Embodying and destabilising disability and childhood

Young people's bodies have been at the centre of much policy and media discourse of late, forming the focal point of moral panics about obesity, substance abuse, and anti-social behaviour, to name just a few. Political responses to these issues are often focused on finding 'pragmatic' solutions based on a normative understanding of child development. This book, instead, demonstrates the contested and differentiated nature of childhood and youth embodiment. It combines the critical analysis of imagined and disciplined youthful bodies with a focus on young people's lived and performed, embodied subjectivities. Contested Bodies of Childhood and Youth points towards ways of addressing the issues that affect young people's wellbeing without criminalising and stigmatising them. It presents cutting edge interdisciplinary research in an accessible style that seeks to bridge the divide between theory and practice in research.

Preoperative predictors for postoperative problems in heart transplantation: psychiatric and psychosocial considerations

The psychiatric and psychosocial evaluation of the heart transplant candidate can identify particular predictors for postoperative problems. These factors, as identified during the comprehensive evaluation phase, provide an assessment of the candidate in context of the proposed transplantation protocol. Previous issues with compliance, substance abuse, and psychosis are clear indictors of postoperative problems. The prolonged waiting list time provides an additional period to evaluate and provide support to patients having a terminal disease who need a heart transplant, and are undergoing prolonged hospitalization. Following transplantation, the patient is faced with additional challenges of a new self-image, multiple concerns, anxiety, and depression. Ultimately, the success of the heart transplantation remains dependent upon the recipient's ability to cope psychologically and comply with the medication regimen. The limited resource of donor hearts and the high emotional and financial cost of heart transplantation lead to an exhaustive effort to select those patients who will benefit from the improved physical health the heart transplant confers.

Changes in extracellular levels of glutamate in the nucleus accumbens after ethanol-induced behavioral sensitization in adolescent and adult mice

Repeated administration of low doses of ethanol gradually increases locomotor responses to ethanol in adult Swiss mice. This phenomenon is known as behavioral sensitization. However, we have shown that adolescent Swiss mice show either behavioral tolerance or no sensitization after repeated ethanol injections. Although the mesolimbic dopamine system has been extensively implicated in behavioral sensitization, several studies have demonstrated an important role of glutamatergic transmission in this phenomenon. In addition, relatively few studies have examined the role of developmental factors in behavioral sensitization to ethanol. To examine the relationship between age differences in behavioral sensitization to ethanol and the neurochemical adaptations related to glutamate within nucleus accumbens (NAc), in vivo microdialysis was conducted in adolescent and adult Swiss mice treated with ethanol (1.8 g/kg) or saline for 15 days and subsequently challenged with an acute dose (1.8 g/kg) of ethanol 6 days later. Consistent with previous findings, only adult mice demonstrated evidence of behavioral sensitization. However, ethanol-treated adolescent mice demonstrated a 196.1 +/- 40.0% peak increase in extracellular levels of glutamate in the NAc after ethanol challenge in comparison with the basal values, whereas ethanol-treated adult mice demonstrated a 52.2 +/- 6.2% reduction in extracellular levels of glutamate in the NAc after ethanol challenge. These observations suggest an age-dependent inverse relationship between behavioral and glutamatergic responses to repeated ethanol exposure. (C) 2011 Elsevier Inc. All rights reserved.

Ethanol consumption and pineal melatonin daily profile in rats

It is well known that melatonin participates in the regulation of many important physiological functions such as sleep-wakefulness cycle, motor coordination and neural plasticity, and cognition. However, as there are contradictory results regarding the melatonin production diurnal profile under alcohol consumption, the aim of this paper was to study the phenomenology and mechanisms of the putative modifications on the daily profile of melatonin production in rats submitted to chronic alcohol intake. The present results show that rats receiving 10% ethanol in drinking water for 35 days display an altered daily profile of melatonin production, with a phase delay and a reduction in the nocturnal peak. This can be partially explained by a loss of the daily rhythm and the 25% reduction in tryptophan hydroxylase activity and, mainly, by a phase delay in arylalkylamine N-acetyltransferase gene expression and a 70% reduction in its peak activity. Upstream in the melatonin synthesis pathway, the results showed that noradrenergic signaling is impaired as well, with a decrease in beta 1 and alpha 1 adrenergic receptors` mRNA contents and in vitro sustained loss of noradrenergic-stimulated melatonin production by glands from alcohol-treated rats. Together, these results confirm the alterations in the daily melatonin profile of alcoholic rats and suggest the possible mechanisms for the observed melatonin synthesis modification.

Neuropsychological Assessment of Current and Past Crack Cocaine Users

Background: Cognitive changes due to crack cocaine consumption remain unclear Methods: For clarification, 55 subjects were assigned to three groups: control group, crack cocaine current users, and ex-users. Participants were submitted to Mini-Mental State Examination (MMSE) and tasks evaluating executive functioning and verbal memory Mood state was also measured. Intergroup comparisons were carried out. Results: Control group performance on the MMSE was better than that of users and ex-users. Verbal memory performance for logical memory of users was impaired. Ex-users scored lower on DSST and Trail Making Test (Part B). Conclusion: Chronic crack cocaine use seems to disrupt general cognitive functioning (MMSE), verbal memory, and attentional resources, but findings suggest that some of these effects could be reversed by abstinence.

What do we know about preventing drug-related harm through social developmental intervention with children and young people

This chapter examines the evidence for the effectiveness of interventions aiming to reduce drug-related harm by improving conditions for healthy develeopment in the earliest years through adolescence. Of the interventions beginning prior to birth, there is efficacy evidence that family home visitation is a feasible strategy for implementation with disadvataged families and can reduce risk factors for early developmental deficits and thereby improve childhood development outcomes. There is efficacy evidence for strategies such as parent education and school preparation through the pre-school age period. Some of the strongest evidence for efficacy in reducing developmental pathways to drug-related harm comes from interventions delivered through the early school years to improve educational environments. Of the interventions targeting the high school age period, school drug education has been the most commonly evaluated. The evidence suggests that short term reduction in both drug use and progression to frequent drug use may be achievable through this strategy, but the prospects for longer-term and population-level behaviour change is still unclear. In overview, a range of prevention strategies have been developed and evaluated. Most of the exisiting evidence is restricted to efficacy studies and there are future challenges to progress evaluation through to studies of effectiveness. In general, prevention programmes appear more successful where they maintain intervention activities over a number of years and incorporate more than one strategy. Much of the existing research has been based in North America and evaluates discrete programmes. Future research should test effects in other countries, in different social contexts and seek to better understand the interrelated effects of combining interventions within the community. Developmental prevention programmes target different age periods and social settings, hence communities have the challenge of coordinating a mixture of programmes that address the local conditions that adversely influence child and youth development. There are opportunities in this work to coordinate prevention activities using funding from different jurisdictions (e.g., crime prevention, health promotion, mental health, education, substance abuse prevention).

Prediction of alcohol-related harm from controlled drinking stragegies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.
Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.
Design Longitudinal follow-up across five waves of data collection.
Setting Post high school in Victoria, Australia.
Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.
Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.
Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.

Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.

Design Longitudinal follow-up across five waves of data collection.

Setting Post high school in Victoria, Australia.

Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.

Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.

Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

Comparison of the structure of adolescent problem behavior in the United States and Australia

Some extant theory and empirical research suggests that youth problem behaviors, such as substance abuse and delinquency, reflect a single underlying dimension of behavior, whereas others suggest there are several different dimensions. Few studies have examined potential international differences in the structure of problem behavior, where cultural and policy differences may create more variation in behavior and different structures. This study explored the structure of problem behavior in two representative samples of youth (ages 12-17) from Maine and Oregon in the United States (N = 33,066) and Victoria, Australia (N = 8,500). The authors examined the degree to which data from the two countries produce similar model structures using indicators of problem behavior. Results show that the data are best represented by two factors, substance use and delinquency, and there appear to be more similarities than differences in the models across countries. Implications for understanding problem behavior across cultural and developmental groups and practical and policy implications are discussed.

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.

School, parent, and student perspectives of school drug policies

Background: Schools use a number of measures to reduce harmful tobacco, alcohol, and drug use by students. One important component is the school's drug policy, which serves to set normative values and expectations for student behavior as well as to document procedures for dealing with drug-related incidents. There is little empirical evidence of how policy directly or indirectly influence students' drug taking. This study compares how effectively schools communicate school drug policies to parents and students, how they are implemented, and what policy variables impact students' drug use at school and their perceptions of other students' drug use at school.

Methods: Data were obtained from 3876 students attending 205 schools from 2 states in the United States and Australia, countries with contrasting national drug policy frameworks. School policy data were collected from school personnel, parents, and students.

Results: Schools' policies and enforcement procedures reflected national policy approaches. Parents and students were knowledgeable of their school's policy orientation.

Conclusions: When delivered effectively, policy messages are associated with reduced student drug use at school. Abstinence messages and harsh penalties convey a coherent message to students. Strong harm-minimization messages are also associated with reduced drug use at school, but effects are weaker than those for abstinence messages. This smaller effect may be acceptable if, in the longer term, it leads to a reduction in harmful use and school dropout within the student population.

Measuring the impact of intimate partner violence on the health of women in Victoria, Australia

Objective: Using burden of disease methodology, estimate the health risks of intimate partner violence (IPV) among women in Victoria, Australia.

Methods: We calculated population attribute fractions (from survey data on the prevalence of IPV and the relative risks of associated health problems in Australia) and determined health outcomes by applying them to disability-adjusted life year estimates for the relevant disease and injury categories for Victoria, Australia for 2001.

Findings: For women of all ages IPV accounted for 2.9% (95% uncertainty interval 2.4-3.4%)  of the total disease and injury burden.  Among women 18-44 years of age, IPV was associated with 7.9% (95% uncertainty interval 6.4-935%) of the overall disease burden and was a larger risk to health than risk factors traditionally included in burden of disease studies, such as raised blood pressure, tobacco use and increased body weight.  Poor mental health contributed 73% and substance abuse 22% to the disease burden attributed to IPV.

Conclusion: Our findings suggest that IPV constitutes a significant risk to women's health.  Mental health policy-makers and health workers treating common mental health problems need to be aware that IPV is an important factor.  Future research should concentrate on evaluating effective interventions to prevent women being exposed to violence, and identifying the most appropriate mental health care for victims to reduce short- and long-term disability