School Leavers With Verified Disabilities

Globally, young adult employment rates have declined in the 21st century. In Australia, youth from non-metropolitan areas have a lower engagement rate in employment than their metropolitan peers, despite one rarely hearing declarations from school leavers that they aim to be unemployed and never work. This chapter investigates transition outcomes for young adults from a non-metropolitan area through a small retrospective study. The purpose is to identify influences that may impact youth engagement in employment or training for school leavers in a small town, and that may be dissimilar from influences affecting their metropolitan counterparts. Research also focuses on the influences affecting transition to employment for school leavers with verified disabilities in non-metropolitan areas and what barriers they experience to accessing employment or study.

Exploring the Factors that Impact Students' Transitions to University in Australia

There are prominent gaps in educational opportunities and academic outcomes in the Australian education system. The government has made efforts to narrow the gaps and increase the proportion of Australians with higher education qualifications. However, disadvantaged students still lack access to educational opportunities and resources, and are underrepresented in university populations. This essay explores the influential factors that can affect young people's academic and transition outcomes, which involve students' socioeconomic status (SES) backgrounds, engagement in extra-curricular activities and geographical locations. This essay also mainly draws on Bourdieu's theory on social and cultural capital to explain the associations between those factors and students' transitions to university in Australia.

A novel transition clinic structure for adolescent and young adult patients with childhood onset rheumatic disease improves transition outcomes

Background The transition of health care from Pediatric to Adult providers for adolescents and young adults with chronic disease is associated with poor outcomes. Despite the importance of this transition, over 80% of these patients do not receive the services necessary to transition to Adult health care. In 2018, we initiated a transition clinic structure, integrating an Internal Medicine - Pediatrics trained Adult Rheumatologist in a Pediatric Rheumatology clinic to guide this transition. Our goal was to improve transition outcomes. We report the methods of this clinic and its preliminary outcomes. Methods For patients referred to the transition clinic, the Adult Rheumatologist assumed medical management and implemented a six-part modular transition curriculum. This curriculum included a Transition Policy, Transition Readiness Assessment, medication review and education, diagnosis review and education, and counseling on differences between Pediatric and Adult-oriented care. Eligible patients and their families were enrolled in a prospective observational outcomes research registry. Initial data from this transition clinic is reported including adherence with certain aspects of the transition curriculum and clinic utilization. Results The transition clinic Adult Rheumatologist saw 177 patients in 2 years, and 57 patients were eligible for, approached, and successfully enrolled in the registry. From this registry, all patients reviewed the Transition Policy with the Adult Rheumatologist and 45 (78.9%) completed at least one Transition Readiness Assessment. Of the 22 patients for whom transition was indicated, all were successfully transitioned to an Adult Rheumatologist. 17 (77.3%) continued care post-transition with the transition clinic Adult Rheumatologist, and 5 (22.7%) continued care post-transition with a different Adult Rheumatologist. The median time between the last transition clinic visit and first Adult clinic visit was 5.1 months. Conclusions Our experience demonstrated the success of our clinic model regarding participation in the transition curriculum and improved clinic utilization data. Our results are an improvement over transition rates reported elsewhere that did not implement our model. We believe that this structure could be applied to other primary care and subspecialty clinics. Trial registration This research was approved by the University of Utah Institutional Review Board (IRB) in January 2019 (IRB_00115964). Patients were retrospectively registered if involved prior to this date.

Continuity of Caregivers’ Ensuring Medical Care and Care-Transition Preparedness: A Mediation Model

Studies show that informal support provided during hospitalization is essential for communicating with the healthcare team and explaining medical care. Less is known about factors explaining family caregivers' Ensuring and Explaining Medical Care (EEMC) during hospitalization and its impact on care-transition-preparedness of patients in terms of their understanding of the explanations and instructions for continued care. This study examined whether EEMC during the current hospitalization mediates the association between involvement of the caregiver in ensuring and explaining medical care prior the current hospitalization and patients’ care-transition-preparedness for discharge. A prospective cohort study includes 456 internal-medicine-patients at a tertiary medical center in Israel, who were accompanied by an informal caregiver. Involvement in EEMC prior and during the hospitalization, covariates such as health literacy (HL) levels, demographic, health, and functional status were reported by the patients during the hospitalization; and care-transition-preparedness was reported by the patients in a week after discharge. After controlling for covariates, only high HL levels of patients and their caregivers were positively associated with EEMC during hospitalization and care-transition-preparedness (P<0.05). Moreover, mediation analysis indicated significant direct (B(unstandardized)=1.69; p=0.003) and indirect effect (Mediated effect (ME)=1.28; CI= 0.81 to 1.87) of prior involvement in EEMC on care-transition-preparedness through high EEMC during the current hospitalization, controlling for baseline characteristics of patients and their caregivers (total effect: B=2.95; p<0.001). These findings suggest that caregivers' experience and involvement prior the hospitalization may be an essential factor in improving EEMC during the current hospitalization, and in turn improve transition outcomes.

Transition outcomes for young people discharged from adolescent medium secure services in England: A qualitative study exploring adolescents’ and carers’ experiences

Background Young people in secure services present with multiple vulnerabilities; therefore, transition periods are especially challenging for this group. In this study, we followed up young people discharged from adolescent medium secure services to adult and community settings with the aim to explore transition experiences and outcomes. Methods Participants were recruited from 15 child and adult mental health services in England. We conducted qualitative semi-structured interviews with 13 young people, aged 18–19 years, moving from adolescent medium secure units 2–6 months post-transition, and five carers 1–3 months pre-transition. Thematic analysis was performed to identify predetermined or data-driven themes elicited from face-to-face interviews. Results The findings indicated poor transition outcomes for young people with the most severe mental health symptoms and those who committed serious offences. Three overarching themes were identified: (1) unsettling environmental factors within adult services; (2) experiences of transition management and preparation and (3) parental experiences of transition process and engagement with adult services. Conclusion The findings of this study indicate that young people and carers value ongoing involvement in the transition process by well-informed parallel care. They also highlight the need for a national integrative care model that diverges from the traditional ‘one-size-fits-all’ approach.

Mind the gap: Sex, gender, and intersectionality in military-to-civilian transitions

LAY SUMMARY The authors conducted a review of existing research on sex, gender, and intersectionality in relation to military-to-civilian transition (MCT). Extensive international studies and government resources, mostly from the United States, provide insight into the potential vulnerabilities and challenges encountered by historically under-represented military members and Veterans during MCT (i.e., by women, lesbian, gay, bisexual, transgender, and other sexual or gender minority, Black, Indigenous, and People of Colour military service members and Veterans). The reviewed sources also highlight government initiatives and tailored programs that exist internationally to address diverse Veteran needs. Canadian research and government initiatives on the topic are limited, and this gap needs to be kept in mind. To support equitable transition outcomes for all Veterans, research as well as policies, programs, and supports need to pay attention to sex and gender as well as intersecting factors such as sexuality, race, Indigeneity, and more.

The Effects of Peers’ Career Goal Appraisals on School to Work Transition Outcomes

Despite the growing body of research on the transition from school to work, an important aspect of young people’s social realities in this phase has been largely overlooked: their peers. This study investigates to what extent peer networks in late adolescence, and particularly peers’ appraisals of their own career goals, are related to young people’s subjective early transition outcomes in a Finnish sample ( N = 322) between the ages 17 and 20. The results show that having peers who positively appraise their goals as attainable is associated with more positive transition outcomes as young people more often reported having reached a (temporarily) satisfactory transition outcome which they intended to maintain unchanged. Negative peer appraisals showed no associations with transition outcomes. The present study offers an important step toward a comprehensive understanding of the social lives of young people in career transitions and provides new directions for research and counseling.

A New Adulthood

This chapter takes a critical lens to the field of youth transitions. The authors argue that the concept of youth as a period of transition has tended to ossify around school-to-work trajectories, obscuring the significance of other life spheres, such as leisure, friendship, and culture. Although youth transitions scholars can, and indeed are, beginning to account for a wider variety of transitions and do attempt to interrogate the impact of class, gender, and race on transition outcomes, the concept of transitions to adulthood underestimates the historically specific nature of youth, and adulthood, and is ill-suited to identifying the life course effects of youth experience. The authors draw on examples from their longitudinal research on two generations of young Australians to introduce a social generational framework that highlights the changing nature of youth and adulthood, as the stalwarts of transition patterns (education into work) are disrupted by trends toward lifelong learning and precarious work. The current generation of young Australians, like their counterparts in many other countries, have to navigate new transition regimes that involve a considerable investment of time and money in education. Yet globally competitive labor markets mean that the pay-off for education is often difficult to attain. These conditions, the authors argue, create a “new adulthood,” which is an outcome of a generational accommodation to the changing rules of the game of transition from education to work. They use this concept to move debate beyond claims that youth is simply an extended transition before adult status is reached.