RESUMEN
BACKGROUND: Alcohol consumption among youth is a major public health problem due to its association with negative outcomes which are generally preventable. Schools can play an important role in increasing health knowledge and promoting healthy behaviours that can reduce alcohol-associated risks. This paper describes and evaluates an innovative experiential project that aims to augment existing alcohol high school educational programmes. METHODS: Students of 11th grade classes, age 16-17 years, participated in a one-school-day programme which included: a lecture on alcohol related risks; an enacted scenario of violent behaviour related to alcohol use; meeting with a disabled person injured in an alcohol-associated road accident, and discussion of two video movies regarding consequences of excessive alcohol drinking. The students filled a preintervention alcohol-related knowledge, attitude and practice questionnaire, a feedback questionnaire at the end of the one-day programme, and a 3-months postintervention questionnaire on their alcohol-related behaviours. RESULTS: 665 eleventh grade students participated in the project. The preintervention questionnaire revealed adequate knowledge on alcohol-related risks by 65% of the students. The feedback questionnaire revealed that most students felt that the programme added to their knowledge and that it might change their alcohol use behaviour. The postintervention questionnaire filled by 195 students revealed that 81% would not refrain from alcohol drinking following the project; however 47% reported consuming alcohol in moderation, and 24% specified decrease in the amount of alcoholic beverages. CONCLUSIONS: An experiential educational programme regarding negative outcomes of alcohol consumption resulted in reported alcohol-related behaviour change in a proportion of high school students.
Asunto(s)
Conducta del Adolescente , Consumo de Bebidas Alcohólicas/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Poder Psicológico , Servicios de Salud Escolar , Adolescente , Consumo de Bebidas Alcohólicas/psicología , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Medición de Riesgo , Instituciones Académicas , Estudiantes , Encuestas y CuestionariosRESUMEN
Although the unique characteristics and abilities of youths were noted in ancient ages, it was only later that the process of adolescence was studied and understood. Adolescents are considered a healthy population when compared to younger kids and adults. However, unlike other age groups, the morbidity and mortality of adolescents has not decreased in the last decades, probably due to risk-taking behaviors. Since the 1950s, the need for a special medical and health approach in treating adolescents was established. Yet, only a few countries incorporate such approaches when educating and training students, residents and fellows in physicians programs. Youths are treated by physicians of many disciplines, despite the fact that only a minority were trained in adolescent medicine. Simulation of medical situations with standard patients has become a significant tool for improving the communication skills of healthcare providers. The article in this edition of Harefuah describes the use of a simulated-patient-based education system in improving the communication skills of physicians of different fields. The authors presented the positive feedback of the participants in the program and demonstrated that following the program there was a positive influence on their practice when dealing with adolescents. We call to incorporate the teaching of adolescent medicine in all Levels, starting at medical school. Using the simulation tool is very helpful in improving the communication skills of medical personnel.
Asunto(s)
Comunicación , Simulación de Paciente , Relaciones Médico-Paciente , Adolescente , Conducta del Adolescente , Educación Médica/métodos , Humanos , Desarrollo de Programa , Evaluación de Programas y Proyectos de SaludRESUMEN
PURPOSE OF REVIEW: Vitamin D has become the focus of many studies in recent years. Vitamin D deficiency has been linked to many chronic illnesses other then the well known musculoskeletal complications. In this review, we summarize new data regarding causes, prevalence, and complications of vitamin deficiency in adolescents and discuss them in the context of what is known in adults. In addition, we emphasize adolescence as a unique period for growth and development, and distinguish the consequences of vitamin D deficiency in young teenage patients from those in adults with regard to the presentation and potential health implications. RECENT FINDINGS: Vitamin D deficiency is common among both healthy and ill adolescents worldwide, even in sunny countries. Although much of the data relating vitamin D status to biological markers and complications has been obtained in adults, the information emerging from studies of adolescents supports the premise that maintaining sufficient levels of vitamin D during the teenage years can improve long-term health outcomes. There are currently knowledge gaps regarding the most well tolerated and appropriate supplementation regimen to prevent vitamin D deficiency among adolescents. SUMMARY: Further studies are needed to examine the implications of vitamin D deficiency among adolescents and the most appropriate treatment regimens to prevent this problem. There are sufficient data to support the importance of educating, preventing, and treating vitamin D deficiency in adolescents to improve their long-term health.
Asunto(s)
Desarrollo del Adolescente , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/fisiopatología , Vitamina D/uso terapéutico , Adolescente , Biomarcadores , Huesos/metabolismo , Causalidad , Enfermedad Crónica , Salud Global , Humanos , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/fisiopatología , Resultado del Tratamiento , Vitamina D/metabolismo , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/epidemiologíaRESUMEN
BACKGROUND: The new syndrome, known as PFAPA, of periodic fever characterized by abrupt onset of fever, malaise, aphthous stomatitis, tonsillitis, pharyngitis and cervical adenopathy has been described only in pediatric patients. It usually begins before the age of 5 years and in most cases resolves spontaneously before age 10. OBJECTIVES: To describe a series of adults with PFAPA syndrome. METHODS: This 6 year retrospective descriptive study includes all newly diagnosed incident adult cases aged 18 years and over referred to our center with symptomatology suggestive of PFAPA syndrome. Patients' medical records were reviewed for past history of the disease, demographic characteristics, symptoms and signs, course of the disease, laboratory findings, and outcome following corticosteroid therapy. The comparison group included our pediatric cohort children (N=320, age 0-18 years) followed for the last 14 years (1994-2008). RESULTS: Fifteen adult patients were diagnosed with PFAPA syndrome. Episodes of fever occurred at 4.6 +/- 1.3 week intervals, beginning at the age of 20.9 +/- 7.5. All patients had monthly attacks at the peak of the disease, with attacks recurring at 4-8 week intervals over the years. Between episodes the patients were apparently healthy, without any accompanying diseases. Attacks were aborted by a single 60 mg dose of oral prednisone in all patients. CONCLUSIONS: This study reports the presence of PFAPA syndrome in adult patients. Although the disease is rare, an increased awareness by both patients and family physicians of this clinical syndrome has resulted in more frequent diagnosis in adult patients.
Asunto(s)
Fiebre/complicaciones , Linfadenitis/complicaciones , Faringitis/complicaciones , Estomatitis Aftosa/complicaciones , Adolescente , Adulto , Antiinflamatorios/uso terapéutico , Sedimentación Sanguínea , Niño , Femenino , Fiebre/diagnóstico , Fiebre/tratamiento farmacológico , Humanos , Leucocitosis/complicaciones , Linfadenitis/diagnóstico , Linfadenitis/tratamiento farmacológico , Masculino , Periodicidad , Faringitis/diagnóstico , Faringitis/tratamiento farmacológico , Prednisona/uso terapéutico , Estudios Retrospectivos , Estomatitis Aftosa/diagnóstico , Estomatitis Aftosa/tratamiento farmacológico , SíndromeRESUMEN
The arrival of an adolescent at the hospital provides a window of opportunity to help those exposed to abuse or neglect, by looking beyond the presenting symptom. The Child Protection Team (CPT) assesses cases of suspected abuse or neglect (SCAN) referred by hospital staff. As adolescents pose a particular array of presentations, this study assessed their socio-demographic features and characteristics of hospitalization in order to improve procedures for identifying SCAN. The study group included all 674 referrals of 10-17-year-olds to the CPT from 1991-2007. Their files were abstracted and demographics compared to similarly-aged Emergency Department (ED) admissions. Different patterns were found by gender and age group. The youngest group (10-13 years) included a higher rate of boys than girls (47.9% vs. 27.6%), and among the oldest (16-17 years) the rate of girls was higher (31.9% vs 15.8%). Comparison with all ED admissions indicated a lower rate of younger girls and a higher rate of 14-15-year-old girls in the study group. The study group also had a higher rate of immigrants (12.8% vs. 4.7%). The most frequent reason for arrival at the hospital was suicidal behavior (30.9%). Older age was related to fewer arrivals for trauma/burn and more suicidal behavior. In 83.1% of the referrals, reports were made to welfare authorities and/or police. The suspicion in 64.2% of the referrals was emotional abuse or physical/emotional neglect; in 18.8%, physical and/or sexual abuse was suspected. The older groups had lower rates of physical and/or sexual abuse and higher rates of emotional abuse or physical/emotional neglect. This study highlights the importance of age-by-gender analysis and understanding of the differential susceptibility of early, middle and late adolescence to SCAN.
Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Hospitales Pediátricos , Derivación y Consulta/estadística & datos numéricos , Adolescente , Distribución por Edad , Niño , Maltrato a los Niños/psicología , Servicio de Urgencia en Hospital , Femenino , Humanos , Israel , Masculino , Distribución por Sexo , Factores Socioeconómicos , Intento de Suicidio/estadística & datos numéricosRESUMEN
PURPOSE: To evaluate whether the use of an algorithm including reticulocyte hemoglobin content (CHr), a new hematologic parameter, in addition to the screening complete blood count (CBC), improves detection of iron deficiency and iron deficiency anemia in healthy adolescents. METHODS: After initiation of an algorithm using CHr in addition to CBC results for identifying iron-deficient patients in a primary care hospital-based adolescent clinic, we reviewed results of all hematological tests performed in the clinic during an 8-month period. Electronic medical records were screened for health status and inclusion criteria. We determined the number of patients with low hematocrit values, low mean cell volume (MCV), and low CHr. To evaluate the impact of the protocol, we calculated the percentage of cases in which the CHr results suggested a management plan different from that which would have been formulated using the CBC results only. RESULTS: A total of 381 patients (mean age 16.8 +/- 3.1 years) were included in the study. Anemia was diagnosed by the Centers for Disease Control (CDC) guidelines in 63 patients (16.5%), low MCV in 170 patients (44.6%), and a low CHr in 80 (21%) patients. In 68% of anemia cases, a normal CHr suggested that iron deficiency was not the cause of the anemia. Although low MCV values were found in 38 (60.4%) of all anemic cases, mean MCV was significantly (p < 0.001) lower in the 19 cases with a low CHr as well. In 19% of 318 patients with a normal hematocrit (HCT), a low CHr suggested the need for treatment of early iron deficiency. In 103 (27%) cases, CHr suggested a different treatment plan from that which would have been formulated using the screening CBC only. CONCLUSIONS: The use of an algorithm including CHr to screen for iron deficiency anemia may increase the accuracy of diagnosis, enabling early detection and treatment of iron deficiency in adolescents without the need for additional costly iron studies.
Asunto(s)
Medicina del Adolescente , Anemia Ferropénica/diagnóstico , Índices de Eritrocitos , Hemoglobinas , Deficiencias de Hierro , Recuento de Reticulocitos , Adolescente , Algoritmos , Anemia Ferropénica/sangre , Niño , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVE: Not reaching an optimal peak bone mass during adolescence puts young patients with anorexia nervosa (AN) at risk for osteoporosis. Qualitative techniques were employed to determine whether having a bone mineral density (BMD) measurement affected the attitudes and behaviors of young women with AN. METHODS: Nineteen adolescents with AN who had undergone BMD measurements were questioned about the experience of having the test and reactions to the results. Themes were identified and statistical analyses were performed. RESULTS: Participants perceived a normal or low BMD in healthy and unhealthy ways. Although not all healthy feelings led to behavioral change, they appeared to serve as driving forces later in their illness. DISCUSSION: Providing young women with BMD results is not always enough to change unhealthy behaviors and may generate some unhealthy thoughts. However, the experience may lead to positive behavioral changes and result in long-term improvement. Clinicians must be careful and sensitive when presenting these results.