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PubMedDate not supplied

[Puberal development in Cuban adolescents].

Within the sample of the National Investigation of Development and Growth in Cuba in 1972, the mean age of menarche in girls and the different stages of sexual development in both sexes were analyzed. For menarche, the status method was employed with logit analysis in a national aleatory sample that comprised 13,143 girls. The mean age for menarche was 13.01 +/- 0.02 years with a value of 12.77 for urban population and 13.26 for the rural. The study was also made by provinces. The sexual development, according with the stages of Tanner's method was investigated. The sample included about 26,000 individuals from 8 to 18 years old. The results obtained for the different percentiles with the logit analysis are offered. The importance that adolescents have a different maturation rhythm; precocious, average and late, becomes evident and the importance of the knowledge of these variants in normal individuals by the personnel in charge is pointed out.

Adolescent↗
PubMed1997

Anabolic-androgenic steroid exposure during adolescence and aggressive behavior in golden hamsters.

Anabolic androgenic steroid (AAS) abuse by adolescents represents a significant health care risk due to the potential for long-term negative physical and psychological sequelae, including increased aggressive behavior. The current experiments examined the effects of AAS use in young male adolescent hamsters (Mesocricetus auratus) and their consequences on aggressive behavior. It was hypothesized that AAS administration during adolescence predisposes hamsters to heightened levels of aggressive behavior (i.e., offensive aggression). To test this hypothesis adolescent male hamsters were administered high doses of synthetic AAS to mimic a 'heavy use' self-administration regimen used by athletes. Immediately following the exposure to AAS hamsters were tested for aggressive behavior using a resident-intruder model. Animals treated with high doses of AAS during their adolescent development showed heightened measures of offensive aggression i.e., decreased latency to bite and increased total number of attacks and bites) during the test period, while measures of total activity (total contact time) between the animals remained unchanged. AAS-treated males did not differ in body weight from controls, suggesting that the increased aggression was not due to increased body mass. The results of this study show that exposure to AAS during adolescence facilitates aggressive response patterns, but does not alter body weight.

Aggression↗
PubMed1999

How do vocational and relationship stressors and identity formation affect adolescent mental health?

PURPOSE: This article examines the effects of stressors in both the vocational and relationship career of youngsters in the formation of their identity; the effects of identity formation on adolescent mental health; the influence of career stressors on mental health, directly or via identity, and differences in these effects on boys and girls. METHODS: Data were used from the Dutch national panel study, Utrecht Study of Adolescent Development, a study of developmental processes as they occur in the life course of young people during the 1990s. Using LISREL, we tested hypotheses on two waves of a sample of 1222 respondents between 15 and 24 years of age in Wave 1 (1991). RESULTS: The correlation between relationship stressors and relationship identity can be neglected, while vocational stressors lead to a less achieved vocational identity, particularly in boys. Occupational and relationship identity have similar effects on mental health (i.e., the more achieved the identity, the better the person's mental health). Vocational and especially relationship stressors lead to poorer mental health, but did not affect the mental health of boys and girls differently. The same goes for the influence of relationship and vocational identity formation on mental health. CONCLUSIONS: Career stressors, especially stressors in the relationship domain, appear to have significant long-term effects on adolescent mental health. Vocational and relationship identity formation are also significant predictors for adolescent mental health.

Adolescent↗
PubMed1995

Posterolateral cervical or thoracic approach with spinal cord rotation for vascular malformations or tumors of the ventrolateral spinal cord.

This report describes a technique for exposing the ventrolateral quadrant of the spinal cord through an extended posterolateral approach that can be used in both cervical and thoracic regions. The surgical technique includes the following: 1) a midline skin incision with a transverse extension at the level of pathology; 2) unilateral division and retraction of the paraspinous muscles; 3) laminectomy and unilateral removal of facets and pedicles; 4) dural incision over the dorsal root entry zone; 5) multilevel division of the ipsilateral dentate ligaments; and 6) elevation and rotation of the spinal cord with dentate traction stiches. This technique provides exposure of the ventral root entry zone, the ipsilateral half of the ventral surface of the cord, and the anterior spinal artery. The surface of the spinal cord beyond the anterior spinal artery is not seen. This approach has been used for the treatment of seven ventrolateral spinal cord lesions: five spinal arteriovenous malformations (two Type II, one Type III, two Type IV), one hemangioblastoma, and one cavernous angioma. All the lesions were completely excised. Two patients had mild new neurological deficit after surgery, and one adolescent developed mild asymptomatic thoracic kyphosis, but no other spinal instability was observed over a follow-up period of 1 to 4 years. This operative approach provides significant advantages for ventrolateral perimedullary or intramedullary lesions of the cervical or thoracic spinal cord.

Adolescent↗
PubMed2002

Developmental factors in the treatment of adolescents.

Most empirically supported interventions for adolescent mental health problems are either downward adaptations of adult treatments or upward adaptations of child treatments. Although these treatments show respectable effects with teens, a review of the outcome research reveals significant gaps. both in coverage of adolescent conditions and problems (e.g., eating disorders, suicidality) and in attention to the biological, psychological, and social dimensions of adolescent development. The authors critique the field, propose a biopsychosocial framework for the development of dysfunction and intervention, and discuss ways the developmental literature can and cannot inform intervention and research. A long-term goal is an array of developmentally tailored treatments that are effective with clinically referred teens and an enriched understanding of when, how, and why the treatments work.

Adolescent↗
PubMed1998

Incidence and predictors of suicidal behaviors in a longitudinal sample of young adolescents.

OBJECTIVE: This analysis examines 1-year transition probabilities and baseline predictors for suicidal behaviors in young adolescents. METHOD: Adolescents from a two-stage, community-based longitudinal study were classified into suicidal behavior categories (attempt, plan, ideation, and none) for baseline and follow-up years. Transition probabilities for movement among categories were calculated, and polytomous logistic regression analysis was used to examine predictors of suicidal behaviors. RESULTS: Among those with no suicidal behaviors at baseline, 1-year incidence rates were 1.3% for attempts and 1.7% each for plans and ideation. Increasing family cohesion was protective for suicide attempts (odds ratio [OR] = 0.9). Female subjects were more likely than males to report plans (OR = 8.9) and ideation (OR = 4.1). Increasing impulsivity (OR = 2.3), prior suicidal behavior (OR = 10.6), and undesirable life events (OR = 1.1) were significant predictors of plans. CONCLUSIONS: While there are a number of predictors of suicidal behaviors, the false-positive rate is high. Focusing on proximal risk factors, particularly stressors in adolescent development, may overlook the fundamental role of underlying mental disorder and familial factors--both biological and environmental. Suicide and suicidal behaviors are the result of a constellation of adverse factors requiring a range of interventions for prevention.

Adolescent↗
PubMed2002

Adolescent victimization and problem drinking.

This study explores the connection between violent victimization in adolescence and subsequent problem drinking. Using national data we estimate the effects of adolescent victimization on a 3-category problem drinking measure (Abstainers, Moderate, and Binge Drinkers). We also examine the differences in the social and personal consequences of drinking across victims and non-victims. These consequences include harm to friendships, health, outlook on life, marriage, work, studies, and financial position. Victims of adolescent violence are more likely to engage in subsequent binge drinking and experience negative drinking consequences, particularly negative financial consequences. The findings are consistent with the adolescent development literature, which has highlighted the importance of violent victimization in the transition to adult roles and responsibilities. Additional research, particularly longitudinal data on violent victimization and substance abuse on a nationally representative sample of young people and adults is needed to further explore the connection between violent victimization and subsequent problem drinking.

Adolescent↗
PubMed1998

[Mitochondrial encephalomyopathies starting in childhood and adolescence].

INTRODUCTION: In this chapter we carry out a review of the current basic clinical and diagnostic aspects of mitochondrial cytopathies due to deficiencies in the mitochondrial respiratory chain complexes, which appear clinically during childhood and/or adolescence. DEVELOPMENT: The description has been divided into two groups: mitochondrial cytopathies secondary to alterations of the mitochondrial DNA (mtDNA) and mitochondrial cytopathies secondary to alterations of the nuclear DNA (nDNA). CONCLUSIONS: We conclude by considering the importance of such conditions at this age.

Adolescent↗
PubMedDate not supplied

Hypertension-induced cardiac damage in children and adolescents.

Blood pressure elevation has numerous sequelae, including myocardial infarction, stroke, congestive heart failure, end-stage renal disease, and peripheral vascular disease in adults. The impact of blood pressure elevation on target organs in children and adolescents has been less well studied. The most useful measure of cardiac effects of hypertension is the echocardiogram. Studies have now defined normal standards for left ventricular mass in young patients. In order to account for differences in body size, it is most appropriate to use left ventricular mass divided by the individual s height raised to a power of 2.7. It has been demonstrated that there is a high prevalence of left ventricular hypertrophy in adolescents with essential hypertension. Some adolescents develop severe hypertrophy and abnormal left ventricular geometry, even to a degree that would be associated with increased risk of cardiovascular disease morbidity in an adult patient. Further research is needed to better evaluate the regression of left ventricular hypertrophy. Clinicians should assess left ventricular mass index in the evaluation of pediatric patients with hypertension.

Adolescent↗
PubMed1992

Sponsorship for adolescents with diabetes.

In this intervention, teenagers with diabetes were introduced to insulin-dependent adults who served as their sponsors. The study used an experimental design with 54 adolescents randomized into experimental and control groups. Data were collected from biochemical markers, psychometric instruments, and interviews. Analysis of hemoglobins showed no differences between groups, although means for the intervention group declined. Intervention adolescents were less likely to agree that "I wish I could run away" and "I wish I didn't have diabetes" and showed higher self-esteem with regard to social acceptance and romantic appeal. Interview data showed that the adolescent-sponsor relationship provided a vital source of support that helped the adolescents develop awareness of their potential, contributing to feelings of validation and responsible regimen management. This study provides an evaluation of an innovative strategy for improving compliance in a high-risk population. The effectiveness of the intervention for black and Hispanic teenagers suggests that the program would be particularly viable in medical centers in minority communities.

Adaptation, Psychological↗
PubMed2002

Anatomical pathways and molecular mechanisms for plasticity in the barrel cortex.

The barrel cortex has yielded a wealth of information about cortical plasticity in recent years. Barrel cortex is one of the few cortical areas studied so far where plasticity can be examined from birth through to adulthood. This review looks at plasticity mechanisms in three periods of life: early post-natal development, adolescence and adulthood. Separate consideration is given to depression and potentiation mechanisms. Plasticity can be induced in barrel cortex by whisker deprivation. Single whisker experience leads to expansion of the area of cortex responding to the spared whisker. In early post-natal life, plasticity occurs in thalamocortical pathways, while later in adolescence, intracortical pathways become more important. Ablation of the spared whisker's barrel prevents expression of plasticity in the cortex. A row of lesions between the spared and an adjacent barrel prevents expression of plasticity in the adjacent barrel. This evidence, together with latency of response data and an analysis of pathways capable of inducing long-term potentiation (LTP) within barrel cortex, leads to the view that horizontal and/or diagonal pathways between barrels are responsible for plasticity expression. The mouse has become the most commonly mutated mammalian species and has a well-developed barrel cortex. Therefore, mutations can be used to study the role of particular molecules in experience-dependent plasticity of barrel cortex. Through this work, it has become clear that the major post-synaptic density protein, alpha-CaMKII, and its T286 autophosphorylation site are essential for experience-dependent plasticity. This points to a major role for excitatory transmission in cortical plasticity and raises the possibility that LTP like mechanisms are involved. Furthermore, transgenic mice carrying a reporter gene for CRE have provided evidence that CRE-mediated gene expression is also involved in barrel cortex plasticity. This view is supported by studies on alpha/delta CREB knockouts, and provides a starting point for studying the role of gene expression in experience-dependent cortical plasticity.

Age Factors↗
PubMed1975

Body composition at menarche: The Frisch-Revelle hypothesis revisited.

Figures for height and weight and derived values for total body water and fat were assembled for groups of girls with a variety of disorders to examine their conformity to the hypothesis of Frisch and Revelle that menarche occurs at a "critical" weight associated with a decline in metabolic rate and achievement of a characteristic body composition. The groups examined included girls with unusually tall stature, central idiopathic precocity, precocity associated with hypothyroidism, girls with hypothyroidism but lacking signs of sexual maturation, one group with gonadal dysgenesis, and another of girls with obesity. Girls with tall stature significantly exceeded the "critical" weight of 47.8 kg before achieving menarche but had onset of menses in accordance with the body composition hypothesis. The body composition of girls with idiopathic sex precocity was altered toward that at menarche of normals although the patients were much smaller and younger. The same trend was exaggerated in girls in whom precocity was associated with hypothyroidism; equally hypothyroid girls showing no signs of adolescent development had body compositions similar to those of age-matched controls. Girls with gonadal dysgenesis showed an alteration in body composition paralleling that of normals between the ages when the latter begin the pubertal growth spurt and achieve menarche. Girls under 8 years of age with simple obesity had an even greater percentage of body fat than normal menarchal girls but showed no signs of puberty. It is concluded that menarche is not necessarily triggered by achievement of a critical body weight or lowering of metabolism. Neither are the rising levels of estrogen in adolescence solely responsible for the characteristic increase in body fat. Only the data on girls with obesity failed to accord with the generalization that, when the ovaries are competent, menarche is highly correlated with achievement of a characteristic body composition. The observations, particularly in gonadal dysgenesis, suggest the pituitary gonadotropins may play a role in determining body composition in menarche.

Adolescent↗
PubMed2001

Psychosocial outcomes of urban African American adolescents born to teenage mothers.

This is a study of psychosocial outcomes of adolescents born to teenage mothers. Adolescents'problem behaviors, psychological well-being, social support, school variables, and sexual behaviors are compared across three groups- those born to mothers 17 or younger, mothers 18-19 years old, and mothers 20 or older. Analyses from two samples of African American adolescents from Maryland (n = 205) and Michigan (n = 570) are reported. The results from both samples indicate that mother's age at birth is unrelated to adolescents' psychosocial outcomes. These two studies add to the limited number of analyses that examine adolescent outcomes for children of teen mothers. The results suggest that efforts to understand social structural determinants of healthy and problematic adolescent development may be more informative than examining the effects of mother's age. They also suggest that teen pregnancy prevention programs may be more effective if they are part of a larger prevention strategy that incorporates social structural change efforts and not only a focus on individual level change.

Adolescent↗
PubMedDate not supplied

[The Croatian Society for Infant, Child and Adolescent Psychiatry: present state and proposals for improving the development of child and adolescent psychiatric services in Croatia].

The paper presents the current state of child and adolescent psychiatry in the Republic of Croatia. Thirty-seven psychiatrists practicing child and adolescent psychiatry in the entire Republic point to the lack of staff in this subspecialty profession. The subspecialty was approved by the Ministry of Health in 1994. The city of Zagreb satisfies the criteria of some European countries as regards the number of staff, but not as regards the organization of the service for child and adolescent psychiatry (e.g. lack of university hospital department as the base for medical teaching and further specialist training). In other and larger centers in the Republic the situation is well below the criteria achieved in this profession, particularly in the countries of the European Union and the USA. Still, psychiatric services in some towns tend to support the development of child and adolescent psychiatry in their environment by providing facilities and staff. There are still attempts, even in the health service itself, to overcome this lack of personnel and organization by transferring numerous cases from the domain of child and adolescent psychiatry to experts in other medical specialties or non-medical professionals, instead of improving the development of child and adolescent psychiatry. In some countries of the European Union and the USA it has already reached the monospecialty status, a tendency supported by the UEMS, which also makes efforts to coordinate programs of specialist training in the European countries. The described situation certainly has consequences in the of mental health care of children, adolescents and their families, because their treatment often begins only when a disorder has visibly developed. Its clinical manifestations can take very different forms.

Adolescent↗
PubMed2003

Two approaches to derive a proposal for added sugars intake for German children and adolescents.

OBJECTIVE: Intake of sugars is restricted in most international food guides. However, in recent recommendations quantified limits of added sugars intake have not been given, although deemed necessary by those who criticised the recommendations. DESIGN: Two approaches to derive a scientifically based quantified limit of added sugars intake for German children and adolescents are suggested. For the first dietary survey approach, 5120 three-day weighed dietary records from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study were used. Added sugars intakes in records of high vs. low dietary quality, measured by a nutrient intake score, were compared. For the second approach, a total dietary concept for German children and adolescents developed and evaluated by the Research Institute of Child Nutrition - the Optimised Mixed Diet - was used. RESULTS: Whereas in the latter dietary concept an added sugars intake of about 6% of energy intake is tolerated, the dietary survey approach resulted in only small differences between high and low dietary quality, with a median added sugars intake of 12% of energy in records with high dietary quality. CONCLUSIONS: A reasonable dietary quality is possible within higher ranges of added sugars intake than derived from the dietary concept approach. Therefore we suggest a range of intake of added sugars for German children and adolescents, from 6% to 12% of energy.

Adolescent↗
PubMedDate not supplied

Preventing secondary pregnancy in adolescents: a model program.

The Dollar-A-Day program in Greensboro, North Carolina, was established in 1990 to prevent subsequent pregnancies in girls under 16 years of age who had already given birth to one child. Conceptualized by nursing professors and using principles from theories of adolescent development and social exchange, the program was planned and implemented in collaboration with nurses from the local health department. Weekly meetings featured food, an informal program focused on needs identified by members, setting of short-term goals, and an award of a dollar for each day they remained nonpregnant. After five years of operation with a series of small grants, only 15% of the 65 girls who had been enrolled in the program experienced subsequent pregnancies. The success of the program convinced health department officials to incorporate Dollar-A-Day into their budget as a permanent service to the population of adolescents they serve. It remains as a model program for others to emulate.

Adolescent↗
PubMedDate not supplied

Does milk make children grow? Relationships between milk consumption and height in NHANES 1999-2002.

In the United States, milk (usually cow's milk) is widely considered an "essential food" to support bone growth among post-weaning age children, as evident in government-sponsored nutrition policies that mandate milk for children. Milk contains calories, protein, and calcium, among other nutrients, and bioactive components such as insulin-like growth factor-I (IGF-I), all of which may facilitate bone growth. There is a large literature on milk and/or calcium intake and its effects on bone density, but one aspect of bone mass--height--is not well studied in relation to milk consumption. Limited experimental studies show no consistent relationship across populations. To investigate this linkage among American children, analysis of the NHANES 1999-2002 was undertaken. NHANES data allow two hypotheses to be tested: (1) reported frequency of childhood milk consumption will be positively related to adult height and (2) height of children 5-18 years will be predicted by the reported frequency of milk consumption and/or milk intake from a 24-h dietary recall. Results indicate that adult height was positively associated with milk consumption at ages 5-12 and 13-17, after controlling for sex, education, and ethnicity. Among contemporary children, milk consumption had no effect on the height of 5-11 year olds after controlling for age, birthweight, energy intake, and ethnicity. In contrast, milk consumption frequency and milk intake (measured as grams of milk, or protein or calcium from milk) were significant predictors of the height of 12-18 year olds, along with age, sex, household income, and ethnicity. The greatest ethnic contrasts were between Mexican Americans and non-Hispanic whites and blacks, and milk variables remained significant predictors of height in these comparisons. Thus NHANES data show substantial variability in the effects of milk consumption on height.

Adolescent↗