Assessing the short-term effects of heatwaves on mortality and morbidity in Brisbane, Australia : comparison of case-crossover and time series analyses

Background Heat-related impacts may have greater public health implications as climate change continues. It is important to appropriately characterize the relationship between heatwave and health outcomes. However, it is unclear whether a case-crossover design can be effectively used to assess the event- or episode-related health effects. This study examined the association between exposure to heatwaves and mortality and emergency hospital admissions (EHAs) from non-external causes in Brisbane, Australia, using both case-crossover and time series analyses approaches. Methods Poisson generalised additive model (GAM) and time-stratified case-crossover analyses were used to assess the short-term impact of heatwaves on mortality and EHAs. Heatwaves exhibited a significant impact on mortality and EHAs after adjusting for air pollution, day of the week, and season. Results For time-stratified case-crossover analysis, odds ratios of mortality and EHAs during heatwaves were 1.62 (95% confidence interval (CI): 1.36–1.94) and 1.22 (95% CI: 1.14–1.30) at lag 1, respectively. Time series GAM models gave similar results. Relative risks of mortality and EHAs ranged from 1.72 (95% CI: 1.40–2.11) to 1.81 (95% CI: 1.56–2.10) and from 1.14 (95% CI: 1.06–1.23) to 1.28 (95% CI: 1.21–1.36) at lag 1, respectively. The risk estimates gradually attenuated after the lag of one day for both case-crossover and time series analyses. Conclusions The risk estimates from both case-crossover and time series models were consistent and comparable. This finding may have implications for future research on the assessment of event- or episode-related (e.g., heatwave) health effects.

Australia’s rural youth, online storytelling and identity performance

Online storytelling spaces provide young people who live in rural and remote parts of Australia with an opportunity to develop their personal identities and connect and communicate with other young people. The Australian Broadcasting Corporation’s (ABC’s) rural and regional youth network, Heywire, is such a space (http://www.abc.net.au/heywire/). Heywire invites 16-22 year old Australians who identify as ‘rural’ or ‘regional’ to create an online profile and upload stories about their lives in the form of text, audio, video or photographs. Emerging from my PhD project, this paper describes how rural and regional youth perform their identities through creating stories for the Heywire website, addressing notions of individual and social identities as a sub-theme. Compared with their city counterparts, the youth who live in regional towns or isolated properties have fewer opportunities to socialise with other people their own age. Subsequently computer mediated technologies, particularly the internet, can enable this group of people to connect with each other and develop a sense of community. In this paper I outline how these possibilities exist within an online storytelling space. I describe a number of reasons for young people’s story-sharing on the Heywire website in order to demonstrate the potential for spaces such as this to enable isolated youth to experience a sense of connection and belonging, despite geographical dispersion and physical isolation.

Popular Appeal : Books and Films in Contemporary Youth Culture

Now is an opportune moment to consider the shifts in youth and popular culture that are signalled by texts that are being read and viewed by young people. In a world seemingly compromised by climate change, political and religious upheavals and economic irresponsibility, and at a time of fundamental social change, young people are devouring fictional texts that focus on the edges of identity, the points of transition and rupture, and the assumption of new and hybrid identities. This book draws on a range of international texts to address these issues, and to examine the ways in which key popular genres in the contemporary market for young people are being re-defined and re-positioned in the light of urgent questions about the environment, identity, one's place in the world, and the fragile nature of the world itself. The key questions are: what are the shifts and changes in youth culture that are identified by the market and by what young people read and view? How do these texts negotiate the addressing of significant questions relating to the world today? Why are these texts so popular with young people? What are the most popular genres in contemporary best-sellers and films? Do these texts have a global appeal, and, if so, why? These over-arching themes and ideas are presented as a collection of inter-related essays exploring a rich variety of forms and styles from graphic novels to urban realism, from fantasy to dystopian writing, from epic narratives to television musicals. The subjects and themes discussed here reveal the quite remarkable diversity of issues that arise in youth fiction and the variety of fictional forms in which they are explored. Once seen as not as important as adult fiction, this book clearly demonstrates that youth fiction (and the popular appeal of this fiction) is complex, durable and far-reaching in its scope.

Re-imagining youth justice

Persistent high levels of recidivism among young offenders (Luke and Lind 2002; Weatherburn et al. 2012) and the over‐representation of Indigenous young people (Cunneen and White 2011; Snowball 2008; Tauri 2012) have long been features of youth justice in Australia. Other problems – such as the increased rates of young people committing sex offences (Dwyer 2011; O’Brien 2010), increasing numbers of young people criminalised for new offences such as ‘sexting’ (Lee and McGovern 2013), and increasing numbers of young female offenders being drawn into youth justice systems (Carrington 2006; Carrington and Pereira 2009) – have emerged more recently. In this paper, we draw on the concept of ‘imaginary penalities’ (Carlen 2010) to argue these chronic problems are partly informed by ‘imaginary’ understandings of how and why young people (re)offend; reflect ‘imaginary’ understandings of what works to address young people’s (re)offending; and reflect ‘imaginary’ ideals about the primary purposes of the youth justice system. We acknowledge up front that answers to these questions require a great deal of new empirical research. This paper is only a beginning that sets out exactly what such an ambitious project might look like.

Screening for youth depression in schools : a review of the literature

This paper provides a review of the literature pertaining to screening for youth depression in schools. It provides the rationale regarding this topic – why this topic is important and needs to be explored. This justification is followed by an investigation of the importance of mental health intervention in general – including depression. Analysis will then shift to the current literature surrounding screening for youth depression in schools, followed by additional information relating to this topic.

Sexualities and sensitivities: Queer(y)ing the ethics of youth research in the field

In contemporary Western societies, the years between childhood and young adulthood are commonly understood to be (trans)formative in the reflexive project of sexual self-making (Russell et al. 2012). As sexual subjects in the making, youthful bodies, desires and sexual activities are often perceived as both volatile and vulnerable, thus subjected to instruction and discipline, protection and surveillance. Accordingly, young people’s sexual proximities are closely monitored by social institutions and ‘(hetero)normalising regimes’ (Warner 1999) for any signs that may compromise the end goal of development—a ‘normal’ reproductive heterosexual monogamous adult...

Theatre-arts pedagogy for social justice : case study of the area youth foundation in Jamaica

In this paper I describe and analyse the socio-educational significance of a theatre arts approach to learning for young adults in Jamaica, implemented by the Area Youth Foundation (AYF). Briefly outlining the genesis and development of the AYF, I provide snapshots of the experiences and destinations of some of its young participants. The paper discusses AYF workshops to show how the pedagogy was shaped by the expressive arts and based on the critical praxis approach systematized by Paulo Freire in adult education and Augusto Boal in theatre. Based on interviews with AYF’s leader and some of the learners, I discuss how the foundation’s motto, “Youth Empowerment Through the Arts,” is played out in workshops and creative productions that are simultaneously learner-driven and teacher-guided, with the powerful impact of inspiring politically thoughtful creativity and skills in youths from less-privileged communities.

Re-visioning the Queensland Youth Sector : principles to inform the Queensland Government's youth strategy and review process

This discussion paper has been provided to assist the Department of Communities, Child Safety and Disability Services (DOCCSDS) in developing the Queensland Government’s Youth Strategy and inform the review of state government funded youth services. The paper lists a number of key concepts and social determinants which need to be considered in this undertaking. Additionally, it proposes a number key concepts and principles pertinent to understanding and working with young people, and for quality youth service provision.

The Child Behavior Checklist and Youth Self-Report in adolescents with epilepsy : testing measurement invariance of the Attention and Thought Problems subscales

The objective of this study was to test for the measurement invariance of the Attention and Thought Problems subscales of the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) in a population-based sample of adolescents with and without epilepsy. Data were obtained from the 14-year follow-up of the Mater University Study of Pregnancy in which 33 adolescents with epilepsy and 1068 healthy controls were included for analysis. Confirmatory factor analysis was used to test for measurement invariance between adolescents with and without epilepsy. Structural equation modeling was used to test for group differences in attention and thought problems as measured with the CBCL and YSR. Measurement invariance was demonstrated for the original CBCL Attention Problems and YSR Thought Problems. After the removal of ambiguous items (“confused” and “daydreams”),measurement invariance was established for the YSR Attention Problems. The original and reduced CBCL Thought Problems were noninvariant. Adolescents with epilepsy had significantly more symptoms of behavioral problems on the CBCL Attention Problems, β = 0.51, p = 0.002, compared with healthy controls. In contrast, no significant differences were found for the YSR Attention and Thought Problems, β = −0.11, p = 0.417 and β = −0.20, p = 0.116, respectively. In this population-based sample of adolescents with epilepsy, the CBCL Attention Problems and YSR Thought Problems appear to be valid measures of behavioral problems, whereas the YSR Attention Problems was valid only after the removal of ambiguous items. Replication of these findings in clinical samples of adolescents with epilepsy that overcome the limitations of the current study is warranted.

Submission : Proposed reforms to youth justice in Queensland

The proposed reforms to the youth justice system in Queensland are premised on the assumption that offending by young people is increasing. We noted (Carrington, Dwyer, Hutchinson and Richards 2012, 8) in a recent submission about the boot camps legislation that: "Statistics suggest that this concern is not warranted. Certainly studies show that ‘rates per 100,000 juveniles in detention in Queensland have been relatively stable compared with the national trend’ (Richards 2011) and that rates of detention of child offenders have declined generally in Australia over the last three decades. Youth offending statistics are affected by the diversion options used by the police, as well as by the numbers and levels of policing, and any special strategies such as Operation Colossus in the northern part of the state. ‘Community concern’ about crime does not always reflect the true rates of crime across Queensland. Policy should be based on valid evidence, not on ‘community concern’. With stable numbers of young people being detained in Australia, the research clearly suggests that youth offending is not escalating."...

The CLIMATE schools combined study : a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

Background Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined. Discussion Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge

A comparison of methods to identify alcohol involvement in youth injury-related emergency department presentation data

Aims: To compare different methods for identifying alcohol involvement in injury-related emergency department presentation in Queensland youth, and to explore the alcohol terminology used in triage text. Methods: Emergency Department Information System data were provided for patients aged 12-24 years with an injury-related diagnosis code for a 5 year period 2006-2010 presenting to a Queensland emergency department (N=348895). Three approaches were used to estimate alcohol involvement: 1) analysis of coded data, 2) mining of triage text, and 3) estimation using an adaptation of alcohol attributable fractions (AAF). Cases were identified as ‘alcohol-involved’ by code and text, as well as AAF weighted. Results: Around 6.4% of these injury presentations overall had some documentation of alcohol involvement, with higher proportions of alcohol involvement documented for 18-24 year olds, females, indigenous youth, where presentations occurred on a Saturday or Sunday, and where presentations occurred between midnight and 5am. The most common alcohol terms identified for all subgroups were generic alcohol terms (eg. ETOH or alcohol) with almost half of the cases where alcohol involvement was documented having a generic alcohol term recorded in the triage text. Conclusions: Emergency department data is a useful source of information for identification of high risk sub-groups to target intervention opportunities, though it is not a reliable source of data for incidence or trend estimation in its current unstandardised form. Improving the accuracy and consistency of identification, documenting and coding of alcohol-involvement at the point of data capture in the emergency department is the most desirable long term approach to produce a more solid evidence base to support policy and practice in this field.

Exploring functional concerns in help-seeking youth : a qualitative study

Aim This study aimed to explore the functional concerns of help-seeking young people 12-25 years of age. Method Semistructured interviews with n=10 young people seeking help from a youth mental health clinic were conducted. Data were transcribed verbatim and analysed using content analysis. Results were verified by member checking. Results Participants identified reasons for seeking help, with the main themes being relationships, emotional management, risk-taking behaviour and difficulties with employment. There appeared to be a difference between the concerns of the older, post-school-age group and the younger participants. Conclusion Young people are able to identify their functional concerns and reasons for seeking help from mental health services. Understanding the concerns of these young people provides weight to the model of youth-specific mental health services. Future work examining concerns of 12-25 year olds should ensure adequate representation of the older group as their needs and concerns seem to differ from those of younger participants in this study. Post-school-age youth seem to be under-represented in existing literature in this field. However, a limitation with this study is the small sample sizes once the cohort is divided by age. Future studies with a larger, more detailed examination of the needs and concerns of this population are warranted to inform service delivery advancements and clarify the difference in needs between the post-school and current school attendee groups.

Blurred lines : reconsidering the concept of ‘diversion’ in youth justice systems in Australia

This article revisits ‘diversion’ in the context of youth justice in Australia. Although ‘diversion’ is omnipresent in youth justice, it is rarely subject to critical examination. This article raises four interrelated questions: what young people are to be ‘diverted’ from and to; whether young people are to be ‘diverted’ from the criminal justice system or from offending; whether young people are to be ‘diverted’ from criminal justice processes or outcomes; and whether ‘diversion’ should be considered distinct from crime prevention and early intervention. The article concludes that the confusion about youth ‘diversion’ may foster individualised interventions in young people’s lives.

Arts practice and disconnected youth in Australia : impact and domains of change

Background: This paper describes research conducted with Big hART, Australia's most awarded participatory arts company. It considers three projects, LUCKY, GOLD and NGAPARTJI NGAPARTJI across separate sites in Tasmania, Western NSW and Northern Territory, respectively, in order to understand project impact from the perspective of project participants, Arts workers, community members and funders. Methods: Semi-structured interviews were conducted with 29 respondents. The data were coded thematically and analysed using the constant comparative method of qualitative data analysis. Results: Seven broad domains of change were identified: psychosocial health; community; agency and behavioural change; the Art; economic effect; learning and identity. Conclusions: Experiences of participatory arts are interrelated in an ecology of practice that is iterative, relational, developmental, temporal and contextually bound. This means that questions of impact are contingent, and there is no one path that participants travel or single measure that can adequately capture the richness and diversity of experience. Consequently, it is the productive tensions between the domains of change that are important and the way they are animated through Arts practice that provides sign posts towards the impact of Big hART projects.