A descriptive social and health profile of a community sample of adults and adolescents with Asperger syndrome

<p>Abstract</p> <p>Background</p> <p>Little is known about the health and social profile of adolescents and adults with Asperger syndrome (AS) living in the community. We conducted a study to describe the living, employment and psycho-social situation of a community sample of forty two adults and adolescents with AS, and to describe these indivdiuals' experiences of accessing health services and taking medication.</p> <p>Findings</p> <p>Most respondents (including those over eighteen years of age) lived at home with their parents. Most had trouble reading and responding to other people's feelings, and coping with unexpected changes. Difficulties with life skills, such as cleaning, washing and hygiene were prevalent. The majority of respondents were socially isolated and a large minority had been sexually or financially exploited. Almost all respondents had been bullied. Mental health problems such as anxiety or depression were common. 30% of respondents said that they regularly became violent and hit other people and 15% had attempted suicide. More positively, the majority of respondents felt that they could access health services if they had a health problem.</p> <p>Conclusions</p> <p>The results of this study suggest a relatively poor social and health profile for many people with Asperger syndrome living in the community, with high levels of social problems and social exclusion, and difficulties managing day to day tasks such as washing and cleaning; these findings support the results of other studies that have examined psycho-social functioning in this group.</p

Diabetes and the student body

In this study I examine young peoples' experiences of managing their diabetes in university. Previous studies of students with diabetes have highlighted the problematic effects that the transition from home to university can have for these young people. Young people with diabetes are thought to be at risk of experiencing peer pressure, drinking too much alcohol and eating unhealthy foods. Such practices are often figured to be representative of a `student lifestyle', one governed by selfindulgence, and are seen to be in conflict with the lifestyle that a well controlled young person with diabetes should maintain. Earlier studies are themselves problematic in several respects, however. First of all they typically see the young person's `student identity' as being an a priori risk to their diabetes care. Secondly these studies often ignore young people's own understandings of risk, or fail to recognize the socially embedded nature of risk for young people with diabetes. Thirdly they often see the transition from home to university as an undifferentiated, uni-directional phenomenon whose effect is the same for all young people with diabetes. Once these students make the transition to university, their diabetes control is thought to take second place to more `pressing', risky concerns. In this study I argue otherwise. By attending to young people's own narratives of practice in relation to their food, alcohol and technological consumption, I show that young people with diabetes are often extremely concerned about their diabetes control at university, though the meaning of control for these students is mediated by their positions within and dispositions towards discourses of gender and health, the stages they are at in their university careers, and what they consider to be `normal' behaviours. Overall, my findings challenge the received wisdom of much medical research on young people with diabetes who have been characterised as leading `hedonistic' lifestyles, taking undue risks with little apparent concern for the future. By attending to students' own narrative accounts of living with diabetes a very different picture emerges where risks are embedded within specific social contexts. This more relational view of respondents' experience has implications for how health professionals care for young people with diabete

Life course outcomes and developmental pathways for children and young people with harmful sexual behaviour

Most outcome studies for children and young people who have displayed harmful sexual behaviour have focused on sexual recidivism as their primary outcome measure. Relatively little is known about broader life outcomes for children displaying such behaviours, nor about the processes involved with longer-term developmental success or failure. This paper examines long-term life course outcomes for 69 adults in the UK who presented with abusive sexual behaviour as children. Between 10 and 20 years after their childhood sexual behaviour problems, few in the sample had sexually reoffended, but general life course outcomes were much less positive. A range of individual, relational and social/environmental factors appeared to be associated with successful and unsuccessful outcomes. Successful outcomes were associated with stable partner relationships, wider supportive relationships, and educational opportunity and achievement. The findings highlight the importance of broad-based, developmental interventions in assisting those with childhood sexual behaviour problems to live successfully

Dealing with the devil: weight loss concerns in young adult women with type 1 diabetes.

AIMS AND OBJECTIVES: To examine the weight loss concerns of young adults with type 1 diabetes. BACKGROUND: Eating disorders are prevalent in young women with type 1 diabetes. DESIGN: Qualitative. METHODS: Interviews with 35 young adults (23-30 years of age) with type 1 diabetes and 13 healthcare professionals. RESULTS: Most female interviewees were concerned about the difficulties of losing weight when having diabetes. Six female interviewees developed severe eating disturbances when they were younger. These women initially regarded their disturbed eating behaviour positively and engaged in weight loss activities intermittently. However, over time, they lost control of their behaviour, and it came to dominate their lives. Family conflict often intensified disordered eating behaviours. Eventually all of these women managed to transition away from their behaviour, although this process took, for some of them, several years. Several of them (now in their early to late twenties), however, continued to struggle with weight loss impulses. Healthcare professionals felt that eating- and weight-related issues often went undiagnosed and undocumented in young adult women with type 1 diabetes. CONCLUSION: Many young women with type 1 diabetes are worried about their weight, but will not engage in risky weight loss activities because of concerns about their health. A minority of young adult women will develop more severe eating-related disturbances. These eating disturbances may last a significant amount of time before clinicians become aware of them. These women may also experience disordered weight loss impulses for sometime after clinical interventions. RELEVANCE TO CLINICAL PRACTICE: Clinicians should screen young adult women with type 1 diabetes for eating disorders and monitor young adult women who have developed eating disorders over the longer term. There may be a need to provide asymptomatic young women with diabetes with information about the potential risks of insulin omission

Considering quality of care for young adults with diabetes in Ireland.

BACKGROUND: Research on the quality of diabetes care provided to young adults with Type 1 diabetes is lacking. This study investigates perceptions of quality of care for young adults with Type 1 diabetes (23--30 years old) living in the Republic of Ireland. METHODS: Thirty-five young adults with Type 1 diabetes (twenty-nine women, six men) and thirteen healthcare professionals (ten diabetes nurse specialists, three consultant Endocrinologists) were recruited. All study participants completed semi-structured interviews that explored their perspectives on the quality of diabetes services in Ireland. Interviews were analyzed using standard qualitative thematic analysis techniques. RESULTS: Most interviewees identified problems with Irish diabetes services for young adults. Healthcare services were often characterised by long waiting times, inadequate continuity of care, overreliance on junior doctors and inadequate professional-patient interaction times. Many rural and non-specialist services lacked funding for diabetes education programmes, diabetes nurse specialists, insulin pumps or for psychological support, though these services are important components of quality Type 1 diabetes healthcare. Allied health services such as psychology, podiatry and dietician services appeared to be underfunded in many parts of the country. While Irish diabetes services lacked funding prior to the recession, the economic decline in Ireland, and the subsequent austerity imposed on the Irish health service as a result of that decline, appears to have additional negative consequences. Despite these difficulties, a number of specialist healthcare services for young adults with diabetes seemed to be providing excellent quality of care. Although young adults and professionals identified many of the same problems with Irish diabetes services, professionals appeared to be more critical of diabetes services than young adults. Young adults generally expressed high levels of satisfaction with services, even where they noted that aspects of those services were sub-optimal. CONCLUSION: Good quality care appears to be unequally distributed throughout Ireland. National austerity measures appear to be negatively impacting health services for young adults with diabetes. There is a need for more Endocrinologist and diabetes nurse specialist posts to be funded in Ireland, as well as allied health professional posts

Why do young adults with Type 1 diabetes find it difficult to manage diabetes in the workplace?

This article explores how and why workplace environments impact diabetes management for adults people with Type 1 diabetes, 23-30 years of age. Interviews were conducted with 35 young adults, 29 women and 6 men. The majority of these interviewees worked in sectors such as banking, technology and administration. Young adults found it difficult to manage diabetes in the workplace for two main reasons: work-related time pressures and the non-routine nature of interviewees\u27 work and working environment. Young adults also found it difficult to get the time to exercise both inside and outside of work. Young adults with Type 1 diabetes need to be provided with the tools and technologies that they need to manage diabetes in modern flexible workplaces

Why don’t young women go for Chlamydia testing? A qualitative study employing Goffman’s stigma framework

Many women who might be at risk of having the sexually transmitted infection(STI) Chlamydia trachomatis either delay going, or do not go, for testing. Weaimed to examine the factors that either prevent or discourage Irish young women from going for Chlamydia testing. We conducted in-depth interviews with 35 women in the Republic of Ireland who were between 18 and 29 years of age. Accounts were analysed using Goffman’s stigma framework. Study respondents strongly associated Chlamydia and Chlamydia testing with stigma and felt that only irresponsible, promiscuous risk takers were at risk of contracting the infection. Respondents saw themselves as responsible, moral actors who avoided risk and took good care of their bodies; they were therefore not at risk of having Chlamydia. Going for Chlamydia testing was seen as a risky activity that could shift respondents identities into a negative ‘Other’ category. Respondents feared that if they found themselves in this ‘Other’ category they would open themselves to bullying and ostracism. While a negative act from a medical perspective, for respondents the act of not testing was seen as a positive activity that helped to reinforce their identities as good, ‘worthy’ individuals and avoided negative social consequences that might otherwise arise from the testing process

What’s distressing about having type 1 diabetes? A qualitative study of young adults’ perspectives

Background: Diabetes distress is a general term that refers to the emotional burdens, anxieties, frustrations, stressors and worries that stem from managing a severe, complex condition like Type 1 diabetes. To date there has been limited research on diabetes-related distress in younger people with Type 1 diabetes. This qualitative study aimed to identify causes of diabetes distress in a sample of young adults with Type 1 diabetes. Methods: Semi-structured interviews with 35 individuals with Type 1 diabetes (23–30 years of age). Results: This study found diabetes related-distress to be common in a sample of young adults with Type 1 diabetes in the second phase of young adulthood (23–30 years of age). Diabetes distress was triggered by multiple factors, the most common of which were: self-consciousness/stigma, day-to-day diabetes management difficulties, having to fight the healthcare system, concerns about the future and apprehension about pregnancy. A number of factors appeared to moderate distress in this group, including having opportunities to talk to healthcare professionals, attending diabetes education programmes and joining peer support groups. Young adults felt that having opportunities to talk to healthcare professionals about diabetes distress should be a component of standard diabetes care. Conclusions: Some aspects of living with diabetes frequently distress young adults with Type 1 diabetes who are in their twenties. Clinicians should facilitate young adults’ attendance at diabetes education programmes, provide them with opportunities to talk about their diabetes-related frustrations and difficulties and, where possible, assist in the development of peer-support networks for young adults with diabetes