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ABSTRACTIn Australia, as elsewhere, there is consensus that new and more effective ways of responding to young people who commit crimes need to be identified and, when available, implemented and evaluated. In this paper we review youth justice legislation across each Australian jurisdiction and consider how it provides the mandate for service delivery. We contextualise this with an account of historical variations in how the seemingly competing goals of welfare and justice have been balanced. This is followed by an overview of contemporary understandings of child development and human rights which are increasingly recognised as both relevant and important to the way in which the community works with justice-involved children and young people. The analysis illustrates how youth justice agencies are still expected to achieve multiple and, at times, conflicting legislated objectives which results in a lack of coherence in policy and practice. This serves only to limit effectiveness. We conclude that legislative reform will be necessary to realise any new vision for youth justice, especially if one of the overarching purposes is to protect vulnerable children.

In Australia, Aboriginal and Torres Strait Islander peoples are much more likely to be arrested, charged with criminal offences and imprisoned than other Australians. Aboriginal and Torres Strait Islanders comprise 49% of young people in detention but only 5.8% of the Australian population aged 10–17. This study investigated changes between 1997 and 2019 in the interaction of Aboriginal and non‐Aboriginal young people with the justice system in the Northern Territory (NT) of Australia. The prevalence of young people being charged with an alleged offence decreased by more than 60% between 1999 and 2001, co‐incident with the introduction of the Juvenile Diversion Scheme in August 2000. Thereafter, for non‐Aboriginal young people there was a small and temporary increase, but for Aboriginal young people prevalence increased almost back to pre‐2000 levels by 2015 before starting to decrease. Aboriginal young people comprised 57% of those charged with any offence in 1997, rising to 88% in 2019. Further investigation is needed to understand the reasons for divergent trends in the prevalence of alleged offending for Aboriginal and non‐Aboriginal young people, which may include the role of diversion, differences in the nature of offences and systemic bias and racism.

ABSTRACTChildren who have ‘early contact’ with youth justice (YJ) are a group of significant policy interest. Understanding circumstances which precede or co-occur with YJ contact can support the development of preventive investments and inform debates about systemic reform, such as ‘raise the age’. Using whole-of-population administrative data from the SA Better Evidence Better Outcomes Linked Data (BEBOLD) platform, we examine differences between children who have early (i.e. between the ages of 10 and 13 years) versus late (i.e. at age 14 or older) YJ contact, relative to the general population. Children born 1991–2022 were followed from birth to age 18 (N = 249,995). Compared to the late-contact group, children with early contact experienced more serious YJ contact (91% versus 59% experienced custody); were more disadvantaged at birth (e.g. 66% versus 45% born into jobless families); had more serious child protection contact by age 10 (26% versus 12% experienced out-of-home care); and experienced mental health-related hospitalisations from ages 12–18 (43% versus 34%). Relative to the general population, both groups were characterised by significant social and economic disadvantage, child protection contact and mental health challenges. The need for investment in early prevention to divert children from the justice system is clear.

ABSTRACTIntroductionPsoriasis is a chronic inflammatory skin disease that most commonly presents as plaque psoriasis. The understanding of the pivotal pathogenetic role of the IL-23/IL-17 axis has dramatically changed the therapeutic approach to the disease. The identification of intracellular signaling pathways mediating IL-23 activity provided the rationale for targeting TYK2.Areas coveredThis review assesses the underlying rationale that led to development of deucravacitinib, a novel oral TYK2 inhibitor, as a therapeutic option for the treatment of moderate-to-severe psoriasis, primarily focusing on pre-clinical and early phase clinical studies.Expert opinionInnovative therapies used in patients with moderate-to-severe psoriasis include biologic agents and small molecules, which are associated with less adverse events than traditional systemic agents. Deucravacitinib, which selectively targets TYK2, has demonstrated to be effective in treating psoriasis, preserving a more favorable safety profile compared to other JAK inhibitors approved for the treatment of other immune diseases that block the ATP-binding site. Because of its oral administration, deucravacitinib represents an intriguing option in the therapeutic armamentarium of psoriasis, though the evaluation of long-term efficacy and safety is necessary to establish its place-in-therapy.

ABSTRACTIntroductionThe therapeutic armamentarium for the treatment of psoriasis, a chronic inflammatory skin disease, is now reasonably broad and structured, with several therapeutic agents that demonstrated a successful long-term control of this condition. However, there are still unfulfilled gaps resulting from the inherent limitations of existing therapies, which have paved the way for the identification of new therapeutic strategies or the improvement of the existing ones.Areas coveredThe aim of this review is to thoroughly explore new therapeutic strategies and novel drugs that are currently in the pipeline for the treatment of psoriasis, focusing primarily on agents that are currently in phase I/II of clinical development. Some of which retrace already existing therapeutic approaches, such as the IL23/Th17 pathway inhibition, while others unveil new and yet unexplored ones.Expert opinionSince the therapeutic landscape of psoriasis is wide, it is not yet clear whether novel agents will fill the remaining gaps in the context of a broader and more diversified set of oral and biologic therapies. Nevertheless, with the development of precision medicine approaches, the development of innovative targeted drugs will still have a therapeutic rationale in psoriasis.

ABSTRACTIntroductionAtopic dermatitis (AD) is a chronic inflammatory skin disease mediated by multiple signals including janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway. Current therapeutic armamentarium consists of a limited number of drugs which may result in the insufficient management of AD. Preclinical evidence regarding inhibition of JAK/STAT led to the development of a promising class of therapeutics, namely, JAK inhibitors. Baricitinib, a novel JAK1/JAK2 inhibitor is currently under investigation in AD clinical trials.Areas coveredThis review offers an overview of Baricitinib and examines clinical efficacy and safety data in patients with moderate-to-severe AD.Expert opinionBaricitinib showed promising preliminary data in terms of efficacy in phase II and III trials, with a very rapid onset of response and great improvements of itch and sleep disturbances. These aforementioned aspects combined with the advantage of an oral formulation have reduced drug production costs compared to biologic agents and could lead to consideration of baricitinib as a first line systemic treatment. Also, in some countries, it could be a therapeutic option in the case of contraindication or failure of conventional systemic drugs prior to biologic therapies. Data related to long-term safety and efficacy will be important to refine the place-in-therapy of this drug.

A 66-year-old woman complained of a 3-year history of left ankle focal spasticity. Brain MRI revealed subcortical white matter hyperintensity in the medial region of the right precentral gyrus. Subsequently, motor impairment spread proximally, to the contralateral lower limb and then to ipsilateral arm, ultimately resulting in a progressive asymmetric tetraparesis and a mild dysarthria. After a 4-year follow-up, a diagnosis of definite primary lateral sclerosis was established.1Clinical progression was mirrored by corresponding spreading of the MRI hyperintensity through motor areas (Figure, A) and extensive microstructural damage of the corticospinal tract shown by diffusion tensor MRI tractography (Figure, B), consistently with a model of TDP-43 protein prion-like transmission through the complex 3D anatomy of the motor system.2

Leaving statutory out-of-home care (OOHC) is a challenging time for many young people; however, certain groups have greater difficulty transitioning to independence. This includes young people with multiple and complex needs, such as those suffering from mental health problems and disabilities, as well as young people with borderline conditions or who disengage from services. The aim of this study was to gain a deeper understanding of the service issues pertaining to these vulnerable groups in South Australia, as well as to identify ways that policy and practice can be enhanced to better facilitate service engagement. Twenty-nine individual interviews and focus groups were conducted with people working in organisations who have knowledge of, or contact with, young people leaving care (N= 66). Thematic analysis was used to organise responses according to two overarching themes: (1) Issues with current leaving care services and preparation, and (2) Enhancing policy and practice. The principal challenges related to difficulties in matching the structure of formal services to a population with highly unstructured living arrangements, a history of problematic engagement with the care system, and difficulties arising due to service ineligibility issues. Potential improvements to the current system and program delivery are discussed.

AbstractIn the last 20 years, a unique but limited body of literature has surfaced focusing specifically on how student affairs professionals can assist student-athletes with critical transitional periods, specifically preparation for career fields. Considering Astin and Kuh’s theoretical discussion on student engagement, this article discusses the need to consider a more holistic model across NCAA divisions to guide campus-level student-athlete development programs. The authors synthesize findings from the literature on the unique elements of the student-athlete experience, which provide recommendations for NCAA student-athlete development policy. Finally, the authors provide implications for how campus-level student affairs practitioners who work with student-athletes can work to enhance campus and civic engagement, as well as prepare these individuals for life after college.

Les ichtyoses héréditaires sont des maladies monogéniques de la cornification qui se traduisent par une altération de la barrière cutanée, une desquamation anormale et des degrés variables d’inflammation. Au sein de ce groupe hétérogène, les ichtyoses congénitales (ARCI, 11 gènes identifiés) se caractérisent par leur début congénital, leur transmission autosomique récessive et leur caractère non syndromique et non bulleux. Des études récentes ont révélé que certaines ichtyoses génétiques pourraient partager des mécanismes pathogéniques avec le psoriasis mais aucune étude ne s’est intéressée à l’association de ces deux dermatoses chez un même sujet.

IMPORTANCE: Face masks have been associated with effective prevention of diffusion of viruses via droplets. However, the use of face masks among children, especially those aged younger than 3 years, is debated, and the US Centers for Disease Control and American Academy of Physicians recommend the use of face mask only among individuals aged 3 years or older. OBJECTIVE: To examine whether the use of surgical facial masks among children is associated with episodes of oxygen desaturation or respiratory distress. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted from May through June 2020 in a secondary-level hospital pediatric unit in Italy. Included participants were 47 healthy children divided by age (ie, group A, aged =24 months, and group B, aged >24 months to =144 months). Data were analyzed from May through June 2020. INTERVENTIONS: All participants were monitored every 15 minutes for changes in respiratory parameters for the first 30 minutes while not wearing a surgical face mask and for the next 30 minutes while wearing a face mask. Children aged 24 months and older then participated in a walking test for 12 minutes. MAIN OUTCOMES AND MEASURES: Changes in respiratory parameters during the use of surgical masks were evaluated. RESULTS: Among 47 children, 22 children (46.8%) were aged 24 months or younger (ie, group A), with 11 boys (50.0%) and median (interquartile range [IQR]) age 12.5 (10.0-17.5) months, and 25 children (53.2%) were aged older than 24 months to 144 months or younger, with 13 boys (52.0%) and median (IQR) age 100.0 (72.0-120.0) months. During the first 60 minutes of evaluation in the 2 groups, there was no significant change in group A in median (IQR) partial pressure of end-tidal carbon dioxide (Petco2; 33.0 [32.0-34.0] mm Hg; P for Kruskal Wallis =?.59), oxygen saturation (Sao2; 98.0% [97.0%-99.0%]; P for Kruskal Wallis =?.61), pulse rate (PR; 130.0 [115.0-140.0] pulsations/min; P for Kruskal Wallis =?.99), or respiratory rate (RR; 30.0 [28.0-33.0] breaths/min; P for Kruskal Wallis =?.69) or for group B in median (IQR) Petco2 (36.0 [34.0-38.0] mm Hg; P for Kruskal Wallis =?.97), Sao2 (98.0% [97.0%-98.0%]; P for Kruskal Wallis =?.52), PR (96.0 [84.0-104.5] pulsations/min; P for Kruskal Wallis test?=?.48), or RR (22.0 [20.0-25.0] breaths/min; P for Kruskal Wallis =?.55). After the group B walking test, compared with before the walking test, there was a significant increase in median (IQR) PR (96.0 [84.0-104.5] pulsations/min vs 105.0 [100.0-115.0] pulsations/min; P?<?.02) and RR (22.0 [20.0-25.0] breaths/min vs 26.0 [24.0-29.0] breaths/min; P?<?.05). CONCLUSIONS AND RELEVANCE: This cohort study among infants and young children in Italy found that the use of facial masks was not associated with significant changes in Sao2 or Petco2, including among children aged 24 months and younger.