Paediatrics (RCH) - Research Publications
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ItemExcessive alcohol use and its association with risky sexual behaviour: a cross-sectional analysis of data from Victorian secondary school students(WILEY, 2013-02)OBJECTIVE: Estimate the prevalence of sexual behaviour and alcohol use and examine the association between excessive alcohol use and risky sexual behaviour in late secondary students in Victoria, Australia. METHOD: The sample of Year 11 students from government and independent schools participating in the 2008 International Youth Development Study (n=450) was representative of the Victorian school population. Logistic regression analyses examined the associations between sexual behaviour, binge and compulsive drinking, adjusting for socio-demographic, school and family factors. RESULTS: Under half (44%) the students had experienced sex in the past year, half (50%) had engaged in binge drinking in the past two weeks and 26% reported compulsive drinking in the past year. Of those who reported sex in the past year (n=197), 34% had sex without a condom at the last sexual encounter and 28% later regretted sex due to alcohol. The likelihood of experiencing sex was increased by binge (OR=2.44, 95%CI 1.44-4.12) and compulsive drinking (OR=2.15, 95%CI 1.29-3.60). For those sexually active, binge drinking increased the risk of having three or more sexual partners (OR=3.37, 95%CI 1.11-10.26) and compulsive drinking increased the likelihood of regretted sex due to alcohol (OR=4.43, 95%CI 2.10-9.31). Excessive drinking was not associated with condom non-use. CONCLUSION AND IMPLICATIONS: Risky sex - multiple sexual partners and regretted sex due to alcohol - and excessive drinking are highly prevalent and co-associated among Victorian late secondary students.
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ItemmyTREEHOUSE Self-Concept Assessment: preliminary psychometric analysis of a new self-concept assessment for children with cerebral palsy.(Wiley, 2017-06)AIM: To evaluate the preliminary validity and reliability of the myTREEHOUSE Self-Concept Assessment for children with cerebral palsy (CP) aged 8 to 12 years. METHOD: The myTREEHOUSE Self-Concept Assessment includes 26 items divided into eight domains, assessed across three Performance Perspectives (Personal, Social, and Perceived) and an additional Importance Rating. Face and content validity was assessed by semi-structured interviews with seven expert professionals regarding the assessment construct, content, and clinical utility. Reliability was assessed with 50 children aged 8 to 12 years with CP (29 males, 21 females; mean age 10y 2mo; Gross Motor Function Classification System [GMFCS] level I=35, II=8, III=5, IV=1; mean Wechsler Intelligence Scale for Children - Fourth Edition [WISC-IV]=104), whose data was used to calculate internal consistency of the scale, and a subset of 35 children (20 males, 15 females; mean age 10y 5mo; GMFCS level I=26, II=4, III=4, IV=1; mean WISC-IV=103) who participated in test-retest reliability within 14 to 28 days. RESULTS: Face and content validity was supported by positive expert feedback, with only minor adjustments suggested to clarify the wording of some items. After these amendments, strong internal consistency (Cronbach's α 0.84-0.91) and moderate to good test-retest reliability (intraclass correlation coefficient 0.64-0.75) was found for each component. INTERPRETATION: The myTREEHOUSE Self-Concept Assessment is a valid and reliable assessment of self-concept for children with CP aged 8 to 12 years.
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ItemThe role of risk and protective factors in the modification of risk for sexual victimization, sexual risk behaviors, and survival sex among homeless youth: A meta-analysis(WILEY, 2017-06)Abstract Youth homelessness is a multifaceted and significant social problem. For many homeless youth, the risk for exposure to sexual exploitation is high, with the experience of sexual victimization and engaging in sexual risk behaviors and survival sex commonplace. This meta‐analysis appraised internationally published literature to investigate the role of risk and protective factors in modifying the occurrence of sexual victimization, sexual risk behaviors, and survival sex among homeless youth. A comprehensive search of psychology, sociology, medicine, health, and criminology electronic abstraction databases was conducted for the period 1990–2016. Search terms included “homeless,” “rape,” “sexual victimization,” “unsafe sex,” and “survival sex.” The perpetration of sexual offences was included in the search strategy. Eighteen studies, examining sexual victimization, sexual risk behavior, and survival sex, met the inclusion criteria and were included in the meta‐analysis. All but two studies were conducted in the United States. No retrieved studies examined sexual offending; hence, this could not be included in the meta‐analysis. Findings showed that substance use, exposure to violence and crime (as victims and perpetrators), childhood abuse, sexual behavior, and peers' antisocial and sexual behavior were unique factors increasing the likelihood for each of sexual victimization, engagement in sexual risk behavior, and engagement in survival sex. Protective factors were peer and family social support. Moderator analyses showed that the influence of risk factors may differ based on study design, sample size, study country of origin, and participant age and gender. Findings suggest that risk and protective factors may be important mechanisms by which to modify the occurrence of adverse sexual behavior outcomes and better contextualize prevention and early intervention strategies for homeless youth.
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ItemThe impact of transitional programmes on post-transition outcomes for youth leaving out-of-home care: a meta-analysis(WILEY-HINDAWI, 2018-01)Youth residing in out-of-home care settings have often been exposed to childhood trauma, and commonly report experiencing adverse outcomes after transitioning from care. This meta-analysis appraised internationally published literature investigating the impact of transitional programme participation (among youth with a baseline age of 15-24 years) on post-transition outcomes of housing, education, employment, mental health and substance use. A comprehensive search of sociology (e.g. ProQuest Sociology), psychology (e.g. PsycInfo) and health (e.g. ProQuest Family Health) electronic abstraction databases was conducted for the period 1990-2014. Search terms included 'out-of-home care', 'transition', 'housing', 'education', 'employment', 'mental health' and 'substance use'. Nineteen studies, all from the United States, met the inclusion criteria and were included in the meta-analysis. Living independently and homelessness were the most commonly described housing outcomes. Rates of post-transition employment varied, while rates of post-secondary education were low. Depression and alcohol use were commonly reported among transitioning youth. Findings of the meta-analysis showed that attention should be given to the potential benefit of transitional programme participation on outcomes such as housing, employment and education. Moderator analyses showed that these benefits may differ based on study design, sample size and sampling unit, but not for mean age or gender. Detailed and rigorous research is needed internationally to examine the characteristics of transitional programmes resulting in more successful outcomes for youth, and whether these outcomes are sustained longitudinally.
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ItemDelinquency, School Context, and Risk Factors in India, Australia, and the United States: Implications for Prevention(WILEY, 2020-01)There is a dearth of research on delinquency, school context, and risk factors across developed and developing nations. Using representative samples and matched surveys, we examined delinquency among cohorts in Mumbai, India (N = 3,717); Victoria, Australia (N = 1,842); and Washington State (WA), United States (N = 1,828). We used multivariate Poisson hierarchical linear modeling. Risk factor and delinquency levels varied across sites. Delinquency clustered within certain schools, particularly in Mumbai. Community disorganization exhibited an association with delinquency as a school-level context effect in Mumbai and Victoria. Peer delinquency, sensation seeking, and poor family management exhibited cross-nationally consistent associations with delinquency. Programs that target schools, the clustering of problem behaviors, and cross-nationally consistent risk factors should be considered internationally.
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ItemChildhood social environmental and behavioural predictors of early adolescent onset cannabis use(WILEY, 2020-05)INTRODUCTION AND AIMS: This study prospectively investigates behavioural and social antecedents of different patterns of adolescent cannabis use, specifically, early adolescent onset cannabis use and late onset occasional use. DESIGN AND METHODS: The sample comprised 852 adolescents (53% female) drawn from the Australian arm of the International Youth Development Study. Data were collected via self-report surveys. Risk and protective factors from a modified version of the Communities That Care youth survey were measured in fifth grade (mean [M] = 10.9 years, SD = 0.4). Frequency of cannabis use was measured at six time-points throughout adolescence (ages 12-19 years). RESULTS: Early adolescent onset cannabis use (10.7% of the sample [n = 91]) was predicted by childhood family-related factors including poor family management, family history of antisocial behaviour and attachment to parents. Cigarette use and drinking until drunk were the strongest predictors of early adolescent onset cannabis use. Cumulative risks associated with community, family, peer/individual environments and early substance use (cigarettes, alcohol) in childhood were predictive of early adolescent onset cannabis use (e.g. relative risk ratio = 2.64; 95% confidence interval 1.40-4.97 for early substance use). Family and early substance use-related cumulative risks were predictive of late adolescent onset occasional cannabis use (n = 231; 27%). Cumulative early substance use risk was the strongest independent predictor of both early adolescent onset and late adolescent onset occasional cannabis use. DISCUSSION AND CONCLUSIONS: Primary prevention efforts should focus on reducing exposure and access to licit substances during late childhood and delaying the onset of use. Prevention and intervention targeted toward the family environment also appears likely to be important in the prevention of early adolescent onset cannabis use.
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ItemDepression and Anxiety Outcomes Associated with Failed Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis(PUBLIC LIBRARY SCIENCE, 2016-11-11)OBJECTIVE: Our study examined the psychological outcomes associated with failed ART treatment outcomes in men and women. SEARCH STRATEGY: A systematic search for studies published between January 1980 and August 2015 was performed across seven electronic databases. INCLUSION CRITERIA: Studies were included if they contained data on psychosocial outcomes taken pre and post ART treatment. DATA EXTRACTION AND SYNTHESIS: A standardised form was used to extract data and was verified by two independent reviewers. Studies were meta-analysed to determine the association of depression and anxiety with ART treatment outcomes. Narrative synthesis identified factors to explain variations in the size and directions of effects and relationships explored within and between the studies. MAIN RESULTS: Both depression and anxiety increased after a ART treatment failure with an overall pooled standardised mean difference (SMD) of 0.41 (95% CI: 0.27, 0.55) for depression and 0.21 (95% CI: 0.13, 0.29) for anxiety. In contrast, depression decreased after a successful treatment, SMD of -0.24 (95% CI: -0.37,-0.11). Both depression and anxiety decreased as time passed from ART procedure. Nonetheless, these remained higher than baseline measures in the group with the failed outcome even six months after the procedure. Studies included in the narrative synthesis also confirmed an association with negative psychological outcomes in relation to marital satisfaction and general well-being following treatment failure. CONCLUSION: Linking ART failure and psychosocial outcomes may elucidate the experience of treatment subgroups, influence deliberations around recommendations for resource allocation and health policy and guide patient and clinician decision making.
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ItemSelf-reported injury in Australian young adults: demographic and lifestyle predictors(ELSEVIER SCIENCE INC, 2020-04)OBJECTIVES: Injury is the major cause of mortality and morbidity among adolescents and young adults. This study examined the use of injury self-reports and various causes of injury among adolescents. METHODS: A cohort recruited in 2002 as a representative sample of students from the State of Victoria in south-east Australia was followed and resurveyed in young adulthood in 2010 (mean age 21.0) and 2012 (mean age 23.1) with 75% of the target sample retained (N=2,154, 55.8% female). RESULTS: Prior injuries were reported by 55.5% in 2010 and 54.6% in 2012, leaving 18% with continuing disability. Reported causes of injury in 2012 were sports (55.1%) and alcohol use (9.7%). Logistic regression revealed that injury in 2012 was predicted by rural school attendance in 2002 (Adjusted Odds Ratio [OR] 1.4 CI 1.1-1.7) and in 2010 by male gender (OR 2.2, CI 1.8-2.6), reported self-harm (OR 1.6 CI 1.1-2.2), and unemployment (OR 0.7, CI 0.5-1.0). CONCLUSIONS: Self-reported injury among young adults is reliably reported, and suggests the need to further examine gender, rural communities and self-harm, and indicates modifiable contributors to injury. Implications for public health: Modifiable contributors to injury prevention are revealed as work environment, sports participation and alcohol use.
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ItemPrevent crime and save money: Application of return-on-investment models in the Australian context(Criminology Research Council, 2018)The project investigates rates and predictors of antisocial behaviour and violence from the early waves of the IYDS (age 11 years) to young adulthood (age 25 years) to estimate the return-on-investment in Victoria achievable with a $150 million investment in a mix of 6 evidence-based prevention strategies.
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ItemPositive associations between school suspension and student problem behaviour: Recent Australian findings(Australian Institute of Criminology, 2017-06)School suspension—the temporary removal of a student from school—is one of the most severe responses to student misbehaviour in Australian schools. Evidence suggests school suspension is associated with negative behavioural outcomes in adolescence. Using data from the International Youth Development Study, a large longitudinal study of adolescent development, this research found positive associations between school suspension and adolescent problem behaviour. These associations remained after taking into account other known risk factors for such behaviours. The paper discusses the implications for policy development around the management of student misbehaviour and conduct breaches.