Promoting adolescent health

The aim is to discuss why paediatricians should be involved in adolescent health care and provide youth-friendly-health-services. Global epidemiological data on morbidity and mortality demonstrate that much of ill health in the short and long run are connected to adolescent behaviour and in theory available for prevention. Young people seemingly lose their heads and do not consider dangers. Recent research on brain development provides us with an understanding how this may have a biological base. Also psychology has long taught us how adolescents use experimental behaviours as means to satisfy developmental needs and explore identity. Prevention and health promotion are areas of research where much more needs to be done. There is also a lack of venues for publishing even excellent studies in this field.     

Improving adolescent health outcomes

Adolescent morbidity and mortality are more often due to preventable causes and to risky behavioral choices than to "natural" causes, such as cardiovascular disease or cancer. The leading causes of death among adolescents in Western, industrialized nations are unintentional injuries, especially motor vehicle crashes, homicide, and suicide. The physical and cognitive development of adolescents also results in increased risky behavioral choices, and to high rates of sexually transmitted diseases, substance use and misuse, and inadequate nutrition. These lifestyle choices also have repercussions that last into adulthood. Brief counseling interventions by physicians or other clinicians have been shown to be effective in modifying health risk behaviors in adolescents. Adolescents also have indicated both a belief that physicians should counsel them on risk behaviors and a willingness to discuss risk behaviors if asked about them in a confidential manner. In this paper, we review the leading causes of adolescent morbidity and mortality in the United States and Western Europe, including injuries, violence, depression and suicide, substance use, sexual activity, and nutrition, physical activity, and eating disorders. In addition, we describe the effectiveness of physician counseling for reduction or prevention of specific risk behaviors and the importance of providing comprehensive, confidential care. Additionally, we describe the results of a recent study of implementation of Adolescent Preventive Service Guidelines in community and migrant health centers that increased risky behavior screening and counseling for adolescent patients seen for routine/well care visits.     

Interdisciplinary education in adolescent health

Abstract To date, evidence suggests that, across disciplines, the educational preparation of health professionals has not kept pace. Those involved in the education of clinicians, researchers, and educators in adolescent health are currently faced with the need to rethink traditional educational strategies. Concurrent with a shift in the primary causes of morbidity and mortality in adolescence, from infectious to social aetiologies, is an emerging clarity about the success of integrated comprehensive service settings in addressing adolescents' health needs. One approach for better preparing health providers to work in multiservice settings is to provide training in interdisciplinary programmes. Various models for interdisciplinary education in adolescent health exist; characteristics common to all are delineated. Whereas obstacles to the creation and implementation of interdisciplinary programmes, including institutional, financial, and educational barriers, are great, the need to overcome them is critical if we are to keep pace with the changing needs of the adolescent population.     

Social networking sites and adolescent health

Social networking sites are popular among and consistently used by adolescents. These sites present benefits as well as risks to adolescent health. Recently, pediatric providers have also considered the benefits and risks of using social networking sites in their own practices.     

Time trends in adolescent mental health

BACKGROUND: Existing evidence points to a substantial rise in psychosocial disorders affecting young people over the past 50 years (Rutter & Smith, 1995). However, there are major methodological challenges in providing conclusive answers about secular changes in disorder. Comparisons of rates of disorder at different time points are often affected by changes in diagnostic criteria, differences in assessment methods, and changes in official reporting practices. Few studies have examined this issue using the same instruments at each time point. METHODS: The current study assessed the extent to which conduct, hyperactive and emotional problems have become more common over a 25-year period in three general population samples of UK adolescents. The samples used in this study were the adolescent sweeps of the National Child Development Study and the 1970 Birth Cohort Study, and the 1999 British Child and Adolescent Mental Health Survey. Comparable questionnaires were completed by parents of 15-16-year-olds at each time point (1974, 1986, and 1999). RESULTS AND CONCLUSIONS: Results showed a substantial increase in adolescent conduct problems over the 25-year study period that has affected males and females, all social classes and all family types. There was also evidence for a recent rise in emotional problems, but mixed evidence in relation to rates of hyperactive behaviour. Further analyses using longitudinal data from the first two cohorts showed that long-term outcomes for adolescents with conduct problems were closely similar. This provided evidence that observed trends were unaffected by possible changes in reporting thresholds.     

Male adolescent sexual and reproductive health care

Male adolescents' sexual and reproductive health needs often go unmet in the primary care setting. This report discusses specific issues related to male adolescents' sexual and reproductive health care in the context of primary care, including pubertal and sexual development, sexual behavior, consequences of sexual behavior, and methods of preventing sexually transmitted infections (including HIV) and pregnancy. Pediatricians are encouraged to address male adolescent sexual and reproductive health on a regular basis, including taking a sexual history, performing an appropriate examination, providing patient-centered and age-appropriate anticipatory guidance, and delivering appropriate vaccinations. Pediatricians should provide these services to male adolescent patients in a confidential and culturally appropriate manner, promote healthy sexual relationships and responsibility, and involve parents in age-appropriate discussions about sexual health with their sons.     

Parents' views of adolescent health issues.

To determine how important the parents of teenagers consider adolescent health issues to be and the kind of involvement they would like from their schools and physicians, a questionnaire was sent to 1090 families with children attending two public high schools in a suburban community. The 438 parents who completed the questionnaire (40% response rate) indicated that their adolescents had a mean age of 16.2 years, 52% were male, 54% were in grades 11 and 12, and 70% received regular care from a pediatrician. Most parents considered substance use, sexuality, mental health issues, nutritional concerns, and general medical issues to be issues requiring attention nationally; many considered these issues to require attention locally; fewer considered these issues to require attention for their teenager's friends; and only some indicated these issues require attention for their own teenagers. More than 95% of respondents said parents should discuss these topics with their teenagers, more than 80% said they themselves did, and more than 85% said they wanted these issues discussed with their adolescents in school. Approximately three quarters of parents said that they would bring their adolescent to their regular doctor for management of these issues, expected that their physician would be comfortable with such care, and wanted their doctor to discuss these issues with their teenagers.(ABSTRACT TRUNCATED AT 250 WORDS)     

Indigenous child oral health at a regional and state level

AIM: To compare the dental disease experience of Indigenous and non-Indigenous children in South Australia's mid-north region (regional area) and to assess Indigenous oral health differences at a regional- and state-level. METHODS: Data were collected from a School Dental Service based in an Aboriginal-owned medical health service and standard school dental clinics in the regional area from March 2001 to March 2006. State-level data were obtained over a 12-month period in 2003. Caries prevalence (per cent dmft or DMFT >0) and severity (mean dmft or DMFT, SiC and SiC10) measures were used to assess dental disease experience. RESULTS: In the regional area, Indigenous children aged <10 years had 1.6, 1.9, 1.6 and 1.4 times the percent dmft >0, mean dmft, SiC primary and SiC(10) primary, respectively, of their non-Indigenous counterparts, while Indigenous children aged 6+ years had 1.3, 1.7, 1.7 and 1.6 times the percent DMFT > 0, mean DMFT, SiC permanent and SiC10 permanent, respectively, of non-Indigenous children. Indigenous children in the regional area had significantly higher caries prevalence and severity than Indigenous children at a state-level. CONCLUSION: Indigenous children in South Australia's mid-north region are dentally disadvantaged in comparison with their non-Indigenous counterparts and with the general South Australian Indigenous child population.