Full Text Available Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community’s efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.
Agampodi Thilini C
Full Text Available Abstract Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners
Introduction: For families of children with mental illness, adolescence is a major struggle and few parents find service systems to be helpful during this period . These difficulties seem to span across various dimensions such as availability of health, educational and community resources, barriers to accessing services, understanding of health care providers and specially those related to the transition to adult healthcare service system and the restrictions imposed by confidentially. Par...
Garralda, Elena M
Outcome auditing of specialist child and adolescent mental health services (CAMHS) is now well under way internationally. There is, however, debate about objectives and tools. A case is made for the achievable goal of enhancing service accountability through user satisfaction information and clinician-rated contextualised measures of improvements in symptoms and impairment.
Tilahun Mesfin; Mengistie Bezatu; Egata Gudina; Reda Ayalu A
Abstract Background Adolescents in developing countries face a range of sexual and reproductive health problems. Lack of health care service for reproductive health or difficulty in accessing them are among them. In this study we aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried adolescents in Ethiopia. Methods We conducted a descriptive cross-sectional survey among 423 health care service providers working in eastern Ethiopia in 2010....
Costa, M C; Formigli, V L
To evaluate the technical and scientific quality of care provided adolescents, pregnant adolescents and their offspring by the Emaús community's health service in Belém, state of Pará, Brazil, between 1994 and 1996. Data for population and health care assessment were collected from medical records and compared with the PAHO/WHO and Brazilian Ministry of Health guidelines. The following features were satisfactory: anthropometric measurements and sexual maturity in adolescent health care program; visits scheduling, weight and blood pressure recording and proceedings in the event of medical problem in prenatal care; early registration in the health program, completing of the immunization schedule, weight and motor development recording and adequacy of medical visits in children care. Other aspects were less satisfactory, such as poor recording of clinical procedures and high level of inadequate or partially adequate procedures for the adolescent group; late admission to prenatal care and low recording of pregnant anti-tetanus immunization in prenatal care; high prevalence of early weaning and poor recording of children's height. This easy-to-perform assessment allowed to evaluate the quality of care provided and made it possible to reallocate services and medical procedures to offer health care service better organized and of better quality to meet the population needs.
Delfini, Patricia Santos de Souza; Reis, Alberto Olavo Advincula
The objective of this paper was to describe and analyze the articulation between children and adolescent mental health care interventions undertaken by teams working under the Family Health Strategy (FHS) and Psychosocial Care Centers for Children and Adolescents (CAPSI). In order to achieve these objectives, semi-structured interviews were conducted with five CAPSI and 13 FHS managers from five different regions of the city of São Paulo, Brazil. The 18 interviews were transcribed and analyzed froma hermeneutic perspective. It was found that interactions between the FHS and CAPSI occur mainly through referral of cases, matrix support or partnerships in cases concerning CAPSI. Obstacles, such as a lack of human resources, productivity goals and lack of training in mental health of FHS professionals were mentioned. The referral system and passing responsibility for mental health cases to specialized services and the hegemonic biomedical model and the fragmentation of care are common place in these services.
Coyne, I; McNamara, N; Healy, M; Gower, C; Sarkar, M; McNicholas, F
Service user involvement is essential for quality care in the Child and Adolescent Mental Health Services (CAMHS). This study was conducted to explore adolescents' and parents' experiences of CAMHS in relation to accessibility, approachability and appropriateness. This study used a descriptive qualitative design, and focus groups and single interviews were conducted with adolescents (n = 15) and parents (n = 32) from three mental health clinics. Data were analysed using thematic analysis. Accessing mental health services was a challenging experience for many parents and adolescents due to knowledge deficit, lack of information and limited availability of specialist services. Some parents and adolescents reported positive experiences while others reported negative experiences. They expressed a need for more information, involvement in decision making, flexible scheduling of appointments, school support and parent support groups. The nature and quality of the relationship with staff was critical to positive experience with the service; therefore, frequent changes of medical staff was disruptive. Mental health nurses can play a vital role in ensuring continuity, assessing adolescents' participation preferences and advocating for their information needs with other members of the interdisciplinary team.
Conclusions: Effectively planning, implementation and also evaluation of health programs in adolescent health is required to change attitude of adolescents, the health providers and also that of the setting where adolescents are addressed. Health professionals have their credibility towards adolescents, and the advice they give may be important for teenage behavior. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 2968-2972
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?
Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna
Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.
Tsai, Meng-Che; Lin, Sheng-Hsiang; Chou, Yen-Yin; Lin, Shio-Jean
There have been few reports about adolescent experiences with and expectations of health service utilization in an Asian societal setting. The aim of this study is to analyze the use of healthcare services in relation to health status and explore adolescents' preferences for youth-friendly service among Taiwanese high school students. A cross-sectional questionnaire-based survey was conducted on Taiwanese adolescents aged 12–18 years in 2010.We invited participants to rate their health status, report their previous healthcare service use, and rank their health service preferences.We used logistic regression analysis to investigate the association between self-rated health status and healthcare utilization and used nonparametric analysis to compare health service preferences among sociodemographic subgroups. A total of 4,907 students (97.2 % response rate) returned valid questionnaires for analysis. Poor health status and chronic illness were most salient factors independently associated with frequent healthcare service use. Only 40 % of respondents reported having a regular doctor, and pediatrics (57.7 %) was the most commonly identified professional source of medical care. A great majority (86.2 %) of respondents made clinical visits with parents. For characteristics of youth-friendly clinician, the top-ranked items included competency and patience, while having helpful and friendly personnel was highlighted for clinical setting. Family participation is critical in healthcare for adolescents in Asian cultures. Health service use is significantly influenced by health status and chronic illness in the general health insurance system. Understanding these background influences on expectations for healthcare may help to create youth-friendly health services that are more culturally appropriate.
Wegner, R E
Children and adolescents increasingly show health-related problems which may not be considered as diseases to be treated but nevertheless severely affect academic performance and social behaviour. Regarding the consequences, e.g. from the PISA study, the significance of health problems and their negative impact on academic success are still not sufficiently taken into account. The tasks of paediatric public health services include: (1) health promotion in schools and kindergartens, (2) preventive and other medical checkups in kindergartens and schools to detect the individual needs of children and adolescents for support, (3) reducing the risk of long-term damage in handicapped or retarded children and adolescents by seeking out these children where necessary, and (4) advising the political decision makers by reporting on the population's health and social situation. The main aim is to provide children with special needs with what they need in order to prevent them, especially those whose parents cannot ensure this support themselves, developing a deeper disturbance, or to make sure that these young people are able to participate in social life and to integrate into society in spite of health problems or handicaps. To achieve these goals and to improve the health of children and adolescents, a community-based paediatric public health service has to cooperate with other institutions such as youth authorities, social welfare, education authorities, schools and other local institutions with an input into the health of children and adolescents.
Fazel, Mina; Garcia, Jo; Stein, Alan
Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services.
F. Jörg (Frederike); J. Ormel (Johan Hans); S.A. Reijneveld (Sijmen); D.E.M.C. Jansen (Daniëlle); F.C. Verhulst (Frank); A.J. Oldehinkel (Albertine)
textabstractBackground: The increased use and costs of specialist child and adolescent mental health services (MHS) urge us to assess the effectiveness of these services. The aim of this paper is to compare the course of emotional and behavioural problems in adolescents with and without MHS use in a
Mburu, Gitau; Hodgson, Ian; Teltschik, Anja; Ram, Mala; Haamujompa, Choolwe; Bajpai, Divya; Mutali, Beatrice
A rights-based approach in HIV service delivery for adults is increasingly taking root in sub-Saharan Africa in the context of greater availability of antiretroviral therapy. Yet there has been comparatively little progress in strengthening a rights-based approach to adolescent HIV services, which we learned during a qualitative study in 2010 among 111 adolescents living with HIV, 21 parents and 38 health providers in three districts in Zambia. Adolescents in the study expressed a range of information and support needs and wanted locally relevant interventions to meet those needs. They wanted greater access to HIV, sexual and reproductive health information, information on how to protect themselves, privacy and confidentiality in service sites, skills training so as to be able to earn money, and better control over disclosure of their HIV status to others. Both health workers and parents acknowledged that information and services needed to be improved to meet those needs far better. This paper provides examples of successful programmes in Zimbabwe, Uganda, Tanzania, Botswana and South Africa and calls for adolescent services to be linked to both paediatric and adult services, peer networks to be established to increase adolescents' ability to collectively voice their concerns and support each other, interventions supporting adolescents' control over self-disclosure, and lastly that adolescent health should become a training specialty in sub-Saharan Africa.
Shahabuddin, A S M; Delvaux, Thérèse; Abouchadi, Saloua; Sarker, Malabika; De Brouwere, Vincent
To understand the health-seeking behaviour of adolescent women in Bangladesh with respect to the use of maternal health services. Literature review of seven electronic databases: PubMed, ISI Web of Knowledge, PsycINFO, Embase, CINAHL, POPLINE and Global Health. Studies published in English between 1990 and 2013 which describe Bangladeshi adolescent women's healthcare-seeking behaviour during pregnancy, delivery and post-partum were included. Twelve studies were included in this review. 11 used quantitative methods and one used a mixed-methods approach. All studies included married adolescent women only. Women with lower educational levels are less likely to seek skilled maternal health services than those with higher levels of education. Use of maternal health services is also less common among rural married adolescent women than women in urban areas. Being part of the richest bands of wealth, having had previous experiences of childbirth and higher women's autonomy positively influence the use of skilled maternal health services among married adolescent women in Bangladesh. Antenatal care is a key predictor of the use of skilled birth attendants for delivery and post-natal care. Maternal health-related programmes should be designed targeting rural and uneducated married adolescent women in Bangladesh. More qualitative investigations are required to broaden our understanding on maternal health-seeking behaviour of both married and unmarried adolescent women. © 2015 John Wiley & Sons Ltd.
Ronzoni, Pablo; Dogra, Nisha
The use of service users' views as performance indicators highlights the trend to make services more responsive to patients' needs. However, recent research indicates that there is a lack of clear understanding about specialist CAMHS and the outcomes that children, adolescents and their parents hope to achieve from treatment differ. To explore children/young people's and parents/carers' expectations of CAMHS in Leicestershire, England. Sixty children/young people and their parents/carers were asked to identify goals they want to achieve following contact with CAMHS. Qualitative thematic analysis in relation to Hoagwood's SFCES model (Symptoms, Functional, Consumer perspectives, Environment and Systems) was used. The question was answered by 46.7% of children and young people and 60% of carers. Overall, children, young people and parents/carers agreed that symptomatic modification and functional aspects were the most important goals. However, internalising items seemed more important for parents/carers than children and adolescents, who in contrast hoped for improvement in externalising factors. Goals outside the scope of CAMHS were also noted for both groups. Attention to children/young people and their parents/carers' expectations of services is needed to improve therapeutic relationships and engagement. Improvement in mental health literacy and practitioners' guidance is required to allow service users to set realistic and achievable treatment goals.
Okonofua, F E; Ogonor, J I; Omorodion, F I; Temin, M T; Coplan, P A; Kaufman, J A; Heggenhougen, H K
The available evidence indicates that Nigerian adolescents use various health practitioners for the treatment of sexually transmitted diseases (STDs). However, the quality of the STD treatment used by adolescents has not been investigated previously. To investigate the quality of services provided by health practitioners for the treatment and prevention of STDs among adolescents in Benin City, Nigeria. In-depth interviews were conducted with 48 formal and informal sector health practitioners who were identified by key informants as being the main providers of STD treatment in the city. Their facilities were visited to evaluate the quality of services they provide for STD treatment. Health providers in the informal sector showed inadequate knowledge of the appropriate treatment methods for STDs. Although providers in the formal sector had better knowledge, they lacked appropriate management guidelines and were poorly oriented to the problems of STDs in adolescents. There was consensus among the health providers that adolescents most frequently use informal treatment for STDs. Nevertheless, among all providers, there was evidence of inadequate counseling of adolescents, a poor attitude toward the promotion of condom use, and inadequate use of referral opportunities. Comprehensive public health measures are needed to address these problems in Nigeria. These include the provision of reproductive health education for adolescents, the retraining of health providers, and the consolidation of services for the prevention and treatment of STDs.
Madkour, Aubrey S.; Xie, Yiqiong; Harville, Emily W.
Background: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. Methods: Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants…
Cummings, Janet R.; Druss, Benjamin G.
Objective: Little is known about racial/ethnic differences in the receipt of treatment for major depression in adolescents. This study examined differences in mental health service use in non-Hispanic white, black, Hispanic, and Asian adolescents who experienced an episode of major depression. Method: Five years of data (2004-2008) were pooled…
Goodwin, John; Savage, Eileen; Horgan, Aine
Adolescents and young people are known to hold negative views about mental illness. There is less known about their beliefs about mental health services and care. The aim of this study was to systematically examine literature on the beliefs of adolescents and young people from the general population about mental health services and care. Factors that positively and negatively influence these beliefs are also explored. Relevant electronic databases were searched for papers published in the English language between January 2004 and October 2015. Culture seemed to influence how adolescents and young adults perceived mental health interventions. This was particularly evident in countries such as Palestine and South Africa where prayer was highly valued. Adolescents and young people were uninformed about psychiatric medication. They believed that accessing mental health care was a sign of weakness. Furthermore, they viewed psychiatric hospitals and various mental health professionals negatively. Film was found to have a negative impact on how adolescents and young people perceived mental health services, whereas open communication with family members was found to have a positive impact. Adolescents and young adults hold uninformed and stigmatizing beliefs about mental health treatments, mental health professionals, and access to care. The sources of these beliefs remain unclear although some at least seem influenced by culture. Further research, (particularly qualitative research) in this area is recommended in order to address current gaps in knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.
Berra, S.; Tebé, C.; Erhart, M.; Ravens-Sieberer, U.; Auquier, P.; Detmar, S.; Herdman, M.; Alonso, J.; Rajmil, L.
Objective: To examine the association between use of health care services and health status, sociodemographic, and health care system characteristics in children and adolescents from 11 European countries. Research Design: Cross-sectional surveys in representative samples included using phone or
Berra, S.; Tebé, C.; Erhart, M.; Ravens-Sieberer, U.; Auquier, P.; Detmar, S.; Herdman, M.; Alonso, J.; Rajmil, L.
Objective: To examine the association between use of health care services and health status, sociodemographic, and health care system characteristics in children and adolescents from 11 European countries. Research Design: Cross-sectional surveys in representative samples included using phone or sch
This Annual Report provides the first comprehensive survey carried out on community CAMHS teams and includes preliminary data collected by The Health Research Board on the admission of young people under the age of 18 years to inpatient mental health facilities. As many measures in this report do not have historic comparators it provides a baseline foundation that will be built upon in subsequent years providing an indication of trends that cannot yet be drawn on the basis of this report. The next report will include day hospital, liaison and inpatient services. Subsequent reports will further extend the mapping of mental health services for young people.
Ashby, Bethany; Ranadive, Nikhil; Alaniz, Veronica; St John-Larkin, Celeste; Scott, Stephen
Purpose Mental health issues in perinatal adolescents are well documented and studies have shown high rates of depressive disorders among this population. Treatment is challenging because pregnant adolescents are poorly adherent with mental health services. We describe a novel integrated mental health care program for pregnant and parenting adolescent mothers and their children. Methods The Colorado Adolescent Maternity Program (CAMP) is a comprehensive, multidisciplinary teen pregnancy and parenting medical home program serving an ethnically diverse and low socioeconomic status population in the Denver metro area. We describe the Healthy Expectations Adolescent Response Team (HEART), an embedded mental health care program focused on improving identification of mental health symptoms and increasing rates mental health treatment in adolescent mothers. Results From January 1, 2011-January 16 2014, 894 pregnant adolescents were enrolled in CAMP and 885 patients were screened for mental health issues. Prior to HEART's inception, 20 % of patients were identified as having mood symptoms in the postpartum period. Successful referrals to community mental health facilities occurred in only 5 % of identified patients. Following the creation of HEART, 41 % of patients were identified as needing mental health services. Nearly half of the identified patients (47 %) engaged in mental health treatment with the psychologist. Demographic factors including age, parity, ethnicity, and parent and partner involvement did not have a significant impact on treatment engagement. Trauma history was associated with lower treatment engagement. Conclusion Our findings suggest that an embedded mental health program in an adolescent obstetric and pediatric medical home is successful in improving identification and engagement in mental health treatment. Key components of the program include universal screening, intensive social work and case management involvement, and ready access to onsite
Deogan, Charlotte; Ferguson, Jane; Stenberg, Karin
In order to achieve Millennium Development Goals 4, 5 and 6, it is essential to address adolescents' health. To estimate the additional resources required to scale up adolescent friendly health service interventions with the objective to reduce mortality and morbidity among individuals aged 10 to 19 years in 74 low- and middle- income countries. A costing model was developed to estimate the financial resources needed to scale-up delivery of a set of interventions including contraception, maternity care, management of sexually transmitted infections, HIV testing and counseling, safe abortion services, HIV harm reduction, HIV care and treatment and care of injuries due to intimate partner physical and sexual violence. Financial costs were estimated for each intervention, country and year using a bottom-up ingredients approach, defining costs at different levels of delivery (i.e., community, health centre, and hospital level). Programme activity costs to improve quality of care were also estimated, including activities undertaken at national-, district- and facility level in order to improve adolescents' use of health services (i.e., to render health services adolescent friendly). Costs of achieving universal coverage are estimated at an additional US$ 15.41 billion for the period 2011-2015, increasing from US$ 1.86 billion in 2011 to US$ 4,31 billion in 2015. This corresponds to approximately US$ 1.02 per adolescent in 2011, increasing to 4.70 in 2015. On average, for all 74 countries, an annual additional expenditure per capita ranging from of US$ 0.38 in 2011 to US$ 0.82 in 2015, would be required to support the scale-up of key adolescent friendly health services. The estimated costs show a substantial investment gap and are indicative of the additional investments required to scale up health service delivery to adolescents towards universal coverage by 2015.
Full Text Available BACKGROUND: In order to achieve Millennium Development Goals 4, 5 and 6, it is essential to address adolescents' health. OBJECTIVE: To estimate the additional resources required to scale up adolescent friendly health service interventions with the objective to reduce mortality and morbidity among individuals aged 10 to 19 years in 74 low- and middle- income countries. METHODS: A costing model was developed to estimate the financial resources needed to scale-up delivery of a set of interventions including contraception, maternity care, management of sexually transmitted infections, HIV testing and counseling, safe abortion services, HIV harm reduction, HIV care and treatment and care of injuries due to intimate partner physical and sexual violence. Financial costs were estimated for each intervention, country and year using a bottom-up ingredients approach, defining costs at different levels of delivery (i.e., community, health centre, and hospital level. Programme activity costs to improve quality of care were also estimated, including activities undertaken at national-, district- and facility level in order to improve adolescents' use of health services (i.e., to render health services adolescent friendly. RESULTS: Costs of achieving universal coverage are estimated at an additional US$ 15.41 billion for the period 2011-2015, increasing from US$ 1.86 billion in 2011 to US$ 4,31 billion in 2015. This corresponds to approximately US$ 1.02 per adolescent in 2011, increasing to 4.70 in 2015. On average, for all 74 countries, an annual additional expenditure per capita ranging from of US$ 0.38 in 2011 to US$ 0.82 in 2015, would be required to support the scale-up of key adolescent friendly health services. CONCLUSION: The estimated costs show a substantial investment gap and are indicative of the additional investments required to scale up health service delivery to adolescents towards universal coverage by 2015.
Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have
Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.
Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela
Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.
Solorio, M Rosa; Milburn, Norweeta G; Andersen, Ronald M; Trifskin, Sharone; Rodríguez, Michael A
The Expanded Behavioral Model for Vulnerable Populations was used to examine the predisposing, enabling, and need factors associated with mental health service use in a homeless adolescent sample (N = 688). Among all youth, 32% perceived a need for help with mental health problems and 15% met Brief-Symptom Inventory (BSI) criteria for emotional distress. The rate of mental health service use in our sample was 32%. One enabling factor, having a case manager/discussed mental health concerns, and one need factor, which met criteria for BSI, were found to be associated with mental health service use in the past 3 months. The majority of youth who used mental health services had obtained services from crisis centers. Among those who perceived a need for help with mental health problems but who did not use services, the most common barrier was not knowing where to go or what service to use (57%). These findings suggest that due to the high prevalence of mental health problems among homeless youth, it would be helpful for service providers coming into contact with youth to make them aware of existing community resources for mental health services; making youth aware of these resources may in turn decrease the rate of crisis center use and instead allow youth to receive mental health services in outpatient settings that provide continuity of care.
Fortes, P A; Kurita, G de P
In an effort to better understand some of the ethical and legal dilemmas that health professionals face in their daily activities, this study identified and analyzed the opinions and expectations of medical and nursing students at the University of São Paulo, Brazil, regarding the autonomy of adolescents in receiving health care services. Over the 1995-1996 period, interviews were done with students in the first and last years of their programs in the School of Medicine and the School of Nursing of the University of São Paulo. The results from the first-year students were compared with those of the final-year students. The interview questions dealt with such issues as providing medical care to adolescents when a parent or guardian was not present, adolescents making their own decisions on health care services, the confidentiality of information that adolescents provide, the circumstances in which that information could be given to parents or guardians, and situations where there were conflicts between the decisions of parents and adolescents. Despite variations among the opinions and expectations of the students, the overall results suggest that most of the medical and nursing students do not accept the concept of "health adulthood" or autonomy for adolescents and that the students instead choose to rely on current legal definitions of adulthood.
Damodaran, J; Sherlock, C
This paper explores children's rights in the child and adolescent mental health arena in Ireland. It begins by outlining the legal and policy contexts of both children's services and mental health policy and practice. It specifically focuses on the notion of participation as a key factor in addressing rights-based approaches in the provision of services. The article explores current practice in Child and Adolescent Mental Health Services, highlights some of the disparities in services, which result in questions about human rights. Mainly reflective in its approach, it does, however, provide data from a small scale qualitative study carried out in relation to young people diagnosed with ADHD and their perceptions of psychopharmacological approach. The issue of consent is explored as an example of how current practice approaches fall short of a rights-based framework. It concludes with recommendations for changes incorporating a more participatory and collaborative approach.
Brett M. McDermott
Full Text Available Background: From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. Objective: To critique existing child and adolescent mental health services (CAMHS models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. Method: A narrative review of traditional CAMHS is presented. Important elements of a disaster response – individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Results: Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. Conclusion: In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.
Full Text Available Aim: Physical, psychological and social changes occurring in adolescence period may be cause for concern. In this study, it was aimed to determine concerns on growth and development in adolescence period, related factors and utilization of health services. Methods: In this study, data related youths' concerns, utilization of health services and socio-demographic variables obtained from multi-purpose cross-sectional survey named Needs Assesment of Seasonal Agricultural Worker Families Survey-2011 were used. Survey framework was consisted of aged 15-24 young people of families who worked as a seasonal agricultural farmworker in the year of research conducted. Survey was completed in 1021 households total 915 youths selected by probability cluster sampling method of 1200 households by Turkish Statistical Institution (Response rates were 90,7% in women, and 77,2% in men. and lsquo;Woman and Men Questionnaires' were applied by face to face interview. University Research Ethics Committee approval was obtained. Data entry and analysis performed using SPSS 11.5 software, descriptive statistics, t-test, chi-square test and logistic regression analysis were conducted. Results: Of participants 63,6% of female and 46,6% of male adolescents reported at least one concern related to growth and development inadolescent period. While having any concern prevalence in women were changed working time in the fields and health perception, marital status and education level with adolescent's concerns were related in men significantly (P <0,05. 13,8% of females and 10,9% of males utilized the health services because of concerns. Conclusion: By Family Health Centers at this risky young group during their period of residence in their address, adolescent follow-up should be done, should be asked concerns and given early diagnosis and treatment. On the other hand, health education programs on adolescence period by Community Health Centers will be useful. [TAF Prev Med Bull
Full Text Available Objective: This study examines the associations of childhood attention-deficit/hyperactivity disorder (ADHD risk status with subsequent parental social network characteristics and caregiver strain in adolescence; and examines predictors of adolescent mental health service use. Methods: Baseline ADHD screening identified children at high risk (n = 207 and low risk (n = 167 for ADHD. At eight-year follow-up, parents reported their social network characteristics, caregiver strain, adolescents’ psychopathology and mental health service utilization, whereas adolescents self-reported their emotional status and ADHD stigma perceptions. Analyses were conducted using ANOVAs and nested logistic regression modeling. Results: Parents of youth with childhood ADHD reported support networks consisting of fewer spouses but more healthcare professionals, and lower levels of support than control parents. Caregiver strain increased with adolescent age and psychopathology. Increased parental network support, youth ADHD symptoms, and caregiver strain, but lower youth stigma perceptions were independently associated with increased service use. Conclusions: Raising children with ADHD appears to significantly impact parental social network experiences. Reduced spousal support and overall lower network support levels may contribute to high caregiver strain commonly reported among parents of ADHD youth. Parental social network experiences influence adolescent ADHD service use. With advances in social networking technology, further research is needed to elucidate ways to enhance caregiver support during ADHD care.
Okado, Yuko; Ewing, Emily; Rowley, Christina; Jones, Damon E
To inform efforts to reduce costly service utilization, the present study examined longitudinal trajectories of mental health-related outpatient and residential service use among at-risk youth with a history of early externalizing problems. A cohort of 809 children in the Fast Track Project, a multisite longitudinal study of children at risk for conduct disorder, were followed prospectively from kindergarten through 12th grade. They resided in high-risk areas with high rates of poverty, crime, and violence. Their outpatient and residential service use was assessed annually between sixth and 12th grades through parent report. Growth mixture modeling was applied to model individual differences in trajectories of service use during this period. Teacher, parent, and observer-reported childhood predictors of those trajectories were also examined. Most youths had minimal service use during preadolescence into adolescence. However, approximately 31% had moderate probability of using outpatient counseling services, and approximately 8% had elevated probability of seeing a family doctor for mental health needs. For residential services, approximately 6% had moderate to high probability of service use that peaked during transition to high school, whereas close to 5% had service use that dramatically increased during high school. Childhood predictors of these trajectories included earlier externalizing, internalizing, and emotion regulation problems. This study is the first to use person-centered analytic methods to examine longitudinal trajectories in mental health-related service use among at-risk adolescents. Timely treatment for severe externalizing problems, comorbid internalizing problems, and emotion dysregulation during childhood may be crucial for preventing chronic service use. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Beth S. Russell
Full Text Available Family intervention literature on adolescent parenting describes the pathways between outcomes for adolescent mothers and their children and the contexts of the pregnancy itself (e.g., poverty, low or no prenatal care, lower educational attainment. The aim of these descriptions is often to inform intervention designs that promote adaptive functioning for the child, the mother, and the dyad. Mental health services are an important component of many of these interventions; these services may be delivered by a clinician within the organization providing the intervention, or the organization may connect mothers with external mental health services in their communities. Using in-house clinicians rather than external providers may be beneficial by decreasing the high attrition rates common to this population. Although this service delivery approach is theoretically appealing, it has not been subject to rigorous empirical evaluation. In the current randomized study, we examine outcomes for teenage mothers based on two service delivery methods: Integrated Mental Health Services (IMHS and the Standard of Care (SoC which outsources clients’ mental health needs through community referrals. Information about the effectiveness of service delivery strategies can help program providers make decisions about how best to allocate limited funds to provide effective services.
Khansaheb, Hamda; Hussein, Ayman; Hamidi, Samer; Brown, David; Younis, Mustafa Z
The United Arab Emirate (UAE) of Dubai, faces significant adolescent health problems. In 2009, evidence based clinical guidelines were developed for primary health care professionals in Dubai to help reduce adolescent health problems. This research study explores adolescents' self-reports about health education services received between 2008 and 2010. The sample consisted of 730 public high school students in grades 10 through 12 between the ages of 15 and 19. 357 (48.9%) of the sample were males and 373 (51.1%) were female. The major language spoken in the home was Arabic (77.4%). All students completed a 27-item survey in Arabic that was adapted from the Young Adult Health Care Survey (YAHCS). The YAHCS is a 56-item research instrument traditionally administered in English and Spanish. The sample reported they had received little or no health education from their health care providers. 94.2% reported receiving no information about using a helmet for bicycle and motorbike safety; 88.2% reported receiving no information about drug use; and 81.9% reported that they received no information about smoking. The instrument also explored the health education material students received within the last 12 months. 65.5% of the sample reported seeing and/or hearing safety tips; 84.9% reported hearing and/or seeing health information about healthy diet, physical activity and exercise; and 79.2% reported seeing and/or hearing information about the risks of smoking and substance abuse.
Elvinia Pinilla G
Full Text Available Adolescents face different dilemmas, which may happen tobe not timely solved, pose major risks to health. Objective:To characterize the basic needs and expectations of maleadolescents in Bucaramanga, Colombia, from its perception with respect to services for sexual and reproductive health(SRH. Methodology: qualitative ethnographic study, using astrategy of discussion groups. We used informal discussions,interviews and focal point. Was selected by a conveniencesample of male adolescents in Bucaramanga, 2-6 strata, frompublic and private institutions, and school, between 13 and 18years, with a total of 52 participants and 7 focus groups.Results: Despite the cultural and socioeconomic differences,young people are consistent in their perceptions, needs andexpectations about sexuality and SRH services. The finalanalysis showed four categories: service experiences SSR, SSR ideal services, pornography and sexuality. Conclusions:It is apparent invisibility of the SSR and the perception ofunfavorable, from the experience of those who know her.Nevertheless, adolescents need to consider this type of service.This research leads to reflection on the ignorance of youngboys from their being, their feelings and their wish to be.
Black, Georgina; Roberts, Rachel M; Li-Leng, Tan
There is growing evidence in the literature which indicates that the prevalence of depression is similar in both non-metropolitan and metropolitan areas. However, it is generally perceived that factors associated with compromised mental health in rural residents include deprivation and lack of access to healthcare services. This study examines the relationship between depression and possible determinants of mental health among rural adolescents. The determinants identified were degree of remoteness, gender, socioeconomic status and the perception of rural community characteristics. Rural community characteristics examined were long waiting lists and lack of mental health professionals. Respondents were 531 South Australian adolescents (55.7% female) aged 13 to 18 years, living outside the Adelaide (state capital) metropolitan area. Respondents completed a questionnaire including: demographic questions; the Kutcher Adolescent Depression Scale (KADS); and questions regarding individual perceptions of community characteristics. The data were obtained by self-report, degree of remoteness was measured using the Accessibility and Remoteness Index of Australia Plus, and socio-economic status was determined from the Australian Bureau of Statistics (ABS) Socio-Economic Index of Relative Socio-Economic Advantage and Disadvantage (SEIFA). The rate of depression obtained from this sample of rural adolescents is concerning; 18% screened positive for depression on the KADS, 41% reported low mood much of the time or more often, and 20% experienced occasional or more frequent self-harm or suicidal thoughts, plans or actions. Depression was related to gender, with more females (23%) screening positive for depression than males (11.8%). Prevalence of depression was unrelated to degree of remoteness or the socioeconomic status of the participants. This finding is not consistent with other research that identifies socioeconomic status as a psychosocial determinant of mental health. It
Cheng, Tyrone C.; Lo, Celia C.
This research is a secondary data analysis of the impact of adolescents' mental/substance-use disorders and dual diagnosis on their utilization of drug treatment and mental health services. By analyzing the same teenagers who participated in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, logistic…
Callaghan, Jane Em; Fellin, Lisa Chiara; Warner-Gale, Fiona
Policy on Child and Adolescent Mental Health Services (CAMHS) in England has undergone radical changes in the last 15 years, with far reaching implications for funding models, access to services and service delivery. Using corpus analysis and critical discourse analysis, we explore how childhood, mental health and CAMHS are constituted in 15 policy documents, 9 pre-2010 and 6 post-2010. We trace how these constructions have changed over time and consider the practice implications of these changes. We identify how children's distress is individualised, through medicalising discourses and shifting understandings of the relationship between socio-economic context and mental health. This is evidenced in a shift from seeing children's mental health challenges as produced by social and economic inequities to a view that children's mental health must be addressed early to prevent future socio-economic burden. We consider the implications of CAMHS policies for the relationship between children, families, mental health services and the state. The article concludes by exploring how concepts of 'parity of esteem' and 'stigma reduction' may inadvertently exacerbate the individualisation of children's mental health.
Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise
The objectives of the study were: 1) to describe the choice of dental care system among 16-year-olds, 2) to describe the utilization of dental services among 16-17-year-olds enrolled in either public or private dental care systems, and to compare the dental services provided by the alternative...... systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88......% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (Pdental services were provided more frequently by the public than the private system (P
Goicolea, Isabel; Coe, Anna-Britt; San Sebastián, Miguel; Hurtig, Anna-Karin
Adolescent-Friendly Health Services (AFHSs) are those that are accessible, acceptable, equitable, appropriate and effective for different youth sub-populations. This study investigated the process through which four clinics in two countries - Peru and Ecuador - introduced, developed and sustained AFHSs. A multiple case study design was chosen, and data from each clinic were collected through document review, observations and informant interviews. National level data were also collected. Data were analysed following thematic analysis. The findings showed that the process of introducing, developing and sustaining AFHSs was long term, and required a creative team effort and collaboration between donors, public institutions and health providers. The motivation and external support was crucial to initiating and sustaining the implementation of AFHSs. Health facilities' transformation into AFHSs was linked to the broader organisation of country health systems, and the evolution of national adolescent health policies. In Peru, the centralised approach to AFHSs introduction facilitated the dissemination of a comprehensive national model to health facilities, but dependency on national directives made it more difficult to systemise them when ideological and organisational changes occurred. In Ecuador, a less centralised approach to introducing AFHSs made for easier integration of the AFHSs model.
Yassaee, Arrash A; Hargreaves, Dougal S; Chester, Kayleigh; Lamb, Stephanie; Hagell, Ann; Brooks, Fiona M
The aim of this study was to investigate adolescents' (11-15 years) experience of their general practitioner (GP), whether poor reported GP experience was associated with worse physical and mental health measures and whether poor previous GP experience was linked to lower utilization of these services. We used logistic regression to analyze data from the 2014 Health Behaviour in School-aged Children study. Four aspects of recent care experience were studied: feeling at ease, feeling treated with respect, satisfaction with doctor's explanation, and feeling able to discuss personal matters. Five dichotomized measures of health status were used: ever self-harmed; fair or poor self-reported health; frequent (at least weekly) low mood; sleeping problems; or headaches. Of 5,335 students, 4,149 reported having visiting their GP within the past year. Of these, 91.8% felt treated with respect, 78.7% felt at ease, 85.7% were satisfied with explanation, and 53.9% felt able to discuss personal matters. After adjusting for ethnicity, age, gender, and family affluence score, poor experience on any indicator was strongly associated with increased risk of self-harm (adjusted odds ratio range, 2.01-2.70; all p experience on all indicators, except discussing personal matters, was associated with worse self-reported health. Nearly half of this large, national study of adolescents did not feel able to discuss personal matters with their doctor. There was a consistent, strong association between reported lack of good GP experience and poor health measures. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
It is estimated that 20% of children experience psychological problems at any one time. 1 Child and adolescent mental health services (CAMHS) in Ireland are under-resourced. Recent economic downturn has hindered the possibility of increased funding to alleviative these deficits. It is now imperative that mental health professionals create innovative and cost effective solutions to promote positive mental health. Recent literature has focused on the benefits of self delivered parenting programmes, with minimal costs incurred. 2,3 Based on the developing evidence supporting self directed approaches, the Lucena Foundation has initiated a series of parent information evenings. These evenings are offered on a monthly basis, and are free to attend. To date 1,538 parents have attended. Feedback from parents has been very positive with 80.5% of them finding them useful or very useful.
Davoglio, Rosane Silvia; Aerts, Denise Rangel Ganzo de Castro; Abegg, Claídes; Freddo, Silvia Letícia; Monteiro, Lisiane
This was a cross-sectional study of 1,170 seventh-grade adolescents from the municipal public school system in Gravataí, Rio Grande do Sul State, Brazil, investigating the association between socio-demographic, psychosocial, and lifestyle factors and oral health habits and use of dental services. Data were analyzed by Cox regression, modified for cross-sectional studies. Females showed higher frequency of brushing, as did adolescents that reported not feeling alone or discriminated. Daily flossing was associated with higher socioeconomic status (SES), use of private dental services, parental understanding, and lack of feeling of loneliness. Frequency of annual dental visits was higher among individuals with higher SES. Preventive dental checkups were more frequent among individuals with higher SES, those who felt understood by their parents, and those who did not habitually eat candy. Oral health habits were associated with family SES and psychosocial factors except for frequency of annual dental visits. As for lifestyle, low candy consumption had a positive impact on reasons for use of dental appointments.
Full Text Available BACKGROUND: School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors. METHODS: Analyses are based on weighted data (N = 6483 from the United States National Comorbidity Survey Replication Adolescent Supplement (participants' age: 13-18 years. Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents. RESULTS: School mental health service use predicted subsequent out-of-school service utilization for mental disorders i in the medical specialty sector, in adolescents with affective (hazard ratio (HR = 3.01, confidence interval (CI = 1.77-5.12, anxiety (HR = 3.87, CI = 1.97-7.64, behavior (HR = 2.49, CI = 1.62-3.82, substance use (HR = 4.12, CI = 1.87-9.04, and eating (HR = 10.72, CI = 2.31-49.70 disorders, and any mental disorder (HR = 2.97, CI = 1.94-4.54, and ii in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17-4.56, behavior (HR = 1.99, CI = 1.29-3.06, and substance use (HR = 2.48, CI = 1.57-3.94 disorders, and any mental disorder (HR = 2.33, CI = 1.54-3.53, but iii not in the mental health specialty sector. CONCLUSIONS: Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders, thereby
Ms Marijeta Kurtin
Full Text Available BACKGROUND:Up to 20% of Australian adolescents experience the burden of having a mental health problem. Priorresearch has suggested that inhabitants of rural areas are at particular risk of mental healthmorbidity due to their location. The current study sought to investigate how ‘rurality’ influences themental health of adolescents in rural South Australia, and to explore the perceptions of the mentalhealth needs of adolescents as described by service providers in rural South Australia.METHODS:Four focus group discussions and 14 interviews were conducted with 38 human (allied health serviceproviders in the Eyre Peninsula, Spencer Gulf, Limestone Coast and Greater Green Triangle regions ofSouth Australia. Semi-structured telephone interviews were also conducted with three Victorianhuman service providers. Interviews were transcribed verbatim and analysed to identify emergentthemes.RESULTS:Ninety codes were developed and subsequently categorised into five major themes: Community andSociety Factors; Youth Issues, Indigeneity; Service Delivery and Utilisation; and Occupational Factors.Significant gaps in mental health service delivery were identified. Better utilisation of currentresources was identified as a greater concern than the absence of resources per se.CONCLUSIONS:This study provided a unique opportunity for rural allied and primary health care service providers todiscuss adolescent mental health issues in their communities and as part of their work. The datagenerated by these discussions identified areas where practice could be improved.
Full Text Available Abstract Background To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS. This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence. The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants with a target population of 633,725 subjects aged 0-17 years. Methods Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009, which were then analysed in detail. Results Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%. First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years
Full Text Available This paper presents results from a three-part study on diagnosis of children with affective and behavior disorders. We examined the reliability, discriminant, and predictive validity of common diagnoses used in mental health services research using a research diagnostic interview. Results suggest four problems: a some diagnoses demonstrate internal consistency only slightly better than symptoms chosen at random; b diagnosis did not add appreciably to a brief global functioning screen in predicting service use; c low inter-rater reliability among informants and clinicians for six of the most common diagnoses; and d clinician diagnoses differed between sites in ways that reflect different reimbursement strategies. The study concludes that clinicians and researchers should not assume diagnosis is a useful measure of child and adolescent problems and outcomes until there is more evidence supporting the validity of diagnosis.
Morsi Magdi M
Full Text Available Abstract Background Recent corpus of research suggests that psychiatric disorders amongst adolescents and youths are an emerging global challenge, but there is paucity of studies exploring health services utilization by this age group in Arab region. Aim This study focus on the health services utilization and the barriers among school going adolescents and youths with DSM IV disorders in the country Oman, whose population is predominantly youthful. Methods Representative sample of secondary school Omani adolescents and youths were concurrently interviewed for the (i presence of DSM IV mental disorders using the face-to-face interview, World Mental Health-Composite International Diagnostic Interview (WMH-CIDI, (ii tendency for health care utilization and (iii predictors of utilization with clinical and demographic background. Results The proportions of lifetime cases having ever made treatment contact are low, being 5.2% for any anxiety disorder and 13.2% for any mood disorder category. None of these anxiety cases made treatment contact in the year of onset of the disorder, and the median delay when they eventually made treatment contact is about 14 years. In any mood disorders category only 3.6% made contact within the 1st year of onset with the median delay in initial treatment contact is two years for the Bipolar disorder (broad, four years for Any Mood disorder and nine years for the Major Depressive Disorder group. Male gender is significantly associated with less likelihood of making treatment contact when suffering from Social phobia (p = 0.000, Major Depressive Disorder (p = 0.000 and Bipolar Disorder (p = 0.000. The younger cohorts of 14-16 years and 17-18 years of Social phobic made significantly less lifetime any treatment contact (p = 0.000. The 14-16 year olds were significantly less likely to make lifetime any treatment contact for Bipolar Mood disorder (p = 0.000, while the 17-18 group were 1.5 times more likely to do so. Over past
Willoughby, Jessica Fitts
Sexual health text message services are becoming increasingly popular, but little is known about who uses such services and why. This project details the implementation of a campaign promoting a state-wide sexual health text message service that allows teens to text directly with a health educator and uses a mixed method design to assess who uses the service, what motivates use, and potential barriers to using the service. A theory of information seeking through text messaging is posited based on previous information seeking and communication theory and tested with adolescents. A social marketing campaign was created promoting a North Carolina sexual health text message service and conducted in six middle and high schools in the North Carolina Piedmont region in Fall 2012. More than 2000 students in four schools completed online questionnaires that assessed awareness of the service, perceptions, and use. Focus groups and in depth interviews were then conducted with middle and high school students. Results indicate teens who are sexually active and in relationships are more likely to use the service. A teens' level of uncertainty about sexual health influences affect, which in turn leads adolescents to assess various information options. Positive attitudes toward the service and credibility perceptions are direct predictors of intentions to use. Efficacy was found to be an indirect predictor, working through credibility perceptions to influence intentions to use. Although teens may have an interest in using the service, there are barriers associated with use. Survey findings and qualitative results indicate that teens are interested in using a sexual health text message service, but perceived costs, fear of parents finding out about service use, and a lack of understanding of how to use the service were barriers for some teens. This study has implications for sexual health text message services, especially those that allow teens to connect directly with a health
Edbrooke-Childs, J H; Gondek, D; Deighton, J; Fonagy, P; Wolpert, M
Sessional monitoring of patient progress or experience of therapy is an evidence-based intervention recommended by healthcare systems internationally. It is being rolled out across child and adolescent mental health services (CAMHS) in England to inform clinical practice and service evaluation. We explored whether patient demographic and case characteristics were associated with the likelihood of using sessional monitoring. Multilevel regressions were conducted on N = 2609 youths from a routinely collected dataset from 10 CAMHS. Girls (odds ratio, OR 1.26), older youths (OR 1.10), White youths (OR 1.35), and youths presenting with mood (OR 1.46) or anxiety problems (OR 1.59) were more likely to have sessional monitoring. In contrast, youths under state care (OR 0.20) or in need of social service input (OR 0.39) were less likely to have sessional monitoring. Findings of the present research may suggest that sessional monitoring is more likely with common problems such as mood and anxiety problems but less likely with more complex cases, such as those involving youths under state care or those in need of social service input.
Conger, Katherine J.
Objective Children and adolescents living in rural communities may be at particular risk for psychiatric problems, yet factors associated with mental health service use in these populations are not clear. This study examined the role of father warmth in offspring psychological treatment utilization in community sample of rural families (n = 298). Methods Observer ratings of paternal warmth were examined as a predictor of adolescent treatment seeking and as a moderator of the longitudinal association between adolescent depressive symptoms and treatment seeking. Results Paternal warmth was a marginally significant predictor of adolescent mental health service use. The association between adolescent depressive symptoms and treatment seeking varied as a function of paternal behavior; adolescents were more likely to seek needed help in the context of a warm, supportive father. Conclusions These findings suggest that fathers can play an important role in the intrafamilial processes through which rural adolescents recognize and seek help for their psychological problems. PMID:21586425
Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela
Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people’s access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers’ mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people’s efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689
Machekano, Rhoderick; Chideme, Memory; Muchuchuti, Cephas; Mushavi, Angela; Mahomva, Agnes; Guay, Laura
Background: Age-disaggregated analyses of prevention of mother-to-child transmission (PMTCT) program data to assess the uptake of HIV services by pregnant adolescent women are limited but are critical to understanding the unique needs of this vulnerable high-risk population. Methods: We conducted a retrospective analysis of patient-level PMTCT data collected from 2011 to 2013 in 36 health facilities in 5 districts of Zimbabwe using an electronic database. We compared uptake proportions for PMTCT services between adolescent (≤19 years) and adult (>19 years) women. Multivariable binomial regression analysis was used to estimate the association of the women's age group with each PMTCT service indicator. Results: The study analyzed data from 22,215 women aged 12–50 years (22.5% adolescents). Adolescents were more likely to present to antenatal care (ANC) before 14 weeks of gestational age compared with older women [adjusted relative risk (aRR) = 1.34; 95% confidence interval: 1.22 to 1.47] with equally low rates of completion of 4 ANC visits. Adolescents were less likely to present with known HIV status (aRR = 0.34; 95% confidence interval: 0.29 to 0.41) but equally likely to be HIV tested in ANC. HIV prevalence was 5.5% in adolescents vs 20.1% in adults. While >84% of both HIV-positive groups received antiretroviral drugs for PMTCT, 44% of eligible adolescents were initiated on antiretroviral therapy vs 51.3% of eligible adults, though not statistically significant. Conclusions: Pregnant adolescents must be a priority for primary HIV prevention services and expanded HIV treatment services among pregnant women to achieve an AIDS-free generation in Zimbabwe and similar high HIV burden countries. PMID:28234687
Zubarew, Tamara; Correa, Loreto; Bedregal, Paula; Besoain, Carolina; Reinoso, Alejandro; Velarde, Macarena; Valenzuela, María Teresa; Inostroza, Carolina
The Adolescent Branch from Sociedad Chilena de Pediatría supports the implementation of planned programs for transition from child to adult health centers, oriented to adolescents with chronic diseases, in order to ensure an appropriate follow-up and a high-quality health care. Recommendations for care are set out in the FONIS and VRI PUC project carried out by the Division of Pediatrics of the Universidad Católica de Chile: Transition process from pediatric to adult services: perspectives of adolescents with chronic diseases, caregivers and health professionals, whose goal was to describe the experience, barriers, critical points, and facilitators in the transition process. Critical points detected in this study were: existence of a strong bond between adolescents, caregivers and the pediatric team, resistance to transition, difficulty developing autonomy and self-management among adolescents; invisibility of the process of adolescence; and lack of communication between pediatric and adult team during the transfer. According to these needs, barriers and critical points, and based on published international experiences, recommendations are made for implementation of gradual and planned transition processes, with emphasis on the design and implementation of transition policies, establishment of multidisciplinary teams and transition planning. We discuss aspects related to coordination of teams, transfer timing, self-care and autonomy, transition records, adolescent and family participation, need for emotional support, ethical aspects involved, importance of confidentiality, need for professional training, and the need for evaluation and further research on the subject.
Colognori, Daniela; Esseling, Petra; Stewart, Catherine; Reiss, Philip; Lu, Feihan; Case, Brady; Warner, Carrie Masia
Social anxiety disorder is highly prevalent in adolescence, persistent into adulthood, and associated with multiple impairments. Despite the development of efficacious treatments for socially anxious youth, few affected adolescents receive such treatment. This study examined service use in a sample of high school students (n = 1,574), as well as predictors of treatment delay and factors associated with adolescents’ disclosure of social difficulties. Self-report measures of social anxiety and ...
Cabral de Mello Meena
Full Text Available Abstract Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for
Svirydzenka, Nadzeya; Ronzoni, Pablo; Dogra, Nisha
Defining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders" understanding of the meaning of quality in the context of CAMHS. The study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24). Semi-structured interviews were used to collect data and thematic analysis was applied to explore participant's views on the meaning and measurement of quality and how these might reflect the IOM indicators and their relevance in CAMHS. An initial barrier to implementing quality care in CAMHS was the difficulty and limited agreement in defining the meaning of quality care, its measurement and implementation for all participants. Clinical staff defined quality as personal values, a set of practical rules, or clinical discharge rates; while patients suggested being more involved in the decision-making process. Commissioners, while supportive of adequate safeguarding and patient satisfaction procedures, did not explicitly link their view on quality to commissioning guidelines. Identifying practical barriers to implementing quality care was easier for all interviewees and common themes included: lack of meaningful measures, recourses, accountability, and training. All interviewees considered the IOM six markers as comprehensive and relevant to CAMHS. No respondent individually or within one stakeholder group identified more than a few of the indicators or barriers of a quality CAMHS service. However, the composite responses of the respondents enable us to develop a more complete picture of how to improve quality care in practice and guide future research in the area.
Gifty Apiung Aninanya
Full Text Available While many Ghanaian adolescents encounter sexual and reproductive health problems, their usage of services remains low. A social learning intervention, incorporating environment, motivation, education, and self-efficacy to change behaviour, was implemented in a low-income district of northern Ghana to increase adolescent services usage. This study aimed to assess the impact of this intervention on usage of sexual and reproductive health services by young people.Twenty-six communities were randomly allocated to (i an intervention consisting of school-based curriculum, out-of-school outreach, community mobilisation, and health-worker training in youth-friendly health services, or (ii comparison consisting of community mobilisation and youth-friendly health services training only. Outcome measures were usage of sexually-transmitted infections (STIs management, HIV counselling and testing, antenatal care or perinatal services in the past year and reported service satisfaction. Data was collected, at baseline and three years after, from a cohort of 2,664 adolescents aged 15-17 at baseline.Exposure was associated with over twice the odds of using STI services (AOR 2.47; 95%CI 1.78-3.42, 89% greater odds of using perinatal services (AOR 1.89; 95%CI 1.37-2.60 and 56% greater odds of using antenatal services (AOR 1.56; 95%CI 1.10-2.20 among participants in intervention versus comparison communities, after adjustment for baseline differences.The addition of targeted school-based and outreach activities increased service usage by young people more than community mobilisation and training providers in youth-friendly services provision alone.
Background According to World Health Organization, adolescents are people between 10 and 19 years of age; one-fifth of Ethiopian population constitutes adolescents and four-fifth live in rural areas. Local evidence about adolescents’ reproductive health knowledge, services utilization and associated factors are relevant to design age-appropriate program interventions and strategies. Hence, this study assessed the level of reproductive health knowledge and services utilization among rural adolescents in Machakel district, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted to assess the level of reproductive health knowledge and services utilization of rural adolescents in Machakel district. The study employed both quantitative and qualitative methods. A systematic random sampling technique was used to select 415 adolescents from eligible households. Data were collected using pre-tested structured questionnaires and in-depth interview guides. The data were entered into Epi Info and analyzed by SPSS software for windows. Univariate, bivariate and multivariate analyses were done. Result More than two-third (67%) of the adolescents had knowledge about reproductive health. Age (AOR = 3.77, 95% CI: 3.1-8.98), living arrangement (AOR = 2.21, 95% CI: 1.81-6.04) and economic status (AOR = 3.37, 95% CI: 1.65-6.87) were associated with reproductive health knowledge. However, only one-fifth (21.5%) of the adolescents had ever used reproductive health services including family planning, sexually transmitted infections treatment and information, education and communication. Reproductive health services utilization was significantly associated with age (AOR = 2.18, 95% CI: 1.13-8.03) and knowledge for reproductive health (AOR = 1.23, 95% CI: 1.23-4.21). Parent disapproval, lack of basic information and pressure from partners were found to deter adolescents from accessing and using reproductive health services. Conclusion
Full Text Available A financial grant was received from the World Health Organization (WHO during 1998 to establish whether adolescent mothers (aged 19 or younger at the birth of their babies utilized contraceptive, emergency contraceptive and termination of pregnancy (TOP services in the Republic of South Africa (RSA. This report refers to data obtained from 111 questionnaires completed by dolescent mothers between January 2000 and May 2000 in the Gauteng Province; 61 in the Pretoria and 50 in the Garankuwa areas, and excluding the 12 completed questionnaires used foi pretesting the research instrument. The biographic data of the 111 adolescent mothers indicated that the minority were married, employed or earned sufficient income to care for themselves and their babies. However, the minority used contraceptives prior to conception, none used emergency contraceptives or termination of pregnancy (TOP services. The minority attended ante-natal clinics five or more times during their pregnancies, and a negligible number indicated that they had ever been treated for sexually transmitted diseases (STDs. These findings indicate that the 111 adolescent mothers in Gauteng who participated in this survey did not make optimum use of the available reproductive health (RH care services. Education about sex, pregnancy and contraceptives should commence at the age of 10, but no later than the age of 12 as the majority of respondents did not have the necessary knowledge to make informed decisions about their futures. The accessibility of contraceptive, emergency contraceptive and TOP services for adolescents should be investigated in specific areas and attempts made to enhance such accessi- bility. This might necessitate offering these services over weeker| ds or during evenings when school girls could attend without fear of meeting their mothers, aunts or teachers at these clinics.
Tint, Ami; Weiss, Jonathan A; Lunsky, Yona
Girls and women in the general population present with a distinct profile of clinical needs and use more associated health services compared to boys and men; however, research focused on health service use patterns among girls and women with Autism Spectrum Disorder (ASD) is limited. In the current study, caregivers of 61 adolescent girls and women with ASD and 223 boys and men with ASD completed an online survey. Descriptive analyses were conducted to better understand the clinical needs and associated service use patterns of girls and women with ASD. Sex/gender comparisons were made of individuals' clinical needs and service use. Adolescent girls and women with ASD had prevalent co-occurring mental and physical conditions and parents reported elevated levels of caregiver strain. Multiple service use was common across age groups, particularly among adolescent girls and women with intellectual disability. Overall, few sex/gender differences emerged, although a significantly greater proportion of girls and women accessed psychiatry and emergency department services as compared to boys and men. Though the current study is limited by its use of parent report and small sample size, it suggests that girls and women with ASD may share many of the same high clinical needs and patterns of services use as boys and men with ASD. Areas for future research are discussed to help ensure appropriate support is provided to this understudied population. Autism Res 2017, 10: 1558-1566. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Belling, Ruth; McLaren, Susan; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim; Hovish, Kimberly; Islam, Zoebia; White, Sarah; Singh, Swaran P
To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS). Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services in four English NHS Mental Health Trusts and voluntary organisations. Data were analysed thematically using a structured framework. Findings revealed a lack of clarity on service availability and the operation of different eligibility criteria between child and adult mental health services, with variable service provision for young people with attention deficit hyperactivity disorder, autism spectrum disorders and learning disabilities. High workloads and staff shortages were perceived to influence service thresholds and eligibility criteria. A mutual lack of understanding of services and structures together with restrictive eligibility criteria exacerbated by perceived lack of resources can impact negatively on the transition between CAMHS and AMHS, disrupting continuity of care for young people. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
In May 2015 the UK elected a new government. In election campaigns, health is one of the most important areas of debate and over the preceding 12 months, the state of child and adolescent mental health services (CAMHS) had held a particularly high profile in the media and in political debate. Many had suggested that the rate of mental illness starting in adolescence is increasing and that service provision is not of sufficient quality or scale to meet this need. A brief review of the sources for these statistics reveals that whilst this may be true, there is a dearth of accurate and up to date data on the scale of the need for CAMHS or the extent to which it is being met. Nonetheless, members of all parties claimed to support improvements in mental health service provision for children and adolescents through increases in funding. A key question for policy makers has therefore become, from where any additional funding might be derived. One suggestion has been that funding be transferred from spending on adult mental health services. The exact practical nature of such a policy is yet to be explored in detail by government or stakeholders. The primary purpose of the present discussion is therefore to consider the possible ethical implications of such a policy in principle. The discussion forms part of a wider and evolving political and professional discourse on society's and government's attitude towards mental illness, towards the balance of individual and societal needs and towards the balance between preventative and supportive interventions to improve health.
Vandenbroeck, Philippe; Dechenne, Rachel; Becher, Kim; Eyssen, Marijke; Van den Heede, Koen
The prevalence of mental health problems among children and adolescents in Western countries is high. Belgium, like many other Western countries, struggles with the set-up of a coherent and effective strategy for dealing with this complex societal problem. This paper describes the development of a policy scenario for the organization of child and adolescent mental health care services (CAMHS) in Belgium. The development process relied on Soft Systems Methodology including a participatory process with 66 stakeholders and a review of the existing (inter-)national evidence. A diagnostic analysis illustrated that the Belgian CAMHS is a system in serious trouble characterized by fragmentation and compartmentalization. A set of 10 strategic recommendations was formulated to lay down the contours of a future, more effective CAMHS system. They focus on mastering the demands made on scarce and expensive specialized mental health services; strengthening the range of services - in particular for those with serious, complex and multiple mental health problems - and strengthening the adaptive capacity of and the ethical guidance within the future CAMHS system.
Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A
Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.
Hansen, I.; Foldspang, Anders; Poulsen, S.
Abstract –Objective: To evaluate the use of a national register for strategic management of dental health services for 0–17-year-old Danish children and to identify determinants for their use of the system as a strategic tool in management of the services. Methods: During the period December 1997......) the population and the socio-economic, cultural and political environment of the municipality; and 2) dental morbidity was collected as antecedent data from various official sources. Results: Seventy-seven percent of municipalities with public clinics and 68% of municipalities without public clinics used SCOR...... decreased from 1995 to 1996. Otherwise no associations between dental health and use of the system could be demonstrated. Conclusions: SCOR is widely used as a strategic planning instrument concerning the Danish dental services for children and adolescents. The predictors associated with its use are partly...
Full Text Available Abstract Background Although young people's transition from Child and Adolescent Mental Health Services (CAMHS to Adult Mental Health Services (AMHS in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods A questionnaire survey (Jan-April 2005 of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results Forty two of the 65 teams contacted (65% responded to the survey. Teams varied in type (generic/targeted/in-patient, catchment area (locality-based, wider or national and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37 was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33. In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in
Williams, Paula G; Holmbeck, Grayson N; Greenley, Rachel Neff
In this article, a biopsychosocial model of adolescent development is used as an organizing framework for a review of primary, secondary, and tertiary prevention research with adolescent populations. During adolescence many critical health behaviors emerge, affecting future disease outcomes in adulthood. In addition, most of the predominant causes of morbidity and mortality in adolescence are unique to this period of development, indicating that health-focused interventions must be tailored specifically to adolescents. Moreover, it is during adolescence that lifelong patterns of self-management of and adjustment to chronic health conditions are established. Thus, an increased focus on adolescence in health psychology research is important both to improve the health of adolescents per se and to optimize health trajectories into adulthood.
Dolan, Margaret A; Fein, Joel A
Emergency department (ED) health care professionals often care for patients with previously diagnosed psychiatric illnesses who are ill, injured, or having a behavioral crisis. In addition, ED personnel encounter children with psychiatric illnesses who may not present to the ED with overt mental health symptoms. Staff education and training regarding identification and management of pediatric mental health illness can help EDs overcome the perceived limitations of the setting that influence timely and comprehensive evaluation. In addition, ED physicians can inform and advocate for policy changes at local, state, and national levels that are needed to ensure comprehensive care of children with mental health illnesses. This report addresses the roles that the ED and ED health care professionals play in emergency mental health care of children and adolescents in the United States, which includes the stabilization and management of patients in mental health crisis, the discovery of mental illnesses and suicidal ideation in ED patients, and approaches to advocating for improved recognition and treatment of mental illnesses in children. The report also addresses special issues related to mental illness in the ED, such as minority populations, children with special health care needs, and children's mental health during and after disasters and trauma.
Hampanda, Karen; Ybarra, Michele; Bull, Sheana
Youth represent almost half of all new HIV infections globally. Although condom use is an effective method of HIV prevention among sexually active youth in sub-Saharan Africa (SSA), they face substantial barriers in obtaining condoms in environments where adults hold attitudes condemning premarital sex. More research is needed to better understand the multitude of factors that affect SSA youths' behaviors regarding safe sex practices, including factors that may influence their ability to obtain condoms, and decisions to be tested for HIV. In this study of Uganda youth (n = 1503) from five secondary schools, logistic regression models highlight factors that influence perceptions regarding respect and confidentiality at health centers, condom acquisition, and HIV testing. Family support appears to be an especially important factor that affects youth perceptions about how they will be treated when seeking condoms and HIV testing. Condom acquisition and HIV-testing behaviors are also associated with peer influence, self-esteem, and demographic characteristics, such as age.
Van Lith, Lynn M.; Mallalieu, Elizabeth C.; Waxman, Aliza; Hatzhold, Karin; Marcell, Arik V.; Kasedde, Susan; Lija, Gissenge; Hasen, Nina; Ncube, Gertrude; Samuelson, Julia L.; Bonnecwe, Collen; Seifert-Ahanda, Kim; Njeuhmeli, Emmanuel; Tobian, Aaron A. R.
Background Voluntary medical male circumcision (VMMC) is a critical HIV prevention tool. Since 2007, sub-Saharan African countries with the highest prevalence of HIV have been mobilizing resources to make VMMC available. While implementers initially targeted adult men, demand has been highest for boys under age 18. It is important to understand how male adolescents can best be served by quality VMMC services. Methods and Findings A systematic literature review was performed to synthesize the evidence on best practices in adolescent health service delivery specific to males in sub-Saharan Africa. PubMed, Scopus, and JSTOR databases were searched for literature published between January 1990 and March 2014. The review revealed a general absence of health services addressing the specific needs of male adolescents, resulting in knowledge gaps that could diminish the benefits of VMMC programming for this population. Articles focused specifically on VMMC contained little information on the adolescent subgroup. The review revealed barriers to and gaps in sexual and reproductive health and VMMC service provision to adolescents, including structural factors, imposed feelings of shame, endorsement of traditional gender roles, negative interactions with providers, violations of privacy, fear of pain associated with the VMMC procedure, and a desire for elements of traditional non-medical circumcision methods to be integrated into medical procedures. Factors linked to effective adolescent-focused services included the engagement of parents and the community, an adolescent-friendly service environment, and VMMC counseling messages sufficiently understood by young males. Conclusions VMMC presents an opportune time for early involvement of male adolescents in HIV prevention and sexual and reproductive health programming. However, more research is needed to determine how to align VMMC services with the unique needs of this population. PMID:26938639
Michelle R Kaufman
Full Text Available Voluntary medical male circumcision (VMMC is a critical HIV prevention tool. Since 2007, sub-Saharan African countries with the highest prevalence of HIV have been mobilizing resources to make VMMC available. While implementers initially targeted adult men, demand has been highest for boys under age 18. It is important to understand how male adolescents can best be served by quality VMMC services.A systematic literature review was performed to synthesize the evidence on best practices in adolescent health service delivery specific to males in sub-Saharan Africa. PubMed, Scopus, and JSTOR databases were searched for literature published between January 1990 and March 2014. The review revealed a general absence of health services addressing the specific needs of male adolescents, resulting in knowledge gaps that could diminish the benefits of VMMC programming for this population. Articles focused specifically on VMMC contained little information on the adolescent subgroup. The review revealed barriers to and gaps in sexual and reproductive health and VMMC service provision to adolescents, including structural factors, imposed feelings of shame, endorsement of traditional gender roles, negative interactions with providers, violations of privacy, fear of pain associated with the VMMC procedure, and a desire for elements of traditional non-medical circumcision methods to be integrated into medical procedures. Factors linked to effective adolescent-focused services included the engagement of parents and the community, an adolescent-friendly service environment, and VMMC counseling messages sufficiently understood by young males.VMMC presents an opportune time for early involvement of male adolescents in HIV prevention and sexual and reproductive health programming. However, more research is needed to determine how to align VMMC services with the unique needs of this population.
Full Text Available Objectives. To examine whether age of First diagnosis, gender, psychiatric comorbidity, and treatment modalities (pharmacotherapy or psychotherapy at Child and Adolescent Mental Health Services (CAMHS moderate the risk of Adult Mental Health Services (AMHS utilization in patients diagnosed with hyperkinetic disorder at CAMHS. Methods. Data were derived from the Madrid Psychiatric Cumulative Register Study. The target population comprised 32,183 patients who had 3 or more visits at CAMHS. Kaplan-Meier curves were used to assess survival data. A series of logistic regression analyses were performed to study the role of age of diagnosis, gender, psychiatric comorbidity, and treatment modalities. Results. 7.1% of patients presented with hyperkinetic disorder at CAMHS. Compared to preschool children, children and adolescents first diagnosed with hyperkinetic disorder at CAMHS were more likely to use AMHS. Female gender and comorbidity with affective disorders, schizophrenia, schizotypal and delusional disorders increased the risk of use of AMHS. Pharmacological or combined treatment of hyperkinetic disorder diagnosed at CAMHS was associated with increased risk of use at AMHS. Conclusions. Older age of first diagnosis, female gender, psychiatric comorbidity, and pharmacological treatment at CAMHS are markers of risk for the transition from CAMHS to AMHS in patients with hyperkinetic disorder diagnosed at CAMHS.
Full Text Available The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5 years. The majority (82.7% was between 6 and 17 years of age, and 50.3% were males. The majority (76.6% was Australian-born and spoke English at home (89.1%. The overall mean DMFT was 1.0 (SD: 2.1 teeth, with a mean dmft of 3.16 (SD: 5.79 teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
Full Text Available Background. Despite the frequency of traumatic or stressful events experienced by refugee children and adolescents prior to migration and following resettlement, the majority do not experience mental health problems emphasising the critical nature of resilience. While a host of factors deemed to be protective of mental health in young refugees have been identified, there has been little research exploring the role of resilience as a distinct psychological construct. This study aimed to explore the nature of psychological resilience in refugee adolescents and the relationship between resilience and depression, other emotional and behavioural problems, and mental health service uptake. Method. One hundred and seventy multiethnic refugee adolescents aged 13–17 from South Australia were administered a survey comprising the Connor-Davidson Resilience Scale (CD-RISC, Children’s Depression Inventory (CDI, and Strengths and Difficulties Questionnaire (SDQ. Results. Females tended to have higher resilience, as did those adolescents who had been living in Australia longer. Adolescents suffering from depressive symptoms or other emotional or behavioural problems had lower resilience. There was little evidence of an association between resilience scores and exposure to trauma or service utilisation. Discussion. Fostering resilience may be critical to efforts to prevent or reduce mental health problems in refugee adolescents.
Nguyen, Tram; Embrett, Mark G; Barr, Neil G; Mulvale, Gillian M; Vania, Diana K; Randall, Glen E; DiRezze, Briano
Optimizing the transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) is a priority for healthcare systems. The purpose of this systematic review is to: (1) identify and compare models of care that may be used to facilitate the transition from CAMHS to AMHS; and (2) discuss trends and implications to inform future research and practice. Results identified three models of care which move beyond healthcare services and incorporate a broader range of services that better meet the dynamic needs of transition-aged youth. Joint working among providers, coupled with individualized approaches, is essential to facilitating continuity of care.
Ashley Wilder Smith
Full Text Available Introduction: Cancer for adolescents and young adults (AYA differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under- or inadequately served by current support services, which may affect health-related quality of life (HRQOL.Methods: We examined unmet service needs and HRQOL in the National Cancer Institute’s Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE study, a population-based cohort (n=484, age 15-39, diagnosed with cancer 6-14 months prior, in 2007-2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical and health insurance variables.Results: Over one-third of respondents reported at least one unmet service need. The most common were financial (16%, mental health (15%, and support group (14% services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p’s<0.0001. Specific unmet services were related to particular outcomes (e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p’s<0.001. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains.Discussion: Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental
Joffe, A; Radius, S M
Health counseling is a fundamental aspect of health care for adolescents and is a natural extension of the concept of anticipatory guidance. It is a dynamic process involving active participation by adolescents. Pediatricians are a valued source of health-relevant information, but must also recognize how their attitudes and beliefs can affect the counseling process. Knowledge of the multitude of changes occurring during adolescence and an understanding of the role of health-risking behaviors in meeting various developmental needs are critical to successful counseling. Particular attention must be focused on ways to help adolescents develop the skills necessary to maintain health-promoting lifestyles and to resist peer pressure to engage in health-risking behaviors.
Tøt-Strate, Simone; Dehlholm-Lambertsen, Gitte; Lassen, Karin
AIM: Functional somatic symptoms (FSS) are common in paediatric patients who are referred to Child and Adolescent Mental Health Service (CAMHS), but little is known about current referral practices. The aim of this study was to systematically investigate clinical features of paediatric inpatients...... with FSS referred to CAMHS and to describe why paediatricians referred them. METHODS: The study population comprised 60 children with FSS admitted to a large Danish paediatric department during 2012. We compared medical record data on the clinical characteristics and paediatric management of 16 children...... who had been referred and 44 children who had not. RESULTS: Most paediatric records lacked information on psychosocial factors and symptoms. Referred children were significantly more multisymptomatic of FSS (p
Pallesen, Ulla; van Dijken, Jan W.V.; Halken, Jette
Objectives: the aim of the study was to investigate reasons for replacement and repair of posterior resin composite (RC) restorations placed in permanent teeth of children and adolescents attending Public Dental Health Service in Denmark. Material and method: all posterior RC placed consecutively...
Full Text Available BackgroundThe acceptability of Child and Adolescent Mental Health Services (CAMHS to Indigenous peoples is little studied. There has been a lack of evaluation tools able to take account of the more holistic approach to the attainment of mental health that characterises Māori, the Indigenous population of Aotearoa (New Zealand. This study aimed to develop such an instrument and establish some of its psychometric properties. Then, to use the measure to establish whānau (family or caregiver views on desirable CAMHS characteristics.MethodA self-administered survey, Te Tomokanga, was developed by modifying a North American questionnaire, the Youth Services Survey for Families (YSS-F. The intent of the tool was to record whānau experiences and views on service acceptability.The Te Tomokanga survey is unique in that it incorporates questions designed to examine CAMHS delivery in light of the Whare Tapa Whā, a Māori comprehensive model of health with a focus on whānau involvement and culturally responsive services. This mail or telephone survey was completed by a cohort of 168 Māori whānau. Their children had been referred to one of the three types of CAMHS, mainstream, bicultural, and kaupapa Māori, of the District Health Board (DHBs in the Midland health region, Aotearoa. The Midland health region is an area with a large Māori population with high levels of social deprivation.ResultsThe Te Tomokanga instrument was shown to have a similar factor structure to the North American questionnaire from which it had been derived. It identified issues relevant to Māori whānau satisfaction with CAMHS. The work supports the concept that Māori desire therapeutic methods consistent with the Whare Tapa Whā, such as whānau involvement and the importance of recognising culture and spirituality.The participants were generally positive about the services they received from the three different CAMHS types, which shows good acceptability of CAMHS for
Crespi, Tony D.; Hughes, Tammy L.
Adolescents are in crisis in school, home, and in the community. With an increasing array of problems, from alcohol and drug addiction to teenage pregnancy, the nation's youth are facing difficult challenges. In particular, family problems experienced by adolescents alone can seem daunting, with such issues as divorce, abuse, and discord changing…
Skinner, Harvey; Biscope, Sherry; Poland, Blake; Goldberg, Eudice
.... To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents...
Karow, A; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Lambert, M
Numerous birth-control studies, epidemiological studies, and observational studies investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use of children, adolescents and young adults is low, even lower than in adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the border of child and adolescent and adult psychiatry. Emerging studies show that these health care structures are effective and efficient. Part 2 of the present review focuses on illness burden including disability and costs, deficits of the present health care system in Germany, and efficacy and efficiency of early intervention services. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Abstract Background Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a to identify differences in psychosocial adjustment and health-related quality of life (HRQoL among adolescents and young adults with parents suffering from palliative cancer or cancers in other disease stages, b to relate psychosocial adjustment and health-related quality of life to adolescent coping, and c to explore significant mediator and predictor variables. Methods Cross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45, 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis. Results Adolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390 and HRQoL (R2adj =.239 best. Conclusion The study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning.
Grizzard, Tarayn; González, Electra; Sandoval, Jorge; Molina, Ramiro
Reproductive and sexual health (RSH) education is a key component of most family planning programs around the world and is particularly important for adolescents, for whom parenthood is more likely to have difficult or dangerous health outcomes. A lack of comprehensive RSH education targeted at adolescents may augment the poor outcomes associated with early pregnancy by creating barriers to optimal care. This article discusses the creation of the Centro de Medicina Reproductiva y Desarrollo Integral de la Adolescencia clinic, a comprehensive adolescent reproductive health center in Santiago de Chile, and its RSH education programs. In particular, the role of the physician in originating and leading the RSH education efforts, the controversy associated with RSH education in Chile, and the effects of comprehensive RHS education on the local and regional adolescent populations are discussed.
Full Text Available Abstract Background High prevalence rates for rheumatoid arthritis, spondyloarthopathies, and systemic lupus erythematosus have been described in American Indian and Alaskan Native adults. The impact of these diseases on American Indian children has not been investigated. Methods We used International Classification of Diseases-9 (ICD-9 codes to search two Indian Health Service (IHS patient registration databases over the years 1998–2000, searching for individuals 19 years of age or younger with specific ICD-9-specified diagnoses. Crude estimates for disease prevalence were made based on the number of individuals identified with these diagnoses within the database. Results Rheumatoid arthritis (RA / juvenile rheumatoid arthritis (JRA was the most frequent diagnosis given. The prevalence rate for JRA in the Oklahoma City Area was estimated as 53 per 100,000 individuals at risk, while in the Billings Area, the estimated prevalence was nearly twice that, at 115 per 100,000. These rates are considerably higher than those reported in the most recent European studies. Conclusion Chronic arthritis in childhood represents an important, though unrecognized, chronic health challenge within the American Indian population living in the United States.
Willoughby, Jessica Fitts
Sexual health text message services are becoming increasingly popular, but little is known about who uses such services and why. This project details the implementation of a campaign promoting a state-wide sexual health text message service that allows teens to text directly with a health educator and uses a mixed method design to assess who uses…
Myers, Kathleen M; Palmer, Nancy B; Geyer, John R
Over the past decade telepsychiatry, and more broadly telemental health (TMH), services with children and adolescents have been implemented with diverse populations in many geographic areas across the United States. The feasibility and acceptability of child and adolescent TMH have been well demonstrated, but little research exists on the efficacy and effectiveness of TMH in improving the mental health care and outcomes for underserved youth. This article summarizes the state of research in child and adolescent telemental health TMH and examines studies in other areas of telemedicine that may inspire and guide child and adolescent telepsychiatrists to collect data on the process and outcomes of their own work.
Westwood, Michael; Pinzon, Jorge
Although adolescent males have as many health issues and concerns as adolescent females, they are much less likely to be seen in a clinical setting. This is related to both individual factors and the health care system itself, which is not always encouraging and set up to provide comprehensive male health care. Working with adolescent boys involves gaining the knowledge and skills to address concerns such as puberty and sexuality, substance use, violence, risk-taking behaviours and mental health issues. The ability to engage the young male patient is critical, and the professional must be comfortable in initiating conversation about a wide array of topics with the teen boy, who may be reluctant to discuss his concerns. It is important to take every opportunity with adolescent boys to talk about issues beyond the presenting complain, and let them know about confidential care. The physician can educate teens about the importance of regular checkups, and that they are welcome to contact the physician if they are experiencing any concerns about their health or well-being. Parents of preadolescent and adolescent boys should be educated on the value of regular health maintenance visits for their sons beginning in their early teen years.
van Gent, Tiejo; Goedhart, Arnold W; Treffers, Philip D A
In this study socio-demographic, deafness-related and diagnostic characteristics of hearing impaired children and adolescents referred to a national mental health service for deaf and hard of hearing children and adolescents were examined. Socio-demographic and diagnostic characteristics were compared to corresponding characteristics of hearing referred peers with identified mental health problems. The difference in characteristics between them and hearing referred peers with identified mental health problems was analyzed. A total of 389 deaf and hard of hearing and 3361 hearing children and adolescents was extracted from a database, all first referrals of patients of a center for child and adolescent psychiatry over a 15-year period. With deaf and hard of hearing patients we found higher rates of environmental stress, as indicated by conditions such as more one parent families (38.6% versus 25.8%), and more parents with a low educational level (44.2% versus 31.1%). Moreover, deaf and hard of hearing patients were older at their first referral (10.8 versus 9.4 years) and had higher rates of pervasive developmental disorders (23.7% versus 12.3%) and mental retardation (20.3% versus 3.9%). Within the target group of deaf and hard of hearing patients, most patients were deaf (68.9%; 22.3% was severely hard of hearing), relatively few (13.7%) had a non-syndromal hereditary hearing impairment, and more (21.3%) had a disabling physical health condition, especially those with a pervasive developmental disorder (42.6%). These findings illustrate both the complexity of the problems of deaf and hard of hearing children and adolescents referred to specialist mental health services, and the need for preventive interventions aimed at early recognition.
Alexander, H. M.
In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.
Kulyk, Olga Anatoliyivna; Roskam, R.V.; David, Silke; van Veen, M.; van Gemert-Pijnen, Julia E.W.C.
Background: More and more adolescents primarily use online resources and mobile applications to find the answers on all kinds of questions about sexual health, such as first time sex, sexually transmitted infections (STD), pregnancy prevention and so on. Current Dutch national program for improving
Kulyk, O.; Roskam, V. R.; David, S.; van Veen, M.; Gemert-Pijnen, van J.E.W.C.
Background: More and more adolescents primarily use online resources and mobile applications to find the answers on all kinds of questions about sexual health, such as first time sex, sexually transmitted infections (STD), pregnancy prevention and so on. Current Dutch national program for improving
McKenzie, Karen; Murray, George C.; Prior, Seamus; Stark, Lynda
An evaluation of a Scottish secondary school-based counselling service for students aged 11 to 18 is presented. Improvement in student emotional well-being was measured using the Young Persons Clinical Outcomes for Routine Evaluation (YP CORE) questionnaire and participant questionnaires which were developed for the study. Significant improvements…
Oh, Jean-Yin; Rajasegaran, Kumudhini
The introduction of adolescent medicine as a medical subspecialty in Singapore was a welcome in an evolving health care system that is unique in terms of both efficiency, in financing and the results achieved in community health outcomes. The Ministry of Health (MOH) already recognized the need to accommodate the health care concerns related to adolescent psychosocial health risk behaviors and an increased prevalence of young people living with chronic illness. The challenge for the pioneer team of physicians trained in adolescent medicine was to develop and sustain a model of care that integrated (i) core clinical services that include quality measures of care to adolescents; (ii) professional development and capacity building needing an expansive teaching agenda at every level of health education; (iii) strong inter-sectorial collaborations within hospital and community partners; and (iv) robust research and evaluation strategies that keep clinical practice relevant and evidence based.
Anyon, Yolanda; Whitaker, Kelly; Shields, John P.; Franks, Heather
Background: This article examines whether school contextual factors, such as referral practices and peer dynamics, contribute to Chinese American students' underrepresentation in school health programs. Methods: Data from the 2007 Youth Risk Behavior Survey (N?=?1,744) as well as interviews and focus groups (N?=?51) with Chinese American users and…
Ram Bilas Jain
Full Text Available Context: 'Adolescence' is a period of substantial change and hence associated with the risk of many health-related problems. Teachers and grass-root level health service providers i.e. multi-purpose health workers (female/male are one of the key stakeholders who are to understand and respond to adolescent needs. Aims: To assess knowledge level regarding changes in adolescence among teachers and multi-purpose health workers. Settings and Design: It was a cross-sectional study conducted in rural block in the field practice area attached to Department of Community Medicine, Pt BD Sharma PGIMS Rohtak (India. Materials and Methods: All the 49 multi-purpose health workers (male and female [ie., MPHW (M and F] who were working in the study area are those posted at the sub centers, Primary Health Centers, or Community Health Centers for more than six months were included in the study. In addition, four large schools with strength of more than 250 students (two girls and two boys/co-ed Senior Secondary Schools were randomly selected by lottery technique. All the 94 teachers who were involved in teaching the classes 9-12 in those schools were included in the study. Data were collected on predesigned, pre-tested and semi-structured schedules by conducting face-to-face interviews while maintaining the confidentiality of the responses. Statistical analysis used: Proportions, chi-square test. Results and Conclusion: 68/94 (72.3% teachers were able to mention at least one sexual change which occur in adolescents. Among the sexual changes, menarche was the most common change familiar to the teachers. 48/49 (97.96% workers were aware of at least one sexual change. Behavioral changes (emotional/social changes were the ones which are least conversant to both health workers 10/49 (20.4% and the teachers 24/94 (25.5%.
Klein, J D; Graff, C A; Santelli, J S; Hedberg, V A; Allan, M. J.; Elster, A. B.
OBJECTIVE: To demonstrate the feasibility of directly surveying adolescents about the content of preventive health services they have received and to assess the validity of adolescent self-reported recall. DATA SOURCES/SETTING: Audiotaped encounters, telephone interviews, and chart reviews with 14-21 year olds being seen for preventive care visits at 15 pediatric and family medicine private practices, teaching hospital clinics, and health centers. DESIGN: 537 adolescents presenting for well v...
Jacobs, Myrthe; Downie, Helen; Kidd, Gill; Fitzsimmons, Lorna; Gibbs, Susie; Melville, Craig
Background: Children and young people with learning disabilities experience high rates of mental health problems. Methods: The present study reviewed the literature on mental health services for children with learning disabilities, to identify known models of service provision and what has been experienced as effective or challenging in providing…
Nair, M K C; Chacko, D S; Indira, M S; Siju, K E; George, Babu; Russell, P S
Adolescents can have mental, emotional, and behavior problems that are a source of stress for the child as well as the family, school and community. These may disrupt the adolescent's ability to function normally. Adolescents also have reproductive concerns especially at menarche. Considering the extent of problems of adolescents and the lack of adolescent care and counseling services, it was felt that community adolescent care counseling services should be made available. This article describes the steps involved in the setting up of Taluk model of adolescent care and counseling services. Following steps were involved in setting up a Taluk model of adolescent care counseling service delivery system. Step I: Focus Group Discussions (FGDs) among Stakeholders. Step II: Conceptualization and Strategy planning for service delivery. III: Finalization of service delivery model Step IV: Workshops for finalization of TSQ-T 2008 version the tool to be used for assessing the adolescents in the ARSH clinics. Step V: Training Programme for Medical/Paramedical health staff. Step VI: Awareness programs for mothers of adolescents. Step VII: Setting up of ACS/ARSH clinics at Taluk hospitals. Step VIII: Evaluation of the utilization of services at Taluk hospitals. The clinic has been well utilized with 1,588 adolescents being seen in 2 years. Medical and Reproductive problems among adolescent girls were anemia, underweight, dysmenorrhoea, menstrual irregularities and symptoms of Polycystic Ovarian Syndrome, whereas among boys problems were mostly related to concerns about masturbation and its perceived ill effects. The psychosocial problems ranged from minor anxieties, sadness and adjustment problems to psychiatric disorders. Scholastic problems included poor concentration, poor study habits and low intelligence quotient. The success of the clinics in these five hospitals can be replicated in other parts of the state as well as the country. These will go a long way to ameliorate
Ascione, Flora; Cascone, Diana; Napolitano, Francesco; Di Giuseppe, Gabriella
The objectives of this investigation are to evaluate the use of health care services for non-communicable disease and prevention by children and adolescents and to identify the factors linked to the use of health care services. This cross-sectional survey was conducted between December 2014 and January 2015 among 1198 parents of students aged between 5 and 18 years attending 12 selected schools in the geographic area of Salerno and Naples, Italy, using a self-administered questionnarie. 68.2% of parents stated that had visited their general practitioner (GP) or family pediatrician (FP) with their child in the last year. 66.2% of children had had at least one visit to a specialist and more than half (54.8%) had had preventive care visits in the last year. The use of preventive care visits within last year was significantly higher amongst female, among those who had visited their GP or FP and among those who had a parent with a college degree or higher. The proportion of emergency department visits and hospital admissions reported were 12.8% and 4.7% respectively. This results highlights the need of educational interventions for parents and adolescents in order to increase the utilization of preventive health services.
Gloff, Nicole E; LeNoue, Sean R; Novins, Douglas K; Myers, Kathleen
Most children and adolescents across the USA fail to receive adequate mental health services, especially in rural or underserved communities. The supply of child and adolescent psychiatrists is insufficient for the number of children in need of services and is not anticipated to grow. This calls for novel approaches to mental health care. Telemental health (TMH) offers one approach to increase access. TMH programmes serving young people are developing rapidly and available studies demonstrate that these services are feasible, acceptable, sustainable and likely as effective as in-person services. TMH services are utilized in clinical settings to provide direct care and consultation to primary care providers (PCPs), as well as in non-traditional settings, such as schools, correctional facilities and the home. Delivery of services to young people through TMH requires several adjustments to practice with adults regarding the model of care, cultural values, participating adults, rapport-building, pharmacotherapy and psychotherapy. Additional infrastructure accommodations at the patient site include space and staffing to conduct developmentally appropriate evaluations and treatment planning with parents, other providers, and community services. For TMH to optimally impact young people's access to mental health care, collaborative models of care are needed to support PCPs as frontline mental health-care providers, thereby effectively expanding the child and adolescent mental health workforce.
Shrivastava, Saurabh Rambiharilal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh
Mental health is an integral and essential component of health. The World Health Organization (WHO) constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." More than 450 million people suffer from mental disorders worldwide. In India, mental health services, especially for children and adolescents, are limited both in terms of number of facilities as well as trained professionals. The majority of mental health services are restricted to urban areas, that is, medical colleges or regional mental health institutes. Mere presence of a treatment facility does not guarantee that all children/adolescents suffering from mental illness will utilize such services. In fact, most of the time there is a significant delay from the patient side in accessing mental health services either because of lack of awareness or associated stigma. It is high time to promote positive mental health in children, adolescents and their parents through health education. Parental counseling is of utmost importance in order to avoid the delay in treatment seeking.
In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.
Bains, Ranbir Mangat; Diallo, Ana F.
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…
Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.
Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…
AbdulKarim Said Al Makadma
Full Text Available This review article documents the evidence regarding the health status of adolescents aged between 10 and 19 years in the Arab region and the Gulf Cooperation Council countries (GCC and also considers the state of adolescent health care in the region compared to the recommended guidelines for such services. Adolescents make up more than 25% of the population of the GCC countries, a percentage that is far higher than that in other high-income countries, yet their health status and health care needs are not given proportional attention in the region. Thus, the burden of mortality and morbidity for adolescents in the region has shifted from communicable diseases to road traffic injuries, mental health issues, non-communicable diseases, and health-compromising behaviors and conditions that contribute to those issues. Whereas the sources of evidence are limited with respect to some issues, such as mental health issues, sexual and reproductive health, and alcohol use, other health issues, such as rising rates of tobacco use, low levels of physical activity, minimal consumption of fruit and vegetables, and high levels of obesity, are better-documented. Many health care providers see adolescents who have limited or no training in adolescent health care and adolescents who are transitioned to the adult care system at young ages without the necessary health care transition services, thus creating challenges for these individuals to access developmentally appropriate health care. Recommendations include prioritizing health care practice, health care facilities, clinical education, and adolescent health research to address key aspects of adolescent health and adolescent medical care in the GCC countries. This could be accomplished through the development of adolescent health care centers that bring together expert interdisciplinary care, excellent health provider training, and cutting-edge adolescent health research to provide leadership throughout the
Ahmet Reşit Ersay
Full Text Available In Turkey, one out of five person belonging to 10-24 age group, is at risk concerning reproductive health. Topics related to the reproductive health, are neither discussed within the family or society, nor within the educational system. Adolescents, who have to experience sexual intercourse with insufficient and incorrect knowledge, have to face with sexually transmitted diseases (STD, teenage pregnancy, abortion and other problems as a consequence of this experience. Research on this area has showed that both adolescents and young adults, especially health personnel, requested training on reproductive health. In terms of planning health services effectively, these topics should be evaluated carefully in Turkey. In this research, reproductive health regarding adolescents and young adults is examined under the four headings of sexual experience, STD, use of protection and productivity. As a result, depending on all the cultural restrictions and health service limitations, it is observed that adolescents and young adults experience sexual relationship with an inadequate knowledge and consequently, they have to face with problems. Within this context, it is suggested to expand the reproductive health educational programmes involving family, school and society within long term.
Full Text Available With the Westernization and opening of our society, adolescents’ smoking is increasing and being popularized. Many adolescents start smoking at an early age out of curiosity and venturesomeness, and earlier start of smoking makes it more difficult to quit smoking. Adolescents’ habitual smoking not only becomes a gateway to all kinds of substance abuse but also causes various health problems including upper respiratory infection, immature lung development, reduced maximum vital capacity, and lung cancer. Therefore, it is quite important to prevent adolescents from smoking. The lowering of adolescents’ smoking rate cannot be achieved only through social restrictions such as stereotyped education on the harms of smoking and ID checking. In order to lower adolescents’ smoking rate substantially, each area of society should develop standardized programs and make related efforts. As adolescents’ smoking is highly influenced by home environment or school life, it is necessary to make efforts in effective education and social reinforcement in school, to establish related norms, and to execute preventive education using peer groups. When these efforts are spread throughout society in cooperation with homes and communities, they will be helpful to protect adolescents’ health and improve their quality of life.
Since the 1950s, a significant amount of work has been done on behalf of the comprehensive health of young people in South America. This article focuses on the regional process of training health professionals to work with this age group. There are countries in which the growth of adolescent health training has been significant, others that have made progress but still have a narrower offer of teaching activities, and a few where only very basic and limited training is available. Latin American professional associations, scientific societies, and international organizations have also contributed to the education of the adolescent health work force. Although the training in the region has advanced in some countries to the point that there is specialization in adolescent medicine, much remains to be done. Certain regional conditions have contributed to the education of providers in adolescent care. The most important has been the existence of professionals who have been highly motivated to improve the health of young people. They have worked very hard and with great commitment to achieve this goal. There have also been important obstacles to educating professionals in adolescent care. Aside from the usual lack of funding, barriers have existed in the health care system and its providers, as well as the training entities and because of certain South American conditions. Finally, this article describes the regional adolescent medicine programs and the status of recognition of this specialty, and addresses the opportunities and challenges for adolescent health training.
Tsai, Meng-Che; Chou, Yen-Yin; Lin, Shio-Jean; Lin, Sheng-Hsiang
To identify health needs, preferred sources of health information and associated factors in Taiwanese adolescents. Cross-sectional questionnaire-based survey conducted in Taiwanese adolescents aged 12-18 years in 2010. Adolescents were queried about their health needs, healthcare service utilisation and preferred sources of health information. We compared differences in reported health needs and available sources among gender groups and grade levels. Demographic correlates of adolescent health needs were further examined using multiple ordinal logistic regression analysis. Participants (n=5018) needed weight and height information most, followed by dietary health advice. Academic stress was emphasised more than behavioural issues. Perceived needs for health information varied by age and gender. General high school programme, suburban location and chronic illness were associated with higher need. Only a small proportion (4.3%) of adolescents used healthcare services for mental and emotional concerns. Parents were the primary sources of health information, although students also turned to teachers, particularly for sensitive issues. Moreover, the mass media and internet were increasingly popular sources of information. To achieve continuous care from childhood through adolescence to adulthood, paediatricians should understand adolescents' diverse views of health needs and preferred sources of health information. Several demographic variables were shown to influence their health needs, reflecting the East Asian cultural context. Anticipatory guidance on body image, dietary health and academic stress should be emphasised while caring for these adolescents. We therefore advocate the development and effective delivery of culturally relevant adolescent-friendly health services.
Müller, Alexandra; Röhrs, Stefanie; Hoffman-Wanderer, Yonina; Moult, Kelley
South Africa's legal framework on sexual and reproductive health (SRH) care for teenagers is complex. On the one hand, the law protects their right to make decisions regarding reproduction--e.g. giving girls of any age the right to terminate a pregnancy, and allowing adolescents to consent to receive contraception from age 12. On the other hand, the Sexual Offences Act sets the age of consent to sex at 16 years, and requires mandatory reporting of anyone younger. These contradictory obligations mean that nurses, doctors and counsellors are expected to provide care, and counsel teenagers about their choices, but also report and enforce the law. They must therefore make judgments about inherently moral issues: should teenagers be having sex, and what services should they receive? Based on in-depth interviews at 28 healthcare facilities conducted in 2012, and data from workshops on the 'conflicting laws' held in 2014, the paper uses the theoretical framework of street-level bureaucracy to understand barriers to nurses providing SRH care for teenagers in South Africa, and the implication that this has for adolescents' SRH. The paper argues that nurses' adaptation of the law is a response to significant structural constraints, moral discomfort, and poor understanding of the law--all taken against an ethical framework that emphasizes quality, responsive patient care. The result is uneven implementation that undermines SRH information, access to services, and ultimately increases risks for teens.
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Ameri, Cinzia; Fiorini, Fulvio
The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.
Maria Conceição O Costa
Full Text Available OBJETIVO: Avaliar a qualidade técnico-científica do atendimento oferecido a adolescentes, gestantes adolescentes e seus filhos, por um serviço de saúde. MÉTODOS: Os dados para caracterização da clientela e dos critérios do atendimento de saúde foram coletados de 360 prontuários e comparados com padrões da Organização Panamericana da Saúde/Organização Mundial da Saúde e do Ministério da Saúde. RESULTADOS: Os resultados foram satisfatórios: no atendimento de adolescentes, na avaliação antropométrica e de maturação sexual; no pré-natal, o intervalo entre consultas, os registros de peso e de pressão arterial e as condutas nas intercorrências; no atendimento a crianças: na inserção precoce no serviço, o calendário vacinal atualizado, os registros de peso/desenvolvimento motor e a adequação nas condutas clínicas. Os resultados menos satisfatórios foram: baixo registro de condutas clínicas para adolescentes e elevado percentual de condutas inadequadas ou parcialmente adequadas; ingresso tardio ao pré-natal e baixa freqüência de registros de imunização antitetânica de gestantes; índices elevados de desmame precoce e sub-registro da estatura de crianças. CONCLUSÃO: O tipo de avaliação adotado é de fácil execução, permite avaliar a qualidade do atendimento prestado e possibilita o redirecionamento de atividades e condutas clínicas, no sentido de oferecer uma atenção à saúde mais qualificada e voltada às necessidades e demandas da população.OBJECTIVE: To evaluate the technical and scientific quality of care provided adolescents, pregnant adolescents and their offspring by the Emaús community's health service in Belém, state of Pará, Brazil, between 1994 and 1996. METHODS: Data for population and health care assessment were collected from medical records and compared with the PAHO/WHO and Brazilian Ministry of Health guidelines. RESULTS: The following features were satisfactory: anthropometric
Hansen, I.; Foldspang, Anders; Poulsen, S.
) the population and the socio-economic, cultural and political environment of the municipality; and 2) dental morbidity was collected as antecedent data from various official sources. Results: Seventy-seven percent of municipalities with public clinics and 68% of municipalities without public clinics used SCOR......-tables for planning purposes and preventive intervention. Forty percent reported data for all age groups to the SCOR-system and 36% used non-obligatory special codes in order to monitor more specific questions. Use of SCOR data was positively associated with the dental health services being organized in public...
Vicki A Nejtek
Full Text Available Vicki A Nejtek, Sarah Hardy, Scott WinterUniversity of North Texas Health Science Center, Fort Worth, TX, USAAbstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient’s mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother’s actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.Keywords: adolescent, suicide, maternal treatment noncompliance, maternal neglect
Ungar, Michael; Liebenberg, Linda; Dudding, Peter; Armstrong, Mary; van de Vijver, Fons J. R.
Background: Very little research has examined the relationship between resilience, risk, and the service use patterns of adolescents with complex needs who use multiple formal and mandated services such as child welfare, mental health, juvenile justice, and special educational supports. This article reports on a study of 497 adolescents in…
School health services reduce absenteeism and improve academic achievement according to research. If you have school-aged children, youâll want to listen to this podcast to learn more about healthy school environments and the link between health and academic achievement. Created: 9/13/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 9/13/2017.
Full Text Available Abstract Background There has been a considerable increase in the need for psychiatric services for adolescents. Primary health care practitioners have a major role in detecting, screening and helping these adolescents. An intervention entitled SCREEN is described in this article. The SCREEN intervention was developed to help practitioners to detect and screen adolescent needs, to care for adolescents at the primary health care level and to facilitate the referral of adolescents to secondary care services in collaboration between primary and secondary health care. Secondly, the article presents the background and clinical characteristics of youths seeking help from the SCREEN services, and compares the background factors and clinical characteristics of those patients referred and not referred to secondary care services. Methods The SCREEN intervention consisted of 1 to 5 sessions, including assessment by a semi-structured anamnesis interview, the structured Global Assessment Scale, and by a structured priority rating scale, as well as a brief intervention for each adolescent's chosen problem. Parents took part in the assessment in 39% of cases involving girls and 50% involving boys. During 34 months, 2071 adolescents (69% females entered the intervention and 70% completed it. The mean age was 17.1 years for boys and 17.3 years for girls. Results For 69% of adolescents, this was the first contact with psychiatric services. The most common reasons for seeking services were depressive symptoms (31%. Self-harming behaviour had occurred in 25% of girls and 16% of boys. The intervention was sufficient for 37% of those who completed it. Psychosocial functioning improved during the intervention. Factors associated with referral for further treatment were female gender, anxiety as the main complaint, previous psychiatric treatment, self-harming behaviour, a previous need for child welfare services, poor psychosocial functioning and a high score in the
... Ordering Information Printed Publications Birth, Death, Marriage and Divorce Certificates Government Printing Office Bookstore How to Order ... This Page Key findings Approximately 4% of adolescents aged 12â17 have a serious emotional or ...
Jaruseviciene, Lina; Zaborskis, Apolinaras; Sauliune, Skirmante
BACKGROUND: In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. This study sets out to explore changes in Lithuanian residents' attitudes towards confidentiality protection in adolescent sexual...... was employed to estimate absolute differences in prevalence of belief in whether or not adolescents would find confidentiality important when consulting a physician on SRH issues. A log-binomial regression model was fitted to estimate the relative changes (prevalence ratio) of the independent variables....... RESULTS: The total number of respondents was 1054 (response rate 83%) in 2005 and 1002 (response rate 80%) in 2012. The proportion of respondents who reported a belief that adolescents would find confidentiality important when seeing a physician for SRH issues increased significantly from 62% in 2005...
Martin, Anne-Marie; Fishman, Roza; Baxter, Laura; Ford, Tamsin
There is tension within Child and Adolescent Mental Health Services (CAMHS) assessments between the richness of differing practitioner's perspectives and maintaining a basic level of assessment that is acceptable to all disciplines. Standardized assessments are mandatory in research, yet are rarely applied systematically across CAMHS.The use of standardized assessments in routine practice might aid the allocation of families to the practitioners best able to meet their needs and free up time for intervention. However, practitioners' attitudes towards standardized assessment will dictate the success of such an approach. Fifty practitioners working in two CAMHS completed semi-structured interviews that explored their attitudes towards the use of standardized assessments in clinical practice, which were analysed using thematic analysis. Practitioners could identify both advantages and disadvantages of the routine use of standardized assessment. While they valued standardization, opportunities for service organization and increased information, some expressed concerns related to the choice, accuracy and influence of measures, as well as labelling. Almost one-third complained about their lack of pre-registration training in working with children, let alone their assessment. Practitioners, clinicians and policy makers need to consider these issues if they wish to introduce standardized assessments into routine practice. Senior staff need to be aware how unskilled some junior practitioners feel when they start working in CAMHS and offer appropriate support and supervision.
Van Hoof, Thomas J; Sherwin, Tierney E; Baggish, Rosemary C; Tacy, Peter B; Meehan, Thomas P
Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism for addressing their students' mental health needs. Understanding that need requires data to guide the services and programs a school may put in place. Having data helps inform those services, and comparative data from other schools provides feedback and perspective. This project surveyed type and frequency of mental health problems experienced by students who received a formal evaluation at 11 private schools in Connecticut during academic year 2001-2002.
English, Abigail; Ford, Carol A; Kahn, Jessica A; Kharbanda, Elyse Olshen; Middleman, Amy B
Vaccines currently recommended for adolescents by the Advisory Committee on Immunization Practices have the potential to improve the health of youth by preventing conditions such as: tetanus, pertussis, meningococcal disease, influenza, and genital warts, as well as later adult outcomes such as cervical and other human papillomavirus-related cancers. Adolescent vaccine coverage lags behind that for younger age groups. A requirement to obtain parental consent for vaccination can present a significant barrier to improving adolescent vaccine uptake across all health care settings in which adolescents access care. The ability of minors to consent to vaccination can influence whether adolescents receive indicated vaccines during adolescent health care visits when parents are absent and when adolescents are seen for confidential services. State laws govern consent for the delivery of health care to minors. All states have some laws that allow minors to consent to health care based either on their status or on the services they are seeking. Some of these laws would allow them to consent to vaccination. It is the Position of the Society for Adolescent Health and Medicine that, within ethical and legal guidelines, it will be important to develop strategies that maximize opportunities for minors to receive vaccinations when parents are not physically present, including opportunities for them to give their own consent.
Laurie Schwab Zabin
@@ The field of reproductive health has had long experience negotiating challenging environments in ways that other health fields have not -- perhaps because other health fields usually deal with illness which everyone agrees is not a good thing. Or maybe because we have all been born, we all think we know something about reproduction. Whatever the reason,we have over the years seen bitter political and ideological debates over population and family planning, abortion, the treatment of HIV/AIDS, in vitro fertilization, new contraceptive technologies--and now adolescent reproductive health. We shouldn't be surprised.But just as we have had to prevail in those debates in the past, they are crucial today: the numbers of young people entering their reproductive years throughout the world, especially the developing world, make it essential that youth be reached not only with messages and services crafted in the last 40 years but also with new messages, new ideas and new services.
De Sanctis, V; Filati, G; Fiscina, B; Marsciani, A; Piacentini, G; Timoncini, G; Reggiani, L; Zucchini, A
The purpose of this mini-review is to present the National Health System and services available for adolescents in Italy, and to review the most relevant data on morbidity and mortality in Italian teens. Adolescent medicine in Italy is not a separate speciality, but there are some distinct services for adolescents in paediatric departments or gynaecologic wards, mostly in large cities where university hospitals or hospital of national relevance are located. Primary health care in Italy is provided mainly by general practitioners (GPs) and pediatricians, and on-call physicians (Guardia Medica) for after-hours medical care and services. The number of centres providing care for adolescents in Italy is 4097 (50% of these are in the North of Italy, 20% in the Central regions and 20% in the South and Islands). The population of Italy on January 1st 2011 was approximately 60,477,881 and the number of adolescents, aged 10 to 19 years, was 6,214,000. The most frequent causes of death in adolescents are motor vehicle accidents - more than half of which are related to drug or alcohol use - followed by cancer and suicide. In primary care, adolescents present with a large number of issues, particularly upper respiratory infections, musculoskeletal problems, pain syndromes, obesity, eating disorders, dermatological issues, mood and somatoform disorders, school and mental health problems, and chronic fatigue, many of which require a coordinated, multidisciplinary management approach. The estimated population with a chronic illness is 8%. There are no specific protocols for the transition to adult medicine physicians for patients with chronic diseases or special health needs. In order to improve the quality and quantity of education in adolescent health for paediatricians and GPs, the Study Group of Emilia and Romagna Region for Adolescent Health Care (SGA-ER) is going to organize, beginning in 2012, a two year educational intervention course in adolescent health.
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...... a discursive approach in order to develop a conceptual framework for understanding the social values of health service robots. First a discursive approach is proposed to develop a typology of conceptions of health service robots. Second, a model identifying four basic conceptions of health service robots...
Lee, Matthew T.; Pagano, Maria E.; Johnson, Byron R.; Post, Stephen G.
This article is one of the first to examine the relationships among a specific combination of ?spiritual virtues? (helping others and the experience of divine love) and outcomes related to criminal involvement, sobriety, and character development among adolescents. One-hundred ninety five adolescents with substance dependency court-referred to residential treatment were assessed at intake, discharge, and 6 months post-treatment. Higher service to others predicted reduced recidivism, reduced r...
Opportunities and limitations for using new media and mobile phones to expand access to sexual and reproductive health information and services for adolescent girls and young women in six Nigerian states.
Akinfaderin-Agarau, Fadekem; Chirtau, Manre; Ekponimo, Sylvia; Power, Samantha
Reproductive health problems are a challenge affecting young people in Nigeria. Education as a Vaccine (EVA) implements the My Question and Answer Service, using mobile phones to provide sexual and reproductive health (SRH) information and services. Use of the service by adolescent girls and young women is low. Focus group discussions were held with 726 females to assess their access to mobile phones, as well as the barriers and limitations to the use of their phones to seek SRH information and services. Results demonstrate high mobile phone access but limited use of phones to access SRH information and services. Barriers to use of these services include cost of service for young female clients, request for socio-demographic information that could break anonymity, poor marketing and publicity, socio-cultural beliefs and expectations of young girls, individual personality and beliefs, as well as infrastructural/network quality. It is therefore recommended that these barriers be adequately addressed to increase the potential use of mobile phone for providing adolescent and young girls with SRH information and services. In addition, further initiatives and research are needed to explore the potentials of social media in meeting this need.
... brain. Decades of imaging work have led to remarkable insight and a more than a few surprises. ... sponsored by the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, to ...
Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Bravender, Terrill; Davis, J. Kelly; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Shields, Cleveland G.
Importance Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. Objective To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Design, Setting, and Participants Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Main Outcomes and Measures Total time per visit during which sexuality issues were discussed. Results One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant
Alexander, Stewart C; Fortenberry, J Dennis; Pollak, Kathryn I; Bravender, Terrill; Davis, J Kelly; Ostbye, Truls; Tulsky, James A; Dolor, Rowena J; Shields, Cleveland G
Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Total time per visit during which sexuality issues were discussed. RESULTS One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥ 36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥ 36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant associations between adolescent, physician, and visit characteristics were
Mendes, Neuza; Palma, Fátima; Serrano, Fátima
As adolescent pregnancy and sexually transmitted infections (STIs) are major sources of morbidity, preventing them is an important health goal for Portuguese society. To review data on the knowledge, attitudes and statistics on sexual and reproductive health. A systematic review was conducted including peer-reviewed articles addressing issues influencing the sexuality of Portuguese adolescents (aged 13 to 19), published up to 2011 and conducted in any type of setting. After crossing-cleaning the reference list, 33 articles were included. The rate of sexual activity by Portuguese adolescents is high (44%-95%), but there has been an increase in the age of intercourse debut (currently 15.6 years). Early commencement of sexual intercourse is associated with smoking and regular alcohol consumption. Condoms are the most frequently chosen contraceptive method for first (76%-96%) and subsequent (52%-69%) sexual encounters. The perception of a double standard in sex still exists in teenage culture for both genders and influence behavior. There are significant differences between migrant and native adolescents: African adolescents initiate sexual intercourse at earlier ages and are more likely to have unprotected sex. Only one-third of Portuguese teenagers have ever visited a health facility to seek counseling concerning contraception or STIs, and less than half have ever attended classes on reproductive health. Very few (12%) have knowledge about Chlamydia trachomatis infection. The prevalence of STIs in Portuguese youth is unknown. The adolescent fertility rate is still high (14.7 births per 1000 females aged 15-19 years), but it, as well as the rate of abortion, is steadily decreasing. There is still a long way to go towards promoting a resourceful young population. Citizens and institutions must focus on increasing both the competence of youths and external supports. Information must be provided systematically and health services must have greater accessibility. Studies
A brief consultation and advice (BCA) approach to dealing with routine referrals was introduced into a child and adolescent mental health service (CAMHS) over an 18-month period. This is a time-limited, client-centred and solution-focused approach to dealing with common non-complex referrals. The model proposes that all families are seen for an initial \\'consultation\\' appointment followed by a maximum of two further appointments. A randomized controlled study compared the clinical effectiveness of BCA treatment with treatment as usual (TAU) over a 6-month period. The parents of children referred to CAMHS were eligible to participate if their child was deemed \\'non-complex\\'. Ethical approval was granted by the relevant ethics committee. Families who consented to participate in the study were randomly allocated to either the BCA or TAU group. Sixty children enrolled in the study. Both groups showed improvements on a number of variables at 3 months post treatment, but only those receiving BCA showed continued improvement at 6 months. Participants in both groups showed high levels of satisfaction with the treatment received. Participants in the TAU group expressed dissatisfaction with long waiting times and had a higher drop out rate than the BCA treatment group. During the time frame studied, the introduction of the BCA approach did not lead to a decrease in overall mean waiting time. These results and the usefulness of a BCA model are discussed.
Lee, Matthew T; Pagano, Maria E; Johnson, Byron R; Post, Stephen G
This article is one of the first to examine the relationships among a specific combination of "spiritual virtues" (helping others and the experience of divine love) and outcomes related to criminal involvement, sobriety, and character development among adolescents. One-hundred ninety five adolescents with substance dependency court-referred to residential treatment were assessed at intake, discharge, and 6 months post-treatment. Higher service to others predicted reduced recidivism, reduced relapse, and greater character development. Experiencing divine love enhanced the effect of service on recidivism. Greater attention to spiritual virtues might improve treatment for youth involved with alcohol, drugs, and certain forms of crime.
Full Text Available AiM: This study was planned as a descriptive study in order to investigate risky health behaviors of immigrant and non immigrant adolescents. METHODS: The study was performed in a high school situated Izmir between the dates of October and November 2008. Sample group of this research was included 293 immigrant and 813 non immigrant adolescents. Data were collected by using Socio-demographic question form and and Health Risk Behaviors Scale. Data were collected from students with a technical pencil-paper by researcher in classroom. Frequencies, one way anova (post-hoc bonferroni and independent t test were used with Stastical Package for Social Science 13.0 program for statistical analysis of data. Written consent was taken from Izmir Directorate of Education to carry out the study. Oral consent was taken from the school manager and the students. RESULTS: Mean age of adolescents was 15.42+/-0.03. It was determined that risky health behaviors mean score (t: 2.161, p: 0.031 and physical activity (t: 2.132, p: 0.033, nutrition (t:3.030, p: 0.003, hygiene (t: 3.850, p: 0.000 sub-scales mean scores of immigrant adolescent were statistically higher than non immigrant adolescents (p<0.05. CONCLUSiONS: Consequently, this study was important to health professionals worked primary health services and school health services The study have significant data about migration affects on health behaviors of adolescent to show health professionals worked primary care and school health services and to plan health services towards adolescents. [TAF Prev Med Bull 2014; 13(4.000: 289-294
Midgley, Nick; Parkinson, Sally; Holmes, Joshua; Stapley, Emily; Eatough, Virginia; Target, Mary
The causal beliefs which adults have regarding their mental health difficulties have been linked to help-seeking behaviour, treatment preferences, and the outcome of therapy; yet, the topic remains a relatively unexplored one in the adolescent literature. This exploratory study aims to explore the causal beliefs regarding depression among a sample of clinically referred adolescents. Seventy seven adolescents, aged between 11 and 17, all diagnosed with moderate to severe depression, were interviewed using a semi-structured interview schedule, at the beginning of their participation in a randomised controlled trial. Data were analysed qualitatively using framework analysis. The study identified three themes related to causal beliefs: (1) bewilderment about why they were depressed; (2) depression as a result of rejection, victimisation, and stress; and (3) something inside is to blame. Although some adolescents struggled to identify the causes of their depression, many identified stressful life experiences as the cause of their current depression. They also tended to emphasise their own negative ways of interpreting those events, and some believed that their depression was caused by something inside them. Adolescents' causal beliefs are likely to have implications for the way they seek help and engage in treatment, making it important to understand how adolescents understand their difficulties.
Askeland, Kristin Gärtner; Haugland, Siren; Stormark, Kjell Morten; Bøe, Tormod; Hysing, Mari
School absenteeism is linked to a range of health concerns, health risk behaviors and school dropout. It is therefore important to evaluate the extent to which adolescents with absenteeism are in contact with health care and other services. The aim of the current study was to investigate service use of Norwegian adolescents with moderate and high absenteeism in comparison to students with lower rates of absence. The study employs data from a population-based study from 2012 targeting all pupils in upper secondary education in Hordaland County, Norway (the youth@hordaland-survey). A total of 8988 adolescents between the ages of 16 and 18 were included in the present study. Information on service use was based on adolescent self-report data collected in the youth@hordaland-survey. Absence data was collected using administrative data provided by the Hordaland County Council. High absence (defined as being absent 15% or more the past semester) was found among 10.1% of the adolescents. Compared to their peers with low absence (less than 3% absence the past semester), adolescents with high absence were more likely to be in contact with all the services studied, including mental health services (odds ratio (OR) 3.96), adolescent health clinics (OR 2.11) and their general practitioner (GP) (OR 1.94). Frequency of contact was higher among adolescents with moderate and high absence and there seems to be a gradient of service use corresponding to the level of absence. Still, 40% of the adolescents with high absence had not been in contact with any services. Adolescents with high absence had increased use of services, although a group of youth at risk seems to be without such contact. This finding suggests a potential to address school absenteeism through systematic collaboration between schools and health personnel.
Tahereh Ziaian; Helena de Anstiss; Georgia Antoniou; Peter Baghurst; Michael Sawyer
Background. Despite the frequency of traumatic or stressful events experienced by refugee children and adolescents prior to migration and following resettlement, the majority do not experience mental health problems emphasising the critical nature of resilience. While a host of factors deemed to be protective of mental health in young refugees have been identified, there has been little research exploring the role of resilience as a distinct psychological construct. This study aimed to explor...
Tahereh Ziaian; Helena de Anstiss; Georgia Antoniou; Peter Baghurst; Michael Sawyer
Background. Despite the frequency of traumatic or stressful events experienced by refugee children and adolescents prior to migration and following resettlement, the majority do not experience mental health problems emphasising the critical nature of resilience. While a host of factors deemed to be protective of mental health in young refugees have been identified, there has been little research exploring the role of resilience as a distinct psychological construct. This study aimed to explor...
Fruchter, Eyal; Beck-Fruchter, Ronit; Hourvitz, Ariel; Weiser, Mark; Goldberg, Shira; Fenchel, Daphna; Lerner-Geva, Liat
To evaluate the general health, mental health, and cognitive ability of assisted reproductive technology (ART)-conceived adolescents. A nested case-control study within a historic cohort. Not applicable. A total of 253 ART-conceived adolescents born between 1982 and 1993 and 253 matched references according to birth year, gender, and the high-school they attended. None. Medical and psychiatric diagnoses, and cognitive ability recorded at the military preinduction screening (ages 16-17 years) and doctor's appointments throughout the military service. No differences were detected in general and mental health of ART adolescents or cognitive ability, compared with the reference group. Similar results were obtained after stratification for gender and singleton births. The ART adolescents had fewer cases of discharge from military service due to health reasons (4% vs. 8.3%). Follow-up during the military service revealed that male ART adolescents had significantly more doctor's appointments compared with the reference group (23.80 ± 15.59 vs. 19.95 ± 13.79). Our preliminary results provide reassurance that in the long-run health and functioning of ART-conceived adolescents is not compromised. Further studies with larger cohorts are needed to confirm these results. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Aratani, Yumiko; Schwarz, Susan Wile; Skinner, Curtis
Adolescence is a critical period in the human lifecycle, a time of rapid physical and socioemotional growth and a time when individuals establish lifestyle habits and health behaviors that often endure into and have lasting effects in adulthood. Adolescent health promotion programs play a critical role in helping youth establish healthy lifestyles. In this article, we present a socio-ecological model as a framework for identifying effective policy and program areas that have a positive impact on adolescent health behaviors. Our discussion focuses on 4 key areas: reproductive health; obesity prevention; mental health and substance use, including smoking; and injury and violence prevention. We proceed with an overview of the current status of state-led adolescent health promotion policies and programs from a newly created policy database and then examine the evidence on the cost of preventable adolescent health problems and the cost-effectiveness of health promotion programs and policies. We conclude by discussing the threat posed to adolescent health promotion services and state-led policy initiatives by proposed and implemented federal and state-level budget cuts and examine the possible health and economic repercussions of reducing or eliminating these programs.
Sivagurunathan, C; Umadevi, R; Rama, R; Gopalakrishnan, S
Adolescence is a phase of rapid growth and development during which physical, physiological and behavioural changes occur. They constitute more than 1.2 billion worldwide, and about 21% of Indian population. Morbidity and mortality occurring in this age group is mostly due to preventable causes. Young and growing children have poor knowledge and lack of awareness about physical and psychological changes that occurs during adolescence and the ill health affecting them. Existing Adolescent health programmes focus on rendering services like immunization, health education for sexual and reproductive health, nutritional education and supplementation, anemia control measures and counseling. Adolescent health programmes are fragmentary at present and there is no comprehensive programme addressing all the needs of adolescents. Access and availability of health care services are severely limited. Lack of accurate information, absence of proper guidance, parent's ignorance, lack of skills and insufficient services from health care delivery system are the major barriers. Interventions should focus on providing psychological and mental health services and behaviour change communication towards leading a healthy lifestyle, restricting advertisement related to junk food products, awareness creation about reproductive and sexual health, educating parents to prevent early marriage, teenage pregnancy and to counsel their children on nutrition and reproductive health. Universal coverage of Adolescent friendly clinics is highly recommended. To be cost effective, all health services addressing adolescent should come under single programme. This review is intended to create awareness among the stakeholders about the importance of strengthening adolescent health services in order to meet their felt needs.
What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius, god of medicine, and Hygeia, goddess of hygiene and health, generated a dichotomy between disease and health that remains with us until today. The confusing substitution of Health Services with Medical Services began toward the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world with its model being adopted by many countries with resulting distortion of the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by their names and not deceive society. To correct the serious imbalance between Medical Services and Health Services, Hygeia and Asclepius must become a brother and sisterhood. PMID:24893062
Girard, Gustavo A
Although poverty is not a new phenomenon, currently it has peculiar characteristics: globalization, inequity, new features in education, exclusion, gender inequalities, marginalization of native peoples and migrations, difficulties found by different sectors to have access to technology, and unemployment. These characteristics are seen not only in countries considered to be developing nations, but affect the whole world. The present international financial crisis, this time originating in industrialized countries, represents an aggravating factor, the consequences of which are still difficult to estimate. It has a particular impact on adolescents and young people in terms of health as a whole, mortality rates, violence, nutrition, reproductive health, HIV/AIDS, substance abuse, mental health, and disabilities, all being aggravated by the difficulties of access to ap propriate health services. Social capital is seriously affected, and this entails a strong and deleterious impact not only on present generations but also on future ones. It is a challenge that cannot be ignored.
a young girl's body, high rates of unintended ... often drop out and only a few return after .... had lower rates of virological suppression than ... Department for Children, Schools and Families, Department of Health, Royal College of Midwives.
Full Text Available Background: The German statutory health insurance (GKV reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK, individual health services (IGeL are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions: The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL? What ethical, social, and legal aspects are related to IGeL? For two of the most common IGeL, the screening for glaucoma and the screening for ovarian and endometrial cancer by vaginal ultrasound (VUS, the following questions are addressed: What is the evidence for the clinical effectiveness? Are there sub-populations for whom screening might be beneficial? Methods: The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. Results: 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by
Champion, Jane Dimmitt; Pierce, Sherrie; Collins, Jennifer L
Obesity impacts the physical and psychological health of children and adolescents, and is a risk factor for development of episodic and chronic illness. Rural Mexican-American adolescents are at risk for obesity and associated chronic illnesses.The study used a retrospective chart review of data collected routinely in a rural health clinic setting from 1 January 2005 to 31 December 2010 to assess incidence of overweight/obesity status and episodic or chronic illness among Mexican-American adolescents aged 12-18 years. Analyses included body mass index, age, gender, and episodic or chronic illness diagnoses. Two hundred twelve charts were audited; women (n = 114, 53.8%), men (n = 98 46.2%); normal (n = 105, 49.5%), overweight/obese (n = 107, 50.5%). There were more female normal (n = 61, 53.5%) vs. overweight/obese (n = 53, 46.5%). More male overweight/obese (n = 54, 55.1%) than normal weight (n = 44, 44.9%). Age at first documented overweight/obesity status occurred in early adolescence (median = 13 years, mode = 12 years). Chronic illness incidence was higher among men than women, and overweight/obese vs. normal weight adolescents and in sub-categorizations by weight and specific illness. Incidence of episodic illness was higher among women than men, with variation by weight and specific illness. Disproportionately high incidence of episodic or chronic illness and overweight/obesity identified among rural Mexican-American adolescents compels intervention modification to improve effectiveness. © 2014 Wiley Publishing Asia Pty Ltd.
As abstract reasoning increases in complexity, adolescents may face dissonance between new thoughts and prior beliefs. Students in the health professions may be forced to resolve these dissonances in order to execute their professional responsibilities. In developing an undergraduate interdisciplinary course on adolescent health, the authors anticipated challenges in teaching adolescents about adolescence. Over the course of the semester, the anticipated challenges became reality. The author discusses pertinent developmental theories and their application in facilitating late adolescent identity formation and professional role development.
Crutzen, Rik; De Nooijer, Jascha
Mental health problems are highly prevalent among adolescents, but a majority of adolescents is reluctant to seek help at mental health services because of shame and lack of anonymity. Intervening via chat (i.e. offering online support) could be a solution to remove these barriers and to reach adolescents. The dimensions of the RE-AIM model (reach, efficacy, adoption, implementation and maintenance) served as a guiding principle for discussing the potential of offering online support via chat. It appeared that the use of chat may be an appropriate way to reach adolescents and may have a positive impact on outcome measures related to mental health. Additional efforts are needed to stimulate adoption at the individual level (target group, intermediaries) and the organizational level. Future research needs to focus on the dissemination of chat-based interventions, differences between online peer support and online professional support, and the content of conversations via chat about mental health problems.
MacKay, Andrea P.; Duran, Catherine
This report presents data on the current status of adolescent health. Many of the measures of health status are shown by single year of age or by 2- or 3-year age intervals to highlight the changes that occur in health status as adolescents move through this important developmental period. Summary measures combining 5- or 10-year age groups (the…
Brown, E F; Hendee, W R
During adolescence, teenagers are expected to develop standards of behavior and reconcile them with their perceptions of adult standards. In this context, music, a powerful medium in the lives of adolescents, offers conflicting values. The explicit sexual and violent lyrics of some forms of music often clash with the themes of abstinence and rational behavior promoted by adult society. Identification with rock music, particularly those styles that are rejected by adults, functions to separate adolescents from adult society. Some forms of rock music extend well beyond respectability in fulfilling this definitional role. Total immersion into a rock subculture, such as heavy metal, may be both a portrait of adolescent alienation and an unflattering reflection of an adolescent's perception of the moral and ethical duplicity of adult society. Physicians should be aware of the role of music in the lives of adolescents and use music preferences as clues to the emotional and mental health of adolescents.
Sawyer, Susan M; Afifi, Rima A; Bearinger, Linda H; Blakemore, Sarah-Jayne; Dick, Bruce; Ezeh, Alex C; Patton, George C
Adolescence is a life phase in which the opportunities for health are great and future patterns of adult health are established. Health in adolescence is the result of interactions between prenatal and early childhood development and the specific biological and social-role changes that accompany puberty, shaped by social determinants and risk and protective factors that affect the uptake of health-related behaviours. The shape of adolescence is rapidly changing-the age of onset of puberty is decreasing and the age at which mature social roles are achieved is rising. New understandings of the diverse and dynamic effects on adolescent health include insights into the effects of puberty and brain development, together with social media. A focus on adolescence is central to the success of many public health agendas, including the Millennium Development Goals aiming to reduce child and maternal mortality and HIV/AIDS, and the more recent emphases on mental health, injuries, and non-communicable diseases. Greater attention to adolescence is needed within each of these public health domains if global health targets are to be met. Strategies that place the adolescent years centre stage-rather than focusing only on specific health agendas-provide important opportunities to improve health, both in adolescence and later in life.
Jones, Diana L; Heflinger, Craig Anne; Saunders, Robert C
This paper presents an ecological-community model toward the explanation of variation in patterns of substance abuse (SA) service utilization among adolescents who are enrolled in Tennessee's Medicaid program (TennCare). Guided by a theoretical framework that draws from the social ecology work of Bronfenbrenner and health services utilization models promoted by Aday and Andersen, we apply a social indicators approach toward explaining the impact of community ecology on identification of SA and treatment engagement. Both county-level rates and individual-level treatment utilization are examined and hierarchical linear modeling is incorporated to examine the individual-in-community phenomenon. This study is an expansion of previous service utilization research and suggests that explanations of youth's service utilization must necessarily include not only individual, familial, and service system characteristics, but community factors, as well.
Health promotion needs of Hammanskraal families with adolescents ... the health promotion needs of families with adolescents orphaned by human ... Keywords: health promotion; families; adolescents orphaned by HIV/AIDS; basic needs; ...
... Updates March 2013 March 2013 Health Snapshot - Hispanic Adolescents in the United States Our nation’s adolescents are ... care and more positive health outcomes. 5 Hispanic adolescents in the U.S... Increasingly have health care coverage. ...
Hoagwood, Kimberly Eaton; Jensen, Peter S.; Arnold, L. Eugene; Roper, Margaret; Severe, Joanne; Odbert, Carol; Molina, Brooke S.G.
Objective: To describe the psychometric properties and test the reliability of a new instrument designed to measure mental health services use within pediatric clinical samples, the Services for Children and Adolescents-Parent Interview (SCAPI), which was developed by the National Institute of Mental Health Multimodal Treatment Study of Children…
Chang Ho Hong
Full Text Available During the adolescent period, they experience rapid physical, emotional, cognitive developments while they establish their lifestyle and habitual routines that strongly influence adult health and life. Recent rapid economic growth in Korea, and the earlier onset of physical, sexual, and psychological maturation of adolescents, has resulted in changes in the health status of adolescents from many years ago. Risk-taking behaviors such as drinking alcohol, smoking, and sexual experiences are critical issues that affect the health of, adolescents. Therefore, it is important for pediatricians to note the that risk-taking behaviors of adolescents in Korea that are caused by individual psychosocial factors. This review article illustrates the current health status of Korean adolescents and provides an overview of risktaking behaviors, to inform pediatricians about some of the key issues.
Beers, Lee; Southammakosane, Cathy; Lewin, Amy
Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. Teen mothers are also more likely to be impoverished and reside in communities and families that are socially and economically disadvantaged. These circumstances can adversely affect maternal mental health, parenting, and behavior outcomes for their children. In this report, we provide an overview of the mental health challenges associated with teen parenthood, barriers that often prevent teen mothers from seeking mental health services, and interventions for this vulnerable population that can be integrated into primary care services. Pediatricians in the primary care setting are in a unique position to address the mental health needs of adolescent parents because teens often turn to them first for assistance with emotional and behavioral concerns. Consequently, pediatricians can play a pivotal role in facilitating and encouraging teen parents’ engagement in mental health treatment. PMID:24298010
Elders, M J
The state of US children's health and recommendations for improvement are reported. The 1st table identifies youth as risk, i.e., at the current rate, 1 in 10 women will give birth by the time they turn 18. Among black children, white children 1-4 years, and blacks 15-24 years, death rates actually increased from 1985 to 1987. Injuries, particularly due to violence, have replaced communicable diseases as the primary cause of death among adolescents. Since 1976, immunization has deteriorated. There is a refusal to recognize sexually active adolescents, in spite of 2.5 million cases of sexually transmitted disease. The 6 strategies discussed intervention begin with providing high quality preschool education programs for all children. The 2nd urges educational programs from kindergarten through 12th grade that help children make healthy choices, improve their self-esteem, and accept as much responsibility for their own lives as possible. Parenting education, as the 3rd strategy, promotes the education and support of parents, especially for young and poor parents. The 4th strategy involves male responsibility and instruction on obligations in pregnancy and parenthood, including a requirement of financial commitment from fathers and identification of the father by Social Security number on an infant's birth certificate. The 5th strategy is the provision for school-based health services, including family life counseling and contraceptive services for adolescents. The 6th strategy is to provide free college tuition and books at a state supported school for students with at least a B average, good citizenship record, and a family income of $20,000. It is cheaper to offer children opportunity than to pay the costs of the consequences of poverty.
Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge
Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.
Merlino, James I; Raman, Ananth
The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.
Pallesen, Ulla; van Dijken, Jan W V; Halken, Jette;
To investigate in a prospective follow up the longevity of posterior resin composites (RC) placed in permanent teeth of children and adolescents attending Public Dental Health Service.......To investigate in a prospective follow up the longevity of posterior resin composites (RC) placed in permanent teeth of children and adolescents attending Public Dental Health Service....
Rous, Elizabeth; Clark, Andrew
Abstract This review developed from a discussion with the late Professor Richard Harrington about interventions in Child and Adolescent Mental Health services (CAMHS) that lacked an evidence base. Our aim is to investigate the literature for signs that child psychoanalysis is a declining paradigm within the Child and Adolescent Mental Health Services (CAMHS) in the United Kingd...
Faustino R Pérez-López
Full Text Available Faustino R Pérez-López, Gonzalo Pérez-Roncero, María T López-BaenaGrupo de Investigación sobre Salud de la Mujer en Aragón (GRISAMAR, Universidad de Zaragoza, Hospital Clínico Zaragoza, SpainAbstract: Vitamin D is a hormone sequentially produced at different body sites, and which plays a significant role in human health, particularly bone health. However, other roles are emerging. When the serum concentration of vitamin D is very low, the risk of rickets, osteomalacia and osteoporosis is increased. In children and adolescents there is a high prevalence of low vitamin D status, especially in females and during the winter–the prevalence being lower than during the summer. Although there is no unanimous agreement over the minimum values necessary for good health, serum 25-hydroxyvitamin D [25(OHD] levels below 20 ng/mL may be regarded as a vitamin D-deficient condition, and levels between 20–30 ng/mL may be the range of vitamin D insufficiency. Mild low levels have been associated with bone mass accrual alterations in children and adolescents, diminished muscle strength, negative cardiovascular outcomes, insulin resistance and obesity, and neurological disorders. Effective preventive strategies are needed to guarantee adequate vitamin D levels throughout childhood and adolescence, taking into account the geographical setting, season of the year, the level of environmental pollution, skin characteristics, eating habits and body weight, with a view to securing optimum health during these phases, and the prevention of complications in adulthood. There needs to be a renewed appreciation of the beneficial effect of moderate sunlight for providing all humans with the vitamin D needed for ensuring good health. Prolonged sun exposure is not advised, however, due to the risk of skin cancer. In addition, a balanced diet is indicated, since vitamin D-rich foods are better assimilated than supplements. When such conditions cannot be met, then the
... provide for community health. A variety of programs, disciplines, strategies and interventions work together to pursue the ... Office of Finance and Accounting - 10E54 Office of Human Resources - 11E53A Office of Information Technology - 07E57B Office of ...
... 5 items) Post-Traumatic Stress Disorder (27 items) Schizophrenia (84 items) Social Phobia (5 items) Populations Children and Adolescents (158 items) Diversity and Ethnic Groups (23 items) Men’s Mental Health (12 items) Women’s Mental Health (16 items) Military Service Members (6 ...
Miller, Marilyn P.; Swanson, Elizabeth
Community health nursing students performed community assessments and proposed and implemented service learning projects that addressed adolescent smoking in middle schools, home safety for elderly persons, industrial worker health, and sexual abuse of teenaged girls. Students learned to apply epidemiological research methods, mobilize resources,…
Full Text Available Background & aim: Qualitative perspectives of the reproductive health (RH facilities and Adolescent Friendly Health Services (AFHS are still unexplored issues among the Indian adolescents. Regarding this, the aim of the present study was to explore the perceptions and awareness about the RH and its facilities among the adolescents in two districts in India. Methods: This qualitative study was conducted on 197 individuals (i.e., 102 boys and 95 girls within the age of 15-19 years, selected from two Indian districts through stratified purposeful sampling method. For the purpose of the study, 16 focus group discussions (FGD were held using pre-tested FGD guide. All tape-recorded data were fully transcribed and thematic analysis was performed using inductive coding. Results: As the results indicated, a set of four themes, 12 subthemes, 52 open codes, and 12 categories was developed. The boys had lower parent-child proximity for discussing puberty changes, compared to the girls. They were totally unaware of the state sponsored RH services. On the other hand, the girls had better access to health care schemes provided by the government. Conclusion: According to the findings,the utilization of the RH services was poor among the adolescents in the two districts investigated in this study. It would be advisable to carry out more studies addressing the RH-related concerns of the adolescents, especially the boys.
Full Text Available 14.00 800x600 Normal 0 21 false false false ES-CO X-NONE X-NONE MicrosoftInternetExplorer4 What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius god of medicine and Hygeia goddess of hygiene and health, generated a dichotomy between disease and health that remains until today. The confusing substitution of Health Services with Medical Services began by the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world and its model was adopted by many countries, having distorted the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by its name not to deceive society and to correct the serious imbalance between Medical Services and Health Services. Hygeia and Asclepius must become a brotherhood.
Yuwen, W; Chen, A C C
Asian Americans are one of the fastest-growing minority groups in the USA, and Chinese constitute the largest group. Evidence suggests that Asian American adolescents experience higher levels of depressive symptoms than their same-gender white counterparts. Quantitative findings suggest associations between parenting factors and Chinese American adolescents' mental health. A qualitative understanding regarding Chinese American adolescents' perceived parenting styles and its relationship with adolescents' psychosocial health is warranted. To gain an in-depth understanding of Chinese American adolescents' perceived parenting styles and how parenting styles might influence adolescents' psychosocial health. In this qualitative study, we recruited 15 Chinese American adolescents aged 12-17 years in a southwest metropolitan area. We conducted two focus group interviews. Participants also filled out a brief questionnaire that included their socio-demographic information, immigration history and level of acculturation. Participants reported perceiving that parents had high expectations about academic performance and moral values. They also perceived stricter family rules regarding choices of friends compared with their non-Asian peers. Parents tended to be more protective of girls than of boys. Both Chinese American boys and girls reported poor or ineffective communication with their parents, which contributed to increased conflict between parents and adolescents and emotional distress of the adolescents. The findings provide evidence for nurses to develop linguistically and culturally tailored resources (e.g. parent support groups, programs aimed to improving parent-child communication) or connect these families with existing resources to enhance parenting skills and consequently reduce emotional distress of their adolescent children. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.
Carmen Ildes Rodrigues Fróes Asmus
Full Text Available Este artigo apresenta a experiência do Programa de Saúde do Trabalhador Adolescente (PSTA do Núcleo de Estudos da Saúde do Adolescente da Uerj. Na área assistencial, a equipe multidisciplinar do Núcleo vem desenvolvendo um modelo de atenção integral aos adolescentes trabalhadores, buscando analisar as questões ligadas ao nexo causal entre os agravos à saúde e o processo produtivo em que estão envolvidos. No que se refere à extensão, os profissionais, em associação com alguns adolescentes trabalhadores, vêm desenvolvendo uma metodologia de educação em saúde resgatando a discussão sobre o potencial produtivo de maneira abrangente, abordando temas que vão além da questão do trabalho. Devido ao conhecimento adquirido, a equipe, em parceria com a OIT, recebeu a incumbência de elaborar materiais pedagógicos para a formação e capacitação de recursos humanos sobre saúde e segurança no trabalho infanto-juvenil. Conclui-se que, diante das políticas públicas para a eliminação do trabalho infantil e proteção do trabalhador adolescente, já em vigência em nível nacional, a experiência relatada aponta para a necessidade da criação de programas semelhantes para a garantia dos direitos desta população.This article presents the collected experiences of the Health Program for Adolescent Workers (PSTA at the Center for the Study of Adolescent Health at the State University of Rio de Janeiro. In terms of health services, the multidisciplinary team has developed a model of comprehensive health care for adolescent workers that seeks to analyze the causal links between health problems and the work conditions in which these young people are usually involved. In terms of health outreach, the health professionals have been working with a group of adolescent workers to develop a specific health education methodology. This methodology seeks to promote a broad discussion of the meaning of work in a empowering way that transcends
Hardie, Jessica Halliday; Pearce, Lisa D.; Denton, Melinda Lundquist
This study examines changes in religious service attendance over time for a contemporary cohort of adolescents moving from middle to late adolescence. We use two waves of a nationally representative panel survey of youth from the National Study of Youth and Religion (NSYR) to examine the dynamics of religious involvement during adolescence. We…
Hardie, Jessica Halliday; Pearce, Lisa D.; Denton, Melinda Lundquist
This study examines changes in religious service attendance over time for a contemporary cohort of adolescents moving from middle to late adolescence. We use two waves of a nationally representative panel survey of youth from the National Study of Youth and Religion (NSYR) to examine the dynamics of religious involvement during adolescence. We…
Chandra, Anita; Minkovitz, Cynthia S.
Unmet mental health need is a significant problem for adolescents. Although stigma is identified as a major barrier to the use of mental health services among youth, there is limited research on this topic. In-depth interviews (n = 57) among a sample of 8th grade students in a suburban, mid-Atlantic community portray adolescent mental health…
Grist, Rebecca; Porter, Joanna; Stallard, Paul
Background There are an increasing number of mobile apps available for adolescents with mental health problems and an increasing interest in assimilating mobile health (mHealth) into mental health services. Despite the growing number of apps available, the evidence base for their efficacy is unclear. Objective This review aimed to systematically appraise the available research evidence on the efficacy and acceptability of mobile apps for mental health in children and adolescents younger than ...
Jacobson, Cara; Bailin, Alexandra; Milanaik, Ruth; Adesman, Andrew
This article examines the health implications of new age technology use among adolescents. As Internet prevalence has increased, researchers have found evidence of potential negative health consequences on adolescents. Internet addiction has become a serious issue. Pornography is now easily accessible to youth and studies have related pornography with several negative health effects. Cyberbullying has become a large problem as new age technologies have created a new and easy outlet for adolescents to bully one another. These technologies are related to increased morbidity and mortality, such as suicides due to cyberbullying and motor vehicle deaths due to texting while driving.
Strasburger, Victor C; Jordan, Amy B; Donnerstein, Ed
The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media.
Ten Hoope-Bender, Petra; Nove, Andrea; Sochas, Laura; Matthews, Zoë; Homer, Caroline S E; Pozo-Martin, Francisco
A competent, enabled and efficiently deployed health workforce is crucial to the achievement of the health-related sustainable development goals (SDGs). Methods for workforce planning have tended to focus on 'one size fits all' benchmarks, but because populations vary in terms of their demography (e.g. fertility rates) and epidemiology (e.g. HIV prevalence), the level of need for sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) workers also varies, as does the ideal composition of the workforce. In this paper, we aim to provide proof of concept for a new method of workforce planning which takes into account these variations, and allocates tasks to SRMNAH workers according to their competencies, so countries can assess not only the needed size of the SRMNAH workforce, but also its ideal composition (the 'Dream Team'). An adjusted service target model was developed, to estimate (i) the amount of health worker time needed to deliver essential SRMNAH care, and (ii) how many workers from different cadres would be required to meet this need if tasks were allocated according to competencies. The model was applied to six low- and middle-income countries, which varied in terms of current levels of need for health workers, geographical location and stage of economic development: Azerbaijan, Malawi, Myanmar, Peru, Uzbekistan and Zambia. Countries with high rates of fertility and/or HIV need more SRMNAH workers (e.g. Malawi and Zambia each need 44 per 10,000 women of reproductive age, compared with 20-27 in the other four countries). All six countries need between 1.7 and 1.9 midwives per 175 births, i.e. more than the established 1 per 175 births benchmark. There is a need to move beyond universal benchmarks for SRMNAH workforce planning, by taking into account demography and epidemiology. The number and range of workers needed varies according to context. Allocation of tasks according to health worker competencies represents an efficient way to allocate
Madge, Nicola; Foreman, David; Baksh, Faiza
Current UK child mental health policy seeks to engage primary care personnel in improving service delivery under the heading of 'Comprehensive CAMHS' but little is known about the size of this resource, the sufficiency of its training or its commitment to children's mental health. We surveyed local health, education and social services agencies within a UK Unitary Authority just outside London, using both questionnaire and focus group methodologies: 150 primary care personnel were identified in 14 teams. Of these 122 participated in the questionnaire survey, and 60 took part in focus groups. There was, approximately, one such team member for every 30 children with a mental health problem. Respondents reported deficiencies in skills and knowledge, but wanted training and support to increase their involvement provided it related to their daily practice, professional roles, and was developed in accordance with local needs and resources. Lack of training and organization impedes the effective deployment of a potentially huge resource for children with mental health problems. This could be addressed by appropriately tailored training courses, combined with managerial work on systems and remits. Such a programme would be needed to realize the National Service Framework's concept of a 'comprehensive CAMHS'.
Full Text Available Background: Namibia bears a large burden of Human Immunodeficiency Virus (HIV, and the youth are disproportionately affected. Objectives: To explore the current knowledge, attitudes and behaviour of female adolescents attending family planning to HIV prevention.Methods: A cross-sectional study design was used on a sample 251 unmarried female adolescents aged from 13 years to 19 years accessing primary care services for contraception using an interviewer-administered questionnaire. Data were analysed using Epi Info 2002. Crude associations were assessed using cross-tabulations of knowledge, attitude and behaviour scores against demographic variables. Chi-square tests and odds ratios were used to assess associations from the cross-tabulations. All p-values < 0.05 were considered statistically significant.Results: A quarter of sexually active teenagers attending the family-planning services did not have adequate knowledge of HIV prevention strategies. Less than a quarter (23.9% always used a condom. Most respondents (83.3% started sexual intercourse when older than 16 years, but only 38.6% used a condom at their sexual debut. The older the girls were at sexual debut, the more likely they were to use a condom for the event (8% did so at age 13 years and 100% at age 19 years.Conclusions: Knowledge of condom use as an HIV prevention strategy did not translate into consistent condom use. One alternate approach in family-planning facilities may be to encourage condom use as a dual protection method. Delayed onset of sexual activity and consistent use of condoms should be encouraged amongst schoolchildren, in the school setting.
Moreno, Megan A; Kolb, Jennifer
Social networking sites are popular among and consistently used by adolescents. These sites present benefits as well as risks to adolescent health. Recently, pediatric providers have also considered the benefits and risks of using social networking sites in their own practices.
Atuyambe, Lynn; Mirembe, Florence; Annika, Johansson; Kirumira, Edward K; Faxelid, Elisabeth
To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. This was a qualitative study that employed focus group discussions (FGDs) among adolescent girls (10-19 years) and key informant (KI) interviews with health workers. Age for FGD participants ranged from 16 to 19 years. The FGD participants were recruited while seeking antenatal care for their first pregnancy or immunization service for their first child, not being older than 6 months. Six health facilities were selected. Key informants were purposefully selected on the basis of being in-charge of maternity units. Thirteen FGDs comprising of a total of 92 adolescent girls were conducted. The FGDs were held with homogeneously constituted categories; married pregnant adolescents (5), unmarried pregnant adolescents (3) and married or not married adolescents with children (5). Semi structured interviews were held with six KIs who were in-charge of maternity units of health facilities. Latent content analysis technique was used for data analysis. Two main themes emerged; 'feeling exposed and powerless', and 'seeking safety and empathy'. The categories identified in the first theme were "the dilemma of becoming an adolescent mother" and "lack of decision power". In the second theme the following categories were identified: "cultural practices and beliefs about birth", "expectations and experiences", "transport, a key determinant to health seeking", and "dealing with constraints". Adolescents felt exposed and powerless due to the dilemma of early motherhood and lack of decision making power. The adolescent mothers seemed to be in continuous quest for safety and empathy. In so doing they are part of cultural practices and beliefs about birth. They had expectations about the health
Viner, Russell M; Ozer, Elizabeth M; Denny, Simon; Marmot, Michael; Resnick, Michael; Fatusi, Adesegun; Currie, Candace
The health of adolescents is strongly affected by social factors at personal, family, community, and national levels. Nations present young people with structures of opportunity as they grow up. Since health and health behaviours correspond strongly from adolescence into adult life, the way that these social determinants affect adolescent health are crucial to the health of the whole population and the economic development of nations. During adolescence, developmental effects related to puberty and brain development lead to new sets of behaviours and capacities that enable transitions in family, peer, and educational domains, and in health behaviours. These transitions modify childhood trajectories towards health and wellbeing and are modified by economic and social factors within countries, leading to inequalities. We review existing data on the effects of social determinants on health in adolescence, and present findings from country-level ecological analyses on the health of young people aged 10-24 years. The strongest determinants of adolescent health worldwide are structural factors such as national wealth, income inequality, and access to education. Furthermore, safe and supportive families, safe and supportive schools, together with positive and supportive peers are crucial to helping young people develop to their full potential and attain the best health in the transition to adulthood. Improving adolescent health worldwide requires improving young people's daily life with families and peers and in schools, addressing risk and protective factors in the social environment at a population level, and focusing on factors that are protective across various health outcomes. The most effective interventions are probably structural changes to improve access to education and employment for young people and to reduce the risk of transport-related injury. Copyright © 2012 Elsevier Ltd. All rights reserved.
Dil, L. M.; Vuijk, P. J.
Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…
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Merrick, Joav; Birnbaum, Liora; Kandel, Isack; Morad, Mohammed
Obesity in adolescence has increased significantly over the past 30-40 years and a recent international comparison study (13 European countries, Israel and the US) showed that the highest prevalence in adolescents was found in the US (12.6% in 13 year old boys, 10.8% in girls; 13.9% in 15 year old boys and 15.1% in 15 year old girls) and the lowest in Lithuania. This increase in adolescence is a public health concern, because most obese adolescents continue their obesity into adulthood with serious risk for chronic disease. Focus should therefore be on prevention programs that increase healthier patterns of lifestyle and physical activity.
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...
Department of Health
The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here
Full Text Available The AMA Guidelines for Adolescent Preventive Services (GAPS has been the cornerstone of preventive care for teenagers since its publication in 1994. Despite this, there has been little documentation of their implementation in the family medicine literature. This article gives an overview of a family practice–based adolescent preventive health program based on GAPS recommendations, and reports on compliance, feasibility and health issues. A Community-Oriented Primary Care (COPC program targeted all adolescent patients aged 12—18 years in two Israeli family practices. 321 teenagers were invited to participate. Every 7th and 10th grader was invited for a preventive health visit with the family physician and nurse. The visits included a medical evaluation, screening and counseling regarding health issues recommended by GAPS, and counseling regarding personal health concerns. Parents were also invited to meet with the staff. 184 (57% of the adolescents invited for health visits attended. The overall visit time was 47 minutes, including 12 minutes for a questionnaire and 35 minutes with providers. Common biomedical problems included overweight, acne and dysmenorrhea. Health risk behaviors and psychosocial problems included cigarette or alcohol use, dieting, infrequent/never seat belt use, and feeling depressed. 78% wanted to discuss at least one personal health issue. 27% were invited for follow-up visits. Only 3% of the parents came for visits. A community-oriented approach facilitates bringing adolescents for preventive health visits. Many previously undetected health issues, particularly psychosocial and behavioral, are revealed during these visits. A concerns checklist aids in addressing personal health concerns.
Anshari, Muhammad; Almunawar, Mohammad Nabil
Mobile technology enables health-care organizations to extend health-care services by providing a suitable environment to achieve mobile health (mHealth) goals, making some health-care services accessible anywhere and anytime. Introducing mHealth could change the business processes in delivering services to patients. mHealth could empower patients as it becomes necessary for them to become involved in the health-care processes related to them. This includes the ability for patients to manage their personal information and interact with health-care staff as well as among patients themselves. The study proposes a new position to supervise mHealth services: the online health educator (OHE). The OHE should be occupied by special health-care staffs who are trained in managing online services. A survey was conducted in Brunei and Indonesia to discover the roles of OHE in managing mHealth services, followed by a focus group discussion with participants who interacted with OHE in a real online health scenario. Data analysis showed that OHE could improve patients' confidence and satisfaction in health-care services.
Guss, Carly E; Wunsch, Caroline A; McCulloh, Russell; Donaldson, Abigail; Alverson, Brian K
Less than one-half of sexually active adolescents have received counseling regarding contraception and sexually transmitted disease (STD) from their health care provider. We hypothesized that hospitalized adolescents would be interested in receiving reproductive health education and/or STD testing. In addition, we assessed the opinion of female adolescents on initiation of contraception during hospitalization. A convenience sample of 13- to 18-year-old male and female adolescent patients hospitalized at a tertiary pediatric hospital were approached for inclusion. Consenting patients completed a self-administered anonymous questionnaire. Questionnaires from 49 female adolescents and from 51 male adolescents were collected. Based on their answers, 37% of female adolescents and 44% of male adolescents want to learn more about contraception and/or abstinence in the hospital independent of sexual activity. Thirty percent of respondents reported a desire for STD testing in the hospital. Fifty-seven percent of female subjects answered that adolescents should be offered contraception while in the hospital. Among hospitalized adolescents in this study, there was an interest in reproductive health education and contraception even among those with a primary care provider and without sexual experience. Thus, hospital-based pediatricians can play a pivotal role in expanding critical sexual health services by discussing and offering sexual health care to hospitalized adolescents. We recommend that hospitals make a brochure available to all admitted adolescents, with opportunity for follow-up discussions with their hospitalist. Copyright © 2015 by the American Academy of Pediatrics.
Elizabeth Andress: Partnerships Produce a National Center for Home Food Preservation. Diana Friedman: National 4-H Healthy Lifestyles Grant. H. Wallace Goddard: Big Surprises on the Road to Happiness. Nancy Kershaw: Connecting the 4-H Clothing Project and Community. Jane A. Landis: NEAFCS Living Well Public Service Campaign. Rhea Lanting: The Healthy Diabetes Plate. Phyllis B. Lewis: Product Look-Alikes. Anna Martin: Raising Diabetes Awareness in Latino Communities. Earl Mcalexander: Youth Fi...
Roemer, M I
Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.
Abernathy, Thomas J.; Webster, Greg; Vermeulen, Marian
Examines data on 1,759 adolescents to assess the effect of low socioeconomic status on their health. Results confirm the relationship between income and health. Explains how the pathway to poor health care operates through the social environment, lifestyle differences, access to care, and self-esteem problems. Findings do suggest that physical…
Rachel Franklin da Costa
Full Text Available AbstractOBJECTIVEAnalyze adolescents' perceptions about support networks and their health needs.METHODAnalytical and interpretive study using focus groups conducted in municipal state schools in Fortaleza, in the State of Ceará during the first semester of 2012. The sample comprised 36 male and female adolescents aged between 13 and 16 years attending the ninth grade of the second phase of elementary school.RESULTSThematic analysis revealed that the health care support network and interaction between health professionals, education professionals and family members was insufficient, constituting a lack of an integrated network to enable and provide support for health promotion.CONCLUSIONCoordination between education, health and family services has the potential to act as a support network to help meet adolescents' healthcare needs and demands.
Full Text Available The Chinese health system was once held up as a model for providing universal health care in the developing world in the 1970s, only to have what is now considered one of the least equitable systems in the world according to the World Health Organization. This article begins with a brief look at what equity in health services entails, and considers the inequities in access to health services in China among different segments of the population. This article will consider challenges the current inequities may present to China in the near future if reforms are not implemented. Finally, it will take a look at reforms made by China’s neighbors, Singapore and Thailand, which made their health care more equitable, affordable, and sustainable.
Patton, George C; Sawyer, Susan M; Ross, David A; Viner, Russell M; Santelli, John S
In May 2016, The Lancet published a report titled, "Our Future: A Lancet Commission on Adolescent Health and Wellbeing," the culmination of three years of work from a geographically diverse interdisciplinary group. The report argued that healthy growth across adolescence and young adulthood shapes life course and intergenerational trajectories so that health investments yield a "triple dividend." With current global interest in adolescent health at an unprecedented level, it outlines three next steps to advance from advocacy to effective action: (1) there is a pressing need for comprehensive and integrated strategies, inclusive of, but extending beyond, sexual and reproductive health, and HIV; (2) interventions should address both adolescent health service coverage and determinants of health that lie in sectors such as education, justice, transport, and industry and employment, as well as families and local communities; and (3) scale-up of responses will require not only investments in country-level capacities for measuring need and responding with evidence-based practice but also the establishment of processes for accountability and meaningful youth engagement.
Murphey, David; Barry, Megan; Vaughn, Brigitte
Mental disorders are diagnosable conditions characterized by changes in thinking, mood, or behavior (or some combination of these) that can cause a person to feel stressed out and impair his or her ability to function. These disorders are common in adolescence. This "Adolescent Health Highlight" presents the warning signs of mental disorders;…
毛红芳; 史慧静; 龙翔
[目的]探讨青少年发育过程中的自感生理健康问题及对卫生服务的需求。[方法]对上海市嘉定区1555名10～18岁青少年和1482名家长进行有关学生自感生理卫生状况以及卫生服务需求的调查。[结果]1年内经常遇到的身体问题自我报告率为77．8％；青春发育期性征改变的困惑发生率为51．7％；有生殖系统疾病症状的自感发生率为16．9％；青春发育时相自我评价明显过早或过迟的发生率为5．3％；学生面对这些生殖健康问题时积极求助率不高。[结论]青少年的保健服务需求是多方面的，不同特征群体的需求也存在很大不同。医疗保健机构应提供及时有效的青少年保健服务，并在实践中不断完善。%To investigate the adolescent self-perceived health problems during devel-opment and their demand for service needs of health care ,thus enhancing the healthy level of adolescents . [ Methods] A questionnaire survey , focusing on self-perceived physiological health and demand for health service , was conducted among 1 555 adolescents aged 10 -18 and 1 482 parents in Jiading District . [ Results] The incidence of self-reported frequent physiological problems within one year was 77.8%.A total of 51.7%students felt confused with changes in sexual characteristics during puberty .The rate of self-perceived reproductive system symptoms was 16.9%.Prevalence of self-reported early/late puberty timing was 5 .3%, while few students were seeking help towards these health issues . [ Conclusion ] The health service needs of adolescents are versatile , and there is a glaring discrepancy in different feature groups .Medical and health care institutions need to think deeply of how to timely and effectively provide adolescent health services and improve the quality of care in practice .
Kulyk, Olga Anatoliyivna; van Gemert-Pijnen, Julia E.W.C.; David, Silke
Background: Nowadays adolescents primarily use modern, often web-based technology, such as social media and mobile applications to find the answers on all kinds of questions about their health and healthcare services (Kulyk et al., 2013; van Velsen et al., 2013). National program Sense in the
Kulyk, O.; Gemert-Pijnen, van J.E.W.C.; David, Silke
Background: Nowadays adolescents primarily use modern, often web-based technology, such as social media and mobile applications to find the answers on all kinds of questions about their health and healthcare services (Kulyk et al., 2013; van Velsen et al., 2013). National program Sense in the Nether
Nichollas Martins Areco
Full Text Available A relação entre Estado e atendimento às demandas dos adolescentes sofreram mudanças históricas, tendo como importante marco a criação do Estatuto da Criança e do Adolescente (ECA. Analisamos, com enfoque qualitativo, como os serviços de saúde mental e drogadição de um município do Estado de São Paulo compreendem a demanda dos adolescentes em situação de vulnerabilidade social. As cinco instituições participantes informaram, por meio de questionários, as características dos serviços oferecidos e sua aproximação com a população atendida. Identificamos a fragmentação entre as ações públicas, havendo ora sobreposição de serviços, ora ausência desses, além do distanciamento das necessidades dos adolescentes, o que impossibilita que essas ações ofereçam elementos para que esse público mantenha uma relação positiva frente aos elementos vulnerabilizantesThe relationship between the State and the demands of the adolescents has historically changed, having as a landmark the establishment of "Child and Adolescent Statute" (ECA. We have analyzed under the scope of qualitative research how mental health services and drug addiction of a city of São Paulo State comprehended the demands of adolescents under social vulnerability. The five participating institutions in this study have reported through questionnaires the characteristics of their services and how they approach the population served. We identified the fragmentation of public actions, with either overlapping of services, sometimes their absence, besides the distance of the needs of adolescents, avoiding public action to raise elements capable of keeping a positive relationship between this public and the elements that turn them vulnerable.
Hainsworth, Gwyn; Engel, Danielle Marie Claire; Simon, Callie; Rahimtoola, Minal; Ghiron, Laura Jane
Poor sexual and reproductive health outcomes among adolescents aged 10-19 years are indicative of the barriers this group faces in accessing health services and highlights a gap in the availability of appropriate services, including adolescent-friendly contraceptive services (AFCS). The HIV Investment Framework identifies contraceptive services as an entry point for HIV counseling, testing, and treatment, and as a component of HIV prevention. To effectively meet the needs of adolescents, greater understanding of effective scale-up strategies for adolescent-friendly services is needed. The authors conducted a retrospective analysis of AFCS scale-up experiences in Ethiopia, Ghana, Mozambique, Tanzania, and Vietnam using the ExpandNet/World Health Organization framework for systematic scale-up. The authors analyzed the type of scale (expansion or institutionalization), dissemination and advocacy, organizational process, costs and resource mobilization, and monitoring and evaluation. The analysis showed that all programs simultaneously pursued expansion and institutionalization, contributing to sustainable scale-up. Advocacy complemented by intensive capacity building at all levels of the health system contributed to adoption of AFCS in national and district work plans and budgets as well strengthening collection of age-disaggregated data. To achieve scale-up of AFCS, the authors identified the importance of institutionalization and expansion in tandem for synergy and reinforcement, empowering adolescents to be agents of change and hold government accountable to its commitments, and strengthening health systems to sustain AFCS. This article contributes to a growing body of evidence around scale-up of AFCS, which can inform the implementation and sustainable scale-up of HIV and other services for adolescents.
Dogra, Nisha; Vostanis, Panos; Abuateya, Hala; Jewson, Nick
The aim of this study was to explore Gujarati parents' and adolescents' perceptions of child and adolescent mental health services and how these should be improved to best meet their needs. Semi-structured qualitative interviews were carried out with 15 parents and 15 young people, recruited from a community centre. Overall, the quality of the service appeared more important than its responsiveness to culture or ethnicity for both young people and their parents. These findings indicate the need for further evidence and debate on whether Black and ethnic minority families should be treated as though they are a homogenous group.
Shahhosseini, Zohreh; Hamzehgardeshi, Zeinab
One of the most important and basic needs of adolescent girls is reproductive health services and education, which is different from that required by adults. The aim of this study was to determine reproductive health education needs from the perspective of adolescent girls living in urban and rural areas, as well as to explore adolescents' understanding of reproductive health needs. The first phase was a cross-sectional study conducted on 1274 female adolescents. In the second phase, 77 girls in the form of 11 groups participated in focused group discussions. This sequential explanatory mixed methods study using follow-up variants was conducted in two phases. Questionnaires, including items on socio-demographic characteristics and reproductive health needs from adolescents' perspectives, were completed using the self-administered method. The quantitative results of the study revealed city and village girls' perspectives on reproductive health education needs. These results showed that village adolescents were nearly 1.5-2 times more in favor of a same sex counselor, reproductive health group education, and the need for sexual health education than city adolescents. A review of the transcripts of the qualitative phase led to the extraction of two themes including the characteristics of the reproductive health educator and priorities of reproductive health education, which explains the adolescent girls' understanding of reproductive health education needs. The findings of this study confirm the importance of determining reproductive health education needs from the perspective of adolescent girls. The present study shows how a sequential mixed design can be used for a better understanding of reproductive health needs of adolescent girls. The results of this study can be used in health research, education, policy making, and planning associated with adolescent health.
Full Text Available The service sector plays an increasingly large modern market economies. By being unable to provide customers a tangible product in the hands of service providers makes the situation more difficult. Their success depends on customer satisfaction, which expect a certain benefit for the money paid, on quality, on mutual trust and many other attributes. What is very interesting is that they may differ from client to client, and there is no guarantee satisfaction to all customers, even if the service provided is the same. This shows the complex nature of services and efforts on service providers would have to be made permanent in order to attract more customers. This paper addresses the issues of continuous quality improvement of health services as an important part of the services sector. Until recently, these services in Romania although under strict control of the state, had a large number of patients who are given very little attention, which is why quality improvement acestoraa was compulsory. Opening and changing economic environment, increasing customer demands, forced hospitals that serve as a nodal point between these services and their applicants to adopt modern management methods and techniques to become competitive and to give patients the quality service expected. Modern society has always sought to provide the means to ensure good health closer to the needs of modern man. These have become more complex and more expensive and naturally requires financial resources increasingly mari.Este why, every time, all the failures alleging lack of money and resources in general. Is it true? Sometimes yes, often, no! The truth is that human and material resources are not used in an optimal way. The answer lies mainly in quality management. We will see what should be done in this regard.
U.S. Department of Health & Human Services — A search-based Web service that provides access to disease, condition and wellness information via MedlinePlus health topic data in XML format. The service accepts...
The mass media rank among the most important socialization agents influencing the health behaviors of today's youth, with some researchers estimating that youth spend 33-50% of their waking hours with some form of media (Strasburger and Wilson 2002). The impact of the media on health and the large amount of time adolescents spend with media make…
Obermeyer, Carla Makhlouf; Bott, Sarah; Sassine, Anniebelle J
This article reviews the evidence about adolescent health in the Arab world, against the background of social, economic, and political change in the region, and with a particular focus on gender. For the literature review, searches were conducted for relevant articles, and data were drawn from national population- and school-based surveys and from the Global Burden of Disease project. In some parts of the Arab world, adolescents experience a greater burden of ill health due to overweight/obesity, transport injuries, cardiovascular and metabolic conditions, and mental health disorders than those in other regions of the world. Poor diets, insufficient physical activity, tobacco use, road traffic injuries, and exposure to violence are major risk factors. Young men have higher risks of unsafe driving and tobacco use and young women have greater ill-health due to depression. Several features of the social context that affect adolescent health are discussed, including changing life trajectories and gender roles, the mismatch between education and job opportunities, and armed conflict and interpersonal violence. Policy makers need to address risk factors behind noncommunicable disease among adolescents in the Arab region, including tobacco use, unhealthy diets, sedentary lifestyles, unsafe driving, and exposure to violence. More broadly, adolescents need economic opportunity, safe communities, and a chance to have a voice in their future.
Ford, Carol A; Cheek, Courtney; Culhane, Jennifer; Fishman, Jessica; Mathew, Leny; Salek, Elyse C; Webb, David; Jaccard, James
Patient-centered health care recognizes that adolescents and parents are stakeholders in adolescent health. We investigate adolescent and parent interest in receiving information about health topics and parent-teen communication from clinicians. Ninety-one parent-adolescent dyads in one practice completed individual interviews. Items assessed levels of interest in receiving health and health communication information from the adolescent's doctor about 18 topics, including routine, mental health, sexual health, substance use, and injury prevention issues. Analyses tested differences between parents and adolescents, within-dyad correlations, and associations with adolescent gender and age. Most parents were female (84%). Adolescents were evenly divided by gender; 36 were aged 12-13 years, 35 were aged 14-15 years, and 20 were aged 16-17 years. Adolescent race reflected the practice population (60% black; 35% white). The vast majority of parents and adolescents reported moderate or high levels of interest in receiving information about all 18 health issues and information to increase parent-teen communication about these topics. Parents' interest in receiving information varied by adolescent age when the expected salience of topics varied by age (e.g., acne, driving safety), whereas adolescents reported similar interest regardless of age. Adolescent gender influenced parent and adolescent interest. Level of interest in receiving information from doctors within adolescent-parent pairs was not significantly correlated for one-half of topics. Parents and adolescents want health care professionals to help them learn and talk about a wide range of adolescent health topics. Feasible primary care interventions that effectively improve parent-teen health communication, and specific adolescent health outcomes are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
BERNSTEIN, ROSE; HERZOG, ELIZABETH
FROM REPORTS AND DATA THAT WERE AVAILABLE TO THE UNITED STATES CHILDREN'S BUREAU THROUGH 1962, A REVIEW WAS MADE OF RESEARCH AND DEMONSTRATIONS THAT RELATED TO AVAILABILITY AND USE OF HEALTH SERVICES BY UNMARRIED MOTHERS. INCLUDED ARE COMPLICATIONS OF PREGNANCY IN BIRTHS OUT OF WEDLOCK--(1) STUDIES OF PRENATAL MEDICAL CARE FOR UNMARRIED MOTHERS,…
Bacikova-Sleskova, Maria; Benka, Jozef; Orosova, Olga
The paper deals with parental employment status and its relationship to adolescents' self-reported health. It studies the role of the financial situation, parent-adolescent relationship and adolescent resilience in the relationship between parental employment status and adolescents' self-rated health, vitality and mental health. Multiple regression analyses were used to analyse questionnaire data obtained from 2799 adolescents (mean age 14.3) in 2006. The results show a negative association of the father's, but not mother's unemployment or non-employment with adolescents' health. Regression analyses showed that neither financial strain nor a poor parent-adolescent relationship or a low score in resilience accounted for the relationship between the father's unemployment or non-employment and poorer adolescent health. Furthermore, resilience did not work as a buffer against the negative impact of fathers' unemployment on adolescents' health.
Full Text Available Abstract Background Adolescents' consultation of primary health care services remains problematic despite their accessibility. The reproductive health service seeking behavior of adolescents is the object of much research but little is known about how this behavior is influenced by the gatekeeping system. This study aimed to explore general practitioners' perceptions of the appropriateness of gatekeeping in adolescent reproductive health care. Methods Twenty in-depth interviews regarding factors affecting adolescent reproductive health care were carried out on a diverse sample of general practitioners and analyzed using grounded theory. Results The analysis identified several factors that shaped GPs' negative attitude to gatekeeping in adolescent reproductive health care. Its appropriateness in this field was questionable due to a lack of willingness on the part of GPs to provide reproductive health services for teenagers, their insufficient training, inadequately equipped surgeries and low perceived support for reproductive health service provision. Conclusion Since factors for improving adolescent reproductive health concern not only physicians but also the health system and policy levels, complex measures should be designed to overcome these barriers. Discussion of a flexible model of gatekeeping, encompassing both co-ordination of care provided by GPs and the possibility of patients' self-referral, should be included in the political agenda. Adolescents tend to under-use rather than over-use reproductive health services and every effort should be made to facilitate the accessibility of such services.
George, Melissa W.; Trumpeter, Nevelyn N.; Wilson, Dawn K.; McDaniel, Heather L.; Schiele, Bryn; Prinz, Ron; Weist, Mark D.
The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program. PMID:24297005
Thomas, Christopher R; Penn, Joseph V
As the second century of partnership begins, child psychiatry and juvenile justice face continuing challenges in meeting the mental health needs of delinquents. The modern juvenile justice system is marked by a significantly higher volume of cases, with increasingly complicated multiproblem youths and families with comorbid medical, psychiatric, substance abuse disorders, multiple family and psychosocial adversities, and shrinking community resources and alternatives to confinement. The family court is faced with shrinking financial resources to support court-ordered placement and treatment programs in efforts to treat and rehabilitate youths. The recognition of high rates of mental disorders for incarcerated youth has prompted several recommendations for improvement and calls for reform [56,57]. In their 2000 annual report, the Coalition for Juvenile Justice advocated increased access to mental health services that provide a continuum of care tailored to the specific problems of incarcerated youth . The specific recommendations of the report for mental health providers include the need for wraparound services, improved planning and coordination between agencies, and further research. The Department of Justice, Office of Juvenile Justice and Delinquency Prevention has set three priorities in dealing with the mental health needs of delinquents: further research on the prevalence of mental illness among juvenile offenders, development of mental health screening assessment protocols, and improved mental health services . Other programs have called for earlier detection and diversion of troubled youth from juvenile justice to mental health systems [31,56]. Most recently, many juvenile and family courts have developed innovative programs to address specific problems such as truancy or substance use and diversionary or alternative sentencing programs to deal with first-time or nonviolent delinquents. All youths who come in contact with the juvenile justice system
Ortabag, Tulay; Ozdemir, Serpil; Bakir, Bilal; Tosun, Nuran
Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The…
de Graaf, J.C.
Although sexual development is a lifelong process, it is especially striking during adolescence. This dissertation contains one literature review and three empirical studies. It provides insight into sexual trajectories and its correlates, associations between parenting and a broad range of sexual h
Diana Paola Betancourth-Loaiza
Full Text Available Objective: To analyze the characteristics of studies on health behaviors of school adolescents, models and strategies in health promotion applicability. Method: Review articles and published texts (2003 - 2012 through electronic and manual search, consulted with the descriptors: health promotion, lifestyle, teens, school and health education in electronic sources such as search engines, libraries electronic and international databases (Schoolar Google, SciELO, PubMed, JSTOR and Ovid. Results: Were found in the scientific literature a total of 92 texts were reviewed, of these 66 were recovered in full text, evidence possible to define two main categories: health behaviors of adolescent students and the different models and strategies in promoting health that can be used with this group. Conclusions: There is evidence of the importance of nursing as an active part in actions from the health promotion under theoretical underpinnings with adolescent students, it must transcend individual counseling with an interdisciplinary approach, based on integrating aspects from objectivities, subjectivity and the obvious need to show results through measurements of effectiveness, as a basis for decisions on public health and point to select strategies based on the best available knowledge.
Patricia Santos de Souza Delfini
Full Text Available O objetivo do estudo é descrever e analisar as articulações que se realizam entre as equipes da Estratégia Saúde da Família (ESF e Centro de Atenção Psicossocial Infantojuvenil (CAPSI, tendo em vista as ações voltadas à saúde mental de crianças e adolescentes. Foram realizadas entrevistas semidirigidas com gerentes de cinco CAPSI e 13 Unidades Básicas de Saúde com ESF, de 5 regiões distintas no Município de São Paulo, Brasil, que foram transcritas e analisadas mediante perspectiva hermenêutica. A articulação entre as equipes da ESF e CAPSI se dá prioritariamente por encaminhamento de casos, apoio matricial ou parceria para casos considerados pertinentes ao CAPSI. Falta de recursos humanos, cobrança por produtividade e ausência de capacitação dos profissionais da ESF para trabalhar com saúde mental foram mencionadas como obstáculos para a efetiva articulação entre os serviços. A lógica do encaminhamento e da desresponsabilização, bem como a hegemonia do modelo biomédico e a consequente fragmentação dos cuidados se mostram vigentes no cotidiano dos serviços.The objective of this paper was to describe and analyze the articulation between children and adolescent mental health care interventions undertaken by teams working under the Family Health Strategy (FHS and Psychosocial Care Centers for Children and Adolescents (CAPSI for. In order to achieve these objectives, semi-structured interviews were conducted with five CAPSI and 13 FHS managers from five different regions of the city of São Paulo, Brazil. The 18 interviews were transcribed and analyzed froma hermeneutic perspective. It was found that interactions between the FHS and CAPSI occur mainly through referral of cases, matrix support or partnerships in cases concerning CAPSI. Obstacles, such as a lack of human resources, productivity goals and lack of training in mental health of FHS professionals were mentioned. The referral system and passing
... appropriate communications with young patients, Copen said. Michael Resnick, immediate past president of the Society for Adolescent ... communication between parents and their adolescent children, said Resnick, chair of adolescent health and development at the ...
Canetti, Laura; Bachar, Eytan; Galili-Weisstub, Esti; De-Nour, Atara Kaplan; Shalev, Arieh Y.
Examines the relationship between parental bonding and mental health in healthy adolescents. Results, based on 847 Israeli high school students, show that those who reported high care and low control (optimal bonding) reported less distress, better general well-being, and better social support than did all other groups. (RJM)
Gans, Janet E.; And Others
Many adolescent health problems are linked with educational performance, family relationships, poverty, and the general lifestyles that adolescents experience in their communities. Although serious, chronic medical and psychiatric disorders affect about 6 percent of the adolescent population, many more adolescents are at risk for death and for…
Manning, Amy R
The state of child and adolescent overall health in the United States evidences the need for both prevention and treatment. Although much time and energy has been spent in recent years discussing and improving health benefit coverage and affordability for children, physical access to services has not kept pace with these changes. This article will introduce four major physical health issues (obesity, diabetes, asthma, and teen pregnancy/STD) and five key mental health issues (suicide, depression, ADHD, aggression, and violence) facing young people today. In an effort to answer the question, "What can be done?" school-based health clinics and their impact on health and educational outcomes are examined.
Sara Mota Borges Bottino; Cássio M. C. Bottino; Caroline Gomez Regina; Aline Villa Lobo Correia; Wagner Silva Ribeiro
Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS). The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrator...
May 5, 1999 ... the technicians aimed at improving the services in health centres within ... Settings: Twenty seven health centres in Amhara region, north .... man power in the laboratory .... service consumption in a teaching hospital in Gondar,.
Manchester, Ralph A.; Greenland, Philip
This paper reviews the concept of behavioral risk factors for atherosclerosis which become entrenched in adolescence or young adulthood. Evidence favoring intervention in the adolescent years and a screening program at the University of Rochester Health Service are described. A preliminary strategy for prevention of atherosclerosis on campus is…
There has been, and still is a firm belief that regular use of dental services is beneficial for all. Thus governments in most European countries have shown some interest in training oral health care professionals, distributing the dental workforce and cost sharing. Constantly evolving treatment options and the introduction of new methods make dental clinicians feel uncertain as to which treatments are most useful, who would benefit from them, and which treatments will achieve cost-effective health gain. Although there is a considerable quantity of scientific literature showing that most available preventive measures are effective, and the number of sensible best-practice guidelines in prevention is growing, there are few studies on cost-efficiency of different methods and, secondly, the prevention and treatment guidelines are poorly known among general practitioners. In the eyes of the public, it is obvious that preventive methods practised by patients at home have been eclipsed by clinical procedures performed in dental clinics. Reliance on an increasingly individualistic approach to health care leads to the medicalisation of issues that are not originally health or medical problems. It is important to move general oral disease prevention back to the people who must integrate this in their daily routines. Prevention primarily based on healthy lifestyles, highlighted in the new public health strategy of the European Union (EU), is the key to future health policy.
Moriarty Daley, Alison; Sadler, Lois S; Dawn Reynolds, Heather
Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15-19-year-old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher-order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the healthcare system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood.
Francis, Greta; Radka, Dale F.
This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…
Gearing, Robin E; Brewer, Kathryne B; Schwalbe, Craig S J; MacKenzie, Michael J; Ibrahim, Rawan W
Stigma is a fundamental barrier to individuals seeking out mental health treatment in the Middle East. The impact of stigma may be amplified if the engagement in and utilization of mental health services for psychosis further stigmatizes individuals and their families. One hundred four Jordanians (N = 104) participated in an experimental vignette survey examining stigma perceptions and social exclusion related to adolescents with psychosis, with the vignettes varying in sex of the youth and whether their family had sought mental health services. The results found that seeking treatment did not add to perceived stigma, and both the male and female adolescents receiving mental health treatment were viewed as significantly more likely to be helped than those not in treatment (p mental health treatment did not further stigmatize these Arab youth with psychosis. In addition, seeking out and engaging adolescents and their family in mental health treatment were positively perceived and may help to improve the youth's prognosis and outcomes.
Nichols, Don D.
This paper provides a synoptic review of student health services at the community college level while giving a more detailed description of the nature of health services at Orchard Ridge, a campus of Oakland Community College. The present College Health Service program provides for a part-time (24 hrs./wk.) nurse at Orchard Ridge. A variety of…
Prashant Kumar Singh
Full Text Available BACKGROUND: Coupled with the largest number of maternal deaths, adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed. METHODOLOGY/PRINCIPAL FINDINGS: Using the data from third wave of National Family Health Survey (2005-06, available in public domain for the use by researchers, this paper examines the factors associated with the utilization of maternal healthcare services among married adolescent women (aged 15-19 years in rural India. Three components of maternal healthcare service utilization were measured: full antenatal care, safe delivery, and postnatal care within 42 days of delivery for the women who gave births in the last five years preceding the survey. Considering the framework on causes of maternal mortality proposed by Thaddeus and Maine (1994, selected socioeconomic, demographic, and cultural factors influencing outcome events were included as the predictor variables. Bi-variate analyses including chi-square test to determine the difference in proportion, and logistic regression to understand the net effect of predictor variables on selected outcomes were applied. Findings indicate the significant differences in the use of selected maternal healthcare utilization by educational attainment, economic status and region of residence. Muslim women, and women belonged to Scheduled Castes, Scheduled Tribes, and Other Backward Classes are less likely to avail safe delivery services. Additionally, adolescent women from the southern region utilizing the highest maternal healthcare services than the other regions. CONCLUSIONS: The present study documents several socioeconomic and cultural factors affecting the utilization of maternal healthcare services among rural adolescent women in India. The ongoing healthcare programs should start
Boone, Tanya L.; Lefkowitz, Eva S.
Fifty-two mother-adolescent dyads (mean adolescent age = 16.3) participated in an observational study of communication about health topics. The aim of the study was to examine mother-adolescent conversations about health issues--drugs/alcohol, sexuality, nutrition/exercise--to determine the extent to which the mothers treat these issues similarly.…
Uddin, Md Jashim; Choudhury, Abdul Mannan
This article presents the status of rural Bangladeshi adolescent girls' awareness about reproductive health. Analysis of data revealed that a sizable proportion of adolescent girls had incorrect knowledge or misconceptions about the fertile period, reproduction, sexually transmitted diseases, and HIV/AIDS. Age, education either of adolescents or their mothers, residence, and exposure to mass media were the significant predictors of adolescent girls' knowledge about reproductive health. Strong efforts are needed to improve awareness and to clarify misconceptions about reproductive health. Improved access to mass media and education could improve rural Bangladeshi adolescent girls' awareness about reproductive health.
Okunseri, Christopher; Okunseri, Elaye; Garcia, Raul I.; Visotcky, Alexis (Dye); Szabo, Aniko
Objective To examine longitudinal trends and associated factors in dental service utilization by adolescents progressing to early adulthood in the United States. Data Source The National Longitudinal Study of Adolescent Health from Waves I (1994-95), II (1996), III (2001-2002) and IV (2007-2008). Study Design This is a retrospective, observational study of adolescents' transition to early adulthood. We obtained descriptive statistics and performed logistic regression analyses to identify the effects of baseline and concurrent covariates on dental service utilization from adolescence to early adulthood over time. Principal Findings Dental service utilization within the prior 12 months peaked at age 16 (72%), gradually decreased until age 21 (57%), and thereafter remained flat. Whites and Asians had a 10-20 percentage points higher proportion of dental service utilization at most ages compared to Blacks and Hispanics. Dental service utilization at later follow-up visits was strongly associated with baseline utilization with OR= 10.7, 2.4 and 1.5 at the 1-year, 7-year and 13-year follow-ups respectively. These effects decreased when adjusted for current income, insurance and education. Compared to Whites, Blacks were consistently less likely to report any dental examination. Conclusion Dental service utilization was highest in adolescents. Gender, education, health insurance and income in young adulthood were significant predictors of reporting a dental examination. Blacks had lower odds of reporting a dental examination either as adolescents or as young adults. PMID:23850156
Selkie, Ellen M.; Benson, Meghan; Moreno, Megan
Background: Adolescents frequently report barriers to obtaining sexual health education. Purpose: The purpose of this study was to determine adolescents' views regarding how new technologies could be used for sexual health education. Methods: Focus group interviews were conducted with a purposeful sample of adolescents between 14 and 19 years old.…
Nixon, Charisse L
Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents' health and well-being. A plethora of correlational studies have demonstrated a cogent relationship between adolescents' involvement in cyberbullying and negative health indices. Adolescents who are targeted via cyberbullying report increased depressive affect, anxiety, loneliness, suicidal behavior, and somatic symptoms. Perpetrators of cyberbullying are more likely to report increased substance use, aggression, and delinquent behaviors. Mediating/moderating processes have been found to influence the relationship between cyberbullying and adolescent health. More longitudinal work is needed to increase our understanding of the effects of cyberbullying on adolescent health over time. Prevention and intervention efforts related to reducing cyberbullying and its associated harms are discussed.
Hill, Peter S; Dodd, Rebecca; Dashdorj, Khurelmaa
Since its transition to democracy, Mongolia has undergone a series of reforms, both at national level and in the health sector. This paper examines the pace and scope of these reforms, the ways in which they have impacted on sexual and reproductive health services and their implications for the health workforce. Formerly pro-natalist, Mongolia has made significant advances in contraceptive use, women's education and reductions in maternal mortality. However, rising adolescent pregnancy and sexually transmitted infections, and persisting high levels of abortion, remain challenges. The implementation of the National Reproductive Health Programme has targeted skills development, outreach and the provision of resources. Innovative adolescent-friendly health services have engaged urban youth, and the development of family group practices has created incentives to provide primary medical care for marginalised communities, including sexual and reproductive health services. The Health Sector Strategic Masterplan offers a platform for coordinated development in health, but is threatened by a lack of consensus in both government and donor communities, competing health priorities and the politicisation of emerging debates on fertility and abortion. With previous gains in sexual and reproductive health vulnerable to political change, these tensions risk the exacerbation of existing disparities and the development by default of a two-tiered health care system.
Jan 18, 2011 ... health services, nursing services, and health education. Other areas ... (2001) sees school health services to be those services that take care of the health needs ..... Network, Family Health International 14:2:30. Chisango, T.
Over the past decade, there has been a dramatic increase in the population of juvenile offenders in the United States. Juveniles detained or confined in correctional care facilities have been shown to have numerous health problems. Such conditions may have existed before incarceration; may be closely associated with legal problems; may have resulted from parental neglect, mental health disorders, or physical, drug, or sexual abuse; or may develop within the institutional environment. Delinquent youths are often disenfranchised from traditional health care services in the community. For these adolescents, health care provided through correctional services may be their major source of health services. Pediatricians and correctional health care systems have an opportunity and responsibility to help improve the health of this underserved and vulnerable group of adolescents.
Murcott, W J
A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.
Begun, James W; Kaissi, Amer
The definition and scope of health services administration are important to public policy, educational programs, new entrants to the field, and practitioners. Formal definition of the field of health services administration has not received concerted attention since 1975. Significant changes in the field have occurred since that time, widening opportunities for graduates of educational programs and increasing interdependencies between health services organizations and public policy organizations, supplier organizations, insurers, and other businesses that are not involved directly in health services delivery. Stakeholders in the field of health services administration should consider a broadened definition of the field that would institutionalize and build on those increased opportunities and interdependencies.
Hauff, Alicia J; Secor-Turner, Molly
The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.
Lee, Dong-Yun; Kim, Seo-Hee; Woo, Sook Young; Yoon, Byung-Koo; Choi, DooSeok
Abstract Homosexual adolescents may face significant health disparities. We examined health-risk behaviors and health cognition related to homosexual behavior in a representative sample of adolescents. Data were obtained from 129,900 adolescents between 2008 and 2012 over 5 cycles of the Korean Youth Risk Behavior Survey, a national survey of students in grades 7 to 12. Various health-risk behaviors and aspects of health cognition were compared between homosexual and heterosexual adolescents ...
Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis
In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.
Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan
Abstract Introduction: To describe the Danish National Health Service Register in relation to research. Content: The register contains data collected for administrative and scientific purposes from health contractors in primary health care. It includes information about citizens, providers...
Shahabuddin, Asm; Nöstlinger, Christiana; Delvaux, Thérèse; Sarker, Malabika; Delamou, Alexandre; Bardají, Azucena; Broerse, Jacqueline E W; De Brouwere, Vincent
The huge proportion of child marriage contributes to high rates of pregnancies among adolescent girls in Bangladesh. Despite substantial progress in reducing maternal mortality in the last two decades, the rate of adolescent pregnancy remains high. The use of skilled maternal health services is still low in Bangladesh. Several quantitative studies described the use of skilled maternal health services among adolescent girls. So far, very little qualitative evidence exists about attitudes and practices related to maternal health. To fill this gap, we aimed at exploring maternal health care-seeking behavior of adolescent girls and their experiences related to pregnancy and delivery in Bangladesh. A prospective qualitative study was conducted among thirty married adolescent girls from three Upazilas (sub-districts) of Rangpur district. They were interviewed in two subsequent phases (2014 and 2015). To triangulate and validate the data collected from these married adolescent girls, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with different stakeholders. Data analysis was guided by the Social-Ecological Model (SEM) including four levels of factors (individual, interpersonal and family, community and social, and organizational and health systems level) which influenced the maternal health care-seeking behavior of adolescent girls. While adolescent girls showed little decision making-autonomy, interpersonal and family level factors played an important role in their use of skilled maternal health services. In addition, community and social factors and as well as organizational and health systems factors shaped adolescent girls' maternal health care-seeking behavior. In order to improve the maternal health of adolescent girls, all four levels of factors of SEM should be taken into account while developing health interventions targeting adolescent girls.
Shahabuddin, Asm; Nöstlinger, Christiana; Delvaux, Thérèse; Sarker, Malabika; Delamou, Alexandre; Bardají, Azucena; Broerse, Jacqueline E. W.; De Brouwere, Vincent
Background The huge proportion of child marriage contributes to high rates of pregnancies among adolescent girls in Bangladesh. Despite substantial progress in reducing maternal mortality in the last two decades, the rate of adolescent pregnancy remains high. The use of skilled maternal health services is still low in Bangladesh. Several quantitative studies described the use of skilled maternal health services among adolescent girls. So far, very little qualitative evidence exists about attitudes and practices related to maternal health. To fill this gap, we aimed at exploring maternal health care-seeking behavior of adolescent girls and their experiences related to pregnancy and delivery in Bangladesh. Methods and Findings A prospective qualitative study was conducted among thirty married adolescent girls from three Upazilas (sub-districts) of Rangpur district. They were interviewed in two subsequent phases (2014 and 2015). To triangulate and validate the data collected from these married adolescent girls, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with different stakeholders. Data analysis was guided by the Social-Ecological Model (SEM) including four levels of factors (individual, interpersonal and family, community and social, and organizational and health systems level) which influenced the maternal health care-seeking behavior of adolescent girls. While adolescent girls showed little decision making-autonomy, interpersonal and family level factors played an important role in their use of skilled maternal health services. In addition, community and social factors and as well as organizational and health systems factors shaped adolescent girls’ maternal health care-seeking behavior. Conclusions In order to improve the maternal health of adolescent girls, all four levels of factors of SEM should be taken into account while developing health interventions targeting adolescent girls. PMID:28095432
This paper describes the setting up and the first year of running of an innovative outreach service for adolescents on the edge of care that aimed at redressing family breakdown and preventing placements in the care system. It was a collaborative endeavour between social services and a child and adolescent mental health provision to facilitate the…
Mark, Daniella; Armstrong, Alice; Andrade, Catarina; Penazzato, Martina; Hatane, Luann; Taing, Lina; Runciman, Toby; Ferguson, Jane
In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries. Two hundred and eighteen facilities, responsible for an estimated 80,072 HIV-infected adolescents in care, were surveyed. Sixty per cent of the sample were from PATA's network, with the remaining gathered via local NGO partners and snowball sampling. Data were analysed using descriptive statistics and coding to describe central tendencies and identify themes. Respondents represented three subregions: West and Central Africa (n = 59; 27%), East Africa (n = 77, 35%) and southern Africa (n = 82, 38%). Half (50%) of the facilities were in urban areas, 17% peri-urban and 33% rural settings. Insufficient data disaggregation and outcomes monitoring were critical issues. A quarter of facilities did not have a working definition of adolescence. Facilities reported non-adherence as their key challenge in adolescent service provision, but had insufficient protocols for determining and managing poor adherence and loss to follow-up. Adherence counselling focused on implications of non-adherence rather than its drivers. Facilities recommended peer support as an effective adherence and retention intervention, yet not all offered these services. Almost two-thirds reported attending to adolescents with adults and/or children, and half had no transitioning protocols. Of those with transitioning protocols, 21% moved pregnant adolescents into adult services earlier than their peers. There was limited sexual and reproductive health integration, with 63% of facilities offering
Dixon, Decia Nicole
Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…
To describe perceptions of health status among a sample of urban minority adolescents and the contribution of demographics, intrinsic motivation, general self-efficacy, risk taking, and stressful life experiences on the adolescent's perception of health status. Correlational design. A total of 71 adolescents were studied using the Adolescent Health Chart for perceived health status, the Health Self-Determinism Index for Children, the Self-Efficacy Scale, the Risk Taking Instrument, and the Life Events Checklist. There were no statistically significant effects of demographics on perceived health status. Scores of Perceived Health Status correlated with scores of self-efficacy (r = 0.56; p perceived health status in urban minority adolescents. The results contribute to the present body of knowledge about patterns of adolescent health as perceived by the adolescent. In addition to expanding the understanding of the minority adolescent experience in relation to health promotion attributes and health compromising behaviors, the results identify antecedents that are predictive of improved perceived health status for the urban adolescent.
Estes, Rebecca I.; Fette, Claudette; Scaffa, Marjorie E.
The need for system reform for child and adolescent mental health services, long recognized as a vital issue, continues to challenge mental health professionals. While past legislation has not adequately addressed the issues, the 2003 President's New Freedom Commission may begin to reorient mental health systems toward recovery. Supported by this…
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Vera Lúcia Almeida Formigli
Full Text Available Foram avaliados a cobertura, a adequação, a acessibilidade e o padrão de utilização do Serviço de Saúde dos Adolescentes da comunidade de Emaús, Belém, Pará, no período de 1994 a 1996. A cobertura foi estimada com base nos registros da unidade de saúde e de informações colhidas junto à população-alvo; a adequação foi analisada por comparação com as condições estabelecidas para esse tipo de serviço pela OPS/OMS; a acessibilidade e o padrão de utilização foram avaliados tomando-se por base inquérito populacional com os adolescentes da área. Os resultados apontaram: bom grau de adequação do programa à sua finalidade, necessitando ajustes, especialmente no item recursos humanos; inexistência de barreiras de acesso dos usuários ao serviço; cobertura das ações satisfatória, embora com baixa concentração de atendimentos por adolescente; padrão de utilização compatível com o perfil de oferta, direcionado principalmente à assistência curativa e individual. Recomendações são feitas no sentido de reverter o modelo assistencial prevalecente, de modo a enfatizar atividades preventivas, coletivas e educativas com maior potencial de efetividade para a promoção da saúde da população adolescente.The authors evaluate the Adolescent Health Clinic in the Emaús community in Belém, Pará, Brazil with regard to coverage, adequacy, accessibility, and utilization for the period 1994 to 1996. Coverage was calculated on the basis of clinical records and information collected from the target population. Adequacy was analyzed by comparing the service performance with goals established by PAHO/WHO for this kind of institution. Accessibility and utilization patterns were evaluated from information obtained by a population-based survey among adolescents living in the area. Results showed: a good degree of program adequacy vis-à-vis the final purpose, although some adjustments are needed, especially in human resources
Full Text Available Abstract Background Children and adolescents from complex or disadvantaged backgrounds and multiple needs often are reluctant to seek help and this is particularly relevant in the context of mental health difficulties. Further, the complexity of the health system can be overwhelming to the family who are likely to be chaotic and less able to seek help. The current project piloted an integrated service delivery model involving a child psychiatry service and the department of education to promote access to mental health assessment and intervention to young people attending special education schools in Sydney, Australia. Findings and conclusion The project allowed improved access to mental health services for a group of young people who would otherwise not have sought help through traditional referral pathways. Our findings support strategies to promote the social milieu of schools as a way of achieving better mental health and learning outcomes.
Full Text Available Background: Adolescents are an important age-group for preventing disease and supporting health yet little is known about their health-seeking behaviours. Objective: We describe socio-demographic characteristics and health-seeking behaviours of adolescents in Soweto, South Africa, in order to broaden our understanding of their health needs. Design: The Botsha Bophelo Adolescent Health Study was an interviewer-administered cross-sectional survey of 830 adolescents (14–19 years conducted in Soweto from 2010 to 2012. Health-seeking behaviours were defined as accessing medical services and/or being hospitalised in the 6 months prior to the survey. Chi-square analysis tested for associations between gender, other socio-demographic and behavioural characteristics, and health-seeking behaviours. Results: Of 830 adolescents, 57% were female, 50% were aged 17–19 years, 85% were enrolled in school, and 78% reported experiencing medium or high food insecurity. Males were more likely than females to report sexual debut (64% vs. 49%; p<0.0001 and illicit drug use (11% vs. 3%; p<0.0001. Approximately 27% (n=224 and 8% (n=65 reported seeking healthcare or being hospitalised respectively in the previous 6 months, with no significant differences by gender. Services were most commonly sought at medical clinics (75%, predominantly because of flu-like symptoms (32%, followed by concerns about HIV (10%. Compared to females, males were more likely to seek healthcare for condom breakage (8% vs. 2%; p=0.02. Relative to males, a significantly higher proportion of females desired general healthcare services (85% vs. 78%; p=0.0091, counselling (82% vs. 70%; p<0.0001, and reproductive health services (64% vs. 56%; p=0.02. Conclusions: A quarter of male and female adolescents accessed health services in the 6 months prior to the interview. Adolescents reported a gap between the availability and the need for general, reproductive, and counselling services. Integrated
Panini, Roberta; Fiorini, Fulvio
In the last twenty years, the hospitals have become firms, therefore they have had the necessity to differentiate from each other.Thus, as it is done in the commercial firms, in the health service different formality of communication are studied and introduced in order to attract new consumers and to maintain their trust. Furthermore, due to the introduction of the digitization in the Public Administrations, the communication has become more transparent.A systematic application of communication tools is more and more spread among the Sanitary Firms, whether they are Local Firm or Hospital Firm.Regarding the reference population, communication tools are used with different purposes such as educational and informative. In addition, they are applied as institutional marketing tool, in order to show the offered potentialities and also to increase the level of satisfaction in the patients/consumers who perceive the typology of reception and treatment during the sanitary performance.
Phillips, Natalie Lynette; Milne, Bronwyn; Silsbury, Catherine; Zappia, Popi; Zehetner, Anthony; Klineberg, Emily; Towns, Susan; Steinbeck, Katharine
The aim of this study is to review the operation of a specialist adolescent drug and alcohol consultation liaison service in a tertiary paediatric hospital. A retrospective review of patient records was conducted to identify patient characteristics and assess service utilisation. Two hundred adolescents were referred over 4 years. Most presented during mid-adolescence (14-16 years). Alcohol, cannabis and nicotine were the most frequently reported substances, and almost half of referrals involved polysubstance use. Mental health diagnoses and behavioural problems were commonly reported. Almost two-thirds (63.5%) attended an appointment for drug and alcohol assessment and intervention (n = 92) or were referred to appropriate services (n = 35). Adolescents more likely to engage and attend an appointment with the specialist adolescent addiction medicine service included those with amphetamine use, polysubstance use, chronic illness, any mental health diagnosis and mood disorder. Indigenous Australians and those with a history of aggression were more difficult to engage. Adolescents present to paediatric health settings with drug- and alcohol-related issues, including associated harms. These comprise, but are not limited to, physical and sexual assault, family conflict, mood and behavioural concerns (including psychosis), and forensic issues. Early intervention aims to reduce long-term risks such as dependence in adulthood. Specialist adolescent drug and alcohol services may assist in identifying and engaging these high-risk and often complex young people in developmentally appropriate treatment. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Hansen, Claus D.; Andersen, Johan Hviid
to school performance and subsequent educational achievements. The aim of this study was to examine the impact of health measures on school performance at the end of compulsory school (9 years of school). Methods Information from a birth cohort study of adolescents born in 1989 (n = 3058) living...... and depressive symptoms. If parents report health problems for the participant between ages 7 and 14, grades decrease with 0.89 (95% CI 0.44 to 1.32). Conclusions Frequent headache, perceived stress and depressive symptoms contributes to lower grades at the end of compulsory school, thereby indicating...
Tucker, Corinna Jenkins; Van Gundy, Karen; Sharp, Erin Hiley; Rebellon, Cesar
We describe adolescents' perpetration of sibling aggression and its link to physical health two years later. In-school surveys at Time 1 (N = 331) and Time 2 (two-years later, N = 283) were administered to adolescents (at Time 1, Mage = 15.71 years, SD = .63; 52% female) living in the United States querying about perpetration of aggression toward a sibling closest in age and perceived physical health. The majority of adolescents perpetrated aggression towards their sibling (74%). Adolescents who were part of brother-brother pairs reported the most aggression. Hierarchical regression analysis showed that perpetrating sibling aggression more often at Time 1 was predictive of lower physical health at Time 2 controlling for Time 1 physical health and demographic characteristics. Perpetration of aggression toward a sibling is common and has negative health consequences in late adolescence suggesting this issue should be targeted to improve adolescents' sibling dynamics and physical health.
Chang, Fong-Ching; Chiu, Chiung-Hui; Chen, Ping-Hung; Miao, Nae-Fang; Lee, Ching-Mei; Chiang, Jeng-Tung; Pan, Ying-Chun
This study examined the relationship between parental and adolescent eHealth literacy and its impact on online health information seeking. Data were obtained from 1,869 junior high school students and 1,365 parents in Taiwan in 2013. Multivariate analysis results showed that higher levels of parental Internet skill and eHealth literacy were associated with an increase in parental online health information seeking. Parental eHealth literacy, parental active use Internet mediation, adolescent Internet literacy, and health information literacy were all related to adolescent eHealth literacy. Similarly, adolescent Internet/health information literacy, eHealth literacy, and parental active use Internet mediation, and parental online health information seeking were associated with an increase in adolescent online health information seeking. The incorporation of eHealth literacy courses into parenting programs and school education curricula is crucial to promote the eHealth literacy of parents and adolescents.
Feb 15, 2013 ... Community Health, Ambrose Alli University, Ekpoma, Edo State. Corresponding ... significant relationship between smoking and self-reported academic performance (X2 = 5.002; p=0.025; OR = 0.47; ... of the common habits that young people develop ... twin social vice of alcohol abuse which altogether.
Adlung, R.; Carzaniga, A.
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). ...
Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick
In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.
... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...
Charisse L Nixon Pennsylvania State University, the Behrend College, Erie, PA, USA Abstract: Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents' health...
Blythe, Margaret J; Del Beccaro, Mark A
Privacy and security of health information is a basic expectation of patients. Despite the existence of federal and state laws safeguarding the privacy of health information, health information systems currently lack the capability to allow for protection of this information for minors. This policy statement reviews the challenges to privacy for adolescents posed by commercial health information technology systems and recommends basic principles for ideal electronic health record systems. This policy statement has been endorsed by the Society for Adolescent Health and Medicine.
Dwairy, Marwan; Menshar, Kariman E.
Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female…
Dwairy, Marwan; Menshar, Kariman E.
Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female…
Pennington, Nicole; Johnson, Molly; Delaney, Elizabeth; Blankenship, Mary Beth
A new hazard for adolescents is the negative health effects of energy drink consumption. Adolescents are consuming these types of drinks at an alarming amount and rate. Specific effects that have been reported by adolescents include jitteriness, nervousness, dizziness, the inability to focus, difficulty concentrating, gastrointestinal upset, and…
Pennington, Nicole; Johnson, Molly; Delaney, Elizabeth; Blankenship, Mary Beth
A new hazard for adolescents is the negative health effects of energy drink consumption. Adolescents are consuming these types of drinks at an alarming amount and rate. Specific effects that have been reported by adolescents include jitteriness, nervousness, dizziness, the inability to focus, difficulty concentrating, gastrointestinal upset, and…
Hokororo, Adolfine; Kihunrwa, Albert F; Kalluvya, Samuel; Changalucha, John; Fitzgerald, Daniel W; Downs, Jennifer A
In Tanzania, approximately 25% of adolescents give birth and 50% more become sexually active during adolescence. We hypothesised that reproductive health education and services for adolescent girls are inaccessible and conducted this study to gain insights into their perceptions of sexually transmitted infections (STIs) and barriers to reproductive health service utilisation in rural Mwanza, Tanzania. We conducted nine focus groups among pregnant adolescents aged 15-20 years. Data were transcribed, translated and coded for relevant themes using NVivo10 software for qualitative data analysis. Most participants were aware of the dangers of STIs to themselves and their unborn babies, but did not perceive themselves as at risk of acquiring STIs. They viewed condoms as ineffective for preventing STIs and pregnancies and unnecessary for those in committed relationships. Stigma, long waiting times, and lack of privacy in the clinics discouraged adolescent girls from seeking reproductive health care. Reproductive health care for adolescent girls who are not pregnant is practically nonexistent in Tanzania. Healthcare access for pregnant young women is also limited. Targeted changes to increase clinic accessibility and to provide reproductive health education to all rather than only pregnant women have the potential to address these gaps. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior
Leroy, Zanie C.; Wallin, Robin; Lee, Sarah
Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for…
Leroy, Zanie C.; Wallin, Robin; Lee, Sarah
Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for…
Dwairy, Marwan; Menshar, Kariman E
Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female adolescents. In urban communities, on the other hand, the authoritarian style was more predominant in the parenting of female adolescents. The connectedness of all female adolescents with their family was stronger than that of male adolescents. The connectedness of girls was found to be more emotional and financial in villages and to be more functional in town. Female adolescents reported a higher frequency of psychological disorders. Mental health was associated with authoritative parenting, but not with authoritarian parenting. It seems that authoritarian parenting within an authoritarian culture is not as harmful as within a liberal culture.
Banspach, Stephen; Zaza, Stephanie; Dittus, Patricia; Michael, Shannon; Brindis, Claire D; Thorpe, Phoebe
Approximately 42 million adolescents aged 10-19 years, representing 13% of the population, resided in the United States in 2014 (1). Adolescence is characterized by rapid and profound physical, intellectual, emotional, and psychological changes (2), as well as development of healthy or risky behaviors that can last a lifetime. Parents have strong influence on their adolescent children's lives, and family-based programs can help parents support healthy adolescent development. Because schools are natural learning environments, implementing and improving school-based policies and programs are strategic ways to reinforce healthy behaviors and educate adolescents about reducing risky behaviors. Health care during adolescence should be tailored to meet the changing developmental needs of the adolescent while providing welcoming, safe, and confidential care. Parents, educators, care providers, public health officials, and communities should collaborate in fostering healthy environments for all adolescents, now and into the future.
Johnson, Jeffrey G; Cohen, Patricia; Kasen, Stephanie
Data from a community-based prospective longitudinal study were used to investigate the association of minor depressive disorder during adolescence with adverse mental health outcomes during adulthood...
De Sanctis, V; Clemente, S; Gallotta, M; Filati, G; Fiscina, B; Marsciani, A; Piacentini, G; Timoncini, G; Reggiani, L; Zucchini, A; Zunelli, C
Adolescent medicine is a field dedicated to helping young people grow and thrive, in relation to their particular stage of development. In Italy, adolescent medicine is not a distinct speciality, but it is practised in some services for adolescents in paediatric departments. Increasing educational opportunities in adolescent health may help to accelerate the development and dissemination of new and improved therapeutic approaches for serving youth and also attract a larger cadre of physicians. Other pediatric subspecialties, e.g. oncology, rheumatology and adolescent psychiatry, have developed successfully and may represent excellent models for adolescent medicine specialists to emulate. The Adolescent Health Study Group of the Emilia and Romagna Region (SGA-ER) was established in 2010 in an effort to generate strategies and possible solutions to improve the quality and quantity of knowledge in adolescent health care for pediatricians and GPs. Several methods and approaches have been implemented to improve physicians' skills in adolescent health care. The authors report the goals, content and instructional design of an educational course in adolescent medicine. Alliances with other adolescent health groups may provide an additional opportunity for networking, interaction and exchange of ideas amongst professionals.
Turner, Win C; Muck, Randolph D; Muck, Rebekah J; Stephens, Robert L; Sukumar, Bhuvana
This article explores the rates of co-occurring disorders in two large federally-funded programs that target youth. In the mental health treatment system, the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) supports the Comprehensive Community Mental Health Services for Children and Their Families Program. SAMHSA's Center for Substance Abuse Treatment (CSAT) supports a number of grant programs providing substance abuse treatment for adolescents. The data from these programs underscores the need for the use of systematic, validated, biopsychosocial assessment instruments for all youth entering either the substance abuse or mental health treatment systems. The current evidence base for models of co-occurring treatment for youth is discussed and recommendations made for future activity related to adolescent co-occurring treatment.
Hamdan, Sami; Auerbach, Judy; Apter, Alan
The objective is to study the influence of polygamous versus monogamous marriage on the mental health of adolescents in an Israeli Bedouin population. Pupils aged 11-18 years attending schools in Bedouin Arab communities in southern Israel were asked to complete a demographic questionnaire and a panel of psychological instruments measuring competence and behavioral problems, anxiety and depression. Findings were compared between pupils of families with one wife and pupils of families with more than one wife. The population comprised 406 pupils of mean age 14.5 years; 56% were female. Fifty-three percent were from polygamous marriages and 47% from monogamous marriages. After allowing for the influence of socioeconomic factors, there were no differences between offspring of polygamous marriages and those of monogamous marriages for any of the psychological scales. When polygamy is the accepted practice in a particular social milieu, it does not have a deleterious psychological effect on adolescents.
Bottino, Sara Mota Borges; Bottino, Cássio M C; Regina, Caroline Gomez; Correia, Aline Villa Lobo; Ribeiro, Wagner Silva
Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS). The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrators of cyberbullying. Daily use of three or more hours of Internet, web camera, text messages, posting personal information and harassing others online were associated with cyberbullying. Cybervictims and cyberbullies had more emotional and psychosomatic problems, social difficulties and did not feel safe and cared for in school. Cyberbullying was associated with moderate to severe depressive symptoms, substance use, ideation and suicide attempts. Health professionals should be aware of the violent nature of interactions occurring in the virtual environment and its harm to the mental health of adolescents.
Sara Mota Borges Bottino
Full Text Available Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS. The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrators of cyberbullying. Daily use of three or more hours of Internet, web camera, text messages, posting personal information and harassing others online were associated with cyberbullying. Cybervictims and cyberbullies had more emotional and psychosomatic problems, social difficulties and did not feel safe and cared for in school. Cyberbullying was associated with moderate to severe depressive symptoms, substance use, ideation and suicide attempts. Health professionals should be aware of the violent nature of interactions occurring in the virtual environment and its harm to the mental health of adolescents.
Betancourt, Theresa S; Yudron, Monica; Wheaton, Wendy; Smith-Fawzi, Mary C
To examine the role of caregiver mental health and risk and protective factors in influencing levels of internalizing and externalizing emotional and behavioral symptoms over time among a sample of refugee adolescents. Prospective study of 153 Kunama refugee adolescents receiving an emergency education intervention while living in a camp in Ethiopia. Surveys were collected in 2001 (T1) and 2002 (T2). Adolescent and caregiver mental health were assessed using a Kunamenga adaptation of the Youth Self Report; caregiver mental health was assessed using the Hopkins Symptom Checklist-25. Attitudes toward education, satisfaction with education programming, socioeconomic status, and perceptions of access to services were also explored as variables potentially influencing adolescent mental health at follow-up. Caregiver distress was significantly associated with youth externalizing behavior symptoms (β = 8.34, p refugee displacement. Results suggest that programs targeting mental health in refugee children should consider children within the larger family system, including caregiver influence on child and adolescent mental health adjustment over time. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Background: Low contraceptive use amongst unmarried sexually active young men and women presents an ethical dilemma in Indonesia, particularly in realising reproductive rights as a fundamental human right. This study aims to address the difficulties in extending access to family planning for unmarried sexually active youths. Methods: A review of the laws relating to the provision of family planning was combined with a secondary data analysis of the 2012 Indonesian Demographic Health Survey throughout 6 provinces on the island of Java. The sample population included 5,150 unmarried adolescents, aged 15 to 24 years. The 2012 Indonesian Demographic Health Survey was the first and only survey that included unmarried young women in Indonesia. The association between subjects who had 'ever had sex' and three groups of predictors (demographic characteristics, peer influences, and knowledge of contraceptive methods were examined using multivariate logistic regressions. Results:Results of the study found that subjects who were unmarried but had engaged in sexual activity were more likely to be those aged 19 to 21 years (OR = 2.36 and 22 to 24 years (OR = 6.81, of low education status (OR = 2.1, with a boyfriend or girlfriend (OR = 2.38, and those who approved of pre-marital sex (OR = 8.5. Conclusions: Results from this research suggest that new interpretations of the Law 52/2009 regarding family planning and Law 36/2009 that prohibits health services to unmarried sexually active youths are required in order to address the issues faced by Indonesia's youth
Willoughby, Jessica Fitts
Sexual health text message services are becoming an increasingly popular way to provide adolescents with accurate sexual health information, but promotion of such services is often limited. This study uses three quantitative methods (service use data, a text message-based questionnaire, and an in-school online survey) to assess the effectiveness of an in-school social marketing campaign promoting a sexual health text message service that connects teens directly with a health educator. The 3-month campaign was associated with increased service use, but use was still relatively low. Follow-up qualitative work that included focus groups and interviews found a number of barriers to use. Teens indicated they did not have sexual health questions, did not think of the service, or were unsure how to use it. Teens also brought up additional barriers such as concern over parents seeing the messages. Implications for text message service providers and health educators are discussed.
Childhood and adolescent mental health is a major public health concern. Childhood behavioral problems and low self-esteem can predispose children to future depression. Mental health issues often emerge in adolescence making examination of potential early modifiable risk factors for these three mental health indicators crucial. Potential risk factors for mental health issues often reflect findings from Western settings where confounding by low socioeconomic position may occur, making it diffi...
McGuerty, Amber B.; Cater, Melissa; Prinyawiwatkul, Witoon; Tuuri, Georgianna
Interventions to increase adolescents' healthful food and beverage consumption often fail to demonstrate change. An alternative is to measure a shift in willingness to consume these items as an indicator of movement toward change. A survey was developed to estimate willingness to consume a variety of foods and beverages. Twenty items were…
Bennett, David L; Chown, Peter; Kang, Melissa S-L
In Australia, where about 16% of young people are born overseas and 24% are from a non-English-speaking background, adolescent health care is a multicultural challenge. "Cultural competency" involves challenging one's own cultural assumptions and beliefs, developing empathy for people from other cultures, and applying specific communication and interaction skills in clinical encounters. For health professionals, sensitivity to the cultural, ethnic, linguistic and social diversity among young people helps to avert problems and misunderstandings, improves satisfaction for all concerned and leads to better outcomes. Engaging the family and gaining the trust of parents is critical in treating young people from cultural backgrounds in which participation in health care is a family concern rather than an individual responsibility.
Full Text Available Background: Disengagement of patients from psychiatric care is a known and a serious issue worldwide. However, very limited data are available on dropout of adolescent patients with mental health disorders. Aim: This study was planned to look into the profile and diagnosis of adolescents with single visit to psychiatry outpatient department (OPD. Materials and Methods: A retrospective chart review of cases in the age group of 12-18 years reporting to Psychiatry OPD of a tertiary care hospital of India was carried out. Diagnosis and profile of those who came only once were noted and analyzed for the present study. Results: From 2008 to 2011, a total of 2006 adolescents were registered which included 560 cases with mental retardation, epilepsy, and nil psychiatry. From the remaining 1446 adolescents, 659 (45.57% did not come after the first visit. The rate of dropout at the single visit was significantly higher in females and in the age group of 16-18 years. It was highest in those with borderline intelligence, adjustment disorders, anxiety disorders, dissociative and somatoform disorders, and substance use disorders. Conclusions: There is huge dropout rate at single visit itself in adolescents. Adolescents do not present themselves to psychiatric services in India. Parental understanding of mental disorders needs to be improved to prevent early dropout.
Su, Jing Jing; Lindell, Deborah
In China, nurses have limited presence in schools, thus, adolescent girls often lack accurate information about menstrual health, which may lead to incorrect and unhealthy menstrual-related behavior. This study investigated the effects of a culturally and developmentally tailored nursing intervention on the menstrual health of adolescent girls in China. Following institutional review board approval, adolescent girls aged 12-15 were recruited from two schools. A quasi-experimental, pretest-posttest design examined the effects of five interactive education sessions on menstrual health. The final sample included 116 adolescent girls. Significant improvement was observed in the intervention group regarding menstrual knowledge, confidence in performing menstrual healthcare behavior, and dysmenorrhea related self-care behavior. A nurse-managed education program improved adolescent girls' menstrual knowledge, promoted a more positive attitude, encouraged confidence, and improved pain relief practice. We recommend that professional nurses globally advocate for school nursing and routine menstrual health education for adolescent girls.
Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim
The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and
Full Text Available Jane Burns, Emma Birrell Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia Abstract: International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence
Ali, Moazzam; Bhatti, Mohammad Ayaz; Ushijima, Hiroshi
This is the first study done to explore reproductive health needs of adolescent males in Pakistan. The purpose of this exploratory study was to obtain qualitative information on existing knowledge and perceptions on puberty and reproductive health needs and to identify effective communication channels for imparting reproductive health education to adolescent males. Seventy-eight unmarried adolescent males participated in the survey, conducted through in-depth interviews by a semi-structured questionnaire using purposive sampling, in eight rural districts in Pakistan. The study pointed out that there existed misconceptions and gaps in knowledge regarding puberty and reproductive health. These young men also have poor knowledge about sexually transmitted diseases dynamics. The communication between parents or siblings on the said issues was found to be poor and they mainly get information from friends followed by the media. The majority showed interest in getting quality information. Multiple entry points and settings can be used to enhance access to information and services. In-school adolescents could be effectively approached through teachers and peer group. Out-of-school adolescents could be reached via media and local health care providers. The results imply that there is a dire need for reproductive health education for adolescent males and suggestions from this study might be utilized when initiating any reproductive health educational service for male adolescents in rural areas in Pakistan. Future efforts should thus focus on assuring access to timely, comprehensive and high-quality reproductive health education for all teenagers and reducing gaps in access related to gender and school attendance.
Full Text Available Objectives: To identify the reproductive health issues associated with adolescence and their readiness to avail services like Adolescent Friendly Clinic (AFC among rural school going children. Materials and Methods: A quantitative survey was carried out using a self-administered structured questionnaire among 768 (428 boys and 340 girls students from 15 schools by systematic random sampling from schools (3 schools from 5 talukas. Focus group discussions, 5 each with adolescent boys and girls and teachers were held. Results and Discussion: Only 31% of the boys and 33% of the girls mentioned that they had heard about contraception. More than half of the adolescent boys and girls knew correctly about various modes of transmission of HIV/AIDS. A large proportion of boys and girls have mentioned changes in the opposite sex such as increase in height, change in voice, breast development, and growth of facial hair, growth of hair in private parts, onset of menstruation in girls, etc. Nearly 70% of adolescents were ready to use AFC. Teachers perceived that adolescents become curious about the changes taking place in them, but they lack information and opportunities for open-discussions to get answers to their queries related to reproductive health. They are willing to take help from teachers but teachers are not equipped with knowledge nor are they comfortable discussing these issues with their students. Recommendations: Information on the human reproductive system and related issues on reproductive health need special attention. Teachers′ sensitization to "adolescent health care" is required.
Geckova, A.M.; van Dijk, J.P.; Zezula, I.; Tuinstra, J.; Groothoff, J.W.; Post, Doeke
Objectives: To explore socio-economic health differences among Slovak adolescents. Methods: Socio-economic differences in health (psychological health: GHQ-12, vitality and mental health scale of RAND, experienced health complaints, chronic illness, use of medicines, self-reported health,
Nixon, Charisse L
Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents’ health and well-being. A plethora of correlational studies have demonstrated a cogent relationship between adolescents’ involvement in cyberbullying and negative health indices. Adolescents who are targeted via cyberbullying report increased depressive affect, anxiety, loneliness, suicidal behavior, and somatic symptoms. Perpetrators of cyberbullying are more likely to report increased substance use, aggression, and delinquent behaviors. Mediating/moderating processes have been found to influence the relationship between cyberbullying and adolescent health. More longitudinal work is needed to increase our understanding of the effects of cyberbullying on adolescent health over time. Prevention and intervention efforts related to reducing cyberbullying and its associated harms are discussed. PMID:25177157
万方荣; 卢祖洵; 张金隆
Summary: Based on a survey of community health service organization in several cities, communi-ty health service model based on the family clinic was compared with state-owned communityhealth service model, and status quo, advantages and problems of family community health serviceorganization were analyzed. Furthermore, policies for the management of community health ser-vice organization based on the family clinic were put forward.
Efendi, Ferry; Chen, Ching-Min; Kurniati, Anna; Berliana, Sarni Maniar
Due to the high number of maternal deaths, provision of antenatal care services (ANC) in Indonesia is one of the key aims of the post-Millennium Development Goals agenda. This study aimed to assess the key factors determining use of ANC by adolescent girls and young women in Indonesia. Data from the Indonesia Demographic and Health Survey 2012 were used, with a focus on married adolescent girls (aged 15-19 years, n = 543) and young women (20-24 years, n = 2,916) who were mothers. Bivariate and multiple logistic regression analyses were performed to determine the factors associated with ANC use. The findings indicated that adolescents were less likely to make ANC visits than young women. Richer women were more likely to make four ANC visits in both groups compared to the poorer women. Living in urban areas, higher educational attainment, and lower birth order were also all associated with higher levels of receiving ANC among young women. The results showed that socio-economic factors were related to the use of ANC among adolescent girls and young women. Ongoing health-care interventions should thus put a priority on adolescent mothers coming from poor socio-economic backgrounds.
Wartberg, L; Kriston, L; Kramer, M; Schwedler, A; Lincoln, T M; Kammerl, R
Internet gaming disorder (IGD) has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Currently, associations between IGD in early adolescence and mental health are largely unexplained. In the present study, the relation of IGD with adolescent and parental mental health was investigated for the first time. We surveyed 1095 family dyads (an adolescent aged 12-14 years and a related parent) with a standardized questionnaire for IGD as well as for adolescent and parental mental health. We conducted linear (dimensional approach) and logistic (categorical approach) regression analyses. Both with dimensional and categorical approaches, we observed statistically significant associations between IGD and male gender, a higher degree of adolescent antisocial behavior, anger control problems, emotional distress, self-esteem problems, hyperactivity/inattention and parental anxiety (linear regression model: corrected R(2)=0.41, logistic regression model: Nagelkerke's R(2)=0.41). IGD appears to be associated with internalizing and externalizing problems in adolescents. Moreover, the findings of the present study provide first evidence that not only adolescent but also parental mental health is relevant to IGD in early adolescence. Adolescent and parental mental health should be considered in prevention and intervention programs for IGD in adolescence. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Jung, Mary-Louise; Loria, Karla
Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
Bryant, Carol A; Mayer, Alyssa B; McDermott, Robert J; Panzera, Anthony D; Trainor, John K
Social marketing applies some of the same principles used in commercial marketing for the analysis, planning, execution, and evaluation of programs designed to motivate voluntary behavioral change. It relies on consumer research for understanding the people they hope to change, including their values, aspirations, fears, lifestyle, and factors that motivate and deter them from adopting desired behaviors. Social marketing has been applied in public health settings since the 1980s for promoting such behaviors as safer sex, hypertension and cholesterol control, reduced occurrence of alcohol-impaired driving, improved utilization of public health prevention and screening services, and enactment of better school nutrition policies in schools. Although most evidence for social marketing's utility comes from interventions directed at adult audiences, its application with adolescents may help to address issues that have been challenging or unresponsive to health behavior change specialists. This article describes the basic tenets of social marketing as a behavior change process, identifies its previously successful applications with adolescent audience segments, and offers both lessons learned and projected future applications that employ emerging communication technologies.
The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.
Austin, S B; Rich, M
Marketplace practices are integral to the larger economic and social context of adolescent health risk behaviors. To corporations and marketers, adolescents represent a gold mine of current and future profits. Adolescent incomes increased by almost a third in the 1990s. The annual spending of the U.S. adolescent population is estimated now to have reached 155 billion US dollars. The sheer size of the adolescent population and its spending power are of keen interest to corporations and marketers. This chapter presents a brief history of youth-targeted marketing and examines the major avenues in the media and inside schools that marketers and corporations use today to reach adolescents with their messages and products. It outlines the impact of consumerism and marketing on adolescent health using five case examples: tobacco, alcohol, cosmetic surgery, laxatives, and diet pills. It then concludes with a discussion of resistance efforts, led by health advocates, policy makers, parents, and youth themselves to restrict sales of harmful products to youth and curtail advertisers' access to adolescents in schools. A critical role for adolescent health researchers and advocates is to contribute a public health perspective into ongoing debates over regulating business practices that negatively affect the health of young people.
Elfers, John; Carlton, Lidia; Gibson, Paul; Puffer, Maryjane; Smith, Sharla; Todd, Kay
The Adolescent Sexual Health Work Group commissioned the development of core competencies that define the knowledge, skills, and attitudes necessary for all providers of adolescent sexual and reproductive health. This article describes the background and rationale for this set of competencies, the history and use of competencies, and the process…
Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra H.
The influence of family, school, and religious social contexts on the mental health of Black adolescents has been understudied. This study used Durkheim's social integration theory to examine these associations in a nationally representative sample of 1,170 Black adolescents, ages 13-17. Mental health was represented by positive and negative…
Mason, Michael J.; Korpela, Kalevi
This study analyzed routine locations (activity spaces) of urban adolescents enrolled in a substance abuse treatment program to understand the relationship between their spatial lives and health outcomes such as substance use and mental health. Sixty-eight adolescents were interviewed and produced a list of 199 locations identified as most…
Elfers, John; Carlton, Lidia; Gibson, Paul; Puffer, Maryjane; Smith, Sharla; Todd, Kay
The Adolescent Sexual Health Work Group commissioned the development of core competencies that define the knowledge, skills, and attitudes necessary for all providers of adolescent sexual and reproductive health. This article describes the background and rationale for this set of competencies, the history and use of competencies, and the process…
Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra H.
The influence of family, school, and religious social contexts on the mental health of Black adolescents has been understudied. This study used Durkheim's social integration theory to examine these associations in a nationally representative sample of 1,170 Black adolescents, ages 13-17. Mental health was represented by positive and negative…
Crotty, Bradley H; Slack, Warner V
Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly active role in their health care, online health services should be made easier for them to use and better suited to their health-related needs. Further, the online services should be more welcoming to people of all literacy levels and from all socioeconomic backgrounds.
韩俏英; 李雪云; 李蕾; 汪广秀
目的 评价短信教育对青少年高血压患者健康行为的影响.方法 将50例青少年高血压患者按随机数字表法分为观察组和对照组各25例,对照组进行常规教育,即在患者就诊时由专职教育护士根据收集的信息对患者进行一次即时的面对面口头教育,教育内容包括疾病相关知识、饮食、运动、药物、情绪应对等.观察组由护士根据对照组教育内容有计划地进行为期3个月的短信教育.干预前后采用健康行为量表对患者的健康行为情况进行评定及比较.结果 实施健康教育后,观察组患者健康行为总分为(95.72±4.23)分,对照组为(76.08±3.77)分,两组比较差异有统计学意义(t=17.172,P＜0.01).观察组在自我实现、健康责任、压力处理、人际关系、营养及运动各维度的得分均明显高于对照组[(30.24±2.42)/(23.56±2.26)分,(18.44±1.74)/(15.60±1.76)分,(14.68±1.25)/(9.92±1.35)分,(12.04±1.43)/(10.80±1.08)分,(13.08±1.55)/(11.80±1.22)分,(7.24±1.54)/(4.40±1.32)分],两组比较,差异有统计学意义(t值分别为10.095,5.754,12.933,3.462,3.237,7.007；P＜0.05).结论 对青少年高血压患者进行短信教育,有利于患者养成良好的健康行为,有效地控制血压.%Objective To explore and evaluate the effect of short messaging service (SMS) education on health behavior of adolescent patients with hypertension.Methods Fifty adolescent patients with hypertension were divided into the experimental group and the control group according to random number table method,with 25 cases per group.The patients in the control group received routine education,which meant that the patients were gave a real-time face-to-face verbal education by the full-time education nurses basing on the information collected when they went to hospital,including knowledge of the disease,diet,exercise,drugs,emotional response and so on.The patients in the experimental group were gave SMS education in a
Full Text Available Abstract Background Adolescents with intellectual disability often have poor health and healthcare. This is partly as a consequence of poor communication and recall difficulties, and the possible loss of specialised paediatric services. Methods/Design A cluster randomised trial was conducted with adolescents with intellectual disability to investigate a health intervention package to enhance interactions among adolescents with intellectual disability, their parents/carers, and general practitioners (GPs. The trial took place in Queensland, Australia, between February 2007 and September 2010. The intervention package was designed to improve communication with health professionals and families’ organisation of health information, and to increase clinical activities beneficial to improved health outcomes. It consisted of the Comprehensive Health Assessment Program (CHAP, a one-off health check, and the Ask Health Diary, designed for on-going use. Participants were drawn from Special Education Schools and Special Education Units. The education component of the intervention was delivered as part of the school curriculum. Educators were surveyed at baseline and followed-up four months later. Carers were surveyed at baseline and after 26 months. Evidence of health promotion, disease prevention and case-finding activities were extracted from GPs clinical records. Qualitative interviews of educators occurred after completion of the educational component of the intervention and with adolescents and carers after the CHAP. Discussion Adolescents with intellectual disability have difficulty obtaining many health services and often find it difficult to become empowered to improve and protect their health. The health intervention package proposed may aid them by augmenting communication, improving documentation of health encounters, and improving access to, and quality of, GP care. Recruitment strategies to consider for future studies in this population
Full Text Available Nikolas Aho, Marie Proczkowska Björklund, Carl Göran Svedin Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden Abstract: The main objective of this article was to study the relationship between the different areas of victimization (eg, sexual victimization and psychological symptoms, taking into account the full range of victimization domains. The final aim was to contribute further evidence regarding the bias that studies that focus on just one area of victimization may be introduced into our psychological knowledge. The sample included 5,960 second-year high school students in Sweden with a mean age of 17.3 years (range =16–20 years, standard deviation =0.652, of which 49.6% were females and 50.4% males. The Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children were used to assess victimization and psychological problems separately. The results show that a majority of adolescents have been victimized, females reported more total events and more sexual victimization and childhood maltreatment, and males were more often victims of conventional crime. The majority of victimization domains as well as the sheer number of events (polyvictimization [PV] proved to be harmful to adolescent health, affecting females more than males. PV explained part of the health effect and had an impact on its own and in relation to each domain. This suggests the possibility that PV to a large degree explains trauma symptoms. In order to understand the psychological effects of trauma, clinicians and researchers should take into account the whole range of possible types of victimization. Keywords: victimization, childhood trauma, psychological symptoms, JVQ, TSCC
Wilson-Mitchell, Karline; Bennett, Joanna; Stennett, Rosain
A recent Jamaican school-based survey revealed that 23.1% of 13–15 year-olds, had attempted suicide one or more times during the last 12 months. Research that links adolescent pregnancy and suicidal behaviour is lacking in Jamaica. Psychological distress and suicidal behaviours amongst pregnant adolescents elsewhere in the Americas has been documented at prevalence of between 13.3%–20%. The purpose of the study was to explore the experiences and the impact of pregnancy on pregnant adolescent psychological health. Individual interviews and focus groups were conducted with adolescents in two Jamaican antenatal clinics. One clinic was designed as a ‘Teen Pregnancy Clinic’ and the other used the standard antenatal clinic design. The following themes were identified: decision-making, resilience, social support, community support system, distress, and perceptions of service. Participants reported positively on the specific interventions tailored to their needs at the Teen Clinic. Although motherhood is valued, none of the pregnancies in this study were planned by the mother. Of the 30 adolescents interviewed, seven cases were referred for counseling due to their need for emotional and psychological support. One of the adolescents reported recent sexual violence and another reported having experienced childhood sexual abuse. Historically, Jamaican adolescent mothers faced barriers to education, self determination, and family planning. Empowering, adolescent-centred healthcare and comprehensive reproductive health education may mitigate psychosocial distress. PMID:24785743
Full Text Available A recent Jamaican school-based survey revealed that 23.1% of 13–15 year-olds, had attempted suicide one or more times during the last 12 months. Research that links adolescent pregnancy and suicidal behaviour is lacking in Jamaica. Psychological distress and suicidal behaviours amongst pregnant adolescents elsewhere in the Americas has been documented at prevalence of between 13.3%–20%. The purpose of the study was to explore the experiences and the impact of pregnancy on pregnant adolescent psychological health. Individual interviews and focus groups were conducted with adolescents in two Jamaican antenatal clinics. One clinic was designed as a ‘Teen Pregnancy Clinic’ and the other used the standard antenatal clinic design. The following themes were identified: decision-making, resilience, social support, community support system, distress, and perceptions of service. Participants reported positively on the specific interventions tailored to their needs at the Teen Clinic. Although motherhood is valued, none of the pregnancies in this study were planned by the mother. Of the 30 adolescents interviewed, seven cases were referred for counseling due to their need for emotional and psychological support. One of the adolescents reported recent sexual violence and another reported having experienced childhood sexual abuse. Historically, Jamaican adolescent mothers faced barriers to education, self determination, and family planning. Empowering, adolescent-centred healthcare and comprehensive reproductive health education may mitigate psychosocial distress.
With this paper, five key domains of advocacy, clinical care and health promotion, education and health services delivery, workforce and professional development, and research are identified. All five require attention in order to reach the overarching goal of health equity for adolescents and young adults. SAHM believes that achieving health equity is related to its organizational mission and vision and is a key factor in driving excellence in adolescent health and medicine. SAHM will continue to expand its capacity, being introspective as an organization as well as make recommendations to others, in an effort to be collaborative and inclusive of professionals, programs, and systems that represent and serve the diverse populations for whom the Society advocates.
Krumm, Silvia; Becker, Thomas
User involvement in mental health services research is discussed in Great Britain, and a number of user-led research initiatives can be found. In Germany, less attention is paid to the concept while virtually no initiatives can be found. The concept of user involvement is introduced by reviewing the relevant literature. After discussion of theoretical and methodological implications, practicability of the concept for mental health services research is illustrated by some examples from Great Britain. User involvement in mental health services may promote the provision of user focused services. User involvement aims at the empowerment of mental health service users and can also improve the quality of mental health services research. Frequently, user-led/collaborative studies are focused on mental health service assessment. Some problematic aspects (e. g. representativeness, knowledge/skills of users) are discussed. Although more research is needed to document the additional benefit of user involvement in mental health services research it is conceivable that the concept will gain in importance.
Crosnoe, Robert; McNeely, Clea
Peer relations are central to adolescent life and, therefore, are crucial to understanding adolescents' engagement in various behaviors. In recent years, public health research has increasingly devoted attention to the implications of peer relations for the kinds of adolescent behaviors that have a direct impact on health. This article advocates for a continuation of this trend. With this aim, we highlight key themes in the rich literature on the general developmental significance of adolescent-peer relations, provide an overview of how these themes have been incorporated into public health research and practice, and suggest future avenues for peer-focused public health research that can inform adolescent health promotion in the United States.
Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in
Hall, Charlotte L; Newell, Karen; Taylor, John; Sayal, Kapil; Swift, Katie D; Hollis, Chris
Once considered to be a disorder restricted to childhood, Attention Deficit/Hyperactivity Disorder (ADHD) is now recognised to persist into adult life. However, service provision for adults with ADHD is limited. Additionally, there is little guidance or research on how best to transition young people with ADHD from child to adult services. We report the findings of a survey of 96 healthcare professionals working in children's (Child and Adolescent Mental Health Services and Community Paediatrics) and adult services across five NHS Trusts within the East Midlands region of England to gain a better understanding of the current provision of services for young people with ADHD transitioning into adult mental health services. Our findings indicate a lack of structured guidelines on transitioning and little communication between child and adult services. Child and adult services had differing opinions on what they felt adult services should provide for ADHD cases. Adult services reported feeling ill-prepared to deal with ADHD patients, with clinicians in these services citing a lack of specific knowledge of ADHD and a paucity of resources to deal with such cases. We discuss suggestions for further research, including the need to map the national provision of services for adults with ADHD, and provide recommendations for commissioned adult ADHD services. We specifically advocate an increase in ADHD-specific training for clinicians in adult services, the development of specialist adult ADHD clinics and greater involvement of Primary Care to support the work of generic adult mental health services in adult ADHD management.
INTRODUCTION: The study was done to assess the educational needs of the adolescent girl students regarding their reproductive health. METHODS: The data were collected by administering an open-ended self-administered questionnaire to the participating students seeking their opinion on several issues related to adolescent reproductive health. RESULTS: The students preferred their teachers next only to doctors as health educator. Their health problems included menstrual probl...
Havas, Jano; Bosma, Hans; Spreeuwenberg, Cor; Feron, Frans J
We studied the hypothesis of socioeconomic equalization regarding adolescents' mental health problems by examining whether a low educational level of adolescents and their parents shows independent (cumulative) or dependent (including interactive) associations with adolescents' mental health problems, or whether equalization occurred. Cross-sectional data were obtained from the preventive Youth Health Care Centre in a relatively deprived Dutch former mining area. Participants were 1861 adolescents aged 13 or 14 years (response rate 71.7%). The self-administered Dutch version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify adolescents' mental health problems. Multiple logistic regression analyses were used to examine the associations, and linear regression models to check the robustness of the findings. A low educational level of adolescents was strongly related to their mental health problems (OR = 5.37; 95% CI: 3.31-8.70). The initially high odds ratios for adolescents with low-educated parents (OR = 1.72; 95% CI: 1.14-2.59) disappeared after controlling for the adolescents' own educational level (OR = 1.12; 95% CI: 0.73-1.74). In terms of interactions, no specifically increased odds were found, e.g. for low-educated adolescents with high-educated parents. There was no evidence for socioeconomic equalization regarding adolescents' mental health problems. Lower educated adolescents had substantially higher odds of having mental health problems, regardless of their parents' education. The odds may be affected by differences in intelligence and life events. Youth healthcare workers should collaborate closely with schools to intervene in time, particularly among low-educated adolescents. More interventions are probably needed to reduce these major inequities.
Hansen, Claus D.; Andersen, Johan Hviid
to school performance and subsequent educational achievements. The aim of this study was to examine the impact of health measures on school performance at the end of compulsory school (9 years of school). Methods Information from a birth cohort study of adolescents born in 1989 (n = 3058) living...... years has between 0.27 [95% confidence interval (CI) 0.13 to 0.40] and 0.34 (95% CI 0.21 to 0.48) lower grades, adjusted for a range of other factors influencing school performance. Specific symptoms leading to poorer school performance includes frequent headaches, high levels of perceived stress...... and depressive symptoms. If parents report health problems for the participant between ages 7 and 14, grades decrease with 0.89 (95% CI 0.44 to 1.32). Conclusions Frequent headache, perceived stress and depressive symptoms contributes to lower grades at the end of compulsory school, thereby indicating...
@@ Intruduction The United Nations International Conference on Population and Development (ICPD), held in Cairo in 1994, recognized that adolescents and young people have unique reproductive health needs that are distinct from those of adults, and that this population sub-group has been poorly served, and it highlighted the need to address their information and service needs in appropriate and acceptable ways.
Full Text Available Charisse L Nixon Pennsylvania State University, the Behrend College, Erie, PA, USA Abstract: Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents' health and well-being. A plethora of correlational studies have demonstrated a cogent relationship between adolescents' involvement in cyberbullying and negative health indices. Adolescents who are targeted via cyberbullying report increased depressive affect, anxiety, loneliness, suicidal behavior, and somatic symptoms. Perpetrators of cyberbullying are more likely to report increased substance use, aggression, and delinquent behaviors. Mediating/moderating processes have been found to influence the relationship between cyberbullying and adolescent health. More longitudinal work is needed to increase our understanding of the effects of cyberbullying on adolescent health over time. Prevention and intervention efforts related to reducing cyberbullying and its associated harms are discussed. Keywords: cyberbullying, adolescent health, prevention, intervention
Migdole, Scott; Robbins, Judith P
The role of preadjudicated juvenile detention centers (JDCs) in treating children and adolescents with mental health needs has continued to receive national attention. Legal actions mandating improved health care services over the past decade, coupled with a national focus on detainees' mental health needs, have led to the increased presence of mental health professionals in JDCs. In this context, we must build on the current "call to action" and develop innovative blueprints for the provision of mental health services for detained youth. Although operationalizing this movement is complicated, we must be prepared to sustain its effects by developing effective communication and planning among correctional health care organizations, universities, municipalities, and other stakeholders.
Askeland, Kristin Gärtner; Hysing, Mari; La Greca, Annette M; Aarø, Leif Edvard; Tell, Grethe S; Sivertsen, Børge
To investigate whether mental health problems differ between internationally adopted adolescents and their non-adopted peers and examine design and sample characteristics that might underlie differences among studies. Studies published through August 2015 were collected through Embase, Medline, PsychINFO, Web of Science, ERIC, and Svemed+. Combined effect estimates were calculated using random-effects models. Eleven studies investigating 17,919 adoptees and 1,090,289 non-adopted peers were included in the meta-analysis. Internationally adopted adolescents reported more mental health problems across domains than their peers, with effect estimates (standardized mean differences [SMDs]) of 0.16 (95% CI 0.03 to 0.28) for questionnaire-based studies and 0.70 (95% CI 0.50 to 0.90) for register-based studies. They also reported significantly more externalizing difficulties (SMD 0.20, 95% CI 0.03 to 0.38), although the effect estimate for internalizing difficulties was not statistically significant (SMD 0.10, 95% CI -0.03 to 0.24). Studies using categorical measurements of mental health problems, indicating more serious problems, yielded larger effect estimates than continuous measurements (SMD 0.31, 95% CI 0.21 to 0.41; SMD 0.13, 95% CI -0.01 to 0.26, respectively). The difference in mental health problems between international adoptees and their peers was somewhat larger when using parent report compared with self-report. More recent studies (conducted in 1995 and later) yielded larger estimates than older studies, although no significant difference was found for this analysis or subgroup analyses investigating sex and age at adoption. Although most internationally adopted adolescents are well adjusted, adoptees as a group report higher levels of mental health problems compared with non-adopted peers. This difference should be acknowledged and adequate support services should be made available. Copyright © 2016 American Academy of Child and Adolescent Psychiatry
MacPherson, Peter; Munthali, Chigomezgo; Ferguson, Jane; Armstrong, Alice; Kranzer, Katharina; Ferrand, Rashida A; Ross, David A
Adolescents living with HIV face substantial difficulties in accessing HIV care services and have worse treatment outcomes than other age groups. The objective of this review was to evaluate the effectiveness of service delivery interventions to improve adolescents' linkage from HIV diagnosis to antiretroviral therapy (ART) initiation, retention in HIV care and adherence to ART. We systematically searched the Medline, SCOPUS and Web of Sciences databases and conference abstracts from the International AIDS Conference and International Conference on AIDS and STIs in Africa (ICASA). Studies published in English between 1st January 2001 and 9th June 2014 were included. Two authors independently evaluated reports for eligibility, extracted data and assessed methodological quality using the Cochrane risk of bias tool and Newcastle-Ottawa Scale. Eleven studies from nine countries were eligible for review. Three studies were randomised controlled trials. Interventions assessed included individual and group counselling and education; peer support; directly observed therapy; financial incentives; and interventions to improve the adolescent-friendliness of clinics. Most studies were of low to moderate methodological quality. This review identified limited evidence on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on ART and adherence to ART. Although recommendations are qualified because of the small numbers of studies and limited methodological quality, offering individual and group education and counselling, financial incentives, increasing clinic accessibility and provision of specific adolescent-tailored services appear promising interventions and warrant further investigation. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Ghaddar, Suad F.; Valerio, Melissa A.; Garcia, Carolyn M.; Hansen, Lucy
Background: Little research has examined adolescent health literacy and its relationship with online health information sources. The purpose of this study is to explore health literacy among a predominantly Hispanic adolescent population and to investigate whether exposure to a credible source of online health information, MedlinePlus[R], is…
Lusi Herawati Sunyoto Usman Mark Zuidgeest
Full Text Available Equitable health care is a basic right for citizens and must be fulfilled by the government. This research analyzed communitydiscrepancy in access to reach health services in public hospitals and Puskesmas (health centers in Banyuwangi Regency.This research identified community accessibility to health facilities services using travel time and transport modes choiceas indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Yarger, Jennifer; Decker, Martha J; Campa, Mary I; Brindis, Claire D
The purpose of this study was to compare awareness and use of family planning services by rural and urban program site among a sample of adolescent women before participation in the federal Personal Responsibility Education Program in California. We conducted a secondary analysis of survey data collected from youth before participation in California's Personal Responsibility Education Program. Bivariate and multivariate analyses were conducted for a sample of 4,614 females ages 14-18 years to compare awareness and use of family planning services between participants at rural and urban program sites, controlling for the program setting and participant demographic, sexual, and reproductive characteristics. Overall, 61% of participants had heard of a family planning provider in their community, and 24% had visited a family planning provider. Awareness and use of family planning services were lower among rural participants than urban participants. After adjusting for the program setting and participant characteristics, rural participants were less likely to know about a family planning provider in their community (odds ratio, .64; 95% confidence interval, .50-.81) or receive family planning services (odds ratio, .76; 95% confidence interval, .58-.99) than urban participants. Findings suggest that adolescents in rural areas face greater barriers to accessing family planning services than adolescents in urban areas. Targeted efforts to increase awareness and use of family planning services among adolescents in rural areas and among other underserved populations are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Jeng Yi-Jong; Wang Edward K; Chen Mei-Yen
Abstract Background Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6–8 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was to examine the relationship between AS during schooldays and excessive body weight, frequency o...
Fine, Jodene Goldenring; Sung, Connie
Recent advances in technology and neuroscience have increased our understanding of human neurodevelopment. In particular, research on neuroplasticity and psychosocial genomics lends compelling support to a biopsychosocial perspective by elucidating mechanisms through which psychosocial forces and environments shape neurobiology. This article summarizes selected results from recent investigations of neuroplasticity and psychosocial genomics, which demonstrate complex interaction between genes, epigenetic processes, and environmental experience that confers neural growth into adulthood. Counseling psychologists working with children and adolescents need to be familiar with recent literature to be more effective in their work so that they can provide developmentally appropriate counseling services. Social cognitive theory and resilience theory are introduced to illustrate how counseling psychologists can incorporate neuroscience research findings in a counseling context and hypotheses are proposed for future counseling psychology research.
Price, Megan; Hides, Leanne; Cockshaw, Wendell; Staneva, Aleksandra A; Stoyanov, Stoyan R
Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10-18 years) seeking help from a national youth counselling service for a romantic relationship concern to: (i) explore what types and stage (pre, during, post) of romantic concerns adolescents seek help for; (ii) how they are associated with mental health problems, self-harm and suicide risk; and (iii) whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence). Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups) were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%). Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.
Full Text Available Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10–18 years seeking help from a national youth counselling service for a romantic relationship concern to: (i explore what types and stage (pre, during, post of romantic concerns adolescents seek help for; (ii how they are associated with mental health problems, self-harm and suicide risk; and (iii whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence. Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%, self-harm (22.6% and suicide (9.9%. Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.
Jepson, Lisa; Juszczak, Linda; Fisher, Martin
Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…
Bushong, C; Coverdale, J; Battaglia, J
Over the past 30 years, adolescents represent the only age group in the United States whose health status has not improved significantly. In this population, major health problems that are becoming increasingly important in regard to preventive intervention include substance abuse, depression, teenage pregnancy, and AIDS. Research in adolescent mental health during the past decade has focused on both the etiology and the prevention of problem behaviors. We review the development and application of various preventive intervention approaches in the field of adolescent mental health and discuss implications for future directions.
Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky
High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.
The major threats to the health of American teenagers are behavioral-risky and reckless things adolescents do that threaten their well-being and that of others. The primary approach to preventing adolescent risk taking has been classroom-based health education. Yet, most systematic research indicates that even the best programs are successful mainly at changing adolescents' knowledge but not in altering their behavior. Research on adolescent brain development has revolutionized our understanding of this stage of life, but our approach to deterring adolescent risk taking remains grounded in old, antiquated, and erroneous views of the period. Classroom-based health education is an uphill battle against evolution and endocrinology, and it is not a fight we are likely to win. Instead of trying to change teenagers into something they are not, we should try to reduce the risks they are exposed to. We should spend less money and effort trying to influence how adolescents think, and focus more on limiting opportunities for their inherently immature judgment to hurt themselves or others. Although there is evidence that some programs aimed at strengthening adolescents' self-regulation may also deter risky behavior, our public health policies should emphasize changing the context in which adolescents live, rather than solely attempting to change adolescents themselves.
Inostroza Quezada, Carolina; Correa Venegas, María Loreto; Besoain Arrau, Carolina; Reinoso Medinelli, Alejandro; Velarde Lizama, Macarena; Valenzuela Mujica, María Teresa; Bedregal García, Paula; Zubarew Gurtchin, Tamara
Chronic illnesses during adolescence are a big challenge for the patient, his or her family, and health care providers. The transition from paediatric health services to adult health services involves a programmed and planned transfer process of adolescent sufferers of chronic illnesses, in order to maintain a high quality of life and bio-psycho-social development. There is currently no transition model. The objective of the study is to understand the transition process from the perspective of hospitalised adolescents to collaborate towards the design of a model that meets the needs studied. Semi-structured interviews with 13 adolescent sufferers of chronic illnesses, hospitalised in two healthcare centres in Santiago, Chile, in one analytical-relational study, supported by qualitative methodology. In the analysis, 5 major themes stand out: experience of living with the illness, the importance of the doctor-patient relationship, the concept of limited autonomy to the pharmacology, the absence of the transition process as such, and the identification of barriers and needs for an adequate transition. This study is new in Chile in that it explores the phenomenom of the transition of adolescents with chronic illnesses. It emphasises the need to reinforce the concept of self-care and autonomy from early stages of care, and the importance of early planning of a healthy transition process, in accordance to the detected needs of the adolescents themselves. Copyright © 2015. Publicado por Elsevier España, S.L.U.
Children and adolescents who enter foster care often do so with complicated and serious medical, mental health, developmental, oral health, and psychosocial problems rooted in their history of childhood trauma. Ideally, health care for this population is provided in a pediatric medical home by physicians who are familiar with the sequelae of childhood trauma and adversity. As youth with special health care needs, children and adolescents in foster care require more frequent monitoring of their health status, and pediatricians have a critical role in ensuring the well-being of children in out-of-home care through the provision of high-quality pediatric health services, health care coordination, and advocacy on their behalves. Copyright © 2015 by the American Academy of Pediatrics.
Perrott, Bruce E
This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.
JOICFP is producing a still photo video consisting of three segments from photos shot in Bangladesh (April 22 - May 2), Thailand (May 2-15), and Mexico (June 29 - July 7) in 1995. The first segment highlights the daily life of a husband, aged 20, and his wife, Moni, aged 14. Moni married at age 13, before the onset of menstruation, and now serves and feeds her husband's large extended family. The Family Planning Association of Bangladesh (FPAB), the local implementing agent of the Sustainable Community-based Family Planning/Maternal and Child Health (FP/MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA) and executed by JOICFP, introduced Moni to the concept of reproductive health and encouraged her to join other women in activities designed to improve their health and raise their economic status. The second segment depicts the life of a former commercial sex worker who is undergoing occupational skill development training promoted by the Population and Community Development Association. The girl is now a leader of teenagers in her village; she works to change attitudes that sent her to work as a prostitute with an estimated 150,000 other poor rural teenage women. The third segment focuses on teen pregnancy and the efforts of the Mexican Foundation for Family Planning (MEXFAM) in the areas of health care and education for adolescents.
Adlung, R; Carzaniga, A
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services.
Fuller Jeffrey D
Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.
Montgomery, Kristen S
A guiding theoretical framework in research serves not only to guide a single research study, but also to link previous and future research that is guided by the same framework. Existing theoretical perspectives appropriate for use with adolescent health promotion research were reviewed. Instead of randomly selecting several theories for comparison, an intensive review of the literature was conducted to identify which theories were most commonly used with adolescent health promotion research. The results of this review revealed some interesting and noteworthy information regarding the state of theory use in adolescent health research for the last decade. Information is provided on theoretical perspectives by journal and year of publication. Trends are analyzed so that nurses can evaluate the current state of the science. Social cognitive theory (Bandura, 1986), the health belief model (Becker, 1978), and the health promotion model (Pender, 1996) emerged as the most significant theories for adolescent health promotion research and thus are discussed at the end of the article.
Ana Caroline Gonçalves Cavalcante
Full Text Available This descriptive, exploratory and qualitative study was performed with the objective to evaluate the structure of the Mental Health Service Network of the Municipal Health Department of Goiania, the capital city of Goias state, Brazil. Data were collected using a semi-structured instrument and photographic records, and analyzed using Atlas.ti 6.2, and based on Donabedian’s theoretical framework. Various conditions were observed for service facilities; from structures that were precarious and unsuitable for therapy, to facilities that were welcoming and had good accessibility. The main positive aspect was the diversity of multidisciplinary teams. Making service facilities appropriate is imperative, although it is recognized that the municipality is currently undergoing reformulation, aiming at meeting the needs of the National Policy for Mental Health. Furthermore, intersectoral partnerships should be established for evaluation processes, particularly in the academia and service domains, which could generate the desired impact on health care to clients of specialized services. Descriptors: Health Services Evaluation; Mental Health; Structure of Services.
Barter, Christine; Stanley, Nicky
This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents' intimate relationships. It draws on the authors' own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people's tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness.
Levine, Deborah; McCright, Jacqueline; Dobkin, Loren; Woodruff, Andrew J; Klausner, Jeffrey D
In response to rising gonorrhea rates among African American youth in San Francisco, Calif, Internet Sexuality Information Services, Inc, in partnership with the San Francisco Department of Public Health, developed SEXINFO, a sexual health text messaging service. SEXINFO is an information and referral service that can be accessed by texting "SEXINFO" to a 5-digit number from any wireless phone. A consortium of community organizations, religious groups, and health agencies assisted with identifying culturally appropriate local referral services. We conducted focus group sessions among youth aged 15 to 19 years to discuss the viability of the service. Usage of the service has been greater than expected, and an initial evaluation to assess the impact of SEXINFO on increasing access to sexual health services among at-risk adolescents has had promising results.
Jiang, Han; Petersen, Poul Erik; Peng, Bin
effect of socio-behavioral risk factors on perceived dental health, perceived need for dental care, and experience of dental symptoms. A cross-sectional survey of 2662 adolescents was conducted in eight capital cities in China; the response rate was 92%. The study population was chosen by multistage......The objectives of this study were: to describe perceived dental health status and oral health-related knowledge, attitudes, and behavior in Chinese urban adolescents; to assess the associations of oral health variables with socio-economic status and school performance; and to analyse the relative...
van Goethem, Anne A. J.; van Hoof, Anne; Orobio de Castro, Bram; van Aken, Marcel A. G.
This study examined the effect of community service program-quality on changes in adolescents' intentions to volunteer. Based on the literature, volunteering intentions were expected to increase by programs with high quality community service activities (e.g., instructive activities) and educational activities including reflection. Adolescents (N=…
Leskinen, Salme; Häyrinen, Kristiina; Saranto, Kaija; Ensio, Anneli
It is often said that we are living in an information society and information technology (IT) is a normal part of life in many fields. But IT is not used effectively in health care. The purpose of this study was to survey what kind of Internet-based health services and related electronic services are offered to clients by the web-pages of health care organizations in Finland.
Randy M. Page
Full Text Available Background and Objectives: Although studied extensively among adults, self-rated health (SRH has not received the same research attention among adolescents. It has been suggested that SRH in adolescents may be a function of adolescents' overall sense of functioning and may reflect psychosocial functioning more so than in adults. The rating of health as poor by adolescents might be a somatic expression of life distress and may be connected with risky behaviors. Therefore, the purpose of this study was to investigate self-rated health (SRH in Central and Eastern European (CEE adolescents and determine its association with psychosocial functioning and other dimensions of adolescent health. Methods: A survey was administered to 3,123 students in 34 secondary schools across CEE which included measures of SRH, psychosocial functioning (loneliness, hopelessness, shyness, perceptions of social status, self-rated happiness, and perception of physical attractiveness, and other dimensions of adolescent health (height/weight, physical activity, eating breakfast, sleep. Results: More girls (19.4 % than boys (11.3 % rated themselves as "not healthy" and this was true in each of the six countries. Significant predictors of SRH in the logistic regression model were gender, country of residence, hopelessness, shyness, subjective social status-society, self-rated happiness, perception of physical attractiveness, vigorous physical activity, eating breakfast, overweight status, and usually get 7-8 hours or more sleep a night. Conclusions: SRH appears to be associated with psychosocial functioning and other dimensions of adolescent health in CEE youth.
Rachel C. Vreeman
Conclusions: Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV, particularly throughout lifespan changes from childhood to adolescence to adulthood. The lack of research and support for mental health needs in resource-limited settings presents an enormous burden for which cost-effective solutions are urgently needed.
Rest, K M
In the rush to capture new segments of the health care market, occupational health services have become an attractive "product line" for some provider groups. However, providers may not appreciate the significant ethical dimensions of delivering occupational health services. The environment of the workplace gives rise to competing goals, interests, and expectations and creates thorny ethical issues for health care providers. It is important that providers develop a framework for recognizing and addressing these ethical issues and the influence of their own and other parties' values on their decision-making processes.
Castaño, Paula M; Martínez, Raquel Andrés
Sexually active adolescents are at risk for unintended pregnancy. Teen pregnancies can be prevented by consistent use of birth control, such as oral contraceptives. However, many teens forget their daily doses and eventually stop using oral contraceptives altogether. Teen pregnancies are more likely to be medically complicated and can adversely impact the teen, her child, and their community. Cell-phone use is becoming widespread, and teen cell-phone users frequently use text messaging. We describe a study in which we use cell-phone text-messaging technology in a novel way: we provide daily oral contraceptive dosing reminders and educational messages and evaluate oral contraceptive continuation at 6 months. We will use the information we obtain to develop specific, practice-based interventions to improve reproductive health programs and policies.
Furukawa, Shunichi; Fujieda, Yumiko; Shimizu, Kimiko; Ishibashi, Aya; Eguchi, Satoshi
Outreach services are very important in community mental health care. There are two types for outreach services. One is mental health activities, such as early intervention and consultation, and the other is intended to prevent recurrence and readmission by supporting the daily living activities of a patient in a community. We have 2.73 psychiatric care beds in hospitals per 1,000 population. So, it is just the beginning in changing from hospital centered psychiatry to community mental health care. Outreach services are being tried in several places in our country. In this essay, we describe mental health outreach services in Japan and we have illustrated vocational rehabilitation and outreach job support in our day treatment program.
Evaluation of Aboriginal Health Services (AHSs) has become a topic of importance to service providers and governments in recent years. This paper examines some of the difficulties AHSs have in conducting evaluation and presents an example of an inappropriate evaluation methodology as proposed by the Commonwealth Department of Aboriginal Affairs (DAA) in 1986. The paper examines the contradictory nature of the DAA proposal and the mistrust it has engendered in many AHSs. It then highlights some of the political difficulties in developing meaningful national and community health objectives as a basis for sound evaluation of health services. The paper concludes by identifying some of the processes whereby more appropriate evaluation methodologies might be developed and suggests that negotiation and consultation with the Aboriginal communities and their health services are imperative to successful evaluation.
Adolescence and sexuality in the everyday lives of the nursing team of the basic health care service Adolescência e sexualidade no cotidiano da equipe de enfermagem do serviço de atenção básica de saúde
Rosângela Aparecida Pimenta Ferrari
Full Text Available This is a descriptive-quantitative survey to identify the perception of the nursing team of the Basic Health Care Service about questions concerning sexuality and adolescence. Fifty-five professionals took part in this research: (52% nurses and (43,9% nursing assistants. The female sex was predominant, 84%. Most of them (54% claims to be Catholic. Masturbation practice is a natural way to know the body for 84% of the team. Homosexuality is a choice as any other one for 56% of the Catholic people, whereas 42% of the evangelicals consider it as a psychological disorder. It is mentioned that sexual initiation should happen between the ages of 20 to 24 years old (61% and it should be with someone they feel really attracted to. It is considered that those who should talk about sexuality with adolescents are the parents and the health and education professionals (96%. As for the approach to adolescents at work, 63% consider themselves prepared even though 37% consider it difficult to answer questions about the theme for not being a part of their everyday lives. The professionals of this study demonstrate responsibility as for the educational and preventive process, but they all agree that there still exist some taboos and prejudice which may interfere in the process of health education, concerning non-planned pregnancy prevention and risks of Sexually Transmitted Diseases (STDs and AIDS. Trata-se de uma investigação descritiva quantitativa para identificar a percepção da equipe de enfermagem, do Serviço de Atenção Básica de Saúde, a respeito das questões referentes à sexualidade e a adolescência. Participaram da pesquisa 57 profissionais, (52% enfermeiros e (43,9% auxiliares de enfermagem. O sexo feminino foi predominante, 84%. A maioria (54% refere ser da religião católica. A prática da masturbação é uma forma natural de conhecer o corpo para 84% da equipe. A homossexualidade é uma escolha como outra qualquer para 56% dos cat
Kulyk, Olga Anatoliyivna
In oktober heeft een workshop 'Kwaliteitseisen Digitale Hulpverlening in het Kader van e-health Sense' plaatsgevonden tijdens de digitale leerweek van Soa Aids Nederland en V&VN. Tijdens een focusgroepdiscussie met sociaal-verpleegkundigen seksuele gezondheid kwamen vragen aan de orde over het
Lassi, Zohra S; Salam, Rehana A; Das, Jai K; Wazny, Kerri; Bhutta, Zulfiqar A
The Millennium Development Goal era has resulted in improvements in maternal and child health worldwide. As more children are surviving past their fifth birthday, the population of adolescents is increasing. Adolescence is a time of significant developmental transition; adolescence sets the stage for adult health through risks taken and beneficial and detrimental habits that are formed and it is thus an optimal time to target health interventions. Beginning interventions in adolescence or even earlier in childhood maximizes the impact on the individual's health in adult life. Evidence suggests that interventions to promote sexual and reproductive health, physical activity and healthy lifestyle, mental health and wellbeing, safe and hazard-free environment, improving access to nutritious and healthy foods, and minimizing exposure to substance abuse can improve health outcomes in young adolescents. School-based delivery strategies appear to be the most highly evaluated for improving adolescent health; they have been used to deliver interventions such as sexual health, substance abuse prevention, and nutritional interventions. Use of social media and information technologies, cash transfers, social protection, and micro-finance initiatives are promising strategies; however, given the lack of rigorous evaluations, there is a need for further research. Additional research is also warranted to strengthen the evidence base by establishing causality, understanding the differential impacts of adolescent health in different contexts particularly in low- and middle-income countries. In addition, research and evaluation in the domain of adolescent health must focus on how to implement interventions effectively at-scale, sustain the impacts over time and ensure equitable outcomes.
... HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... and Services Administration (HRSA) publishes periodic summaries of proposed projects being developed...: The Health Resources and Services Administration (HRSA) plans to conduct a survey of the...
Danielsen, Solveig; Centeno, Julio; López, Julio
Establishing a few community-based plant clinics in Nicaragua led to a series of innovations in plant health service delivery. A grassroots experiment became a nationwide initiative involving local service providers, universities, research institutions and diagnostic laboratories. This led to the...
Hallal, Pedro C; Victora, Cesar G; Azevedo, Mario R; Wells, Jonathan C K
Physical activity in adolescence may contribute to the development of healthy adult lifestyles, helping reduce chronic disease incidence. However, definition of the optimal amount of physical activity in adolescence requires addressing a number of scientific challenges. This article reviews the evidence on short- and long-term health effects of adolescent physical activity. Systematic reviews of the literature were undertaken using a reference period between 2000 and 2004, based primarily on the MEDLINE/PubMed database. Relevant studies were identified by examination of titles, abstracts and full papers, according to inclusion criteria defined a priori. A conceptual framework is proposed to outline how adolescent physical activity may contribute to adult health, including the following pathways: (i) pathway A--tracking of physical activity from adolescence to adulthood; (ii) pathway B--direct influence of adolescent physical activity on adult morbidity; (iii) pathway C--role of physical activity in treating adolescent morbidity; and (iv) pathway D - short-term benefits of physical activity in adolescence on health. The literature reviews showed consistent evidence supporting pathway 'A', although the magnitude of the association appears to be moderate. Thus, there is an indirect effect on all health benefits resulting from adult physical activity. Regarding pathway 'B', adolescent physical activity seems to provide long-term benefits on bone health, breast cancer and sedentary behaviours. In terms of pathway 'C', water physical activities in adolescence are effective in the treatment of asthma, and exercise is recommended in the treatment of cystic fibrosis. Self-esteem is also positively affected by adolescent physical activity. Regarding pathway 'D', adolescent physical activity provides short-term benefits; the strongest evidence refers to bone and mental health. Appreciation of different mechanisms through which adolescent physical activity may influence adult
Full Text Available Adolescents are reproductive potential of society. Protection of their reproductive health is one of the biggest challenges of modern society. Adolescent reproductive health is endangered by early sexual activities, inadequate protection against unwanted pregnancy and sexually transmitted infections. It is necessary to take measures which would protect and improve adolescent reproductive health.Adoption of knowledge about sexuality, physiology of reproduction, protection against unwanted pregnancy and sexual infections are prerequisites for formation of correct attitudes related to family planning and taking over responsibility for their own sexual behaviour.
Purcell, Rachael; McGirr, Joe
To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.
Van de Mortel, Thea; Bird, Jennifer; Chown, Peter; Trigger, Robert; Ahern, Christine
General practitioners play an important role in the primary care of adolescents in both community and clinical settings. Yet studies show that GPs can lack confidence, skills and knowledge in adolescent health. This study evaluates the effectiveness of an innovative training intervention on medical participants' knowledge and confidence as adolescent health educators in a school setting. 15 general practitioners, 12 general practice registrars and 18 medical students participated in an adolescent health education workshop followed by field experience in health education sessions in secondary schools. The mixed method design included a pre and post intervention survey and focus group interviews. Mean scores on the Confidence to Teach scale increased significantly (3.34 ± 0.51 to 4.09 ± 0.33) (p teaching skills especially lesson planning and design, practicing experiential teaching strategies and finding the 'sweet spot' when communicating with adolescents. Some participants reported that these skills would transfer to the practice setting. An applied training intervention that uses evidence-based, experiential teaching strategies and focuses on developing knowledge and practical teaching skills appropriate for the health education of adolescents can enhance knowledge and confidence to engage in community-based adolescent health education.
Ferro, Mark A
To examine the mediating effect of family functioning on the relation between maternal and adolescent depressive symptoms and determine whether the magnitude of the mediating effect is different for adolescents with and without chronic physical health conditions. Data come from the National Longitudinal Survey of Children and Youth. A representative survey of 11,813 adolescents and their mothers was included. Maternal and adolescent depressive symptoms were measured using the 12-item Center for Epidemiological Studies Depression Scale. Family functioning was measured using the McMaster Family Assessment Device. Multilevel multiple-group path analysis was used to examine potential mediating and moderating effects. Family functioning measured when adolescents were 14-15 years mediated the relation between maternal depressive symptoms (measured at 10-13 years) and adolescent depressive symptoms (measured at 16-19 years) for both adolescents with [αβ = 0.02 (0.02, 0.03)] and without chronic health conditions [αβ = 0.01 (0.00, 0.01)]. These findings provided evidence to suggest mediated moderation, Δαβ = 0.02 (0.01, 0.03), that is, the mediating effect of family functioning was significantly larger for adolescents with chronic health conditions. The mediating effect of family functioning in the relation between maternal and adolescent depressive symptoms is larger for adolescents with chronic health conditions. Within the framework of family-centered care, maternal depressive symptoms and family functioning are suitable targets for preventive intervention for adolescents with chronic health conditions.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS....
Dupere, Veronique; Leventhal, Tama; Vitaro, Frank
Self-efficacy beliefs are central to mental health. Because adolescents' neighborhoods shape opportunities for experiences of control, predictability, and safety, we propose that neighborhood conditions are associated with adolescents' self-efficacy and, in turn, their internalizing problems (i.e., depression/anxiety symptoms). We tested these…
Petersen, Poul Erik; Jiang, Han; Peng, Bin
distributions, regression analyses and factor analyses. RESULTS: Oral health-related behaviours among adolescents were associated with socioeconomic status of parents, school performance and peer relationships. The odds of a dental visit was 0.63 in adolescents of poorly educated parents and the corresponding...
Murphey, David; Barry, Megan; Vaughn, Brigitte; Terzian, Mary
Cigarette smoking has steadily declined among adolescents during the last fifteen years, although use of some tobacco products, like cigars, has seen recent increases. However, large numbers of teens continue to use tobacco products. This "Adolescent Health Highlight" presents key research findings; describes prevalence and trends; illustrates…
Kranke, Derrick; Floersch, Jerry
This study investigated adolescents with a mental health diagnosis and their experience of stigma in schools. Forty adolescents between the ages of twelve and seventeen who met DSM-IV criteria for a psychiatric illness and who were prescribed psychiatric medication were selected. The Teen Subjective Experience of Medication Interview was used to…
Smith, Carolyn R.; Fisher, Bonnie S.; Gillespie, Gordon L.; Beery, Theresa A.; Gates, Donna M.
Aggression exposure is a critical health issue facing adolescents in the United States. Exposure occurs in various settings including home, school, and the community. An emerging context for aggression exposure is in the workplace. Thirty adolescent employees age 16-18 participated in a qualitative study exploring proposed responses to future…
Kranke, Derrick; Floersch, Jerry
This study investigated adolescents with a mental health diagnosis and their experience of stigma in schools. Forty adolescents between the ages of twelve and seventeen who met DSM-IV criteria for a psychiatric illness and who were prescribed psychiatric medication were selected. The Teen Subjective Experience of Medication Interview was used to…
United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.
This package is one of a series of repackaged products aimed at alerting UNESCO users to a wealth of highly valuable educational resources that exist in the field of adolescent reproductive and sexual health. This document focuses on what research says is the impact of peer education in promoting necessary changes among adolescents in attitudes…
de Wit, M; Delemarre-van de Waal, Henriette A; Pouwer, F
Particularly in chronic conditions, monitoring health related quality of life (HRQoL) of adolescents in clinical practice is increasingly advocated. We set out to identify and review the clinical utility of available generic and diabetes specific HRQoL questionnaires suitable for use in adolescents...
The Internet has turned during the past decade into a major information resource in various domains of life and a communication venue among adolescents who seek health information via the net. The increasing availability of computers in homes, as well as wireless Internet access, means that adolescents today can go online anywhere, at any time. The media are not the leading cause of any major health problem, but they do contribute significantly to a variety of adolescent health problems, including aggressive behavior, sexual activity, drug use, obesity, sleep disorders, eating disorders, depression, suicide and self harm. This paper focuses on 3 major health issues in adolescents' Internet use: Body image and eating behaviors; sexuality and reproductive health behaviors; and self harm and suicidal behavior. This paper also demonstrates Internet venues where reliable health information is provided to young people by health professionals. Health professionals need to recognize the hazards of adolescents Internet use, and to address potential Internet abuse when encountering adolescents in clinical settings.
Yarcheski, Adela; Mahon, Noreen E; Yarcheski, Thomas J
The purposes of this methodological study were to factor analyze the Laffrey Health Conception Scale (LHCS) and to assess construct validity of the instrument with early adolescents. The final sample consisted of 230 early adolescents, aged 12 to 14, who responded to instrument packets in classrooms in an urban middle school. Data obtained on the LHCS were subjected to principal components factor analysis with oblique rotation. A two-factor solution was accepted, which is consistent with early adolescents' conceptions of health. Factor I was labeled Wellness and Factor II was labeled Clinical Health. A higher order factor analysis yielded one factor with 26 items, labeled the LHCS for Early Adolescents. The 26-item LHCS had a coefficient alpha of .95. Construct validity was assessed by testing three theoretical propositions, which significantly linked health conception to social support, self-esteem, and positive health practices. The findings indicate that the LHCS is a reliable and valid measure of health conceptions in early adolescents. Results also offer flexibility to researchers interested in testing theory involving the constructs of the definition of health, wellness, and clinical health in early adolescents.
Amaral, Gorette; Geierstanger, Sara; Soleimanpour, Samira; Brindis, Claire
Background: The purpose of this study is to compare the mental health risk profile and health utilization behaviors of adolescent school-based health center (SBHC) users and nonusers and discuss the role that SBHCs can play in addressing adolescent health needs. Methods: The sample included 4640 students in grades 9 and 11 who completed the…
Grossman, David C; Bibbins-Domingo, Kirsten; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen
Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes. Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom). To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older. The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF
Champion, Jane Dimmitt; Collins, Jennifer L
To report a retrospective analysis of data routinely collected in the course of healthcare services at a rural health clinic and to assess obesity incidence and associated interventions among rural Mexican-American adolescents. Two hundred and twelve charts reviewed; 98 (46.2%) males and 114 (53.8%) females. Data extracted included Medicaid exams conducted at the clinic within 5 years. Equal overweight or obese (n = 105, 49.5%), versus normal BMI categorizations (n = 107, 50.5%) documented overall and by gender. Female obesity higher (25.4%) than national norms (17.4%); male rates (25.5%) were within national norm. Interventions provided by nurse practitioners (94%) for 34.8%-80% of overweight/obese had limited follow-up (4%). Obesity incidence markedly increased between 13 and 18 years of age without associated interventions; 51.4%-75.6% without interventions. Obesity is a healthcare problem among rural Mexican-American adolescents accessing care at the rural health clinic. Obesity intervention and follow-up was suboptimal within this setting. Rural and ethnic minority adolescents experience health disparities concerning obesity prevalence and remote healthcare access. Obesity prevention and treatment during adolescence is a national health priority given physiologic and psychological tolls on health and potential for obesity into adulthood. Obesity assessment and translation of evidence-based interventions for rural Mexican-American adolescents at rural health clinics is implicated. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.
Gunn, Anthony; Menzies, Ross G; O'Brian, Sue; Onslow, Mark; Packman, Ann; Lowe, Robyn; Iverach, Lisa; Heard, Robert; Block, Susan
The purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents. Participants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12-14 years; n=20) and older adolescents (15-17 years; n=17). Thirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate-severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15-17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12-14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status. These results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations. The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental
Gardner, Molly H; Barnes, Margaux J; Bopanna, Shilpa; Davis, Caroline S; Cotton, Pat B; Heron, Bethany L; Henninger, Alison; Alva, Elizabeth; Gleason, Michael W; Whelan, Kimberly F; Madan-Swain, Avi
Purpose: Adolescent and young adult (AYA) survivors of pediatric cancer commonly report both functional and emotional difficulties, yet many of their mental health needs are not met. Given the unique needs of these survivors, this study examined barriers to psychosocial support service utilization in this population, including accessibility, personal preferences, and practical barriers such as insurance and transportation. Methods: Thirty-six adolescent and young adult survivors of pediatric cancer (aged 15-29) with mental health difficulties (i.e., anxiety or depression) completed surveys assessing access and utilization of services and barriers to utilization. Services assessed included the use of mental health professionals, a pastor or someone in a place of worship, and support groups. Results: Half of the participants utilized a mental health professional, but other forms of support were used less frequently. Utilization of services was related to insurance status and use of prescription medication. Greater time since completion of treatment was a barrier to utilizing psychosocial support services. Conclusion: Use of psychosocial support services is linked closely with use of other healthcare services, including taking prescription medication for mood difficulties. Results have implications for how primary care and oncology providers address barriers to these services among AYA survivors of pediatric cancer.
Yi, Jaehee; Kim, Min Ah; Kim, Kihyun; Hong, Jun Sung
Recently arrived immigrant adolescents experience difficulties in adjusting to school in South Korea. However, the existing social services do not meet their psychosocial needs. This study investigates the perspectives of social service providers about challenges in providing services for immigrant adolescents early in their adjustments. We conducted qualitative, in-depth interviews with 27 South Korean social service providers. We identified barriers to social services, categorized into three themes: (1) Initial Contact Phase; (2) Service Delivery Phase; and (3) Structural Challenges. We suggest interventions concerning work-related stress for the social service providers, family-level involvement, diversity training, and integrated and collaborative immigration services. An examination of social service providers' challenges in working with immigrant adolescents is a necessary first step toward the development of programs and policies.
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
Shlafer, Rebecca; Hergenroeder, Albert C; Jean Emans, S; Rickert, Vaughn I; Adger, Hoover; Spear, Bonnie; Irwin, Charles E; Kreipe, Richard E; Walker, Leslie R; Resnick, Michael D
The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration's Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with less attention paid to adolescents as either the "maternal" or "child" elements of MCH discourse. Adolescence is a distinct developmental period with unique opportunities for the development of health, competence and capacity and not merely a transitional phase between childhood and adulthood. Adequately addressing adolescents' emergent and ongoing health needs requires well-trained and specialized professionals who recognize the unique role of this developmental period in the LCP.
Atkins, Robert; Sulik, Michael J; Hart, Daniel; Ayres, Cynthia; Read, Nichole
Using National Longitudinal Study of Adolescent Health data, hierarchical linear modeling was conducted to estimate the association of school poverty concentration to the sexual health knowledge of 6,718 adolescents. Controlling for individual socio-economic status, school poverty had modest negative effects on sexual health knowledge. Although not directly associated with sexual health knowledge, after controlling for demographic characteristics, school poverty interactions showed that sexual health knowledge was associated with higher grade point average (GPA) and age. The combination of low GPA and high-levels of school poverty was especially detrimental for students' sexual health knowledge. There are differences in the sexual health knowledge of adolescents attending low poverty and high poverty schools that can be attributed to the school environment.
Jill M Hagey
Full Text Available Introduction: Avoiding unintended pregnancies is important for the health of adolescents living with HIV and has the additional benefit of preventing potential vertical HIV transmission. Health facility providers represent an untapped resource in understanding the barriers and facilitators adolescents living with HIV face when accessing contraception. By understanding these barriers and facilitators to contraceptive use among adolescent females living with HIV, this study aimed to understand how best to promote contraception within this marginalized population. Methods: We conducted structured in-depth interviews with 40 providers at 21 Family AIDS Care & Education Services - supported clinics in Homabay, Kisumu and Migori counties in western Kenya from July to August 2014. Our interview guide explored the providers’ perspectives on contraceptive service provision to adolescent females living with HIV with the following specific domains: contraception screening and counselling, service provision, commodity security and clinic structure. Transcripts from the interviews were analyzed using inductive content analysis. Results: According to providers, interpersonal factors dominated the barriers adolescent females living with HIV face in accessing contraception. Providers felt that adolescent females fear disclosing their sexual activity to parents, peers and providers, because of repercussions of perceived promiscuity. Furthermore, providers mentioned that adolescents find seeking contraceptive services without a male partner challenging, because some providers and community members view adolescents unaccompanied by their partners as not being serious about their relationships or having multiple concurrent relationships. On the other hand, providers noted that institutional factors best facilitated contraception for these adolescents. Integration of contraception and HIV care allows easier access to contraceptives by removing the stigma of coming
Hagey, Jill M; Akama, Eliud; Ayieko, James; Bukusi, Elizabeth A; Cohen, Craig R; Patel, Rena C
Avoiding unintended pregnancies is important for the health of adolescents living with HIV and has the additional benefit of preventing potential vertical HIV transmission. Health facility providers represent an untapped resource in understanding the barriers and facilitators adolescents living with HIV face when accessing contraception. By understanding these barriers and facilitators to contraceptive use among adolescent females living with HIV, this study aimed to understand how best to promote contraception within this marginalized population. We conducted structured in-depth interviews with 40 providers at 21 Family AIDS Care & Education Services - supported clinics in Homabay, Kisumu and Migori counties in western Kenya from July to August 2014. Our interview guide explored the providers' perspectives on contraceptive service provision to adolescent females living with HIV with the following specific domains: contraception screening and counselling, service provision, commodity security and clinic structure. Transcripts from the interviews were analyzed using inductive content analysis. According to providers, interpersonal factors dominated the barriers adolescent females living with HIV face in accessing contraception. Providers felt that adolescent females fear disclosing their sexual activity to parents, peers and providers, because of repercussions of perceived promiscuity. Furthermore, providers mentioned that adolescents find seeking contraceptive services without a male partner challenging, because some providers and community members view adolescents unaccompanied by their partners as not being serious about their relationships or having multiple concurrent relationships. On the other hand, providers noted that institutional factors best facilitated contraception for these adolescents. Integration of contraception and HIV care allows easier access to contraceptives by removing the stigma of coming to a clinic solely for contraceptive services. Youth
... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas....
Michaelson, Valerie; McKerron, Margaret; Davison, Colleen
... seeking out the information for a particular purpose. In this Ontario-based qualitative study, grounded theory methods were used to explore ways that health knowledge is obtained in adolescents (age 10-16...
this type of study had not been carried out in Awka South Local Government hence the need for ... study consisted of all adolescent pregnant women in Awka South Local ... good diet during pregnancy and may lead to serious health problem.
Full Text Available One of the main objectives of military health services is to prevent suffering, injuries and death caused by wars which lead to great destructions on societies as much as possible. If the subject is considered for Turkish history, it is noted that personnel and duty processes of health services had an institutional feature and that duty was controlled by the government at Ottoman Empire. Public health practices, as a main component of military health services at both peace and war, has great importance. These practices should be determined thoroughly at peacetime by managers and preparations in that direction should be done and implemented. [TAF Prev Med Bull 2012; 11(1.000: 103-118
Full Text Available Background: When developing intervention research, it is important to explore issues from the community perspective. Interventions that promote adolescent health in South Africa are urgently needed, and Project Ntshembo (‘hope’ aims to improve the health of young women and their offspring in the Agincourt sub-district of rural northeast South Africa, actively using stakeholder involvement throughout the research process. Objective: This study aimed to determine adolescent health priorities according to key stakeholders, to align stakeholder and researcher priorities, and to form a stakeholder forum, which would be active throughout the intervention. Design: Thirty-two stakeholders were purposefully identified as community members interested in the health of adolescents. An adapted Delphi incorporating face-to-face discussions, as well as participatory visualisation, was used in a series of three workshops. Consensus was determined through non-parametric analysis. Results: Stakeholders and researchers agreed that peer pressure and lack of information, or having information but not acting on it, were the root causes of adolescent health problems. Pregnancy, HIV, school dropout, alcohol and drug abuse, not accessing health services, and unhealthy lifestyle (leading to obesity were identified as priority adolescent health issues. A diagram was developed showing how these eight priorities relate to one another, which was useful in the development of the intervention. A stakeholder forum was founded, comprising 12 of the stakeholders involved in the stakeholder involvement process. Conclusions: The process brought researchers and stakeholders to consensus on the most important health issues facing adolescents, and a stakeholder forum was developed within which to address the issues. Stakeholder involvement as part of a research engagement strategy can be of mutual benefit to the researchers and the community in which the research is taking place.
Ameri, Cinzia; Fiorini, Fulvio
The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).
Zang, Yu-Li; Liu, Qian; Pu, Lin-Zhe
To evaluate the effects on master student participants of an intensive interdisciplinary educational programme aiming at improving adolescent health and development services in urbanising China. There is a need for interdisciplinary education and collaborative practice in health, but few educational programmes have been reported. Experimental design including a qualitative component. Purposive sampling was used to identify master students in relevant disciplinary areas for the four-day classroom learning, four-day field learning and a half-day reflection, focusing on key aspects of adolescent health and development in the face of rapid urbanisation. Data about family function, cognitive development, adolescent health and development competency, and difficulties caused by health conditions were collected using quantitative and qualitative methods. Master student participants reported positive outcomes in adolescent health and development competency, and cognitive development. Six themes were identified about the programme and its impact: 'programme evaluation', 'programme characteristics', 'changed views about nursing and nurses', 'lessons learned', 'participation benefits' and 'suggestions for future action'. Interdisciplinary educational programmes are possible and beneficial at masters level but may be very challenging given the need for administrative, financial and human resources. Interdisciplinary educational programmes require to start with small health sector trials to accumulate evidence and skills. Faculty development is a prerequisite for such programmes towards collaborative practice. © 2012 Blackwell Publishing Ltd.
Musavian, Azra Sadat; Pasha, Afsaneh; Rahebi, Seyyedeh-Marzeyeh; Atrkar Roushan, Zahra; Ghanbari, Atefeh
Health maintenance and promotion are the fundamental prerequisites to community development. The best time for establishing healthy lifestyle habits is during adolescence. Due to importance of health promotion behaviors in adolescents, this study was conducted to investigate health-promoting behaviors and its associated factors among high school students in Rasht, Iran. A cross-sectional descriptive study was conducted on 424 students during the first semester of the year 2012. We employed the multistage sampling design to recruit from private and public high schools in Rasht, Iran. The data collection instrument was a self-report questionnaire consisting of two parts. The first part of instrument was consisted of demographic questionnaire and the second part was adolescent health promotion scale (AHPS) questionnaire. AHPS questionnaire was consisted of six dimensions (nutrition, social support, health responsibility, life appreciation, physical activity, and stress management) to measure health promoting lifestyles. Statistical analysis was performed by SPSS 16 software employing ANOVA (analysis of variance) test, t-test, Mann-Whitney, and the Kruskal-Wallis. The score of total Adolescent Health Promotion Scale were 3.58 ± 0.52 (possible range was 1-5). The highest score was in life appreciation dimension (3.99 ± 0.068) and the lowest score was in health responsibility dimension. Moreover, Significant associations were found between the adolescent health promotion Scale with age (P educational level (P educational level (P risk of developing unhealthy lifestyle. Consequently, healthcare providers, health instructors, schoolteachers, and families must pay more attention to these students. Moreover, as most of lifelong healthy and unhealthy lifestyle habits are established during adolescence, developing effective health promotion and disease prevention strategies for adolescents seems crucial.
Raviv, Amiram; Raviv, Alona; Vago-Gefen, Idit; Fink, Abby Schachter
The study explores adolescents' attitudes toward seeking help for emotional problems. The personal service gap is examined by asking adolescents about their willingness to refer themselves and others to formal (psychologists) and informal (friends) help sources, using a within-subjects design. The study included 662 Israeli adolescents in the 10th…
Ruffing, T; Danko, S; Danko, T; Henzler, T; Winkler, H; Muhm, M
A differentiated knowledge of trauma in children and adolescents is essential for the treatment of injured minors. The aim of this study was to present the focus of treatment in trauma emergency services. Over a period of 2 years all acutely injured children and adolescents (n = 4784) in the emergency service were analyzed prospectively. The data were analyzed according to sex, age, date of examination, indications for x-ray imaging, diagnosis and therapy. Seasonal differences in the treatment spectrum were detected. In total 34.4 % of the patients presented with bruises/contusions, 23 % wounds, 19.9 % fractures, 14.9 % sprains/strains/ligament ruptures, 4.1 % craniocerebral trauma, 1.5 % dislocations, 1.1 % muscle/tendon injuries and 0.9 % burns. Of the patients 60 % underwent an x-ray examination and 8.3 % were hospitalized. Different injuries were found in the different age groups. Most fractures (25.7 %) were found at the distal forearm and most osteosyntheses (22.5 %) were also carried out at this anatomical location. Knowledge of the frequency and age dynamics is essential for competent treatment of injuries in children and adolescents. Analysis of the reality of the treatment in emergency services allows a much better evaluation of the requirements with respect to this clientele. The collected data can serve as a basis for the development of major capability foci, training concepts, treatment algorithms as well as prevention measures.
Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the following categories for reporting the findings: school-based interventions (n = 12); c...
Suleiman, Ahna Ballonoff; Dahl, Ronald E
In this article, we consider how to leverage some of the rapid advances in developmental neuroscience in ways that can improve adolescent health. We provide a brief overview of several key areas of scientific progress relevant to these issues. We then focus on two examples of important health problems that increase sharply during adolescence: sleep problems and affective disorders. These examples illustrate how an integrative, developmental science approach provides new insights into treatment and intervention. They also highlight a cornerstone principle: how a deeper understanding of potentially modifiable factors-at key developmental inflection points along the trajectory toward clinical disorders-is beginning to inform, and may eventually transform, a broad range of innovative early intervention strategies to improve adolescent health. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Striegel-Moore, RH; Dohm, FA; Kraemer, HC; Schreiber, GB; Crawford, PB; Daniels, [No Value
Objective: The current study examined health services use during the past 12 months in a sample of young women with a history of an adolescent eating disorder (bulimia nervosa [BN] or binge eating disorder [BED]). Method: A community sample of 1,582 young women (mean age = 21.5 years) was classified
Pevec, Illene Susan
The severe youth health crisis involving overweight and obesity requires a complex policy response involving multiple domains: education, agriculture, health services, and community planning. This research examines gardening's affective benefits for adolescents and the potential school and youth gardens have to support healthy communities.…
Valerie J. Lewis
Full Text Available Adolescents, like adults, frequently experience discrimination, which can be particularly salient in the context of reproductive health care. We examined urban Black adolescent females’ perceived experiences of racial discrimination during reproductive health care encounters. Structured face-to-face interviews were conducted with female African American patients, from age 13 through 20, who obtained reproductive health care services at a single site. Twenty-four participants were enrolled. All were in or graduated from high school, with a mean age of 16.8 years. These young Black women reported infrequent race-based discrimination in the health care setting; however, many reported commonly experiencing discrimination in other places. An awareness of the discrimination that minority young women experience in non–health care settings can help providers demonstrate cultural humility when addressing such concerns with their patients. With this information, providers can provide anticipatory guidance and the tools necessary to navigate complex social systems.
Shanafelt, Amy; Hearst, Mary O.; Wang, Qi; Nanney, Marilyn S.
Background: Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security…
Shin, Sunny Hyucksun; Edwards, Erika M.; Heeren, Timothy
The purpose of this study was to examine the relationship between child maltreatment and adolescent binge drinking. Given that many victimized children have been maltreated in multiple ways, we examine the effects of co-occurrence of multiple types of maltreatment on adolescent binge drinking. We used the National Longitudinal Study of Adolescent Health (AddHealth), which included a nationally representative sample of adolescents (n = 12,748). Adolescent binge drinking was defined as five or ...
Full Text Available INTRODUCTION: The study was done to assess the educational needs of the adolescent girl students regarding their reproductive health. METHODS: The data were collected by administering an open-ended self-administered questionnaire to the participating students seeking their opinion on several issues related to adolescent reproductive health. RESULTS: The students preferred their teachers next only to doctors as health educator. Their health problems included menstrual problems, weakness, eye problems, headache and weight gain. Other problems were tension with studies, inability to concentrate, depression and irritability. Two most important areas of their concern are safe motherhood and AIDS. CONCLUSIONS: Need exists for reproductive health education. Keywords: adolescent, reproductive health education, school.
Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary
A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.
Ika Parmawati; Ova Emilia; Wenny Artanty Nisman
Background: Adolescent development affects the sexual desire and acitivity. Gender inequality may lead to discrimination and an increase in the vulnerability of adolescent girls to sexual coercion. Meanwhile, gender-sensitive reproductive health education is known to be able to decrease such vulnerability. Researcher wants to find the effects of gender-sensitive reproductive health education towards the adolescent girls' attitude improvements. Methods: This study was quasi experiment resea...
Rudolph, L; Deitchman, S; Dervin, K
Despite the human and monetary costs of occupational injury and illness, occupational health care has focused more on treatment than prevention, and prevention is not part of many clinical occupational health practices. This represents a failure of occupational health care to meet the health care needs of the working patients. MEDLINE searches were conducted for literature on occupational medical treatment and the prevention of occupational injury and illness were reviewed to for linkages between prevention and treatment. Policy discussions which identify examples of programs that integrated prevention and treatment were included. Although examples of the integration of clinical and preventive occupational health services exist, there are challenges and barriers to such integration. These include inaction by clinicians who do not recognize their potential role in prevention; the absence of a relationship between the clinician and an employer willing to participate in prevention; economic disincentives against prevention; and the absence of tools that evaluate clinicians on their performance in prevention. Research is needed to improve and promote clinical occupational health preventive services. Copyright 2001 Wiley-Liss, Inc.
Full Text Available Abstract Background Two new sets of stratification indicators – family's material affluence and adolescent's personal social position- were compared with traditional indicators of familial social position based on parental occupation and education for their ability to detect health inequality among adolescents. Methods Survey data were collected in the Adolescent Health and Lifestyle Survey in 2003 from nationally representative samples of 12-, 14- and 16-year-old Finns (number of respondents 5394, response rate 71%. Indicators of the familial social position were father's socio-economic status, parents' education, parents' labour market position. Indicators of material affluence were number of cars, vacation travels, and computers in the family, own room and amount of weekly spending money. Adolescent's personal social position was measured as school performance. Measures of health were long-standing illness, overweight, use of mental health services, poor self-rated health and number of weekly health complaints. Ordinal logistic regression analysis was applied to study the associations between stratification indicators and health variables. Results All three groups of indicators of social stratification showed inequality in health, but the strongest associations were observed with the adolescent's personal social position. Health inequality was only partly identifiable by the traditional indicators of familial social position. The direction of the inequality was as expected when using the traditional indicators or personal social position: adolescents from higher social positions were healthier than those from lower positions. The indicators of family's material affluence showed mainly weak or no association with health and some of the indicators were inversely associated, although weakly. Conclusion In addition to traditional indicators describing the socio-structural influences on the distribution of health among adolescents, indicators of
Villalba, E.; Casas, I.; Abadie, F.
Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... for successful health systems integration. Results: Out of the 27 cases, we focused on 11 which continued beyond the pilot stage. The key facilitators that are necessary for successful deployment and adoption in the European regions of our study are reorganisation of services, patient focus, governance...
Meilman, P W
To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.
Lopes, P M; Nichols, A W
The concept of a health service district, as a variation of the special tax district, is described and discussed. Tax districts have traditionally been used to support both capital construction (revenue bonds) and operational expenses of single-purpose governmental entities. The health service district, where authorized by state laws, may be used by local areas to subsidize the delivery of ambulatory health care. A particular case, the Ajo-Lukeville Health Service District in Arizona, illustrates what can be accomplished by this mechanism with the cooperation of local residents and outside agencies. Both the process of establishing such a district and the outcome of the Ajo-Lukeville experience is described. Reasons why health service districts may prove potentially attractive at this time are reviewed. Impediments to the development of more health service districts are also explored, including the lack of technical assistance, an inadequate awareness of the potential of health service districts, and the absence of a widespread orientation toward community financed and controlled health care. Movement in this direction should facilitate the development of additional health service districts.
... No: 2012-25192] DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration... Resources and Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600... Service, Health Resources and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers...
Grist, Rebecca; Porter, Joanna; Stallard, Paul
There are an increasing number of mobile apps available for adolescents with mental health problems and an increasing interest in assimilating mobile health (mHealth) into mental health services. Despite the growing number of apps available, the evidence base for their efficacy is unclear. This review aimed to systematically appraise the available research evidence on the efficacy and acceptability of mobile apps for mental health in children and adolescents younger than 18 years. The following were systematically searched for relevant publications between January 2008 and July 2016: APA PsychNet, ACM Digital Library, Cochrane Library, Community Care Inform-Children, EMBASE, Google Scholar, PubMed, Scopus, Social Policy and Practice, Web of Science, Journal of Medical Internet Research, Cyberpsychology, Behavior and Social Networking, and OpenGrey. Abstracts were included if they described mental health apps (targeting depression, bipolar disorder, anxiety disorders, self-harm, suicide prevention, conduct disorder, eating disorders and body image issues, schizophrenia, psychosis, and insomnia) for mobile devices and for use by adolescents younger than 18 years. A total of 24 publications met the inclusion criteria. These described 15 apps, two of which were available to download. Two small randomized trials and one case study failed to demonstrate a significant effect of three apps on intended mental health outcomes. Articles that analyzed the content of six apps for children and adolescents that were available to download established that none had undergone any research evaluation. Feasibility outcomes suggest acceptability of apps was good and app usage was moderate. Overall, there is currently insufficient research evidence to support the effectiveness of apps for children, preadolescents, and adolescents with mental health problems. Given the number and pace at which mHealth apps are being released on app stores, methodologically robust research studies
Discusses connecting with the Middle Ages in adolescent fiction. Discusses how, in "The Owl Service," Garner addresses a relationship between adolescence in the late twentieth century and an aspect of the past--specifically the Middle Ages. Considers how "The Owl Service" is a story energized by myth, concerning the…
Johnson, Sara B; Blum, Robert W; Giedd, Jay N
Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well into the 20s. This has prompted intense interest in linking neuromaturation to maturity of judgment. Public policy is struggling to keep up with burgeoning interest in cognitive neuroscience and neuroimaging. However, empirical evidence linking neurodevelopmental processes and adolescent real-world behavior remains sparse. Nonetheless, adolescent brain development research is already shaping public policy debates about when individuals should be considered mature for policy purposes. With this in mind, in this article we summarize what is known about adolescent brain development and what remains unknown, as well as what neuroscience can and cannot tell us about the adolescent brain and behavior. We suggest that a conceptual framework that situates brain science in the broader context of adolescent developmental research would help to facilitate research-to-policy translation. Furthermore, although contemporary discussions of adolescent maturity and the brain often use a deficit-based approach, there is enormous opportunity for brain science to illuminate the great strengths and potentialities of the adolescent brain. So, too, can this information inform policies that promote adolescent health and well-being.
Hansen, Claus D.; Andersen, Johan Hviid
adult educational achievement. Data are taken from a birth cohort study of all adolescents born in 1989 (n=3,058) living in a rural county in Denmark. Information was obtained from questionnaires (sent to the adolescents and their parents) and from different national registers (e.g. hospitalization...
Pérez-Wilson, Patricia; Hernán, Mariano; Morgan, Antony R; Mena, Angel
This study uses a health asset (HA) framework to explore current perspectives on health, wellbeing and their determinants amongst a group of 15-18-year-old adolescents living in the neighbourhood of Zaidin (Granada, Spain). The study was carried out in Summer 2011 using a qualitative approach. It included 20 semi-structured interviews, 2 focus groups with adolescents and 4 semi-structured interviews with key informants (adults who work with adolescents). Narrative data were analysed by means of content analysis methodology, considering the concept of health, HAs and how they are prioritized as dimensions for the analysis. The concept of health defined by adolescents involves physical, psychological and social dimensions. According to them, health is associated with happiness and quality of life. A range of HAs were identified and classified as internal (belonging to the adolescents) and external or contextual. Internal assets are classified into three types: personal traits (assets of 'being'), behaviour (assets of 'doing') and social resources which contribute to their feeling of health and well-being (assets of 'having'). The latter connects internal and external assets. The classification of HAs ('being', 'doing' and 'having') proposed in this study provides a useful starting framework of thinking about how these assets could be organized to support the development of health promotion programmes. The study highlights the opportunity for public policy to contribute to the improvement of the conditions and local scenarios that improve the possibilities for positive connections at the community level.
Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.
Laure, P; Meyer, C
To describe certain aspects of the physical and mental health of adolescents with restricted or deprived liberty as ordered by the court within the Youth Judicial Protection Service (YJP), and their ability to project themselves into the future. Survey by on-line self-administered questionnaires. Among the adolescents, 373 were randomly selected with restricted or deprived liberty, in the Lorraine region (eastern France). The data were managed and analyzed using the Modalisa(®) 7.0 (Kynos, Paris, France) survey processing software. Depending on the type of variable, comparisons were made using the chi-square test or analysis of variance. The significance threshold used was Pself-esteem score was 32.4±6.4, roughly the same as their peers in the general population (girls, 28.2; boys, 33.2; Pparents. To our knowledge, these facts had never been explored among adolescents with restricted or deprived liberty. This study shows results that do not match the usual representation of these adolescents by healthcare or education professionals. The quality of the work during the educational support given by the YJP Service could help explain these results. These findings need to be explored further by additional studies, which could also aim to measure the impact on physical and mental health of the educational support given by Youth Judicial Protection Service. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...
Jocelyne Kane Berman
Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.
Petra C Gronholm
Full Text Available Many children and adolescents experiencing mental health problems do not receive appropriate care. Strategies to encourage appropriate access to services might be improved by a more detailed understanding of service use determinants within this group. In view of caregivers' key role in young people's pathways to care, this study aimed to advance understanding of caregiver-related characteristics that influence service use among young people.We interviewed 407 primary caregivers of young people aged 9-18 years, recruited from a Greater London (United Kingdom community sample. Caregivers reported on young people's service use in health care sector and/or education settings, and caregivers' intended stigmatising behaviours, help-seeking attitudes, and personal service use. Logistic regression analyses examined the relationship between these caregiver characteristics and young people's service use, controlling for young people's clinical and socio-demographic factors.Caregivers' intended stigmatising behaviours in particular exerted a strong influence on young people's service use within each service setting. The impact of this characteristic interacted with caregivers' service use in influencing young people's service use across health care and education settings and health care settings specifically. For young people's service use within education settings, caregivers' intended stigmatising behaviours score had a main effect.This study highlights the key role caregivers' attitudes and experiences hold in young people's service use. The findings indicate that strategies aiming to bridge the gap between young people's service needs and utilisation might be improved by targeting stigma amongst caregivers.
From the answers to the questionnaire on mental health of adolescents by 4366 middle school students in Beijing, we can see that the knowledge about masturbation, emission, menstruation, the easiest time period of pregnancy and at which age males get fertile is very limited, especially to the question "at which time females are easy to be pregnant," only 7.21% of the students answered correctly. The % of girls who had advanced preparation at menarche, knowing that menstruation is a normal phenomenon is 55.7%. As for the resources of knowledge of emission and menstruation, almost half of the girls' knowledge on menstruation is from their mothers, followed by friends and peers. Newspapers and magazines rank 1st of the resources of knowledge emission, followed by friends and peers. Only 10% of the knowledge is learned from teachers. It suggests that school sex education has a long way to go. What we must pay attention to is that some of the students are ignorant of emission and menstruation, some of them have totally erroneous views. For example, 5.2% of the rural girls believed that menstruation is "bleeding from the urethra" while 15 students answered that menstruation is "bleeding from the anus." About 1.4 to 1.3 of the students knew that syphilis and gonorrhea were sexually transmitted diseases; fewer students knew that AIDS was a sexually transmitted disease. 25% were not afraid of AIDS; 30% did not know that AIDS could be transmitted through sexual intercourse. The results suggest that sex education needs to be strengthened. With regard to the behavior of adolescents, 42.14% of boys and 30.29% of girls have the experience of masturbation. 52.8% of male senior high schools students had masturbated once. The rate of students who are in love is 10-12% for boys and girls. The % of students who consider that dating is not necessarily bad while studying are: 36.9% for junior high school boys; 42.12% for girls; 63.54% for senior high school boys and 65.94% for the
Aiming to investigate adolescents' perceptions of oral health, with a focus on gender differences, quantitative and qualitative studies were conducted in Skaraborg County, Sweden. Adolescents (13-18 years; n = 17,280) answered a school questionnaire, epidemiological indices on oral health were collected, and 17 semi-structured interviews were conducted. Most adolescents perceived their oral health as good, girls more often than boys. The oral behavior of girls was also more often healthy (floss usage: girls 31%, boys 21%), and they were consistently less satisfied with the appearance of their teeth than boys. Girls considered their own consumption of candy to be too high more often than boys. Acknowledging the importance of sound teeth was strongly associated with self-perceived oral health: boys, odds ratio (OR) 8.58 [confidence interval (CI) 7.12-10.34]; girls, OR 5.56 [CI 4.23-7.30]. Adolescents living with a single mother (13-15-yr-olds OR 1.37 [CI 1.20-1.57], 16-18-yr-olds OR 1.51 [CI 1.28-1.77]), or with neither parent, more often reported bleeding gums than those who lived with both parents, while adolescents who lived with a single father did not. Weak correlations between epidemiological indices and self-perceived oral health were found at the school level. In the interviews, adolescents perceived the possibilities to influence their own oral health as limited. Perceptions of influences on oral health were related to personal and professional care, social support, social impact, and external factors such as time and economy. Support from the mother--more than from the father--was emphasized. This thesis showed that positive oral health attitudes and parental support are of great importance if oral health is to be perceived as good. There were gender differences in all issues related to self-perceived oral health.
Lindberg, L D; Ku, L; Sonenstein, F
Reproductive health education is a key strategy for promoting safe sexual behavior among teenagers. In the last decade, new initiatives in response to AIDS and growing interest in abstinence education may have changed the prevalence, content or timing of the reproductive health education provided by schools and parents. Formal reproductive health education and communication with parents about reproductive health among males aged 15-19 were analyzed using data from the 1988 and 1995 National Surveys of Adolescent Males. Young men's reports of formal instruction were compared with reports by adolescent females from the 1995 National Survey of Family Growth. Between 1988 and 1995, formal reproductive health education became nearly universal among adolescent males: In 1988, 93% of teenage males received some formal instruction, compared with 98% in 1995. The percentage of teenage males who received instruction about AIDS increased from 73% to 97% and the proportion who received instruction about how to say no to sex increased from 58% to 75%. Adolescent males who had dropped out of school received significantly less reproductive health education than those who had stayed in school, however. In addition, the median age at initial instruction decreased from age 14 to 13. Many males did not receive instruction prior to first intercourse, with non-Hispanic blacks being significantly less likely than other males to receive education prior to first intercourse. In 1995, 54% of black males had received reproductive health education before they first had sex, compared with 68% of Hispanic males and 76% of non-Hispanic white males. A smaller share of adolescent males than females received reproductive health education, and males were less likely than females to receive instruction prior to first intercourse. During the last decade, many types of formal reproductive health education for adolescents expanded. Further efforts should focus on assuring access to timely
Chalmers, Kathryn J.; Bond, Kathy S.; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Williams-Tchen, AJ
Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian...
The purpose of this study was to discuss the implementation of nutritional education in public health services from the perspective of health professionals (physicians and nurses) working in them. The study was conducted in the Municipality of Campinas, São Paulo State, Brazil, from October 1993 to July 1995, using action-based research methodology. The results describe the construction of nutritional knowledge in training and professional institutions; behavior towards food-related problems ...
Martha J. Decker
Full Text Available Through considerable efforts and investments of resources, adolescent pregnancy and birth rates in the United States have decreased significantly over the past two decades. Nonetheless, large disparities persist for many populations of youth. Reducing unintended adolescent pregnancies is considered a “winnable public health battle,” but one that will require innovative thinking and continued persistence. This paper reviews the recent research literature and innovative programmatic efforts to identify six promising strategies that address the challenge of adolescent pregnancy in new ways. These strategies aim to: (1 understand and address the complexity of adolescent lives; (2 expand the provision of quality sexual health education; (3 engage youth through technology and media; (4 increase access to contraceptives and other sexual health services; (5 create tailored interventions for populations with special needs; and (6 create a supportive policy environment. By building upon lessons learned from past efforts, we can move the field toward the development, strengthening, and promotion of future strategies that enhance the sexual well-being of all adolescents.
Stewart, Shannon L; Baiden, Philip; Theall-Honey, Laura
The objectives of this study were to examine the prevalence of non-suicidal self-injury (NSSI) among adolescents with mental health needs and specific factors associated with NSSI among adolescents aged 14 to 18 years who received mental health services in adult mental health facilities in Ontario, Canada. Data on 2,013 adolescents were obtained from the Ontario Mental Health Reporting System using the Resident Assessment Instrument-Mental Health (RAI-MH) and were analyzed using logistic regression. Approximately, 20.2% (407 adolescents) of the sample engaged in NSSI within the last 12 months. Results from multivariate logistic regression indicate that females were 2.19 times more likely to engage in NSSI than males. Intentional misuse of prescription medication emerged as the most important factor associated with NSSI. Other factors found to be associated with NSSI included multiple psychiatric admissions, sexual abuse, use of alcohol, mood disorders (e.g., depression), adjustment disorders, personality disorders and symptoms of depression. The article discusses the implications of the findings, with suggestions for future research.
El Taguri A
Full Text Available Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints.
Icks, A; Chernyak, N; Bestehorn, K; Brüggenjürgen, B; Bruns, J; Damm, O; Dintsios, C-M; Dreinhöfer, K; Gandjour, A; Gerber, A; Greiner, W; Hermanek, P; Hessel, F; Heymann, R; Huppertz, E; Jacke, C; Kächele, H; Kilian, R; Klingenberger, D; Kolominsky-Rabas, P; Krämer, H; Krauth, C; Lüngen, M; Neumann, T; Porzsolt, F; Prenzler, A; Pueschner, F; Riedel, R; Rüther, A; Salize, H J; Scharnetzky, E; Schwerd, W; Selbmann, H-K; Siebert, H; Stengel, D; Stock, S; Völler, H; Wasem, J; Schrappe, M
On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e. V. (DNVF e. V.)] approved the Memorandum III "Methods for Health Services Research", supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III "Methods for Health Services Research", part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e. g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed. © Georg Thieme Verlag KG Stuttgart · New York.
Beatriz Sabina Roméu; Daimí Sarmiento González; Mario Isaías Alzuri Falcato; Anais Leyva Madrigales
Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of...
Meier, Ann; Allen, Gina
Theories on romantic relationship development posit a progression of involvement and intensity with age, relationship duration, and experience in romantic relationships. Using the National Longitudinal Study of Adolescent Health, this study tests these propositions by considering relationship type and patterns of relationships over the course of adolescence and their influence on relationship formation in young adulthood. Findings indicate that relationships become more exclusive, dyadic, of longer duration, and more emotionally and sexually intimate over the course of adolescence. Moreover, relationship experience in adolescence is associated with an increased likelihood of cohabitation and marriage in young adulthood. These findings indicate that instead of being trivial or fleeting, adolescent romantic relationships are an integral part of the social scaffolding on which young adult romantic relationships rest.
do Nascimento, Leticia; de Paula, Cristiane Cardoso; Magnago, Tania Solange Bosi de Souza; Padoin, Stela Maris de Mello; Harzheim, Erno; da Silva, Clarissa Bohrer
Abstract Objective: to evaluate the quality of health care for children and adolescents living with HIV, among the different types of Primary Health Care services of Santa Maria, Rio Grande do Sul. Method: cross-sectional study, developed with 118 Primary Health Care professionals. The Primary Care Evaluation Instrument, Professional version, was used. For verification of the variables associated with the high score, Poisson Regression was used. Results: the professionals of the Family Health Strategy, when compared to those of the Primary Health Units, obtained a greater degree of orientation to primary care, both for the overall score and for the derived attributes score, as well as for the integrality and community orientation attributes. A specialization in Primary Health Care, other employment and a statutory work contract were associated with quality of care. Conclusion: the Family Health Strategy was shown to provide higher quality health care for children and adolescents living with HIV, however, the coverage is still low. The need was highlighted to expand this coverage and invest in vocational training directed toward Primary Care and making the professionals effective, through public selection procedure, as well as an improvement program that recognizes the care requirements, in these settings, of children and adolescents infected with HIV. PMID:27579927
Dura-Vila, G.; Hodes, M.
Background: An emerging literature suggests that ethnic and cultural factors influence service utilisation among people with intellectual disability (ID), but this has not previously been reviewed. Aims: To investigate possible ethnic variation in uptake of mental health services in children, adolescents and adults with ID in high-income…
Villalba, E.; Casas, I.; Abadie, F.
Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessa...... of Integrated Personal Health and Care Services in European regions has increased. Further research will reveal the weight of each facilitator and which combinations of facilitators lead to rapid adoption.......Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...
Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.
van 't Klooster, J.W.J.R.
This thesis describes a method to offer personalised healthcare. It is motivated by a desire for more efficient healthcare, as population ages and care demand and costs increase. Developing and testing individually tailored health services using ICT fits in this motivation, as it leads to more
Walker, D K; Cross, A W; Heyman, P W; Ruch-Ross, H; Benson, P; Tuthill, J W
A youth health survey was administered to 247 students in an inner-city ghetto high school and 404 students in a private boarding school. Significant differences between the two socioeconomic groups were found for responses about health information, health concerns and problems, and health status and service utilization. Sex-related issues were of greater concern to the private school youth and they desired more help with depression-sadness and birth control. Inner-city youth had more health worries and indicated a desire for more help with physical problems such as toothaches, headaches, and stomach aches, and social problems such as racial discrimination and parent relations. From a list of 22 health problems, the inner-city youth ranked dental problems, acne, and health worries highest while the private school youth ranked depression-sadness, tiredness, and acne highest. Regardless of social class, most adolescents perceived large gaps in their health education. One implication of our data is that the specific self-reported needs and concerns of adolescents should be considered in planning health services and education programs.
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is designed to collect information from all specialty mental health facilities in the United States, both public...
Smith, Carolyn R; Fisher, Bonnie S; Gillespie, Gordon L; Beery, Theresa A; Gates, Donna M
Aggression exposure is a critical health issue facing adolescents in the United States. Exposure occurs in various settings including home, school, and the community. An emerging context for aggression exposure is in the workplace. Thirty adolescent employees age 16-18 participated in a qualitative study exploring proposed responses to future workplace aggression. Semistructured interviews were used to gather participants' proposed responses to a series of hypothetical aggressive incidents in the workplace. Conventional content analysis identified patterns and themes among the participants' responses. Results indicated adolescent employees' proposed responses to workplace aggression are similar to other forms of aggression such as peer-bullying and teen dating violence. Education and training are needed within the school setting to promote appropriate responses to various forms of aggression encountered by adolescents. Implications for school health professionals' involvement in addressing responses to such aggression and further research opportunities are explored.
Jensen, Bente; Jensen, B. B.
The publication presents for the first time selected data from a survey of the attitudes of 13 to 15 year olds in Denmark. The survey indicates that the adolescents know that health is inequitably distributed. In addition. they strongly believe that everyone should have the sam opportunities...
LaFleur, E K; Taylor, S L
More than 75% of the female respondents in this study would choose a women's health center (WHC) over a standard health facility. Women who worked outside the home perceived a greater WHC need. And almost all respondents were interested in communications from the center via a quarterly newsletter. Significant test results related to age, income, education, and work status as segmentation variables, offering WHC's an opportunity to target their patients with specialized services such as cosmetic surgery, infertility treatment, breast imaging, etc. If enough resources are allocated, a WHC can design itself to attract highly lucrative patients. Little difference was found in the opinions of women regarding the need for a WHC or the core services desired, but the specific service mix decision must be carefully considered when designing a WHC.
Levy, J S
The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.
Lusi Herawati Sunyoto Usman Mark Zuidgeest
as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Oborn, Eivor; Barrett, Michael; Darzi, Ara
Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. The Royal Society of Medicine Press Ltd 2011.
Full Text Available BACKGROUND: Adolescent (10–19 years is a transition of age during which hazardous sexual health behaviors may be adopted; increasing vulnerability to several kinds of behavioral disorders like drug use, unsafe sexual act leading to reproductive ill health. Objective of the study was to assess sexual health behaviors of adolescents in Pokhara, Nepal. METHODS: An institution based cross-sectional study was conducted among 15–19 years adolescents studying in grades 11 and 12. Probability sampling techniques were applied. A structured, pretested, envelope sealed self administered questionnaire was distributed among all (1584 adolescents of the 11 and 12 grades of selected institutions. Data were analyzed using Statistical Package for Social Sciences (16 versions. Descriptive and inferential statistics were applied. RESULTS: About 19.37% adolescents had sexual contact and male participation was higher than females (P<0.05. Nearly one fifth of unmarried were found to be involved in sexual activities and most of them had first sex between 15-19 years age (median age 15.26 years. Of those who had sex, 6.91% had adopted all the three: vaginal, oral and anal sexes and majority had single followed by 2-5 sex partners in their sexual intercourse in the last one year and last month. About 13.93% adolescents were found to be indulged in group sex. Most of them had sex with regular partners and commercial sex workers. More than eight out of every ten who had sex had used contraceptive methods and condom was method of choice (94.77%. CONCLUSIONS: Premarital sexual involvement was prevalent among adolescents; sex with commercial sex workers and non commercial sex partners was perceived to be risk. Behavior change intervention strategies need to be formulated and implemented to promote adolescent reproductive and sexual health.
Coverdale, J H; Battaglia, J; Bushong, C P
This paper describes a school-based program in which psychiatry residents educate adolescents about a variety of mental health topics. Adolescents responded positively to the program and were principally concerned about drugs, depression, suicide, and family problems. Residents also liked presenting in the schools. Participation in this program allowed residents to learn about agency consultation and secondary prevention. Possibilities for program expansion are discussed.
Overweight and obesity are pandemic health problems, not just among the adult population, but in children and adolescents as well. This article presents information on the prevalence, causes, prevention, and treatment of overweight and obesity in young people, with particular focus on the medical and psychological complications associated with the diseases. In addition, the challenges of imaging the obese pediatric population are discussed, and public policy changes that could help reverse obesity trends in children and adolescents are introduced.
Viel Vicuna, B
Throughout Western civilization the fundamental unit of society is the family. The union of a couple guarantees their responsibility to future children. Prior to the renaissance, when life expectancy was very low, the preservation of the human species required reproduction at a young age. Since the beginning of the 19th century, life expectancy has increased greatly. The extremes of reproductive age have been noted to be times when pregnancy carries increase risks, and the risks of grand multiparity have been noted. The sexual revolution has resulted in the loss of previous principles of conduct. Youth are incited by pornography in the media, and without the controlling influence of the traditional family, become sexually active at a younger age. In Chile, as elsewhere, there have always been out of wedlock births, but in 1970 these reached 18.5% of all births. By 1980, it had reached 27.6% of all births and 45.7% of births to mothers under age 20. Since the family is the basic unit of society, this number of illegitimate births indicates a grave social problem. This also represents a public health risk due to the increased risks of young mothers. Illegitimate children of adolescent mothers have the added problem that the fathers are usually also young, so both parents are still in school and cannot assume full responsibility for the child. These babies have a much higher infant mortality than those of older mothers. The only solution is education, and legislation requiring paternal responsibility. School teachers often have an inadequate knowledge of reproduction and sexuality, and can not serve as sources of information to the students. Without supportive education and legislation requiring both parents to be responsible for their children, we will not be able to solve this situation.
Kassebaum, N.L.; Hmwe Kyu, Hmwe; Zoeckler, Leo; Geleijnse, J.M.
Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.
Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and
Brugman, E.; Meulmeester, J.F.; Spee-Wekke, A. van der; Beuker, R.J.; Zaadstra, B.M.; Radder, J.J.; Verloove-Vanhorick, P.S.
OBJECTIVE: To estimate the prevalence of dieting and the relationship between dieting, nutritional habits, and health among young adolescents in the Netherlands. METHODS: Out of 1359 secondary school children, aged 13 through 15 y, who were invited for a routine health assessment by school doctors
Brekke, Idunn; Reisel, Liza
This article examines the relationship between birthweight, adolescent health (general health and psychological distress) and high school completion in Norway, using survey data linked to longitudinal registry data (n = 5,354). The findings show that the positive association between birthweight and high school completion can be attributed to…
Kassebaum, N.L.; Hmwe Kyu, Hmwe; Zoeckler, Leo; Geleijnse, J.M.
Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.
Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescen
Brugman, E.; Meulmeester, J.F.; Spee-Wekke, A. van der; Beuker, R.J.; Zaadstra, B.M.; Radder, J.J.; Verloove-Vanhorick, P.S.
OBJECTIVE: To estimate the prevalence of dieting and the relationship between dieting, nutritional habits, and health among young adolescents in the Netherlands. METHODS: Out of 1359 secondary school children, aged 13 through 15 y, who were invited for a routine health assessment by school doctors o
Full Text Available The state policy in the health care area must take into account the complexity and specificity of the domain. Health means not only “to treat”, but also “to prevent” and “to recover and rehabilitate the individual physically”. Regardless of the adopted health insurance system, the health system is facing a big problem and this is the insufficient funds necessary to function properly. The underfunding may have various causes, from a wrong health policy, based on “treating” instead of “preventing”, by the misuse of funds. This papers intended to formulate assumptions that underpin the research I am conducting within the Doctoral Research Program held at the Valahia University of Targoviste, which aims at using the management control in increasing the health services performance. The application of the accounting and management control methods in determining health costs can be a beginning to streamline the system. This is also a result of the fact that health care is a public service with specific characteristics: it can not be subject only to market requirements but at the same time he must undergo an administrative savings, representing a typical case of market failure. The increased cost of treatment, as well as the decline in their quality can be determined by the discrepancy between the funding and payment mechanisms. Different payment systems currently available do nothing but perpetuate the shortcomings in the system. Switching to the introduction of cost and budgets by cost centers or object (if solved can be a step forward for a better management of resources. In this context, we consider as a necessity to be imposed the cost analysis on responsibility centers, the definition of the cost object and cost center identification and determination of direct costs and those indirect services to choose the basis for the allocation of cost centers and the determination of each actual cost per diagnosis.
Hirani, Kajal; Payne, Donald; Mutch, Raewyn; Cherian, Sarah
Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals.
Edelman, Marion Wright
For poor and minority teenagers the lack of adequate life options may increase their desire for early pregnancy. Since teen mothers face probable poverty and single parenthood, it is imperative that schools and school social workers provide counseling, health services, and work preparation as well as academic skills training. (VM)
Marston, Cicely; Hinton, Rachael; Kean, Stuart; Baral, Sushil; Ahuja, Arti; Costello, Anthony; Portela, Anayda
The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. We outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals.
Chen, Rui; Zhao, Yali; Du, Juan; Wu, Tao; Huang, Yafang; Guo, Aimin
To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China. A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (Purban CHS centers.
E-Health applications have to take the business perspective into account. This is achieved by adding a fourth layer reflecting organizational and business processes to an existing three layer model for IT-system functionality and management. This approach is used for designing a state-wide e-Health service delivery allowing for distributed responsibilities: clinical organizations act on the fourth layer and have established mutual cooperation in this state-wide approach based on collectively outsourced IT-system services. As a result, no clinical organization can take a dominant role based on operating the IT-system infrastructure. The implementation relies on a central infrastructure with extended means to guarantee service delivery: (i) established redundancy within the system architecture, (ii) actively controlled network and application availability, (iii) automated routine performance tests fulfilling regulatory requirements and (iv) hub-to-spoke and end-to-end authentication. As a result, about half of the hospitals and some practices of the state have signed-up to the services and guarantee long-term sustainability by sharing the infrastructural costs. Collaboration takes place for more than 1000 patients per month based on second opinion, online consultation and proxy services for weekend and night shifts.
Powell, Lisa M; Nguyen, Binh T
To examine the effect of fast-food and full-service restaurant consumption on total energy intake, dietary indicators, and beverage consumption. Individual-level fixed-effects estimation based on 2 nonconsecutive 24-hour dietary recalls. Nationally representative data from the 2003-2004, 2005-2006, and 2007-2008 National Health and Nutrition Examination Survey. Children aged 2 to 11 years (n = 4717) and adolescents aged 12 to 19 years (n = 4699). Daily total energy intake in kilocalories; intake of grams of sugar, total fat, saturated fat, and protein and milligrams of sodium; and total grams of sugar-sweetened beverages, regular soda, and milk consumed. Fast-food and full-service restaurant consumption, respectively, was associated with a net increase in daily total energy intake of 126.29 kcal and 160.49 kcal for children and 309.53 kcal and 267.30 kcal for adolescents and with higher intake of regular soda (73.77 g and 88.28 g for children and 163.67 g and 107.25 g for adolescents) and sugar-sweetened beverages generally. Fast-food consumption increased intake of total fat (7.03-14.36 g), saturated fat (1.99-4.64 g), and sugar (5.71-16.24 g) for both age groups and sodium (396.28 mg) and protein (7.94 g) for adolescents. Full-service restaurant consumption was associated with increases in all nutrients examined. Additional key findings were (1) adverse effects on diet were larger for lower-income children and adolescents and (2) among adolescents, increased soda intake was twice as large when fast food was consumed away from home than at home. Fast-food and full-service restaurant consumption is associated with higher net total energy intake and poorer diet quality.
Powell, Lisa M.; Nguyen, Binh T.
Objective To examine the impact of fast-food and full-service restaurant consumption on total energy intake, dietary indicators and beverage consumption. Design Individual-level fixed effects estimation based on two non-consecutive 24-hour dietary recalls. Setting Nationally representative data from the 2003–2004, 2005–2006, and 2007–2008 National Health and Nutrition Examination Survey. Participants Children aged 2 to 11 (N=4717) and adolescents aged 12 to 19 (N=4699) Main Outcome Measures Daily total energy intake in kilocalories, intakes of grams of sugar, fat, saturated fat and protein and milligrams of sodium and total grams of sugar-sweetened beverages (SSBs), regular soda and milk consumed. Results Fast-food and full-service restaurant consumption, respectively, was associated with a net increase in daily total energy intake of 126 kcal and 160 kcal for children and 310 kcal and 267 kcal for adolescents and higher intakes of regular soda (+74g and +88g for children and +163g and +107g for adolescents) and SSBs generally. Fast-food consumption increased intakes of total fat (+7–8g), saturated fat (+2–5g) and sugar (+6–16g) for both age groups and sodium (+396mg) and protein (+8g) for adolescents. Full-service restaurant consumption was associated with increases in all nutrients examined. Additional key findings were 1) adverse impacts on diet were larger for lower-income children and adolescents; and, 2) among adolescents, increased soda intake was twice as large when fast food was consumed away from home than at home. Conclusions Fast-food and full-service restaurant consumption is associated with higher net total energy intake and poorer diet quality. PMID:23128151
Due, P; Lynch, J; Holstein, B
To investigate the role of different types of social relations in adolescent health inequalities.......To investigate the role of different types of social relations in adolescent health inequalities....
Garcia, Leila Posenato; Zanetti-Ramos, Betina Giehl
The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.
Currently, little is known about adolescents' self-stigma experiences as mental health (MH) treatment recipients. Hence, this study addresses the following two questions: (a) what are adolescents' and parents' perceptions of stigma and perceptions of the cause, controllability, and anticipated outcome (illness perceptions) of adolescents' MH…
Currently, little is known about adolescents' self-stigma experiences as mental health (MH) treatment recipients. Hence, this study addresses the following two questions: (a) what are adolescents' and parents' perceptions of stigma and perceptions of the cause, controllability, and anticipated outcome (illness perceptions) of adolescents' MH…
Hunt, Jenny; Wheatley, Malcolm
To date there is limited research examining the use of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) with adolescents in secure care. The aim of this article is to examine the inter-rater reliability, concurrent validity and clinical utility of HoNOSCA in an adolescent secure psychiatric unit. Twenty-four…
van der Velde, J. L.; Flokstra-de Blok, B. M. J.; Hamp, A.; Knibb, R. C.; Duiverman, E. J.; Dubois, A. E. J.
Background: Food-allergic adolescents are at highest risk for food allergy fatalities, which may be partly due to compromised self-management behavior. Such behavior may be negatively influenced by conflictual situations caused by adolescent-parent disagreement on the adolescent's health-related qua
Suárez-Pinto, Tatiana A; Blanco-Gómez, Argénida; Díaz-Martínez, Luis A
Seventy percent of adolescent morbidity and mortality is related to six risky behaviors. The Rapid Assessment for Adolescent Preventive Services is a screening questionnaire consisting of 21 questions but there is not a validated Spanish-language version. The obj ective of this study was to validate the Spanish-language version of the Rapid Assessment for Adolescent Preventive Services in two Colombian cities: Bucaramanga and Medellin. The questionnaire was administered to 270 randomly selected adolescent students aged between 11 and 19 years old. Its internal consistency measured using Cronbach's alpha was 0.7207. The factor analysis showed that two factors accounted for 84.5% of variance, but factor loading indicates that only one of these is valid in Colombia: substance use (tobacco, alcohol, narcotics, and psychoactive substances).
Ryder, Nathan; McNulty, Anna M
Confidentiality concerns are often described as barriers to seeking sexual health care. There has been little research describing the relative importance of confidentiality to clients of sexual health clinics, and whether members of high-risk groups have greater concerns. This study aimed to determine the importance of confidentiality and anonymity to clients of a public sexual health clinic, and determine associations with gender and sexuality. A self-administered questionnaire was offered to consecutive new English-speaking clients in October and November 2007. Participants were asked to describe the reasons for presenting, likelihood of disclosing identifying information, and concern should specific people and agencies become aware of their attendance. Of 350 eligible clients, 270 (77%) participated in the survey. Expert care was included in the top three reasons for choosing a sexual health clinic rather than a general practitioner by over half of participants, while confidentiality and cost were each included in the top three reasons by one-third of respondents respectively. Over 90% of clients reported they were likely to give accurate identifying information to the clinic. Participants were comfortable with disclosure of information to other health-care workers but became increasingly unwilling for information to be shared with services not directly involved in their care. Overall there were few associations with gender or sexuality. Clients choose to attend our clinic for a variety of reasons, with confidentiality and anonymity being of lesser importance than competence and cost. Confidentiality is important to the majority of clients, whereas few desire anonymity. Most clients would accept information being shared with other health services, suggesting that confidentiality may not be a barrier to the use of electronic health records in sexual health clinics.
Mary-Louise Jung; Karla Loria
Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting... Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific... health care delivery and management, and nursing research. Applications are reviewed for scientific and...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting... Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific... health care delivery and management, and nursing research. Applications are reviewed for scientific and...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting..., Program Manager, Scientific Merit Review Board, Department of Veterans Affairs, Health Services Research.... App. 2, that the Centers of Innovation subcommittee of the Health Services Research and Development...
Wagner, Gudrun; Zeiler, Michael; Waldherr, Karin; Philipp, Julia; Truttmann, Stefanie; Dür, Wolfgang; Treasure, Janet L; Karwautz, Andreas F K
This is a nationwide epidemiological study using DSM-5 criteria to assess the prevalence of mental disorders in a large sample of Austrian adolescents between 10 and 18 years including hard-to-reach samples. A sample of 3615 adolescents from four cohorts (school grades 5, 7, 9, 11; age range 10-18 years) was recruited from 261 schools, samples of unemployed adolescents (n = 39) and adolescents from mental health institutions (n = 137) were added. The Youth Self-Report and SCOFF were used to screen for mental health problems. In a second phase, the Childrens' Diagnostic Interview for Mental Disorders was used to make point and lifetime psychiatric diagnoses. Mental health service use was also assessed. Point prevalence and lifetime prevalence rates for at least one psychiatric disorder were 23.9% and 35.8%. The highest lifetime prevalence rates were found for anxiety disorders (15.6%), neurodevelopmental disorders (9.3%; ADHD 5.2%) and depressive disorders (6.2%). Forty-seven percent of adolescents with a lifetime psychiatric disorder had a second diagnosis. Internalising disorders were more prevalent in girls, while neurodevelopmental disorders and disruptive, impulse control and conduct disorders were more prevalent in boys. Of those with a lifetime psychiatric disorder, 47.5% had contacted mental health services. Of the residual 52.5% who had not contacted mental health services, 18.1% expressed an interest in treatment. DSM-5 mental health disorders are highly prevalent among Austrian adolescents. Over 50% had or were interested in accessing treatment. Early access to effective interventions for these problems is needed to reduce burden due to mental health disorders.
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting... States Code Appendix 2, that the Health Services Research and Development Service Scientific Merit Review... Services Research (HSR) subcommittees and its Nursing Research Initiative (NRI) subcommittee. The HSR...
The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.
Calderon, Susana J.; Mallory, Caroline
Despite improvements in prevention, oral diseases are a problem among adolescents, linked to poor health outcomes and poor school performance. Little is known about adolescent oral health behavior. This systematic review describes factors that influence oral health behavior in adolescents. Inclusion criteria for the literature search were American…
Calderon, Susana J.; Mallory, Caroline
Despite improvements in prevention, oral diseases are a problem among adolescents, linked to poor health outcomes and poor school performance. Little is known about adolescent oral health behavior. This systematic review describes factors that influence oral health behavior in adolescents. Inclusion criteria for the literature search were American…
Sarah E Wiehe
Full Text Available BACKGROUND: Various forms of community disorder are associated with health outcomes but little is known about how dynamic context where an adolescent spends time relates to her health-related behaviors. OBJECTIVE: Assess whether exposure to contexts associated with crime (as a marker of community disorder correlates with self-reported health-related behaviors among adolescent girls. METHODS: Girls (N = 52, aged 14-17, were recruited from a single geographic urban area and monitored for 1 week using a GPS-enabled cell phone. Adolescents completed an audio computer-assisted self-administered interview survey on substance use (cigarette, alcohol, or marijuana use and sexual intercourse in the last 30 days. In addition to recorded home and school address, phones transmitted location data every 5 minutes (path points. Using ArcGIS, we defined community disorder as aggregated point-level Unified Crime Report data within a 200-meter Euclidian buffer from home, school and each path point. Using Stata, we analyzed how exposures to areas of higher crime prevalence differed among girls who reported each behavior or not. RESULTS: Participants lived and spent time in areas with variable crime prevalence within 200 meters of their home, school and path points. Significant differences in exposure occurred based on home location among girls who reported any substance use or not (p 0.04 and sexual intercourse or not (p 0.01. Differences in exposure by school and path points were only significant among girls reporting any substance use or not (p 0.03 and 0.02, respectively. Exposure also varied by school/non-school day as well as time of day. CONCLUSIONS: Adolescent travel patterns are not random. Furthermore, the crime context where an adolescent spends time relates to her health-related behavior. These data may guide policy relating to crime control and inform time- and space-specific interventions to improve adolescent health.
Hale, F A; Jacobs, A R
While home health services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified home health agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health
Sveinsdottir, E G; Wang, N J
In 2008, Iceland experienced a major financial crisis, with serious effects on the economy of the country and its inhabitants. To describe the opinions of dentists in Iceland regarding the influence of economic changes on the demand for dental health services for children and adolescents, aged 0-18 years, and also to describe the preventive dental care the dentists reported providing for children and adolescents. Questionnaires were sent by electronic mail to all dentists in Iceland in January 2013. Of the dentists working with children, 161 (62%) returned the questionnaire. Important findings were that 119 (74%) of the respondents reported increased caries experience in children and adolescents and 150 (93%) reported that decreased reimbursement for dental treatment of children in recent years had affected the dental health of most or some children and adolescents. Most dentists reported reduced parental demand for most aspects of caries prevention and treatment, apart from treatment for acute dental pain. The mean interval between dental visits was reported to be 9.4 months (sd 2.8) and the mean maximal interval 12.1 months (sd 2.8). The mean proportion of working time allocated for caries preventive services was reported to be 31% (sd 21). The results indicate a contrast between increased need for children's dental care perceived by the dentists and reduced demand for care from the parents. This may be a temporary phenomenon, as the economic crisis passes, reimbursement for dental care may increase.