Cap a una escola secundària inclusiva: sabers i experiències de joves en situació d'exclusió

[cat] Aquest projecte revisa la narrativa al voltant del fracàs escolar a partir del desenvolupament de deu històries de joves - set nois i tres noies- de Catalunya en situació d'exclusió escolar. Dins d'aquest marc la recerca s'ha articulat a partir de tres eixos: (1) La realització d'un mapa dels estudis realitzats a Catalunya entorn l'anomenat fracàs escolar, amb la finalitat de situar i contextualitzar les seves narratives dominants. (2) La recerca entorn a les històries biogràfiques d'un grup de joves per explorar alternatives a l'actual crisi internacional de l'escola secundària que es reflecteix, entre d'altres fenòmens, en els elevats índexs d'abandonament d'aquesta etapa educativa per part dels estudiants. (3) La recerca conclou amb una sèrie de consideracions que pretenen contribuir a una narrativa a favor d¿una escola inclusiva per a l'educació secundària que tingui en compte les experiències i sabers d'aquests joves que, per diferents raons, no finalitzen la seva educació bàsica.

Which change talk dimensions are associated with subsequent drinking among young men receiving a brief motivational intervention in a non-clinical setting?

Background: Patient change talk (CT) during brief motivational interventions (BMI) has been linked with subsequent changes in drinking in clinical settings but this link has not been clearly established among young people in non-clinical populations. Objective: To determine which of several CT dimensions assessed during an effective BMI delivered in a non-clinical setting to 20-year old men are associated with drinking 6 months later. Methods: Of 125 individuals receiving a face-to-face BMI session (15.8 ± 5.4 minutes), we recorded and coded a subsample of 42 sessions using the Motivational Interviewing Skill Code 2.1. Each patient change talk utterance was categorized as `Reason´, `Ability´, `Desire´, `Need´, `Commitment´, `Taking steps´, or `Other´. Each utterance was graded according to its strength (absolute value from 1 to 3) and direction (i.e. towards (positive sign) or away (negative sign) from change/in favor of status quo). `Ability´, `Desire´, and `Need´ to change (`ADN´) were grouped together since these codes were too scarce to conduct analyses. Mean strength scores over the entire session were computed for each dimension and later dichotomized in towards change (i.e. mean core > 0) and away from change/in favor of status quo. Negative binomial regression models were used to assess the relationship between CT dimensions and drinking 6 months later, adjusting for drinking at baseline. Results: Compared to subjects with a `Taking steps´ score away from change/in favor of status quo, subjects with a positive `Taking steps´ score reported significantly less drinking 6 months later (Incidence Rate Ration [IRR] for drinks per week: 0.56, 95% Confidence Interval [CI] 0.31, 1.00). IRR (95%CI) for subjects with a positive `ADN´ score was 0.58, (0.32, 1.03). For subjects with a positive `Reason´, `Commitment´, and `Other´ scores, IRR (95%CI) were 1.28 (0.77; 2.12) 1.63 (0.85; 3.14) and 1.03 (0.61; 1.72), respectively. Conclusion: A change talk dimension reflecting steps taken towards change (`Taking steps´) is associated with less drinking 6 months later among young men receiving a BMI in a non-clinical setting. Encouraging patients to take steps towa change may be a worthy objective for clinicians and may explain BMI efficacy.

Mentoría para fomentar el éxito socioeducativo de jóvenes peruanos residentes en Barcelona

El programa de mentoría propuesto, toma como punto de partida la actual situación académica y social de jóvenes peruanos residentes en Barcelona y cercanías. Diversos estudios señalan la existencia de un alto índice de abandono escolar en Catalunya, así como un bajo rendimiento escolar que afecta principalmente a estudiantes extranjeros. El objetivo general es fomentar y optimizar la adecuada escolarización de jóvenes peruanos de entre 12 y 20 años. A través de procesos de mentoría y voluntariado se pretenden mejorar sus competencias escolares y sociales favoreciendo la creación de modelos de referencia positivos para los jóvenes en riesgo, así como espacios de aprendizaje, intercambio y acercamiento que fomenten la integración y la cohesión social entre las comunidades extranjera y autóctona. Para la realización del programa se prevé optimizar los recursos ya existentes, como los puntos de información juvenil y los centros de Asesoramiento Académica para jóvenes (CAAJ) y por otro lado se cuenta con la colaboración del Consulado General del Perú en Barcelona y de la escuela Virolai de Barcelona

Implicación de la ansiedad y la depresión en los trastronos de alimentación de jovenes con obesidad

Objectives: the goals of the present study were: 1) to compare the levels of anxiety, depression, and eating disorders in young patients assisted at a children"s hospital for obesity; 2) to determine whether anxiety and depression explain the symptoms of the eating disorders; and 3) to know which of these symptoms better discriminate the young people with different degrees of obesity. Materials and method: Descriptive, cross-sectional study with a sample comprised by 281 youngsters (56% girls) aged 11-17 years. The BMI percentiles were calculated by using the WHO growth tables. Two study groups were created: severe obesity and overweight/light-moderate obesity. The following questionnaires were used: Eating Disorders Inventory-2 (EDI-2), depression questionnaire (DQ), and Status-Trait Anxiety Questionnaire (STAI). Results: The youngsters with obesity showed more psychological problems than youngsters with overweight/ light-moderate obesity, 12% had anxiety, and 11% depression. In both groups, the behaviours related with eating disorders were partially explained by the presence of symptoms of anxiety and depression. Dissatisfaction with the body and high anxiety trait increased the risk for perpetuating the obesity and were the two symptoms that better discriminated the patients with or without severe obesity. Conclusion: Obesity prevention programmes should include body dissatisfaction and the anxiety trait into the assessment and management protocols, and prevent anxiety getting fixed as a personality trait.

Averting risk in the face of large losses: Bernoulli vs. Tversky and Kahneman

We experimentally question the assertion of Prospect Theory that people display risk attraction in choices involving high-probability losses. Indeed, our experimental participants tend to avoid fair risks for large (up to ? 90), high-probability (80%) losses. Our research hinges on a novel experimental method designed to alleviate the house-money bias that pervades experiments with real (not hypothetical) loses.Our results vindicate Daniel Bernoulli?s view that risk aversion is the dominant attitude,But, contrary to the Bernoulli-inspired canonical expected utility theory, we do find frequent risk attraction for small amounts of money at stake.In any event, we attempt neither to test expected utility versus nonexpected utility theories, nor to contribute to the important literature that estimates value and weighting functions. The question that we ask is more basic, namely: do people display risk aversion when facing large losses, or large gains? And, at the risk of oversimplifying, our answer is yes.

Prestacions en benefici de la comunitat i realització de tasques socioeducatives en justícia juvenil

Els joves als quals se’ls ha imposat una mesura de realització de tasques socioeducatives (RTS) o de prestacions en benefici de la comunitat (PBC) presenten un alt fracàs escolar, majoritàriament amb baix rendiment i abandonament dels estudis en la meitat dels casos. Un de cada tres joves prové d’una família amb algun tipus de problemàtica específica o una economia insuficient. Els resultats indiquen, però, que els joves que realitzen tasques socioeducatives solen acumular més problemàtiques que els de PBC, ja sigui a nivell personal, familiar o social. Quant al perfil penal i criminològic, el 63% dels nois i noies d’aquestes dues mesures té antecedents. La taxa de reincidència de RTS és del 31,1% i la de PBC del 25,2%. Alguns dels factors que els joves reincidents mostren en més proporció són tenir un grup d’iguals dissocial, estar en contacte amb els serveis socials o tenir antecedents. Els reincidents de RTS també presenten més proporció de consum de tòxics, problemes de salut mental, fracàs escolar i una ocupació del temps desestructurada i amb conductes de risc. Comparant aquests resultats amb estudis respecte altres programes i mesures de Justícia juvenil podem concloure que la taxa de reincidència global a Catalunya és del 28,9% i l’específica de Medi obert és del 27,8%.

Opportunities for prevention in primary care in a country with universal insurance coverage.

Data from studies in the United States suggest that young people engaging in health-compromising behaviors have lower access to health care. Using data from a Swiss national survey we tested the hypothesis that in a country with universal insurance coverage, adolescents engaging in health-compromising behaviors access primary care to the same extent as those who do not engage in these behaviors.

La contraception d'urgence chez les adolescents en Suisse: une étude sur la sexualité des 16-20 ans

Objectifs: Faire le point sur les connaissances concernant la contraception post-coïtale (CPC) et son utilisation par les adolescentes, et réunir les recommandations utiles aux médecins prescripteurs. Matériel et méthodes: La revue de littérature concernant la CPC et les résultats d'une enquête concernant les comportements sexuels des adolescents de 16-20 ans en Suisse sont utilisés. Résultats: Plusieurs méthodes peuvent être utilisées incluant les oestroprogestatifs et les progestatifs seuls. C'est surtout à l'occasion de rupture de préservatif, d'oubli de pilule ou d'absence de contraception que la CPC peut être utile. Les adolescents sexuellement actifs semblent connaître l'existence de la CPC et 20% des jeunes filles y ont eu recours en Suisse. Mais les obstacles qui limitent l'accès à la CPC sont nombreux au niveau de l'information et de la qualité des services dans cette situation d'urgence. Discussion et conclusion: La sensibilisation des adolescents et des jeunes aux conditions d'utilisation de la CPC est nécessaire, et doit être associée à un effort de formation des professionnels et de qualité des services pour faciliter l'accès à la CPC. Mots-clefs: contraception d?urgence, contraception post-coïtale, pilule du lendemain, adolescents.<br/><br/>Purpose: To describe and analyze emergency contraception (EC) awareness and use among sexually active Swiss teenagers. Methods: Anonymous computerized questionnaires were distributed to a national representative sample of 4283 in-school adolescents (aged 16 to 20 years) in high schools and professional centers. Young people who were sexually active (51.5% of the sample: 1058 girls and 1073 boys) responded to questions on EC awareness and use and on sexual perception, attitude and behaviors. Univariate analyses and multiple regression analyses were used to describe EC awareness and use and their correlates. Results: Most of the sexually active girls (89.3%) and boys (75.2%) knew of the existence of EC. Of girls, 20% reported having used EC, and the majority of them used it only once (64.1%) or twice (18.5%). EC awareness was positively associated with the father's level of education (girls: odds ratio:5.18), and the scholastic curriculum of the respondent. Gender differences in the correlates of EC awareness demonstrate that girls who had a confidant, or a group of friends or boys of Swiss nationality and those who have had the opportunity to discuss the issue of contraception declare greater awareness of EC. EC use was higher among girls who lived in urban areas (odds ratio: 1.91) and occasionally had unprotected intercourse. We did not find any significant difference in the profile of multiple vs. one-time users. Conclusion: EC awareness and use should be improved through better information and accessibility, especially among teenagers who place themselves in at-risk situations. Keywords: Adolescents, Emergency contraception, Gender differences, Teenage pregnancy prevention, Switzerland.

Est-ce qu'en discuter fait la différence ? Opinions de jeunes adultes atteints de maladies chroniques après avoir été transférés vers des soins pour adultes [Does talking about it make a difference? Opinions of chronically ill young adults after being transferred to adult care].

1) Introduction: pour les jeunes souffrant de maladie chronique, l'objectif de la transition vers les soins pour adultes est d'optimiser leur fonctionnement et leur potentiel. Le but de cette étude pilote était d'évaluer si les jeunes adultes souffrant de maladie chronique jugeaient que le passage vers les soins adultes était plus facile lorsque la question de la transition avait été discutée au préalable avec leur pédiatre. 2) Matériel et méthodes: deux groupes de jeunes adultes atteints de maladie chronique ont été identifiés selon l'existence (n = 70) ou non (n = 22) d'une discussion préalable avec leur pédiatre à propos de la transition vers une prise en charge pour adultes. Ces deux groupes ont été comparés pour des variables démographiques et de santé. Les variables significatives en analyse bivariée ont été incluses dans une régression logistique descendante pas à pas. 3) Résultats: les jeunes adultes qui avaient discuté de la transition étaient significativement plus nombreux à se sentir prêts (72,9 % vs 45,5 %) et accompagnés (58,6 % vs 27,3 %) pour le transfert, à avoir consulté leur spécialiste pour adultes (60 % vs 31,8 %) et à voir leur médecin sans la présence de leurs parents (70 % vs 40,9 %). En analyse multivariée, seuls, le fait de se sentir accompagné (odds ratio ajustée [ORa] : 3,56) et celui d'avoir consulté leur spécialiste pour adultes (ORa : 4,14) étaient significatifs. 4) Conclusions: la préparation des jeunes souffrant de maladie chronique au transfert vers les soins pour adultes semble bénéfique. Cependant, le transfert lui-même n'est qu'une petite partie du concept beaucoup plus large de la transition vers la vie adulte. Une transition bien planifiée doit permettre à ces jeunes adultes d'atteindre tout leur potentiel. INTRODUCTION: The goal of transition in healthcare for young people with chronic illnesses is to maximize their functioning and potential. The purpose of this pilot study was to assess whether young adults with chronic illnesses found that the transition to adult care was easier when the transition was discussed in advance with their pediatric specialist. METHODS: Two groups were created according to whether patients had discussed (n=70) or not (n=22) the transition with their pediatric specialist and compared regarding demographic and health-related variables. All the significant variables at the bivariate level were included in a backward stepwise logistic regression. RESULTS: Youth who had discussed the transition were significantly more likely to feel ready for the transfer (72.9% vs 45.5%) and accompanied (58.6% vs 27. %) during transfer, to have consulted their specialist for adults (60.0% vs 31.8%), and seen their doctor without the presence of their parents (70.0% vs 40.9%). At the multivariate level, only feeling accompanied during transfer (adjusted odds ratio (aOR): 3.56) and having consulted their specialist for adults (aOR: 4.14) remained significant. CONCLUSIONS: Preparing chronically ill youths for transfer to adult care appears to be beneficial for them. However, transfer is only a small part of the much broader transition that is preparation for adult life. A well-planned transition should allow these young people to reach their full potential.

Prestaciones en beneficio de la comunidad y realización de tareas socioeducativas en justicia juvenil

Los jóvenes a los que se les ha impuesto una medida de realización de tareas socioeducativas (RTS) o de prestaciones en beneficio de la comunidad (PBC) presentan un alto fracaso escolar, mayoritariamente con bajo rendimiento y abandono de los estudios en la mitad de los casos. Uno de cada tres jóvenes proviene de una familia con algún tipo de problemática específica o una economía insuficiente. Los resultados indican, sin embargo, que los jóvenes que realizan tareas socioeducativas suelen acumular más problemáticas que a los que se les ha impuesto una PBC, ya sea a nivel personal, familiar o social. En cuanto el perfil penal y criminológico, el 63% de los chicos y chicas de estas dos medidas tiene antecedentes. La tasa de reincidencia de la RTS es del 31,1% y la de PBC del 25,2%. Algunos de los factores que los jóvenes reincidentes muestran en mayor proporción son tener un grupo de iguales disocial, estar en contacto con los servicios sociales o tener antecedentes. Los reincidentes de RTS también presentan mayor proporción de consumo de tóxicos, problemas de salud mental, fracaso escolar y una ocupación del tiempo desestructurada y con conductas de riesgo. Comparando estos resultados con estudios respecto a otros programas y medidas de Justicia juvenil podemos concluir que la tasa de reincidencia global en Cataluña es del 28,9% y la específica de Medio abierto es del 27,8%.

Implicación de la ansiedad y la depresión en los trastronos de alimentación de jovenes con obesidad

Objectives: the goals of the present study were: 1) to compare the levels of anxiety, depression, and eating disorders in young patients assisted at a children"s hospital for obesity; 2) to determine whether anxiety and depression explain the symptoms of the eating disorders; and 3) to know which of these symptoms better discriminate the young people with different degrees of obesity. Materials and method: Descriptive, cross-sectional study with a sample comprised by 281 youngsters (56% girls) aged 11-17 years. The BMI percentiles were calculated by using the WHO growth tables. Two study groups were created: severe obesity and overweight/light-moderate obesity. The following questionnaires were used: Eating Disorders Inventory-2 (EDI-2), depression questionnaire (DQ), and Status-Trait Anxiety Questionnaire (STAI). Results: The youngsters with obesity showed more psychological problems than youngsters with overweight/ light-moderate obesity, 12% had anxiety, and 11% depression. In both groups, the behaviours related with eating disorders were partially explained by the presence of symptoms of anxiety and depression. Dissatisfaction with the body and high anxiety trait increased the risk for perpetuating the obesity and were the two symptoms that better discriminated the patients with or without severe obesity. Conclusion: Obesity prevention programmes should include body dissatisfaction and the anxiety trait into the assessment and management protocols, and prevent anxiety getting fixed as a personality trait.

Sistema educativo e igualdad de oportunidades entre los jóvenes tutelados: estudios recientes en el Reino Unido

Educational system and equal opportunities for young people in care: Recent studies in the UK. Publications on research about formal educational itineraries of people who were cared for by the social protection public systems when they were children are scarce, and restricted to a few countries. In recent years, statistics from some European countries have been published, showing that the young people who were cared for are overrepresented in practically all the clusters of people that accumulate indicators of social disadvantage, and it has therefore been argued that they can be considered one of the groups of population with the highest risk for social exclusion. In the present review, the emergence of new data and research results in some European countries —particularly in the United Kingdom, where the fact that less than 5% of this population reaches university studies has been underlined— is tentatively contextualised. Although the extent to which current available data can be extrapolated to other contexts and countries is yet unclear, such results raise important challenges for social intervention and social policies, as well as for psychosocial research, in all countries of the European space

Venäläistä rulettia – Nuorten perhesuunnittelun esteet ja tarpeet Pietarissa ja Riiassa

Latviassa ja Venäjällä heikko demografinen tilanne on lisännyt keskustelua seksuaali- ja kansalaisoikeuksista sekä valtion merkityksestä niiden toteuttamisessa. Väestöpolitiikassa näkyy yhteiskunnallinen tilanne sekä sen kyky ja mahdollisuudet huomioida nuorten perhesuunnitteluun liittyviä tarpeita. Huomion kohteena on myös palvelujärjestelmä ja siinä toteutuva yksilöllinen taso. Tutkin perhesuunnittelua kokonaisvaltaisesti, mikä ilmenee erilaisten polkuriippuvuuksien tarkasteluina. Mielenkiintoiseksi kohteen tekee entisten sosialististen valtioiden erityislaatuisen murroksen läpikäyminen. Perhesuunnittelu on osa seksuaali- ja ihmisoikeuksia. Siihen kuuluu seksuaaliterveydestä tiedottaminen ja ohjaus sekä siihen liittyvät toimenpiteet. Perhesuunnittelu sisältää niin sosiaaliset, kasvatukselliset kuin lääketieteellisetkin näkökulmat. Siihen liitetään myös moraalisia ja taloudellisia näkemyksiä, sekä politiikkaa ja henkilökohtaisuutta. Tutkimustehtäväni on nuorten perhesuunnittelun esteet ja tarpeet Riiassa ja Pietarissa. Sovellan metodologisena lähestymistapana sosiaalihistoriallista ja etnografista tutkimusotetta, jolloin perinteen vaikutusten, kulttuuristen rakenteiden ja yksilöllisten toimintatapojen ymmärtäminen mahdollistuu. Aineisto koostuu viranomaishaastatteluista sosialismin kaudella toteutuneesta sekä nykyisestä perhesuunnittelusta ja nuorten haastatteluista Pietarissa ja Riiassa. Perehdyn myös lisääntymisterveyteen liittyviin sanomalehtiartikkeleihin sekä Latviassa että Venäjällä. Lisäksi havainnoin seksuaalineuvontatilanteita Pietarissa. Sekä sosialismin aikana että nykyään painottuvat väestönkasvun odotukset, joita tuetaan sukupuoli- ja moraalikasvatuksen avulla. Perhesuunnittelun esteiden analyysin tuloksissa on nähtävissä sosiaalisten olosuhteiden ja rakenteiden merkitys. Jälkisosialistisesta riskiyhteiskunnasta puuttuvat yhteiskuntaan integroitumisen mahdollistavat instituutiot. Tämä ilmenee yhteiskunnallisena vastuuttomuutena. Universaalit palvelut ovat suurelta osin peräisin sosialismin ajalta. Kaupalliset yritykset tekevät lähinnä teknisiä, yksittäisiä ehkäisyvälineisiin liittyviä interventioita nuorten elämään. Teini-ikäiset jätetään oman harkintansa varaan. Latviassa perhesuunnitteluun liittyvä ennalta ehkäisevä toiminta on huomioitu uudessa lisääntymisterveyslaissa, mutta sen heikko toteutus tuo sen lähelle neuvostoaikaista kulttuurikonventiota, jossa määrällisillä suoritteilla ja sekundaaripreventiolla on arvoa. Venäjällä voimavarat kohdentuvat jälkihuollon palveluihin. Foucaultin valta-analyysi kertoo strategiasta, jossa ihminen sisäistää vallankäytön osaksi omaa ajatteluaan ja toimintaansa. Tässä näkökulmassa yksilöllinen, yhteiskunnallinen ja historiallinen ulottuvuus limittyvät toisiinsa. Vallan muodot ovat yhteiskunnan rakenteissa. Väestöpolitiikan avulla tuotetaan tietoa ja muovataan hallitsemisen kohteita. Osa haastatelluista nuorista omaksui yhteiskunnan passiivisuuden osaksi omaa toimintaansa. He eivät tiedostaneet palvelujärjestelmän puutteita eivätkä kyseenalaistaneet sen oikeutusta. Myös lehtiartikkelit ja viranomaishaastattelut tukivat osittain seksuaalikasvatuksen sivuuttamista. Silloin hyväksyttävänä totuutena pidettiin väestöpolitiikkaa, jossa on annettu tilaa populistisille suuntauksille. Sekä Latviassa että Venäjällä ilmaistiin tavoitteita väestön kasvusta. Kansainvälisten seksuaalioikeuksien maihinnousu ei ole poistanut ääri uskonnollisten ja osittain kansalaisjärjestöjen puitteissa tapahtuvaa perhesuunnittelun vastustusta. Näissä suuntauksissa vaikutetaan ihmisten moraaliin ja vastustetaan yhteiskunnan interventioita kieltämällä seksuaalikasvatus. Sosialismin aikana sosiaali- ja terveydenhuoltoa toteutettiin totalitaristisessa, suljetussa yhteiskunnassa tiukasti rajatuilla voimavaroilla. Tuolta ajalta peräisin oleva viranomaisten yleinen medikalisoitunut ja tekninen lähestymistapa estää osittain nuoren valtaistumista. Vieläkin heikko tiedottaminen ja puutteellinen koulutus vaikuttavat ammattilaisten keskuudessa. Yksi haitallisista perhesuunnitteluun kuuluvista uskomuksista oli hormonaalisen ehkäisyn aiheuttamat ongelmat. Lisäksi pelättiin heikkotasoisesti tehtyjen aborttien aiheuttavan hedelmättömyyttä. Uskomukset ovat eläneet vieläkin, kun osa asiantuntijoista kannusti ensimmäisen raskauden päättymistä synnytykseen. Näillä käsityksillä on ollut taipumus siirtyä sukupolvelta toiselle myös kansalaisten keskuudessa. Sukuyhteisöjen ja verkostojen oleellinen merkitys teini-ikäisen arjessa ja selviytymisessä painotti perinteistä sosialisaatiota. Uskomusten lisäksi nuorten heikko taloudellinen tilanne on ohjannut heitä ehkäisyssä luonnonmenetelmien käyttöön. Neuvostoaikainen seksuaalikielteisyyden perinne on vaikuttanut myös sukupolvien kyvyttömyyteen keskustella aiheesta. Yleisen ennaltaehkäisevän neuvonnan puuttuminen on suunnannut suurta osaa nuoria mallioppimiseen, jossa esimerkit ovat nousseet satunnaisista löydöistä. Toisaalta työntekijöiden neuvokkuus ja aloitteellisuus erilaisissa ohjaamistilanteissa, toimintatavoissa ja instituutioiden perustamisissa kuvaavat eettistä vastuunottoa ja paneutumista nuorten perhesuunnittelun toteutumiseen sekä sen mahdollisuuksiin. Perhesuunnitteluun liittyvän tiedonsaannin parantamiseksi viranomaiset ovat aloittaneet nuorten vertaisryhmiä. Lisäksi yhtenä uutena virallisena lähestymistapana oli neuvostoaikana kielletty psykoterapeuttisen suuntauksen avoin käyttöönotto. Myös nuorille suunnattuja palveluja niin lainsäädännön kuin instituutioiden tasolla on saatu aikaan. Nämä myönteiset tapaukset jäivät kuitenkin yksittäisiksi, osittain joidenkin työntekijöiden omakohtaisen sitoutumisen varaan toimiviksi. Tutkimuksessa nousee esiin yhteiskunnan vastuu erityisesti haavoittuvien ryhmien kohdalla. Nuoret ovat tiedoiltaan ja kokemuksiltaan heikossa asemassa. Sosiaalipoliittisesta näkökulmasta julkisilla ja ennaltaehkäisevillä palveluilla on keskeinen merkitys etenkin niiden kohdalla, jotka tarvitsevat runsaasti palveluja. Usein tähän ryhmään kuuluvat ovat passiivisia tiedon hakijoita. Tutkimus tuo esille perhesuunnittelun palvelujärjestelmään ja sen kohderyhmään kuuluvan moniulotteisuuden, jossa toisiinsa nivoutuvat kulttuuriset myytit, uskomukset, tabut, toimintatavat ja tietämys. Näiden polkujen avaaminen tässä tutkimuksessa edistää perhesuunnittelun esteiden tunnistamista ja niihin soveltuvien ratkaisukeinojen löytymistä.

Health Related Quality of Life after Childhood Cancer - A Finnish Nationwide survey

The purpose of this Finnish epidemiological nationwide cross-sectional study was to evaluate the Health Related Quality of Life (HRQL) of young people that have survived childhood cancer at least four years after cancer diagnosis. The study aims were (1) to increase knowledge and understanding about the relationship between childhood cancer and its treatment and HRQL of childhood cancer survivors and (2) to identify survivors who need and could benefit from ongoing long-term follow-up, as well as (3) to identify what kind of aftercare the childhood cancer survivors will possibly need. HRQL and fatigue of currently still young survivors of extracranial childhood malignancies were evaluated with self-reports and parent proxy reports. HRQL was measured with age-appropriate generic instruments: PedsQL™, SF-36, 15D, 16D and 17D. Fatigue for children and adolescents aged below 18 years was measured with the PedsQL™ Multidimensional Fatigue Scale Finnish version. PedsQL™ parent-proxy and the PedsQL™ Multidimensional Fatigue Scale Parentproxy instruments were used to assess the perception of the parents on HRQL and fatigue of their children and adolescents. Postal-survey questionnaires were mailed to 852 childhood cancer survivors aged 11-27 years and their randomly selected gender-, age and living-place matched controls, as well as under 18-year-old children´s parents. A total of 474 survivors, 595 controls, 209 survivor’s parent and 253 control’s parent replied. The mean age of survivors at the time of the study was 18.4 years. The mean length of survival was 12.3 years, and the mean age at diagnosis 5.5 years. The most of the Finnish childhood cancer survivors evaluated that their HRQL as good. Survivors rated their HRQL equal or higher than their controls. The only dimension where the survivors scored poorer than the controls was the 15D mobility dimension. Survivors of childhood cancer did not suffer from significant fatigue. There were subgroups of childhood cancer survivors who had poorer level of HRQL, and suffered from fatigue more than the reference group. The demographic factors that associated with poorer HRQL were female gender, greater weight, living alone, need of remedial education, an additional non-cancer diagnosis, survivors with siblings, and self-reported unhappiness. Disease-related factors that associated with poorer HRQL were higher age at the time of diagnosis, the diagnosis of Wilms tumor, neuroblastoma, or osteosarcoma, and treatment with stem cell transplantation. The factors associated with more fatigue in survivors were male gender, older age at evaluation, the need of remedial education at school, lower overall average grade in the latest school marks report, length of survival more than 10 years, lower HRQL-scores, and a sarcoma diagnosis. However, all the used demographic and disease related factors explained only about one third of the variation in the HRQL scores. In open questions, the survivors were most worried about their physical health, but were also worried about their mental health, cancer inheritance, late-effects, and fertility and relapse issues. It seems that there are subgroups of survivors who need and could benefit from ongoing long-term follow-up. In the future, the survivors of childhood cancer need more information about their physical and mental health, as well as on their cancer inheritance, possible late-effects including fertility issues, and on the risk of relapse.

Importance of multidisciplinary trauma prevention program for youth

OBJECTIVE: present the experience of the P.A.R.T.Y. program in Campinas, thereby changing the habits of young people.METHODS: The organizers visited the participating schools talking to the students, who are aged between 14-18 years. These students spent an afternoon at the Clinics Hospital of Unicamp, where, for four hours, they attended lectures of the organizers, partners and municipal sectors, and also visited the hospital, talking with trauma victims. Questionnaires were evaluated between2010-2012, being applied before and after the project.RESULTS:2,450 high school students attended the program. The mean age is 16 ± 0,99 years and 37.6% were male. 3.6% of males already drive while drunk versus 0.8% of women. Before the project 116 (11.3%) thought that drunk driving wasn't a risk, and only 37 (3.6%) knew the alcohol effects. After the project, 441 (43%) began to consider drunk driving a risk and 193 (18.8%) know the alcohol effects when driving. 956 (93.3%) considered that prevention projects have a huge impact on their formation.CONCLUSION: It's expected that the attendees will act as multipliers of information, conveying the message of prevention to their entire social circles resulting in reduction in the number of trauma events involving the young, in the long term.