It is time for an ethical, evidence-based approach to youth presenting to the ED with an opioid overdose.

Currently, there is a dangerous inconsistency between our current understanding of adolescent development and the effects of drugs on cognition when compared to our collective approach to youth who present in the emergency department with an opioid overdose. We call upon practitioners to embrace a new paradigm and we ask the Canadian Pediatric Society (CPS) to spearhead the development of guidelines to advise on best practices to manage youth who present to the emergency department with an illicit drug overdose.

Coming of age on the streets: survival sex among homeless young women in Hollywood.

This study examined childhood physical or sexual abuse, involvement in dependency or delinquency systems, psychiatric hospitalization, and suicide as possible risk factors for survival sex among homeless young women. Homeless young women were found to have similarly high rates of childhood sexual abuse, dependency and delinquency systems involvement, and psychiatric hospitalization. Homeless young women involved in survival sex disclosed higher rates of attempted suicide and reported marginally higher rates of childhood physical abuse. Analysis of qualitative data showed that those engaged in survival sex were motivated primarily by desperation to meet basic needs including a place to stay, food and money, and one third mentioned that peers commonly were influential in decisions to engage in survival sex. Others were influenced by coercion (10%) or pursuit of drugs (10%). Young women engaged in survival sex generally experienced regret and shame about their experience.

Children, adolescents, and war: the systematic engagement of youth in collective violence.

Increasingly health personnel are called on to address the needs of adolescents affected by armed conflict. Adolescents suffer as combatants, direct and indirect casualties, as dependents of combatants, and as citizens of countries whose resources are destroyed and/or consumed by war and other forms of organized violence. Survivors of war, ex-child soldiers, refugees, and others are found today in cities on all continents. This paper will review the epidemiology of armed conflict, especially with respect to children and youth, examine the etiology of youth involvement in armed conflict including social risk factors and developmental vulnerabilities, and review the peace-building efforts of the United Nations, communities, and youth themselves. Finally we will briefly review the efforts of those committed to the well-being of adolescents in the areas of advocacy and treatment.

Effectiveness of interventions to prevent youth violence a systematic review.

OBJECTIVES: To identify interventions effective in preventing youth violent behavior and commonalities of effective and ineffective interventions. METHODS: A systematic review of the literature on the effectiveness of youth violence interventions was conducted. Interventions were categorized according to the level of the intervention: primary (implemented universally to prevent the onset of violence), secondary (implemented selectively with youth at increased risk for violence), and tertiary (focused on youth who had already engaged in violent behavior). An intervention was considered effective if one or more violence outcome indicators was reported as significantly different at the p<0.05 level, and ineffective if none of the violence outcome indicators was significantly different at the p<0.05 level. Data collection and analysis were conducted in 2003 and updated in 2006. RESULTS: Forty-one studies were included in the review. Overall, 49% of interventions were effective. Tertiary-level interventions were more likely to report effectiveness than primary- or secondary-level interventions. Effective interventions evaluated by randomized controlled trials included Responding in Peaceful and Positive Ways, Aban Aya Youth Project, Moving to Opportunity, Early Community-Based Intervention Program, Childhaven's Therapeutic Child-Care Program, Turning Point: Rethinking Violence, and a multisystemic therapy program. Differences among programs and within subpopulations could not be assessed because of inadequate data. CONCLUSIONS: Increasing effectiveness was reported as the level of intervention increased from primary to tertiary. Approaches to evaluate prevention interventions need to be clarified and standardized.