The COVID-19 pandemic exacerbated the vulnerability of adolescents and young adults (AYAs) who face economic disadvantage, depend on social safety net resources, have politically targeted identities, are geopolitically displaced, and/or are racially or ethnically marginalized. A rapid change in social safety net policies has impacts that reverberate throughout interrelated domains of AYA health, especially for vulnerable AYAs. The authors analyze policy-related changes in mental health, climate change, and bodily autonomy to offer a paradigm for an equitable path forward.

This study aims to assess the service quality and user satisfaction of a community support program (CSP) in a specific administrative region of Taiwan. Employing a cross-sectional design, data were collected from 450 CSP users in the region via a questionnaire. Statistical analyses, including descriptive analysis, ANOVA, and Scheffe\'s Test, were conducted using SPSS 22.0. The findings reveal that users aged 70-79 years with primary education, as well as those with demand or unknown demand for long-term care, reported the highest level of satisfaction with CSP services (mean = 4.5, SD = 0.7, p < 0.05). The study underscores the influence of user characteristics and their understanding of the services on satisfaction levels. These insights provide clear direction for policymakers in shaping the future of CSPs, emphasizing the importance of addressing user needs and enhancing awareness and the utilization of available services.

Compulsive sexual behaviour or hypersexuality has been the subject of growing interest among academic circles. However, relatively few reliable predictors have been identified. The aim of the present study was to examine whether different types of sexual motivations based on Self-Determination Theory can account for compulsive sexual behaviour.
The study was conducted on a non-clinical sample of nearly 1000 participants. Sexual motivation was assessed using the Sexual Motivation Scale and compulsive sexual behaviour was assessed using the Hypersexual Behaviour Inventory. Both measures showed adequate reliability. Multiple linear regression was performed to analyse the relationship between the variables.
In the regression, controlling for gender, of the six motivational factors, integrated (β = 0.167), introjected (β = 0.074) and amotivation (β = 0.128) were found significant (p <0.001), and identified was nearly significant (β = 0.53; p = 0.065). The intrinsic (β = -0.032; p = 0.366) and extrinsic (β = -0.027; p = 0.168) forms of motivation had no impact on hypersexuality. The total explained variance of the model was 18% (p <0.001). Results indicated that three of the six motivational factors positively and weakly predicted hypersexuality.
The original hypothesis of the study, that less self-determined motivated sexual behaviour would be a better predictor of compulsive sexual behaviour, was not confirmed. In practice, positively related variables, especially amotivation, may play an important role in psychotherapeutic processes. However, in order to better understand compulsive sexual behaviour, additional factors still need to be explored.

This paper has as its theme the autonomy of pregnant women in relation to choosing the method of birth for their child. The objective was to carry out a scoping review to study the literature and evidence of how autonomy is being offered to parturient women. Study design and location: In October 2023, a search was carried out using the terms \"pregnant women\" AND \"delivery\" AND \"autonomy\" in the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. The search included articles from 2016 to 2023. Of the 179 articles found, 15 met the criteria and were selected for this review. Results: the pregnant woman\'s autonomy in choosing the method of childbirth is influenced by several factors, such as the obstetrician\'s recommendation, the medical team, and negative and positive experiences. Thus, when this autonomy is shared with the obstetrician, the obstetrician recommends cesarean section as the safest route, but does not explain the benefits and harms of both routes (vaginal and cesarean section), causing the woman to accept the cesarean section. Midwives recommend vaginal birth because they believe it to be natural and safe and explain the benefits and harms of both methods, respecting the pregnant woman\'s choice of the method she prefers. Conclusion: women have the fundamental right to choose their method of birth and must be properly guided throughout prenatal care, whether by an obstetrician or a midwife, about the options, risks and benefits of each method of childbirth, respecting the ethical principle of beneficence.

UNASSIGNED: Bioethicists have long been concerned with the mistreatment of institutionalized patients, including those suffering from mental illness. Despite this attention, the built environments of health care settings have largely escaped bioethical analysis. This is a striking oversight given that architects and social scientists agree that buildings reflect and reinforce prevailing social, cultural, and medical attitudes. Architectural choices are therefore ethical choices. We argue that mental health institutions are fertile sites for ethical analysis. Examining the ethics of architecture calls attention to the potential for hospitals to hinder autonomy. Additionally, such examination highlights the salutogenic possibilities of institutional design, that is to care, nurture, and enhance patient and provider well-being.

Nineteen people refusing a blood transfusion in anticipation of thoracic surgery were met at the Clinical Ethics Center (AP-HP, Paris, France). The article reflects on the right place that respect for autonomy plays in medical decisions regarding (non)transfusion when medical practice would recommend it. Three patient profiles emerge: \"categorical refusals\", \"refusals while affirming the need to live\" and \"refusals accompanied by doubt\". Without neglecting the arguments relating to other principles of biomedical ethics (beneficence, non-maleficence, justice), the idea is to enable healthcare professionals to better assess the different situations they face and in particular those in which respect for autonomy seems essential. If the majority of people concerned by the issue are Jehovah\'s Witnesses, and although this religion is sometimes stigmatized, this work sheds light on the place of their wishes hold in medical decisions on (non)transfusion. Healthcare professionals could contact ethics units and ask them to carry out this same assessment in their own different.

When Old People Suffer Because of the Sex of the Young: A Commentary on Korte, A. & Tschuschke, V. (2023). The Media\'s Stranglehold on Sturm und Drang - The Sorrows of Generation Z Regarding Sex and Gender Abstract: In their article \"Sturm und Drang im Würgegriff der Medien - Die Leiden der jungen Generation am eigenen Geschlecht\" in the Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie (volume 51, issue 5), our colleagues Korte and Tschuschke address the question of the extent to which the increase in gender identity deviations among adolescents \"also results from upheavals the cultural landscape and, above all, in media technology.\" The authors look critically at the planned German \"Self-Determination Law,\" the social transition of children and adolescents, the so-called puberty blockade, and hormone therapy in adolescents and justify their preference for a gender-critical over a transaffirmative therapy approach. Although the article introduces some interesting hypotheses from the perspective of cultural studies and philosophy (among others), it may contribute to uncertainty among colleagues in treating trans*people because of its trans-critical tone. This stems from linguistic devices, misleading and erroneous quotations, and incomplete or incorrect descriptions of facts. This contribution therefore takes a critical look at the article by Korte and Tschuschke, using critical linguistic analysis and examining the facts, data, and sources cited by the authors. It encourages our colleagues to engage in a joint, participatory, trans*respectful treatment process with gender-dysphoric children and adolescents while exploring the sizeable intermediate area between \"gender-critical\" and \"transaffirmative\" attitudes, which the authors Korte and Tschuschke barely touch on in their article.
Zusammenfassung: Im Artikel „Sturm und Drang im Würgegriff der Medien – Die Leiden der jungen Generation am eigenen Geschlecht“ in der Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie (Jahrgang 51, Heft 5) setzen sich die Kollegen Korte und Tschuschke mit der Frage auseinander, inwiefern der Anstieg von Abweichungen im Geschlechtsidentitätserleben bei Jugendlichen „auch ein Resultat kultureller und vor allem medientechnologischer Umbrüche ist“. Die Autoren beziehen kritisch Stellung zum geplanten deutschen „Selbstbestimmungsgesetz“, zu sozialer Transition bei Kindern und Jugendlichen, zur sogenannter Pubertätsblockade sowie zur Hormontherapie bei Jugendlichen, und rechtfertigen den Vorzug eines genderkritischen gegenüber dem eines transaffirmativen Therapieansatzes. Obgleich der Artikel einige interessante Hypothesen aus dem Blickwinkel u. a. der Kulturwissenschaft und Philosophie einbringt, kann er doch auf Grund des transkritischen Grundtenors zur Verunsicherung von Kolleg_innen in der Behandlung von trans*Personen beitragen. Dies ist auf sprachliche Mittel, irreführende und fehlerhafte Zitate und unvollständige bzw. inkorrekte Schilderung von Fakten zurückzuführen. Die vorliegende Arbeit möchte sich daher kritisch mit dem zur Diskussion gestellten Artikel der Autoren Korte und Tschuschke befassen und bedient sich dabei einer sprachkritischen Untersuchung sowie einer Überprüfung der von den Autoren angeführten Fakten, Daten und Quellen. Sie möchte versuchen, Kolleg_innen dazu zu ermuntern, sich mit geschlechtsdysphorischen Kindern und Jugendlichen in einen gemeinsamen, partizipativen, trans*respektvollen Behandlungsprozess zu begeben und den von den Autoren Korte und Tschuschke im Artikel wenig beachteten, großen Zwischenbereich zwischen „genderkritischer“ und „transaffirmativer“ Haltung auszuloten.

Overall rates of opioid use are low in adolescents; however, recent increases in mortality from overdose in adolescents have outpaced increases in the general population. This article highlights the importance of expanding evidence-based treatment for adolescent opioid use, especially medication, while also addressing key ethical considerations of harm reduction practices and how application of such practices with adolescents may differ from adults. Concepts related to adolescent populations are discussed, including autonomy, confidentiality, and brain development. Application of harm reduction practices should be age appropriate, express respect for patients\' autonomy, include social support, and be accompanied by broader aims to minimize adolescent initiation, escalation, and overall harm caused by opioid use.

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The use of technical aids has a positive impact on the autonomy and quality of life of elderly or disabled people, and is also beneficial for the caregivers and professionals who support them. Nevertheless, there are still major obstacles to their use, notably a general lack of information on technical aids. This observation led us to produce a set of information tools to help people better understand these aids and how to use them.