A naturalistic study of treatment outcomes with aripiprazole in young people with first episode psychosis

Objective: Adequate treatment of a first psychotic episode in young people is a difficult challenge but may be of critical importance for changing the course of psychotic illness. Pharmacotherapy is the standard treatment of psychosis, however there is a paucity of data specific to first-episode psychosis.
Methods: In this study 12 young people who presented with a psychotic episode at a specialised early intervention service were commenced on treatment with aripiprazole. They were assessed at baseline and weeks 4, 6, 24 and 48 using a broad battery of outcome measures. Case notes were also examined.
Results: Data was available for 6 participants at week 48, and of those, one remained on treatment with Aripiprazole at endpoint. Case histories were typified by presentations that included illicit substance use and treatments characterised by several changes in medications. No single treatment choice predominated. Most participants tolerated treatment and showed symptomatic improvement with individualised therapy.
Conclusion: Most participants showed improvement during the treatment period. Aripiprazole was one of many medications used in this study and may have been useful for the treatment of some individuals with first episode psychosis.

Tracking of sedentary behaviours of young people : a systematic review

Objective : To review the empirical evidence concerning the strength of tracking of sedentary behaviours from childhood and adolescence.

Methods : Published English language studies were located from computerised and manual searches in 2009. Included studies were prospective, longitudinal studies with at least one sedentary behaviour for at least two time-points, with tracking coefficients reported, and included children (aged 3–11 years) and adolescents (12–18 years) at baseline.

Results : Based on data from 21 independent samples, tracking coefficients (r) ranged from 0.08 (over 16 years) to 0.73 (over 2 years) for TV viewing, from 0.18 (boys over 3 years) to 0.52 (over 2 years) for electronic game/computer use, from 0.16 (girls over 4 years) to 0.65 (boys over 2 years) for total screen time, and from −0.15 (boys over 2 years) to 0.48 (over 1 year) for total sedentary time. Study follow-up periods ranged from 1 to up to 27 years, and tracking coefficients tended to be higher with shorter follow-ups.

Conclusions : Sedentary behaviours track at moderate levels from childhood or adolescence. Data suggest that sedentary behaviours may form the foundation for such behaviours in the future and some may track slightly better than physical activity.

Forming and sustaining partnerships to provide integrated services for young people : an overview based on the headspace Geelong experience

Aim: To discuss critical considerations in the formation and maintenance of agency partnerships designed to provide integrated care for young people.

Methods: Two years after its establishment, an evaluation of the headspace Barwon collaboration and a review of the health-care and management literature on agency collaboration were conducted. The principal findings together with the authors' experience working at establishing and maintaining the partnership are used to discuss critical issues in forming and maintaining inter-agency partnerships.

Results: Structural and process considerations are necessary but not sufficient for the successful formation and maintenance of inter-agency partnerships and integrated care provision. Specifically, organizational culture change and staff engagement is a significant challenge and planning for this is essential and often neglected.

Conclusions: Although agreeing on common goals and objectives is an essential first step in forming partnerships designed to provide integrated care, goodwill is not enough, and the literature consistently shows that most collaborations fail to meet their objectives. Principles and lessons of organizational behaviour and management practices in the business sector can contribute a great deal to partnership planning.

Risk-taking in young people: the role of impulsivity

This study investigated rash impulsivity, reward sensitivity and a range of adolescent risk-taking behaviours using both self-report and behavioural measures of each of these variables. It found that (a) rash impulsivity and reward sensitivity were related dimensions of the impulsivity construct, (b) self-report and behavioural measures were not correlated even when theoretically assessing the same dimension of impulsivity, and (c) of all the risk-taking behaviours examined, rash impulsivity and reward sensitivity were significantly correlated with riding without a seatbelt.

I don't know anyone that has two drinks a day : young people, alcohol and the government of pleasure

Problematic alcohol consumption is a major public health, health education and health promotion issue in Australia and internationally. In an effort to better understand young people's drinking patterns and motivations we investigated the cultural drivers of drinking in 14–24 year-old Australians. We interviewed 60 young people in the state of Victoria aged 20–24 about their drinking biographies. At the time of interviewing, the draft guidelines on low-risk drinking were released by the National Health and Medical Research Council, Australia, and we asked our participants what they knew about them and if they thought they would affect their drinking patterns. Their responses indicate that pleasure and sociability are central to young people's drinking cultures which is supported by a range of research. However, O’Malley and Valverde claim that pleasure is silenced and/or deployed strategically in neo-liberal governance discourses about drugs and alcohol such as these guidelines which raises questions about the limits of such discourses to affect changes in drinking patterns.

Use of the program explication method to explore the benefits of a service for homeless and marginalized young people

Maintaining the alignment between the dynamic development of health and social services and the rapidly advancing scientific evaluation literature is a central challenge facing service administrators. We describe “program explication,” a consulting method designed to assist services to identify and review implicit program logic assumptions against the evaluation literature. Program explication initially facilitates agency staff to identify and document service components and activities considered critical for improving client outcomes. Program assumptions regarding the relationship between service activities and client outcomes are then examined against available scientific evidence. We demonstrate the application of this method using an example of its use in reviewing a service for homeless young people operating in Melbourne, Australia, known as the Young People's Health Service (YPHS). The YPHS involved 21 activities organized within 4 components. The intended benefits of each of the activities were coherently articulated and logically consistent. Our literature search revealed moderate to strong evidence for around 1 quarter of the activities. The program explication method proved feasible for describing and appraising the YPHS service assumptions, thereby enhancing service evaluability.