Parents Demand and Teenager Refuses Epidural Anesthesia.

A 15-year-old girl is scheduled to undergo an upper lobectomy to debulk metastatic Ewing sarcoma. The anesthesiologist recommended placement of a thoracic epidural catheter to provide postoperative analgesia. The patient did not want a needle to be placed near her spine. She was terrified that the procedure would be painful and that it might paralyze her. Although the anesthesiologist reassured her that sedation and local anesthesia would make the procedure comfortable, she remained vehemently opposed to the epidural procedure. The parents spoke privately to the anesthesiologist and asked for placement of the epidural after she was asleep. They firmly believed that this would provide optimal postoperative analgesia and thus would be in her best interest. Experts discuss the pros and cons of siding with the patient or parents.

The Relationship between Moral Climate of Sports and the Moral Behavior of Young Athletes: A Multilevel Meta-analysis.

Sports are among the most important leisure activities for youth and adolescents. Both positive (i.e., prosocial) and negative (i.e., antisocial) moral behaviors occur on the playing field. To stimulate positive sports experiences, it is important to understand which factors are related to the moral behavior of young athletes; one of these is the moral climate, that is, the socio-moral environment in which sports take place. Little is known about the overall strength of the relationship between moral climate and moral behavior of young athletes, as well as the potential moderating factors of this relationship. A meta-analysis of 27 studies containing 117 effect sizes and N = 7726 young athletes (age < 18 years) was conducted. The results show that there is an overall significant association between these two variables (r= 0.40), indicating that a prosocial moral climate is related to less antisocial and more prosocial behavior, while an antisocial moral climate is associated with more antisocial and less prosocial behavior of young athletes. Two study characteristics significantly moderated this relationship: specifically, stronger associations were found in cross-sectional and in older studies. In addition, the strength of the association between moral climate and moral behavior was stronger for antisocial moral climate compared to prosocial moral climate. Finally, associations for team members were stronger than those of coaches or a broad moral club climate. Implications for further research and sports practice are discussed.

Evaluación del continuo deportividad-violencia en el fútbol base / Sportsmanship and violence assessment in youth football / Avaliação do contínuo desportivismo-violência no futebol base

Dada la trascendencia que tiene en nuestra sociedad el deporte, en especial el fútbol desde edades muy tempranas, se hace necesario que los gestores de las competiciones dispongan de herramientas que permitan evaluar los comportamientos de deportividad y no deportividad que se observan en contextos deportivos de fútbol. En la presente investigación, se muestra la implementación de un protocolo de evaluación continua de la deportividad en los partidos de fútbol, durante tres temporadas deportivas. Participaron 64 equipos; 1192 futbolistas, 64 entrenadores y 292 árbitros, de la categoría primera cadete de la Federación Alavesa de Fútbol (F.A.F.). El instrumento de recogida de información utilizado fue el "Registro de Evaluación de Partidos de Fútbol" (REPF) (Gimeno, Sáenz, Ariño y Aznar, 2007). Los resultados reflejan: puntuaciones positivas, en relación a la deportividad de árbitros, entrenadores y jugadores en cada una de las temporadas evaluadas; una mayor frecuencia de actitudes y conductas deportivas en comparación con las no-deportivas; una mayor percepción de deportividad en aquellos partidos en los que el equipo local es el ganador; y una correlación negativa entre la percepción de deportividad de un partido y el número de tarjetas mostradas por los árbitros. Como conclusión, se puede afirmar que el instrumento que se presenta permite: 1. Utilizar una herramienta de evaluación específica de la deportividad para la disciplina del fútbol en edad escolar; 2. Evaluar la deportividad a lo largo de toda la temporada; 3. Identificar los agentes que presentan comportamientos inadecuados durante la práctica deportiva de los jóvenes deportistas, pudiendo proponer las mejores medidas de intervención

Taking into account the gained relevance of the sport in the current society, particularly focusing on football since early age, it is necessary for the different competition managers to have tools designed for assessing fair and unfair play behaviors observed in football context. This research introduces the implementation of a protocol to continuously assess the fair-play during football matches along three seasons. 64 teams, 1192 players, 64 coaches and 292 referees took part within this study, all corresponding to first cadet category of Football Federation of Álava (FFA).The tool employed to gather information was the so called "A record of football match evaluations" (RFME) (Gimeno, Sáenz, Ariño y Aznar, 2007). The results show the following: positive punctuation related to fair play of referees, coaches and players along the studied seasons; greater frequency of fairplay attitudes in comparison to unfair ones; greater fair-play perception on those local teams which won the match; and finally, a negative correlation between fair-play perception and amount of warnings cards shown by referees. As conclusion it can be affirmed that the developed tool allow: 1. Employment of a specific tool to assess fair-play in school age football; 2. Evaluate fair-play during the whole season.; 3. Identity the agents which trigger inadequate behaviors when practicing football and propose the most appropriate countermeasures

Devido à transcendência que o desporto tem na nossa sociedade, especialmente o futebol a partir de idades muito precoces, torna-se necessário que os gestores das competições disponham de ferramentas que permitam avaliar os comportamentos de desportivismo e não desportivismo que se observam nos contextos desportivos do futebol. Na presente investigação apresentase a implementação de um protocolo de avaliação permanente do desportivismo nos jogos de futebol, durante três épocas desportivas. Participaram 64 equipas; 1192 futebolistas, 64 treinadores e 292 árbitros, da categoria primeira cadete da Federação Alavesa de Futebol (F.A.F.). O instrumento de recolha de informação utilizado foi o "Registo de Avaliação de Jogos de Futebol" (REPF) (Gimeno, Sáenz, Ariño e Aznar, 2007). Os resultados refletem pontuações positivas no que respeita ao desportivismo dos árbitros, treinadores e jogadores em cada uma das épocas avaliadas; uma maior frequência de atitudes e comportamentos desportivos em comparação com os não desportivos; uma maior perceção de desportivismo naqueles jogos em que a equipa local é a vencedora; e uma correlação negativa entre a perceção de desportivismo de um jogo e o número de cartões mostrados pelos árbitros. Como conclusão, pode afirmar-se que o instrumento que se apresenta permite: 1. Utilizar uma ferramenta de avaliação específica do desportivismo para a disciplina do futebol na idade escolar; 2. Avaliar o desportivismo ao longo de toda a época; 3. Identificar os agentes que apresentam comportamentos inadequados durante a prática desportiva dos jovens desportistas, podendo propor as melhores medidas de intervenção

Why we sometimes punish the innocent: The role of group entitativity in collective punishment.

Because punishments are expected to give offenders what they deserve proportionally to the severity of their offenses, the punishment of an entire group because of the misdeed of a few of its members is generally considered as unfair. Group entitativity might increase support for such collective punishment, because members of highly entitative groups are perceived as more similar and interchangeable. We designed three experiments comparing support for third-party collective punishment of low versus high entitative groups. As comparison base-rate, we included conditions in which participants punish an individual wrongdoer (Experiments 1 & 2). Results show that although support for individual punishment is higher than support for collective punishment, this difference was reduced (Experiment 1) or absent (Experiment 2) when the group was highly entitative. Experiment 3 replicated the increasing effect of group entitativity on support for collective punishment. We conclude that group entitativity increases the likelihood of an entire group being treated as a single unit, facilitating collective punishment when a few group members commit an offense.

Pragmatic Neuroethics: Lived Experiences as a Source of Moral Knowledge.

In this article, we present a pragmatic approach to neuroethics, referring back to John Dewey and his articulation of the "common good" and its discovery through systematic methods. Pragmatic neuroethics bridges philosophy and social sciences and, at a very basic level, considers that ethics is not dissociable from lived experiences and everyday moral choices. We reflect on the integration between empirical methods and normative questions, using as our platform recent bioethical and neuropsychological research into moral cognition, action, and experience. Finally, we present the protocol of a study concerning teenagers' morality in everyday life, discussing our epistemological choices as an example of a pragmatic approach in empirical ethics. We hope that this article conveys that even though the scope of neuroethics is broad, it is important not to move too far from the real life encounters that give rise to moral questions in the first place.

Adolescents' lived experiences of making health choices: an ethical point of view.

This study describes and interprets adolescents' lived experiences of their rights, duties and responsibilities in relation to their health choices. Fourteen focus group interviews with 67 adolescents aged 15 and 16 were conducted and analysed using the phenomenological hermeneutical method. Adolescents' lived experiences of their rights in relation to their health choices were described as things that were allowed. Duties and responsibilities were perceived as something that they were required to carry out for their own health or other people's health. Although their experiences of rights, duties and responsibilities overlapped, they referred to different aspects of their health choices. Adolescents viewed their rights, duties and responsibilities in the wider context, with parents and society defining their opportunities to make independent choices. We found that ethical considerations influenced adolescents' choices and, the opportunities to exercise their rights, duties and responsibilities varied. Further consideration and recognition of these issues are needed.

The Sequential Intercept Model and Juvenile Justice: Review and Prospectus.

Behavioral health needs in justice-involved adolescents are an increasing concern, as it has been estimated that two-thirds of youths in the juvenile justice system now meet the criteria for one or more psychological disorders. This article describes the application of the Sequential Intercept Model (SIM), developed to describe five "points of interception" from standard prosecution into rehabilitation-oriented alternatives for adults (Munetz & Griffin, 2006), to juvenile justice. The five SIM intercepts are: (1) first contact with law enforcement or emergency services; (2) initial hearings and detention following arrest; (3) jails and courts (including problem-solving courts); (4) re-entry from jails, prisons and forensic hospitals; and (5) community corrections and community support, including probation and parole. Modifying the SIM for application with justice-involved adolescents, this article describes three examples of interventions at different intercepts: Intercept 1 (the Philadelphia Police School Diversion Program), Intercept 3 (problem-solving courts for juveniles), and Intercept 5 (juvenile probation). Relevant research evidence for each example is reviewed, and the further application of this model to juveniles is described. Copyright © 2017 John Wiley & Sons, Ltd.

High school students' experiences of bullying and victimization and the association with school health center use.

BACKGROUND: Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of school-based bullying and victimization and their use of SHCs. METHODS: Data was analyzed from 2063 high school students in 5 Northern California school districts using the 2009-2010 California Healthy Kids Survey. Chi-square tests and multivariate logistic regression were used to measure associations. RESULTS: Students who were bullied or victimized at school had significantly higher odds of using the SHCs compared with students who were not, and were also significantly more likely to report confidentiality concerns. The magnitude of associations was largest for Asian/Pacific Islander students, though this was likely due to greater statistical power. African American students reported victimization experiences at approximately the same rate as their peers, but were significantly less likely to indicate they experienced bullying. CONCLUSIONS: Findings suggest that SHCs may be an important place to address bullying and victimization at school, but confidentiality concerns are barriers that may be more common among bullied and victimized youth.

Dutch adolescents from lesbian-parent families: how do they compare to peers with heterosexual parents and what is the impact of homophobic stigmatization?

In this study, we compared internalizing and externalizing problem behavior of 67 Dutch adolescents (M(age) = 16.04) in planned lesbian families who were matched with 67 adolescents in heterosexual-parent families. We also examined whether homophobic stigmatization was associated with problem behavior in adolescents with lesbian mothers after taking into account demographic characteristics, mothers' scores on emotional involvement, and adolescents' earlier problem behavior (measured at age 4-8 years old). Standardized instruments measuring problem behavior were completed by parents and adolescent offspring, and questions about stigmatization were answered by adolescents with lesbian mothers. The results revealed no differences in internalizing and externalizing problem behavior associated with family type. Offspring in lesbian families who reported more experiences of homophobic stigmatization also demonstrated more internalizing and externalizing problem behavior.

Nivel de conocimientos sobre las Infecciones de trasmisión sexual (ITS) y conducta en adolescentes estudiantes de enfermería / Knowledge about sexually transmitted Infections (STIs) and behavior among adolescent nursing students

INTRODUCCIÓN: en la actualidad, las Infecciones de Transmisión Sexual (ITS) constituyen un serio problema de salud. En el mundo, anualmente, se registran más de 333 millones de casos nuevos, siendo los adolescentes el grupo más afectado. OBJETIVOS: determinar el nivel de conocimientos sobre las ITS/VIH y su correspondencia con factores demográficos, así como la relación entre el sexo, la conducta y la percepción en un grupo de adolescentes. MÉTODOS: se realizó un estudio observacional de corte transversal en 92 estudiantes de Enfermería de la Facultad de Ciencias Médicas Dr. Enrique Cabrera, en marzo/2011. Se utilizaron las variables: factor demográfico, nivel de conocimientos sobre ITS/VIH, conducta y percepción en los adolescentes. RESULTADOS: se observó un 84,7 por ciento y un 15,2 por ciento para el nivel de conocimientos adecuado e inadecuado, respectivamente. La edad y el sexo influyeron en el nivel de conocimientos sobre ITS/VIH (p=0,0077 y p=0,0097; comparativamente). Asimismo, se constató que el sexo puede influir de manera significativa en la edad de inicio de la actividad sexual (p=0,0002) siendo ésta cada vez más precoz en los adolescentes. CONCLUSIONES: se pudo determinar que el nivel de conocimientos sobre las ITS/VIH de los estudiantes de Enfermería es inadecuado. Asimismo, el factor demográfico puede influir sobre el nivel de conocimientos sobre las ITS/VIH y el género puede actuar sobre la edad de inicio de la actividad sexual(AU)

INTRODUCTION: sexually Transmitted Infections are a serious health problem. More than 333 million new cases are reported worldwide every year, and adolescents are the most commonly affected age group. OBJECTIVES: determine the level of knowledge about STIs/HIV and its correspondence with demographic factors, as well as the relationship between gender, behavior and perception in a group of adolescents. METHODS: a cross-sectional observational study was conducted with 92 nursing students from Dr. Enrique Cabrera School of Medical Sciences in March 2011. The variables considered were demographic factors, level of knowledge about STIs/HIV, behavior and perception among adolescents. RESULTS: adequate and inadequate knowledge was 84.7 percent and 15.2 percent, respectively. Age and gender influenced the level of knowledge about STIs/HIV (p=0.0077 and p=0.0097, respectively). It was also found that gender may significantly influence the age when sexual relations are started (p=0.0002), and that adolescents start their sexual life at an increasingly early age. CONCLUSIONS: it was determined that the level of knowledge about STIs/HIV among nursing students is inadequate. It was also found that demographic factors may influence the level of knowledge about STIs/HIV, and gender may influence the age when sexual relations are started(AU)

[The contagion of adolescent suicide: cultural, ethical and psychosocial aspects]. / La contagion du suicide chez les adolescents: aspects culturels, éthiques et psychosociaux.

Suicide is the second leading cause of death among adolescents. The risk factors are many and varied. The contagion of suicide was raised as a potential cause of youth suicide. In support of this argument, we did a review of the literature on the possible contagion of adolescent suicide. Several types of situations can support this hypothesis : when a youth is faced with the suicide of a relative or close friend, when he lived in a community, through the media or via the Internet. The way suicide is reported in the press shows a correlation with increased incidence of suicide among adolescents. In summary, there is evidence increasingly obvious that the contagion is the source of some youth suicides. For this reason, it seems important that preventive measures are in place. However, although this mechanism has been instrumental in initiating the act, it is important to note that suicide is always the result of several factors including the personal history of the subject.

Brief report: Does exposure to violent video games increase moral disengagement among adolescents?

Several studies have repeatedly shown that violent/action video games increase aggressive tendencies. The present study provides preliminary evidence that exposure to these games also affects the process of moral disengagement. High school students (N = 385) were recruited, and the impact of both recency and frequency of their exposure to the video game Grand Theft Auto IV (GTA; 2008) on moral disengagement was explored. Results showed that exposure to GTA predicted higher levels of moral disengagement. Recency of exposure had a primary impact on the considered mechanisms of moral disengagement. These findings provide insights into a relevant detrimental effect of exposure to video games, to our knowledge not explored yet. Future research is needed to provide evidence of the causal link in the observed relationships.

Adaptación española del "Mobile Phone Problem Use Scale" para población adolescente / Spanish adaptation of the "Mobile Phone Problem Use Scale" for adolescent population

El uso problemático del teléfono móvil es un fenómeno emergente en nuestra sociedad, que parece afectar especialmente a la población adolescente. El conocimiento acerca del uso problemático de esta tecnología resulta necesario, dado que puede desarrollarse un patrón comportamental con características adictivas. Apenas existen escalas que midan el posible uso problemático del móvil y ninguna adaptada exclusivamente a población adolescente española. La escala más utilizada internacionalmente es la Mobile Phone Problem Use Scale (MPPUS). El objetivo de este estudio es adaptar el MPPUS a la población adolescente española. Se administró la versión española del cuestionario a una muestra de 1132 de 12 a 18 años. La fiabilidad y la validez factorial eran comparables a las obtenidas en población adulta, por lo que la medida del uso problemático del móvil en los adolescentes españoles es unidimensional. Se detectó una prevalencia del 14.8% de usuarios problemáticos(AU)

Problematic use of the mobile telephone is an emerging phenomenon in our society, and one which particularly affects the teenage population. Knowledge from research on the problematic use of this technology is necessary, since such use can give rise to a behavioural pattern with addictive characteristics. There are hardly any scales for measuring possible problematic use of mobile phones, and none at all adapted exclusively for the Spanish adolescent population. The scale most widely used internationally is the Mobile Phone Problem Use Scale (MPPUS). The aim of the present study is to adapt the MPPUS for use with Spanish adolescents. The Spanish version of the questionnaire was administered to a sample of 1132 adolescents aged 12 to 18. Reliability and factorial validity were comparable to those obtained in adult population, so that the measure of problematic mobile phone use in Spanish teenagers is one-dimensional. A prevalence of 14.8% of problematic users was detected(AU)

"Too much of that stuff can't be good": Canadian teens, morality, and fast food consumption.

Recently, public health agents and the popular media have argued that rising levels of obesity are due, in part, to "obesogenic" environments, and in particular to the clustering of fast food establishments in Western urban centers that are poor and working class. Our findings from a multi-site, cross-national qualitative study of teenaged Canadians' eating practices in urban and rural areas offer another perspective on this topic, showing that fast food consumption is not simply a function of the location of fast food outlets, and that Canadian teens engage in complex ways with the varied dimensions of choosing (or rejecting) fast foods. Drawing on evidence gleaned from semi-structured interviews with 132 teenagers (77 girls and 55 boys, ages 13-19 years) carried out between 2007 and 2009, we maintain that no easy relationship exists between the geographical availability of fast food and teen eating behaviors. We use critical obesity literature that challenges widely accepted understandings about obesity prevalence and etiology, as well as Lamont's (1992, 2000) concept of "moral boundary work," to argue that teen fast food consumption and avoidance is multifaceted and does not stem exclusively nor directly from spatial proximity or social class. Through moral boundary work, in which teens negotiated with moralistic notions of healthy eating, participants made and re-made themselves as "good" and successful subjects by Othering those who were "bad" in references to socially derived discourses of healthy eating.

Adolescents of the USA National Longitudinal Lesbian Family Study: can family characteristics counteract the negative effects of stigmatization?

This investigation examines the impact of homophobic stigmatization on the well-being of 17-year-old adolescents who were conceived through donor insemination and whose mothers enrolled before they were born in the largest, longest-running, prospective study of lesbian families, with a 93% retention rate to date. The data for the current report were collected through questionnaires completed by the adolescents and their mothers. The adolescents (39 girls and 39 boys) were queried about family connection and compatibility. They were also asked to indicate if they had experienced discrimination based on their mothers' sexual orientation. Adolescent well-being was assessed through the parental report of the Child Behavior Checklist/6-18. Forty-one percent of the adolescents had experienced stigmatization based on homophobia. Hierarchical, multiple-regression analyses revealed that stigmatization was associated with more problem behavior in these adolescents, but that family compatibility neutralized this negative influence. The results indicate that adolescents who have close, positive relationships with their lesbian mothers demonstrate resilience in response to stigmatization.