Children's symptoms and items of behaviour. An epidemiological study of sociocultural aetiology.

The aim of this article is to present the results from a point-prevalence study of symptoms and items of behaviour among children and adolescents in the western part of Norway. Empirical manifestations of personality traits and psychopathology in the ordinary population are factor-analysed. The prevalences in different types of local communities are calculated, and the variations are discussed using the concept of socialization, especially development and internalization of values, norms and behaviour in cultures with different rates of change.     

Changes in physical activity, self-efficacy and depressive symptoms in adolescent girls

The purpose of this study was to examine the longitudinal relationships between naturally occurring changes in leisure-time physical activity, depressive symptoms and self-efficacy in adolescent girls. We also aimed to test whether depressive symptoms would moderate the self-efficacy-physical activity relationship. Participants were 181 urban adolescent girls. Physical activity was measured using the 3-Day Physical Activity Recall. Self-efficacy and depressive symptoms were assessed using questionnaires. Body height and body mass were measured and body mass index (BMI) was calculated. Data were collected on three occasions over a 2-year period. There was a decrease in physical activity and self-efficacy and increase in depressive symptoms across three measurement occasions. There were statistically significant and negative relationships between initial level and change for physical activity and depressive symptoms. Initially higher levels of physical activity were related with initially lower levels of depressive symptoms, and change in physical activity across time was inversely associated with change in levels of depressive symptoms across measurements. There were statistically significant and positive relationships between initial level and change for physical activity and self-efficacy after controlling effect of BMI. Latent growth modeling (LGM) also indicated a moderating effect of depressive symptoms on the self-efficacy-physical activity relationship. Girls who had high initial levels of self-efficacy and smaller increases in depressive symptoms had the lowest decline in physical activity participation. Our results encourage the design of interventions that reduce depressive symptoms and increase self-efficacy as a possible of means of increasing adolescent girls' physical activity.     

Nutritional disorders in adolescent girls.

Four hundred and fifty four adolescent girls (11-18 years) were screened for nutritional disorders by anthropometry (weight, height and triceps skinfold measurements), clinical examination and hemoglobin estimation. Of these, 56% belonged to high socio-economic groups (Group A) and the rest (44%) to lower middle class (Group B). A large number of girls from Group B were undernourished (35.5% had weight/height2 less than the fifth percentile of reference standard) stressing the need for nutritional screening, nutrition and health education. Obesity was prevalent in 3.1% of Group A adolescents. Goitre grade I or more was observed in a high proportion of Group B girls, stressing the need for continued consumption of iodized salt in Delhi. Anemia appears to be a major health problem in adolescent girls in both groups (47, 56% in Groups A and B, respectively) underlying the ned for iron supplementation along with health education.     

Douching: a problem for adolescent girls and young women.

OBJECTIVE: To compile available published data on the prevalence of douching practices in adolescent girls and young women and the effects of douching on gynecologic health, including studies of gynecologic changes due to douching in adolescent girls and young women, surveys that demonstrated the prevalence of douching in the populations, and policy statements or lack thereof from professional and medical organizations with regard to the practice of douching. DATA SOURCES: We did Internet searches, including a MEDLINE search, a literature review, and used the telephone, mail, and e-mail to contact professional organizations. RESULTS: Douching has been found to be strongly associated with increased risk for pelvic inflammatory disease, bacterial vaginosis, and ectopic pregnancy, the former of which is especially prevalent in adolescent girls and young women. Douching is practiced by 15.5% of adolescent girls and young women in the United States, with significantly higher prevalences in certain groups in the population. We have not found any official position of professional and medical organizations on the practice of douching. CONCLUSIONS: Because vaginal douching has been shown to be associated with bacterial vaginosis, pelvic inflammatory disease, and ectopic pregnancy, and because no benefits are conferred on those who practice it, douching should be discouraged among adolescent girls and young women. There is a great need for further studies, particularly prospective ones, to determine if there is evidence of a direct causative influence of douching on pelvic inflammatory disease, ectopic pregnancy, and/or bacterial vaginosis, and to determine why adolescent girls and young women douche.     

Mainstreaming children with handicaps: implications for pediatricians

The judicial precedents and legislative mandates passed during the past two decades to ensure full appropriate public education for all children have resulted in a movement toward mainstreaming children with a wide range of physical and developmental disabilities into regular education classroom settings. Although some child development and pediatric literature has addressed the effects of these initiatives on the children with handicaps, less attention has been paid to the effect that mainstreaming has on their nondisabled peers in the classroom. As knowledgeable community advocates, pediatricians should be informed about the specifics of the mainstreaming movement. This paper outlines the movement's historical underpinnings, discusses current definitions of "mainstreaming", and briefly reviews the literature on the effects of this policy on classrooms, teachers, and students with and without disabilities. The impact of mainstreaming children with handicaps in regular classroom settings is equivocal, with many studies lacking methodological sophistication to yield reliable and valid data. Results of the few well-designed studies do show, however, that academic and social outcomes for both the handicapped child and for his/her nondisabled peers are consistently better in mainstreamed classrooms where adequate resources have been made available to the child and teacher than in more segregated settings. Furthermore, the literature consistently points out the key role both regular and special education teachers play in successful mainstreamed classrooms. Pediatricians can help families with children with disabilities negotiate the educational system in order to achieve the appropriate classroom placement.     

Asymptomatic bacteriuria in adolescent girls: I. Epidemiology.

Because the incidence of bacteriuria in asymptomatic school girls is low (1% to 2%), we examined possible risk factors in adolescents, such as previous history of urinary tract infection (UTI) and sexual intercourse (previous and recent). Eight (1.6%) of 500 adolescent girls were detected with asymptomatic bacteriuria (ABU). Of 47 patients reporting a previous UTI, four (9%) were bacteriuric. Two other patients detected with bacteriuria had a history of enuresis; thus 6/8 adolescents with ABU had a history that suggests a need to screen for infection. A history of sexual activity was not helpful in case detection. Of the 500 girls, 133 had a routine pelvic examination at the time of the visit. The procedure was not associated with bacteriuria, as measured by a home nitrite test each day for three days following the clinic visit.     

Wolfram syndrome: important implications for pediatricians and pediatric endocrinologists

Kumar S. Wolfram syndrome: important implications for pediatricians and pediatric endocrinologists.     

Common athletic injuries in adolescent girls.

Teenaged girls constitute the fastest growing segment of children and adolescents participating in organized athletics. Adolescent girls appear to have similar injury rates as boys in comparable activities but different injury patterns. To properly diagnose and manage athletic injuries in adolescent girls, pediatric health care providers must be aware of these differences, especially as the literature and their knowledge base may be skewed to the traditional predominance of males in sport. This review identifies athletic injuries that are unique to or especially common in adolescent girls, including apophyseal injuries; breast and pelvic injuries; scoliosis and spondylolysis; multidirectional shoulder instability and "gymnast's wrist"; anterior cruciate ligament injuries and patellofemoral pain syndrome; chronic exertional lower-leg compartment syndrome, ankle sprains, and reflex sympathetic dystrophy; and stress fractures. It also briefly discusses possible risk factors for these injuries, emphasizing the female athlete triad.     

Asymptomatic bacteriuria in adolescent girls: II. Screening methods.

Of 500 asymptomatic adolescent girls who were screened for bacteriuria by three methods-dipslide (Uricult), dipstrip (Microstix-3 reagent strips), and home nitrite test (Microstix-Nitrite reagent strips)-eight cases (1.6%) were detected: 6/8 by dipslide and dipstrip; 5/8 by nitrite testing. The false-positive-rate (greater than 10(4) colonies/ml) of the dipslide test was 6.4%, and the dipstrip test, 2.8%. A history of vaginal discharge was not associated with "contaminated" specimens. False-positive nitrite tests were reported by 0.6% of the patients who returned the postcards. Overall, 70.4% of the patients returned the postcards for the home nitrite test. The patients were divided by method of payment (Medicaid vs non-Medicaid) in order to provide an approximation of socioeconomic status; non-Medicaid patients were significantly more likely to return postcards than Medicaid patients (75.8% vs 63.7%). Of the group reporting previous urinary tract infection, 79% of both Medicaid and non-Medicaid patients returned postcards, suggesting that a prior experience with the diagnosis increased compliance with a home test.     

BMI distribution changes in adolescent British girls.

Body mass index (BMI) distribution changes were assessed in 2547 relatively affluent English girls, aged 12-16 years, during the UK childhood obesity epidemic (1986-96). An increase in BMI variability was observed only in 12-14 year olds, suggesting that BMI changes for population subgroups were complex, and inconsistent with a generalised increase in BMI.