Adolescent ecstasy use and depression: cause and effect, or two outcomes of home environment?

Background: This study assessed the association between adolescent ecstasy use and depressive symptoms in adolescence. Methods: The Belfast Youth Development Study surveyed a cohort annually from age 11 to 16 years. Gender, Strengths and Difficulties Questionnaire emotional subscale, living arrangements, parental affluence, parent and peer attachment, tobacco, alcohol, cannabis and ecstasy use were investigated as predictors of Short Mood and Feelings Questionnaire (SMFQ) outcome. Results: Of 5371 respondents, 301 (5.6%) had an SMFQ > 15, and 1620 (30.2) had missing data for SMFQ. Around 8% of the cohort had used ecstasy by the end of follow-up. Of the non-drug users, ∼2% showed symptoms of depression, compared with 6% of those who had used alcohol, 6% of cannabis users, 6% of ecstasy users and 7% of frequent ecstasy users. Without adjustment, ecstasy users showed around a 4-fold increased odds of depressive symptoms compared with non-drug users [odds ratio (OR) = 0.26; 95% confidence interval (CI) = 0.10, 0.68]. Further adjustment for living arrangements, peer and parental attachment attenuated the association to under a 3-fold increase (OR = 0.37; 95% CI = 0.15, 0.94). There were no differences by frequency of use. Conclusions: Ecstasy use during adolescence may be associated with poorer mental health; however, this association can be explained by the confounding social influence of family dynamics. These findings could be used to aid effective evidence-based drug policies, which concentrate criminal justice and public health resources on reducing harm.

Pain in care home residents with dementia: an exploration of frequency, prescribing and relatives' perspectives

Objectives: This study aims to determine pain frequency amongst care home residents with dementia, to investigate variables associated with pain, to explore analgesic use among residents and to seek residents' relatives' views on provision of care and management of pain by the care home. Methods: Structured face-to-face interviews were conducted with residents, nursing staff and relatives from nine dementia care homes in Northern Ireland, between May 2010 and March 2012. Demographic information was collected from participants, neuropsychiatric tests were used to assess residents' cognitive functioning, medication use was determined from care home records and residents' pain was assessed using a verbal descriptor scale. Relatives' views were sought on care provision and management of pain. Results: Forty-two residents, 16 nurses/care assistants and 35 relatives participated; the participation rate of residents was low (27.6%). Most residents were suffering moderate-severe dementia, and some residents (26.2%) were unable to provide a self-report of pain. A significantly higher proportion of relatives (57.1%) deemed residents to be experiencing pain at the time of the interview, compared with residents (23.8%, p = 0.005) and nurses/care assistants (42.9%, p = 0.035). Most residents (88.1%) were prescribed with analgesia; non-opioid analgesics were most commonly prescribed. High proportions of residents were prescribed with psychoactive medications. Antipsychotic drug use was associated with presence of pain (p = 0.046). Conclusions: This study has reinforced the challenge of assessing and managing pain in this resident population and highlighted issues to be addressed by long-term care providers and clinicians. Participation of people with dementia, and their families, in healthcare research needs to be improved.

Belfast: A study on built heritage

This book is a compilation of 5th year architecture dissertations dealing with the value of the existing built fabric of Belfast city center and the potential reuse of that fabric. This hopefully begins a tradition of disseminating the extensive work students undertake in describing, understanding and analyzing built heritage in Belfast and Northern Ireland. It does not aim to be innovative in its findings nor revolutionary in its position, but hopefully it will be a seed in a quest to get architecture students involved in their city and the value of the existing built fabric.

Home Is Where the Self Is: Monodrama, Journey-Play Structure, and the Modernist Fairy Tale

The first decade of the twentieth century witnessed the creation of two of the most beloved works of children’s literature ever produced. L. Frank Baum’s 1900 novel The Wizard of Oz and Maurice Maeterlinck’s 1908 play each gave rise to many adaptations, including, well beloved film versions, and both have become a deeply ingrained part of the cultural memory and construction of childhood in both Europe and the United States. And while these works are deeply original in content and detail, the structure of these works harkens back to the form of the journey play (traceable, on some level, back to the medieval morality play Everyman), a form that had undergone a considerable revival in the second half of the nineteenth century in the work of writers such as Henrik Ibsen and August Strindberg. This article explores the structural and conceptual links between Baum and Maeterlinck’s children’s classics, Ibsen’s Norwegian folk play Peer Gynt, and August Strindberg’s Lucky Per’s Journey and The Road to Damascus, Part I. In these works, the protagonists, disenchanted with their homes or current situations, set out on an epic journey in which they come upon characters and situations that act as commentary upon their situations before the journey. Ultimately, the characters return to where they started, with the journey seeming to have been a dream or merely a pointless excursion. But in these journeys of self-discovery, the protagonist that emerges at the end has undergone a significant transformation, a process at the heart of all of these works.

Built environment interventions for increasing physical activity in adults and children

Primary objective: Assess the effects of interventions targeting increased use of the built environment for overall PA in both adults and children.
Secondary objectives

Compare the effects of interventions encouraging the use of existing built environments with interventions that, with or without involving informational approaches, involve building or regenerating environments.
Describe other health benefits (e.g. mental health, risk factors for cardiovascular and other diseases) where outcomes are available.
Explore whether the effects of interventions differ between adults and children and between advantaged and disadvantaged populations.
Identify gaps in the evidence and highlight future research needs in the area.

When terror hits home: Identity Fused Americans who saw Boston bombing victims as “family” provided aid

When tragedy strikes a group, only some group members characteristically rush to the aid of the victims. What motivates the altruism of these exceptional individuals? Here, we provide one set of answers based on data collected before and shortly after the 15 April 2013, Boston Marathon bombings. The results of three studies indicated that Americans who were strongly “fused” with their country were especially inclined to provide various forms of support to the bombing victims. Moreover, the degree to which participants reported perceiving fellow Americans as psychological kin statistically mediated links between fusion and pro-group outcomes. Together, these findings shed new light on relationships between personal and group identity, cognitive representations of group members, and personally costly, pro-group actions.

Echoes of the future: Adults with disabilities living at home with their parents

Almost 90% of all adult sons and daughters with disabilities live at home with their parents. Consequently, they have life experiences that are atypical for most of their adult peers and their aging caregivers are under stress due to failing health, financial pressures, bereavement, and worry about the future.

Adults with intellectual disabilities and aging parents took part in focus groups and interviews. results show a loving and caring home environment but evidence a lack of effective life skills development and futures planning. the paper draws attention to the inevitable crisis that occurs when aging caregivers are no longer able to care. The urgent need for skill development and timely futures planning is outlined.