schools within this sample. Furthermore, a high number of Indigenous staff members are working in multiple roles within these schools. The implications of these findings are twofold. First, the current Indigenous education policy environment is focused heavily on ‘Closing the Gap’, emphasising the urgent need for significant improvement of educational outcomes for Indigenous young people. The findings from this study propose that flexi schools are playing a significant role in supporting Indigenous young people to remain engaged in education, yet there remains a limited focus on this within the literature and education policy. Second, the high participation rates of Indigenous young people and staff suggest an urgent need to explore this context through research. Further research will assist in understanding the culture of the flexi school context. Research should also explore why a high number of Indigenous young people and staff members participate in this educational context and how this could influence the approach to engagement of Indigenous young people in conventional school settings.

Young people's uses of music for well-being

The period between 15 and 25 years is characterised by much personal change and is the peak age of onset of mental health problems. This prompts an interest in everyday strategies that young people might use to support their well-being. Music use is the preferred leisure activity among young people yet little is known about how music is linked to well-being in this population. This study aimed to develop and test a model of the relationships between young people’s use of music and their well-being, drawing on theories from the music psychology and clinical psychology fields. A qualitative analysis of transcripts from focus groups with 11 participants aged 15–25 years revealed four ways in which music listening links with well-being: relationship building, modifying emotions, modifying cognitions and emotional immersion. These linking variables were operationalised using questionnaire scores and tested on a new sample of 107 young people. Results of a multiple mediation analysis revealed that music listening was significantly related to all four linking variables, but not directly related to well-being as measured by the Mental Health Continuum. Nevertheless, the four linking variables indirectly mediated the effect of music listening on social wellbeing. The findings are consistent with earlier research on the role of music in emotion regulation and social connection although there are clearly other factors involved in determining young peoples’ well-being. These findings will help inform music-based interventions for young people.

Children and Adolescents Coping with Loneliness

This chapter examines the ways young people cope with loneliness and the influences on these coping strategies. Loneliness is a distressing, complex and universal phenomena. It is an absence of fulfilling social relationships. Children, adolescents and young adults experience loneliness with an estimated 10-20% of young people experiencing continuous or recurrent feelings of loneliness (Perlman & Landolt, 1999). While there is a body of research examining how adults cope with loneliness there is scant research on how children and adolescents try to alleviate this unpleasant feeling. In this chapter definitions of coping are examined and different theoretical bases of coping are explored. Measurement issues with this population are discussed and implications for future research and for professionals helping young people are provided.

The use of telephone help-lines by lonely children and adolescents

Loneliness is a subjective distressing feeling of being disconnected from a desired group or intimate relationship. Most children and adolescents experience loneliness at some time but for 10-20% of young people it can be severe and chronic. While there are many avenues for help for distressed young people, such as friends and family as well as the professional help of counselors and psychologists, lonely young people often do not seek help. Telephone help-lines are one way to assist young people in difficulty which is cost effective, accessible and anonymous. Many countries provide this free or low cost help with specific services for youth either by telephone or online. From the call records of help-lines however, it would seem that lonely young people do not often utilize these services. The reasons for this apparent reluctance are discussed.

Destinations: 3 Large Cast Plays for Young People

This book is a collection of three large-cast plays written in response to a very specific problem. My work as a teacher of drama often required me to locate a script that would somehow miraculously work for a cast of unknown number and gender, and most likely uneven skills and enthusiasm, who I hadn’t even met yet. It’s a familiar dilemma for teachers and students of drama in education contexts, at whatever level you’re teaching. I’d first addressed this creative problem with scripts such as Gate 38 (2010). I had tried using scripts that already existed, but found they required such extensive editing to suit the parameters of cast and performance duration that I may as well have been writing them myself. Even in the setting of a closed studio, in altering these plays I felt I was bending the vision of the playwright, and certainly their narrative structure, out of shape. Everyone who’s attempted to stage a performance with a large cast of students in an educational setting knows it takes time to truly connect with a play, its social contexts, themes and characters. It also takes a lot of time to get on top of the practicalities of learning, rehearsing, directing and running a performance with young people. Often the curtain goes up on something unfinished and unstable. I was looking for ways to reduce the complexity of staging a script, while maintaining the potential of this process as a site of rich, enjoyable learning. Two of the plays (Duty Free and Please Be Seated) are comprised of multiple monologues, combined with music-driven ensemble sequences. The monologues enable individuals to develop and polish their own performances, work in small groups, and cut down on the laborious detail of directing naturalistic scenes based in character interaction. The third (Australian Drama) involves a lot of duologues, meaning that its rehearsal process can happily employ that mainstay of the drama classroom: small group work. There’s plenty of room to move in terms of gender-blind casting as well. Please be Seated is mainly young women. The scripts also contain ensemble-based interludes which are non-verbal, music driven, with a choreographic element. They have also springboarded further explorations in form. The ethical and aesthetic complexities of verbatim works; the interaction between music and theatre; and meta-concerns related to the performing of performance: ‘how can the act of acting ‘acted’. The narratives of all three of these plays are deliberately open, enabling the flexible casting and on-the hop editing that large-group, time-poor processes sometimes necessitate. Duty Free is about the overseas ‘adventures’ of young people. Please Be Seated is based in verbatim text about young people falling in and out of love. Australian Drama is about young people in a drama classroom trying to connect with each other and put their own shine on dull fragments of the theatrical canon. The plays were published as a collection in hardcopy and digital editions by Playlab Press in 2015. Please be Seated is a co-write with a large group. These co-author’s names are listed in the publication, and below in ‘additional information’.

Dystopian fiction for young people: Instructive tales of resilience

The rise and popularity of dystopian fiction in recent years is quite marked and critics often attribute such high sales of books and box office as being linked to the impact September 11 has had on the world, especially in the United States. While the events of September 11, 2001 saw a heightened anxiety by nations and their citizens about the fear and threat of terrorism – an anxiety which is paradoxically lowered and raised by increased surveillance practices, security checks and warnings – other changes since the last stages of the twentieth century have also raised concerns and anxieties. In this paper I use examples of Young Adult (YA) dystopian fiction to illustrate the potential these texts have for providing their readers with alternative ways of thinking about the challenges that others face and their capacity for resilience.

Initial prototype testing of Ray's Night Out: A new mobile app targeting risky drinking in young people

Background Risky single occasion drinking (RSOD; 4 or more drinks in <6 h) more than doubles the risk of injury in young people (15 - 25 years). The potential role of smartphone apps in reducing RSOD in young people is yet to be explored. Objective: To describe the initial prototype testing of ‘Ray's Night Out’, a new iPhone app targeting RSOD in young people. Method Quantitative and qualitative methods were used to evaluate the quality, perceived utility, and acceptability of the app among nine young people (19e23 years). Results Participants reported Ray's Night Out had good to excellent levels of functionality and visual appeal, acceptable to good levels of entertainment, interest and information, and acceptable levels of customization and interactivity. Young people thought the app had high levels of youth appeal, would prompt users to think about their alcohol use limits, but was unlikely to motivate a change in alcohol use in its current form. Qualitative data provided several suggestions for improving the app. Conclusion Following revision, Ray's Night Out could provide an effective intervention for RSOD in non help-seeking young people. A randomized controlled trial is currently underway to test the final prototype of the app.

Post-school needs of young people with high-functioning Autism Spectrum Disorder

This study describes the post-school circumstances and service needs of older teenagers and adults with high-functioning Autism Spectrum Disorder, living in Queensland, Australia. The respondents were 95 parents. Results indicated that the majority of the young people lived in the family home and were unemployed. Of those who worked, 56% had unskilled jobs. They were estimated to spend a significant proportion of their time engaged in solitary, technology-based activities, and comparatively little time in employment or socialising. Parents rated employment support as the greatest service priority for their sons and daughters, followed by specialised support to assist with completing post-school education and training, assistance to support the transition from high school to adulthood, and social skills training.

The social supply of cannabis among young people in Australia

Cannabis is the most prolifically used illicit drug in Australia, however, there is a gap in our understanding concerning the social interactions and friendships formed around its supply and use. The authors recruited cannabis users aged between 18 and 30 years throughout Australia, to explore the impact of supply routes on young users and their perceived notions of drug dealing in order to provide valuable insight into the influence that reciprocal relationships have on young people’s access to cannabis. Findings reveal that the supply of cannabis revolves around pre-existing connections and relationships formed through associates known to be able to readily source cannabis. It was found that motivations for proffering cannabis in a shared environment were related more to developing social capital than to generating financial gain. Given this, often those involved in supply do not perceive that they are breaking the law or that they are ‘dealers’. This social supply market appears to be built on trust and social interactions and, as such, presents several challenges to law enforcement. It is suggested that there would be benefit in providing targeted education campaigns to combat social supply dealing among young adults.

The relationship of loneliness and social anxiety with children’s and adolescents��� online communication

Children and adolescents now communicate online to form and/or maintain relationships with friends, family, and strangers. Relationships in “real life” are important for children’s and adolescents��� psychosocial development; however, they can be difficult for those who experience feelings of loneliness and/or social anxiety. The aim of this study was to investigate differences in usage of online communication patterns between children and adolescents with and without self-reported loneliness and social anxiety. Six hundred and twenty-six students aged between 10-16 years completed a survey on the amount of time they spent communicating online, the topics they discussed, the partners they engaged with, and their purposes for communicating over the Internet. Participants were administered a shortened version of the UCLA Loneliness Scale and an abbreviated sub-scale of the Social Anxiety Scale for Adolescents (SAS-A). Additionally, age and gender differences in usage of the aforementioned online communication patterns were examined across the entire sample. Findings revealed that children and adolescents who self-reported being lonely communicated online significantly more frequently about personal things and intimate topics than did those who did not self-report being lonely. The former were motivated to use online communication significantly more frequently to compensate for their weaker social skills to meet new people. Results suggest that Internet usage allows them to fulfill critical needs of social interactions, self-disclosure, and identity exploration. Future research, however, should explore whether or not the benefits derived from online communication may also facilitate lonely children’s and adolescents��� offline social relationships.

The relationship of loneliness and social anxiety with children's and adolescents' online communication

Children and adolescents are now using online communication to form and/or maintain relationships with strangers and/or friends. Relationships in real life are important for children and adolescents in identity formation and general development. However, social relationships can be difficult for those who experience feelings of loneliness and social anxiety. The current study aimed to replicate and extend research conducted by Valkenburg and Peter (2007b), by investigating differences in online communication patterns between children and adolescents with and without selfreported loneliness and social anxiety. Six hundred and twenty-six students aged 10-16 years completed a questionnaire survey about the amount of time they engaged in online communication, the topics they discussed, who they communicated with, and their purposes of online communication. Following Valkenburg and Peter (2007b), loneliness was measured with a shortened version of the UCLA Loneliness Scale (Version 3) developed by Russell (1996), whereas social anxiety was assessed with a sub-scale of the Social Anxiety Scale for Adolescents (La Greca & Lopez, 1998). The sample was divided into four groups of children and adolescents: 220 were “non-socially anxious and non-lonely”, 139 were “socially anxious but not lonely”, 107 were “lonely but not socially anxious”, and 159 were “lonely and socially anxious”. A one-way ANOVA and chi-square tests were conducted to evaluate the aforementioned differences between these groups. The results indicated that children and adolescents who reported being lonely used online communication differently from those who did not report being lonely. Essentially, the former communicated online more frequently about personal things and intimate topics, but also to compensate for their weak social skills and to meet new people. Further analyses on gender differences within lonely children and adolescents revealed that boys and girls communicated online more frequently with different partners. It was concluded that for these vulnerable individuals online communication may fulfil needs of self-disclosure, identity exploration, and social interactions. However, future longitudinal studies combining a quantitative with a qualitative approach would better address the relationship between Internet use and psychosocial well-being. The findings also suggested the need for further exploration of how such troubled children and adolescents can use the Internet beneficially.