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Adolescent Population (adolescent + population)
Selected AbstractsTraumatic dental injuries in an urban adolescent population in Tirana, AlbaniaDENTAL TRAUMATOLOGY, Issue 5 2010Dorina Sula Thelen Material & methods: A cross-sectional survey was carried out to acquire epidemiological data about TDI in the permanent incisors of Albanian adolescents. Participants (n = 2789) were adolescents of both genders, aged 16,18 years, attending public high schools in Tirana. Results: The occurrence of TDI in the incisors ranged from 8.9% of 16-year-olds to 10.5% of 18-year-olds. A greater proportion of boys (12.4%) had TDI compared with girls (7.7). The most commonly reported causes were collisions (27.5%) followed by physical leisure activities and sports (mainly cycling and swimming/diving) (14.1%) and falls (13.4%). Of the adolescents affected by TDI, 32% had unmet treatment need because of no or inadequate treatment. Adolescents living in districts with low socio-economic level had significantly more TDI with unmet treatment need than those living in districts with high socio-economic level. Conclusion: The occurrence of TDI among Albanian adolescents was moderate. Adolescents who came from low socio-economic districts had a greater probability of having TDI with unmet treatment need. [source] Thyroid fine-needle aspiration biopsy in children and adolescents: Experience with 218 aspiratesDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2005Mojghan Amrikachi M.D. Abstract To evaluate the role of fine-needle aspiration (FNA) biopsy of thyroid nodules in pediatric and adolescent patients, the cytology reports of 218 thyroid FNA biopsies performed on children and adolescents ranging from10 to 21 yr of age were reviewed. The cytology diagnoses were categorized into four groups: unsatisfactory, benign, suspicious, and malignant. One hundred nineteen (54%) of the aspirates were diagnosed as "benign," 20 (9%) were diagnosed as suspicious for malignancy; and 17 (8%) were diagnosed as malignant. Sixty-two (28%) of the aspirates were read as unsatisfactory for interpretation. Sensitivity of thyroid FNA in diagnosing thyroid malignancy relative to final histological diagnoses was 100%, and specificity was 65%. FNA of thyroid nodules in the pediatric and adolescent population is comparably as sensitive and specific as in the adult population. The acceptance of this procedure in the routine evaluation of young patients' thyroid nodules should reduce the number of unnecessary surgeries for benign thyroid disease. Diagn. Cytopathol. 2005;32:189,192. © 2005 Wiley-Liss, Inc. [source] Treatment emergent mania responding to valproate in a Chinese female adolescent population with eating disorders: A case seriesEUROPEAN EATING DISORDERS REVIEW, Issue 6 2008Phern Chern Tor Abstract Eating disorders are commonly associated with depressive symptoms. In an adolescent and binge eating population fluoxetine is commonly used to treat co-morbid depression associated with eating disorders. In some patients this may precipitate treatment emergent mania (TEM). Risk factors in the adolescent population include being older, female, having a longer duration of illness, more previous mood episodes, a higher prevalence of subclinical hypothyroidism, early-onset anxiety and recent exposure to a mood-elevating agent. Diagnosis and management of these co-morbid conditions is challenging due to the overlapping symptomatology and the adverse effects of both conditions complicating pharmacological management. This is illustrated with three cases in a Chinese female adolescent population that experienced TEM while on fluoxetine and responded to valproate. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Understanding anorexia nervosa through analysis of thematic content of letters in an adolescent sampleEUROPEAN EATING DISORDERS REVIEW, Issue 5 2006Glen Freedman Abstract Objective Positive and negative themes about their illness have been identified in an adult population with anorexia nervosa. It was our goal to explore the thematic content of the letters written by an adolescent population in order to better our understanding of how this different population relates to the illness. Method Twenty-seven adolescents with anorexia nervosa were asked to write two letters to their eating disorder, one addressing it as a friend and the other, as an enemy. The coding scheme initially developed by Serpell and Treasure, with minor adjustments, was used to code the letters by two trained raters, with high inter-rater reliability. Results Many similarities and a few notable differences between the adolescent population and an adult population were noted. Compared to an adult population, adolescents valued to a greater degree the sense of feeling looked after by the disorder and the increased attention that they felt the disorder provided. In contrast, they did not view loss of periods as a benefit. Regarding perceived costs of anorexia nervosa, adolescents described a greater degree of psychological distress in relation to the disorder, and a greater sense of having been tricked by the disorder. They did not describe as much frustration with preoccupation with thoughts about food or of being controlled by food. All other themes were not considered appreciably different in terms of percentage of statements or of subjects. Discussion An understanding of how adolescents relate to their illness in terms of themes can help to provide the therapist with a sense of where a patient is in terms of motivation and readiness for recovery. This in turn can aid in the determination of an appropriate treatment approach that is most likely to foster an optimal therapeutic alliance and to enhance motivation to recover. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Long-Term, Open-Label Safety Study of Oral Almotriptan 12.5 mg for the Acute Treatment of Migraine in AdolescentsHEADACHE, Issue 5 2010Frank Berenson MD (Headache 2010;50:795-807) Objectives., This study evaluated the long-term safety of oral almotriptan 12.5 mg for the treatment of multiple migraine episodes in adolescents over a 12-month period. Efficacy outcomes were assessed as a secondary objective. Methods., Adolescent migraineurs aged 12-17 years were enrolled in this 12-month, open-label study (Study ID CR002827). Patients were instructed to record their assessments on paper headache records whenever they experienced a migraine headache that they treated with study medication. Safety was assessed descriptively and assessments included adverse event (AE) recording, change in laboratory values, vital signs, and electrocardiogram parameters. Efficacy outcomes were assessed descriptively and outcomes included rates for 2- and 24-hour pain relief and sustained pain relief, 2- and 24-hour pain-free and sustained pain-free, and presence of migraine-associated symptoms of photophobia, phonophobia, nausea and vomiting. Results., Overall, 67.1% of patients reported ,1 AE over the course of the trial, 7.6% had an AE judged by the study investigator to be related to treatment with almotriptan, 2.4% discontinued because of an AE, and 1.9% reported serious AEs. The most commonly reported treatment-related AEs (occurring in ,1% of patients) were nausea (1.4%) and somnolence (1.4%). Pain relief responses for treated migraines of moderate or severe intensity at baseline were 61.7% and 68.6%, at 2 and 24 hours, respectively; the sustained pain relief rate was 55.5%. Pain-free responses were reported for 40.5% of all treated migraines at 2 hours and 65.9% of treated migraines at 24 hours; the sustained pain-free rate was 38.4%. The proportion of migraines that achieved the pain relief, sustained pain relief, pain-free and sustained pain-free endpoints were similar in the 12- to 14-year and 15- to 17-year age groups. Treating with almotriptan 12.5 mg when headache pain was mild was associated with higher rates of pain relief and pain-free at 2 and 24 hours, and sustained pain relief and sustained pain-free, compared with treatment initiated when pain was severe. Conclusions., Almotriptan 12.5 mg was well tolerated in this adolescent population over a 12-month period. No unexpected safety or tolerability concerns were revealed over the course of this study. The results are consistent with almotriptan 12.5 mg being effective for the acute treatment of pain and symptoms associated with migraine in both younger and older adolescents. [source] Migraine in Adolescents: Validation of a Screening QuestionnaireHEADACHE, Issue 2 2009Luca Valentinis MD Background., Few studies in adolescents deal with the level of agreement between questionnaire and interview information in relation to headache symptoms. Objective., To evaluate the validity of a self-administered questionnaire on headache for use in epidemiological studies of Italian high school students. Methods., The questionnaire incorporated all items required for diagnosing migraine according to the criteria from the 2004 International Classification of Headache Disorders. The migraine diagnoses obtained from questionnaires were validated against the gold standard diagnoses by a headache specialist. Results., Out of 104 students answering the questionnaires, 93 (89.4%) participated in extensive semi-structured interviews by a neurologist. The chance-corrected agreement rate (kappa) was 0.66, which is considered good. The questionnaire-based migraine diagnosis had a sensitivity of 67.3%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 73.3%. Conclusions., The results indicate that our self-administered questionnaire may be an acceptable instrument in determining the prevalence of migraine sufferers in the northeast Italy adolescent population, useful in identifying subjects with "definite" migraine. [source] Brazilian attitudes toward English: dimensions of status and solidarityINTERNATIONAL JOURNAL OF APPLIED LINGUISTICS, Issue 1 2001Linda Gentry El-Dash The implications of the prestige and vitality of English as a foreign language in Brazil were investigated using both direct and indirect measures of attitudes and beliefs (a subjective vitality questionnaire and a classic matched-guise instrument). Aspects of solidarity and status identi ?ed by factor analysis were investigated in a Brazilian adolescent population, and four statistically distinctive pro ?les were found. Approximately half of the subjects evaluated English-speaking guises more favorably than those of the native Portuguese in terms of status,which is typical of the adult population, who tend to feel the prestige of English as an international language, but half also valued this guise in terms of solidarity, a totally unexpected result which was attributed to the symbolic use of English within the adolescent peer group. [source] Reliability and validity of the Youth Self-Report, Bangladesh versionINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2005Takashi Izutsu Abstract The objectives of this study were to develop the Bangladesh version of the Youth Self-Report (YSR), and assess its reliability and validity in an adolescent population in Dhaka city, Bangladesh. One-hundred-and-eighty-seven boys (mean age: 14.6 years, SD: 2.1) and 137 girls (mean age: 15.2 years, SD: 2.0) from residential areas, and 27 boys (mean age: 17.0, SD: 1.4) and 14 girls (mean age: 15.4, SD: 2.8) from a psychiatric hospital, all within the range of 11,18 years, were interviewed using a questionnaire that consisted of the Bangla translation of the YSR and other questions. Thirty-eight randomly selected adolescents were administered the same questionnaire one week after the first administration. All the core scores and most of the subscales showed high internal consistency other than small item-number subscales, and satisfactory test- retest reliability. Good discriminant validity was shown for most of the scale scores. This study showed that the Bangla translation of the YSR had sufficient reliability and validity for use in Bangladesh. The cutoff scores of the scales were higher for the Bangla version than for the original English version, and further studies exploring this point would be an asset. Copyright © 2005 John Wiley & Sons, Ltd. [source] Biopsychosocial Approach to Treating Self-Injurious Behaviors: An Adolescent Case StudyJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 3 2009Mary Askew DNP TOPIC:, Self-injurious behaviors (SIBs) are a common coping mechanism in the adolescent population. A marked increase in SIB has been seen in recent years, yet effective treatment remains elusive. PURPOSE:, This study aims to review current theoretical perspectives and treatment options that reflect a biopsychosocial framework. SOURCES:, Selected multidisciplinary literature related to SIB. CONCLUSIONS:, A 6-month multidisciplinary approach targeting the unique physical, emotional, and social needs of a 14-year-old girl in residential treatment led to the complete cessation of SIB. [source] Promising outcomes of an adolescent chronic fatigue syndrome inpatient programmeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2009Brett Gordon Introduction: Chronic fatigue syndrome (CFS) is a condition of prolonged and disabling fatigue, which is accompanied by characteristic constitutional and neuropsychiatric symptoms. In children and adolescents, this condition occurring at a developmentally vulnerable time adds to the disability affecting self-concept, autonomy, body image, socialisation, sexuality and academic problems. This case series looks at the effects of a graded exercise programme on physical outcomes, fatigue and mental state in an adolescent population. Methods: Data sets from 16 adolescents who completed combined exercise training as part of the 4-week inpatient intensive CFS programme at the Austin Hospital, Melbourne were analysed. All patients completed an exercise assessment and three questionnaires before beginning any training. A paediatrician (LL) confirmed the diagnosis according to the Fukuda criteria in all patients. Exercise was carefully supervised and prescribed daily by an exercise physiologist (BG) according to each individual's ability and response with the basic aim of increasing exercise tolerance and improving muscle strength and endurance. Results: There was an 18% improvement in volitional time to fatigue (P= 0.02) and 17% improvement in peak oxygen uptake (VO2peak) (P= 0.01). Upper body strength and function improved with a remarkable 70% increase in the number of push-ups. Fatigue severity was reported to improve by 13% (P= 0.01) and depression index improved significantly by 42% (P= 0.02). Conclusions: The significance of these improvements cannot be underestimated as an improvement in physical capacity through increased time to fatigue and less severe fatigue allows adolescents to resume school, social and family activities. [source] Effect of active smoking on asthma symptoms, pulmonary function, and BHR in adolescents ,PEDIATRIC PULMONOLOGY, Issue 10 2009S. Yoo MD Abstract Background Active smoking is known to increase asthma symptoms and bronchial hyper-responsiveness (BHR) while decreasing pulmonary function in adults, but few studies have addressed these issues in adolescents. Methods We conducted a cross-sectional survey involving questionnaires and assessment of urinary cotinine levels among 1,492 adolescents from three urban areas of South Korea. Current smoking was defined as having smoked more than 1 day in the prior 30 days or having urine cotinine levels ,100,ng/ml. Spirometry, skin tests, and methacholine challenge tests were performed on adolescents in Seoul (n,=,724). Results The prevalence of current smoking was 8.2% in boys and 2.4% in girls. Reports of wheeze and exercise-induced wheeze in the previous 12 months were more frequent in smokers than nonsmokers (15.2% vs. 8.5%, P,=,0.024, and 20.4% vs. 10.7%, P,=,0.004, respectively). In multiple logistic regression analysis, current smoking was found to be a significant risk factor for having wheezed in previous 12 months (OR,=,4.5, 95% CI 1.5,13.2) and having exercise-induced wheezing in previous 12 months (OR,=,8.7, 95% CI, 3.7,20.9). The subgroup analysis revealed that the FEV1/FVC was lower in smokers than nonsmokers (mean,±,SD, 105.1,±,8.6% vs. 107.8,±,7.8%, P,=,0.019). In contrast, there was no significant difference in BHR. The effect of smoking on asthma symptoms were more pronounced in non-atopic compared with atopic adolescents. Conclusion Current smoking was significantly associated with symptoms of asthma, such as having recent wheezing and recent exercise-induced wheezing, especially for non-atopics, in Korean adolescent population. Current smoking was further associated with lower pulmonary function, but not BHR. Pediatr Pulmonol. 2009; 44:954,961. ©2009 Wiley-Liss, Inc. [source] Relationship between body image and lifestyle factors in Japanese adolescent girlsPEDIATRICS INTERNATIONAL, Issue 4 2009Kyoko Mori Abstract Background:, Body image, defined here as an inaccurate perception of personal bodyweight, plays a significant role in the development of obesity, eating problems and eating disorders. Certain lifestyle factors may influence an individual's body image, but current knowledge is based mainly on studies in Western populations. Methods:, The associations between body image and lifestyle factors were investigated in samples of the Japanese female adolescent population. Results:, Respondents who reported that they ate meals slowly (odds ratio [OR] 1.81, P < 0.001) or only consumed small amounts of food (OR 3.17, P < 0.001) were more likely to underestimate their body image, as determined by their body mass index, than eaters who had average behavior for this age group. Individuals who reported eating faster (OR 1.47, P < 0.001) or consuming large amounts (OR 1.67, P < 0.001); those who do not eat breakfast on a daily basis (OR 1.35, P = 0.006); those who go to bed later than the average time for this age group (OR 1.38, P < 0.001) or sleep <7 h (OR 1.40, P < 0.001) and those individuals who rarely exercise (OR 1.27, P = 0.03) were more likely to overestimate their body image, as determined by BMI, compared with those who had average eating, sleeping and exercise behaviors for this age group. Conclusions:, Variation from the norm in eating, sleeping and exercise behaviors showed a relationship with a distorted perception of body image in Japanese adolescent girls. These findings are of potential importance in understanding the underlying mechanisms involved in the development of body image and for exploring interventional approaches. [source] Breast Hamartomas in Adolescent FemalesTHE BREAST JOURNAL, Issue 5 2009Henry L. Chang MD Abstract:, Breast hamartomas are uncommon lesions that have not been extensively characterized in the adolescent population. A search of patient records at our institution over a 17-year period identified seven cases of breast hamartomas in patients less than 18 years of age. We examine and report the clinical, radiographic, and pathologic characteristics of these cases. Breast hamartomas present as painless, palpable masses in the adolescent population. Ultrasonography reveals a well-defined, solid, oval mass, similar to the more common fibroadenoma. Two of the patients underwent core needle biopsy for diagnosis as the only intervention with the remainder undergoing surgical excision. None of the patients had any complications from surgery. There was one recurrence 9 months after initial excision. Histologically, the hamartomas consisted of densely packed, enlarged lobules set within a fibrous stroma. Breast hamartomas are rare in the adolescent population. The clinical and radiographic features are similar to the more common fibroadenoma, but the pathologic findings are diagnostic. Recurrence can occur if excision is incomplete. Increased recognition and accurate diagnosis will improve our understanding of the natural history of these lesions. [source] Adolescent endometriosis in the Waikato region of New Zealand , A comparative cohort study with a mean follow-up time of 2.6 yearsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010Jose D ROMAN Study objective:, To describe our experience with laparoscopic excision of endometriosis on an adolescent population and to compare it with a non-adolescent population treated during the same period. Design:, Comparative cohort study of patients with endometriosis treated consecutively between July 2003 and January 2009 with a follow-up between six months and six years. Setting:, Braemar Hospital, Hamilton, New Zealand. Results:, We treated 20 adolescents. Ninety-five per cent (19/20) of adolescents were using pain relief other than Paracetamol, in contrast to only 59% (84/143) of non-adolescents. Thirty per cent (6/20) of adolescents had a first-degree relative with endometriosis, in contrast to 8% (11/143) of non-adolescents. Endometriosis was found to be stage I in 40% (8/20) of patients, stage II in 45% (9/20) of patients, stage III in 5% (1/20) of patients and stage IV in 10% (2/20) of patients. The main type of endometriotic lesion in the adolescent was an atypical red vascular lesion, which was present in 60% (12/20) of adolescents; but it was present in only 20% (29/143) of non-adolescents. There were no intra-operative complications. Minor postoperative complications included one case of urinary tract infection and one case of port infection. The operative complications that developed when treating the non-adolescent group are presented for comparison. Pain scores recorded at follow-up revealed a significant reduction in dysmenorrhoea and pelvic pain and there was a positive effect on the quality of life of adolescents as measured by the EQ-5D questionnaire tool. Conclusion:, Adolescents with endometriosis use significantly more pain relief than non-adolescents to control symptoms. They have a higher rate of a first degree relative with the disease and they present with more atypical endometriotic lesions when compared with an adult population with endometriosis. All the stages of disease are present in the adolescent, including stages III and IV. The laparoscopic excision of endometriosis has a positive effect on the relief of pain symptoms and on the improvement in quality of life in the adolescent. [source] Are rural adolescents necessarily at risk of poorer obstetric and birth outcomes?AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2005Mavis Gaff-Smith Abstract Objective:,The purpose of the present study were to describe the sociodemographic and clinical characteristics of adolescent women giving birth at Wagga Wagga Base Hospital, and compare these with those with all adolescents in New South Wales. Design:,An investigative approach. Main outcome measures:,Obstetric complications, delivery intervention and adverse infant outcomes. Setting:,Wagga Wagga Base Hospital. Participants:,One hundred and sixteen adolescents aged 15,19 years. Results:,In relation to obstetric complications and infants with complications, the study sample was found to be representative of New South Wales adolescents. However, for type of delivery there was a higher rate of forceps delivery (12.3% (15) vs 4.7% (415) P = 0.0001), forceps rotation (4.1% (5) vs 0.9% (80) P = 0.004) and fewer normal vaginal deliveries (67.2% (82) vs 80.8% (7108) P = 0.006) at Wagga Wagga Base Hospital. Conclusion:,These findings suggest that rural adolescents are at risk of delivery complications and are less likely to have a normal vaginal delivery. More research is required into obstetric and birth outcomes for the rural adolescent population. [source] How do you initiate oestrogen therapy in a girl who has not undergone puberty?CLINICAL ENDOCRINOLOGY, Issue 1 2009Peter C. Hindmarsh Summary The physiology of puberty needs to be taken into consideration in the induction of puberty. Puberty is a relatively slow process and replacement therapy should mimic this. Long-term maintenance requires careful monitoring and long-term assessment of risk-benefit. This has not been appreciably defined in the adolescent population. Options for fertility need careful consideration and may depend on the adequacy of pubertal induction in terms of uterine development. A number of regimens are available for pubertal induction but the lack of comparisons makes it difficult to advocate for a particular regimen. There remain a number of areas of uncertainty, and future studies need to consider these issues and whether there are cardiovascular risk factor advantages to certain preparations. The long-term risks of breast and gynaecological malignancy remain uncertain. Long-term cohort studies are required to address these issues. [source] Correlates of smoking among adolescents with asthmaJOURNAL OF CLINICAL NURSING, Issue 5-6 2010Su-Er Guo Aims and objective., This study examined the correlates of smoking among asthmatic adolescents to gain a better understanding of who is at particular risk. Background., Smoking is especially harmful to individuals with asthma. However, smoking is surprisingly prevalent among asthmatic individuals, with prevalence rates similar to or higher than those of the general adult or adolescent populations. Despite this notable finding, there has been little research about factors (i.e. biophysical, psychosocial and behavioural) influencing asthmatic adolescents' tobacco use patterns. Design., A Canadian provincial cross-sectional survey. Method., The study about adolescents' tobacco use and health status was conducted in secondary schools in 2004, 608 asthmatic adolescents participated. Demographic factors, biophysical (body mass index and physical health), psychosocial factors (parents' and peers' smoking, environmental tobacco smoke exposure and depression) and behavioural factors (marijuana use, alcohol use and exercise frequency) were explored. Multinomial logistic regression analyses were conducted to identify risk factors associated with tobacco use. Results and conclusions., Of the 608 asthmatic adolescents, 17·4% currently smoked and 12·0% formerly smoked. Girls, compared with boys, were more likely to smoke (OR: 3·34, 95% CI: 1·62,6·96) after adjusting for differences in the other demographic, biophysical, psychosocial and behavioural factors. Asthmatic girls who had relatively higher body mass index, were in the higher school grades, used marijuana or alcohol, had minor to severe depressive symptoms, had environmental tobacco smoke exposure in their homes and had friends who smoked or were currently more likely to smoke. The former smokers had similar risk factors including higher body mass index, environmental tobacco smoke exposure at home, friends who smoked and marijuana use. Relevance to clinical practice., Despite their health condition, asthmatic adolescents continue currently or formerly to smoke. Gender appropriate prevention and cessation interventions for asthmatic adolescents may need to address important psychosocial and environmental factors that increase the risk of these adolescents initiating and maintaining tobacco use. [source] Social status and shaming experiences related to adolescent overt aggression at schoolAGGRESSIVE BEHAVIOR, Issue 1 2009Cecilia Åslund Abstract Feelings of rejection and humiliation in interpersonal interaction are strongly related to aggressive behavior. The aim of this study was to investigate the association between social status, shaming experiences, gender and adolescent aggressive behavior by using a status,shaming model. A population-based sample of 5,396 adolescents aged from 15 to 18 completed a questionnaire that asked questions regarding psychosocial background, shaming experiences, social status of family, peer group and school and involvement in physical or verbal aggression at school. Shaming experiences, i.e. being ridiculed or humiliated by others, were strongly related to aggressive behavior. Social status and shaming were related in the prediction of aggressive behavior, suggesting that a person's social status may influence the risk for taking aggressive action when subjected to shaming experiences. Medium social status seemed to have a protective function in the association between shaming experiences and aggression. This study confirms the importance of further evaluation of the role of perceived social status and shaming experiences in the understanding of aggressive behavior. Moreover, the results indicate the need for different kinds of status measures when investigating the associations between status and behavior in adolescent populations. The results may have important implications for the prevention of bullying at school as well as other deviant aggressive behavior among adolescents. Aggr. Behav. 35:1,13, 2009. © 2008 Wiley-Liss, Inc. [source] Neurocognitive and behavioral impact of sleep disordered breathing in children,PEDIATRIC PULMONOLOGY, Issue 5 2009Judith A. Owens MD Abstract The consequences of poor quality and/or inadequate sleep in children and adolescents have become a major public health concern, and one in which pediatric health care professionals have become increasingly involved. In particular, insufficient and/or fragmented sleep resulting from primary sleep disorders such as obstructive sleep apnea (OSA), often compounded by the presence of comorbid sleep disorders as well as by voluntary sleep curtailment related to lifestyle and environmental factors, has been implicated in a host of negative consequences. These range from metabolic dysfunction and increased cardiovascular morbidity to impairments in mood and academic performance. The following review will focus on what is currently known about the effects of sleep disordered breathing (SDB) specifically on neurobehavioral and neurocognitive function in children. Because of the scarcity of literature on the cognitive and behavioral impact of sleep disorders in infants and very young children, this review will target largely the preschool/school-aged child and adolescent populations. In addition, the focus will be on a review of the most recent literature, as a supplement to several excellent previous reviews on the topic.1,4 Pediatr Pulmonol. 2009; 44:417,422. © 2009 Wiley-Liss, Inc. [source] Changing trends in pediatric transplantation: 2001 Annual Report of the North American Pediatric Renal Transplant Cooperative StudyPEDIATRIC TRANSPLANTATION, Issue 4 2003Mark R. Benfield This cooperative group now includes over 150 participating medical centers in the United States, Canada, Mexico, and Costa Rica. This report covers the years from 1987 through 2001 and includes data on 7545 renal transplants in 6878 patients. This report demonstrates changing trends in many areas of pediatric transplantation including increasing numbers of African American and Hispanic children receiving transplantation, remarkable improvements in the rate of acute rejection, rejection reversal, and short- and long-term allograft survival. In the most recent cohorts of patients, we now see that 1-yr allograft survival is no different in cadaver donor compared to living donor recipients and in infants compared to all other age groups. However, this analysis also reveals areas of continued challenges including inferior outcomes in African American and adolescent populations, chronic rejection, and the adverse effects of immunosuppression. [source] An Interactive Voice Response (IVR) System for Adolescents with Alcohol Use Disorders: A Pilot StudyTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 2006Yifrah Kaminer MD In order to understand predictors of relapse among adolescents treated for alcohol use disorders (AUD), it is important to accurately assess the daily circumstances associated with use. This pilot study investigates the feasibility and acceptability of an interactive voice response (IVR) system in adolescents with AOSUD. Twenty-six adolescents 14 to 19 years old, with a mean age of 16.8, who were enrolled into an adolescent treatment program for AUD consented to make phone calls for 14 successive evenings to an IVR system and answer 14 questions pertaining to daily use of alcohol and other drugs. The subjects were compensated for their participation. A satisfaction questionnaire was administered at the end of the study. Participants completed 72% of scheduled recordings, with an average of 10.1 calls per subject. Most participants reported that they answered the questions honestly and accurately and were very much satisfied with the IVR system. The preliminary data presented here suggests that the use of IVR for the purpose of generating daily reports in youth is feasible and acceptable. The utilization of IVR systems should be explored to improve efficacy and attainment of generalizability to heterogeneous adolescent populations and lifestyles including for other psychiatric disorders. [source] Annotation: The role of prefrontal deficits, low autonomic arousal, and early health factors in the development of antisocial and aggressive behavior in childrenTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 4 2002Adrian Raine Background: This article selectively reviews the biological bases of antisocial and aggressive behavior in children with a focus on low autonomic functioning, prefrontal deficits, and early health factors. Results: Low resting heart rate is thought to be the best-replicated biological correlate of antisocial and aggressive behavior in child and adolescent populations and may reflect reduced noradrenergic functioning and a fearless, stimulation-seeking temperament. Evidence from neuropsychological, neurological, and brain imaging studies converges on the conclusion that prefrontal structural and functional deficits are related to antisocial, aggressive behavior throughout the lifespan. A prefrontal dysfunction theory of antisocial behavior is advanced. This argues that social and executive function demands of late adolescence overload the late developing prefrontal cortex, giving rise to prefrontal dysfunction and a lack of inhibitory control over antisocial, violent behavior that peaks at this age. Birth complications and minor physical anomalies are selectively associated with later violent behavior, especially when combined with adverse psychosocial risk factors for violence. Cigarette smoking during pregnancy may increase the risk for antisocial and violent behavior in later life by disrupting noradrenergic functioning and enhancement of cholinergic receptors that inhibit cardiac functioning. Malnutrition during pregnancy is associated with later antisocial behavior and may be mediated by protein deficiency. Conclusions: It is argued that early health intervention and prevention studies may provide the most effective way of reversing biological deficits that predispose to antisocial and aggressive behavior in children and adults. [source] Quality of life measurement in paediatric and adolescent populations with HIV: a review of the literatureCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2009P. A. Garvie Abstract Purpose To review the quality and utility of currently available self-report generic quality of life (QOL) and health-related quality of life (HRQOL) measures for use with children and adolescents with human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV/AIDS). Methods Literature searches were conducted to identify QOL and HRQOL measures developed for, adapted for, or otherwise used with paediatric and adolescent populations with HIV/AIDS. The quality of measures (i.e. item generation techniques, instrument properties including reliability, validity and responsiveness) were compared and critically evaluated. Results Nineteen QOL/HRQOL measures were identified. Item content was generated from the respondent (adult) population in only eight (42%) measures. Seventeen (90%) measures reported internal reliability in the accepted range between 0.70 and 0.90 and four (21%) reported reproducibility statistics in this range. Although validity was reported for 19 (100%) measures, only six (32%) showed evidence for three or more properties, with construct validity being the most commonly reported aspect. The authors of eight (42%) measures reported evidence for responsiveness. Conclusions While almost all measures reviewed demonstrated adequate psychometric properties, only one-third demonstrated all aspects of validity, and less than half demonstrated responsiveness. None included paediatric or adolescent populations with HIV/AIDS in their development, neglecting to obtain input from target respondents in item generation to determine what health-related and daily functioning factors are of importance to them. Despite noted limitations, the AUQUEI or the SWED-QUAL appear the best currently available generic measure, and the MQOL-HIV the preferred disease-specific measure, at least for use with older adolescents/young adults. [source] | |||||||||||||||||||||||||