Interventions to reduce harm associated with adolescent substance use

A major proportion of the disease burden and deaths for young people in developed nations is attributable to misuse of alcohol and illicit drugs. Patterns of substance use established in adolescence are quite stable and predict chronic patterns of use, mortality, and morbidity later in life. We integrated fi ndings of systematic reviews to summarise evidence for interventions aimed at prevention and reduction of harms related to adolescent substance use. Evidence of efficacy was available for developmental prevention interventions that aim to prevent onset of harmful patterns in settings such as vulnerable families, schools, and communities, and universal strategies to reduce attractiveness of substance use. Regulatory interventions aim to increase perceived costs and reduce availability and accessibility of substances. Increasing price, restricting settings of use, and raising legal purchase age are eff ective in reducing use of alcohol and tobacco and related harms. Screening and brief intervention are efficacious, but efficacy of a range of treatment approaches has not been reliably established. Harm-reduction interventions are effective in young people involved in risky and injecting substance use.

Pubertal stage and deliberate self-harm in adolescents

Objective: To ascertain the association between pubertal stage and deliberate self-harm.

Method: Cross-sectional survey of 12- to 15-year-olds in 300 secondary schools in the U.S. state of Washington in February-April 2002 and the Australian state of Victoria in June-August 2002. A total of 3,332 students in grades 7 and 9 provided complete data on episodes of deliberate self-harm in the previous 12 months and pubertal stage. Pubertal stage was assessed with the Pubertal Development Scale.

Results: The prevalence of deliberate self-harm was 3.7% with a more than twofold higher rate in females. Late puberty was associated with a more than fourfold higher rate of self-harm (odds ratio 4.6, 95% confidence interval 1.5-14) after adjustment for age and school grade level. In contrast age had a protective association (odds ratio 0.7, confidence interval 0.4-1.0). The sharpest rises in prevalence across puberty were for self-laceration and self-poisoning in females. Higher rates of depressive symptoms, frequent alcohol use, and initiation of sexual activity largely accounted for the association between self-harm and pubertal stage in multivariate models.

Conclusions: Puberty is associated with changes in the form and frequency of self-harm. For adolescents with a gap between puberty and brain development, risk factors such as early sexual activity and substance abuse may be particularly potent.

Responding to self-harm in borderline personality disorder : from clinician frustration to therapeutic enquiry

Pessimistic attitudes and reactive behavioural management strategies act as a major barrier to effective service provision for patients with borderline personality disorder. This paper reviews research on countertransference reactions (negative professional attitudes) towards these patients and the professional response to the common presentation of self harm in this particular client group. The psychotherapeutic treatment of patients with borderline personality disorder is complex and both professionally and personally demanding. A clinical framework is proposed that enables clinicians to develop a more nuanced and empathic understanding of self harm within the context of personality disorder in order to facilitate enhanced therapeutic engagement with these challenging patients. A clinical case study illustrates the use of this framework and the potential for enhanced therapeutic management in conjunction with the recognition and reduction of clinician indifference and rejection, thus improving patient outcomes. (editor abstract)Pessimistic attitudes and reactive behavioural management strategies act as a major barrier to effective service provision for patients with borderline personality disorder. This paper reviews research on countertransference reactions (negative professional attitudes) towards these patients and the professional response to the common presentation of self harm in this particular client group. The psychotherapeutic treatment of patients with borderline personality disorder is complex and both professionally and personally demanding. A clinical framework is proposed that enables clinicians to develop a more nuanced and empathic understanding of self harm within the context of personality disorder in order to facilitate enhanced therapeutic engagement with these challenging patients. A clinical case study illustrates the use of this framework and the potential for enhanced therapeutic management in conjunction with the recognition and reduction of clinician indifference and rejection, thus improving patient outcomes.

Sex and the surgeon's knife: the family court's dilemma...informed constent and the specter of iatrogenic harm to children with intersex characteristics

The article focuses on the opinion of the Australian High Court on the doctrine of informed consent and the judicial reasoning including the supporting medical evidence in sex assignment cases. The author explains that the remaining credible basis for the jurisdiction assumed by the Family Court in such cases rests in the inability of parents as guardians to give their informed consent to irreversible surgical procedures.

A social identity approach to party drug use and associated harm minimisation

This project investigated party (club) drug use and associated harm minimisation strategies of party drug users (N = 72), by gender and sexual
orientation, to determine whether drug use and harm minimisation behaviours differ in particular social groups.Adopting a social identity approach, this project also explored the existence of a party drug user social identity in relation to harmful party drug behaviours and harm minimisation
strategies.Results indicated that males and females showed similar patterns of harmful party drug use and harm minimisation, whilst heterosexuals and homosexuals differed slightly in their patterns of harmful party drug use, and more substantially in their patterns of harm minimisation.Furthermore, results showed some evidence for the existence of a party drug user social identity, which was related to party drug use within a clear social context, and to experiencing fewer party drug related problems.The authors conclude that harm minimisation initiatives need to be designed for particular social groups, such as heterosexuals or homosexuals, targeting their particular patterns of party drug use, and
suggest that effective harm minimisation strategies should incorporate both the social context in which the behaviour occurs, and the social norms of party drug use by particular social groups.

Framing the discourses of harm and loss: a case study of power relations, mobile phones, and children in Australia

The current penetration of mobile phones in Australia is 92% and it records one of the world’s highest rates of ownership among children under 18. The paper reviews the literature on mobile phones and Australian children and examines the various discourses dominating the public debates; the systematic frames used in these discourses; and whose interests are served in the process. The frames discussed fall under the optimistic (gains); pessimistic (losses, costs or harms); pluralistic (technology per se is neutral but how it is used matters); historical development (skills learnt and the importance of using mobiles); futuristic predictions (promises and dangers for the future); current uses (connectivity, convergence and interactivity); and the techno-realist view (as a mixed blessing) views of technology. Taking the critical perspective and borrowing from Joshua Meyrowitz, the paper illustrates how mobile phones have eroded parental power over how, when, where and with whom their children communicate, surpassing adult supervision, intervention or knowledge, while at the same time, becoming a ‘digital leash’ for parents to re-establish their control an d an ‘umbilical cord’ for their off spring to remain connect! ed with parents, at all times.

Can the overcommercialization of cause-related marketing harm society?

The role of social responsibility within business has been debated for decades. It appears that there is a growing understanding that doing the right thing for society can not only be good for business but is also a responsibility of the modern corporation. Causes, corporations, and society have benefited from corporate involvement with social issues. However, it also appears that in some cases, there may be potential pitfalls associated with merging social and corporate objectives. The "overcommercialization" of some activities designed to benefit society may in fact harm those that these activities are trying to help. This article examines potential pitfalls associated with cause-related marketing and provides recommendations for reducing the potential negative consequences

Harm reduction and decision making among recreational ecstasy users

Recent research indicates that 3,4-methylene-dioxymethamphetamine (MDMA), also known as ‘ecstasy’, is becoming increasingly popular as an illicit drug among young people. This study investigated risk and harm reduction practices among recreational ecstasy users. A semi-structured interview with 40 participants was designed to investigate how ecstasy users identify and manage the harms associated with their drug use, and the underlying decision-making process. Overall, the participants identified both positive and negative effects. The reported positive effects predominantly centred around enhanced psychological, physiological and social experiences. However, there were a number of factors that contributed to regulating ecstasy use. These included specific in-group and out-group practices executed within the peer group, preventative harm-reducing practices, shared decision making, and shared responsibility for harm prevention. Recommendations for promoting harm reduction strategies and suggestions for future research are discussed.

Minimization of reversible adder circuits

Losing information causes losing power. Information is lost when the input vector cannot be uniquely recovered from the output vector of a combinational circuit. The input vector of reversible circuit can be uniquely recovered from the output vector. In this study we have emphasized on the design of reversible adder circuits that is efficient in terms of gate count, garbage outputs and quantum cost and that can be technologically mapped. It has been analyzed and demonstrated that the results of our proposed adder circuits shows better performance compared to similar type of existing designs. Technology independent equations required to evaluate these circuits have also been given.

The evidence of harm to adults relating to exposure to extreme pornographic material: a rapid evidence assessment (REA)

This document reports on a rapid evidence assessment (REA) of the evidence of harm to adults relating to exposure to extreme pornographic materials.

The evidence of harm to adults relating to exposure to extreme pornographic material : a rapid evidence assessment (REA)

This document reports on a rapid evidence assessment (REA) of the evidence of harm to adults relating to exposure to extreme pornographic materials