Maternal anxiety and attention problems in children at 5 and 14 years

Objective: This study examines the association between maternal anxiety from pregnancy to 5 years and child attention problems at 5 and 14 years. Method: Birth cohort of 3,982 individuals born in Brisbane between 1981 and 1983 are assessed. Self-reported measures of maternal anxiety are assessed at four time points. Maternal reports of child attention problems using Achenbach’s Child Behavior Checklist are assessed at 5 and 14 years. Results: Children of mothers experiencing anxiety during or after pregnancy are at greater risk of experiencing attention problems at 5 and 14 years. After adjusting for maternal age and child’s gender, antenatal anxiety is strongly associated with persistent attention problems (OR = 3.65, 95% CI = 2.19, 6.07). Children with chronically anxious mothers are 5.67 (95% CI = 3.56, 9.03) times more likely to have persistent attention problems. These associations remain consistent after adjusting for potential confounders. Conclusions: Maternal anxiety appears to increase the rate of child attention problems and identifies a need for treatment programs to have a dual focus—the mother and her child. (J. of Att. Dis. 2009; XX(X) 1-XX)

Safeguarding rural Australia : addressing masculinity and violence in rural settings. Data report no. 5. Consequences of violence - juvenile offenders, long-term health consequences, anxiety and repression, other chronic disabilities

This report considers extant data which have been sourced with respect to some of the consequences of violent acts and incidents and risky behaviour for males living in regional and remote Australia . This has been collated and presented under the headings: juvenile offenders; long-term health consequences; anxiety and repression; and other chronic disabilities. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in complementary reports in this series.

Development of a computer simulation tool for application in adolescent spinal deformity surgery

Scoliosis is a three-dimensional spinal deformity which requires surgical correction in progressive cases. In order to optimize correction and avoid complications following scoliosis surgery, patient-specific finite element models (FEM) are being developed and validated by our group. In this paper, the modeling methodology is described and two clinically relevant load cases are simulated for a single patient. Firstly, a pre-operative patient flexibility assessment, the fulcrum bending radiograph, is simulated to assess the model's ability to represent spine flexibility. Secondly, intra-operative forces during single rod anterior correction are simulated. Clinically, the patient had an initial Cobb angle of 44 degrees, which reduced to 26 degrees during fulcrum bending. Surgically, the coronal deformity corrected to 14 degrees. The simulated initial Cobb angle was 40 degrees, which reduced to 23 degrees following the fulcrum bending load case. The simulated surgical procedure corrected the coronal deformity to 14 degrees. The computed results for the patient-specific FEM are within the accepted clinical Cobb measuring error of 5 degrees, suggested that this modeling methodology is capable of capturing the biomechanical behaviour of a scoliotic human spine during anterior corrective surgery.

Depression, anxiety and body image after treatment for invasive stage one epithelial ovarian cancer

Background: Diagnosis of epithelial ovarian cancer (EOC) in young women has major implications including those to their reproductive potential. We evaluated depression, anxiety and body image in patients with stage I EOC treated with fertility sparing surgery (FSS) or radical surgery (RS). We also investigated fertility outcomes after FSS.----- Methods: A retrospective study was undertaken in which 62 patients completed questionnaires related to anxiety, depression, body image and fertility outcomes. Additional information on adjuvant therapy after FSS and RS and demographic details were abstracted from medical records. Both bi and multivariate regression models were used to assess the relationship between demographic, clinical and pathological results and scores for anxiety, depression and body image.----- Results: Thirty-nine patients underwent RS and the rest, FSS. The percentage of patients reporting elevated anxiety and depression (subscores ≥ 11) were 27 % and 5% respectively. The median (inter quartile range) score for body image scale (BIS) was 6 (3-15). None of the demographic or clinical factors examined showed significant association with anxiety and BIS with the exception of ‘time since diagnosis’. For depression, post-menopausal status was the only independent predictor. Among those 23 patients treated by FSS, 14 patients tried to conceive (7 successful), resulting in 7 live births, one termination of pregnancy and one miscarriage.----- Conclusion: This study shows that psychological issues are common in women treated for stage I EOC. Reproduction after FSS is feasible and lead to the birth of healthy babies in about half of patients who wished to have another child. Further prospective studies with standardised instruments are required.

Protective behavior in adolescent friendships : the influence of attitudes toward the consequences, friendship norms and perceived control

The current study sought to understand adolescent protective behavior in friendship using a Theory of Planned Behavior framework. In particular, the study sought to consider a young persons’ direct and active intervention to inhibit their friends’ risky behavior or to assist them when the behavior leads to injury. The role of attitudes regarding the consequences, norms and control about protective behavior were examined both qualitatively through focus groups (n= 50) and quantitatively through surveys from a sample of 540 Year 9 students (13-14 years old). There was some support for the theory with attitudes regarding the consequences of the behavior and norms predicting intended protective behavior. A path analysis was conducted with a sub-sample of 140 students which showed that intentions to be protective and perceived control to undertake protective behavior directly predicted such behavior after a 3 month interval. Attitudes towards the consequences and norms only indirectly predicted protective behavior via intention. The findings provide important applied information for interventions designed to increase adolescent protective behavior in their friendships.

An adolescent injury intervention : selecting targeted behaviours with implications for program design and evaluation

Objectives: This paper sought to identify the behaviour change targets for an injury prevention program; Skills for Preventing Injury in Youth, SPIY. The aim was to explore how such behaviours could subsequently be implemented and evaluated in the program. Methods and Design: The quantitative procedure involved a survey with 267 Year 8 and 9 students (mean age 13.23 years) regarding their engagement in risk-taking behaviours that may lead to injury. The qualitative study involved 30 students aged 14 to 17 years reporting their experiences of injury and risk-taking. Results: Injury risk behaviours co-occurred among three-quarters of those who reported engaging in any alcohol use or transport or violence related injury risk behaviour. Students described in detail some of these experiences. Conclusions: The selection process of identifying target behaviours for change for an injury prevention program is described. Adolescents’ description of such risk behaviours can inform the process of operationalising and contextualising program content and deciding on evaluation methodology. The design of an effective injury prevention program involves considerable preparatory work and this paper was able to describe the process of identifying the behavioural targets for change that can be operationalised and evaluated in the injury prevention program, SPIY.

A short-term evaluation of a school-based early adolescent injury prevention program

This paper reports on the development of a school-based intervention to reduce risk-taking and associated injuries. There is limited but important evidence that intervention design should ensure participation does not lead to an increase in target risk behaviors with some studies in alcohol and drug prevention finding unexpected negative effects. The short-term evaluation of Skills for Preventing Injury in Youth (SPIY) examined change in interpersonal violence, alcohol and transport-related risks. Intervention (n = 360) and comparison (n = 180) students were surveyed pre/post-intervention. A qualitative analysis based on focus groups (70 students) explored experiences of change. Findings indicate significant positive changes reinforced by students’ reports. A decrease in reported risk-taking for the intervention group and an increase in the comparison group were observed. These findings endorse SPIY as a useful curriculum approach to reducing injuries and lend support to the future conduct of a long-term outcome evaluation.

Building resilience to prevent mental health problems in young people : The resourceful adolescent programme (RAP)

This chapter describes an evidence-based programme called the Resourceful Adolescent Program (RAP), which has been successful in building resilience in young people to prevent depressive symptoms developing.The programme adopts a strengths-focused approach. It aims to build a range of coping resources that foster teenagers’ abilities to maintain a positive sense of self and regulate emotions in the face of the vicissitudes of everyday struggles and difficult life events.This groupbased programme can be implemented routinely in schools or by counselling professionals as an early intervention or prevention programme. While there is no universal definition, ‘resilience’ generally means the process of avoiding the negative trajectories associated with exposure to risk factors (Fergus and Zimmerman, 2005). Current models of resilience are also very clear that there ‘are many pathways to resilience’ (Bonanno, 2004) and there is no

The millennial adolescent

The Millennial Adolescent' offers contemporary, stimulating insights for those currently teaching as well as those preparing to teach. This book investigates the characteristics of Generation Y, using students own voices, generational theory and case studies. The text is structured around the principle that effective teachers need to know who they are teaching as well as what to teach, how to teach it, and how to assess the outcome. Using generational theory, 'The Millennial Adolescent' investigates the characteristics of Generation Y, or the Millennial Generation, and points out what all teachers need to know about working with this current generation of students who are described in a number of ways digital natives, team oriented, confident, multi-taskers, high achievers, and a generation unlike any other. The book contains well-known frameworks for developing understandings about adolescents, blended and contrasted with a contemporary socio-cultural construction of adolescence, set in our particular time, era and society. This book reflects the uniqueness of Australian contexts, while connecting with international trends and global patterns. Engaging and full of insights, this book is essential reading for all professionals dealing with adolescents.

Skydweller and representations of the adolescent crisis : group identity versus alienation

This document contains a creative work – the text of a young adult novel, Skydweller – and an exegesis discussing the ways in which identity and the adolescent crisis of group identity versus alienation are represented in young adult science fiction/fantasy novels.

Secondary curve behaviour in Lenke IC class adolescent idiopathic scoliosis following video assisted thoracoscopic spinal fusion

Introduction. Ideally after selective thoracic fusion for Lenke Class IC (i.e. major thoracic / secondary lumbar) curves, the lumbar spine will spontaneously accommodate to the corrected position of the thoracic curve, thereby achieving a balanced spine, avoiding the need for fusion of lumbar spinal segments1. The purpose of this study was to evaluate the behaviour of the lumbar curve in Lenke IC class adolescent idiopathic scoliosis (AIS) following video-assisted thoracoscopic spinal fusion and instrumentation (VATS) of the major thoracic curve. Methods. A retrospective review of 22 consecutive patients with AIS who underwent VATS by a single surgeon was conducted. The results were compared to published literature examining the behaviour of the secondary lumbar curve where other surgical approaches were employed. Results. Twenty-two patients (all female) with AIS underwent VATS. All major thoracic curves were right convex. The average age at surgery was 14 years (range 10 to 22 years). On average 6.7 levels (6 to 8) were instrumented. The mean follow-up was 25.1 months (6 to 36). The pre-operative major thoracic Cobb angle mean was 53.8° (40° to 75°). The pre-operative secondary lumbar Cobb angle mean was 43.9° (34° to 55°). On bending radiographs, the secondary curve corrected to 11.3° (0° to 35°). The rib hump mean measurement was 15.0° (7° to 21°). At latest follow-up the major thoracic Cobb angle measured on average 27.2° (20° to 41°) (p<0.001 – univariate ANOVA) and the mean secondary lumbar curve was 27.3° (15° to 42°) (p<0.001). This represented an uninstrumented secondary curve correction factor of 37.8%. The mean rib hump measured was 6.5° (2° to 15°) (p<0.001). The results above were comparable to published series when open surgery was performed. Discussion. VATS is an effective method of correcting major thoracic curves with secondary lumbar curves. The behaviour of the secondary lumbar curve is consistent with published series when open surgery, both anterior and posterior, is performed.

Computed tomography analysis of sagittal plane parameters in adolescent idiopathic scoliosis treated by video assisted thoracoscopic spinal fusion and instrumentation

One of the primary treatment goals of adolescent idiopathic scoliosis (AIS) surgery is to achieve maximum coronal plane correction while maintaining coronal balance. However maintaining or restoring sagittal plane spinal curvature has become increasingly important in maintaining the long-term health of the spine. Patients with AIS are characterised by pre-operative thoracic hypokyphosis, and it is generally agreed that operative treatment of thoracic idiopathic scoliosis should aim to restore thoracic kyphosis to normal values while maintaining lumbar lordosis and good overall sagittal balance. The aim of this study was to evaluate CT sagittal plane parameters, with particular emphasis on thoracolumbar junctional alignment, in patients with AIS who underwent Video Assisted Thoracoscopic Spinal Fusion and Instrumentation (VATS). This study concluded that video-assisted thoracoscopic spinal fusion and instrumentation reliably increases thoracic kyphosis while preserving junctional alignment and lumbar lordosis in thoracic AIS.

3D lung and rib cage reconstruction using low dose CT scans of adolescent idiopathic scoliosis pre and post anterior thoracoscopic correction

Adolescent Idiopathic Scoliosis (AIS) has been associated with reduced pulmonary function believed to be due to a restriction of lung volume by the deformed thoracic cavity. A recent study by our group examined the changes in lung volume pre and post anterior thoracoscopic scoliosis correction using pulmonary function testing (1), however the anatomical changes in ribcage shape and left/right lung volume after thoracoscopic surgery which govern overall respiratory capacity are unknown. The aim of this study was to use 3D rendering from CT scan data to compare lung and ribcage anatomical changes from pre to two years post thoracoscopic anterior scoliosis correction. The study concluded that 3D volumetric reconstruction from CT scans is a powerful means of evaluating changes in pulmonary and thoracic anatomy following surgical AIS correction. Most likely, lung volume changes following thoracoscopic scoliosis correction are multifactorial and affected by changes in height (due to residual growth), ribcage shape, diaphragm positioning, Cobb angle correction in the thoracic spine. Further analysis of the 3D reconstructions will be performed to assess how each of these factors affect lung volume in this patient cohort.