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Progression to higher education in England varies markedly by region, with lower rates of participation outside of London. While some previous studies have explored challenges in accessing higher education in rural and coastal areas, there is a lack of research which considers both individual-level and geographic effects in relation to regional variations in HE progression. In this study, using multivariate regression analysis, we examine whether regional differences in transition to higher education can be explained by the rural/coastal nature of the geographic area in which young people grow up, by area-level deprivation, or by the characteristics of young people living within these regions. The analysis uses the Longitudinal Study of Young People in England, a representative cohort study. These data have been linked to information on the proximity to the coast. Consistent with other work, we find that individual differences and area-level deprivation predict HE aspirations and progression. The newly introduced coastal/rural indicator also predicts HE aspirations and progression, but this is mitigated by the inclusion of individual differences and area-level deprivation. However, we find that unexplained regional differences persist. In particular, the South West of England emerges as a regional cold spot for HE. Consequently, policy makers should consider the role that regional dynamics may have in influencing the choices and constraints faced by young people. The approach may also be applicable to understanding inequalities in progression to HE in other countries. [ABSTRACT FROM AUTHOR]

The quality of romantic relationships is associated with mental health and wellbeing throughout the life course. A number of programmes have been developed to support young people in navigating healthy relationships, and a larger role for relationship education was recently formalised in statutory guidance in England. This study aimed to systematically review the evidence base for relationship education programmes. Evaluations of relationship education programmes for young people, including charting of outcome domains and measures, were reviewed, followed by a focussed synthesis of data from studies that included outcome domains of relevance to healthy relationships. Thirty-six studies of seven programmes were found that focussed on one or more outcomes relating to healthy relationship skills, knowledge and attitudes, none of which were assessed as high quality. All evaluated programmes were developed in the US, and only one evaluation was conducted in the UK. The evaluations had a diverse set of outcome domains and outcome measures, few had longitudinal measures. No evidence was found for young people's involvement in programme or evaluation development. High-quality longitudinal evaluations and a core set of validated outcome measures are needed. This research also highlights the need to co-create programmes with young people, teachers and relationship experts that are feasible, acceptable and integrated into a mental health-informed curriculum [ABSTRACT FROM AUTHOR]

Following the introduction of highly active antiretroviral therapy, an expanding cohort of adolescents with perinatally acquired HIV (PaHIV) is surviving and emerging from pediatric services with complex transition health care requirements. Transfer from pediatric to adult services has been associated with poorer health outcomes in other chronic diseases. Young people with HIV have the additional burden of stigma, secrecy, and the risk of transmitting HIV to partners and offspring. Maintaining engagement in health care during adolescence is critical. We compare reported satisfaction surveys of health care experiences and preferences of young people with PaHIV attending a U.K. transition outpatient service with young people attending a young persons' diabetes transition service in Australia. All 21 patients in the United Kingdom and 39 young people approached in Australia agreed to participate. The median age for both groups was 19 years, 67% of the PaHIV group were black African and 74% of diabetic group white Australian. Ninety-five percent (18/19) of those with PaHIV and 87% (34/39) with diabetes felt their transition was an easy process. Sixty-eight percent (13/19) of young people with PaHIV and 72% (28/39) of diabetic patients felt moving to their current service had a positive effect on their health. Being treated as an individual, comprehensive management explanations and encouragement to develop independence were cited as 'strongly important' by over three quarters of participants with PaHIV. This service evaluation illustrates that careful transition can be a positive event for young people with PaHIV, comparable to that of a well-established diabetes services. [ABSTRACT FROM AUTHOR]

Aim: Although laparoscopic appendicectomy (LA) is an accepted alternative to the open appendicectomy (OA) approach, it has been suggested that there is a higher incidence of intraabdominal abscesses (IAAs). Our aim was to determine the incidence of IAA in 3 pediatric surgical centers routinely practicing both techniques., Methods: Data were collected retrospectively for pediatric patients undergoing LA or OA over an 8-year period. Analysis included IAA formation, appendicitis complexity, radiologic/histologic investigations, grade of surgeon, and wound infection., Main Results: A total of 1267 appendicectomies were performed (514 LAs and 753 OAs). There was no difference between the incidences of IAA (LA, 3.9% [19/491] vs OA, 3.9% [28/714]; P = 1.0). The incidence of IAA was increased in those with complicated appendicitis (34/375 [9.1%] vs 13/830 [1.6%]; P ≤ .0001). There was an increased proportion of those with complicated appendicitis in the LA group (182/491 [37.1%] vs 193/714 [27.0%]; P = .0002). Surgical trainees were more likely to be the primary surgeon in the OA group (79% vs 63%; P = .0001), although the incidence of IAA did not correlate with grade of surgeon. There was no significant difference in incidence of wound infection between groups (LA, 4.6% [8/173] vs OA, 2.5% [18/377]; P = .93)., Conclusion: This large retrospective study shows that the technique of appendicectomy does not appear to affect the incidence of IAAs. Patients with complicated appendicitis are more likely to develop an IAA regardless of technique., (Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.)