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PubMedDate not supplied

Tetanus antibody levels among adolescent girls in developing countries.

Neonatal and maternal tetanus infections remain an important cause of death in many countries. Few studies have reported tetanus toxoid antibody levels of adolescent girls. As part of the Expanded Programme on Immunization most girls receive up to 3 injections in early childhood, and many subsequently do not receive booster vaccinations until pregnant. We determined (by ELISA) tetanus antibody seropositivity in adolescent girls from Malawi (in 1996), Nigeria (in 1993) and Pakistan (in 1996), and response to tetanus vaccination in adolescent girls from Pakistan. Geometric mean titres (GMT, IU/mL) were 0.94 in 117 Malawian, 0.32 in 154 Nigerian and 1.08 in 162 Pakistani girls. In Nigeria, 54.7% of adolescents were seronegative, of whom 26.8% had a history of unsafe abortion. In Malawi and Pakistan all girls were seropositive and in Pakistan, following a booster vaccination, titres increased 3-fold, with a lower response in older girls. The results indicated that adequate childhood immunization is likely to provide protective levels through adolescence. Booster vaccination in late childhood/early adolescence should protect the majority of women throughout their reproductive lives. This practice would reduce the risks of girls exposed to infection through unsafe abortions, and may be the best option for countries seeking to improve their vaccination schedule, especially where tetanus vaccine coverage in pregnant women is unacceptably low.

Adolescent↗
PubMedDate not supplied

Modeling stability and change in strength development: a study in adolescent boys.

The purpose of this study was to investigate stability and change in different expressions of strength development in adolescent boys using structural equation modeling. Three models were used: Markov simplex to study stability or tracking, Wiener or random walk to investigate fanning-out or spread effects in change, and latent growth to study differences in individual pathways of change as well as group changes. In the Leuven Growth Study, 588 male subjects were followed for 6 years with a mean age of 12.7 years at the onset of the study. Vertical jump, arm pull, and bent arm hang were used to mark the following strength factors: explosive strength, static strength, and functional strength. All models were tested with robust estimation procedures based on the software EQS 6.0. Main results and conclusions are as follows: 1) all strength factors showed moderate to high tracking, with low values of instability in relative position of the subjects in their developmental channels; 2) the fanning-out effect is not obvious, although some evidence showed a spread effect in functional and explosive strength; 3) there are marked interindividual differences in developmental pathways of strength manifestations; 4) strength development is linear and also has some curvilinearity, something akin to a breaking effect; 5) linear trend is negatively correlated with initial status and the leveling-off effect is also negatively correlated with the linear change.

Adolescent↗
PubMed2005

The Bath Adolescent Pain Questionnaire (BAPQ): development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents.

Chronic pain causes significant problems in the lives of many adolescents, considerably affecting their physical, psychological and social functioning. The assessment of the multidimensional impact of chronic pain is an essential clinical task. This study reports on the development and psychometric evaluation of the Bath Adolescent Pain Questionnaire (BAPQ); an assessment tool designed specifically for use with adolescents who experience chronic pain. A sample of 222 adolescents (11-18 years) experiencing chronic pain completed the 109-item draft inventory. Participants were recruited from two different UK clinics. All participants responded to items using a 5-point frequency scale. Psychometric evaluation of the data resulted in a reduced inventory length of 61 items. Internal consistency of all seven questionnaire subscales was established using Cronbach's alpha. Comparative validity was undertaken by comparison of all individual subscales with existing validated measures (SCAS, CDI-S, FDI, Brief FAM. PCS and CASAFS). The temporal reliability of each inventory subscale was established using a sub-sample of 30 adolescent participants over a 17-day period. Psychometric evaluation of the data suggests the inventory yields both a reliable and valid assessment of the impact of chronic pain on the lives of adolescents. The BAPQ may offer a comprehensive way to assess the widespread deleterious impact of adolescent chronic pain in both a research and clinical setting. Further investigation is needed on the predictive validity of the subscales. Additional data from samples of patients with diagnoses that are not musculoskeletal in origin would be of great assistance.

Adolescent↗
PubMed2006

Cancer in children and adolescents in Europe: developments over 20 years and future challenges.

This special issue contains 18 articles describing population-based analyses of incidence and survival for cancer among children and adolescents in Europe over the period 1978-1997. The analyses were derived from the large database of the ACCIS project (Automated Childhood Cancer Information System), which was built through collaboration of 62 population-based cancer registries in 19 European countries. Data on 88,465 cancers in children and 15,369 in adolescents (age 15-19 yrs) were included in the various analyses, making this the largest database on cancer in these age-groups in the world. National data were grouped into five European regions to allow comparisons of incidence and survival, for all cancers and by tumour type, including analysis of trends in both over time. This overview paper focuses on the comparability of the data from multiple registries and describes the potential confounding factors. Age-standardised annual incidence rates of many, but not all, cancers in children and adolescents are clearly rising. There are geographical differences in survival for the majority of tumour types. Survival rates increased for nearly all types of cancer in children and adolescents. The implications of these findings for aetiological factors and treatment delivery for cancer in children and adolescents are discussed.

Adolescent↗
PubMed1999

Choice of feeding method of adolescent mothers: does ego development play a role?

STUDY OBJECTIVES: The purpose of this study was to determine whether, among childbearing adolescents, ego development was associated with intention to breast-feed and with actual breast-feeding behavior at birth and at 2 weeks postpartum. In addition, we sought to determine whether positive attitudes toward breast-feeding influenced pregnant adolescents' intentions to breast-feed and actual breast-feeding at the hospital and at 2 weeks postpartum. We hypothesized that adolescents with higher levels of ego development and positive attitudes toward breast-feeding would be more likely to intend to breast-feed and to actually breast-feed. DESIGN: Prospective cohort study of pregnant adolescents who completed questionnaires, Loevinger's Sentence Completion Tests, and attitudes toward breast-feeding scales before delivery and a follow-up questionnaire at 2 weeks postpartum assessing feeding practice in the hospital and at 2 weeks postpartum. SETTING: Two adolescents' clinics and two "teen-and-tot" clinics in urban teaching hospitals. PARTICIPANTS: Fourteen- to 22-year-old pregnant adolescents who had never given birth and who planned to carry their pregnancy to term and parent their children. MAIN OUTCOME MEASURES: 1) Intended feeding practice during pregnancy, 2) feeding method in the hospital, and 3) feeding method at 2 weeks postpartum. RESULTS: Of the 125 subjects enrolled in the study, 106 were at 2 weeks postpartum or more. Of these 106 participants, 75% (n = 78) completed more than 75% of the attitudes toward breast-feeding scale and Loevinger's Sentence Completion Test and are included in these analyses. Mean age at entry was 17.8 +/- 1.5 years (range, 14.3 to 21.8 years). Mean gestational age at enrollment was 21.2 +/- 11.6 weeks (range, 4 to 41 weeks). Of the 78 participants, 12% (n = 9) were at the preconformist, 85% (n = 66) at the conformist, and 4% (n = 3) at the postconformist level of ego development as determined by the Sentence Completion Test. Attitudes toward breast-feeding, intention to breast-feed, breast-feeding in the hospital, and breast-feeding at 2 weeks postpartum were not significantly associated with adolescents' stages of ego development. Almost three fourths of the adolescents intended to breast-feed, and 85% tried breast-feeding in the hospital. A total of 97% (56 of 58) of those who intended to breast-feed tried breast-feeding in the hospital compared with 40% (4 of 10) of those who did not intend to breast-feed (P < .0001). At 2 weeks postpartum, 58% of the participants were still breast-feeding. Of those participants who intended to breast-feed, 67% (39 of 58) were breast-feeding at 2 weeks postpartum compared with 10% (1 of 10) who did not intend to breast-feed (P = .001). The mean breast-feeding attitude score was 53.7 +/- 11.6 (range, 25 to 72). The mean breast-feeding attitude score was higher for those who intended to breast-feed than for those who intended to formula-feed (P = .009), but the score was not associated with breast-feeding in the hospital or at 2 weeks postpartum. CONCLUSION: Adolescent mothers were predominantly in ego stages 4 and 5, the conformist level. Because ego development was not associated with outcome measures in this study, ego development may not be a crucial factor when designing interventions to facilitate breast-feeding among adolescents. Attitudes toward breast-feeding were associated with the intention to breast-feed but not behaviors; the intention to breast-feed was significantly associated with breast-feeding behaviors.

Adolescent↗
PubMed2002

[Development of body image in adolescence].

In a prospective study the development of body experience in adolescence and associations with psychosocial characteristics as well as development of symptoms were investigated. Body experience, physical and psychological well-being as well as sense of coherence were assessed three times over the course of 18 months in 325 male and female adolescents aged 16-19 years. During the course of the study the participants reported an improvement of their body experience. Female adolescents reported at all assessment times lower levels of attractiveness/self-confidence and higher levels of insecurity/worry than males. Body experience, physical and psychological well-being as well as sense of coherence were closely associated with each other. The results indicate that body experience generally consolidates during the course of adolescence. However, the development on individual levels can vary considerably. The body experience reflects the physical and psychosexual development as well as the adolescents' well-being. Thus, more consideration should be given to body experience in therapies with adolescents who suffer from psychosomatic illness.

Adaptation, Psychological↗
PubMed2005

[Parental relationship from the perspectives of children, adolescents and clinicians. Development and clinical validation of the Parental-Representation-Screening-Questionnaire (PRSQ)].

The Parental-Representation-Screening-Questionnaire (PRSQ) is a new instrument designed to asses how children and adolescents evaluate their relationship with their parents. The aim of the questionnaire is to assess those aspects in the child-parent relationship that are crucial for a psychopathological risk. Conceptually, the PRSQ is based on cognitive self theory and systemic family theory. The PRSQ consists of 8 scales (36 items) for each parent: "freedom of decision", "emotional burden by the parents", "fears / overprotection", "conflict", "hostility / indifference", "aid for the parents", "punishment", and "support from the parents''. A clinic-referred consecutive sample of 152 patients of a Berlin child and adolescent psychiatry, aged 10 to 18 years, were surveyed. Adverse educational and psychosocial family factors were assessed by clinicians according to the fifths axis of the multiaxial classification system (MAS, Dilling et al. 2000). The internal reliability for 13 of the 16 scales ranges from .90 to .72. Factor analyses confirmed the factorial independence of six of the eight scales separately for mother and father. Moreover, adolescent girls reported significantly worse relations to both parents on five of the 16 scales than boys. Furthermore we found concordant correlations with the clinician's diagnosis of adverse educational and psychosocial family situations. The present results confirm the PRSQ as an economic and discriminating instrument to assess the representation of parent-child relation for clinical and for scientific purposes.

Adolescent↗
PubMed2004

Adolescent smoking cessation: development of a school nurse intervention.

The purpose of this study was to examine the feasibility of a range of strategies to engage and to enhance secondary school nurse involvement in teenage smoking prevention and cessation. School nurses were willing to assist students to quit smoking, but they felt unprepared. Information provided by nurses involved in a three-stage review, pilot-testing, and trial design resulted in the development of a resource for nurses. This resource comprised individual student approaches (brief intervention based on motivational interviewing and written activities designed to help students examine their smoking behavior), approaches to assist parents (letter of support for parents of students who smoke), and school newsletter items. Each component of the resource was found by school nurses to be appropriate, useful, and complementary to their other school- wide approaches to assist adolescents to quit smoking. Nurses also reported an interest to expand or to enhance their smoking cessation role in the school.

Adolescent↗
PubMed1997

[Early functional surgery as a component of interceptive treatment of developing dysmorphosis in adolescents].

A discordance in the shape and relation between dental arches may be corrected by functional orthopaedics. Discovered in the adolescence, the dysgnathia has yet run its course and it remains just a bit of growth power, this situation justifies to recourse to interceptive surgery, meant for facilitation of oral reeducation and thus harmonisation of residual facial growth. This "functional surgery" is composed of tongue myoplasty, functional genioplasty and the early corrective orthopaedic surgery which is defined by its association with immediate reeducation. It is characterized by its benignity and stability of its results if occlusal and functional surroundings are equilibrated. Moreover, its profits by residual growth power which became well guided, and assures improvement of immediate postoperative results, if needed.

Adolescent↗