Youth mental health first aid: a description of the program and an initial evaluation

BACKGROUND: Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions.

METHODS: The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries.

RESULTS: The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were maintained at follow-up. Over the first 3 years of this program, a total of 318 instructors were trained to deliver the course and these instructors have delivered courses to 10,686 people across all states and territories in Australia. The program has also spread to Canada, Singapore and England, and will spread to Hong Kong, Sweden and China in the near future.

CONCLUSIONS: Initial evaluation suggests that the Youth Mental Health First Aid course improves participants' knowledge, attitudes and helping behaviour. The program has spread successfully both nationally and internationally.

On-line dating; is a digital kiss and virtual wink the new way of finding love?

In 2007, I asked for a show of hands of people who ‘might consider online dating as a way of finding a partner’. Not a single hand went up and the lecture theatre was stony silent. The same question, some five years later resulted in a significant show of hands and a buzz of chatter. Something had changed and perceptions around online dating had shifted. Nielsen Research last year found most Australians (51 per cent) had either tried online dating or would consider doing so. RSVP and eHarmony claim to have 2 million members and more than 4 million people have apparently joined RSVP since it was launched 17 years ago. Online dating is experiencing significant growth in Asia as well, with the number of new web services (some, like ‘Muslima’, are tightly focused) growing exponentially. Online dating is a global phenomenon. This paper will use current media studies research literature and data from conversations with university students in Australia and Indonesia to explore how the changing world of online dating is helping/hindering young people as they shape and develop identity, represent themselves in the virtual world and ultimately, how they find love on line.

BMI and healthcare cost impact of eliminating tax subsidy for advertising unhealthy food to youth

INTRODUCTION: Food and beverage TV advertising contributes to childhood obesity. The current tax treatment of advertising as an ordinary business expense in the U.S. subsidizes marketing of nutritionally poor foods and beverages to children. This study models the effect of a national intervention that eliminates the tax subsidy of advertising nutritionally poor foods and beverages on TV to children aged 2-19 years. METHODS: We adapted and modified the Assessing Cost Effectiveness framework and methods to create the Childhood Obesity Intervention Cost Effectiveness Study model to simulate the impact of the intervention over the 2015-2025 period for the U.S. population, including short-term effects on BMI and 10-year healthcare expenditures. We simulated uncertainty intervals (UIs) using probabilistic sensitivity analysis and discounted outcomes at 3% annually. Data were analyzed in 2014. RESULTS: We estimated the intervention would reduce an aggregate 2.13 million (95% UI=0.83 million, 3.52 million) BMI units in the population and would cost $1.16 per BMI unit reduced (95% UI=$0.51, $2.63). From 2015 to 2025, the intervention would result in $352 million (95% UI=$138 million, $581 million) in healthcare cost savings and gain 4,538 (95% UI=1,752, 7,489) quality-adjusted life-years. CONCLUSIONS: Eliminating the tax subsidy of TV advertising costs for nutritionally poor foods and beverages advertised to children and adolescents would likely be a cost-saving strategy to reduce childhood obesity and related healthcare expenditures.

Contact lens fitting and training in a child and youth population

PURPOSE: To determine the ease with which children and youths without previous soft contact lens (SCL) experience were able to handle, care for, adapt and be fitted with SCLs. METHODS: 179 children aged 8-16 were recruited. Study visits included: screening and training visits, 1-week and 3-month follow-ups. During the training visit, the time taken to demonstrate proficiency in lens insertion and removal and care was recorded. A second training visit was scheduled if necessary. RESULTS: Nine children did not complete the screening visit and eight discontinued during the study. Of those eight, seven discontinued during the first week and one before the 3-month visit. Of those recruited, 90.5% (162/179) were successfully fitted and completed the study. A majority of children were dispensed with lenses at the first training visit (94.6%, 162/171). The mean training time for all children was 30min. There were no statistically significant differences in the number of lenses required to fit or instruction time by age group (p>0.05) or gender (p>0.05). Nine participants (5.3%, 9/171) required a second training visit with four still unable to handle lenses (2.3%, 4/171). By the 1-week visit 13.2% (22/167) of participants either lost or tore lenses, no subsequent lost or torn lenses occurred. No serious adverse events occurred during the study. CONCLUSION: Children and youths with no previous contact lens experience were easily fitted, able to successfully wear and care for lenses. The results of this study should encourage practitioners to recommend SCLs as a vision correction option.

Objectively measured physical activity and sedentary time in youth: The International children's accelerometry database (ICAD)

Background: Physical activity and sedentary behaviour in youth have been reported to vary by sex, age, weight status and country. However, supporting data are often self-reported and/or do not encompass a wide range of ages or geographical locations. This study aimed to describe objectively-measured physical activity and sedentary time patterns in youth. Methods: The International Children's Accelerometry Database (ICAD) consists of ActiGraph accelerometer data from 20 studies in ten countries, processed using common data reduction procedures. Analyses were conducted on 27,637 participants (2.8-18.4 years) who provided at least three days of valid accelerometer data. Linear regression was used to examine associations between age, sex, weight status, country and physical activity outcomes. Results: Boys were less sedentary and more active than girls at all ages. After 5 years of age there was an average cross-sectional decrease of 4.2 % in total physical activity with each additional year of age, due mainly to lower levels of light-intensity physical activity and greater time spent sedentary. Physical activity did not differ by weight status in the youngest children, but from age seven onwards, overweight/obese participants were less active than their normal weight counterparts. Physical activity varied between samples from different countries, with a 15-20 % difference between the highest and lowest countries at age 9-10 and a 26-28 % difference at age 12-13. Conclusions: Physical activity differed between samples from different countries, but the associations between demographic characteristics and physical activity were consistently observed. Further research is needed to explore environmental and sociocultural explanations for these differences.

Interrogating conceptions of “vulnerable youth” in theory, policy and practice

Young people who are considered ‘vulnerable’ or ‘at risk’ are a particular target of various policies, schemes and interventions. But what does vulnerability mean? Interrogating Conceptions of “Vulnerable Youth” explores this question in relation to various policy fields that are relevant to young people, as well for how this plays out in practice and how it is experienced by young people themselves. What makes this book unique is that most authors had the opportunity to jointly explore these issues during a two-day workshop, and their chapters are informed by their cross-agency and cross-discipline discussions, making for a nuanced and thoughtful set of contributions. This collection is highly recommended for researchers and research students in the social sciences, as well as professional staff working in youth policy and youth services, in government departments and in NGOs. “Those who are most vulnerable should receive our greatest moral attention. However, the translation of generalised moral principles into effective policy and programs has never been easy. Political interests have invariably intervened, leading to complex debates about how vulnerability should be defined, classified, measured and represented. In recent years, these debates have become further complicated, as nation-states around the world have preached austerity. This timely book suggests that the responsibility for protecting the vulnerable cannot be left to individuals, but demands collective action, through institutions such as education, health and welfare. It examines some of the ways in which public policies and programs represent those who are vulnerable, involving a range of assumptions about the social, economic and political conditions that produce their vulnerabilities.” From the Foreword by Professor Fazal Rizvi

Theatre Australia (un)limited: review

 Review of Geoffery Milne's text 'Theatre Australia (Un)Limited'

Cyborg presence in narrative theatre

New technologies are transforming the shape and function of contemporary performance practice. Dance in particular has been at the forefront of dissolving the boundaries between humans and technology. In Australia alone, works such as Gideon Obarzanek's GLOW (Chunky Move) and Garry Stewart's Proximity (Australian Dance Theatre) have offered technology a role traditionally preserved only for the live human performer. As these technologies infiltrate theatre practice and their capacity to be co-actors with humans on stage increases, we need to carefully interrogate the notion of the actor's presence. For an overwhelming number of scholars and critics, presence is the defining quality of theatrical performance. Theatre has been privileged as the site where people witness other people together in the same physical space. Digital technologies can be seen as a threat to this and to the actor's presence. Cormac Power's Presence in Play provides a comprehensive analysis of theatrical presence that encapsulates a poststructuralist critique of presence while maintaining the notion of 'presence' as a key aspect of theatre. In this article, I take up Power's category of the literal mode of presence and examine three case studies that use digital technology in ways that disturb traditional conceptions of presence. I investigate the impact that digital technologies in live performance have on theatre's claims to literal presence. I also investigate the indirect impact that these technologies have on forms of fictional and auratic presence (these are Power's terms, which I will define shortly). First, I will establish the centrality of presence to the vast body of commentary on theatre; then, I will draw on Derrida's analysis of the metaphysics of presence to unsettle dominant assumptions about the function of presence in theatre, arguing that such a privileging of presence demonises projected media as a form of contamination that impedes theatre's ability to represent 'truth'. I use Jennifer Parker-Starbuck's term 'Cyborg Theatre' to discuss three examples of digital performance that have used technology to question and challenge our relationship to technology in everyday life. These works challenge traditional notions of selfhood and force us to interrogate the borders between the live and the mediated.

Sayonara interviews: android-human theatre

Featuring a life-like humanoid robot, Seinendan Theatre Company (Japan) brought their performance Sayonara: Android-Human Theatre to Melbourne in August 2012. Geminoid F, an android, starred alongside Canadian actress Bryerly Long, in a performance that asks the question: What does life and death mean for humans as opposed to robots?

Youth Depression Alleviation-Augmentation with an anti-inflammatory agent (YoDA-A): protocol and rationale for a placebo-controlled randomized trial of rosuvastatin and aspirin

AIM: There is growing support for the role of inflammation and oxidative stress in the pathophysiology of major depressive disorder (MDD). This has led to the development of novel strategies targeting inflammation in the treatment of depression. Rosuvastatin and aspirin have well-documented, anti-inflammatory and antioxidant properties. The aim of the Youth Depression Alleviation: Augmentation with an anti-inflammatory agent (YoDA-A) study is to determine whether individuals receiving adjunctive anti-inflammatory agents, aspirin and rosuvastatin experience a reduction in the severity of MDD compared with individuals receiving placebo. METHODS: YoDA-A is a 12-week triple-blind, randomized controlled trial funded by the National Health and Medical Research Council, Australia. Participants aged 15-25, with moderate-to-severe MDD, are allocated to receive either 10 mg/day rosuvastatin, 100 mg/day aspirin, or placebo, in addition to treatment as usual. Participants are assessed at baseline and at weeks 4, 8, 12 and 26. The primary outcome is change in the Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline to week 12. RESULTS: The study is planned to be completed in 2017. At date of publication, 85 participants have been recruited. CONCLUSION: Timely and targeted intervention for youth MDD is crucial. Given the paucity of new agents to treat youth MDD, adjunctive trials are not only pragmatic and 'real-world', but additionally aim to target shortfalls in conventional medications. This study has the potential to first provide two new adjunctive treatment options for youth MDD; aspirin and rosuvastatin. Second, this study will serve as proof of principle of the role of inflammation in MDD.

Performing desistance: how might theories of desistance from crime help us understand the possibilities of prison theatre?

Despite the ubiquity of theatre projects in prisons there has been little (published) discussion of the application of theatre to the theories of criminology or rehabilitation of offenders, and scant examination of the potential for criminological theories to inform theatre practice in criminal justice settings. This article seeks to address this deficit and argues that positioning prison theatre within the discipline of positive criminology, specifically contemporary theories of desistance from crime, provides a theoretical framework for understanding the contribution that prison theatre might be making in the correctional setting. Through a review of related literature, the article explores how prison theatre may be motivating offenders toward the construction of a more adaptive narrative identity and toward the acquisition of capabilities that might usefully assist them in the process of desisting from crime.