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Knipschild R, Hein I, Pieters S, Lindauer R, Bicanic IAE, Staal W, de Jongh A, Klip H. Childhood adversity in a youth psychiatric population: prevalence and associated mental health problems. Eur J Psychotraumatol 2024; 15:2330880. [PMID: 38530708 DOI: 10.1080/20008066.2024.2330880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/06/2024] [Indexed: 03/28/2024] Open
Abstract
Background: Childhood adversity can have lasting negative effects on physical and mental health. This study contributes to the existing literature by describing the prevalence rates and mental health outcomes related to adverse childhood experiences (ACEs) among adolescents registered for mental health care.Methods: Participants in this cross-sectional study were youths (aged 12-18 years) who were referred to outpatient psychiatric departments in the Netherlands. Demographic information was collected from the medical records. The Child Trauma Screening Questionnaire (CTSQ) was used to examine the presence of ACEs and posttraumatic stress symptoms (PTSS). To assess mental health problems, we used the Dutch translation of the Youth Self Report. Descriptive statistics and frequencies were used to calculate prevalence rates across the various ACEs domains. ANOVA and chi-square tests were used to explore the relationship between ACEs and mental health.Results: Of the 1373 participants, 69.1% reported having experienced at least one ACE and 17.1% indicated exposure to four or more ACEs in their lives. Although there was substantial overlap among all ACE categories, the most frequently reported were bullying (49.2%), emotional abuse (17.8%), physical abuse (12.2%), and sexual abuse (10.1%). Female adolescents (72.7%) reported significantly more ACEs than their male counterparts (27.0%). Furthermore, a higher number of ACEs was associated with significantly more self-reported general mental health problems, an elevated prevalence of both mood and post-traumatic stress disorders, and a greater presence of two or more co-existing psychiatric diagnoses (comorbid psychiatric classification).Conclusions: This cross-sectional study on childhood adversity and its association with mental health showed that ACEs are highly prevalent in youth registered for mental health care. This study provides support for a graded and cumulative relationship between childhood adversity and mental health problems.
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Affiliation(s)
- Rik Knipschild
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
| | - Irma Hein
- Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sara Pieters
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
- Department of Psychology, Radboud University, Nijmegen, the Netherlands
| | - Ramon Lindauer
- Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Iva A E Bicanic
- National Psychotrauma Centre for Children and Youth, University Medical Centre Utrecht, Utrecht, Leiden, the Netherlands
| | - Wouter Staal
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Leiden Institution for Brain and Cognition, the Netherlands
| | - Ad de Jongh
- Psychotrauma Expertise Centre (PSYTREC), Bilthoven, the Netherlands
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, the Netherlands
- School of Health Sciences, Salford University, Manchester, UK
- Institute of Health and Society, University of Worcester, Worcester, UK
- School of Psychology, Queen's University, Belfast, Northern Ireland
| | - Helen Klip
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
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Kerbage H, Elbejjani M, El-Hage W, Purper-Ouakil D. 'Life should go on': a qualitative inquiry of parental reactions, experiences, and perceived needs following adolescents' recent traumatic exposure. Eur J Psychotraumatol 2024; 15:2299660. [PMID: 38285906 PMCID: PMC10826792 DOI: 10.1080/20008066.2023.2299660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024] Open
Abstract
Background: Parents have a significant role in supporting children who have been exposed to traumatic events. Little is known about parental experiences and needs in the wake of traumatic exposure, which could help in designing tailored early interventions.Objective: This qualitative study explored experiences, perceived needs, and factors impacting those needs being met, in parents of adolescents aged 11-16 years who had been exposed in the past 3 months to a potentially traumatic event, in the city of Montpellier, France.Method: We purposively sampled 34 parents of 25 adolescents aged 11-16 years meeting the inclusion criteria and used semi-structured in-depth interviews. Thematic analysis was applied using a multistage recursive coding process.Results: Parents lacked trauma-informed explanations to make sense of their child's reduced functioning. They experienced stigma attached to the victim label and were reluctant to seek help. School avoidance and lack of collaboration with schools were major obstacles experienced by parents. Parents trying to navigate conflicting needs fell into two distinct categories. Those who experienced distressing levels of shame and guilt tended to avoid discussing the traumatic event with their child, pressuring them to resume life as it was before, despite this perpetuating conflictual interactions. Others adapted by revisiting their beliefs that life should go on as it was before and by trying to come up with new functional routines, which improved their relationship with their child and helped them to restore a sense of agency and hope, but at the cost of questioning their parental role.Conclusions: Key domains of parental experiences could provide potential early intervention targets, such as psychoeducation on traumatic stress, representations about recovery and the victim status, parent-child communication, and involvement of schools and primary caregivers. Further research is needed to validate the impact of these domains in early post-traumatic interventions.
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Affiliation(s)
- Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint-Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP) INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Paris, France
| | - Martine Elbejjani
- Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Wissam El-Hage
- UMR 1253, iBrain, University of Tours, INSERM, Tours, France
| | - Diane Purper-Ouakil
- Department of Child and Adolescent Psychiatry, Saint-Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP) INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Paris, France
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Sille Schandorph Løkkegaard, Ask Elklit, Maria Louison Vang. Examination of ICD-11 PTSD and CPTSD using the International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) in a sample of Danish children and adolescents exposed to abuse. Eur J Psychotraumatol; 14:2178761. [PMID: 37052084 PMCID: PMC9980161 DOI: 10.1080/20008066.2023.2178761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background: International research has established that children and adolescents are at risk for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined by the WHO ICD-11. There is a need for a Danish language version of the International Trauma Questionnaire – Child and Adolescent (ITQ-CA) to assess symptoms of PTSD and CPTSD. Objective: To test the ICD-11 formulations of PTSD and DSO (Disturbances of Self-Organization) using the ITQ-CA version in a sample of children exposed to abuse. Additionally, to study the distribution of symptoms and probable prevalence of ICD-11 PTSD and CPTSD among the population of children exposed to violence or sexual abuse. Method: Confirmatory factor analysis of competing models of the dimensionality of the ITQ-CA was tested among a sample of 119 children and adolescents that were referred to the Danish Children Centres on suspicion of physical or sexual abuse or both. Latent class analysis (LCA) was used to study the distribution of symptoms and consequences of different operationalisations of functional impairment were explored. Results: Findings supported a two-factor second-order model corresponding to the operationalisation of CPTSD in ICD-11 as the best representation of the data. Findings from the LCA suggested that symptoms were distributed in a pattern consistent with the ICD-11 proposal for CPTSD. CPTSD was more prevalent than PTSD regardless of the operationalisation of functional impairment. Conclusion: ITQ-CA is a valid tool for identifying symptoms of ICD-11 PTSD and CPTSD among Danish children exposed to physical or sexual abuse. Further research is needed to study the relationship between ICD-11 C/PTSD symptomatology and anxiety and depression in this population. The International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) is a valid measure of symptoms of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD among Danish children exposed to physical or sexual violence. The structure of the ITQ-CA in the Danish sample reflects the ICD-11 diagnostic algorithm. CPTSD is a more prevalent disorder among children recently exposed to violence than PTSD.
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Fontenele TMDO, Nunes PPDB, Silva FVM, Menezes CNB, Andrade RFD, Mont'Alverne DGB, Saintrain MVDL, Frota MA, Abdon APV. Smartphone addiction and postural alterations in the cervical region in adolescents. Rev Paul Pediatr 2023; 42:e2023051. [PMID: 38126601 PMCID: PMC10742370 DOI: 10.1590/1984-0462/2024/42/2023051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/03/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To evaluate smartphone addiction and postural alterations in the cervical region in adolescents. METHODS A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis. RESULTS Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05). CONCLUSIONS The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.
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Bain V, Abramczyk ML, Costa RLS, Paixão MR, Souza Junior JLD. Pediatric COVID-19: clinical and epidemiological data of 1303 cases in a general hospital in Brazil. Rev Paul Pediatr 2023; 42:e2023031. [PMID: 38126598 PMCID: PMC10742344 DOI: 10.1590/1984-0462/2024/42/2023031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/03/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study aimed to describe the clinical characteristics of the pediatric population with COVID-19 in an Emergency Department (ED) of a Brazilian general hospital. METHODS Epidemiological and clinical data of patients younger than 20 years old were collected from patients' medical records from February 2020 to July 2021. Most of the epidemiological data described pertains to hospitalized patients. We also reviewed coinfections, treatment, and outcomes and compared the first and second waves of COVID-19. RESULTS We identified a total of 1303 episodes of SARS-CoV-2 infection. The median time from symptom onset to diagnosis was three days. Symptoms were present in 92.3% of the patients. The most common symptoms were fever (45.2%), nasal congestion/discharge (44.2%), and cough (39.4%). Chest radiography and tomography were performed in 7.7 and 3.3% of cases, with abnormal findings in 29.7 and 53.4%, respectively. Hospital admissions occurred in 3.5% of patients, mainly in the presence of comorbidities, in children under five years old and in those who presented to the ED during the first wave of COVID-19. Coinfection with a viral agent was identified in 20% of the 71 cases tested in this study, and a positive rapid test for Streptococcus pyogenes was found in 8% of the 174 cases tested, with no impact of these coinfections on hospitalization. CONCLUSIONS We found that COVID-19 was a mild disease in most children in our study population, with most hospitalizations and readmissions occurring during the first wave of COVID-19.
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Affiliation(s)
- Vera Bain
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Silva LAN, Nunes BP, Lima JG, Tomasi E, Facchini LA. [Contextual characteristics and demand for health services among Brazilian adolescents: Brazilian National Health Survey, 2019]. CAD SAUDE PUBLICA 2023; 39:e00070223. [PMID: 38088738 PMCID: PMC10715569 DOI: 10.1590/0102-311xpt070223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 12/18/2023] Open
Abstract
This study aimed to describe the prevalence of demand for health services among Brazilian adolescents and to investigate its association with contextual characteristics of the territory. Study with data from the Brazilian National Health Survey, conducted in 2019, including 43,774 individuals aged from 10 to 19 years. Adolescent's information was obtained through a proxy resident of 18 years or more who answered for all the residents of the household. Poisson regression was used to assess the demand for health services according to geopolitical region, economic status, and type of municipality. The interaction of the health insurance was also evaluated in these associations. Of the total, 11.7% (95%CI: 11.1; 12.3) of the adolescents sought health services in the two weeks prior to the survey. Greater figures of demand were observed in the Southeast (PR = 1.32; 95%CI: 1.15; 1.52) and South regions (PR = 1.31; 95%CI: 1.13; 1.52) compared to the Northern Region of Brazil. Having a health insurance increased the demand for services by adolescents living in rural areas and in capitals and the municipalities of the Metropolitan Areas and/or Integrated Development Regions. The study showed a low prevalence of demand for health services among adolescents and contextual inequalities for the geopolitical region. Having a health insurance was an important marker to understand the disparities in the economic status and in the type of municipality.
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Affiliation(s)
| | | | - Juliana Gagno Lima
- Instituto de Saúde Coletiva, Universidade Federal do Oeste do Pará, Santarém, Brasil
| | - Elaine Tomasi
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Luiz Augusto Facchini
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
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de Oliveira ECF, Rocha ALL. Five-year Contraceptive Use of 52-mg Levonorgestrel Releasing Intrauterine System in Young Women, Menstrual Patterns, and New Contraceptive Choice. Rev Bras Ginecol Obstet 2023; 45:e654-e660. [PMID: 38029767 PMCID: PMC10686754 DOI: 10.1055/s-0043-1776032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/24/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE To evaluate the continuation rates of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) during the first 5 years of use, reasons for its discontinuation, bleeding patterns, and new contraceptive choice after the 5th year, in adolescents and young women. METHODS The present study was a 5-year prospective cohort conducted in a Family Planning Service of a tertiary hospital in Brazil. We selected 100 healthy women between 15 and 24 years old who used 52-mg LNG-IUS for contraception. The clinical follow-up of these women took place from June 2017 to December 2022. The study evaluated the continuation rates of the method, reasons for its discontinuation, bleeding patterns, and new contraceptive choice after the 5th year. Continuous data were reported as mean ± standard deviation (SD) and range (minimum-maximum). Categorical variables were described as percentages. RESULTS The continuation rates of LNG-IUS were 89.1% (82/92), 82.9% (72/87), 75.3% (64/85), 70.5% (60/85), and 64.2% (54/84) in the 1st, 2nd, 3rd, 4th, and 5th years of use, respectively. The main reason for discontinuation was acne (11/30). Amenorrhea rates were 50, 54.1, 39, 35.7, and 51.8% at 12, 24, 36, 48, and 60 months, respectively. All patients who completed the study and needed contraception after the 5th year opted for long-acting contraceptive methods (LARC). CONCLUSION The LNG-IUS showed high continuation rates in adolescents and young women in the first 5 years of use. Most patients who completed the study chose a LARC method after the 5th year.
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Affiliation(s)
| | - Ana Luiza Lunardi Rocha
- Departament of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Doerr CM, Hoeffler A, Goessmann K, Olorunlambe W, Hecker T. Sexual violence affects adolescents' health and prosocial behaviour beyond other violence exposure. Eur J Psychotraumatol 2023; 14:2263319. [PMID: 37843878 PMCID: PMC10580796 DOI: 10.1080/20008066.2023.2263319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/22/2023] [Indexed: 10/17/2023] Open
Abstract
Background: Sexual violence is a public health issue among adolescents globally but remains understudied in Sub-Saharan Africa.Objective: The present study focused on the association of cumulative exposure to different types of sexual violence with mental and physical health problems and prosocial behaviour.Method: We conducted a survey with a regionally representative sample of both in-school and out-of-school adolescents, aged 13-17 years, living in south-western Nigeria. Self-reported exposure to sexual violence, behavioural problems, physical complaints, and prosocial behaviour were assessed.Results: About three quarters of the participants reported the experience of sexual violence (74.6%). Multiple regression models revealed that the more types of sexual violence an individual reported, the more mental and physical health problems, and the fewer prosocial behaviours they reported when controlling for other forms of violence exposure. Latent class analysis revealed three severity classes of sexual violence. Symptoms of mental and physical health indicators were significantly higher as exposure increased by group whereas prosocial behaviours were non-significantly fewer in the opposite direction.Conclusion: This study revealed a consistent and unique relation between sexual violence exposure and negative health outcomes among adolescents. Further research on sexual violence in Sub-Saharan Africa and its associations is needed.
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Affiliation(s)
- Carla Maria Doerr
- Department of Psychology & Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, Bielefeld, Germany
| | - Anke Hoeffler
- Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | - Kate Goessmann
- Department of Psychology & Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, Bielefeld, Germany
| | - Wasiu Olorunlambe
- Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | - Tobias Hecker
- Department of Psychology & Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, Bielefeld, Germany
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Torres MLGM, Sampaio ALL, Caracas HCPM. Changes in the communicative skills of young people as a result of a communication training. Codas 2023; 35:e20220041. [PMID: 37672409 PMCID: PMC10546987 DOI: 10.1590/2317-1782/20232022041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/28/2022] [Indexed: 09/08/2023] Open
Abstract
PURPOSE To analyze the effect of communication training developed for adolescents on the youth's communication skills. METHODS Forty-one young people participated in the study and were divided into two groups. Group I received intervention - communication training for five weeks; Group II - were guided on the importance of voice for communication. Participants had their communication skills assessed before/after interventions through a self-administered questionnaire, answered by the participant and parents. Both groups had oral presentations recorded on video, which were analyzed by speech therapists through the evaluation of the communication profile, listing the aspects that should be observed as a point of strength/opportunity for improvement. Association between qualitative variables was assessed using Fischer's exact test, Pearson's chi-square test, McNemar's test, and McNemar-Bowker's test. To compare groups, paired t-test and t-test for independent samples, p level <0.05, were used. RESULTS The analysis of questionnaires showed improvement in GI in two of the four skills assessed and no difference for GII. The video evaluations showed a significant difference between the groups in terms of eye contact and speech velocity. CONCLUSION This study points out that the communication training method applied to young people might improve communicative skills, providing some insights into their communication strengths and potential areas for development.
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Affiliation(s)
| | - André Luiz Lopes Sampaio
- Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Universidade de Brasília - Brasília (DF), Brasil.
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Lima LDM, Aurilio RB, Fonseca AR, Parente AAAI, Sant’Anna MDFBP, Sant’Anna CC. Tuberculosis in children and adolescents with rheumatic diseases using biologic agents: an integrative review. Rev Paul Pediatr 2023; 42:e2022084. [PMID: 37436237 PMCID: PMC10332438 DOI: 10.1590/1984-0462/2024/42/2022084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 02/05/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE To conduct a bibliographic review on tuberculosis (TB) disease in children and adolescents with rheumatic diseases, being managed with biologic therapy. DATA SOURCE An integrative review with a search in the U.S. National Library of Medicine and the National Institutes of Health (PubMed) using the following descriptors and Boolean operators: (["tuberculosis"] AND (["children"] OR ["adolescent"]) AND ["rheumatic diseases"] AND (["tumor necrosis factor-alpha"] OR ["etanercept"] OR ["adalimumab"] OR ["infliximab"] OR ["biological drugs"] OR ["rituximab"] OR ["belimumab"] OR ["tocilizumab"] OR ["canakinumab"] OR ["golimumab"] OR ["secukinumab"] OR ["ustekinumab"] OR ["tofacitinib"] OR ["baricitinib"] OR ["anakinra"] OR ["rilonacept"] OR ["abatacept"]), between January 2010 and October 2021. DATA SYNTHESIS Thirty-seven articles were included, with the total number of 36,198 patients. There were 81 cases of latent tuberculosis infection (LTBI), 80 cases of pulmonary tuberculosis (PTB), and four of extrapulmonary tuberculosis (EPTB). The main rheumatic disease was juvenile idiopathic arthritis. Among LTBI cases, most were diagnosed at screening and none progressed to TB disease during follow-up. Of the TB cases using biologics, most used tumor necrosis factor-alpha inhibitors (anti-TNFα) drugs. There was only one death. CONCLUSIONS The study revealed a low rate of active TB in pediatric patients using biologic therapy. Screening for LTBI before initiating biologics should be done in all patients, and treatment, in cases of positive screening, plays a critical role in preventing progression to TB disease.
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Affiliation(s)
- Lenita de Melo Lima
- Instituto de Puericultura e Pediatria Martagão Gesteira, Rio de Janeiro, RJ, Brazil
| | | | - Adriana Rodrigues Fonseca
- Instituto de Puericultura e Pediatria Martagão Gesteira, Rio de Janeiro, RJ, Brazil
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Régio L, Barros S, Ballan C, Aguiar C, Candido BDP, de Oliveira MAF. The care provided to black-skinned children and adolescents with mental health problems in the intersection between gender and race. Rev Lat Am Enfermagem 2023; 31:e3941. [PMID: 37341257 PMCID: PMC10306061 DOI: 10.1590/1518-8345.6058.3941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 03/28/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE to characterize the sociofamily profile of black-skinned children and adolescents with mental health problems and to intersectionally describe who assumes responsibility for their care. METHOD a descriptive and exploratory study with a quantitative approach, developed in the Psychosocial Care Center for Children and Adolescents from the North region of the municipality of São Paulo. The data were collected from 47 family members of black-skinned children and adolescents, using a script with predefined variables submitted to statistical analysis. RESULTS a total of 49 interviews were conducted: 95.5% women with a mean age of 39 years old, 88.6% mothers and 85.7% black-skinned. Family income comes from wages for all the male caregivers and for 59% of the women. Among the black-skinned female caregivers, 25% live in their own house, whereas this percentage is 46.2% among the brown-skinned ones. Of all the caregivers, 10% have a job, 20% live in transferred properties, 35% in houses of their own and 35% in rented places. The social support network is larger among white-skinned people (16.7%), followed by brown-skinned (3.8%), and absent among black-skinned individuals (0%). CONCLUSION those responsible for the care of black-skinned children and adolescents monitored by the CAPS-IJ are almost entirely women, black-skinned (black or brown) "mothers or grandmothers", with unequal access to education, work and housing, constitutional social rights in Brazil.
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Affiliation(s)
- Luciane Régio
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Faculdade de Ciências Médicas da Santa Casa, Curso de Enfermagem, São Paulo, SP, Brasil
| | - Sônia Barros
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Universidade de São Paulo, Instituto de Estudos Avançados, São Paulo, SP, Brasil
| | - Caroline Ballan
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
| | - Carla Aguiar
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
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Elena Alcover Bloch, Anna Gatell Carbó, Josep Vicent Balaguer Martínez, Tomás Perez Porcuna, Olga Salvado Juncosa, Emilio Fortea Gimeno, Patricia Álvarez Garcia. Evolución De La Salud Mental Infanto-Juvenil En Catalunya En El Contexto De La Pandemia Por La Covid-19 Durante El Curso Escolar 2020-2021 ◊◊. An Pediatr (Barc) 2023. [ DOI: 10.1016/j.anpedi.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Introducción: La pandemia por SARS-CoV-2 ha tenido un alto impacto en la salud física y psicológica de la población. Nuestro objetivo fue evaluar la salud mental infanto-juvenil de una cohorte poblacional a lo largo del curso 2020-21. Métodos: estudio longitudinal y prospectivo de una cohorte de niños escolarizados entre 5 y 14 años en Cataluña entre septiembre 2020 y julio 2021. Los participantes fueron seleccionados de forma aleatoria y seguidos por el pediatra de referencia en la atención primaria. La evaluación del riesgo de psicopatología fue realizada a través del cuestionario Strengths and Difficulties Questionnaire (SDQ) contestada por un tutor legal del niño. Fueron recogidas también variables sociodemográficas y de salud del individuo y su núcleo de convivencia. Los datos fueron recogidos mediante una encuesta on line a través de la plataforma RedCap al inicio del curso y al final de cada trimestre (4 cortes). Resultados: Al inicio del curso escolar el 9,8% de los pacientes fueron casos probables de psicopatología, frente al 6,2% de final de curso. La percepción del nivel de preocupación de los niños por su salud y la de su familia se relacionó con presentar psicopatología, especialmente al inicio del curso, mientras que la percepción de un buen ambiente familiar se relacionó en todo momento con menor riesgo. Ninguna variable relacionada con el COVID-19 se asoció con resultado alterado del SDQ. Conclusiones: A lo largo del curso escolar 2020-2021 el porcentaje de niños con probabilidad de presentar psicopatología mejoró y pasó del 9,8% al 6,2%.
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Alonso-Naranjo L, Berna-Rico E, Blanco Abbad-Jaime de Aragón C, Castañeda-Vozmediano R, Prieto-López L, Sánchez-Moya AI, Pérez-Hortet C, González-Cantero Á. Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation. Actas Dermosifiliogr 2023; 114:T299-T307. [PMID: 36868511 DOI: 10.1016/j.ad.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/15/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS A prospective study with 133 patients (between 12-19 years old), attended at the dermatology department of Toledo University Hospital, Spain, (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The Confirmatory Factor Analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test-retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. CONCLUSION Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.
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Affiliation(s)
- L Alonso-Naranjo
- Departamento de Dermatología, Hospital Universitario de Toledo, Toledo, España
| | - E Berna-Rico
- Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España
| | | | | | - L Prieto-López
- Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España
| | - A I Sánchez-Moya
- Departamento de Dermatología, Hospital Universitario de Toledo, Toledo, España
| | - C Pérez-Hortet
- Departamento de Dermatología, Hospital Universitario de Toledo, Toledo, España
| | - Á González-Cantero
- Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España.
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Lemos VC, Barros MBDA, Lima MG. Chronic diseases and health conditions in adolescents: Sex inequalities. Rev Bras Epidemiol 2023; 26:e230009. [PMID: 36629621 PMCID: PMC9838238 DOI: 10.1590/1980-549720230009.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/13/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group. METHODS This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group. RESULTS Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27). CONCLUSION The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.
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Urrutia-Pereira M, Mocelin LP, Ellwood P, Garcia-Marcos L, Simon L, Rinelli P, Chong-Neto HJ, Solé D. Prevalence of rhinitis and associated factors in adolescents and adults: a Global Asthma Network study. Rev Paul Pediatr 2023; 41:e2021400. [PMID: 36888752 PMCID: PMC9984151 DOI: 10.1590/1984-0462/2023/41/2021400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/26/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To determine the prevalence of allergic rhinitis and associated factors in adolescents and in their parents/guardians. METHODS A cross-sectional study, applying a standardized and validated written questionnaire. Adolescents (13-14 years old; n=1,058) and their parents/guardians (mean age=42.1 years old; n=896) living in the city of Uruguaiana, southern Brazil, responded to the Global Asthma Network standard questionnaires. RESULTS The prevalence of allergic rhinitis in adolescents was 28.0%, allergic rhinoconjunctivitis, 21.3%, and severe forms of allergic rhinitis, 7.8%. In the adults, the prevalence of allergic rhinitis was 31.7%. Some associated factors with allergic rhinitis in adolescents include low physical exercise (OR 2.16; 95%CI 1.15-4.05), having only one older sibling (OR 1.94; 95CI 1.01-3.72) and daily meat consumption (OR 7.43; 95% CI 1.53-36.11). In contrast, consuming sugar (OR 0.34; 95%CI 0.12-0.93) or olive oil (OR 0.33; 95%CI 0.13-0 .81) once or twice a week, and eating vegetables daily (OR 0.39; 95%CI 0.15-0.99) were considered factors negatively associated. In adults, exposure to fungi at home (OR 5.25; 95%CI 1.01-27.22) and consumption of meat once or twice a week (OR 46.45; 95CI 2.12-1020.71) were factors associated with the medical diagnosis of allergic rhinitis, while low education (OR 0.25; 95%CI 0.07-0.92) was found to be a factor negatively associated. CONCLUSIONS The prevalence of allergic rhinitis in adolescents is high, as well as its medical diagnosis in adults living in Uruguaiana. Environmental factors, especially food habits, were associated with findings in both groups.
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Affiliation(s)
| | | | | | | | - Laura Simon
- Universidade Federal do Pampa, Bagé, RS, Brazil
| | | | | | - Dirceu Solé
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Van Dijk I, Boelen PA, de Keijser J, Lenferink LIM. Assessing DSM-5-TR and ICD-11 prolonged grief disorder in children and adolescents: development of the Traumatic Grief Inventory - Kids - Clinician-Administered. Eur J Psychotraumatol 2023; 14:2197697. [PMID: 37078208 PMCID: PMC10120442 DOI: 10.1080/20008066.2023.2197697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Around 10% of bereaved youths experience symptoms of prolonged grief disorder (PGD). Recently, PGD was included in the two main classification systems for mental disorders: the ICD-11 and DSM-5-TR. Assessing PGD symptoms in youth is currently hindered by the lack of instruments for ICD-11 and DSM-5-TR criteria. To fill this gap, we developed an instrument to assess PGD symptoms in children and adolescents, the Traumatic Grief Inventory - Kids - Clinician-Administered (TGI-K-CA), based on input of grief experts and bereaved children. METHODS Five experts rated the items on alignment with DSM-TR and ICD-11 PGD symptoms and comprehensibility. The adjusted items were then presented to seventeen bereaved youths (Mdnage = 13.0 years, range = 8-17 years). Using the Three-Step Test Interview (TSTI), children were asked to verbalize their thoughts while answering the items. RESULTS Issues raised by experts were mostly related to alignment with the DSM-5-TR/ICD-11 symptom, ambiguous formulation of the items, or low comprehensibility for children and adolescents. Items raising fundamental issues according to experts were adjusted. The TSTI showed that children encountered relatively few problems with the items. Frequently reported problems with some of the items (e.g. regarding comprehensibility) led to final adjustments. CONCLUSION With input from grief experts and bereaved youths, an instrument to assess PGD symptoms as defined in DSM-5-TR and ICD-11 in bereaved youths was finalized. Further quantitative research is currently undertaken to evaluate the instrument's psychometric qualities.
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Affiliation(s)
- I Van Dijk
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - P A Boelen
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
- ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - J de Keijser
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - L I M Lenferink
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
- Department of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, Enschede, the Netherlands
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Kaminer D, Simmons C, Seedat S, Skavenski S, Murray L, Kidd M, Cohen JA. Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial. Eur J Psychotraumatol 2023; 14:2181602. [PMID: 37052081 PMCID: PMC10013405 DOI: 10.1080/20008066.2023.2181602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Background: In low- and middle- income countries (LMICs) trauma exposure among youth is high, but mental health services are critically under-resourced. In such contexts, abbreviated trauma treatments are needed.Objective: To evaluate the efficacy of an abbreviated eight-session version of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) for improving posttraumatic stress disorder (PTSD) and depression symptoms in a sample of South African adolescents.Method: 75 trauma-exposed adolescents (21 males, 54 females; mean age = 14.92, range = 11-19) with posttraumatic stress disorder (PTSD) symptoms were randomly assigned to eight sessions of TF-CBT or to usual services. At baseline, post-treatment and three-month follow-up, participants completed the Child PTSD Symptom Scale for DSM 5 (CPSS-5) and the Beck Depression Inventory II (BDI-II). The trial is registered on the Pan African Trial Registry (PACTR202011506380839).6.Results: 95% of TF-CBT participants completed treatment while only 47% of TAU participants accessed treatment. Intention-to-treat analyses found that the TF-CBT group had a significantly greater reduction in CPSS-5 PTSD symptom severity at post-treatment (Cohen's d = 0. 60, p < .01) and three-month follow-up (Cohen's d = 0.62, p < . 01), and a greater reduction in the proportion of participants meeting the CPSS-5 clinical cut-off for PTSD at both time points (p = .02 and p = .03, respectively). There was also a significantly greater reduction in depression symptom severity in the TF-CBT group at post-treatment (Cohen's d = 0.51, p = .03) and three-month follow-up (Cohen's d = 0.41, p = .05), and a greater reduction in the proportion of TF-CBT participants meeting the BDI clinical cut-off for depression at both time points (p = .02 and p = .03, respectively).Conclusion: The findings provide preliminary evidence of the efficacy of an abbreviated eight-session version of TF-CBT for reducing PTSD and depression symptoms in a LMIC sample of adolescents with multiple trauma exposure.
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Affiliation(s)
- Debra Kaminer
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Candice Simmons
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stephanie Skavenski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laura Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Martin Kidd
- Centre for Statistical Consultation, Department of Statistics and Actuarial Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Judith A Cohen
- Allegheny Health Network, Drexel University College of Medicine, Pittsburgh, PA, USA
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Silvério ABG, Souza DLD, Kuzma GDSP, Mudri GS, Nagel IBF, Silva JCD, Cecconello L, Oliveira RPD, Marchinhacki RW, Soejima SN. Toxic stress on a pediatric population during the COVID-19 pandemic. Rev Paul Pediatr 2023; 41:e2021399. [PMID: 36921169 PMCID: PMC10014016 DOI: 10.1590/1984-0462/2023/41/2021399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/07/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the impact of social isolation as a result of the coronavirus-19 disease (COVID-19) pandemic in children and adolescents aged 0-17 years in Southern Brazil. METHODS This is a cross-sectional study in which 542 questionnaires answered by parents or legal guardians of children and adolescents aged 0-17 years residing in the Brazilian South region, through Google Forms®. Questionnaires answered incompletely or from children outside the stipulated age group and from other regions of the country were excluded from the research. The collected data were organized into descriptive and association tables containing absolute and relative frequencies, medians, averages, standard deviations, quartile deviations, average, and proportion estimates in the form of 95% confidence intervals and the result of the chi-square test of independence. Data analysis was fulfilled with the application aid of Microsoft Excel 2016 and Epi Info version 7.2.1.0 of 01/27/2017. Statistically significant associations were considered when p<0.05. RESULTS There was an increase in the perception of nervousness (62.7%), anxiety (67.7%), and sadness (51.3%) in children and adolescents during the pandemic period. This study evidenced a high prevalence of screens overuse (50.9%) and sedentary lifestyle (39.1%) in this age group during the period. Furthermore, the occurrence of regressive behaviors occurred more frequently in the age group of 3-6 years (57.1%) and between 7 and 10 years (44.6%). CONCLUSIONS It is inferred from this study that one of the implications resulting from the pandemic period is the increase of toxic stress in the pediatric population.
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Orellana L, Schnettler B, Adasme-Berríos C, Lobos G, Miranda-Zapata E, Lapo M. Family profiles based on family life satisfaction in dual-earner households with adolescent children in Chile. Fam Process 2022; 61:906-925. [PMID: 34389987 DOI: 10.1111/famp.12714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 05/31/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
Research has stressed the importance of the family domain for the individual's well-being, but the heterogeneity/homogeneity of satisfaction with family life between and within families have not previously assessed. This study identifies family profiles based on the level of family life satisfaction in mother-father-adolescent triads and determines whether profiles differ in terms of the three family members' perceived family support, importance assigned to the family, both parents' work-life balance and mental health, and the household's economic situation. The sample was composed of 303 families of different-sex dual-earner parents with one child aged between 10 and 17 years, from Temuco, Chile. A Latent Profile Analysis was used to identify three profiles: Families with low family satisfaction (17.80%), Families with medium family satisfaction (68.14%), and Families with high family satisfaction (14.06%). Profiles also differed in the three family members' perceived family support and importance assigned to the family, both parents' work-life balance and mental health, and in the household's income. Mothers, fathers, and adolescents in these profiles also differed from one another in these variables. The main variable related to the family members' satisfaction with family life was the parents' mental health problems. Family life satisfaction in dual-earner couples with adolescent children is heterogenous, and these profiles draw attention to indicators of parent-child well-being. Families with lower levels of family satisfaction require particular attention in research and interventions, as these families may report a lower household income, and the parents may experience higher rates of depression, anxiety, and stress, and diverging levels of work-life balance.
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Affiliation(s)
- Ligia Orellana
- Centro de Excelencia en Psicología Economía y del Consumo, Núcleo Científico Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| | - Berta Schnettler
- Centro de Excelencia en Psicología Economía y del Consumo, Núcleo Científico Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
- Facultad de Ciencias Agropecuarias y Forestales, Universidad de La Frontera, Temuco, Chile
- Scientific and Technological Bioresource Nucleus (BIOREN-UFRO), Universidad de La Frontera, Temuco, Chile
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | | | - Germán Lobos
- Facultad de Economía y Negocios, Universidad de Talca, Talca, Chile
| | - Edgardo Miranda-Zapata
- Centro de Excelencia en Psicología Economía y del Consumo, Núcleo Científico Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| | - María Lapo
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Ibrahim M, Levy S, Gallop B, Krauthamer Ewing S, Hogue A, Chou J, Diamond G. Therapist Adherence to Two Treatments for Adolescent Suicide Risk: Association to Outcomes and Role of Therapeutic Alliance. Fam Process 2022; 61:183-197. [PMID: 33904589 DOI: 10.1111/famp.12660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In psychotherapy research, adherence refers to the extent to which therapists deliver a treatment as intended. This study examined whether therapist adherence to two different manualized treatments was associated with improved client outcomes and whether the association was moderated by therapeutic alliance. The study sample included 320 video recordings of therapy sessions from 118 cases in a randomized controlled trial (RCT) comparing attachment-based family therapy (ABFT) with family-enhanced nondirective supportive therapy (FE-NST). Recordings were selected from early, middle, and late stages of treatment. The adherence measure consisted of 24 items representing essential therapist interventions from both treatments. Trained raters coded tapes from both therapies. Adolescent self-report of alliance was measured at session 4. Adherence to ABFT was associated with a significant increase in family cohesion at mid-treatment but not at posttreatment. Adherence to FE-NST was significantly associated with an increase in suicide ideation posttreatment. Using therapeutic alliance as a moderator, adherence to ABFT was significantly associated with a reduction in suicide ideation, family conflict, and higher client satisfaction posttreatment. Alliance did not positively affect the association of FE-NST adherence to outcomes. Findings suggest that adherence to ABFT interventions may be better linked to treatment outcomes when adolescents feel a strong alliance with their therapist. Implications for future research and therapist training are explored.
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Affiliation(s)
| | - Suzanne Levy
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
| | - Bob Gallop
- University of West Chester, Philadelphia, PA, USA
| | - Stephanie Krauthamer Ewing
- Counseling and Family Therapy Program, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | | | - Jessica Chou
- Counseling and Family Therapy Program, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
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Shaw D, Allen L, Chan C, Kives S, Popadiuk C, Robertson D, Shapiro J. Directive clinique n o 423 : Interventions chirurgicales et thérapeutiques esthétiques génitales féminines. J Obstet Gynaecol Can 2022; 44:215-226.e1. [PMID: 35181012 DOI: 10.1016/j.jogc.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIF Fournir aux chirurgiens et autres fournisseurs de soins canadiens qui réalisent des interventions chirurgicales ou thérapeutiques esthétiques génitales féminines, et tout praticien demandeur, des directives fondées sur des données probantes en réponse à l'augmentation des demandes et de la disponibilité des interventions chirurgicales et thérapeutiques vaginales et vulvaires sortant du cadre traditionnel de la reconstruction avec indication médicale. POPULATION CIBLE Les femmes de tous âges qui consultent pour subir une intervention chirurgicale ou thérapeutique esthétique génitale. BéNéFICES, RISQUES ET COûTS: Les professionnels de la santé qui prodiguent des soins aux femmes jouent un rôle important en renseignant les femmes sur leur anatomie et en les aidant à prendre conscience des variations individuelles. La plupart des femmes qui demandent une intervention chirurgicale ou thérapeutique esthétique génitale féminine ont des organes génitaux normaux, et jusqu'à 87 % d'entre elles sont rassurées par des conseils. À l'heure actuelle, étant donné le manque de données probantes cliniques et scientifiques rigoureuses sur l'efficacité et l'innocuité à court et à long terme, il n'y a aucune base pour se prononcer en faveur des interventions chirurgicales ou thérapeutiques esthétiques génitales féminines sans indication médicale. Les interventions chirurgicales ou thérapeutiques esthétiques génitales féminines sont généralement réalisées dans le secteur privé, où les coûts sont assumés par la patiente. DONNéES PROBANTES: La littérature publiée a été rassemblée par des recherches dans les bases de données Medline, Scopus et Cochrane Library au moyen de termes et mots clés pertinents et validés. Les termes de recherche sélectionnés se composaient de mots clés sur les interventions chirurgicales ou thérapeutiques esthétiques génitales féminines (labiaplasty, surgery, vaginal laser therapy, laser vaginal tightening, vaginal laser, vaginal rejuvenation, vaginal relaxation syndrome, hymenoplasty, vaginal cosmetic procedures) combinés à female genital counselling, consent, satisfaction, follow-up, adolescent et body dysmorphic or body dysmorphia. La recherche a été limitée aux articles publiés après 2012 afin de mettre à jour la documentation depuis la dernière directive à ce sujet. Les résultats ont été restreints aux revues systématiques, aux essais cliniques randomisés et aux études observationnelles. Les études ont été limitées à celles menées chez l'humain seulement, et aucune restriction linguistique n'a été appliquée. La recherche a été effectuée le 20 mai 2020 et mise à jour le 10 novembre 2020. MéTHODES DE VALIDATION: Les auteures ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique d'évaluation, de développement et d'évaluation (GRADE). Voir l'annexe A en ligne (tableau A1 pour les définitions et tableau A2 pour l'interprétation des recommandations fortes et faibles). PROFESSIONNELS CONCERNéS: Gynécologues, fournisseurs de soins primaires, chirurgiens réalisant des interventions chirurgicales et/ou thérapeutiques esthétiques génitales féminines. RECOMMANDATIONS.
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Teixeira JC, Vianna MSC, Vale DB, Arbore DM, Perini THW, Couto TJT, Neto JP, Zeferino LC. School-based HPV Vaccination: The Challenges in a Brazilian Initiative. Rev Bras Ginecol Obstet 2021; 43:926-931. [PMID: 34933386 PMCID: PMC10183876 DOI: 10.1055/s-0041-1740279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE The present study assesses the implementation and the impact after 2 years of a school-based human papillomavirus (HPV) vaccination program in a Brazilian city. METHODS A prospective study assessing the implementation of the program, offering quadrivalent HPV vaccine in two annual doses to girls and boys aged from 9 to 10 years old. The program was started in the city of Indaiatuba, state of São Paulo, Brazil, in 2018, and had authorization from the National Immunization Program. The number of HPV vaccine first doses applied and the coverage in 2018 was calculated and compared to the year 2017. There were described events that have influenced the results. RESULTS The program invited 4,878 children through schools (87.1% of the target population), and 7.5% refused vaccination. Several concurrent events required or competed for health professionals of the vaccination teams. The coverage of the first dose (between 9 and 10 years old) was 16.1% in 2017 and increased to 50.5% in 2018 (p < 0.0001). The first dose in all ages increased 78% in 2018 compared with 2017 (6,636/3,733). Competing demands over the program continued in 2019, and the first dose coverage dropped (26.9%). For 2020, a municipal law instituted school-based vaccination and the creation of dedicated teams for vaccination, and these strategies are waiting to be tested. CONCLUSION School-based annual HPV vaccination in children between 9 and 10 years old was feasible and increased vaccination coverage, regardless of gender, although the program was vulnerable to competing events.
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Affiliation(s)
- Julio Cesar Teixeira
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Mariana Silva Castro Vianna
- Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
| | - Diama Bhadra Vale
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Daniella Moretti Arbore
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Thais Helena Wilmers Perini
- Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
| | - Tulio Jose Tomass Couto
- Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
| | - Jose Pedroso Neto
- Epidemiological Surveillance and Women Health Secretariat, Administration of the City of Indaiatuba – Mayor's Office, Indaiatuba, SP, Brazil
| | - Luiz Carlos Zeferino
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Rigatto K. Pre-Hypertension in Adolescents: A New Old Issue. Arq Bras Cardiol 2021; 117:655-656. [PMID: 34709292 PMCID: PMC8528357 DOI: 10.36660/abc.20210702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Katya Rigatto
- Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS – Brasil
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Simmons C, Meiser-Stedman R, Baily H, Beazley P. A meta-analysis of dropout from evidence-based psychological treatment for post-traumatic stress disorder (PTSD) in children and young people. Eur J Psychotraumatol 2021; 12:1947570. [PMID: 34377359 PMCID: PMC8344790 DOI: 10.1080/20008198.2021.1947570] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Despite the established evidence base of psychological interventions in treating PTSD in children and young people, concern that these trauma-focused treatments may 'retraumatise' patients or exacerbate symptoms and cause dropout has been identified as a barrier to their implementation. Dropout from treatment is indicative of its relative acceptability in this population. OBJECTIVE Estimate the prevalence of dropout in children and young people receiving a psychological therapy for PTSD as part of a randomized controlled trial (RCT). METHODS A systematic search of the literature was conducted to identify RCTs of evidence-based treatment of PTSD in children and young people. Proportion meta-analyses estimated the prevalence of dropout. Odds ratios compared the relative likelihood of dropout between different treatments and controls. Subgroup analysis assessed the impact of potential moderating variables. RESULTS Forty RCTs were identified. Dropout from all treatment or active control arms was estimated to be 11.7%, 95% CI [9.0, 14.6]. Dropout from evidence-based treatment (TFCBTs and EMDR) was 11.2%, 95% CI [8.2, 14.6]. Dropout from non-trauma focused treatments or controls was 12.8%, 95% CI [7.6, 19.1]. There was no significant difference in the odds of dropout when comparing different modalities. Group rather than individual delivery, and lay versus professional delivery, were associated with less dropout. CONCLUSIONS Evidence-based treatments for children and young people with PTSD do not result in higher prevalence of dropout than non-trauma focused treatment or waiting list conditions. Trauma-focused therapies appear to be well tolerated in children and young people.
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Affiliation(s)
- Caroline Simmons
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.,Child and Adolescent Mental Health Services Eating Disorder Pathway, Cambridgeshire and Peterborough Mental Health Foundation Trust (CPFT)
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Hannah Baily
- Child and Adolescent Mental Health Services Eating Disorder Pathway, Cambridgeshire and Peterborough Mental Health Foundation Trust (CPFT)
| | - Peter Beazley
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
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Obach A, Hasen F, Cabieses B, D’Angelo C, Santander S. [Knowledge, access and use of the health system by migrant adolescents in Chile: results of an exploratory study]. Rev Panam Salud Publica 2020; 44:e175. [PMID: 33417659 PMCID: PMC7778462 DOI: 10.26633/rpsp.2020.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/20/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To identify the knowledge, access, and use of the health system by migrant adolescents, and the barriers to access and use of the health system in that population in Chile. METHODS Observational, cross-sectional exploratory study applied in a participatory workshop with migrant adolescents (N=30) in three municipalities of the city of Santiago, Chile. Multimethods study. A baseline survey on the migration process and experiences in the health system was applied, with descriptive data analysis. From the qualitative point of view, discussion groups (n=5) and participatory workshops (n=2) were carried out with migrant adolescents. RESULTS Sixty percent of the adolescents said they did not know if they were registered in the health system, and half of them had not used it. Time of residence was identified as a relevant factor for the effective use of some health benefits. Administrative barriers to access the health system were recognized, such as immigration status, perception of obligatory adult companionship, and experiences of discrimination in care. Specific needs were identified in sexual and reproductive health, such as access to condoms, and mental health care from specialists. As facilitators of access and use, experiences of proper treatment and the presence of the health sector in schools were highlighted. CONCLUSIONS Lack of information about the health system and various barriers to access and use by migrant adolescents were identified. Based on the results, general recommendations are proposed for the country and the region to improve the health of migrant adolescents.
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Affiliation(s)
- Alexandra Obach
- Universidad del DesarrolloSantiagoChileUniversidad del Desarrollo, Santiago, Chile.
| | - Felipe Hasen
- Ministerio de Salud de ChileSantiagoChileMinisterio de Salud de Chile, Santiago, Chile
| | - Báltica Cabieses
- Universidad del Desarrollo, Santiago, Chile; Universidad de York, YorkReino UnidoUniversidad del Desarrollo, Santiago, Chile; Universidad de York, York, Reino Unido
| | - Cettina D’Angelo
- Ministerio de Salud de ChileSantiagoChileMinisterio de Salud de Chile, Santiago, Chile
| | - Sylvia Santander
- Ministerio de Salud de ChileSantiagoChileMinisterio de Salud de Chile, Santiago, Chile
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Abstract
Family connectedness has important implications for adolescents' well-being, contributing to their physical, psychological, and social health. However, little is known about the mechanisms underlying these effects. The present longitudinal study examined the process by which family connectedness, as perceived by adolescents, predicted greater positive and fewer negative health behaviors in adolescents over time. In particular, we sought to determine whether adaptive and maladaptive coping strategies mediated the link between family connectedness and adolescents' self-reported health status. Data were obtained from 1,774 New Zealand adolescents aged 10-17 years, who completed a self-report survey three times at one-year intervals. With longitudinal mediation path models, we tested whether maladaptive and adaptive coping strategies at T2 functioned as mediators between family connectedness at T1 and overall health, vitality, sleep sufficiency, body satisfaction, substance use, and self-harm at T3. Findings revealed that family connectedness predicted greater levels of adaptive coping, which, in turn, predicted better health indicators but not decreases in ill-health indicators. Furthermore, family connectedness predicted lower maladaptive coping, which, in turn, predicted higher levels of positive health outcomes and fewer negative health outcomes. Results showed that the positive effect of family connectedness on adolescents' health occurred through increased use of adaptive coping strategies, decreased use of maladaptive coping strategies, or both. These results have important implications for practitioners working with adolescents and parents, as well as for health promotion program developers.
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Affiliation(s)
- Christine Gervais
- Department of Nursing, Universite du Quebec en Outaouais, St-Jérôme, QC, Canada
| | - Paul E Jose
- Department of Psychology, Victoria University of Wellington, Wellington, New Zealand
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de Oliveira JM, Bernardes PS, Serpa GHC, Siqueira GDDJ, Noll M, Venâncio PEM, Soares V. BIOELECTRICAL VECTOR ANALYSIS IN OBESE ADOLESCENTS. Rev Paul Pediatr 2020; 38:e2019017. [PMID: 32667470 PMCID: PMC7357597 DOI: 10.1590/1984-0462/2020/38/2019017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/23/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the hydration of obese and non-obese adolescents by vectorial bioimpedance analysis, in addition to verifying the associations between obesity and bioelectrical impedance vectorial analysis (BIVA) parameters. METHODS A cross-sectional study with adolescents between 14 and 18 years old (n=489, 300 boys and 189 girls). Electric bioimpedance (BIA; Quantum_II, RJL system, Rome, Italy) provided resistance and reactance parameters to calculate phase angle (PA), fat-free mass (FFM) and body fat (%BF). The confidence ellipses were compared, and the construction of the tolerance ellipses allowed individual and qualitative evaluation of the vectors and classification in dehydrated, normohydrated and hyperhydrated. RESULTS 78 obese and 411 eutrophic adolescents participated. Resistance (p<0.001) and reactance (p<0.001) and their normalization by stature (p<0.001) were reduced in the obese, whereas the PA was higher (p=0.003). %BF was 11.3% higher in obese adolescents. The main vector of the obese, both male (D=1.38; p<0.001) and female (D=1.49; p<0.001), indicated greater hydration. The ellipse of tolerance of the total sample showed that 25 (32.1%) were hyperhydrated and 02 (2.6%) vectors positioned in the sense of dehydration. A total of 17 (53.2%) girls and 16 (34.8%) boys were hyperhydrated. Logistic regression showed an inverse relation of BMI with resistance (p<0.001), reactance (p<0.001) and both normalized by stature. Adolescents with increased PA (p<0.001) were twice as likely to present obesity. CONCLUSIONS Obese adolescents were hyperhydrated and there was an inverse relationship of BMI with resistance and direct with PA.
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Benson J, Severn C, Hudnut-Beumler J, Simon SL, Abramson N, Shomaker LB, Gulley LD, Taylor A, Kelsey MM, Nadeau KJ, Zeitler PS, Pyle L, Cree-Green M. Depression in Girls With Obesity and Polycystic Ovary Syndrome and/or Type 2 Diabetes. Can J Diabetes 2020; 44:507-513. [PMID: 32792104 DOI: 10.1016/j.jcjd.2020.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Polycystic ovary syndrome (PCOS) is a common reproductive/metabolic condition associated with obesity, type 2 diabetes (T2D) and depression in adult women. Depression in adults is related to PCOS dermatologic manifestations. Adolescents with obesity with or without T2D have elevated depression symptoms, but data from youth with PCOS and obesity with/without T2D are limited. METHODS Our study included girls, aged 11 to 17 years, with obesity and PCOS, PCOS+T2D or T2D, who were newly seen in an obesity complications clinic after March 2016. All participants had Center for Epidemiologic Studies-Depression (CES-D, 20 items) scores obtained within 6 months of PCOS or T2D diagnosis. Data on history of psychiatric diagnosis and treatment, metabolic syndrome and severity of acne and hirsutism were collected through chart review. RESULTS One hundred five girls (47 with PCOS, 14 with PCOS+T2D, 44 with T2D) had similar age (15±1.8 years) and body mass index z scores (2.2±0.4). CES-D scores ≥16, indicating elevated depression symptoms, and CES-D scores ≥24, indicating severe depression symptoms, were observed in 60% and 30% of girls with PCOS, 78% and 71% of those with PCOS+T2D and 39% and 21% of those with T2D, respectively (p<0.0001 for both cutpoints). A higher CES-D score was not associated with severity of hirsutism or acne (p>0.05 for both). CONCLUSIONS Adolescents with PCOS and obesity have higher rates of elevated depression symptoms compared with girls with T2D, which is not related to worse dermatologic symptoms. Because depression may impact both PCOS and T2D management and adherence to therapy, greater efforts should be made to screen for and address mental health in adolescents with PCOS and obesity, especially if T2D is present.
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Affiliation(s)
- Jessie Benson
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Cameron Severn
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States
| | - Julia Hudnut-Beumler
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Stacey L Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Natalie Abramson
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Lauren B Shomaker
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, United States
| | - Lauren D Gulley
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, United States
| | - Anya Taylor
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Megan M Kelsey
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Kristen J Nadeau
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Philip S Zeitler
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Laura Pyle
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Melanie Cree-Green
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States.
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Zanini JLSS, Rodrigues TMB, Barra CB, Filgueiras MFTF, Silva IN. INTIMA-MEDIA THICKNESS OF THE CAROTID ARTERIES IS AFFECTED BY PUBERTAL MATURATION IN HEALTHY ADOLESCENTS. Rev Paul Pediatr 2019; 37:428-434. [PMID: 31291443 PMCID: PMC6821474 DOI: 10.1590/1984-0462/;2019;37;4;00010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/24/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To contribute to the assessment of normal parameters of carotid intima-media thickness (CIMT) in healthy adolescents. METHODS A cross-sectional study was conducted through clinical, laboratory and ultrasound evaluation in 61 healthy adolescents. The inclusion criteria consisted of being in good health. The exclusion criteria were: presence or history of any chronic disease; being obese or overweight according to the World Health Organization (WHO) established criterion; continuous use of medication; or presenting a febrile condition or requiring medication within 48-hours prior to assessment. The pubertal stages were evaluated using the Tanner criteria. The high-resolution B-mode ultrasound examinations were performed according to the recommendations of the Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. RESULTS Adolescents were 14±2.6 years old, 62.3% female, 19 (31%) at early puberty (Tanner II and III), and 38 (62%) at late puberty (Tanner IV and V). They presented normal clinical and laboratorial parameters. CIMT values were 0.46±0.04 to 0.55±0.04 mm on the right and 0.48±0.02 to 0.53±0.04 mm on the left, according to pubertal maturation. CIMT values increased significantly on the right and left sides, according to pubertal stage (p<0.001 and p=0.016), and maximum internal diameters of the common carotid artery (p<0.025 and p<0.003). It was higher in males compared to females. CONCLUSIONS An increase in CIMT in the healthy adolescents group, according to both age, and the degree of pubertal maturation should be considered when evaluating adolescents in diagnostic procedures.
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Emerson ND, Morrell HER, Neece C, Tapanes D, Distelberg B. Longitudinal Model Predicting Self-Concept in Pediatric Chronic Illness. Fam Process 2019; 58:100-113. [PMID: 29663349 DOI: 10.1111/famp.12361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although self-concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent-child attachment have been linked to self-concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3-month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self-concept, as predicted by depressive symptoms and parent-child attachment, in a sample of 50 youths (Mage = 14.56, SDage = 1.82) participating in MEND. Both "time spent in the program" and decreases in depressive symptoms were associated with increases in self-concept over time. Higher baseline levels of avoidant attachment to both mother and father were also associated with greater initial levels of self-concept. Targeting depressive symptoms and supporting adaptive changes in attachment may be key to promoting a healthy self-concept in pediatric CI populations. The association between avoidant attachment and higher baseline self-concept scores may reflect differences in participants' autonomy, self-confidence, or depression. Limitations of the study include variability in the amount of time spent in the program, attrition in final time point measures, and the inability to fully examine and model all potential covariates due to a small sample size (e.g. power).
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Affiliation(s)
| | | | - Cameron Neece
- Department of Psychology, Loma Linda University, Loma Linda, CA
| | - Daniel Tapanes
- Behavioral Medicine Center, Loma Linda University, Redlands, CA
| | - Brian Distelberg
- Department of Counseling and Family Sciences and Behavioral Medicine Center, Loma Linda University, Loma Linda, CA
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Gómez CO, Monsiváis MGM. Intención de implementar un plan de acción para el uso del condón en adolescentes: Action plan for condom use implementation intentions in adolescents. Hisp Health Care Int 2018; 16:1540415318802421. [PMID: 30270656 DOI: 10.1177/1540415318802421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Introducción: La intención de implementar un plan para el uso del condón ha sido efectiva para alcanzar diversas conductas de salud, desarrollarla permitirá a los adolescentes contemplar conductas anticipadas para su uso, de esta manera podrán disminuir riesgo de adquirir una Infección de Transmisión Sexual (ITS). El objetivo del estudio fue determinar si los adolescentes cuentan con la intención de implementar un plan de acción para el uso del condón. Método: El diseño del estudio fue descriptivo transversal. La muestra se conformó por 130 adolescentes inscritos en una preparatoria pública del área metropolitana de Monterrey, Nuevo León, México. Se incluyeron adolescentes que declararon haber iniciado vida sexual y aceptaron participar en el estudio. Resultados: Los participantes cuentan con la intención de implementar un plan para el uso del condón de forma incompleta, principalmente para negociar y usar el condón. Los hombres mostraron ligeramente mayor intención de implementar un plan de forma general, para adquirir y llevar un condón. Conclusión: Es necesario que los adolescentes adquieran habilidades que le permitan fortalecer la intención de implementar un plan para el uso del condón. Se requiere incorporar en los programas de prevención de ITS diferentes estrategias que puedan brindar o reforzar habilidades para planear el uso del condón.
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Affiliation(s)
- Claudia Orozco Gómez
- 1 Estudiante de Doctorado en Ciencias de Enfermería, Universidad Autónoma de Nuevo León, Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Monterrey, Nuevo León, México Contribución: Conceptualización, diseño, análisis e interpretación de datos
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Brody JL, Scherer DG, Turner CW, Annett RD, Dalen J. A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents. Fam Process 2018; 57:510-524. [PMID: 28590541 PMCID: PMC5720926 DOI: 10.1111/famp.12298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Individual and group-based psychotherapeutic interventions increasingly incorporate mindfulness-based principles and practices. These practices include a versatile set of skills such as labeling and attending to present-moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy. This paper describes the benefits of mindfulness-based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family-based mindfulness intervention might be evaluated.
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Affiliation(s)
- Janet L. Brody
- Center for Family and Adolescent ResearchOregon Research InstituteAlbuquerqueNM
| | - David G. Scherer
- Department of Psychological and Brain SciencesUniversity of MassachusettsAmherstMA
| | | | - Robert D. Annett
- Department of PediatricsUniversity of Mississippi Medical CenterJacksonMS
| | - Jeanne Dalen
- Center for Family and Adolescent ResearchOregon Research InstituteAlbuquerqueNM
- Department of PediatricsUniversity of New Mexico Health Sciences CenterAlbuquerqueNM
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Mejia R, Mejia R, Morello P, Pérez A, Peña L, Braun SN, Santillan EA, Gutierrez IB, Hernández RP, Viveros ENA, Kollath-Cattano C, Thrasher JF, Sargent J. Movies promote tobacco use amongst adolescents: The need for policies to prevent this phenomenon. Rev Asoc Med Argent 2018; 131:24-31. [PMID: 30294003 PMCID: PMC6172004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Tobacco use is the primary preventable cause of death and disability in the world. To combat the tobacco epidemic, most countries have signed and ratified the World Health Organzation's Framework Convention on Tobacco Control (WHO FCTC). Article 13 of this treaty requires implementation of a comprehensive ban on tobacco advertising, promotion and sponsorship. Implementation guidelines for Article 13 recognize that the depiction of tobacco use in commercially-produced films promotes tobacco use amongst young people. In this article we review the relationship between the tobacco industry and the movie industry over the past 100 years; the cross sectional and longitudinal studies that demonstrate a causal relationship between exposure to movie smoking depictions and youth smoking initiation; and the policy interventions recommended by the WHO to limit youth exposure to tobacco in movies.
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Affiliation(s)
- Raul Mejia
- "Tabaco en el Cine y Tabaquismo en los Jóvenes en América Latina"
| | - Raul Mejia
- Centro de Estudios de Estado y Sociedad (CEDES) y Hospital de Clínicas Jose de San Martín UBA
| | | | | | - Lorena Peña
- Centro de Estudios de Estado y Sociedad (CEDES)
| | - Sandra Noemí Braun
- Centro de Estudios de Estado y Sociedad (CEDES) y Hospital de Clínicas Jose de San Martín UBA
| | | | | | | | | | | | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - James Sargent
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, USA
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Colón-López V, Fernández-Espada N, Vélez C, Gonzalez VJ, Diaz-Toro EC, Calo WA, Savas LS, Pattatucci A, Fernández ME. Communication about sex and HPV among Puerto Rican mothers and daughters. Ethn Health 2017; 22:348-360. [PMID: 27882783 PMCID: PMC5557394 DOI: 10.1080/13557858.2016.1246938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Although opportunities to vaccinate against human papillomavirus (HPV) are available, vaccination rates in Puerto Rico remain low. Communication between parents and adolescents about sexual topics may influence decisions about HPV vaccination uptake, particularly among young women; yet, few studies have addressed this issue. This qualitative study explored Puerto Rican mothers' and daughters' communication on sex-related topics, and HPV, including the HPV vaccine. DESIGN Thirty participants, including 9 mothers and 21 daughters, participated in seven focus groups. Participants were divided into groups of mothers and daughters, and further stratified by vaccination status. Transcripts were analyzed using a modified grounded theory approach to identify emergent themes. RESULTS Focus group data revealed four main themes: (1) limited parent-daughter communication about sex-related topics; (2) daughters' discomfort discussing sex-related topics with their parents; (3) parental focus on abstinence; and, (4) limited parent-daughter communication about HPV and the HPV vaccine. CONCLUSION Although daughters in this study struggled with feelings of embarrassment, invasion of privacy, encouragement of abstinence, and the fear of parents' reaction to them being sexually active prior to marriage, they also recognized the need to increase the parent-daughter communication about sex-related topics including HPV and the HPV vaccine. Educational efforts should target both daughters and parents to increase communication skills and self-efficacy and to enable them to discuss sexual health in open and nonjudgmental conversations.
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Affiliation(s)
- Vivian Colón-López
- Division of Population Health Sciences, PR Comprehensive Cancer Center, University of Puerto Rico, Medical Sciences Campus, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344 787-772-8300 ext. 1225
- Health Services Administration, Evaluation Program, Graduate School of Public Health, University of Puerto Rico; PMB 371 P.O. Box 70344 San Juan, PR 00936-8344, 787-772-8300 ext. 1225
| | - Natalie Fernández-Espada
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin Street, 25 floor, Houston, Texas 77030-3875. 713-500-9659, 713-500-9626, 713-500-9638
| | - Camille Vélez
- UPR-MDACC Partnership for Excellence in Cancer Research Program, University of Puerto Rico, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344, 787-772-8300 ext. 1150
| | - Velda J. Gonzalez
- School of Nursing, University of Puerto Rico, Medical Sciences Campus, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344, 787-758-2525 ext. 1986
| | - Elba C. Diaz-Toro
- Division of Population Health Sciences, PR Comprehensive Cancer Center, University of Puerto Rico, Medical Sciences Campus, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344 787-772-8300 ext. 1225
- Department of Restorative Sciences, School of Dental Medicine, University of Puerto Rico; PMB 371 P.O. Box 70344 San Juan, PR 00936-8344, 787-772-8300 ext. 1101
| | - William A. Calo
- University of North Carolina, Gillings School of Global Public Health, Department of Health Policy and Management, 1104-I McGavran-Greenberg Bldg, CB 7411, Chapel Hill, NC 27599, (919) 966-4784
| | - Lara S. Savas
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin Street, 25 floor, Houston, Texas 77030-3875. 713-500-9659, 713-500-9626, 713-500-9638
| | - Angela Pattatucci
- UPR-MDACC Partnership for Excellence in Cancer Research Program, University of Puerto Rico, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344, 787-772-8300 ext. 1150
- Health Services Administration, Evaluation Program, Graduate School of Public Health, University of Puerto Rico; PMB 371 P.O. Box 70344 San Juan, PR 00936-8344, 787-772-8300 ext. 1225
| | - María E. Fernández
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin Street, 25 floor, Houston, Texas 77030-3875. 713-500-9659, 713-500-9626, 713-500-9638
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da Costa IFAF, Medeiros CCM, da Costa FDAF, de Farias CRL, Souza DR, Adriano WS, Simões MODS, Carvalho DF. Adolescentes: comportamento e risco cardiovascular. J Vasc Bras 2017; 16:205-213. [PMID: 29930648 PMCID: PMC5868936 DOI: 10.1590/1677-5449.011816] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/24/2017] [Indexed: 11/22/2022] Open
Abstract
Contexto Os benefícios para a saúde decorrentes da prática regular de atividade física estão bem documentados. Entretanto, são raros os estudos associando essa prática ao comportamento sedentário e ao risco cardiovascular em adolescentes. Objetivos Pretende-se avaliar a prática de atividade física, o comportamento sedentário e a associação com o risco cardiovascular mensurado pelo escore Pathobiological Determinants of Atherosclerosis in Youth (PDAY). Métodos Estudo transversal desenvolvido nas escolas públicas estaduais de Campina Grande, PB, Brasil, com 576 adolescentes de 15 a 19 anos, incluindo variáveis socioeconômicas, demográficas, de estilo de vida e clínicas. Os dados foram coletados através de formulário validado, antropometria, aferição da pressão arterial e exames laboratoriais. Foram utilizadas medidas descritivas, teste do qui-quadrado de Pearson e regressão logística binomial. Trabalhou-se com o SPSS 22.0 se adotou intervalo de confiança de 95%. Resultados A idade média foi de 16,8 anos. A maioria dos adolescentes era do sexo feminino (66,8%), não branco (78.7%) e pertencente às classes C, D e (69,1%). Quanto ao sedentarismo e à insuficiência de atividade física, as prevalências foram de 78,1% e 60,2%, respectivamente. De acordo com o escore PDAY, 10,4% dos adolescentes apresentaram alto risco cardiovascular; 31,8% risco intermediário; e 57,8%, risco baixo. Verificou-se que PDAY esteve associado ao sexo e à adiposidade abdominal. Conclusões Ficou comprovado que adiposidade abdominal e sexo masculino representam importantes fatores de risco cardiovascular em adolescentes. Considerando-se a presença de um fator de risco modificável, medidas preventivas voltadas ao estilo de vida são essenciais.
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Affiliation(s)
| | | | | | | | - Diogo Rodrigues Souza
- Universidade Estadual da Paraíba – UEPB, Programa de Mestrado em Saúde Pública, Campina Grande, PB, Brasil.
| | - Wellington Sabino Adriano
- Universidade Federal de Campina Grande – UFCG, Centro de Educação e Saúde, Campina Grande, PB, Brasil.
| | | | - Danielle Franklin Carvalho
- Universidade Estadual da Paraíba – UEPB, Programa de Mestrado em Saúde Pública, Campina Grande, PB, Brasil.
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36
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Ahmed S, Sabelli RA, Simon K, Rosenberg NE, Kavuta E, Harawa M, Dick S, Linzie F, Kazembe PN, Kim MH. Index case finding facilitates identification and linkage to care of children and young persons living with HIV/AIDS in Malawi. Trop Med Int Health 2017; 22:1021-1029. [PMID: 28544728 PMCID: PMC5575466 DOI: 10.1111/tmi.12900] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Evaluation of a novel index case finding and linkage-to-care programme to identify and link HIV-infected children (1-15 years) and young persons (>15-24 years) to care. METHODS HIV-infected patients enrolled in HIV services were screened and those who reported untested household members (index cases) were offered home- or facility-based HIV testing and counselling (HTC) of their household by a community health worker (CHW). HIV-infected household members identified were enrolled in a follow-up programme offering home and facility-based follow-up by CHWs. RESULTS Of the 1567 patients enrolled in HIV services, 1030 (65.7%) were screened and 461 (44.8%) identified as index cases; 93.5% consented to HIV testing of their households and of those, 279 (64.7%) reported an untested child or young person. CHWs tested 711 children and young persons, newly diagnosed 28 HIV-infected persons (yield 4.0%; 95% CI: 2.7-5.6), and identified an additional two HIV-infected persons not enrolled in care. Of the 30 HIV-infected persons identified, 23 (76.6%) were linked to HIV services; 18 of the 20 eligible for ART (90.0%) were initiated. Median time (IQR) from identification to enrolment into HIV services was 4 days (1-8) and from identification to ART start was 6 days (1-8). CONCLUSIONS Almost half of HIV-infected patients enrolled in treatment services had untested household members, many of whom were children and young persons. Index case finding, coupled with home-based testing and tracked follow-up, is acceptable, feasible and facilitates the identification and timely linkage to care of HIV-infected children and young persons.
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Affiliation(s)
- Saeed Ahmed
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi.,Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Rachael A Sabelli
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi
| | - Katie Simon
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi.,Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | | | - Elijah Kavuta
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi
| | - Mwelura Harawa
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi
| | - Spencer Dick
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi
| | | | - Peter N Kazembe
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi.,Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Maria H Kim
- Abbott Fund Children's Clinical Center of Excellence, Baylor College of Medicine, Lilongwe, Malawi.,Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
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Abstract
Family efficacy, which refers to a family's belief in its ability to produce a desired outcome, has been shown to protect adolescents from risky health behaviors. Few studies have examined family efficacy within diverse populations, however, and understanding of how efficacy is framed and formed within the context of cultural and familial values is limited. This descriptive qualitative study examined sources of family efficacy within ethnically and socioeconomically diverse families, evaluating how such families develop and exercise family efficacy with the intent to protect adolescents from risky health behaviors (i.e., marijuana and alcohol use and early sexual activity). We collected qualitative data via two semi-structured interviews, 4-6 months apart, with 31 adolescents (ages 12-14) and their parent/s, for total of 148 one-on-one interviews. Thematic analysis identified three distinct domains of family efficacy: relational, pragmatic, and value-laden. Prior experiences and cultural background influenced the domain/s utilized by families. Significantly, families that consistently tapped into all three domains were able to effectively manage personal and family difficulties; these families also had family strategies in place to prevent adolescents from risky behaviors. Health professionals could utilize this concept of multidimensional family efficacy to promote health within culturally diverse families.
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Affiliation(s)
- Tsui-Sui A Kao
- School of Nursing, University of Michigan, Ann Arbor, MI
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38
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Robbins MS, Alexander JF, Turner CW, Hollimon A. Evolution of Functional Family Therapy as an Evidence-Based Practice for Adolescents with Disruptive Behavior Problems. Fam Process 2016; 55:543-57. [PMID: 27329051 DOI: 10.1111/famp.12230] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This article summarizes the evolution of functional family therapy (FFT) based upon four decades of clinical practice and scientific scrutiny through research evidence. FFT research has evolved from an initial focus upon clinical process research, which examined sequential exchanges between therapists and family members. A key element of this research has been an examination of the way in which clinicians acquire, consolidate, and maintain the skills needed to implement FFT effectively with youth and families. Many randomized efficacy and effectiveness studies have evaluated the impact of FFT across diverse clinical populations. Subsequent research investigated factors that influence the effectiveness of implementation across more than 300 clinical settings in which more than 2,500 trained clinicians have provided service to nearly 400,000 families. Another important set of investigations concerned the cost-effectiveness of the interventions.
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Affiliation(s)
- Michael S Robbins
- Functional Family Therapy LLC, Pembroke Pines, FL.
- Oregon Research Institute, Highland Park, NJ.
| | | | | | - Amy Hollimon
- Functional Family Therapy LLC, Pembroke Pines, FL
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39
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Rowe CL, Alberga L, Dakof GA, Henderson CE, Ungaro R, Liddle HA. Family-Based HIV and Sexually Transmitted Infection Risk Reduction for Drug-Involved Young Offenders: 42-Month Outcomes. Fam Process 2016; 55:305-20. [PMID: 26879671 DOI: 10.1111/famp.12206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study tested a family-based human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention approach integrated within an empirically supported treatment for drug-involved young offenders, Multidimensional Family Therapy (MDFT). A randomized, controlled, two-site community-based trial was conducted with 154 youth and their parents. Drug-involved adolescents were recruited in detention, randomly assigned to either MDFT or Enhanced Services as Usual (ESAU), and assessed at intake, 3, 6, 9, 18, 24, 36, and 42-month follow-ups. Youth in both conditions received structured HIV/STI prevention in detention and those in MDFT also received family-based HIV/STI prevention as part of ongoing treatment following detention release. Youth in both conditions and sites significantly reduced rates of unprotected sex acts and STI incidence from intake to 9 months. They remained below baseline levels of STI incidence (10%) over the 42-month follow-up period. At Site A, adolescents who were sexually active at intake and received MDFT showed greater reduction in overall frequency of sexual acts and number of unprotected sexual acts than youth in ESAU between intake and 9-month follow-ups. These intervention differences were evident through the 42-month follow-up. Intervention effects were not found for STI incidence or unprotected sex acts at Site B. Intensive group-based and family intervention in detention and following release may reduce sexual risk among substance-involved young offenders, and a family-based approach may enhance effects among those at highest risk. Site differences in intervention effects, study limitations, clinical implications, and future research directions are discussed.
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Affiliation(s)
- Cynthia L Rowe
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Linda Alberga
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Gayle A Dakof
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Craig E Henderson
- Department of Psychology, Sam Houston State University, Huntsville, TX
| | - Rocio Ungaro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Howard A Liddle
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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40
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Pérez GR, Reyes GR, Villanueva VL, Torres GJT, Díaz EB, Varas-Díaz N, Villaruel A. [STIGMA AND HIV / AIDS AMONG PUERTO RICAN PARENTS / MOTHERS AND ADOLESCENTS]. Rev Puertorriquena Psicol 2016; 27:134-145. [PMID: 27099649 PMCID: PMC4834922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Communication between parents and adolescents about sexuality is important for the healthy development of young people. Stigmatizing attitudes towards HIV/AIDS may adversely impact this communication. The aim of this study was to identify stigmatizing attitudes towards HIV/AIDS among Puerto Rican parents and adolescents. This effort is part of the Cuídalos Project which aimed to test a web-based intervention to increase communication about sexuality and health among parents and adolescents through an experimental design with 458 parent/adolescent (13-17 years of age) dyads. For the purposes of this article we report descriptive statistics on HIV/AIDS stigma attitudes gathered as part of our baseline measurement. Both parents and adolescents manifested stigmatizing attitudes towards HIV/AIDS. In light of these results it is necessary to continue developing interventions to reduce stigma among this population. Parents can be an invaluable asset to reduce stigma among adolescents and to help prevent sexual risk behaviors and new infection.
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41
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Cumba-Avilés E, Sáez-Santiago E. Research Program on Type 1 Diabetes and Youth Depression in Puerto Rico. Rev Puertorriquena Psicol 2016; 27:44-60. [PMID: 27818725 PMCID: PMC5091806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This work reviews the progress and current state of a research program on Diabetes and youth depression in Puerto Rico. Given the high depression rate, its impact in youth with Type 1 Diabetes (T1D), and the lack of interventions to target this link in an integrative way, the manual titled Cognitive-Behavioral Treatment for Depression in Adolescents with T1D was developed. After its first use in an Open Trial, we currently assess the initial efficacy of its revised version to reduce depression and improve glycemic control, self-care, and quality of life. We present its approach, and initial data on its feasibility, acceptability and potential to reduce emotional problems in T1D youth. We discuss implications of this line of research for health psychology, and its utility to model the development of interventions alike focused on other chronic illnesses.
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Affiliation(s)
- Eduardo Cumba-Avilés
- Institute for Psychological Research, University of Puerto Rico, Río Piedras Campus
| | - Emily Sáez-Santiago
- Institute for Psychological Research, University of Puerto Rico, Río Piedras Campus
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Darcy AM, Fitzpatrick KK, Manasse SM, Datta N, Klabunde M, Colborn D, Aspen V, Stiles-Shields C, Labuschagne Z, Le Grange D, Lock J. Central coherence in adolescents with bulimia nervosa spectrum eating disorders. Int J Eat Disord 2015; 48:487-93. [PMID: 25146149 DOI: 10.1002/eat.22340] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Weak central coherence-a tendency to process details at the expense of the gestalt-has been observed among adults with bulimia nervosa (BN) and is a potential candidate endophenotype for eating disorders (EDs). However, as BN behaviors typically onset during adolescence it is important to assess central coherence in this younger age group to determine whether the findings in adults are likely a result of BN or present earlier in the evolution of the disorder. This study examines whether the detail-oriented and fragmented cognitive inefficiency observed among adults with BN is observable among adolescents with shorter illness duration, relative to healthy controls. METHOD The Rey-Osterrieth Complex Figure Test (RCFT) was administered to a total of 47 adolescents with DSM5 BN, 42 with purging disorder (PD), and 25 healthy controls (HC). Performance on this measure was compared across the three groups. RESULTS Those with BN and PD demonstrated significantly worse accuracy scores compared to controls in the copy and delayed recall condition with a moderate effect size. These findings were exacerbated when symptoms of BN increased. DISCUSSION Poorer accuracy scores reflect a fragmented and piecemeal strategy that interferes with visual-spatial integration in BN spectrum disorders. This cognitive inefficiency likely contributes to broad difficulties in executive functioning in this population especially in the context of worsening bulimic symptoms. The findings of this study support the hypothesis that poor global integration may constitute a cognitive endophenotype for BN.
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Affiliation(s)
- Alison M Darcy
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Kathleen Kara Fitzpatrick
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Stephanie M Manasse
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Nandini Datta
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Megan Klabunde
- Department of Psychiatry and Behavioral Sciences, Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, California
| | - Danielle Colborn
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Vandana Aspen
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
| | - Zandre Labuschagne
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
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MacPherson P, Munthali C, Ferguson J, Armstrong A, Kranzer K, Ferrand RA, Ross DA. Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care. Trop Med Int Health 2015; 20:1015-32. [PMID: 25877007 PMCID: PMC4579546 DOI: 10.1111/tmi.12517] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objectives Adolescents living with HIV face substantial difficulties in accessing HIV care services and have worse treatment outcomes than other age groups. The objective of this review was to evaluate the effectiveness of service delivery interventions to improve adolescents' linkage from HIV diagnosis to antiretroviral therapy (ART) initiation, retention in HIV care and adherence to ART. Methods We systematically searched the Medline, SCOPUS and Web of Sciences databases and conference abstracts from the International AIDS Conference and International Conference on AIDS and STIs in Africa (ICASA). Studies published in English between 1st January 2001 and 9th June 2014 were included. Two authors independently evaluated reports for eligibility, extracted data and assessed methodological quality using the Cochrane risk of bias tool and Newcastle–Ottawa Scale. Results Eleven studies from nine countries were eligible for review. Three studies were randomised controlled trials. Interventions assessed included individual and group counselling and education; peer support; directly observed therapy; financial incentives; and interventions to improve the adolescent‐friendliness of clinics. Most studies were of low to moderate methodological quality. Conclusions This review identified limited evidence on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on ART and adherence to ART. Although recommendations are qualified because of the small numbers of studies and limited methodological quality, offering individual and group education and counselling, financial incentives, increasing clinic accessibility and provision of specific adolescent‐tailored services appear promising interventions and warrant further investigation.
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Affiliation(s)
- Peter MacPherson
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Chigomezgo Munthali
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - Katharina Kranzer
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Rashida A Ferrand
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - David A Ross
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
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Gelin Z, Fuso S, Hendrick S, Cook-Darzens S, Simon Y. The effects of a multiple family therapy on adolescents with eating disorders: an outcome study. Fam Process 2015; 54:160-172. [PMID: 25243337 DOI: 10.1111/famp.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty-two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI-2), the Outcome Questionnaire 45 (OQ-45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ-45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions.
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Affiliation(s)
- Zoé Gelin
- Systemic and Psychodynamic Clinical Psychology Department, University of Mons, Mons, Belgium
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45
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Vélez YD, Dávila PT, Hernández SL. [CHALLENGES IN THE INTERVENTION OF PUERTO RICAN ADOLESCENTS THAT SHOW SUICIDAL BEHAVIOR]. Rev Puertorriquena Psicol 2015; 26:90-106. [PMID: 26702337 PMCID: PMC4686126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article is a case study of a Puerto Rican adolescent with suicidal behavior. The adolescent began a Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT), an ambulatory treatment, after being hospitalized for a suicide attempt. The SCBT incorporates an ecological and developmental perspective to CBT. She initially presented low self-esteem, and significant depressive and anxiety symptoms. At the end of treatment, the adolescent revealed a significant change in symptoms, and a better use of her coping skills. No suicidal ideation was presented during previous months, neither during follow up. Case analysis allowed treatment protocol modifications, particularly family sessions and communication skills, thus contributing to its further feasibility.
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46
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González ITM, Ramírez VE, Martínez JW. [Self-esteem Level in Scholarized Adolescents of the Rural Area of Pereira, Colombia]. Rev Colomb Psiquiatr 2012; 41:485-495. [PMID: 26572107 DOI: 10.1016/s0034-7450(14)60024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Accepted: 06/26/2012] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess the level of self-esteem of adolescents in a rural school of a district of Pereira. METHODS Students were called upon to participate, 292 agreed to undergo the test, while 20 abstained. RESULTS After a previous reliability test analysis, we found that 47.9% of students had low and very low self esteem. A multivariate model reported that self-esteem was reduced as age increased. CONCLUSIONS The academic community and the family must work together in order to improve self-esteem among teenagers in general.
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Affiliation(s)
- Iris Tatiana Montes González
- Estudiante de XI semestre de Medicina y Cirugía, de la Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | - Viviana Escudero Ramírez
- Estudiante de XI semestre de Medicina y Cirugía, de la Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | - José William Martínez
- Médico general de la UTP, magister y doctor en Epidemiologia, especialista en Docencia Universitaria, docente titular de la Facultad de Ciencias de la Salud, del Programa de Medicina de la Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
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Medina-Pérez ÓA, Rubio LA. [Psychoactive Drug Abuse in Adolescent Addicts of a Colombian Rehabilitation Foundation. Descriptive Study]. Rev Colomb Psiquiatr 2012; 41:550-561. [PMID: 26572111 DOI: 10.1016/s0034-7450(14)60028-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 05/02/2012] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To describe the use of psychoactive substances (PAS) in addict population between 14 and 18 years of a foundation devoted to rehabilitation in the Department of Quindío, Colombia. METHODS Quantitative-descriptive research. The VESPA (Epidemiological surveillance for psychoactive substance abuse) Forms of the people admitted to the institution between 2006 and 2009. RESULTS During the study, 333 adolescents between 14 and 18 were attended. 75.4% were men, only 31.2% had primary education, 56% reported being unemployed, and 34.5% stated they were admitted at the foundation after legal indication. Upon admission, the PAS was: 44.2%, tobacco; 25.8%, marijuana; 18.0%, alcohol and 5.7% cocaine. The average starting age for men was 12.33, while for women was 11.96; reported substances showed the following starting averages: alcohol, 12.26 ys old; tobacco, 12.49 ys old; marijuana, 13.39 ys old; inhalants, 13.98 ys old; cocaine, 14.01 ys old; crack, 14.27 ys old; and heroin, 15 ys old. The average admission age to the institution was 15.7 ys old. CONCLUSIONS Figures found highlight the need for greater and better prevention programs regarding PAS abuse in adolescents and children.
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Affiliation(s)
- Óscar Adolfo Medina-Pérez
- Magíster. Docente Investigador, Escuela de Ciencias Sociales, Artes y Humanidades de la Universidad Nacional a Distancia (UNAD). Bogotá, Colombia.
| | - Luz Adriana Rubio
- Investigadora de la Universidad San Buenaventura, seccional Medellín. Medellín, Colombia
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Rueda-Jaimes GE, Ramírez JLP, Martínez-Villalba AMR, López PAC. [Alcohol Abuse and Associated Factors in Student Children and Adolescents]. ACTA ACUST UNITED AC 2012; 41:273-83. [PMID: 26573493 DOI: 10.1016/s0034-7450(14)60004-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 06/01/2012] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Previous studies have confirmed high prevalence of alcohol abuse in adolescent students from Bucaramanga, Colombia. However, few studies on the associated factors have been carried out. OBJECTIVE Assessment of prevalence of alcohol abuse and associated factors in student children and adolescents from Bucaramanga. METHODOLOGY A random sample of adolescent students completed an anonymous questionnaire about the consumption of alcohol, illegal and legal substances, together with the CAGE questionnaire and a series of scales and questionnaires assessing risk factors for alcohol abuse. To adjust for confusing variables, a multivariate analysis was performed using a logistic regression model. RESULTS 2916 students were surveyed with an average age between 10 and 22, and a mean of 14.4 years (SD 1.65), 51.1% were female, 36% were in the last two years of high school (10(th) and 11(th) grades), and 17.66% were in private schools. The alcohol abuse pattern as measured by the CAGE scale was 14.6% (95% CI, 13.3 - 16.0%). The associated factors were: age (OR: 1.15, 95% CI 1.04 - 1.27), having a smoking or consuming alcohol sibling (OR: 1.48, 95% CI, 1.01 - 1.17) antisocial behavior (OR 3.03, 95% CI, 2.12 - 4.32) and best friend who uses illicit substances (OR 1.71, 95% CI, 1.06 - 2.76), best friend who smokes or drinks alcohol (OR 2.01, 95% CI, 1.40 - 2.88). CONCLUSIONS One out of 7 students showed a pattern of alcohol abuse. The associated factors were the influence of friends, family, age and antisocial behavior.
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Affiliation(s)
- Germán Eduardo Rueda-Jaimes
- Médico, profesor asociado, Facultad de Ciencias de la Salud, director del Grupo de Neuropsiquiatría, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia.
| | - Jessica Liliana Pinto Ramírez
- Médica, egresada de la Facultad de Ciencias de la Salud, Grupo de Neuropsiquiatría, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Andrés Mauricio Rangel Martínez-Villalba
- Médico, residente de segundo año, Universidad de Antioquia, investigador del Grupo de Neuropsiquiatría, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Paul Anthony Camacho López
- investigador invitado del Grupo de Neuropsiquiatría, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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Some DT, Some DA, Hien H, Diallo R, Zingue D, Diallo I, Diagbouga S, Dao B. [Sexual and reproductive health of adolescent girls in Bobo Dioulasso, Burkina Faso: the role of parent-adolescent communication for risk reduction]. Pan Afr Med J 2012; 11:65. [PMID: 22655099 PMCID: PMC3361203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 03/04/2012] [Indexed: 10/27/2022] Open
Abstract
Introduction Méthodes Résultats Conclusion
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Affiliation(s)
- Donmozoun Télesphore Some
- Centre Muraz, Avenue Mamadou Konaté, porte 2006, BP 390, Bobo Dioulasso, Burkina Faso,Corresponding author: Donmozoun Télesphore Some, Centre Muraz, Avenue Mamadou Konaté, porte 2006, BP 390, Bobo-Dioulasso, Burkina Faso
| | - Der Adolphe Some
- Centre Hospitalier Universitaire Sanou Souro, 01 BP 3482 Bobo Dioulasso, Burkina Faso
| | - Hervé Hien
- Centre Muraz, Avenue Mamadou Konaté, porte 2006, BP 390, Bobo Dioulasso, Burkina Faso
| | - Ramata Diallo
- Centre Muraz, Avenue Mamadou Konaté, porte 2006, BP 390, Bobo Dioulasso, Burkina Faso
| | - Dézémon Zingue
- Centre Muraz, Avenue Mamadou Konaté, porte 2006, BP 390, Bobo Dioulasso, Burkina Faso
| | - Ibrahim Diallo
- Centre Muraz, Avenue Mamadou Konaté, porte 2006, BP 390, Bobo Dioulasso, Burkina Faso
| | - Serge Diagbouga
- Centre Muraz, Avenue Mamadou Konaté, porte 2006, BP 390, Bobo Dioulasso, Burkina Faso
| | - Blami Dao
- Centre Hospitalier Universitaire Sanou Souro, 01 BP 3482 Bobo Dioulasso, Burkina Faso
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Abstract
The study aim was to classify youths into homogenous groups based on their symptoms of Alcohol Abuse and Dependence. An NIDA-funded cross-sectional survey was administered to 622 middle and high school students in San Juan, Puerto Rico in 2000. Latent class analysis (LCA) examined the Alcohol Abuse and Dependence symptoms. Three distinct classes of drinkers were found: low (86.0% of sample), moderate (11.7% of sample), and high (2.3% of sample) severity classes which were distinguished by differing estimated probabilities of symptom reporting. The study has implications for the diagnosis of Alcohol Abuse and Dependence among Puerto Rican youths. Limitations are also noted.
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Affiliation(s)
- Brent Edward Mancha
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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