Sample records for adolescent hospitalized

  1. Some psychological characteristics of adolescents hospitalized following a suicide attempt. (United States)

    Maraš, J S; Kolundžija, K; Dukić, O; Marković, J; Okanović, P; Stokin, B; Mitrović, D; Ivanović-Kovačević, S


    In most countries, suicide is second or third leading cause of death in youth. Suicidal tendencies among youth have been the subject of extensive research. Reports of increased rate of suicide attempts in the past few decades indicate that this phenomenon has not been fully understood. The aim of this study was to better understand the phenomenon of adolescent suicide behavior by defining some specific psychological characteristics of adolescents who were hospitalized at the psychiatric ward because of the suicide attempt. 62 participants were assigned to two groups: clinical (adolescents who were hospitalized after a suicide attempt) and non-clinical (adolescents without psychiatric symptoms). They filled in a series of instruments: a questionnaire examining adolescents' demographic characteristics, Rosenberg's Self-Esteem Scale, Youth Self Report. Compared to the non-clinical populaton adolescents attempting suicide had significantly more frequent suicidal thoughts (χ2 = 18.627, df = 1, p self-esteem (t = 4.23, p suicide attempt.  

  2. Adolescent alcohol intoxication in the dutch hospital Departments of Pediatrics

    NARCIS (Netherlands)

    Hoof, J.J. van; Lely, N. van der; Pereira, R.R.; Dalen, W.E. van


    Objective This study was conducted to investigate the number and characteristics of adolescent alcohol intoxication cases in hospital Departments of Pediatrics. The study also analyzes drinking patterns and intoxication characteristics. Method: Data were collected using the Dutch Pediatric

  3. Effects of Assertive Training on Hospitalized Adolescents and Young Adults. (United States)

    Fiedler, Phyllis E.; And Others


    This study focuses on reducing the hostility of hospitalized adolescent and young adult psychiatric patients through assertive training techniques designed to teach appropriate responses to interpersonal conflict. It was predicted that, after treatment, the assertive group would show greater assertiveness, less hostility, and a more positive…

  4. A Prospective Study of Adolescent Suicidal Behavior Following Hospitalization. (United States)

    King, Cheryl A.; And Others


    Identifies specific predictors of suicidal behavior in 100 adolescents during a 6-month follow-up period after psychiatric hospitalization. Eighteen percent reported suicidal behavior during the follow-up period, and this behavior was associated with suicidal thoughts, family dysfunction, and dysthymia. It was not associated with initial…

  5. Is family size related to adolescence mental hospitalization? (United States)

    Kylmänen, Paula; Hakko, Helinä; Räsänen, Pirkko; Riala, Kaisa


    The aim of this study was to investigate the association between family size and psychiatric disorders of underage adolescent psychiatric inpatients. The study sample consisted of 508 adolescents (age 12-17) admitted to psychiatric impatient care between April 2001 and March 2006. Diagnostic and Statistical Manual of Mental Disorders, fourth edition-based psychiatric diagnoses and variables measuring family size were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL). The family size of the general Finnish population was used as a reference population. There was a significant difference between the family size of the inpatient adolescents and the general population: 17.0% of adolescents came from large families (with 6 or more children) while the percentage in the general population was 3.3. A girl from a large family had an about 4-fold risk of psychosis other than schizophrenia. However, large family size was not associated with a risk for schizophrenia. Large family size was overrepresented among underage adolescents admitted for psychiatric hospitalization in Northern Finland. Copyright 2009 Elsevier Ltd. All rights reserved.

  6. Transitioning home: A four-stage reintegration hospital discharge program for adolescents hospitalized for eating disorders. (United States)

    Dror, Sima; Kohn, Yoav; Avichezer, Mazal; Sapir, Benjamin; Levy, Sharon; Canetti, Laura; Kianski, Ela; Zisk-Rony, Rachel Yaffa


    Treatment for adolescents with eating disorders (ED) is multidimensional and extends after hospitalization. After participating in a four-step reintegration plan, treatment success including post-discharge community and social reintegration were examined from perspectives of patients, family members, and healthcare providers. Six pairs of patients and parents, and seven parents without their children were interviewed 2 to 30 months following discharge. All but two adolescents were enrolled in, or had completed school. Five worked in addition to school, and three completed army or national service. Twelve were receiving therapeutic care in the community. Adolescents with ED can benefit from a systematic reintegration program, and nurses should incorporate this into care plans. © 2015, Wiley Periodicals, Inc.

  7. Out-of-hospital cardiac arrests in children and adolescents

    DEFF Research Database (Denmark)

    Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik


    BACKGROUND: There is insufficient knowledge of out-of-hospital cardiac arrest (OHCA) in the very young. OBJECTIVES: This nationwide study sought to examine age-stratified OHCA characteristics and the role of parental socioeconomic differences and its contribution to mortality in the young...... population. METHODS: All OHCA patients in Denmark, ≤21 years of age, were identified from 2001 to 2010. The population was divided into infants (adolescents/young adults (16-21 years). Multivariate logistic regression......-school children, school children and high school adolescents were 11.5, 3.5, 1.3 and 5.3 per 100,000 inhabitants. Overall bystander CPR rate was 48.8%, and for age groups: 55.4%, 41.2%, 44.9% and 63.0%, respectively. Overall 30-day survival rate was 8.1%, and for age groups: 1.4%, 4.5%, 16.1% and 9...

  8. Use of social networking websites as a care instrument for hospitalized adolescents

    Directory of Open Access Journals (Sweden)

    Camila Amaral Borghi


    Full Text Available Abstract Objective: This study aimed to understand how social networking websites are used by adolescents and their importance during the hospitalization process. Method: A descriptive and qualitative study was supported by the virtual ethnographic method and resorted to the symbolic interactionism as theoretical framework. Eleven hospitalized adolescents were interviewed. Results: Three categories were identified based on the analysis of interviews and posts: Being able to use social networking websites during hospitalization; Using the Facebook® chat to keep connected to friends; Seeking support from friends through social networking websites. Final considerations: Facebook® was the social networking website that adolescents used the most, standing out as an important form of entertainment during hospitalization that facilitates communication and social support. Healthcare professionals should value the use of social networking websites by hospitalized adolescents and encourage access to these tools, providing hospital resources to expand and facilitate this access.

  9. Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives (United States)

    Wong, Matthew; Katzman, Debra K.; Akseer, Nadia; Steinegger, Cathleen; Hancock-Howard, Rebecca L.; Coyte, Peter C.


    Background Admission to hospital is the treatment of choice for anorexia nervosa in adolescent patients who are medically unstable; however, stays are often prolonged and frequently disrupt normal adolescent development, family functioning, school and work productivity. We sought to determine the costs of inpatient treatment in this population from a hospital and caregiver perspective, and to identify determinants of such costs. Methods We used micro-costing methods for this cohort study involving all adolescent patients (age 12–18 yr) admitted for treatment of anorexia nervosa at a tertiary care child and adolescent eating disorder program in Toronto, between Sept. 1, 2011, and Mar. 31, 2013. We used hospital administrative data and Canadian census data to calculate hospital and caregiver costs. Results We included 73 adolescents in our cohort for cost-analysis. We determined a mean total hospital cost in 2013 Canadian dollars of $51 349 (standard deviation [SD] $26 598) and a mean total societal cost of $54 932 (SD $27 864) per admission, based on a mean length of stay of 37.9 days (SD 19.7 d). We found patient body mass index (BMI) to be the only significant negative predictor of hospital cost (p adolescents with anorexia nervosa on hospitals and caregivers is substantial, especially among younger patients and those with lower BMI. Recognizing the symptoms of eating disorders early may preclude the need for admission to hospital altogether or result in admissions at higher BMIs, thereby potentially reducing these costs. PMID:26389097

  10. Children and adolescents ostomized in a reference hospital. Epidemiological profile

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    Orlando José dos Santos


    Full Text Available Objectives: To assess the epidemiological profile of children and adolescents with intestinal stoma, assisted at the Presidente Dutra University Hospital (HUPD, São Luís (MA. Methods: Observational, descriptive, retrospective, and individuated study. Data were collected from 110 children and adolescents with elimination intestinal stoma, from January 2006 to February 2013. The following variables were analyzed: age, gender, patient origin, and stomata indication, type, and temporal character. After data collection, descriptive analysis was made by Bioestat 5.0 program. Results: Of 110 patients, 78.2% were male and 21.8% female. The average age was 9.4 years old. 55.5% came from the Maranhão state countryside, and 44.5% from the capital, São Luís. Regarding stoma type, colostomies made up 88.2%, and were 11.8% ileostomies, all temporary stoma. The main cause was trauma (42.7%, with firearm abdominal puncture being the most frequent cause (71.5% of the category; followed by congenital anomalies (38.2%, and obstructive (5.4% and inflammatory (4.5% causes. Conclusion: Studied children and adolescents were mostly male, from Maranhão state countryside. The main cause was trauma, and colostomy was the most common stoma type. Resumo: Objetivos: Avaliar o perfil epidemiológico de crianças e adolescentes portadores de estomas intestinais atendidos no Hospital Universitário Presidente Dutra (HUPD em São Luís (MA. Métodos: Estudo observacional, descritivo, retrospectivo e individuado em que foram coletados dados de 110 crianças e adolescentes com estomas intestinais de eliminação de janeiro de 2006 a fevereiro de 2013. Analisaram-se as variáveis: idade, sexo, procedência dos pacientes, indicação, tipo e caráter temporal dos estomas. Após coleta dos dados, foi feita análise descritiva pelo programa Bioestat 5.0. Resultados: Dos 110 pacientes, 78,2% eram do sexo masculino e 21,8% do sexo feminino. A idade média foi de 9,4 anos. 55

  11. Adolescent alcohol intoxication in the dutch hospital departments of pediatrics: A 2-year comparison study

    NARCIS (Netherlands)

    Hoof, J.J. van; Lely, N. van der; Bouthoorn, S.H.; Dalen, W.E. van; Pereira, R.R.


    Purpose: To monitor the prevalence of, and the circumstances leading to, adolescent alcohol intoxication admissions in Dutch hospital departments of pediatrics. Methods: Data were collected in 2007 and 2008, using the Dutch Pediatric Surveillance System, in which pediatricians received

  12. Does family-based treatment reduce the need for hospitalization in adolescent anorexia nervosa? (United States)

    Lock, James; Agras, W Stewart; Bryson, S W; Brandt, Harry; Halmi, Katherine A; Kaye, Walter; Wilfley, Denise; Woodside, Blake; Pajarito, Sarah; Jo, Booil


    We examined the timing and number of days of hospitalization during the course of treatment, hospitalization effects on outcome, and predictors and moderators of the use of hospitalization in adolescents with anorexia nervosa (AN). Data used in this study were collected from 158 adolescents (ages 12 to 18 years of age) who met DSM-IVTR criteria for AN (exclusive of the amenorrhea criteria) randomized to receive either Family Based Treatment (FBT) or Systemic Family Therapy (SyFT) in a 7 site study. The trajectory of hospital day use is similar in the first 5 weeks irrespective of treatment allocation. However, days of hospitalization continued to increase throughout SyFT but leveled off in FBT after ∼5 weeks of treatment. Early hospitalization was a negative predictor for improvements in percent weight change for both treatment groups (t(1)=2.6, p = 0.011). Co-morbid psychopathology predicted early hospital use in both treatments. Higher levels of eating related obsessions and depression moderated hospitalization rates suggesting that FBT reduces early hospitalization rates compared to SyFT for these subgroups. These data support and extend findings from previous studies by identifying patterns of hospital use, and predictors and moderators of treatment effect for early hospitalization use in adolescent AN. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:891-894). © 2016 Wiley Periodicals, Inc.

  13. Gender, age, and educational level attribute to blood alcohol concentration in hospitalized intoxicated adolescents: A cohort study

    NARCIS (Netherlands)

    van Zanten, Eva; van der Ploeg, Tjeerd; van Hoof, Joris Jasper; van der Lely, Nicolaas


    Background The prevalence of adolescents hospitalized with acute alcohol intoxication, mainly because of severe reduced consciousness, is increasing. However, the characteristics of these adolescents are mainly unidentified. In this clinical research, we aimed to identify factors that attribute to

  14. Psychopathology of adolescents with an intellectual disability who present to general hospital services. (United States)

    Theodoratos, Oreste; McPherson, Lyn; Franklin, Catherine; Tonge, Bruce; Einfeld, Stewart; Lennox, Nicholas; Ware, Robert S


    Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.

  15. Changing patterns of psychiatric inpatient care for children and adolescents in general hospitals, 1988-1995. (United States)

    Pottick, K J; McAlpine, D D; Andelman, R B


    The authors examine patterns in utilization of psychiatric inpatient services by children and adolescents in general hospitals during 1988-1995. National Hospital Discharge Survey data were used to describe utilization patterns for children and adolescents with primary psychiatric diagnoses in general hospitals from 1988 to 1995. During the study period, there was a 36% increase in hospital discharges and a 44% decline in mean length of stay, resulting in a 23% decline in the number of bed-days, from more than 3 million to about 2.5 million. The number of nonpsychotic major depressive disorders increased significantly. Discharges from public hospitals have declined, and those from proprietary hospitals have risen. Concurrently, the role of private insurance declined and the role of Medicaid increased. During the period of study, the mean and median length of stay declined most for children and adolescents who were hospitalized in private facilities and those covered by private insurance. Across the United States, the mean length of stay declined significantly; this decline was almost 60% in the West. Discharges also declined in the West, in contrast to the Midwest and the South, where they significantly increased. Increased numbers of discharges and decreased length of stay may reflect evolving market forces and characteristics of hospitals. Further penetration by managed care into the public insurance system or modifications in existing Medicaid policy could have a profound impact on the availability of inpatient resources.

  16. Respiratory acidosis in adolescents with anorexia nervosa hospitalized for medical stabilization: a retrospective study. (United States)

    Kerem, Nogah C; Riskin, Arieh; Averin, Elvira; Srugo, Isaac; Kugelman, Amir


    To examine the effect of malnutrition due to anorexia nervosa (AN) on venous blood gases of adolescents with AN hospitalized for medical stabilization. This retrospective study included 45 adolescents with recent onset (respiratory acidosis (pH 45 mm Hg) was observed in 78% of the patients on admission and only in 35% at discharge (p = .0003). Positive correlations were found between % of weight loss and pCO(2) on admission and between BMI on admission and the delta pCO(2) during hospitalization. Mild respiratory acidosis is common in adolescents with recently diagnosed AN, hospitalized for medical stabilization. Respiratory acidosis improves with bed rest and refeeding. The clinical significance of these findings should be further evaluated. Copyright © 2011 Wiley Periodicals, Inc.

  17. Determinants in Adolescence of Stroke-Related Hospital Stay Duration in Men: A National Cohort Study. (United States)

    Bergh, Cecilia; Udumyan, Ruzan; Appelros, Peter; Fall, Katja; Montgomery, Scott


    Physical and psychological characteristics in adolescence are associated with subsequent stroke risk. Our aim is to investigate their relevance to length of hospital stay and risk of second stroke. Swedish men born between 1952 and 1956 (n=237 879) were followed from 1987 to 2010 using information from population-based national registers. Stress resilience, body mass index, cognitive function, physical fitness, and blood pressure were measured at compulsory military conscription examinations in late adolescence. Joint Cox proportional hazards models estimated the associations of these characteristics with long compared with short duration of stroke-related hospital stay and with second stroke compared with first. Some 3000 men were diagnosed with nonfatal stroke between ages 31 and 58 years. Low stress resilience, underweight, and higher systolic blood pressure (per 1-mm Hg increase) during adolescence were associated with longer hospital stay (compared with shorter) in ischemic stroke, with adjusted relative hazard ratios (and 95% confidence intervals) of 1.46 (1.08-1.89), 1.41 (1.04-1.91), and 1.01 (1.00-1.02), respectively. Elevated systolic and diastolic blood pressures during adolescence were associated with longer hospital stay in men with intracerebral hemorrhage: 1.01 (1.00-1.03) and 1.02 (1.00-1.04), respectively. Among both stroke types, obesity in adolescence conferred an increased risk of second stroke: 2.06 (1.21-3.45). Some characteristics relevant to length of stroke-related hospital stay and risk of second stroke are already present in adolescence. Early lifestyle influences are of importance not only to stroke risk by middle age but also to recurrence and use of healthcare resources among stroke survivors. © 2016 American Heart Association, Inc.

  18. Admission to acute care hospitals for adolescent substance abuse: a national descriptive analysis

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    Chisolm Deena J


    Full Text Available Abstract Background Use of alcohol and illicit drugs by adolescents remains a problem in the U.S. Case identification and early treatment can occur within a broad variety of healthcare and non-healthcare settings, including acute care hospitals. The objective of this study is to describe the extent and nature of adolescent admissions to the acute inpatient setting for substance abuse (SA. We use the Agency for Healthcare Research and Quality (AHRQ 2000 Healthcare Cost and Utilization Project Kids Inpatient Database (HCUP-KID which includes over 2.5 million admissions for youth age 20 and under to 2,784 hospitals in 27 states in the year 2000. Specifically, this analysis estimates national number of admissions, mean total charges, and mean lengths of stay for adolescents between the ages of 12 and 17 admitted to an acute care hospital for the following diagnostic categories from the AHRQ's Clinical Classifications Software categories: "alcohol-related mental disorders" and "substance-related mental disorders". Frequency and percentage of total admissions were calculated for demographic variables of age, gender and income and for hospital characteristic variables of urban/rural designation and children's hospital designation. Results SA admissions represented 1.25 percent of adolescent admissions to acute care hospitals. Nearly 90 percent of the admission occurred in non-Children's hospitals. Most were for drug dependence (38% or non-dependent use of alcohol or drugs (35%. Costs were highest for drug dependence admissions. Nearly half of admissions had comorbid mental health diagnoses. Higher rates of admission were seen in boys, in older adolescents, and in "self-pay" patients. Alcohol and drug rehabilitation/detoxification, alone or in combination with psychological and psychiatric evaluation and therapy, was documented for 38 percent of admissions. Over 50 percent of cases had no documentation of treatment specific to substance use behavior

  19. Birth rates and pregnancy complications in adolescent pregnant women giving birth in the hospitals of Thailand. (United States)

    Butchon, Rukmanee; Liabsuetrakul, Tippawan; McNeil, Edward; Suchonwanich, Yolsilp


    To determine the rates of births in adolescent pregnant women in diferent regions of Thailand and assess the rates of complications occurring at pregnancy, childbirth, and postpartum in women admitted in the hospitals ofThailand. The secondary analysis of data from pregnant women aged 10 to 49 years, who were admitted to hospitals and recorded in the National Health Security Office database between October 2010 and September 2011 was carried out. Adolescent birth rate by the regions and rate of complications ofpregnancy, delivery, and postpartum by age groups were analyzed. Highest birth rate was found among women aged 19 years (58.3 per 1, 000 population). The distribution of adolescent births varied across regions of Thailand, which was high in central region. Rate of preterm delivery was highest (10%) in adolescent aged 10 to 14 years. Rate of diabetes mellitus (6%), preeclampsia (4%), and postpartum hemorrhage (3%) among women aged 35 to 49 years were substantially higher than those among women aged 34 years or less. Adolescent birth rate varied across regions of Thailand. Complications occurred differently by ages of women. Holistic policy and planning strategies for proper prevention and management among pregnant women in different age groups are needed

  20. Pattern Of Epilepsy In Childhood And Adolescence : A Hospital ...

    African Journals Online (AJOL)

    Background This hospital-based study aimed to evaluate the frequency and diagnostic pattern of epilepsy in our locality among population with age range from birth to 18 years. Methods 127 patients out of a total of 565 regularly attended the out-patient epilepsy clinic, were included in this study over 6 months period.

  1. Contributing factors in self-poisoning leading to hospital admission in adolescents in northern Finland. (United States)

    Liisanantti, Janne Henrik; Ala-Kokko, Tero Ilmari; Dunder, Teija Sinikka; Ebeling, Hanna Elina


    To evaluate the frequencies of different agents used in self-poisonings and acute factors contributing to intoxication of patients aged 12-18 years in northern Finland. Retrospective medical record review of all hospitalized patients during the period from January 1, 1991 to December 31, 2006. Cause of the admission, contributing factors, readmissions within one year. There were 309 admissions during the period, 54% were females. The leading cause of admission was alcohol, in 222 cases (71.8%). Hospitalizations related to alcohol consumption were associated with accidental poisoning in recreational use. There were no acute contributing factors in the majority of all patients. Over one-third of all intoxications were intentional self-harm, although previously diagnosed psychiatric diseases were rare. It is crucial to recognize adolescent psychiatric disorders in time and consult child and adolescent psychiatrist in case of poisoning.

  2. Adolescent inpatient activity 1999-2010: analysis of English Hospital Episode Statistics data. (United States)

    Hargreaves, Dougal S; Viner, Russell M


    To investigate patterns and trends of adolescent (10-19 years) inpatient activity in England by sex, disease category, and admitting speciality. 9 632 844 Finished Consultant Episodes (FCEs) from English patients aged 1-19 between 1999/2000 and 2010/2011 (Hospital Episode Statistics data). Age trends by sex and major International Classification of Disease 10 (ICD10) chapter; differences in activity rates by age and sex; inpatient activity trends over the past decade, disaggregated by sex, admitting speciality and ICD10 chapter. Adolescent female patients account for more activity than girls aged 1-9 (139.4 vs 107.2 FCEs/1000). Female inpatient activity increases significantly between age 10 (70.9 FCEs/1000) and 19 (281.7 FCES/1000, of which non-obstetric care accounts for 155.9 FCEs/1000). Male activity increases much less during adolescence, with lower overall rates among adolescents than younger children (93.7 vs 142.9 FCEs/1000). Between 1999 and 2010, total adolescent inpatient activity increased faster among adolescents (10-19 years) (+14.2%) than younger children (1-9 years) (+11.0%). Adolescent FCEs/1000 increased by 12.8%, including higher rates admitted under Paediatrics (+47.5%) and Paediatric Surgery (+23.2%). Adolescents were admitted across a range of specialities. These data challenge the belief that adolescents are a healthy group who rarely use inpatient services. In England, use of inpatient services is higher among female patients aged 10-19 years than those aged 1-9 years, while adolescent activity has increased faster than for younger children over the past 11 years. Improving service quality for adolescents will require engagement of the many different teams that care for them. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  3. Presentations and Preceding factors of Drug Overdose amongst adolescents admitted to a Large Regional Hospital.

    LENUS (Irish Health Repository)

    Maduemem, KE


    Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32 – 16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.

  4. Using Hospitalization and Mortality Data to Identify Areas at Risk for Adolescent Suicide. (United States)

    Chen, Kun; Aseltine, Robert H


    The purpose of this study is to use statewide data on inpatient hospitalizations for suicide attempts and suicide mortality to identify communities and school districts at risk for adolescent suicide. Five years of data (2010-2014) from the Office of the Connecticut Medical Examiner and the Connecticut Hospital Inpatient Discharge Database were analyzed. A mixed-effects Poisson regression model was used to assess whether suicide attempt/mortality rates in the state's 119 school districts were significantly better or worse than expected after adjusting for 10 community-level characteristics. Ten districts were at significantly higher risk for suicidal behavior, with suicide mortality/hospitalization rates ranging from 154% to 241% of their expected rates, after accounting for their community characteristics. Four districts were identified as having significantly lower risk for suicide attempts than expected after accounting for community-level advantages and disadvantages. Data capturing hospitalization for suicide attempts and suicide deaths can inform prevention activities by identifying high-risk areas to which resources should be allocated, as well as low-risk areas that may provide insight into the best practices in suicide prevention. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Daniela Tavares Gontijo


    Full Text Available The adolescence is a human development time characterized by biopsychosocial changes, influenced by personal life experiences. In this context pregnancy along adolescence has been regarded as a relevant social issue due to the high prevalence in this age group. This study aims to describe biopsychosocial characteristics of adolescent mothers in a school hospital (SH of a public university in Minas Gerais, Brazil. This is a cross-sectional descriptive study with 40 adolescent mothers in this hospital. Data were collected through a form and analyzed using descriptive statistics. The data in this study were similar to findings in studies conducted in other urban centers especially as regards the participants’ average age and the precarious economic condition of their families and school performance. The data analysis has highlighted the need to Características de mães adolescentes understand teenage pregnancy as an experience with different factors as biological, psychological, economic and social development. teenage pregnancy, adolescent, reproduction

  6. Venous thrombotic events in hospitalized children and adolescents with inflammatory bowel disease. (United States)

    Nylund, Cade M; Goudie, Anthony; Garza, Jose M; Crouch, Gary; Denson, Lee A


    Adults with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events (TEs). We sought to evaluate the risk for TE in children and adolescents with IBD using a large population database. The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database was used in a retrospective cohort study of hospitalized children in the United States across 1997, 2000, 2003, 2006, and 2009. Billing codes were used to identify discharges with Crohn disease, ulcerative colitis, pulmonary embolism, deep vein thrombosis, thrombophlebitis, thrombosis of intracranial venous sinus, Budd-Chiari syndrome, and portal vein thrombosis. A logistic regression model was fitted to quantify the increased risk of TE in children with IBD, while adjusting for other risk factors of thrombosis. The total weighted number of pediatric discharges was 7,448,292, and 68,394 (0.92%) were identified with IBD. The incidence of any TE in a hospitalized child or adolescent with IBD was 117.9/10,000 with a relative risk (95% confidence interval) of 2.36 (2.15-2.58). The adjusted odds ratio for any TE in a patient with IBD without surgery was 1.22 (1.08-1.36). Risk factors for TE among patients with IBD include older age, central venous catheter, parenteral nutrition, and an identified hypercoagulable condition. There is an increasing trend of TE in both the IBD and non-IBD patients. Hospitalized children and adolescents with IBD are at increased risk for TE. Conservative methods of TE prevention including hydration, mobilization, or pneumatic devices should be considered in hospitalized patients with IBD.

  7. Posttraumatic stress disorder in hospitalized adolescents: psychiatric comorbidity and clinical correlates. (United States)

    Lipschitz, D S; Winegar, R K; Hartnick, E; Foote, B; Southwick, S M


    To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients. Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression. Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms. In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted.

  8. The relation of parental alcoholism to the prevalence of suicide attempts among hospitalized psychiatric adolescents

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    Katarzyna Krajewska


    Full Text Available Suicide is the third cause of death at the age group 10–19 in the world. There are inter multiple risk factors of suicidal behaviours. In the case of children of alcoholics the increased number of suicide attempts is explained by genetic predisposition and accumulation of environmental risk factors. The aim of this study is to check whether parental alcoholism is associated with the number and repetition of suicide attempts and the age at which the first suicide attempt occurred among hospitalized psychiatric adolescents. Material and methods: A retrospective analysis – based on medical documentation – of 119 patients aged 13–18, treated during 2013–2014 at the Department of Adolescent Psychiatry in Łódź for: schizophrenia, schizotypal and delusional disorders, mood disorders, neurotic, stress-related and somatoform disorders, behavioural and emotional disorders according to ICD-10. The exclusion criteria were other psychiatric diagnoses, incomplete family history and lack of information about intended self-harm behaviours. The patients were selected at random. The number and repetition of suicide attempts, the age at which the first suicide attempt occurred, parental alcoholism and family history of suicidal behaviours were examined. Analyses were carried out using Statistica 9.1. Results: Parental alcoholism did not statistically significantly affect (p > 0.05the prevalence or repetition of suicide attempts among psychiatrically treated adolescents. The first suicide attempts were not made by adolescents – also considering the gender, diagnosis, and familial suicidal behaviours. Conclusions: In almost half of the examined psychiatrically hospitalized adolescents at least one parent met the parental alcoholism criteria. Suicide attempts occurred in over 50% of the examined patients, with somewhat higher incidence in girls whose parents met the parental alcoholism criteria, as compared to those without parental alcoholism

  9. Lifestyle Factors in Late Adolescence Associate With Later Development of Diverticular Disease Requiring Hospitalization. (United States)

    Järbrink-Sehgal, M Ellionore; Schmidt, Peter T; Sköldberg, Filip; Hemmingsson, Tomas; Hagström, Hannes; Andreasson, Anna


    The burden of diverticular disease on society is high and is increasing with an aging population. It is therefore important to identify risk factors for disease development or progression. Many lifestyle behaviors during adolescence affect risk for later disease. We searched for adolescent lifestyle factors that affect risk of diverticular disease later in life. We performed a retrospective analysis of data from 43,772 men (age, 18-20 y) conscripted to military service in Sweden from 1969 through 1970, with a follow-up period of 39 years. All conscripts underwent an extensive mental and physical health examination and completed questionnaires covering alcohol consumption, smoking, and use of recreational drugs; cardiovascular fitness was assessed using an ergometer cycle at the time of conscription. Outcome data were collected from national registers to identify discharge diagnoses of diverticular disease until the end of 2009. We performed Cox regression analysis to determine whether body mass index, cardiovascular fitness, smoking, use of recreational drugs, alcohol consumption, and risky use of alcohol, at time of conscription are independent risk factors for development of diverticular disease. Overweight and obese men had a 2-fold increased risk of diverticular disease compared to normal-weight men (hazard ratio, 2.00; P diverticular disease requiring hospitalization (P = .009). Smoking (P = .003), but not use of recreational drugs (P = .11), was associated with an increased risk of diverticular disease requiring hospitalization. Risky use of alcohol, but not alcohol consumption per se, was associated with a 43% increase in risk of diverticular disease requiring hospitalization (P = .007). In a retrospective analysis of data from 43,772 men in Sweden, we associated being overweight or obese, a smoker, a high-risk user of alcohol, and/or having a low level of cardiovascular fitness in late adolescence with an increased risk of developing diverticular

  10. Biopsychosocial characteristics of adolescent mothers assisted at a school hospital in a City of Minas Gerais, Brazil

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    Daniela Tavares Gontijo


    Full Text Available The adolescence is a human development time characterized by biopsychosocial changes, influenced by personal life experiences. In this context pregnancy along adolescence has been regarded as a relevant social issue due to the high prevalence in this age group. This study aims to describe biopsychosocial characteristics of adolescent mothers in a school hospital (SH of a public university in Minas Gerais, Brazil. This is a cross-sectional descriptive study with 40 adolescent mothers in this hospital. Data were collected through a form and analyzed using descriptive statistics. The data in this study were similar to findings in studies conducted in other urban centers especially as regards the participants’ average age and the precarious economic condition of their families and school performance. The data analysis has highlighted the need to understand teenage pregnancy as an experience with different factors as biological, psychological, economic and social development.

  11. Adolescent pregnancy in a Greek public hospital during a six-year period (2000-2005)--a retrospective study. (United States)

    Panagopoulos, P; Salakos, N; Bakalianou, K; Davou, E; Iavazzo, C; Paltoglou, G; Liapis, A


    Adolescent pregnancy constitutes a multidimensional social problem in modern Greece. The purpose of this study was to investigate the trends of teenage childbearing and to determine the relationship between the incidence of teenage pregnancy and immigrant status of the mother. This is a retrospective correlational study. The birth registry of the hospital was examined for a 6-year period, from January 2000 to December 2005. Information about the age and nationality of the mothers was collected. The hospital under investigation is Tzaneio Hospital, a public general hospital that provides health services to the residents of Piraeus, a large municipality next to Athens. During the study period 4628 women gave birth at Tzaneio Hospital, among which 349 (7.54%) were under the age of 19. The study hypothesis, that adolescent childbearing prevails among immigrant population, was confirmed (P Greek government, health professionals, and sexuality educators should all work together in order to confront this problem.

  12. [Sociodemographic characteristics of the pregnant adolescent in a high specialty hospital]. (United States)

    Blanquet-García, Jaime; Montoya-Cázarez, Aminta; Carranza-Lira, Sebastián


    The adolescents' pregnancy is a public health problem related to sociocultural and economic factors which compromise the mother-son binomial. The aim of this paper is to identify the socio-demographic characteristics of pregnant adolescents from the hospital. Retrospective, descriptive and observational study, in which all pregnant patients between 10 and 19 years from the Hospital, during June 2012 and January 2014, were studied. The following data were collected: age, scholarship, occupation, marital status, age at beginning of sexual relations, number of sexual partners, contraceptive use and type of contraceptive method, pregnancies, parturition, cesarean section and abortions. Statistical analysis: Descriptive statistic was used, consistent in central tendency and dispersion measures. 608 adolescent were studied, age was 16.7 ± 1.2 years, 50.2% were students, 35.1% unemployed, 29.5% were single and 25.2% married. In 79% was its first pregnancy. The age at beginning of sexual relations was at 15.0 ± 1.3 years; 39% didn't use contraceptive method and 24.5% hadn't addictions. The pregnancy wasn't planned nor wished in 78.1%. Gestational age was between 8 and 44 weeks, this latter due to no confident amenorrhea and 56.7% had associated pathology. The mean age of the couple was 20.6 ± 3.8 years, 84.1% worked and 64.2% hadn't addictions. The opportune detection of risk factors will allow the prevention and attention of the teenage pregnancy.

  13. What helps or undermines adolescents' anticipated capacity to cope with mental illness stigma following psychiatric hospitalization. (United States)

    Moses, Tally


    Better understanding of the individual and environmental factors that promote adolescents' use of more or less adaptive coping strategies with mental illness stigma would inform interventions designed to bolster youth resilience. This cross-sectional study draws on data from research on adolescents' well-being after discharge from a first psychiatric hospitalization to explore the relationships between anticipated coping in reaction to a hypothetical social stigma scenario, and various factors conceptualized as 'coping resource' and 'coping vulnerability' factors. Focusing on coping strategies also identified in the companion article, we hypothesize that primary and secondary control engagement coping would relate to more coping resource and less coping vulnerability factors, and the opposite would be true for disengagement, aggression/confrontation and efforts to disconfirm stereotypes. Data were elicited from interviews with 102 adolescents within 7 days of discharge. Hypothesized coping resource factors included social resources, optimistic illness perceptions, better hospital experiences and higher self-esteem. Vulnerability factors included more previous stigma experiences, desire for concealment of treatment, more contingent self-worth, higher symptom levels and higher anticipated stress. Multivariate ordinary least squares (OLS) regression was used to analyze associations between coping strategy endorsement and correlates. Although some coping correlates 'behaved' contrary to expectations, for the most part, our hypotheses were confirmed. As expected, youth anticipating reacting to the stigmatizing situation with greater disengagement, aggression/confrontation or efforts to disconfirm stenotypes rated significantly lower on 'coping resources' such as self-esteem and higher on vulnerability factors such as symptom severity. The opposite was true for youth who anticipated exercising more primary and secondary control engagement coping. This study begins to

  14. A Prospective Examination of Weight Gain in Hospitalized Adolescents With Anorexia Nervosa on a Recommended Refeeding Protocol (United States)

    Garber, Andrea K.; Michihata, Nobuaki; Hetnal, Katherine; Shafer, Mary-Ann; Moscicki, Anna-Barbara


    Purpose Current refeeding recommendations for adolescents hospitalized with anorexia nervosa (AN) are conservative, starting with low calories and advancing slowly to avoid refeeding syndrome. The purpose of this study was to examine weight change and clinical outcomes in hospitalized adolescents with AN on a recommended refeeding protocol. Methods Adolescents aged 13.1–20.5 years were followed during hospitalization for AN. Weight, vital signs, electrolytes, and 24-hour fluid balance were measured daily. Percent median body mass index (%MBMI) was calculated as 50th percentile BMI for age and gender. Calories were prescribed on admission and were increased every other day. Results Thirty-five subjects with a mean (SD) age of 16.2 (1.9) years participated over 16.7 (6.4) days. Calories increased from 1,205 (289) to 2,668 (387). No subjects had refeeding syndrome; 20% had low serum phosphorus. Percent MBMI increased from 80.1 (11.5) to 84.5 (9.6); overall gain was 2.10 (1.98) kg. However, 83% of subjects initially lost weight. Mean %MBMI did not increase significantly until day 8. Higher calories prescribed at baseline were significantly associated with faster weight gain (p = .003) and shorter hospital stay (p = .030) in multivariate regression models adjusted for %MBMI and lowest heart rate on admission. Conclusions Hospitalized adolescents with AN demonstrated initial weight loss and slow weight gain on a recommended refeeding protocol. Higher calorie diets instituted at admission predicted faster weight gain and shorter hospital stay. These findings support the development of more aggressive feeding strategies in adolescents hospitalized with AN. Further research is needed to identify caloric and supplementation regimens to maximize weight gain safely while avoiding refeeding syndrome. PMID:22188830

  15. Motorcycle-related hospitalization of adolescents in a Level I trauma center in southern Taiwan: a cross-sectional study. (United States)

    Liang, Chi-Cheng; Liu, Hang-Tsung; Rau, Cheng-Shyuan; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua


    The aim of this study was to investigate and compare the injury pattern, mechanisms, severity, and mortality of adolescents and adults hospitalized for treatment of trauma following motorcycle accidents in a Level I trauma center. Detailed data regarding patients aged 13-19 years (adolescents) and aged 30-50 years (adults) who had sustained trauma due to a motorcycle accident were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2012. The Pearson's chi-squared test, Fisher's exact test, or the independent Student's t-test were performed to compare the adolescent and adult motorcyclists and to compare the motorcycle drivers and motorcycle pillion. Analysis of Abbreviated Injury Scale (AIS) scores revealed that the adolescent patients had sustained higher rates of facial, abdominal, and hepatic injury and of cranial, mandibular, and femoral fracture but lower rates of thorax and extremity injury; hemothorax; and rib, scapular, clavicle, and humeral fracture compared to the adults. No significant differences were found between the adolescents and adults regarding Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma-Injury Severity Score (TRISS), mortality, length of hospital stay, or intensive care unit (ICU) admission rate. A significantly greater percentage of adolescents compared to adults were found not to have worn a helmet. Motorcycle riders who had not worn a helmet were found to have a significantly lower first Glasgow Coma Scale (GCS) score, and a significantly higher percentage was found to present with unconscious status, head and neck injury, and cranial fracture compared to those who had worn a helmet. Adolescent motorcycle riders comprise a major population of patients hospitalized for treatment of trauma. This population tends to present with a higher injury severity compared to other hospitalized trauma patients and a bodily injury pattern differing from that of adult motorcycle riders, indicating the

  16. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

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    Di Lorenzo R


    Full Text Available Rosaria Di Lorenzo,1 Nina Cimino,2 Elena Di Pietro,3 Gabriella Pollutri,4 Vittoria Neviani,5 Paola Ferri2 1Service of Psychiatric Diagnosis and Treatment, Department of Mental Health, AUSL Modena, Modena, 2School of Nursing, University of Modena and Reggio Emilia, 3School of Neuro-Psychiatry, 4School of Psychiatry, University of Modena and Reggio Emilia, 5 “The Medlar”, Villa Igea Hospital, Modena, Italy Background: Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods: This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT, and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18 who had acute hospitalizations (n=140 in SPDT and had been successively transferred to “The Medlar” (n=83, from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results: Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient -2.28, 95% confidence interval [CI]: -3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic

  17. Spending on Hospital Care and Pediatric Psychology Service Use Among Adolescents and Young Adults With Cancer. (United States)

    McGrady, Meghan E; Peugh, James L; Brown, Gabriella A; Pai, Ahna L H


    To examine the relationship between need-based pediatric psychology service use and spending on hospital care among adolescents and young adults (AYAs) with cancer. Billing data were obtained from 48 AYAs with cancer receiving need-based pediatric psychology services and a comparison cohort of 48 AYAs with cancer not receiving services. A factorial analysis of covariance examined group differences in spending for hospital care. Pending significant findings, a multivariate analysis of covariance was planned to examine the relationship between need-based pediatric psychology service use and spending for inpatient admissions, emergency department (ED) visits, and outpatient visits. Spending for hospital care was higher among AYAs receiving need-based pediatric psychology services than in the comparison cohort (p psychology services. The behavioral and psychosocial difficulties warranting need-based pediatric psychology services may predict higher health care spending. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail:

  18. [Family characteristics, organic risk factors, psychopathological picture and premorbid adjustment of hospitalized adolescent patients]. (United States)

    Małkiewicz-Borkowska, M; Namysłowska, I; Siewierska, A; Puzyńska, E; Sredniawa, H; Zechowski, C; Iwanek, A; Ruszkowska, E


    The relation of some family characteristics such as cohesion and adaptability with organic risk factors, developmental psychopathology, clinical picture and premorbid adjustment was assessed in the group of 100 hospitalized adolescent patients and families. We found correlation between: some of organic risk factors (pathology of neonatal period, pathology of early childhood), some of indicators of developmental psychopathology (eating disorders, conduct disorders), some of clinical signs (mannerism, grandiosity, hostility, suspciousness, disturbances of content of thinking), premorbid adjustment, and variables related to families, described before. We think that biological variables characterizing child (pathology of neonatal period, pathology of early childhood) have an influence on some family characteristics as independent variable. General system theory and circular thinking support these conclusions. In order to verify them, it is necessary to undertake further investigations, based on other methodology, using this results as preliminary findings.

  19. Child and Adolescent Inpatient Unit in General Hospital “Tzaneio”

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    E. Tseva


    Full Text Available The Child and Adolescent Psychiatry Inpatient Service offers comprehensive diagnostic evaluation and treatment of children and adolescents (typical age ranges from 3-16 years old with a variety of emotional and behavioral problems including mood disorders, anxiety disorders, psychotic disorders, severe disruptive behavior, and suicide attempts. Treatment Team. The inpatient treatment team includes psychiatrists, psychologists, registered nurses, special education teacher, social worker, speech and occupational therapists. In addition, pediatricians from a full range of medical subspecialties are available for consultations. The multi-disciplinary staff emphasizes a family-oriented approach and parents and care-givers are encouraged to be active participants in the treatment team throughout a child’s stay. Treatment Program. The program offers developmentally appropriate therapeutic activities in a closely supervised environment. Extensive opportunities for observation, assessment, and intervention are possible in this intensive setting. Specialized assessments including neuropsychological testing, speech and language testing, and occupational therapy assessments are all available. Treatment plans typically include a combination of individual psychotherapy, behavior management, family counseling and medications. Staff members develop an individualized treatment plan emphasizing safety for each patient during the hospital stay. The plan is closely coordinated with families, outpatient providers, and resource programs to coordinate aftercare plans and facilitate a smooth transition to home.

  20. Prediction of suicidality and violence in hospitalized adolescents: comparisons by sex. (United States)

    Becker, Daniel F; Grilo, Carlos M


    To examine psychological correlates of suicidality and violent behaviour in hospitalized adolescents and the extent to which these associations may be affected by their sex. A sample of 487 psychiatric inpatients (207 male, 280 female), aged 12 to 19 years, completed a battery of psychometrically sound self-report measures of psychological functioning, substance abuse, suicidality, and violent behaviour. We conducted multiple regression analyses to determine the joint and independent predictors of suicide risk and violence risk. In subsequent analyses, we examined these associations separately by sex. Multiple regression analysis revealed that 9 variables (sex, age, hopelessness, self-esteem, depression, impulsivity, alcohol abuse, drug abuse, and violence risk) jointly predicted suicide risk and that an analogous model predicted violence risk. However, we found several differences with respect to which variables made significant independent contributions to these 2 predictive models. Female sex, low self-esteem, depression, drug abuse, and violence risk made independent contributions to suicide risk. Male sex, younger age, hopelessness, impulsivity, drug abuse, and suicide risk made independent contributions to violence risk. We observed a few additional differences when we considered male and female subjects separately. We found overlapping but distinctive patterns of prediction for suicide risk and violence risk, as well as some differences between male and female subjects. These results may reflect distinct psychological and behavioural pathways for suicidality and violence in adolescent psychiatric patients and differing risk factors for each sex. Such differences have potential implications for prevention and treatment programs.

  1. Psychotropic Drug Prescription in Adolescents: A Retrospective Study in a Swiss Psychiatric University Hospital. (United States)

    Ansermot, Nicolas; Jordanov, Véronique; Smogur, Michal; Holzer, Laurent; Eap, Chin B


    This retrospective study aims to evaluate off-label prescriptions and administrations of psychotropic medications in adolescents in a university psychiatric hospital in Switzerland. Data were collected during the entire stays from the electronic database for 76 inpatients in 2008 and 76 inpatients in 2014. Data collected included gender, age, psychiatric diagnosis, duration of hospitalization, and psychotropic drug prescriptions and administrations. A total of 224 psychotropic drugs (mean 2.9 drugs/patient) were prescribed in 2008 and 268 (mean 3.5 drugs/patient) in 2014. Due to the prescriptions of some drugs as required, only 76% of the prescriptions were actually administered in 2008 (mean 2.3 drugs/patient) and 55% in 2014 (mean 1.9 drugs/patient). Antipsychotics were the most frequently prescribed drugs in 2008 (74% of patients) and 2014 (86% of patients). Anxiolytics were also highly prescribed in 2008 (54% of patients) and 2014 (66% of patients), as well as antidepressants in 2008 (30% of patients), but less in 2014 (13% of patients). Overall, 69% of prescriptions were found to be off label in 2008 and 68% in 2014, according to age, diagnosis, dose, or formulation as approved by Swissmedic. The medication classes with the highest rate of off-label prescriptions were antidepressants (100% for both years), antipsychotics (94% in 2008 and 92% in 2014), and hypnotics (67% in 2008 and 100% in 2014). For both study periods, at least one off-label psychotropic drug prescription and administration was recorded in 96% and 79% of the patients, respectively. The high rate of off-label psychotropic drug use strengthens the need for clinical trials to better evaluate the efficacy and safety of these treatments in adolescents.

  2. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

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    Zbojniewicz, Andrew M.; Emery, Kathleen H.; Maeder, Matthew E.; Salisbury, Shelia R.


    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  3. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

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    Zbojniewicz, Andrew M.; Emery, Kathleen H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Maeder, Matthew E. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lenox Hill Hospital, Department of Radiology, New York, NY (United States); Salisbury, Shelia R. [University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)


    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  4. The use of story boxes as an adjuvant strategy to cope with hospitalization of children and adolescents with cancer

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    Nathália Rodrigues Garcia-Schinzari


    Full Text Available Introduction: Storytelling in hospital environments contributes to the reduction of tension and anxiety; it is, therefore, a possible strategy to cope with hospitalization of patients under cancer treatment. Objective: To identify and analyze the contributions of the program “Box of Stories” (storytelling program in coping with hospitalization of children and adolescents. Methodological Procedures: It is a non-experimental, cross-sectional, descriptive, applied research of quali-quantitative approach conducted in a pediatric oncology unit in the countryside of Sao Paulo state. Twenty children and adolescents ages 4 to 15 participated in the study. Data collection consisted of (1 pretest (indication on the scale of faces or verbal expression of one’s feeling at that moment; (2 record of the behaviors of children during the storytelling; and (3 posttest (indication on the scale of faces or verbal expression of one’s feeling after the storytelling. Results: The participants interacted with the people present during storytelling (interaction with undergraduate students of occupational therapy and with peers as well as with material from the boxes (manipulation of objects and participation in the activity proposed, and demonstrated cognitive abilities (attention and imagination and motivation (liveliness and curiosity about the stories. Nine participants presented significant changes in their emotional state after the storytelling (p=0.0111. Conclusions: The use of story boxes proved to be an important intervention in improving the way children and adolescents with cancer cope with hospitalization, restoring their playful universe and facilitating health recovery.

  5. Dysthymia in male adolescents is associated with increased risk of later hospitalization for psychotic disorders: a historical-prospective cohort study. (United States)

    Weiser, Mark; Lubin, Gad; Caspi, Asaf; Rabinowitz, Jonathan; Shmushkevitz, Mordechai; Yoffe, Rinat; Werbeloff, Nomi; Halperin, Demian; Davidson, Michael


    Retrospective studies indicate that patients with psychotic disorders and schizophrenia often suffer from depressive symptoms before the onset of psychosis. In a historical-prospective design, we studied the association between dysthymia in adolescence and later hospitalization for psychotic disorders and schizophrenia. The Israeli Draft Board screens the entire, unselected population of 16-17 years old male adolescents for psychiatric disorders. These adolescents were followed for hospitalization for psychotic disorders and schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry. Of 275,705 male adolescents screened, 1267 (0.5%) were hospitalized for psychotic disorders (International Classification of Diseases [ICD]-10 20.0-29.9), and 757 (0.3%) were hospitalized for schizophrenia (ICD-10 20.0-20.9) over the next 1-10 years. Of 275,705 male adolescents screened, 513 (0.2%) were diagnosed as suffering from dysthymia by the Draft Board. Of these adolescents, 10/513 (2.0%) were later hospitalized for psychotic disorders (including schizophrenia, HR=3.967, 95%CI (confidence intervals): 2.129-7.390), and 4/513 (0.8%) were later hospitalized for schizophrenia (HR=2.664, 95%CI: 0.997-7.116). In this population-based cohort of male adolescents, dysthymia was associated with increased risk for future psychotic disorders. Dysthymia in some adolescents might be a prodromal symptom, while in others it might be a risk factor for later psychosis. Clinicians assessing dysthymic adolescents should be aware that these symptoms might be part of the prodrome. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.

  6. Polycystic Ovary Syndrome: An Under-recognized Cause of Abnormal Uterine Bleeding in Adolescents Admitted to a Children's Hospital. (United States)

    Maslyanskaya, Sofya; Talib, Hina J; Northridge, Jennifer L; Jacobs, Amanda M; Coble, Chanelle; Coupey, Susan M


    To evaluate whether ovulatory dysfunction due to polycystic ovary syndrome (PCOS) is a common underlying etiology of abnormal uterine bleeding (AUB) in adolescents who require hospitalization and to explore etiology, treatment, and complications of AUB with severe anemia in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We identified female patients aged 8-20 years admitted to a children's hospital for treatment of AUB from January 2000 to December 2014. Our hospital protocol advises hormonal testing for PCOS and other disorders before treatment for AUB. We reviewed medical records and recorded laboratory evaluations, treatments, and final underlying diagnoses as well as recurrences of AUB and readmissions in the subsequent year. Of the 125 subjects, the mean age was 16.5 ± 2.9 years; mean hemoglobin level was 7.0 ± 1.8 g/dL; 54% were overweight/obese; and 41% sexually active. PCOS accounted for 33% of admissions; hypothalamic pituitary ovarian axis immaturity 31%; endometritis 13%; bleeding disorders 10%. Girls with PCOS were more likely to be overweight/obese (74% vs 46%; P < .01) and girls with hypothalamic pituitary ovarian axis immaturity had lower hemoglobin levels (6.4 g/dL vs 7.4 g/dL; P < .05), than girls with all other etiologies of AUB. Treating physicians failed to diagnose endometritis as the etiology for AUB in 4 of 8 girls with positive tests for sexually transmitted infection and no other etiology. PCOS was the most common underlying etiology in adolescents hospitalized with AUB. Screening for hyperandrogenemia is important for early diagnosis of PCOS to allow ongoing management and prevention of comorbidities. Endometritis was frequently underestimated as an etiology for AUB. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  7. Hospitals (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  8. Description of an intensive nutrition therapy in hospitalized adolescents with anorexia nervosa. (United States)

    Pettersson, Cecilia; Tubic, Bojan; Svedlund, Anna; Magnusson, Per; Ellegård, Lars; Swolin-Eide, Diana; Forslund, Heléne Bertéus


    To describe an intensive nutrition therapy for hospitalized adolescents and young adults with anorexia nervosa (AN) in terms of body weight, body composition, energy balance and food related anxiety. Twenty-six young females, 16-24years of age, with AN were invited to participate at admission to a specialized eating disorder unit in Göteborg, Sweden. Intensive nutrition therapy comprised 12weeks on a structured meal plan. Six meals were served daily, in combination with high-energy liquid nutritional supplements from start. Energy and nutrient intakes, energy expenditure, body composition and food related anxiety were measured during the study. A 3-month follow-up of body weight and food related anxiety was conducted. Twenty-one patients participated. The total daily energy intake was, during the first week of treatment, (mean±SD) 3264±196kcal (74kcal/kg), and decreased gradually during treatment to 2622±331kcal (49kcal/kg). Total daily energy expenditure was initially 1568±149kcal and increased gradually to 2034±194kcal. Patients gained on average 9.8±2.1kg and body mass index increased from 15.5±0.9 to 19.0±0.9kg/m(2). Body fat increased from 13±6% to 26±6%. Fat free mass remained unchanged, but skeletal muscle mass increased from 16.7±2.0 to 17.6±2.4kg, p=0.009. Patients' food related anxiety decreased significantly during treatment and was still unchanged 3months later. The presented intensive nutrition therapy with initially high energy and nutrient intakes produced substantial weight gain, increased fat and muscle mass and decreased food related anxiety in AN patients, without any clinical side effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hospital. (United States)

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M


    Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

  10. Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization

    NARCIS (Netherlands)

    Prinstein, M.J.; Nock, M.K.; Simon, V.A.; Aikins, J.W.; Cheah, C.S.L.; Spirito, A.


    Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents

  11. Association of positive responses to suicide screening questions with hospital admission and repeated emergency department visits in children and adolescents. (United States)

    Ballard, Elizabeth D; Horowitz, Lisa M; Jobes, David A; Wagner, Barry M; Pao, Maryland; Teach, Stephen J


    Although validated suicide screening tools exist for use among children and adolescents presenting to emergency departments (EDs), the associations between screening positive for suicide risk and immediate psychiatric hospital admission or subsequent ED use, stratified by age, have not been examined. This is a retrospective cohort study of a consecutive case series of patients aged 8 to 18 years presenting with psychiatric chief complaints during a 9-month period to a single urban tertiary care pediatric ED. Eligible patients were administered a subset of questions from the Risk of Suicide Questionnaire. Outcomes included the odds of psychiatric hospitalization at the index visit and repeated ED visits for psychiatric complaints within the following year, stratified by age. Of the 568 patients presenting during the study period, responses to suicide screening questions were available for 442 patients (78%). A total of 159 (36%) of 442 were hospitalized and 130 (29%) of 442 had 1 or more ED visits within the following year. The proportion of patients providing positive responses to 1 or more suicide screening questions did not differ between patients aged 8 to 12 years and those aged 13 to 18 years (77/154 [50%] vs 137/288 [48%], P = 0.63). A positive response to 1 or more of the questions was significantly associated with increased odds of psychiatric hospitalization in the older age group [adjusted odds ratio, 3.82; 95% confidence interval, 2.24-6.54) and with repeated visits to the ED in the younger age group (adjusted odds ratio, 3.55 95% confidence interval, 1.68-7.50). Positive responses to suicide screening questions were associated with acute psychiatric hospitalization and repeated ED visits. Suicide screening in a pediatric ED may identify children and adolescents with increased need of psychiatric resources.

  12. [Acute ethanol intoxication among children and adolescents. A retrospective analysis of 173 patients admitted to a university children hospital]. (United States)

    Schöberl, S; Nickel, P; Schmutzer, G; Siekmeyer, W; Kiess, W


    In the last time the alcohol consumption among children and adolescents is a big theme in all kind of media. The ethanol consumption among children and adolescents has risen during the last years, but also new hazardous drinking patterns like "binge-drinking" are increasing. These drinking episodes are responsible for many hospital presentations of children and adolescents with acute ethanol intoxication. This study is a retrospective analysis of 173 patients admitted to the university children hospital of Leipzig due to acute ethanol intoxication during the period 1998-2004. Investigated parameters were: socio-demographic factors, clinical presentation and management as well as quantity and type of alcohol. During the years 1998-2004 the rate of alcohol intoxicated patients in this study increased, from 1998-2003 at about 171.4%. Totally 173 patients with an average age of 14.5 years were admitted to the university children hospital. There were significantly more boys than girls. The mean blood alcohol concentration of these patients was 1.77%. Some of the patients had severe symptoms. 62 were unconscious, 2 were in coma and at least 3 patients had to be ventilated. A difference between socioeconomic groups could be observed by comparing the different school types. 44.8% of the patients went to the middle school. Furthermore 17 patients of this study had mental disorders or psychosocial problems and were therefore in psychological or psychiatric treatment. In this study a significant influence of social classes or psychosocial problems on alcohol consumption such as binge-drinking leading to acute ethanol intoxication could not be found. Alarming is the increasing number of ethanol intoxicated patients, the young age, the high measured blood ethanol concentrations and the severe symptoms of these patients. This is the reason why early and intensive prevention strategies are required.

  13. ["FESZEK": A program based on cognitive behavioral therapy in Vadaskert Child and Adolescent Psychiatry Hospital and Outpatient Clinic]. (United States)

    Kis, Dóra Sarolta; Miklós, Martina; Füz, Angelika; Farkas, Margit; Balázs, Judit


    Attention-deficit/hyperactivity disorder (ADHD) is a common child psychiatric disorder, which occurs in approximately 4-6% of school-aged children. The symptoms of ADHD cause difficulties in academic performance, during leisure activities and affect family-, and peer relations as well. The most effective treatment for managing ADHD is the combination of non-pharmacological and pharmacological interventions. The aim of this paper is to introduce the "Fészek" program - which takes place in Vadaskert Child and Adolescent Psychiatry Hospital and Outpatient Clinic - where children with the diagnosis of ADHD or showing the symptoms of ADHD go through the diagnostic procedure and participate in a cognitive behavioral therapy program.

  14. Child and adolescent abuse recorded at a national referral hospital, 2006-2011


    Escalante-Romero, Lorena; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.; Huamaní, Charles; Oficina General de Informática y Sistemas, Instituto Nacional de Salud. Lima, Perú. Médico cirujano.; Serpa, Hilda; Departamento de Investigación, Docencia y Atención en Salud Mental, Instituto Nacional de Salud del Niño. Lima, Perú. médico psiquiatra.; Urbano-Durand, Carlos; Departamento de Atención y Servicios al Paciente, Instituto Nacional de Salud del Niño. Lima, Perú. médico pediatra.; Farfán-Meza, Gaudy; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.; Ferrer-Salas, Carolina; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.; Granados-Chávez, Gilda; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.


    Objectives. To describe the records of child and adolescent abuse of the Instituto Nacional de Salud del Niño (INSN) from January 2006 to September 2011, characterizing the victim and perpetrator. Materials and methods. A secondary sources analysis was performed, based on the domestic violence and child abuse records, from froms administered by Child Abuse and Adolescent Health Unit (MAMIS) at the INSN. The records include data of the victim, offender and characteristics of the aggression...

  15. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael


    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  16. Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan

    Directory of Open Access Journals (Sweden)

    Fazal A


    Full Text Available Akil Fazal1, Riaz H Lakdawala21Hospital for Joint Disease, New York University, New York, USA; 2Section of Orthopaedics, Department of Surgery, The Aga Khan University Hospital, Karachi, PakistanObjective: To evaluate the radiological and functional outcome of surgical treatment of adolescent idiopathic scoliosis using fourth-generation posterior spinal instrumentation at The Aga Khan University, Karachi, Pakistan.Design: Case series.Place and duration of study: The Aga Khan University Hospital after a minimum of 2 years postoperatively.Patients and methods: A total of 20 patients with adolescent idiopathic scoliosis were recruited into the study and evaluated for radiological and functional outcome. The study period was from 2000 to 2005. Radiological outcome was assessed using Cobb angle measurement pre and postoperatively, hence assessing percentage correction. The lower instrumented vertebra was taken as the neutral vertebra and the level was recorded. Functional outcome was determined using the Scoliosis Research Society patient administered questionnaire. All patients were called to the clinic and asked to fill in the form. Those patients who were out of the city were mailed the forms and requested via telephone to complete and return.Results: Of the 20 patients operated on, twelve were female and eight were male. The average age at operation was 12.7 years. The mean Cobb angle was 69° preoperatively and 20° postoperatively, representing a percentage correction of 71%. The average duration of follow-up was 3.6 years. There was one major complication involving neurological injury post-op and two minor complications involving wound infection. The average Scoliosis Research Society score (on a scale of 1–5, with 5 being best for pain was 4.5, self-image was 4.2, functional status was 4.1, mental status was 3.8, and satisfaction was 4.4. There was no relationship between the percentage correction of scoliosis and the functional outcome

  17. Perceived barriers to implementing screening and brief intervention for alcohol consumption by adolescents in hospital emergency department in Spain. (United States)

    Falcón, María; Navarro-Zaragoza, Javier; García-Rodríguez, Rosa María; Nova-López, Daniel; González-Navarro, María Dulce; Mercadal, María; García-Algar, Oscar; Luna Ruiz-Cabello, Aurelio


    Screening for alcohol consumption in adolescents is widely justified in the health care field because of the particular vulnerability of this population, which starts drinking alcohol at a very early age and frequently consumes high levels of the same. Hospital emergency departments (ED) could be a good venue to manage early detection and carry out brief intervention (BI) programmes. The aim of this study was to identify perceived barriers for medical staff of three hospitals in Spain to successfully implement a protocol for alcohol detection and BI for minors in the ED. Exploratory qualitative analysis using focus groups with semi-structured, flexible and open-ended questions to explore beliefs, attitudes, and barriers perceived by professionals to screening alcohol consumption and implementing BI in adolescents attended at the ED. The main perceived barriers by health professionals were lack of time, work overload, mistrust, lack of validated and simple screening tools, lack of training/awareness and legal concerns about informed consent and confidentiality. Barriers to screening and intervention in ED are similar to those described previously. It is necessary to improve organization of time allocated for medical consultations, avoid limiting ED resources, motivate staff and provide appropriate training.


    Directory of Open Access Journals (Sweden)

    Ferial Lotfian


    Full Text Available Abstract OBJECTIVE: To identify the pattern of the clinical, radiological, diagnostic procedures and loss to follow -up of the diagnosed cases of active tuberculosis (TB adolescents. METHODS: This study was a retrospective analysis of the medical records of 143 adolescents aged 10 to 18 years with tuberculosis who were admitted TB wards of National Research Institute of Tuberculosis and Lung Disease (NRITLD in Tehran, Iran, between March 2006 and March2011. RESULTS: Of the 143 patients identified, 62.9% were females. Median age of the patients was 16 years. The contact source was identified in 47.5%.The most common presenting symptom was cough (86%.Isolated pulmonary TB (PTB was detected in 113 patients (79%, 21 patients (14.7% had extrapulmonary TB(EPTB, and 9 patients (6.3% had PTB and EP TB .The most common site of  EPTB was pleural (14% .The most common radiographic finding was infiltration (61%.Positive acid fast smears were seen in 67.8%.Positive cultures for Mycobacterium tuberculosis(M. TB were seen in 31.6%. Positive PCR results were seen in 60%.The adolescents aged 15 to 18 years were more likely to lose weight (p=0.001, smear positive (p=0.002and have positive PCR results (p=0.009. The type of TB (p=0.017 was a significant factor influencing loss to follow-up. CONCLUSIONS: Adolescents with the high rate of positive sputum smear results and the high treatment default rate are more likely to increase risk for TB transmission to the community. The TB control programs should pay more attention to prevention and treatment of TB in adolescents.     Key words: adolescents, tuberculosis, Lost to follow-up, prevention

  19. Readiness to Recover in Adolescent Anorexia Nervosa: Prediction of Hospital Admission (United States)

    Ametller, L.; Castro, J.; Serrano, E.; Martinez, E.; Toro, J.


    Objectives: To determine if motivation to change in anorexia nervosa during treatment is a predictor of hospitalisation in adolescent patients. Method: The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), the Eating Disorders Inventory-2 (EDI-2) and the Beck Depression Inventory (BDI) were administered to a group of 70 anorexia nervosa…

  20. Is Bipolar Disorder the Most Common Diagnostic Entity in Hospitalized Adolescents and Children? (United States)

    Isaac, George


    An evaluation of all children and adolescents (n=57) admitted to an acute psychiatric unit over a 3-month period was undertaken to determine the presence of bipolar disorder. Findings indicated that bipolar disorder was the most common diagnosis; thus, this disorder has to be ruled out in all youth admitted to acute care psychiatric units. (JPS)

  1. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication: A randomized controlled trial

    NARCIS (Netherlands)

    Wurdak, M.; Wolstein, J.; Kuntsche, E.N.


    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized

  2. A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

    DEFF Research Database (Denmark)

    Mollerup, Pernille Maria; Gamborg, Michael Orland; Trier, Cæcilie


    BACKGROUND: Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. METHODS: In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS......) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations...... was invested per child per year. CONCLUSION: BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility....

  3. Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan. (United States)

    Fazal, Akil; Lakdawala, Riaz H


    To evaluate the radiological and functional outcome of surgical treatment of adolescent idiopathic scoliosis using fourth-generation posterior spinal instrumentation at The Aga Khan University, Karachi, Pakistan. Case series. The Aga Khan University Hospital after a minimum of 2 years postoperatively. A total of 20 patients with adolescent idiopathic scoliosis were recruited into the study and evaluated for radiological and functional outcome. The study period was from 2000 to 2005. Radiological outcome was assessed using Cobb angle measurement pre and postoperatively, hence assessing percentage correction. The lower instrumented vertebra was taken as the neutral vertebra and the level was recorded. Functional outcome was determined using the Scoliosis Research Society patient administered questionnaire. All patients were called to the clinic and asked to fill in the form. Those patients who were out of the city were mailed the forms and requested via telephone to complete and return. Of the 20 patients operated on, twelve were female and eight were male. The average age at operation was 12.7 years. The mean Cobb angle was 69° preoperatively and 20° postoperatively, representing a percentage correction of 71%. The average duration of follow-up was 3.6 years. There was one major complication involving neurological injury post-op and two minor complications involving wound infection. The average Scoliosis Research Society score (on a scale of 1-5, with 5 being best) for pain was 4.5, self-image was 4.2, functional status was 4.1, mental status was 3.8, and satisfaction was 4.4. There was no relationship between the percentage correction of scoliosis and the functional outcome. Those patients with a high preoperative Cobb angle tended to have a better outcome for functional and mental status postoperatively. There was no relation between the lower instrumented vertebra and functional outcome. In the correct indications, fourth-generation posterior instrumentation

  4. Urban Rural Comparisons of Polycystic Ovary Syndrome Burden among Adolescent Girls in a Hospital Setting in India

    Directory of Open Access Journals (Sweden)

    Swetha Balaji


    Full Text Available Background. Polycystic ovarian syndrome (PCOS is a multifaceted disorder characterized by varying clinical presentations. Objective. The aim of this study was to determine urban and rural differences in the burden of polycystic ovarian syndrome among Indian adolescent females aged 12 to 19 years. Methods. A pilot cross-sectional study was conducted for a period of one month (August-September 2013 at Balaji Hospital, Vellore, Tamil Nadu, India. The final sample included 126 study participants located in various urban (50%, n=63 and rural (50%, n=63 settings. Information was gathered on sociodemographic and anthropometric characteristics, clinical history, occurrence of acne and hirsutism, serum testosterone levels, obstetric history, family history of chronic diseases, menstrual history, physical activity, and dietary intake. Results. Eighteen percent of the participants were confirmed of having PCOS by recent guidelines of Rotterdam Consensus for adolescent diagnosis of PCOS (presence of all three elements. Majority of the individuals with PCOS had an average age of 16 (SD = 2 (P=.02 years with an average age of menarche 12 years (SD = 1. Conclusion. The proportion of participants diagnosed with PCOS was higher among urban participants in comparison to rural participants.

  5. Improving outcomes from out-of-hospital cardiac arrest in young children and adolescents. (United States)

    Atkins, Dianne L; Berger, Stuart


    Out-of-hospital cardiac arrest (OHCA) is an unusual but devastating occurrence in a young person. Years of life-lost are substantial and long-term health care costs of survivors can be high. However, there have been noteworthy improvements in cardiopulmonary resuscitation (CPR) standards, out-of hospital care, and postcardiac arrest therapies that have resulted in a several-fold improvement in resuscitation outcomes. Recent interest and research in resuscitation of children has the promise of generating improvements in the outcomes of these patients. Integrated and coordinated care in the out-of-hospital and hospital settings are required. This article will review the epidemiology of OHCA, the 2010 CPR guidelines, and developments in public access defibrillation for children.

  6. Adolescent Linkage to Care After a Large-scale Transfer From a Hospital-based HIV Clinic to the Public Sector in South Africa. (United States)

    Ramirez-Avila, Lynn; Regan, Susan; Cloete, Christie; Crankshaw, Tamaryn; Rabideau, Dustin J; Freedberg, Kenneth A; Parker, Robert A; Walensky, Rochelle P; Losina, Elena; Bassett, Ingrid V


    HIV clinics formerly supported by the President's Emergency Plan for AIDS Relief are transferring patients to public-sector clinics. We evaluated adolescent linkage to care after a large-scale transfer from a President's Emergency Plan for AIDS Relief-subsidized pediatric HIV clinic in Durban, South Africa. All adolescents (11-18 years) in care at a pediatric state-subsidized, hospital-based clinic (HBC) were transferred, from May to June 2012, to government sites [primary health care (PHC) clinic; community health center (CHC); and HBCs] or private clinics. Caregivers were surveyed 7-8 months after transfer to assess their adolescents' linkage to care and their reports were validated by clinic record audits in a subset of randomly selected clinics. Of the 309 (91%) caregivers reached, only 5 (2%) reported that their adolescent did not link. Of the 304 adolescents who linked, 105 (35%) were referred to a PHC, 73 (24%) to a CHC and 106 (35%) to a HBC. A total of 146 (48%) linked adolescents attended a different clinic than that assigned. Thirty-five (20%) of the 178 who linked and were assigned to a PHC or CHC ultimately attended a HBC. Based on clinic validation, the estimated transfer success was 88% (95% confidence interval: 77%-97%). The large majority of adolescents successfully transferred to a new HIV clinic, although nearly half attended a clinic other than that assigned.

  7. An evaluation of the impact of 'Lifeskills' training on road safety, substance use and hospital attendance in adolescence. (United States)

    Teyhan, Alison; Cornish, Rosie; Macleod, John; Boyd, Andy; Doerner, Rita; Sissons Joshi, Mary


    To evaluate if attendance at Lifeskills, a safety education centre for children in Year 6 (10-11 years), is associated with engagement in safer behaviours, and with fewer accidents and injuries, in adolescence. The sample are participants in the Avon Longitudinal Study of Parents and Children who attended school in the Lifeskills catchment area in Year 6; 60% attended Lifeskills. At 14-15 years, participants (n approximately 3000, varies by outcome) self-reported road safety behaviours and accidents, and perceived health effects and use of alcohol, cannabis, and tobacco. Additional outcomes from linkage to Hospital Episodes Statistics were available for a sub-sample (n=1768): hospital admittance (for accident-related reason, from 11-16 years) and A&E attendance (for any reason, from approximately 14-16 years). Children who attended Lifeskills were more likely to report using pedestrian crossings on their way to school than children who did not attend (59% versus 52%). Lifeskills attendance was unrelated to the ownership of cycle helmets, or the use of cycle helmets, seat belts, or reflective/fluorescent clothing, or to A&E attendance. Use of cycle helmets (37%) and reflective/fluorescent clothing (<4%) on last cycle was low irrespective of Lifeskills attendance. Lifeskills attendance was associated with less reported smoking and cannabis use, but was generally unrelated to perceptions of the health impact of substance use. Lifeskills attendance was associated with some safer behaviours in adolescence. The overall low use of cycle helmets and reflective/fluorescent clothing evidences the need for powerful promotion of some safer behaviours at Lifeskills and at follow-up in schools. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Problematic video game use scale: initial psychometric properties with psychiatrically hospitalized adolescents. (United States)

    Topor, David R; Swenson, Lance P; Liguori, Gina M; Spirito, Anthony; Lowenhaupt, Elizabeth A; Hunt, Jeffrey I


    Excessive video game use among youth has been a growing concern in the United States and elsewhere. The aims of this study are to establish validity of a video game measure in a large adolescent inpatient sample, identify clinical factors underlying problem video game use, and identify associations with measures of psychopathology. Three hundred eighty participants admitted to an adolescent inpatient psychiatric unit between November 2007 and March 2009 were administered a battery of self-report measures, including a questionnaire developed for this study that assessed reinforcers and consequences of past-year video game use (ie, Problematic Video Game Use Scale). Factor analysis was used to identify the underlying structure of behaviors associated with problem video game use. A factor analysis of the Problematic Video Game Use Scale indicated 2 primary factors. One was associated with engaging in problem behaviors that impaired the adolescent's functioning as a result of playing video games and one reflected the reinforcing effects of playing video games. Both factors were associated with measures of psychopathology, although associations were generally stronger for impairment in functioning than for reinforcing effects. Both factors were significantly correlated with self-reported daily video game use (P video game playing: impairment in functioning and reinforcing effects. Initial evidence of the content validity of the video game measure was established. Findings highlight the importance of assessing video game use among an adolescent population, the factors associated with video game use, and associations with symptoms of psychopathology. Limitations include a common reporter for multiple measures and cross-sectional data that do not allow for causal links to be made. © Copyright 2011 Physicians Postgraduate Press, Inc.

  9. Cognitive and Social Factors Associated with NSSI and Suicide Attempts in Psychiatrically Hospitalized Adolescents


    Wolff, Jennifer; Frazier, Elisabeth A.; Esposito-Smythers, Christianne; Burke, Taylor; Sloan, Emma; Spirito, Anthony


    Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1% female) b...

  10. Refeeding Low Weight Hospitalized Adolescents With Anorexia Nervosa: A Multicenter Randomized Controlled Trial. (United States)

    O'Connor, Graeme; Nicholls, Dasha; Hudson, Lee; Singhal, Atul


    Refeeding patients with anorexia nervosa (AN) is associated with high morbidity and mortality. A lack of evidence from interventional studies has hindered refeeding practice and led to worldwide disparities in management recommendations. In the first randomized controlled trial in this area, we tested the hypothesis that refeeding adolescents with AN with a higher energy intake than what many guidelines recommend improved anthropometric outcomes without adversely affecting cardiac and biochemical markers associated with refeeding. Participants aged 10-16 years with a body mass index (BMI) refeeding at 1200 kcal/d (n = 18, intervention) or 500 kcal/d (n = 18, control). Compared with controls, adolescents randomized to high energy intake had greater weight gain (mean difference between groups after 10 days of refeeding, -1.2% mBMI; 95% confidence interval, -2.4% to 0.0%; P = .05), but randomized groups did not differ statistically in QTc interval and other outcomes. The nadir in postrefeeding phosphate concentration was significantly related to percentage mBMI at the start of refeeding (baseline; P = .04) and baseline white blood cell count (P = .005) but not to baseline energy intake (P = .08). Refeeding adolescents with AN with a higher energy intake was associated with greater weight gain but without an increase in complications associated with refeeding when compared with a more cautious refeeding protocol-thus challenging current refeeding recommendations. © 2016 American Society for Parenteral and Enteral Nutrition.

  11. Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study (United States)

    Sheehy, Kathy A; Lippold, Caroline; Rice, Amy L; Nobrega, Raissa; Finkel, Julia C; Quezado, Zenaide MN


    Background Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. Purpose We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting. Methods This is a longitudinal cohort study of patients treated with subanesthetic ketamine infusions in regular patient care units in a tertiary pediatric hospital. Primary outcomes included changes in pain scores and morphine-equivalent intake. Results The study cohort included 230 different patients who during 360 separate hospital admissions received subanesthetic ketamine infusions for pain management. Overall, ketamine infusions were associated with significant reductions in mean pain scores from baseline (mean pain scores 6.64 [95% CI: 6.38–6.90]) to those recorded on the day after discontinuation of ketamine (mean pain scores 4.38 [95% CI: 4.06–4.69]), pketamine on pain scores varied according to clinical diagnosis (p=0.011), infusion duration (p=0.004), and pain location (p=0.004). Interestingly, greater reductions in pain scores were observed in patients with cancer pain and patients with pain associated with pancreatitis and Crohn’s disease. There were no records of psychotomimetic side effects requiring therapy. Conclusion These data suggest that administration of subanesthetic ketamine for pain management is feasible and safe in regular inpatient care units and may benefit children, adolescents, and young adults with acute and chronic pain. This study is informative and can be helpful in determining sample and effect sizes when planning clinical trials to

  12. Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study

    Directory of Open Access Journals (Sweden)

    Sheehy KA


    Full Text Available Kathy A Sheehy,1,* Caroline Lippold,1,* Amy L Rice,1 Raissa Nobrega,1 Julia C Finkel,1 Zenaide MN Quezado1,2 1Division of Anesthesiology, Pain, and Perioperative Medicine, The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s Research Institute, Children’s National Health System, George Washington University School of Medicine and Health Sciences, 2Center for Neuroscience Research, Children’s Research Institute, Children’s National Health System, Washington, DC, USA *These authors contributed equally to this work Background: Subanesthetic doses of ketamine, an N-methyl-D-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. Purpose: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting. Methods: This is a longitudinal cohort study of patients treated with subanesthetic ketamine infusions in regular patient care units in a tertiary pediatric hospital. Primary outcomes included changes in pain scores and morphine-equivalent intake. Results: The study cohort included 230 different patients who during 360 separate hospital admissions received subanesthetic ketamine infusions for pain management. Overall, ketamine infusions were associated with significant reductions in mean pain scores from baseline (mean pain scores 6.64 [95% CI: 6.38–6.90] to those recorded on the day after discontinuation of ketamine (mean pain scores 4.38 [95% CI: 4.06–4.69], p<0.001. Importantly, the effect of ketamine on pain scores varied according to clinical diagnosis (p=0.011, infusion duration (p=0.004, and pain location (p=0

  13. Psychological workshops for children and adolescents suffering from malignant disease: The model of psychosocial support during hospitalization and treatment

    Directory of Open Access Journals (Sweden)

    Klikovac Tamara


    Full Text Available Pediatric psycho-oncology within psycho-oncology is a highly developed scientific discipline in the world, both at the level of basic research and the development of theoretical concepts and at the practical level, which refers to the creation and implementation of various models of psychosocial support to children and young people who are suffering from various malignant diseases and their families during all stages of the demanding oncology treatment. One of the models of psychosocial support for children are workshops, as a form of group psychological treatment in which children and young people who are in distress, crisis, shock and even trauma, acquire a new positive experience and which provides new insights and knowledge to empower and boost the quality of life for overcoming severe malignant disease and treatment through meaningful games, all of which leads to overcoming the 'downtime' and regression and encouraging further psychological development. The outcome of workshop activities are various products (drawings, photographs, videos, posters, written material, but also positive feelings and behaviours in children and adolescents. The main objectives of introducing psychological workshops at the department of pediatric hematology-oncology in our community are, on the one hand, to provide professional counselling and support to children and young people during hospitalization and, on the other, to introduce a standard psychological procedure and quality psychological practice of group psychological counselling for sick children and young people in the hospital environment.

  14. Injury-related hospital admissions of military dependents compared with similarly aged nonmilitary insured infants, children, and adolescents. (United States)

    Pressley, Joyce C; Dawson, Patrick; Carpenter, Dustin J


    Military deployment of one or both parents is associated with declines in school performance, behavioral difficulties, and increases in reported mental health conditions, but less is known regarding injury risks in pediatric military dependents. Kid Health Care Cost and Utilization Project 2006 (KID) was used to identify military dependents aged 0.1 year to 17 years through expected insurance payer being CHAMPUS, Tricare, or CHAMPVA (n = 12,310) and similarly aged privately insured nonmilitary in CHAMPUS, Tricare, or CHAMPVA states (n = 730,065). Mental health diagnoses per 1,000 hospitalizations and mechanisms of injury per 1,000 injury-related hospitalizations are reported. Unweighted univariate analyses used Fisher's exact, χ(2), and analysis of variance tests for significance. Odds ratios are age and sex adjusted with 95% confidence intervals. Injury-related admissions were higher in military than in nonmilitary dependents (15.5% vs. 13.2%, p sex-adjusted motor vehicle occupant and pedestrian injuries were significantly lower in all-age military dependents but not in age-stratified categories. Very young military dependents had higher all-cause injury admissions (p < 0.0001), drowning/near drowning (p < 0.0001), and intracranial injury (p < 0.0001) and showed a tendency toward higher suffocation (p = 0.055) and crushing injury (p = 0.065). Military adolescents and teenagers had higher suicide/suicide attempts (p = 0.0001) and poisonings from medicinal substances (p = 0.0001). Mental health diagnoses were significantly higher in every age category of military dependents. All-cause in-hospital mortality tended to be greater in military than in nonmilitary dependents (p = 0.052). This study suggests that military dependents are a vulnerable population with special needs and provides clues to areas where injury prevention professionals might begin to address their needs. Prognostic/epidemiologic study, level II.

  15. Trauma na infância e adolescência: epidemiologia, tratamento e aspectos econômicos em um hospital público Epidemiology, treatment and economical aspects of multiple trauma in children and adolescents in a public hospital

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo da Silveira Franciozi


    Full Text Available INTRODUÇÃO: A realização deste trabalho foi motivada pela escassez de artigos encontrados na literatura que estudam o politrauma na infância e na adolescência.. O objetivo é descrever o perfil epidemiológico das lesões traumáticas na infância tratadas num centro de trauma, avaliar os aspectos econômicos relacionados com o gasto hospitalar e o tempo de internação de acordo com o tratamento realizado. MATERIAIS E MÉTODOS: analisamos todos os prontuários do hospital Geral de Pirajussara no período de dezembro de 2005 a dezembro de 2006. Obtivemos 182 pacientes, sendo 71% do sexo masculino e 29% do feminino; 48% brancos e 52% não brancos. RESULTADOS: houve predominância dos indivíduos do sexo masculino com 71% dos pacientes. O mecanismo de trauma mais freqüente foi a queda (36%. A média de dias de internação foi 4,1 dias, com gasto estimado de R$ 649,50 para cada paciente. A taxa de mortalidade foi de 2,74%, sendo o traumatismo crânio-encefálico responsável por 80% da mortalidade e os maus tratos presentes em 40% dos óbitos. CONCLUSÃO: a população pediátrica tem particularidades que a tornam distinta da população adulta em relação à epidemiologia e manejo das lesões.INTRODUCTION: the motivation to conduct this study was the reduced number of articles in literature correlating multiple trauma in childhood and infancy. The objective here was to describe the epidemiological profile of traumatic injuries treated in a trauma center, evaluating the economic aspects associated with hospitalized patients' costs and the period of hospital stay according to the treatment provided. MATERIAL AND METHODS: we assessed all Pirajussara Hospital patients' files in the period of December of 2005 to December 2006. We selected 182 patients, 129 (71% males and 53 (29% females; 88 (48% Caucasian and 94 (52% non-Caucasian children. RESULTS: male patients were prevalent, with 129 (71% cases. The most frequent trauma mechanism was fall

  16. [Gestational history and prenatal care characteristics of adolescent and adult mothers in a maternity hospital in the interior of Minas Gerais, Brazil]. (United States)

    Santos, Luciana Angélica Vieira; Lara, Maristela Oliveira; Lima, Renata Caroline Ribeiro; Rocha, André Freire; Rocha, Euza Mara; Glória, José Cristiano Ramos; Ribeiro, Gabriela de Cássia


    The scope of this research was to analyze the gestational history and prenatal care characteristics of adolescent and adult mothers in a maternity hospital located in a city in Minas Gerais, which is a hospital of reference in the macro-region of health of Jequitinhonha. It involved a descriptive cross-sectional study. A total of 327 mothers were interviewed between May 2013 and March 2014 using a semi-structured questionnaire. With a sample of 255, the number of adult women was predominant. With respect to prenatal care, 324 pregnant women had medical appointments. In terms of the location for prenatal care, 79.2% of adolescents were attended in the public health service, while that percentage was 60.4% among adult women. Regarding the type of birth, 54.7% of mothers had normal delivery and 45% had cesarean section. Among adolescents, there was a higher percentage of normal delivery compared to adult women and this data had a statistically significant relationship with the age of the pregnant women. With respect to gestational age at birth, 85.9% had full-term deliveries, 13.5% had preterm delivery and 0.6% had post-term delivery. It was revealed that adolescent mothers were at a disadvantage compared to the other mothers in terms of both socioeconomic characteristics and prenatal care received.

  17. Hospitalization of adolescents for psychiatric and substance abuse treatment. Legal and ethical issues. (United States)

    Schwartz, I M


    It has been estimated that as many as 12%-15% of the nations 63 million children are in need of mental health treatment. We have a responsibility to do everything we can to see to it that these children receive the services they need. Unfortunately, there is mounting evidence that a significant proportion of our health care resources are being misspent on the unnecessary and inappropriate hospitalization of children and youths in psychiatric and substance abuse treatment programs. More alarming is the evidence of poor quality programs, abusive practices, and greed. The intense competition to capture a "share of the market" and turn a profit or keep a nonprofit hospital from closing its doors is contributing to unprofessional and unethical advertising and public relations practices. In the end these practices will reflect poorly on the broader mental health and health care community. Hopefully, the stakeholders in the system will recognize these problems and assume a leadership role in turning the situation around. If not, we can expect intervention from forces outside the system (e.g., courts, elected public officials, public interest groups, the business community, and child advocates).

  18. Substance use patterns and in-hospital care of adolescents and young adults attending music concerts. (United States)

    Ruest, Stephanie M; Stephan, Alexander M; Masiakos, Peter T; Biddinger, Paul D; Camargo, Carlos A; Kharasch, Sigmund


    Few studies describe medical complaints and substance use patterns related to attending music concerts. As such, the objective of this study is to describe patient demographics, substance use and intoxication patterns, and medical interventions provided to adolescents and young adults assessed in an emergency department (ED) for complaints directly related to concert attendance. A retrospective chart review of patients 13-30 years old who were transported to the ED directly from music concerts between January 2011 and December 2015 was conducted. Descriptive statistics and logistic regression were used to analyze patient demographic, intervention, and substance use data. There were 115 concerts identified, of which 48 (42%) were linked to 142 relevant ED visits; the total number of attendees at each concert is unknown. The mean age of the 142 described patients was 19.5 years (SD 3.3) with 72% pop and electronic dance music concerts was associated with the widest ranges of GCS scores (8-15 and 6-14 respectively), mass casualty incident declarations, and among the highest mean blood alcohol levels (246 and 244 mg/dL, respectively). Substance use is the predominant reason for music concert related ED visits and patients may have serious levels of intoxication, receiving multiple medical interventions. These data demonstrate the need for additional large-scale studies to confirm trends and increase awareness of this important public health problem.

  19. Prevalent Poisonings in Adolescents and Adults in Dubai: A Compendium from Rashid Hospital

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    Fahad Akhtar Hameed


    Full Text Available Background: Profile of acute poisonings varies from country to country depending on the ease of availability of substances and socio-economic condition of people; however, very little information from the United Arab Emirates (UAE have been published, so far. This study was designed to find out the most common causes of overdose and poisoning in patients admitted to the emergency department of Rashid Hospital (RH, Dubai, UAE. Methods: In this retrospective cross sectional study, medical records of poisoned patients admitted to RH from 1st January 2012 to 31st December 2012 were reviewed. Demographic data, types of substances used, intention, length of hospital stay and outcomes were recorded in pre-designed checklists. Results: Overall, 163 patients were studied that among them gender distribution was relatively equal (male: female = 1.04: 1. Mean age of patients was 30.3 ± 11.5 and most patients were in the age group of 20 to 29 years age old (41.7%. Rgarding the type of poisons, the majority of patients were poisoned with pharmaceuticals (55.8% followed by chemical substances (23.3%. In pharmaceutical poisonings, most cases were due to multi-drug ingestion (22.6%, followed by ingestion of paracetamol (14.1% and benzodiazepines (4.3%. Considering the gender distribution, women were significantly more involved with pharmaceutical poisoning (P = 0.046, while venomous envenomation occurred only in men indicating a significant difference (P = 0.004. In chemical poisoning, most cases were due to ingestion of corrosive agents (19%. Suicidal poisoning was significantly more common in women (P < 0.001, while abuse was significantly more common in men (P < 0.001. Length of hospital stay averaged on 8.1 days. Only 3 patients died during the admission (mortality rate: 1.8%. Conclusion: Study on, training for and prevention of poisoning should receive more attention in the UAE. Over-the-counter drugs especially paracetamol should be prescribed in a more

  20. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication - A randomized controlled trial. (United States)

    Wurdak, Mara; Wolstein, Jörg; Kuntsche, Emmanuel


    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized controlled trial, 254 adolescents received a psychosocial intervention plus motive-tailored (intervention group; IG) or general exercises (control group; CG). Adolescents in the IG received exercises in accordance with their drinking motives as indicated at baseline (e.g. alternative ways of spending leisure time or dealing with stress). Exercises for the CG contained alcohol-related information in general (e.g. legal issues). The data of 81 adolescents (age: M = 15.6, SD = 1.0; 42.0% female) who participated in both the baseline and the follow-up were compared using ANOVA with repeated measurements and effect sizes (available case analyses). Adolescents reported lower alcohol use at the four-week follow-up independently of the kind of intervention. Significant interaction effects between time and IG were found for girls in terms of drinking frequency (F = 7.770, p effect sizes of drinking frequency (d = - 1.18), binge drinking (d = - 1.61) and drunkenness (d = - 2.87) were much higher than the .8 threshold for large effects. Conducting psychosocial interventions in a motive-tailored way appears more effective for girls admitted to hospital due to alcohol intoxication than without motive-tailoring. Further research is required to address the specific needs of boys in such interventions. (German Clinical Trials Register, DRKS ID: DRKS00005588).

  1. The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study

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    Christina Lindemann


    Full Text Available BackgroundAttention deficit/hyperactivity disorder (ADHD is a common neuropsychiatric disorder in children and adolescents worldwide, and children with ADHD have elevated risk of injuries. Our aim was to assess the risk of hospitalizations with injury diagnoses and their various subtypes in children and adolescents with newly diagnosed ADHD compared to those without ADHD, as well as to study sex effects on this risk in the setting of the German health care system.MethodsThe German Pharmacoepidemiological Research Database, in which 20 million insured from four statutory health insurances in Germany are included, was used to set up a matched cohort study of 3- to 17-year-old children and adolescents with and without ADHD. We calculated age-specific incidence rates and used Cox regression to obtain hazard ratios (HRs for hospitalizations with injury diagnoses. We used the injury mortality diagnosis matrix for classification of injuries.ResultsThe matched cohort comprised a total of 75,300 children. The age-specific incidence rates for hospitalization with injury diagnosis for males with ADHD displayed a u-shaped form with highest incidences in the in the age groups 3–6 years [26.2 per 1,000 person-years; 95% confidence interval (CI 20.5–33.0] and 18–21 years (28.6; 22.4–36.0. Girls with ADHD were less affected in younger age-groups, but the incidence rate for 18–21 year olds was similar to boys with ADHD (26.4; 17.4–38.4. The adjusted HR for children with ADHD was 1.40 (95% CI 1.30–1.49 compared to non-affected children. With respect to nature of injury, ADHD was associated with hospitalization with injury diagnoses of the internal organs, open wounds, and contusions but not with other injuries. With respect to body regions, children with ADHD were more prone to hospitalizations with injuries of the abdomen, traumatic brain injuries, other head injuries, and system-wide injuries such as poisoning and intoxication. No significant

  2. [Children's Psychiatric Hospital Dr. Juan N. Navarro: 50 years of attention to the mental health of children and adolescents in Mexico]. (United States)

    Márquez-Caraveo, Maria Elena; Arroyo-García, Eduardo; Granados-Rojas, Armida; Ángeles-Llerenas, Angélica


    The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016) at the Children's Psychiatric Hospital "Dr. Juan N. Navarro" (HPI), as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital has progressed towards diagnostic and therapeutic care of outpatients through the creation of specialized clinics (emotions, behavior, development, adolescence, among others) and the development of more actualized and integral therapeutic programs (behavioral psychotherapy, cognitive behavioral, psychodynamic; individual, group, family, etc.). In the field of education, the hospital has been the most important institution in the training of child psychiatrists in Mexico and its recognition as a research interdisciplinary center has grown.

  3. Children’s Psychiatric Hospital Dr. Juan N. Navarro: 50 years of attention to the mental health of children and adolescents in Mexico

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    María Elena Márquez-Caraveo


    Full Text Available The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016 at the Children’s Psychiatric Hospital “Dr. Juan N. Navarro”(HPI, as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital has progressed towards diagnostic and therapeutic care of outpatients through the creation of specialized clinics (emotions, behavior, development, adolescence, among others and the development of more actualized and integral therapeutic programs (behavioral psychotherapy, cognitive behavioral, psychodynamic; individual, group, family, etc.. In the field of education, the hospital has been the most important institution in the training of child psychiatrists in Mexico and its recognition as a research interdisciplinary center has grown.

  4. Epidemiological and Clinical Characteristics of Children and Adolescents with Leprosy Admitted Over 16 Years at a Rural Hospital in Ethiopia: A Retrospective Analysis. (United States)

    Ramos, José M; Ortiz-Martínez, Sonia; Lemma, Deriba; Petros, Matheus M; Ortiz-Martínez, Carmen; Tesfamariam, Abraham; Reyes, Francisco; Belinchón, Isabel


    To analyse differences in children and adolescents aged ≤18 years admitted to the leprosy ward in a rural Ethiopian hospital >16 years. We retrospectively collected data from leprosy admission registry books on patients with leprosy who were admitted to a referral hospital from September 2000 to September 2016. There were 2129 admissions for leprosy during the study period: 180 (8.4%) patients were s ≤ 18 years old. Of these, 98 (54.4%) were male and 82 (45.6%) were female. The proportion of new diagnoses in children and adolescents was 31.7%, significantly higher than in adults (11.7%; p < 0.001). There were also significant differences in the prevalence of lepromatous ulcers (46.9 vs. 61.7%), leprosy reaction (29.4 vs. 13.0%) and neuritis (16.9 vs.5.3%) between these age groups. There were more new diagnoses, leprosy reactions and neuritis, and fewer lepromatous ulcers, in children and adolescents compared with adults, with younger patients being referred more frequently to reference centres.

  5. Hospitalizations for varicella in children and adolescents in a referral hospital in Hong Kong, 2004 to 2008: A time series study

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    Chan WM


    Full Text Available Abstract Background Varicella accounts for significant morbidities and remains a public health issue worldwide. Climatic factors have been shown to associate with the incidence and transmission of various infectious diseases. We describe the epidemiology of varicella in paediatric patients hospitalized at a tertiary referral hospital in Hong Kong from 2004 to 2008, and to explore the possible association between the occurrence of varicella infection and various climatic factors. Methods The hospital discharge database of Princess Margaret Hospital was retrospectively analyzed for admissions associated with varicella from 2004 to 2008. Meteorological data were obtained from the monthly meteorological reports from the Hong Kong Observatory website. Time series analysis was performed with Poisson regression using a Generalized Estimating Equation (GEE approach. Results During the study period, 598 children were hospitalized for varicella. The mean age on admission was 57.6 months, and the mean duration of hospitalization was 3.7 days. The overall complication rate was 47%. The mean monthly relative humidity, especially in cool seasons, was inversely correlated with the monthly varicella cases of the same month. Conclusions Varicella can lead to serious complications and prolonged hospitalization, even in previously healthy children. Lower relative humidity in cool seasons is associated with higher number of paediatric varicella hospital admissions. These findings are useful for a better understanding of the pattern of paediatric varicella hospitalization in Hong Kong.

  6. Effectiveness of self-esteem and social skills group therapy in adolescent eating disorder patients attending a day hospital treatment programme. (United States)

    Lázaro, L; Font, E; Moreno, E; Calvo, R; Vila, M; Andrés-Perpiñá, S; Canalda, G; Martínez, E; Castro-Fornieles, J


    To evaluate self-esteem and social skills in adolescent eating disorder patients before and after specific group therapy as part of a Day Hospital Programme. One hundred and sixty adolescent eating disorder patients, classified as anorexia nervosa and related disorders (AN-rd) (N = 116) or bulimia nervosa and related disorders (BN-rd) (N = 44) received structured group therapy for developing self-esteem and social skills. BN-rd patients had poorer perceptions of some self-esteem and social skills variables. After group therapy, both groups presented significant improvements in their perceptions of physical appearance, their self-concept related to weight and shape and to others, happiness and satisfaction, social withdrawal and leadership. BN-rd patients presented more changes on many of the variables. Specific self-esteem and social skills group therapy in patients with eating disorders can be useful in improving certain core features. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.

  7. Negotiating the transition from adolescence to motherhood: Coping with prenatal and parenting stress in teenage mothers in Mulago hospital, Uganda

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    Kaye Dan K


    Full Text Available Abstract Background Adolescence is a transitional stage from childhood to adulthood that is characterized by physical, physiological, psychosocial and behavioral changes that are influenced to a large extent by the age, culture and socialization of the individual. To explore what adolescent mothers perceive as their struggles during the period of transition from childhood to parenthood (through motherhood and to describe strategies employed in coping with stress of pregnancy, motherhood and parenthood. Methods Longitudinal qualitative study involving twenty two in-depth interviews and six focus group discussions among pregnant adolescents who were followed from pregnant to delivery, from January 2004 to August 2005. Participant were selected by theoretical sampling and data was analyzed using grounded theory. Results Overall, young adolescents reported more anxiety, loss of self esteem (when they conceived, difficulty in accessing financial, moral and material support from parents or partners and stigmatization by health workers when they sought care from health facilities. Three strategies by which adolescent mothers cope with parenting and pregnancy stress that were described as utilizing opportunities (thriving, accommodating the challenges (bargaining and surviving, or failure (despairing, and varied in the extent to which they enabled adolescents to cope with the stress. Conclusion Adolescents on the transition to motherhood have variable needs and aspirations and utilize different strategies to cope with the stress of pregnancy and parenthood.

  8. Routine hospital data - is it good enough for trials? An example using England's Hospital Episode Statistics in the SHIFT trial of Family Therapy vs. Treatment as Usual in adolescents following self-harm. (United States)

    Wright-Hughes, Alexandra; Graham, Elizabeth; Cottrell, David; Farrin, Amanda


    Use of routine data sources within clinical research is increasing and is endorsed by the National Institute for Health Research to increase trial efficiencies; however there is limited evidence for its use in clinical trials, especially in relation to self-harm. One source of routine data, Hospital Episode Statistics, is collated and distributed by NHS Digital and contains details of admissions, outpatient, and Accident and Emergency attendances provided periodically by English National Health Service hospitals. We explored the reliability and accuracy of Hospital Episode Statistics, compared to data collected directly from hospital records, to assess whether it would provide complete, accurate, and reliable means of acquiring hospital attendances for self-harm - the primary outcome for the SHIFT (Self-Harm Intervention: Family Therapy) trial evaluating Family Therapy for adolescents following self-harm. Participant identifiers were linked to Hospital Episode Statistics Accident and Emergency, and Admissions data, and episodes combined to describe participants' complete hospital attendance. Attendance data were initially compared to data previously gathered by trial researchers from pre-identified hospitals. Final comparison was conducted of subsequent attendances collected through Hospital Episode Statistics and researcher follow-up. Consideration was given to linkage rates; number and proportion of attendances retrieved; reliability of Accident and Emergency, and Admissions data; percentage of self-harm episodes recorded and coded appropriately; and percentage of required data items retrieved. Participants were first linked to Hospital Episode Statistics with an acceptable match rate of 95%, identifying a total of 341 complete hospital attendances, compared to 139 reported by the researchers at the time. More than double the proportion of Hospital Episode Statistics Accident and Emergency episodes could not be classified in relation to self-harm (75%) compared

  9. Analysis of image acquisition, post-processing and documentation in adolescents with spine injuries. Comparison before and after referral to a university hospital

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    Lemburg, S.P.; Roggenland, D.; Nicolas, V.; Heyer, C.M.


    Purpose: Systematic evaluation of imaging situation and standards in acute spinal injuries of adolescents. Materials and Methods: Retrospective analysis of imaging studies of transferred adolescents with spinal injuries and survey of transferring hospitals (TH) with respect to the availability of modalities and radiological expertise and post-processing and documentation of CT studies were performed. Repetitions of imaging studies and cumulative effective dose (CED) were noted. Results: 33 of 43 patients (77 %) treated in our hospital (MA 17.2 years, 52 % male) and 25 of 32 TH (78 %) were evaluated. 24-hr availability of conventional radiography and CT was present in 96 % and 92 % of TH, whereas MRI was available in only 36 %. In 64 % of TH, imaging expertise was guaranteed by an on-staff radiologist. During off-hours radiological service was provided on an on-call basis in 56 % of TH. Neuroradiologic and pediatric radiology expertise was not available in 44 % and 60 % of TH, respectively. CT imaging including post-processing and documentation matched our standards in 36 % and 32 % of cases. The repetition rate of CT studies was 39 % (CED 116.08 mSv). Conclusion: With frequent CT repetitions, two-thirds of re-examined patients revealed a different clinical estimation of trauma severity and insufficient CT quality as possible causes for re-examination. A standardization of initial clinical evaluation and CT imaging could possibly reduce the need for repeat examinations. (orig.)

  10. Higher caloric intake in hospitalized adolescents with anorexia nervosa is associated with reduced length of stay and no increased rate of refeeding syndrome. (United States)

    Golden, Neville H; Keane-Miller, Casey; Sainani, Kristin L; Kapphahn, Cynthia J


    To determine the effect of higher caloric intake on weight gain, length of stay (LOS), and incidence of hypophosphatemia, hypomagnesemia, and hypokalemia in adolescents hospitalized with anorexia nervosa. Electronic medical records of all subjects 10-21 years of age with anorexia nervosa, first admitted to a tertiary children's hospital from Jan 2007 to Dec 2011, were retrospectively reviewed. Demographic factors, anthropometric measures, incidence of hypophosphatemia (≤3.0 mg/dL), hypomagnesemia (≤1.7 mg/dL), and hypokalemia (≤3.5 mEq/L), and daily change in percent median body mass index (BMI) (%mBMI) from baseline were recorded. Subjects started on higher-calorie diets (≥1,400 kcal/d) were compared with those started on lower-calorie diets (Refeeding hypophosphatemia depends on the degree of malnutrition but not prescribed caloric intake, within the range studied. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.


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    Full Text Available Introduction. There are increasing interests about pharmacotherapy in depressed children and adolescents. Althought TCAs (such as imipramine are approved for use in enuresis and ADHD, but controlled studies have failed to demonstrate efficacy of them over placebo in the treatment of depressive disorders in both children or adolescents. On the other hand, a relatively more amount of studies address SSRls (such as fluoxetine, as the drug of choice for treatment of depressed children and adolescents, because of theire effectiveness and safety.
    Methods. In this retrospective study, 306 depressed child and adolescent (7-18 year old who admitted to a psychiatric out patient clinic were studied (196 male and 110 female. Imipramine and fluoxetin were administered for 47 percent and 43 percent of cases, respectively.
    Results. In imipramin geoup and fluoxetine group the symptoms of 126 (87 percent and 102 (77 percent patient was improved, respectively. The frequency of side effects was 21 percent for imipramin (specialy sedation, dizziness and palpitation and 22 percent for fluoxatine (specially headache, insomnia and agitation.
    Discussion. This study suggests that both imipramin and fluoxetine are efficient for tratment of children and adolescents depression. However, because of high theraputic index of fluoxetine, this drug may be a better choice.

  12. Convivendo com a hospitalização do filho adolescente Conviviendo con la hospitalización de hijo adolescente Living with a hospitalized adolescent

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    Lindalva Carvalho Armond


    , los sentimientos vividos por la familia y la adaptación al mundo hospitalario, la religiosidad y la presencia de amigos en el proceso de enfrentamiento de la hospitalización, las transformaciones del hijo. Al reflexionar sobre la experiencia de los padres, contemplo la necesidad de considerar al adolescente y a su familia como un ser ahí, siendo en el mundo y siendo en el mundo con los otros.This study aimed to understand the experience of parents living with a hospitalized adolescent. Fifteen parents of hospitalized adolescents were interviewed from August to October of 2002. Data were analyzed through Martin Heidegger's phenomenological approach. Four themes were identified: the impact of the illness on the family, the feelings of the family members and the adaptation to the hospital world, religiousness and the presence of friends in the process of coping with hospitalization; changes in the adolescent. The results showed the importance of seeing the adolescent and his/her family as a being there, being-in-the-world and being-in-the-world-with-others.

  13. The clinical profile of young and adolescent women with laparoscopically diagnosed endometriosis in a Singapore tertiary hospital

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    Yoke-Fai Fong


    Conclusion: Endometriosis can cause severe disease even in adolescents and young females. Increased awareness among patients and healthcare providers would raise a higher index of suspicion for endometriosis in these women, with consequent early treatment which may result in better functional and fertility outcomes.

  14. Maltrato infantil y del adolescente registrado en un hospital de referencia nacional, 2006 - 2011 Child and adolescent abuse recorded at a national referral hospital, 2006 - 2011

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    Lorena Escalante-Romero


    Full Text Available Objetivos. Realizar una descripción de los registros del Instituto Nacional de Salud del Niño (INSN, desde enero de 2006 hasta septiembre de 2011, sobre maltrato infantil y del adolescente, lo cual permite la caracterización del agredido y del agresor. Materiales y métodos. Se realizó un análisis de fuentes secundarias, basado en registros de la "Ficha de evaluación de violencia familiar y maltrato infantil", aplicada por el Módulo de Atención al Maltrato Infantil y del Adolescente en Salud (MAMIS del INSN. La ficha incluye datos del agredido, del agresor y las características de la agresión. Se diferenció el tipo de agresión como: sexual, física, psicológica o por abandono. Se muestran los resultados en frecuencias y porcentajes. Resultados. Se incluyeron 1798 registros. El 63,9% eran niñas y el 39,9% fueron adolescentes. El 60,6% de los agresores fueron varones y el 65,8% de las agresiones ocurrieron en casa. El 48,6% fueron registros de agresión sexual, que fue más frecuente en niñas (73,2% y adolescentes (44,4%; en el 9,6% de los casos existió coito. Conclusiones. En los registros del MAMIS del INSN, la agresión en niñas fue la más frecuente; el agresor con frecuencia era un varón y la mayoría de las agresiones ocurrieron en el domicilio del menor. La agresión sexual fue casi la mitad de la serie.Objectives. To describe the records of child and adolescent abuse of the Instituto Nacional de Salud del Niño (INSN from January 2006 to September 2011, characterizing the victim and perpetrator. Materials and methods. A secondary sources analysis was performed, based on the domestic violence and child abuse records, from froms administered by Child Abuse and Adolescent Health Unit (MAMIS at the INSN. The records include data of the victim, offender and characteristics of the aggression. Types of aggression were categorized as: sexual, physical, psychological or neglection. Frequencies and percentages are presented

  15. Determinants of Quality of Life in Nigerian Children and Adolescents with Epilepsy: A Hospital-based Study

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    Abiola Duro Akingbohungbe


    Full Text Available Purpose: Though studies abound on the quality of life (QoL in chronic illnesses, there has been little focus on children and adolescents. This study investigated the determinants of QoL in children and adolescents with epilepsy in a Nigerian Tertiary Mental Health Institution.Methods: The study involved 67 adolescents between 11 and 18 years of age, diagnosed with epilepsy. Depression was assessed using the Centre for Epidemiology Study Depression Scale, and their QoL was assessed using the Comprehensive QoL Scale (ComQol-S.  Data was analysed using Spearman’s Correlation Coefficients and linear regression (pResults: The mean age of the participants was 14.5±4.0 years. Twenty-two (32.8% of them were depressed. Participants scored significantly higher (p in health, productivity, community participation and emotional domains and total QoL scores in the subjective axis than in the objective axis of QoL. When controlled for age and gender, the lower the educational attainments of the participants, the higher was their depression scores. Depression, seizure frequency at presentation at the clinic, seizure frequency at onset and age predicted poor QoL. Parents’ socio-economic status predicted seizure frequency.Conclusion: There is a high prevalence of depression in Nigerian adolescents with epilepsy. Epilepsy has a negative impact on their QoL. Therefore, it is necessary to pay more attention to the condition in order to reduce the frequency of seizures and improve their psycho-social well-being.DOI: 10.5463/dcid.v22i3.99

  16. Treatment of non-Hodgkin lymphoma and mature В-cell acute leukemia in children and adolescents: data of Russian regional hospitals

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    Ye. V. Samochatova


    Full Text Available The article presents treatment results of 233 patients (children and adolescents under 19 years old; median — 8.76 years with CD20-positive non-Hodgkin lymphomas and B-cell acute leukemia (B-NHL/B-AL received chemotherapy (BFM B-NHL 90–95 protocols or combined chemo-immunotherapy with rituximab (B-NHL-2004mab protocol. Combined chemo-immunotherapy was used for patients with Burkitt lymphoma, diffuse large cells lymphomas stage III–IV and B-AL, and included cytoreductive phase, 6 polychemotherapy (PCT courses and rituximab. PCT courses are similar to those of original BFM B-NHL90 protocol, except for the first 2 courses, where daily methotrexate dose was reduced from 5 to 1 g/m2/24 h. Rituximab infused IV 12 hours before the start of first 4 chemotherapy courses at a dose of 375 mg/m2. The data in the questionnaires form have been submitted from 28 pediatric specialized hospitals from 27 Russia regions over the past 5 years (2005–2009. Protocol with rituximab has proved to be more effective than chemotherapy alone. The authors discuss the possibility of using combined chemo-immunotherapy for the treatment of B-NHL/B-AL at regional hospitals and the prospects for further treatment results improvement in this group of tumors.

  17. Treatment of non-Hodgkin lymphoma and mature В-cell acute leukemia in children and adolescents: data of Russian regional hospitals

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    Ye. V. Samochatova


    Full Text Available The article presents treatment results of 233 patients (children and adolescents under 19 years old; median — 8.76 years with CD20-positive non-Hodgkin lymphomas and B-cell acute leukemia (B-NHL/B-AL received chemotherapy (BFM B-NHL 90–95 protocols or combined chemo-immunotherapy with rituximab (B-NHL-2004mab protocol. Combined chemo-immunotherapy was used for patients with Burkitt lymphoma, diffuse large cells lymphomas stage III–IV and B-AL, and included cytoreductive phase, 6 polychemotherapy (PCT courses and rituximab. PCT courses are similar to those of original BFM B-NHL90 protocol, except for the first 2 courses, where daily methotrexate dose was reduced from 5 to 1 g/m2/24 h. Rituximab infused IV 12 hours before the start of first 4 chemotherapy courses at a dose of 375 mg/m2. The data in the questionnaires form have been submitted from 28 pediatric specialized hospitals from 27 Russia regions over the past 5 years (2005–2009. Protocol with rituximab has proved to be more effective than chemotherapy alone. The authors discuss the possibility of using combined chemo-immunotherapy for the treatment of B-NHL/B-AL at regional hospitals and the prospects for further treatment results improvement in this group of tumors.

  18. Clinical Commentary by Barbara Segal, a Consultant Child and Adolescent Psychotherapist Working in University College London Hospitals (United States)

    Segal, Barbara


    This moving clinical account describes the psychotherapeutic work of a child psychotherapist undertaken in a hospital room with 13-year-old Maya, after the sudden onset of a terrifying and serious illness, Guillain-Barre syndrome, leaving her with paralysis and extreme weakness. The first session takes place almost three weeks after Maya's…

  19. Prediction of Long-Term Outcomes in Young Adults with a History of Adolescent Alcohol-Related Hospitalization. (United States)

    Groß, Cornelius; Kraus, Ludwig; Piontek, Daniela; Reis, Olaf; Zimmermann, Ulrich S


    Empirical data concerning the long-term psychosocial development of adolescents admitted to inpatient treatment with alcohol intoxication (AIA) are lacking. The aim of this study was to identify the factors that, at the time of admission, predict future substance use, alcohol use disorders (AUD), mental health treatment, delinquency and life satisfaction. We identified 1603 cases of AIA treated between 2000 and 2007 in one of five pediatric departments in Germany. These former patients were invited to participate in a telephone interview. Medical records were retrospectively analyzed extracting potential variables predicting long-term outcomes. Interviews were conducted with 277 individuals, 5-13 [mean 8.3 (SD 2.3)] years after treatment, with a response rate of 22.7%; of these, 44.8% were female. Mean age at the interview was 24.4 (SD 2.2) years. Logistic and linear regression models revealed that being male, using illicit substances and truancy or runaway behavior in adolescence predicted binge drinking, alcohol dependence, use of illicit substances and poor general life satisfaction in young adulthood, explaining between 13 and 24% of the variance for the different outcome variables. This naturalistic study confirms that known risk factors for the development of AUD also apply to AIA. This finding facilitates targeted prevention efforts for those cases of AIA who need more than the standard brief intervention for aftercare. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  20. How to stay in touch with adolescents and young adults after a suicide attempt? Implementation of a 4-phones-calls procedure over 1 year after discharge from hospital, in a Parisian suburb. (United States)

    Normand, D; Colin, S; Gaboulaud, V; Baubet, T; Taieb, O


    Post-discharge treatment is a major part of youth suicide prevention. However, many adolescents and young adults suicidal patients released from emergency department (ED) fail to follow through with subsequent outpatient psychiatric appointments. The aims were to (1) implement a one-year follow-up phone-call program for adolescent and young adults suicide attempters admitted at the ED (2) assess its feasibility (3) describe outcomes measures (repeated suicide attempt and observance of outpatient care) and (4) access risk factors to be out of sight at one year follow up and (5) elicit subjective feedback after one year, using narrative data. A cohort of adolescents and young adults aged 15-21 years admitted to Avicenne University Hospital ED for suicide attempt (SA) was created and re-contacted using phone calls at one week, one month, six months and twelve months after discharge. Sociodemographic information was collected at baseline. At one year, qualitative data was collected from patients or their parents. One hundred and seventy-three adolescents and young adults were included. At 1 year, 93 young patients had been successfully contacted, among whom 23 had reattempted suicide, at least once. Adolescents and young adults that were unreachable at one year showed a higher rate of school dropout and had more migration history at baseline. Feedback showed that the intervention was experienced as supportive. Phone-calls after discharge from hospital might help enhance compliance to aftercare treatment, and were well-accepted by both adolescents and parents. Nevertheless, half of our sample was lost of sight at one year. Further studies are needed to find the most effective prevention strategy with young suicide attempters, especially for migrants and school droppers. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  1. Use of the Suicide Status Form-II to investigate correlates of suicide risk factors in psychiatrically hospitalized children and adolescents. (United States)

    Romanowicz, Magdalena; O'Connor, Stephen S; Schak, Kathryn M; Swintak, Cosima C; Lineberry, Timothy W


    Suicide is the third leading cause of death in the United States for youth 12-17 years or age. Acute psychiatric hospitalization represents a clear worst point clinically and acute suicide risk is the most common reason for psychiatric admission. We sought to determine factors associated with differences in individual suicide risk assessment for children and adolescents during acute psychiatric admission. Study participants were 1153 youth consecutively admitted to an inpatient psychiatry unit who completed a self-administered Suicide Status Form (SSF) within 24h of admission. Additional information on suicide risk factors was obtained through medical chart abstraction. Females reported significantly greater psychological pain, stress, hopelessness, and self-hate on the SSF and were significantly more likely to have made a suicide attempt just prior to the index hospital admission (OR=1.59, SE=0.29; CI=1.12-2.26), report a family history of suicide (OR=2.02, SE=0.33; CI=1.47-2.78), and had experienced a greater number of inpatient psychiatry admissions related to suicidal ideation (RR=1.33, SE=0.13; CI=1.10-1.61). High school aged youth and those with a primary diagnosis of depression displayed consistently elevated SSF scores and risk factors for suicide compared to comparison groups. Diagnosis was determined through chart abstraction. Responses to access to firearm question had missing data for 46% of the total sample. Systematic administration of a suicide-specific measure at admission may help clinicians improve identification of suicide risk factors in youth in inpatient psychiatry settings. © 2013 Elsevier B.V. All rights reserved.

  2. Pushing Harder, Pushing Faster, Minimizing Interruptions… But Falling Short of 2010 Cardiopulmonary Resuscitation Targets During In-hospital Pediatric and Adolescent Resuscitation (United States)

    Sutton, Robert M.; Wolfe, Heather; Nishisaki, Akira; Leffelman, Jessica; Niles, Dana; Meaney, Peter A.; Donoghue, Aaron; Maltese, Matthew R.; Berg, Robert A.; Nadkarni, Vinay M.


    Aim The objective of this study was to evaluate the effect of instituting the 2010 Basic Life Support Guidelines on in-hospital pediatric and adolescent cardiopulmonary resuscitation (CPR) quality. We hypothesized that quality would improve, but that targets for chest compression (CC) depth would be difficult to achieve. Methods Prospective in-hospital observational study comparing CPR quality 24 months before and after release of the 2010 Guidelines. CPR recording/feedback-enabled defibrillators collected CPR data (rate (CC/min), depth (mm), CC fraction (CCF, %), leaning (% > 2.5 kg.)). Audiovisual feedback for depth was: 2005 ≥ 38mm; 2010 ≥ 50mm; for rate: 2005 ≥ 90 and ≤ 120 CC/min; 2010 ≥ 100 and ≤ 120 CC/min. The primary outcome was average event depth compared with Student’s t-test. Results 45 CPR events (25 before; 20 after) occurred, resulting in 1336 thirty-second epochs (909 before; 427 after). Compared to 2005, average event depth (50 ± 13 vs. 43 ± 9 mm; p=0.047), rate (113 ± 11 vs. 104 ± 8 CC/min; p<0.01), and CCF (0.94 [0.93, 0.96] vs. 0.9 [0.85, 0.94]; p=0.013) increased during 2010. CPR epochs during the 2010 period more likely to meet Guidelines for CCF (OR 1.7; CI 95: 1.2–2.4; p<0.01), but less likely for rate (OR 0.23; CI 95: 0.12–0.44; p<0.01), and depth (OR 0.31; CI 95: 0.12–0.86; p=0.024). Conclusions Institution of the 2010 Guidelines was associated with increased CC depth, rate, and CC fraction; yet, achieving 2010 targets for rate and depth was difficult. PMID:23954664

  3. Endometriosis in the adolescence: a six year follow-up in the General Hospital of Medellín

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    Catalina Cuervo Valencia


    Full Text Available Background: Endometriosis is a disease that can get to be highlyincapacitating and with lethal consequences in the reproductive future of women. Objective: To know the incidence and to describe theclinical manifestations, diagnosis and treatment in a specific population group. Methodology: Descriptive, retrospective, longitudinal study in 34 patients, whose criteria of inclusion were: female sex, age between 11 and 22, diagnosis of endometriosis between 1,998 and 2,003 HGM (Medellin General Hospital and having attended to a minimum of two evaluations where complementary diagnostic studies were asked for. Results: The found incidence was 2.7%. The main complaints were dysmenorrhea and chronic pelvic pain.41.2% of the studied patients referred at least one alteration in their menstrual cycles; the physical examination was normal in 32.4%.Laparoscopy was the most used surgical diagnostic and therapeuticmethod. The main medical treatment was the oral contraceptives(ACOs. During the follow-up period, symptoms improved in 55.9%of the patients. Conclusion: Endometriosis is a frequent pathologyin the gynecological consultation. The pain was the main reason forconsultation and it is the most frequent fi nding of clinical examination. The laparoscopy and the ACOs are part of the first class handling, showing improvement of the symptoms in most of the studied group.

  4. [Does consumption of tobacco, alcohol, and cannabis in adolescents and young adults with cancer affect the use of analgesics during hospitalizations?]. (United States)

    Bertrand, A; Boyle, H; Moreaux, J; Guillot, L; Chvetzoff, G; Charbonnel, J-F; Marec-Berard, P


    The specificities of adolescents and young adults (AYAs) aged 15-25 years with cancer are now well recognized. Dedicated care was initiated in 2012 in France under the leadership of the INCa (National Cancer Institute). Research on supportive care and particularly pain management are still rare. This study aimed to evaluate the consumption of toxic substances (tobacco, cannabis, alcohol) in AYAs with cancer as well as its progression during the month following the diagnosis and to analyze its influence on opioid analgesic prescriptions during treatment. This is a prospective study including all new patients aged 15-25 years in two centers between January and June 2013. Data on consumption of psychoactive substances were obtained during an individual interview with a questionnaire. National surveys were used to compare this cohort with the general population. Data on opioid treatments were collected from the computerized prescription software and computerized patient record. Thirty-seven AYAs were eligible and 30 were included; 67% of them were male and the median age was 18.7 years. The questionnaire on tobacco, alcohol, and cannabis consumption at diagnosis was well accepted. Consumption profiles were comparable to the general population. Changes in behavior were observed during the 1st month after diagnosis, with a decrease or cessation of consumption, particularly among young people. This study showed differences in the use and requirements for opioid analgesics during hospitalization according to these consumption data. Prevention and support for AYAs who are regular consumers of toxic substances must be organized during initial care in oncology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Bone mineral density among systemic lupus erythematosus patient age 5-18 years with glucocorticoid treatment in child and adolescent outpatient clinic, Cipto Mangunkusumo Hospital, Jakarta (United States)

    Indriyani, N.; Tridjaja, B.; Medise, B. E.; Kurniati, N.


    Systemic lupus erythematosus (SLE) is an autoimmune disease affecting children; its morbidity and mortality rates are significant. One risk factor for morbidity is chronic corticosteroid use. The aim of this study is to determine the occurrence rate of low bone mineral density; discuss the characteristics, including cumulative and daily doses of corticosteroid, body mass index, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), calcium, and vitamin D intake; and assess bone metabolism laboratory parameters, including serum calcium, vitamin D, alkaline phosphatase (ALP), phosphorus, and cortisol among children with SLE receiving corticosteroids. This was a descriptive, cross-sectional study involving 16 children with SLE attending the child and adolescent outpatient clinic at Cipto Mangunkusumo Hospital in November-December 2016. Low bone mineral density occurred among 7/16 patients. The mean total bone mineral density was 0.885 ± 0.09 g/cm2. Children with SLE receiving corticosteroid had low calcium (8.69 ± 0.50 mg/dl), vitamin D (19.3 ± 5.4 mg/dl), ALP (79.50 [43.00-164.00] U/l), and morning cortisol level (1.20 [0.0-10.21] ug/dl), as well as calcium (587.58 ± 213.29 mg/d) and vitamin D (2.9 [0-31.8] mcg/d) intake. The occurrence of low bone mineral density was observed among children with SLE receiving corticosteroid treatment. Low bone mineral density tends to occur among patients with higher cumulative doses and longer duration of corticosteroid treatments.

  6. A retrospective chart review of the clinical and psychosocial profile of psychotic adolescents with co-morbid substance use disorders presenting to acute adolescent psychiatric services at Tygerberg Hospital

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    Anusha Lachman


    Full Text Available Background. A large number of adolescents meet criteria for ‘dual diagnosis’ (a psychiatric disorder plus co-morbid substance use disorder (SUD, which prolongs treatment response and complicates intervention strategies. The current service model in Cape Town divides the care of such patients into psychiatric treatment and a separate substance use intervention. Child and adolescent mental health services face the challenge of high rates of readmission of adolescents into psychiatric facilities before utilisation of community-based substance abuse services. Objective. There is a scarcity of available treatment guidelines for dual-diagnosis adolescents, and a lack of systematically documented epidemiological and clinical data in South African adolescent populations. Method. A retrospective chart review of adolescent psychiatric admissions to the Tygerberg Adolescent Psychiatric Unit during 2010 was conducted. Relevant epidemiological, clinical and demographic data for those presenting with a dual diagnosis (specifically psychotic disorders and SUD was recorded. Results. Results suggest a high prevalence of SUD among adolescents presenting with a first-episode psychosis. Statistically significant correlations with lower levels of education were found in those with ongoing substance abuse (specifically cannabis and methamphetamine, and a significant relationship between choice of debut drug and ongoing drug use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages, risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described. Conclusions. This cohort had an enhanced risk as a result of genetic vulnerability and environmental availability of substances, and the findings emphasise the differences in presentation, choice of drugs of abuse and psychosocial difficulties of adolescents with a dual

  7. Greater retention in care among adolescents on antiretroviral treatment accessing "Teen Club" an adolescent-centred differentiated care model compared with standard of care: a nested case-control study at a tertiary referral hospital in Malawi. (United States)

    MacKenzie, Rachel K; van Lettow, Monique; Gondwe, Chrissie; Nyirongo, James; Singano, Victor; Banda, Victor; Thaulo, Edith; Beyene, Teferi; Agarwal, Mansi; McKenney, Allyson; Hrapcak, Susan; Garone, Daniela; Sodhi, Sumeet K; Chan, Adrienne K


    There are numerous barriers to the care and support of adolescents living with HIV (ALHIV) that makes this population particularly vulnerable to attrition from care, poor adherence and virological failure. In 2010, a Teen Club was established in Zomba Central Hospital (ZCH), Malawi, a tertiary referral HIV clinic. Teen Club provides ALHIV on antiretroviral treatment (ART) with dedicated clinic time, sexual and reproductive health education, peer mentorship, ART refill and support for positive living and treatment adherence. The purpose of this study was to evaluate whether attending Teen Club improves retention in ART care. We conducted a nested case-control study with stratified selection, using programmatic data from 2004 to 2015. Cases (ALHIV not retained in care) and controls (ALHIV retained in care) were matched by ART initiation age group. Patient records were reviewed retrospectively and subjects were followed starting in March 2010, the month in which Teen Club was opened. Follow-up ended at the time patients were no longer considered retained in care or on 31 December 2015. Cases and controls were drawn from a study population of 617 ALHIV. Of those, 302 (48.9%) participated in at least two Teen Club sessions. From the study population, 135 (non-retained) cases and 405 (retained) controls were selected. In multivariable analyses, Teen Club exposure, age at the time of selection and year of ART initiation were independently associated with attrition. ALHIV with no Teen Club exposure were less likely to be retained than those with Teen Club exposure (adjusted odds ratio (aOR) 0.27; 95% CI 0.16, 0.45) when adjusted for sex, ART initiation age, current age, reason for ART initiation and year of ART initiation. ALHIV in the age group 15 to 19 were more likely to have attrition from care than ALHIV in the age group 10 to 14 years of age (aOR 2.14; 95% CI 1.12, 4.11). This study contributes to the limited evidence evaluating the effectiveness of service delivery

  8. Analysis of image acquisition, post-processing and documentation in adolescents with spine injuries. Comparison before and after referral to a university hospital; Bildgebung bei wirbelsaeulenverletzten Kindern und jungen Erwachsenen. Eine Analyse von Umfeld, Standards und Wiederholungsuntersuchungen bei Patientenverlegungen

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    Lemburg, S.P.; Roggenland, D.; Nicolas, V.; Heyer, C.M. [Berufsgenossenschaftliches Universitaetsklinikum Bergmannshell, Bochum (Germany). Inst. fuer Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin


    Purpose: Systematic evaluation of imaging situation and standards in acute spinal injuries of adolescents. Materials and Methods: Retrospective analysis of imaging studies of transferred adolescents with spinal injuries and survey of transferring hospitals (TH) with respect to the availability of modalities and radiological expertise and post-processing and documentation of CT studies were performed. Repetitions of imaging studies and cumulative effective dose (CED) were noted. Results: 33 of 43 patients (77 %) treated in our hospital (MA 17.2 years, 52 % male) and 25 of 32 TH (78 %) were evaluated. 24-hr availability of conventional radiography and CT was present in 96 % and 92 % of TH, whereas MRI was available in only 36 %. In 64 % of TH, imaging expertise was guaranteed by an on-staff radiologist. During off-hours radiological service was provided on an on-call basis in 56 % of TH. Neuroradiologic and pediatric radiology expertise was not available in 44 % and 60 % of TH, respectively. CT imaging including post-processing and documentation matched our standards in 36 % and 32 % of cases. The repetition rate of CT studies was 39 % (CED 116.08 mSv). Conclusion: With frequent CT repetitions, two-thirds of re-examined patients revealed a different clinical estimation of trauma severity and insufficient CT quality as possible causes for re-examination. A standardization of initial clinical evaluation and CT imaging could possibly reduce the need for repeat examinations. (orig.)

  9. [Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966)]. (United States)

    Afschar-Hamdi, Sima; Schepker, Klaus


    Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966) The patient admissions at the children's ward of the State Psychiatric Hospital Weissenau in the years 1951, 1956, 1961 and 1966 were analyzed regarding documented coercive measures. Shortage of staff, mainly inadequately skilled personnel, a mixing of age groups in the patient cohort, neurological and psychiatric disorders and of patients who were in need of nursing and of those who needed treatment constituted the general work environment. Coercive measures against patients, mostly disproportionate isolations, were a constant part of daily life on the ward. This affected in particular patients who had to stay longer at the hospital and whose stay was financed by public authority. The uselessness of such measures was known, which can be seen e. g. in the Caretaker's Handbook of that time and the comments in the patient files. The situation still escalated in some cases (for example by transfer to an adult ward). For a long time, coercive measures against patients were part of everyday life at the children's ward of the Weissenau; the actual figures are suspected to be much higher.

  10. A hospitalização e o adoecimento pela perspectiva de crianças e jovens portadores de fibrose cística e osteogênese imperfeita The hospitalization and the process of becoming ill through the children's and adolescents' perspective with cystic fibrosis and osteogenesis imperfecta

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    Daniele Borges de Mello


    Full Text Available O presente artigo visa discutir os resultados de uma pesquisa realizada em um hospital localizado no município do Rio de Janeiro, considerado referência em saúde da criança, do adolescente e da mulher. Analisamos os significados da hospitalização e do adoecimento crônico na infância e adolescência pela perspectiva de crianças e adolescentes com fibrose cística e osteogênese imperfeita durante suas internações hospitalares com vistas a explorar suas vivências e suas possibilidades de expressão enquanto sujeitos de conhecimento. Para tanto, privilegiamos a observação e a construção de suas produções mediadas pelo suporte lúdico, utilizando o desenho e/ou história como relevantes vias de acesso aos conteúdos infanto-juvenis. Os dados advindos desse estudo apontam para a capacidade de aquisição e produção de conhecimento que crianças e jovens possuem acerca de sua situação de adoecimento.The present article intends to discuss the results of a study completed in a hospital located in the municipal district of Rio de Janeiro, considered most prominent for child, adolescent and woman's health. We analyzed the meanings of hospitalization and chronic illness in childhood and adolescence through the perspective of children and adolescents with cystic fibrosis and osteogenesis imperfecta during their hospitalizations in order to explore their experience and communicative possibilities as knowledgeable informants. Hence, we privileged the observation and the construction of their productions through games, using drawings and/or story-telling as a relevant approach to childhood and adolescence contents. The data collected signify the acquisition and knowledge production capacity of children and adolescents concerning their illness processes.

  11. Intervención educativa sobre la atención a niños de madres adolescentes: Hospital Ginecoobstétrico Guanabacoa, 2002-2008 Educational intervention on the attention to adolescent mothers' children: Gyneco-Obstetric Hospital of Guanabacoa, 2002-2008

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    Rosa María Alonso Uría


    Full Text Available El embarazo en la adolescencia constituye un problema de salud por su inmadurez en la esfera reproductiva y en la atención al niño. Se realizó una intervención educativa a 253 madres adolescentes en el Hospital Ginecoobstétrico de Guanabacoa durante el período 2002-2008 para identificar conocimientos y preparación de las madres adolescentes para la atención de sus hijos y diseñar un programa educativo a través técnicas de exploración cualitativa, diseñándose el programa educativo aplicado durante los tres primeros años de vida de sus hijos. El contenido del programa se basó en: cuidados generales del neonato, lactancia materna, crecimiento y desarrollo, nutrición, accidentes, inmunizaciones, incorporación estudio y/o trabajo. Las madres adolescentes presentaron bajos niveles de conocimiento y falta de habilidades en el cuidado de sus hijos. La aplicación del programa educativo contribuyó a la transformación en estilos de vida más saludables de la madre adolescente y una mejor atención de sus hijos.Pregnancy in adolescents is a major problem due to immaturity in the reproductive system and baby care inability. An educative intervention was carried out in the "Gyneco-Obstetric Hospital of Guanabacoa" from 2002 to 2008. The research included 253 adolescent mothers to identify preparation and knowledge for baby care. An educative program was designed and applied during the first three years of the babies" life. The content of the program was based on general care of the newborn, breastfeeding, growth and development, nutrition, accidents, vaccination and work or study incorporation. Adolescent mothers showed low levels of knowledge and lack of abilities for baby care. The application of the educative program helped to develop healthier life styles in the adolescent mother and a better care for babies.

  12. Psycho-social Issues among Adolescents with Diabetes Mellitus ...

    African Journals Online (AJOL)

    social functioning of the adolescent but its magnitude is poorly documented. Objective: To describe the psychosocial issues observed among Nigerian adolescent diabetics attending the Paediatric outpatient clinics of two Nigerian hospitals.

  13. Hospitals; hospitals13 (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  14. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007-2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe. (United States)

    Socolov, Demetra-Gabriela; Iorga, Magdalena; Carauleanu, Alexandru; Ilea, Ciprian; Blidaru, Iolanda; Boiculese, Lucian; Socolov, Razvan-Vladimir


    Aim . To determine pregnancy and delivery outcomes among teenagers. Materials and Methods . An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20-24 years of age in a university hospital. Results . Teenage is a risk factor for preterm birth teenagers than in adults (0.75 [0.70-0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10-1.17]), low urinary tract infection (1.10 [1.03-1.18]), pediculosis (2.42 [1.90-3.00]), anogenital condyloma (1.50 [1.04-2.17]), and trichomoniasis (1.74 [1.12-2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26-0.71), 0.90 (0.85-0.96), and 0.29 (0.20-0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion . Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers.

  15. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007–2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe (United States)

    Socolov, Demetra-Gabriela; Carauleanu, Alexandru; Ilea, Ciprian; Blidaru, Iolanda; Boiculese, Lucian; Socolov, Razvan-Vladimir


    Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20–24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth teenagers than in adults (0.75 [0.70–0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10–1.17]), low urinary tract infection (1.10 [1.03–1.18]), pediculosis (2.42 [1.90–3.00]), anogenital condyloma (1.50 [1.04–2.17]), and trichomoniasis (1.74 [1.12–2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26–0.71), 0.90 (0.85–0.96), and 0.29 (0.20–0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers. PMID:28133615

  16. The prevalence of metabolic syndrome and cardiovascular risk factors in a group of obese Saudi children and adolescents: A hospital-based

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    Taha, Doris; Ahmed, Omaima; Sadiq Bakr bin


    We assessed the distribution of risk factors associated with the metabolic syndrome in a group of obese Saudi children and adolescents. No previous studies had addressed this issue in the Saudi pediatric population. We retrospectively reviewed the medical records of patients evaluated for obesity between 2004 and 2008 and collected data on age, weight, height, body mass index (BMI), BP, fasting lipid profile, fasting glucose, insulin concentrations, and insulin resistance based on the homeostasis assessment model-insulin resistance (HOMA-IR) score. Obesity was defined as a BMI above the 95th percentile for age and gender and metabolic syndrome was diagnosed according to standard criteria. We studied 57 obese Saudi children and adolescents with a mean (standard deviation) age of 9.8 (3.5) years. Mean weight and body mass index (BMI) were 63.7 (28.3) kg and 31.6 (8.0) kg/m 2 , respectively. Systolic BP was elevated in 24 (42%) of the 57 subjects. Of the 39 children who had a lipid profile in their records, 10 had hypertriglyceridemia, 8 had hypercholesterolemia, 6 had elevated LDL cholesterol levels, and 6 had low HDL cholesterol levels. Impaired fasting glucose was found in 10 of 38 patients in which it was measured, and 9 of 25 patients had fasting hyperinsulinemia. Eleven of 37 patients (29.7%) met the diagnosis of the metabolic syndrome. Diastolic BP correlated positively with BMI (r=0.440, P =.001), and HDL cholesterol correlated negatively with weight and BMI (r=-0.487, P =.002 and r=-0.317, P =.05). HOMA-IR correlated positively with BMI and triglyceride levels and negatively with HDL cholesterol levels. Obese Saudi children and adolescents have multiple risk factors associated with metabolic syndrome. (author)

  17. Children’s Psychiatric Hospital Dr. Juan N. Navarro: 50 years of attention to the mental health of children and adolescents in Mexico


    María Elena Márquez-Caraveo; Eduardo Arroyo-García; Armida Granados-Rojas; Angélica Ángeles-Llerenas


    The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016) at the Children’s Psychiatric Hospital “Dr. Juan N. Navarro”(HPI), as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital ha...

  18. Estado nutricional de crianças e adolescentes hospitalizados em enfermaria de cirurgia pediátrica Nutritional status of children and adolescents hospitalized at the pediatric surgery unit

    Directory of Open Access Journals (Sweden)

    Ana Paula B. Simões


    Full Text Available OBJETIVO: Avaliar o estado nutricional, o tempo de internação e as especialidades clínicas de pacientes internados na enfermaria de Cirurgia Pediátrica do Hospital São Paulo da Unifesp-EPM. MÉTODOS: Estudo transversal retrospectivo, com 749 crianças e adolescentes de ambos os gêneros acompanhados por equipe interdisciplinar durante o período de agosto de 2007 a julho de 2008. Foram coletados dados antropométricos, dias de internação e procedimento cirúrgico segundo a especialidade. Para a classificação do estado nutricional, utilizou-se o escore Z do índice de massa corporal (Z IMC e da estatura/idade (Z E/I segundo a curva da Organização Mundial de Saúde (OMS, 2007. As crianças foram classificadas segundo diagnóstico estabelecido previamente à cirurgia. Utilizou-se o programa STATA 8.0 para análise dos dados e aplicou-se o teste ANOVA e comparações múltiplas de Bonferroni, considerando-se significante pOBJECTIVE: To evaluate the nutritional status, duration of hospital stay and clinical specialties of patients hospitalized in the Pediatric Surgery Unit of São Paulo Hospital, Unifesp-EPM. METHODS: This cross-sectional retrospective study enrolled 749 children and adolescents of both genders admitted to the Pediatric Surgery Unit during the period of August 2007 to July 2008. The following data were collected: anthropometric variables, duration of hospital stay and surgical procedures. For nutritional status classification, the Z score for body mass index (Z BMI and height-for-age (Z H/A were used according to the World Health Organization growth chart (WHO, 2007. The children were classified according to the surgical procedures performed. Results were compared by ANOVA followed by Bonferroni multiple comparisons test, being significant p<0.05. Statistical analysis was carried out through STATA 8.0 software. RESULTS: Patients' mean age was seven years old (0 to 18, 59% were males and 18% had ear, neck or throat surgery

  19. [Symptomatic rickets in adolescents]. (United States)

    Mallet, E; Gaudelus, J; Reinert, P; Le Luyer, B; Lecointre, C; Léger, J; Loirat, C; Quinet, B; Bénichou, J J; Furioli, J; Loeuille, G A; Roussel, B; Larchet, M; Freycon, F; Vidailhet, M; Varet, I


    Although systematic vitamin D supplementation in adolescents remains debated, rickets is nevertheless a well recognized pathology in this age group. Adolescence is an at-risk period because of rapid growth, insufficient calcium intake and/or vitamin D status. Surveys have shown that calcium intake is insufficient (population at risk. Forty-one adolescents with rickets were hospitalized between 1985 and 2000. Most of the cases were from the Northern France: 20 from Paris and suburbs, eight from the North-West, four from the North, four from the North-East; five were from the Center of France. The mean age was 13 years and two months for the 28 girls, and 14 years and four months for the 13 boys. Eighty per cent of the adolescents were from immigrant families (33/41): 15 were from sub-Saharan Africa, ten from North Africa, six from Pakistan and two from Turkey. Two thirds of the adolescents were hospitalized in the 2nd quarter of the year. Some adolescents suffered from lower limb pain, 16 had deformations of lower limbs, particularly genu valgum, associated with pain; seven others had either muscle spasms (4), tetany (3). Serum calcium level was low (average 1.84 mmol/l: [1.1-2.5]), and serum 25-OH D level was extremely low. Radiographic characteristics observed were metaphyseal strips on the knees, with condensed edges at times, with the presence of bone demineralization. The treatment combined calcium and vitamin D, and was often administered intravenously when a hypocalcemia was detected. Rickets is not frequent in adolescents, but nonetheless this pathology is not exceptional, and the number of cases is probably under-estimated. Rickets affects immigrant adolescents in particular but nevertheless could also present a certain risk period for the general population.

  20. Maltrato infantil en hijos de madres adolescentes en el Hospital Docente Ginecoobstétrico de Guanabacoa (2005-2006 Infantile ill-treatment in children from adolescent mothers born in the Gynecologic and Obstetrics Teaching Hospital of Guanabacoa (2005-2006

    Directory of Open Access Journals (Sweden)

    Ana Campo González


    Full Text Available Introducción: El síndrome de maltrato infantil es un fenómeno que surge con el hombre. No se presenta de forma aislada, sino que involucra gran variedad de factores biopsicosociales. Objetivo: Caracterizar el maltrato infantil en los hijos de madres adolescentes. Métodos: Se realizó un estudio descriptivo, prospectivo longitudinal de todos los hijos de madres adolescentes que nacieron en el Hospital Ginecoobstétrico de Guanabacoa, durante el periodo 2005-2006. La muestra la conformaron 62 niños en los cuales se constató maltrato. Estos fueron seguidos en consulta mensualmente hasta el año de edad. Se utilizó como fuente de información las historias clínicas de las madres, y el interrogatorio que se les realizó. Los resultados fueron expuestos en tablas. Resultados: El 82,3 % correspondió a madres de 15-19 años, el 50,1 % correspondió a las madres solteras, en un 74,2 % existía disfunción familiar. Coexistió antecedentes de maltrato en las madres en un 60,3 %; la manifestación de maltrato de mayor incidencia en los niños fue la negligencia física con un 62,9 %. Conclusiones: La negligencia física se observa de manera frecuente en las madres adolescentes.Introduction: The infantile ill-treatment syndrome is a phenomenon appearing with the man. It is not present in a isolated way, but involving many biosychosocial factors. Objective: To characterize the infantile ill-treatment in children from adolescent mothers. Methods: A longitudinal, prospective and descriptive study was conducted in all children from adolescent mothers born in the Gynecology and Obstetric Hospital of Guanabacoa during 2005-2006. Sample included 62 children in whom it was possible to confirm the ill-treatment and who were followed-up monthly in the consultation until the first year old. As information source authors used the medical records of mothers and the questioning performed in them. Results were showed in tables. Results: The 82.3 % belonged to

  1. Elements of Successful School Reentry after Psychiatric Hospitalization (United States)

    Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.


    Psychiatric hospitalization is an intensive intervention designed to stabilize adolescents who are experiencing an acute mental health crisis. Reintegrating to school after discharge from psychiatric hospitalization can be overwhelming for many adolescents (E. V. Clemens, L. E. Welfare, & A. M. Williams, 2010). The authors used a consensual…

  2. Creación de juegos personalizados para niños y adolescentes hospitalizados = The creation of personalized toys for children and adolescent hospitalized

    Directory of Open Access Journals (Sweden)

    Daniel Zapatero Guillén


    Full Text Available Resumen Desde el año 2003, el Departamento de Didáctica de la Expresión Plástica de la Universidad Complutense de Madrid, el Museo Pedagógico de Arte Infantil y Departamento de Psicología Social de la Universidad de Salamanca están desarrollando una serie de investigaciones en torno a las posibilidades de mejora de los niños y adolescentes hospitalizados a través del juego, la creatividad y el arte, enmarcadas en el proyecto curArte. En este proyecto, desde 2008, se ha trabajado en el diseño de materiales de juego creativo especialmente adaptados para el contexto hospitalario. Entre otras actividades, los talleres “Tuning” se han centrado en el diseño y creación de un muñeco estándar susceptible de ser tuneado en donde han participado adolescentes hospitalizados, educadores, investigadores y diseñadores1. Palabras clave: Talleres creativos, diseño juguetes, niños hospitalizados Abstract From 2003, the Didactic Department of art education of the Universidad Complutense de Madrid, the pedagogical museum of children art and the department of social psychology of the Universidad de Salamanca are developing investigations (Curarte Project around the possibilities to improve the stay of children hospitalized through games, creativity and art. In this project, from 2008, they have been working in the materials designs for creative toys specially adapted into a hospital context. The “tuning” workshops were focus on the design and creation of a standard doll that hospitalized children, educators, researchers and designers could modify. Key words: Creative workshops, toys design, children hospitalized.

  3. Avaliação do atendimento anestésico da criança e do adolescente em um hospital universitário Evaluación del servicio anestésico del niño y del adolescente en un hospital universitario Evaluation of the anesthetic management of children and adolescents in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Andressa Simões Aguiar


    Servicio de Anestesiología tuvieron mayor frecuencia entre 7 y 10 (97,4%. CONCLUSIONES: Se considera que el Servicio de Anestesiología desarrolla un buen trabajo, a pesar de fallos en la comunicación, que son de fácil solución y dependen más de la voluntad del Servicio que de su conocimiento científico.BACKGROUND AND OBJECTIVES: Anesthetic quality and patients' satisfaction has been increasingly praised. Our objective was to evaluate anesthetic management of children and adolescents in our Hospital, by interviewing parents and/or tutors. METHODS: 230 parents or tutors of children and adolescents submitted to anesthesia in the period April-December 2003 were interviewed during the postoperative visit through a four-item questionnaire: children and adolescents and their parents or tutors identification (item 1; explanations during preanesthetic evaluation (item 2 about anesthesia (item 3 and post-anesthetic recovery (PACU (item 4. Person informing respondents was identified and the presence of post-anesthetic complications made known. Respondents have scored the Anesthesiology Department from 0 to 10. RESULTS: Survey was answered by mothers in 189 (82.2% of cases. Most respondents (114, 75.6% were aged 20 to 39 years, were married (148, 64.3%, and 140 (60.9% had no job. Anesthesiologists have introduced themselves to 89%; for 37% and 77.4% they have explained the importance and duration the fasting period; 82% were informed about anemia; 90% were informed about allergy; 46.8% were informed about PACU importance; 42.2% were explained about length of stay; 72.9% were informed about the health status of their children. There have been no concerns for 49%, 58% and 58%, respectively about pre, intra and post-anesthetic period; 78.9% would like to have been with their children at PACU arrival. Pre, intra and post-anesthetic concerns were related to patients' age and gender - no concern whatsoever for most respondents - and to respondents' education - the better the

  4. Sequelae of Aggression in Acutely Suicidal Adolescents (United States)

    Kerr, David C. R.; Washburn, Jason J.; Feingold, Alan; Kramer, Anne C.; Ivey, Asha Z.; King, Cheryl A.


    The consequences of aggression on problem course and suicide risk were examined in 270 acutely suicidal adolescents (ages 12-17 years; 184 girls). Participants were assessed during psychiatric hospitalization (T1), 6-months post-hospitalization (T2), and 15 or more months post-hospitalization (T3). Study variables included self- and…

  5. Hospital Compare (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  6. HCAHPS - Hospital (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  7. Functional status and its associated factors in Nigerian adolescents ...

    African Journals Online (AJOL)

    Objective: This study assessed general functioning in Nigerian adolescents with bipolar disorder. It also determined the factors associated with functioning in these adolescents. Methods: Adolescents with bipolar disorder diagnosed over one year or more attending the outpatient unit of Federal Neuro-Psychiatric Hospital, ...

  8. Adolescent-onset psychosis: A 2-year retrospective study of ...

    African Journals Online (AJOL)

    Background. KwaZulu-Natal had no dedicated inpatient adolescent psychiatric service during the study period, and adolescents were admitted to general psychiatric wards. Aim of study. This is a descriptive review of adolescents with psychotic symptoms admitted to a psychiatric hospital. It aims to describe their ...

  9. Cultural Sensitive Care Provision in a Public Child and Adolescent Mental Health Centre: A Case Study from the Toulouse University Hospital Intercultural Consultation. (United States)

    Sturm, Gesine; Bonnet, Sylvie; Coussot, Yolaine; Journot, Katja; Raynaud, Jean-Philippe


    Child and adolescent mental health services in Europe are confronted with children with increasingly diverse socio-cultural backgrounds. Clinicians encounter cultural environments of hyperdiversity in terms of languages and countries of origin, growing diversity within groups, and accelerated change with regards to social and administrational situations (Hannah, in: DelVecchio Good et al. (eds) Shattering culture: American medicine responds to cultural diversity, Russel Sage Foundation, New York, 2011). Children and families who live in these complex constellations face multiple vulnerabilizing factors related to overlapping or intersecting social identities (Crenshaw in Univ Chic Leg Forum 140:139-167, 1989). Mobilizing existing resources in terms of social and family support, and encouraging creative strategies of interculturation in therapeutic work (Denoux, in: Blomart and Krewer (eds) Perspectives de l'interculturel, L'Harmattan, Paris, 1994) may be helpful in order to enhance resilience. Drawing from experiences in the context of French transcultural and intercultural psychiatry, and inspired by the Mc Gill Cultural Consultation in Child Psychiatry, we developed an innovative model, the Intercultural Consultation Service (ICS). This consultation proposes short term interventions to children and families with complex migration experiences. It has been implemented into a local public health care structure in Toulouse, the Medical and Psychological Centre la Grave. The innovation includes the creation of a specific setting for short term therapeutic interventions and team training via shared case discussions. Our objectives are (a) to improve outcomes of mental health care for the children through a better understanding of the child's family context (exploration of family dynamics and their relatedness to complex migration histories), (b) to enhance intercultural competencies in professionals via shared case discussions, and, (c) to improve the therapeutic

  10. Gender dysphoria in adolescence: current perspectives


    Kaltiala-Heino,Riittakerttu; Bergman,Hannah; Työläjärvi,Marja; Frisen,Louise


    Riittakerttu Kaltiala-Heino,1–3 Hannah Bergman,4 Marja Työläjärvi,2 Louise Frisén4 1Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; 2Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland; 3Vanha Vaasa Hospital, Vaasa, Finland; 4Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden Abstract: Increasing numbers of adolescents are seeking treatment at gender identi...

  11. Fatores de risco para hospitalização de crianças e adolescentes asmáticos Risk factors for hospital admissions among asthmatic children and adolescents

    Directory of Open Access Journals (Sweden)

    Laura Lasmar


    prestar adequada assistência a crianças e adolescentes asmáticos, especialmente para os menores de dois anos de idade.OBJECTIVE: To assess the prevalence rate and risk factors for hospital admissions among asthma children and to evaluate care delivered to these patients. METHODS: Three-hundred and twenty-five asthmatic children attending a public outpatient reference clinic were studied. Of them, 202 were hospitalized. Care was evaluated using a questionnaire covering general aspects of hospital stay and biological, demographics, socioeconomic and asthma-related factors. Univariate and multivariate analyses were performed to measure the association between hospital admissions and selected independent variables. RESULTS: Of the total, 62.2% had already been hospitalized due to asthma, 64.9% developed asthma episodes, and 60.9% were hospitalized in their first year of life. Most (76.0% had moderate to severe asthma. Despite that, 94.2% were not on anti-inflammatory drugs and were treated only during isolated acute episodes. None of these were regularly seen in primary health care centers for a periodic control of their steroid inhalants. Most parents (97.8% referred not to know how to take care of asthma children. Symptoms onset is normally seen before the age of 12 months (OR=3.20; 95%CI 1.55-6,61 or between 12 and 24 months (OR=3.89; 95%CI 1.62-9.36. Mothers have attended school for less than 7 years (OR=3.06; 95%CI 1.62-5.76. Disease severity (OR=2.32; 95%CI 1.24-3.88, 2 or more monthly visits to emergency wards (OR=2.19; 95%CI 1.24-3.88, and referred recurrent pneumonia (OR=2.00; 95%IC 1.06-3.80 were the main risk factors for hospital admissions. CONCLUSIONS: Organizing health care services is crucial to reduce hospital admissions and provide adequate care for asthma children and adolescents, especially those less than 2 years old.

  12. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007–2014 in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe

    Directory of Open Access Journals (Sweden)

    Demetra-Gabriela Socolov


    Full Text Available Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20–24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth <37 weeks (1.21 [1.08–1.35], foetal growth restriction (1.34 [1.21–1.48], episiotomy (1.27 [1.21–1.34], uterine revision (1.15 [1.06–1.25], APGAR <7 at 1 min (2.42 [1.21–1.67], cephalopelvic disproportion (1.26 [1.07–1.48], and postpartum haemorrhage (1.42 [1.25–1.62]; however, caesarean delivery occurs less frequently in teenagers than in adults (0.75 [0.70–0.80]. The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]: anaemia (1.13 [1.10–1.17], low urinary tract infection (1.10 [1.03–1.18], pediculosis (2.42 [1.90–3.00], anogenital condyloma (1.50 [1.04–2.17], and trichomoniasis (1.74 [1.12–2.68]. The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26–0.71, 0.90 (0.85–0.96, and 0.29 (0.20–0.41, while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers.

  13. Adolescent rationality. (United States)

    Moshman, David


    Adolescents are commonly seen as irrational, a position supported to varying degrees by many developmentalists, who often appeal to recent research on adolescent brains. Careful review of relevant evidence, however, shows that (1) adults are less rational than is generally assumed, (2) adolescents (and adults) are categorically different from children with respect to the attainment of advanced levels of rationality and psychological functioning, and (3) adolescents and adults do not differ categorically from each other with respect to any rational competencies, irrational tendencies, brain structures, or neurological functioning. Development often continues in adolescence and beyond but categorical claims about adolescents as distinct from adults cannot be justified. A review of U.S. Supreme Court decisions concerning intellectual freedom, reproductive freedom, and criminal responsibility shows ongoing ambivalence and confusion about the rationality of adolescents. Developmental theory and research suggest that adolescents should be conceptualized as young adults, not immature brains, with important implications for their roles, rights, and responsibilities.

  14. Parenting adolescents with cystic fibrosis: the adolescents' and young adults' perspectives


    Bregnballe, Vibeke; Schiøtz, Peter Oluf; Lomborg, Kirsten


    Vibeke Bregnballe1, Peter Oluf Schiøtz1, Kirsten Lomborg21Department of Pediatrics, Aarhus University Hospital; 2Department of Nursing Science, Institute of Public Health, Aarhus University, Aarhus, DenmarkBackground: When suffering from cystic fibrosis (CF), a number of problems may arise during adolescence; for example, poor adherence. The problems may be attributed to the adolescent being insufficiently prepared for adult life. Research on different ways of parenting adolescents...

  15. Hospital staffing and hospital costs. (United States)

    Andrew, R R


    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  16. Endocardite infecciosa em adolescentes. Análise dos fatores de risco de mortalidade intra-hospitalar Infective endocarditis in adolescents. analysis of risk factors for in-hospital mortality

    Directory of Open Access Journals (Sweden)

    Nádia Barreto Tenório Aoun


    patients. Congenital heart disease (24% and cardiac prosthesis (12% were the other affections involved. The majority of patients (78% were in functional class III and IV, with more deaths than the 22% who were in functional class I and II (p=0.01. Staphylococcus aureus was the most frequently isolated agent (42% of the positive blood cultures, followed by Staphylococcus viridans, 21%. Multivariate analysis identified total leukocyte count above 10,000/mm³ and functional class, both at admission (p=0.01 and p=0.004, respectively, and the occurrence of embolic complications (p=0.03 as independent predictors of in-hospital mortality. CONCLUSION: Rheumatic heart disease remains, as in adults, the main predisposing factor for infective endocarditis in adolescents, and S.aureus is, like in children, the leading agent. Mortality is high and functional class at hospital admission, embolic complications and leukocytosis are independent predictors of in-hospital mortality.

  17. Gender dysphoria in adolescence: current perspectives

    Directory of Open Access Journals (Sweden)

    Kaltiala-Heino R


    Full Text Available Riittakerttu Kaltiala-Heino,1–3 Hannah Bergman,4 Marja Työläjärvi,2 Louise Frisén4 1Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; 2Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland; 3Vanha Vaasa Hospital, Vaasa, Finland; 4Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden Abstract: Increasing numbers of adolescents are seeking treatment at gender identity services in Western countries. An increasingly accepted treatment model that includes puberty suppression with gonadotropin-releasing hormone analogs starting during the early stages of puberty, cross-sex hormonal treatment starting at ~16 years of age and possibly surgical treatments in legal adulthood, is often indicated for adolescents with childhood gender dysphoria (GD that intensifies during puberty. However, virtually nothing is known regarding adolescent-onset GD, its progression and factors that influence the completion of the developmental tasks of adolescence among young people with GD and/or transgender identity. Consolidation of identity development is a central developmental goal of adolescence, but we still do not know enough about how gender identity and gender variance actually evolve. Treatment-seeking adolescents with GD present with considerable psychiatric comorbidity. There is little research on how GD and/or transgender identity are associated with completion of developmental tasks of adolescence. Keywords: gender dysphoria, gender identity, adolescence, developmental tasks

  18. ADHD in Danish children and adolescents

    DEFF Research Database (Denmark)

    Jensen, Christina Mohr

    The most frequent reason for referral to the child and adolescent psychiatric hospitals in Denmark is the suspicion that a child or an adolescent may have Attention-Deficit/Hyperactivity Disorder (ADHD). The purpose of this dissertation was to assess how often ADHD has been diagnosed in Denmark......, to assess the validity of the ADHD diagnoses given to children and adolescents, to describe the socio-demographic and clinical characteristics of Danish children and adolescents with ADHD, and to assess their long-term risk for crimes. In the years under investigation, the incidence rates of diagnosed ADHD...... had significantly increased and the majority of ADHD diagnoses given to children and adolescents could be confirmed and were given based on high-quality clinical assessments. Results supported that children and adolescents with ADHD constitute a heterogeneous group that often have comorbid psychiatric...

  19. Adolescent murderers. (United States)

    Labelle, A; Bradford, J M; Bourget, D; Jones, B; Carmichael, M


    Clinical, developmental and environmental factors were retrospectively studied in 14 adolescent murderers who had been referred to a forensic psychiatric clinic over an 11 year period. Results of these analyses were compared with findings from previous reports. The majority of subjects came from split families. There was a greater than expected degree of psychiatric illness in the adolescents. Previous psychiatric contact, antisocial behaviour and substance abuse were common among these adolescents. A tentative profile of adolescents who are likely to commit murder can therefore be drawn up, which may suggest direction for preventive action and rehabilitation.

  20. Pregnant Adolescents Admitted to an Inpatient Child and Adolescent Psychiatric Unit: An Eight-Year Review. (United States)

    Fletcher, Teresa M; Markley, Laura A; Nelson, Dana; Crane, Stephen S; Fitzgibbon, James J


    To assess patient outcomes and describe demographic data of pregnant adolescents admitted to an inpatient child and adolescent psychiatric unit, as well as to determine if it is safe to continue to admit pregnant adolescents to such a unit. A descriptive retrospective chart review conducted at a free-standing pediatric hospital in northeast Ohio of all pregnant adolescents aged 13 to 17 years admitted to the inpatient child and adolescent psychiatric unit from July 2005 to April 2013. Data collection included details on demographic, pregnancy status, and psychiatric diagnoses. Eighteen pregnant adolescents were admitted to the psychiatric unit during the time frame. Sixteen of those were in the first trimester of pregnancy. Pregnancy was found to be a contributing factor to the adolescent's suicidal ideation and admission in 11 of the cases. Admission to an inpatient psychiatric facility did not lead to adverse effects in pregnancy. Pregnant adolescents did not have negative pregnancy outcomes related to admission to an inpatient psychiatric unit. Results of this study suggest that it is safe to continue to admit uncomplicated pregnant adolescents in their first trimester to an inpatient child and adolescent psychiatric unit for an acute stay. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  1. Hospital Inspections (United States)

    U.S. Department of Health & Human Services — Welcome to, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  2. Caracterização de crianças e adolescentes atendidos por maus tratos em um hospital de emergência no município de Fortaleza-CE Characterization of maltreated children and adolescents taken into a paediatric emergency health care service in Fortaleza-CE-Brazil

    Directory of Open Access Journals (Sweden)

    Arcelina Maria da Silva


    Full Text Available O estudo teve como objetivo caracterizar o perfil da criança e adolescente maltratados e atendidos em um hospital de emergência, no Município de Fortaleza, Ceará. Utilizou-se a pesquisa documental retrospectiva com análise dos formulários da Comissão de Maus Tratos à Infância e Adolescência. Os resultados revelaram que o sexo masculino e a faixa etária de 1 a 5 anos foram os mais atingidos; o principal agressor é o pai biológico e os tipos de violência mais freqüentes foram o hematoma, o abuso sexual e as lesões por objetos cortantes. Conclui-se que o tema requer estudos aprofundados que modifiquem o ambiente em que a criança, adolescente e famílias estão inseridos.This study aimed to characterise the profile of the child and the adolescent who were maltreated and taken into paediatric emergency care in a hospital, in Fortaleza, Ceará. It was used a documented retrospective evaluation. The results showed that the children in the age group of 1-5 years were the most victimised as well as the children of the male sex. The main perpetrator was a biological father and the most frequent kind of violence were hematomas, sexual abuse and wounds by slashing objects. In conclusion, this subject needs to be more investigated for providing changes within the' environment where a child, adolescent and families were inserted.

  3. Hospital marketing. (United States)

    Carter, Tony


    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  4. Adolescent Abuse. (United States)

    Foreman, Susan; Seligman, Linda


    Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)

  5. Cáncer y adolescencia en el contexto hospitalario: Una visión a través de la película "Planta 4ª" Cancer and adolescence in the one hospital context: A vision by means of the movie Planta 4ª

    Directory of Open Access Journals (Sweden)

    Cristina Torres Luzón


    Full Text Available El cine tiende a visualizar reflejos de la sociedad, situaciones cotidianas que impactan sobre los espectadores para transmitir su particular enfoque de la realidad. Información que puede resultar relevante como objeto de análisis y reflexión. El propósito de este trabajo ha sido indagar en las vivencias asociadas al cáncer en los adolescentes dentro del contexto hospitalario por medio del análisis descriptivo-interpretativo de la película "Planta 4ª". "Planta 4ª" muestra la lucha por la supervivencia y las estrategias de afrontamiento ante el cáncer de un grupo de adolescentes ingresados en un hospital. El ocio, la información, las relaciones afectivas, la enfermedad, la muerte, la amistad, la relación con los profesionales, la adolescencia, las relaciones de poder, etc. son algunas de las categorías emergentes tras el análisis de la película. El análisis fílmico se convierte en una buena fuente de información sobre la imagen que la sociedad tiene ante determinadas situaciones de salud y enfermedad.The cinema tend to visualize reflections of the society, daily situations have made impact on the spectators to convey their specified outlook of the reality. Information that can be excellent as analysis and reflection object. The aims of this work has been to investigate in the histories associated to the cancer in the adolescents inside the hospital context by means of the analysis descriptive -interpretive of the movie "Planta 4ª". "Planta 4ª" show the fight for the survival and the confrontation strategies before the cancer of a group of adolescents hospitalized in a hospital. The leisure, the information, the affective relationships, the illness, the death, the friendship, the relationship with the professionals, the adolescence, the relationships of power, etc. are a few of the emergent categories after the analysis of the movie. This analysis becomes a good source of information on the image that the society has before

  6. Características clínicas de los episodios de hipoglucemia en niños y adolescentes con diabetes tipo 1 atendidos en el Hospital Pediátrico "William Soler" Clinical features of hypoglycemic episodes in children and adolescents presenting with type 1 diabetes seen in "William Soler" Children Hospital

    Directory of Open Access Journals (Sweden)

    Pedro González Fernández


    more serious problem associated with the disease. OBJETIVE: to determine the frequencies and the clinical features of hypoglycemia in a group of diabetic children and adolescents diagnosed with type 1 diabetes mellitus seen in the Endocrinology of the "William Soler" Children Hospital from January, 1987 and January, 2000. Medical records, general data of patient, insulin therapy , results of glycosylated hemoglobin were registered, as well as the recounted hypoglycemia episodes which were classified as slight and severe. RESULTS: there was a high frequency of hypoglycemia episodes (56,25 %. The first severe hypoglycemia was registered as more frequent at the age group of 5 years. The first severe hypoglycemia episode occurred before the first year of diagnosis of diabetes mellitus. Patients under a intensive regime had a greater percentage of episodes of severe hypoglycemia than those under a conventional regime. The metabolic control not influenced in occurrence of severe hypoglycemia episodes. CONCLUSIONS: the above mentioned episodes had a high frequency with predominance of the severe ones during the dawn and with more involvement in the group aged under 5 being a neurodevelopmental affection of development in this age group.

  7. A 12 year chart review of childhood and adolescent onset psychosis ...

    African Journals Online (AJOL)

    Objectives: To review the profile of children and adolescents presenting with psychosis at a specialist mental health facility, and to compare childhood with adolescent onset psychosis. Method: Hospital records of all children and adolescents over a 12-year period (1999–2010) were perused to identify those falling under the ...

  8. Adolescent Idiopathic Scoliosis (United States)

    ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Common Questions & Glossary Resources ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Juvenile Idiopathic Scoliosis Diagnosed ...

  9. A patient with autism and severe depression: medical and ethical challenges for an adolescent medicine unit. (United States)

    Skinner, S Rachel; Ng, Cindy; McDonald, Ann; Walters, Tamara


    An adolescent with autism and intellectual disability presented with severe depression related to menstruation. Because of the complex medical, psychiatric and ethical issues involved, her care was coordinated by a hospital-based adolescent medicine unit. After trials of other therapies over an extended period and interdisciplinary and intersectoral case conferencing, it was decided that hysterectomy was the most appropriate management. This case highlights the complexity of adolescent health care in a tertiary hospital, the importance of intersectoral cooperation between hospital and community, and the integral role of interdisciplinary care of adolescent patients with chronic conditions.

  10. Substance use in adolescents with mental illness in Durban, South ...

    African Journals Online (AJOL)

    Comorbid substance use in adolescents with mental illness is often an indicator of poor treatment outcome. This study aims to determine the prevalence of, and associated risk factors for, substance use in adolescents with mental illness attending a mental health service. Data was collected from hospital records of 162 ...

  11. Brain germinoma presenting as a first psychotic episode in an adolescent male



    Brain germinoma presenting as a first psychotic episode in an adolescent male phone: +34-93-2275477 (Undurraga, Juan) (Undurraga, Juan) Department of Psychiatry, Institute of Neuroscience, Hospital Clinic de Barcelona - Servicio de Psiquiatria (Escalera 9, Planta 6), Calle Villarroel, 170 - 08036 - Barcelona - SPAIN (Undurraga, Juan) Department of Child and Adolescent Psychology and Psychiatry, Institute of Neuroscience, Hospital Clinic de Barcelona - Barc...

  12. Care of adolescents sheltered in maternity hospitals from the perspective of health professionals Asistencia a las adolescentes albergadas en una maternidad bajo la óptica de profesionales de salud Assistência às adolescentes abrigadas em maternidade sob a ótica de profissionais de saúde

    Directory of Open Access Journals (Sweden)

    Lucia Helena Garcia Penna


    Full Text Available OBJECTIVE: Discuss determinant aspects of quality care of pregnant adolescents sheltered in a maternity hospital, according to the perspective of health professionals. METHODS: Study with a qualitative, exploratory approach, conducted in a maternity hospital in the Municipality of Rio de Janeiro - RJ, reference for sheltered youngsters. The subjects of the study were 14 health professionals. The data were treated according to the Content Analysis technique. RESULTS: Two categories of analysis emerged: Characteristics of care provided by health professionals at the maternity hospital directed towards the sheltered adolescent mother and her child; Characteristics of the organization/structure of the maternity hospital that affected the care of the sheltered pregnant adolescents. CONCLUSION: It is necessary to incorporate the guiding practices of integrality/interdisciplinarity into the service. The stigmatization of these youngsters is one of the greatest challenges to full assistance and care. The maternity hospital space is a rich environment for the nurse-adolescent dialogic process.OBJETIVO: Discutir aspectos determinantes de una asistencia de calidad a adolescentes embarazadas, albergadas en una maternidad, conforme la óptica de profesionales de salud. MÉTODOS: Estudio de abordaje cualitativo, exploratorio, realizado en una maternidad del Municipio de Rio de Janeiro - RJ, referencia para jóvenes albergadas. Los sujetos del estudio fueron 14 profesionales del equipo de salud. Los datos fueron tratados, conforme a la técnica del análisis de contenido. RESULTADOS: Emergieron del análisis dos categorías: Características de la atención de los profesionales de salud de la maternidad direccionadas a la madre adolescente albergada y su hijo; Características de la organización/estructura de la maternidad que afectan la atención a las adolescentes albergadas embarazadas. CONCLUSIÓN: Se hace necesario incorporar las prácticas norteadoras

  13. Academic Hospitality (United States)

    Phipps, Alison; Barnett, Ronald


    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  14. Adolescent Gynecomastia. (United States)

    Guss, Carly E; Divasta, Amy D


    Gynecomastia, defined as the presence of glandular breast tissue in men, is a common, typically benign physical exam finding during adolescence. Although the exact pathogenesis of gynecomastia is unknown, it is likely due to a hormonal imbalance between estrogens and androgens. Most cases are idiopathic and do not require further evaluation if the history and physical examination are reassuring. Although the majority of cases will resolve spontaneously, surgical correction may be an option for adolescents with persistent and problematic gynecomastia. Gynecomastia can have significant negative impact on one's self-esteem, and it is crucial that primary care providers screen adolescents with gynecomastia for mental health concerns. Future studies are necessary to elucidate the true incidence and prevalence of gynecomastia in adolescent males, and to further investigate the short-term and long-term physical and emotional effects of gynecomastia. Copyright© of YS Medical Media ltd.

  15. Management of migraine in adolescents

    Directory of Open Access Journals (Sweden)

    Marielle A Kabbouche


    Full Text Available Marielle A Kabbouche1,2, Deborah K Gilman31Department of Pediatrics, Department of 2Neurology, Cincinnati Children’s Hospital Medical Center; 3Department of Psychology, Columbus Children’s Hospital, OH, USAAbstract: Headaches in children and adolescents are still under-diagnosed. 75% of children are affected by primary headache by the age of 15 with 28% fitting the ICHD2 criteria of migraine. Migraine is considered a chronic disorder that can severely impact a child’s daily activities, including schooling and socializing. Early recognition and aggressive therapy, with acute and prophylactic treatments, as well as intensive biobehavioral interventions, are essential to control the migraine attacks and reverse the progression into intractable disabling headache.Keywords: migraine, children, adolescents, headache, biofeedback

  16. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn


    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  17. Parental monitoring protects against the effects of parent and adolescent depressed mood on adolescent drinking. (United States)

    Kelly, Lourah M; Becker, Sara J; Spirito, Anthony


    Parental monitoring is a well-established protective factor for adolescent drinking. This study examined whether parental monitoring protected against three common risk factors for alcohol use in a sample of high-risk adolescents: parental depressed mood, adolescent depressed mood, and parental alcohol use. Participants included 117 adolescents (mean age=15.5; 52% female) who presented to the hospital emergency department due to an alcohol-related event and their primary parent/guardian. Adolescents completed self-report measures of alcohol use frequency, depressed mood, and parental monitoring, while parents completed self-report measures of problematic alcohol use and depressed mood. Hierarchical regression confirmed that parental monitoring was associated with lower frequency of adolescent alcohol use, even after controlling for the three risk factors. Significant interactions were found between parental monitoring and both adolescent and parental depressed mood. Parental monitoring had significant protective effects against drinking frequency among adolescents with higher levels of depressed mood, but not among adolescents with lower levels of depressed mood. By contrast, parental monitoring only had protective effects among those parents with lower levels of depressed mood. Parental problematic alcohol use did not affect the relationship between parental monitoring and adolescent alcohol use. Our results suggest that adolescents with high levels of depressed mood may be more likely to benefit from parental monitoring, whereas parents with high levels of depressed mood may be less likely to monitor effectively. Interventions targeting parental monitoring in high-risk adolescents should take into account the influence of both adolescent and parental depressed mood. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Adolescent Pregnancy Guidelines. (United States)

    Fleming, Nathalie; O'Driscoll, Teresa; Becker, Gisela; Spitzer, Rachel F


    and postpartum, and more frequently if deemed necessary, is one option for such screening. (II-2A) 10. Pregnant adolescents should have a nutritional assessment, vitamins and food supplementation if needed, and access to a strategy to reduce anemia and low birth weight and to optimize weight gain in pregnancy. (II-2A) 11. Conflicting evidence supports and refutes differences in gestational hypertension in the adolescent population; therefore, the care usual for adult populations is supported for pregnant adolescents at this time. (II-2A) 12. Practitioners should consult gestational diabetes mellitus (GDM) guidelines. In theory, testing all patients is appropriate, although rates of GDM are generally lower in adolescent populations. Practitioners should be aware, however, that certain ethnic groups including Aboriginal populations are at high risk of GDM. (II-2A) 13. An ultrasound anatomical assessment at 16 to 20 weeks is recommended because of increased rates of congenital anomalies in this population. (II-2A) 14. As in other populations at risk of intrauterine growth restriction (IUGR) and low birth weight, an ultrasound to assess fetal well-being and estimated fetal weight at 32 to 34 weeks gestational age is suggested to screen for IUGR. (III-A) 15. Visits in the second or third trimester should be more frequent to address the increased risk of preterm labour and preterm birth and to assess fetal well-being. All caregivers should be aware of the signs and symptoms of preterm labour and should educate their patients to recognize them. (III-A) 16. It should be recognized that adolescents have improved vaginal delivery rates and a concomitantly lower Caesarean section rate than their adult counterparts. (II-2A) As with antenatal care, peripartum care in hospital should be multidisciplinary, involving social care, support for breastfeeding and lactation, and the involvement of children's aid services when warranted. (III-B) 17. Postpartum care should include a focus

  19. Neurotic manifestations in adolescents with thalassemia major. (United States)

    Moorjani, J D; Issac, Chithira


    To study the neurotic manifestations in thalassemic adolescents as a consequence of long-term illness. From July 2003, thirty six thalassemic adolescents and forty normal adolescents were selected with age ranging from 13 to 18 and with same socio economic status and family background. Middlesex Hospital Questionnaire by Crown and Crisp [1966] was administered and Mann Whiteny 'U' test was employed to measure free-floating anxiety, phobia, somatic anxiety, obsession, depression, hysteria and total neuroticism score. An interview was conducted along with the questionnaire to detect the problems in depth. Parents of thalassemic adolescents were interviewed subsequently to realize the behavioral problems existing along with neuroticism. Thirty-six of thalassemic and all forty normal adolescents returned the questionnaires. The responses suggest a marked difference in total neuroticism score and all other variables except that of hysteria. The interview on parents of thalassemic adolescents exposed various behavioral problems in these adolescents. Thalassemic adolescents were having higher scores in neuroticism. Some behavioral problems are also found to exist along with neurotic manifestations. There remains a need to improve the management of thalassemia in terms of psychological aspects in order to improve the mental health of this group.

  20. Hospital Malnutrition


    Asumadu-Sarkodie, Samuel


    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  1. An adolescent ward; 'in name only?'. (United States)

    Hutton, Alison


    The aim of the study was to explore how an adolescent ward was used by the two main users, nurses and adolescents, on a purpose-built adolescent ward. In Australia, caring for the adolescent is part of paediatric nursing and many Australian hospitals boast of 'adolescent-only facilities'. These wards are established on the premise that adolescent patients are a 'special' group deserving their own ward space. With the development of adolescent wards, set ideals around what this type of environment provides have also arisen. These ideals are increased privacy and independence for the patient, a chance for peer interaction, to be nursed by specially trained staff and to provide opportunities for adolescent patients to participate in their own care. This study used ethnography to gain a perspective of how ward space was used. Data were collected using participant observation and formal and informal interviews. Data were then analysed using the works of Lefebvre and Foucault. This study found that patient allocation, nursing observation and patient labels impact on how adolescent patients are nursed. Patients are expected to fit in, accepting all ministrations of nursing and staff. On this ward, nursing work was paramount. Nurses treated the adolescent patient like any other. In saying this, the adolescent patient still found ways to adapt to the ward space and its rules and routines; so in this sense, the ward still worked for them, even if nursing work was paramount. This study contributes to current discourse on the formation of specialized facilities in general, as it shows that no matter how a ward space is set up, if the space is not used in that way, then the purported purpose of that ward space will be lost.

  2. [Nonnative guidelines for allocating human resources in child and adolescent psychiatry using average values under convergence conditions instead of price determination - analysis of the data of university hospitals in Germany concerning the costs of calculating day and minute values according to Psych-PV and PEPP-System]. (United States)

    Barufka, Steffi; Heller, Michael; Prayon, Valeria; Fegert, Jörg M


    Despite substantial opposition in the practical field, based on an amendment to the Hospital Financing Act (KHG). the so-called PEPP-System was introduced in child and adolescent psychiatry as a new calculation model. The 2-year moratorium, combined with the rescheduling of the repeal of the psychiatry personnel regulation (Psych-PV) and a convergence phase, provided the German Federal Ministry of Health with additional time to enter a structured dialogue with professional associations. Especially the perspective concerning the regulatory framework is presently unclear. In light of this debate, this article provides calculations to illustrate the transformation of the previous personnel regulation into the PEPP-System by means of the data of §21 KHEntgG stemming from the 22 university hospitals of child and adolescent psychiatry and psychotherapy in Germany. In 2013 there was a total of 7,712 cases and 263,694 calculation days. In order to identify a necessary basic reimbursement value th1\\t would guarantee a constant quality of patient care, the authors utilize outcomes, cost structures, calculation days, and minute values for individual professional groups according to both systems (Psych-PV and PEPP) based on data from 2013 and the InEK' s analysis of the calculation datasets. The authors propose a normative agreement on the basic reimbursement value between 270 and 285 EUR. This takes into account the concentration phenomenon and the expansion of services that has occurred since the introduction of the Psych-PV system. Such a normative agreement on structural quality could provide a verifiable framework for the allocation of human resources corresponding to the previous regulations of Psych-PV.

  3. Sleep and its importance in adolescence and in common adolescent somatic and psychiatric conditions

    Directory of Open Access Journals (Sweden)



    Full Text Available Serge Brand1, Roumen Kirov21Depression and Sleep Research Unit, Psychiatric Hospital of the University of Basel, Basel, Switzerland; 2Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, BulgariaThe authors contributed equally to this workAbstract: Restoring sleep is strongly associated with a better physical, cognitive, and psychological well-being. By contrast, poor or disordered sleep is related to impairment of cognitive and psychological functioning and worsened physical health. These associations are well documented not only in adults but also in children and adolescents. Importantly, adolescence is hallmarked by dramatic maturational changes in sleep and its neurobiological regulation, hormonal status, and many psychosocial and physical processes. Thus, the role of sleep in mental and physical health during adolescence and in adolescent patients is complex. However, it has so far received little attention. This review first presents contemporary views about the complex neurobiology of sleep and its functions with important implications for adolescence. Second, existing complex relationships between common adolescent somatic/organic, sleep-related, and psychiatric disorders and certain sleep alterations are discussed. It is concluded that poor or altered sleep in adolescent patients may trigger and maintain many psychiatric and physical disorders or combinations of these conditions, which presumably hinder recovery and may cross into later stages of life. Therefore, timely diagnosis and management of sleep problems appear critical for growth and development in adolescent patients.Keywords: cognitive, psychological, neurobiology, growth, development, sleep physiology, rapid eye movement, non-REM sleep, behavioral disorders, adolescents

  4. Adolescent Onset Psychosis: A 2-year retrospective study of adolescents admitted to a general psychiatric unit

    Directory of Open Access Journals (Sweden)

    S Paruk


    Full Text Available Background:KwaZulu-Natal had no dedicated in-patient adolescent psychiatric service during the study period and adolescents were admitted to general psychiatric wards. Aim of Study: This is a descriptive review of adolescents admitted with psychotic symptoms to a psychiatric hospital. It aims to describe their demographic profile, associated risk factors, clinical profile and management strategies utilized. Method: The files of all adolescent patients with psychotic symptoms, aged twelve to eighteen years old, admitted to a psychiatric hospital from July 2005 to June 2007 were reviewed. Results: 70 adolescents with psychosis were admitted to adult psychiatric wards over the 2 year period. The age range was 13 to 18 years old. 80% of the adolescent patients were male, 37% reported a positive family history of mental illness, 50% smoked nicotine and 61.4% reported cannabis use. The most common diagnoses were schizophrenia (30% and schizophreniform disorder (27.1%. 85.5%(60 of adolescent patients had a trial on a first generation antipsychotic and 10 patients were initiated on a second generation antipsychotic de- novo. The average length of stay in hospital was 27.8 days. 40% defaulted follow up post discharge. Conclusion: Schizophrenia was the most common diagnosis. There were high rates of cannabis use. The adolescents were managed in psychiatric wards for significant periods and the majority of patients were initiated on first-generation antipsychotics. There is a need to develop specialized inpatient adolescent psychiatric facilities and services, as well as to address the issues of co-morbid substance use and non-adherence to treatment.

  5. Punishing adolescents

    DEFF Research Database (Denmark)

    Ryberg, Jesper


    Should an adolescent offender be punished more leniently than an adult offender? Many theorists believe the answer to be in the affirmative. According to the diminished culpability model, adolescents are less mature than adults and, therefore, less responsible for their wrongdoings and should...... consequently be punished less harshly. This article concerns the first part of the model: the relation between immaturity and diminished responsibility. It is argued that this relation faces three normative challenges which do not allow for easy answers and which are still widely ignored in the comprehensive...

  6. Contraceptive counseling for adolescents. (United States)

    Potter, Julia; Santelli, John S


    The majority of adolescents become sexually active during their teenage years, making contraceptive counseling an important aspect of routine adolescent healthcare. However, many healthcare providers express discomfort when it comes to counseling adolescents about contraceptive options. This Special Report highlights the evidence supporting age-appropriate contraceptive counseling for adolescents and focuses on best practices for addressing adolescents' questions and concerns about contraceptive methods.

  7. Cushing's syndrome in children and adolescents

    DEFF Research Database (Denmark)

    Holst, Johanne Marie; Horváth-Puhó, Erzsebet; Jensen, Rikke Bodin Beck


    OBJECTIVE: Cushing's syndrome (CS) affects all age groups, but epidemiologic data in young patients are very limited. We therefore examined the incidence, prevalence and hospital morbidity of CS in children and adolescents. DESIGN: In a nationwide cohort study, we included all Danish citizens aged...

  8. Adolescents and Young Adults with Cancer (United States)

    ... a Doctor and Hospital View this video on YouTube. Experts in the field of adolescent and young adult (AYA) cancers and cancer survivors answer the ... trials. Fertility Preservation Options View this video on YouTube. ... on fertility is a special concern for young cancer patients. It is important to talk with ...

  9. OROS Methylphenidate in Adolescents with ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The efficacy and tolerability of osmotic-release oral system (OROS methylphenidate in adolescents with attention deficit hyperactivity disorder (ADHD were evaluated in a multisite controlled study at the Massachusetts General Hospital, Boston, and other centers in the United States.

  10. Pediatric inpatient hospital resource use for congenital heart defects. (United States)

    Simeone, Regina M; Oster, Matthew E; Cassell, Cynthia H; Armour, Brian S; Gray, Darryl T; Honein, Margaret A


    Congenital heart defects (CHDs) occur in approximately 8 per 1000 live births. Improvements in detection and treatment have increased survival. Few national estimates of the healthcare costs for infants, children and adolescents with CHDs are available. We estimated hospital costs for hospitalizations using pediatric (0-20 years) hospital discharge data from the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) for hospitalizations with CHD diagnoses. Estimates were up-weighted to be nationally representative. Mean costs were compared by demographic factors and presence of critical CHDs (CCHDs). Up-weighting of the KID generated an estimated 4,461,615 pediatric hospitalizations nationwide, excluding normal newborn births. The 163,980 (3.7%) pediatric hospitalizations with CHDs accounted for approximately $5.6 billion in hospital costs, representing 15.1% of costs for all pediatric hospitalizations in 2009. Approximately 17% of CHD hospitalizations had a CCHD, but it varied by age: approximately 14% of hospitalizations of infants, 30% of hospitalizations of patients aged 1 to 10 years, and 25% of hospitalizations of patients aged 11 to 20 years. Mean costs of CHD hospitalizations were higher in infancy ($36,601) than at older ages and were higher for hospitalizations with a CCHD diagnosis ($52,899). Hospitalizations with CCHDs accounted for 26.7% of all costs for CHD hospitalizations, with hypoplastic left heart syndrome, coarctation of the aorta, and tetralogy of Fallot having the highest total costs. Hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with CCHD diagnoses accounted for 27% of CHD hospital costs. © 2014 Wiley Periodicals, Inc.

  11. Adolescent homosexuality. (United States)

    Stronski Huwiler, S M; Remafedi, G


    Homosexuality has existed in all civilizations, but societal disapproval and cultural taboos have negatively influenced its recognition. A significant percentage of youths identify themselves as homosexual, and even more experience sex with the same sex or are confused about sexual feelings. A unifying etiological theory attributes the expression of sexual orientation to genes that shape the central nervous system's development, organization, and structure via prenatal sex steroids. Environmental factors may influence the expression of genetic potential. Several models of psychosocial development describe initial stages of awareness and confusion about same-sex attractions, followed by acknowledgement of homosexuality, disclosure to others, and eventual integration of sexual identity into a comprehensive sense of self. Stressors related to isolation, stigma, and violence may predispose homosexual adolescents to impaired social, emotional, and physical health, resulting in depression and suicide, school problems, substance abuse, running away eating disorders, risky sexual behavior, and illegal conduct. As with all adolescents, the overall goals in the care of homosexual youth are to promote normal adolescent development, social and emotional well-being, and physical health. A comprehensive, multidisciplinary approach is required to address medical, mental health, and psychosocial issues within the context of the adolescents' community and culture.

  12. [Adolescent sexuality]. (United States)

    Calero, Juan del Rey


    The social Adolescent features are insecurity, narcissism, eroticism, more impetuosity than reason. 1/3 of adolescents have risk behaviour for health. The pregnancy rate in adolescent are 9/1,000 (11,720, the abort about 50 %). The total abort (2009) were 114,480. Increase the rate of 8,4 (1990) to 14,6/ 1,000 (2009). The sexual education fails. The consulting about contraceptives get pregnancy of the OR 3,2, condom OR 2,7. The adolescent are influenced in his matter: oeer have 70-75 % of influence, mother 30-40 %, father 15 %, for yhe environment and education Cyberspace access to information: 33 % exposed to unwanted sexual materials, 1 in 7 solicited sexual online. The argument have 4 central topic: Morality and Responsibility, Desire (responsibility vs gratification), Danger (fear related to pregnancy and STD/VIH), and Victimization. The prevention of STD: so called safe sex, delayed, and abstinence, Prevention HPV vaccine. The information is not enough, are necessary personal integral formation in values as self control, abstinence, mutual respect, responsibility, reasonable decisions.

  13. Transition in adolescents across time, disease and gender

    DEFF Research Database (Denmark)

    Aagaard, Hanne; Ludvigsen, Mette Spliid; Svanholm, Jette Rolf

    interview with the adolescent at outpatient clinics at Aarhus University Hospital. Follow-up is planned at 15 and 18 years of age. A comparative approach is employed to show central characteristics across time, disease and gender. Results: Results from analysis inspired by Ricoeur's phenomenological......Background: Despite a growing number of studies on transition to adulthood in adolescents, literature is scarce on qualitative, longitudinal studies of transitions in adolescents with severe chronic diseases. The aim is to study transition in adolescents with cystic fibrosis, congenital heart...... diseases and chronic kidney diseases. We specifically focus on the adolescents’ experiences, 'what is important to them', 'what characterises their interaction with health care staff' and 'the communication between the adolescents and health care staff as perceived by the adolescents'. Methods...

  14. Injuries across adolescence: an investigation using the extended adolescent injury checklist (E-AIC). (United States)

    Chapman, Rebekah; Buckley, Lisa; Sheehan, Mary


    Injuries are the leading cause of death among adolescents. The current research examined a measure of adolescent injury in terms of whether it encompasses the diverse injury experiences of Australian adolescents, including high-risk and normative adolescents, and thus determine its utility as a tool for health promotion research. Grade 9 students from two Brisbane high schools (n=202, aged 13-14 years) and adolescents recruited from the Emergency Department waiting rooms of four Brisbane hospitals (n=98, aged 16-18 years) completed the Extended Adolescent Injury Checklist (E-AIC). The most common cause of injury among adolescents was a sports activity, followed by fights for all participants except school-based males, who experienced more bicycle injuries. Alcohol use was most frequently reported in association with interpersonal violence injuries. A broad variety of injuries, occurring in context of multiple risk as well as normative behaviours, were reported by adolescents in both school and ED settings, and were captured by the E-AIC.

  15. Gender and Disorder Specific Criminal Career Profiles in Former Adolescent Psychiatric In-Patients. (United States)

    Kjelsberg, Ellen


    A Norwegian nation-wide sample of 1087 former adolescent psychiatric in-patients, 584 males and 503 females, were followed up 15-33 years after first hospitalization. On the basis of detailed hospital records from index hospitalization all were rediagnosed according to DSM-IV. The patient list was linked to the national criminal register and the…

  16. Risk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia. (United States)

    Borschmann, Rohan; Stark, Patrick; Prakash, Chidambaram; Sawyer, Susan M


    Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm; adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour. We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia. Routinely collected data were used to generate a risk profile. We found that 212 of 271 (78.2%) admissions were due to suicidal behaviour. Of these, 107 (51%) adolescents were diagnosed with one or more mental disorders at discharge, most commonly major depressive disorder. Beyond known distal determinants of health risk, the proximal risk profile of these adolescents included factors relating to gender, substance use, prior mental health diagnoses and prior admission to hospital. Poor sleep was also a risk factor, with 159 (75%) reporting a recent history of sleeping problems. The very high proportion of admissions to the mental health inpatient unit due to suicidal behaviour reinforces the importance of finding effective methods of identification of the risk processes underpinning suicidal behaviours to reduce the unnecessary waste of young lives by suicide. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  17. 6-Month Trajectory of Suicidal Ideation in Adolescents with Borderline Personality Disorder (United States)

    Selby, Edward A.; Yen, Shirley


    Few studies have longitudinally examined suicidal ideation in those with adolescent-onset BPD. The current study aimed to examine the trajectory of suicidal ideation in adolescents with BPD longitudinally over six months, with follow-ups at 2, 4, and 6 months post-hospitalization for elevated suicide risk. Resulted indicated that the BPD group exhibited a greater decrease in suicidal ideation in the months following hospitalization than those without a BPD diagnosis. The findings of this study indicated that suicidal ideation in adolescents with BPD is not stable, and although ideation may decrease quickly after hospitalization, regular assessment of ideation is recommended. PMID:24112120

  18. Distinctions of bipolar disorder symptoms in adolescence. (United States)

    Gudiene, Devika; Leskauskas, Darius; Markeviciūte, Aurelija; Klimavicius, Dalius; Adomaitiene, Virginija


    Bipolar disorder in adolescents is a serious mental illness with problematic diagnosis that adversely affects social, academic, emotional, and family functioning. The objective of this study was to analyze features of premorbid and clinical symptoms, comorbidity, and course of bipolar disorder in adolescence. Data for analysis were collected from all case histories (N=6) of 14-18-year-old patients, hospitalized with diagnosis of bipolar disorder in the Unit of Children's and Adolescents' Psychiatry, Department of Psychiatry, Hospital of Kaunas University of Medicine, during the period from 2000 to 2005. Analysis of bipolar disorder course showed that five patients previously had been diagnosed with an episode of depression. The most frequent symptoms typical to bipolar disorder were disobedience and impulsive behavior, rapid changes of mood. The most common premorbid features were frequent changes of mood, being active in communication, hyperactive behavior. Adolescence-onset bipolar disorder was frequently comorbid with emotionally instable personality disorder, borderline type. Findings of the study confirm the notion that oppositional or impulsive behavior, rapid changes of mood without any reason, dysphoric mood and euphoric mood episodes with increased energy were cardinal symptoms of bipolar disorder with mania in adolescents. Most frequent premorbid features of these patients were quite similar to attention-deficit/hyperactivity disorder making differential diagnosis problematic.

  19. Hospital Outpatient PPS Partial Hospitalization Program LDS (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  20. Can hospitals compete on quality? Hospital competition. (United States)

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W


    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

  1. Health and School Performance among Danish adolescents

    DEFF Research Database (Denmark)

    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......This study examines the impact of a wide range of health measures on school performance at the end of compulsory school (9 years of school). The key questions raised are whether different health problems lowers school performance contributing to a health selection process that could lead to lower...... health and school performance....

  2. [Burns in adolescents]. (United States)

    Ortiz Rodríguez, R; Domínguez Amillo, E; Soto Beauregard, C; Díaz González, M; López Gutiérrez, J C; Ros Mar, Z; Tovar Larrucea, J A


    The aim of this study was to know the epidemiology of burns in teenagers. Burn patients over 11 years old admitted in our Institution in the last 10 years were included. Etiology, burn size, hospital stay, quirurgical interventions and long term sequelae were registered. One thousand and eight patients were admitted, 89 were over 11 years (8.8%), 70.7% were boys and 29.3% girls. Fire was the principal agent in 58 cases (65.1%), due to fireworks in 13 (22.4%), alcohol in 7 (12%), explosion of flammable containers (spray) in 4 (6.8%) and gasoline in 3 (5.2%). Fireworks injuries and spray explosions affected face and hand in 88% cases. The median hospital stay was 8 days after admission (1 to 90). 83.1% required surgical treatment with mean of 1.8 +/- 1.4 interventions and 21.3% had long-term sequelaes that required at least one surgical intervention. Fire is the main cause of burns in adolescents. Fireworks injuries represented a quarter of that lesions, and highlights paint spray explosions as new causative agents. Considering the high morbidity in this age group, with permanent functional and aesthetic sequelae, prevention campaigns are needed to reduce such accidents.

  3. Dimensions of Adolescent Employment. (United States)

    Mael, Fred A.; Morath, Ray A.; McLellan, Jeffrey A.


    Examines positive and negative correlates of adolescent work as a function of work dimensions. Results indicate that concurrent costs and benefits of adolescent employment may depend on dimensions of work as well as adolescent characteristics. Adolescent employment was generally related to subsequent work motivation and nonacademic performance.…

  4. Spirituality in adolescent patients. (United States)

    Weaver, Meaghann S; Wratchford, Dale


    Adolescence, the transition between childhood and adulthood, represents a time of rapid biological, neurocognitive, and psychosocial changes. These changes have important implications for the development and evolution of adolescent spirituality, particularly for adolescents with chronic or life-limiting illnesses. To contribute positively to adolescent spiritual formation, palliative care teams benefit from understanding the normative changes expected to occur during adolescence. This paper provides a narrative review of adolescent spirituality while recognizing the role of religious, familial, and cultural influences on spiritual development during the teenage years. By giving explicit attention to the contextual norms surrounding adolescence and still recognizing each adolescent-aged patient as unique, palliative care teams can help adolescents transition toward meaningful and sustainable spiritual growth. This paper reviews the clinical and research implications relevant to integrating adolescent spiritual health as part of comprehensive palliative care.

  5. Help prevent hospital errors (United States)

    ... this page: // Help prevent hospital errors To use the sharing features ... in the hospital. If You Are Having Surgery, Help Keep Yourself Safe Go to a hospital you ...

  6. Family therapy for adolescents with functional somatic symptoms: A systemic narrative approach on a biopsychosocial foundation

    DEFF Research Database (Denmark)

    Dehlholm-Lambertsen, Birgitte; Hulgaard, Ditte Roth

    -established collaboration with the Pediatric department, University Hospital of Southern Denmark. The treatment is based on a biopsychosocial understanding combined with family therapy with elements of systemic and narrative theories. Objective: • Presentation of the family therapy approach used in the department of Child...... and Adolescent Psychiatry, University Hospital of Southern Denmark. • Discussion of different approaches to family therapy for adolescents with functional somatic symptoms • Discussion of challenges and advantages of a systemic narrative approach to families of adolescents with functional somatic symptoms....... evidence on the effect of psychological treatment. At the department of Child and Adolescent Psychiatry, University Hospital of Southern Denmark, a team of experienced therapists has developed an approach for the treatment of adolescents with FSS. This approach includes a formalized and well...

  7. Development of Adolescent Relationships


    de Goede, I.H.A.


    This dissertation on “Development of Adolescent Relationships” addresses relationships with parents, friends, and romantic partners in adolescence from a developmental perspective. By studying both parent-adolescent relationships and peer relationships at the same time, as well as interrelations between these types of relationships, this dissertation provides more information on the processes taking place in relationships during adolescence. Findings indicate that parent-adolescent relationsh...

  8. Adolescent deliveries in semi-urban Cameroon: prevalence and adverse neonatal outcomes. (United States)

    Njim, Tsi; Agbor, Valirie Ndip


    Adolescent pregnancies are high risk due to the increased probability of adverse outcomes; as adolescents are usually considered to be ill-equipped to deal with the burden of pregnancy. We sought to determine the prevalence of adolescent deliveries in a secondary-level care hospital in semi-urban Cameroon-Bamenda, the adverse neonatal outcomes and to assess if previous obstetric history could preclude adolescents from having adverse outcomes in their present pregnancy. The prevalence of adolescent deliveries was 8.7% (95% CI 7.01-10.73%). The neonates of adolescent mothers were more likely to have severe asphyxia (OR 4.0; 95% CI 1.2-12.9; p = 0.03) and low birth weight (OR 2.4; 95% CI 1.3-4.4; p adolescents were just as likely to have complications as multipara adolescents. The prevalence of adolescent deliveries (8.7%) in the Regional Hospital Bamenda is high. Their babies are at a high risk of adverse neonatal outcomes irrespective of their previous obstetric history (previous delivery) emphasising that adolescents are generally ill-prepared to deal with pregnancy. Strategies to reduce the prevalence of adolescent deliveries should be investigated and implemented in view of attaining the sustainable development goals.

  9. Gender differences in comorbidity of conduct disorder among adolescents in Northern Finland


    Ilomaki, Essi; Hakko, Helina; Ilomaki, Risto; Rasanen, Pirkko; STUDY-70 Workgrp; Marttunen, Mauri


    Objectives: Conduct disorder (CD) refers to a pattern of severe antisocial and aggressive behaviour manifested in childhood or adolescence, with heavy costs to society. Though CD is a common psychiatric diagnosis among adolescents of both genders, gender differences in comorbidity of CD have been little studied. In this study we examined gender differences among adolescents with CD in causes for hospitalization, comorbid psychiatric diagnoses and somatic conditions. Study design: The original...

  10. Family risk factors associated with adolescent pregnancy: study of a group of adolescent girls and their families in Ecuador. (United States)

    Guijarro, S; Naranjo, J; Padilla, M; Gutiérez, R; Lammers, C; Blum, R W


    To identify characteristics within the family that were associated with adolescent pregnancy in a group of adolescent girls in Quito, Ecuador. Of 135 female adolescents (12-19 years of age), 47 were pregnant and seen at the adolescent prenatal care clinic at an inner city hospital in Quito, and 88 were students from schools located within the same geographic area. Family variables were compared for pregnant and nonpregnant adolescents using chi-square, Student's t-test, and analysis of variance. More nonpregnant adolescents lived with their biological parents when compared with their pregnant peers (p problems in or outside the family (p Parental education was lower in the families of pregnant adolescents (p parents worked outside the home (p parental separation or divorce, and poor parent-daughter communication were associated with adolescent pregnancy. Families of nonpregnant adolescents had a higher educational level, and both parents worked to provide financial support to the family in an environment where family authority is shared by both parents. There were also better problem-solving strategies and parent-daughter communication, higher levels of cohesion, connectedness, and life satisfaction in general, and higher future expectations.

  11. Treatment of Co-Occurring Substance Abuse and Suicidality among Adolescents: A Randomized Trial (United States)

    Esposito-Smythers, Christianne; Spirito, Anthony; Kahler, Christopher W.; Hunt, Jeffrey; Monti, Peter


    Objective: This study tested a cognitive-behavioral treatment protocol for adolescents with a co-occurring alcohol or other drug use disorder (AOD) and suicidality in a randomized clinical trial. Method: Forty adolescents (M[subscript age] = 15 years; 68% female, 89% White) and their families recruited from an inpatient psychiatric hospital were…

  12. Innovative Adolescent Chemical Dependency Treatment and Its Outcome: A Model Based on Outward Bound Programming. (United States)

    McPeake, John D.; And Others


    Describes adolescent chemical dependency treatment model developed at Beech Hill Hospital (New Hampshire) which integrated Twelve Step-oriented alcohol and drug rehabilitation program with experiential education school, Hurricane Island Outward Bound School. Describes Beech Hill Hurricane Island Outward Bound School Adolescent Chemical Dependency…

  13. Reactions to Hill End Adolescent Unit: Interviews with 20 Ex-Patients. (United States)

    Stuart-Smith, Sue


    Interviewed 20 adolescents recently discharged from Hill End Adolescent Unit. Over one-half of sample described some benefit, most notably from drama therapy, family therapy, and peer group support. Areas of difficulty included objections to video recording and one-way mirrors; dislike of being on grounds of psychiatric hospital; inadequate…

  14. Compliance with the Legislation on Alcohol Serving and Selling and Alcohol Intoxications in Adolescents

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; Boeynaems, Gerben; van der Lely, Nicolaas


    Purpose: study the relation between compliance to the legal age limits for alcohol sales and alcohol intoxication in adolescents. Methods: from 2007 till 2012 we collected data on adolescents, with a positive BAC, treated in a hospital. Within the Dutch Pediatric Surveillance System (NSCK),

  15. Development of hypertension in overweight adolescents: a review

    Directory of Open Access Journals (Sweden)

    Kelly RK


    Full Text Available Rebecca K Kelly,1 Costan G Magnussen,1,2 Matthew A Sabin,3 Michael Cheung,3 Markus Juonala3–5 1Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; 2Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; 3Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Parkville, Australia; 4Department of Medicine, University of Turku, 5Division of Medicine, Turku University Hospital, Turku, Finland Abstract: The upward trend in adolescent hypertension is widely attributed to the adolescent obesity epidemic. Secular trends in adolescent prehypertension and hypertension have risen in congruence with increasing trends in the prevalence of overweight and obesity. The correlation between body mass index and blood pressure in adolescence is moderate to strong in most studies and strongest in those classified as overweight or obese. The mechanisms relating to the development of hypertension in overweight adolescents are unclear; however, a number of nonmodifiable and modifiable factors have been implicated. Importantly, certain clinical and biochemical markers in overweight adolescents are indicative of high risk for hypertension, including family history of hypertension and hyperinsulinemia. These characteristics may prove useful in stratifying overweight adolescents as high or low risk of comorbid hypertension. The treatment of overweight and obesity related hypertension in this population focuses on two key modalities: lifestyle change and pharmacotherapy. These approaches focus almost exclusively on weight reduction; however, a number of emerging strategies target hypertension more specifically. Among adolescents with overt hypertension there are also several factors that indicate higher risk of concurrent subclinical disease, persistent adult hypertension, and adult cardiovascular disease. This group may benefit substantially from more

  16. Pediatric chronic patients at outpatient clinics: a study in a Latin American University Hospital. (United States)

    Alveno, Renata A; Miranda, Caroline V; Passone, Caroline G; Waetge, Aurora R; Hojo, Elza S; Farhat, Sylvia C L; Odone-Filho, Vicente; Tannuri, Uenis; Carvalho, Werther B; Carneiro-Sampaio, Magda; Silva, Clovis A


    To describe the characteristics of children and adolescentes with chronic diseases of outpatient clinics at a tertiary university hospital. A cross-sectional study was performed with 16,237 patients with chronic diseases followed-up in one year. The data were collected through the electronic system, according to the number of physician appointments in 23 pediatric specialties. Patients were divided in two groups: children (0-9 years) and adolescents (10-19 years). Early (10-14 years) and late (15-19 years) adolescent groups were also analyzed. Of the total sample, 56% were children and 46% were adolescents. The frequencies of following pediatric specialties were significantly higher in adolescents when compared with children: cardiology, endocrinology, hematology, nephrology/renal transplantation, neurology, nutrology, oncology, palliative and pain care, psychiatry, and rheumatology (p<0.05). The frequencies of emergency service visits (30% vs. 17%, p<0.001), hospitalizations (23% vs. 11%, p<0.001), intensive care unit admissions (6% vs. 2%, p<0.001), and deaths (1% vs. 0.6%, p=0.002) were significantly lower in adolescents than in children. However, the number of physician appointments (≥13) per patient was also higher in the adolescent group (5% vs. 6%, p=0.018). Further analysis comparison between early and late adolescents revealed that the first group had significantly more physician appointments (35% vs. 32%, p=0.025), and required more than two pediatric specialties (22% vs. 21%, p=0.047). Likewise, the frequencies of emergency service visits (19% vs. 14%, p<0.001) and hospitalizations (12% vs. 10%, p=0.035) were higher in early adolescents. This study evaluated a large population in a Latin American hospital and suggested that early adolescents with chronic diseases required many appointments, multiple specialties and hospital admissions. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. Hospital marketing revisited. (United States)

    Costello, M M


    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  18. Hospital Library Administration. (United States)

    Cramer, Anne

    The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

  19. Cumulative Vulnerability: A Case Study on intrafamilial violence, Drug Addiction and Adolescent Pregnancy. (United States)

    Miura, Paula Orchiucci; Passarini, Gislaine Martins Ricardo; Ferreira, Loraine Seixas; Paixão, Rui Alexandre Paquete; Tardivo, Leila Salomão de La Plata Cury; Barrientos, Dora Mariela Salcedo


    A pregnant adolescent's vulnerability increases when she is a victim of intrafamilial violence and drug addiction, which cause physical and biopsychosocial damage to the mother and her baby. Objective Present and analyze the case of an adolescent who is addicted to drugs, pregnant and the victim of lifelong intrafamilial violence. Method A case study based on a semi-structured interview conducted in the Obstetrics Emergency Unit at the Teaching Hospital of the University of São Paulo. The data were interpreted and analyzed using Content Analysis. Results intrafamilial violence experienced at the beginning of the adolescent's early relationships seriously affected her emotional maturity, triggering the development of psychopathologies and leaving her more susceptible to the use and abuse of alcohol and other drugs. The adolescent is repeating her history with her daughter, reproducing the cycle of violence. Conclusion Adolescent pregnancy combined with intrafamilial violence and drug addiction and multiplies the adolescent's psychosocial vulnerability increased the adolescent's vulnerability.

  20. Condom misuse among adolescents. (United States)

    Wood, V D; Buckle, R A


    In the adolescent clinic of the Children's Center at the District of Columbia General Hospital, the proficiency of high-risk adolescents in condom usage was investigated. The majority of patients are served for sexually transmitted diseases (STDs), contraception, and the diagnosis of pregnancy. In December 1990 and March 1991, each teenager who visited the clinic was given a latex reservoir-tipped condom and the plastic cover of a 60 mL syringe and was instructed to place the condom on the plastic cover. Then each was asked if it is better to remove the condom while the penis is still hard (erect) or when it is soft (flaccid). A performance score was assigned to each subject based on the following variables: 1) pinch the reservoir tip, 2) orient the condom correctly (not inside out), 3) roll the condom down the shaft, and 4) know that condoms should be removed while the penis is still erect. The maximum performance score was 4 with 1 point awarded for each successfully completed component. 38 females and 19 males with an age range from 13 to 19 years were included in the study group. 3 males (15.8%) and 22 females (57.8%) were either treated or were receiving follow-up for an STD, for an overall STD rate of 43.9%. The mean performance score for the study population was 2.3. Females averaged a performance score of 2.34, versus 2.31 for males. Females with STDs averaged higher scores than females who were infection-free (2.4 versus 2.1). Conversely, males with STDs averaged lower scores than those without STDs (2.0 versus 2.4). The most common deficiency was the failure to pinch the reservoir tip (67%) followed by failure to remove the condom while the penis is erect (61%), incorrect (inside out) orientation (25%), and failure to roll the condom completely down the shaft (9%). Among adolescents, health-compromising sexual behavior continues. Health-care workers should provide information on sexuality issues such as genital tract infections and contraception.



    Maximiliano Emanuel Korstanje


    Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle ...

  2. Adolescents with gender dysphoria

    NARCIS (Netherlands)

    Cohen-Kettenis, P.T.; Klink, D.T.


    Young people with gender dysphoria are increasingly seen by pediatric endocrinologists. Mental health child specialists assess the adolescent and give advice about psychological or medical treatment. Provided they fulfill eligibility and readiness criteria, adolescents may receive pubertal

  3. Adolescent and School Health (United States)

    ... Search Form Controls Cancel Submit Search the CDC Adolescent and School Health Note: Javascript is disabled or ... help strengthen their capacity to improve child and adolescent health. More > DASH Home About DASH At A ...

  4. Encyclopedia of adolescence

    NARCIS (Netherlands)

    Brown, B.B.; Prinstein, M.J.


    The period of adolescence involves growth, adaptation, and dramatic reorganization in almost every aspect of social and psychological development. The Encyclopedia of Adolescence offers an exhaustive and comprehensive review of current theory and research findings pertaining to this critical decade

  5. Hospitable Classrooms: Biblical Hospitality and Inclusive Education (United States)

    Anderson, David W.


    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  6. Hospitality Healthscapes: The New Standard for Making Hospitals More Hospitable

    Directory of Open Access Journals (Sweden)

    Courtney Suess Raeisinafchi


    Full Text Available What comes to mind when you think of a hospital room? Stark. Sterile. Bare. Clinical. What might it mean for patients if the association with the environment shifted to something like: Comforting. Bright. Elegant. Personal?

  7. Group therapy for adolescents


    Nada Hribar


    The group included adolescents from secondary school and some students. The group had weekly sessions or twice on mounth. The adolescents had varied simptoms: depressive, anxiety, psychosomatic disorders, learning difficulties, cunduct problems. All of adolescents were common on many problems in social interactions. The goal of therapeutic work were: to increase assertiveness skills and to reduce the anxious in social situations. The adolescents in group raised a self-esteem and developed som...

  8. The characteristics of serious suicide attempters in Japanese adolescents- comparison study between adolescents and adults

    Directory of Open Access Journals (Sweden)

    Kawashima Yoshitaka


    Full Text Available Abstract Background Suicide is the leading cause of death among Japanese adolescents, and they may commit suicide differently from adults. However, there are few studies in medical-based data concerning adolescent patients seriously attempting suicide. We aimed to explore the characteristics of serious suicide attempts in Japanese adolescents, comparing them with those in adults. Methods We investigated adolescents who seriously attempted suicide and were treated at the Critical Care Medical Center (CCMC of Nippon Medical School Hospital between 2000 and 2010, and we compared them with adult suicide attempters treated during 2009. We retrospectively studied medical records and collected clinical data and socio-demographic factors, including age, sex, psychiatric symptoms or diagnosis, methods of suicide attempt, motives for suicide attempt, previous deliberate self-harm, previous psychiatric history, parent loss experience, and previous psychiatric history in the family. Results Adolescent attempters were 15 males and 44 females, 13 to 18 years old (mean 16.39. Adult attempters were 37 males and 65 females, 19 to 79 years old (mean 39.45. In comparison to adult attempters, adolescent attempters were more frequently diagnosed with Borderline Personality Disorder (BPD, had more school problems and parent loss experience, but they had less financial problems. Gender differences between adolescents and adults were examined, and male adolescent attempters were found to be more frequently diagnosed with schizophrenia and had less financial problems than their adult counterparts, while female adolescent attempters were more frequently diagnosed with BPD, had more school problems and parent loss, but they had less previous psychiatric history than their adult counterparts. Conclusions Our findings indicated that adolescent attempters were more frequently diagnosed with BPD and had more school problems and parent loss experience but had less financial

  9. Children and adolescents admitted to a university-level trauma centre in Denmark 2002-2011

    DEFF Research Database (Denmark)

    Ekström, Danny Stefan; Hviid Larsen, Rasmus; Lauritsen, Jens Martin


    INTRODUCTION: The epidemiology of children or adolescents admitted to a Scandinavian trauma centre is largely unknown. The aim of this paper was to describe the epidemiology and severity of potentially severely injured children and adolescents admitted to a university hospital trauma centre....... METHODS: This was a descriptive study of all children and adolescents aged 0-17 admitted to the university level trauma centre at Odense University Hospital, Denmark in the 2002-2011 period. Data were extracted from the Southern Danish Trauma Register and from medical records. RESULTS: A total of 950...

  10. The application of hospitality elements in hospitals. (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke


    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

  11. Adolescence and Mythology (United States)

    Anastasopoulos, Dimitris; Soumaki, Eugenia; Anagnostopoulos, Dimitris


    The article begins with a brief exploration of the various aspects of adolescent's psychic qualities as these are described in Greek mythology. It is argued that myths are an integral part of the way that adolescence is perceived and myths play an important role in adolescents' psychic and external world, as well as in their mythological thinking.…

  12. Development of Adolescent Relationships

    NARCIS (Netherlands)

    de Goede, I.H.A.


    This dissertation on “Development of Adolescent Relationships” addresses relationships with parents, friends, and romantic partners in adolescence from a developmental perspective. By studying both parent-adolescent relationships and peer relationships at the same time, as well as interrelations

  13. Danish Registry of Childhood and Adolescent Diabetes

    Directory of Open Access Journals (Sweden)

    Svensson J


    Full Text Available Jannet Svensson,1 Charlotte Cerqueira,2 Per Kjærsgaard,3 Lene Lyngsøe,4 Niels Thomas Hertel,5 Mette Madsen,6 Henrik B Mortensen,1 Jesper Johannesen1 1Pediatric and Adolescent Department, Copenhagen University Hospital, Herlev and Gentofte, Herlev, 2Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, 3Pediatric Department, County Hospital Herning, Herning, 4Pediatric and Adolescent Department, Nordsjællands Hospital, Hillerød, 5HC Andersen Childrens Hospital, Odense University Hospital, Odense, 6Pediatric Department, Aalborg University Hospital, Aalborg, Denmark Aim: The aims of the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids are to monitor and improve the quality of care for children and adolescents with diabetes in Denmark and to follow the incidence and prevalence of diabetes. Study population: The study population consists of all children diagnosed with diabetes before the age of 15 years since 1996. Since 2015, every child followed up at a pediatric center (<18 years of age will be included. Main variables: The variables in the registry are the quality indicators, demographic variables, associated conditions, diabetes classification, family history of diabetes, growth parameters, self-care, and treatment variables. The quality indicators are selected based on international consensus of measures of good clinical practice. The indicators are metabolic control as assessed by HbA1c, blood pressure, albuminuria, retinopathy, neuropathy, number of severe hypoglycemic events, and hospitalization with ketoacidosis. Descriptive data: The number of children diagnosed with diabetes is increasing with ~3% per year mainly for type 1 diabetes (ie, 296 new patients <15 years of age were diagnosed in 2014. The disease management has changed dramatically with more children treated intensively with multiple daily injections, insulin pumps

  14. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton


    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  15. The interstices of hospitality

    African Journals Online (AJOL)


    School of Hospitality and Tourism, Anhembi Morumbi University, São Paulo, Brazil ... aspects of hospitality, and the approach of the social sciences, which study the dynamics of ..... in the virtual media, the ritual always begins with an invitation.

  16. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton


    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  17. Unplanned Hospital Visits - National (United States)

    U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...

  18. The Hospitable Meal Model

    DEFF Research Database (Denmark)

    Justesen, Lise; Overgaard, Svend Skafte


    This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...

  19. Structural Measures - Hospital (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the structural measures they report. A structural measure reflects the environment in which hospitals care for patients, for example, whether...

  20. Hospital Compare - Archived Data (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...

  1. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management (RHM) is a peer-reviewed journal ... to the quintessential managerial areas of Finance, Human Resources, Operations, ... competency and career development of hospitality management students · EMAIL ...

  2. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L


    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  3. Endometriosis is an important cause of pelvic pain in adolescence

    Directory of Open Access Journals (Sweden)

    Marina de Paula Andres


    Full Text Available Objective: despite endometriosis being a common disease, where early detection is key to preventing its progression, it is a condition often overlooked in adolescents. The aim of this study was to report the clinical characteristics of adolescent patients with endometriosis monitored in a tertiary hospital. Methods: a retrospective study of 394 patients undergoing surgery with a histological diagnosis of endometriosis at the Endometriosis Division of the Gynecology Department at the Hospital das Clínicas of the University of São Paulo Medical School from 2008 to 2013. 21 adolescents were included (aged under 21 years. Results: the age ranged from 17.95 ± 1.48 years, the average time for diagnostic confirmation was 2.96 ± 2.93 years, and the age at the onset of symptoms was 15.28 ± 3.03 years on average. The sites affected were ovarian (38%, peritoneal (47.6% and retrocervical (23.8%. Dysmenorrhea was found in 80.9 % of adolescents (severe in 33.3% of cases and chronic pelvic pain in 66.6%. Conclusion: endometriosis in adolescents is an important differential diagnosis from pelvic pain and ovarian cysts, mainly among those with no response to conventional treatment. The main forms of involvement are peritoneal and ovarian. Despite the onset of symptoms in adolescence and advances in imaging methods, the diagnosis of this disease is still delayed.

  4. Determinants of Effective Caregiver Communication After Adolescent Traumatic Brain Injury. (United States)

    Hobart-Porter, Laura; Wade, Shari; Minich, Nori; Kirkwood, Michael; Stancin, Terry; Taylor, Hudson Gerry


    To characterize the effects of caregiver mental health and coping strategies on interactions with an injured adolescent acutely after traumatic brain injury (TBI). Multi-site, cross-sectional study. Outpatient setting of 3 tertiary pediatric hospitals and 2 tertiary general medical centers. Adolescents (N = 125) aged 12-17 years, 1-6 months after being hospitalized with complicated mild to severe TBI. Data were collected as part of a multi-site clinical trial of family problem-solving therapy after TBI. Multiple regression analyses were used to examine the relationship of caregiver and environmental characteristics to the dimensions of effective communication, warmth, and negativity during caregiver-adolescent problem-solving discussions. Adolescent and caregiver interactions, as measured by the Iowa Family Interaction Rating Scales. Caregivers who utilized problem-focused coping strategies were rated as having higher levels of effective communication (P teen interactions. Problem-focused coping strategies are associated with higher levels of effective communication and lower levels of caregiver negativity during the initial months after adolescent TBI, suggesting that effective caregiver coping may facilitate better caregiver-adolescent interactions after TBI. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  5. Risk of malnutrition of hospitalized children in a university public hospital. (United States)

    Muñoz-Esparza, Nelly Carolina; Vásquez-Garibay, Edgar Manuel; Romero-Velarde, Enrique; Troyo-Sanromán, Rogelio


    The study aimed to demonstrate that the duration of hospitalization has a significant effect on the nutritional status of children treated in a university hospital. A longitudinal study was conducted during 2014, with a non-random sampling site concentration in children from birth to 19 years who were admitted to the hospital in the past 24 hours and who met the inclusion criteria and had signed informed consent. Upon entering, at 7 days, and at discharge, anthropometric indices, including weight/age, height/age, weight/height, BMI/age, head circumference/age, triceps and subscapular skin folds, and fat percentage, were obtained. Student's t-test, U Mann-Whitney, ANOVA, chi square, Wilcoxon, and odds ratios were used to analyze the data. In total, 206 patients were included: 40% infants, 25% preschoolers, 15% schoolchildren, and 20% teenagers. Infants had a significant improvement from admission to discharge in the indices weight/length (p = 0.042) and BMI (p = 0.002); adolescents showed decreased BMI from admission to discharge from the hospital (p = 0.05). Patients with longer hospitalization (more than 10 days) had an increased deficit in anthropometric indices at admission (p malnutrition and require greater monitoring of nutritional status during hospitalization.

  6. Nutrition in adolescent pregnancy. (United States)

    Lenders, C M; McElrath, T F; Scholl, T O


    Prevention of unintended adolescent pregnancy is a primary goal of the American Academy of Pediatrics and of many health providers. Nevertheless, many adolescents become pregnant every year in America. Pediatricians therefore should be aware of nutritional recommendations for pregnant adolescents to provide optimal care. The importance of nutrition during pregnancy is here reviewed from a pediatric perspective. Pregnancy, particularly during adolescence, is a time of extreme nutritional risk. The adolescents most likely to become pregnant are often those with inadequate nutritional status and unfavorable socio-economic background. There is increasing evidence of competition for nutrients between the growing pregnant adolescent and her fetus. Also, the prenatal environment has been implicated in the development of obesity, cardiovascular disease, and diabetes in both the mother and her offspring. Many adolescents have poor diet quality and poor knowledge of appropriate nutrition; these habits may not change during pregnancy. Current knowledge and recommendations regarding the intake of energy, calcium, and folate are discussed in detail.

  7. Psychiatric Problems among Adolescent Southeast Asian Refugees: A Descriptive Study. (United States)

    Williams, Carolyn L.; Westermeyer, Joseph


    Presenting complaints and problems of 28 Southeast Asian adolescent refugees who were seen by therapists at a U.S. hospital psychiatry department are described. Journal Availability: Subscription Department, The Williams Wilkins Co., 428 East Preston St., Baltimore, MD 21202. (SEW)

  8. An Outcome Study of Anorexia Nervosa in an Adolescent Unit. (United States)

    Jenkins, M. E.


    Adolescent girls (N=21) treated for anorexia nervosa in a hospital operating a strict refeeding program were examined 3 years after treatment. Outcome was considered good for 10 girls, intermediate for 4 girls, and poor for 5 girls. Found lack of separation from parents at follow-up. Discusses relevance of findings to treatment approach and to…

  9. Aftercare, Emergency Department Visits, and Readmission in Adolescents (United States)

    Carlisle, Corine E.; Mamdani, Muhammad; Schachar, Russell; To, Teresa


    Objective: U.S. and Canadian data demonstrate decreasing inpatient days, increasing nonurgent emergency department (ED) visits, and short supply of child psychiatrists. Our study aims to determine whether aftercare reduces ED visits and/or readmission in adolescents with first psychiatric hospitalization. Method: We conducted a population-based…

  10. Oral Glucose Tolerance Test among Adolescents with Impaired ...

    African Journals Online (AJOL)


    Tamunopriye Jaja, Boma Okoh. Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers. State ... history of diabetes mellitus and 17(25%) had hypertension. Seven (10.3%) of the ... Oral Glucose Tolerance among Adolescents - Jaja T, Okoh B degree of insulin resistance leading to ...

  11. Caries and dental erosion: are Soroti children and adolescents at ...

    African Journals Online (AJOL)

    Department of Pediatric Dentistry, British Columbia Children's Hospital, Canada. All authors have ... trend of lower erosion scores was seen in children compared to adolescents. Greater frequency of .... marketing efforts by major soft-drink companies. Nev- ertheless ... liability of a food frequency questionnaire. Community.

  12. Medicare Hospital Spending Per Patient - Hospital (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  13. Hospitality and prosumption | Ritzer | Research in Hospitality ...

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

  14. Comparison of parental and adolescent views on the confidential interview and adolescent health risk behaviors within the gynecologic setting. (United States)

    Trotman, Gylynthia E; Mackey, Eleanor; Tefera, Eshetu; Gomez-Lobo, Veronica


    To explore parental and adolescent views on the confidential interview in the gynecologic setting and compare adolescent reported risk-taking behaviors with parental perception. Anonymous surveys were administered separately to parents/guardians and adolescents between the ages of 11-17. Information pertaining to the patient's Tanner stage and reason for visit was obtained from the provider. This first phase served as the usual care group. In the second phase of the study, surveys were once again distributed after a brief educational intervention. Linear regression analysis, Wilcoxon rank sum test, and Fisher exact test were used where appropriate. Pediatric and Adolescent Gynecology clinics in two tertiary hospitals INTERVENTION: Brief educational handout on key concepts of the confidential interview MAIN OUTCOME MEASURES: Parental perception of the confidential interview and adolescent risk- taking behaviors RESULTS: A total of 248 surveys were included in the final analysis, which accounts for 62 adolescent and parent/guardian pairs in each group. The majority of parents and adolescents reported perceived benefit to the confidential interview. However, parents were less likely to rate benefits of private time specifically for their own adolescent and less than half of parents believed that adolescents should have access to private time in the gynecologic setting. Both parents/guardians and adolescents feared that the confidential interview would limit the parent's ability to take part in decision-making. The low support for confidential time for their adolescent was not different in the usual care group as compared to the intervention group, although there was a trend toward parental acceptance with increased adolescent age. Adolescents were consistently more likely to report more risk-taking behaviors than their parents perceived. There is a discord between parental perception and adolescent reports of risk taking behaviors. This is coupled with a lack of

  15. Screening for nutritional risk in hospitalized children with liver disease. (United States)

    Song, Tiantian; Mu, Ying; Gong, Xue; Ma, Wenyan; Li, Li


    Malnutrition is a major contributor to morbidity and mortality from pediatric liver disease. We investigated the prevalence of both malnutrition and high nutritional risk in hospitalized children with liver disease as well as the rate of in-hospital nutritional support. A total of 2,874 hospitalized children and adolescents with liver disease aged 1 to 17 years (inclusive) were enrolled. Malnutrition was screened by anthropometric measures (height-for-age, weight-for-height, weight-for-age, and BMI- for-age z-scores). The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) was used to evaluate nutritional risk status. Nutrition markers in blood, rate of nutritional support, length of hospital stay, and hospital fees were compared among nutritional risk groups. The overall prevalence of malnutrition was 38.6%. About 20.0% of children had high nutritional risk, and prevalence of malnutrition was markedly greater in the high nutritional risk group compared with the moderate risk group (67.9% vs 31.3%). Serum albumin and prealbumin differed significantly between high and moderate risk groups (pnutritional risk and 3.5% with moderate nutritional risk received nutrition support during hospitalization. Children with high nutritional risk had longer hospital stays and greater hospital costs (pnutritional risk is also prevalent at admission. Albumin and prealbumin are sensitive markers for distinguishing nutritional risk groups. High nutritional risk prolongs length of stay and increases hospital costs. The nutritional support rate is still low and requires standardization.

  16. Trends in adolescent bariatric surgery evaluated by UHC database collection. (United States)

    Pallati, Pradeep; Buettner, Shelby; Simorov, Anton; Meyer, Avishai; Shaligram, Abhijit; Oleynikov, Dmitry


    With increasing childhood obesity, adolescent bariatric surgery has been increasingly performed. We used a national database to analyze current trends in laparoscopic bariatric surgery in the adolescent population and related short-term outcomes. Discharge data from the University Health System Consortium (UHC) database was accessed using International Classification of Disease codes during a 36 month period. UHC is an alliance of more than 110 academic medical centers and nearly 250 affiliate hospitals. All adolescent patients between 13 and 18 years of age, with the assorted diagnoses of obesity, who underwent laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) were evaluated. The main outcome measures analyzed were morbidity, mortality, length of hospital stay (LOS), overall cost, intensive care unit (ICU) admission rate, and readmission rate. These outcomes were compared to those of adult bariatric surgery. Adolescent laparoscopic bariatric surgery was performed on 329 patients. At the same time, 49,519 adult bariatric surgeries were performed. One hundred thirty-six adolescent patients underwent LAGB, 47 had SG, and 146 patients underwent LRYGB. LAGB has shown a decreasing trend (n = 68, 34, and 34), while SG has shown an increasing trend (n = 8, 15, and 24) over the study years. LRYGB remained stable (n = 44, 60, and 42) throughout the study period. The individual and summative morbidity and mortality rates for these procedures were zero. Compared to adult bariatric surgery, 30 day in-hospital morbidity (0 vs. 2.2 %, p adolescent bariatric surgery, while the ICU admission rate (9.78 vs. 6.30 %, p adolescent laparoscopic bariatric surgery reveal the increased use of sleeve gastrectomy and adjustable gastric banding falling out of favor.

  17. Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

    Directory of Open Access Journals (Sweden)

    Ng HY


    Full Text Available Hak Yung Ng Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong, China Abstract: Obesity in adolescence is a public health priority because it usually tracks into adulthood, resulting in enormous medical and social costs. This underscores the importance of early identification and intervention. Acanthosis nigricans (AN was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese adolescents. Current understanding suggests that it is associated with insulin resistance and has a unique role in secondary prevention. The purpose of this narrative review is to provide a comprehensive overview of AN in obese adolescents, covering its history, current knowledge on the condition, its clinical significance, management challenges, and the direction of future research. Keywords: Differential diagnosis, screening, insulin resistance, type 2 diabetes mellitus, metabolically healthy obesity, behavioral weight management, pharmacotherapy, bariatric surgery

  18. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We......Hospitals are complex and dynamic organisms that are vital to the well-being of societies. Providing good quality healthcare is the ultimate goal of a hospital, and it is what most of us are only concerned with. A hospital, on the other hand, has to orchestrate a great deal of supplementary...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...

  19. Hospitality and Institutional Meals

    DEFF Research Database (Denmark)

    Justesen, Lise; Strøjer, Anna-Lise


    Abstract: There is a growing interest in articulating institutional meal serving practices as a hospitality activity involving host and guest interactions. This study aims to qualify institutional hospitality and meal activities by exploring private hospitality events. The study is based......-structured interview, students reflected on their hospitality experiences. The interviews were transcribed and analyzed using a thematic analysis method. The emerging themes on hospitality activities were identified. It was found that hospitality activities could be characterized as a process where the individual...... was transformed into a guest. Information on purpose of the event and other information given in the invitation were part of this process. Furthermore, hospitality activities could be characterized by blurred host-guest relations and by being able to embrace unexpected events as well. The activities were...

  20. Hospital turnaround strategies. (United States)

    Langabeer, James


    Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.


    Directory of Open Access Journals (Sweden)

    Maximiliano Emanuel Korstanje


    Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin.  Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.

  2. [Intelligence, socio-economic status and hospital admissions of young adults]. (United States)

    Bosma, H; Traag, T; Berger-van Sijl, M; van Eijk, J; Otten, F


    To determine whether socio-economic differences in hospital admissions of adolescents and young adults are related to differences in intelligence. . Retrospective cohort study. The data were derived from a group of 10,231 young adults and adolescents who were followed for a total of 47,212 person years with regard to their hospital admissions. Intelligence was measured in the first year of secondary school by 2 non-verbal intelligence tests for fluid intelligence. Data from hospital admissions were matched to a large-scale educational and occupational cohort. Data were analysed with Cox proportional hazards analysis. Intelligence was not found to be related to hospital admissions. However, a low occupational and educational level of the young adults or their parents, was strongly related to heightened risk for hospital admissions. In particular, the low socio-economic status of a respondent was associated with heightened risk for hospital admissions due to accidents (relative risk: 3.49; 95% confidence interval: 1.91-6.39). The small extent to which the socio-economic differences in hospital admissions seem to be based upon fluid intelligence, at least in adolescents and young adults, as well as the heightened risks of hospital admissions in lower socio-economic status groups and the associated high costs for health care legitimise further study of the determinants of these differences.

  3. Being adolescent with chronic renal failure: a view through existential phenomenology

    Directory of Open Access Journals (Sweden)

    Marcela Astolphi de Souza


    Full Text Available Abstract Objective: To understand adolescent's experiences with chronic renal failure disease, attended in a pubic teaching hospital at São Paulo state. Method: Phenomenological study, based on the philosophical reference of Martin Heidegger, with six adolescents interviewed by the following question: "What is it like to be an adolescent with chronic renal failure?" Results: Three ontological categories emerged: feeling different; experiencing renal insufficiency through renal replacement therapy; seeking normality. Conclusion: It was evidenced that the experiences of these adolescents were demonstrated by their behaviors of acceptance and denial, both related to chronic renal failure as a peculiar condition of their lives. Implications for practice: It is crucial that nursing directs a more careful look at adolescents with chronic renal failure, going beyond the disease and also considering the particularities of the adolescents necessary to face the adversities that arise from this experience.

  4. Outcome of Adolescent Pregnancy: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    S Ozdogan


    Full Text Available Objective: The aim of this study is to review the sociodemographic characteristics, maternal, natal and postnatal outcomes of adolescent pregnancy. Subjects and method: The records of all adolescent pregnancies (aged 13–19 years delivered at Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey, over a period of two years were reviewed. Structured survey was conducted with adolescent mothers over the phone. Results: The incidence of adolescent pregnancy was 7.06%; 91.1% of the cases were reported to be married. Consanguineous marriage was found to be 27.6%. Maternal anaemia was detected in 43.1% of cases. Premature birth rate was 6.3%. The rate of Cesarean section was 31.8%. Adolescent mothers were categorized into two groups: 17 years and below and above 17 years. The maternal, natal and postnatal outcomes were not statistically different between the two groups. Conclusions: Health policies should be revised and improved to take the necessary steps for providing adequate health services for adolescents and for improving prenatal, natal and postnatal care of pregnant adolescents.

  5. Adolescent Pregnancy among Ethnic Variants at Lumbini Medical College

    Directory of Open Access Journals (Sweden)

    Subha Shrestha


    Full Text Available Introduction: Adolescent pregnancy is a common social phenomenon that results to both maternal and fetal related health consequences globally. Important factors affecting this high risk group of pregnancies are social, cultural, ethnic and racial disparities which may limit the care during pregnancy thereby affecting the perinatal outcome. The main objective of this study was to estimate the maternal and fetal outcome of adolescent pregnancies visiting Lumbini Medical college among ethnic variants of mid-western region. Methods: A retrospective observational study was conducted in Lumbini Medical College and Teaching Hospital for one year duration. Data was retrieved from the medical records of the admitted adolescent pregnant mothers with hospital delivery after 20 weeks’ gestation. Variables of interest were the selective demographic characteristics like place of residence and ethnicity of women, parity, and obstetrical &fetal outcomes. Results: The total numbers of admission for deliveries during the study period were 1905, out of which 462 (24.3% were adolescent pregnancy. A total of 184 (39% adolescent mothers were at the age of 19 and 334 (72.2% of them were from Palpa district. The highest number of teenagers were from Janajati group i.e. 240 (52%. Among all, 38 (10% had preterm delivery and 7 (1.5% had intrauterine fetal death. While 407 (88.3% adolescent pregnancies had vaginal deliveries, 54 (11.7%of them had lower segment cesarean section (LSCS. Fifty-one (11.4% neonates had low birth weight (below 2500 gmand 11 (2.4% had stillbirths. Among the low birth weight, 32 (51% newborns were admitted to neonatal intensive care unit (NICU. Conclusions: Adolescent pregnancy is higher common in Palpa district of Nepal. Janajati adolescent girls are becoming pregnant early after marriage. Higher numbers of teenagers are 19 years of age and are primigravida. On reaching the tertiary center, obstetrical outcome is better with less maternal

  6. Hospital diversification strategy. (United States)

    Eastaugh, Steven R


    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

  7. Post-abortion and induced abortion services in two public hospitals in Colombia. (United States)

    Darney, Blair G; Simancas-Mendoza, Willis; Edelman, Alison B; Guerra-Palacio, Camilo; Tolosa, Jorge E; Rodriguez, Maria I


    Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services. Copyright © 2014. Published by Elsevier Inc.

  8. Adolescent childbearing. (United States)

    Vernon, M


    The concern for the consequences of adolescent pregnancy are discussed. Childbirth among unmarried teenagers results in a higher incidence of low birth weight babies, a higher infant mortality and morbidity rate, a higher percentage of childbirth complications, a decreased likelihood of completing school, a higher risk of unemployment and welfare dependency, limited vocational opportunities, larger families, and vulnerability to psychological problems and distress. In 1988, 66% of all births to teens occurred outside of marriage. Out of wedlock live births to teens 14 years rose from 80.8% in 1970 to 92.5% in 1986, and for teens 15-19 years, 29.5% to 60.8%. 70% have a repeat pregnancy within the 1st year following their 1st childbirth. 50% have a 2nd child within 3 years. Most 2nd pregnancies occur in teenagers who are not using effective contractive methods, and the pregnancy is frequently unplanned and unwanted. The factors affecting the rate of 2nd pregnancy are age, race, marital status, education, and economic status. Teenage mothers tend to come from disadvantaged backgrounds, and childbearing compounds the poverty. Aid to families with dependent children 50% of payments were to teen mothers for the birth of their 1st child. Teen fathers are usually low income providers. The public costs are high. Some teen fathers abandon their children after birth, but many are interested in supporting their child. Specific programs to help prepare fathers are needed. Teenage mothers are stressed by child care arrangements, living arrangements, employment, school, relationships with peers, relationships with parents, housework and errands, health, finances, job counseling, community services, and child care information. Parents play an important role in guiding sexual involvement and early childbearing, and need to understand why teens get pregnant and to keep channels of communication open. Teens are influenced by media, peer pressure, lack of self-esteem, unhappiness

  9. A closer look at the developmental interplay between parenting and perceived health in adolescents with congenital heart disease. (United States)

    Rassart, Jessica; Luyckx, Koen; Goossens, Eva; Apers, Silke; Moons, Philip


    The present study examined associations between parenting and perceived health in adolescents with congenital heart disease (CHD) using a longitudinal trajectory approach. Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven. A total of 429 adolescents (M age = 16 at T1) participated in the present study, comprising four measurement waves spanning approximately 3 years. Latent class growth analysis was used to identify trajectory classes of parenting and perceived health. Whereas adolescents from democratic households reported the most favorable health outcomes, adolescents from authoritarian, overprotective, and psychologically controlling families (all characterized by relatively high levels of psychological control) showed an increased risk for poor perceived health over time. Hence, the present study found substantial developmental associations between parenting and perceived health in adolescents with CHD. Future research should investigate whether working on the parent-adolescent relationship can foster patients' health.

  10. [Status of music therapy in inpatient pediatrics and child and adolescent psychiatry]. (United States)

    Evers, S


    In order to study the present situation of music therapy in hospitals of pediatrics and of child and adolescent psychiatry in the FRG, a postal survey at these hospitals was performed. The personnel situation, methods of music therapy and indications for music therapy were examined. The data are analysed according to the kind and the size of hospital; they are compared to results obtained in a survey at out-patient pediatrics and to a similar survey from the year 1990.

  11. Refeeding Hypophosphatemia in Adolescents With Anorexia Nervosa (United States)

    Nicholls, Dasha


    The rate of adolescents presenting with anorexia nervosa (AN) is increasing. Medically unstable adolescents are admitted to the hospital for nutrition restoration. A lack of global consensus on appropriate refeeding practices of malnourished patients has resulted in inconsistent refeeding practices. Refeeding hypophosphatemia (RH) is the most common complication associated with refeeding the malnourished patient. This review sought to identify the range of refeeding rates adopted globally and the implication that total energy intake and malnutrition may have on RH while refeeding adolescents with anorexia nervosa. Studies were identified by a systematic electronic search of medical databases from 1980 to September 2012. Seventeen publications were identified, including 6 chart reviews, 1 observational study, and 10 case reports, with a total of 1039 subjects. The average refeeding energy intake was 1186 kcal/d, ranging from 125–1900 kcal/d, with a mean percentage median body mass index (% mBMI) of 78%. The average incidence rate of RH was 14%. A significant correlation between malnutrition (% mBMI) and post-refeeding phosphate was identified (R 2 = 0.6, P = .01). This review highlights the disparity in refeeding rates adopted internationally in treating malnourished adolescents with anorexia nervosa. Based on this review, the severity of malnutrition seems to be a marker for the development of RH more so than total energy intake. PMID:23459608

  12. The Changing Concept of Adolescence in Kenya

    Directory of Open Access Journals (Sweden)

    Pauline E. Ginsberg


    Full Text Available Kenya has at least 42 tribes. Each of these tribes had a unique way of marking the boundary between childhood and adulthood. It is like once pubertal signs emerged, the adolescent was said to be ready for adulthood. Traditional conceptualization of adolescence is not clearly defined, because while puberty marks the beginning of adolescence today, this was not the case in the traditional society. In the traditional society, when a girl started getting her menstrual periods, she was considered mature and arrangements for marriage were started. Modern rites of passage tend to come closer to how modern text books define adolescence. Most boys undertake circumcision after completing primary school, as they wait to join high school. Upon realizing that the hospital ceremony, unlike the traditional one, is lacking in complementary teachings, some Churches have organized teachings prior to circumcision. For girls, after circumcision for them was banned, alternative rites of passage (ARPs are being instituted, most often targeting urban girls, but these, too, raise questions: Do alternative rites of passage fulfill the same functions for modern society that traditional ceremonies once fulfilled? And, if they do so for girls, is there reason to believe that they ought to be developed for both genders? This paper examines self-reports of Kenyans spanning three generations regarding social roles and identity-seeking among those who did (primarily older men and did not (primarily younger men and women of all ages participate in traditional initiation ceremonies.

  13. Hospital Dermatology, Introduction. (United States)

    Fox, Lindy P


    Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.

  14. Hospital-acquired listeriosis. (United States)

    Graham, J C; Lanser, S; Bignardi, G; Pedler, S; Hollyoak, V


    We report four cases of listeriosis that occurred over a two-month period in north east England. Due to the apparent nosocomial acquisition of infection and the clustering of cases in time and place, extended epidemiological investigation was performed and the outbreak was traced to a caterer who was providing sandwiches for hospital shops. We discuss the difficulties in preventing food-borne listeriosis in the hospital setting. Copyright 2002 The Hospital Infection Society.

  15. Hospital Management Software Development


    sobogunGod, olawale


    The purpose of this thesis was to implement a hospital management software which is suitable for small private hospitals in Nigeria, especially for the ones that use a file based system for storing information rather than having it stored in a more efficient and safer environment like databases or excel programming software. The software developed within this thesis project was specifically designed for the Rainbow specialist hospital which is based in Lagos, the commercial neurological cente...

  16. Adolescents with congenital heart disease: the importance of perceived parenting for psychosocial and health outcomes. (United States)

    Luyckx, Koen; Goossens, Eva; Missotten, Lies; Moons, Philip


    : Little is known about how parenting relates to psychosocial functioning and health behavior in adolescents with congenital heart disease (CHD). Different parenting styles were identified through relying on adolescent perceptions of multiple dimensions (regulation, responsiveness, and psychological control). The degree to which parents were perceived as consistent in their rearing style was assessed. : Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven; control individuals were recruited at secondary schools. A total of 429 adolescents (14-18 years) with CHD participated; 403 were matched on gender and age with control individuals. Adolescents completed questionnaires on maternal and paternal regulation, psychological control, and responsiveness. Main outcome measures were depressive symptoms, loneliness, quality of life, health status, alcohol, cigarette, and drug use. : No significant differences emerged between adolescents with CHD and controls in perceived parenting styles. Democratic parenting was accompanied by the most optimal pattern of outcomes in adolescents with CHD, whereas psychologically controlling parenting by the least optimal pattern. Overprotective parenting was related to high patient substance use. Perceiving both parents as democratic turned out most favorably for psychosocial functioning and quality of life, whereas parental consistency was unrelated to substance use in adolescents with CHD. : By building bridges between the fields of adolescent medicine and family studies, the present study generated important information on the role of parents in psychosocial and behavioral functioning of adolescents with CHD. Future longitudinal studies could inform family-based interventions for this population.

  17. Fraud in Hospitals


    Musau, Steve; Vian, Taryn


    Hospitals are vulnerable to corruption. In the U.S., health care fraud has been stimated to cost $60 billion per year, or 3% of total health care expenditures - much of it in the hospital sector. Hospitals account for 50% or more of health care pending in many countries. Fraud and corruption in hospitals negatively affect access and quality, as public servants make off with resources which could have been used to reduce out-of-pocket expenditures for patients, or improve needed services. This...

  18. Group therapy for adolescents

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    Nada Hribar


    Full Text Available The group included adolescents from secondary school and some students. The group had weekly sessions or twice on mounth. The adolescents had varied simptoms: depressive, anxiety, psychosomatic disorders, learning difficulties, cunduct problems. All of adolescents were common on many problems in social interactions. The goal of therapeutic work were: to increase assertiveness skills and to reduce the anxious in social situations. The adolescents in group raised a self-esteem and developed some assertiveness skills: eye contact" and effective communication skills, persistence, refusing and requesting, giving and receiving critism, etc. The methods of work and techniques were based on principles of cognitive-behaviour therapy.

  19. Indian Adolescent Living with HIV-AIDS: Current Clinical Scenario. (United States)

    Joshi, Kavita S; Bhaware, Bhushan D; Pazare, Amar R


    Statistics suggest that, HIV has now largely become the disease of young patients. Hence, the adolescent HIV/AIDS needs to be handled and managed separately from adult HIV. Relatively fewer Indian data exist to characterize the associations in adolescents and young adults infected with HIV disease. The present study explores the current challenges in the management of HIV infected adolescents. The study was aimed at evaluating, relationship between CD4 count and duration of antiretroviral therapy (ART), effects of ART on body mass index and the adverse effects of antiretroviral drugs in adolescent HIV positive patients. This was a cross-sectional study involving 60 HIV positive adolescent patients attending tertiary care Institute KEM Hospital, Parel over duration of one year conducted at Mumbai. Patients on ART between age group 12 to 19 years. ART naïve patients were excluded from the study. 60 adolescent HIV positive patients attended our OPD including 37 males (61.67%) and 23 females (38.33%).The most common mode of transmission was vertical (80%). Education level was: school dropouts - 15%, primary education - 30%, Completed SSC - 31.7%, higher secondary - 23%. Among ADRs were 12 (63.15%) cases of anaemia due to Zidovudine, 4 (21.05%) hepatitis due to Nevirapine, 2 (10.52%) Tenofovir induced AKI and 1 (5.26%) Nevirapine rash. Wilcoxon matched pairs test showed a highly significant increase in the BMI (p ART under government programme has increased the duration of survival of the adolescent population with HIV. Treatment with HAART showed a favourable response with a statistical significant increase in CD4 count. Longer the duration of HAART, higher was the gain in CD4 count. Indian adolescent receiving long term ART, Lipodystrophy is not a troubling issue. Indian adolescent seems to be more tolerance of ART than the other parts of world.

  20. Perfil de internações hospitalares por doenças respiratórias em crianças e adolescentes da cidade de São Paulo, 2000-2004 Perfil de internaciones hospitalares por enfermedades respiratorias en niños y adolescentes de la ciudad de São Paulo, 2000-2004 Hospital admissions due to respiratory diseases in children and adolescents of São Paulo city, 2000-2004

    Directory of Open Access Journals (Sweden)

    Renata Martins de T Natali


    digo Internacional de Enfermedades 10ª Revisión J00-J99 en hospitales conveniados al Sistema Único de Salud, ubicados en la ciudad de São Paulo, entre 2000 y 2004. Se describieron las principales características de distribución temporal, por franja de edad y por causa de morbilidad respiratoria en la niñez y adolescencia. RESULTADOS: Las neumonías y bronconeumonías (51%, el asma (18% y las enfermedades agudas y crónicas de las vías aéreas superiores (10% contestan por la mayor parte de las internaciones. Los niños de hasta cinco años son los más internados, independiente de la causa específica. Entre los adolescentes, se observó que las principales causas de internaciones fueron las enfermedades respiratorias que afectan el intersticio pulmonar (0,1% y las afecciones necróticas y supurativas de las vías aéreas inferiores (0,2%. En la franja de edad de los 6 a los 10 años, predominan las internaciones por enfermedades agudas y crónicas de las vías aéreas superiores (10%. Hubo una tendencia de aumento de las internaciones por enfermedades respiratorias a lo largo del periodo analizado, además de la constatación de que el pico de morbilidad se da en el comienzo del otoño. CONCLUSIONES: Las internaciones por enfermedades respiratorias de niños y adolescentes presentan estándar de distribución dependiente de la franja de edad y de la estacionalidad. Cuanto menor sea la franja de edad, mayor será el número de internaciones.OBJECTIVE: To analyze the profile of children and adolescents' hospital admissions due to respiratory diseases in São Paulo (SP, Brazil. METHODS: This is an ecological time series study. Data was obtained on hospital admissions for respiratory diseases (International Classification of Diseases, 10th Revision: J00-J99 in hospitals under the Brazilian Unified Health System located in São Paulo between 2000 and 2004. Main characteristics of the temporal distribution of respiratory morbidity in childhood and adolescence by age and cause are

  1. High Body Mass Index in Adolescent Girls Precedes Psoriasis Hospitalization

    DEFF Research Database (Denmark)

    Bryld, L.E.; Sørensen, T.I.A.; Andersen, Klaus Kaae


    for being overweight in adulthood. The study cohort was based on the Copenhagen School Health Records Register, birth years 1930 to 1984 (309,152 schoolchildren). Cases were found through the Danish National Patient Register for the period 1977 to 2001. A total of 1074 (0.36%) of the schoolchildren were...

  2. Conflict Resolution in Parent-Adolescent Relationships and Adolescent Delinquency (United States)

    Van Doorn, Muriel D.; Branje, Susan J. T.; Meeus, Wim H. J.


    This study examines the relation between conflict resolution styles in parent-adolescent relationships and adolescent delinquency. Questionnaires about conflict resolution styles were completed by 284 early adolescents (mean age 13.3) and their parents. Adolescents also completed a questionnaire on delinquency. Hierarchical regression analyses…

  3. Going to the Hospital (United States)

    ... and therapists will show you how to use pieces of equipment, like crutches, if you need them. Some hospitals have child life specialists. Their job is to make sure kids in the hospital understand what's going on around them and help them feel more ...

  4. Hospitality Services Reference Book. (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…


    African Journals Online (AJOL)

    In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...

  6. Hospital 360°. (United States)

    Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia


    There are forces that are greater than the individual performance of each hospital institution and of the health system structural of each country. The world is changing and to face up to the future in the best possible way, we need to understand how contexts and emerging trends link up and how they affect the hospital sector. The Columbian Association of Hospitals and Clinics, ACHC, has thus come up with the Hospital 360° concept which uses hospitals capable of anticipating changing contexts by means of the transition between present and future and takes on board the experience of global, socio-economic, demographic, political, environmental and technological fields as its model. Hospital 360° is an invitation to reinvent processes and institution themselves allowing them to adapt and incorporate a high degree of functional flexibility. Hospital 360° purses goals of efficiency, effectiveness and relevance, but also of impact and sustainability, and is coherent with the internal needs of hospital institutions and society for long-term benefits.

  7. Hospitality services generate revenue. (United States)

    Bizouati, S


    An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider.

  8. Virtual Pediatric Hospital (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: | | Virtual Pediatric Hospital is curated by Donna M. D' ...

  9. Hospitality Services. Curriculum Guide. (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  10. Hospitality Occupations. Curriculum Guide. (United States)

    California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  11. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper


    Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept for the collaborat......Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept...... of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...

  12. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...

  13. Hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Frandsen, F; Nielsen, J R; Gram, L


    During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5......%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac...... arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement...

  14. Adolescence and Body Image. (United States)

    Weinshenker, Naomi


    Discusses body image among adolescents, explaining that today's adolescents are more prone to body image distortions and dissatisfaction than ever and examining the historical context; how self-image develops; normative discontent; body image distortions; body dysmorphic disorder (BDD); vulnerability of boys (muscle dysmorphia); who is at risk;…

  15. Improving adolescent maternal health

    African Journals Online (AJOL)

    2 Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Nelson R ... of information concerning their bodies and ..... improve quality of healthcare services for adolescents[15] – services that .... equipment, medicines, supplies and technology needed to ensure effective service provision to adolescents.

  16. Hypermobility in Adolescent Athletes

    DEFF Research Database (Denmark)

    Schmidt, Heidi; Pedersen, Trine Lykke; Junge, Tina


    Study Design Cross-sectional. Background Generalized joint hypermobility (GJH) may increase pain and likelihood of injuries and also decrease function and health-related quality of life (HRQoL) in elite-level adolescent athletes. Objective To assess the prevalence of GJH in elite-level adolescent...

  17. Hispanic Adolescent Fertility. (United States)

    Darabi, Katherine F.; And Others


    Discusses fertility of Hispanic adolescents in the United States. Summarizes what is known about sexuality, contraception, pregnancy, and childbearing among male and female Hispanics of various countries of origin. Indicates Hispanic adolescent birthrates fall between those of non-Hispanic Whites and Blacks, but there is considerable within-group…

  18. Gender and Adolescent Development (United States)

    Perry, David G.; Pauletti, Rachel E.


    This article summarizes and critiques recent trends in research and theory on the role of gender in adolescent development. First, gender differences in key areas of adolescent functioning are reviewed. Second, research on 3 constructs that are especially relevant to the investigation of within-gender individual differences in gender…

  19. Inside the Adolescent Brain (United States)

    Drury, Stacy S.


    Dr. Jay Giedd says that the main alterations in the adolescent brain are the inverted U-shaped developmental trajectories with late childhood/early teen peaks for gray matter volume among others. Giedd adds that the adolescent brain is vulnerable to substances that artificially modulate dopamine levels since its reward system is in a state of flux.

  20. Physical activity among adolescents

    DEFF Research Database (Denmark)

    Henriksen, P W; Ingholt, L; Rasmussen, M


    The objectives of this study were (a) to examine the association between various kinds of parental social support and adolescents' physical activity (PA) and (b) to examine whether various kinds of social support from mothers and fathers were differently associated with boys' and girls' PA. Data...... to understand why some adolescents are physically active and others are not....

  1. [The status of diabetic adolescents in search of apprenticeship]. (United States)

    Schoberberger, C; Schober, E; Frisch, H


    Chronic diseases like diabetes may be a disadvantage in several professions. The aim of the study was to analyse the situation of juvenile diabetics searching for apprenticeship in Austria. 177 individuals (30 adolescent diabetics, 50 healthy adolescents of the same age and 97 masters) were asked by a special questionnaire about their opinions concerning employment and professional changes of juvenile diabetics. Following dimensions were tested: subjective knowledge about juvenile diabetes, objective knowledge about juvenile diabetes, physical capacity, psychological factors, life expectation, stay at home because of illness--admittance to hospital, diabetes--profession, exceptions necessary at work because of diabetes, attitude of the state towards the professional situation of the diabetics.

  2. [GEITDAH consensus on conduct disorders in children and adolescents]. (United States)

    Sasot-Llevadot, Jordi; Ibáñez-Bordas, Rosa M; Soto-López, Antonio; Montañés-Rada, Francisco; Gastaminza-Pérez, Xavier; Alda-Díez, José A; Cantó-Díez, Tomás; Catalá, Miguel A; Ferrin-Erdozáin, Maite; García-Giral, Marta; Graell-Bernal, Montserrat; Granada-Jiménez, Olvido; Herreros-Rodríguez, Óscar; Mardomingo-Sanz, María J; Mojarro-Práxedes, Dolores; Morey-Canyelles, Jaume; Ortiz-Guerra, Juan; Pàmies-Massana, Montserrat; Rey-Sánchez, Francisco; Romera-Torrens, María; Rubio-Morell, Belén; Ruiz-Lázaro, Pedro M; Ruiz-Sanz, Francisco


    In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quiron-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder.

  3. Self-reported peer victimization and suicidal ideation in adolescent psychiatric inpatients: the mediating role of negative self-esteem. (United States)

    Jones, Heather A; Bilge-Johnson, Sumru; Rabinovitch, Annie E; Fishel, Hazel


    The current study investigated relationships among self-reported peer victimization, suicidality, and depression in adolescent psychiatric inpatients. Sixty-seven adolescent psychiatric inpatients at a Midwestern children's hospital completed measures of bullying and peer victimization, suicidal ideation, and depression during their inpatient stay. Analyses indicated significant moderate correlations among victimization, suicidal ideation, and depression in adolescents. Results from mediational analyses found that negative self-esteem mediated the relationship between peer victimization and suicidal ideation. To date, this study is the first to directly examine the mechanisms underlying the relationship between peer victimization and suicidal ideation in adolescent psychiatric inpatients. © The Author(s) 2013.

  4. [The treatment needs of migrant children according to child and adolescent psychiatrists from medical clinics and in private practice]. (United States)

    Siefen, Georg; Kirkcaldy, Bruce; Adam, Hubertus; Schepker, Renate


    How does the German child and adolescent psychiatry system respond to the increasing number of migrant children and adolescents? Senior doctors from German child and adolescent psychiatric hospitals (Association of Medical Hospital Directors in Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany, BAG) completed a specially constructed questionnaire about the treatment needs of migrant children, while a «random, representative» sample of child and adolescent psychiatrists in private practice (German Professional Association for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, BKJPP) was administered a slightly modified version. The 100 psychiatrists in private practice represented only about one-eighth of their group, whereas the 55 medical directors comprised a representative sample. One-third of the hospitals has treatments tailored to the specific needs of migrants. In both settings, however, competent interpreters were rarely found, despite the treatment problems arising from the understanding the illness by the parents, language problems, and the clinical knowledge of the patient. Cultural diversity is perceived as enriching. The migration background and the sex of child and adolescent psychiatrists influence the treatment of migrants. Facilitating the process of «cultural opening» in child and adolescent psychiatry involves enacting concrete steps, such as the funding of interpreter costs.

  5. Breakfast frequency among adolescents

    DEFF Research Database (Denmark)

    Pedersen, Trine Pagh; Holstein, Bjørn E; Damsgaard, Mogens Trab


    OBJECTIVE: To investigate (i) associations between adolescents' frequency of breakfast and family functioning (close relations to parents, quality of family communication and family support) and (ii) if any observed associations between breakfast frequency and family functioning vary...... (n 3054) from a random sample of forty-one schools. RESULTS: Nearly one-quarter of the adolescents had low breakfast frequency. Low breakfast frequency was associated with low family functioning measured by three dimensions. The OR (95 % CI) of low breakfast frequency was 1·81 (1·40, 2......·33) for adolescents who reported no close relations to parents, 2·28 (1·61, 3·22) for adolescents who reported low level of quality of family communication and 2·09 (1·39, 3·15) for adolescents who reported low level of family support. Joint effect analyses suggested that the odds of low breakfast frequency among...

  6. Puberty and adolescent sexuality. (United States)

    Fortenberry, J Dennis


    This article is part of a Special Issue "Puberty and Adolescence". Sexuality emerges as a major developmental element of puberty and the adolescent years that follow. However, connecting the sexuality that emerges with puberty and elements of adult sexuality is difficult because much adolescent sexuality research addresses the transition to partnered sexual behaviors (primarily coitus) and consequences such as unplanned pregnancy and sexually transmitted infections. This review proposes a framework of an expanded understanding of puberty and adolescent sexuality from the perspective of four hallmarks of adult sexuality: sexual desire; sexual arousal; sexual behaviors; and, sexual function. This approach thus addresses important gaps in understanding of the ontogeny of sex and the continuum of sexuality development from adolescence through the adult lifespan. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Menstrual management in developmentally delayed adolescent females. (United States)

    Chuah, Irene; McRae, Alexandra; Matthews, Kim; Maguire, Ann M; Steinbeck, Katharine


    Requests for assistance in menstrual management and menstrual suppression are a common, emotive and sometimes controversial aspect of adolescent disability care. To review the uptake and outcomes of menstrual suppression among adolescent patients with developmental delay. A retrospective review of the medical records of adolescent females with intellectual disability referred for menstrual management to the Paediatric and Adolescent Gynaecology Clinic, Children's Hospital at Westmead, Sydney, for the three-year period between January 1, 2010 and January 1, 2013. Eighty adolescent patients with developmental delay were identified. A third (n = 28) of the patients were pre-menarcheal at first review with parent/caregivers seeking anticipatory advice. Of the post-menarcheal patients, the median age of menarche was 12 years (range 10-15 years). First and second line interventions were documented as were reasons for change where applicable. The combined oral contraceptive pill (COCP) was the most frequently used therapy (67%), and 19 patients in total had a levonorgestrel releasing intrauterine system (LNG-IUS) inserted (31%). Our study population differs from similar previously published groups in the marked absence of the use of depot medroxyprogesterone acetate or the subdermal etonogestrel releasing device. As a paediatrician, it is important to address menstrual management issues and allay caregiver concerns with appropriate advice. Our study supports the use of the COCP as sound first line management in achieving menstrual suppression. The LNG-IUS appears to be a favourable second line option. Further investigation into longer-term outcomes and potential complications of device insertion is recommended. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  8. Guidelines for Adolescent Preventive Services: the GAPS in practice. (United States)

    Gadomski, Anne; Bennett, Shannon; Young, Margaret; Wissow, Lawrence S


    Pre- and post-Guidelines for Adolescent Preventive Services (GAPS) comparison of outcomes gathered via chart audit. A rural hospital-based general pediatric clinic. Adolescents who underwent annual examinations between April 1, 1998, and March 31, 2001. A random sample of 441 medical records was reviewed. Training in the GAPS model and use of the questionnaire began in April 1998. Detection of, discussion of, and referrals for GAPS-related risk behavior. The medical records of 162 younger adolescents (aged 11-15 years) and 279 older adolescents (aged 16-19 years) were audited. Detection of risk behaviors increased from 19% at baseline to 95% with the initial GAPS and 87% with the periodic GAPS. The most prevalent risk factor was having a rifle or gun in the home (younger adolescents, 47% and older adolescents, 39%). The mean number of risk behaviors and health concerns documented was higher in the initial GAPS (4.8 and 1.3, respectively) than in the periodic GAPS (3.8 and 0.7) (P =.01 and.006). The GAPS questionnaires detected lower levels of risk behavior compared with a local Youth Risk Behavior Survey. Controlling for sex, age, and clinician, discussion of psychosocial topics increased during the study period; however, there was considerable variation among clinicians regarding the topics addressed. The GAPS-related referral rate did not change significantly. The GAPS model increases clinicians' detection and discussion of risk behaviors.

  9. Adherence to vitamin supplementation following adolescent bariatric surgery. (United States)

    Modi, Avani C; Zeller, Meg H; Xanthakos, Stavra A; Jenkins, Todd M; Inge, Thomas H


    Adolescents with extreme obesity, who have undergone bariatric surgery, must adhere to many lifestyle and nutritional recommendations, including multivitamin therapy. Little is known about multivitamin adherence following adolescent bariatric surgery. The present study aims to document self-reported and electronically-monitored adherence to multivitamins, determine convergence between self-report and electronic monitoring adherence for multivitamins, and identify barriers to multivitamin adherence for adolescents who have undergone bariatric surgery. The study used a prospective, longitudinal observational design to assess subjective (self-reported) and objective (electronic monitors) multivitamin adherence in a cohort of 41 adolescents (Mean age = 17.1 ± 1.5; range = 13-19) who have undergone bariatric surgery at Cincinnati Children's Hospital Medical Center. Mean adherence as derived from electronic monitoring for the entire 6-month study period was 29.8% ± 23.9. Self-reported adherence was significantly higher than electronically monitored adherence across both the 1 and 6-month assessment points (z = 4.5, P bariatric surgery, high rates of nonadherence to multivitamin therapy were observed in adolescents who had undergone bariatric surgery with forgetting and difficulty swallowing pills as reported barriers to adherence. These high rates of nonadherence to multivitamin therapy should be considered when devising treatment and family education pathways for adolescents considering weight loss surgery. Copyright © 2012 The Obesity Society.

  10. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital - Hospital (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  11. Notes on Adolescent's Peer Relationships




    The purpose of this paper is to review the influence of adolescents' peer relationships on their psychosocial development. Adolescents influence on each other, though some psychosocial merit and demerit emerge in peer influence on adolescents. The merit improves adolescents' identity, self-esteem, satisfaction of life and happiness, provides support under the crisis as well. A case of the demerit can be seen as the negative peer pressure. Adolescents are willing to conform to the norm of peer...

  12. Obstetric complications as a risk factor for first psychotic episodes in childhood and adolescence



    Abstract There are reports of significant association between obstetric complications (OC) and childhood psychosis. Authors conducted a case-control study of 102 children and adolescents with a first episode psychosis (FEP) and 94 healthy controls (HC), using the obstetric complications scale (OCS) and their medical records, to examine the risk of FPE. Patients were recruited from child and adolescent psychiatry units at six university hospitals and controls from publicly-funded sc...

  13. Asthma and Respiratory Foundation NZ child and adolescent asthma guidelines: a quick reference guide. (United States)

    Asher, Innes; McNamara, David; Davies, Cheryl; Demetriou, Teresa; Fleming, Theresa; Harwood, Matire; Hetaraka-Stevens, Lorraine; Ingham, Tristram; Kristiansen, John; Reid, Jim; Rickard, Debbie; Ryan, Debbie


    The purpose of the New Zealand Child and adolescent asthma guidelines: a quick reference guide is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment and management of asthma in children and adolescents in New Zealand, with the aim of improving outcomes and reducing inequities. The intended users are health professionals responsible for delivering asthma care in the community and hospital emergency department settings, and those responsible for the training of such health professionals.

  14. Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence


    Silva, Ítalo Rodolfo; Gomes, Antonio Marcos Tosoli; Valadares, Glaucia Valente; Santos, Nereida Lúcia Palko dos; Silva, Thiago Privado da; Leite, Joséte Luzia


    Objective: to understand the perception of nurses on the vulnerabilities to STD/AIDS in light of the process of adolescence.Method: qualitative research conducted with 15 nurses in a centre for the studies of adolescent healthcare of a university hospital in Rio de Janeiro/Brazil. The adopted theoretical and methodological frameworks were the Complexity Theory and the Grounded Theory, respectively. The semi-structured interview was used to collect data from January to August 2012.Results: thi...

  15. [Aggressive behaviour and substance abuse among schizophrenic adolescents compared to antisocial adolescents--a follow-up study]. (United States)

    Sevecke, Kathrin; Dreher, Jan; Walger, Petra; Junglas, Jürgen; Lehmkuhl, Gerd


    The objective of this study was to analyze aggressive behaviour towards others by schizophrenic as opposed to antisocial adolescents, and the influence of substance abuse before, during and after their hospitalization. We analyzed 21 schizophrenic adolescents and compared their aggressive behaviour and their substance abuse to that of 21 antisocial juveniles before and during their hospitalization and again at the time of a follow-up interview. The two samples were matched for age, sex and intelligence. In a first step, data were gathered from the hospital records, in a second step, for follow-up data we conducted standardized telephone interview with the patient and his or her parent or caregiver. Within the analysis we focused on aggressive behaviour towards other people and objects, as well as on criminal acts and regular substance abuse. We found less aggressive behaviour among psychotic patients during and post-hospitalization than among their antisocial counterparts. As inpatients, the acutely psychotic juveniles were at higher risk for aggressive acts, but adequate treatment subdued their offensive behaviour. In the long term, there were fewer criminal arrests among psychotic patients. Only in connection with their substance abuse, their aggressive misconduct towards others increased. Our results suggest that drug treatment during adolescence might help to lessen the risk of aggressive behaviour towards others.

  16. Adolescent and Parental Contributions to Parent-Adolescent Hostility across Early Adolescence (United States)

    Weymouth, Bridget B.; Buehler, Cheryl


    Early adolescence is characterized by increases in parent-adolescent hostility, yet little is known about what predicts these changes. Utilizing a fairly large sample (N = 416, 51% girls, 91% European American), this study examined the conjoint and unique influences of adolescent social anxiety symptoms and parental intrusiveness on changes in parent-adolescent hostility across early adolescence. Higher mother and father intrusiveness were associated with increased mother- and father-adolescent hostility. An examination of reciprocal effects revealed that mother- and father-adolescent hostility predicted increased mother and father intrusiveness. Significant associations were not substantiated for adolescent social anxiety symptoms. These findings suggest that intrusive parenting has important implications for subsequent parent-adolescent interactions and that similar patterns may characterize some aspects of mother- and father-adolescent relationships. PMID:26346035

  17. Adolescent and Parental Contributions to Parent-Adolescent Hostility Across Early Adolescence. (United States)

    Weymouth, Bridget B; Buehler, Cheryl


    Early adolescence is characterized by increases in parent-adolescent hostility, yet little is known about what predicts these changes. Utilizing a fairly large sample (N = 416, 51 % girls, 91 % European American), this study examined the conjoint and unique influences of adolescent social anxiety symptoms and parental intrusiveness on changes in parent-adolescent hostility across early adolescence. Higher mother and father intrusiveness were associated with increased mother- and father-adolescent hostility. An examination of reciprocal effects revealed that mother- and father-adolescent hostility predicted increased mother and father intrusiveness. Significant associations were not substantiated for adolescent social anxiety symptoms. These findings suggest that intrusive parenting has important implications for subsequent parent-adolescent interactions and that similar patterns may characterize some aspects of mother- and father-adolescent relationships.

  18. Premier Hospital Historical Data (United States)

    U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...

  19. [Ryazan hospital--80 years]. (United States)

    Klimov, A S; Gromov, M F


    In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area.

  20. Hospital Compare Data (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...

  1. Hospital Outpatient PPS (United States)

    U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...

  2. VT Hospital Site Locations (United States)

    Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...

  3. Critical Access Hospitals (CAH) (United States)

    ... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... hospitals and improve access to healthcare by keeping essential services in rural communities. To accomplish this goal, ...

  4. Physician-Owned Hospitals (United States)

    U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

  5. Hospitals as health educators (United States)

    ... offer discounts to healthy activities in the area: Biking, hiking, or walking tours Museums Fitness clubs Farms Festivals Your hospital may offer discounts for: Retail stores such as sporting goods, health food, and art stores Acupuncture Skin care Eye ...

  6. Hospital Readmission Reduction (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  7. Hospital Readmissions Reduction Program (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  8. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

  9. Allegheny County Hospitals (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...

  10. Practice Hospital Bed Safety (United States)

    ... Home For Consumers Consumer Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options ... It depends on the complexity of the bed." Safety Tips CDRH offers the following safety tips for ...

  11. Racial differences in suicidal ideation among school going adolescents

    Directory of Open Access Journals (Sweden)

    Santosh Kumar


    Full Text Available Background: Young adults are at increased risk for suicidal behavior and there is growing concern about racial differences in suicidal ideation, especially in the younger population. Aim: The aim of this study is to assess suicidal ideation in school going tribal and nontribal adolescents and to study its relationships with psychological well-being, depression, and anxiety. Materials and Methods: A total of 259 students of Classes X, XI, and XII of three Schools of Ranchi, who fulfilled inclusion and exclusion criteria, were screened for suicidal ideation by Suicidal Ideation Questionnaire (SIQ and psychological well-being by General Health Questionnaire-12 (GHQ-12. The level of anxiety and depression was assessed by Hospital Anxiety Depression Scale (HADS. Results: Overall 33.2% of the adolescents had suicidal ideation out of which 34.2% were tribal-students and 32.8% nontribal-students with no significant intergroup difference. Psychological discomfort (GHQ-12 Score ≥3 was noticed in 59.1% of adolescents, but no racial difference was found. However, the mean HADS depression score was significantly higher in tribal adolescents, more so in tribal boys than nontribal adolescents or boys, respectively. There was a significant positive correlation of SIQ total score in all the adolescents with GHQ-12 total score, HADS total score, HADS anxiety score, and HADS depression score. Conclusion: There were no racial differences in suicidal ideation and psychological discomfort among tribal and nontribal adolescents. Tribal adolescents, and more specifically tribal boys, had more depression than their nontribal counterparts. Suicidal ideation was positively correlated with psychological discomfort, anxiety, and depression.

  12. Characteristics of adolescents with poor mental health after bariatric surgery. (United States)

    Järvholm, Kajsa; Karlsson, Jan; Olbers, Torsten; Peltonen, Markku; Marcus, Claude; Dahlgren, Jovanna; Gronowitz, Eva; Johnsson, Per; Flodmark, Carl-Erik


    About 20% of adolescents experience substantial mental health problems after bariatric surgery. The aim of this study was to explore differences between adolescents with poor mental health (PMH) 2 years after surgery and those with average/good mental health. Three university hospitals in Sweden. Mental health and health-related quality of life were assessed in 82 of 88 adolescents (mean age: 16.8 yr, 67% female) at baseline and 1 and 2 years after laparoscopic gastric bypass. Possible associations among mental health, weight, and biochemical outcomes were explored. Two years after surgery 16 (20%) adolescents were identified as having PMH. More symptoms of anxiety and depression and worse mental health at baseline significantly predicted PMH 2 years later. The decline in mental health for the PMH group happened mainly during the second year after surgery. Suicidal ideation was reported in 14% of the total sample 2 years postsurgery and was more frequent in the PMH group. Weight outcomes between groups were comparable at all time points, and physical health was equally improved 2 years after surgery. Although adolescents with PMH after surgery lose as much weight and have similar improvements in physical health compared with other adolescents, special attention should be given to adolescents who report mental health problems at baseline and follow-up, especially during the second year after gastric bypass. The high prevalence of suicidal ideation in adolescents 2 years after bariatric surgery is another indication that longer follow-up is necessary. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  13. [Adolescent pathological gambling]. (United States)

    Petit, A; Karila, L; Lejoyeux, M


    Although experts have long thought that the problems of gambling involved only adults, recent studies tend to show that teenagers are also affected. The objective of this paper is to show the characteristics of pathological gambling in adolescents. This review focuses on the clinical features, prevalence, psychopathology, prevention and treatment of this disorder. A review of the medical literature was conducted, using PubMed, using the following keywords alone or combined: pathological gambling, dependence, addiction and adolescents. We selected 12 English articles from 1997 to 2014. Recent work estimate that between 4 and 8% of adolescents suffer from problem gambling, and the prevalence of pathological gambling is 2-4 times higher in adolescents than in adults. The term adolescent pathological gambler starts early around the age of 10-12 years, with a quick change of status from casual to that of problem gambler and player. Complications appear quickly and comorbidities are common. There is no curative pharmacological treatment approved by health authorities. Pathological gambling among adolescents has grown significantly in recent years and should be promptly taken care of. Further studies must be performed to improve our understanding of this problem among adolescents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Atopic dermatitis in adolescence

    Directory of Open Access Journals (Sweden)

    Giampaolo Ricci


    Full Text Available Atopic dermatitis (AD is a chronic inflammatory skin disorder that typically occurs during childhood especially in the first year of life, with a variable frequency from 10% to 30%. Recent studies have shown that in Europe among 10-20% of children with AD suffer from this disorder also in adolescence. AD is a chronic inflammatory skin disease with a typical onset in the first years of life and with a 10- 30% prevalence among young children. AD prevalence in adolescence has been estimated around 5-15% in European countries. AD persists from childhood through adolescence in around 40% of cases and some risk factors have been identified: female sex, sensitization to inhalant and food allergens, allergic asthma and/or rhinoconjunctivitis, the practice of certain jobs. During adolescence, AD mainly appears on the face and neck, often associated with overinfection by Malassezia, and on the palms and soles. AD persistence during adolescence is correlated with psychological diseases such as anxiety; moreover, adolescents affected by AD might have problems in the relationship with their peers. Stress and the psychological problems represent a serious burden for adolescents with AD and cause a significant worsening of the patients’ quality of life (QoL. The pharmacological treatment is similar to other age groups. Educational and psychological approaches should be considered in the most severe cases.

  15. Avoidant/Restrictive Food Intake Disorder: Illness and Hospital Course in Patients Hospitalized for Nutritional Insufficiency. (United States)

    Strandjord, Sarah E; Sieke, Erin H; Richmond, Miranda; Rome, Ellen S


    Avoidant/restrictive food intake disorder (ARFID), a recently defined Diagnostic and Statistical Manual of Mental Disorders-5 eating disorder diagnosis, has not been extensively studied in the inpatient population. This study compares hospitalized ARFID and anorexia nervosa (AN) patients, including differences in presentation, treatment response, and 1-year outcomes. We conducted a retrospective chart review of ARFID and AN patients hospitalized between 2008 and 2014 for acute medical stabilization at an academic medical center. Data, including characteristics on admission, during hospitalization, and 1 year after discharge, were recorded for each patient and compared between ARFID and AN patients. On presentation, ARFID patients (n = 41) were younger with fewer traditional eating disorder behaviors and less weight loss, comorbidity, and bradycardia than AN patients (n = 203). During hospitalization, although ARFID and AN patients had similar caloric intake, ARFID patients relied on more enteral nutrition and required longer hospitalizations than AN patients (8 vs. 5 days; p = .0006). One year after discharge, around half of ARFID and AN patients met criteria for remission (62% vs. 46%; p = .18), and less than one-quarter required readmission (21% vs. 24%; p = .65). The findings from this study reveal several differences in hospitalized eating disorder patients and emphasize the need for further research on ARFID patients, including research on markers of illness severity and optimal approaches to refeeding. Similar remission and readmission rates among ARFID and AN patients highlight both the success and the continued need for improvement in eating disorder treatment regardless of diagnosis. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Ionizing radiation in hospitals

    International Nuclear Information System (INIS)

    Blok, K.; Ginkel, G. van; Leun, K. van der; Muller, H.; Oude Elferink, J.; Vesseur, A.


    This booklet dels with the risks of the use of ionizing radiation for people working in a hospital. It is subdivided in three parts. Part 1 treats the properties of ionizing radiation in general. In part 2 the various applications are discussed of ionizing radiation in hospitals. Part 3 indicates how a not completely safe situation may be improved. (H.W.). 14 figs.; 4 tabs

  17. Preventing falls in hospital. (United States)

    Pearce, Lynne


    Essential facts Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 a day, according to the Royal College of Physicians (RCP). But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%.

  18. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens


    Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

  19. [Hospital organizational structure]. (United States)

    Bittar, O J


    The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.

  20. Hospital waste management in nonteaching hospitals of Lucknow City, India

    Directory of Open Access Journals (Sweden)

    Manish Kumar Manar


    Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

  1. Bipolar disorder in adolescence. (United States)

    DeFilippis, Melissa; Wagner, Karen Dineen


    Bipolar disorder is a serious psychiatric condition that may have onset in childhood. It is important for physicians to recognize the symptoms of bipolar disorder in children and adolescents in order to accurately diagnose this illness early in its course. Evidence regarding the efficacy of various treatments is necessary to guide the management of bipolar disorder in youth. For example, several medications commonly used for adults with bipolar disorder have not shown efficacy for children and adolescents with bipolar disorder. This article reviews the prevalence, diagnosis, course, and treatment of bipolar disorder in children and adolescents and provides physicians with information that will aid in diagnosis and treatment.

  2. [Adolescent vulnerabilities and radicalisation]. (United States)

    Lenjalley, Adrien; Radjack, Rahmeth; Ludot, Maude; Touhami, Fatima; Moro, Marie Rose


    Radicalisation resonates with the psychological vulnerabilities of adolescents. The ups and downs encountered as they attempt to construct their identity and their need to dominate favour the destructive nature of young people lacking a sense of filiation and belonging. An adolescent's engagement corresponds to a search for limits, with an adherence to religious values and to a group to establish self-esteem. Subjectification, authorising the adolescent to separate themselves from their parents and their values through a period of crisis must be supported. Copyright © 2017. Published by Elsevier Masson SAS.


    Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy


    This article is a case study of a Puerto Rican adolescent with suicidal behavior. The adolescent began a Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT), an ambulatory treatment, after being hospitalized for a suicide attempt. The SCBT incorporates an ecological and developmental perspective to CBT. She initially presented low self-esteem, and significant depressive and anxiety symptoms. At the end of treatment, the adolescent revealed a significant change in symptoms, and a better use of her coping skills. No suicidal ideation was presented during previous months, neither during follow up. Case analysis allowed treatment protocol modifications, particularly family sessions and communication skills, thus contributing to its further feasibility.

  4. Hospital Contacts With Infection and Risk of Schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Philip Finn Rising; Benros, Michael E; Mortensen, Preben B


    Infections and immune responses have been suggested to play an important role in the etiology of schizophrenia. Several studies have reported associations between maternal infections during pregnancy and the child's risk of schizophrenia; however, infection during childhood and adolescence...... a hospital contact with infection before their schizophrenia diagnosis (45%). Our results indicate that individuals who have had a hospital contact with infection are more likely to develop schizophrenia (relative risk [RR] = 1.41; 95% CI: 1.32-1.51) than individuals who had not had such a hospital contact....... Bacterial infection was the type of infection that was associated with the highest risk of schizophrenia (RR = 1.63; 95% CI: 1.47-1.82). Our study does not exclude that a certain type of infection may have a specific effect; yet, it does suggest that schizophrenia is associated with a wide range...

  5. Adolescent Endocrinology for Counselors of Adolescents (United States)

    Thomas, Jerill K.


    In this paper, the author attempted to outline a program, aimed at the middle and junior high school student, which would inform students of the extent, type and variation of physiological changes of early adolescence in order to relieve anxiety and augment self-acceptance through assurance. (Author/RK)

  6. A case series of family-based treatment for adolescents with atypical anorexia nervosa. (United States)

    Hughes, Elizabeth K; Le Grange, Daniel; Court, Andrew; Sawyer, Susan M


    The aim of this case series was to examine engagement in and outcomes of family-based treatment (FBT) for adolescents with DSM-5 atypical AN, that is, adolescents who were not underweight at presentation. Consecutive referrals for FBT of adolescents with atypical AN to a specialist child and adolescent eating disorder program were examined. Engagement in treatment (i.e., dose of treatment, completion rate), and changes in psychological symptomatology (i.e., eating disorder symptoms, depressive symptoms, self-esteem, obsessive compulsiveness), weight, and menstrual function were examined. The need for additional interventions (i.e., hospitalization and medication), and estimated remission rates were also examined. The sample comprised 42 adolescents aged 12-18 years (88% female). Engagement in FBT was high, with 83% completing at least half the treatment dose. There were significant decreases in eating disorder and depressive symptoms during FBT (p adolescents who were not admitted to hospital prior to FBT gained some weight (M = 3.4 kg) while those who were admitted did not gain weight during FBT (M = 0.2 kg, p adolescents with atypical AN. However, more research is needed into systematic adaptations of FBT and other treatments that could improve overall remission rates. © 2017 Wiley Periodicals, Inc.

  7. The Benefits and Challenges of Involving Adolescents in Medical Education: A Qualitative Study. (United States)

    Moreau, Katherine A; Eady, Kaylee


    To explore the potential benefits and challenges of involving adolescents in the education of medical students and residents from the perspectives of adolescents who are hospitalized with chronic health conditions. We conducted qualitative interviews with adolescents at a Canadian pediatric hospital. Eligible participants were those between 13-18 years of age, with chronic health conditions lasting more than three months who were feeling well enough to participate in an interview. We used conventional content analysis to analyze the data. Sixteen adolescents participated in the study. In terms of benefits, the participants described how involving adolescents in the education of medical students and residents would improve patient-physician interactions, increase patients' confidence and self-worth, encourage patients to self-reflect and gain knowledge about their health conditions and themselves, as well as enable patients to socialize with other patients. When asked about the challenges, the participants discussed how it might be difficult to include diverse patient perspectives, manage adolescents' negativity, and ensure that learners are non-judgmental towards adolescents and take them seriously. While many of the reported benefits and challenges correspond with those featured in the literature on adult patient involvement in medical education, our findings underscore the distinctive benefits and challenges that medical educators may experience in designing and implementing educational initiatives that involve adolescents. Through the future design and implementation of educational initiatives, it is important to further explore the benefits and challenges of such adolescent involvement, as we know that adolescents can be valuable contributors to medical education. Copyright © 2018. Published by Elsevier Inc.

  8. Teaching hospital planning: a case study and the need for reform. (United States)

    Davis, Christopher K; Smith, Harry


    Academic teaching hospitals and their networks can best serve patients and other stakeholders by achieving critical mass and scope of clinical services, teaching and research. Successful hospital reconfigurations are associated with a convincing case and majority clinician buy-in. The inscrutable political decision to relocate services away from a major teaching hospital campus and into a merged Queensland Children's Hospital was determined without broad stakeholder consultation or a transparent and accountable business case. This compromised process poses a significant and enduring risk to patient care and Queensland's paediatric, perinatal, adolescent and obstetric academic teaching hospital services. As the proposed major stakeholder in Australia's public hospitals and medical workforce training, the federal government should review this decision using an effective methodology incorporating relevant criteria. National guidelines are needed to ensure best practice in the future planning and auditing of major health care projects. The medical profession is responsible for ensuring that health care policy complies with reliable evidence and good practice.

  9. School Discipline, Hospitalization, and Police Contact Overlap among Individuals with Autism Spectrum Disorder (United States)

    Turcotte, Paul; Shea, Lindsay L.; Mandell, David


    The objective was to examine the frequency, correlates, and overlap of school disciplinary actions, psychiatric hospitalizations, and police contact among children and adolescents with autism. Survey results from 2525 caregivers of individuals with autism in elementary through high school were examined. Logistic regression was used to examine…

  10. Higher retention and viral suppression with adolescent-focused HIV clinic in South Africa.

    Directory of Open Access Journals (Sweden)

    Brian C Zanoni

    Full Text Available To determine retention in care and virologic suppression among HIV-infected adolescents and young adults attending an adolescent-friendly clinic compared to those attending the standard pediatric clinic at the same site.Retrospective cohort analysis.Government supported, hospital-based antiretroviral clinic in KwaZulu-Natal, South Africa.Two hundred forty-one perinatally HIV-infected adolescents and young adults aged 13 to 24 years attending an adolescent-friendly clinic or the standard pediatric clinic from April 2007 to November 2015.Attendance in an adolescent-friendly clinic compared to a standard pediatric clinic.Retention in care defined as one clinic visit or pharmacy refill in the prior 6 months; HIV-1 viral suppression defined as < 400 copies/ml.Overall, among 241 adolescents and young adults, retention was 89% (214/241 and viral suppression was 81% (196/241. Retention was higher among those attending adolescent clinic (95% versus standard pediatric clinic (85%; OR 3.7; 95% confidence interval (CI 1.2-11.1; p = 0.018. Multivariable logistic regression adjusted for age at ART initiation, gender, pre-ART CD4 count, months on ART, and tuberculosis history indicated higher odds of retention in adolescents and young adults attending adolescent compared to standard clinic (AOR = 8.5; 95% CI 2.3-32.4; p = 0.002. Viral suppression was higher among adolescents and young adults attending adolescent (91% versus standard pediatric clinic (80%; OR 2.5; 95% CI 1.1-5.8; p = 0.028. A similar multivariable logistic regression model indicated higher odds of viral suppression in adolescents and young adults attending adolescent versus standard pediatric clinic (AOR = 3.8; 95% CI 1.5-9.7; p = 0.005.Adolescents and young adults attending an adolescent-friendly clinic had higher retention in care and viral suppression compared to adolescents attending the standard pediatric clinic. Further studies are needed to prospectively assess the impact of adolescent

  11. Dental trauma that require fixation in a children's hospital. (United States)

    Bruns, Timothy; Perinpanayagam, Hiran


    Children and adolescents who suffer traumatic injuries often seek emergency treatment at a Children's Hospital. Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5-10 years) to early adolescence (11-15 years) and then decreased rapidly in late adolescence (16-19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint.

  12. Temporomandibular disorders in adolescents with headache. (United States)

    Sojka, Anna; Żarowski, Marcin; Steinborn, Barbara; Hedzelek, Wiesław; Wiśniewska-Spychała, Beata; Dorocka-Bobkowska, Barbara


    Headache is a common complaint in all age groups and is a frequent cause of medical consultations and hospitalization. The aim of this study was to evaluate the prevalence of bite and non-bite parafunctions as well as the signs and symptoms of temporomandibular disorder (TMD) in adolescents presenting with primary headaches. Parents of adolescents presented with headaches to the Department of Developmental Neurology within a 12-month period were asked to complete a questionnaire developed by the authors of this study. Of the 1000 patients evaluated, 19 females and 21 males, aged 13 to 17 years, met the inclusion criterion - a confirmed clinical diagnosis of migraine or a tension headache according to the International Classification of Headache Disorders, 2nd edition. The diagnostic algorithm of the study group consisted of a full medical history, an assessment of the occurrence of bite habits and a physical examination based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bite and non-bite parafunctions were found in 36 of the study group patients. A significant difference (p = 0.0003) between the number of bite parafunctions and non-bite parafunctions was found in females but not in males. However, bite parafunctions were more frequent in boys compared to girls (p = 0.01). Our findings suggest that it may be useful for pediatricians and neurologists to include TMD dysfunctions as a part of a standard examination of adolescents presenting with persistent headaches.

  13. Hospitals look to hospitality service firms to meet TQM goals. (United States)

    Hard, R


    Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

  14. Managing suicidal adolescents

    African Journals Online (AJOL)


    May 9, 2008 ... Adolescents with suicidal tendencies have a rather distinct set of problems compared with ... Disorders (4th edition, text revision) (DSM IV)1 represent a fairly standardised approach. ... Depressed mood. Reduced interest in ...

  15. Stages of Adolescence (United States)

    ... themselves from Mom and Dad. The march toward autonomy can take myriad forms: less overt affection, more ... learning to anticipate the shifting currents of adolescent emotion, mothers and fathers may be struggling with some ...

  16. [Adolescence and sexuality]. (United States)

    Kjellberg, G


    Different pathological states occurring during adolescence, such as anorexia, bulimia and suicidal attempts are seen as possible manifestations of psychological defence mechanisms against the anxiety-provoking bodily changes of puberty and the necessary psychological transformations inherent to adolescence and sexual maturation. The changes of object of desire and some sexual risk behaviours are illustrated by clinical vignettes. Music is suggested to play a role in the mobilisation of emotions, bodily sensations and in the construction of an imaginary world and thus to be a factor--a part from biological and psycho-social ones--influencing the sexual behaviour of adolescents. Some communication techniques are suggested enabling access to adolescents on sexual matters - a domain of increasing public health importance.

  17. Experiences of adolescents living with cancer: A descriptive qualitative study. (United States)

    Ang, Sin Hui; Koh, Serena Siew Lin; Lee, Xiu Hua Hideka Tamamura; Shorey, Shefaly


    This study aimed to explore the experiences of adolescents from Singapore, aged 10-18 years old, living with cancer and their perceptions on how their psychosocial outcomes can be improved. A descriptive qualitative study design was used. Convenience sampling was used to recruit 10 participants from a pediatric oncology ward in a Singapore hospital. Individual semi-structured interviews were conducted. Thematic analysis was used to analyze the data. Five major themes emerged: (1) experience of physical symptoms, (2) emotional response to their condition, (3) changes in social dynamics, and (4) falling behind in academics. The psychosocial outcomes of Singaporean adolescents with cancer could be improved by thorough pain assessments and creating a more conducive hospital environment.

  18. Adolescents and oral contraceptives. (United States)

    Sanfilippo, J S


    Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development

  19. Trauma-Focused Early Intensive Cognitive Behavioral Intervention (TF-EICBI) in children and adolescent survivors of suicide bombing attacks (SBAs). A preliminary study. (United States)

    Leor, Agnes; Dolberg, Orna T; Eshel, Shira Pagorek; Yagil, Yaron; Schreiber, Shaul


    To describe and evaluate the impact of an early intervention (Trauma-Focused Early Intensive Cognitive Behavioral Intervention, TF-EICBI) in children and adolescents who were victims of suicide bombing attacks (SBAs) in Israel. Description of an intervention and preliminary experience in its use. An acute trauma center of a Child and Adolescent Psychiatric Unit in a Department of Psychiatry of a university-affiliated medical center. Ten children and adolescents who were victims of SBAs and underwent early interventions (EIG) were compared to 11 adolescent victims who received no intervention (NEIG). The EIG included all the children and adolescent survivors of various SBAs that had occurred during 1 year who presented to our hospital after the TF-EICBI was implemented (June 2001). The NEIG comprised all adolescents girls children and adolescents after SBAs.

  20. Vitamin D and adolescent health

    Directory of Open Access Journals (Sweden)

    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

  1. Endometriosis in Adolescence


    Dessole, Margherita; Melis, Gian Benedetto; Angioni, Stefano


    Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies pr...

  2. Sexting among peruvian adolescents


    West, Joshua H; Lister, Cameron E; Hall, P Cougar; Crookston, Benjamin T; Snow, Paola Rivera; Zvietcovich, Maria Elena; West, Richard P


    Background Sexting (sexual messaging via mobile devices) among adolescents may result in increased risky sexual practices, psychological distress and in some cases, suicide. There is very little research on sexting in developing nations, such as Peru. In particular, little is known about gender differences in the correlates of sexting. The purpose of this study was to determine the sexting prevalence and correlates of sexting among adolescent boys and girls in Cusco, Peru. Methods The study s...

  3. Editorial: Reducing adolescent suicide. (United States)

    Bloch, Michael H


    Suicide is currently the second leading cause of death in young people ages 10-19 (CDC, 2015). Current statistics suggest that in the US one in every seven youths has seriously considered or made a plan to commit suicide and one in every 13 youths has attempted suicide in the previous year (CDC, 2015). Suicide represents a - if not the - major public health problem in adolescents. © 2016 Association for Child and Adolescent Mental Health.

  4. Trick questions: cosmopolitan hospitality

    Directory of Open Access Journals (Sweden)

    Eleanor Byrne


    Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.

  5. [Communication among hospital leaders]. (United States)

    Haberey-Knuessi, Véronique; Heeb, Jean-Luc; De Morgan, Paula Emilie


    New management styles imposed on hospital institutions in recent years, have fundamentally changed the organization of the latter. Many texts discuss the consequences, specifically on the field of communication. The aim of this study was to understand the real impact of new management methods on communication by managers in hospital, but also on care teams in termes of satisfaction and/or stress. This two-year study was conducted among 900 executives in hospitals in Western Switzerland using a mixed methodology. A first phase of questionnaires highlighted the problematic areas, while a second phase in the form of organized group interviews in each hospital, had the objective of achieving a better understanding of the relationship between management and communication. The latter proved to be particularly significant in terms of results, and this is the one we focused on in this article.These results indeed show that a crucial role is given to communication by carers, and, at the same time a lessening of the time devoted to relationships, both among peers and with patients. Frustration then arises, which is not without consequences both for the management of patients and the institutions themselves. It is by means of these results that awareness is raised of the omnipresence of communication at all levels and the major advantages that positive dynamic supports. And, on the contrary, of the serious problems which may arise from management practice that do not give due importance to the dimension of communication, present in all sectors of the hospital.

  6. Peers and adolescent smoking. (United States)

    Kobus, Kimberly


    There is a considerable body of empirical research that has identified adolescent peer relationships as a primary factor involved in adolescent cigarette smoking. Despite this large research base, many questions remain unanswered about the mechanisms by which peers affect youths' smoking behavior. Understanding these processes of influence is key to the development of prevention and intervention programs designed to address adolescent smoking as a significant public health concern. In this paper, theoretical frameworks and empirical findings are reviewed critically which inform the current state of knowledge regarding peer influences on teenage smoking. Specifically, social learning theory, primary socialization theory, social identity theory and social network theory are discussed. Empirical findings regarding peer influence and selection, as well as multiple reference points in adolescent friendships, including best friendships, romantic relationships, peer groups and social crowds, are also reviewed. Review of this work reveals the contribution that peers have in adolescents' use of tobacco, in some cases promoting use, and in other cases deterring it. This review also suggests that peer influences on smoking are more subtle than commonly thought and need to be examined more carefully, including consideration of larger social contexts, e.g. the family, neighborhood, and media. Recommendations for future investigations are made, as well as suggestions for specific methodological approaches that offer promise for advancing our knowledge of the contribution of peers on adolescent tobacco use.

  7. Terror explosive injuries: a comparison of children, adolescents, and adults. (United States)

    Jaffe, Dena H; Peleg, Kobi


    We sought to characterize injuries and outcomes from terror explosions with specific attention to children (0-10 years) and adolescents (11-15 years) compared to adults (16-45 years). Terror explosions target vulnerable populations and result in multidimensional injuries that may vary according to age group. The relative dearth of information regarding terror-related injuries among children inhibits proper preparedness and optimum management during such an event. A retrospective study was performed using data from the national Israel Trauma Registry (October 2000 to December 2005). Included were civilians and nonactive military personnel hospitalized as a result of a terror explosion. During the 5.3-year study period, 49 children (0-10 years), 65 adolescents (11-15 years), and 723 adults (16-45 years) were hospitalized from terror explosions. Children were more likely than adults to sustain severe injuries (27% vs. 12%) and traumatic brain injury (35% vs. 20%) and less likely to sustain injuries to their extremities (35% vs. 57%) or open wounds (39% vs. 59%) (P profile was similar to that of adults, however, adolescents presented with less internal injuries, more contusions, and superficial wounds to extremities and were more likely to require surgery for mild to moderate wounds. Differences in hospital utilization and outcomes by age groups were observed when data were stratified by injury severity. Compared to adults, children, and adolescents exposed to terror explosions present with different injuries and hospital utilization and outcomes. These results further confirm that preparedness of a pediatric healthcare system is essential for effective management in the event of a future mass casualty incident.

  8. A randomized controlled trial of in-patient treatment for anorexia nervosa in medically unstable adolescents. (United States)

    Madden, S; Miskovic-Wheatley, J; Wallis, A; Kohn, M; Lock, J; Le Grange, D; Jo, B; Clarke, S; Rhodes, P; Hay, P; Touyz, S


    Anorexia nervosa (AN) is a serious disorder incurring high costs due to hospitalization. International treatments vary, with prolonged hospitalizations in Europe and shorter hospitalizations in the USA. Uncontrolled studies suggest that longer initial hospitalizations that normalize weight produce better outcomes and fewer admissions than shorter hospitalizations with lower discharge weights. This study aimed to compare the effectiveness of hospitalization for weight restoration (WR) to medical stabilization (MS) in adolescent AN. We performed a randomized controlled trial (RCT) with 82 adolescents, aged 12-18 years, with a DSM-IV diagnosis of AN and medical instability, admitted to two pediatric units in Australia. Participants were randomized to shorter hospitalization for MS or longer hospitalization for WR to 90% expected body weight (EBW) for gender, age and height, both followed by 20 sessions of out-patient, manualized family-based treatment (FBT). The primary outcome was the number of hospital days, following initial admission, at the 12-month follow-up. Secondary outcomes were the total number of hospital days used up to 12 months and full remission, defined as healthy weight (>95% EBW) and a global Eating Disorder Examination (EDE) score within 1 standard deviation (s.d.) of published means. There was no significant difference between groups in hospital days following initial admission. There were significantly more total hospital days used and post-protocol FBT sessions in the WR group. There were no moderators of primary outcome but participants with higher eating psychopathology and compulsive features reported better clinical outcomes in the MS group. Outcomes are similar with hospitalizations for MS or WR when combined with FBT. Cost savings would result from combining shorter hospitalization with FBT.

  9. Rural hospital wages (United States)

    Hendricks, Ann M.


    Average fiscal year 1982 wages from 2,302 rural American hospitals were used to test for a gradient descending from hospitals in counties adjacent to metropolitan areas to those not adjacent. Considerable variation in the ratios of adjacent to nonadjacent averages existed. No statistically significant difference was found, however. Of greater importance in explaining relative wages within States were occupational mix, mix of part-time and full-time workers, case mix, presence of medical residencies, and location in a high-rent county within the State. Medicare already adjusts payments for only two of these variables. PMID:10313454

  10. Hospital mergers: a panacea? (United States)

    Weil, Thomas


    Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders.

  11. Costs of hospital malnutrition. (United States)

    Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H


    Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well

  12. Optimal Hospital Layout Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine

    foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities...... a correlation matrix. The correlation factor defines the framework for conceptual design, whereby the design considers functionalities and their requirements and preferences. It facilitates implementation of evidence-based design as it is prepared for ongoing update and it is based on actual data. Hence......, this contribution is a model for hospital design, where design derives as a response to the defined variables, requirements and preferences....

  13. Hospitality, Tourism, and Politics

    Directory of Open Access Journals (Sweden)

    Stephen W. Litvin


    Full Text Available Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The author suggests that practitioners should seek election to political office, to better influence government policy.

  14. Prenatal diagnostic decision-making in adolescents. (United States)

    Plaga, Stacey L; Demarco, Kristin; Shulman, Lee P


    We sought to evaluate the prenatal decision-making of pregnant adolescents identified at increased risk for identifiable fetal genetic abnormalities. A retrospective review of records of gravid women 19 years old or younger undergoing genetic counseling from 2001-2003 (inclusive) was undertaken. Hospital-based academic center. Thirty-seven women were identified; four cases did not meet inclusion criteria. None. Decision to undergo or forgo invasive prenatal testing. Of the 33 women included in this study, the average age was 17.6 years (range: 15-19). Eighteen were Latinas, eight were African-Americans, and seven were Caucasians. Sixteen women had positive maternal serum screening outcomes; nine women sought counseling because of personal/family histories of genetic abnormalities, seven sought counseling after fetal structural anomalies were detected by ultrasound, and one woman sought counseling because she and her partner were positive for Mendelian disorder screening (sickle cell disease). Sixteen of the women (48.5%) chose to undergo invasive testing (15 amniocenteses, one chorionic villus sampling) whereas 17 (51.5%) chose to forgo invasive testing. Adolescents offered invasive prenatal diagnosis will chose to undergo or forgo such testing based on diagnostic and personal criteria as do adult women. Nonetheless, unique adolescent issues may make the process by which information is obtained and communicated during counseling to be different from counseling provided to adults. The development of new genetic screening and diagnostic protocols has and will increase the number of pregnant adolescent women who will be offered genetic counseling during their pregnancies. Such an increase in numbers will place considerably more pressure on an already taxed genetic counseling system; accordingly, new counseling paradigms will need to be developed to provide service to an expanded patient population seeking information for an increasing number of genetic issues.

  15. Parent-Adolescent Conflicts, Conflict Resolution Types, and Adolescent Adjustment (United States)

    Branje, Susan J. T.; van Doorn, Muriel; van der Valk, Inge; Meeus, Wim


    The current study examined the moderating role of conflict resolution on the association between parent-adolescent conflicts and adolescent problematic adjustment. Participants were 1313 Dutch early and middle adolescents who completed measures on conflict frequency, conflict resolution with parents, and internalizing and externalizing adjustment…

  16. Evaluation of paediatric injury hospitalization incidence at Hospital Ward in Grudziądz

    Directory of Open Access Journals (Sweden)

    Ewa Barczykowska


    4Correction Unit No. 2 in Grudziadz     Mailing address: Marta Lewicka, Collegium Medicum im. L. Rydygiera w Bydgoszczy, UMK w Toruniu, ul. Techników 3, 85-801 Bydgoszcz, Poland; Phone 52 585 21 93, e-mail:   Abstract Introduction. Children's and adolescents' injuries are a serious medical problem, as they lead to substantial medical and socio-economic effects. Aim of the paper. The aim of the conducted research was to analyze incidence and causes of hospitalizing children between birth and 18 years of age on the grounds of injuries. Material and methods. Medical histories of 2 832 children between birth and 18 years of age treated for injuries in 2006-2010 in Wladyslaw Bieganski Regional Specialist Hospital in Grudziadz were analyzed. Results. Correlations between treatment method and subsequent years of research (p<0,05, between children's age group and type of injury, and between type of injury and season of the year and hospitalization time, were shown to be statistically significant. No correlation was found in the studied population between subsequent years of research and injury types or residence of the injured. Conclusions. 1. The most frequent causes for placing children in the hospital were cranioencephalic injuries, injuries to the osteoarticular system, and burns. 2. The children's age determined the type of injury inflicted. Children in the youngest age group were most frequently hospitalized for burns, children in the age of 3-6 years for foreign bodies, and in the group of 7-18 years of age for injuries to the chest and to the osteoarticular system. 3. Boys were more frequently injured in a manner requiring hospital treatment than girls were. 4. A decisive majority of injured children required only conservative treatment and a stay in the hospital for no more than 3 days. 5. A constant tendency of higher occurence of injuries in children during spring and summer, was observed. Keywords: children, injuries

  17. CONCLUSIONS Urban Children and Adolescents

    Indian Academy of Sciences (India)

    CONCLUSIONS Urban Children and Adolescents. Increasing prevalence of overweight and obesity and measures of regional (central) adiposity. High prevalence of markers of dysmetabolic state in urban adolescents. ~10% prevalence of dysglycemia in overweight / obese school children.

  18. On Variations in Adolescent Subcultures (United States)

    Kandel, Denise B.


    The attributes of adolescents involved in marihuana and nonmarihuana-using peer groups are described. Adolescent subcultures are highly differentiated and involvement with peers does not necessarily entail rejection and estrangement from parents. (Author/AM)

  19. Dual Disorders in Adolescent Populations

    NARCIS (Netherlands)

    van West, D.; Vermeiren, R.R.J.M.


    Psychiatric comorbidity in adolescents who abuse substances is the rule rather than the exception, and common comorbidities include depression, anxiety disorder, bipolar disorder, conduct disorder, and Attention Deficit Hyperactivity Disorder (ADHD). Among adolescents, the presence of both mental

  20. Adolescents: Health Risks and Solutions (United States)

    ... some high-income countries. Rights of adolescents The rights of children (people under 18 years of age) to survive, ... the child rights convention, published guidelines on the right of children and adolescents to the enjoyment of the highest ...

  1. Strategies to optimize treatment adherence in adolescent patients with cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Bishay LC


    Full Text Available Lara C Bishay, Gregory S Sawicki Division of Respiratory Diseases, Boston Children’s Hospital, Boston, MA, USA Abstract: While development of new treatments for cystic fibrosis (CF has led to a significant improvement in survival age, routine daily treatment for CF is complex, burdensome, and time intensive. Adolescence is a period of decline in pulmonary function in CF, and is also a time when adherence to prescribed treatment plans for CF tends to decrease. Challenges to adherence in adolescents with CF include decreased parental involvement, time management and significant treatment burden, and adolescent perceptions of the necessity and value of the treatments prescribed. Studies of interventions to improve adherence are limited and focus on education, without significant evidence of success. Smaller studies on behavioral techniques do not focus on adolescents. Other challenges for improving adherence in adolescents with CF include infection control practices limiting in-person interactions. This review focuses on the existing evidence base on adherence intervention in adolescents with CF. Future directions for efforts to optimize treatment adherence in adolescents with CF include reducing treatment burden, developing patient-driven technology to improve tracking, communication, and online support, and rethinking the CF health services model to include assessment of individualized adherence barriers. Keywords: compliance, adolescence, medication, self management, intervention

  2. Predictors of Preoperative Program Non-Completion in Adolescents Referred for Bariatric Surgery. (United States)

    Brode, Cassie; Ratcliff, Megan; Reiter-Purtill, Jennifer; Hunsaker, Sanita; Helmrath, Michael; Zeller, Meg


    Factors contributing to adolescents' non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery ("completers") or withdrew from treatment ("non-completers"). Adolescents were from a bariatric surgery program within a pediatric tertiary care hospital. A retrospective chart review was conducted of consecutive patients who completed bariatric surgery psychological intake evaluations from September 2009 to April 2013. Data involving completer (n = 61) versus non-completer (n = 65) status were analyzed using two-tailed independent t tests, Chi-squared tests, and logistic regressions. Forty-three percent of adolescents completed surgery, similar to adult bariatric samples. Significantly more males were non-completers (p adolescents (p = 0.06). No other demographic, psychological, or caregiver/family variables were significant predictors of non-completion. These findings indicate that demographic variables, rather than psychological or family factors, were associated with the progression to or withdrawal from surgery. Further assessment is needed to determine specific reasons for completing or withdrawing from treatment, particularly for males and older adolescents, to improve clinical care and reduce attrition.

  3. Follicular thyroid cancer in children and adolescents. Clinicopathologic features, long-term survival, and risk factors for recurrence

    International Nuclear Information System (INIS)

    Enomoto, Keisuke; Enomoto, Yukie; Uchino, Shinya; Yamashita, Hiroto; Noguchi, Shiro


    Children and adolescents represent 1-1.5% of all patients with thyroid cancer (TC). The vast majority of TC in children and adolescents is papillary TC; follicular TC (FTC) is exceedingly rare. In this study, we evaluate the clinical and pathological features of FTC in children and adolescents. We also report the risk factors for post-operative tumor recurrence and the associated outcomes. Twenty children and adolescents (under 21 years old) with FTC have been treated and followed at Noguchi Thyroid Clinic and Hospital Foundation since 1946. All patients underwent surgery (lobectomy, 11; subtotal thyroidectomy, 8; and total thyroidectomy, 1), and 8 patients received postoperative external beam radiation therapy. The incidence of FTC in children and adolescents was 1.9% among all FTC patients treated in our hospital. Histopathology revealed vascular and capsular invasion in 9 and 20 patients, respectively. The tumor recurrence rate in FTC with vascular invasion is significantly higher than in those without it (p=0.038). No other factors were significant. Patients with recurrences were treated with completion thyroidectomy and 131 I radioactive iodine therapy. There were no significant differences in the rates of disease-free survival or cause-specific survival when pediatric/adolescent FTC patients were compared to adults with FTC. FTC is very rare among children and adolescents, but the outcomes are similar to those observed among adults. Vascular invasion is poor prognostic indicator in pediatric/adolescent FTC patients. (author)

  4. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service. (United States)

    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.

  5. Subclinical atherosclerosis in obese adolescents with normal left ventricular function. (United States)

    Abdel-Wahab, Amina M; Atwa, Hoda A; El-Eraky, Azza Z; El-Aziz, Mohamed A


    To assess the impact of obesity on carotid intima media thickness and left ventricular (LV) mass in obese adolescents. The study included 52 obese adolescents (mean age 14.16+/-2.64 years) and 52 healthy adolescents who served as a control group (mean age 12+/-2.3 years), who were attended the outpatient clinic at Suez Canal University Hospital, Ismailia, Egypt. The study population was submitted for medical history, clinical examination, laboratory investigations (fasting blood sugar and lipid profile), and echocardiographic examination of LV mass and dimensions. Assessment of carotid intima-media thickness was carried out by using carotid duplex. All children had normal LV function. Obese adolescents had a significant increase in total cholesterol, triglyceride, LDL-C, and low HDL-C compared to the control group. Also, there was a significant increase in blood pressure, carotid intima media thickness, LV mass, and LV mass index. There was a significant correlation between BMI and dyslipidemia, blood pressure, carotid intima/media thickness, LV mass, and posterior wall thickness. Carotid intima-media thickness had a significant correlation with increased LDL-C and low HDL-C, blood pressure, LV mass, and posterior wall thickness. Obesity in childhood and adolescents is associated with subclinical atherosclerosis. Although obese children had no LV dysfunction, yet there are LV structure changes.

  6. Anaemia in pregnant adolescent girls with malaria and practicing pica. (United States)

    Intiful, Freda Dzifa; Wiredu, Edwin Kwame; Asare, George Awuku; Asante, Matilda; Adjei, David Nana


    Pregnancy during the adolescent period is challenging mainly because of the nutritional demands of both the adolescent and pregnancy period. The risk for anaemia increases especially in developing countries such as Ghana where malaria is endemic and the practice of pica is common. In this study, we sought to determine the prevalence of anaemia, pica practice and malaria infection among pregnant adolescent girls and assess the extent to which these factors are associated. Two hundred and sixty five (265) pregnant adolescent girls were recruited from three hospitals in Accra. Haemoglobin levels, malaria infection and the practice of pica were assessed. Pearson's Chi squared tests were used to determine associations and logistic regression analysis was used to determine the odds of being anaemic. Significance was set at p≤0.05. Anaemia prevalence was 76% with severity ranging from mild (47.8%) to severe (0.8%). About 27.5% were moderately anaemic. Pica was practiced in only 9.1% of the girls. Malaria infection was prevalent in 17.7% of the girls. The logistic regression analysis indicated that pregnant girls with malaria infection were 3.56 times more likely to be anaemic when compared to those without malaria. Also, those who practiced pica were 1.23 times more likely to be anaemic when compared to those who did not practice pica. Anaemia is very prevalent in pregnant adolescent girls and is a public health problem. Drastic measures should be taken to reduce the high prevalence.

  7. Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

    Directory of Open Access Journals (Sweden)

    Glenn A. Melnick PhD


    Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

  8. Poor diet quality among Brazilian adolescents with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Luana Fiengo Tanaka


    Full Text Available OBJECTIVE: This study aimed to assess diet quality among adolescents with HIV/AIDS. METHOD: A cross-sectional study was conducted involving patients with HIV/AIDS treated in a referral hospital in Sao Paulo, Brazil. Eighty-eight adolescents (10-19 years of age participated in the study. Information on disease history and use of medication were obtained from medical records. The participants responded to two 24-hour diet recalls. Diet quality was assessed by means of the Healthy Eating Index-2005 (HEI-2005 adapted to the Brazilian population. Pearson's correlation coefficients were calculated. Mean HEI-2005 scores were compared according to the independent variables using either the Student's t-test or the Mann-Whitney test. RESULTS: The mean HEI-2005 score was 51.90 (SE = 0.90. The components with the lowest means were whole grains and sodium. Components with highest means were total grains and oils. No correlations were found between the independent variables and HEI score. Adolescents living in foster homes had higher means for total fruit and lower means for meat and beans in comparison to adolescents living with their families. Girls had higher means for milk and lower means for calories from solid fats, alcoholic beverages, and added sugars in comparison to boys. CONCLUSIONS: Adolescents with HIV/AIDS exhibited a similar eating pattern to that of adolescents in the general population: high consumption of added sugar, saturated fat, and sodium, and insufficient ingestion of whole grains and fruits. Special attention should be paid to the diet of adolescents with HIV/AIDS, who are at greater risk of developing cardiovascular and other chronic diseases.

  9. Spirituality and Dignity of Thai Adolescents Living with HIV

    Directory of Open Access Journals (Sweden)

    Karnsunaphat Balthip


    Full Text Available (1 Background: Adolescents are a key asset and resource for the social and economic development of any country, with the potential to make a significant contribution to their families, communities and countries. Healthy and educated adolescents are important. However, there are still significant rates of death, illness and disease among adolescents in some countries, where HIV is one of the most prevalent causes of death in this group. Adolescents living with HIV may experience and encounter social restrictions and physiological limitations. Therefore, this investigation explored whether the concepts of spirituality and dignity had any relevance to participants sense of meaning and purpose and whether these had any impact upon their health and well-being (2 Methods: A qualitative descriptive design was used involving twenty-two adolescents living with HIV attending one regional hospital in Southern Thailand. One to one interviews and descriptive diaries were used to collect the data and thematic analysis enabled the identification of attributes of spirituality and dignity. (3 Results: The findings revealed that spirituality and dignity were present in the lives of Thai adolescents living with HIV expressed in the main category of living life responsibly. This comprised of six themes: (a Understanding the disease and accepting the truth about life, (b Maintaining hope for a cure, (c Focusing on life’s purposes, (d Making life choices, (e Caring for oneself and (f Responsibility towards other. (4 Conclusions: The findings provide helpful insights for parents, nurses, and other health professionals supporting adolescents living with HIV to obtain a holistic, dignified approach to care that includes attention to the spiritual dimension.

  10. Adolescents with congenital heart disease: their opinions about the preparation for transfer to adult care. (United States)

    Burström, Åsa; Bratt, Ewa-Lena; Frenckner, Björn; Nisell, Margret; Hanséus, Katarina; Rydberg, Annika; Öjmyr-Joelsson, Maria


    The aim of the study was to explore what adolescents with congenital heart disease (CHD) view as important in the preparation for the transfer to adult care. We performed interviews in four focus groups with adolescents (14-18 years old) at four university hospitals in Sweden. Data was analysed using qualitative content analysis. The analysis revealed one main category; Becoming a manager of the condition and four subcategories; Sufficient knowledge about the health, Be a participant in the care, Parental support, and Communicate with others about the health. The adolescents' ages differentiated the discussion in the groups. The older adolescents seemed to have more interest in transition planning, information and transfer. The younger described more frustrations about communication and handling the disease. To become a manager of the CHD in daily life, the adolescents want disease specific knowledge, which should be communicated in a developmentally appropriate way. Adolescents want to participate and be involved in the transition process. They need support and guidance in how to communicate their CHD. Parental support is fundamental but it change over time. Moreover, peer-support is becoming more significant during the transition process. What is Known: • Transition during adolescence and transfer to adult care for adolescents with CHD is complex, and there is a shift in roles. • Adolescents often have poor knowledge and understanding about their heart condition and the consequences. What is New: • Adolescents call for disease specific information regarding health issues of importance for them in daily life. • Communicating the disease with other is a challenge- peer support from other adolescents with CHD could be a facilitator.

  11. Parenting adolescents with cystic fibrosis: the adolescents’ and young adults’ perspectives

    Directory of Open Access Journals (Sweden)

    Bregnballe V


    Full Text Available Vibeke Bregnballe1, Peter Oluf Schiøtz1, Kirsten Lomborg21Department of Pediatrics, Aarhus University Hospital; 2Department of Nursing Science, Institute of Public Health, Aarhus University, Aarhus, DenmarkBackground: When suffering from cystic fibrosis (CF, a number of problems may arise during adolescence; for example, poor adherence. The problems may be attributed to the adolescent being insufficiently prepared for adult life. Research on different ways of parenting adolescents with CF and the influence of different parenting styles on the adolescents' adherence to treatment is still limited.Aim: The aim of this study was to identify the types of parental support that adolescents and young adults with CF want and find helpful in terms of preparing them for adult life.Methods: Sixteen Danish adolescents with CF, aged 14–25, participated in the study. Two focus group interviews were carried out, one for 14–18-year-olds and one for 19–25-year-olds. Individual interviews were conducted, with three subjects. Using interpretive description strategy, a secondary analysis of the interview data was conducted.Results: The adolescents and young adults wanted their parents educated about the adolescent experience. They wanted their parents to learn a pedagogical parenting style, to learn to trust them, and to learn to gradually transfer responsibility for their medical treatment. Additionally, the adolescents noted that meeting other parents may be beneficial for the parents.Conclusion: The findings of this study suggest that adolescents and young adults with CF want their parents to be educated about how to handle adolescents with CF and thereby sufficiently prepare them for adult life.Keywords: chronic illness, parenting style, qualitative research, patient preferences, interpretive description

  12. Investigating self-efficacy, disease knowledge and adherence to treatment in adolescents with cystic fibrosis. (United States)

    Faint, Nicholas R; Staton, Janelle M; Stick, Stephen M; Foster, Juliet M; Schultz, André


    Patient adherence is integral to the effectiveness of prescribed treatment, and is associated with beneficial disease outcomes, yet in adolescents with cystic fibrosis, adherence is often sub-optimal. Multiple factors may contribute to treatment adherence, including disease knowledge and self-efficacy. In adolescents with cystic fibrosis: (i) to compare the disease knowledge of adolescents and their parents before transition to adult care; (ii) to determine the relationship between disease knowledge (adolescent, parent) and adherence; and (iii) to evaluate self-efficacy and its association with disease knowledge and adherence. Adolescents with cystic fibrosis and their parents were recruited from a tertiary children's hospital. Disease knowledge and self-efficacy was assessed using the Knowledge of Disease Management-CF and General Self-Efficacy Scales respectively. Using pharmacy records, medication possession ratio was calculated to measure treatment adherence in the preceding year. Thirty-nine adolescent (aged 12-17 (median 14) years) and parent pairs were recruited. Adherence to hypertonic saline, but not other medications, was significantly associated with disease knowledge in adolescents (r 2  = 0.40, P = 0.029). Mean (SD) adolescent self-efficacy was 30.8 (4.0), and not associated with disease knowledge or adherence. Mean (SD) disease knowledge was less in adolescents than parents (55 (16)% and 72 (14)% respectively, P < 0.001). Disease knowledge is sub-optimal in adolescents with cystic fibrosis, even in the 2 years immediately before transition to adult care. Given that adherence with some treatments has been associated with disease knowledge our results suggest the need for educational interventions in adolescents with cystic fibrosis to optimise self-management and health outcomes. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  13. Hacking the hospital environment

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth


    BACKGROUND: There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. OBJECTIVE: To involve young people in designing youth-friendly ward environment. METHODS: We arranged a design competition lasting 42 h (Hackathon...

  14. Vocabulary of hospitality

    NARCIS (Netherlands)

    Bedir, M.


    Attitudes about refugees begin with the words we ascribe them. In Turkey – which has historically absorbed newcomers from a variety of outside conflicts – the term ‘guest’ is commonly used. Taking this as a starting point, Merve Bedir questions the laws of hospitality in Turkey, and the inherent

  15. Innovations in Hospitality Industry (United States)

    Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.


    The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…

  16. Drawing Hospital Foodscapes

    DEFF Research Database (Denmark)

    Tvedebrink, Tenna Doktor Olsen; Fisker, Anna Marie; Kirkegaard, Poul Henning

    This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food...

  17. Nigerian Hospital Practice

    African Journals Online (AJOL)

    Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. The aim of the Nigerian Hospital Practice Journal is to aid in enhancing the advancement of medicine globally by acting as a medium for disseminating information on current clinical and drug practices in ...

  18. American Hospital Association (United States)

    ... Central Office-Coding Resources AHA Team Training Health Career Center Health Forum Connect More Regulatory Relief The regulatory burden faced by hospitals is substantial and unsustainable. Read the report . More AHA Opioid Toolkit Stem the Tide: Addressing the Opioid Epidemic More ...

  19. Responsible Hospitality. Prevention Updates (United States)

    Colthurst, Tom


    Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

  20. Nigerian Hospital Practice: Submissions

    African Journals Online (AJOL)

    It also publishes miscellaneous articles – hospital administration, business practice, accounting, Law for health practitioners and letters about published papers. All manuscript will be subject to blinded peer-review and the decision of the editor would be final. Articles submitted for consideration by the author should not have ...

  1. Hospitals as food arenas

    DEFF Research Database (Denmark)

    Poulsen, Signe; Jørgensen, Michael Søgaard


    also identified. Research limitations: The assessment of the dietary changes based on the canteen take-away food was only based on indirect assessments based on interviews with users and non-users and furthermore based on a questionnaire at one of the hospitals. Value/originality: Canteen take...

  2. Tygerberg Hospital, 1980

    African Journals Online (AJOL)

    haematocrit, cord bilirubin, number of liveborn babies, birth weight, neonatal death, hyaline membrane disease .... report the outcome of babies of mothers with severe. Rh disease treated at Tygerberg Hospital since 1980 by ..... Walker W. Haemolytic disease of the newborn. In: Gairdner D, Hull 0, eds. Recent Advances iD ...

  3. Hospitals : a design manual

    NARCIS (Netherlands)

    Wagenaar, C.; Mens, N.

    Hospitals as a building type have undergone a substantial evolution in the past years. Changes in healthcare, the impact of evidence-based medicine and aspects of healthcare economics (such as the clustering of diagnostic procedures in specialized clinics) pose new and different challenges for the

  4. Surgery, Hospitals, and Medications (United States)

    ... involved in your hospital care that you have Sjögren’s syndrome. • Share information about your dryness symptoms and routine ... neck, jaw, or back. For more information on Sjögren’s syndrome, visit the SSF Web site at www.sjogrens. ...

  5. Drama Therapies in Hospitals (United States)

    Goodman, Judith; Prosperi, Mario


    Explores the use of drama as a therapeutic tool at various hospitals and records specific therapy groups dialogues. Available from: The Drama Review, 51 West 4th Street, Room 300, New York, N.Y. 10012. Subscription Rates: $12.50 per year. (MH)

  6. Official Centre Hospitality

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sylvain Dufour

    Approved by the Management Executive Committee. - 1 -. Version 3.1.0 effective 2017-06-28. Official Centre Hospitality. 1. Objective. 2. Application. 3. Definitions. 4. Roles and Responsibilities. 5. Authorization. 6. Consultants and Contractors. 7. Reimbursement. 1. Objective. To define the circumstances under which ...

  7. Enhancing hospital productivity

    NARCIS (Netherlands)

    van Hulst, B.L.


    Healthcare expenditure in Western countries is substantial and outpaces economic growth, therefore cost containment in healthcare is high on the political agenda. One option is to increase productivity in healthcare, do more with less. This thesis uses the Dutch hospitals as a case-study and

  8. Hospital emergency preparedness

    African Journals Online (AJOL)

    Tamara Shefer

    to make informed decisions about prioritising hazards in view of limited resources ... contingency plan, for instance, the Oshikoto Regional Council has identified ..... hospital relies on exercises conducted by the Namibia Airports Company (NAC) ... Small scale exercises can also be done in which certain elements of the plan ...

  9. Maternal Employment and Adolescent Development. (United States)

    Montemayor, Raymond; Clayton, Mark D.


    The relationship between maternal employment and adolescent development is enormously complex, and no simple generalizations are possible. Many intervening variables alter the impact that maternal employment has on adolescent development. There is an urgent need to discover what impact this arrangement has on adolescent development. (CJ)

  10. Adolescents' Intergenerational Narratives across Cultures (United States)

    Reese, Elaine; Fivush, Robyn; Merrill, Natalie; Wang, Qi; McAnally, Helena


    Adolescents' intergenerational narratives--the stories they tell about their mothers' and fathers' early experiences--are an important component of their identities (Fivush & Merrill, 2016; Merrill & Fivush, 2016). This study explored adolescents' intergenerational narratives across cultures. Adolescents aged 12 to 21 from 3 cultural…

  11. Child Maltreatment and Adolescent Development (United States)

    Trickett, Penelope K.; Negriff, Sonya; Ji, Juye; Peckins, Melissa


    Child abuse and neglect, often collectively called child maltreatment, are huge social problems affecting millions of children and adolescents in America. Adolescents are affected both by maltreatment which occurred during childhood with lingering effects and by maltreatment that continues into or begins in adolescence. Several decades of research…

  12. Adolescents' experience of complex persistent pain. (United States)

    Sørensen, Kari; Christiansen, Bjørg


    Persistent (chronic) pain is a common phenomenon in adolescents. When young people are referred to a pain clinic, they usually have amplified pain signals, with pain syndromes of unconfirmed ethology, such as fibromyalgia and complex regional pain syndrome (CRPS). Pain is complex and seems to be related to a combination of illness, injury, psychological distress, and environmental factors. These young people are found to have higher levels of distress, anxiety, sleep disturbance, and lower mood than their peers and may be in danger of entering adulthood with mental and physical problems. In order to understand the complexity of persistent pain in adolescents, there seems to be a need for further qualitative research into their lived experiences. The aim of this study was to explore adolescents' experiences of complex persistent pain and its impact on everyday life. The study has an exploratory design with individual in-depth interviews with six youths aged 12-19, recruited from a pain clinic at a main referral hospital in Norway. A narrative approach allowed the informants to give voice to their experiences concerning complex persistent pain. A hermeneutic analysis was used, where the research question was the basis for a reflective interpretation. Three main themes were identified: (1) a life with pain and unpleasant bodily expressions; (2) an altered emotional wellbeing; and (3) the struggle to keep up with everyday life. The pain was experienced as extremely strong, emerging from a minor injury or without any obvious causation, and not always being recognised by healthcare providers. The pain intensity increased as the suffering got worse, and the sensation was hard to describe with words. Parts of their body could change in appearance, and some described having pain-attacks or fainting. The feeling of anxiety was strongly connected to the pain. Despair and uncertainty contributed to physical disability, major sleep problems, school absence, and withdrawal from

  13. [Leadership in the hospital]. (United States)

    Schrappe, Matthias


    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.

  14. El hospital universitario

    Directory of Open Access Journals (Sweden)

    José Félix Patiño-Restrepo


    Full Text Available Según el Diccionario de la Real Academia Española (1, el vocablo hospital viene del latín hospitālis y en su primera acepción se define como: “1. m. Establecimiento destinado al diagnóstico y tratamiento de enfermos, donde a menudo se practican la investigación y la docencia”. Sin embargo, las otras acepciones se refieren a sus orígenes medievales: “2. m. Casa que servía para recoger pobres y peregrinos por tiempo limitado. 3. adj. ant. Afable y caritativo con los huéspedes. 4. adj. ant. Perteneciente o relativo al buen hospedaje”. El hospital moderno, en realidad, es la combinación de ciencia, tecnología, hospedaje y humanitarismo. ¿Cuándo nació el hospital y cuál es su historia? En la Edad Media temprana surgieron los xenodochia, albergues para pobres y peregrinos fundados por la iglesia católica en el marco del sentido humanitario del cristianismo. En los comienzos del siglo XIII, cuando las ciudades acumularon riqueza para sostener sus propios ejércitos, se presentó un fenómeno de crecimiento en el número de albergues y estos empezaron a caracterizarse por atender enfermos; ya para esta época no eran solo fundados por la iglesia, sino también por autoridades civiles. Aunque se siguió el modelo del Hospital del Santo Spirito de Roma, construido por orden del papa Inocencio III (1161-1216, en Francia se fundaron los Hôtel-Dieu, generalmente en la vecindad de las catedrales, que aún conservaban la característica de ser más bien albergues para los más necesitados y desamparados.

  15. Correlates of Adolescent-reported and Parent-reported Family Conflict Among Canadian Adolescents With Bipolar Disorder. (United States)

    Timmins, Vanessa; Swampillai, Brenda; Hatch, Jessica; Scavone, Antonette; Collinger, Katelyn; Boulos, Carolyn; Goldstein, Benjamin I


    Family conflict exacerbates the course of bipolar disorder (BP) among adults. However, few studies have examined family conflict among adolescents with BP, and fewer have looked at adolescent-reported and parent-reported family conflict separately. Subjects were 89 adolescents, aged 13 to 19 years, with a diagnosis of BP on the basis of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL). Subjects were divided into high-conflict and low-conflict groups using a median split on the Conflict Behavior Questionnaire (child report and parent report). The χ(2) analyses and independent samples t tests were performed for univariate analyses. Multivariable logistic regression analyses were performed on variables with Padolescent-reported Conflict Behavior Questionnaire scores were significantly correlated (r=0.50, Padolescent-reported family conflict was positively associated with recent manic symptoms and emotional dysregulation, and negatively associated with socioeconomic status and lifetime psychiatric hospitalization. Bipolar subtype was significantly associated with high versus low family conflict. The limitations of this study included being a cross-sectional study, use of a medium-sized sample, and lack of a control group. Despite substantial agreement between adolescents and parents regarding the amount of family conflict, there were meaningful differences in the factors associated with adolescent-reported and parent-reported conflict. These findings demonstrate the importance of ascertaining family conflict from adolescents as well as from parents. Moreover, these findings can potentially inform family therapy, which is known to be effective for adolescents with BP.

  16. The founding of Zemun Hospital

    Directory of Open Access Journals (Sweden)

    Milanović Jasmina


    Full Text Available This year Zemun Hospital - Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia. The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the “Kontumac” - a quarantine established in 1730. Soon after, two more confessional hospitals were opened. The Serbian (Orthodox Hospital was founded before 1769, whereas the German (Catholic Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall - the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time. The final, physical merging of these hospitals was completed in 1795. [Projekat Ministarstva nauke Republike Srbije, br. 47030

  17. Hospital pharmacy workforce in Brazil. (United States)

    Santos, Thiago R; Penm, Jonathan; Baldoni, André O; Ayres, Lorena Rocha; Moles, Rebekah; Sanches, Cristina


    This study aims to describe the distribution of the hospital pharmacy workforce in Brazil. Data were acquired, during 2016, through the Brazilian National Database of Healthcare Facilities (CNES). The following variables were extracted: hospital name, registry number, telephone, e-mail, state, type of institution, subtype, management nature, ownership, presence of research/teaching activities, complexity level, number of hospital beds, presence of pharmacists, number of pharmacists, pharmacist specialization. All statistical analyses were performed by IBM SPSS v.19. The number of hospitals with a complete registry in the national database was 4790. The majority were general hospitals (77.9%), managed by municipalities (66.1%), under public administration (44.0%), had no research/teaching activities (90.5%), classified as medium complexity (71.6%), and had no pharmacist in their team (50.6%). Furthermore, almost 60.0% of hospitals did not comply with the minimum recommendations of having a pharmacist per 50 hospital beds. The Southeast region had the highest prevalence of pharmacists, with 64.4% of hospitals having a pharmaceutical professional. This may have occurred as this region had the highest population to hospital ratio. Non-profit hospitals were more likely to have pharmacists compared to those under public administration and private hospitals. This study mapped the hospital pharmacy workforce in Brazil, showing a higher prevalence of hospital pharmacists in the Southeast region, and in non-profit specialized hospitals.

  18. Treatment of adolescent obesity. (United States)

    Steinbeck, Katharine S; Lister, Natalie B; Gow, Megan L; Baur, Louise A


    The increased prevalence of adolescent obesity and associated short-term and long-term complications emphasize the need for effective treatment. In this Review, we aim to describe the evidence for, and elements of, behaviour management and adjunctive therapies and highlight the opportunities and challenges presented by obesity management in adolescence. The broad principles of treatment include management of obesity-associated complications; a developmentally appropriate approach; long-term behaviour modification (dietary change, increased physical activity, decreased sedentary behaviours and improved sleep patterns); long-term weight maintenance strategies; and consideration of the use of pharmacotherapy, more intensive dietary therapies and bariatric surgery. Bariatric surgery should be considered in those with severe obesity and be undertaken by skilled bariatric surgeons affiliated with teams experienced in the medical and psychosocial management of adolescents. Adolescent obesity management strategies are more reliant on active participation than those for childhood obesity and should recognize the emerging autonomy of the patient. The challenges in adolescent obesity relate primarily to the often competing demands of developing autonomy and not yet having attained neurocognitive maturity.

  19. [Suicide in adolescence]. (United States)

    Bouvard, M P; Doyen, C


    With 1500 death each year, suicide does represent the second cause of death in young people (between 15 and 25 years). There is a clear increase of suicide rate during adolescence, with an higher rate of suicide attempts in females, but an higher mortality in boys. Suicidal behaviors in adolescents are clinically characterized by impulsivity, rhythmicity (during schooling) and seasonality. Risks factors are numerous. However, psychiatric disorders represent the main one, especially depressive states, conduct disorders and their association. In adolescents familial and environment events may have an important role in suicidal behaviors, especially the role of imitation behavior. These different factors interact and constitute dynamic models. The role of each factor can be involved differently considering the sex. Dangerosity of suicide in adolescents should not be under-estimated, as it has been the case in the past. It is particularly true if we consider the high rate of recidive (approximatively 50%) in this population. These data emphasized the importance of a careful evaluation of all suicidal adolescents more precisely of depressive symptoms and aggressive and/or delinquent behavior and of prevention.

  20. Sexting among Peruvian adolescents. (United States)

    West, Joshua H; Lister, Cameron E; Hall, P Cougar; Crookston, Benjamin T; Snow, Paola Rivera; Zvietcovich, Maria Elena; West, Richard P


    Sexting (sexual messaging via mobile devices) among adolescents may result in increased risky sexual practices, psychological distress and in some cases, suicide. There is very little research on sexting in developing nations, such as Peru. In particular, little is known about gender differences in the correlates of sexting. The purpose of this study was to determine the sexting prevalence and correlates of sexting among adolescent boys and girls in Cusco, Peru. The study sample comprised 949 high school aged adolescents from Cusco, Peru. Adolescents responded to questions about demographics, sexting behavior, and risk/protective factors. Separate regression models were constructed to compare correlates of sexting for boys and sexting for girls. Twenty percent of the sample reported engaging in at least one instance of sexting. Boys reported higher rates of sexting than girls (35.17% vs. 13.19%, p = 0.000). Significant correlates for girls' sexting included having been cyberbullied and parental factors. For boys, hypertexting, fighting, parental factors, and parental rules about sexting were significant. Peruvian health officials with an interest in reducing the effects of sexting among adolescents may choose to target boys differently than girls. These efforts may include advising parents to set clear rules and expectations about sexting and the appropriate use of mobile devices.

  1. An Examination of Incentive Strategies to Increase Participation in Outcomes Research for an Adolescent Inpatient Unit. (United States)

    Ha, Carolyn; Madan, Alok; Long, Tessa A; Sharp, Carla


    Tracking adolescent outcomes after inpatient hospitalization is important in informing clinical care for this age group, as inpatient care is one of the most expensive treatment modalities. This study examined 4 incentive strategies used to maintain adolescent participation in follow-up research (at 6, 12, and 18 mo) after their discharge from the hospital (N=267). A generalized estimation equation approach was taken to investigate whether different incentive strategies predicted adolescent completion of the follow-up assessments at each time point. Findings demonstrate that implementation of social worker contact significantly differed from other incentive strategies in increasing adolescent completion of follow-up assessments (Z=2.51, P=0.012) over the 3 time points, even when controlling for age and sex. Although these findings ultimately need to be confirmed through a randomized controlled study of incentive strategies, they provide preliminary support for the notion that relational incentives, such as maintaining contact with a member of the clinical team at the hospital, may be particularly important in promoting adolescent participation in outcomes research.

  2. Adolescent Perceptions of Parental Behaviors, Adolescent Self-Esteem, and Adolescent Depressed Mood (United States)

    Plunkett, Scott W.; Henry, Carolyn S.; Robinson, Linda C.; Behnke, Andrew; Falcon, Pedro C., III


    Using symbolic interaction, we developed a research model that proposed adolescent perceptions of parental support and psychological control would be related to adolescent depressed mood directly and indirectly through self-esteem. We tested the model using self-report questionnaire data from 161 adolescents living with both of their biological…

  3. Abortamento na adolescência: um estudo epidemiológico Abortion and miscarriage in adolescence: an epidemiological study

    Directory of Open Access Journals (Sweden)

    Leila Maria Vieira


    Full Text Available O presente trabalho foi desenvolvido no Hospital Maternidade Santa Izabel da cidade de Bauru, São Paulo, Brasil, e teve como objetivo investigar o abortamento na adolescência e compará-lo com o das mulheres adultas. Os indicadores buscaram traçar o perfil epidemiológico das mulheres internadas, por meio de dados coletados em prontuários, entre aquelas com diagnóstico de aborto, independente da forma clínica, entre os anos de 2000 a 2003. O total de abortamentos registrados foi de 2.286, sendo 459 (20,08% na faixa etária da adolescência e a forma completa foi significativamente maior nas adolescentes quando comparada às das mulheres adultas; segundo o ano de análise, constatou-se decréscimo de ocorrência entre as adolescentes, com maior incidência em 2000 (30,50%, seguida dos anos de 2001 (25,05%, 2002 (23,53% e 2003 (20,92%, sendo que as adolescentes apresentaram tendência a permanecer dois ou mais dias hospitalizadas. Enfatiza-se a implementação de políticas e programas direcionados à saúde sexual e reprodutiva e suas co-morbidades.This study was conducted at the Santa Izabel Maternity Hospital in the town of Bauru, São Paulo State, Brazil, in order to investigate abortions and miscarriages in adolescence, comparing them to terminations among adult women. The indicators are used to draw up an epidemiological profile of hospitalized women through data collected from documents on women with diagnoses of abortion or miscarriage from 2000 to 2003, regardless of their clinical form. The total number of registered early terminations of pregnancy reached 2,286, with 459 (20.08% during adolescence, with the complete form being significantly higher among teenagers than adults; a decrease in the occurrence among adolescents was noted, dropping from 30.5% in 2000 to 25.05% in 2001, 23.53% in 2002 and 20.92% in 2003; with adolescents tending to remain in hospital for two or more days. The implementation is stressed of policies and

  4. Hospitality within hospital meals—Socio-material assemblages

    DEFF Research Database (Denmark)

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.


    Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fie...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future......Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...

  5. Planning Study Hospital, Cape Town The Hospital Information at ...

    African Journals Online (AJOL)

    Tile HOspital Information Plan- ning Study ... Hospital, and based on. the Business Systems Plan- ... technology can be of considerable benefit in dealing with these issues. .... coherenr, flexible information systems with a minimum of data.

  6. Suicide in children and young adolescents: a 25-year database on suicides from Northern Finland. (United States)

    Lahti, Anniina; Harju, Aleksi; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko


    Despite the large amount of research on adolescent suicidality, there are few detailed studies illustrating the characteristics of child and adolescent completed suicide. Our study presents the characteristics of child and adolescent suicides occurring over a period of 25 years within a large geographical area in Northern Finland, with a special focus on gender differences. The study sample included all 58 suicides among children and adolescents (suicide victims were male. Violent suicide methods predominated in both genders (males 98%, females 83%). While symptoms of mental illness were common, only a minority (15% of males and 17% of females) had a previous history of psychiatric hospitalization. 17% of females but none of the males had been hospitalized previously due to self-poisoning. A greater proportion of females than males had a history of self-cutting (33% vs. 7%) and previous suicide attempts (25% vs. 4%). 48% of males and 58% of females were under the influence of alcohol at the time of their suicide, and alcohol intoxication was related to suicides during the night. One fifth of the adolescents screened positive for substances other than alcohol. The results of this study indicate that there are similarities but also some differences in the characteristics of male and female suicides in adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Safak Ekinci


    Full Text Available Scoliosis is called idiopathic when no other underlying disease can be identified. The etiology of adolescent idiopathic scoliosis (AIS is still unknown despite many years of research effort. Theories on AIS's etiology have included mechanical, hormonal, metabolic, neuromuscular, growth, and genetic abnormalities. Skeletally immature patients with adolescent idiopathic scoliosis are at risk of curve progression. The adolescent onset of severe idiopathic scoliosis has traditionally been evaluated using standing posteroanterior radiographs of the full spine to assess lateral curvature with the Cobb method. Scoliosis in children of school age and above primarily occurs in girls. The therapeutic goal in children is to prevent progression. In children, scoliosis of 20 and deg; or more should be treated with a brace, and scoliosis of 45 and deg; or more with surgery. [Arch Clin Exp Surg 2014; 3(3.000: 174-182

  8. Counseling the pregnant adolescent. (United States)

    Dibiasi, V; Sturgis, S H


    Approaches employed in counseling pregnant adolescents at the Crittenton Clinic in Boston are described. Concentrating on concrete issues of management of the pregnancy -- supplying information and exploring the pros and cons of various alternatives are advocated; probing into the psychological and emotional background of the pregnant adolescent is discouraged. Counseling about contraceptives and taking into account each individual situation are considered essential. Case studies are reviewed and figures representing the attitudes and contraceptive use of patients 1 year after abortion are presented. It is considered important to establish a trusting relationship with the adolescent, which will increase the likelihood that she will return for follow-up and additional help if she needs it.

  9. The impact of HMO and hospital competition on hospital costs. (United States)

    Younis, Mustafa Z; Rivers, Patrick A; Fottler, Myron D


    This study examines the impact of HMO penetration and competition on health system performance, as measured by hospital cost per adjusted admissions. The study population consisted of acute-care hospitals in the United States. The findings of this study suggest that there is no relationship between HMO competition and hospital cost per adjusted admission. Governmental efforts to stimulate competition in the hospital market, if focused on promoting HMOs, are not likely to produce cost-containing results quickly.

  10. Pediatric out-of-hospital deaths following hospital discharge: a ...

    African Journals Online (AJOL)

    Background: Out-of-hospital death among children living in resource poor settings occurs frequently. Little is known about the location and circumstances of child death following a hospital discharge. Objectives: This study aimed to understand the context surrounding out-of-hospital deaths and the barriers to accessing ...

  11. The Hospital Information Planning Study at Groote Schuur Hospital ...

    African Journals Online (AJOL)

    Information is an increasingly important resource in an academic hospital. Effective planning and control of this resource are essential in order to maximize its usefulness. Tile HOspital Information Planning Study (HIPS) undertaken at Groote Schuur Hospital, and based on. the Business Systems Planning (BSP) ...

  12. [Hospital emergency rooms]. (United States)

    Tudela, Pere; Mòdol, Josep Maria


    Overuse of hospital emergency rooms (HERs) is parallel to their controversy. To understand this problem, some concepts should be first clarified. In HERs, there are some intrinsic aspects which are directly related to the emergency itself and thus cannot be modified (intermittent patient flow, need to prioritize, difficulty to achieve a rapid diagnosis, influence of time on treatment, value of clinical follow up, patient's expectations, impact of HER on the overall hospital working dynamics). On the other hand, there are some extrinsic aspects which indeed are not related to HER itself but are rather historically associated with it (precarious structure, delay on admission, lack of privacy, inadequate triage of cases, lack of professionalization); these latter aspects may be potentially modified and should be reconsidered.


    Directory of Open Access Journals (Sweden)

    Ray F. IUNIUS


    Full Text Available As a wise man once said, “Don’t worry about what you don’t know. Be worried about what you think you know, but don’t.” Regarding different ways “hospitality” is understood, the root of the problem lies in part in the different interpretations that hospitality has in different cultures and languages. In American English, for example, when we speak about “hospitality” we first think of it as an industry and only secondarily as an attribute of an individual or community. In other cultures, the primary meaning of hospitality is more a characteristic of people, or of a country or city, etc., and encompasses such ideas as welcome, reception, amiability, generosity, etc. – not an industry! Even in American English, other words are sometimes used to describe the same economic activity: lodging, accommodation, etc.


    Directory of Open Access Journals (Sweden)

    E. V. Sibirskaya


    Full Text Available Aim: The purpose of the study was to evaluate the endocrine profile condition in adolescent girls with abnormal uterine bleeding. Patients and methods: The participants of the study were 110 adolescent girls in the age between 11 and 15 years taken to hospital by emergency indication in the period between 2010–2013 years with dysfunctional uterine bleeding for the term from 3 to 48 days. In the first day of hospitalization before starting the hormonal therapy all patients underwent the physical examination, ultrasonic examination of pelvic organs and endocrine profile assessment. Concentration of follicle-stimulating hormone (FSH and luteinizing hormone (LH and the levels of mammotropic hormone, thyrotropic hormone, estradiol, progesterone and testosterone in their blood were determined. Besides that physicians assessed the complete blood count indices: hemoglobin concentration, erythrocyte number and hematocrits. Results: It was determined that the predisposing causes of abnormal uterine bleeding development in adolescents: high somatic pathology frequency, abnormalities of neuroendocrinal system and menstrual cycle. Gynecological pathology in adolescents is represented by significant disorders of menstrual function establishment expressed in the later beginning of menstruation, its intensity and duration. The authors also note the higher frequency of inflammatory diseases such as adnexitis, edeitis, vulvovaginitis and coleitis in comparison with the control group (37.3 and 30%, respectively. Another tendency was observed while studying the endocrine profile: in patients with hyperestrogenism the normal or increased content of FSH at the normal or lowered LH concentration is observed. At the same time, in patients with hypestrogenism FSH concentration at the lower limits of the age group is lowered, while LH concentration is lowered or normal. Conclusion: Abnormal uterine bleeding in adolescents in the most cases is developing in the setting

  15. Tuberculosis in adolescents: A French retrospective study of 52 cases. (United States)

    de Pontual, Loïc; Balu, Laurent; Ovetchkine, Philippe; Maury-Tisseron, Barbara; Lachassinne, Eric; Cruaud, Philippe; Jeantils, Vincent; Valeyre, Dominique; Fain, Olivier; Gaudelus, Joël


    The only available data about tuberculosis (TB) among adolescents date back to the 1980s, although the incidence of tuberculosis has been increasing in this age group. Medical records were reviewed for all adolescents aged 12 to 18 years hospitalized with the diagnosis of TB in Avicenne/Jean Verdier Teaching hospital (Seine-Saint-Denis, suburb of Paris) between September 2000 and December 2004. Of the 52 patients identified, 52% were female. Median age at diagnosis was 15 years (range, 12-18 years). The proportion of adolescents known to be born abroad was 90%. Diagnoses resulted from the examination of a sick child in 79% of cases, a case contact investigation of an adult suspected of having TB in 19% and routine tuberculin skin test in 2%. Twenty-seven of 52 patients (52%) had isolated pulmonary disease. Sixteen patients (31%) had pulmonary and extrapulmonary TB and 8 cases (17%) had exclusively extrapulmonary disease. The site of extrapulmonary TB included pleural (n = 8), meningitis (n = 4), lymph node (n = 4), peritoneal (n = 5), osteoarticular (n = 3) and genitourinary (n = 1). TB was confirmed by the isolation of Mycobacterium tuberculosis from sputum (n = 21), gastric aspirate (n = 8), bone (n = 1) or cerebrospinal fluid (n = 2). No case had a relapse or recurrence of disease in median 3.2 years of follow up. Our results indicate that demographic and clinical characteristics of adolescents with TB differed from adults and children. A specific approach to the prevention and treatment of TB in adolescents is absolutely necessary.

  16. [Play therapy in hospital]. (United States)

    Gold, Katharina; Grothues, Dirk; Leitzmann, Michael; Gruber, Hans; Melter, Michael


    The following article presents an overview of current research studies on play therapy in the hospital. It highlights individual diagnoses for which play therapy has shown reasonable success. The aim of this review is to describe the current status of the scientific debate on play therapy for sick children in order to allow conclusions regarding the indications for which play therapy is or might be useful.

  17. Hospital nurses' work motivation. (United States)

    Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja


    The knowledge surrounding nurses' work motivation is currently insufficient, and previous studies have rarely taken into account the role of many influential background factors. This study investigates the motivation of Estonian nurses in hospitals, and how individual and organisational background factors influence their motivation to work. The study is quantitative and cross-sectional. An electronically self-reported questionnaire was used for data collection. The sample comprised of 201 Registered Nurses working in various hospital settings in Estonia. Data were analysed using descriptive statistics, two-sample Wilcoxon rank-sum (Mann-Whitney) test, Kruskal-Wallis equality-of-populations rank test and Spearman's correlation. Both extrinsic and intrinsic motivations were noted among hospital nurses. Nurses were moderately externally motivated (M = 3.63, SD = 0.89) and intrinsically strongly motivated (M = 4.98, SD = 1.03). A nurses' age and the duration of service were positively correlated with one particular area of extrinsic work motivation, namely introjected regulation (p extrinsic motivation (p = 0.016) and intrinsic work motivation (p = 0.004). The findings expand current knowledge of nurses' work motivation by describing the amount and orientation of work motivation among hospital nurses and highlighting background factors which should be taken into account in order to sustain and increase their intrinsic work motivation. The instrument used in the study can be an effective tool for nurse managers to determine a nurse's reasons to work and to choose a proper motivational strategy. Further research and testing of the instrument in different countries and in different contexts of nursing is however required. © 2014 Nordic College of Caring Science.

  18. Patient life in hospital

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... are created through stories about three roughly framed aspects of hospitalisation: A. Being together with fellow patients entails a constant dilemma, B. Relationships between patients are restricted and extended and C. Shifting perspectives in solidarity. Conclusion Patients' hospitalisation is strongly...

  19. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles


    Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

  20. Adolescent rampant caries

    Directory of Open Access Journals (Sweden)



    Full Text Available Adolescent rampant caries is a new and growing challenge in Conservative Dentistry. It has the same etiology and pattern as that of nursing bottle syndrome. Herein, a case is presented in which the main cause of rampant caries is the patient′s habit of keeping cariogenic food in her mouth and going to sleep. Educating this etiology and introduction of preventive strategies not only assists in meeting the special oral needs of the adolescent population, but also helps to establish lifelong healthful habits.

  1. [Adolescence and AIDS]. (United States)


    The myths and prejudices that distort the reality and hide the true causes and effects of natural and social phenomena related to sexuality have a fertile ground in AIDS, given its obvious link to sex. The alarming spread of AIDS has been 1 result of these myths and prejudices. Human beings are sexual by nature; genital organs determine sex and also induce sexual behavior. It is by not fairly well accepted that an individual's sexuality exists from birth. Puberty usually begins at 12-16 years for both sexes. The physical changes of puberty terminate in the ability of the female to conceive and the male to procreate. The sexual excitation of adolescents resulting from production of various hormones can only be eliminated by some type of sexual satisfaction or sublimation. Sexuality, according to Freud, is an organizing principle of the personality. The sexual organs exist not merely for reproduction but to provide pleasure. Puberty signifies entry into active sex life. But the ideological structure of society, perpetuated by the family, schools, religion, the mass media, and other social institutions, sends confused signals to adolescents, requiring abstinence and virginity until marriage for women while encouraging sexual adventures for men. Adolescents are confronted by their new sexual feelings in the midst of a virtual bombardment of visual sexual stimuli from the mass media. It becomes impossible for adolescents to satisfy the requirements of appearances while also resolving the problems and pressures of their newly gained sexual maturity. Many adolescents become sexually active, and the problem is not to prevent sexual activity but to improve the conditions under which it occurs. Adolescents, lacking education and information about sex, begin their sex lives without protection. AIDS has now been added to the list of dire consequences that can result. A true sex education beginning in the home is needed to enable young people to develop healthy and full sex

  2. Endometriosis in Adolescence

    Directory of Open Access Journals (Sweden)

    Margherita Dessole


    Full Text Available Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies provide new options, in particular the use of serological markers.

  3. Influences on adolescent smoking

    Directory of Open Access Journals (Sweden)

    Helena Koprivnikar


    Full Text Available Abstract There are numerous and intertwining factors that influence adolescent smoking and have to be considered when we develop and implement programmes and measures for the prevention and reduction of adolescent smoking. In different environments (schools, health system, local communities we have to reduce risk factors and strenghten protective factors through programmes incorporated in the system. The protective factors are low prevalence of smoking, healthy lifestyle, physical activity and good mental health, indicating the importance of links to programmes outside of the tobacco control.

  4. Creativity in adolescence. (United States)

    Rothenberg, A


    Findings from an empirical research project on creativity, including controlled experimental assessment, indicate that the development of creative capacity occurs primarily during the adolescent period. Defined as the production of entities that are both new and valuable, creativity necessarily involves two specific types of cognition designated as the janusian and homospatial processes. Although there are precursors to the development of creativity during earlier childhood, both the motivation and the capacity to create appear first in the adolescent period. Important motivational factors derive from adolescent conflicts and developmental tasks such as the impetus to solve and consolidate issues relating to identity, the return of oedipal conflicts, and the pressures toward autonomy and independence. Engaging in creative types of fields and outlets helps generally to establish coherent identity during adolescence and beyond; the beginnings of a specific creative identity in adolescence are a necessary foundation for creative motivation and ability to create throughout life. The return of the oedipal conflict at the onset of puberty motivates the dual compliance and competition of the creatively disposed adolescent with his or her same-sex parent. The pressures toward autonomy and independence provide the motivational and affective substrate for the development of the homospatial and janusian processes. The homospatial process arises from the vacillating and concomitant experiences of autonomy (or separation) and connectedness. In the creatively disposed adolescent, one who activates and uses cognition to express and explore affect, the creative aspect of those experiences begins to be manifested in the concomitant cognitive separation and connection involved in superimposition of mental images. The janusian process arises from the experiences of rebellious oppositionality and intense emotional ambivalence. The creative cognitive aspect of these experiences is

  5. Fatores associados à recorrência da gravidez na adolescência em uma maternidade escola: estudo caso-controle Factores asociados con la recurrencia de embarazos de adolescentes en una maternidad escuela: estudio de casos y controles A case-control study of factors associated with repeat teen pregnancy based on a sample from a university maternity hospital

    Directory of Open Access Journals (Sweden)

    Leila Katz


    Full Text Available Recorrência da gravidez na adolescência é uma situação frequente, sendo considerada como um fator agravante tanto para o aumento da morbidade materna e fetal quanto para aumento de problemas sociais. O objetivo desta pesquisa foi identificar fatores associados à recorrência de gravidez em adolescentes. Realizou-se estudo caso-controle com puérperas, incluindo 90 adolescentes com mais de uma gravidez (caso e 90 adultas, mulheres que tiveram uma gestação na adolescência, mas que não recorreram (controle. Para análise estatística, utilizou-se regressão logística hierarquizada, com nível de significância de 5%. Os fatores que permaneceram associados à recorrência da gravidez na adolescência foram: coitarca La recurrencia del embarazo en la adolescencia es una situación frecuente, siendo considerada como un factor agravante, tanto para el aumento de la morbilidad materna y fetal, como para el aumento de problemas sociales. El objetivo de esta investigación fue identificar factores asociados a la recurrencia de embarazo en adolescentes. Se realizó un estudio de caso-control con puérperas, incluyendo 90 adolescentes con más de un embarazo (caso y 90 adultas, mujeres que tuvieron una gestación en la adolescencia, pero que no recurrieron (control. Para el análisis estadístico, se utilizó la regresión logística jerarquizada, con un nivel de significancia de un 5%. Los factores que permanecieron asociados a la recurrencia de embarazo en la adolescencia fueron: coitarca Repeat teen pregnancy is a frequent issue and is considered an aggravating factor for increased maternal and fetal morbidity and social problems. The aim of the study was to identify factors associated with repeat teen pregnancy. A case-control study was conducted in 90 postpartum adolescents with more than one pregnancy (cases and 90 adult women with a history of only one pregnancy during adolescence (controls. Statistical analysis used hierarchical logistic

  6. [The status of music therapy in inpatient child and adolescent psychiatry]. (United States)

    Stegemann, Thomas; Mauch, Christine; Stein, Vera; Romer, Georg


    Although music therapy is very common in child and adolescent psychiatry, no data are available that describe the working conditions for music therapists or the situation with regard to coverage of the patient population. A cross-sectional questionnaire study in all German hospitals of child and adolescent psychiatry with inpatient treatment programmes (n = 134) collected data on the structure and content of the respective music therapy treatment offered. 63.4% of the hospitals provide music therapy as a method of inpatient psychotherapy (77.7% response rate). This article focuses on the duties, setting, and clientele in music therapy, the available equipment and instruments, and the formation and methodological spectrum of music therapists. In summary, we conclude that music therapists working in child and adolescent psychiatry are well trained and experienced. To strengthen the professional identity of music therapists and to evaluate the efficacy of music therapy further research is needed and professional representation and proofs of efficacy must be emphasized.

  7. [Trends in hospital care]. (United States)

    Vecina Neto, Gonzalo; Malik, Ana Maria


    This paper analyses trends in the delivery of hospital services in Brazil, considering the setting, the current situation and its challenges, examining what still remains to be done. The variables studied for the analysis of the setting are: demography, epidemiological profile, human resources, technology, medicalization, costs, review of the role of the citizen, legislation, equity, hospital-centricity and regionalization, care fractioning and bed availability. The Brazilian setting was studied through the supplementary healthcare model, financing and the healthcare area production chain. The observations of the current situation present external evaluation models, outsourcing, public-private relationships, de-hospitalization and financing. The analysis of the challenges examines the need for long range planning, the quest for new legal models for the 'business', the use of information and information systems, cost controls and the need for enhanced efficiency and compliance with legal directives, guaranteed universal access to full healthcare facilities, the inclusion of primary prevention in healthcare procedures, integrating the public and private sectors and engaging physicians in solving problems.

  8. Suicidal Adolescents' Social Support from Family and Peers: Gender-Specific Associations with Psychopathology (United States)

    Kerr, David C. R.; Preuss, Lesli J.; King, Cheryl A.


    Perceptions of social support from family, non-family adults, and peers were examined in relation to the psychopathology reported by 220 suicidal adolescents (152 females) during a psychiatric hospitalization. Results of regression analyses showed that, among females, family support was negatively related to hopelessness, depressive symptoms, and…

  9. Population attributable risk for adverse pregnancy outcomes related to smoking in adolescents and adults

    NARCIS (Netherlands)

    Delpisheh, A.; Kelly, Y.; Rizwan, S.; Attia, E.; Drammond, S.; Brabin, B. J.


    BACKGROUND: Little is known about how population-attributable risks (PAR) for adverse birth outcomes due to smoking differ in adolescent and adult pregnancies. METHODS: An analysis of community and hospital-based cross-sectional studies in Liverpool was undertaken to estimate the PAR values of low

  10. The Effects of Traumatic Brain Injury during Adolescence on Career Plans and Outcomes (United States)

    Balaban, Tammy; Hyde, Nellemarie; Colantonio, Angela


    Traumatic brain injury (TBI) often occurs during the years when individuals are aiming for vocational goals and acquiring skills needed to achieve vocational success. This exploratory study aimed to describe the perceived long-term impact on career outcomes for individuals who were hospitalized with a TBI during adolescence. This study used a…

  11. Facts about Hospital Worker Safety (United States)

    ... statistics show that hospitals are still relatively hazardous workplaces, and they have much room to improve. OSHA has developed this factbook to help hospital safety managers and other stakeholders understand the challenges of worker ...

  12. HSIP Hospitals in New Mexico (United States)

    Earth Data Analysis Center, University of New Mexico — Hospitals in New Mexico The term "hospital" ... means an institution which- (1) is primarily engaged in providing, by or under the supervision of physicians, to...

  13. Pseudomonas aeruginosa from hospital environment

    Directory of Open Access Journals (Sweden)

    Milind Davane


    Full Text Available Hospital acquired infection is an additional affliction to the patient admitted to the hospital for some serious illness and is caused by pathogens which are prevalent in hospital environment. In the hospital, microbes are ubiquitous; and can reach the sick patient through various sources, such as air, water, food, contaminated equipments, linen, catheters, scopes, ventilators, contaminated disinfectants and other preparations used for treatment, visitors, infected patients, etc.

  14. Parametric Optimization of Hospital Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.


    Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...... and preferences of the hospital with respect to performances. The design model takes point of departure in the hospital functionalities as a set of defined parameters and rules describing the design requirements and preferences....

  15. Exploring hospitality within hospital meals by means of visual methodologies

    DEFF Research Database (Denmark)

    Justesen, Lise


    ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways....... This includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well...

  16. On Hospital Design – Identifying Building Attributes of Hospital Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, Lars D.

    The present paper surveys the input parameters in hospital design and describes them formally as building attributes in preparation for facilitating planning and designing of hospitals with the aim of a more optimal design process. The overview of the hospital functionalities, bonds, logistics...... and needs is based on an approach of understanding the complexity of the hospital functionalities based on capacities, qualities and times beforehand specific department or units are described. This approach attempts to create an overview of the hospital functionalities respecting capacities, qualities...

  17. Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients. (United States)

    Cha, Christine B; Augenstein, Tara M; Frost, Katherine H; Gallagher, Katie; D'Angelo, Eugene J; Nock, Matthew K


    To examine the use of implicit and explicit measures to predict adolescent nonsuicidal self-injury (NSSI) before, during, and after inpatient hospitalization. Participants were 123 adolescent psychiatric inpatients who completed measures at hospital admission and discharge. The implicit measure (Self-Injury Implicit Association Test [SI-IAT]) and one of the explicit measures pertained to the NSSI method of cutting. Patients were interviewed at multiple time points at which they reported whether they had engaged in NSSI before their hospital stay, during their hospital stay, and within 3 months after discharge. At baseline, SI-IAT scores differentiated past-year self-injurers and noninjurers (t121 = 4.02, p < .001, d = 0.73). These SI-IAT effects were stronger among patients who engaged in cutting (versus noncutting NSSI methods). Controlling for NSSI history and prospective risk factors, SI-IAT scores predicted patients' subsequent cutting behavior during their hospital stay (odds ratio (OR) = 8.19, CI = 1.56-42.98, p < .05). Patients' explicit self-report uniquely predicted hospital-based and postdischarge cutting, even after controlling for SI-IAT scores (ORs = 1.82-2.34, CIs = 1.25-3.87, p values <.01). Exploratory analyses revealed that in specific cases in which patients explicitly reported low likelihood of NSSI, SI-IAT scores still predicted hospital-based cutting. The SI-IAT is an implicit measure that is outcome-specific, a short-term predictor above and beyond NSSI history, and potentially helpful in cases in which patients at risk for NSSI explicitly report that they would not do so in the future. Ultimately, both implicit and explicit measures can help to predict future incidents of cutting among adolescent inpatients. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. [The adolescent manages fertility badly. Uncertainty and pursuit of self in a society in transition]. (United States)

    Diadhiou, F


    In Senegal, adolescents live in a socioeconomic climate that is between traditional society with its well-structured rites and customs and an extroverted modern society. They are often plunged into uncertainty and into a search of themselves. With a weak and not-yet-determined personality, sexuality erupts into their life experience. In Senegal, adolescent fertility, once encouraged by tradition, has become a social phenomenon which challenges all those interested in problems of youth. Major risks throughout the pregnancy and the puerperium confront adolescents. Complications may include grave vomiting, preeclampsia, hypertension and hemorrhaging, and more severe malaria than normal due to pregnancy. 12.9% of adolescent pregnancies end in miscarriage, 5.8% in premature births. Low birth weight and fetal death are also risk factors of adolescent pregnancy. Incomplete physical development exacerbates childbirth among adolescents, often leading to cesarean section, infection, and hemorrhaging. A combination of several risks appearing unexpectedly during pregnancy and during and after delivery can lead to a tragic death. During 1988-1989 at the gynecologic-obstetric clinic of the Aristide Le Dantac University Hospital Center of Dakar, adolescents comprised 8.1% of maternal deaths. If adolescents survive pregnancy, they may suffer after effects, e.g., genital scar tissue or psychological disorders. Infertility can also be an after effect. An unwanted pregnancy ended by illegal induced abortion can also lead to infertility. 2% of adolescents attending the clinic have common infections and/or sexually transmitted diseases (STDs). These infections almost always are a result of poor hygiene of the genital region. Family life education should prepare adolescents for sexuality and contraceptive use. Barrier methods can best prevent STDs and AIDS. Other contraceptive methods require compliance with strict rules. Emergency contraception should be reserved for cases of rape or

  19. Adolescent Sexual Behaviour and Practices in Nigeria: A Twelve ...

    African Journals Online (AJOL)

    ... given in this review have the potential to increase sexual awareness in adolescents, encourage contraceptive use and improve adolescent reproductive and sexual health in the country. Keywords: Adolescent sexual behaviour, Adolescent health and development, secondary school students, adolescent pregnancy.

  20. Borderline personality disorder in adolescence: the case for medium stay inpatient treatment. (United States)

    Williams, Laurel; Sharp, Carla


    The diagnosis of personality disorders in adolescents has been a topic of debate in recent years. This manuscript reviews the case of an adolescent girl admitted for a medium length combined inpatient and partial hospitalization program. This program has developed protocols to assess for Axis I and II pathology as well as various psychological processes. Comprehensive outcome measures were administered to the patient at discharge and follow-up. Diagnosis of a personality disorder in adolescence appears to be associated with psychological processes usually identified in adults. Against the background of an emerging debate about the need to reform a culture of ultra-short inpatient care, this case study provides some support for more thorough assessment, diagnosis, and treatment of adolescents who appear to have comorbid Axis I and II disorders.

  1. Self-esteem, social support perception and seizure controllability perception in adolescents with epilepsy

    Directory of Open Access Journals (Sweden)

    Nathália F. Siqueira


    Full Text Available OBJECTIVE: Compare the self-esteem of adolescents with epilepsy and adolescents without epilepsy and relate it to social support and seizure controllability perception. METHOD: The study sample consisted: case participants (34 subjects attending the pediatric epilepsy clinic of University Hospital and control participants (30 subjects from public schools in Campinas-SP. The instruments utilized were: identification card with demographic and epilepsy data, a semi-structured interview on aspects of the disease, and a Self-Esteem Multidimensional Scale. RESULTS: There was no significant difference between the two groups but majority of adolescents with epilepsy presented higher self esteem rate, have knowledge about epilepsy, presented high levels of social support and seizure controllability perception. There was no significant relationship between social support and seizure controllability perception with self-esteem. CONCLUSION: Knowledge about epilepsy, social support such good controllability seizure perception seem are important contingencies for a better evaluation of self esteem in adolescents with epilepsy.

  2. Income smoothing by Dutch hospitals

    NARCIS (Netherlands)

    Boterenbrood, D.R.


    Research indicates that hospitals manage their earnings. However, these findings might be influenced by methodological issues. In this study, I exploit specific features of Dutch hospitals to study income smoothing while limiting these methodological issues. The managers of Dutch hospitals have the

  3. Hospitality Services. Student Activity Book. (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…

  4. Library Hospitality: Some Preliminary Considerations (United States)

    Johnson, Eric D. M.; Kazmer, Michelle M.


    Library scholars and practitioners have frequently reflected on the various factors that in combination make up a hospitable library, but there has been little theoretical synthesis of the notion of the library as a place of hospitality. The hospitality industry provides a rich vein of theoretical material from which to draw definitions of…

  5. Hospitality in College Composition Courses (United States)

    Haswell, Janis; Haswell, Richard; Blalock, Glenn


    There has been little discussion of hospitality as a practice in college writing courses. Possible misuses of hospitality as an educational and ethical practice are explored, and three traditional and still tenable modes of hospitality are described and historicized: Homeric, Judeo-Christian, and nomadic. Application of these modes to…

  6. Hospitality Studies: Escaping the Tyranny? (United States)

    Lashley, Conrad


    Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…

  7. Blood pressure and lipid profiles in adolescents with hypertensive parents

    Directory of Open Access Journals (Sweden)

    Julia Fitriany


    significant median blood pressure differences. However, adolescents with hypertensive parents have This study was presented at Pertemuan Ilmiah Tahunan V (PIT V/The 5th Child Health Annual Scientific Meeting Bandung, October 15–17, 2012. From the Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera, Indonesia. Reprint requests to: Dr. Julia Fitriany, Department of Child Health, University of North Sumatera Medical School/H. Adam Malik Hospital, Jl. Bunga Lau No.17, Medan 20136. Tel +6261 8361721 – +6261 8365663. Fax. +6261 8361721. E-mail: Adolescent hypertension is an important health problem of increasing prevalence that affects morbidity and mortality.1 The prevalence of hypertension in adolescents has increased due to several factors such as obesity, a sedentary lifestyle, smoking, stress, sleep disorders and increased intake of high-calorie foods, sodium, alcohol, and caffeine.2 In the pediatric population, essential hypertension, also known as primary hypertension, mostly afsignificantly higher median total cholesterol and mean LDL-C. Furthermore, we find a correlation between parental history of hypertension and increased LDL-C in adolescents.

  8. Nursing magnet hospitals have better CMS hospital compare ratings

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.

  9. Hospitalized children's representations of their relationship with nurses and doctors. (United States)

    Corsano, Paola; Majorano, Marinella; Vignola, Valentina; Cardinale, Elisa; Izzi, Giancarlo; Nuzzo, Maria Josè


    This article reports an explorative study which aims to investigate hospitalized children's views of their relationships with nurses and doctors. Twenty-seven school-aged children and adolescents from 6 to 15 years old in the paediatric haematology and oncology ward of an Italian hospital participated in the study. Each participant was asked to draw him or herself with a doctor or nurse from the ward while they were doing something. The drawings were analysed using Pictorial Assessment of Interpersonal Relationships (PAIR) and a qualitative analysis. The results showed that the participants viewed their relationships with health professionals positively, in particular with the nurses. This relationship was perceived as close, intimate, cohesive and without conflict. In some cases it became an emotional bond. Finally, this relationship helped the patients to cope with painful and uncomfortable medical procedures, which gradually became familiar and accepted. The clinical implications of this study are discussed.

  10. The Impact of Hospital Size on CMS Hospital Profiling. (United States)

    Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J


    The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

  11. Defensive Passivity in Adolescence (United States)

    Rosenheim, Eliyahu; Gaoni, Bracha


    There are potentially healthy adolescents who display excessive reluctance to move toward independent decision and action. This research presents a clinical description of this "syndrome", conceptualizes it as a defensive maneuver against mourning over cherished childhood dreams and offers steps for therapeutic intervention. (Editor/RK)

  12. Adolescents and Television (United States)

    Hendry, Leo B.; Patrick, Helen


    Over 2,000 15-16 year old adolescents from central Scotland were surveyed to determine characteristics of high- vs. low-frequency television viewers. Personality characteristics, attitudes toward school and sports, and socioeconomic status were related to viewing habits. Sex of the viewer was found to be related to choice of programs. (GDC)

  13. Moral Development in Adolescence (United States)

    Hart, Daniel; Carlo, Gustavo


    Themes in the papers in this special issue of the "JRA" on moral development are identified. We discuss the intersection of moral development research with policy concerns, the distinctive qualities of moral life in adolescence that warrant investigation, the multiple connotations of "moral", the methods typical of moral development research, and…

  14. Adolescent Culture and Music. (United States)

    Andersen, Neil


    Discusses adolescent anxieties, rebelliousness, and media preferences in the 1990s, especially Hip Hop, and relates today's trends to past trends, from Sinatra to Break Dancing. Suggests classroom activities using music and music videos: analyzing fans; providing biographies, discographies, lyrics; writing reviews of albums and videos; studying…

  15. Internet Addiction among Adolescence (United States)

    Sargin, Nurten


    Each innovation brings along many risks. One of the risks related with the Internet use is Internet addiction. The aim of this study is to examine Internet addiction in adolescence in terms of gender, Internet access at home and grades. The research design used was survey method. The study population consisted of second stage students attending…

  16. Victimization of Obese Adolescents (United States)

    Robinson, Sabrina


    Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and…

  17. Popularity Contagion among Adolescents (United States)

    Marks, Peter E. L.; Cillessen, Antonius H. N.; Crick, Nicki R.


    This study aimed to support the theory of popularity contagion, which posits that popularity spreads among friends spontaneously and regardless of behavioral changes. Peer nominations of status and behavior were collected annually between 6th and 12th grades from a total of 1062 adolescents. Longitudinal hypotheses were mostly supported using path…

  18. Adolescent Substance Abuse. (United States)

    Thorne, Craig R.; DeBlassie, Richard R.


    Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)

  19. Addictions in adolescence

    NARCIS (Netherlands)

    Kleinjan, M.; Engels, R.C.M.E.; Brown, B.B.; Prinstein, M.J.


    An overview of the prevalence, health consequences, and determinants of adolescents’ substance use is provided in this article on adolescence and addictions. Additionally, prevention and treatment efforts and the effectiveness are discussed. The emphasis is on alcohol, smoking, and cannabis use.

  20. Problems of adolescence

    CERN Document Server



    Le Prof.Feldmann, Prof. de psychiatrie à l'Université de Genève, donne une suite de la conférence du novembre 1967 en parlant des besoins de l'adolescent et l'aspect pratique, suivi d'une discussion

  1. From birth to adolescence

    DEFF Research Database (Denmark)

    Pietrobelli, A; Flodmark, C E; Lissau, I


    that despite the fact that childhood obesity is a crisis facing worldwide youth, it is necessary that action to control it must be taken now. All the six relevant levels (ie, family, schools, health professionals, government, industry and media) could be involved in prevention of child and adolescent obesity....

  2. Adolescents Who Murder. (United States)

    Bailey, Susan


    Presents descriptive data on a 5-year cohort of 20 adolescent murderers from England and Wales, and provides an outline of their pathway through the criminal justice system together with a framework for their ongoing individual therapy. Suggests refinement of categories of juvenile homicide and increased information sharing among professionals.…

  3. [Adolescent psychosocial development]. (United States)

    Gaete, Verónica


    It is increasingly necessary that pediatricians have greater knowledge of adolescent health. To begin with they should be familiar with the psychosocial development of this period, an issue which is imperative for the health care of the age group. With that purpose, this article reviews the normal adolescent psychosocial development. Adolescence is a stage that has been progressively prolonged, during which fast and big changes occur, that lead human beings to become biologically, psychologically and socially mature, and potentially able to live independently. Developmental tasks of this period are the establishment of identity and the achievement of autonomy. Although it is a process of high individual variability in terms of its beginning and end, the progression through stages, the synchrony of development between the various areas, and in other aspects, the psychosocial development of this period usually have common characteristics and a progressive pattern of 3 phases: early, middle and late adolescence. Psychological, cognitive, social, sexual and moral development of young people in each of them are described in this article. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Communicating with adolescents

    African Journals Online (AJOL)


    May 18, 2008 ... theories concur that adolescence is a distinct developmental period characterised by ... Thus the initial self-righteous black-and- white thinking of early ... their daughter temporarily needs to hole herself up in her dirty room ...

  5. Adolescent Growth and Development


    Morgan, Erin; Huebner, Angela


    Adolescence is a time of many transitions for both teens and their families. It is important for both to understand what is happening to the teen physically, cognitively, and socially; how these transitions effect teens; what adults can do about it; and what resources are available.

  6. Abortion among Adolescents. (United States)

    Adler, Nancy E.; Ozer, Emily J.; Tschann, Jeanne


    Reviews the current status of abortion laws pertaining to adolescents worldwide, examining questions raised by parental consent laws in the United States and by the relevant psychological research (risk of harm from abortion, informed consent, consequences of parental involvement in the abortion decision, and current debate). Discusses issues…

  7. Nutritional disturbances by adolescent


    Stassart, Martine


    The nutritional disturbances are frequent by adolescents. That is a psychological defense against dependance toward the mother but also a middle to remain in a childish position i.e. either as a fat baby - in the fall of obesity- or as the ideal pre- or bisexual great child - in the case of anorexia.

  8. Adolescent Sociopaths. Revised. (United States)

    Chapple, Eliot D.

    Presented is the final report of a research project on the programed training and placement of nonpsychotic disturbed adolescents. Eleven chapters cover topics which include the following: psychiatry and the sociopaths and psychopaths; boys dealt with in the project; development of the programed interaction diagnostic interview; disturbances to…

  9. Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide. (United States)

    Dougherty, Donald M; Mathias, Charles W; Marsh-Richard, Dawn M; Prevette, Kristen N; Dawes, Michael A; Hatzis, Erin S; Palmes, Guy; Nouvion, Sylvain O


    This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI+SA; n=25) or without (NSSI-Only; n=31) suicide attempts. We hypothesized that adolescent with NSSI+SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, self-reported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4-6 weeks after discharge. During hospitalization, NSSI+SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI+SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI+SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well.

  10. Perceived social support in pregnant adolescents in Mersin area in Turkey. (United States)

    Yurdakul, Mine


    The study examines the level and source of perceived social support in pregnant adolescents and the factors related to their perception of social support. This descriptive study was conducted with the voluntary participation of 127 adolescent pregnant females who visited the Gynecology and Pediatric Hospital in Mersin, Turkey. The data were collected based on the participants' self-expression, using the Socio-demographic Information Form and Multidimensional Scale of the Perceived Social Support. The average age of the pregnant adolescents was 18 years. Approximately one-fifth of all participant females were either illiterate or had dropped out of the primary school. All pregnant adolescents were housewives with a low economic status. Findings pertaining to the participants'fertility showed that 69.3% were primiparous, 24.4% had at least one living child. The mean score for pregnant adolescents' perception of social support was 50.79±8.72. The mean score on the subscales was 23.32±3.23 for family support; 16.17±4.35 for friend support; and 12.29 ± 5.54 for special person support. Pregnant adolescents had a low perception of social support. Families were found to be the most common source of social support available to pregnant adolescents, and they lacked the support from their friends and other special people.

  11. Focus on anorexia nervosa: modern psychological treatment and guidelines for the adolescent patient

    Directory of Open Access Journals (Sweden)

    Espie J


    Full Text Available Jonathan Espie,1 Ivan Eisler2 1Child and Adolescent Eating Disorders Service, Michael Rutter Centre, South London and Maudsley Hospital Foundation NHS Trust, 2Institute of Psychiatry, King's College London, London, UK Abstract: Anorexia nervosa is a serious condition associated with high mortality. Incidence is highest for female adolescents, and prevalence data highlight a pressing unmet need for treatment. While there is evidence that adolescent-onset anorexia has relatively high rates of eventual recovery, the illness is often protracted, and even after recovery from the eating disorder there is an ongoing vulnerability to psychosocial problems in later life. Family therapy for anorexia in adolescence has evolved from a generic systemic treatment into an eating disorder-specific format (family therapy for anorexia nervosa, and this approach has been evidenced as an effective treatment. Individual treatments, including cognitive behavioral therapy, also have some evidence of effectiveness. Most adolescents can be effectively and safely managed as outpatients. Day-patient treatment holds promise as an alternative to inpatient treatment or as an intensive program following a brief medical admission. Evidence is emerging of advantages in detecting and treating adolescent anorexia nervosa in specialist community-based child and adolescent eating-disorder services accessible directly from primary care. Limitations and future directions for modern treatment are considered. Keywords: AN, evidence, family, therapy, FT-AN, inpatient, outpatient, day patient, specialist 

  12. Substance use in adolescents with mental illness in Durban, South Africa. (United States)

    Taukoor, Bhoodeo; Paruk, Saeeda; Karim, Enver; Burns, Jonathan K


    Comorbid substance use in adolescents with mental illness is often an indicator of poor treatment outcome. This study aims to determine the prevalence of, and associated risk factors for, substance use in adolescents with mental illness attending a mental health service. Data was collected from hospital records of 162 adolescents, using a structured data sheet, over a two-year period. Substance use was more significant in older adolescents and those with severe mental illness. Sixty-two (38.3%) adolescents used substances. Thirty-seven (38.1%) male adolescents reported substance use compared to 25 (38.5%) female adolescents. Alcohol was the most commonly used substance (n = 48; 29.6%), followed by cannabis (n = 32; 19.8%). There were significant direct associations between substance use and history of abuse or neglect, forensic history, educational setting, admission status, and the psychiatric diagnoses of schizophrenia, other psychotic disorders, and bipolar mood disorder. Inverse associations were found between substance use and adjustment disorders, attention deficit hyperactivity disorder, and intellectual disability. The results of this study indicate an urgent need for substance misuse programmes for at risk youth, and the introduction of dual diagnosis intervention programmes in this age group.

  13. Descriptive epidemiology of metabolic syndrome among obese adolescent population. (United States)

    Mahbuba, Sharmin; Mohsin, Fauzia; Rahat, Farhana; Nahar, Jebun; Begum, Tahmina; Nahar, Nazmun


    The study was done to assess the magnitude of problems of metabolic syndrome among obese adolescents. It was a cross-sectional study done from January 2013 to June 2014 in paediatric endocrine outpatient department in BIRDEM General Hospital, Dhaka, Bangladesh. Total 172 adolescents having exogenous obesity aged 10-18 years were included. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) were defined as per WHO criteria.The adolescents having Body Mass Index (BMI) ≥95th centile were classified as obese.Waist circumference was measured at the level midway between the lower rib margin & the iliac crest, at the level of umbilicus with the person breathing out gently in centimeter. Hip circumference was measured at the maximum width over the buttocks at the level of the greater trochanters in centimeter. Among 172 obese adolescents, metabolic syndrome was found in 66 patients (38.4%). The commonest metabolic abnormality among those having metabolic syndrome was low HDL level (77.3%) followed by high triglyceride level(71.2%). Glucose intolerance (IFG and/or IGT) was found in 16.7%, Type 2 DM in 10.6%, systolic hypertension in 10.7% and diastolic hypertension in 12.1%. Triglyceride (p = 0.042) and Cholesterol level (p = 0.016) were significantly higher and HDL-cholesterol level (p = 0.000) was significantly lower among obese adolescents having metabolic syndrome. Less physical activity (p = 0.04) was significantly related to the development of metabolic syndrome. On logistic regression analysis male sex, family history of obesity and low HDL-cholesterol correlated to metabolic syndrome. The High rate of metabolic syndrome among obese adolescents is alarming. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  14. Adolescent health in urban India

    Directory of Open Access Journals (Sweden)

    S Ramadass


    Full Text Available Adolescence is the period in human growth and development that occurs after childhood and before adulthood, from ages 10 to 19 years. It is a period of dynamic brain development. During this period, adolescents learn from the social behavior and environmental surroundings of their community. Because of rapid urbanization without accounting for the basic health-care amenities, health disparities tend to arise. In this review, we have tried to describe the health profile of adolescents in urban India. Relevant articles were extracted from PubMed and related websites. Adolescents in urban areas perceive their physical environment as very poor. Social capital and social cohesion are very important in their development. Increasing child marriage and poor antenatal care among adolescents are key challenges in improving the reproductive and sexual health. More than half of adolescents are undernourished. About 56% of adolescent girls are anemic. At this time of fighting against under-nutrition, burden of overweight and obesity is increasing among the urban adolescents. Mass media use and increased sedentary lifestyle increase the risk factors for noncommunicable diseases. Labile mental and emotional behavior makes them prone to suicide and intentional self-harm. Another avoidable key challenge among adolescents is addiction. Urban living and regular media exposure are positively associated with smoking and alcohol consumption. Among unintentional injuries, road traffic accidents dominate the picture. Various health programs targeting adolescent health have been launched in the recent past.

  15. Genetics Home Reference: adolescent idiopathic scoliosis (United States)

    ... Facebook Twitter Home Health Conditions Adolescent idiopathic scoliosis Adolescent idiopathic scoliosis Printable PDF Open All Close All ... Javascript to view the expand/collapse boxes. Description Adolescent idiopathic scoliosis is an abnormal curvature of the ...

  16. Early adolescent sexual debut in peer networks

    NARCIS (Netherlands)

    Savickaite, Ruta; Dijkstra, Jan; Veenstra, René


    Emerging adolescent sexual activity is considered a normative aspect of adolescent development and the transition to adulthood, however, there are potential risks involved when adolescents start having sex, such as teenage pregnancies, sexually transmitted infections, and undesirable long-term

  17. Mobile Robots for Hospital Logistics


    Özkil, Ali Gürcan


    Hospitals are complex and dynamic organisms that are vital to the well-being of societies. Providing good quality healthcare is the ultimate goal of a hospital, and it is what most of us are only concerned with. A hospital, on the other hand, has to orchestrate a great deal of supplementary services to maintain the quality of healthcare provided. Logistics is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is...

  18. Strategic management process in hospitals. (United States)

    Zovko, V


    Strategic management is concerned with strategic choices and strategic implementation; it provides the means by which organizations meet their objectives. In the case of hospitals it helps executives and all employees to understand the real purpose and long term goals of the hospital. Also, it helps the hospital find its place in the health care service provision chain, and enables the hospital to coordinate its activities with other organizations in the health care system. Strategic management is a tool, rather than a solution, that helps executives to identify root causes of major problems in the hospital.

  19. Reproductive outcomes in adolescents who had a previous birth or an induced abortion compared to adolescents' first pregnancies

    Directory of Open Access Journals (Sweden)

    Wenzlaff Paul


    Full Text Available Abstract Background Recently, attention has been focused on subsequent pregnancies among teenage mothers. Previous studies that compared the reproductive outcomes of teenage nulliparae and multiparae often did not consider the adolescents' reproductive histories. Thus, the authors compared the risks for adverse reproductive outcomes of adolescent nulliparae to teenagers who either have had an induced abortion or a previous birth. Methods In this retrospective cohort study we used perinatal data prospectively collected by obstetricians and midwives from 1990–1999 (participation rate 87–98% of all hospitals in Lower Saxony, Germany. From the 9742 eligible births among adolescents, women with multiple births, >1 previous pregnancies, or a previous spontaneous miscarriage were deleted and 8857 women Results In bivariate logistic regression analyses, compared to nulliparous teenagers, adolescents with a previous birth had higher risks for perinatal [OR = 2.08, CI = 1.11,3.89] and neonatal [OR = 4.31, CI = 1.77,10.52] mortality and adolescents with a previous abortion had higher risks for stillbirths [OR = 3.31, CI = 1.01,10.88] and preterm births [OR = 2.21, CI = 1.07,4.58]. After adjusting for maternal nationality, partner status, smoking, prenatal care and pre-pregnancy BMI, adolescents with a previous birth were at higher risk for perinatal [OR = 2.35, CI = 1.14,4.86] and neonatal mortality [OR = 4.70, CI = 1.60,13.81] and adolescents with a previous abortion had a higher risk for very low birthweight infants [OR = 2.74, CI = 1.06,7.09] than nulliparous teenagers. Conclusion The results suggest that teenagers who give birth twice as adolescents have worse outcomes in their second pregnancy compared to those teenagers who are giving birth for the first time. The prevention of the second pregnancy during adolescence is an important public health objective and should be addressed by health care providers who attend the first birth or the abortion

  20. An ideal hospital. (United States)

    Chandrasiri, Singithi Sidney


    Purpose The purpose of this paper is to explore a novel overarching strategy in tackling the key issues raised by the recent inquiry into bullying, harassment and discrimination in surgical practice and surgical training in Australian and New Zealand hospitals. Design/methodology/approach The approach taken is an analysis of the available evidence-based literature to inform the proposed viewpoint. The theoretical subject scope presented is a discussion of how and why the various strategies put forward in this paper should be integrated into and led from an overarching workforce engagement platform. Findings The key themes isolated from the Inquiry into Australian and New Zealand surgical practice ranged from abuse of power by those in leadership positions, gender inequity in the surgical workforce, opaque and corrupt complaints handling processes, excessive surgical trainee working hours to bystander silence secondary to a fear of reprisal. A workforce engagement perspective has elicited the potential to counter various impacts, that of clinical ineffectiveness, substandard quality and safety, inefficient medical workforce management outcomes, adverse economic implications and the operational profitability of a hospital. Generic strategies grounded in evidence-based literature were able to then be aligned with specific action areas to provide a new leadership framework for addressing these impacts. Originality/value To the author's knowledge, this is one of the first responses providing a framework on how medical managers and hospital executives can begin to lead a comprehensive and practical strategy for changing the existing culture of bullying, harassment and discrimination in surgical practice by using a staff engagement framework.

  1. Hospital Web site 'tops' in Louisiana. Hospital PR, marketing group cites East Jefferson General Hospital. (United States)

    Rees, Tom


    East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing.

  2. Radiation protection in hospitals

    International Nuclear Information System (INIS)

    MOuld, R.F.


    A book on radiation protection in hospitals has been written to cater for readers with different backgrounds, training and needs by providing an elementary radiation physics text in Part I and an advanced, comprehensive Part II relating to specific medical applications of X-rays and of radioactivity. Part I includes information on basic radiation physics, radiation risk, radiation absorption and attenuation, radiation measurement, radiation shielding and classification of radiation workers. Part II includes information on radiation protection in external beam radiotherapy, interstitial source radiotherapy, intracavitary radiotherapy, radioactive iodine-131 radiotherapy, nuclear medicine diagnostics and diagnostic radiology. (U.K.)

  3. Hospital Ship Replacement (United States)


    serious contender. Although it is a proven hull design for stability, integrating the ability to quickly transfer patients aboard is challenging . The...Waste management afloat is a constant challenge for the Navy. It is even more so when designing a hospital ship. In addition to the typical waste...0.97 Optbrs: Corrmon rail fuellrijacllon,crude oil. Rated power generating sets 61:ili:ln()q;to~ 50Htl760rpm &.gne type -1801.\\ Vlc )l ~W.’/cyl SI;O k

  4. Hospital Acquisitions Before Healthcare Reform. (United States)

    McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun


    The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities.

  5. Strategic management for university hospitals

    Directory of Open Access Journals (Sweden)

    Martha Isabel Riaño-Casallas


    Full Text Available Introduction: There are several approaches and schools that support strategic management processes. University hospitals require the implementation of a strategic approach to their management, since they are a particular type of organization with the triple mission of providing health care, education and research. Objective: To propose a strategic profile for a university hospital. Materials and methods: The theoretical framework of strategic management was analyzed and some particular components of hospital management were studied; based on these criteria, the strategic management process in three high complexity hospitals of Bogotá, D.C. was examined and a profile of both the objectives and the functional strategies for the hospital was proposed. Results: The main strategic thinking schools are presented; the processes and components of strategic management are described, and a strategic management profile for a university hospital is proposed. Conclusion: The strategic orientation of management for an institution with the characteristics of a university hospital facilitates achieving organizational objectives.

  6. Factors associated with body image distortion in Korean adolescents

    Directory of Open Access Journals (Sweden)

    Hyun MY


    Full Text Available Mi-Yeul Hyun,1 Young-Eun Jung,2 Moon-Doo Kim,2 Young-Sook Kwak,2 Sung-Chul Hong,3 Won-Myong Bahk,4 Bo-Hyun Yoon,5 Hye Won Yoon,6 Bora Yoo61College of Nursing, Jeju National University, Jeju, Korea; 2Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Korea; 3Department of Preventive Medicine, School of Medicine, Jeju National University, Jeju, Korea; 4Department of Psychiatry, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; 5Department of Psychiatry, Naju National Hospital, Naju, Korea; 6School of Medicine, Jeju National University, Jeju, KoreaPurpose: Body image incorporates cognitive and affective components as well as behaviors related to own body perception. This study evaluated the occurrence of body image distortion and its correlates in Korean adolescents.Methods: In a school-based cross-sectional survey, a total of 2,117 adolescents were recruited. They filled out self-completing questionnaires on body image distortion, eating attitudes, and behaviors (Eating Attitude Test-26 and related factors.Results: Body image distortions were found in 51.8 percent of adolescents. Univariate analyses showed that boys and older adolescents had higher rates of body image distortion. In the multivariate analyses, body image distortion was associated with high risk for eating disorders (odds ratio [OR] =1.69; 95% confidence interval [CI] 1.11–2.58; P=0.015 and being over weight (OR =33.27; 95% CI 15.51–71.35; P<0.001 or obese (OR =9.37; 95% CI 5.06–17.34; P<0.001.Conclusion: These results suggest that body image distortion is relatively common in Korean adolescents, which has implications for adolescents at risk of developing eating disorders.Keywords: body image distortion, high risk for eating disorders, Korean adolescent

  7. Impact of hospitalisation on the outcome of adolescent anorexia nervosa. (United States)

    Gowers, S G; Weetman, J; Shore, A; Hossain, F; Elvins, R


    Owing to the lack of controlled trials of treatment setting in adolescent anorexia nervosa, the benefits and costs of in-patient treatment are not established. To clarify the relationship between a range of presenting features, treatment received and medium- to long-term outcome in adolescent anorexia nervosa. A range of presenting variables were rated for 75 cases of DSM-III-R anorexia nervosa at presentation to an adolescent service, including the Morgan-Russell Global Assessment Score. Cases were followed up at 2-7 years and outcome rated according to reliable methods. Setting of treatment received was also recorded. Two out of 75 cases had died by the time of follow-up. Adequate data for 72 enabled an outcome category to be assigned. The 21 who had received inpatient treatment had a significantly worse outcome than the 51 never admitted to hospital. Multivariate analysis suggests admission to be the major predictor of poor outcome. The benefits and costs of admission to hospital require further investigation, ideally in a randomised-controlled trial. The negative consequences of in-patient treatment are neglected in research.

  8. Self-esteem deficits and suicidal tendencies among adolescents. (United States)

    Overholser, J C; Adams, D M; Lehnert, K L; Brinkman, D C


    Self-esteem can play an important role in suicidal tendencies among adolescents. The present study was designed to examine the relationship between self-esteem deficits and suicidal tendencies in 254 adolescent psychiatric inpatients and 288 high school students. The direct relationship between self-esteem and suicidal tendencies was examined by assessing suicidal ideation and history of suicide attempts. An indirect relationship between self-esteem and suicidality was examined by assessing depression and hopelessness. Differences were found across gender and hospitalization status, with males reporting higher self-esteem than females and high school students scoring higher in self-esteem than psychiatric inpatients. However, correlations among variables remained similar across gender and hospitalization status. Thus, low self-esteem was related to higher levels of depression, hopelessness, suicidal ideation, and an increased likelihood of having previously attempted suicide. Furthermore, self-esteem added to the understanding of suicidal ideation beyond what could be explained by depression and hopelessness. Low self-esteem was closely related to feelings of depression, hopelessness, and suicidal tendencies. Assessment of adolescents should include an evaluation of self-esteem, and therapy should attempt to address any self-esteem deficits.

  9. Hospitals - HOSPITALS_HAZUS_IN: Hospitals and Clinics in Indiana, Derived from HAZUS (Federal Emergency Management Agency, Point Shapefile) (United States)

    NSGIC State | GIS Inventory — HOSPITALS_HAZUS_IN is a point shapefile that shows locations of hospitals and clinics in Indiana. HOSPITALS_HAZUS_IN was derived from the shapefile named "HOSPITAL."...

  10. Impulsivity and Suicidality in Adolescent Inpatients. (United States)

    Auerbach, Randy P; Stewart, Jeremy G; Johnson, Sheri L


    Suicide is the second leading cause of death among adolescents, and impulsivity has emerged as a promising marker of risk. The present study tested whether distinct domains of impulsivity are differentially associated with suicide ideation, plans, and attempts. Adolescents (n = 381; boys = 106, girls = 275) aged 13-19 years (M = 15.62, SD = 1.41) were recruited from an acute, residential treatment program. Within 48 h of admission to the hospital, participants were administered structured clinical interviews assessing mental health disorders and suicidality. Following these interviews, participants completed self-report questionnaires assessing symptom severity and impulsivity. Consistent with past research, an exploratory factor analysis of our 90-item impulsivity instrument resulted in a three-factor solution: Pervasive Influence of Feelings, Feelings Trigger Action, and Lack of Follow-Through. Concurrent analysis of these factors confirmed hypotheses of unique associations with suicide ideation and attempts in the past month. Specifically, whereas Pervasive Influence of Feelings (i.e., tendency for emotions to shape thoughts about the self and the future) is uniquely associated with greater suicidal ideation, Feelings Trigger Action (i.e., impulsive behavioral reactivity to emotions) is uniquely associated with the occurrence of suicide attempts, even after controlling for current psychiatric diagnoses and symptoms. Exploratory gender analyses revealed that these effects were significant in female but not male adolescents. These findings provide new insight about how specific domains of impulsivity differentially increase risk for suicide ideation and attempts. Implications for early identification and prevention of youth suicide are discussed.

  11. Safeguarding nutritional status of adolescent mothers

    International Nuclear Information System (INIS)

    Calderon de la Barca, A.M.; Casanueva, E.; Bolanos, A.V.; Caire Juvera, G.; Valencia, M.E.; Roman Perez, R.


    The Baby-Friendly Hospital Initiative (BFHI) has been introduced in Mexico in order to increase breast feeding. The Mexican health care system may be contributing negatively to the nutritional status of adolescent mothers and their infants due to the reduction of baby formulas which were previously supplied as a benefit. The aim of this study is to evaluate breast-milk production, the quantity and quality of protein and changes in body composition in adolescent and adult mothers in order to design the right ways to help mother and infants fulfill their requirements or obtain support to apply to the BFHI program. We propose to measure breast-milk intake and total body water by deuterium kinetics using infrared spectroscopy. Protein concentration and composition will be measured by electrophoresis. Adolescent and adult mothers who are breast-feeding exclusively and living in two different urban regions, northwest and central Mexico, will be dosed with deuterium oxide; saliva and breast milk samples will be taken. Currently, both of the working groups are standardized. A sublimation system for separation of water and D 2 O of the saliva samples under reduced pressure was designed and it has a 100% of D 2 O recovery. The setting up of conditions for D 2 O determination using infrared spectroscopy was achieved and calibration curves of absorbance of sequentially diluted D 2 O were obtained with an r=0.9948. Total body water was measured in 12 women after 1, 3, 6, 9 and 14 days of the D 2 O dose. Zero-time values obtained by extrapolation were similar to those directly obtained after 4 h equilibrium. In addition, 50 women (under inclusion criteria) have signed consent letters to participate and part of the study is currently underway. For 1998, we intend to have 40 women and their infants with both dosing periods analyzed, as well as the analysis of breast milk composition. (author)

  12. [Long-term psychiatric hospitalizations]. (United States)

    Plancke, L; Amariei, A


    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  13. Services Use of Children and Adolescents before Admission to Psychiatric Inpatient Care. (United States)

    Zechmeister-Koss, Ingrid; Winkler, Roman; Fritz, Corinna; Thun-Hohenstein, Leonhard; Tuechler, Heinz


    Although 20% of children and adolescents in Europe suffer from overt mental health problems, their illness-related service utilisation is often unknown. If at all, existing research has only addressed the health care sector while services requirements in mental health care go far beyond the health care system, including the social, the educational and the criminal justice system. This paper aims at describing the service contact patterns of children and adolescents within and outside the health care sector before they are admitted to a child and adolescent mental health hospital. Additionally, we evaluate the private out-of-pocket payments that occur for primary carers. A cohort of consecutive admissions to a child and adolescent hospital in Austria was prospectively analysed. We collected data on service use and out-of-pocket expenses before hospital admission from primary carers through face-to-face interviews using an adapted version of the European Child and Adolescent Mental Health Service Receipt Inventory (EU-CAMHSRI). Clinical data came from validated questionnaires (CBCL, YSR) and from the anamnestic documentation. Ninety percent from a cohort of 441 patients had some contact with services or took medication before they were admitted to hospital. Most often, services in the health care outpatient setting were used. Outside of the health care system, support in school, as well as counselling services, were used most frequently, whereas the persons hardly sought support in living or employment. Roughly 32,400 per 100 patients was spent privately, yet these out-of pocket expenses were very unevenly distributed. Service use and out-of-pocket spending increased with social status and were gender-specific. The more severe external behaviour symptoms were, the more non-health care services were used. Mentally ill children and adolescents use a broad range of services across sectors before admission to hospital. Service use is associated with specific symptoms of

  14. Characterization of Hospital Residuals

    International Nuclear Information System (INIS)

    Blanco Meza, A.; Bonilla Jimenez, S.


    The main objective of this investigation is the characterization of the solid residuals. A description of the handling of the liquid and gassy waste generated in hospitals is also given, identifying the source where they originate. To achieve the proposed objective the work was divided in three stages: The first one was the planning and the coordination with each hospital center, in this way, to determine the schedule of gathering of the waste can be possible. In the second stage a fieldwork was made; it consisted in gathering the quantitative and qualitative information of the general state of the handling of residuals. In the third and last stage, the information previously obtained was organized to express the results as the production rate per day by bed, generation of solid residuals for sampled services, type of solid residuals and density of the same ones. With the obtained results, approaches are settled down to either determine design parameters for final disposition whether for incineration, trituration, sanitary filler or recycling of some materials, and storage politics of the solid residuals that allow to determine the gathering frequency. The study concludes that it is necessary to improve the conditions of the residuals handling in some aspects, to provide the cleaning personnel of the equipment for gathering disposition and of security, minimum to carry out this work efficiently, and to maintain a control of all the dangerous waste, like sharp or polluted materials. In this way, an appreciable reduction is guaranteed in the impact on the atmosphere. (Author) [es

  15. The psychoanalyst of the adolescent. (United States)

    Laufer, M


    The adolescent who comes for psychoanalytic treatment has probably experienced a developmental breakdown-a rejection of his or her body and a distorted image of himself or herself as being male or female. A critical requisite for work with such adolescents is an understanding of one's own adolescent development. The internal freedom of the psychoanalyst is an essential ingredient in the treatment of the adolescent. This means that the psychoanalyst of the adolescent can separate his own sexual life and thoughts from what is lived out in the analytic sessions and thus can ensure that the treatment will confront whatever is essential and that he will avoid deriving gratification from the treatment process through taking over the adolescent's body or feeling that he is secretly sharing the intimacies of the patient.

  16. Refeeding hypophosphatemia in adolescents with anorexia nervosa: a systematic review. (United States)

    O'Connor, Graeme; Nicholls, Dasha


    The rate of adolescents presenting with anorexia nervosa (AN) is increasing. Medically unstable adolescents are admitted to the hospital for nutrition restoration. A lack of global consensus on appropriate refeeding practices of malnourished patients has resulted in inconsistent refeeding practices. Refeeding hypophosphatemia (RH) is the most common complication associated with refeeding the malnourished patient. This review sought to identify the range of refeeding rates adopted globally and the implication that total energy intake and malnutrition may have on RH while refeeding adolescents with anorexia nervosa. Studies were identified by a systematic electronic search of medical databases from 1980 to September 2012. Seventeen publications were identified, including 6 chart reviews, 1 observational study, and 10 case reports, with a total of 1039 subjects. The average refeeding energy intake was 1186 kcal/d, ranging from 125-1900 kcal/d, with a mean percentage median body mass index (% mBMI) of 78%. The average incidence rate of RH was 14%. A significant correlation between malnutrition (% mBMI) and post-refeeding phosphate was identified (R (2) = 0.6, P = .01). This review highlights the disparity in refeeding rates adopted internationally in treating malnourished adolescents with anorexia nervosa. Based on this review, the severity of malnutrition seems to be a marker for the development of RH more so than total energy intake.

  17. Breast tumours of adolescents in an African population

    Directory of Open Access Journals (Sweden)

    Umanah Ivy


    Full Text Available Background: Tumours of the breast are uncommon in childhood and adolescence. Patients in this age group often require a different approach to diagnosis and treatment. The purpose of this study is to highlight the clinicopathologic features of breast tumours in adolescents in a Nigerian city. Materials and Methods: Eighty-four breast tumour materials from patients aged 10-19 years were analyzed over a 10-year period at the Department of Pathology, University of Benin Teaching Hospital (UBTH, Benin City, Edo State, Benin City, Nigeria. Results: A majority of the breast tumours were benign. Fibroadenoma was the most common tumour with 46 cases (54.8%, followed by fibrocystic changes with 15 cases (17%. Malignancy was extremely rare in this group, with only one case (1.2% of an invasive ductal carcinoma. Histologically, most tumours were indistinguishable from the adult types. Conclusion: Fibroadenoma is the most common breast tumour in adolescents in Benin City, Nigeria. Breast cancer and male breast tumours are rare in this age group. Routine complete physical examination of children and adolescents should include breast examination.

  18. Sexual Health of Adolescent Patients Admitted to a Psychiatric Unit. (United States)

    Harrison, Megan E; van Zanten, Stephanie Veldhuijzen; Noel, Ariana; Gresham, Louise; Norris, Mark L; Robinson, Amy; Chan, Jason; Boafo, Addo


    To review sexual health screening practices during admission to an adolescent psychiatry unit. Retrospective chart review of randomly selected youth admitted over a one-year period (2013). Data extracted included demographics, reasons for admission, sexual health history, as well as any comorbid behaviours noted. The main outcome measure was whether sexual health details were documented at any time during admission; if so, this information was extracted for analysis. Statistical analysis was done using univariate associations and logistic association. Mean age of subjects (n=99, 79 females and 20 males) was 15.24 years (SD = 1.30). Most common reasons for admission were suicidal gestures/self harm (n=57, 58%) and mood disorders (n=53, 54%). Thirty-seven patients (37%) had sexual health information documented in their charts. No demographic variables were significantly associated with being asked sexual health questions. Patients who had mood disorder diagnoses had 6 times the odds (95%CI: 1.18 to 29.96, P=0.03) of sexual health questions being documented compared to those not diagnosed with mood disorders. Screening for sexual health concerns is not being documented in the majority of adolescent psychiatry inpatients. Omitting sexual health screening during hospitalizations represents a missed opportunity for investigation and management of sexual health issues in this high-risk group. As many adolescents, particular those struggling with mental illness, do not attend preventative health visits, screening for pregnancy risk and other reproductive health needs is recommended at every adolescent encounter and in all settings.

  19. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru]. (United States)

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro


    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

  20. Cannabis Use Disorder in Adolescence. (United States)

    Simpson, Annabelle K; Magid, Viktoriya


    Cannabis use in the adolescent population poses a significant threat of addiction potential resulting in altered neurodevelopment. There are multiple mechanisms of treatment of cannabis use disorder including behavioral therapy management and emerging data on treatment via pharmacotherapy. Recognizing the diagnostic criteria for cannabis use disorder, cannabis withdrawal syndrome, and mitigating factors that influence adolescent engagement in cannabis use allows for comprehensive assessment and management in the adolescent population. Copyright © 2016 Elsevier Inc. All rights reserved.