Sample records for adolescent hospitalized

  1. Anhedonia and Pessimism in Hospitalized Depressed Adolescents

    Zinoviy Gutkovich


    Full Text Available This longitudinal study investigates whether anhedonia and pessimistic attributional style represent a clinical state or a trait in hospitalized depressed adolescents. 81 consecutive adolescent inpatients were screened with the Beck Depression Inventory (BDI and the clinician-rated Major Depressive Disorder (MDD criteria sheet. 51 patients with BDI score ≥10 and/or ≥4 symptoms on MDD criteria sheet were assessed at Time 1 upon admission, with 39 patients (78% assessed at discharge (Time 2 with the Pleasure Scale for Children and Children's Attributional Style Questionnaire—Revised. Anhedonia and pessimism at admission were associated with BDI scores at admission and discharge as well as number of depressive symptoms and depression severity. MDD diagnosis was associated with anhedonia, but not with pessimism. Pessimism—but not anhedonia—improved significantly by discharge. Results suggest that while some adolescents exhibit enduring anhedonia, pessimistic attributional style appears to be a concomitant feature of an acute depressive state.

  2. Using the hospital as a venue for reproductive health interventions: a survey of hospitalized adolescents.

    Guss, Carly E; Wunsch, Caroline A; McCulloh, Russell; Donaldson, Abigail; Alverson, Brian K


    Less than one-half of sexually active adolescents have received counseling regarding contraception and sexually transmitted disease (STD) from their health care provider. We hypothesized that hospitalized adolescents would be interested in receiving reproductive health education and/or STD testing. In addition, we assessed the opinion of female adolescents on initiation of contraception during hospitalization. A convenience sample of 13- to 18-year-old male and female adolescent patients hospitalized at a tertiary pediatric hospital were approached for inclusion. Consenting patients completed a self-administered anonymous questionnaire. Questionnaires from 49 female adolescents and from 51 male adolescents were collected. Based on their answers, 37% of female adolescents and 44% of male adolescents want to learn more about contraception and/or abstinence in the hospital independent of sexual activity. Thirty percent of respondents reported a desire for STD testing in the hospital. Fifty-seven percent of female subjects answered that adolescents should be offered contraception while in the hospital. Among hospitalized adolescents in this study, there was an interest in reproductive health education and contraception even among those with a primary care provider and without sexual experience. Thus, hospital-based pediatricians can play a pivotal role in expanding critical sexual health services by discussing and offering sexual health care to hospitalized adolescents. We recommend that hospitals make a brochure available to all admitted adolescents, with opportunity for follow-up discussions with their hospitalist. Copyright © 2015 by the American Academy of Pediatrics.

  3. Older adolescent presentations to a children's hospital emergency department.

    Batra, Shweta; Ng, Elaine Yu Ching; Foo, Feng; Noori, Omar; McCaskill, Mary; Steinbeck, Katharine


    To describe the characteristics, diagnoses and outcomes of older adolescents, aged 16-19 years, presenting to a paediatric ED. A retrospective review of total ED presentations by older adolescents to a tertiary paediatric hospital between 2010 and 2012, inclusive, was undertaken to determine if behavioural or mental health problems were common. A total of 1184 ED presentations by 730 older adolescents were identified. Injury and abdominal pain were the most common complaints for presentations by older adolescents to the ED. The median length of stay in ED was 241 (range: 0-3873) min. More than 60% of the older adolescent ED presentations were triaged urgent or semi-urgent, and 39% of all these presentations resulted in hospital admission. Two-thirds of these older adolescents had a chronic illness, which accounted for 77% of all ED presentations by older adolescents. The history of chronic illness was considered related or relevant in the evaluation and management of over 80% of older adolescents. Of all the ED presentations by older adolescents with chronic illness, only one quarter had transition planning documentation. A high prevalence of chronic illness was found in older adolescents attending the paediatric ED. There was no evidence that behavioural and mental health issues dominated. These findings reflect admission policy. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. Family therapy in the hospital treatment of children and adolescents.

    Hyland, P S


    Psychiatric hospitalization is sometimes necessary for seriously symptomatic or out-of-control children and adolescents. In the past, individual therapists, hospital therapists, and family therapists thought that family therapy and individual hospital treatment could not be combined effectively. Today, however, family involvement, participation, and therapy are considered essential components of short-term and extended hospital treatment for young people. The author presents Bowen family systems theory as a basis for informed family therapy in a psychiatric hospital setting. Bowen therapy with patients and close family members elicits significant information, reduces tension, expands options, and facilitates solutions for young patients and their families.

  5. Attachment, Parenting, and Separation-Individuation in Adolescence: A Comparison of Hospitalized Adolescents, Institutionalized Delinquents, and Controls

    Delhaye, Marie; Kempenaers, Chantal; Burton, Julie; Linkowski, Paul; Stroobants, Rob; Goossens, Luc


    The authors compared parent-related perceptions by hospitalized adolescents (i.e., who were admitted to a specialized psychiatric unit; n = 50) and delinquent adolescents (i.e., who were placed at a juvenile treatment institution; n = 51) with adolescents from the general population (n = 51). All adolescents completed a broad set of measures of…

  6. Attachment, Parenting, and Separation-Individuation in Adolescence: A Comparison of Hospitalized Adolescents, Institutionalized Delinquents, and Controls

    Delhaye, Marie; Kempenaers, Chantal; Burton, Julie; Linkowski, Paul; Stroobants, Rob; Goossens, Luc


    The authors compared parent-related perceptions by hospitalized adolescents (i.e., who were admitted to a specialized psychiatric unit; n = 50) and delinquent adolescents (i.e., who were placed at a juvenile treatment institution; n = 51) with adolescents from the general population (n = 51). All adolescents completed a broad set of measures of…

  7. A Prospective Study of Adolescent Suicidal Behavior Following Hospitalization.

    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…

  8. Attachment, parenting, and separation--individuation in adolescence: a comparison of hospitalized adolescents, institutionalized delinquents, and controls.

    Delhaye, Marie; Kempenaers, Chantal; Burton, Julie; Linkowski, Paul; Stroobants, Rob; Goossens, Luc


    The authors compared parent-related perceptions by hospitalized adolescents (i.e., who were admitted to a specialized psychiatric unit; n = 50) and delinquent adolescents (i.e., who were placed at a juvenile treatment institution; n = 51) with adolescents from the general population (n = 51). All adolescents completed a broad set of measures of attachment, perceived parenting, and separation-individuation. Contrary to initial expectations, hospitalized adolescents scored higher than controls on indices of excessive autonomy. Ambivalence regarding issues of interpersonal closeness and distance was found among delinquent adolescents. In addition, hospitalized and delinquent adolescents were found to be struggling, each in their specific way, with attachment-related experiences of trauma. Finally, delinquent adolescents also showed a stage-appropriate form of potentially adaptive narcissism. These findings add to the growing consensus in the literature that associations between adolescent psychopathology and parent-related perceptions are typically complex and somewhat counterintuitive.

  9. Risk factors leading to increased rehospitalization rates among adolescents admitted to an acute care child and adolescent psychiatric hospital.

    McCarthy, Logan; Pullen, Lisa M; Savage, Jennifer; Cayce, Jonathan


    Suicide is the third leading cause of death in adolescents in the United States, with suicidal behavior peaking in adolescence. Suicidal and self-harming behavior is often chronic, with an estimated 15-30% of adolescents who attempt suicide having a second suicide attempt within a year. The focus of acute psychiatric hospitalization is on stabilization of these psychiatric symptoms resulting at times in premature discharge. Finding from studies based on high rehospitalization rates among adolescents admitted to an acute psychiatric hospital indicates that adolescents continue to experience crisis upon discharge from an acute psychiatric hospital, leading to the question of whether or not these adolescents are being discharged prematurely. A chart review was performed on 98 adolescent clients admitted to an acute psychiatric hospital to identify risk factors that may increase rehospitalization among adolescents admitted to an acute psychiatric hospital. Clients admitted to the hospital within a 12-month time frame were compared to clients who were not readmitted during that 12-month period. History of self-harming behavior and length of stay greater than 5 days were found to be risk factors for rehospitalization. Adolescent clients who are admitted to an acute psychiatric hospital with a history of self-harming behavior and extended length of stay need to be identified and individualized treatment plans implemented for preventing repeat hospitalizations. © 2017 Wiley Periodicals, Inc.

  10. Adolescent presentations to an adult hospital emergency department.

    Noori, Omar; Batra, Shweta; Shetty, Amith; Steinbeck, Katharine


    Age-related policies allow adolescents to access paediatric and adult EDs. Anecdotally, paediatric and adult EDs report challenges when caring for older and younger adolescents, respectively. Our aim was to describe the characteristics of an adolescent population attending an adult ED, co-located with a tertiary paediatric ED. The Westmead Hospital ED database was accessed for 14.5-17.9 years old presentations between January 2010 and December 2012. Patient diagnosis coding (SNOMED) was converted to ICD-10. De-identified data were transferred into Microsoft Excel with analysis performed using spss V22. There were 5718 presentations made to the Westmead Hospital, Sydney, Australia ED by 4450 patients, representing 3.3% (95% CI 3.2-3.4) of total visits from all patients 14.5 years and above. The mean age of the sample was 16.6 years (male 51.8%). Presentations triaged as level 4 or 5 represented 61.0% (95% CI 58.7-61.3) of visits. The proportion of patients who did not wait to receive care was 13.8% (95% CI 12.9-14.7), which was significantly higher than adult rates (P < 0.01). There were 279 unscheduled return visits (visits made <72 h of discharge) representing 4.9% (95% CI 4.4-5.8) of all presentations. Injury was the most common diagnosis (30.2%, 95% CI 28.8-31.6). Chronic physical illness and alcohol-related visits comprised 2.1% (95% CI 1.7-2.5) and 0.8% (95% CI 0.6-1.0) of adolescent presentations, respectively. Contrary to reported staff perceptions, adolescent chronic physical illness presentations were not a major burden. Alcohol was likely under-recorded as a contributing factor to presentations. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  11. Transitioning home: A four-stage reintegration hospital discharge program for adolescents hospitalized for eating disorders.

    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.

  12. Therapy of acute hypertension in hospitalized children and adolescents.

    Webb, Tennille N; Shatat, Ibrahim F; Miyashita, Yosuke


    Acute hypertension (HTN) in hospitalized children and adolescents occurs relatively frequently, and in some cases, if not recognized and treated promptly, it can lead to hypertensive crisis with potentially significant morbidity and mortality. In contrast to adults, where acute HTN is most likely due to uncontrolled primary HTN, children and adolescents with acute HTN are more likely to have secondary HTN. This review will briefly cover evaluation of acute HTN and various age-specific etiologies of secondary HTN and provide more in-depth discussion on treatment targets, potential risks of acute HTN therapy, and available pediatric data on intravenous and oral antihypertensive agents, and it proposes treatment schema including unique therapy of specific secondary HTN scenarios.

  13. Therapy of Acute Hypertension in Hospitalized Children and Adolescents

    Webb, Tennille N.; Shatat, Ibrahim F.


    Acute hypertension (HTN) in hospitalized children and adolescents occurs relatively frequently and in some cases, if not recognized and treated promptly, it can lead to hypertensive crisis with potentially significant morbidity and mortality. In contrast to adults, where acute HTN is most likely due to uncontrolled primary HTN, children and adolescents with acute HTN are more likely to have secondary HTN. This review will briefly cover evaluation of acute HTN and various age specific etiologies of secondary HTN and provide more in-depth discussion on treatment target, potential risks of acute HTN therapy, available pediatric data on intravenous and oral antihypertensive agents, and propose treatment schema including unique therapy of specific secondary HTN scenarios. PMID:24522943

  14. [Treatment of eating disorders in adolescents--the view of a child and adolescence psychiatric hospital].

    Pfeiffer, Ernst; Hansen, Berit; Korte, Alexander; Lehmkuhl, Ulrike


    The paper presents--in the sense of clinical guidelines--reality of clinical care in a child and adolescence university hospital specialised on eating disorders. Need of a multimodal therapeutic approach is emphasized, including normalisation of weight and eating behaviour, nursing and pedagogical measures, individual, group and family therapy, completed by body therapy, art and music therapy and in case psychopharmacotherapy. Recommendations for overcoming weak spots are made.

  15. Music listening preferences and preadmission dysfunctional psychosocial behaviors of adolescents hospitalized on an in-patient psychiatric unit.

    Weidinger, C K; Demi, A S


    This study investigated the relationship between music listening preferences and preadmission, dysfunctional psychosocial behaviors (PDPB) of 60 adolescents who were hospitalized on an in-patient psychiatric unit. Findings were that hospitalized adolescents who primarily listened to music with negative lyrics/themes had a history of more PDPB than hospitalized adolescents who primarily listened to music that did not contain negative lyrics/themes; and hospitalized adolescents who primarily listened to heavy metal music had a history of more PDPB than hospitalized adolescents who primarily listened to other types of music.

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

    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 questionnaire

  17. A Comparison of Rural and Urban Partial Hospital Programs for Children and Adolescents.

    Doan, Richard J.; Petti, Theodore A.


    Compares rural and urban child and adolescent partial hospital mental health programs in Pennsylvania. Rural areas were much smaller, more exclusively served adolescents, had stronger financial and administrative links to local community health centers and special education authorities, and had more deficient educational facilities. (KS)

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

    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

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

    Zanten, van E.; Ploeg, van der T.; Van Hoof, Joris J.; Lely, van der 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 h

  20. [Crisis Intervention in a Health Care Hospital for Child and Adolescent Psychiatry].

    Burchard, Falk; Diebenbusch, Teresa


    Crisis Intervention in a Health Care Hospital for Child and Adolescent Psychiatry In the past years the pressure in society and psychological problems in Germany have risen up. This can especially be verified by the great influx of utilization of child and adolescent psychiatric clinics through the admission of crisis. In this connection social disadvantaged female adolescents with a low socio-economic status, students of the secondary school, children in care and the ones whose parents have to manage their upbringing alone are preferentially affected. These developments require a fast adaptation of the supply system to the transformed demands, in particular in terms of outpatient treatment, as well as a closely and structured cooperation between the youth welfare and child and adolescent psychiatric clinics in their function as systems of help. In the script statistical data and adaptive approaches of a supply department of child and adolescent psychiatry are presented.

  1. Predicting Length of Psychiatric Hospital Stay in Children and Adolescents.

    Leininger, Michele; Stephenson, Laura A.

    Length of stay in psychiatric inpatient units has received increasing attention with the external pressures for treatment cost-effectiveness and evidence that longer hospital stays do not appear to have significant advantages over shorter hospital stays. This study examined the relationship between length of psychiatric hospital stay and…

  2. Characteristics of Tuberculosis among Children and Adolescents at a Referral TB’s Hospital, 2006 - 2011



    Full Text Available Background Tuberculosis (TB is a globally significant cause of morbidity and mortality in children. Few data on tuberculosis in children and adolescents are available in Iran. Objectives The current study aimed to describe the case characteristics and clinical-epidemiological aspects of children and adolescents with TB. Methods A retrospective review was undertaken on 203 patients aged less than 19 years admitted to a referral TB hospital from 2006 to 2011. Results Out of the 203 children and adolescents diagnosed with TB, 57.6% of cases were female. Median age was 15 years and 51% were 10 -18 years old; 83% had pure pulmonary TB. The common type of extrapulmonary TB (EPTB was pleuritis (64% and 80% of the EPTB cases were observed in adolescents aged 15 - 18 years. Female adolescents aged 15-18 years were more likely to have positive smear (88%, cultural growth (63.6% and drug resistant TB infection (71%. Conclusions In this referral hospital setting, more pediatric patients with TB were found among adolescent cases especially females. Early detection of adolescents at risk to developing infection is the essential constituent of TB control.

  3. Determinants in Adolescence of Stroke-Related Hospital Stay Duration in Men: A National Cohort Study.

    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.

  4. Out-of-Hospital Cardiac Arrests in Children and Adolescents

    Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik


    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...

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

    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

  6. Audit of child and adolescent psychiatry in a teaching hospital in ...

    Audit of child and adolescent psychiatry in a teaching hospital in Nigeria: ... The major diagnoses were schizophrenia (50%), delirium (15%) and seizure disorders (9%). ... outpatient department (40%) and the internal medicine and paediatrics ... The pattern of patient presentation and management had not changed to any ...

  7. Higher Calorie Diets Increase Rate of Weight Gain and Shorten Hospital Stay in Hospitalized Adolescents With Anorexia Nervosa

    Garber, Andrea K.; Mauldin, Kasuen; Michihata, Nobuaki; Buckelew, Sara M.; Shafer, Mary-Ann; Moscicki, Anna-Barbara


    Purpose Current recommendations for refeeding in anorexia nervosa (AN) are conservative, beginning around 1,200 calories to avoid refeeding syndrome. We previously showed poor weight gain and long hospital stay using this approach and hypothesized that a higher calorie approach would improve outcomes. Methods Adolescents hospitalized for malnutrition due to AN were included in this quasi-experimental study comparing lower and higher calories during refeeding. Participants enrolled between 2002 and 2012; higher calories were prescribed starting around 2008. Daily prospective measures included weight, heart rate, temperature, hydration markers and serum phosphorus. Participants received formula only to replace refused food. Percent Median Body Mass Index (% MBMI) was calculated using 50th percentile body mass index for age and sex. Unpaired t-tests compared two groups split at 1,200 calories. Results Fifty-six adolescents with mean (±SEM) age 16.2 (±.3) years and admit %MBMI 79.2% (±1.5%) were hospitalized for 14.9 (±.9) days. The only significant difference between groups (N = 28 each) at baseline was starting calories (1,764 [±60] vs. 1,093 [±28], p refeeding syndrome were seen using phosphate supplementation. These findings lend further support to the move toward more aggressive refeeding in AN. PMID:24054812

  8. Dengue infection in children and adolescents: Clinical profile in a reference hospital in northeast Brazil

    Roberto da Justa Pires Neto


    Full Text Available Introduction This study aimed to describe the clinical spectrum of dengue in children and adolescents from a hyperendemic region who were admitted for hospitalization. Methods A retrospective study was conducted on patients diagnosed with dengue infection upon admission to a reference center in Fortaleza, Brazil. Results Of the 84 patients included, 42 underwent confirmatory testing. The main symptoms were fever, abdominal pain and vomiting. The median level of serum aspartate aminotransferase was 143.5±128mg/dL. Conclusions A peculiar clinical profile was evident among children and adolescents with dengue infection in a reference center in northeast Brazil, including gastrointestinal symptoms and liver involvement.

  9. Staff perceptions of sexuality-related problems and behaviors of psychiatrically hospitalized children and adolescents.

    Zeanah, P D; Hamilton, M L


    Clinical staff at two hospitals serving children and adolescents were surveyed regarding their observations and experiences regarding the sexuality-related behaviors and issues of patients. Results of this descriptive study indicate that staff frequently encounter a wide range of such problems, including the effects sexual abuse, sexually aggressive or inappropriate behavior, lack of knowledge about basic hygiene and sexual development, pregnancy and contraception, high-risk behaviors, and sexually-transmitted diseases, including AIDS. Similarities and differences of the perceptions by staff of these problems are compared across unit types (children's, adolescents, dually-diagnosed, developmentally-disabled). Implications for staff training, clinical policies, and further research are discussed.

  10. Cachexia & debility diagnoses in hospitalized children and adolescents with complex chronic conditions: evidence from the Kids’ Inpatient Database

    Bryce A Van Doren


    Full Text Available Objective: To characterize the frequency, cost, and hospital-reported outcomes of cachexia and debility in children and adolescents with complex chronic conditions (CCCs. Methods: We identified children and adolescents (aged ≤20 years with CCCs, cachexia, and debility in the Kids’ Inpatient Database [Healthcare Cost and Utilization Project, Agency for Healthcare Research & Quality]. We then compared the characteristics of patients and hospitalizations, including cost and duration of stay, for CCCs with and without cachexia and/ or debility. We examined factors that predict risk of inpatient mortality in children and adolescents with CCCs using a logistic regression model. We examined factors that impact duration of stay and cost in children and adolescents with CCCs using negative binomial regression models. All costs are reported in US dollars in 2014 using Consumer Price Index inflation adjustment. Results: We estimated the incidence of hospitalization of cachexia in children and adolescents with CCCs at 1,395 discharges during the sample period, which ranged from 277 discharges in 2003 to 473 discharges in 2012. We estimated the incidence of hospitalization due to debility in children and adolescents with CCCs at 421 discharges during the sample period, which ranged from 39 discharges in 2003 to 217 discharges in 2012. Cachexia was associated with a 60% increase in the risk of inpatient mortality, whereas debility was associated with a 40% decrease in the risk of mortality. Cachexia and debility increased duration of stay in hospital (17% and 39% longer stays, respectively. Median cost of hospitalization was $15,441.59 and $23,796.16 for children and adolescents with cachexia and debility, respectively. Conclusions: Incidence of hospitalization for cachexia in children and adolescents with CCCs is less than that for adults but the frequency of cachexia diagnoses increased over time. Estimates of the incidence of hospitalization with

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

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


    Psoriasis is associated with being overweight, but the temporal relationship is not known. This historical cohort study tested whether severe psoriasis resulting in hospitalization in adulthood was preceded by excess increase in age-adjusted body mass index, a known risk factor in childhood for b...

  12. The youth alternative solutions program: evaluating a hospital-based intervention for adolescent substance use.

    Brown, Whitney N; D'Errico, Ellen; Morrell, Holly E R


    Issues of alcohol and drug use are more pronounced during adolescence than at any other period of the lifespan and represent a significant public health concern in the United States. As a result, there is currently a need for research on developmentally appropriate interventions for adolescent substance use (SU). Nurses and other mental health professionals working with adolescents need effective evidenced-based programs to refer clients having issues with SU. The current pilot study evaluated the effectiveness of the Youth Alternative Solutions Program, a hospital-based intervention program at a Level I trauma center in Southern California that partners with community stakeholders to accomplish its goals. A sample of 27 adolescents was recruited from August 2010 until October 2011. Twenty-seven total participants completed both pretest and posttest questionnaires; 14 of these participants also completed follow-up data collection. Results indicated a significant increase in negative alcohol outcome expectancies between the three study time points. More comprehensive studies of the Youth Alternative Solutions Program should be conducted in the future to determine the utility of hospital-based SU interventions and to provide evidence of the program's long-term effects.

  13. Assessment of nutritional status among adolescents: a hospital based cross sectional study

    J. P. Singh


    Full Text Available Background: Adolescence, a period of transition between childhood and adulthood, occupies a crucial position in the life of human beings. The primary causes of under nutrition in India are its large population, socio-economic differences and inadequate access to health facilities. Nutritional assessments among adolescents are important as they are the future parents and constitute a potentially susceptible group. Studies on the assessment of nutritional status of adolescents are less in number and a National database has not yet been developed. Methods: The present hospital based cross sectional study was conducted in year 2013 among 344 rural adolescents of 10-19 years age (166 boys and 178 girls attending the outpatient department at rural health training centre (RHTC Dhaura Tanda, district Bareilly, Uttar Pradesh, belonging to the Muslim and Hindu caste communities. The nutritional status was assessed in terms of under nutrition (weight-for-age below 3rd percentile, stunting (Height-for-age below 3rd percentile and thinness (BMI-for-age below 5th percentile. Diseases were accepted as such as diagnosed by pediatrician, skin specialist and medical officer. Results: The prevalence of underweight, stunting and thinness were found to be 32.8%, 19.5% and 26.7% respectively. The maximum prevalence of malnutrition was observed among early adolescents (28%-47% and the most common morbidities were URTI (38.6%, diarrhea (16.8%, carbuncle / furuncle (16% and scabies (9.30%. Conclusion: The study concluded that the most common morbidities among adolescents were related to nutrition and personal hygiene. Regular health programmes should focus to educate and promote health among adolescent. [Int J Res Med Sci 2014; 2(2.000: 620-624

  14. Injury-related mortality among adolescents: findings from a teaching hospital's post mortem data

    Tettey Yao


    Full Text Available Abstract Background Injuries are noted to be an important cause of death among adolescents. There is however limited data on the injury related deaths among adolescents in Ghana. Findings Using data from post-mortem records derived from the Department of Pathology of the Korle-Bu Teaching Hospital (KBTH, Accra Ghana from 2001 to 2003, the causes of injury related deaths among adolescents 10 to 19 years were analyzed by gender and age groups 10 to 14 and 15 to 19 years. There were 151 injury-related deaths constituting 17% of the autopsies performed among adolescents in the study period. The male-to-female ratio was 2.1:1. Drowning was the most common cause of death (37% in the study population. This was followed by road traffic accidents (RTA (33%. Over 70% of the RTA victims were pedestrians knocked downed by a vehicle. Deaths from electrocution, poisoning, burns, stab/gunshot, hanging and other miscellaneous causes (example blast injury, traumatic injury from falling debris, fall from height made up the remaining 30% of the injury related mortality. Among males and in both age categories, drowning was the leading cause of death. In females, the highest mortality was from road traffic accidents accounting for almost half (49% of the deaths; significantly more than that occurring in males (25%, p = .004. Conclusions Findings from Korle-Bu Teaching Hospital post-mortem data on adolescents show that drowning and road traffic accidents are the leading causes of injury-related mortality. Appropriate injury reducing interventions are needed to facilitate a decrease in these preventable deaths.


    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

  16. Risk Factors of Acute Behavioral Regression in Psychiatrically Hospitalized Adolescents with Autism

    Périsse, Didier; Amiet, Claire; Consoli, Angèle; Thorel, Marie-Vincente; Gourfinkel-An, Isabelle; Bodeau, Nicolas; Guinchat, Vincent; Barthélémy, Catherine; Cohen, David


    Aim: During adolescence, some individuals with autism engage in severe disruptive behaviors, such as violence, agitation, tantrums, or self-injurious behaviors. We aimed to assess risk factors associated with very acute states and regression in adolescents with autism in an inpatient population. Method: Between 2001 and 2005, we reviewed the charts of all adolescents with autism (N=29, mean age=14.8 years, 79% male) hospitalized for severe disruptive behaviors in a psychiatric intensive care unit. We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), associated organic conditions, etiologic diagnosis of the episode, and treatments. Results: All patients exhibited severe autistic symptoms and intellectual disability, and two-thirds had no functional verbal language. Fifteen subjects exhibited epilepsy, including three cases in which epilepsy was unknown before the acute episode. For six (21%) of the subjects, uncontrolled seizures were considered the main cause of the disruptive behaviors. Other suspected risk factors associated with disruptive behavior disorders included adjustment disorder (N=7), lack of adequate therapeutic or educational management (N=6), depression (N=2), catatonia (N=2), and painful comorbid organic conditions (N=3). Conclusion: Disruptive behaviors among adolescents with autism may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic diseases such as epilepsy. The management of these behavioral changes requires a multidisciplinary functional approach. PMID:20467546

  17. Potential drug-drug interactions in infant, child, and adolescent patients in children's hospitals.

    Feinstein, James; Dai, Dingwei; Zhong, Wenjun; Freedman, Jason; Feudtner, Chris


    Hospitalized infants, children, and adolescents are typically exposed to numerous distinct medications during inpatient admissions, increasing their risk of potential drug-drug interactions (PDDIs). We assessed the prevalence and characteristics of PDDI exposure of pediatric patients treated in children's hospitals. This retrospective cohort study included patients hospitalized in children's hospitals throughout the United States. PDDIs were identified by using the MicroMedex DRUG-REAX system. We calculated the patients exposed to PDDIs, stratified according to the seriousness of the interaction; daily and cumulative counts of PDDI exposures; and characterization of the cited potential adverse effects. Of 498 956 hospitalizations in 2011, 49% were associated with ≥1 PDDI, with a "contraindicated" PDDI occurring in 5% of all hospitalizations, a "major" PDDI present in 41%, a "moderate" PDDI in 28%, and a "minor" PDDI in 11%. Opioids were involved in 25% of all PDDIs, followed by antiinfective agents (17%), neurologic agents (15%), gastrointestinal agents (13%), and cardiovascular agents (13%). One-half of all PDDI exposures were due to specific drug pairs occurring in ≤3% of patients per hospital day. The most common potential adverse drug events included additive respiratory depression (in 21% of PDDIs), bleeding risk (5%), QT interval prolongation (4%), reduced iron absorption/availability (4%), central nervous system depression (4%), hyperkalemia (3%), and altered diuretic effectiveness (3%). Exposure to PDDIs is common among hospitalized children. Empirical data are needed to determine the probability and magnitude of the actual harm for each specific PDDI, particularly for less common drug pairs. Copyright © 2015 by the American Academy of Pediatrics.

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

    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

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

    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.

  20. Antipsychotic polypharmacy in children and adolescents at discharge from psychiatric hospitalization.

    Saldaña, Shannon N; Keeshin, Brooks R; Wehry, Anna M; Blom, Thomas J; Sorter, Michael T; DelBello, Melissa P; Strawn, Jeffrey R


    Antipsychotic polypharmacy-the use of more than one antipsychotic concomitantly-has increased in children and adolescents and may be associated with increased adverse effects, nonadherence, and greater costs. Thus, we sought to examine the demographic and clinical characteristics of psychiatrically hospitalized children and adolescents who were prescribed antipsychotic polypharmacy and to identify predictors of this prescribing pattern. Retrospective medical record review. The inpatient psychiatric unit of a large, acute care, urban children's hospital. One thousand four hundred twenty-seven children and adolescents who were consecutively admitted and discharged between September 2010 and May 2011. At discharge, 840 (58.9%) of the 1427 patients were prescribed one or more antipsychotics, and 99.3% of these received second-generation antipsychotics. Of these 840 patients, 724 (86.2%) were treated with antipsychotic monotherapy, and 116 (13.8%) were treated with antipsychotic polypharmacy. Positive correlations with antipsychotic polypharmacy were observed for placement or custody outside the biological family; a greater number of previous psychiatric admissions; longer hospitalizations; admission for violence/aggression or psychosis; and intellectual disability, psychotic, disruptive behavior, or developmental disorder diagnoses. Negative correlations with antipsychotic polypharmacy included admission for suicidal ideation/attempt or depression, and mood disorder diagnoses. Significant predictors of antipsychotic polypharmacy included admission for violence or aggression (odds ratio [OR] 2.76 [95% confidence interval (CI) 1.36-5.61]), greater number of previous admissions (OR 1.21 [95% CI 1.10-1.33]), and longer hospitalizations (OR 1.08 [95% CI 1.04-1.12]). In addition, diagnoses of intellectual disability (OR 2.62 [95% CI 1.52-4.52]), psychotic disorders (OR 5.60 [95% CI 2.29-13.68]), and developmental disorders (OR 3.18 [95% CI 1.78-5.65]) were predictors of

  1. Cancer survival among children and adolescents at a state referral hospital in southeastern Brazil

    Glaucia Perini Zouain-Figueiredo


    Full Text Available OBJECTIVES: to analyze the patient characteristics and evaluate overall survival, survival according to demographic variables, the most common tumor groups and subgroups, the stages of disease, and risk factors after at least 5 years among children and adolescents with cancer who were admitted to a state referral hospital between 2000 and 2005. METHODS: the Kaplan-Meier method was employed to estimate survival. The survival curves were compared using the log-rank test. The Cox regression model was used to estimate the effect of independent variables. RESULTS: a total of 571 new cases were registered. The most frequent cancer groups were leukemia (34%, lymphoma (18%, and central nervous system (CNS tumors (15%.The overall survival rate was 59%. The risk factors associated with lower survival were an age of more than 4 years or less than 1 year, the presence of CNS tumors, and non-localized disease. CONCLUSION: although this was not a populationbased study, it provides important epidemiological information about a state where population data on childhood and adolescent cancer are scarce and where hospital-based data do not exist. The survival rate found here should serve as a framework for future improvements, helping to guide policymakers focused on pediatric oncology in the state.

  2. What helps or undermines adolescents' anticipated capacity to cope with mental illness stigma following psychiatric hospitalization.

    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

  3. Adolescents with sickle cell anaemia: Experience in a private tertiary hospital serving a tertiary institution

    Sarah John-Olabode


    Full Text Available Background: Many adolescents with sickle cell disease (SCD have adjustment difficulties in the transition period from paediatric care to the adult system because they find themselves in unfamiliar waters where they have to learn to manage themselves. The aim of this study is to evaluate the prevalent crises and morbidities associated with SCD in adolescents in Babcock University Teaching Hospital (BUTH, to also assess the level of knowledge of these adolescents about SCD and to determine their emotional response to the disease. Materials and Methods: This was a retrospective review of case notes of adolescents with sickle cell anaemia that were seen in BUTH, from May 2013 to April 2014. Data extracted from the case notes was entered into a Microsoft (MS Excel and analysed using descriptive statistics. Results were presented in tables. Results: A total of 50 subjects were seen in the department during this study period. Vaso-occlusive crises in the form of bone pains (93.1% were the commonest crises encountered. Associated morbidities were malaria 34 (85%, tonsilitis 1 (2.5%, pneumonia 1 (2.5%, leg ulcer 1 (2.5%, azotaemia 1 (2.5% and subarachnoid haemorrhage 2 (5%. Majority (88% had adequate knowledge about general health maintenance while knowledge on nutrition and appropriate analgesia use is still inadequate. Eleven (22% had symptoms of depression, four (8% had suicidal ideation while one (2% had a history of attempted suicide. Conclusion: This study emphasizes the importance of psychosocial intervention as part of a comprehensive health management for people with SCD.

  4. Motorcycle-related hospitalization of adolescents in a Level I trauma center in southern Taiwan: a cross-sectional study.

    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

  5. Assessment of access to primary health care among children and adolescents hospitalized due to avoidable conditions

    Ana Paula Scoleze Ferrer

    Full Text Available Introduction: Hospitalizations for ambulatory care-sensitive conditions (HACSC are considered an indicator of the effectiveness of primary health care (PHC. High rates of HACSC represent problems in the access or the quality of health care. In Brazil, HACSC rates are high and there are few studies on the factors associated with it. Objective: To evaluate the access to PHC offered to children and adolescents hospitalized due to ACSC and analyze the conditioning factors. Method: Cross-sectional study with a quantitative and qualitative approach. Five hundred and one (501 users (guardians/caregivers and 42 professionals of PHC units were interviewed over one year. Quantitative data were obtained using Primary Care Assessment Tool validated in Brazil (PCATool-Brazil, while qualitative data were collected by semi-structured interview. The independent variables were: age, maternal education, family income, type of diagnosis, and model of care offered, and the dependent variables were access and its components (accessibility and use of services. Results: Sixty-five percent (65.2% of hospitalizations were ACSC. From the perspective of both users and professionals, access and its components presented low scores. Age, type of diagnosis, and model of care affected the results. Conclusion: The proportion of HACSC was high in this population. Access to services is inappropriate due to: barriers to access, appreciation of the emergency services, and attitude towards health needs. Professional attitudes and opinions reinforce inadequate ideas of users reflecting on the pattern of service use.

  6. Determinants of mental illness stigma for adolescents discharged from psychiatric hospitalization.

    Moses, Tally


    Little is known about the factors that increase the risk for enacted mental illness stigma (i.e. rejection, devaluation and exclusion) as perceived by the stigmatized person. This is particularly true for the population of adolescents diagnosed with a mental illness. The aim of this study was to address this question and examine select social and clinical factors that predict enacted stigma (self-reported) with research that follows eighty American adolescents for 6 months following a first psychiatric hospitalization. Drawing on social identity theory, and research on stigma-threatening environments, social group identification and social support, this study tested four hypotheses: affiliation or identification with higher status and lower status peers predicts more and less stigma respectively (H1); a greater and more supportive social network, and more perceived family support predict less stigma (H2); greater severity of internalizing and externalizing symptoms predicts more stigma (H3); and poorer school functioning predicts more stigma (H4). Results indicated that about 70% of adolescents reported experiencing enacted stigma (at 6 months); disrespect or devaluation was more common than outright social rejection. Using OLS regression analyses, the results provided partial support for H1, H3 and H4, while H2 was not supported. The baseline factors found to be most predictive of enacted stigma ratings at 6-months were: affiliating with more friends with mental health problems, identifying with the 'populars' peer group, higher internalizing symptom ratings, and self-reported disciplinary problems at school. These four factors remained significant when controlling for initial enacted stigma ratings, pointing to their importance in determining changes in social stigma experiences in the follow-up period. They also remained significant when controlling for perceived public stigma ratings at follow-up, indicating that the findings were not due to generalized

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

    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.

  8. A survey of blood utilization in children and adolescents in a German university hospital.

    Zimmermann, R; Handtrack, D; Zingsem, J; Weisbach, V; Neidhardt, B; Glaser, A; Eckstein, R


    There are no detailed data on blood use with regard to diagnoses of recipients during infancy, childhood and adolescence. Available information on this issue is incomplete and no longer current. We conducted a survey of blood component use in children and adolescents in an acute-care university hospital in the greater area of Nuremberg between June 1994 and September 1996. Packed red blood cells (RBCs), fresh-frozen plasmas (FFPs) and platelet (PLT) components were evaluated for the recipients discharge diagnoses. Source study files were extracted from the hospital transfusion service and the medical records department. Transfused units were listed by broad diagnostic categories and leading diagnostic groups formed from principal diagnoses of the recipients according to the International Classification of Diseases, 9th edn (ICD-9). 34.3% of 2869 RBC cell units, 35.0% of 1095 FFP units and 5.0% of 1028 PLT components were used in patients with congenital diseases, mainly cardiac defects. The disease category neoplastic diseases was next most frequently associated with blood transfusion diagnosed in recipients of 23.9% of all RBCs, 15.6% of all FFP units and in 66.4% of all PLT units. Malignant diseases and benign haematological diseases (diagnostic categories II and IV) accounted for 68.9% of all costs of blood component transfusion. These findings demonstrate the increased importance of platelet transfusion for the organization of local and regional blood donation programmes and for cost analysis exercises. The study shows that detailed information on local blood use may be obtained quickly using available data collections of transfusion services and medical record departments.

  9. Psychiatric Disorders in Children and Adolescents Attending Pediatric Out Patient Departments of Tertiary Hospitals

    Akhter Jesmin


    Full Text Available Objectives: Psychiatric disorders are increasingly recognized among children and adolescents in Bangladesh. Psychiatric disorders are more common in children with chronic and acute pediatric disorders. Our study was designed to determine the psychiatric disorders among children and adolescents attending pediatric outpatient departments of tertiary care hospitals. Methods: This cross-sectional study was carried out from July 2012 to February 2013 in pediatric outpatient departments of three prime tertiary level hospitals of Dhaka, Bangladesh. A purposive sampling technique was used. A total of 240 male and female children aged 5 to 16 years old were included in the study. We used a semi-structured questionnaire to obtain sociodemographic and other relevant clinical information about the children and their families from their parents or caregivers and a validated parent version of the Bangla Development and Well-Being Assessment (DAWBA for measuring psychopathology. Results: The mean age of the children was 9.0± 2.6 years. The majority (71% of children were in the 5–10 year age group. The male/female ratio was 1.2:1. Among the respondents, 18% were found to have a psychiatric disorder. Behavioral disorders, emotional disorders, and developmental disorders were found in 9.0%, 15.0% and 0.4% respectively. Hyperkinetic disorder was the single most frequent (5.0% psychiatric disorder. Conclusions: A significant number of children were found to have psychiatric disorders. Our study indicates the importance of identification and subsequent management of psychiatric conditions among the pediatric population.

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

    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

  11. Knowledge gaps and misconceptions about over-the-counter analgesics among adolescents attending a hospital-based clinic.

    Wilson, Karen M; Singh, Pamela; Blumkin, Aaron K; Dallas, Lindsay; Klein, Jonathan D


    Although many adolescents use over-the-counter (OTC) analgesics, their knowledge about these drugs is unclear. This study evaluates misconceptions and knowledge gaps about OTC side effects, risks, and interactions among adolescents attending a hospital-based clinic. Adolescents aged 14 to 20 years presenting to an outpatient clinic were surveyed using a computer-administered instrument. Participants answered questions regarding their use of specific OTC medications and knowledge of side effects, risks, and interactions of these drugs. A summary score of percent correct answers on knowledge questions was created, and univariate and multivariate statistical techniques examined differences between groups. Ninety-six adolescents completed the survey. Most (78%) adolescents had used OTC medications in the previous month. The most frequently reported OTC medications used were analgesics, including ibuprofen (46%), and Tylenol (45%); acetaminophen ingestion was reported by 15% of respondents. Although 35% reported knowing what acetaminophen is, 37% of these did not correctly identify acetaminophen and Tylenol as the same medication. The average overall knowledge score was 44%. In regression models including demographics, and OTC product use, older adolescents had higher overall average knowledge scores. Hispanic teens had less reported use and lower knowledge scores than adolescents of other race/ethnicities. Most adolescents use OTC analgesics, but many are confused about generic and brand name forms. There were also significant knowledge gaps about OTC use, side effects, and contraindications, especially for acetaminophen. Clinicians should be aware of the potential for OTC medication misuse by adolescent patients. 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  12. Impact of hospital delivery on child mortality: An analysis of adolescent mothers in Bangladesh.

    Pal, Sarmistha


    New medical inventions for saving young lives are not enough if these do not reach the children and the mother. The present paper provides new evidence that institutional delivery can significantly lower child mortality risks, because it ensures effective and timely access to modern diagnostics and medical treatments to save lives. We exploit the exogenous variation in community's access to local health facilities (both traditional and modern) before and after the completion of the 'Women's Health Project' in 2005 (that enhanced emergency obstetric care in women friendly environment) to identify the causal effect of hospital delivery on various mortality rates among children. Our best estimates come from the parents fixed effects models that help limiting any parents-level omitted variable estimation bias. Using 2007 Bangladesh Demographic Health Survey data from about 6000 children born during 2002-2007, we show that, ceteris paribus, access to family welfare clinic particularly boosted hospital delivery likelihood, which in turn lowered neo-natal, early and infant mortality rates. The beneficial effect was particularly pronouncedamong adolescent mothers after the completion of Women's Health Project in 2005; infant mortality for this cohort was more than halved when delivery took place in a health facility. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Dating violence victimization, dispositional aggression, and nonsuicidal self-injury among psychiatrically hospitalized male and female adolescents.

    Rizzo, Christie J; Esposito-Smythers, Christianne; Swenson, Lance; Hower, Heather M; Wolff, Jennifer; Spirito, Anthony


    The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self-injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty-five adolescents (ages 13-17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children clinical interview to assess NSSI and child abuse; adolescents completed self-report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI.

  14. Low birth weight among adolescents at Cape Coast Metropolitan Hospital of Ghana

    James Afriyie


    Conclusions: Adolescents are at a higher risk of giving birth to babies of LBW than adults. Factors predicting LBW may not be different for adolescent and adult mothers. Interventions for prevention of negative sexual health outcomes should focus on adolescents. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4242-4247

  15. Obstetric profile of pregnant adolescents in a public hospital: risk at beginning of labor, at delivery, postpartum, and in puerperium.

    Martínez, Hugo Tapia; Silva, Marta Angélica Iossi; Cabrera, Iñiga Pérez; Mendoza, Araceli Jiménez


    describe the obstetric profile of adolescents at beginning of labor, at delivery, postpartum, and in puerperium. Cross-sectional descriptive study with 85 pregnant adolescents, selected by convenience, referred by health centers to a public hospital in Mexico City. Risks were evaluated before, during and after delivery and in puerperium, and measured respectively with the "Previgenes" that compose the Reproductive and Perinatal Risk Assessment System. socioeconomic status, occupation and education level had influence on the emotionality of adolescents in relation to labor, whose obstetric risk was low for 55%, medium for 35%, and high for 10%. Risk in labor was low for 55%, medium for 18%, and high for 27%. Risk postpartum was low for 50%, medium for 25%, and high for 25%. In puerperium, most adolescents (90%) had low risk. most adolescents had low risk in the stages evaluated. The study contributed to identify strategies to approach risk considering the vulnerability inherent in this type of population and favored the conduct of appropriate interventions for the respective needs.

  16. Obstetric profile of pregnant adolescents in a public hospital: risk at beginning of labor, at delivery, postpartum, and in puerperium

    Hugo Tapia Martínez


    Full Text Available Objective: describe the obstetric profile of adolescents at beginning of labor, at delivery, postpartum, and in puerperium.Method: Cross-sectional descriptive study with 85 pregnant adolescents, selected by convenience, referred by health centers to a public hospital in Mexico City. Risks were evaluated before, during and after delivery and in puerperium, and measured respectively with the "Previgenes" that compose the Reproductive and Perinatal Risk Assessment System.Results: socioeconomic status, occupation and education level had influence on the emotionality of adolescents in relation to labor, whose obstetric risk was low for 55%, medium for 35%, and high for 10%. Risk in labor was low for 55%, medium for 18%, and high for 27%. Risk postpartum was low for 50%, medium for 25%, and high for 25%. In puerperium, most adolescents (90% had low risk.Conclusion: most adolescents had low risk in the stages evaluated. The study contributed to identify strategies to approach risk considering the vulnerability inherent in this type of population and favored the conduct of appropriate interventions for the respective needs.

  17. Intensive care unit versus hospital floor: a comparative study of postoperative management of patients with adolescent idiopathic scoliosis.

    Shan, Le-Qun; Skaggs, David L; Lee, Christopher; Kissinger, Catherine; Myung, Karen S


    Patients undergoing posterior spinal instrumentation and fusion surgery for adolescent idiopathic scoliosis were admitted to the intensive care unit until two years ago, at which time we changed our protocol to admit these patients to the general hospital floor following a brief stay in a postanesthesia care unit. This study compared postoperative management on a hospital floor with that in the intensive care unit for patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion. A retrospective review of 124 consecutive patients with adolescent idiopathic scoliosis treated with spinal fusion from August 2007 to August 2010 was performed. Inclusion criteria were a diagnosis of adolescent idiopathic scoliosis and posterior spinal instrumentation and fusion surgery. Of 124 patients, sixty-six were managed postoperatively in the intensive care unit and fifty-eight, on the hospital floor. The mean age at the time of surgery was fourteen years. A mean of eleven vertebral levels (range, six to fifteen levels) were fused. No significant difference between the groups was found with respect to the mean age at the time of surgery, mean weight, mean preoperative and postoperative Cobb angles, and mean number of levels fused (p ≥ 0.12). However, the use of analgesic and antianxiety medication, number of postoperative blood tests, days of hospital stay, and number of physical therapy sessions were significantly decreased in the floor group compared with the intensive care unit group (p ≤ 0.05). No patient from the floor group had to be admitted to the intensive care unit. The mean charge was $33,121 for the floor group and $39,252 for the intensive care unit group (p floor, rather than in an intensive care unit, was associated with a shorter hospital stay, fewer blood tests, less analgesic and antianxiety medication usage, and fewer physical therapy sessions at this high-volume, academic, tertiary-care children's hospital. In addition to improved patient

  18. Hospitals

    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...

  19. Maternal and Perinatal Outcomes Among Adolescents and Mature Women: A Hospital-Based Study in the North of Mexico.

    Minjares-Granillo, Ramón O; Reza-López, Sandra A; Caballero-Valdez, Selene; Levario-Carrillo, Margarita; Chávez-Corral, Dora Virginia


    To compare maternal and newborn pregnancy outcomes from adolescents and mature women. A cross-sectional study was carried out in a public hospital, including women with singleton pregnancies, who were classified according to their age, as follows: group 1: younger than 16 years old (n = 37), group 2: 16-19 years old (n = 288), and group 3: 20-34 years old (n = 632). Information on clinical characteristics, gynecological and obstetric history, pregnancy complications, and perinatal outcomes was obtained through interviews and from clinical records. Thirty-four percent of deliveries were from adolescents. Mature women were more likely to have prepregnancy overweight or obesity than adolescents (odds ratio [OR] = 2.4, 95% confidence interval [CI], 1.7-3.4). The frequency of maternal complications during pregnancy or delivery was not different between groups. Birth asphyxia was more frequent in group 2 (P = .02). Women with inadequate prenatal care had an increased risk of preterm deliveries (OR = 1.64; 95% CI, 1.06-2.54) and of having newborns with low birth weight (OR = 2.02; 95% CI, 1.22-3.35). Weight of newborns from noncomplicated pregnancies was lower in group 1 (P = .02), after adjustment for prepregnancy body mass index, gestational weight gain, preterm delivery, and newborn sex. The frequency of maternal and perinatal complications was similar in adolescents and mature women. Birth weight was decreased in noncomplicated pregnancies of adolescents younger than 16 years of age. Adequate prenatal care might be helpful in prevention of some adverse perinatal outcomes. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  20. Adolescent Deliveries in a Secondary-Level Care Hospital of Cameroon: A Retrospective Analysis of the Prevalence, 6-Year Trend, and Adverse Outcomes.

    Njim, Tsi; Choukem, Simeon-Pierre; Atashili, Julius; Mbu, Robinson


    Adolescents are generally ill-equipped to deal with the burden of a pregnancy. A high prevalence of adolescent pregnancies is among the indicators of limitations toward the achievement of the Millennium Development Goals in most developing countries. We sought to determine the prevalence, 6-year trend, and adverse outcomes of adolescent deliveries. We also tested whether being married decreased the risk of adverse fetal outcomes in these adolescents. A 6-year retrospective register analysis. Buea Regional Hospital. Birth records from 2007 to 2012. None. Prevalence and 6-year trend in the rate of adolescent deliveries; adverse fetal outcomes. The overall prevalence of adolescent deliveries was 9.9% (491 of 4941). There was no significant change in the annual prevalence of adolescent deliveries over 6 years (P trend = .8). Adolescent pregnancies were at higher risk of preterm deliveries (deliveries at gestational age <37 completed weeks; odds ratio [OR], 1.7; 95% confidence interval [CI], 1.3-2.2; P < .01), low birth weight (defined as birth weight <2600 g; OR, 1.8; 95% CI, 1.4-2.3; P < .01), and neonatal asphyxia (OR, 1.4; 95% CI, 1.1-1.7; P < .01). There was no significant difference in the frequency of adverse outcomes between married and single adolescents. One of every 10 babies is born from adolescent mothers in the Buea Regional Hospital. Whether these mothers are married or not, their neonates are exposed to higher morbidity. This emphasizes the need for more adolescent-friendly public health policies geared toward reducing the prevalence of this condition to improve the chances of attaining the Millennium Development Goals in Cameroon. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  1. Longitudinal Trajectories and Predictors of Adolescent Suicidal Ideation and Attempts Following Inpatient Hospitalization

    Prinstein, Mitchell J.; Nock, Matthew K.; Simon, Valerie; Aikins, Julie Wargo; Cheah, Charissa S. L.; Spirito, Anthony


    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 12-15 years old was assessed during psychiatric…

  2. Predicting Posttraumatic Stress Symptoms Longitudinally in a Representative Sample of Hospitalized Injured Adolescents

    Zatzick, Douglas F.; Grossman, David C.; Russo, Joan; Pynoos, Robert; Berliner, Lucy; Jurkovich, Gregory; Sabin, Janice A.; Katon, Wayne; Ghesquiere, Angela; McCauley, Elizabeth; Rivara, Frederick P.


    Objective: Adolescents constitute a high-risk population for traumatic physical injury, yet few longitudinal investigations have assessed the development of posttraumatic stress disorder (PTSD) symptoms over time in representative samples. Method: Between July 2002 and August 2003,108 randomly selected injured adolescent patients ages 12 to 18 and…

  3. hospital

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  4. Effect of two types of hospital feeding gift packs on duration of breast-feeding among adolescent mothers.

    Neifert, M; Gray, J; Gary, N; Camp, B


    Two hundred forty-four adolescent mothers under 18 years of age were surveyed during a 15-month period, and 53% elected to breast-feed. A subset of 60 primiparous breast-feeding adolescents were enrolled in an investigator-blind, randomized, prospective study to compare the effects on breast-feeding duration of a standard hospital discharge feeding gift pack containing formula and a specially designed study pack that was free of infant formula. Thirty-five percent of the 60 women breast-fed less than 1 month; 22% nursed longer than 1 month but less than 2 months; and 43% breast-fed more than 2 months. There was no significant difference in breast-feeding duration among mothers by gift pack group, although those who received the study gift pack rated it higher in usefulness (p less than (0.025). The provision of infant formula samples did not appear to have a deleterious effect on the duration of breast-feeding among a population of adolescent mothers.

  5. [Obstetric and neonatal outcomes of adolescent pregnancies: a cohort study in a hospital in Seine-Saint-Denis France].

    Debras, E; Revaux, A; Bricou, A; Laas, E; Tigaizin, A; Benbara, A; Carbillon, L


    The aim of this study was to describe the characteristics, monitoring, obstetrical complications, childbirth and neonatal outcomes of pregnancies among minors in a cohort of adolescents from Seine-Saint-Denis (France). This is a retrospective, cohort, comparative study, conducted from January 1, 1996 to July 31, 2011, made from the database of Jean-Verdier hospital in Seine-Saint-Denis. Three groups were established: patients aged less than 16 years old, patients aged over 16 years old and under 18 years old compared to a group consisting of older primiparas from 18 to 25 years old. The criteria considered were the characteristics of pregnancy, terms of delivery, neonatal outcome and conduct of post-partum. Minor patients were statistically more likely to be single, student, smoking and anemia compared to young adults. The obstetrical care was lower for minor compared to the control group with a number of consultations and ultrasounds lower (P Adolescentes under 16 years old had a higher preterm delivery risk in multivariate analysis (RR = 0.33 CI 95% [0.12; 0.90] P = 0.03). Adolescents had fewer cesarean and instrumental deliveries (P < 0.05). Teenage pregnancy remains an important managing issue for maternities, particularly from a social standpoint. On the medical side, one preterm delivery appears to be more common among these adolescents. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Coping strategies and self-stigma among adolescents discharged from psychiatric hospitalization: a 6-month follow-up study.

    Moses, Tally


    The effects of mental illness stigma on adolescents receiving psychiatric treatment may largely be determined by their coping strategies. Yet, little is known about adolescents' use of stigma-coping strategies, or how helpful these are for addressing stigma-related stress. This study explores how adolescents discharged from psychiatric hospitalization anticipate coping with a hypothetical social stigma event related to hospitalization. We examine how well anticipated coping strategies predict adolescents' self-stigma ratings following 6 months. To evaluate the direction of causality, the reverse order of effects, the influence of self-stigma on coping strategies, is also assessed. A voluntary sample of 80 adolescents participated in two face-to-face interviews that assessed coping and self-stigma. Anticipated (baseline) and actual (follow-up) coping strategies were measured with a modified Response to Stress Questionnaire (primary and secondary control engagement coping, disengagement) and two stigma-specific strategies developed for this study (disconfirming stereotypes and aggression/confrontation). Relationships between anticipated coping strategies and self-stigma were assessed with ordinary least squares (OLS) regression; multivariate general linear modeling (GLM) and structural equation modeling (SEM) explored the reverse associations. Youth reporting higher self-stigma ratings at follow-up anticipated using more disengagement and effort to disconfirm stereotypes and less secondary control engagement coping at baseline. Anticipated use of secondary control engagement coping was uniquely significant in predicting participants' self-stigma when controlling for baseline self-stigma. At the same time, higher baseline self-stigma ratings predicted less adaptive coping (disengagement and effort to disconfirm stereotypes) at follow-up. The results point to the particular importance of secondary control engagement coping for helping to mitigate the impact of peer

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

    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

  8. Multiple episodes in children and adolescents with bipolar disorder: comorbidity, hospitalization, and treatment (data from a cohort of 8,129 patients of a national managed care database).

    Castilla-Puentes, Ruby


    The purpose of this study was to delineate the prevalence, demographic characteristics, comorbidity, hospitalization, and medication use of a large cohort of patients with and without multiple episodes per year. We hypothesized that children and adolescents with multiple episodes per year would have a higher comorbidity and require more hospitalizations and pharmacological treatment than their counterparts without multiple episodes. Analysis was conducted on a cohort of 8,129 children and adolescents patients (bipolar disorders (BD), from the Integrated Healthcare Information Services (IHCIS) identified from June 30, 2000 to July 1, 2003. Demographics variables, type of hospitalization, and psychotropic medication used in the year of follow-up were compared between children and adolescents with multiple and those without multiple episodes per year. Included were 58 patients with multiple episodes (defined as: > or = 4 or more reports of inpatient treatment for any affective disorders per year) and 8,071 without multiple episodes. Children and adolescents with multiple episodes versus those without multiple episodes were differentiated as follows: more comorbid attention deficit disorder (ADD) (80.9% versus 29.4%) (chi2 = 70.61, df = 1, p children and adolescents with multiple episodes per year present a higher comorbidity and require more hospitalizations and pharmacological treatment than those without multiple episodes. The diagnosis and treatment of children and adolescents with BD will have to take into account the high comorbidity of ADD mainly in children and adolescents with multiple episodes. Future prospective studies will help to better characterize the impact of multiple episodes in the course of pediatric BD and facilitate appropriate treatment strategies.


    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

  10. Readiness to Recover in Adolescent Anorexia Nervosa: Prediction of Hospital Admission

    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…

  11. Is Bipolar Disorder the Most Common Diagnostic Entity in Hospitalized Adolescents and Children?

    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)

  12. Suicide attempts by exogenous intoxication among female adolescents treated at a reference hospital in the city of Recife-PE, Brazil

    Juliana Lourenço de Araújo Veras


    Full Text Available This study aimed to assess cases of self-inflicted poisoning among adolescents reported by the Toxicological Care Center of a reference hospital in Recife-PE, Brazil. The data were collected between March and May 2010 from hospital charts and structured interviews with the participants and parents/guardians. Among the 25 cases of attempted suicide registered in the period, 21 were female adolescents, who made up the sample of the present study. The adolescents were between 13 and 19 years of age. Pesticides were the most frequent toxic agent used (61.9%. The results of the present study underscore the importance of studying suicide in this population, with a focus on family relations, in order to lay the foundation for the development of prevention and treatment programs for this vulnerable group.


    Mengole-Amaya, Teresa


    Full Text Available Teenage pregnancy is considered as a public health issue due to its high prevalence and the social, biological and psychological changes that affect the overall health of teenage parents and their children, family and society. Aprospective descriptive crosssectional study was done with 13 first pregnancy adolescents and 60 first pregnancy non-adolescents belonging to Jose Agurto Tello Hospital from Chosica, Lima, Peru in order to determine if a series of sociocultural factors influence the knowledge and attitude toward pregnancy. We used a validated and self-administered questionnaire to investigate those variables that point to the target. It was established that within the sociocultural factors the group of pregnant adolescents was predominantly those who were 14 and 16 years-old, single (marital status, with incomplete secondary education, engaged in household chores, living with her mother with brothers absent a father figure, with sexual intercourse at an average of 14 years of age. The group of non-adolescent pregnant women was dominated by those 20 to 23 years of age, single, engaged in household chores, with complete secondary education and the average of first sexual intercourse at 18 years. There was a knowledge deficit regarding pregnancy among adolescents, while non-adolescent teenagers showed regular knowledge. Adolescents in their first pregnancy showed a negative attitude toward pregnancy.

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

    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....

  15. The Prevalence of Metabolic Syndrome and Cardiovascular Risk Factors in Obese Children and Adolescents in Dalmatia: A Hospital Based Study

    Milić, Lukrecija; Unić, Ivana; Škrabić, Veselin


    Obesity and metabolic syndrome (MS) are one of the biggest public health issues in child and adolescent population. To the best of the authors' knowledge, this hospital based study is the first report on the prevalence of MS in obese children and adolescents in Dalmatia, the Mediterranean part of Croatia. The objectives of this study were to determine the prevalence of individual cardiovascular risk factors and MS. Between January 2009 and June 2014, 201 obese subjects aged 6 to 18 were analyzed retrospectively from our Pediatric Endocrine Unit database. The subjects were then classified in two groups of obesity; subjects with BMI z score 2.0–3.0 were classified as moderately obese and subjects with BMI z score > 3.0 were classified as severely obese. The overall prevalence of MS using the modified IDF criteria was 30.3%. The most common component of MS in both groups was arterial hypertension, while impaired fasting glucose was the least common component of MS. Our finding of high prevalence of MS underlines the importance of early childhood obesity treatment.

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

    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.

  17. Symptoms Analysis of Obsessive-Compulsive Disorder in Adolescents and Adults in a Teaching Hospital.

    Goit, B K; Ghimire, S R


    Obsessive-compulsive disorder has a broadly diverse clinical expression that reflects heterogeneity. Several studies have identified consistent symptom dimensions of obsessive-compulsive disorder. The purpose of this study was to conduct an exploratory symptoms analysis of obsessive-compulsive symptoms in adolescents and adults with obsessive-compulsive disorder. This was a cross-sectional study conducted in the Department of Psychiatry, National Medical College. This study examined lifetime occurrence of obsessive-compulsive symptoms included in the 13 symptom categories of the Yale-Brown Obsessive Compulsive Scale. Symptoms analysis was performed on 60 patients with obsessive-compulsive disorder. Eight categories of obsessions and six categories of compulsions from Yale-Brown Obsessive Compulsive Scale were included in the analyses. SPSS software package (version 16) was used to analyze the data and shown in the table. Of 60 adolescents and adults, female and male were in the ratio of 1.2:1. Contamination was the most common occurring obsession followed by aggressive obsession. The most common occurring compulsion was checking followed by washing. Only a minority of patients (13.33%) presented predominantly with obsessions however 18.33% patients presented predominantly with compulsions. Certain obsessions and compulsions co-occur to form a cluster. In adolescents and adults, obsessive-compulsive disorder is a multidimensional disorder. Symptom dimensions are predominantly congruent with those described in similar studies of adults with obsessive-compulsive disorder.

  18. Improving the assessment and treatment of pelvic inflammatory disease among adolescents in an urban children's hospital emergency department.

    McCallum, Colleen A; Oman, Kathleen S; Makic, Mary Beth Flynn


    Proper pelvic inflammatory disease (PID) assessment and treatment is essential in preventing ectopic pregnancies, repeated PID infections, infertility, chronic pelvic pain, and fetal death. This project measured the effectiveness of interventions directed toward the providers in the emergency department to facilitate a change in the assessment and treatment of PID. Two aims identified for the project included increasing the number of providers who recorded a correct diagnosis of PID in the chart and included a sexual history for female adolescents who presented to the emergency department with abdominal pain. An additional aim was to increase the percentage of adolescents who received the correct treatment for PID. A quality improvement study using pre-post design and Plan-Do-Study-Act cycles over an 18-month period was conducted in the emergency department of an urban children's hospital. Assessment of adolescent female patients' history of recent sexual activity and correct diagnosis and treatment of PID were evaluated. Process improvement interventions consisted of PowerPoint presentations, educational materials, and Centers for Disease Control and Prevention (CDC) treatment guidelines posted in provider areas (Table 1), along with ongoing positive and corrective feedback to providers. A total of 602 patient records were reviewed (119 in the PID diagnosis and treatment arm and 483 in the obtaining sexual history arm). After process improvement interventions, correct PID diagnosis increased from 72% to 95% (z = 3.064, P = .00109, odds ratio [OR] = 7.08). Correct PID treatment increased from 39.3% to 79.3% (z = 4.190, P = .0000139, OR = 5.90). The percentage of providers who obtained a sexual history increased from 65% to 74.2% (z = 1.892, P = .02929, OR = 1.55). The study demonstrated a significant improvement in all 3 aims related to improved care of adolescents with PID. PowerPoint presentations and the physical presence of the CDC treatment guidelines in the

  19. Clinical research participation among adolescent and young adults at an NCI-designated Comprehensive Cancer Center and affiliated pediatric hospital.

    Sanford, Stacy D; Beaumont, Jennifer L; Snyder, Mallory A; Reichek, Jennifer; Salsman, John M


    Minimal clinical trial participation among adolescents and young adults (AYAs) with cancer limits scientific progress and ultimately their clinical care and outcomes. These analyses examine the current state of AYA clinical research participation at a Midwestern comprehensive cancer center and affiliated pediatric hospital to advise program development and increase availability of trials and AYA participation. Enrollment is examined across all diagnoses, the entire AYA age spectrum (15-39), and both cancer therapeutic and supportive care protocols. his study was a retrospective review of electronic medical records via existing databases and registries for all AYAs. Data were collected for AYAs seen by an oncologist at the adult outpatient cancer center or at the pediatric hospital between the years 2010 and 2014. Descriptive statistics and logistic regression analyses were conducted to characterize this sample. In the pediatric setting, 42.3% of AYAs were enrolled in a study compared to 11.2% in the adult setting. Regression analyses in the pediatric setting revealed that AYAs with private insurance or Caucasian race were more likely to participate. Within the adult setting, ethnicity, race, insurance, and diagnosis were associated with study participation; 54.8% of study enrollments were for cancer therapeutic and 43.4% for supportive care studies. These results are comparable to previously published data and support the need for new local and national AYA initiatives to increase the availability of and enrollment in therapeutic clinical trials. The same is true for supportive care studies which play a crucial role in improving quality of life.

  20. [The link between aggressive behavior and depression in adolescence. A cross-sectional study conducted in the psychiatric emergency unit at the Sainte-Anne hospital].

    Benarous, X; Guedj, M J; Braitman, A; Gallois, E; Lana, P


    The link between depression and aggressive behavior in adults has been found in many studies. In adolescents, this relationship is still controversial. Several studies point out that irritability is a key symptom in adolescent depressed. Few studies have analyzed precisely the kind of aggressive behavior. This study sets out to assess the relationship between aggressive behavior and depressive affects in adolescents. We also pay attention in this population to hopelessness feelings, anxiety, global functioning and the type of aggressive behavior. This is a descriptive and observational cross-sectional study. Data was collected from 49 successive adolescents admitted for a 24-hour evaluation in the emergency department of the Sainte-Anne psychiatric hospital. The inclusion period was from February to April 2012, with age limits between 15 and 18. For each patient, the clinician completed with the parents or other caregivers the Modified Overt Aggressive Scale (MOAS) searching for existence of aggressive behavior in the week prior to the consultation. The population was divided into two groups: P- group when the MOAS score was Adolescent Depression Rating Scale for clinicians (ADRSc) were also completed. Each patient completed the self-report Buss-Perry Aggression Questionnaire (QA), the Beck Hopelessness scale and the Adolescent Depression Rating Scale for patients (ADRSp). Forty-nine adolescents with a median age of 16 years and 4 months participated. The first reason for consultation was depressive symptoms, followed by disruptive behavior. The analysis was conducted on 39 questionnaires. The demographic profile of the two groups was similar. We did not find any significant difference between the groups P+ and P- on ADRSc scores and secondary criteria. However, we found higher scores in the QA in the more depressed patient, especially a higher hostility score in this sample. In the subgroup analysis: as expected self-aggressive behavior was associated with a

  1. 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

    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

  2. Obstetric profile of pregnant adolescents in a public hospital: risk at beginning of labor, at delivery, postpartum, and in puerperium1

    Martínez, Hugo Tapia; Silva, Marta Angélica Iossi; Cabrera, Iñiga Pérez; Mendoza, Araceli Jiménez


    Objective: describe the obstetric profile of adolescents at beginning of labor, at delivery, postpartum, and in puerperium. Method: Cross-sectional descriptive study with 85 pregnant adolescents, selected by convenience, referred by health centers to a public hospital in Mexico City. Risks were evaluated before, during and after delivery and in puerperium, and measured respectively with the "Previgenes" that compose the Reproductive and Perinatal Risk Assessment System. Results: socioeconomic status, occupation and education level had influence on the emotionality of adolescents in relation to labor, whose obstetric risk was low for 55%, medium for 35%, and high for 10%. Risk in labor was low for 55%, medium for 18%, and high for 27%. Risk postpartum was low for 50%, medium for 25%, and high for 25%. In puerperium, most adolescents (90%) had low risk. Conclusion: most adolescents had low risk in the stages evaluated. The study contributed to identify strategies to approach risk considering the vulnerability inherent in this type of population and favored the conduct of appropriate interventions for the respective needs. PMID:26487132

  3. 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) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n = 45), SA only (n = 24) or both NSSI and SA (NSSI+SA; n = 79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed.

  4. Hospitalization of adolescents for psychiatric and substance abuse treatment. Legal and ethical issues.

    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).

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

    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

  6. Adverse obstetrical and perinatal outcome in adolescent mothers associated with first birth: a hospital-based case-control study in a tertiary care hospital in North-East India

    Medhi R


    Full Text Available Robin Medhi, Banani Das, Arpana Das, Mansur Ahmed, Sonika Bawri, Suditi Rai Department of Obstetrics and Gynaecology, Silchar Medical College and Hospital, Silchar, Assam, India Purpose: To analyze the adverse obstetrical and perinatal outcome of adolescent mothers associated with first birth. Patients and methods: This prospective case-control study was conducted in a tertiary care teaching hospital of North-East India between January 2014 and December 2014. All adolescent primigravidae completing 28 weeks of gestation with singleton pregnancy and delivered at our institution were included in the study group. Primigravidae aged between 20 and 25 years were taken as a control group. Mothers having pregnancy complicated with diabetes mellitus, renal disorder, thyroid disorders, and cardiac diseases were excluded from the study. Demographic data, maternal complications like severe anemia, pre-eclampsia, eclampsia, gestational age at delivery, mode of delivery, and postpartum complications were compared. Among fetal complications, low-birth weight, preterm birth, neonatal intensive care unit admission, still birth, and early neonatal death were compared. All the patients were interviewed regarding contraceptive knowledge and its use preceding the pregnancy. Results: Quality antenatal care was received by 80.6% of adolescent mothers. The adolescent mothers had a higher incidence of pre-eclampsia (odds ratio [OR] 2.017 95% confidence interval [CI]: 1.045–3.894, P=0.03, preterm deliveries (OR: 1.655, 95% CI: 1.039–2.636, P=0.03. Among fetal outcomes, the low- birth weight babies (OR: 1.59, 95% CI: 1.016–2.478, low mean birth weight (2,544.4±622.09 g versus 2,701.6±582.51 g, and higher admission to neonatal intensive care unit (OR: 1.957, 95% CI: 1.120–3.417 were significantly associated with adolescent mothers. There was no significant difference found regarding the mode of delivery, still birth, and early neonatal death. Moreover

  7. [Sociodemographic characteristics of the pregnant adolescent in a high specialty hospital].

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


    Introducción: el embarazo en la adolescente es un problema de salud pública asociado a factores socioculturales y económicos que comprometen al binomio madre-hijo. Nuestro objetivo es identificar las principales características sociodemográficas de las adolescentes embarazadas del hospital. Métodos: estudio retrospectivo, descriptivo, observacional; incluyó a todas las pacientes embarazadas entre los 10 y 19 años del hospital de junio 2012 a enero 2014. Se recolectaron los siguientes datos: edad, escolaridad, ocupación, estado civil, edad de inicio de vida sexual, número de parejas sexuales, uso de método de planificación familiar, método de planificación familiar, gestas, partos, cesáreas y abortos. Se utilizó estadística descriptiva, medidas de tendencia central y dispersión. Resultados: se estudiaron 608 adolescentes con una edad de 16.7 ± 1.2 años, 50.2% eran estudiantes, 35.1% desempleadas, 29.5% eran solteras, 25.2% casadas y el resto vivía en unión libre. En 79% era su primer embarazo. La edad de inicio de vida sexual fue a los 15.0 ± 1.3 años, 39% no utilizaban método anticonceptivo y el 24.5% no tenía adicciones. El embarazo no fue planeado ni deseado en 78.1%. La edad gestacional estuvo entre las 8 y 44 semanas, esta última debido a amenorrea no confiable y en 56.7% se encontró patología asociada. La edad de la pareja fue de 20.6 ± 3.8 años, 84.1% trabajaba y 64.2% no tenía adicciones. Conclusiones: la detección oportuna de factores de riesgo permitirá incidir para prevenir y atender el embarazo de la mujer adolescente.

  8. Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo

    Carlos Gorios


    Full Text Available ObjectiveTo describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo.MethodsThis was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files covering January to December 2012 were analyzed.ResultsAmong the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8% followed by multiple non-specified trauma (36.4%, in both sexes.ConclusionTransport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over.

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

    Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian


    Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. 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. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3-18), and the median BMI SDS was 2.85 (range: 1.26-8.96) in boys and 2.48 (range: 1.08-4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30-0.45, p0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7-4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0-6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. 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.

  10. Effects of serotonin reuptake inhibitors on aggressive behavior in psychiatrically hospitalized adolescents: results of an open trial.

    Constantino, J N; Liberman, M; Kincaid, M


    Low concentrations of the neurotransmitter serotonin and its 5-hydroxyindoleacetic acid metabolite in the central nervous system have been associated with increased aggressive behavior in animals and humans. Controlled clinical trials of serotonin agonists in depressed adults have suggested that aggressive behavior is less likely during treatment with these medications than with placebo, but there have been no previous studies of selective serotonin reuptake inhibitors (SSRIs) and aggression in children. We prospectively followed the course of aggressive behavior in 19 psychiatrically hospitalized adolescents (not selected for aggressiveness) who received open clinical trials of fluoxetine, paroxetine, or sertraline. The patients received standard doses (equivalent to fluoxetine 10-40 mg daily) for a minimum of 5 weeks. The starting dose was 15 +/- 5 mg, and dosages were raised at a mean rate of 5 mg every 4 days up to a mean dose of 25 +/- 10 mg daily. Results from trials of the three SSRIs were clustered because the sample sizes were not sufficient for separate analyses. Overall, there were no statistically meaningful improvements in the level of aggressive behavior, as measured on a modified version of the Overt Aggression Scale, over the course of these patients' SSRI trials. Symptoms of physical aggression toward others or self were manifest in 12 of the 19 patients while on SSRIs. Of the 19 patients, 13 were assessed both on and off SSRIs: verbal aggression (p = 0.04), physical aggression toward objects (p = 0.05), and physical aggression toward self (p < 0.02) occurred significantly more frequently on SSRIs than off; no increase was observed in physical aggression toward others. Patients with the highest baseline aggressivity scores did not show greater improvement during SSRI treatment. Further research is warranted, particularly to explore whether SSRIs may have therapeutic effects on aggression at higher (or lower) doses than were administered in this

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

    Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian


    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. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. Results From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours 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. PMID:28264043

  12. Effectiveness of self-esteem and social skills group therapy in adolescent eating disorder patients attending a day hospital treatment programme.

    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.

  13. Effectiveness of six core strategies based on trauma informed care in reducing seclusions and restraints at a child and adolescent psychiatric hospital.

    Azeem, Muhammad Waqar; Aujla, Akashdeep; Rammerth, Michelle; Binsfeld, Gary; Jones, Robert B


      The purpose of the study was to determine the effectiveness of six core strategies based on trauma informed care in reducing the use of seclusion and restraints with hospitalized youth.   The hospital staff received training in March 2005 in six core strategies that are based on trauma informed care. Medical records were reviewed for youth admitted between July 2004 and March 2007. Data were collected on demographics, including age, gender, ethnicity, number of admissions, type of admissions, length of stay, psychiatric diagnosis, number of seclusions, and restraints.   Four hundred fifty-eight youth (females 276/males 182) were admitted between July 2004 and March 2007. Seventy-nine patients or 17.2% (females 44/males 35) required 278 seclusions/restraints (159 seclusions/119 restraints), with average number of episodes 3.5/patient (range 1-28). Thirty-seven children and adolescents placed in seclusion and/or restraints had three or more episodes. In the first six months of study, the number of seclusions/restraints episodes were 93 (73 seclusions/20 restraints), involving 22 children and adolescents (females 11/males 11). Comparatively, in final six months of study following the training program, there were 31 episodes (6 seclusions/25 restraints) involving 11 children and adolescents (females 7/males 4). The major diagnoses of the youth placed in seclusion and/or restraints were disruptive behavior disorders (61%) and mood disorders (52%).   This study shows downward trend in seclusions/restraints among hospitalized youth after implementation of National Association of State Mental Health Program Directors six core strategies based on trauma informed care. © 2011 Wiley Periodicals, Inc.

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

    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.

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

    Kaye, Dan K


    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. 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. 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. Adolescents on the transition to motherhood have variable needs and aspirations and utilize different strategies to cope with the stress of pregnancy and parenthood.

  16. Screening of Novice Adolescent Girls for Anemia studying in Medical and Paramedical Colleges at Civil Hospital Campus, Ahmedabad, Gujarat, India

    Mallika V Chavada, Jagruti D Prajapati, Dinesh M Rathod, Pooja Chaudhary, Kriti M Agrawal


    Introduction: Anemia is major public health problem in adoles-cents in India. This study was conducted to estimate the preva-lence of anemia among novice medical and paramedical adolescent girls students and to study the socio-demographic factors associated with anemia in them. Methods: This cross-sectional study was conducted by purposive non random sampling method in March 2011. Data was collected from 357 novice girl students of four medical and paramedical colleges and one nursing sc...




    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.

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

    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.

  19. From primary care to hospitalization: clinical warning signs of severe dengue fever in children and adolescents during an outbreak in Rio de Janeiro, Brazil.

    Gibson, Gerusa; Souza-Santos, Reinaldo; Brasil, Patrícia; Pacheco, Antonio Guilherme; Cruz, Oswaldo G; Honório, Nildimar Alves; Kubelka, Claire; Carvalho, Marilia Sá


    We analyzed factors associated with severe cases of dengue in children and adolescents hospitalized during the 2007/2008 epidemic in Rio de Janeiro, Brazil. This is a retrospective case-control study that covers 88 cases of severe dengue in patients admitted to four tertiary care children's hospitals. Controls consisted of 22 children with non-severe dengue living in the same neighborhood as the patients with severe dengue. Differences in prevalence of the clinical signs - abdominal pain, breathing difficulty, drowsiness or irritability - emerged on the third day after the onset of symptoms, in the febrile stage. Cases and controls received first medical care at the same clinical stage of disease. However, hospital admission of severe cases occurred later, on average between the third and fourth day after the onset of the disease. Early discharge of patients with fever whose condition could have progressed to severe dengue may have been a consequence of the type of medical assistance provided by primary care units, suggesting deficiencies both in the use of the risk classification protocol and patient triage.

  20. 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

    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

  1. Intentional self-harm in children and adolescents: A study from psychiatry consultation liaison services of a tertiary care hospital

    Sandeep Grover


    Full Text Available Objective: The objective of this study was to evaluate the socio-demographic and the clinical profile of children and adolescents presenting with Intentional self-harm. Materials and Methods: Records of all children and adolescents (≤19 years seen by the consultation liaison (CL services during the period of 2000-2012 were screened. Patients with a diagnosis of intentional self-harm (at the time of assessment were taken up for this study. Data was extracted from the records, to study the socio-demographic and clinical profile. Results: During the study period, 101 patients aged ≤19 years and diagnosed with intentional self-harm at the time of admission were evaluated by the psychiatry CL services in various emergency and medical surgical wards. In the study population, females (N = 61; 60.4% outnumbered males. The age of the patients ranged from 12 to 19 with a median and mean of 17.0 years (standard deviation-1.6 years; interquartile range 16-18 years. Children and adolescent with self harm were more commonly females, from nuclear families, middle socio-economic status and Hindu by religion. The common method of self-harm in adolescents is by ingestion of insecticides (65% and the self-harm behavior was often precipitated by interpersonal problems in the family context. About one-fifth of the patients have psychiatric morbidity. Conclusion: Findings suggest that the most common method of intentional self-harm in children and adolescents is consumption of insecticides and precipitated by interpersonal problems in the family context.

  2. Hospitalization in adolescence and young adulthood among twins and singletons: a Swedish cohort study of subjects born between 1973 and 1983.

    Bladh, Marie; Carstensen, John; Josefsson, Ann; Finnström, Orvar; Sydsjö, Gunilla


    Children born with non-optimal birth characteristics - that is, are small for gestational age and/or preterm - have an increased risk for several long-term effects such as neurological sequelae and chronic disease. The purpose of this study was to examine whether twins exhibited a different outcome, compared with singletons, in terms of hospitalization during adolescence and early adulthood, and to what extent differences remain when considering the divergence in birth characteristics between singletons and twins. Persons born between 1973 and 1983 in Sweden and surviving until age 13 were included and followed until the end of 2006. Data on birth characteristics, parental socio-demographic factors, and hospitalizations were collected from national registers. Adjusting for parental socio-demographic factors, twins had a higher risk of being hospitalized than singletons (odds ratio, OR = 1.17, 95% confidence interval, CI = 1.10-1.25) and more often due to 'Congenital anomalies' (OR = 1.18, 95% CI = 1.06-1.28), 'Infections' (OR = 1.14; 95% CI = 1.08-1.20), 'External causes of illness' (OR = 1.10, 95% CI = 1.06-1.15), and 'Diseases of the nervous system' (OR = 1.18, 95% CI = 1.10-1.26). Stratifying for birth characteristics, this difference diminishes, and for some diagnoses non-optimal twins seem to do slightly better than non-optimal singletons. Thus, twins with non-optimal birth characteristics had a lower risk of hospitalization than non-optimal singletons on, for example, 'Congenital anomalies' and 'Diseases of the nervous system' (OR = 0.86, 95% CI = 0.77-0.96; OR = 0.88, 95% CI = 0.81-0.97, respectively) and Total (any) hospitalization (OR = 0.87, 95% CI = 0.83-0.92). Among those with optimal birth characteristics, twins had an increased hospitalization due to 'External causes of illness' (OR = 1.07, 95% CI = 1.02-1.13) compared with optimal singletons. Twins have higher hospitalization rates than singletons. In stratifying for birth characteristics, this

  3. Effects of a music therapy program upon awareness of mood in music, group cohesion, and self-esteem among hospitalized adolescent patients.

    Henderson, S M


    Subjects for this study were 13 hospitalized patients given the diagnosis of adjustment reaction to adolescence. The subjects were randomly divided into experimental and control groups. The experimental period consisted of 18 1-hour sessions. Subjects in the control group did not attend music therapy activities. Experimental subjects engaged in group discussions concerning moods and emotions in music, expression and identification of body language, story composition to recorded music, and drawing to music. Four types of pre and posttests were administered: agreement on mood or emotion expressed in music as measured by an adjective checklist; sociograms to measure group cohesion; the number of pronouns expressing group feelings ("we, our"); and scores of the Coopersmith Self-Esteem Inventory. Significant differences in favor of experimental subjects were found on the adjective checklist (p = .01) and the group versus personal pronouns (p less than .05). The group cohesion measure approached significance (p = .062).

  4. Drug dependence and psychotic symptoms: a retrospective study of adolescents who abuse drugs at Al-Amal Hospital in Jeddah, Saudi Arabia

    Osama Alibrahim


    Full Text Available Drug abuse is reported to be on the increase among young persons using illicit substances but little is known about the frequency with which they occur, the symptoms on presentation to health institutions, and the different substances abused. To establish this, we reviewed patient data collected at Al-Amal Hospital in Jeddah Kingdom of Saudi Arabia on young persons who are refered to the hospital for problems related to drug abuse. Data on 69 adolescent drug users were reviewed and analyzed using the Composite International Diagnostic Interview - Substance Abuse Model (CIDI-SAM to assess dependence on substances including amphetamines, cannabis, cocaine, and opioids. Furthermore, we assessed the adolescents’ data on history of delusions and hallucinations in the context of use of, or withdrawal from, these specific substances. Our analysis shows that 10 to 79.6% of users of amphetamines, cannabis, cocaine, and opiates met DSM-III-R dependence criteria for each specific substance. The prevalence of psychotic symptoms associated with each specific substance ranged from users with no diagnosis to users with severe dependence as follows: amphetamines (3-100%, cannabis (7- 60.0%, cocaine (5-70.7%, and opiates (4- 88%. The risk of psychotic symptoms increased for respondents who abused (OR=7.2 or had mild (OR=8.1, moderate (OR=20.0, or severe dependence (OR=14.0 on cocaine when compared to those who were users with no diagnosis. A similar pattern was evident in cannabis, opiate, and amphetamine users. In conclusion, most adolescent drug users in Saudi Arabia who are dependent on illicit substances experience psychotic symptoms in the context of use of, or withdrawal from, these substances. Psychotic symptoms increased with the severity of the disorders associated with use of all four substances. These findings underscore the importance of developing services to target this population; a population at risk of developing psychotic symptoms.

  5. Negative cognitive style and perceived social support mediate the relationship between aggression and NSSI in hospitalized adolescents.

    Wolff, Jennifer C; Frazier, Elisabeth A; Esposito-Smythers, Christianne; Becker, Sara J; Burke, Taylor A; Cataldo, Andrea; Spirito, Anthony


    Despite the well-documented association between aggression and NSSI among adolescents, relatively little research has been conducted on the mechanisms underlying this relationship. The purpose of this study was to investigate potential socio-cognitive mechanisms through which aggression and NSSI are related. Participants were 186 adolescents (ages 13-18) recruited from a psychiatric inpatient facility in the northeastern United States. According to teen report, 57.5% of the sample endorsed NSSI in the previous year. Mediation was tested using the modern bootstrapping technique described by Hayes, using 5000 resamples with replacement, including sex and depression diagnosis as covariates. Results demonstrated that greater negative self-talk, a more negative cognitive style, and lower perceived family support were all significant mediators of the relationship between aggression and greater frequency of NSSI, whereas perceived social support from friends was not a significant mediator. Limitations, clinical implications, and future research directions of the current research are discussed.

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

    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

  7. Characteristics of children and adolescents at onset of type 2 diabetes in a Tertiary Hospital in Bangladesh

    Bedowra Zabeen


    Full Text Available Introduction: Recent data show that the prevalence of diabetes among children and adolescents is increasing in some ethnic groups. The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of type 2 diabetes (T2D in youth. Methods: The aim of this study was to describe the baseline characteristics of children and adolescents diagnosed ≤18 years who had features of T2D and presented at  Changing Diabetes in Children, Paediatric Diabetes Clinic at Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine, and Metabolic Disorders. All patients who were newly diagnosed and came to the clinic from March 2011 to March 2015 were included. Results: Among 939 newly registered patients, 77 (8% had a diagnosis of T2D. The age at diagnosis was 9-10 years in 11 patients (14%, 11-14 years in 46 (60% and 15-17 years in other 20 patients (26%. Majority of the children had a positive family history of T2D (94% and 58% were obese. Median fasting insulin (27.9 [17.3-99.3] was high in 76% patients. Insulin was started initially along with metformin in 40 patients and could be stopped in six patients in 3 months. Conclusion: Our study reflects that T2D is emerging as a problem in children and adolescents in Bangladesh.

  8. Characteristics of children and adolescents at onset of type 2 diabetes in a Tertiary Hospital in Bangladesh

    Zabeen, Bedowra; Nahar, Jebun; Tayyeb, Samin; Mohsin, Fauzia; Nahar, Nazmun; Azad, Kishwar


    Introduction: Recent data show that the prevalence of diabetes among children and adolescents is increasing in some ethnic groups. The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of type 2 diabetes (T2D) in youth. Methods: The aim of this study was to describe the baseline characteristics of children and adolescents diagnosed ≤18 years who had features of T2D and presented at Changing Diabetes in Children, Paediatric Diabetes Clinic at Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine, and Metabolic Disorders. All patients who were newly diagnosed and came to the clinic from March 2011 to March 2015 were included. Results: Among 939 newly registered patients, 77 (8%) had a diagnosis of T2D. The age at diagnosis was 9–10 years in 11 patients (14%), 11–14 years in 46 (60%) and 15–17 years in other 20 patients (26%). Majority of the children had a positive family history of T2D (94%) and 58% were obese. Median fasting insulin (27.9 [17.3–99.3]) was high in 76% patients. Insulin was started initially along with metformin in 40 patients and could be stopped in six patients in 3 months. Conclusion: Our study reflects that T2D is emerging as a problem in children and adolescents in Bangladesh. PMID:27730073

  9. Avaliação da atenção ao parto por adolescentes em um hospital universitário Evaluation of birthing care provided to adolescents in a university hospital

    Cleci de Fátima Enderle


    Full Text Available OBJETIVOS: avaliar a atenção ao parto na ótica de adolescentes assistidas em um hospital universitário. MÉTODOS: estudo quantitativo, descritivo, desenvolvido em um hospital universitário do Sul do Brasil. A amostra foi 269 adolescentes, entre 10 e 19 anos, de julho de 2008 a outubro de 2009. A coleta de dados foi com entrevista acerca das práticas de parto normal. Para análise estatística, foi utilizado o Teste Exato de Fisher. Os achados foram comparados com as práticas recomendadas à atenção perinatal preconizados pelo Ministério da Saúde (MS. RESULTADOS: a posição litotômica adotada em 99% dos casos; a episiotomia foi realizada em 89,6% das parturientes; os toques vaginais foram realizados por mais de um examinador em 69,4% dos partos; a cateterização venosa profilática de rotina foi instalada em 91,8% das adolescentes e a restrição hídrica e alimentação esteve presente em 87,4 %. Estes achados não condizem com as orientações preconizadas pelo MS acerca da atenção ao parto. CONCLUSÕES: muitas condutas recomendadas pelo MS para o parto são desconsideradas na instituição em estudo, precisando ser revistas de modo a contemplar as diretrizes do MS.OBJECTIVES: evaluate birthing care from the perspective of adolescents seen at a university hospital. METHODS: a quantitative descriptive study deve-loped at a university hospital in the south of Brazil. The research sample was comprised of 269 adolescents, between 10 and 19 years of age, from July 2008 to October 2009. The data was collected through interviews about the practices of vaginal childbirth. Statistical analysis was performed using Fisher's Exact Test. The fin-dings were then compared with the recommended practices for perinatal care recommended by the Ministry of Health (MH. RESULTS: the lithotomic position was adopted in 99% of cases; an episiotomy was performed on 89.6% of delivering women; digital vaginal examinations were conducted by more than one

  10. Differentiated thyroid carcinoma in paediatric and adolescent age group: 10-year experience in a university hospital in Saudi Arabia

    Abdulaziz Abdullah Alsaif


    Full Text Available Background and Objective: To describe the clinical presentation, surgical intervention and treatment, complications, tumour histopathology characteristics, follow-up and survival of 23 patients at or below the age of 21 at the time of diagnosis of differentiated thyroid carcinoma (DTC diagnosis. Materials and Methods: A retrospective medical chart review of 23 patients diagnosed with DTC and treated in our institute from January 2003 to December 2013 was done. Pertinent data were collected regarding clinical presentation, workups, surgical intervention and treatment, postoperative complications, histopathology, follow-up events and survival. Results: The median age at diagnosis was 17 years. 15 patients (65.2% had papillary carcinoma and 7 patients (30.4% had papillary carcinoma with follicular variant. Multifocality and extrathyroidal extension were found in 11 (47.8% and 6 (26.1% patients respectively. 21 patients underwent total thyroidectomy with neck dissection and were subjected to thyroid ablation with radioactive iodine (radioiodine and thyroid stimulation hormone (TSH-suppressant thyroxine replacement therapy. Median follow-up was 6.6 years. Recurrence occurred in 1 patient. No significant postoperative complications were observed. Conclusion: Appropriate investigations should be carried out to exclude thyroid cancer in children and adolescents presenting with a neck mass. Total thyroidectomy with appropriate cervical lymph node dissection, followed by radioiodine ablation therapy and TSH-suppressant thyroxine replacement therapy is the recommended option to manage children and adolescents with DTC. Neck examination should be part of the routine clinical examination in the paediatric and adolescent age group. A local elaborate genetic database for this disease is essential and may help compare its behaviour with that seen in other populations.

  11. Clinical Commentary by Barbara Segal, a Consultant Child and Adolescent Psychotherapist Working in University College London Hospitals

    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…

  12. Clinical Commentary by Barbara Segal, a Consultant Child and Adolescent Psychotherapist Working in University College London Hospitals

    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…

  13. Sociodemographic Characteristics and Diagnoses of Individuals Referred to a Child and Adolescent Psychiatry Outpatient Clinic of a University Hospital

    Sevcan Karakoç Demirkaya


    Full Text Available OBJECTIVE: The aim of this study is to evaluate the sociodemographic characteristics, complaints, and diagnoses of individuals who were admitted to a child and adolescent psychiatry outpatient clinic. MATERIALS AND METHODS: Medical charts of the patients who were admitted to the child and adolescent psychiatry unit of Adnan Menderes University between February 1st and July 31st, 2014 were retrospectively studied. RESULTS: The rate of girls and boys from a total of 832 cases who were referred to the child and adolescent psychiatry outpatient clinic in the six month period was 41.8% and 58.2%, respectively. The mean age of the girls and boys was 10.8±4.9 and 8.5±4.7 years, respectively. The most common age range was between 12 and 18 years. The proportion of patients who lived with both parents was 81.1%; however, the proportion of individuals brought in by institutional caregivers was 0.8%. The proportion of consanguineous marriages was 13.7%. The education level of mothers and fathers was mostly a primary school degree (47% and 45.6%, respectively. A positive psychiatric history was present in 13.7% of the mothers and 7.6% of the fathers. Reasons for child psychiatric assessments were as follows: 21.9% for disability report, 13.8% for forensic evaluation, 11.2% for consultation, and 52.9% for general psychiatric evaluation. Referral complaints were irritability/anger (15.7%, attention deficit/hyperactivity (14.8%, delay in speech (10.5%, fear/anxiety (5.9%, and poor school performance (5.7%. The diagnoses were as follows: attention deficit hyperactivity disorder (ADHD (20.6%, other disruptive behaviors (12.4%, and anxiety disorder (10.2%. CONCLUSION: We revealed that the most common referring complaint was irritability/anger and that the most common diagnosis was ADHD in our patient group, which was similar to previous studies. Our results showed that a low parental educational level and a positive history for parental psychopathology were

  14. Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit


    Critical illness has a major impact on the nutritional status of both children and adults. A retrospective study was conducted to evaluate the incidence of hospital malnutrition at a pediatric tertiary intensive care unit (PICU). Serum concentrations of IL-6 in subgroups of well-nourished and malnourished patients were also evaluated in an attempt to identify those with a potential nutritional risk. METHODS: A total of 1077 patients were enrolled. Nutritional status was evaluated by Z-score (...

  15. Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit

    Artur F. Delgado


    Full Text Available Critical illness has a major impact on the nutritional status of both children and adults. A retrospective study was conducted to evaluate the incidence of hospital malnutrition at a pediatric tertiary intensive care unit (PICU. Serum concentrations of IL-6 in subgroups of well-nourished and malnourished patients were also evaluated in an attempt to identify those with a potential nutritional risk. METHODS: A total of 1077 patients were enrolled. Nutritional status was evaluated by Z-score (weight for age. We compared mortality, sepsis incidence, and length of hospital stay for nourished and malnourished patients. We had a subgroup of 15 patients with severe malnutrition (MN and another with 14 well-nourished patients (WN. Cytokine IL-6 determinations were performed by enzyme-linked immunosorbent assay. RESULTS: 53% of patients were classified with moderate or severe malnutrition. Similar amounts of C- reactive protein (CRP were observed in WN and MN patients. Both groups were able to increase IL-6 concentrations in response to inflammatory systemic response and the levels followed a similar evolution during the study. However, the mean values of serum IL-6 were significantly different between WN and MN patients across time, throughout the study (p = 0.043. DISCUSSION: a considerable proportion of malnourished patients need specialized nutritional therapy during an intensive care unit (ICU stay. Malnutrition in children remains largely unrecognized by healthcare workers on admission. CONCLUSIONS: The incidence of malnutrition was very high. Malnourished patients maintain the capacity to release inflammatory markers such as CRP and IL-6, which can be considered favorable for combating infections On the other hand, this capacity might also have a significant impact on nutritional status during hospitalization.

  16. A cross-sectional survey of complementary and alternative medicine use by children and adolescents attending the University Hospital of Wales

    Lim Alissa


    Full Text Available Abstract Background A high prevalence of CAM use has been documented worldwide in children and adolescents with chronic illnesses. Only a small number of studies, however, have been conducted in the United Kingdom. The primary aim of this study was to examine the use of CAM by children and adolescents with a wide spectrum of acute and chronic medical problems in a tertiary children's hospital in Wales. Methods Structured personal interviews of 100 inpatients and 400 outpatients were conducted over a 2-month period in 2004. The yearly and monthly prevalence of CAM use were assessed and divided into medicinal and non-medicinal therapies. This use was correlated with socio-demographic factors. Results There were 580 patients approached to attain 500 completed questionnaires. The use of at least one type of CAM in the past year was 41% (95% CI 37–46% and past month 26% (95% CI 23–30%. The yearly prevalence of medicinal CAM was 38% and non-medicinal 12%. The users were more likely to have parents that were tertiary educated (mother: OR = 2.3, 95%CI 1.6–3.3 and a higher family income (Pearson chi-square for trend = 14.3, p None of the inpatient medical records documented CAM use in the past month. Fifty-two percent of medicinal and 38% of non-medicinal CAM users felt their doctor did not need to know about CAM use. Sixty-six percent of CAM users did not disclose the fact to their doctor. Three percent of all participants were using herbs and prescription medicines concurrently. Conclusion There is a high prevalence of CAM use in our study population. Paediatricians need to ensure that they ask parents and older children about their CAM usage and advise caution with regard to potential interactions. CAM is a rapidly expanding industry that requires further evidence-based research to provide more information on the effectiveness and safety of many CAM therapies. Statutory or self-regulation of the different segments of the industry is important

  17. Gastos hospitalares com crianças e adolescentes vítimas de violência, no Estado de Pernambuco, Brasil, em 1999 Hospital costs due to violence against children and adolescents in Pernambuco State, Brazil, during 1999

    Roberto Natanael da Silva Mendonça


    Full Text Available Avaliaram-se os gastos do Sistema Único de Saúde (SUS com internações hospitalares de crianças e adolescentes, vítimas de violência no Estado de Pernambuco, no ano de 1999. Utilizou-se o banco de dados do Sistema de Informações Hospitalares do DATASUS, construído a partir das informações contidas nas Autorizações de Internação Hospitalar (AIH. Foram registradas 9.220 internações por causas externas a um custo de R$ 3.659.558,62. O custo médio no Estado de Pernambuco nesse ano, para as internações por todos os diagnósticos na faixa etária de 0 a 19 anos, foi de R$ 306,49. Quando se computaram apenas as causas externas, o custo médio passou para R$ 396,91. Os traumatismos foram as principais causas desses internamentos (84,7%. Na mesorregião Recife ocorreram 65,1% das hospitalizações e 77,9% dos gastos totais em todo o Estado.This study focused on expenditures under the Brazilian National Unified Health System (SUS due to hospitalization of children and adolescents as the result of violence in Pernambuco State in 1999. Data were collected from the Hospital Admittance Forms covering the State of Pernambuco. Some 9,220 hospital admissions due to external causes were identified, with a cost of R$3,659,558.62. Mean cost of hospitalization for children and adolescents in Pernambuco State in 1999 was R$306.49. Mean cost of hospitalization due to external causes was R$396.91. Traumatic lesions were the most common reason for hospital admission (84.7%. Violence against children and adolescents in Greater Metropolitan Recife accounted for 65.1% of hospital admissions and 77.9% of all hospital costs in Pernambuco State.

  18. Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo☆☆☆

    Gorios, Carlos; de Souza, Renata Maia; Gerolla, Viviane; Maso, Bruno; Rodrigues, Cintia Leci; Armond, Jane de Eston


    Objective to describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo. Methods this was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files) covering January to December 2012 were analyzed. Results among the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8%) followed by multiple non-specified trauma (36.4%), in both sexes. Conclusion transport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over. PMID:26229833

  19. 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

    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.

  20. Cost analysis of adolescent idiopathic scoliosis surgery: early discharge decreases hospital costs much less than intraoperative variables under the control of the surgeon.

    Raudenbush, Brandon L; Gurd, David P; Goodwin, Ryan C; Kuivila, Thomas E; Ballock, R Tracy


    Spinal fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) is increasing. Health systems and surgeons are decreasing hospital length of stay (LOS) to decrease costs. The purpose of this study was to review the contribution of an accelerated discharge protocol on the total cost of a single episode of care related to the surgical treatment of AIS at a single institution. A retrospective cost analysis was performed over an 18-month period, from January 2014 through June 2015, before and after the institution of an accelerated discharge program. Patients treated surgically with ICD-9 code 737.30 (Idiopathic Scoliosis) were reviewed. Itemized costs and LOS were analyzed collectively and by surgeon before and after the accelerated discharge protocol. Eighty AIS patients were treated surgically. The accelerated discharge program significantly reduced average LOS from 4.2 days in 2014 to 3.3 days during the first 6 months of 2015 (P≤0.05). There were no increases in complications. There was a 9% decrease in the total average costs per episode of care. A weighted average, a relative average change in costs, and an average cost savings per case were calculated for 12 different categories. Average Surgical Services and Nursing costs decreased during the study period while all other costs increased. The accelerated discharge program did not directly contribute significantly to this decrease in costs. Greatest cost reduction was associated with average bone graft and pedicle screw cost, with an overall 8.5% reduction in pedicle screw use and a 58% reduction in bone graft costs. Intraoperative variables under the direct control of the surgeon contribute much more to cost reduction than an accelerated discharge program for surgically treated AIS patients.

  1. Características del control prenatal de pacientes adolescentes atendidas en la consulta de obstetricia Hospital “Dr. Rafael Ángel Calderón Guardia”, 2010 Characteristics of Prenatal Care of Pregnant Adolescents, Department of Obstetrics, Hospital “Dr. Rafael Angel Calderon Guardia”, 2010

    Loretta Giacomin-Carmiol


    Full Text Available Objetivo: Comparar los resultados perinatales de las pacientes adolescentes que asisten a la consulta de control prenatal del Hospital “Dr. Rafael Ángel Calderón Guardia” con los publicados por el Centro Latinoamericano de Perinatología y Desarrollo Humano (CLAP para la población adolescente de Latinoamérica. Materiales y Métodos: Se estudiaron 360 historias clínicas de pacientes embarazadas menores de 18 años que llevaron su control prenatal en la Clínica de Adolescentes del Servicio de Ginecología y Obstetricia en el 2010. Las variables incluidas en el estudio abarcaban la atención prenatal, el parto y postparto. Para la comparación de los resultados obtenidos en la presente investigación con los reportados por el CLAP se utilizó una Prueba de Conformidad para el Contraste de Hipótesis. Se estableció como el nivel de significancia a valores de Z menores o mayores de 1,96. (p Aim: To compare perinatal results of pregnant adolescents that attend the prenatal control consultation at HCG with those published by the CLAP for adolescent population in Latin America. Materials and methods: 360 medical records of pregnant patients under 18 years, that undertook prenatal control at the Adolescents’ Clinic of the Department of Obstetrics of the HCG in 2010, were studied. The variables included in the study were those related with prenatal care, childbirth and postpartum. Hypothesis Testing was used to compare the results obtained in this investigation with those reported by the CLAP. 1.96 was adopted as the critical value from Z distribution (p <0.05. Results: This study showed that maternal morbidity and mortality of adolescent patients that received attention in our hospital is lower than that reported by the CLAP. Although there was a higher percentage of some diseases such as urinary tract infections or anemia in our population, this might be due to a better case detection system rather than to an increase in disease. With




    Full Text Available INTRODUCTI ON: Adolescents are less frequently studied population as far as tuberculosis is concerned. And their response to the disease as well as clinical manifestations is different from children . MATERIALS AND METHOD S: A retrospective study was done on patients up to the age of 19 years and classified them in to child and adolescent. Up to 12 years was taken as child and beyond that as adolescent. Data col lection was done from the RNTCP registers and medical records. The incidence of pulmonary, extra - pulmonary was found separately. Among pulmonary as well as the total intra - thoracic tuberculosis, sputum positivity was found. The incidence of lymph node tube rculosis, pleural effusion and others were also recorded. The records were checked to find out the completion/cure of disease and any record of relapse. RESULTS: Total 67 patients were included in the study, 35 males and 32 females. 40.3% were adolescents and the rest were children. 48.14% were having pulmonary tuberculosis among adolescents while 85% in childhood had this presentation. (p - 0.001. Intra - thoracic tuberculosis (pulmonary , intra - thoracic nodes and pleural effusion occurred to 62.96% adolescen ts and 87.5% children. 53.84% of adolescents with pulmonary TB were sputum positive whereas in children it was only 18.7%. T he increased chance of sputum positivity among adolescents was statistically significant (p - 0.026. Among the total tuberculosis patients in each category, 29.6% adolescents had extra - thoracic lymph node tuberculosis while only 7.5% children had this (p - 0. 04. There were no statistically significant differences in other forms of extra - pulmonary tuberculosis. All patients were compliant and had completed treatment. DISCUSSION AND CONCL USIONS: Our adolescents had greater incidence of extra - thoracic Tb (37% w hile Cruz et al found 18.6% of this type. Smear positivity of adolescents with intra - thoracic TB was also higher in our study (41

  3. Factors associated with the over-treatment and under-treatment of gonorrhea and chlamydia in adolescents presenting to a public hospital emergency department

    Mutimbwa Anaene


    Conclusion: Adolescents and young adults screened for STIs have a high prevalence of GC/CT. A significant proportion of these patients end up over-treated and an even higher proportion are under-treated.

  4. 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

    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.)

  5. The importance of taking a history of over-the-counter medication use: a brief review and case illustration of "PRN" antihistamine dependence in a hospitalized adolescent.

    Gracious, Barbara; Abe, Naomi; Sundberg, Jane


    Over-the-counter (OTC) and prescription medication abuse has been rapidly increasing, yet publications on OTC abuse in adolescents are limited. We present a brief literature review and a novel report of antihistamine dependence emerging after admission in an adolescent, subsequently treated with naltrexone. This case highlights the need to take a thorough history of OTC, herbal, and prescription drug use from parents and patients separately and repeatedly, at initial presentation, and again if withdrawal symptoms emerge. General strategies for combating OTC and prescription abuse are given.

  6. Adolescent attachment and psychopathology.

    Rosenstein, D S; Horowitz, H A


    The relationships among attachment classification, psychopathology, and personality traits were examined in a group of 60 psychiatrically hospitalized adolescents. The concordance of attachment classification was examined in 27 adolescent-mother pairs. Both adolescent and maternal attachment status were overwhelmingly insecure and were highly concordant. Adolescents showing a dismissing attachment organization were more likely to have a conduct or substance abuse disorder, narcissistic or antisocial personality disorder, and self-reported narcissistic, antisocial, and paranoid personality traits. Adolescents showing a preoccupied attachment organization were more likely to have an affective disorder, obsessive-compulsive, histrionic, borderline or schizotypal personality disorder, and self-reported avoidant, anxious, and dysthymic personality traits. The results support a model of development of psychopathology based partially on relational experiences with parents.

  7. Music Therapy with Adolescents

    Jukko Tervo


    Full Text Available The therapeutic community described in this paper was situated at the University of Oulu Central Hospital Department of Psychiatry, Finland, during the years 1979-1989. The ward consisted of eight beds, four for boys and four for girls. The basic emphasis in the treatment was laid on psychoanalytic psychotherapy and music and art therapies suitable for the stage of adolescent development. Adolescent community therapy (psychoanalytic psychotherapy, music therapy, art therapy, special school etc. creates an environment which supports individual growth of the adolescent and youth culture. This, in turn, simultaneously supports psychotherapy.

  8. QUÉ PASÓ DESPUÉS DEL CIERRE DE LOS HOSPITALES DE DÍA DE PSIQUIATRÍA PARA NIÑOS Y ADOLESCENTES What happens after day psychiatric hospitals for children and adolescents are closed

    Rafael Vásquez-Rojas


    Full Text Available Antecedentes. En Colombia, algunos hospitales públicos ofrecían el servicio de hospital de día de psiquiatría para niños y adolescentes. La gran mayoría fueron cerrados a finales del año 2009. Esta población, asumió la búsqueda de atención para sus hijos, sometiéndose a múltiples recorridos administrativos y jurídicos para poder recibir una atención en salud mental. Objetivos. Describir qué sucedió con los niños y adolescentes que asistían a los hospitales de día, cómo se encuentran ahora y los trámites que han seguido para acceder a los servicios de salud mental. Material y métodos. Se obtuvo una base de datos de 160 pacientes de un hospital de día de niños y adolescentes del año 2007. Por medio de una entrevista telefónica, se explicaba el objetivo del estudio y se citaban a una entrevista semiestructurada entre abril y junio del 2011 para identificar los pasos que han seguido para acceder a los servicios de salud mental. Resultado. De 160 pacientes se pudieron contactar a 24 pacientes vía telefónica, sólo asistieron a la entrevista 8. Las madres referían que todos habían mejorado y estaban muy satisfechas con el tratamiento. Actualmente cinco estaban peor y se evidenciaron importantes barreras para el acceso a consulta especializada. Conclusiones. En promedio los pacientes tardan dos meses en obtener una cita con un especialista en salud mental. De esta forma aun siendo menores de edad presentan barreras administrativas que limitan el rápido, fácil y oportuno acceso al servicio de salud mental.Background. Some public hospitals' in Colombia offered a day hospital psychiatric service for children and adolescents; most were closed at the end of 2009. This population took on the search for gaining attention for their children; they were submitted to a lot of administrative and legal bureaucracy to be able to receive mental health attention. Objectives. Describing what happened to the children and adolescents

  9. 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

    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.

  10. Identifying the Unique Aspects of Adolescent and Young Adult Palliative Care: A Case Study to Propel Programmatic Changes in Pediatric Hospitals.

    Humphrey, Lisa; Dell, Mary Lynn


    Using a case study, in this article we seek to highlight how the distinct developmental needs of adolescent and young adult patients facing a life-threatening condition require a different approach to patient care by pediatric health care workers. The case underscores pitfalls in using a pediatric construct of care in areas of pain management, social stressors, and advanced care planning, and suggests programs to implement for improvement, including partnership with psychiatry, substance abuse, and palliative care specialists.

  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

    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. 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

    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

  13. 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.

    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.

  14. FacilitiesHospitals_HOSPITAL

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

  15. Hospitals; hospitals13

    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....

  16. Late morbidity leading to hospitalization among 5-year survivors of young adult cancer: a report of the childhood, adolescent and young adult cancer survivors research program.

    Zhang, Yang; Lorenzi, Maria F; Goddard, Karen; Spinelli, John J; Gotay, Carolyn; McBride, Mary L


    To estimate the risk of late morbidity leading to hospitalization among young adult cancer 5-year survivors compared to the general population and to examine the long-term effects of demographic and disease-related factors on late morbidity, a retrospective cohort of 902 five-year survivors of young adult cancer diagnosed between 1981 and 1999 was identified from British Columbia (BC) Cancer Registry. A matched comparison group (N = 9020) was randomly selected from the provincial health insurance plan. All hospitalizations until the end of 2006 were determined from the BC health insurance plan hospitalization records. The Poisson regression model was used to estimate the rate ratios for late morbidity leading to hospitalization except pregnancy after adjusting for sociodemographic and clinical risk factors. Overall, 455 (50.4%) survivors and 3,419 (37.9%) individuals in the comparison group had at least one type of late morbidity leading to hospitalization. The adjusted risk of this morbidity for survivors was 1.4 times higher than for the comparison group (95% CI = 1.22-1.54). The highest risks were found for hospitalization due to blood disease (RR = 4.2; 95% CI = 1.98-8.78) and neoplasm (RR = 4.3; 95% CI = 3.41-5.33). Survivors with three treatment modalities had three-fold higher risk of having any type of late morbidity (RR = 3.22; 95% CI = 2.09-4.94) than the comparators. These findings emphasize that young adult cancer survivors still have high risks of a wide range of late morbidities.

  17. Elements of Successful School Reentry after Psychiatric Hospitalization

    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…

  18. 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

    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

  19. 综合医院心理门诊青少年心理问题分析%The analysis of adolescents' mental problems of psychological clinic in general hospital

    易利人; 周丹; 陈娟婷; 李艳嫦; 钟建新


    目的 探讨青少年的心理健康状况及个性特点,为心理治疗和干预提供依据.方法 采用症状自评量表(SCL-90)和艾森克个性问卷(EPQ中国简版)对219名心理门诊就诊青少年进行测评,分为A组(16~20岁)、B组(21~25岁)、C组(26~30岁)进行分析.结果:青少年咨询者SCL-90各因子均数显著高于常模(P<0.01).女性抑郁因子均分显著高于男性(P<0.05).三个年龄组轻度以上心理障碍发生率差异有统计学意义.B组、C组心理障碍发生率高于A组(P<0.01).SCL-90的强迫症状均分与E分量表均分呈负相关,F1~F9各因子均分与P量表呈正相关,与L量表皇负相关.结论 心理门诊青少年心理健康状况明显低于一般人群.21~30岁年龄段很值得关注,应针对不同特点开展心理咨询和心理卫生保健服务.%Objective To investigate the mental health status and related personality type of psychological clinic adoleScent in general hospital and provide data for psychology treatment and intervention.Methods 219 adolescence consulters in 2006 were tested by symptom checklist(SCL-90) and eysenck personality questionnaire(EPQ).The caseswere separatedthree age groups,A group(16~20 years old),B group(21~25 years old),C group(26~30 years old)and disposed by SPSS 13.0.Results All factor scores of SCL-90 in psychological clinic adolescents were higher than those of youth norm in China(P<0.01).The scores of female consulters were significant higher than those of male in depression(P<0.05).The incident rate of mild mental obstacle(factor score>2)in 3 age groups were significant different.The incidence rate of B and C groups were higher A group(P<0.01).The factor scores were positive associated with P in EPQ and negative associated with L in EPQ.The obsession score of SCL-90 was negative associated with E in EPQ.Conclusions The mental health status of psychological clinic adolescents was not as good as norm adolescents

  20. 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

    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

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

    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.

  2. Hospital Compare

    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...

  3. HCAHPS - Hospital

    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...

  4. Norovirus - hospital

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  5. Fatores relacionados a hospitalizações por injúrias em crianças e adolescentes Factors related to hospitalization due to injuries in children and adolescents

    Vera L. V. Gaspar


    Full Text Available OBJETIVO: Analisar alguns fatores relacionados a injúrias que resultaram em hospitalizações de crianças e adolescentes. MÉTODOS: Pesquisa prospectiva, descritiva e observacional realizada no Hospital Márcio Cunha, em Ipatinga, Minas Gerais, no período de 1º de dezembro de 1999 a 30 de novembro de 2000. A amostra incluiu 696 crianças e adolescentes, na faixa etária de 0 a 19 anos, hospitalizados por injúrias. Para classificar os tipos e os locais de ocorrência das injúrias utilizou-se a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, 10ª revisão. RESULTADOS: As injúrias representaram 9,9% das hospitalizações de crianças e adolescentes; 69,7% dos pacientes eram do gênero masculino. Quanto à opinião dos informantes sobre as causas das injúrias, 57,2% citaram falhas humanas, 18% acreditavam que se deviam ao destino, e 12,7% não sabiam opinar. Somente 23,1% dos informantes haviam recebido, anteriormente, orientação sobre a prevenção de injúrias, e as principais fontes foram mídia, escola e empresa. Do total de eventos, 31,9% ocorreram nas residências. Acidentes de transporte causaram 34,5% das internações; quedas, 33,2%; exposição a forças mecânicas inanimadas, 9%; contato com animais venenosos, 5,2%; agressões, 5%; queimaduras, 4,9%; exposição a forças mecânicas animadas, 3,3%; intoxicações, 2,3%; e outros tipos, 2,6%. CONCLUSÕES: Houve predomínio do gênero masculino. Foi baixo o percentual de informantes que haviam recebido, anteriormente, orientação sobre prevenção de injúrias. A faixa etária mais acometida foi a de 15 a 19 anos. Os acidentes de transporte e as quedas foram os mais freqüentes.OBJECTIVE: To analyze some factors related to injuries and children and adolescents hospitalization. METHODS: This is a prospective, descriptive and observational research that took place at Márcio Cunha Hospital, Ipatinga, Minas Gerais, in the period of December

  6. Histories of Child Maltreatment and Psychiatric Disorder in Pregnant Adolescents

    Romano, Elisa; Zoccolillo, Mark; Paquette, Daniel


    Objective: The study investigated histories of child maltreatment and psychiatric disorder in a high-risk sample of pregnant adolescents. Method: Cross-sectional data were obtained for 252 pregnant adolescents from high school, hospital, and group home settings in Montreal (Canada). Adolescents completed a child maltreatment questionnaire and a…


    Sri Endah Rahayuningsih; Rahmat Budi; Herry Garna


    Objective: To detect cardiovascular abnormalities in adolescents with chest pain. Methods: In this cross sectional study, the subjects were 25 adolescents with chest pain who came to the Cardiac Center of Dr. Hasan Sadikin General Hospital, Bandung during the period of January 2008 to January 2011. The presence of established cardiovascular disorders were based on history, physical examination, electrocardiography and echocardiography Results: It was found that 13/25 adolesce...

  8. Adolescent Patients with Sickle Cell Anaemia

    Patients and Methods: One hundred andtwenty four adolescents with SCA as well as the same number ... University of Port Harcourt Teaching Hospital. Department of ..... menarche, pregnancy, fertility, pubescent changes and body growth in ...

  9. Contraception knowledge and practices in pregnant adolescents

    Villanueva, L A; Campos, R; del Milagro Pérez-Fajardo, M


    The purpose of this article is to describe the knowledge and the background in the use of contraceptive methods in 100 pregnant adolescents in the prenatal care of the Hospital General "Dr. Manuel Gea González...

  10. Adolescents' lived experience of epilepsy.

    Eklund, Pernilla Garmy; Sivberg, Bengt


    To improve the well-being of adolescents with epilepsy, research is needed on how adolescents cope. In this study, Lazarus' model of stress and coping and Antonovsky's Theory of Sense of Coherence were used as the theoretical framework. The aim was to describe the lived experience of adolescents with epilepsy and their coping skills. The participants were 13-19 years old with an epilepsy diagnosis but without mental retardation or cerebral palsy. The study was performed in southern Sweden at the pediatric department of a university hospital. Semistructured and open-ended interviews were conducted with 13 adolescents. The transcripts were analyzed with manifest and latent content analysis. All the adolescents had developed strategies to cope with the emotional strains caused by epilepsy. They experienced strains from the seizures, limitation of leisure activities, side effects of medication, and feelings of being different. The coping strategies described were finding support, being in control, and experimenting.

  11. Congruence between urban adolescent and caregiver responses to questions about the adolescent's asthma.

    Houle, Christy R; Joseph, Christine L M; Caldwell, Cleopatra Howard; Conrad, Frederick G; Parker, Edith A; Clark, Noreen M


    In clinical and research settings, it is increasingly acknowledged that adolescents may be better positioned than their caregivers to provide information in regard to their own health status, including information related to asthma. Very little is known, however, about the congruence between adolescent and caregiver responses to questions about asthma beyond reports of symptoms. We analyzed data for 215 urban, primarily African-American adolescent-caregiver pairs. Adolescents and caregiver reports concerning the adolescent's asthma-related medical history were moderately correlated and not found to differ at the aggregate level. Correlations between adolescent and caregiver reports of the adolescent's asthma symptoms and functional status were weak, although these differences deteriorated at the aggregate level. Adolescent-caregiver reports of symptoms and functioning were more likely to be in agreement if the adolescent was older, if school personnel were unaware of the child's asthma, and if the adolescent's asthma was classified as mild intermittent. For questions concerning the frequency of hospitalizations, emergency department visits, and physician visits, moderate correlations between adolescent and caregiver responses were noted, although with some differences at the aggregate level. Findings suggest that, when adolescents and their caregivers are asked about the adolescent's asthma in clinical and research settings, the extent to which the two perspectives are likely to agree depends on the type of information sought. Clinicians and researchers may obtain more accurate information if questions about symptoms and functional status are directed toward adolescents.

  12. Health and School Performance among Danish adolescents

    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...

  13. Utilização de serviços de reabilitação pelas crianças e adolescentes dependentes de tecnologia de um hospital materno-infantil no Rio de Janeiro, Brasil Use of rehabilitation services by technology-dependent children and adolescents in a maternal and child hospital in Rio de Janeiro, Brazil

    Cláudia Zornoff Gavazza


    Full Text Available O objetivo deste estudo é caracterizar descritivamente a dependência tecnológica e a utilização de serviços de reabilitação pela população de crianças e adolescentes de um hospital materno-infantil do Rio de Janeiro, Brasil. O estudo transversal descreveu as características demográficas da criança e sócio-econômicas do cuidador e família, como também o tipo de dependência tecnológica e a utilização de serviços de reabilitação. A população do estudo é composta de pré-escolares (56,3%, do sexo masculino (58,3%, residentes na região metropolitana do Estado do Rio de Janeiro (89,6%. São oriundos de famílias com rendimentos mensais até dois salários mínimos (70,9%, cuidados sobretudo por suas mãe (93,8%, que possuem escolaridade menor ou igual ao ensino fundamental (54,2% e não trabalham (89,6%. Dos entrevistados, um total de 22,9% depende de três tipos diferentes de tecnologias, sendo o suporte medicamentoso (87,5% a mais utilizada. O tratamento de reabilitação é financiado preponderantemente pelo Sistema Único de Saúde (SUS e instituições filantrópicas, sendo o fisioterapeuta motor (60,4% o profissional de maior demanda nesse tratamento. O hospital estudado concentra todos os atendimentos médicos especializados e a maior parte dos tratamentos em reabilitação.The objective of this study was to describe the dependence on technology and use of rehabilitation services by children and adolescents in a maternal and child hospital in Rio de Janeiro, Brazil. Using a cross-sectional design, the following variables were analyzed: gender and age of the children and adolescents, socioeconomic characteristics of the family, technology dependence, and use of rehabilitation services. The majority of the study population consisted of preschoolers (56.3%, boys (58.3%, residing in Greater Metropolitan Rio de Janeiro (89.3%, from low-income families (70.9%, and cared for mainly by their mothers (93.8%, who in turn have

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

    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


    杨佳欣; 沈铿; 冷金花; 郎景和


    Objective.To study the characteristics, diagnosis and treatment of endometriosis in adolescent patients. Method.Six cases of adolescent endometriosis in our hospital were reviewed retrospectively. Result. Endometriosis is the most common cause of chronic pelvic pain in adolescents. There may be a natural progression of endometriosis from atypical lesions in adolescents to classic lesions in adults. Congenital abnormalities of the reproductive tract are the main reasons for the adolescent endometriosis. Conclusion. Endometriosis should be strongly suspected in adolescent girls with chronic pelvic pain,especially unresponsive to oral contraceptives and nonsteroidal anti-inflammatory drugs. The treatment involves the operations and medicines.

  16. Exciting but exhausting: experiences with participatory research with chronically ill adolescents

    Staa, A.L. van; Jedeloo, S.; Latour, J.M.; Trappenburg, J.M.


    Adolescents with chronic conditions are major users of paediatric hospitals, but seldom participate in the evaluation of services or in research. Little is known about the usefulness of the participatory approach in adolescent health research.

  17. hospital's perspective

    Cost effectiveness of autologous blood transfusion - A developing country hospital's ... 4Military Hospital, Lagos. Summary. An autologous blood donation program was set up at. National .... risk of infection for autologous patients was 5.06.

  18. Adolescent development

    ... such experiences may have a harder time with intimate relationships when they are adults. Adolescents very often have ... family, school or social organizations, peer groups, and intimate relationships. PARENTING TIPS ABOUT SEXUALITY Adolescents most often need ...

  19. 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

    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.

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

    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.

  1. Developing quality measures for adolescent care: validity of adolescents' self-reported receipt of preventive services.

    Klein, J D; Graff, C A; Santelli, J S; Hedberg, V A; Allan, M. J.; Elster, A. B.


    OBJECTIVE: To demonstrate the feasibility of directly surveying adolescents about the content of preventive health services they have received and to assess the validity of adolescent self-reported recall. DATA SOURCES/SETTING: Audiotaped encounters, telephone interviews, and chart reviews with 14-21 year olds being seen for preventive care visits at 15 pediatric and family medicine private practices, teaching hospital clinics, and health centers. DESIGN: 537 adolescents presenting for well v...

  2. Hospitality within hospital meals –

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg


    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...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...... 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...

  3. Analysis of intelligence quotient among adolescence students with learning disabilities In general hospitals%综合医院心理咨询门诊93例青春期学习困难学生的智商结构分析

    程敏锋; 温盛霖; 王厚亮; 王相兰


    目的 探讨综合医院心理咨询门诊青春期学习困难学生的智商特点,为制定针对性的治疗措施提供心理学依据.方法 用中国修订的韦氏儿童智力量表或韦氏成人智力量表对93例青春期学习困难学生进行智力测试.结果 93例学生的总智商:(97.15±13.86),|操作智商-言语智商|≥15占44.10%(P>0.05),以平常智商最多,占49.46%(46例).男孩在总智商和知觉组织智商均高于女孩(P0.05). The proportion of cases with normal intelligence quotient was 49.46%. Intelligence quotient of total and perceptual organization of boys was significantly higher than that of girls (P<0.05). Intelli-gence quotient of memory of cases in late adolescence was significantly higher than that of cases in earlier adoles-cence (P<0.05). Conclusions FIQ of children with learning problem in general hospital is normal. The develop-ment of Performances intelligence quotient (PIQ) and Verbal intelligence quotient (VIQ) are balanced. There are differences of intelligence structure development of gender in different adolescence stage. Pertinent strategy of treat-ment and education is necessary for adolescence students with learning problem in general hospitals.

  4. 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

    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.

  5. Hospitality Industry

    Marian Ionel


    Full Text Available Development of accommodation, as basic services offered to tourists, led to the creation of a genuine hospitality industry. Currently, the hospitality industry is no longer just the accommodation service itself but also requires an atmosphere that ensures leisure tourists in the hotel. Thus, hospitable unit manager offers its service in addition to accommodation and catering services, leisure services, treatment services, business services required.. The existence of factors such as revenue growth, increasing leisure time, the development of transport services, the emergence of new tourist attractions have caused increasing international flows of tourists, with consequent development of units hospitable, and therefore a strong hospitality industry. In Romania, after 1990, the tourism sector experienced a true expansion, both through the development of the hotel sector, but also by developing rural hospitality units.

  6. ADHD in Danish children and adolescents

    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...

  7. [Adolescent pregnancy].

    Lachcar, P


    The number of adolescent pregnancies brought to term in France has continued to decline while the number of abortions remains stable. Adolescent pregnancies cannot be considered "accidents" either in their social or psychological aspects. Pregnant adolescents carrying to term tend to be more disadvantaged than those seeking abortions. Early pregnancy may be a response to difficult life conditions. Despite appearing to constitute an infraction of a social code, adolescent pregnancy may in fact represent an attempt at social integration through motherhood. Adolescents failing in school, with poor employment prospects and feeling family pressures may view pregnancy as a means of social recognition. But such factors by themselves do not explain pregnancy; the primordial role of psychological factors must be examined. For some adolescents, pregnancy may represent an attempt to understand their own sexual identity as the transformations of puberty unsettle their previous self-images. Or they may be failing to perceive or actively denying the possibility of pregnancy. Adolescent pregnancies may be the result of transgressions of prohibitions. The traditional prohibition of sexual activity has relaxed to the degree that it is being replaced by a new prohibition on adolescent pregnancy and a prescription to use contraception. But contraception deprives an adolescent in search of sexual identity of proof of fertility as well as of the image of spontaneity and naturalness. Use of contraception is in conflict with the questions, doubts, and anxieties of adolescence. For adolescents in a reactivated oedipal stage, heterosexuality is often at the service of incestuous fantasies involving the mother. Abortion and perhaps pregnancy itself may assume the character of a rite of passage into adulthood for some adolescents. The important thing for many is the ability to become pregnant, to be a mother like their own mother.

  8. 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

    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.

  9. Adolescent idiopathic scoliosis: current perspectives

    Miyanji F


    Full Text Available Firoz MiyanjiBritish Columbia Children's Hospital, Vancouver, BC, CanadaAbstract: Adolescent idiopathic scoliosis (AIS remains a common and potentially severe musculoskeletal disorder. Although its etiology is largely unknown, ongoing research endeavors continue to improve our understanding of its potential origin and its natural history. Advances in understanding its true three-dimensional nature have sought to improve classification and management strategies. This review will attempt to highlight and give an overview of the current concepts in adolescent idiopathic scoliosis.Keywords: AIS, current, natural history, management strategies

  10. Hospital Inspections

    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...

  11. Hospital Inspections

    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...

  12. Positively Adolescent!

    Williamson, Sue


    Believes that music teachers should reassess their views toward adolescent behavior in the music classroom by learning to see their behavior in a positive light. Describes teaching strategies that build on four adolescent behaviors: (1) desire for peer acceptance; (2) abundant energy; (3) love of fun; and (4) limited time-managing skills. (CMK)

  13. Adolescent Loneliness.

    Goldenberg, Sheila

    Research has suggested that the incidence of loneliness peaks at adolescence and decreases with age. Changes in the determinants of loneliness during adolescence were investigated for grade 8, grade 11, and university students. Subjects (N=410) completed a written questionnaire which included ten items from the UCLA Loneliness Scale, the…

  14. Punishing adolescents

    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...

  15. Hospital marketing.

    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.

  16. Vigilância pós-alta das infecções de sítio cirúrgico em crianças e adolescentes em um hospital universitário de Belo Horizonte, Minas Gerais, Brasil Post-discharge surveillance of children and adolescents treated for surgical site infections at a university hospital in Belo Horizonte, Minas Gerais State, Brazil

    Maria A. Martins


    Full Text Available As infecções hospitalares são as principais complicações na prática cirúrgica e, dentre estas, as infecções de sítio cirúrgico são as mais freqüentes. Apesar dessas infecções poderem se manifestar após a alta, no Brasil, a maioria dos serviços não faz vigilância pós-alta. Para avaliar a importância dessa vigilância e o perfil das infecções em crianças e adolescentes, acompanhou-se uma coorte de 730 pacientes cirúrgicos de um hospital universitário de Belo Horizonte, Minas Gerais, Brasil, de 1999 a 2001. Calculou-se a incidência acumulada, aplicou-se o teste t de Student na comparação de médias e o método de Kaplan-Meier na análise do tempo de ocorrência das infecções; considerou-se significativo o valor p Hospital infections are the main complications in surgical practice. Surgical site infections are the most frequent, and can manifest after hospital discharge. In Brazil, the majority of clinical services do not maintain infection surveillance after discharge. In order to evaluate the importance of such surveillance and the profile of these post-discharge infections, a cohort of 730 child and adolescent surgical patients was followed in a teaching hospital, from 1999 to 2001. The accumulated incidence was calculated. Student's t test was used to compare mean values and the Kaplan-Meier method to analyze the period until infection, using a p value of < 0.05. A total of 87 surgical site infections were diagnosed, 37% of which after discharge. The overall surgical infection rate was 11.9%; without outpatient follow-up, the rate would have been 7.5%. Post-charge infections were diagnosed after a mean of 11.3 ± 6.4 days, and in these patients the preoperative and postoperative hospital stays were significantly lower than in the group with in-hospital infections. The study indicates the importance of post-discharge surveillance in determining the real incidence of surgical site infections.

  17. 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

    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

  18. Re-significando a dor e superando a solidão: experiências do parto entre adolescentes de classes populares atendidas em uma maternidade pública de Salvador, Bahia, Brasil Re-signifying pain, overcoming loneliness: childbirth experiences among working-class adolescents in a public maternity hospital in Salvador, Bahia, Brazil

    Cecilia McCallum


    Full Text Available Este artigo examina o parto em uma maternidade pública de Salvador, Bahia, Brasil, com base na perspectiva de mulheres jovens e adolescentes, a maioria das quais negras e de classes populares. O estudo, de caráter antropológico, baseia-se na análise de entrevistas e na etnografia do hospital, particularmente do centro obstétrico. As mulheres descrevem o trabalho de parto como dominado pelo medo, solidão e dor, sensações que se transformam em amor com o nascimento da criança. Enfocando o parto como um processo biossocial, o trabalho mostra como as jovens produzem significados durante o processo de parturição, enquanto se encontram envolvidas nas interações sociais próprias ao parto hospitalar, particularmente com os profissionais de saúde. Do ponto de vista simbólico, as parturientes experienciam o parto como um rito de passagem que legitima a maternidade, em um contexto social e institucional que, ao contrário, deslegitima a reprodução sexual de mulheres negras, jovens e de baixa renda e estigmatiza a maternidade na adolescência.This article examines childbirth in a public maternity hospital in Salvador, Bahia, Brazil, from the perspective of young and adolescent women, mostly black and working-class. As an anthropological study, it is based on the analysis of birth narratives and hospital ethnography, especially in the obstetric ward. The women describe labor as dominated by fear, loneliness, and pain. These feelings are transformed into love with the birth of the child. Viewing childbirth as a biosocial process, the authors show how the young women construct meanings during the birth; meanwhile, social interactions specific to hospital birth develop, particularly with healthcare professionals. Symbolically, women construct birth as a rite of passage legitimating motherhood, against the institution's effective de-legitimization of sexual reproduction in low-income black mothers and stigmatization of adolescent motherhood.

  19. Self-reported efficacy of neurofeedback treatment in a clinical randomized controlled study of ADHD children and adolescents

    Duric NS; Aßmus J; Elgen IB


    Nezla S Duric,1–3 Jörg Aßmus,4 Irene B Elgen1,5 1Department of Clinical Medicine, University of Bergen, Bergen, Norway; 2Center for Child and Adolescent Mental Health, University of Bergen, Bergen, Norway; 3Department of Child and Adolescent Psychiatry, Helse Fonna Haugesund Hospital, Haugesund, Norway; 4Center for Clinical Research, Haukeland University Hospital, Bergen, Norway; 5Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Berge...

  20. Cinco años de tratamiento de niños y adolescentes con trastorno obsesivo compulsivo en el Hospital de la Misericordia en la ciudad de Bogotá Five years of treating children and adolescents suffering obsessive compulsive disorder in the Misericordia Hospital in Bogota

    Rafael Vásquez


    Full Text Available Antecedentes. se encuentran algunos vacíos en las diferentes revisiones científicas respecto al análisis de diversas variables en el trastorno obsesivo compulsivo en niños y adolescentes. Objetivo. describir respuestas a preguntas planteadas por los autores en relación a factores sociodemográficos, interferencias, comorbilidades, curso, seguimiento y tratamiento. Material y métodos. Estudio Descriptivo observacional y retrospectivo; realizado en el servicio de la psiquiatría infantil de consulta externa de la Fundación Hospital la Misericordia, a menores de 18 años que presentaron diagnóstico de trastorno obsesivo compulsivo entre enero del 2006 a diciembre del 2010, con revisión de 88 historias clínicas. Resultados. Los factores sociodemográficos presentaron predominio en género masculino, promedio de edad once años, Comorbilidades se presentaron tanto médicas en un 52%, como psiquiátricas 92%. Interferencias: Se presentó mayor interferencia asociada en colegio y vida social en un 28%, además de mayor dificultad en tener amigos en un 65%. Seguimiento, curso y tratamiento: seguimiento en lapso mayor de un año se presentó en el 34% de los sujetos; con reporte de mejoría en la última consulta realizada del 53%; cuyo principal síntoma en mejorar fue la ansiedad en la totalidad de pacientes en un 69%; con tratamiento farmacológico en el 86% de los 88 sujetos evaluados. Conclusión. Es llamativo en el curso de la enfermedad la presencia como uno de los ejes cardinales de comorbilidades tanto como causa de solicitud de atención médica, como en su curso y pronóstico, seguido por la presencia de interferencia en el paciente que en la mayoría de ocasiones no es evidenciado por los padres razón que probablemente explicaría la demora en el diagnóstico de esta patología.Background. The present study describes gaps in scientific reviews regarding obsessive compulsive disorder (OCD in children and adolescents concerning

  1. 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

    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.

  2. Stages of Adolescence

    ... Español Text Size Email Print Share Stages of Adolescence Page Content Article Body Adolescence, these years from puberty to adulthood, may be roughly divided into three stages: early adolescence, generally ages eleven to fourteen; middle adolescence, ages ...

  3. Hospitalized child and teenager with chronic diseases: feelings about death

    Flávia Moura de Moura


    Full Text Available Objective.Analyze the feelings of hospitalized children and adolescents with chronic diseases towards death. Methodology. Qualitative research, with four children and one teenager with chronic diseases, aged between 11 and 13 years old, who were admitted at a teaching hospital in Brazil, in the period from January to March 2009. In-depth interviews were carried out using a ludic material for therapeutic purposes, named ''As a guest in the hospital". The empirical material was submitted to thematic analysis. Results. Two mains meanings were obtained: Feelings of hospitalized children and adolescents with chronic diseases dealing with the death of the other; and children and adolescents with chronic diseases and the fear of their own deaths. Hospitalization makes children and adolescents come across the death of other sick people, arousing feelings of sadness, consternation, anxiety, making the fear of their own death become a threat. Conclusion. The health team needs to be attentive to the feelings of hospitalized children and adolescents facing death so that they can get the demands, minimizing fears and anguish.

  4. A primary care approach for adolescent care and counseling services.

    Nair, M K C; Chacko, D S; Indira, M S; Siju, K E; George, Babu; Russell, P S


    Adolescents can have mental, emotional, and behavior problems that are a source of stress for the child as well as the family, school and community. These may disrupt the adolescent's ability to function normally. Adolescents also have reproductive concerns especially at menarche. Considering the extent of problems of adolescents and the lack of adolescent care and counseling services, it was felt that community adolescent care counseling services should be made available. This article describes the steps involved in the setting up of Taluk model of adolescent care and counseling services. Following steps were involved in setting up a Taluk model of adolescent care counseling service delivery system. Step I: Focus Group Discussions (FGDs) among Stakeholders. Step II: Conceptualization and Strategy planning for service delivery. III: Finalization of service delivery model Step IV: Workshops for finalization of TSQ-T 2008 version the tool to be used for assessing the adolescents in the ARSH clinics. Step V: Training Programme for Medical/Paramedical health staff. Step VI: Awareness programs for mothers of adolescents. Step VII: Setting up of ACS/ARSH clinics at Taluk hospitals. Step VIII: Evaluation of the utilization of services at Taluk hospitals. The clinic has been well utilized with 1,588 adolescents being seen in 2 years. Medical and Reproductive problems among adolescent girls were anemia, underweight, dysmenorrhoea, menstrual irregularities and symptoms of Polycystic Ovarian Syndrome, whereas among boys problems were mostly related to concerns about masturbation and its perceived ill effects. The psychosocial problems ranged from minor anxieties, sadness and adjustment problems to psychiatric disorders. Scholastic problems included poor concentration, poor study habits and low intelligence quotient. The success of the clinics in these five hospitals can be replicated in other parts of the state as well as the country. These will go a long way to ameliorate

  5. 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

    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

  6. Management of migraine in adolescents

    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

  7. Design of paediatric hospitals.

    Lambert, Veronica


    The impact of healthcare environments on children and young people's (CYP) health and psychosocial wellbeing has attracted much attention in recent years. This sits within the realm of the political drive for enhanced awareness of the need to take account of the rights and voice of the child. Perhaps as a direct result of the United Nations Convention on the Rights of the Child, and recognition from evidence in adult population studies of the impact of healthcare environments on psychosocial healing, contemporary times have witnessed a discernible movement towards enhancing quality care by promoting child and adolescent-friendly hospital environments. The Council of Europe guidelines on child-friendly health care moved to place the rights and needs of children at the heart of health care. The Council acknowledges that the delivery of child-oriented services, which includes the notion of family-centred care, should be delivered in child and family friendly environments. However, knowledge about what constitutes a child-friendly healthcare environment from CYP's perspective is often lacking with hospital architectural blueprints predominantly designed around adult proxy-reported assumptions about the needs and desires of children.

  8. Adolescence depressions

    Matot, J P


    This article considers the depressive problematics emerging during adolescence in the frame of the transformations that characterize this period of life, with a focus on the interference of socio-cultural dimensions...

  9. Adolescent Sexuality.

    Sharpe, Thomasina H.


    This article offers a medical and psychosocial perspective of adolescent sexual development. Sub-types of sexual development are discussed as well as treatment implications for allied health providers. (Contains 38 references.) (Author)

  10. Academic Hospitality

    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…

  11. Hospitality Management.

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  12. Adolescent idiopathic scoliosis: current perspectives


    Firoz MiyanjiBritish Columbia Children's Hospital, Vancouver, BC, CanadaAbstract: Adolescent idiopathic scoliosis (AIS) remains a common and potentially severe musculoskeletal disorder. Although its etiology is largely unknown, ongoing research endeavors continue to improve our understanding of its potential origin and its natural history. Advances in understanding its true three-dimensional nature have sought to improve classification and management strategies. This review will attem...

  13. 住院儿童、青少年恶性肿瘤患者疾病不确定感现状及其影响因素分析%A survey of uncertainty in illness state and its influencing factors in hospitalized children and adolescents with cancer

    赵玉玲; 江锦芳; 韦荣泉; 李亭秀


    目的 探讨未成年的儿童、青少年恶性肿瘤患者疾病不确定感现况,并分析其影响因素.方法 采用中文版儿童、青少年疾病不确定感量表(the uncertainty scale for kids,USK)和基线资料调查问卷对112例7~18岁的恶性肿瘤患者进行横断面调查.结果 112例未成年的儿童、青少年恶性肿瘤患者疾病不确定感的总分平均为(45.16±6.67)分;未成年儿童、青少年恶性肿瘤患者的疾病不确定感受其年龄、性格、病程、治疗方式、目前疾病状况、是否因病休学、住院次数、家庭月收入以及父母对疾病相关知识了解程度的影响;目前疾病状况、家庭月收入、是否因病休学以及父母对疾病相关知识了解程度是患者疾病不确定感的主要影响因素.结论 未成年的儿童、青少年恶性肿瘤患者普遍存在疾病不确定感,日常医疗与护理中应加强该方面的工作,尤其在日常护理工作中,护士应重视疾病不确定感对儿童、青少年恶性肿瘤患者的影响,尽早采取积极、有效的干预措施,以降低患者疾病不确定感,减轻其心理压力,进一步提高生存质量.%Objective To investigate illness uncertainty state and explore its influencing factors in hospitalized children and adolescents with cancer.Methods A cross-sectional survey was performed in 112 children and adolescents with cancer aged 7~18 years old from two hospitals with the Chinese version of Uncertainty Scale for Kids-20 and the self-designed demographic questionnaire.Results The mean total scores of illness uncertainty was (45.16±6.67) points.The results of single-factor analysis showed that the factors influencing the uncertainty in illness of children and adolescents with cancer were as follows:age,personality characteristics,course of disease,the methods of treatment,current disease status,absence from school or not,the times of hospitalization,family monthly income,and the extent of

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



    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

  15. Adolescent loneliness.

    Williams, E G


    The purpose of this study was to investigate the phenomenon of loneliness in delinquent adolescents with regard to types of delinquency offenses committed, demographic characteristics, and personality characteristics in the areas of interpersonal needs for inclusion, control, and affection. The types of delinquency offenses were categorized as burglary, runaway, drugs, assault, and incorrigible. The demographic variables examined were age, sex, race, family rank or birth order, family structure in terms of parental presence, family income level, religion, and geographic locale. A sample of 98 adolescents was obtained from juvenile detention facilities in three metropolitan areas in the United States. Subjects ranged in age from 12 to 18. Subjects were asked to complete the Loneliness Questionnaire as a self-reported measure of loneliness. Subjects also provided information about themselves relative to demographic characteristics and completed the FIRO-B Questionnaire, which measured interpersonal needs for inclusion, control, and affection. The results revealed no significant differences with regard to any of the demographic variables when the effect of each was considered alone. However, there was a significant effect on loneliness by income when considered jointly with other demographic variables. Adolescents from the middle income group expressed more loneliness than those from the upper and lower income groups. No significant differences were observed with regard to personality characteristics related to interpersonal needs for inclusion and affection, but delinquent adolescents with medium to high needs for control indicated significantly more feelings of loneliness than delinquent adolescents with low needs for control.

  16. Hospitalization for pelvic inflammatory disease: a cost-effectiveness analysis.

    Smith, Kenneth J; Ness, Roberta B; Roberts, Mark S


    Nulliparous women are frequently hospitalized for treatment of pelvic inflammatory disease (PID). The goal of this study was to determine the economic feasibility of hospitalizing adolescents and young women for PID. The authors conducted a Markov decision model, estimating the cost-effectiveness of hospitalization compared with outpatient therapy for mild to moderate PID for adolescents and young women, calculating costs per quality-adjusted life-year (QALY) gained under various assumptions about hospitalization effects on complications. If hospitalization decreases PID complications by 10%, 20%, or 30%, the cost/QALY gained is 145,000 dollars, 67,400 dollars, or 42,400 dollars, respectively, compared with outpatient therapy. Assumptions about hospitalization effects on the development of chronic pelvic pain heavily weight the analysis; costs/QALY gained by hospitalization increase considerably if chronic pain is unaffected. Hospitalization for PID treatment to possibly preserve fertility in nulliparous young women and adolescents is unlikely to be economically reasonable even if substantial improvements in PID complication rates are assumed.

  17. OROS Methylphenidate in Adolescents with ADHD

    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.

  18. Language Impairment in Adolescents with Sydenham Chorea

    J. Gordon Millichap


    Full Text Available Investigators from hospitals in Brazil tested verbal fluency in 20 adolescent patients, ages ranged from 11 to 16 years (mean 13.8 years, with Sydenham chorea compared with 20 patients with rheumatic fever without chorea and 20 healthy controls, matched for age and gender.

  19. Adolescent health in Asia: insights from Singapore.

    Oh, Jean-Yin; Rajasegaran, Kumudhini


    The introduction of adolescent medicine as a medical subspecialty in Singapore was a welcome in an evolving health care system that is unique in terms of both efficiency, in financing and the results achieved in community health outcomes. The Ministry of Health (MOH) already recognized the need to accommodate the health care concerns related to adolescent psychosocial health risk behaviors and an increased prevalence of young people living with chronic illness. The challenge for the pioneer team of physicians trained in adolescent medicine was to develop and sustain a model of care that integrated (i) core clinical services that include quality measures of care to adolescents; (ii) professional development and capacity building needing an expansive teaching agenda at every level of health education; (iii) strong inter-sectorial collaborations within hospital and community partners; and (iv) robust research and evaluation strategies that keep clinical practice relevant and evidence based.

  20. Transition in adolescents across time, disease and gender

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

    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......: This is a longitudinal ethnographic study running from 2012 to 2017. Adolescents are consecutively included at the age between 13 and 14, 8-10 participants in each group. The fieldwork is based on participant observation of consultations between the adolescent and healthcare professionals and individual qualitative...... 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...

  1. Transition in adolescents across time, disease and gender

    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...

  2. Treating Children and Adolescents

    ... Children and Adolescents Go Back Treating Children and Adolescents Email Print + Share For the most part, the ... tailored, based upon the child's weight. Children and adolescents are moving through a period of physical and ...

  3. Adolescent growth and development.

    Chulani, Veenod L; Gordon, Lonna P


    Adolescence is a developmental stage defined by physical and psychosocial maturation. This article reviews normal pubertal development and the evaluation and management of adolescents with suspected pubertal abnormalities and provides an overview of adolescent psychosocial development.

  4. Adolescent homosexuality.

    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.

  5. Embarazo adolescente como factor de riesgo para complicaciones obstétricas y perinatales en un hospital de Lima, Perú

    Okumura,Javier A.; Maticorena, Diego A.; José E. Tejeda; Percy Mayta-Tristán


    Objective: to evaluate the risk of obstetric and perinatal outcomes in teenage pregnancy in comparison with adult pregnancy. Methods: retrospective cohort study of 67.693 pregnant women attended in a public hospital in Lima between 2000 and 2010. Obstetric and perinatal outcomes were evaluated. The adolescent group was divided in late adolescents (15-20 years), and early adolescents (

  6. Gender and Disorder Specific Criminal Career Profiles in Former Adolescent Psychiatric In-Patients.

    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…

  7. Adolescent concussions.

    Lee, Michael A; Fine, Benjamin


    The amount of literature dealing with the diagnosis and treatment of adolescent concussions is considerable. Most articles focus on the athlete. This study examines both sports-related and nonsports-related concussions in adolescents, their etiology, mechanisms of injury (categorized by sport), symptoms exhibited, physical findings, computerized tomography scan results and the problem of prolonged recovery (persistent postconcussion syndrome used in this article to mean symptoms lasting over four weeks.) The purpose of this study is to present the data, their significance and a new method of management that has successfully allowed the author's concussed patients to recover more rapidly. A retrospective review of 863 adolescent concussions, in 11-year-old to 19-year-old patients, from July 2004 through December 31, 2008. Subjects were seen as a result of referrals largely from the author's practice (Pediatric Healthcare Associates), other physicians, athletic trainers or patients previously treated. All concussions, including nonsports-related concussions, were included in the study. Some patients had multiple concussions; 774 individuals accounted for the 863 concussions. The number of patients by age and the number of concussions they sustained are listed below.

  8. Adolescent contraception.

    Nelson, A L


    By age 19, the average North American man has had sex with 5.11 people. Almost two thirds of high-school senior-aged women have had sex. While the rates of sexual activity among teens in the US are not substantially different from rates in other developed western countries, adolescent pregnancy rates in the US are several times higher than in most other countries. These high rates of adolescent pregnancy are partly due to the collective reluctance among adults in the US to discuss sexuality issues with adolescents and provide them with contraception. Effective communication is the key to providing contraception to teens. Studies have clearly shown that teens are interested in sexuality and would like to discuss the issue with their physicians. The author notes that any successful program to reduce unwanted pregnancies among teens will understand that teens are often concrete thinkers focused upon their physical appearance and dedicated to taking risks. Oral contraception, long-acting progestin methods, condoms, and other options are discussed. However, emergency contraception with birth control pills is the one most important contraceptive option which can be provided to teens. The approach has recently been approved by the FDA Advisory Board for both safety and efficacy. Recent studies, however, show that less than 10% of US clinicians informed their patients of the availability of emergency contraception. Information on providers of emergency contraception can be obtained by dialing Princeton University's Office of Population Research's toll-free emergency contraception hotline at (800) 584-9911.


    Sri Endah Rahayuningsih


    Full Text Available Objective: To detect cardiovascular abnormalities in adolescents with chest pain. Methods: In this cross sectional study, the subjects were 25 adolescents with chest pain who came to the Cardiac Center of Dr. Hasan Sadikin General Hospital, Bandung during the period of January 2008 to January 2011. The presence of established cardiovascular disorders were based on history, physical examination, electrocardiography and echocardiography Results: It was found that 13/25 adolescents with chest pain had cardiovascular abnormalities. Of the 25 teens that came with chest pain, most of which showed normal electrocardiographic results, only 9/25 of those with dysrhythmias experienced sinus tachycardia and 8 had a first degree AV block. Echocardiography examination showed only four patients with abnormal cardiac anatomy. No correlation between nutritional status and chest pain, and cardiovascular abnormalities and chest pain (p=0.206 and p=0.632, respectively. There was a positive correlation between sex and cardiovascular abnormalities in adolescents with chest pain (p=0.007. Chest pain is a prevalent problem that is usually benign and that it frequently signals underlying cardiac disease. Conclusions: Cardiovascular abnormalities in adolescents with symptoms of chest pain are found in some cases. There is no correlation between female and male adolescents with chest pain and cardiovascular abnormalities.

  10. Hospital Outpatient PPS Partial Hospitalization Program LDS

    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...

  11. Hospital Outpatient PPS Partial Hospitalization Program LDS

    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...

  12. Episiotomy: perceptions from adolescent puerperae

    Graziele Figueiredo


    Full Text Available Objective. To identify the perception of the teenager puerperas regarding the practice of episiotomy. Methodology. This is a study with qualitative nature developed with 11 teenage puerperas in the Obstetrics Unit of one hospital located in the metropolitan region of São Paulo, Brazil. Results. Teens knew of the existence of episiotomy, but they unaware the reasons for its realization. Pain, discomfort and burning were negative repercussions presented, but most of them believe that assisted procedure in their delivery showing confidence in the professional who carried it out. Conclusion. Adolescents have different perceptions on the practice of the episiotomy, ranging from resignation to outrage.

  13. Utopian visions of schizophrenic adolescents.

    Crain, W C; Starace, J


    Twenty-four normal and 24 hospitalized schizophrenic adolescents described an ideal society for an imaginary island. The normals usually tried to establish a functional democracy. The schizophrenics seemed more sensitive to basic biological needs, but their main goal was to create a personal paradise, a place in which every need and desire would be met. In their search for paradise, the schizophrenics often introduced themes that had a Jungian, archetypal flavor - e.g., themes from antiquity, God, sex, homes, animals, opposites (such as love and hate), birth, and death.

  14. The Wolf Boy: Reactive Attachment Disorder in an Adolescent Boy

    Swain, James E.; Leckman, James F.; Volkmar, Fred R.


    An adolescent boy presented with episodic wolf-like aggressive behaviors, for which his rural community planned an exorcism. Admission to a tertiary care hospital revealed an adolescent suffering an array of severe psychiatric symptoms, which best fit the diagnosis of reactive attachment disorder (RAD). The differential diagnosis included delusional disorder, mood problems, anxiety, schizophrenia, and “feral child” syndrome. Nosology and pathophysiology as well as pharmacological and psychoso...

  15. Hospital-acquired pneumonia

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  16. Structural Measures - Hospital

    U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for patients....

  17. Going to the Hospital

    ... Too Short All About Puberty Going to the Hospital KidsHealth > For Kids > Going to the Hospital Print ... you flowers, balloons, or other treats! previous continue Hospital People You'll meet lots of people in ...

  18. Understanding your hospital bill

    ... Understanding your hospital bill To use the sharing features on this ... help you save money. Charges Listed on Your Hospital Bill A hospital bill will list the major ...

  19. Research in Hospitality Management

    Research in Hospitality Management is a peer-reviewed journal publishing papers ... to the understanding of hospitality and hospitality management in a global context. ... financial management, marketing, strategic management, economics, ...

  20. Patient survey (HCAHPS) - Hospital

    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...

  1. Factors related to surgery worries among iranian high school adolescents

    Meshkani Z.S


    Full Text Available Background: Surgery operations are the fearful events among all other medical procedures. This fear causes anxiety and stress which affects the outcome of treatments, recovery from surgery and some maladaptive behaviors. To cope with surgery worries and minimize the fear, it is important to study these fears and its associated factors. This study attempts to explore the surgery worries and the associated factors among Iranian high school adolescents.Methods: To measure surgery worries, high school adolescents of age 11-15 completed the Child Worries Questionnaire (CPCI adolescent form, and also answered the questions about the 14 independent variables (sex, age, parents education and occupation, previous hospitalization experience of child and immediate family and friends, number of hospitalization during Child's life long, previous surgery experience of child and her or his immediate families, death of close friends in hospital. Multivariate regression method was used for statistical analysis to determine the effective factors.Results: The results of this study showed that the Iranian Adolescents have most worries about the "Not being able to do the same things as before" and least worries about "What I will feel during the anesthesia". The factors associated with Surgery worries are; parent's education (P=.021 for father and 0.049 for mother, adolescent previous experience and number of hospitalizations (P=0.025 and P=0.008, respectively, the number of previous hospitalizations (P=.003, previous experience of hospitalization of immediate family and friends (P=0.035. The findings of this study have implications for parents, family, hospitals' staff and care given.Conclusions: It seems, according to the findings of this study, there should be a special educational program for children who are going to be operated in a hospital ward to reduce their worriships.

  2. Competent independent driving as an archetypal task of adolescence.

    Winston, F K; Senserrick, T M


    Supplement Editor, Dr Flaura K Winston, and Co-Editor, Dr Teresa Senserrick, introduce 10 papers covering the current science of safe driving among adolescents from the varied viewpoints of an international panel of experts. This Expert Panel, convened by the Center for Injury Research and Prevention (formerly TraumaLink) at the Children's Hospital of Philadelphia and State Farm Insurance Companies(R), working jointly on the Youthful Driver Research Initiative, represents a wide range of expertise, thereby providing a broad understanding of driving, adolescence, and adolescent driving.

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

    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),

  4. Adult Arrests Records and Court Outcomes of Adolescents with Serious Emotional Disturbance.

    Davis, Maryann; Cooper, Deborah K.

    This study used archival data to examine adult charges and court outcomes for 82 individuals who had been treated in public mental health programs as adolescents. Subjects' clinical records from their adolescent day treatment (18 percent), residential (23 percent) or hospital program (58 percent) were reviewed for sociodemographics, clinical…

  5. Treatment of Co-Occurring Substance Abuse and Suicidality among Adolescents: A Randomized Trial

    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…

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

    Hoof, van Joris J.; Boeynaems, Gerben; Vanderlely, 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), pediatr

  7. Psychiatric Diagnoses as Contemporaneous Risk Factors for Suicide Attempts among Adolescents and Young Adults: Developmental Changes

    Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.


    The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to…

  8. Adolescent health care in Italy: a mini-review.

    De Sanctis, V; Filati, G; Fiscina, B; Marsciani, A; Piacentini, G; Timoncini, G; Reggiani, L; Zucchini, A


    The purpose of this mini-review is to present the National Health System and services available for adolescents in Italy, and to review the most relevant data on morbidity and mortality in Italian teens. Adolescent medicine in Italy is not a separate speciality, but there are some distinct services for adolescents in paediatric departments or gynaecologic wards, mostly in large cities where university hospitals or hospital of national relevance are located. Primary health care in Italy is provided mainly by general practitioners (GPs) and pediatricians, and on-call physicians (Guardia Medica) for after-hours medical care and services. The number of centres providing care for adolescents in Italy is 4097 (50% of these are in the North of Italy, 20% in the Central regions and 20% in the South and Islands). The population of Italy on January 1st 2011 was approximately 60,477,881 and the number of adolescents, aged 10 to 19 years, was 6,214,000. The most frequent causes of death in adolescents are motor vehicle accidents - more than half of which are related to drug or alcohol use - followed by cancer and suicide. In primary care, adolescents present with a large number of issues, particularly upper respiratory infections, musculoskeletal problems, pain syndromes, obesity, eating disorders, dermatological issues, mood and somatoform disorders, school and mental health problems, and chronic fatigue, many of which require a coordinated, multidisciplinary management approach. The estimated population with a chronic illness is 8%. There are no specific protocols for the transition to adult medicine physicians for patients with chronic diseases or special health needs. In order to improve the quality and quantity of education in adolescent health for paediatricians and GPs, the Study Group of Emilia and Romagna Region for Adolescent Health Care (SGA-ER) is going to organize, beginning in 2012, a two year educational intervention course in adolescent health.

  9. Development of hypertension in overweight adolescents: a review

    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

  10. O uso da simulação realística como metodologia de ensino e aprendizagem para as equipes de enfermagem de um hospital infanto-juvenil: relato de experiência = The use of realistic simulation as teaching-learning methodology for nursing staff in a child-adolescent hospital: experience report

    Abreu, Aguilda Gomes de


    Conclusão: O uso da simulação realística mostrou-se como uma metodologia inovadora para realização de treinamentos na instituição, por replicar experiências da vida real favorecendo um ambiente de interatividade entre os participantes, facilitando o processo de ensino - aprendizagem das equipes de enfermagem que atuam no Hospital infanto-juvenil

  11. Daily Changes in Pain, Mood and Physical Function in Youth Hospitalized for Sickle Cell Disease Pain

    William T Zempsky


    Full Text Available BACKGROUND: Youth with sickle cell disease (SCD are commonly hospitalized for treatment of painful vaso-occlusive episodes (VOE. However, limited data are available concerning the course of hospitalization for these children and adolescents and, in particular, whether daily changes occur in pain, emotional status and physical function.

  12. Immunologic cytofluorometric studies in adolescents with anorexia nervosa.

    Silber, T J; Chan, M


    To assess lymphocyte stimulation and lymphocyte phenotype evaluation in adolescent patients with anorexia nervosa (AN). In vitro lymphocyte stimulation and flow cytometric phenotype studies were done on 26 hospitalized patients with AN receiving nutritional rehabilitation. The laboratory assessment consisted of lymphocyte subset analysis and in vitro lymphoproliferative responses to mitogens and antigens. Flow cytometric phenotype analysis showed that only a minority of the patients had abnormal phenotype and immune responses, moreover their immune systems were not significantly impaired. The cytofluorometric study of immune function does not show significant alterations in adolescents hospitalized for anorexia nervosa.

  13. Characterization of the hospitalization of children and adolescents with cancer Caracterización de las internaciones hospitalarias de niños y adolescentes con neoplasias Caracterização das internações hospitalares de crianças e adolescentes com neoplasias

    Raquel Pan


    Full Text Available This study characterizes hospitalizations of children and adolescents with cancer, from 1998 to 2008, to describe the clientele in follow-up in the Regional Health Area of Ribeirão Preto, SP, Brazil. Morbidity was surveyed in Ribeirão Preto, SP, Brazil, using hospitalization data from the Unified Health System. The studied variables included: origin, residence, year when care was provided, deaths, age and gender of patients diagnosed with child and adolescent cancer according to the International Classification of Disease 10th edition, Chapter II. The results indicated 7,234 hospitalizations of individuals younger than 18 years old diagnosed with neoplasm, 95% of which were from Ribeirão Preto, SP, Brazil, and the remainder from cities located in all five of the Brazilian regions. Identifying the characteristics of patients contributes to the identification of information to broaden the sensitization of health professionals concerning the need for secondary preventive actions, such as early diagnosis.Este estudio tuvo por objetivo caracterizar las internaciones hospitalarias de niños y adolescentes con neoplasias, de 1998 a 2008, para conocer la clientela en seguimiento en la Regional de Salud de Ribeirao Preto, Sao Paulo, Brasil. Se realizó un levantamiento de la morbilidad en Ribeirao Preto, utilizando, como fuente de información, las internaciones hospitalarias por el Sistema Único de Salud. Las variables estudiadas fueron: procedencia, residencia, año de la atención, muertes, edad y sexo de los pacientes con diagnóstico de neoplasia infanto-juvenil, según el Capítulo II de la Clasificación Internacional de Enfermedades 10ª edición. Se constataron 7.234 internaciones de menores de 18 años con diagnóstico de neoplasias, de estas, 95% ocurrieron en Ribeirao Preto y las otras en municipios de procedencia pertenecientes a las cinco regiones del país. Conocer las características de la clientela atendida contribuye para

  14. Cumulative Vulnerability: A Case Study on intrafamilial violence, Drug Addiction and Adolescent Pregnancy.

    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.

  15. [Surgery in children and adolescents].

    Ruzafa Martínez, María; Ruiz García, María Jesús; Gómez García, Carmen I


    The authors explain the second phase in surgery procedure which is known as intra-operative, developing a standardized model of nursing care for children and adolescents during the intra-operative phase. This phase commences in the operating room from the moment the child/adolescent arrives after being brought from a hospital ward and lasts until the child/adolescent is transferred to the recovery room. The authors perform a systematic and holistic evaluation, using the Gordon Functional Health Patterns. The authors select the Nursing Diagnoses of NANDA, the North American Nursing Diagnosis Association, which most frequently appear in this intra-operative phase: risk of lesion, risk of infection, risk of hypothermia, and risk of asphyxiation. The authors also mention the potential complications which could appear during an operation according to the age of the child, the type of anesthesia used, the surgical technique used, and the overall health of the patient prior to surgery. Finally, the authors describe the nursing treatments related to the potential complications and the outlined nursing diagnoses.

  16. Hospital marketing revisited.

    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.

  17. Experience with genetic counseling: the adolescent perspective.

    Pichini, Amanda; Shuman, Cheryl; Sappleton, Karen; Kaufman, Miriam; Chitayat, David; Babul-Hirji, Riyana


    Adolescence is a complex period of development that involves creating a sense of identity, autonomy, relationships and values. This stage of adjustment can be complicated by having a genetic condition. Genetic counseling can play an important role in providing information and support to this patient population; however, resources and guidelines are currently limited. In order to appropriately establish genetic counseling approaches and resource development, we investigated the experiences and perspectives of adolescents with a genetic condition with respect to their genetic counseling interactions. Using a qualitative exploratory approach, eleven semi-structured interviews were conducted with adolescents diagnosed with a genetic condition who received genetic counseling between the ages of 12 and 18 years at The Hospital for Sick Children. Transcripts were analyzed thematically using qualitative content analysis, from which three major interrelated themes emerged: 1) understanding the genetic counselor's role; 2) increasing perceived personal control; and 3) adolescent-specific factors influencing adaptation to one's condition. Additionally, a list of suggested tools and strategies for genetic counseling practice were elucidated. Our findings can contribute to the development of an adolescent-focused framework to enhance emerging genetic counseling approaches for this patient population, and can also facilitate the transition process from pediatric to adult care within patient and family-centered contexts.

  18. [Predictors of Resilience in Adolescents with Leukemia].

    Hong, Sung Sil; Park, Ho Ran


    The purpose of this study was to identify the factors relating to resilience for adolescents with leukemia and examine the relationship between these factors. From June to September in 2014, 199 adolescents aged 11 to 21 participated in the study as they visited the out-patient clinic at C university hospital for follow-up care. To verify the predictors and the effects of resilience, uncertainty, symptom distress, perceived social support, spiritual perspective, defensive coping, courageous coping, hope, and self-transcendence were measured. Collected data were analyzed using hierarchical regression analysis with the SAS statistics program. The final regression model showed that courageous coping, hope, and self-transcendence were significant predictors related to resilience in adolescents with leukemia and explained for 63% of the variance in resilience. The findings indicate that adolescent-oriented intervention programs enhancing courageous coping, hope, and self-transcendence should be provide for adolescents with leukemia in order to overcome illness-related stress and support physical, psychological and social adjustment.

  19. Breast fibroadenomas in adolescents: current perspectives

    Lee M


    Full Text Available Michelle Lee, Hooman T SoltanianDepartment of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USAAbstract: Fibroadenomas are one of the most common benign tumors of the breast in the adolescent population. They account for 68% of all breast masses and 44%–94% of all biopsied breast lesions. Fibroadenomas can range from asymptomatic masses to painful and rapidly growing tumors that can cause significant esthetic distortions of the breast. Given the prevalence of fibroadenomas in the adolescent population and the psychosocial morbidity of finding a mass in the adolescent breast, it is imperative for physicians treating adolescent patients to be familiar and up to date with this disease process. The goal of this article is to provide a brief review of the classification, etiology, symptoms, initial work-up, and update on the management of breast fibroadenomas in the adolescent population.Keywords: breast mass, benign breast neoplasm, breast growth, breast development, breast asymmetry

  20. Hospital admissions from birth to early adolescence and early-life risk factors: the 11-year follow-up of the 1993 Pelotas (Brazil birth cohort study Hospitalizações do nascimento ao início da adolescência e fatores de risco precoces: a visita de 11 anos da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 1993

    Ana M. B. Menezes


    Full Text Available The aim of this prospective analysis was to describe the cumulative incidence of hospital admissions in the first year of life and between 1 and 11 years of age and to explore associated factors. Hospital admissions were collected through regular monitoring in the first year of life, and through maternal report on admissions between 1 and 11 years. Analyses were stratified by sex and adjusted for confounding factors. 18.1% of children were hospitalized in the first year of life, and 30.7% between ages 1 and 11 years. Among boys, hospital admission in the first year was associated with low family income, paternal smoking during pregnancy, preterm delivery, and low birthweight. Among girls, in addition to the variables described for boys, black/mixed skin color was also a risk factor for hospital admission. For admissions between 1 and 11 years of age, low family income and gestational age > 37 weeks were found to be significant risk factors.Com o objetivo de descrever a incidência cumulativa de hospitalizações no primeiro ano de vida e entre 1-11 anos de idade, e identificar fatores de risco precoces, foi realizado um estudo de coorte de nascimento de 1993 a 2004-2005. As hospitalizações foram coletadas por meio de monitoramento hospitalar até 1 ano de idade, e relato das mães sobre internações ocorridas de 1-11 anos. As análises foram estratificadas por sexo e ajustadas para fatores de confusão. Os percentuais de hospitalizações de 0-1 ano e de 1-11 anos foram 18,1% e 30,7%, respectivamente. As variáveis associadas com internações de 0-1 ano em meninos foram: baixa renda familiar, tabagismo paterno na gestação, prematuridade e baixo peso ao nascer. No sexo feminino, além dos fatores de risco descritos entre os meninos, observou-se associação com cor da pele preta/parda. Quanto às hospitalizações de 1-11 anos, no sexo masculino, encontrou-se associação com baixa renda familiar e idade gestacional > 37 semanas.

  1. Adolescent and School Health

    ... 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 ...

  2. Treating Children and Adolescents

    ... Children and Adolescents Go Back Treating Children and Adolescents Email Print + Share For the most part, the ... side effects. Side effects from sulfasalazine may include headache, sun sensitivity rash, or other signs of sulfa ...

  3. Adolescent health psychology.

    Williams, Paula G; Holmbeck, Grayson N; Greenley, Rachel Neff


    In this article, a biopsychosocial model of adolescent development is used as an organizing framework for a review of primary, secondary, and tertiary prevention research with adolescent populations. During adolescence many critical health behaviors emerge, affecting future disease outcomes in adulthood. In addition, most of the predominant causes of morbidity and mortality in adolescence are unique to this period of development, indicating that health-focused interventions must be tailored specifically to adolescents. Moreover, it is during adolescence that lifelong patterns of self-management of and adjustment to chronic health conditions are established. Thus, an increased focus on adolescence in health psychology research is important both to improve the health of adolescents per se and to optimize health trajectories into adulthood.

  4. Encyclopedia of adolescence

    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. Dermatologic conditions in teenage adolescents in Nigeria

    Henshaw EB


    Full Text Available Eshan B Henshaw,1 Olayinka A Olasode,2 Evelyn E Ogedegbe,3 Imaobong Etuk4 1Dermatology Unit, Department of Internal Medicine, University of Calabar, Calabar, Cross River State, 2Department of Dermatology, Obafemi Awolowo University, Ile-Ife, Osun State, 3Cedarcrest Hospital, Abuja, Federal Capital Territory, 4Department of Pediatrics, University of Calabar, Calabar, Cross River State, Nigeria Background: Skin disorders are common in adolescents, and the impact on quality of life can be enormous, particularly when viewed against the backdrop of the visibility of skin diseases and the psychologically vulnerable period of adolescence. However, few studies have documented the magnitude of skin disorders in this subset of individuals. We therefore estimated the point prevalence and pattern of dermatologic conditions in adolescents attending various secondary schools in Calabar, Southern Nigeria. Methods: Using a structured questionnaire, relevant sociodemographic information was obtained from 1,447 teenage adolescents from eight secondary schools. Thereafter, a whole body examination was conducted to determine the presence and types of skin disorders seen. Results: Skin diseases were seen in 929 students. The point prevalence was higher in males (72.1% than in females (58.3%. Private schools had a higher prevalence than public schools. The six most common dermatoses were acne vulgaris, pityriasis versicolor, nevi, tinea, miliaria, and keloid/hypertrophic scars, and accounted for over 80% of the dermatoses seen. Conclusion: The point prevalence of dermatoses in senior secondary school adolescents was 64.2%. Although a large number of skin disorders were observed, only a handful accounted for a significant proportion of the diseases seen. This increases the ease of training community health workers in the recognition and treatment of common skin diseases. Age, race, and climatic factors are important determinants of skin diseases in adolescents in

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

    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

  7. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    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…

  8. Demystifying the Adolescent Brain

    Steinberg, Laurence


    Understanding the nature of brain development in adolescence helps explain why adolescents can vacillate so often between mature and immature behavior. Early and middle adolescence, in particular, are times of heightened vulnerability to risky and reckless behavior because the brain's reward center is easily aroused, but the systems that control…

  9. Adolescence and Mythology

    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.…

  10. Danish Registry of Childhood and Adolescent Diabetes

    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

  11. The application of hospitality elements in hospitals.

    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.

  12. The influence of borderline personality features on inpatient adolescent suicide risk.

    Yalch, Matthew M; Hopwood, Christopher J; Fehon, Dwain C; Grilo, Carlos M


    Suicide is a leading cause of death among adolescents and suicidal behavior is one of the primary risk factors for youth psychiatric hospitalizations. A number of studies indicate that depression and substance abuse are associated with suicide risk in this population, but less is known about the role of borderline personality features or their incremental influence over other known risk factors in indicating suicidal behavior among adolescents. This study examined whether borderline features were associated with suicide risk when controlling for symptoms of depression and substance abuse in a sample of adolescents hospitalized in an inpatient psychiatric facility. Self-report data from 477 adolescent psychiatric inpatients were used to test hypotheses about the association of borderline features with suicide risk after controlling for other common risk factors. Borderline features were significantly related to suicide risk even after accounting for symptoms of depression and substance abuse. These findings underscore the clinical value of routinely assessing borderline features among adolescents.

  13. 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

    Rosa María Alonso Uría; Ana Teresa Fariñas Reinoso; Beatriz Rodríguez Alonso; Ana Campo González; Rosa Díaz Aguilar


    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 dur...

  14. Determinants of Effective Caregiver Communication After Adolescent Traumatic Brain Injury.

    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.

  15. Parental perspectives on adolescent hearing loss risk and prevention.

    Sekhar, Deepa L; Clark, Sarah J; Davis, Matthew M; Singer, Dianne C; Paul, Ian M


    Data indicate that 1 in 6 adolescents has high-frequency hearing loss, which is typically noise related and preventable. Parental participation improves the success of adolescent behavioral interventions, yet little is known about parental perspectives regarding adolescent noise-induced hearing loss. To perform a survey to determine parental knowledge of adolescent hearing loss and willingness to promote hearing conservation to discern information that is critical to design adolescent hearing loss prevention programs. A cross-sectional, Internet-based survey of a nationally representative online sample of parents of 13- to 17-year-olds. A survey conducted with the C.S. Mott Children's Hospital National Poll on Children's Health, a recurring online survey. Parental knowledge of adolescent hearing loss and willingness to promote hearing conservation. Of 716 eligible respondents, 96.3% of parents reported that their adolescent was slightly or not at all at risk of hearing problems from excessive noise, and 69.0% had not spoken with their adolescent about noise exposure, mainly because of the perceived low risk. Nonetheless, to protect their adolescents' hearing, more than 65.0% of parents are either willing or very willing to consider limiting time listening to music, limiting access to excessively noisy situations, or insisting on the use of hearing protection (earplugs or earmuffs). Higher parental education increased the odds of promoting hearing-protective strategies. Parents were less likely to insist on hearing protection for older adolescents. Parents who understood that both volume and time of exposure affect hearing damage were more likely to have discussed hearing loss with their adolescent (odds ratio [OR], 1.98; 95% CI, 1.29-3.03). The odds of discussing hearing loss were also increased for those who were willing or very willing to limit time listening to music (OR, 1.88; 95% CI, 1.19-2.26) and to insist on hearing protection (OR, 1.92; 95% CI, 1

  16. The Hospitable Meal Model

    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...

  17. Staph infections - hospital

    ... Staph infections - hospital To use the sharing features on this page, ... one person to another. Staph Infections in the Hospital Staph germs are mostly spread by skin-to- ...

  18. Hospital Compare - Archived Data

    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...

  19. HCAHPS Hospital Survey

    U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...

  20. Adolescent pregnancy outcomes and risk factors in Malaysia.

    Omar, Khairani; Hasim, Suriati; Muhammad, Noor Azimah; Jaffar, Aida; Hashim, Syahnaz Mohd; Siraj, Harlina Halizah


    To assess the outcomes and risk factors of adolescent pregnancies in 2 major hospitals in Malaysia. We conducted a case-control study of pregnant girls aged 10 through 19 years. The controls were women aged 20 through 35 years who did not become pregnant in their adolescence. Cases and controls were matched for parity and place of delivery. Data were collected from questionnaires and the hospitals' medical records. The study included 102 cases and 102 controls. There were significant associations between adolescent pregnancy and low education level, low socioeconomic status, being raised by a single parent, not engaging in extracurricular school activities, engaging in unsupervised activities with peers after school, and substance abuse (PAdolescent pregnancies are high-risk pregnancies. Better sexual health strategies are required to address the associated complications. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Female Adolescents' Educational Choices about Reproductive Health Modules

    Gold, Melanie A.; Chiappetta, Laurel; Young, Amanda J.; Zuckoff, Allan; DiClemente, Carlo C.


    Purpose: To assess girls' reproductive educational choices, satisfaction with choice, and relationship between demographics, module choice, and satisfaction. Methods: We recruited 286 girls, aged 13 to 21 years, from a hospital-based adolescent clinic, from advertisements, and by word of mouth. At enrollment, participants completed a 60-minute…

  2. Very Preterm Birth, Cerebellar Development and Neuropsychological Outcome in Adolescence

    J Gordon Millichap


    Full Text Available Cerebellar volumes were measured on structural MRI at adolescence and adulthood in 65 preterm individuals (born before 33 weeks’ gestation, and a term-born comparison group, in a study at King’s College, Great Ormond Street Hospital, and University College, London; and Seoul National University College of Medicine, Korea.

  3. Female Adolescents' Educational Choices about Reproductive Health Modules

    Gold, Melanie A.; Chiappetta, Laurel; Young, Amanda J.; Zuckoff, Allan; DiClemente, Carlo C.


    Purpose: To assess girls' reproductive educational choices, satisfaction with choice, and relationship between demographics, module choice, and satisfaction. Methods: We recruited 286 girls, aged 13 to 21 years, from a hospital-based adolescent clinic, from advertisements, and by word of mouth. At enrollment, participants completed a 60-minute…

  4. If You Do Not Ask, They Will Not Tell: Evaluating Pregnancy Risk in Young Women in Pediatric Hospitals.

    Coles, Mandy S; Lau, May; Akers, Aletha Y


    Adolescents experience some of the highest rates of unintended pregnancy among women of all reproductive age groups. And despite the fact that adolescents often receive care in pediatric hospital settings, evaluation of pregnancy risk is inconsistent. Pregnancy risk assessments can identify opportunities to deliver reproductive health services, allow earlier pregnancy diagnoses, and reduce morbidity and mortality for medically complex adolescent patients and their pregnancies. In this commentary we discuss some of the challenges and potential solutions to performing pregnancy risk assessments in pediatric hospital settings.

  5. Role of mindfulness in dissociative disorders among adolescents.

    Sharma, Tanya; Sinha, Vinod K; Sayeed, Neha


    Dissociation is understood as maladaptive coping and is common in children and adolescents. Treatment outcome studies show improvement in comorbid conditions suggesting the need to implement programs that target dissociative pathology. To study the effect of practicing mindfulness among adolescents diagnosed with dissociative disorders. It was a hospital-based repeated measures design. 7 adolescents participated in a mindfulness-based therapeutic program for 6 weeks. Scores were expressed as mean ± standard deviation. Friedman test was used to assess significance of the difference in scores at various assessment phases. Wilcoxon signed rank test was used for post hoc analysis. Participants were mostly female adolescents from rural, Eastern India. There was a significant reduction in dissociative experiences and significant improvement in mindfulness. Incorporating mindfulness in clinical practice may prove effective in reducing dissociation and promoting adaptive functioning.

  6. Transition in adolescents across time, disease and gender

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

    Transition in adolescents across time, disease and gender Jette Rolf Svanholm 1,2, Mette Spliid Ludvigsen 1,3, Hanne Aagaard 1,4,5 1 Aarhus University Hospital, Denmark 2 Department of Cardiology 3 Department of Renal Medicine 4 Department of Pediatrics 5 Institute of Public Health, Aarhus...... of transition being in a maturing and independence process and what is important to them? • What characterise their interaction with health care staff? • How is the communication between the adolescents and health care staff as perceived by the adolescents when focus is on their illness? Methods: Qualitative...... central characteristics across time, disease and gender. Perspectives It is expected that this study will create knowledge about the existential and interpersonal challenges of adolescents in transition as seen from the • time perspective • diagnose perspective • gender perspective These results will make...

  7. Medicare Hospital Spending Per Patient - Hospital

    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...

  8. Validity of the Draw-A-Person and Bender Gestalt Tests as Measures of Impulsivity with Adolescents.

    Oas, Peter


    Designated 100 psychiatrically hospitalized and 114 nonhospitalized adolescents as impulsive or nonimpulsive and compared them to determine the validity of signs of impulsivity on the Draw-A-Person and Bender Gestalt tests. Signs of impulsivity and nonimpulsivity on these tests discriminated between impulsive and nonimpulsive adolescents with…

  9. Attachment Theory as a Framework for Understanding Sequelae of Severe Adolescent Psychopathology: An 11-Year Follow-Up Study.

    Allen, Joseph P.; And Others


    Examined long-term sequelae of severe adolescent psychopathology from the perspective of adult attachment theory. Compared 66 upper-middle-class adolescents who were psychiatrically hospitalized at age 14 for problems other than thought or organic disorders, to 76 socio-demographically similar high school students. When reviewed at age 25,…

  10. Adolescent Understanding and Acceptance of the HPV Vaccination in an Underserved Population in New York City

    Jill Blumenthal


    Full Text Available Background. HPV vaccination may prevent thousands of cases of cervical cancer. We aimed to evaluate the understanding and acceptance of the HPV vaccine among adolescents. Methods. A questionnaire was distributed to adolescents at health clinics affiliated with a large urban hospital system to determine knowledge pertaining to sexually transmitted diseases and acceptance of the HPV vaccine. Results. 223 adolescents completed the survey. 28% were male, and 70% were female. The mean age for respondents was 16 years old. Adolescents who had received the HPV vaccine were more likely to be female and to have heard of cervical cancer and Pap testing. Of the 143 adolescents who had not yet been vaccinated, only 4% believed that they were at risk of HPV infection and 52% were willing to be vaccinated. Conclusions. Surveyed adolescents demonstrated a marginal willingness to receive the HPV vaccine and a lack of awareness of personal risk for acquiring HPV.

  11. Towards the collaborative hospital

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper;


    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...... for the collaborative hospital as new organizational form which is better equipped to respond to the challenges facing modern hospitals. The collaborative hospital is an ambidextrous organization that opens for pursuing both exploration and exploitation within the same organizational structure. The basic principles...... of the collaborative organization which is used for a discussion of theoretical and empirical aspects of the collaborative hospital....

  12. Interruptions: Derrida and Hospitality

    Mark W. Westmoreland


    Full Text Available Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of this project is to provide readers of Derrida with a sort of reference guide for his discussions on and deconstructive approach to hospitality.

  13. Evaluation of Maternal and Fetal Outcomes in the Adolescents Pregnancy

    Elif Ağaçayak


    Full Text Available Objective: In this study, our aim is to compare discussing maternal and fetal problems non-adolescent pregnancy with maternal and fetal problems in adolescent pregnancy that seen in hospital. Methods: 15-19 years of age (50 patients and 20-23 years (96 patients who gave birth at the Gynaecologi­cal and Obstetric Clinic under the Faculty of Medicine of Dicle University between January 2015-October 2015 were retrospectively evaluated. Age at birth, parity, blood pressure, pulse, gestational age, complications at birth, cesarean section indications, maternal biochemical pa­rameters, patients with preeclampsia and preterm birth, maternal and fetal complications were recorded. Results: Total number of births between January 2015- October 2015 were 1715 patients in our clinic. 62 of them (3.6% were observed in the adolescent group. Maternal blood transfusion needs were found to be significantly higher in the adolescent group (p=0.004. Fetal abnor­malities and fetal intensive care needs were found to be significantly higher in the adolescent group (p=0.014, p=0.018. Conclusion: Adolescent pregnancies were high-risk pregnancies in terms of maternal anemia and blood transfusion requirements and because of adverse perina­tal outcomes. Therefore, to reduce the adolescent preg­nancy and to minimize perinatal complications should be done more extensive studies.

  14. Outcome of Adolescent Pregnancy: A Retrospective Cohort Study

    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.

  15. Adolescent Pregnancy among Ethnic Variants at Lumbini Medical College

    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


    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.

  17. Post-abortion and induced abortion services in two public hospitals in Colombia.

    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.

  18. A closer look at the developmental interplay between parenting and perceived health in adolescents with congenital heart disease.

    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.

  19. Adolescents' interhospital transfers from a pediatric emergency department

    Cláudia Arriaga


    Full Text Available Introduction: The maternal-infant referral network, established in Portugal since 2001, allows a complementarity between all healthcare units, providing universal access to healthcare. Aim: To characterize adolescents interhospital transfers from the Pediatric Urgency (PU of a B1 hospital.. Methods: Retrospective analytic study. Data from clinical files of adolescents transferred from the PU in 2011 were collected. We defined and compared two age groups: 10 to 14 years old (G1 and 15 to 18 years old (G2 and characterized these about demographics, diagnosis, diagnostic procedures and reason for transfer. Statistical analysis was performed with PASW 18.0® software (p<0,05. Results: There were 43.409 admissions to the PU, 24,2%(n=10.498 from adolescents, with an average age of 14,5 (±2,1 years; 67% were males. Around 1,2% (n=131 of the adolescents were transferred, which counted for 46% of all transfers in pediatric age. When analyzing admissions by age group, 65,8% belonged to G1 from all transfers and 57,3% to G2 (p<0,001. The reason for transfer was trauma in 45%, medical in 37,4%, and surgical in 17,6%. The main diagnosis of the adolescents transferred were ear-nose-throat problems, urologic and psychiatric conditions. Diagnostic procedures were performed in 42,7% of the adolescents and 82,1% were imaging exams. The lack of specialities, in the emergency department, in the local hospital was the reason for the transfer in 90,8%, and the missing speciality was surgical in 72,2%. Psychiatric conditions were more frequently diagnosed in adolescents transferred from G2 (22,7% than G1 (9,1%, p=0,037. Of all the adolescents transferred to A1 hospital, 28,2% were admitted for hospitalization. Conclusions: Although adolescents comprised only a quarter of the admissions of the PU, they represented an important percentage of all transfers, mainly the older ones. The main reason for transfers was the lack of medical and surgical specialities in the PU

  20. Hospital diversification strategy.

    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.

  1. Social cognitive development during adolescence

    Choudhury, Suparna; Blakemore, Sarah-Jayne; Charman, Tony


    Social relationships are particularly important during adolescence. In recent years, histological and MRI studies have shown that the brain is subject to considerable structural development during adolescence...

  2. The Changing Concept of Adolescence in Kenya

    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.

  3. Refeeding Hypophosphatemia in Adolescents With Anorexia Nervosa

    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

  4. Adolescents with congenital heart disease: the importance of perceived parenting for psychosocial and health outcomes.

    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.

  5. Adolescent childbearing.

    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

  6. Nosologia das doenças da mão de crianças e jovens operados em mutirões realizados em hospital de referência no estado de pernambuco Nosology of hand diseases in children and adolescents operated in provisional facilities in a model hospital - pernambuco state, Brazil

    Mauri Cortez


    Full Text Available OBJETIVO: Relatar a frequência das doenças congênitas da mão operadas em sistema de mutirão no SOS Mão de Recife entre 2005 e 2009. MÉTODOS: Foram coletadas as informações de 833 crianças e adolescentes examinados em oito missões. RESULTADOS: Entre os pacientes, 306 (36,7% foram operados; 240 (78,4% por malformações congênitas e 66 (21,6% por lesões adquiridas. As malformações congênitas mais frequentes foram: sindactilia, 72 (30,0% casos; polidactilia, 30 (12,5% casos; polegar bífido, 19 (7,9% casos; malformação complexa da mão, 14 (5,8% casos; mão em fenda, 13 (5,4% casos; dedo em gatilho, 12 (5,0% casos; camptodactilia, 11 (4,6% casos; e braquisindactilia, nove (3,7% casos. As lesões adquiridas mais frequentes foram: lesões por trauma obstétrico, 26 (39,4% casos; sequela de trauma de mão, 18 (27,3% casos; sequela de paralisia cerebral, sete (10,6% casos; sequela de choque elétrico, cinco (7,6% casos; e sequela de queimadura, quatro (6,1% casos. CONCLUSÃO: A nosologia das doenças de mão é similar a de grandes séries de cirurgias eletivas, particularmente no que diz respeito às deformidades congênitas. As frequências das lesões adquiridas parecem ser mais altas do que as das séries internacionais. O sistema de mutirão de cirurgia de mão é importante para diminuir a carência dessa atividade em instituições públicas e tem se mostrado muito eficiente. O êxito do projeto pode oferecer subsídio para o Sistema Único de Saúde admitir cirurgiões da mão em sistema de plantão ou sobreaviso nas unidades de emergência.OBJECTIVE: To report the frequencies of congenital hand diseases in patients who underwent surgery in a provisional clinic as part of the Hand of Recife SOS- Recife, Pernambuco, from 2005 to 2009. METHODS: The information was collected from 833 children and adolescents cared for in eight missions. RESULTS: Among the patients, 306 (36.7% underwent surgery; 240 (78.4% for congenital

  7. Turkish adolescents' loneliness.

    Ayhan, Aynur Bütün; Simşek, Sükran; Aral, Neriman; Baran, Gülen


    The goal of this study was to characterize loneliness among adolescents with respect to socioeconomic level, sex, and mothers' and fathers' education. General information about the 400 adolescents and their families were obtained. The UCLA Loneliness Scale was administered. Results of a hierarchical multiple regression showed that mothers' educational level explained a slight but statistically significant amount of variance in adolescents' loneliness scores while sex, socioeconomic level and fathers' educational level did not.

  8. Nutrition in the adolescent.

    Wahl, R


    This article reviews the nutritional requirements of puberty and the clinical assessment of nutritional status, and discusses the nutritional risks imposed by vegetarian diets, pregnancy, and athletic involvement. Energy (calories) and protein are essential in pubertal development. Adolescent females require approximately 2200 calories/day, whereas male adolescents require 2500-3000 calories/day. Additional intake requirements include fat, calcium, iron, zinc, vitamins, and fiber. The clinical assessment of nutritional status begins with obtaining a good diet history of the patient and this could be offered by the body mass index. Nutritional deficiencies and poor eating habits established during adolescence can have long-term consequences, including delayed sexual maturation, loss of final adult height, osteoporosis, hyperlipidemia, and obesity. As for vegetarian adolescents, nutritional risks include lack of iodine, vitamin B12, vitamin D, and some essential fatty acids. In addition, substances in some grains reduce gut absorption, thus increasing mineral deficiencies. Pregnancy may also be a risk factor for poor nutrition during adolescence. A pregnant adolescent has different nutritional needs because she is still growing. Among adolescent athletes many are turning to nutritional supplements in an attempt to improve athletic performance. A balanced, varied diet provides adequate calories and nutrition to meet the needs of most adolescents. They also have greater water needs than do adult athletes. Details on adolescent health concerns are further discussed in this article.

  9. Adolescence and sexuality

    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...

  10. Adolescent pregnancy and contraception.

    Dalby, Jessica; Hayon, Ronni; Carlson, Jensena


    7% of US teen women became pregnant in 2008, totaling 750,000 pregnancies nationwide. For women ages 15 to 19, 82% of pregnancies are unintended. Adolescents have a disproportionate risk of medical complications in pregnancy. Furthermore, adolescent parents and their infants both tend to suffer poor psychosocial outcomes. Preventing unintended and adolescent pregnancies are key public health objectives for Healthy People 2020. Screening for sexual activity and pregnancy risk should be a routine part of all adolescent visits. Proven reductions in unintended pregnancy in teens are attained by providing access to contraception at no cost and promoting the most-effective methods.

  11. Fatores associados à assistência pré-natal precária em uma amostra de puérperas adolescentes em maternidades do Município do Rio de Janeiro, 1999-2000 Factors associated with precarious prenatal care in a sample of post-partum adolescent mothers in maternity hospitals in Rio de Janeiro, Brazil, 1999-2000

    Silvana Granado Nogueira da Gama


    Full Text Available Caracterizou-se o perfil das gestantes com pré-natal precário, segundo variáveis sócio-demográficas, história reprodutiva da mãe, apoio familiar, satisfação com a gestação e comportamentos de risco durante a gravidez. Foram entrevistadas 1.967 adolescentes no pós-parto imediato de maternidades públicas, conveniadas com o SUS e particulares no Município do Rio de Janeiro. A variável dependente foi o número de consultas de pré-natal (0-3; 4-6; 7 e mais. A análise estatística testou a hipótese de homogeneidade de proporções mediante análises bi e multivariada, com o uso de regressão logística multinomial, cuja categoria de referência da variável-resposta foi a realização de > 7 consultas. Foram encontradas maiores proporções de 0-3 consultas nos grupos de mães com grau de escolaridade This study characterizes the women receiving precarious prenatal care according to socio-demographic variables, mother's reproductive history, family support, satisfaction with pregnancy, and risk behavior during pregnancy. A total of 1,967 adolescents were interviewed in the immediate post-partum in public and outsourced maternity hospitals in the City of Rio de Janeiro. The dependent variable was the number of prenatal appointments (0-3; 4-6; 7 or more. The statistical analysis aimed to test the hypothesis of homogeneity of proportions, including bi- and multivariate analysis, using multinomial logistic regression, in which the reference category for the response variable was 7 or more prenatal visits. Higher (and statistically significant proportions of insufficient number of prenatal visits (0-3 were associated with: precarious sanitation conditions; not living with the child's father; attempted abortion; and smoking, drinking, and/or drug use during pregnancy. The results strongly indicate that mothers with worse living conditions and risk behavior during pregnancy were the same who lacked access to prenatal care.

  12. [Water hygiene in hospitals].

    Kerwat, Klaus; Wulf, Hinnerk


    As a general rule drinking water in hospitals does not represent a risk for the normal patient. However, for high-risk patients with compromised immune defense systems drinking water in hospitals may become a source of nosocomial infections. It may be contaminated with microorganisms that may have the potential to be infectious agents in the hospital environment. Of particular significance in such circumstances are the Gram-negative rods such as Pseudomonas aeruginosa, Acinetobacter spp. and Legionella bacteria. Accordingly, specific behavior patterns and measures in the handling of drinking water in hospitals are meaningful in order to reduce the risks of water-associated nosocomial infections.

  13. Moments of hospitality

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg


    Hospital meals have increasingly become part of the political and scientific agenda of the welfare discussions in Denmark and other European countries. This article employs non-representational theory to analyse hospitalityscapes in order to explore opportunities for adding value to the hospital...... meal experience. By drawing on research carried out in two Danish hospital wards, this article explores how hospitalityscapes are socio-materially constructed. The research strategy was based on performative participant observations, visual ethnography and semi-structured interviews. The empirical data...... that a focus on disruptive micro-events might create opportunities for hospitalityscapes and add value to future hospital meal experiences....

  14. Central line infections - hospitals

    ... infection; Central venous catheter - infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired ...

  15. Restrictive eating disorders among adolescent inpatients.

    Whitelaw, Melissa; Gilbertson, Heather; Lee, Katherine J; Sawyer, Susan M


    Clinicians are increasingly observing adolescents who have lost large amounts of weight, experience typical cognitions and acute medical complications of anorexia nervosa (AN), yet do not meet diagnostic criteria for AN owing to weight. We refer to this category of Eating Disorder Not Otherwise Specified as EDNOS-Wt. We set out to describe the changing incidence of EDNOS-Wt compared with AN, and to compare the characteristics of these 2 groups in a cohort that required hospitalization after weight loss. A 6-year retrospective cohort study (2005 to 2010) was undertaken of first admissions of 12- to 19-year-old patients to a tertiary children's hospital using Diagnostic Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) AN or EDNOS-Wt. Clinical, biochemical, and nutritional data were collected up to day 28 of admission. Ninety-nine adolescents were admitted; 73 had AN and 26 had EDNOS-Wt. Mean (SD) age at admission was 15.2 years (1.3) and 87% were female. In 2005, EDNOS-Wt represented 8% of admissions; by 2009 this proportion had increased to 47%. Hypophosphatemia developed in 41% of AN and in 39% of EDNOS-Wt patients. The lowest mean pulse rate in AN was 45.1 bpm compared with 47.1 bpm in EDNOS-Wt patients. We have experienced more than a fivefold increase in the proportion of adolescents who have EDNOS-Wt admitted over this 6-year period. Despite not being underweight, EDNOS-Wt patients experienced a similar profile of life-threatening complications of weight loss as patients who have AN. Higher-weight adolescents who have extensively lost weight require careful medical assessment. Copyright © 2014 by the American Academy of Pediatrics.

  16. 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

    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

  17. Psychosocial stressors and patterns of coping in adolescent suicide attempters

    Anju Mathew


    Full Text Available Context: Different risk factors associated with adolescent suicide attempts have been identified including those of socio-demographic and clinical variables. Relatively, little research has been done in the area of their stressors and coping patterns. Aims: To study the recent psychosocial stressors and patterns of coping associated with adolescent suicide attempts. Settings and Design: Tertiary care hospital, case-control study. Materials and Methods: One hundred consecutive cases of adolescent attempted suicide admitted to the hospital and an equal number of controls, matched individually for age and sex, from the relatives and friends of other patients in the ward, were studied. Assessment included details regarding socio-demographic data, psychiatric and physical morbidity, their recent stressors, and patterns of coping. Stressors were assessed using Presumptive Stressful Life Event Scale and coping strategies by Ways of Coping Questionnaire (revised. Statistical Analysis: Chi-square test and multivariate logistic regression analysis. Results: The number of stressful life events and mean stress scores in the preceding 1 month and certain coping strategies such as confronting, distancing, and escape-avoidance were found to be significant risk factors associated with adolescent suicide attempts. Strategies such as self-control, seeking social support, accepting responsibilities, problem solving, and positive appraisal act as protective factors. Conclusions: Recent stressors and strategies such as confronting, distancing, and escape-avoidance are significant risk factors associated with adolescent suicide attempts, whereas certain coping strategies act as protective factors. Teaching adolescents these protective coping patterns may be a promising strategy for prevention of adolescent suicide attempts.

  18. Self-reported peer victimization and suicidal ideation in adolescent psychiatric inpatients: the mediating role of negative self-esteem.

    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.

  19. [GEITDAH consensus on conduct disorders in children and adolescents].

    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.

  20. Hospitality Occupations. Curriculum Guide.

    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…

  1. Heritage, Tourism and Hospitality

    Laarse, van der R.; Egberts, L.

    Heritage, Tourism and HospitalityInternational Conference 2015 (HTHIC2015)Preservation, Presentation, Promotion and ProfitResearch Agendas, Best Practices and Hospitable Partnerships in TourismFollowing the success of the first conference in the series in Istanbul, Rotterdam School of

  2. Hospitality, Tourism, and Recreation.

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  3. The Ethic of Hospitality

    Christopher Muller


    The idea of hospitality is evident in several types of human behavior including obligatory duties, commercial activity, and prosocial action. These are intertwined and revolve around the commitment to caring for others whether they are relatives, guests, or strangers. This article explores the ethic of hospitality in its various forms.

  4. The Ethic of Hospitality

    Christopher Muller


    Full Text Available The idea of hospitality is evident in several types of human behavior including obligatory duties, commercial activity, and prosocial action. These are intertwined and revolve around the commitment to caring for others whether they are relatives, guests, or strangers. This article explores the ethic of hospitality in its various forms.

  5. Hospital benefit segmentation.

    Finn, D W; Lamb, C W


    Market segmentation is an important topic to both health care practitioners and researchers. The authors explore the relative importance that health care consumers attach to various benefits available in a major metropolitan area hospital. The purposes of the study are to test, and provide data to illustrate, the efficacy of one approach to hospital benefit segmentation analysis.

  6. Hospitality Services. Curriculum Guide.

    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…

  7. Gender and Adolescent Development

    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…

  8. Adolescence and Body Image.

    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;…

  9. Adolescent Steroid Use.

    Office of Inspector General (DHHS), Washington, DC.

    The study focused on non-medical steroid use by adolescents according to data obtained from the National Institute on Drug Abuse, professional literature, 30 key informants knowledgeable in steroid issues, and 72 current or former steroid users. The findings indicated: (1) over 250,000 adolescents, primarily males, used or have used steroids, and…

  10. Diagnosing ADHD in Adolescence

    Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Garefino, Allison C.; Kuriyan, Aparajita B.; Babinski, Dara E.; Karch, Kathryn M.


    Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and…

  11. Addictions in adolescence

    Kleinjan, M.; Engels, R.C.M.E.


    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.

  12. Inside the Adolescent Brain

    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.

  13. Adolescence Education Newsletter, 2001.

    Villanueva, Carmelita L., Ed.; Espada-Carlos, Lichelle Dara, Ed.


    This document comprises the two 2001 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue contains news from the region on various initiatives related to adolescent health and education, as well as Web links and publications on the…

  14. Adolescence Education Newsletter, 1999.

    Villanueva, Carmelita L., Ed.; Padilla, Teresita M., Ed.


    This document comprises the two 1999 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue contains news from the region on various initiatives related to adolescent heath and education, as well as Web links and publications on the…

  15. Adolescence Education Newsletter, 1998.

    Villanueva, Carmelita L., Ed.; Padilla, Teresita M., Ed.


    This document comprises two issues of a new UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Both issues contain news from the region on various initiatives related to adolescent health and education, as well as Web links and publications on the subject.…

  16. Adolescence Education Newsletter, 2000.

    Villanueva, Carmelita L., Ed.; Padilla, Teresita M., Ed.


    This document comprises the two 2000 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue contains news from the region on various initiatives related to adolescent health and education, as well as Web links and publications on the…

  17. Adolescence Education Newsletter, 2002.

    Villanueva, Carmelita L., Ed.; Espada-Carlos, Lichelle Dara, Ed.


    This document consists of the two 2002 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue includes news from the region on various initiatives related to adolescent health and education, as well as Web links and publications on the…

  18. Gender and Adolescent Development

    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. Relationship violence in adolescence.

    Lin, Alison J; Raymond, Marissa; Catallozzi, Marina; Ryan, Owen; Rickert, Vaughn I


    Previous experience with violence or a deficit in interpersonal skills may lead to violence in adolescent relationships. In this article we focus on various forms of interpersonal violence (bullying, sexual harassment, coercion, and relationship violence) that adolescents may experience and pay special attention to risk factors, help-seeking behaviors, and sequelae.

  20. Adolescent Development Reconsidered.

    Gilligan, Carol


    Emphasizes necessity of reconsideration of adolescent development, for these reasons: the view of childhood has changed; females have not been systematically studied; theories of cognitive development favor mathematical and scientific thinking over the humanities; and because the psychology of adolescence is anchored in separation and independence…

  1. Adolescent Rebellion and Politics.

    Meeus, Wim


    Examination of 352 Dutch secondary school students reveals that adolescents with high-level education who endorse adolescent rebellion have a more distinctly left-wing profile--in both their political party preferences and their political views--than those with low-level education, who more often ratified political intolerance. (BJV)

  2. The Adolescent Brain

    Casey, B. J.; Getz, Sarah; Galvan, Adriana


    Adolescence is a developmental period characterized by suboptimal decisions and actions that give rise to an increased incidence of unintentional injuries and violence, alcohol and drug abuse, unintended pregnancy and sexually transmitted diseases. Traditional neurobiological and cognitive explanations for adolescent behavior have failed to…

  3. Early Adolescent Ego Development.

    James, Michael A.


    Presented are the theoretical characteristics of social identity in early adolescence (ages 10 to 15). It is suggested that no longer is identity thought to begin with adolescence, but may have its beginnings in the preteen years. The article draws heavily on Eriksonian concepts. (Editor/KC)

  4. Adolescents' Perceptions of Alcohol

    Roy, Amit; Ikonen, Risto; Keinonen, Tuula; Kumar, Kuldeep


    Purpose: Rising trends in alcohol consumption and early drinking initiation pose serious health risks especially for adolescents. Learner's prior knowledge about alcohol gained from the social surroundings and the media are important sources that can impact the learning outcomes in health education. The purpose of this paper is to map adolescents'…

  5. Adolescent Literacy. Focus On

    Molineaux, Rebecca


    Evidence suggests that there is a crisis in adolescent literacy. Part of the problem is that students often receive little literacy instruction after elementary school. This "Focus On" examines the literacy instruction that adolescents need to be successful as they move on to more challenging texts in middle and high school. In addition, this…

  6. Medication safety in hospitals.

    Kirke, C


    Medication error and adverse drug reactions occur frequently, leading to a high burden of patient harm in the hospital setting. Many Irish hospitals have established medication safety initiatives, designed to encourage reporting and learning to improve medication use processes and therefore patient safety. Eight Irish hospitals or hospital networks provided data from voluntary medication safety incident and near miss reporting programmes for pooled analysis of events occurring between 1st January 2006 and 30th June 2007. 6179 reports were received in total (mean 772 per hospital; range 96-1855). 95% of reports did not involve patient harm. Forty seven percent of reports related to the prescribing stage of the medication use process, 40% to the administration stage and 9% to the pharmacy dispensing stage. This data is published to increase awareness of this key patient safety issue, to share learning from these incidents and near misses and to encourage a more open patient safety culture.

  7. Patient life in hospital

    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...... in hospitals today. Purpose The purpose was to explore how informal relationships between patients affect their hospital experiences in the hospital. The assumption is that, on the one hand, the impacts on patients' suffering affect the way they act and experience encounters with fellow patients for good....... Methods The study is designed within a phenomenological-hermeneutical philosophic frame of reference and is based on ethnographic fieldwork among hospitalised patients in a Danish university hospital. Data for the study were collected through participant observations over a period of 18 months. Nine males...

  8. Hjertestop uden for hospital

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


    %) 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......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...... 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...

  9. Childhood/Adolescent Pregnancies and Influenza Infections

    Ahmet Gülen


    Full Text Available In this article, we aimed to review child/adolescent pregnancies in general, and the clinical and epidemiological features including prevention and management of influenza in these patients in our country. World Health Organization (WHO defines the children between 10-19 years as adolescents. In Turkey, the rate of marriage in adolescent children aged between 15-19 years is 9.3%. Of the births, 9% are in ages between 15-19 years and the rate of birth in ages between 15-19 years is 40/1000. The pre-birth health care of child/adolescent pregnancies is inadequate and the birth complications are higher than the normal pregnancies. The influenza infections in child/adolescent pregnancies are not different from the influenza infections in normal pregnancies, however it causes more severe diseases, higher rates of hospitalizations and higher mortality in pregnant women. During the pregnancy, influenza can affect mother, embryo or fetus as well as the newborn baby after the delivery. In pregnancy, the effects of influenza on embryo and fetus have not so far been extensively investigated. Transplasental viral transmission of the influenza is rare however it may cause birth defects. The clinical findings and diagnostic approaches in pregnancy are similar to normal population. Chemoprophylaxis or chemotherapy (oseltamivir or zanamivir can be given to pregnant women when they are indicated for both influenza A or B. Vaccination is the preferred way of preventing influenza in pregnancy. Inactive influenza vaccine is safe and effective in every stage of pregnancy. Vaccination in pregnancy can prevent the mother, the fetus and the newborn baby up to 6 months from the complication of influenza. In Turkey the estimated vaccination rate in pregnancy is very low, which is less than 10%. (The Jo­ur­nal of Cur­rent Pe­di­at­rics 2014;1:31-6

  10. Menstrual management in developmentally delayed adolescent females.

    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.

  11. Adolescent depression: a metasynthesis.

    Dundon, Edith Emma


    Concerns about the adequate assessment and treatment of adolescent depression have been in the forefront of pediatric mental health literature in the recent past. While quantitative studies have provided valuable information, the voice of the adolescent has been lacking in the development of theory and treatment of this prevalent disorder. Using approach, a metasynthesis of six qualitative studies was conducted. This process revealed six themes that outline the course of adolescents who struggle with depression: (a) beyond the blues, (b) spiraling down and within, (c) breaking points, (d) seeing and being seen, (e) seeking solutions, and (f) taking control. Knowledge of the experience of adolescent depression will aid practitioners in recognition and early intervention for the increasing number of adolescents suffering with depression, as well as guide educational initiatives to provide needed information on the symptoms of depression and available resources for getting help.

  12. Depression in adolescence

    Thapar, Anita; Collishaw, Stephan; Pine, Daniel S; Thapar, Ajay K


    Unipolar depressive disorder in adolescence is common worldwide but often unrecognised. The incidence, notably in girls, rises sharply after puberty and, by the end of adolescence, the 1 year prevalence rate exceeds 4%. The burden is highest in low-income and middle-income countries. Depression is associated with sub stantial present and future morbidity, and heightens suicide risk. The strongest risk factors for depression in adolescents are a family history of depression and exposure to psychosocial stress. Inherited risks, developmental factors, sex hormones, and psychosocial adversity interact to increase risk through hormonal factors and associated perturbed neural pathways. Although many similarities between depression in adolescence and depression in adulthood exist, in adolescents the use of antidepressants is of concern and opinions about clinical management are divided. Effective treatments are available, but choices are dependent on depression severity and available resources. Prevention strategies targeted at high-risk groups are promising. PMID:22305766

  13. Puberty and adolescent sexuality.

    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.

  14. A multisystems analysis of adolescent suicide attempters.

    Levy, S R; Jurkovic, G L; Spirito, A


    The present study tested an ecologically based model, which predicted that hopelessness (individual level) mediates the effects of family dysfunction (interpersonal level) and socioeconomic status (sociocultural level) on both suicidal intent and suicidal ideation, within a sample of attempters. Subjects included adolescent males and females presenting at a general hospital emergency room following suicide attempts. Baron and Kenny's (1986) criteria for testing mediation models through multiple-regression analyses were employed. Little evidence of mediation was found. Hopelessness proved to be the best predictor of suicidal intent and ideation within a sample of attempters.

  15. Pre-invasive cervical disease and uterine cervical cancer in Brazilian adolescents: prevalence and related factors

    Monteiro, Denise Leite Maia; Trajano, Alexandre José Baptista; Silva,Kátia Silveira da; Russomano, Fábio Bastos


    The objective was to describe the prevalence and factors associated with uterine cervical cancer (CA) and high-grade squamous intraepithelial lesions (HSIL) in adolescents. A cross-sectional study was carried out with 702 sexually active adolescents treated at a general hospital in Rio de Janeiro, Brazil, from 1993 to 2002. Screening was performed by cytopathology and colposcopy and confirmation by biopsy. Exposure variables were socio-demographic characteristics and those related to reproduc...

  16. Profile of pregnancy in adolescence and related clinical-obstetric occurrences

    Maria Veraci Oliveira Queiroz; Eysler Gonçalves Maia Brasil; Caroline Magalhães de Alcântara; Maria da Glória Oliveira Carneiro


    The objective was to characterize the profile of adolescence pregnancy and its clinical and obstetric events. Descriptive, cross-sectional study, with quantitative approach, developed in a tertiary hospital in Fortaleza, CE, Brazil, with one hundred adolescent mothers, through interviews and registers from the medical records, from February to May, 2011. Data were analyzed by Statistical Package for the Social Science software, version 17.0. The majority lived with a partner who earned up to ...

  17. Cardiovascular Risk Factors in Severely Obese Adolescents

    Michalsky, Marc P.; Inge, Thomas H.; Simmons, Mark; Jenkins, Todd M.; Buncher, Ralph; Helmrath, Michael; Brandt, Mary L.; Harmon, Carroll M.; Courcoulas, Anita; Chen, Michael; Horlick, Mary; Daniels, Stephen R.; Urbina, Elaine M.


    IMPORTANCE Severe obesity is increasingly common in the adolescent population but, as of yet, very little information exists regarding cardiovascular disease (CVD) risks in this group. OBJECTIVE To assess the baseline prevalence and predictors of CVD risks among severely obese adolescents undergoing weight-loss surgery. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was conducted from February 28, 2007, to December 30, 2011, at the following 5 adolescent weight-loss surgery centers in the United States: Nationwide Children’s Hospital in Columbus, Ohio; Cincinnati Children’s Hospital Medical Center in Cincinnati, Ohio; Texas Children’s Hospital in Houston; University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania; and Children’s Hospital of Alabama in Birmingham. Consecutive patients aged 19 years or younger were offered enrollment in a long-term outcome study; the final analysis cohort consisted of 242 participants. MAIN OUTCOMES AND MEASURES This report examined the preoperative prevalence of CVD risk factors (ie, fasting hyperinsulinemia, elevated high-sensitivity C-reactive protein levels, impaired fasting glucose levels, dyslipidemia, elevated blood pressure, and diabetes mellitus) and associations between risk factors and body mass index (calculated as weight in kilograms divided by height in meters squared), age, sex, and race/ethnicity. Preoperative data were collected within 30 days preceding bariatric surgery. RESULTS The mean (SD) age was 17 (1.6) years and median body mass index was 50.5. Cardiovascular disease risk factor prevalence was fasting hyperinsulinemia (74%), elevated high-sensitivity C-reactive protein levels (75%), dyslipidemia (50%), elevated blood pressure (49%), impaired fasting glucose levels (26%), and diabetes mellitus (14%). The risk of impaired fasting glucose levels, elevated blood pressure, and elevated high-sensitivity C-reactive protein levels increased by 15%, 10%, and 6%, respectively, per 5-unit

  18. Hospital diversification: evaluating alternatives.

    Hammer, L


    The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival.

  19. Adolescent and Parental Contributions to Parent-Adolescent Hostility Across Early Adolescence.

    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.

  20. [Adolescence yesterday and today: care issues].

    Caramia, G


    In ancient Greece, the chronological boundaries of the stages of life hinged upon Solon's theory of human life as divided into ten seven year stages. At the peak of Latin civilization, the chronological limits of the infant, pueritia and adulescentia were respectively 0-8 years, 8-16 years and 16-17 years, when in a ceremony the adolescent (a term derived from adolescente (m) present participle of the Latin verb adolescere = to grow) wearing the "toga of manhood" is declared an adult (teenager adult) and up to 30 years later iuventus. Throughout the following centuries, the chronological boundaries of the various ages came to acquire only a theoretical worth, since the child, once introduced to the world of work, used to suddenly become an adult. Only in the wave of Humanism in the XVI-XVII century, people started to rediscover the Greek 'paideia' (education), the Latin Humanitas' (recognition and respect towards manhood in every man), and, through the Christian 'caritas' (to recognize and to love the son of God in every man) begins a moral vision of childhood, of his weakness and innocence, a reflection of the 'divine purity'. In this evolution, the twentieth century identifies itself with adolescence, so that history moves from an era devoiced of adolescence to an age in which adolescence appears to be the privileged age: the adolescent is the hero of the twentieth century. Several and many important institutions have proceeded to recognize the essential rights of adolescent care in pediatric departments, but many are still admitted to adult wards with suboptimal therapeutic results, particularly for blood-cancer. The pediatrician, both the family one and the one in the hospital, must be the referees for the health of the adolescent, especially in cases of chronic diseases or in those of psychosocial relevance, following her in the path of the disease especially if other specialists are involved with a view to further investigation, and establishing, since early

  1. Adolescence yesterday and today: care issues

    G. Caramia


    Full Text Available In ancient Greece, the chronological boundaries of the stages of life hinged upon Solon’s theory of human life as divided into ten seven year stages. At the peak of Latin civilization, the chronological limits of the infant, pueritia and adulescentia were respectively 0-8 years, 8-16 years and 16-17 years, when in a ceremony the adolescent (a term derived from adolescente(m present participle of the Latin verb adolescere = to grow wearing the “toga of manhood” is declared an adult (teenager adult and up to 30 years later iuventus. Throughout the following centuries, the chronological boundaries of the various ages came to acquire only a theoretical worth, since the child, once introduced to the world of work, used to suddenly become an adult. Only in the wave of Humanism in the XVI – XVII century, people started to rediscover the Greek ‘paideia’ (education, the Latin Humanitas’ (recognition and respect towards manhood in every man, and, through the Christian ‘caritas’ (to recognize and to love the son of God in every man begins a moral vision of childhood, of his weakness and innocence, a reflection of the ‘divine purity’. In this evolution, the twentieth century identifies itself with adolescence, so that history moves from an era devoiced of adolescence to an age in which adolescence appears to be the privileged age: the adolescent is the hero of the twentieth century. Several and many important institutions have proceeded to recognize the essential rights of adolescent care in pediatric departments, but many are still admitted to adult wards with suboptimal therapeutic results, particularly for blood-cancer. The pediatrician, both the family one and the one in the hospital, must be the referees for the health of the adolescent, especially in cases of chronic diseases or in those of psychosocial relevance, following her in the path of the disease especially if other specialists are involved with a view to further

  2. Racial differences in suicidal ideation among school going adolescents

    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.

  3. On spaces of hospitality

    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 market place, the religious sanctuary and places for the performing arts and cultural heritage. For the modern city they are the tightly woven fabric of social reality, and their configuration can make certain cities more hospitable than others, is the leading idea....

  4. Teaching adolescents about adolescence: experiences from an interdisciplinary adolescent health course.

    Aronowitz, Teri


    As abstract reasoning increases in complexity, adolescents may face dissonance between new thoughts and prior beliefs. Students in the health professions may be forced to resolve these dissonances in order to execute their professional responsibilities. In developing an undergraduate interdisciplinary course on adolescent health, the authors anticipated challenges in teaching adolescents about adolescence. Over the course of the semester, the anticipated challenges became reality. The author discusses pertinent developmental theories and their application in facilitating late adolescent identity formation and professional role development.

  5. [Cultural consensus regarding food in pregnant adolescents from Guadalajara, México].

    Herrera-Suárez, Claudia C; García-De Alba, Javier E; Vásquez-Garibay, Edgar M; Romero-Velarde, Enrique; Romo-Huerta, Hiliana P; Troyo-Sanromán, Rogelio


    Characterising the semantic structure and cultural consensus level of pregnant adolescents attending outpatient consultation at the 'Dr. Juan I Menchaca' civil hospital in Guadalajara. A qualitative study using free-list structured interviews. Non-randomised propositive sampling included 54 pregnant adolescents aged 12-19. There was a significant degree of cultural consensus concerning breakfast and dinner food; 14 foods were detected for breakfast and 8 for dinner. Ascertaining the pattern of cultural consensus concerning food led us to reinforcing, modifying or adding healthy foods to pregnant adolescents' diet.

  6. The anaplastic cancer of the child and adolescent cavum in East Algeria. About 284 cases treated at the Benbadis university hospital center of Constantine. Results at long term; Le cancer indifferencie du cavum chez l'enfant et l'adolescent de l'est algerien. A propos de 284 cas traites au centre hospitalier universitaire Benbadis de Constantine. Resultats a long terme

    Sahli, B.; Bali, M.S.; Meziane, A.; Merikhi, T.; Djemaa, A. [CHU Benbadis, Service d' Oncologie-Radiotherapie, Constantine (Algeria)


    The naso-pharynx cancer in child and adolescent is often diagnosed when it is locally evolved, a multimodal treatment allows a to get a better local control rate with an acceptable early toxicity comparable to the adult's one but with more late toxicity. The introduction of of new chemotherapy drugs and the use of new radiotherapy techniques will certainly allow to improve the results and to reduce the complications. (N.C.)

  7. Atopic dermatitis in adolescence

    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.

  8. Food habits in Mexican pregnant adolescents according to their civil status

    Elizabeth Guzmán-Mercado

    Full Text Available Objective: To identify the feeding habits of pregnant adolescents in four different civil status: married, cohabiting with a partner, single with no partner and single with a partner. Methods: In a cross-sectional study, 321 pregnant adolescents aged 13 to 19 years old who attended the Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara (Jalisco, Mexico were included. They were healthy, in any trimester of pregnancy and had either a low or medium-low socioeconomic status. The civil status of adolescents was stratified into: a married, b cohabiting with a partner, c single with a partner and d single without a partner. Socio-demographic, economic and feeding habits data were included. ANOVA, post-hoc tests for Chi², odds ratio and logistic regression models were used. Results: The frequency of married adolescents was 9.3%; 59.8% of the adolescents were cohabiting, 15.3% of the adolescents were single without a partner and 15.6% of the adolescents were single with a partner. Low schooling (OR 2.6 [1.5-4.4] and occupation in housework (OR 4.47 [1.99-10.0] predominated among adolescents in cohabitating with a partner; an occupation at home (OR 0.28 [0.127 to 0.61] and unaccompanied dining (OR 4.12 [1.62-10.8] were the factors with the most epidemiological significance in single without a partner adolescents. The consumption of vegetables was significantly lower in married adolescents and cohabiting-with-partner adolescents; consumption of beans and sweet bread was significantly lower in pregnant married adolescents. Conclusion: Because some variables and eating habits depended on civil status, it is pertinent to analyze them in each group of pregnant teenagers separately.

  9. Differences between adolescents and young adults at presentation to an eating disorders program.

    Fisher, M; Schneider, M; Burns, J; Symons, H; Mandel, F S


    To describe differences between adolescents and adults in clinical presentation of eating disorders. Data from the charts of 622 female patients treated for an eating disorder in a division of adolescent medicine between 1980 and 1994 were coded and computerized. General categories included demographic and family factors, weight loss and weight changes, eating-related behaviors, diagnosis and severity, and treatment issues. Differences between the 438 patients who were aged 9-19 years (adolescents) and 184 patients who were aged 20-46 years (adults) were analyzed. Adolescents were more likely than adults (p or = 3 lb/month, lower original and maximum weights, and history of fasting and elimination of junk food from their diets. Adults were more likely than adolescents (p 1 year of weight loss, greater total weight loss, history of binge eating and laxative use, history of diuretic and ipecac use, diagnosis of bulimia nervosa, and prior use of psychiatric medications. Adolescents and adults did not differ (p >.05) in parents' occupational level; height, weight, and percent ideal body weight at presentation; original percent ideal body weight; use of diet pills, elimination of meat and use of a low-fat diet; daily calorie intake; prior eating disorder hospitalizations; and hospitalization during the course of treatment. The findings in this study document and confirm that there are important differences between adolescents and adults that must be taken into account in the evaluation and treatment of patients with eating disorders.

  10. Nursing children and adolescents with bipolar disorder: assessment, diagnosis, treatment, and management.

    McDougall, Tim


    The role of the mental health nurse in the assessment, diagnosis, treatment, and management of children and adolescents with bipolar disorder in community and hospital settings. In many areas of clinical practice, mental health nurses have more contact with service users than any other professional group. They are therefore well placed to support children and adolescents with bipolar disorder during first contact with primary care services, through engagement with specialist mental health services, and in accessing early intervention and crisis services. This paper summarizes the contribution that child and adolescent mental health nurses make to the care of children and adolescents with bipolar disorder. This paper is based on evidence from systematic reviews; meta-analyses and best practice evidence from CINAHL; EMBASE; MEDLINE, PsychINFO; Cochrane Collaboration; National Institute for Health and Clinical Excellence; National Collaborating Centre for Mental Health; NHS Centre for Reviews and Dissemination; Oxford Centre for Evidence Based Medicine; United States Agency for Healthcare Research and Quality. Child and adolescent mental health nurses work with children and adolescents who have bipolar disorder in a range of settings. These include community mental health services, hospitals, and schools. Due to the multidisciplinary nature of the treatment and management of bipolar disorder during childhood and adolescence, nurses have a major role to play in providing frontline assessment services, monitoring treatment, and delivering psychosocial interventions.

  11. Outpatient Imaging Efficiency - Hospital

    U.S. Department of Health & Human Services — Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...

  12. Hospitals as health educators

    ... Babysitting courses for teens Exercise classes like yoga, tai chi, qigong, Zumba, Pilates, dance, or strength training Weight- ... blood pressure and other health screenings Giveaways like stress balls Health risk surveys Your hospital may sponsor ...

  13. Service Robots for Hospitals

    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...... 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...... manual work and offer many advantages beyond robotics. Finally, this thesis outlines our contributions in representation of multi-floor buildings, which is a vital requirement to achieve robust and practical, real-world service robot applications....

  14. Mathari psychiatric hospital


    Nov 26, 2007 ... burnout among the staff at the Mathari Psychiatric Hospital. Method: This was .... poor relationship with the management staff were quoted as some of the .... Emotional exhaustion and depersonalization as indicators of burnout ...

  15. Hospital Outpatient PPS

    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...


    reduce the incidence of prematurity and low birth weight babies must be instituted. Key words: Neonatal mortality. risk factors. tertiary hospital. INTRODUCTION .... Classification of Diseases WHO Geneva 1975: 700. 52 Nigerian Journal v_f(.

  17. Allegheny County Diabetes Hospitalization

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data includes the number of people hospitalized with diabetes between 2013-2015, by age group, for Allegheny County Zip Codes.

  18. Optimal Hospital Layout Design

    Holst, Malene Kirstine

    This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities. By visualizing and quantifying costs and performances in the early design phases, it is possible to make design choices based on a qualified, profound...... 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...... and performances. By formal descriptions, a design model can weigh and compare the impact of different perspectives and, even in the early design phase, it can visualize and quantify consequences for design choices. By qualitative study of hospital design and hospital functionality, formal descriptions develop...

  19. Hospital Readmissions Reduction Program

    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...

  20. Critical Access Hospitals (CAH)

    ... CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare ... MDH) Rural Referral Center (RRC) What types of facilities are eligible for CAH status? Facilities applying to ...

  1. Management accounting for hospitals

    Current state. Traditionally hospital systems. especially in the government ... orientated with a system that provides cost-effective, efficient and ... ENT ward activity report. Managers ... categories; {v} consumption based in the same timeframe;.

  2. VT Hospital Site Locations

    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. Physician-Owned Hospitals

    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...

  4. Premier Hospital Historical Data

    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...

  5. Teaching Hospital, Sagamu

    birth asphyxia. It is recommended that greater effort be made through health education to encourage ... subjects, eight (34.8 percent) were born in private. Kehinde hospitals, six ..... plexus injiuries in Malaysian neonates. ] Trap Pedkztr. 1991 ...

  6. Allegheny County Hospitals

    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...

  7. University College Hospital, Ibadan

    Pattern of semen analysis of male partners of infertile couples at the. University College ... Hospital, Ibadan, Nigeria, between 1st January 1990 and 31st. December, 1999. .... reproduction, pregnancy can now be accomplished in area where it.

  8. Hospital Readmission Reduction

    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...

  9. ~ . Teaching Hospital, Sagamu

    Neonatal Mortality at Olabisi Onabanjo University Teaching Hospital, _. -' Sagamu. ..... Africa,3 Bangladesh, 1° and Pakistan.11 Preterrnbirth and septicaemia were almost .... Ibe O. Child Survival in Nigeria: Situation, Response and Prospects.

  10. Hospitality and prosumption


    a hospitable environment. The consumers .... 'essential marketing functions for the producers of consumers' goods' (Smythe ... However, in the age of the internet the media have much less ...... Advertising: The Uneasy Persuasion. New York:.

  11. Speech intelligibility in hospitals.

    Ryherd, Erica E; Moeller, Michael; Hsu, Timothy


    Effective communication between staff members is key to patient safety in hospitals. A variety of patient care activities including admittance, evaluation, and treatment rely on oral communication. Surprisingly, published information on speech intelligibility in hospitals is extremely limited. In this study, speech intelligibility measurements and occupant evaluations were conducted in 20 units of five different U.S. hospitals. A variety of unit types and locations were studied. Results show that overall, no unit had "good" intelligibility based on the speech intelligibility index (SII > 0.75) and several locations found to have "poor" intelligibility (SII speech intelligibility across a variety of hospitals and unit types, offers some evidence of the positive impact of absorption on intelligibility, and identifies areas for future research.

  12. Hospital Compare Data

    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...

  13. Hospitals of The Future


    An overseas biometric and RFID solutions provider eyes up China’s emerging healthcare IT solutions market New mothers in China can look forward to more peaceful hos-pital stays without worries that their precious newborns might be

  14. American Hospital Association

    ... replay of the AHA’s breakdown of the 2016 election results and what they mean for hospitals. Click ... Forum Trustee and Community Leadership Volunteers and Auxiliary Leaders Workforce Center News Center Press Releases AHA Awards ...

  15. Hospitality, Tourism, and Politics

    Stephen W. Litvin


    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 ...

  16. Nutrition support in hospitals

    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....

  17. Graffiti and adolescent personality.

    Peretti, P O; Carter, R; McClinton, B


    Graffiti has been studied for many years from many viewpoints. They have been used to explain accounts of people, styles of life, and assumed relationships. The present paper reports an attempt to analyze graffiti as outward manifestations of adolescent personality. Results suggested that different forms of graffiti could be interpreted from five characterizations of early adolescent personality: sexual maturity, self-identity, idealism, iconoclasm, and rebelliousness. Significant differences were found between boys and girls in numbers of inscriptions for each category. Further, the graffiti were analyzed in relation to early adolescent stages of development.

  18. Bipolar disorder in adolescence.

    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.

  19. Transition in adolescents across time, disease and gender

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

    Transition in adolescents across time, disease and gender Jette Rolf Svanholm 1,2, Mette Spliid Ludvigsen 1,3, Hanne Aagaard 1,4,5 1 Aarhus University Hospital, Denmark 2 Department of Cardiology 3 Department of Renal Medicine 4 Department of Pediatrics 5 Institute of Public Health, Aarhus...... University, Denmark,, Background: Adolescents do not get involved in the preparation and planning of their health care transition, which leaves them with negative experiences and feelings of not having their health care......’ with congenial heart diseases, chronic kidney diseases and cystic fibrosis perspective. Objective: To study experiences of transition in adolescents with severe chronic diseases in the context of child-centred health care to adult-centred health care Research questions: • What are the adolescents’ experiences...

  20. Board certification in psychology: insights from medicine and hospital psychology.

    Robiner, William N; Dixon, Kim E; Miner, Jacob L; Hong, Barry A


    For physicians board certification is an accepted tradition that research suggests improves services and outcomes. In contrast, relatively few psychologists pursue board certification suggesting ambivalence or limited contingencies reinforcing it. The authors report on medical school and hospital-based psychologists' attitudes toward board certification and current certification status. About one-fifth (21.7%) of the sample were certified by the American Board of Professional Psychology, a greater proportion than psychologists generally: Highest rates were seen in neuropsychology (7.5%), clinical psychology (6.4%), clinical child and adolescent psychology (3.2%) and clinical health psychology (2.8%). Few (certification. Half recognized benefits to the profession for psychologists pursuing board certification, yet 70% opposed requiring it for their hospital-based practice. Forces seeking to promote healthcare quality ultimately may increase expectations for board certification. If consumers, employers, hospitals and managed care organizations demand board certification for health professionals, greater numbers of psychologists would likely seek it.

  1. Sisters in Dutch hospitals.

    van den Bergh-Braam, A H


    This study focuses on hospital sisters in 30 Dutch hospitals. The so-called role-set approach has been adopted. In this approach the sisters are the focal persons. Direct superiors, specialists, registered nurses and student nurses acted as role-senders. The possible number of respondents is 600 (120 of each group). The response of hospital sisters is 100%, that of role-senders 88%. The study started out as an attempt to collect background information on the causes of wastage of sisters. High wastage rates are generally regarded as an indication of an unfavourable working environment. Since hospital sisters occupy a key position in hospitals, the ward problems will be studied from their angle. Although wastage rates have dropped recently, it does not necessarily follow that the working environment has improved. Wastage is known to act as a safety valve, thus allowing tensions to resolve. The threat of unemployment clogs this outlet, which increases the tensions on the hospital ward. Data from the study show that work overload is one of the major stress factors for sisters. Analyses demonstrated that there exists a relationship between work overload and tensions with the management and direct superiors, tensions in job execution, irritableness on the ward, low self-esteem, health complaints and psychological condition. Sisters with an excessive job involvement refer to work overload more often than their moderate colleagues. There is a relationship between an unfavourable working environment and irritableness of sisters.

  2. Adolescent Egocentrism in Early and Late Adolescence.

    Enright, Robert D.; And Others


    To assess adolescent egocentrism-sociocentrism, an instrument was devised to measure Elkind's constructs (the imaginary audience, the personal fable, and general self-absorption), plus nonsocial focuses and political focuses. Subjects were ten males and ten females each from three age groups: sixth-grade, eighth-grade, and college. (Author/SJL)

  3. [Adolescence and choice of contraceptive].

    Theunissen, L


    The majority of books, studies, and publications on adolescence are written by adults, whose frequent focus on unbridled adolescent sexuality, adolescents in crisis, or immature adolescents does not seem to correspond to the self-image of adolescents. All authors agree that adolescence is the period between childhood and adulthood beginning at puberty, but opinions differ as to the termination of adolescence and entrance into adulthood. The most significant consensus about adolescence is its tendency to become prolonged. The majority of authors regard adolescence as a preparation for adult life and hence as a natural phase necessary and indispensable to human existence. Ethnographic studies of societies that do not acknowledge adolescence demonstrate, however, that it is not a natural phase. It is also evident that comparatively few roles in modern society require lengthy periods of preparation such as adolescence. It is therefore difficult to regard adolescence as a time of preparation for adult life. From a historic perspective, adolescence emerged with the socioeconomic transformations of industrialization. Mechanization and automation excluded numerous types of workers, especially young workers, from the labor force. Adolescence represents marginalization of young people in response to socioeconomic exigencies rather than a period of preparation for a better adult life. The marginalization is internalized in the consciousness of adults and youth alike and in their hierarchical relations. The marginalization of young people is expressed in the domain of sexuality by the fact that, although physiologically mature, adolescents are not viewed as psychologically mature enough to have children. Adolescents have sexual relations at increasingly young ages, but unlike adults they are not permitted by society the choice of having a child. Contraception, an option for adults, becomes obligatory for sexually active adolescents. The refusal of contraception or failure to

  4. [Anemia and limping in a vegetarian adolescent].

    Chiron, R; Dabadie, A; Gandemer-Delignieres, V; Balençon, M; Legall, E; Roussey, M


    A vegan diet in the child and adolescent can induce severe bone sequelae by rickets and osteomalacia and megaloblastic anemia by cobalamin deficiency. A 15-year-old adolescent was hospitalized because of lameness and pallor. The lameness was explained by femoral epiphysiolysis caused by rickets with severe hypocalcemia. The pallor, jaundice and splenomegalia were due to cobalamin-deficiency megaloblastic anemia. A prolonged supplemental diet with calcium, vitamins D and B12 as well as orthopedic treatment stabilized the bone lesions. The megaloblastic anemia was cured by parenteral cobalamin. The adolescent and his brother were victims of a diet imposed by a cult and a lack of care due to their parents refusing that a vegan diet was the cause of the deficient pathology. Penal proceedings led to the incarceration of the parents and to the placement of the children. Deficiencies in calcium and vitamins D and B12 may be severe in a child's development with a vegan diet. This case report reveals the social and legal problems of an inappropriate diet in infancy imposed by parents who are followers of a fundamentalist church. Beyond the management of children in cults, health professionals have to prevent, screen and supplement the deficient diet.

  5. Adolescent attitudes, beliefs, and concerns regarding breastfeeding.

    Nelson, Antonia M


    To investigate the attitudes, beliefs, and concerns of pregnant and postpartum adolescents regarding breastfeeding. Audiotaped focus groups of low-income, largely minority pregnant and postpartum adolescents were conducted and transcripts analyzed using content analysis techniques. Major themes identified were in the area of beliefs, such as "They say" it's healthy, or "It hurts"; attitudes, such as breastfeeding is the mother's "choice" and "The baby comes first"; and concerns such as privacy, and "Breastfeeding leads to dependency." Adolescents can be encouraged to breastfeed, but require appropriate education beyond what they have heard from others. Myths such as pain during breastfeeding need to be addressed. Since teens want to learn but not be told what to do, active learning strategies such as guided Internet searches could be helpful to guide them into discovery of the benefits of breastfeeding. Since all the teens in this study felt that "the baby comes first," emphasizing the benefits of breastfeeding for the baby should predominate educational efforts. Concerns related to physical exposure while breastfeeding can be addressed antenatally through discussing creative strategies to maintain modesty. This study suggests that, in the postpartum hospital setting, adopting a sensitive, initially "hands-off' approach to supporting breastfeeding might be more well-accepted than tactile assistance, and that following the initial establishment of a milk supply, various levels of breastfeeding exclusivity should be considered as potentially acceptable infant feeding patterns.

  6. Anxiety and Depression in Adolescents With Epilepsy.

    Kwong, Karen Ling; Lam, David; Tsui, Sarah; Ngan, Mary; Tsang, Brian; Lai, Tai Sum; Lam, Siu Man


    The present study examined anxiety and depression in adolescents with epilepsy and the association of these disorders with seizure-related and sociodemographic variables. The Hospital Anxiety and Depression Scale was administered to 140 children with epilepsy and 50 children with asthma aged 10 to 18 years attending mainstream schools. Adolescents with epilepsy had significantly higher scores on the depression subscale than those with asthma (5.2 ± 3.3 vs 4.2 ± 3.2, P = .032). Anxiety subscale scores and the frequency of anxiety and depression in both the epilepsy and asthma groups were not statistically significant. In the epilepsy group, 32.8% had anxiety and 22.1% had depression. Factors associated with anxiety were older age at the time of the study and polytherapy (2 or more antiepileptic drugs). Adolescents who had been seizure-free for 12 months or more at time of the study were less likely to experience anxiety. Factors associated with depression were medical comorbidities, female gender, frequent seizures, and younger age of seizure onset. A common risk factor for both anxiety and depression was the duration of epilepsy. Anxiety and depression were also highly associated with each other. Affective disorders are common in epilepsy and screening for psychiatric symptoms is required.

  7. [Survey of adolescent perception of hospital admission. The importance of hospital humanisation].

    Butragueño Laiseca, Laura; González Martínez, Felipe; Oikonomopoulou, Niki; Pérez Moreno, Jimena; Toledo Del Castillo, Blanca; González Sánchez, María Isabel; Rodríguez Fernández, Rosa

    The humanisation of health care involves considering the patient as an integral human being, providing assistance beyond medical care, and covering other fields such as social, emotional, spiritual, or relational areas. To evaluate the requirements and concerns of the hospitalised children. A cross-sectional, descriptive study was conducted using an anonymous questionnaire on children aged 12-16. The study included 39 patients, with a median age of 14 years. The most unpleasant experience during the hospitalisation was the invasive procedures. Almost all (95%) of patients suffered from pain, and 17% of them felt at some point that a procedure was performed without them being fully aware. More than 75% of children asked for more entertainment, with the lack of Wi-Fi being the more demanded item. The needs of the population included in this survey, showed the importance to consider cognitive (necessity of obtaining clear and extensive information), social (maintaining everyday relationships), emotional (illness and its diagnostic and therapeutic procedures often generate mood disorders), and practical (environmental and architectural aspects can lead to either an improvement or a worsening of the hospitalisation perception) factors. All of these factors have shown a beneficial contribution, leading to an earlier recovery of health. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates

    Bodde AE


    Full Text Available Amy E Bodde,1 Timothy J Beebe,1 Laura P Chen,2 Sarah Jenkins,3 Kelly Perez-Vergara,4 Lila J Finney Rutten,5 Jeanette Y Ziegenfuss6 1Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA; 2Seattle Children’s Hospital, Seattle, WA, USA; 3Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; 4Children’s Hospital, Boston, MA, USA; 5Division of Epidemiology, Mayo Clinic, Rochester, MN USA; 6HealthPartners Institute for Education and Research, Minneapolis, MN, USA Objective: Accurate perceptions of weight status are important motivational triggers for weight loss among overweight or obese individuals, yet weight misperception is prevalent. To identify and characterize individuals holding misperceptions around their weight status, it may be informative for clinicians to assess self-reported body mass index (BMI classification (ie, underweight, normal, overweight, obese in addition to clinical weight measurement. Methods: Self-reported weight classification data from the 2007 Current Visit Information – Child and Adolescent Survey collected at Mayo Clinic in Rochester, MN, were compared with measured clinical height and weight for 2,993 adolescents. Results: While, overall, 74.2% of adolescents accurately reported their weight status, females, younger adolescents, and proxy (vs self reporters were more accurate. Controlling for demographic and behavioral characteristics, the higher an individual's BMI percentile, the less likely there was agreement between self-report and measured BMI percentile. Those with high BMI who misperceive their weight status were less likely than accurate perceivers to attempt weight loss. Conclusion: Adolescents’ and proxies’ misperception of weight status increases with BMI percentile. Obtaining an adolescent's self-perceived weight status in addition to measured height and weight offers clinicians valuable baseline information to discuss motivation for weight

  9. Effect of Hospital Ownership on Outcomes of Heart Failure Hospitalization.

    Akintoye, Emmanuel; Briasoulis, Alexandros; Egbe, Alexander; Orhurhu, Vwaire; Ibrahim, Walid; Kumar, Kartik; Alliu, Samson; Nas, Hala; Levine, Diane; Weinberger, Jarrett


    This study aimed to evaluate the impact of hospital ownership on heart failure (HF) hospitalization outcomes in the United States using data from the National Inpatient Sample of the Agency for Healthcare Research and Quality. Hospital ownership was classified into three, namely, nonfederal government, not-for-profit, and for-profit hospitals. Participants were adults hospitalized with a primary diagnosis of HF (2013 to 2014). End points included inpatient mortality, length-of-stay, cost and charge of hospitalization, and disposition at discharge. Of the estimated 1.9 million HF hospitalizations in the United States between 2013 and 2014, 73% were in not-for-profit hospitals, 15% were in for-profit hospitals, and 12% were in nonfederal government hospitals. Overall, mortality rate was 3%, mean length of stay was 5.3 days, median cost of hospitalization was USD 7,248, and median charge was USD 25,229, and among those who survived to hospital discharge, 51% had routine home discharge. There was no significant difference in inpatient mortality between hospital ownership among male patients, but there was a significant difference for female patients. Compared with government hospitals, mortality in female patients was lower in not-for-profit (odds ratio: 0.85 [95% confidence interval: 0.77 to 0.94]) and for-profit hospitals (odds ratio: 0.77 [0.68 to 0.87]). In addition, mean length of stay was highest in not-for-profit hospitals (5.4 days) and lowest in for-profit hospitals (5 days). Although cost of hospitalization was highest in not-for-profit hospitals (USD 7462) and lowest in for-profit hospitals (USD 6,290), total charge billed was highest in for-profit hospitals (USD 35,576) and lowest in government hospitals (USD 19,652). The average charge-to-cost ratio was 3:1 for government hospitals, 3.5:1 for not-for-profit hospitals, and 5.9:1 for for-profit hospitals. In conclusion, there exist significant disparities in HF hospitalization outcomes between hospital

  10. Abortion in adolescence.

    Greydanus, D E; Railsback, L D


    This article reviews the difficult but complex subject of abortion in adolescents. Methods of abortion are outlined and additional aspects are presented: psychological effects, counseling issues, and legal parameters. It is our conclusion that intense efforts should be aimed at education of youth about sexuality and prevention of pregnancy, utilizing appropriate contraceptive services. When confronted with a youth having an unwanted pregnancy, all legal options need to be carefully explored: delivery, adoption, or abortion. The decision belongs to the youth and important individuals in her environment. Understanding developmental aspects of adolescence will help the clinician deal with the pregnant teenagers. If abortion is selected, a first trimester procedure is best. Finally, physicians are urged to be aware of the specific, ever changing legal dynamics concerning this subject which are present in their states. Abortion is a phenomenon which has become an emotional but undeniably important aspect of adolescent sexuality and adolescent health care, in this country and around the world.

  11. PCP Use among Adolescents.

    Young, Thomas J.


    This article, aimed at professionals in the field of adolescent psychology, briefly reviews the use of phencyclidine (PCP), its pharmacology, clinical effects, diagnosis, treatment, and prevention. (Author/BN)

  12. Health counseling of adolescents.

    Joffe, A; Radius, S M


    Health counseling is a fundamental aspect of health care for adolescents and is a natural extension of the concept of anticipatory guidance. It is a dynamic process involving active participation by adolescents. Pediatricians are a valued source of health-relevant information, but must also recognize how their attitudes and beliefs can affect the counseling process. Knowledge of the multitude of changes occurring during adolescence and an understanding of the role of health-risking behaviors in meeting various developmental needs are critical to successful counseling. Particular attention must be focused on ways to help adolescents develop the skills necessary to maintain health-promoting lifestyles and to resist peer pressure to engage in health-risking behaviors.

  13. Counseling Black Adolescent Parents

    Gilbert, Gwendolyn C.


    Black adolescent parents need counsel from social workers who are able to intervene with a discerning knowledge of concepts, such as neocolonialism, survival, and liberation, that are important to them and to the black community. (Author)

  14. Relationship Between Body Mass Index and Medical Care Expenditures for North Carolina Adolescents Enrolled in Medicaid in 2004

    Paul A. Buescher, PhD


    Full Text Available IntroductionMany studies document that overweight and obese adults have substantially higher medical care expenditures than do adults of normal weight, but comparable data for children or adolescents are few. This study examines patterns of expenditure for medical care and use of medical care services among a sample of North Carolina adolescents enrolled in Medicaid, stratified by body mass index categories.MethodsNorth Carolina public health records, which include clinically measured height and weight, were linked to 2004 North Carolina Medicaid enrollment records to find adolescents aged 12–18 years whose records matched. We then examined all paid claims for 2004 of the 3528 adolescents whose records matched. Total expenditures by sex and race, hospital costs, physician costs, and prescription drug costs were tabulated and stratified by body mass index. We also examined, by body mass index, the percentage of adolescents who had a paid claim for selected diagnosed health conditions.ResultsOverall, and for most demographic and service categories, overweight adolescents and at-risk-for-overweight adolescents had higher average Medicaid expenditures than did normal-weight adolescents. Some of these differences were statistically significant. Overweight adolescents were significantly more likely to have a paid claim for services related to diabetes, asthma, or other respiratory conditions.ConclusionAlthough based on a small sample, our results suggest that overweight has negative health consequences as early as adolescence. Further studies with larger samples could help confirm the findings of our study.

  15. Hospitals look to hospitality service firms to meet TQM goals.

    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.

  16. Vitamin D and adolescent health

    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

  17. Adolescents and oral contraceptives.

    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

  18. Adolescents sexual practices

    Frias, Ana; Chora, Antónia


    Introduction: If teens options are experimenting sexualized practices, we should facilitate their knowledge, make them aware of their choices and help them living their sexuality in a safer mode. Objectives: To identify adolescents sexual practices; characterize the attitudes of teenagers against the use of contraception. Methods: quantitative research with exploratory nature. We studied a convenience sample of 301 adolescents of both sexes whitch attend the 9th grade. Sexual practices and a...

  19. Implants in adolescents.

    Shah, Rohit A; Mitra, Dipika K; Rodrigues, Silvia V; Pathare, Pragalbha N; Podar, Rajesh S; Vijayakar, Harshad N


    Implants have gained tremendous popularity as a treatment modality for replacement of missing teeth in adults. There is extensive research present on the use of implants in adults, but there is a dearth of data available on the same in adolescents. The treatment planning and execution of implant placement in adolescents is still in its infancy. This review article is an attempt to bring together available literature.

  20. Implants in adolescents

    Rohit A Shah


    Full Text Available Implants have gained tremendous popularity as a treatment modality for replacement of missing teeth in adults. There is extensive research present on the use of implants in adults, but there is a dearth of data available on the same in adolescents. The treatment planning and execution of implant placement in adolescents is still in its infancy. This review article is an attempt to bring together available literature.

  1. 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...

  2. Adolescent fertility: worldwide concerns.

    Senderowitz, J; Paxman, J M


    There is growing concern over the adverse health, social, economic, and demographic effects of adolescent fertility. Morbidity and mortality rates ar significantly higher for teenage mothers and their infants, and early initiation of childbearing generally means truncated education, lower future family income, and larger completed family size. Adolescent fertility rates, which largely reflect marriage patterns, range from 4/1000 in Mauritania; in sub-Saharan Africa, virtually all rates are over 100. In most countries, adolescent fertility rates are declining due to rising age at marriage, increased educational and economic opportunities for young women, changes in social customs, increased use of contraception, and access to abortion. However, even if fertility rates were to decline dramatically among adolescent women in developing countries, their sheer numbers imply that their fertility will have a major impact on world population growth in the years ahead. The number of women in the world ages 15-19 years is expected to increase from 245 million in 1985 to over 320 million in the years 2020; 82% of these women live in developing countries. As a result of more and earlier premarital sexual activity, fostered by the lengthening gap between puberty and marriage, diminished parental and social controls, and increasing peer and media pressure to be sexually active, abortion and out-of-wedlock childbearing are increasing among teenagers in many developed and rapidly urbanizing developing countries. Laws and policies regarding sex education in the schools and access to family planning services by adolescents can either inhibit or support efforts to reduce adolescent fertility. Since contraceptive use is often sporadic and ineffective among adolescents, family planning services are crucial. Such programs should aim to reduce adolescents' dependence on abortion through preventive measures and increase awareness of the benefits of delayed sexual activity. Similarly, sex

  3. Adolescent rampant caries

    Namita; Rita Rai


    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 hea...

  4. Idiopathic Adolescent Scoliosis: Living with a Physical Deformity


    A qualitative, phenomenological, hermeneutical study with the aim of explaining the experience of having a body deformity diagnosed as idiopathic adolescent scoliosis. A semistructured interview conducted with scoliosis patients admitted to the unit of spinal cord at the Vall d’Hebron Hospital was used. The youth defined their scoliosis based on how they perceived their deformity. They spoke of pain and deformity as characteristic symptoms of suffering, and explained how this symptom affected...

  5. [Life styles in adolescence: sexual behavior of Portuguese adolescents].

    Ferreira, Maria Margarida da Silva Reis Dos Santos; Torgal, Maria Constança Leite de Freitas Paúl Reis


    Recent studies have shown that adolescents have initiated their sex lives earlier and earlier, without, however, receiving consistent sex education. The objectives of this study were to analyze the sexual behavior of adolescent high school students and identify the habits of sexual health in sexually active adolescent high school students. An exploratory study was conducted with 680 adolescents, whose age ranged between 15 and 19 years. Results showed that most participants had not initiated their sex life; boys are those who most report having had sexual relations; not all the interviewed adolescents used condoms during sex; most adolescents do not practice sexual health surveillance. It is important for sexually active adolescents to receive health care and counseling. Health institutions and their workers must be proactive in trying to approach adolescents.

  6. Adolescent and parent perceptions of media influence on adolescent sexuality.

    Werner-Wilson, Ronald Jay; Fitzharris, Jennifer Lynn; Morrissey, Kathleen M


    Empirical evidence suggests that television and other media influence adolescents' attitudes and behaviors. Much of the research in this area is based on surveys in which adolescents are asked to rank the relative importance of a fixed set of factors such as parents, peers, and media. We reviewed data from focus groups conducted with adolescents and their parents to examine the extent to which adolescents identify--without prompting--media as a source of influence on sexual behavior. Adolescents seemed indifferent to media influence (e.g., media influence was mentioned in only one adolescent focus group), but their parents expressed significant concern about media influence. Future research should investigate the extent to which influences exist outside of adolescents' consciousness. For now, parents and sexuality educators may need to convince adolescents that concerns about the media are valid before trying to change media-influenced behavior.

  7. Trick questions: cosmopolitan hospitality

    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.

  8. Impact of highly active antiretroviral therapy (HAART on the incidence of opportunistic infections, hospitalizations and mortality among children and adolescents living with HIV/AIDS in Belo Horizonte, Minas Gerais State, Brazil Impacto da terapia anti-retroviral de alta potência (HAART na incidência de infecções oportunistas, hospitalização e mortalidade associadas em crianças e adolescentes vivendo com HIV/AIDS em Belo Horizonte, Minas Gerais, Brasil

    Talitah M. S. Candiani


    Full Text Available The impact of highly active antiretroviral therapy (HAART can be evaluated using indicators, such as rates of opportunistic infections, hospitalizations by cause of infection, and associated death. This study aimed to estimate the impact of HAART on the incidence of these indicators, in children and adolescents with HIV/AIDS. It was a hybrid cohort study; 371 patients were followed from 1989 to 2003. In December 2003, 76% of the patients were still being followed, while 12.1% had died, 9.5% had dropped out, and 2.4% had been transferred. The overall rate of opportunistic infections was 18.32 infections/100 persons-year and 2.63 in the pre- and post-HAART periods, respectively. In the multivariate analysis, the risk of developing an opportunistic infection was 5.4 times greater and 3.3 times greater for hospitalization risk before HAART. Respiratory causes represented 65% of the hospitalizations and they were reduced by 44.6% with therapeutic intervention. The average hospital stay of 15 days was reduced to 9.There was a post-HAART decline in deaths of 38%. This study demonstrates the effectiveness of HAART in significantly reducing opportunistic infections, hospitalizations, and deaths in this Brazilian cohort.O impacto da terapia anti-retroviral de alta potência ativa (HAART pode ser avaliado utilizando-se indicadores, como taxas de incidências de infecções oportunistas, hospitalizações por causas infecciosas e mortalidade associada. O objetivo deste trabalho foi estimar o impacto da HAART na incidência desses indicadores em crianças e adolescentes com HIV/AIDS. Trata-se de uma coorte híbrida, na qual foram acompanhados 371 pacientes no período de 1989-2003. Em dezembro de 2003, 76% dos pacientes permaneciam em acompanhamento, 12,1% faleceram, 9,5% foram perda de seguimento e 2,4% transferidos. A taxa de incidência global de infecções oportunistas foi de 18,32 infecções/100 pessoas-ano e 2,63 nos períodos pré e p

  9. A randomized controlled trial of in-patient treatment for anorexia nervosa in medically unstable adolescents.

    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.

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

    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

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

    Ítalo Rodolfo Silva

    Full Text Available 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: this research presents the category: Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence, and the subcategories: Risks and uncertainties of the process of adolescence: paths to STD/AIDS; Age-adolescence complex: expanding knowledge from the perception of nurses.Conclusion: once the nurses understand the complexity of adolescence, they create strategies to reduce the vulnerability of adolescents to STD/AIDS. This signals the need to invest in education, assistance and the management of nursing care for adolescents.

  12. Improving outcomes for underserved adolescents with asthma.

    Britto, Maria T; Vockell, Anna-Liisa B; Munafo, Jennifer Knopf; Schoettker, Pamela J; Wimberg, Janet A; Pruett, Raymond; Yi, Michael S; Byczkowski, Terri L


    Asthma is the most common chronic disease of childhood. Treatment adherence by adolescents is often poor, and their outcomes are worse than those of younger patients. We conducted a quality improvement initiative to improve asthma control and outcomes for high-risk adolescents treated in a primary care setting. Interventions were guided by the Chronic Care Model and focused on standardized and evidence-based care, care coordination and active outreach, self-management support, and community connections. Patients with optimally well-controlled asthma increased from ∼10% to 30%. Patients receiving the evidence-based care bundle (condition/severity characterized in chart and, for patients with persistent asthma, an action plan and controller medications at the most recent visit) increased from 38% to at or near 100%. Patients receiving the required self-management bundle (patient self-assessment, stage-of-readiness tool, and personal action plan) increased from 0% to ∼90%. Patients and parents who were confident in their ability to manage their or their adolescent's asthma increased from 70% to ∼85%. Patient satisfaction and the mean proportion of patients with asthma-related emergency department visits or hospitalizations remained stable at desirable levels. Implementing interventions focused on standardized and evidence-based care, self-management support, care coordination and active outreach, linkage to community resources, and enhanced follow-up for patients with chronically not-well-controlled asthma resulted in sustained improvement in asthma control in adolescent patients. Additional interventions are likely needed for patients with chronically poor asthma control.


    Poonam Singh


    Full Text Available Background: Different risk factors associated with adolescent suicide attempts have been identified across the globe. Relatively few Indian studies are available on this data. Aims: To study the sociodemographic and clinical variables associated with adolescent suicide attempts. Setting and design: tertiary care hospital, retrospective descriptive study. Materials and methods: Participants: - ninety four patients admitted in the pediatric units who had attempted suicide by ingestion. A pretested, semi-open-ended questionnaire was filled for each patient. This data was then compiled and analyzed using statistical methods. Results: Among a total of 94 cases, sociodemographic patient risk factors found were:- male to female ratio is 1:3.5. Mean age found was 14.64 years. 58.5% were in age of 15 - 18 yrs., 54.9% were unemployed and 43.6% were educated only till middle school. Nuclear families with family members more than 5, siblings more than 3, a lower income class, single parents (10.6%, broken homes (9.6%, a history of suicide and alcoholism in family (9.6% were found as familial risk factors associated with suicide attempts. The interpersonal problems (29% and depression (19.1% were the important psychological risk factors. Period prevalence was and #8776;1 per 1000. Case fatality rate was found to be 2.12 Conclusion: The adolescents used the method of deliberate self-harm only to get attention and had no intention of really dying. This was the distress call used by these adolescents. [Natl J Med Res 2015; 5(2.000: 132-135

  14. Complications and outcomes of repeat cesarean section in adolescent women.

    Kaplanoglu, Mustafa; Karateke, Atilla; Un, Burak; Akgor, Utku; Baloğlu, Ali


    The evaluation of the effect of repeat cesarean sections in adolescent pregnancies on the morbidity, obstetric and perinatal results. We reviewed the patient file and hospital records of patients who underwent at least one cesarean section among adolescent age group pregnant women who gave birth at our clinic between January 2010 and May 2013. The patients were divided into two groups as the patients who underwent the second cesarean section (116 patients) and those who underwent the third cesarean section (36 patients). The demographic data, maternal data and obstetric and perinatal results of the patients were evaluated. A significant difference was present between the patients in the evaluation of the total number of examinations during pregnancy (P = 0.001), total maternal weight gain during pregnancy (P = 0.006), and the first examination gestational age (P = 0.006) and all values were less favorable in the third cesarean group. The gestational week at birth (P cesarean section were statistically significantly lower than the second cesarean section. The third cesarean cesarean was found to cause a significant risk increase for placenta accreta risk in adolescent pregnancies (P = 0.042). The increasing number of cesarean sections in the adolescent group is seen to be a significant risk factor for low gestational week of birth, low birth weight and related morbidities. The most important reason for the increased morbidity with increasing cesarean sections in the adolescent age has been defined as placenta accreta.

  15. Anaemia in pregnant adolescent girls with malaria and practicing pica.

    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.

  16. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

    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.

  17. Trends of attempted suicide in Albanian children and adolescents

    Kola, Vuksan


    Full Text Available Background. Attempted suicides and suicides are becoming pertinent social phenomena in Albania, with increasing trend in the last years, exceeding the road traffic accident numbers. Our objective was to examine suicide attempts trends among Albanian children and adolescents. Methods. We conducted a retrospective analysis of standardized suicide attempts rates in Statistic Department at University Hospital Center “Mother Theresa”; epidemiology data for the period spanning from 2006 to 2012. We analyzed the data by age, sex and by suicide attempts method over time for two age groups: 10–14 year old (children and 15–19 year old (adolescents. Results. We found an average annual increase of the suicide attempts rate for children and adolescents (p<0.001, but stratification by age and sex showed significant variation. By comparing the two age groups it came out that the suicidal phenomena is more present at adolescence age (p<0.001. According to the statistic data and by analyzing the cases on yearly bases it resulted that female gender is more attempt to commit suicide that male gender, with a significant statistical variation of (p<0.001. From the study it was noted that the suicidal attempt methods, in the most of cases, were drug overdose (97.6% and 2.4% hang themselves (suffocation or cut their vein. Conclusions. The increasing cases of suicidal tendency among children and adolescents necessitate further studies to identify the causes and risk factors, and to develop suitable preventive programs .

  18. Adolescent-Parent Conflict among Chinese Adolescents in Hong Kong.

    Yau, Jenny; Smetana, Judith G.


    Interviewed 120 early, mid, and late adolescents of lower-class Chinese families to examine adolescent-parent conflict. Found that conflicts were primarily with mothers, of moderate frequency and severity, and occurred over everyday issues. Adolescents wanted greater autonomy in decision making than their parents granted them, but parents' views…

  19. [Marianne in hospital].

    Weium, Frode


    In 1948 Norwegian architect and author Odd Brochmann (1909-92) published his popular children's book Marianne in hospital (Marianne på sykehus). Two years later the book was filmed on the initiative of the Ministry of Social Affairs. This article considers the question of what were the purposes of the film. Officially, it was presented as an attempt to teach children not to be afraid of hospitals. However, in internal notes and letters the health authorities stressed that the film should be an educational film about the social benefits and health services of the welfare state. Furthermore, I will argue that the film was the result of a wish to present the nation's modern hospital care and, by way of conclusion, discuss the characterisation of the film as educational.

  20. Internal auditing in hospitals.

    Edwards, Don; Kusel, Jim; Oxner, Tom


    The authors analyzed two national surveys to determine answers for two basic questions: How do the roles of internal auditors compare with those of their counterparts in other industries and to what extent over the past 6 years have the activities of internal auditors changed? Internal auditors in hospitals allocate their time primarily to financial/compliance and operational types of audits, as do their counterparts. The current trend is toward more operational types of audits. In the early years of employment, staff turnover in hospitals is significantly higher than in all combined industries, often leading to internal auditors' filling other positions in the organization. Hospital staff salaries are higher than are salaries in other industries combined. Staff composition continues to reflect the growing presence of women in the field. The majority of internal auditing directors believe that their salaries are fair, would recommend internal auditing as a career position, and are treated as valued consultants in the organization.

  1. [Stress management in hospitals].

    Miki, Akiko


    Job stress in employees in hospitals has been recognized as a key issue in the workplace. In this paper, characteristics of job stress in the medical profession, especially in doctors and nurses, and the effectiveness of stress management are overviewed. The important points in stress management in hospitals are summarized as follows: 1) improvement of work environment, 2) assurance of participation and autonomy, 3) education or training to reduce job stress (ex. coping behavior, self-care, relaxation), 4) career development, 5) total support among medical professions. Some reports have demonstrated that the establishment of constant meetings is an effective method of reducing job stress and improving mental health in the medical profession, but few prospective intervention studies have been carried out. Further research is necessary to evaluate the effectiveness of stress reduction and to develop effective intervention programs for medical professions in hospitals.

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

    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

  3. Motivational Interviewing and Adolescent Psychopharmacology

    Dilallo, John J.; Weiss, Gony


    The use of motivational interviewing strategies in the practice of adolescent psychopharmacology is described. Motivational interviewing is an efficient and collaborative style of clinical interaction and this helps adolescent patients to integrate their psychiatric difficulties into a more resilient identity.

  4. Psychotherapies for Children and Adolescents

    ... Facts for Families Guide Psychotherapy for Children and Adolescents: Different Types No. 86; updated February 2017 Psychotherapy ... Therapy (DBT) can be used to treat older adolescents who have chronic suicidal feelings/thoughts, engage in ...

  5. Scoliosis in Children and Adolescents

    ... Questions and Answers about Scoliosis in Children and Adolescents This publication defines scoliosis and provides information about ... it is diagnosed and treated in children and adolescents. You may be interested in contacting one or ...

  6. Gay, Lesbian and Bisexual Adolescents

    ... Facts for Families Guide Gay, Lesbian and Bisexual Adolescents No. 63; Updated October 2013 Growing up is a demanding and challenging task for every adolescent. One important aspect is forming one's sexual identity. ...

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

    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.

  8. Toward healthier hospitals.

    Mintzberg, H


    This article builds around a framework of cure, care, control, and community, with collaboration at the center, to consider 12 issues common to many hospitals. These include, among others, the fragmentation of efforts, confusion in mission (and in mission statements), the problems of bundling research with clinical work, selectivity in informing board members, the dangers of professional management, and the difficulties of combining external advocacy with internal reconciliation in the senior manager's job. The article concludes that hospitals could better learn how to solve systemic problems systemically, and that to do so will require not the wish lists of strategic planning and structural reorganizing, but tangible changes in their collective behavior.

  9. Drawing Hospital Foodscapes

    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 and archit......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...

  10. Hospitality, Tourism, and Politics

    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.

  11. Marketing the hospital library.

    Bridges, Jane


    Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations.

  12. Functional status and its associated factors in Nigerian adolescents with bipolar disorder.

    Bakare, M O; Agomoh, A O; Eaton, J; Ebigbo, P O; Onwukwe, J U


    This study assessed general functioning in Nigerian adolescents with bipolar disorder. It also determined the factors associated with functioning in these adolescents. Adolescents with bipolar disorder diagnosed over one year or more attending the outpatient unit of Federal Neuro-Psychiatric Hospital, Enugu (FNHE), Nigeria for follow-up visits were interviewed with a socio-demographic questionnaire and their functioning was rated with the Children Global Assessment Scale (C-GAS) based on the clinical information obtained from the children and their care givers during a one year follow-up period. Further information such as history of sexual risk behavior, pre-morbid peer relationship, relationship with siblings, level of religion activities among others were also obtained through clinical interview. A total of 46 adolescents with bipolar disorder were followed up. Minimal to moderate impairment in functioning in the past year was found in these adolescents. The mean score on C-GAS was 68.41 ± 16.63. Factors including co-morbidity, pre-morbid peer relationship, relationship with siblings, level of religion activities and history of sexual risk behavior were significantly associated with functioning (p = 0.000), while marital status of the parents showed a weak association with functioning in these adolescents (p = 0.068). Negative correlation was also found between mean number of hospital admissions in the past year during follow up and mean score on C-GAS (r = - 0.908, p = 0.000). Functional impairments complicate bipolar disorder in Nigerian adolescents. To ensure good overall outcome in these adolescents, attention needs to be focused on promoting those factors that help good functioning. Future longitudinal follow up studies that would assess long-term outcome and its correlates in children and adolescents with bipolar disorder in this environment are desirable.

  13. Self constructing in adolescence

    Vranješević Jelena


    Full Text Available The aim of this study was to explore “theories” adolescents have about themselves, i.e. about the changes in the ways they construe themselves in the period of middle adolescence: how they construe changes and estimate them according to some dimensions relevant for change (appreciation of change, its importance, expectancy, timing, comprehensiveness, intensity and visibility in social surroundings. The study was explorative and it was performed on the sample of 96 adolescents aged 15-17 (middle adolescence. Instruments used for the study were: interview and Role Construct Repertory Grid, adjusted to the need of study. The results show that the adolescents’ construct system is highly monolithic and tight in regard to constructs (black and white construing, but at the same time vague and predictively unclear in regard to elements, i. e. the stated changes, meaning that adolescents are not able to construe those changes according to certain constructs. It seems that this study included the beginning of the loosening phase (creativity cycle in which the system is still tight and, therefore, protects from threat and anxiety, while the elements are not predictively (this is what Erikson calls moratorium, i.e. the process of active experimenting. Changes which are fully predictively are those which refer to adults' roles, such as: self confident, experienced, independent and has responsibilities, worries. On the hand, changes which are predictably the most clear to adolescents (and not appreciated are depression and nervousness. Adolescents face an implicative dilemma: positive implications of maturity are not enough, while negative implications, such as nervousness, depression and not trusting people are clear, predictable and negative. This dilemma can be the cause of their ambivalence towards growing-up and accepting the roles of adults.

  14. Correlates of Adolescent-reported and Parent-reported Family Conflict Among Canadian Adolescents With Bipolar Disorder.

    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.

  15. German hospital database-allocation of patients to appropriate hospitals.

    Schneider, Rita; Reiners, Christoph


    Effective response to radiological emergencies requires information about available qualified hospitals and defined methods to timely allocate patients to appropriate hospitals. In Germany, updated information about hospitals concerning their qualification and willingness to treat radiological emergency patients is not summarized. The objectives were to identify qualified hospitals, assess hospital capacities and treatment capabilities, to examine willingness to respond to various radiological emergencies and to develop a concept for matching patients to hospitals. A Germany-wide combined postal/Web survey of 99 selected hospitals conducted in 2007 covered relevant organizational characteristics, hospital resources, treatment expertise, and the willingness to accept radiological emergency patients by a self-reported written questionnaire with 57 items. Survey results were documented in a Microsoft Access database. A database-driven Web application was developed to allocate patients to hospitals. Of 99 hospitals, 69 responded and 54 indicated their willingness to accept radiological emergency patients. 17,512 total hospital beds, 2,084 intensive care, and 170 reverse isolation beds were reported. Availability of laboratory and in-patient departments ranged from 14 radiobiology to 47 laboratory medicine departments and from 13 burn care to 52 trauma surgery departments. 48 and 40 hospitals stated treatment competence for local and whole body external exposure, respectively. 34 and 29 hospitals reported treatment expertise for contamination and incorporation, respectively. In this publication baseline data of qualified hospitals concerning capacities and competence to manage radiological emergency patients are presented, and an allocation concept for radiological emergency patients is provided.

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

    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.

  17. Adolescent Pregnancy and Special Education.

    Anastasiow, Nicholas J.


    The article discusses the complex set of factors involved in the phenomena associated with adolescent pregnancy and child bearing, particularly the young adolescent's risk in bearing and/or rearing a handicapped child. Programs to reduce adolescent pregnancies, teach about child development, and child care procedures are described. (Author/CL)

  18. Anger Communication in Bicultural Adolescents

    Novin, Sheida; Rieffe, Carolien


    Little is known about bicultural adolescents' emotional competence. The aim of the present study was to examine anger communication by comparing thirty-eight 16-year-old Moroccan-Dutch adolescents with 40 Dutch and 40 Moroccan peers using hypothetical anger-eliciting vignettes. Findings show that although Moroccan and Dutch adolescents were…

  19. Eating Disorders in Adolescent Males

    Ray, Shannon L.


    Research indicates that the primary onset of eating disorders occurs in adolescence and that there is a growing prevalence of adolescent males with eating disorders. This article describes the eating disorders of anorexia nervosa and bulimia nervosa as they relate to adolescent males. Diagnostic criteria, at-risk groups, and implications for…

  20. Popular Music in Early Adolescence.

    Christenson, Peter G.; Roberts, Donald F.

    This paper examines young adolescents' involvement with popular music and the health implications of that involvement. Initial discussion explores three central concepts: music media, adolescence, and mass media effects. A summary of research on music media in adolescence is offereed in two sections discussing exposure to, and gratifications and…

  1. Rorschach Evaluation of Adolescent Bulimics.

    Smith, Jane E.; And Others


    Used Rorschach Test to contrast 12 diagnosed female adolescent bulimics with 12 female adolescent controls. Bulimics averaged greater number of aggression responses. Data suggest that adolescent bulimics are more depressed, self-punitive, and negativistic than peers and that they have more disordered thoughts, inaccurate perceptions, and impaired…

  2. Child Maltreatment and Adolescent Development

    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…

  3. The interstices of hospitality


    Printed in The Netherlands — All rights reserved. Introduction ... event, the rule of the city is anonymity disguised in the rules of urbanity ... understanding the theoretical meaning of hospitality (in part ... obligation that both behave appropriately in the meeting. ... which the concepts of consumption, commerce, utilitarianism,.

  4. Hospitals as food arenas

    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...

  5. Innovations in Hospitality Industry

    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…

  6. Responsible Hospitality. Prevention Updates

    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…

  7. Surgery, Hospitals, and Medications

    ... 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. ...

  8. Hacking the hospital environment

    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...

  9. Mechanical engineering in hospitals.

    Wallington, J W


    The design of a modern hospital owes more to engineering than the layman may realize. In this context, many engineers are in the position of laymen, being unfamiliar with the multitude of services that lies behind the impressive facade of a modern hospital. In recent years medicine and surgery themselves have taken on many of the characteristics of a technology. This has required a matching development of the services both mechanical and electrical that are required in modern health care buildings. In medical terms, if the architectural features provide the 'skin' of the hospital, the mechanical and electrical engineering services provide the nerves and sinews. If we take as an example the recently completed Freeman Hospital, Newcastle upon Tyne, (Fig. 1), which cost 10 million pounds at current cost, the service network was responsible for about half the total cost. About 400 miles (643 km) of electrical wiring and more than 40 mile (64.5 km) of copper and steel piping were used to service 3000 separate rooms. This compares with percentages of between 18 and 25 per cent for other large buildings such as office blocks, hotels and sports complexes.

  10. Hospital restructuring and burnout.

    Greenglass, Esther R; Burke, Ronald J


    Increasingly, organizations are experiencing changes as a result of extensive downsizing, restructuring, and merging. In Canada, government-sponsored medicine has been affected as hospitals have merged or closed, reducing essential medical services and resulting in extensive job loss for hospital workers, particularly nurses. Hospital restructuring has also resulted in greater stress and job insecurity in nurses. The escalation of stressors has created burnout in nurses. This study examines predictors of burnout in nurses experiencing hospital restructuring using the MBI-General Survey which yields scores on three scales: Emotional exhaustion, Cynicism, and Professional efficacy. Multiple regressions were conducted where each burnout scale was the criterion and stressors (e.g., amount of work, use of generic workers to do nurses' work), restructuring effects, social support, and individual resources (e.g., control coping, self-efficacy, prior organizational commitment) were predictors. There were differences in the amount of variance accounted for in the burnout components by stressors and resources. Stressors contributed most to emotional exhaustion and least to professional efficacy. Individual resources were more likely to contribute to professional efficacy and least to emotional exhaustion. Stressors and resources accounted for approximately equal amounts of variance in cynicism. Three conclusions were drawn. First, present findings parallel others by showing that individual coping patterns contribute to professional efficacy. Second, emotional exhaustion was found to be the prototype of stress. Third, prior organizational commitment, self-efficacy, and control coping resulted in lower burnout.

  11. [Leadership in the hospital].

    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.

  12. Adolescent male health.

    Westwood, Michael; Pinzon, Jorge


    Although adolescent males have as many health issues and concerns as adolescent females, they are much less likely to be seen in a clinical setting. This is related to both individual factors and the health care system itself, which is not always encouraging and set up to provide comprehensive male health care. Working with adolescent boys involves gaining the knowledge and skills to address concerns such as puberty and sexuality, substance use, violence, risk-taking behaviours and mental health issues. The ability to engage the young male patient is critical, and the professional must be comfortable in initiating conversation about a wide array of topics with the teen boy, who may be reluctant to discuss his concerns. It is important to take every opportunity with adolescent boys to talk about issues beyond the presenting complain, and let them know about confidential care. The physician can educate teens about the importance of regular checkups, and that they are welcome to contact the physician if they are experiencing any concerns about their health or well-being. Parents of preadolescent and adolescent boys should be educated on the value of regular health maintenance visits for their sons beginning in their early teen years.

  13. Personality disorders in adolescence.

    Kamila Lenkiewicz


    Full Text Available Adult personality disorders are well recognized and described in the literature. The discussion about the possibility of the presence of personality disorders in adolescents started about 20 years ago. Some authors claim the before the age of 18 it is only possible to identify precursors of future personality disorders and such a standpoint is reflected in diagnostic criteria. This is based on the assumption that personality in adolescence is still not well established. Consequently, the criterion on the persistence of symptoms for the period of time cannot be met (the persistence of symptoms of personality disorders for the period of at least two years. Other approach postulates that problems presented in adolescence should not be exclusively limited to Axis I according to DSM. The proponents of this approach claim that current diagnostic tools are not adjusted to adolescents, thus it is very difficult to measure stability and persistence of symptoms in this age group. This paper presents literature review on personality disorders in adolescence.

  14. Suicide in children and young adolescents: a 25-year database on suicides from Northern Finland.

    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.

  15. Adolescents and their music. Insights into the health of adolescents.

    Brown, E F; Hendee, W R

    During adolescence, teenagers are expected to develop standards of behavior and reconcile them with their perceptions of adult standards. In this context, music, a powerful medium in the lives of adolescents, offers conflicting values. The explicit sexual and violent lyrics of some forms of music often clash with the themes of abstinence and rational behavior promoted by adult society. Identification with rock music, particularly those styles that are rejected by adults, functions to separate adolescents from adult society. Some forms of rock music extend well beyond respectability in fulfilling this definitional role. Total immersion into a rock subculture, such as heavy metal, may be both a portrait of adolescent alienation and an unflattering reflection of an adolescent's perception of the moral and ethical duplicity of adult society. Physicians should be aware of the role of music in the lives of adolescents and use music preferences as clues to the emotional and mental health of adolescents.

  16. Adolescent Perceptions of Parental Behaviors, Adolescent Self-Esteem, and Adolescent Depressed Mood

    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…

  17. Adolescent Perceptions of Parental Behaviors, Adolescent Self-Esteem, and Adolescent Depressed Mood

    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…

  18. [The relation of selected psychiatric disorders to occurrence of suicide attempts among teenage psychiatrically hospitalized patients].

    Krajewska, Katarzyna; Gawlik-Kotelnicka, Oliwia; Gmitrowicz, Agnieszka


    Suicide is the third cause of death globally in the age group 10-19. Multiple risk factors (genetic, psychiatric, psychological, familial, social) increased number of suicide attempts. The aim of this study was to explore whether mental disorders are associated with the number of suicide attempts among psychiatric hospitalized adolescents. Retrospective, chart-based analysis of 119 patients, aged 13-18, treated in 2013-2014 in the Department of Adolescent Psychiatry in Łódź. Inclusion criteria was diagnosis of schizophrenia, schizotypal and delusional disorders, mood disorders, neurotic, stress-related and somatoform disorders, behavioral and emotional disorders according to ICD 10. Exclusion criteria were other psychiatric diagnosis, incomplete information about intention of self-harm behaviors. For statistical analysis used Statistica 9.1. Among psychiatricaly hospitalized patients, 51.2% of people attempted suicide. No relationship was found (p > 0.05) between psychiatric diagnosis and frequency of suicide attempts in adolescents, but the most common suicide attempts related to people with a diagnosis of mood disorders (59.3%) and neurotic disorders (54.6%), and least frequently in patients with a diagnosis of schizophrenia , schizotypal and delusional disorders (40%) and behavioral and emotional disorders (44.4%). There is no relation between the occurrence of suicide attempts and the type of mental disorders among psychiatrically hospitalized adolescents. © 2015 MEDPRESS.

  19. Hospital malnutrition: a 33-hospital screening study.

    Kamath, S K; Lawler, M; Smith, A E; Kalat, T; Olson, R


    A collaborative study involving nutrition screening of 3,047 patients (excluding 125 pregnant women) at admission to 33 hospitals in and around the greater Chicago area was carried out to identify patients at nutritional risk. Information on sex, age, admitting diagnosis, serum albumin, hemoglobin, total lymphocyte count, and height and weight was collected from the medical chart within 48 hours of admission. Nutrition screening could not be completed for a larger number of patients (60%) because data at admission were not available. Of the remaining 40% of patients, more than 50% had below normal values for one or more of the variables studied: serum albumin, hemoglobin, and total lymphocyte count. A large number of the patients (40%) also were considered at nutritional risk as judged by the criteria of weight/height (measured only). Early nutrition intervention for high-risk patients cannot be implemented, nor can the efficacy of nutrition services be evaluated, unless nutrition screening is carried out on patients at admission.

  20. Abandonment of Treatment for Latent Tuberculosis Infection and Socioeconomic Factors in Children and Adolescents: Rio De Janeiro, Brazil

    Angela Marcia Cabral Mendonça; Afrânio Lineu Kritski; Marcelo Gerardin Poirot Land; Clemax Couto Sant'Anna


    Background Routine data on the use of isoniazid preventive therapy (IPT) in children and adolescents are scarce in high tuberculosis (TB) burden countries. Objective To describe the factors related to abandonment of IPT in children and adolescents with latent tuberculosis infection (LTBI) receiving routine care. Methods Retrospective (2005–2009) descriptive study of 286 LTBI cases with indication of IPT and serviced at a pediatric hospital in the State of Rio de Janeiro, Brazil. Survival anal...

  1. The politics of hospital payment.

    Feder, J; Spitz, B


    This paper analyzes the politics of hospital payment over the last decade. The authors explain how provider interests and judgments became a standard for appropriate hospital payment: the impact of that standard on hospital costs; and the political obstacles to imposing an alternative standard and controlling hospital costs. The authors draw lessons from this experience, here and in other countries, to propose an alternative approach to hospital payment that would allow policymakers, accountable to the public, to make explicit choices about the level and nature of hospital expenditures.

  2. Hospital-acquired infections - when are hospitals legally liable?

    McQuoid-Mason, David


    Hospital-acquired infections (nosocomial infections) are acquired in healthcare settings by patients admitted for reasons unrelated to the infection or not previously infected when admitted to the facility. Liability for hospital-acquired infections depends on whether the hospital: (i) has introduced best practice infection control measures; (ii) has implemented best practice infection control measures; or (iii) will be vicariously liable for negligent or intentional failures by staff to comply with the infection control measures implemented. A hospital and hospital administrators may be held directly liable for not introducing or implementing best practice infection control measures, resulting in harm to patients. The hospital may also be held vicariously liable where patients have been harmed because hospital staff negligently or intentionally failed to comply with the infection control measures that have been implemented by the hospital, during the course and scope of their employment.

  3. Why are adolescents violent?

    James Garbarino

    Full Text Available This article discusses how adolescents become violent from the perspective of human development, in which the process of formation of the child and the youth depends on diverse biological, psychological e social variables that constitute the context of life of these individuals. The ecological perspective of human development opposes simple cause-effect relations between antisocial adversities and behaviors and believes that factors such as gender, temperament, cognitive ability, age, family, social environment and culture combine in a complex way influencing the behavior of the child and the adolescent. Some conclusions point to the fact that violence in adolescence usually starts from a combination of early difficulties in relationships associated with a combination of temperamental difficulties. It is concluded that the young seem to be as bad as the social environment surrounding them.

  4. Adolescent Idiopathic Scoliosis

    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

  5. Alcohol consumption in adolescents

    Ilona Plevová


    Full Text Available Aim: To determine the level of alcohol consumption in a selected group of adolescents. Design: A descriptive cross-sectional study. Methods: The data were obtained using a part of the standardized ESPAD questionnaire for assessing consumption of alcoholic beverages. The sample comprised 422 students from seven secondary schools of different types in the city of Ostrava. For statistical analysis, the chi-squared test and Fisher's exact test (for n ≤ 5 were used. The data were processed using Stata v. 10. Results: More than half of respondents first tried alcohol before the age of 15. The most frequent alcohol-related problems were unprotected sex, decreased school performance and problems with parents or friends. Incomplete families were found to be an important factor in adolescents preferring and more frequently drinking beer. Conclusion: The study confirmed results reported by the Europe-wide survey ESPAD, namely that adolescents start to drink alcohol as early as before they turn fifteen.

  6. Physical activity among adolescents

    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...... during leisure time. We used logistic regression analyses to estimate the associations for girls and boys separately, adjusted by age group, parents' occupational social class, family structure, and migration status. There were significant and graded associations between adolescents' PA and all four...... dimensions of parental support for PA. The association patterns were similar for mothers' and fathers' social support and similar for girls and boys. Social processes in the family are important for adolescents' participation in PA. It is important to continue to explore these social processes in order...

  7. Breakfast frequency among adolescents

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


    , quality of family communication and family support. Further, analyses suggested that the associations were more pronounced among girls, immigrants and adolescents from other family structure than traditional. The study highlights the importance of the family setting in promoting regular breakfast......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...

  8. Motivational Interviewing to Reduce Substance Use in Adolescents with Psychiatric Comorbidity.

    Brown, Richard A; Abrantes, Ana M; Minami, Haruka; Prince, Mark A; Bloom, Erika Litvin; Apodaca, Timothy R; Strong, David R; Picotte, Dawn M; Monti, Peter M; MacPherson, Laura; Matsko, Stephen V; Hunt, Jeffrey I


    Substance use among adolescents with one or more psychiatric disorders is a significant public health concern. In this study, 151 psychiatrically hospitalized adolescents, ages 13-17 with comorbid psychiatric and substance use disorders, were randomized to a two-session Motivational Interviewing intervention to reduce substance use plus treatment as usual (MI) vs. treatment as usual only (TAU). Results indicated that the MI group had a longer latency to first use of any substance following hospital discharge relative to TAU (36 days versus 11 days). Adolescents who received MI also reported less total use of substances and less use of marijuana during the first 6 months post-discharge, although this effect was not significant across 12 months. Finally, MI was associated with a significant reduction in rule-breaking behaviors at 6-month follow-up. Future directions are discussed, including means of extending effects beyond 6 months and dissemination of the intervention to community-based settings.

  9. Pain Assessment Using The Adolescent Pediatric Pain Tool: A Systematic Review

    Ananda Maria Fernandes


    Full Text Available BACKGROUND: The Adolescent Pediatric Pain Tool (APPT is a multidimensional pain assessment tool designed to assess pain location (body outline diagram, intensity (word graphic rating scale and quality (list of pain descriptors in hospitalized children eight to 17 years of age.

  10. The Effects of Traumatic Brain Injury during Adolescence on Career Plans and Outcomes

    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. Emotional and Behavioral Disturbances in Adolescents Involved in Witchcraft and Satanism.

    Burket, Roger C.; And Others


    Examined inpatient medical records of 157 consecutive adolescent admissions to private psychiatric hospital. Ten patients with interest in witchcraft and Satanism had significantly more diagnoses of identity disorder, alcohol abuse, and hallucinogen abuse. One-half reported history of self-mutilation. Found no significant difference in criminal…

  12. Emotional Dysregulation and Interpersonal Difficulties as Risk Factors for Nonsuicidal Self-Injury in Adolescent Girls

    Adrian, Molly; Zeman, Janice; Erdley, Cynthia; Lisa, Ludmila; Sim, Leslie


    The purpose of this study was to examine a model of factors that place psychiatrically hospitalized girls at risk for non-suicidal self-injury (NSSI). The role of familial and peer interpersonal difficulties, as well as emotional dysregulation, were examined in relationship to NSSI behaviors. Participants were 99 adolescent girls (83.2% Caucasian;…

  13. A Suicidal Adolescent's Sleeping Beauty Syndrome: Cessation Orientations toward Dying, Sleep, and Drugs.

    Babow, Irving; Rowe, Robin


    In study of hospitalized suicidal youth, account of 16-year-old girl, diagnosed as schizophrenic, is analyzed to gain insight into family's role in suicidal career of adolescent preoccupied with death and dying, sleep, and drugs; the interplay of her construction of reality with her risk-taking, self-injurious way of life; and her perceived…

  14. Self-managed eHealth Disease Monitoring in Children and Adolescents with Inflammatory Bowel Disease

    Carlsen, Katrine; Jakobsen, Christian; Houen, Gunnar


    BACKGROUND: To evaluate the impact of eHealth on disease activity, the need for hospital contacts, and medical adherence in children and adolescents with inflammatory bowel disease (IBD). Furthermore, to assess eHealth's influence on school attendance and quality of life (QoL). METHODS: Patients ...

  15. Adolescent and adult cleft lip and palate, in Ile-Ife, Nigeria


    Dec 17, 2011 ... The purpose of this article is to review adolescent and adult CLP patients .... due to costs. We do not perform labial adhesion[21] in our .... the department of orthodontics, Suidobashi hospital, Tokyo dental college. Bull Tokyo ...

  16. [Hospital clinical ethics committees].

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor


    The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of

  17. [Adolescence and AIDS].


    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

  18. Adolescent rampant caries



    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.

  19. Clinical Characteristics and Pharmacological Treatment of Psychotic Patients Attending the Mental Health Services of the Pediatric Hospital of Cienfuegos

    Beatriz Sabina Roméu; Daimí Sarmiento González; Mario Isaías Alzuri Falcato; Anais Leyva Madrigales


    Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of...

  20. On Hospital Design – Identifying Building Attributes of Hospital Design

    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...

  1. Accuracy and Concordance in Reporting for Secondhand Smoke Exposure among Adolescents Undergoing Treatment for Cancer and Their Parents.

    McDermott, Michael J; Nicholson, Jody S; Tyc, Vida L


    Few studies have examined adolescent reporting accuracy for secondhand smoke exposure (SHSe), and never for youth with cancer. SHSe reporting from adolescents being treated for cancer (Mage=14.92 years, SD=1.67) was examined against parent/guardian reports and urine cotinine among 42 adolescent-parent dyads. Number of days in hospital-based lodgings prior to assessment emerged as the strongest predictor of urine cotinine (β=-0.46, p=0.003) and adolescent SHSe reporting significantly predicted urine cotinine (β=0.37, p=0.011) beyond relevant demographic and contextual variables (overall R(2)=0.40, F(6, 35)=3.90, p=0.004). Findings support adolescents as accurate reporters of discrete SHSe occurrences.

  2. 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

    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


    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.

  4. Self-esteem, social support perception and seizure controllability perception in adolescents with epilepsy

    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.

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

    Dehlholm-Lambertsen, Birgitte; Hulgaard, Ditte Roth

    FSS are common in children and adolescents, resulting in significant morbidity and health expenses. In daily clinical practice there is limited consensus regarding the treatment. To understand FSS, a biopsychosocial framework is generally accepted. This includes, biological, psychological...... by the fact that “family therapy” is based on a broad definition, which encompasses a wide range of interventions with theoretical and technical eclictism dominating the field. Research in adults shows that psychological treatment is effective for FSS. According to children and adolescents there is a growing...... 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...

  6. Online Focus Groups with Parents And Adolescents with Heart Transplants: Challenges and Opportunities.

    Boateng, Beatrice; Nelson, Mary Kathryn; Huett, Amy; Meaux, Julie B; Pye, Sherry; Schmid, Barbara; Berg, Alex; LaPorte, Kelci; Riley, Linda; Green, Angela


    Pediatric heart transplant recipients are scarce and widely dispersed. Previous studies of adolescents in this population were limited to small homogenous samples. Although online focus groups are an emerging data collection method, its use in pediatric populations has not been fully realized. The purpose of this study was to explore the feasibility of using online focus groups with pediatric populations. Adolescents (aged 13 to 21 years) at least 6 months post-heart transplant and their parents were recruited from two children's hospitals. An online discussion forum (iTracks) was used to conduct asynchronous focus groups with separate parent and adolescent groups. Six parents and four adolescents participated in the discussions. iTracks provided a framework for conducting focus groups in dispersed populations. Access to the discussion transcripts enhanced data analysis and eliminated transcription costs. Overall, online discussion forums were a feasible and cost-effective option to conduct online focus groups in this pediatric population.

  7. Hospital Presbiteriano Valley

    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.

  8. Hospital Princesa Margarita

    Powell y Moya, Aquitectos


    Full Text Available El amplio programa desarrollado en este grande e importante Centro sanitario, abarcó tres fases de construcción, al final de las cuales se consiguió el Hospital General, capaz para 600 camas. En la primera parte se construyeron los siguientes departamentos: Enfermos del exterior, Accidentes, Medicina Física, Patología, Rayos X, y el primero de los cuatro núcleos quirúrgicos.

  9. Hospital nurses' work motivation.

    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.

  10. E-procurement in hospitals.

    Hidalgo, Julio Villalobos; Orrit, Joan; Villalobos, Juan Pablo


    This article describes the history, current status, advantages of and opposition to the implementation of e-procurement in hospitals and examines the results of its implementation in a psychiatric hospital.

  11. Preventing Infections in the Hospital

    ... Share | With attention increasing on the incidence of infection in hospitals, patients everywhere need sensible principles to manage their ... will reduce the chance of developing a lung infection while in the hospital and may also improve your healing abilities following ...

  12. Hospitalized Patients and Fungal Infections

    ... These types of infections are called healthcare-associated infections (HAIs). Hospital staff and healthcare providers do everything they can ... IV tube) can increase your risk for fungal infection. During your hospital stay you may need a central venous catheter, ...

  13. Wearing gloves in the hospital

    ... gloves; PPE - wearing gloves; Nosocomial infection - wearing gloves; Hospital acquired infection - wearing gloves ... Wearing gloves in the hospital helps prevent the spread of germs. This helps protect both patients and health care workers from infection.

  14. Hospital labs go under microscope.

    Aston, Geri


    Financial pressures are hitting hospital clinical labs on both the inpatient and outpatient sides. To control expenses, hospitals are teaming up to buy supplies, centralizing services and improving blood management.

  15. Hospitals report on cancer centers.

    Rees, T


    Woman's Hospital, Baton Rouge, La., is first-place winner among cancer centers. Holy Cross Hospital's Michael and Dianne Bienes Comprehensive Cancer Center, Ft. Lauderdale, Fla., is named second; and, Cardinal Health System's Ball Cancer Center, Muncie, Ind., third.

  16. Hospital ICUs May Be Overused

    ... page: Hospital ICUs May Be Overused Single medical center study ... While this is a study of just one hospital and results may differ at other medical centers, ...

  17. HSIP Hospitals in New Mexico

    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...

  18. Prognosis after Hospitalization for Erythroderma

    Egeberg, Alexander; Thyssen, Jacob P; Gislason, Gunnar H


    Erythrodermic psoriasis (EP) and erythroderma exfoliativa (EE) are acute and potentially life-threatening inflammatory reactions. We estimated hazard ratios (HRs) of 3-year mortality following hospitalization for EP or EE compared with general population controls, patients hospitalized for psoria...

  19. Little hospital has big ideas.

    Friedman, E


    Many hospitals have been looking at diversification of services with increased interest in recent years, and a small hospital in rural Wisconsin has shown that the concept need not be limited to large, urban institutions.

  20. Parametric Optimization of Hospital Design

    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....