Trends in Induced Abortions in Greece: A Cross-sectional Study

Study ObjectiveTeenage pregnancies and associated induced abortions represent an important public health issue. The aim of this study was to investigate the prevalence, the time trends, and associated factors of teenage induced abortions in Greece.DesignA cross-sectional study was conducted between 2018 and 2019.SettingThird Academic Department of Obstetrics and Gynecology of the Aristotle University of Thessaloniki.ParticipantsAll pregnant women who underwent a second trimester anomaly scan were eligible for the study.Interventions and Main Outcome MeasuresEpidemiological characteristics were recorded and 5 age groups were created. Trends in the rates of teenage induced abortions were analyzed and we compared several parameters between women with and without history of abortions.ResultsOverall, 3370 women were eligible and agreed to participate in the study. The prevalence of women who reported a history of at least 1 abortion at 15-19 years was 9.7% (n = 328/3370). The abortion rates across the 5 age groups were: 20-24: 7.5%; 25-29: 8.4%; 30-34: 8.2%; 35-39: 12%; and 40 years and older: 13.9%. Moreover, a history of 1 or more teenage abortions was more common in multiparous women (58.2% vs 46.5%; P < .001; odds ratio, 1.605; 95% confidence interval, 1.274-2.022) and in current smokers (27.4% vs 11%; P < .001; odds ratio, 3.066; 95% confidence interval, 2.346-4.008).ConclusionA significant decline in the teenage induced abortion rates was identified in the study population. A history of teenage induced abortion was associated with smoking and multiparity. More efforts are needed to provide appropriate education on effective contraception and family planning.     

团体艺术行为训练对青少年人际交往的影响

目的探讨团体艺术行为训练对青少年人际交往的影响。方法将80名青少年随机分为研究组(n=40)和对照组(n=40),研究组参加团体艺术行为训练(共12次,每次120 min),对照组仅接受自然观察。两组在行为训练前后分别采用自尊量表(self-esteem scale,SES)、羞怯量表(shyness scale,SS)和儿童社交焦虑量表(social anxiety scale for children,SASC)进行评估,验证行为训练的效果。应用SPSS 17.0软件进行统计分析。采用t检验、方差分析、Mann-Whitney U检验比较组内或组间差异。结果研究组在行为训练前后的SES总分[研究组7.00(5.00,9.75)分、对照组1.00(0,2.00)分]、SS总分[研究组7.00(6.00,12.75)分、对照组2.00(1.00,3.00)分]、SASC总分[研究组5.00(2.00,8.75)分、对照组0(0,1.00)分]及害怕否定评价因子分[研究组3.00(0.25,5.00)分、对照组1.00(0,1.00)分]和社交回避及苦恼因子分[研究组2.00(1,4.00)分、对照组0(0,1.00)分]的减分值均明显高于对照组(Z=-7.347,-7.338,-5.841,-4.122,-5.393,均P<0.05)。研究组女生在行为训练前后的SASC总分[女生(7.19±3.82)分、男生(3.21±3.04)分]及害怕否定评价因子分[女生(4.00±2.23)分、男生(1.68±2.05)分]和社交回避及苦恼因子分[女生3.00(1.00,5.00)分、男生2.00(0,2.00)分]的减分值均明显高于研究组男生(t=-3.611,-3.398,Z=-2.111,P=0.001,0.002,0.035)。结论团体艺术行为训练可显著提升青少年的自尊、缓解其羞怯和社交焦虑水平,促进青少年的人际交往。     

Fonctionnements autistiques et perspectives psychopathologiques sur le devenir des personnes autistes

ObjectivesPsychoanalytical and other theories of autism are mainly based on infantile clinical observation. Considering this, the perspective of the personal evolution of autistic persons during their teenage years and adulthood opens questions leading to a necessary reassessment of theoretical knowledge. Over the last decade, our understanding of autistic pathologies has increasingly underlined the importance of sensory elements in their symptomatic expression. The main objective of this theoretical reflection is to formulate new theoretical suggestions to help better understand the evolutions of autistic persons. Notably, this includes hypotheses allowing us to articulate the psychic functioning of autistic persons to other psychopathological functioning.MethodThis research is based on autobiographical writing by autistic persons, leading to a phenomenological point of view, which will be completed with elements of clinical experience. This corpus of knowledge offers insight into dismantling, stimming, and sensory pursuit, allowing us to better understand the peculiar forms of the use of the sensorial in the psychic functioning of autistic subjects. It will refer to existing psychoanalytical writing on autism, thereby suggesting a new psychopathological understanding of the archaic dimension made visible by autistic pathologies.ResultsDifferences between different forms of autism and psychosis are interrogated, in order to further understanding of clinical situations where this distinction is less evident. Autobiographical writing by autistic persons promotes understanding of the ways in which the sensory dimension plays a specific part in psychic functioning. What psychic processes are present in the sensory part of mental functioning of those subjects is theorized. Focusing on self-stimulatory behavior and sensory pursuit as they are seen in autism, it is suggested that psychic functioning builds itself with these sensory elements, thus stabilizing the psychic apparatus. The notion of autistic functioning is introduced to explain subjects’ reliance on the sensorial register as a stabilizer of the psychic apparatus. Psychic drives invest sensory sensations which are preorganized by the Id in order to become a perception. Then, these particular uses of sensory elements and perception find a way to persist in the subject's psychic functioning in diverse forms. This leads to a persistence of archaic functioning in the psyche that also can invest in other functioning. Three outlooks are explored. First, that autistic pathologies can develop in many ways, including evolutions where psychic functioning is closer to what exists in psychotic functioning. Then, how some psychotic subjects can make use of autistic functioning to help them deal with splitting anxiety. Lastly, autistic functioning can also punctually exist in certain types of trauma, opening the question of its existence outside of psychosis and autism.DiscussionThe notion of autistic functioning makes it clears how some archaic functioning, as seen un autistic persons, can maintain itself throughout subjects’ development. In the meantime, other psychic functioning appears and develops during teenage years and adulthood. Furthermore, this notion opens the question of differential diagnosis with psychosis and the possibility for autistic functioning to exist outside of autism.ConclusionsThe notion of autistic functioning leads to another way of thinking about the personal evolution of autistic persons as they get older. It, nonetheless, will require further reflection, particularly as regards evaluating its clinical relevance, as well as its usefulness for differential diagnosis.     

Traverser l’institution de soins au temps fragile de l’adolescence

By exposing on the institutional level the sufferings of his present, the adolescent talks to us about his history, the damaged, destroyed or uninhabited links which mark out his life trajectory and arise in this “meantime” of his existence in so many painful shards in the internal world of his psyche and in the body. During their journey through the care institution, we work with these adolescents and their families, in this space-time, on what could help to reduce the internal breaking lines so that they can again start moving their subjective capacities to think and act in the world. Our work ethic is based on the specific capacity of each institutional actor to deploy his/her containing psychic envelopes around young patients; symbolized deployment of the containing function by the time to think about the care for the caregiver, the time to consent to it in a safe way for the adolescent, then for the latter the time once again acceptable to explore the field of possibilities.     

大理白族自治州青少年对艾滋病认知度调查分析

目的:调查大理白族自治州的青少年对艾滋病的认知程度,为预防和控制该地区艾滋病提供参考。方法:随机抽样方法选取大理白族自治州的1500名青少年作为调查对象,采取自行设计的艾滋病认知调查表进行对其艾滋病认知度的调查,包括艾滋病相关知识、相关行为和性行为等情况。结果:男性青少年对艾滋病的知晓率为61.5%,女性青少年对艾滋病的知晓率为61.1%,两性差异无统计学意义(P0.05)。认为艾滋病是传染性疾病占58.7%,害怕或者恐惧艾滋病占50.0%,愿意与艾滋病感染患者交往占46.7%,了解艾滋病的病原体占40.0%,知道艾滋病病毒入侵人体哪个系统占26.7%,知道世界艾滋病日占50.0%,愿意接受艾滋病病毒检测占60.0%。发生性行为占58.7%,性行为时采取保护措施中使用安全套占26.7%,口服避孕药占26.7%,阴道冲洗占6.6%。性行为安全套使用情况中每次使用占13.3%,经常使用占7.3%,偶尔使用占6.0%,不使用占73.3%。结论:大理白族自治州的青少年对艾滋病的认知程度普遍较低,并对艾滋病存在认识不足的情况,应采取针对性的控制措施和加强健康知识的教育。     

青少年慢性病患者药物素养的研究进展

药物治疗是青少年慢性病患者主要的治疗方式,药物素养不足不仅会降低其用药依从性,甚至可能导致用药不良事件的发生。该文从青少年慢性病患者药物素养的概念、现状、药物素养不足的危害、相关影响因素及干预策略等方面进行综述,旨在为提高患者的药物素养、保障用药安全提供参考。     

Prevalence of vitamin D insufficiency in Swiss teenagers with appendicular fractures: a prospective study of 100 cases

Background

The significance of subclinical vitamin D deficiency in the pathogenesis of fractures in children and adolescents currently remains unclear.

Objective

We aimed to determine the prevalence of vitamin D insufficiency and its effect on bone mineral density (BMD) and bone mineral content (BMC) values in a collective of Swiss Caucasian children with a first episode of appendicular fracture.

Design and methods

One hundred teenagers with a first episode of appendicular fracture [50 upper limb fractures (group 1) and 50 lower limb fractures (group 2)] and 50 healthy controls (group 3) were recruited into a cross-sectional study. The BMC and BMD values were measured by dual-energy X-ray absorptiometry, and serum 25 hydroxyvitamin D [25(OH)D] was assessed by electrochemiluminescence immunoassays.

Results

From the 100 injured teenagers in the study, 12 % had deficient vitamin D levels (<20 ng/mL; <50 nmol/L) and 36 % had insufficient levels (≥20 <30 ng/mL; ≥50 <78 nmol/L), whereas 6 and 34 % of healthy controls were, respectively, vitamin D deficient and insufficient. There were no significant differences for serum 25(OH)D levels, L2–L4 BMD Z-score, and L2–L4 BMC Z-score variables (p = 0.216) between the three groups nor for the calcaneal BMD Z-score variables (p = 0.278) between healthy controls and lower limb fracture victims. Investigations on the influences of serum 25(OH)D on BMD and BMC showed no correlation between serum 25(OH)D and L2–L4 BMD Z-scores (r = −0.15; p = 0.135), whereas low but significant inverse correlations were, surprisingly, detected between serum 25(OH)D and calcaneal BMD Z-scores (r = −0.21; p = 0.034) and between serum 25(OH)D and L2–L4 BMC Z-scores (r = −0.22; p = 0.029).

Conclusions

A significant proportion of Swiss Caucasian teenagers were vitamin D insufficient, independent of limb fracture status, in our study. However, this study failed to show an influence of low vitamin D status on BMD and/or BMC of the lumbar spine and heel.     

离异家庭对青少年应对方式及人际信任的影响

目的探讨离异家庭对青少年应对方式及人际信任的影响。方法选取唐山市职业教育中心的125名学生用特质应对方式量表及人际信任量表进行测量。结果离异家庭与非离异家庭对青少年在应对方式的积极应对因子上存在显著性差异（t=-2.469,P〈0.01）;离异家庭与非离异家庭对青少年在人际信任因子上无显著性差异（t=1.585,P〉0.05）。结论非离异家庭的青少年比离异家庭的青少年更倾向于积极应对;离异家庭与非离异家庭对青少年的人际信任并无显著影响。