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Sample records for adolescent aids clinical

  1. [Adolescence and AIDS].

    PubMed

    1991-01-01

    The myths and prejudices that distort the reality and hide the true causes and effects of natural and social phenomena related to sexuality have a fertile ground in AIDS, given its obvious link to sex. The alarming spread of AIDS has been 1 result of these myths and prejudices. Human beings are sexual by nature; genital organs determine sex and also induce sexual behavior. It is by not fairly well accepted that an individual's sexuality exists from birth. Puberty usually begins at 12-16 years for both sexes. The physical changes of puberty terminate in the ability of the female to conceive and the male to procreate. The sexual excitation of adolescents resulting from production of various hormones can only be eliminated by some type of sexual satisfaction or sublimation. Sexuality, according to Freud, is an organizing principle of the personality. The sexual organs exist not merely for reproduction but to provide pleasure. Puberty signifies entry into active sex life. But the ideological structure of society, perpetuated by the family, schools, religion, the mass media, and other social institutions, sends confused signals to adolescents, requiring abstinence and virginity until marriage for women while encouraging sexual adventures for men. Adolescents are confronted by their new sexual feelings in the midst of a virtual bombardment of visual sexual stimuli from the mass media. It becomes impossible for adolescents to satisfy the requirements of appearances while also resolving the problems and pressures of their newly gained sexual maturity. Many adolescents become sexually active, and the problem is not to prevent sexual activity but to improve the conditions under which it occurs. Adolescents, lacking education and information about sex, begin their sex lives without protection. AIDS has now been added to the list of dire consequences that can result. A true sex education beginning in the home is needed to enable young people to develop healthy and full sex

  2. [Adolescence and AIDS].

    PubMed

    1991-01-01

    The myths and prejudices that distort the reality and hide the true causes and effects of natural and social phenomena related to sexuality have a fertile ground in AIDS, given its obvious link to sex. The alarming spread of AIDS has been 1 result of these myths and prejudices. Human beings are sexual by nature; genital organs determine sex and also induce sexual behavior. It is by not fairly well accepted that an individual's sexuality exists from birth. Puberty usually begins at 12-16 years for both sexes. The physical changes of puberty terminate in the ability of the female to conceive and the male to procreate. The sexual excitation of adolescents resulting from production of various hormones can only be eliminated by some type of sexual satisfaction or sublimation. Sexuality, according to Freud, is an organizing principle of the personality. The sexual organs exist not merely for reproduction but to provide pleasure. Puberty signifies entry into active sex life. But the ideological structure of society, perpetuated by the family, schools, religion, the mass media, and other social institutions, sends confused signals to adolescents, requiring abstinence and virginity until marriage for women while encouraging sexual adventures for men. Adolescents are confronted by their new sexual feelings in the midst of a virtual bombardment of visual sexual stimuli from the mass media. It becomes impossible for adolescents to satisfy the requirements of appearances while also resolving the problems and pressures of their newly gained sexual maturity. Many adolescents become sexually active, and the problem is not to prevent sexual activity but to improve the conditions under which it occurs. Adolescents, lacking education and information about sex, begin their sex lives without protection. AIDS has now been added to the list of dire consequences that can result. A true sex education beginning in the home is needed to enable young people to develop healthy and full sex

  3. Adolescent HIV/AIDS: Issues and challenges.

    PubMed

    Naswa, Smriti; Marfatia, Y S

    2010-01-01

    Adolescence (10-19 years) is a phase of physical growth and development accompanied by sexual maturation, often leading to intimate relationships. Adolescent HIV/AIDS is a separate epidemic and needs to be handled and managed separately from adult HIV. The adolescents can be subdivided into student, slum and street youth; street adolescents being most vulnerable to HIV/AIDS. Among various risk factors and situations for adolescents contracting HIV virus are adolescent sex workers, child trafficking, child labor, migrant population, childhood sexual abuse, coercive sex with an older person and biologic (immature reproductive tract) as well as psychological vulnerability. The most common mode of transmission is heterosexual, yet increasing number of perinatally infected children are entering adolescence. This is due to "bimodal progression" (rapid and slow progressors) among the vertically infected children. Clinically, the HIV infected adolescents present as physically stunted individuals, with delayed puberty and adrenarche. Mental illness and substance abuse are important co-morbidities. The disclosure and declaration of HIV status to self and family is challenging and guilt in sexually infected adolescents and tendency to blame parents if vertically affected need special consideration and proper counseling. Serodiscordance of the twins and difference in disease progression of seroconcordant twins are added causes of emotional trauma. Treatment related issues revolve around the when and what of initiation of ART; the choice of antiretrovirals and their dosages; issues related to long term ADRs; sense of disinhibition following ART commencement; adherence and resistance. PMID:21808429

  4. The adolescent athlete and ergogenic aids.

    PubMed

    Dyment, P G

    1987-01-01

    Amphetamines and anabolic/androgenic steroids are the ergogenic aids with the most serious side effects that adolescents are likely to misuse, although adolescents are more frequently lured into taking expensive and worthless vitamin and protein supplements. Physicians performing preparticipation physical examinations should address the issue of ergogenic aids when they offer anticipatory guidance to adolescent athletes.

  5. Behavioral Risk Factors for AIDS among Adolescents.

    ERIC Educational Resources Information Center

    Millstein, Susan G.

    This document examines the incidence of Acquired Immune Deficiency Syndrome (AIDS) among adolescents in the United States and identifies several risk factors for AIDS among this population. It classifies adolescents' risk for contracting human immunodeficiency virus (HIV) infection by the degree to which adolescents engage in behaviors that are…

  6. Prototypical Images in Condom Scripts among AIDS-Bereaved Adolescents

    ERIC Educational Resources Information Center

    Reich, Warren A.; Rubin, Rachel M.

    2007-01-01

    Twenty-five HIV-negative late adolescents (13 women and 12 men) who had lost a parent to AIDS generated vignettes in which the characters were deciding whether to use a condom (condom scripts). Two clinically trained judges rated the interpersonal tone of the condom scripts on 17 semantic differential scales. Three other clinically trained raters…

  7. Asset Ownership and Health and Mental Health Functioning Among AIDS-Orphaned Adolescents: Findings From a Randomized Clinical Trial in Rural Uganda

    PubMed Central

    Han, Chang-Keun; Neilands, Torsten B

    2010-01-01

    This study evaluated an economic empowerment intervention designed to promote life options, health and mental health functioning among AIDS-orphaned adolescents in rural Uganda. The study used an experimental design in which adolescents (N=267) were randomly assigned to receive an economic empowerment intervention or usual care for orphaned children. The study measured mental health functioning using 20 items of the Tennessee Self-Concept Scale (TSCS: 2)—a standardized measure for self-esteem—and measured overall health using a self-rated health measure. Data obtained at 10-month follow-up revealed significant positive effects of the economic empowerment intervention on adolescents’ self-rated health and mental health functioning. Additionally, health and mental health functioning were found to be positively associated with each other. The findings have implications for public policy and health programming for AIDS-orphaned adolescents. PMID:19520472

  8. Federal Policy and Adolescent AIDS.

    ERIC Educational Resources Information Center

    Wilcox, Brian L.

    1990-01-01

    Maintains that federal policy on adolescent Acquired Immune Deficiency Syndrome health care and research is nonexistent or piecemeal. Despite the work of the Centers for Disease Control, efforts at preventive education are uncoordinated, resulting from the decentralized nature of the public health and education systems, and are hampered by social…

  9. HIV/AIDS Clinical Trials Fact Sheet

    MedlinePlus

    HIV Prevention HIV/AIDS Clinical Trials (Last updated 9/15/2015; last reviewed 9/15/2015) Key Points HIV/AIDS clinical trials are ... and effective in people. What is an HIV/AIDS clinical trial? HIV/AIDS clinical trials help researchers ...

  10. Adolescents, AIDS and HIV. Resources.

    ERIC Educational Resources Information Center

    Resources for Educators, 1990

    1990-01-01

    This compilation of educational resources is designed for communities which have been either overlooked in Acquired Immune Deficiency Syndrome (AIDS) education efforts or disproportionately affected by Human Immunodeficiency Virus (HIV) infection. The materials listed target Blacks, Latinos, Asians and Pacific Islanders, Native Americans, young…

  11. Adolescents' AIDS Risk Taking: A Rational Choice Perspective.

    ERIC Educational Resources Information Center

    Gardner, William; Herman, Janna

    1990-01-01

    Discounts the belief in adolescents' irrational behavior, and proposes a rational choice decision-making theory of adolescent risk-taking behavior. Suggests that social ecology affects risk-taking choices. Proposals for AIDS education concern delayed initiation of sexual activity, promotion of condom use, and counseling of high-risk adolescents.…

  12. HIV/AIDS Researchers Interaction with Schoolteachers: A Key to Combat AIDS among Brazilian Adolescents

    ERIC Educational Resources Information Center

    Kashima, Simone; de Castro, Fabiola Attie; de Castro Amarante, Maria Fernanda; Barbieri, Marisa Ramos; Covas, Dimas Tadeu

    2008-01-01

    Considering the fact that information on HIV/AIDS is a strategy for disease control, this project was planned to provide comprehensive information about HIV infection and AIDS to schoolteachers and their students. Previous analysis of adolescent students' knowledge of HIV/AIDS showed that they still have doubts about transmission, diagnosis, and…

  13. Clinical Criteria for Physician Aid in Dying.

    PubMed

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period.

  14. An Intervention for Parents with AIDS and Their Adolescent Children.

    ERIC Educational Resources Information Center

    Rotheram-Borus, Mary Jane; Lee, Martha B.; Gwadz, Marya; Draimin, Barbara

    2001-01-01

    Evaluated an intervention designed to improve behavioral and mental health outcomes among adolescents and their parents with AIDS. Participants completed intervention or standard care programs. Results indicated that intervention adolescents had significantly lower levels of emotional distress, behavior problems, conduct problems, and…

  15. Knowledge of AIDS and Sexually Transmitted Diseases among Foster Adolescents.

    ERIC Educational Resources Information Center

    Mech, E. V.; Pryde, J. A.

    1994-01-01

    The sample consisted of 533 adolescent state wards. Knowledge levels were classified by sex and race. Scores were compared with results of National Adolescent Student Health Survey. Within sample, females scored higher than males, and whites scored higher than nonwhites. Variations in knowledge levels and implications for AIDS prevention education…

  16. Depression and AIDS Preventive Self-efficacy Among Taiwanese Adolescents.

    PubMed

    Lee, Yi-Hui; Salman, Ali

    2016-02-01

    Effectively reducing adolescents' risky sexual behaviors has been an urgent need since the HIV/AIDS infections among young people has been acknowledged as a priority. Self-efficacy has been considered playing an essential role in behavioral changes, and depressed individuals may demonstrate lower self-efficacy. The purpose of this cross-sectional study was to gain insights into self-reported depression among 16-18 years-old Taiwanese adolescents as well as to explore psychosocial predictors of AIDS preventive self-efficacy. A convenience sample of 734 adolescents from southern Taiwan was recruited, and several reliable and valid questionnaires were used to collect data. Descriptive statistics, odds ratio, independent t-test, and hierarchical multiple regression analyses were utilized to analyze data. Results showed that the differences in self-reported depression and in the AIDS preventive self-efficacy varied by gender, substance use, and having sexual experience. Furthermore, depression was a significant predictor of AIDS preventive self-efficacy while controlling the covariates. This study suggests that gender and mental health status such as depression may play significant roles in AIDS preventive self-efficacy. Nurses and health care providers should take the influence of mental health into consideration when designing AIDS preventive interventions for male and female Taiwanese adolescents. The provided information may also enhance psychiatric nurses' capability to provide care and to enhance the prevention of HIV infection for adolescents. PMID:26804507

  17. AIDS clinical trials at John Hopkins.

    PubMed

    2000-01-01

    AIDS clinical trials at Johns Hopkins are described. Contact information, criteria for volunteers, and a brief description are provided. Trial topics include treatments for HIV-1 disease, neurology, and ocular immunology.

  18. Spanish Aid in Clinical Dietetics.

    ERIC Educational Resources Information Center

    Bringas, Juliet G.; Chan, Teresa Y.

    Designed to aid dietitians, nutritionists, and other health professionals to better serve the nutritional needs of Hispanics, this bilingual booklet describes the different cultural eating habits of Mexican, Cuban, and Puerto Rican Americans, with in-depth description of Mexican Americans. Written in Spanish and English, the booklet includes…

  19. Preventing the sexual transmission of AIDS during adolescence.

    PubMed

    Remafedi, G J

    1988-03-01

    In order to be effective, the national effort to contain the spread of Acquired Immunodeficiency Syndrome (AIDS) must include a youth focus. Knowledge of adolescent sexual behavior, drug use, and sexually transmitted diseases suggests that many adolescents are in jeopardy of acquiring Human Immunodeficiency Virus (HIV) infections; and they are among those most likely to benefit from preventative efforts as they explore adult roles and lifestyles. Preventative education should particularly target gay and other homosexually active young men. Effective teaching uses a variety of approaches and media, both inside and outside the classroom. Learning about AIDS is most likely to effect behavioral change when accompanied by other programs to build social supports, self-esteem, and positive identity. The ethical and rational use of HIV antibody testing may be a helpful adjunct to education for certain adolescents. Ultimately, our society's ability to address complex, associated social issues will determine our ability to control AIDS.

  20. High prevalence of physical inactivity among adolescents living with HIV/AIDS

    PubMed Central

    Tanaka, Luana Fiengo; Latorre, Maria do Rosário Dias de Oliveira; da Silva, Aline Medeiros; Konstantyner, Thais Claudia Roma de Oliveira; Peres, Stela Verzinhasse; Marques, Heloisa Helena de Sousa

    2015-01-01

    Objective: To assess the prevalence of physical inactivity among adolescents with HIV/AIDS, as well as associated factors. Methods: Ninety-one adolescents (from 10 to 19 years old) with HIV/AIDS who are patients at a university follow-up service were interviewed. Anthropometric data (weight, height, and waist circumference) were measured twice; clinical information was obtained from medical records, and habitual physical activity was assessed by a questionnaire proposed by Florindo et al. The cutoff point for sedentariness was 300 minutes/week. Results: The prevalence of inadequate height for age, malnutrition, and overweight/obesity was 15.4%, 9.9% and 12.1%, respectively. The most common physical activities were soccer (44.4%), volleyball (14.4%) and cycling (7.8%). The median times spent with physical activity and walking/bicycling to school were 141 min and 39 min, respectively. Most adolescents (71.4%) were sedentary and this proportion was higher among girls (p=0.046). Conclusions: A high prevalence of physical inactivity among adolescents with HIV/AIDS was observed, similar to the general population. Promoting physical activity among adolescents, especially among girls with HIV/AIDS, as well as monitoring it should be part of the follow-up routine of these patients. PMID:25907024

  1. Helping Mothers Discuss Sexuality and AIDS with Adolescents.

    ERIC Educational Resources Information Center

    Lefkowitz, Eva S.; Sigman, Marian; Au, Terry Kit-fong

    2000-01-01

    Examined impact of experimentally altering mothers' style when discussing sexuality and AIDS with adolescent children. Found that intervention group mothers reduced their amount of speaking, asked more open-ended questions, acted less judgmental, and discussed dating and sexuality more than did control group mothers. Intervention group adolescents…

  2. Adolescents' Behavior and Attitudes toward AIDS.

    ERIC Educational Resources Information Center

    Salehi, Saeed; And Others

    The need for effective programs to delay sexual activity and to educate adolescents regarding the human immunodeficiency virus (HIV) has never been greater. Statistics point out that a significant number of teenagers throughout the United States engage in behavior that increases their risks of becoming infected with HIV. This study examined…

  3. Searching for the Magic Johnson effect: AIDS, adolescents, and celebrity disclosure.

    PubMed

    Brown, B R; Baranowski, M D; Kulig, J W; Stephenson, J N; Perry, B

    1996-01-01

    The objectives of this study were to measure changes in AIDS-related attitudes and behaviors in adolescents in the 13 months following Magic Johnson's disclosure that he was HIV positive, and to test whether gender, race, age, sexual experience, and pre-existing HIV-avoidant behaviors would emerge as significant dependent variables. Adolescent clinic attendees (N = 181) ages 12-19 in four cities completed a questionnaire assessing change in AIDS-related attitudes and behaviors since Johnson's announcement. Respondents were divided into low-risk and at-risk groups. Sixty percent of respondents reported that Magic Johnson's announcement had increased their awareness of AIDS, 65.4% reported increased self-efficacy in a sexual situation, 37.2% reported that they had changed their perceived AIDS risk, 37.8% described increased resistance to peer pressure for sexual intercourse. The low-risk group was more likely to report increased self-efficacy and resistance to peer pressure but no change in perceived risk or increased AIDS awareness. Significant relationships were found between gender and increased AIDS awareness, gender and increased resistance to peer pressure to engage in sexual intercourse, race and increased AIDS awareness, and more lifetime sex partners and increased self-efficacy.

  4. Endemic mycoses in AIDS: a clinical review.

    PubMed Central

    Wheat, J

    1995-01-01

    Histoplasmosis and coccidioidomycosis are serious opportunistic infections in patients with AIDS who reside in areas of endemicity of the United States and Central and South America. Blastomycosis, although less common, also must be recognized as an opportunistic infection in patients with AIDS. Prompt diagnosis requires knowledge of the clinical syndromes and diagnostic tests as well as a high index of suspicion. Histoplasmosis and blastomycosis respond well to antifungal treatment, but relapse is common without chronic suppressive therapy. Improvements in treatment are needed in coccidioidomycosis. Research is needed to identify preventive strategies for patients at risk. These strategies may include use of prophylactic antifungal therapy or vaccination. PMID:7704892

  5. Adolescents' Thoughts and Feelings about AIDS in Relation to Cognitive Maturity.

    ERIC Educational Resources Information Center

    Peterson, Candida C.; Murphy, Lisa

    1990-01-01

    Studied adolescents' (N=163) formal operational reasoning in relation to Acquired Immune Deficiency Syndrome (AIDS) knowledge, AIDS fear, sexual knowledge, and reactions to AIDS victims. Found that advanced reasoning predicted better AIDS knowledge and general sexual knowledge. Advanced reasoning and AIDS knowledge were also linked with heightened…

  6. Utilizing Mutual Aid in Reducing Adolescent Substance Use and Developing Group Engagement

    ERIC Educational Resources Information Center

    Mogro-Wilson, Cristina; Letendre, Joan; Toi, Hiroki; Bryan, Janelle

    2015-01-01

    Objective: This study assessed the effectiveness of mutual aid groups for high school students. Methods: A quasi-experimental design was applied to 242 adolescents, where every other adolescent was assigned to the intervention or the control condition. The study evaluated the influence of implementing mutual aid groups in decreasing perceived risk…

  7. [Knowledge of STD/AIDS among adolescent students].

    PubMed

    Brêtas, José Roberto da Silva; Ohara, Conceição Vieira da Silva; Jardim, Dulcilene Pereira; Muroya, Renata de Lima

    2009-09-01

    This study aims to analyze the degree of knowledge adolescents have on STD/AIDS prevention, transmission, signs, and symptoms, and to contribute with the elaboration of educational actions in the University Extension Program called Corporality and Health Promotion. The research counted on 1,087 adolescents (40% females, 60% males) and was carried out in three elementary and high schools located in the municipality of Embu. A structured, multiple choice questionnaire was applied. Data indicated the achievement of the following results: as per the prevention, 92% of girls and 78% of boys referred to the use of condoms, while 42% of girls and 43% of boys affirmed to wash their genitalia after the sexual relation; 75% females and 52% males quoted television as their source of information. As per the knowledge of STD, girls and boys indicated not to have much information on the issue. Regarding STD healing programs, 57% females and 71% males affirmed not to have any knowledge on the issue; 5% of girls and 6% of boys thought AIDS to be curable. In a general perspective, we can conclude that girls were more familiar with the study's issues than boys.

  8. Transitioning adolescents with HIV to adult care: Lessons learned from twelve adolescent medicine clinics

    PubMed Central

    Tanner, Amanda E.; Philbin, Morgan M.; DuVal, Anna; Ellen, Jonathan; Kapogiannis, Bill; Fortenberry, J. Dennis

    2016-01-01

    Purpose To maximize positive health outcomes for youth with HIV as they transition from youth to adult care, clinical staff need strategies and protocols to help youth maintain clinic engagement and medication adherence. Accordingly, this paper describe transition processes across twelve clinics within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) to provide lessons learned and inform the development of transition protocols to improve health outcomes as youth shift from adolescent to adult HIV care. Design and Methods During a large multi-method Care Initiative program evaluation, three annual visits were completed at each site from 2010–2012 and conducted 174 semi-structured interviews with clinical and program staff (Baseline n=64, Year 1 n=56, Year 2=54). Results The results underscore the value of adhering to recent American Academy of Pediatrics (AAP) transition recommendations, including: developing formal transition protocols, preparing youth for transition, facilitating youth’s connection to the adult clinic, and identifying necessary strategies for transition evaluation. Conclusions Transitioning youth with HIV involves targeting individual-, provider-, and system-level factors. Acknowledging and addressing key barriers is essential for developing streamlined, comprehensive, and context-specific transition protocols. Practice Implications Adolescent and adult clinic involvement in transition is essential to reduce service fragmentation, provide coordinated and continuous care, and support individual and community level health. PMID:27133767

  9. HIV/AIDS Knowledge and Beliefs among Haitian Adolescents in Miami-Dade County, Florida

    ERIC Educational Resources Information Center

    Marcelin, Louis Herns; McCoy, H. Virginia; DiClemente, Ralph J.

    2006-01-01

    This study examined HIV/AIDS knowledge and beliefs in Haitian adolescents in an HIV epicenter, Miami-Dade Florida. This study examined survey data from 300 Haitian adolescents, aged 13 through 18, from both low- and middle-income neighborhoods. A sub-sample of 80 adolescents was selected for in-depth interviews and continuous observations with…

  10. Clinical assessment of adolescents involved in Satanism.

    PubMed

    Clark, C M

    1994-01-01

    Satanism is a destructive religion that promises power, dominance, and gratification to its practitioners. Unfortunately, some adolescents are seduced by these promises, often because they feel alienated, alone, angry, and desperate. This article explores the psychosocial needs of adolescents that are often met by participation in Satanic worship. Gratification of these needs, when met, may make leaving the cult a difficult and lengthy process. Included is a method for determining the adolescents' level of involvement and an assessment strategy for the therapeutic evaluation process. A brief overview of clinical intervention is also discussed.

  11. Gender Differences in HIV/AIDS Preventive Self-Efficacy Among Taiwanese Adolescents.

    PubMed

    Lee, Yi-Hui; Salman, Ali; Cooksey-James, Tawna

    2016-02-01

    The aim of the cross-sectional study was to understand gender differences in HIV/AIDS preventive self-efficacy among Taiwanese adolescents. Self-administered questionnaires were used to measure HIV/AIDS preventive self-efficacy and covariates (age, substance use, and sexual experiences). Data were collected from 734 Taiwanese high school adolescents aged 16 to 18 years. Descriptive statistic analyses, t-test, and ANCOVA were utilized to analyze data. The results indicate significant differences exist between genders in HIV/AIDS preventive self-efficacy among Taiwanese adolescents. Compared to the males, female adolescents were found having significantly higher HIV/AIDS preventive self-efficacy related to refusing sexual intercourse, condom use, and questioning potential sexual partners than those who are males. While controlling age, sexual experience, and substance use, female Taiwanese adolescents also had higher HIV/AIDS preventive self-efficacy than those who are males. The findings suggest the importance of addressing gender differences in HIV/AIDS preventive self-efficacy when developing HIV reduction programs for Taiwanese adolescents.

  12. Child Abuse and Aids-Related Knowledge, Attitudes and Behavior among Adolescents in Zambia

    ERIC Educational Resources Information Center

    Slonim-Nevo, Vered; Mukuka, Lawrence

    2007-01-01

    Objective: To research the correlation between physical and sexual abuse by family members and AIDS-related knowledge, attitudes, self-efficacy and behavior among urban and rural adolescents in Zambia. Sample: The sample comprises 3,360 adolescents, aged 10-19, from urban and rural Zambia; 2,160 of them attended school, while 1,200 of them did…

  13. How Latino American and European American Adolescents Discuss Conflicts, Sexuality, and AIDS with Their Mothers.

    ERIC Educational Resources Information Center

    Lefkowitz, Eva S.; Romo, Laura F.; Corona, Rosalie; Au, Terry Kit-fong; Sigman, Marian

    2000-01-01

    Examined individual, ethnic, and age differences in structure of mother-adolescent conversations. Found Latin American mothers dominated conversations more than European Americans; mothers dominated conversations about sexuality/AIDS more than conversations about conflicts; older adolescents reported less satisfaction, less openness, and more…

  14. Risk and Resilience in Orphaned Adolescents Living in a Community Affected by AIDS

    ERIC Educational Resources Information Center

    Wild, Lauren G.; Flisher, Alan J.; Robertson, Brian A.

    2013-01-01

    The AIDS pandemic has resulted in a dramatic rise in the number of orphans in South Africa. This study was designed to investigate the associations between family, peer, and community factors and resilience in orphaned adolescents. Self-report questionnaires were administered verbally to 159 parentally bereaved adolescents (aged 10-19) in an…

  15. Recommendations for the School Health Nurse in Addressing HIV/AIDS with Adolescents.

    ERIC Educational Resources Information Center

    Uris, Patricia

    The school is a defined setting where health issues can be addressed. School nurses providing health care to adolescents who are infected or affected by HIV/AIDS need strong policies and good training to make their efforts effective. the goal of these recommendations is to strengthen adolescent HIV programs in schools and to improve standards of…

  16. HIV/Aids in South Africa: A Review of Sexual Behavior among Adolescents

    ERIC Educational Resources Information Center

    Hartell, Cycil George

    2005-01-01

    South Africa has a fast-growing HIV/AIDS rate, with the highest prevalence among young people (15 to 24 years), especially females. This paper is a comprehensive analytical review of available research concerning the sexual behavior of adolescents in South Africa. It offers insight into HIV infection among adolescents and provides an important…

  17. Female Secondary School Adolescents' Sexual Behavior and School Based HIV/AIDS Education Program

    ERIC Educational Resources Information Center

    Inyang, Mfrekemfon P.

    2013-01-01

    Most adolescents engage in indiscriminate sexual experimentations. This practice exposes them to the risk of contracting sexually transmitted infections including HIV/AIDS. Human immunodeficiency virus (HIV) and acquired immune deficiency syndromes (AIDS) are among the deadly diseases that exist globally. Twice as many girls, compared to boys…

  18. Development and Evaluation of an HIV/AIDS Knowledge Measure for Adolescents Focusing on Misconceptions

    ERIC Educational Resources Information Center

    de Bruin, Wandi Bruine; Downs, Julie S.; Fischhoff, Baruch; Palmgren, Claire

    2007-01-01

    Measures of adolescents' HIV/AIDS knowledge that cover only die basic facts may fail to assess underlying misunderstandings in need of intervention. We developed and evaluated a measure covering the broad domain of HIV/AIDS knowledge, emphasizing misunderstandings revealed in semi-structured qualitative interviews. These included the cumulative…

  19. Differences in Tunisian adolescents' knowledge, misconceptions and attitudes towards HIV/AIDS from 1997 to 2002.

    PubMed

    Tebourski, Fethi; Najem, Aida

    2005-05-01

    Surveys were conducted to estimate the extent to which knowledge, misconceptions and attitudes of adolescents in Tunisia towards HIV/AIDS had changed after a period of five years. A population of school-going adolescents of both sexes, age 16 to 20, was sampled in 1997 and again in 2002. We found that HIV/AIDS and sexually transmitted diseases became better known, there was more tolerance expressed for people living with AIDS, and the use of condoms was more positively judged. Fewer misconceptions surrounding the condition were also noted. However, many results recorded during the 1997 survey remained unchanged (e.g., scepticism about awareness campaigns; TV as a primary source of information). We discuss the socio-economic and medical/social context in Tunisia during the period 1997-2002 that seemed to allow adolescents to improve their knowledge of HIV/AIDS and to acquire positive attitudes towards persons living with the condition.

  20. Health-Information Sources for Kenyan Adolescents: Implications for Continuing HIV/AIDS Control and Prevention in Sub-Saharan Africa.

    ERIC Educational Resources Information Center

    Pratt, Cornelius B.; Obeng-Quaidoo, Isaac; Okigbo, Charles; James, E. Lincoln

    2000-01-01

    Surveyed and conducted focus groups with Kenyan adolescents to investigate their health information sources, focusing on sexually transmitted diseases (STDs), particularly HIV/AIDS. Respondents relied most heavily on health clinics for information on STDs, their most common health problem. Those with high knowledge of contraceptives were more…

  1. Panic Disorder in Clinically Referred Children and Adolescents

    ERIC Educational Resources Information Center

    Doerfler, Leonard A.; Connor, Daniel F.; Volungis, Adam M.; Toscano, Peter F., Jr.

    2007-01-01

    The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective…

  2. Computer-aided design and computer-aided manufacture (CAD/CAM) system for construction of spinal orthosis for patients with adolescent idiopathic scoliosis.

    PubMed

    Wong, M S

    2011-01-01

    ABSTRACT Spinal orthoses are commonly prescribed to patients with moderate adolescent idiopathic scoliosis (AIS) for prevention of further curve deterioration. In conventional manufacturing method, plaster bandages are used to obtain the patient's body contour and then the plaster cast is rectified manually. With computer-aided design and computer-aided manufacture (CAD/CAM) system, a series of automated processes from body scanning to digital rectification and milling of the positive model can be performed in a fast and accurate fashion. The purpose of this manuscript is to introduce the application of CAD/CAM system to the construction of spinal orthosis for patients with AIS. Based on evidence within the literature, CAD/CAM method can achieve similar clinical outcomes but with higher efficiency than the conventional fabrication method. Therefore, CAD/CAM method should be considered a substitute to the conventional method in fabrication of spinal orthoses for patients with AIS.

  3. Knowledge of sexually transmitted diseases, HIV infection and AIDS among sexually active adolescents in Nairobi, Kenya and its relationship to their sexual behaviour and contraception.

    PubMed

    Lema, V M; Hassan, M A

    1994-02-01

    A total of 675 male and female adolescents, aged 10 to 19 years, who were attending the adolescent antenatal clinic at the Kenyatta National Hospital and the Special STD and Skin Disease Clinic in Nairobi, between April 1, 1991 and July 31, 1991, were interviewed by means of partially structured questionnaire, to determine their level of awareness on sexually transmitted diseases, HIV infection, AIDS and contraception with its relationship to their sexual behaviour and contraceptive practice. Adolescents formed 27.6% of people attending the STD and Skin diseases clinic, of whom 52.9% were females and 41.2% were males. Majority of them were not in any formal employment. A few were students in schools in the city. 70.4% of the total group mentioned gonorrhoea as a sexually transmitted disease, as compared to only 54.3% who mentioned AIDS as a sexually transmitted disease. They only mentioned three diseases, namely gonorrhoea, syphilis, and AIDS (HIV infection). Majority of them had started coitus very early. They were involved with many and different partners, some of whom belonged to the high risk groups for HIV infection as well as STD's. As a reflection of their low awareness on AIDS, most of these sexually active adolescents had not changed their sexual behaviour, nor were they using any protective measure against STD's or HIV infection. The implications of these findings are discussed and possible remedial measures suggested.

  4. False Positives among Adolescent Sex Offenders: Concurrent and Predictive Validity of the Millon Adolescent Clinical Inventory

    ERIC Educational Resources Information Center

    Kennedy, Wallace A.; Licht, Mark H.; Caminez, Mary

    2004-01-01

    The ability of the "Millon Adolescent Clinical Inventory"("MACI"; Millon, 1993) to identify serious adolescent, male sexual-offenders and to predict their recidivism following treatment was examined. "MACI" scores were evaluated for 381 adolescent, male sexual-offenders adjudicated delinquent for felony crimes and given maximum sentences, and, on…

  5. Inclusiveness: a mental health strategy for preventing future mental health problems among adolescents orphaned by AIDS.

    PubMed

    Thupayagale-Tshweneagae, G; Mokomane, Z

    2012-10-01

    The purpose of this paper is to raise an argument that inclusiveness will lessen the pain of losing a parent among adolescents orphaned by AIDS and as a result, prevent future mental health problems that may occur because of inappropriate grieving and maladaptive coping strategies. Participation of adolescents orphaned by AIDS in decisions pertaining to their parents' illnesses and funeral arrangements, for example, may shorten the grieving process and allow for closure. The paper draws data from focus group discussions that were held with 15 adolescents orphaned by AIDS in urban South Africa. The focus group discussions that were structured around four themes: grieving patterns; coping strategies; experience with loss; and expectations. The results of the study demonstrate inclusiveness as an overarching factor in the healing process. The concept is thus a strong recommendation for mental health practice and further study. PMID:22192336

  6. Assessment of comprehensive HIV/AIDS knowledge level among in-school adolescents in eastern Ethiopia

    PubMed Central

    Oljira, Lemessa; Berhane, Yemane; Worku, Alemayehu

    2013-01-01

    Introduction In Ethiopia, more adolescents are in school today than ever before; however, there are no studies that have assessed their comprehensive knowledge of HIV/AIDS. Thus, this study tried to assess the level of this knowledge and the factors associated with it among in-school adolescents in eastern Ethiopia. Methods A cross-sectional school-based study was conducted using a facilitator-guided self-administered questionnaire. The respondents were students attending regular school in 14 high schools located in 14 different districts in eastern Ethiopia. The proportion of in-school adolescents with comprehensive HIV/AIDS knowledge was computed and compared by sex. The factors that were associated with the comprehensive HIV/AIDS knowledge were assessed using bivariate and multivariable logistic regression. Results Only about one in four, 677 (24.5%), in-school adolescents have comprehensive HIV/AIDS knowledge. The knowledge was better among in-school adolescents from families with a relatively middle or high wealth index (adjusted OR [95% CI]=1.39 [1.03–1.87] and 1.75 [1.24–2.48], respectively), who got HIV/AIDS information mainly from friends or mass media (adjusted OR [95% CI]=1.63 [1.17–2.27] and 1.55 [1.14–2.11], respectively) and who received education on HIV/AIDS and sexual matters at school (adjusted OR [95% CI]=1.59 [1.22–2.08]). The females were less likely to have comprehensive HIV/AIDS knowledge compared to males (adjusted OR and [95% CI]=0.60 [0.49–0.75]). Conclusions In general, only about a quarter of in-school adolescents had comprehensive HIV/AIDS knowledge. Although the female adolescents are highly vulnerable to HIV infection and its effects, they were by far less likely to have comprehensive HIV/AIDS knowledge. HIV/AIDS information, education and communication activities need to be intensified in high schools. PMID:23517715

  7. Prevention of Substance Abuse and AIDS Risk Behaviors in Adolescents: Is any Real Progress Being Made? Draft.

    ERIC Educational Resources Information Center

    Evans, Richard I.

    Although a great deal of effort has been devoted to the prevention of substance abuse and AIDS risk behaviors in adolescents, the success of such programs can be difficult to measure. This study, in Northeast Houston-Harris County, Texas, examines adolescent attitudes and behaviors toward sexual activity and AIDS and discusses barriers facing…

  8. Establishment of social club for adolescents living in urban slums: a potential tool to impart HIV/AIDS education.

    PubMed

    Deshpande, Kirti; Shivaswamy, M S; Diwan, Vishal; De Costa, Ayesha; Bhattacharya, Aruna; Mahadik, Vijay K

    2013-05-01

    An interventional study was carried out under a Government of Madhya Pradesh, India supported project with aims to describe establishment of a social club (a youth club), incorporating strategy of life-skill-based education and its potential as a tool for creating HIV/AIDS awareness among adolescents of age 15-19 years living in slums of Ujjain city. The social club activities included AIDS education by combined methods, vocational training and recreational activities for the adolescents. Establishment of social club was feasible with available local resources. Social club activities were need based, thus received good response from adolescents (94% had attendance above 75% in AIDS awareness sessions). Knowledge and attitude improved and misconceptions reduced significantly by AIDS education. Majority (86%) of the participants contributed as AIDS messengers in the community. The social clubs seem to have potential to improve HIV/AIDS awareness and empower adolescents to adopt healthy lifestyle through combination of teen friendly activities and atmosphere. PMID:24765690

  9. HIV/AIDS-Anxiety among Adolescent Students in Botswana

    ERIC Educational Resources Information Center

    Onyewadume, Mary Adeola

    2008-01-01

    This research investigated the incidence of HIV/AIDS anxiety among students in Botswana. The sample comprised 240 randomly selected students from six schools in three districts in Botswana, with data collected via a questionnaire. Percentages and Chi-square were used to analyze the extent to which the students were anxious about HIV/AIDS and if…

  10. AIDS and Adolescents: The Time for Prevention Is Now.

    ERIC Educational Resources Information Center

    Haffner, Debra W.

    Due to indiscriminate experimentation with drugs and sex, teens are increasingly at risk of contracting AIDS. Goals of prevention include reducing the panic and misinformation surrounding the disease, helping teenagers delay sexual intercourse, ensuring condom use, and preventing I.V. drug use. AIDS prevention as a shared responsibility includes…

  11. Factors Associated with Lack of Viral Suppression at Delivery among HAART-Naïve HIV-Positive Women in the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) P1025 Study

    PubMed Central

    Katz, Ingrid T.; Leister, Erin; Kacanek, Deborah; Hughes, Michael D.; Bardeguez, Arlene; Livingston, Elizabeth; Stek, Alice; Shapiro, David E.; Tuomala, Ruth

    2014-01-01

    Background High delivery maternal plasma HIV-1 RNA level (viral load, VL) is a risk factor for mother to child transmission and poor maternal health. Objective To identify factors associated with detectable VL at delivery despite initiation of highly active antiretroviral therapy (HAART) during pregnancy. Design Multicenter observational study. Setting 67 US AIDS clinical research sites. Patients HIV-1-positive pregnant women who initiated HAART during pregnancy. Measurements Descriptive summaries and associations between socio-demographic, HIV disease, treatment and pregnancy-related risk factors and detectable VL (>400copies/mL) at delivery. Results Between October 2002 and December 2011, 671 women met inclusion criteria and 13% had detectable VL at delivery. Factors associated with detectable VL included multiparity (16.4% vs 8% nulliparous, p=0.002), black non-Hispanic ethnicity (17.6% vs 6.6% Hispanic and 6.6% white/non-Hispanic, p<0.001), 11th grade or less education (17.6% vs.12.1% high school graduate and 6.7% some college or higher, p=0.013), and initiation of HAART in third trimester (23.9% vs 12.3% second and 8.6% first, p=0.002), timing of HIV diagnosis prior to current pregnancy (16.1% vs 11% during current pregnancy, p=0.051), and timing of first prenatal visit in 3rd trimester (33.3% vs 14.3% second and 10.5% first, p=0.002). Women who experienced treatment interruptions or reported poor medication adherence during pregnancy were more likely to have detectable VL at delivery than women with no interruptions or who reported better adherence. Limitations Women entered the study at varying times during pregnancy and for this and other reasons there was incomplete data on many covariates. Conclusions In this large U.S.-based cohort of HIV-1 positive women, 13% of women who initiated HAART during pregnancy had detectable VL at delivery. The timing of HAART initiation and prenatal care along with medication adherence during pregnancy appear to be

  12. Efficacy and Tolerability of Pharmacotherapies to Aid Smoking Cessation in Adolescents

    PubMed Central

    Bailey, Steffani R.; Crew, Erin E.; Riske, Emily C.; Ammerman, Seth; Robinson, Thomas N.; Killen, Joel D.

    2012-01-01

    Adolescent smoking remains a public health problem. Despite concerns regarding adolescent nicotine dependence, few well-designed smoking cessation studies have been conducted with teen smokers. This is particularly true regarding pharmacological treatments for nicotine dependence. Currently, pharmacological aids are not recommended for treating adolescent nicotine dependence, as efficacy has not been shown in this population. This review includes studies that have examined the efficacy of pharmacotherapy for smoking abstinence and/or reduction in cigarette consumption among adolescent smokers who want to quit smoking, lab-based adolescent studies that have examined the effectiveness of these medications in reducing cravings and/or withdrawal symptoms, and/or studies that have assessed the tolerability of medications for smoking cessation in adolescent smokers. This review provides information on the pharmacologic action of each medication, the efficacy of each medication for adolescent smoking cessation, the tolerability of each medication based on reported adverse events, and compliance with the medication protocols. Thirteen relevant articles were identified and included in the review. Nicotine patch, nicotine gum, nicotine nasal spray, bupropion, and varenicline have been studied in adolescent smokers. The adverse events reported in the studies on pharmacology for adolescent smoking suggest that the side effect profiles for nicotine replacement therapy, bupropion, and varenicline are similar to those reported in adult studies. There is some evidence of efficacy of nicotine patch and bupropion at end of treatment (efficacy of varenicline has not been assessed), but none of the medications included in this review were efficacious in promoting long-term smoking cessation among adolescent smokers. It is noted that many of the study protocols did not follow the recommended dose or length of pharmacotherapy for adults, rendering it difficult to determine the true

  13. Adolescent health care maintenance in a teen-friendly clinic.

    PubMed

    Chaisson, Nicole; Shore, William B

    2014-09-01

    Adolescence is marked by complex physical, cognitive, social, and emotional development, which can be stressful for families and adolescents. Before the onset of puberty, providers should clearly lay the groundwork for clinical care and office visits during the adolescent years. This article addresses the guidelines and current legal standards for confidentiality in adolescent care, the most frequently used psychosocial screening tools, and current recommendations for preventive health services and immunizations. Through the creation of teen-friendly clinics, primary care providers are well positioned to offer guidance and support to teens and their parents during this time of transition and growth.

  14. Polish Adolescents and Their Beliefs and Attitudes to HIV/AIDS and Sexual Relationships

    ERIC Educational Resources Information Center

    Ganczak, Maria; Boron-Kaczmarska, Anna; Leszczyszyn-Pynka, Magdalena; Szych, Zbigniew

    2005-01-01

    The aim of the study was to survey the needs for HIV/AIDS educational interventions and attitudes and beliefs concerning HIV infection, including sexual relationships, among 17-year-old Polish adolescents. A total of 761 students who attended schools located in urban and rural areas was surveyed. The study, based on the voluntary, self-completed,…

  15. Evaluating AIDS-Related Social Skills in Anglo and Latino Adolescents: Focus on Assessment.

    ERIC Educational Resources Information Center

    Blumberg, Elaine J.; Hovell, Melbourne F.; Werner, Cynthia A.; Kelley, Norma J.; Sipan, Carol L.; Burkham, Susan M.; Hofstetter, C. Richard

    1997-01-01

    Examines the assessment of AIDS-related social skills (measured by role play) in Anglo and Latino Adolescents (N=383) and explores ethnic and gender differences on these skills. Results indicate that anxiety and nonverbal behavior are generalized response classes that transcend specific social skills, suggesting the importance of measuring…

  16. Beliefs about AIDS, Use of Alcohol and Drugs, and Unprotected Sex among Massachusetts Adolescents.

    ERIC Educational Resources Information Center

    Hingson, Ralph W.; And Others

    1990-01-01

    Surveyed 1,773 Massachusetts adolescents to explore relationships among the following topics: (1) alcohol and drug use; (2) perceived susceptibility to human immunodeficiency virus (HIV); (3) use of condoms; (4) effectiveness of condoms in preventing infection; (5) barriers to condom use; and (6) behavioral cues about AIDS related to condom use.…

  17. "Mbizi": Empowerment and HIV/AIDS Prevention for Adolescent Girls in Botswana

    ERIC Educational Resources Information Center

    Nitza, Amy; Chilisa, Bagele; Makwinja-Morara, Veronica

    2010-01-01

    This article describes a small group intervention for HIV/AIDS prevention among adolescent girls in Botswana. The psychoeducational group model is designed to empower girls to overcome the gender inequality that puts women at increased risk of HIV infection in the country. Group goals include heightening group members' awareness of the influence…

  18. What Deaf and Hard-of-Hearing Adolescents Know and Think about AIDS.

    ERIC Educational Resources Information Center

    Luckner, John L.; Gonzales, B. Robert

    1993-01-01

    A survey of 204 secondary students with deafness or hearing impairment suggested that adolescents had a general idea about what human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are and the potential impact of the disease. However, they demonstrated gaps in knowledge of how the disease is transmitted and prevented…

  19. HIV/AIDS Prevention: Effective Instructional Strategies for Adolescents with Mild Mental Retardation.

    ERIC Educational Resources Information Center

    Johnson, Gladys; Jefferson-Aker, Celestine R.

    2001-01-01

    This article considers instructional strategies for developing a curriculum for preventing HIV/AIDS infection among adolescents with mild mental retardation. The strategies help teachers modify instructional materials designed for typical students. The need to encourage parental involvement, use a variety of instructional materials, and consider…

  20. Bereavement among South African adolescents following a sibling’s death from AIDS

    PubMed Central

    Demmer, Craig; Rothschild, Nina

    2011-01-01

    While increasing attention has been paid in recent years to studying the impact of parental death from AIDS on children, we know little about how a sibling’s death from AIDS affects children. In this qualitative descriptive study, 11 in-depth interviews were conducted by trained social workers with adolescents who had lost a sibling to AIDS, in KwaZulu-Natal Province, South Africa. The average time since the sibling’s death was 18 months. These adolescents had been actively involved in caring for their sick sibling, yet they received inadequate emotional support from any source both before and after the sibling’s death. HIV/AIDS stigma as well as the family’s daily struggle to survive caused these adolescents to keep their feelings and their grief to themselves. Despite the trauma of losing a beloved sibling and the hardships of their environment, they demonstrated remarkable fortitude as well as concern for others. More research is needed on the issue of sibling bereavement associated with AIDS, and interventions that address the multiple needs of these vulnerable young people need to be developed. PMID:21852964

  1. Satanism among adolescents: empirical and clinical considerations.

    PubMed

    Steck, G M; Anderson, S A; Boylin, W M

    1992-01-01

    This paper reviews the literature on adolescent involvement in satanism. Results from a pilot study are presented along with a case study to illustrate factors that may alert practitioners to adolescents who are susceptible to satanic influences. Interventions for dealing with this adolescent subpopulation are discussed.

  2. Clinical Assessment of Adolescents Involved in Satanism.

    ERIC Educational Resources Information Center

    Clark, Cynthia M.

    1994-01-01

    Describes Satanism as destructive religion that promises power, dominance, and gratification and that may seduce adolescents who feel alienated, alone, angry, and desperate. Explores psychosocial needs of adolescents that are met by participation in Satanic worship. Includes method for determining adolescents' level of involvement and assessment…

  3. Satanism among Adolescents: Empirical and Clinical Considerations.

    ERIC Educational Resources Information Center

    Steck, Gary M.; And Others

    1992-01-01

    Reviews literature on adolescent involvement in satanism. Presents results from a pilot study along with a case study to illustrate factors that may alert practitioners to adolescents who are susceptible to satanic influences. Discusses interventions for dealing with this adolescent subpopulation. (Author/NB)

  4. [Clinical comparison of a digital with an analog hearing aid].

    PubMed

    Meister, H; Klüser, H; Wolf, A; Walger, M; von Wedel, H

    2000-04-01

    The benefit of innovative hearing aid technology can be evaluated in clinical trials. The present study describes the comparison of a new digital hearing aid with an analogue device serving as a reference. The tests were carried out with 15 experienced hearing aid wearers. To prevent the influence of different fitting algorithms such as prescriptive or loudness-based the digital devices were not renewed fitted but their level- and frequency-depending gain was adjusted to that of the reference. Different tests concerning loudness perception (category loudness scaling) speech discrimination in noise (the Göttingen sentence test) and self-assessment of the benefit by questionnaires were performed. All tests yielded slightly better results for the digital hearing aid. The speech audiometric evaluation showed somewhat better discrimination for the test-device. The questionnaires yielded a marked preference for the digital device. Because the study was not blinded influences due to the knowledge of the subjects of testing a new technology generally can occur. On the other hand, the question arises whether present audiometric tests sufficiently consider signal processing of modern hearing systems. Furthermore, one has to take into account that only a few of the features of digital technology such as noise-reduction and feedback-cancellation were considered in this study to allow for a sensible comparison. Because of the large number of possibilities offered by digital technology additional benefit by the hearing aid can be expected. PMID:10810675

  5. Values Clarification: An Aid to Adolescent Religious Education.

    ERIC Educational Resources Information Center

    McEniry, Robert

    1982-01-01

    Focuses on the contribution that values clarification can make to adolescent religious education. Summarizes the tenets of humanistic psychology that provided the matrix for values clarification and describes the substance of values clarification as expressed in its terminology, theory, process and strategies. (JAC)

  6. The clinical profile of end-stage AIDS.

    PubMed

    Welch, K; Kissinger, P; Bessinger, R; Dascomb, K; Morse, A; Gleckler, E

    1998-02-01

    The purpose of this study was to describe the clinical profile of end-stage AIDS in patients 12 months before death. A cross-sectional examination of HIV-infected patients who attended a public HIV outpatient clinic between 1990 and 1996 and who died was conducted. The prevalence and first-time acquisition of AIDS-defining conditions 12 months before death were evaluated. The AIDS-defining conditions with the highest percentages of first-time acquisition in the last 12 months of life were progressive multifocal leukoencephalopathy (100%), lymphoma (96%), dementia (78.6%), Mycobacterium avium complex (MAC) infection (74.0%), toxoplasmosis (72.6%), and cytomegalovirus (CMV) infection (69.6%). Of the concomitant conditions studied, those with the highest percentages of first-time acquisition in the last 12 months of life were CMV with MAC (99%) and CMV with wasting (88%). Patients who acquire these AIDS-defining conditions may be eligible to receive information about end-stage options, such as hospice care. However, administration of aggressive antiretroviral treatments, such as the protease inhibitors, may affect this profile in the future, as the majority of the patients in this study were receiving the standard antiretroviral treatments of the time, primarily zidovudine.

  7. Engaging Transgender People in NIH-Funded HIV/AIDS Clinical Trials Research.

    PubMed

    Siskind, Rona L; Andrasik, Michele; Karuna, Shelly T; Broder, Gail B; Collins, Clare; Liu, Albert; Lucas, Jonathan Paul; Harper, Gary W; Renzullo, Philip O

    2016-08-15

    In 2009, the National Institutes of Health recognized the need to expand knowledge of lesbian, gay, bisexual, and transgender (LGBT) health and commissioned the Institute of Medicine to report on the health of these populations in the United States. The resulting Institute of Medicine publication called for more knowledge of the health of LGBT populations, as well as improved methodologies to reach them, more LGBT-focused research, and enhanced training programs and cultural competency of physicians and researchers. Several of the National Institutes of Health-funded HIV/AIDS clinical trials networks, including the Adolescent Medicine Trials Network for HIV/AIDS Interventions, HIV Prevention Trials Network, HIV Vaccine Trials Network, and Microbicide Trials Network, have focused attention on engaging transgender (TG) individuals in research. They have identified issues that transcend the nature of research (ie, treatment or prevention, adult or adolescent) and have adopted various approaches to effectively engage the TG community. Each network has recognized the importance of developing partnerships to build trust with and seek input from TG individuals on research plans and policies. They have established standing advisory groups and convened consultations for this purpose. To ensure that trial data are reflective of the participants they are seeking to enroll, they have reviewed and revised data collection forms to incorporate the 2-step method of collecting sex at birth and gender identity as 2 independent variables, and some have also revised research protocol templates and policies for concept development to ensure that they are appropriate for the inclusion of TG participants. The networks have also initiated trainings to enhance cultural sensitivity and developed a range of materials and resources for network and clinical research site staff. They continue to identify TG-specific research needs in an effort to be more responsive to and improve the health of

  8. Engaging Transgender People in NIH-Funded HIV/AIDS Clinical Trials Research

    PubMed Central

    Andrasik, Michele; Karuna, Shelly T.; Broder, Gail B.; Collins, Clare; Liu, Albert; Lucas, Jonathan Paul; Harper, Gary W.; Renzullo, Philip O.

    2016-01-01

    Abstract: In 2009, the National Institutes of Health recognized the need to expand knowledge of lesbian, gay, bisexual, and transgender (LGBT) health and commissioned the Institute of Medicine to report on the health of these populations in the United States. The resulting Institute of Medicine publication called for more knowledge of the health of LGBT populations, as well as improved methodologies to reach them, more LGBT-focused research, and enhanced training programs and cultural competency of physicians and researchers. Several of the National Institutes of Health–funded HIV/AIDS clinical trials networks, including the Adolescent Medicine Trials Network for HIV/AIDS Interventions, HIV Prevention Trials Network, HIV Vaccine Trials Network, and Microbicide Trials Network, have focused attention on engaging transgender (TG) individuals in research. They have identified issues that transcend the nature of research (ie, treatment or prevention, adult or adolescent) and have adopted various approaches to effectively engage the TG community. Each network has recognized the importance of developing partnerships to build trust with and seek input from TG individuals on research plans and policies. They have established standing advisory groups and convened consultations for this purpose. To ensure that trial data are reflective of the participants they are seeking to enroll, they have reviewed and revised data collection forms to incorporate the 2-step method of collecting sex at birth and gender identity as 2 independent variables, and some have also revised research protocol templates and policies for concept development to ensure that they are appropriate for the inclusion of TG participants. The networks have also initiated trainings to enhance cultural sensitivity and developed a range of materials and resources for network and clinical research site staff. They continue to identify TG-specific research needs in an effort to be more responsive to and improve

  9. Adolescent women face triple jeopardy: unwanted pregnancy, HIV / AIDS and unsafe abortion.

    PubMed

    Radhakrishna, A; Gringle, R; Greenslade, F

    1997-01-01

    This article reports the risks of unwanted pregnancy and unsafe abortion relative to HIV/AIDS by adolescent women. Data presented at the XI International Conference on AIDS indicated that adolescents aged 15-19 years form the highest risk group for newly acquired HIV infections and also with the highest rate worldwide of unwanted pregnancy. Contributing factors of this high rate includes physical violence and other forms of coercion; an earlier age of sexual initiation for girls than boys; so-called "sexual mixing", wherein young girls may have sex with older men for a variety of cultural and economic reasons; social pressures faced by young girls; the lack of access to formal education including sex education; the lack of access to contraception and reproductive health services; the high-risk sexual behavior of adolescent female partners; and young women's lack of power to negotiate terms of sex with their partners. When faced with an unwanted pregnancy, adolescent women have always found it difficult to obtain appropriate services to meet their needs, including safe abortion care. The AIDS epidemic exacerbates these difficulties and adds new medical, legal and ethical dimensions to the practice of unsafe and illegal abortion procedures that put young women's health and lives in danger. PMID:12179733

  10. Family Routines and Parental Monitoring as Protective Factors among Early and Middle Adolescents Affected by Maternal HIV/AIDS

    ERIC Educational Resources Information Center

    Murphy, Debra A.; Marelich, William D.; Herbeck, Diane M.; Payne, Diana L.

    2009-01-01

    The influence of parenting skills on adolescent outcomes among children affected by maternal HIV/AIDS (N = 118, M age = 13) was investigated. Among families with more frequent family routines, over time adolescents showed lower rates of aggression, anxiety, worry, depression, conduct disorder, binge drinking, and increased self-concept. Among…

  11. Incarcerated Adolescents' Engagement in AIDS/HIV High-Risk Behaviors: Ethnic-Racial and Gender Differences.

    ERIC Educational Resources Information Center

    Harper, Gary W.

    Incarcerated youth are a subgroup of adolescents who are at particularly high risk for Human Immunodeficiency Virus (HIV) infection. This study explored ethnic-racial and gender differences in incarcerated adolescents' engagement in Acquired Immune Deficiency Syndrome (AIDS)/HIV high-risk behaviors. All subjects for the study were residents of…

  12. Developing an AIDS prevention intervention for incarcerated male adolescents in Brazil.

    PubMed

    Peres, Camila Alves; Peres, Rodrigo Alves; da Silveira, Fernando; Paiva, Vera; Hudes, Esther Sid; Hearst, Norman

    2002-10-01

    The objective of this study was to investigate knowledge, attitudes, and practices regarding AIDS among incarcerated male adolescents in Brazil and to develop an AIDS prevention intervention for this population. A questionnaire administered to 275 boys in São Paulo covered demographic and social characteristics, drugs, and HIV risk perception and behavior. Subsequently, we collected qualitative data on the development and implementation of a prevention program. Ninety-eight percent of adolescents were sexually experienced, most initiating by age 13; 22% were fathers. Injection drug use was reported by 5.5%, 12% had exchanged sex for money, 35% had more than 15 partners and 8% had homosexual experience. Although 72% had used condoms, only 9% used them consistently, and only 35% used one in their last intercourse before incarceration. Predictors of condom use included carrying condoms and endorsing the statement "I would use condoms with my girlfriend." Many said their lives include other risks more important than AIDS, such as survival in the crime scene. Initial efforts at prevention based on commonly used approaches of providing information to guide future rational decisions generated limited participation. However, when we worked with them to develop interventions based on their interests and needs, using modalities such as music, hip-hop arts, graffiti, and helping them to create an AIDS prevention compact disk, they responded with enthusiasm. These incarcerated adolescents are at extremely high social risk and report high levels of risk behavior for HIV infection. Interventions for these youth were better received when developed in collaboration with them and based on their beliefs, aspirations, and culture. The intervention that resulted went beyond AIDS to include issues such as violence, drugs, sexuality and human rights.

  13. Improving Nutrition in Pregnant Adolescents: Recommendations for Clinical Practitioners

    PubMed Central

    Montgomery, Kristen S.

    2003-01-01

    Pregnancy represents an ideal time for health promotion activities. Many women, including adolescents, are interested and willing to change health behaviors to improve the chance that they will deliver a healthy infant. This paper focuses on improving nutrition in pregnant adolescents. Seven recommendations are presented to help achieve this goal: 1) Focus on foods, not nutrients; 2) individualize and work within the pregnant adolescent's current eating habits; 3) consider the context of family and peer groups; 4) reward efforts; 5) make it easy; 6) focus on weight gain patterns for optimal birth outcomes; and 7) refer to a dietician, as needed. Use of these recommendations comprehensively addresses adolescent developmental needs to improve nutrition during pregnancy. These recommendations are not meant to be all-inclusive; rather, they are meant to serve as a guide for clinical management of nutrition for pregnant adolescents. PMID:17273337

  14. Can it be done? Implementing adolescent clinical preventive services.

    PubMed Central

    Ozer, E M; Adams, S H; Lustig, J L; Millstein, S G; Camfield, K; El-Diwany, S; Volpe, S; Irwin, C E

    2001-01-01

    OBJECTIVE: To evaluate the implementation of an intervention to increase the delivery of adolescent preventive services within a large managed care organization. Target health areas were tobacco, alcohol, sexual behavior, and safety (seat belt and helmet use). DATA SOURCE/STUDY DESIGN: Adolescent reports of clinician screening and counseling were obtained from adolescents who attended well visits with their primary care providers. A prepost study design was used to evaluate the preventive services intervention. The intervention had three components: (1) 89 clinicians from three outpatient pediatric clinics attended a training to increase the delivery of preventive services; (2) customized adolescent screening and provider charting forms were integrated into the clinics; and (3) the resources of a health educator were provided to the clinics. DATA COLLECTION: Following a visit, adolescents completed surveys reporting on clinician screening and counseling for each of the target risk areas. Preimplementation (three months), 104 adolescents completed surveys. Postimplementation of the training, tools, and health educator intervention, 211 adolescents completed surveys (five months). For 18 months postimplementation clinicians delivered services and 998 adolescents completed surveys. PRINCIPAL FINDINGS: Chi-square analyses of changes in screening from preimplementation to postimplementation showed that screening increased in all areas (p < .000), with an average increase in screening rates from 47 percent to 94 percent. Postimplementation counseling in all areas also increased significantly, with an average increase in counseling rates from 39 percent to 91 percent. There were slight decreases in screening from postimplementation to follow-up. CONCLUSIONS: This study offers support for the efficacy of providing training, tools, and resources as a method for increasing preventive screening and counseling of adolescents across multiple risky health behaviors during a

  15. Correlation between bullying and clinical depression in adolescent patients

    PubMed Central

    Kaltiala-Heino, Riittakerttu; Fröjd, Sari

    2011-01-01

    A literature review of the associations between involvement in bullying and depression is presented. Many studies have demonstrated a concurrent association between involvement in bullying and depression in adolescent population samples. Not only victims but also bullies display increased risk of depression, although not all studies have confirmed this for the bullies. Retrospective studies among adults support the notion that victimization is followed by depression. Prospective follow-up studies have suggested both that victimization from bullying may be a risk factor for depression and that depression may predispose adolescents to bullying. Research among clinically referred adolescents is scarce but suggests that correlations between victimization from bullying and depression are likely to be similar in clinical and population samples. Adolescents who bully present with elevated numbers of psychiatric symptoms and psychiatric and social welfare treatment contacts. PMID:24600274

  16. They Only See It when the Sun Shines in My Ears: Exploring Perceptions of Adolescent Hearing Aid Users

    ERIC Educational Resources Information Center

    Kent, Bruce; Smith, Sandra

    2006-01-01

    Hard-of-hearing (HOH) young people may encounter multiple challenges to their educational, social, and emotional development. The benefits of wearing hearing aids to enhance communication may be countered by negative stigma associated with hearing aids. This study explored the experience of 16 bilaterally, moderately to severely HOH adolescents in…

  17. Deviant adolescent subcultures: assessment strategies and clinical interventions.

    PubMed

    Clark, C M

    1992-01-01

    Alienation is a contributing factor in adolescents' participation in Satanism, the neo-Nazi skinhead movement, and violent street gangs. Many of their needs are met by gang and/or cult affiliation, including a sense of belonging, self-worth, companionship, and excitement. Emphasizing prevention may minimize deviant subculture involvement, but some adolescents require clinical intervention, ranging from a few outpatient sessions to lengthy inpatient hospitalization. Therapists must be knowledgeable about adolescents' involvement, empathic to their circumstances, and sophisticated in the approach to treatment.

  18. Decision-making orientation and AIDS-related knowledge, attitudes, and behaviors of Hispanic, African-American, and white adolescents.

    PubMed

    Langer, L M; Zimmerman, R S; Warheit, G J; Duncan, R C

    1993-05-01

    How adolescents' personal sense of directedness (i.e., peer, parent, or self-directed orientation) affects the decision-making processes of adolescent students regarding AIDS-related knowledge, attitudes, beliefs, behaviors, and skills (KABBS) is examined. The sample consisted of 10th-grade students in 8 public high schools (N = 2,515) in Dade County (greater Miami), Florida. The findings showed that decision-making orientation and directedness was a significant predictor of AIDS-related KABBS of adolescents. Overall, the level of AIDS-related KABBS that were associated with low risk was found significantly more often among self-directed students and least often among peer-directed students. The findings of this study suggest that future preadult health-risk research should incorporate the concept of differences of information processing across adolescents. PMID:8500453

  19. HIV/AIDS related knowledge among school-going adolescents from the Middle East and North Africa.

    PubMed

    Boneberger, Anja; Rückinger, Simon; Guthold, Regina; Kann, Laura; Riley, Leanne

    2012-05-01

    The aim of this secondary analysis was to present cross-national data about HIV/AIDS related knowledge among 13- to 15-year-old school-going adolescents from the Middle East and North Africa. Data from 23673 school-going adolescents from seven countries (Jordan, Lebanon, Libyan Arab Jamahiriya, Morocco, Oman, Tunisia and United Arab Emirates) that undertook the Global School-Based Student Health Survey between 2004 and 2008 were analysed. HIV/AIDS related knowledge varied significantly between countries and gender. Research for this sensitive topic is scarce in this region. In addition, schools could be among the many key players for HIV/AIDS education.

  20. Parental Behavior and Adolescent Self-Esteem in Clinical and Nonclinical Samples.

    ERIC Educational Resources Information Center

    Nielson, David M.; Metha, Arlene

    1994-01-01

    Investigated relationships between self-esteem and adolescents' perceptions of parental behaviors using nonclinical (n=119) and clinical (n=30) adolescents. Nonclinical adolescents scored higher than clinical adolescents on all self-esteem dimensions. Males scored higher than females only on dimension of Self-Esteem Competence. Perceptions of…

  1. Knowledge, attitudes and sexual practices of adolescents with mild retardation, in relation HIV/AIDS.

    PubMed

    Dawood, Naseema; Bhagwanjee, Anil; Govender, Kay; Chohan, Ebrahim

    2006-05-01

    This study investigates the knowledge, attitudes and sexual practices of adolescents with mild mental retardation (MMR) in relation to HIV/AIDS. Questionnaires were personally administered to a saturation sample of 90 adolescents with MMR drawn from one specialised educational institution in Durban, South Africa. The study revealed critical gaps and erroneous beliefs regarding knowledge of HIV/AIDS, especially with regard to its existence, transmission and cure. Participants indicated a high degree of exposure to various sources of information, particularly media messages. The results indicate that gender-role prescriptions and prevailing social constructions of immorality have had a negative influence on the attitudes and behaviour of participants, particularly with regard to sexual practices and preventative risk behaviours. Furthermore, the sample was found to have low levels of self-efficacy in relation to sexual negotiation and decision-making, more specifically with regard to condom use. It should be noted, however, that only a small proportion of the sample was sexually active and the use of contraceptives was accordingly found to be extremely low. The findings are discussed against the backdrop of the empirical literature on HIV/AIDS, developmental theory, and pertinent theories and models of health behaviour. This study may help to promote a better understanding of the psycho-educational dynamics of HIV infection in this special group of adolescents, and also help to inform attempts to tailor suitable educational programmes, as well as promote further research to add to our knowledge as we address the problems of HIV/AIDS among this group.

  2. Adolescents in the age of AIDS: myths, misconceptions, and misunderstandings regarding sexually transmitted diseases.

    PubMed

    Cohall, A; Kassotis, J; Parks, R; Vaughan, R; Bannister, H; Northridge, M

    2001-02-01

    The purpose of this study is twofold: to evaluate the extent of knowledge possessed by young people residing in an urban sexually transmitted disease (STD) and AIDS epicenter about STDs, including AIDS; and to determine whether knowledge levels varied by age, gender, race/ ethnicity, and/or previous health instruction. A total of 867 adolescents (472 females and 395 males) attending a large public high school in New York City completed a self-administered survey. Levels of knowledge about AIDS transmission and prevention were high (mean percentage correct = 91.8%). Nonetheless, adolescent respondents locked awareness about the prevalence of common STDs, had limited understanding of the ways in which these diseases can be transmitted and prevented, and were unaware of potentially serious sequelae resulting from exposure to infectious agents (e.g., infertility from chlamydial infections). Young people who had taken a health education course in which STDs were discussed did slightly better on the knowledge survey than did their peers. While the prevention of HIV infection is, and should be, a national priority, more concerted efforts are needed to better educate young people about other STDs in the overall context of sexual health.

  3. Clinical Assessment of the Violent Adolescent.

    ERIC Educational Resources Information Center

    Cornell, Dewey G.

    School psychologists may be asked to assess potentially violent adolescents. Research on predicting violence has demonstrated that: (1) most studies show poor predictive ability; (2) clinicians tend to overpredict violence; (3) prediction is difficult because the base rate is low; and (4) the best single predictor is past violent behavior. New…

  4. The value of an aide memoire in the dermatology clinic.

    PubMed

    Dutton, E S; Holder, J E; Graham-Brown, R A

    1999-03-01

    A randomized study was undertaken to investigate the effectiveness of a chart as an aid to memory illustrating the topical medication most frequently prescribed both in the dermatology clinic, and in general practice. One hundred subjects, half new referrals and half follow-ups, were recruited and asked to recall all of the topical preparations that had previously been prescribed for this condition. They were then asked to consult the chart, and any additional medication recognized at this time was noted, along with any clarification of formulation and strength where possible. Despite some limitations, our chart proved to be of considerable value. Thirty-eight patients could identify between three and eight additional preparations. Overall, the mean number of additional preparations recalled per patient was two. Clarification of strength and formulation was achieved by 21 patients. Eight charts were used, and provided additional information at consultation in 87% of subjects interviewed.

  5. Management of pulmonary aspergillosis in AIDS: an emerging clinical problem.

    PubMed Central

    Keating, J J; Rogers, T; Petrou, M; Cartledge, J D; Woodrow, D; Nelson, M; Hawkins, D A; Gazzard, B G

    1994-01-01

    AIMS--To review the clinical, radiographic, and therapeutic features of 11 cases of respiratory Aspergillus infection in patients with AIDS. METHODS--All induced sputum and bronchoalveolar lavage samples obtained from HIV seropositive patients between January 1985 and March 1993 were analysed for Aspergillus species. Additionally, where appropriate, bronchial or renal biopsy specimens, or both, were taken before treatment had started. RESULTS--In 11 patients Aspergillus fumigatus was identified in alveolar samples obtained by sputum induction. This was confirmed by bronchoalveolar lavage in eight. Three patients had Aspergillus plaques in the trachea and bronchus, while a fourth patient had an aspergilloma. Risk factors for Aspergillus infection were present in all patients, including corticosteroid treatment in three cases and neutropenia in four, three of whom had received chemotherapy for Kaposi's sarcoma. Four patients had concomitant cytomegalovirus infection. Ten patients had a CD4 count of less than 50 cells/mm3 while one patient had a disseminated T cell lymphoma with a CD4 count of 242 cells/mm3. Of the three patients with samples obtained by sputum induction who did not undergo bronchoscopy, two had a normal chest x ray picture and the third had a right lobar pneumonia complicating an aggressive lymphoma. All three were treated with itraconazole 200 mg twice a day without further investigation. Survival from the time of diagnosis of Aspergillus infection was short: seven patients died within six weeks, although only one death was directly attributed to pulmonary aspergillosis. At six monthly follow up, one patient, who initially had a positive Aspergillus culture from bronchial washings and a normal chest radiograph, developed a renal aspergilloma despite the disappearance of Aspergillus sp from the sputum. CONCLUSION--Pulmonary aspergillosis is an important clinical problem in patients with AIDS with a CD4 count of less than 50 cells/mm. Furthermore

  6. Mindfulness with children and adolescents: effective clinical application.

    PubMed

    Thompson, Miles; Gauntlett-Gilbert, Jeremy

    2008-07-01

    Mindfulness interventions within adult populations are becoming increasingly popular. Research suggests that mindfulness can deliver lasting improvements in self-awareness and emotional stability to adults with severe and chronic conditions. As yet, research within child and adolescent populations is in its initial stages, although mindfulness shows great clinical promise for young people. This article aims to provide an overview of mindfulness to professionals who are working in child or adolescent settings. Initially, it will provide the reader with some orientation to and definitions from the field, before summarizing the current evidence for the utility of the approach. The article recommends specific clinical modifications for mindfulness with children and adolescents, as well as reviewing how to monitor and enhance the development of this skill. Finally, it highlights important differences among mindfulness, relaxation and other meditative techniques.

  7. Internalizing and Externalizing Personality Dimensions and Clinical Problems in Adolescents

    ERIC Educational Resources Information Center

    Hopwood, Christopher J.; Grilo, Carlos M.

    2010-01-01

    Ostensible psychiatric comorbidity can sometimes be explained by shared relations between diagnostic constructs and higher order internalizing and externalizing dimensions. However, this possibility has not been explored with regard to comorbidity between personality pathology and other clinical constructs in adolescents. In this study,…

  8. Multiple Regression Analyses in Clinical Child and Adolescent Psychology

    ERIC Educational Resources Information Center

    Jaccard, James; Guilamo-Ramos, Vincent; Johansson, Margaret; Bouris, Alida

    2006-01-01

    A major form of data analysis in clinical child and adolescent psychology is multiple regression. This article reviews issues in the application of such methods in light of the research designs typical of this field. Issues addressed include controlling covariates, evaluation of predictor relevance, comparing predictors, analysis of moderation,…

  9. Deviant Adolescent Subcultures: Assessment Strategies and Clinical Interventions.

    ERIC Educational Resources Information Center

    Clark, Cynthia M.

    1992-01-01

    Presents assessment strategies, preventive methods, and clinical interventions to assist clinicians working with teenagers involved with deviant subcultures: Satanism, the neo-Nazi skinhead movement, and violent street gangs. Considers role of alienation as contributing factor in adolescents' participation in these subcultures. Advises therapists…

  10. Psychiatric Illness in Mentally Retarded Adolescents: Clinical Features.

    ERIC Educational Resources Information Center

    Masi, Gabriele

    1998-01-01

    Describes the clinical features of the most important psychiatric disorders in mentally retarded adolescents: mood disorders, psychotic disorders, severe behavioral disorders, personality disorders, anxiety disorders, and attention-deficit The impact of mental retardation on personality development is confirmed by the high psychopathological…

  11. Risk-taking behaviors and AIDS knowledge: experiences and beliefs of minority adolescent mothers.

    PubMed

    Koniak-Griffin, D; Nyamathi, A; Vasquez, R; Russo, A A

    1994-12-01

    Using a qualitative focus-group methodology, this study investigated risk-taking behaviors and AIDS knowledge among minority pregnant and parenting adolescents at risk for heterosexual and perinatal transmission of HIV. Seven focus groups were conducted with a total of 48 young women recruited from alternative schools and residential facilities for pregnant adolescents and young mothers in Southern California. Participants also completed a background questionnaire soliciting sociodemographic information and an AIDS knowledge test. The sample included 33 Latinas and 15 African-Americans, ranging in age from 12 to 19 years. There were bipolar findings regarding risk-taking behaviors. At one end of the continuum were young women with a history of one of more of the following behaviors: multiple sex partners, drug and alcohol use, carrying weapons, and participating in gang-related activities. Contrasting with these, were those who had one or two sex partners and no history of alcohol or drug abuse. A majority of the participants were having unprotected sex. A variety of factors affected condom use, including gender inequality, embarrassment, and personal preferences and values. Risk-taking was also influenced by lack of security and safety in daily living, emotion-focused coping and peer pressure.

  12. Clinical phenomenology of child and adolescent dissociative disorders.

    PubMed

    Hornstein, N L; Putnam, F W

    1992-11-01

    A comparison of two separately diagnosed samples of children and adolescents with dissociative disorders demonstrates good construct validity for these diagnoses in childhood. Descriptive analyses of the total sample reveal a clinical profile characterized by a plethora of affective, anxiety, conduct, posttraumatic, and dissociative symptoms. Children with multiple personality disorder (MPD) differ from those with dissociative disorder not otherwise specified (DDNOS) in having more amnesias, identity disturbances, and hallucinations. Adolescents were more symptomatic than children age 11 or younger and more likely to receive a diagnosis of multiple personality disorder.

  13. Inculcating safe sex attitudes in South African adolescents: a directive for the government's anti-HIV/AIDS policy.

    PubMed

    D'Souza, Jayesh

    2010-01-01

    South Africa has one of the highest rates of HIV/AIDS in the world. Much blame for this has been laid on the apathy of the South African government and the cultural traits of South Africans. AIDS prevention research calls for early childhood education to raise awareness of the causes, dangers, and prevention of HIV/AIDS. This study involved surveys among a select sample of South African adolescents to determine their sexual attitudes before and after a cognitive-behavioral intervention. Overall, the results did not make a significant difference in their attitudes, suggesting pre-adolescent sex education might prove to be a more useful tool in anti-HIV/AIDS education. Risky sexual behavior, under the influence of alcohol, also serves as a warning to educate young consumers of alcohol.

  14. Predictors of Suicide Attempts in Clinically Depressed Korean Adolescents

    PubMed Central

    Kwon, Ahye; Song, Jungeun; Yook, Ki-Hwan; Jon, Duk-In; Jung, Myung Hun; Hong, Narei; Hong, Hyun Ju

    2016-01-01

    We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents. PMID:27776392

  15. Accuracy of computer-aided ultrasound as compared with magnetic resonance imaging in the evaluation of nonalcoholic fatty liver disease in obese and eutrophic adolescents*

    PubMed Central

    do Nascimento, José Hermes Ribas; Soder, Ricardo Bernardi; Epifanio, Matias; Baldisserotto, Matteo

    2015-01-01

    Objective To compare the accuracy of computer-aided ultrasound (US) and magnetic resonance imaging (MRI) by means of hepatorenal gradient analysis in the evaluation of nonalcoholic fatty liver disease (NAFLD) in adolescents. Materials and Methods This prospective, cross-sectional study evaluated 50 adolescents (aged 11–17 years), including 24 obese and 26 eutrophic individuals. All adolescents underwent computer-aided US, MRI, laboratory tests, and anthropometric evaluation. Sensitivity, specificity, positive and negative predictive values and accuracy were evaluated for both imaging methods, with subsequent generation of the receiver operating characteristic (ROC) curve and calculation of the area under the ROC curve to determine the most appropriate cutoff point for the hepatorenal gradient in order to predict the degree of steatosis, utilizing MRI results as the gold-standard. Results The obese group included 29.2% girls and 70.8% boys, and the eutrophic group, 69.2% girls and 30.8% boys. The prevalence of NAFLD corresponded to 19.2% for the eutrophic group and 83% for the obese group. The ROC curve generated for the hepatorenal gradient with a cutoff point of 13 presented 100% sensitivity and 100% specificity. As the same cutoff point was considered for the eutrophic group, false-positive results were observed in 9.5% of cases (90.5% specificity) and false-negative results in 0% (100% sensitivity). Conclusion Computer-aided US with hepatorenal gradient calculation is a simple and noninvasive technique for semiquantitative evaluation of hepatic echogenicity and could be useful in the follow-up of adolescents with NAFLD, population screening for this disease as well as for clinical studies. PMID:26379321

  16. A Randomized Controlled Trial of Online versus Clinic-Based CBT for Adolescent Anxiety

    ERIC Educational Resources Information Center

    Spence, Susan H.; Donovan, Caroline L.; March, Sonja; Gamble, Amanda; Anderson, Renee E.; Prosser, Samantha; Kenardy, Justin

    2011-01-01

    Objective: The study examined the relative efficacy of online (NET) versus clinic (CLIN) delivery of cognitive behavior therapy (CBT) in the treatment of anxiety disorders in adolescents. Method: Participants included 115 clinically anxious adolescents aged 12 to 18 years and their parent(s). Adolescents were randomly assigned to NET, CLIN, or…

  17. Conceptual and Clinical Issues in the Treatment of Adolescent Alcohol and Substance Misusers.

    ERIC Educational Resources Information Center

    Filstead, William J.; Anderson, Carl L.

    1983-01-01

    Describes a system of care and clinical issues central to service delivery to adolescents with alcohol/drug problems. Recognizes the importance of adolescence as a developmental period and its implications for treatment. Develops criteria to distinguish the most appropriate level of care for the adolescent's presenting clinical condition. (CMG)

  18. [Information, attitudes, perceptions, and symbolic representations of AIDS risk and prevention among poor adolescents in Rio de Janeiro, Brazil].

    PubMed

    Merchán-Hamann, E

    1995-01-01

    Four hundred and sixteen poor adolescents of both sexes in Rio de Janeiro were interviewed to study both their level of information and symbolic representations concerning AIDS risk and prevention. The most common source of information on HIV/AIDS was the mass media, particularly television broadcasts. There were doubts and lack of trust regarding official government information on HIV/AIDS. Nearly 70% of the adolescents interviewed believe in HIV transmission through mosquito bites and some 40% through casual contact with wounds or scars or sharing of bathroom utensils. Men seemed to show a greater awareness and autonomy vis- -vis taking initiatives in sex encounters. Attitudes of segregation and exclusion of people with AIDS persist. Lack of prevention was attributed to the impossibility of predicting sexual encounters. The study of symbolic aspects concerning causes of HIV/AIDS displayed broad variability: 80% of the interviewees associated AIDS with excesses in sexual behavior and 40% with homosexual practices. Causal images vary from the predominant view of AIDS as unfair punishment to the less frequent stance considering AIDS as fair punishment (due to sinful behavior). An ambiguous attitude towards transgression (taking as its sterotype the figure of Rio's "malandro", or "streetwise dude") may influence perception of risk and prevention. The paper calls attention to the need for implementing clearer and more direct educational programs. This could be useful for the implementation of culturally sensitive control measures through a reshaping of AIDS symbols. The author recommends a better understanding of the social and economic determinants of disease and reinforcement of the kinds of discourse which empower and raise the self-esteem of poor adolescents by endorsing their civil rights.

  19. Pediatric, Adolescent, and Maternal AIDS Branch. Report to the National Advisory Child Health and Human Development Council.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD. Center for Research for Mothers and Children.

    This report describes current research activities and future plans of the Pediatric, Adolescent, and Maternal AIDS (PAMA) Branch of the National Institute of Child Health and Human Development's Center for Research for Mothers and Children. The mission statement of the Branch notes that PAMA develops, implements, and directs a wide range of…

  20. Community-based participatory research to prevent substance abuse and HIV/AIDS in African-American adolescents.

    PubMed

    Marcus, Marianne T; Walker, Thomas; Swint, J Michael; Smith, Brenda Page; Brown, Cleon; Busen, Nancy; Edwards, Thelissa; Liehr, Patricia; Taylor, Wendell C; Williams, Darryal; von Sternberg, Kirk

    2004-11-01

    Adolescence is a time for exploration and risk-taking; in today's urban environment, with the twin threats of substance abuse and HIV/AIDS, the stakes are particularly high. This paper describes a community-based participatory research project to design, implement, and evaluate a faith-based substance abuse and HIV/AIDS prevention program for African-American adolescents. A coalition of university-based investigators and African-American church member stakeholders collaborated on all aspects of Project BRIDGE, the 3-year intervention to reduce substance abuse and HIV/AIDS in African-American adolescents. Our results support the use of community-based participatory research to create desirable change in this setting. Adolescents who participated in Project BRIDGE reported significantly less marijuana and other drug use and more fear of AIDS than a comparison group. Project BRIDGE has been designated an official ministry of the church and the program has been extended to others in the larger metropolitan community. The church now has a well-trained volunteer staff University faculty developed skills in negotiating with community-based settings. The coalition remains strong with plans for continued collaborative activities.

  1. HIV/AIDS Knowledge and Health-Related Attitudes and Behaviors among Deaf and Hearing Adolescents in Southern Brazil

    ERIC Educational Resources Information Center

    Bisol, Claudia Alquati; Sperb, Tania Mara; Brewer, Toye H.; Kato, Sergio Kakuta; Shor-Posner, Gail

    2008-01-01

    HIV/AIDS knowledge and health-related attitudes and behaviors among deaf and hearing adolescents in southern Brazil are described. Forty-two deaf students attending a special nonresidential public school for the deaf and 50 hearing students attending a regular public school, ages 15-21 years, answered a computer-assisted questionnaire. (There was…

  2. Physical activity in adolescence. A review with clinical suggestions.

    PubMed

    Lotan, Meir; Merrick, Joav; Carmeli, Eli

    2005-01-01

    Despite some inconsistencies in research methodologies, most findings support a positive correlation between participation in physical activities and well-being in adulthood. The results are consistent across the life span of both genders. Favorable connection between physical exercise to physical, psychological, emotional and educational benefits has been constantly proven. Despite such results a comparison between present to past findings show a global tendency for sedentary life style and reduced physical activities in many countries across ages and genders. There are claims that achieving an adult healthy life style is rooted in habits acquired at early ages, thus pointing at childhood and adolescence as the starting point of an active and healthy adulthood. The present article reviews the current literature and findings relating to physical activity with better health and an emphasis on adolescence. Factors correlated to participation of adolescents in physical activities are presented and some clinical issues to promote such activity are discussed. The authors strongly recommend enhanced initiation of community based easily accessed physical exercise programs, for children and adolescents.

  3. Trends in adolescent sexual behavior, impact of information, and attitudes about HIV/AIDS in Portugal.

    PubMed

    Ramiro, Lúcia; Reis, Marta; de Matos, Margarida Gaspar; Diniz, José Alves

    2014-01-01

    There is a recent decline in HIV in a significant number of countries due to the adoption of preventive sexual behaviors, which demonstrates that HIV reduction is possible. The goal of this research was to deepen knowledge of preventive sexual behavior in adolescents, including knowledge and attitudes about HIV/AIDS, and assessing whether they changed from 2002 to 2010. Data were collected through a self-administered questionnaire from the Portuguese sample of the Health Behavior in School-aged Children, a collaborative WHO study. The study provided national representative data of 10,587 Portuguese adolescents attending 8th and 10th grade. In terms of preventive behaviors, results showed an increasing trend regarding the percentage reporting first sexual intercourse at 14 years old or more and condom use at last intercourse and a stabilized trend concerning having had intercourse, contraceptive pill use at last intercourse and having had intercourse under the influence of alcohol or drugs. Nevertheless, results showed a systematic decreasing trend in terms of knowledge and attitudes. This suggested that sex education programs are still too limited to teaching sessions, strongly homogenized in their content and inadequate to enhance knowledge and attitudes regarding HIV, let alone personal and social skills of different target groups. PMID:24128038

  4. Trends in adolescent sexual behavior, impact of information, and attitudes about HIV/AIDS in Portugal.

    PubMed

    Ramiro, Lúcia; Reis, Marta; de Matos, Margarida Gaspar; Diniz, José Alves

    2014-01-01

    There is a recent decline in HIV in a significant number of countries due to the adoption of preventive sexual behaviors, which demonstrates that HIV reduction is possible. The goal of this research was to deepen knowledge of preventive sexual behavior in adolescents, including knowledge and attitudes about HIV/AIDS, and assessing whether they changed from 2002 to 2010. Data were collected through a self-administered questionnaire from the Portuguese sample of the Health Behavior in School-aged Children, a collaborative WHO study. The study provided national representative data of 10,587 Portuguese adolescents attending 8th and 10th grade. In terms of preventive behaviors, results showed an increasing trend regarding the percentage reporting first sexual intercourse at 14 years old or more and condom use at last intercourse and a stabilized trend concerning having had intercourse, contraceptive pill use at last intercourse and having had intercourse under the influence of alcohol or drugs. Nevertheless, results showed a systematic decreasing trend in terms of knowledge and attitudes. This suggested that sex education programs are still too limited to teaching sessions, strongly homogenized in their content and inadequate to enhance knowledge and attitudes regarding HIV, let alone personal and social skills of different target groups.

  5. Community Support and Adolescent Girls' Vulnerability to HIV/AIDS: Evidence From Botswana, Malawi, and Mozambique.

    PubMed

    Underwood, Carol; Schwandt, Hilary M

    2015-01-01

    Girls are vulnerable to HIV in part because the social systems in which they live have failed to support and protect them. The goal of this research was to develop a viable supportive community index and test its association with intermediate variables associated with HIV risk across 16 communities in Botswana, Malawi, and Mozambique. This cross-sectional survey with separate samples randomly drawn in each country (2010) yielded a total sample of 1,418 adolescent girls (aged 11-18). Multilevel, multivariate logistic regression, while controlling for vulnerability, age, religion, and residence, found that an increase in supportive community index is positively associated with the odds of indicating improved community support for girls and with the confidence to refuse unwanted sex with a boyfriend across the three countries, as well as with self-efficacy to insist on condom use in Botswana and Mozambique. Program implementers and decision makers alike can use the supportive community index to identify and measure structural factors associated with girls' vulnerability to HIV/AIDS; this will potentially contribute to judicious decision making regarding resource allocation to enhance community-level, protective factors for adolescent girls. PMID:26470396

  6. Clinical presentation of osgood- schlatter disease in the adolescent population.

    PubMed

    Antich, T J; Lombardo, S J

    1985-01-01

    Osgood-Schlatter disease is a condition affecting knees of adolescents. Males are affected more frequently than females, and unilateral involvement is more common than bilateral. In the 75 cases seen in our clinic in 4l/3 years, participation in basketball was twice as common among our patients as was any other sport. With the addition of our clinical cases to those documented in the literature, the left knee is significantly more involved than the right (P < 0.05). Relationship to hand dominance is discussed as a possible explanation for the unusual prevalence for left knee involvement. J Orthop Sports Phys Ther 1985;7(1):1-4.

  7. Clinical holistic medicine: holistic adolescent medicine.

    PubMed

    Ventegodt, Søren; Morad, Mohammed; Press, Joseph; Merrick, Joav; Shek, Daniel T L

    2004-08-04

    The holistic medical approach seems to be efficient and can also be used in adolescent medicine. Supporting the teenager to grow and develop is extremely important in order to prevent many of the problems they can carry into adulthood. The simple consciousness-based, holistic medicine--giving love, winning trust, giving holding, and getting permission to help the patient feel, understand, and let go of negative beliefs--is easy for the physician interested in this kind of practice and it requires little previous training for the physician to be able to care for his/her patient. A deeper insight into the principles of holistic treatment and a thorough understanding of our fellow human beings are making it work even better. Holistic medicine is not a miracle cure, but rather a means by which the empathic physician can support the patient in improving his/her future life in respect to quality of life, health, and functional capacity--through coaching the patient to work on him/herself in a hard and disciplined manner. When the patient is young, this work is so much easier. During our lifetime, we have several emotional traumas arranged in the subconscious mind with the smallest at the top, and it is normal for the person to work on a large number of traumatic events that have been processed to varying degrees. Some traumas have been acknowledged, some are still being explored by the person, and yet others are still preconscious, which can be seen for example in the form of muscle tension. Sometimes the young dysfunctional patient carries severe traumas of a violent or sexual nature, but the physician skilled in the holistic medical toolbox can help the patient on his/her way to an excellent quality of life, full self-expression, a love and sex life, and a realization of his/her talents--all that a young patient is typically dreaming about. Biomedicine is not necessary or even recommended when the physical or mental symptoms are caused by disturbances in the personal

  8. The clinical implications of ear canal debris in hearing aid users.

    PubMed

    Orji, Foster Tochukwu; O Onyero, Emmanuel; Agbo, Christian Ejiofor

    2014-05-01

    Objective : The ear irritations suffered by hearing aid (HA) users are yet to be related to the clinical state of canal. We undertook this study to examine the nature of debris and the microbial flora of ears of hearing aid users, as well as evaluate the determinant factors of ear irritation in this population. Methods : An observational clinical study was carried out involving 32 unilateral hearing aid users recruited from ENT clinic of a tertiary referral center. Each subject underwent otoscopic assessment of canal debris and microbial analysis of swab cultures taken from the hearing aid-wearing ear and contralateral normal ear without hearing aid. Results : Canal debris [wax (28%), fungal deposits (19%), bacteria exudates (13%)]. as well as microorganisms were identified in significant number of ears with hearing aids than ears without hearing aid (P = 0.003 and P = 0.006 respectively). Coagulase-negative staphylococci were the commonest identified bacteria. Others were Staphylococcus aureus, Pseudomonas aeruginosa, and Proteus species. Intolerable irritations of hearing aid wearing ears were significantly associated with bacterial and fungal otitis externa, and ear discharge (P = 0.005, 0.02, 0.03 respectively). Conclusions : This study demonstrates that using hearing aid alters the ear canal flora; increases risk of both fungal and bacterial otitis externa, as well as encourage wax debris formation, with resultant ear irritations. To ensure compliance their ears should periodically be attended to, by de-waxing or given topical antimicrobial agents where indicated.

  9. Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents.

    PubMed

    Hingson, R W; Strunin, L; Berlin, B M; Heeren, T

    1990-03-01

    In August 1988, 1,773 Massachusetts 16-19-year-olds were surveyed by telephone using anonymous random digit dialing; response rate 82 percent. Logistic regression tested whether alcohol and drug use, perceived susceptibility to human immunodeficiency virus (HIV), severity of HIV if infected, effectiveness of condoms in preventing infection, barriers to condom use, and behavioral cues such as exposure to media or personal communication about acquired immunodeficiency syndrome (AIDS) were independently related to condom use. Among sexually active respondents, (61 percent of those interviewed) 31 percent reported always using condoms. Respondents who believed condoms are effective in preventing HIV transmission and worried they can get AIDS were 3.1 and 1.8 times, respectively, more likely to use condoms all the time. Respondents who carried condoms and who had discussed AIDS with a physician were 2.7 and 1.7 times, respectively, more likely to use them. Those who believed condoms do not reduce sexual pleasure and would not be embarrassed if asked to use them were 3.1 and 2.4 times, respectively, more likely to use condoms. Teens who averaged five or more drinks daily or used marijuana in the previous month were 2.8 and 1.9 times, respectively, less likely to use condoms. Among respondents who drink and use drugs, 16 percent used condoms less often after drinking and 25 percent after drug use. Those counseling adolescents about HIV should assess and discuss beliefs outlined in the Health Belief Model, as well as their alcohol and drug use.

  10. Body Dysmorphic Disorder and Other Clinically Significant Body Image Concerns in Adolescent Psychiatric Inpatients: Prevalence and Clinical Characteristics

    ERIC Educational Resources Information Center

    Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.

    2006-01-01

    Background: This study assessed prevalence and clinical correlates of body dysmorphic disorder (BDD), eating disorders (ED), and other clinically significant body image concerns in 208 consecutively admitted adolescent inpatients. It was hypothesized that adolescents with BDD would have higher levels of depression, anxiety, and suicidality.…

  11. Adolescents with Special Needs: Clinical Challenges in Reproductive Health Care.

    PubMed

    Quint, Elisabeth H

    2016-02-01

    Adolescents with special needs have unique reproductive health care needs related to their physical and cognitive issues. This review discusses some of the most common concerns that are encountered in clinical practice, as the clinician will partner with the adolescent and her family to guide her through the pubertal transition and to help navigate the risks and rights of reproduction. Families often seek anticipatory guidance before menarche on menstrual hygiene, abuse risk and sexuality and can be reassured that most teens with special needs do very well with menstruation. The clinician needs to evaluate the teenager's reproductive knowledge as well her risk for abuse and coercion and her ability to consent to sexual activity, if she requests contraception. Menstrual management is mostly based on the impact of the menstrual cycles on the teenager's life and activities. The adolescents may have a decreased ability to tolerate menses or pain, or experience changes in seizure pattern or altered mood. Hormonal treatment is often used to assist with menstrual hygiene, cyclical mood changes or dysmenorrhea. The goal of treatment can be complete amenorrhea, alleviate pain or regulate and decrease menstrual flow. The unique risks and benefits of hormonal treatment for this special population are highlighted.

  12. Sexuality and AIDS: Attitudes and Behaviors of Adolescents in East and West Berlin.

    ERIC Educational Resources Information Center

    Oswald, Hans; Pforr, Petra

    1992-01-01

    Study conducted in 1990 compared 2 samples of 542 adolescents from west Berlin and 340 adolescents from east Berlin. Findings suggest that general trend toward sexual liberality among adolescents is continuing and that necessary processes of adolescent sexual development appear not to be influenced by the threat of Acquired Immune Deficiency…

  13. Relationships with AIDS patients: clinical metaphors and preventive bioethics.

    PubMed

    Dozor, R B; Meece, K S

    1990-01-01

    AIDS, more than most diseases, evokes compelling and tragic stories. The AIDS epidemic is "The Plague." We seek the optimally therapeutic relationship, embodied in the metaphor of the covenant. There is a fundamental human possibility of healing through dying. "Death teaches us to live." We advocate asking AIDS patients the explicit question, "How do you want me to work with you?" This can generate conversations that facilitate congruence in relationships. A reluctance to talk about uncertainties and limits is a major source of preventable ethical conflict and a major obstacle to fulfillment of the therapeutic possibilities of the doctor-patient relationship. The Durable Power of Attorney for Health Care (DPA) can be helpful in facilitating discussions with patients and their families. Successful "preventive bioethics" is communication that opens for the patient and doctor the broadest possibilities of hearing, understanding, and expressing. The doctor as parent, fighter, technician, teacher, and covenanter may be important roles at appropriate moments with a given patient who may be experiencing the disease variably as infectious chaos, brutal enemy, spiritual challenge, or opportunity for growth. The context of such communication is a real relationship that includes love, respect, humor, hope, and genuine interest in how this other person lives. PMID:2262111

  14. Computer AIDS for Clinical Research Management and Control: General Analysis and Design

    PubMed Central

    Willard, Christopher G.; Gatewood, Laël C.; Ellis, Lynda B. M.

    1979-01-01

    Clinical research projects involve concurrent management of subjects, protocol, analysis and study. This complicated management problem could be aided by the use of computerized data systems. For most effective aid, such a system should consider all aspects of clinical research. We have analyzed clinical research tasks involving data collection, communication, and management and have used this task analysis to develop a system model for clinical research data management and control. The model deals with data control, study monitoring, user interfaces, report and analysis libraries, and study subject and support data bases. It may be used as a basis for computerized data system study and development. The model also indicates that the role of computerized systems in clinical research could be expanded into such areas as automatic report generation and control, process control aids, quality assurance monitoring, and study documentation.

  15. Correlates of the Quality of life of Adolescents in families affected by HIV/AIDS in Benue State, Nigeria

    PubMed Central

    Akpa, Onoja Matthew; Bamgboye, Elijah Afolabi

    2015-01-01

    It was estimated that over 260,000 children are living with HIV/AIDS while close to 2 million are directly or indirectly affected by the disease in Nigeria. Improvements in treatments for infected children have been documented in the literature but there is a gross knowledge gap on the impact of HIV/AIDS on the quality of life and psychosocial functioning (PSF) of affected children in Nigeria. We comparatively explored the association of quality of life with PSF and other factors among adolescents in families affected by HIV/AIDS (FAHA) and in families not affected by HIV/AIDS (FNAHA). Data was extracted for 960 adolescents from a State wide cross-sectional study in which participants were selected through multistage sampling techniques. Data was collected using questionnaires consisting of demographic information, adapted WHO-QOL BREF and the Strength & Difficulty Questionnaire (SDQ). The quality of life scores were categorized into Poor, Moderate and High based on the amount of standard deviation away from the mean while the SDQ scores were categorized into normal, borderline and abnormal based on the SDQ scoring systems. Chi-square test and independent t-test were used for bivariate analyses while logistic regression was used for multivariate analyses at 5% level of significance. Proportion with poor quality of life (27.0%) was significantly higher among adolescents in FAHA than in FNAHA (p=0.0001). Adolescents in FAHA (OR:2.32; 95%CI:1.67-4.09) were twice more likely to have poor quality of life than those in FNAHA. In FAHA, adolescents on the borderline of PSF (OR:2.19; 95%CI:1.23-3.89) were twice more likely to have poor quality of life than those with normal PSF. Adolescents in FAHA have poorer quality of life than those in FNAHA and also face additional burdens of psychosocial dysfunctions. Interventions focusing on functional social support and economic empowerment will benefit adolescents in FAHA in the studied location. PMID:26587049

  16. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

    PubMed Central

    2014-01-01

    Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who

  17. Children's Views Matter Too! A Pilot Project Assessing Children's and Adolescents' Experiences of Clinical Psychology Services

    ERIC Educational Resources Information Center

    Gordon, Michael; Russo, Kate

    2009-01-01

    This pilot study explored the experiences and understanding of clinical psychology practices and services of children and adolescents attending clinical psychology outpatient appointments. Fifteen young participants took part in the study. A content analysis indicated that young children and adolescents have an appropriate understanding of the…

  18. School-Based Health Clinics: An Emerging Approach to Improving Adolescent Health and Addressing Teenage Pregnancy.

    ERIC Educational Resources Information Center

    Kirby, Douglas

    This report discusses the ongoing movement to provide health care and health information to adolescents through school-based clinics and other programs. The report begins with an overview of programs, focusing on: the unique health needs of adolescents; the growth in the number of school-based clinics; goals and objectives of the special programs;…

  19. Understanding Locally, Culturally, and Contextually Relevant Mental Health Problems among Rwandan Children and Adolescents Affected by HIV/AIDS

    PubMed Central

    Betancourt, Theresa Stichick; Rubin-Smith, Julia E.; Beardslee, William R.; Stulac, Sara N.; Fayida, Ildephonse; Safren, Steven

    2011-01-01

    In assessing the mental health of HIV/AIDS-affected children and adolescents in Sub-Saharan Africa, researchers often employ mental health measures developed in other settings. However, measures derived from standard Western psychiatric criteria are frequently based on conceptual models of illness or terminology that may or may not be an appropriate for diverse populations. Understanding local perceptions of mental health problems can aid in the selection or creation of appropriate measures. This study used qualitative methodologies (Free Listing [FL], Key Informant [KI] interviews, and Clinician Interviews [C-KIs]) to understand local perceptions of mental health problems facing HIV/AIDS-affected youth in Rwinkwavu, Rwanda. Several syndrome terms were identified by participants: agahinda kenshi, kwiheba, guhangayika, ihahamuka, umushiha and uburara. While these local syndromes share some similarities with Western mood, anxiety, and conduct disorders, they also contain important culture-specific features and gradations of severity. Our findings underscore the importance of understanding local manifestations of mental health syndromes when conducting mental health assessments and when planning interventions for HIV/AIDS-affected children and adolescents in diverse settings. PMID:21271393

  20. Reflective logs: an aid to clinical teaching and learning.

    PubMed

    Freeman, M

    2001-01-01

    This paper reports on the use of learning logs for clinical teaching and learning in a university clinic. Students were encouraged to submit a written summary of their reflections after each clinical session for discussion at the subsequent session. Evaluation has shown that clinician-teachers and students value this approach because it facilitates clear goal-setting, promotes information exchange and provides opportunities for explicit focus on the student's learning needs. Although most students reported that completion of the learning log is time-consuming, the majority considered that this was balanced by the benefits, including opportunities for additional feedback and the 'licence to ask questions'. The evaluation has also shown, however, that few students elected to use their learning logs in subsequent placements, particularly when these were undertaken away from the university clinic. Some possible reasons for this are explored.

  1. Effectiveness of a School HIV/AIDS Prevention Program for Spanish Adolescents

    ERIC Educational Resources Information Center

    Espada, Jose P.; Orgiles, Mireia; Morales, Alexandra; Ballester, Rafael; Huedo-Medina, Tania B.

    2012-01-01

    Due to a lack of controlled studies on HIV prevention interventions among Spanish adolescents, COMPAS, a five-session behavioral intervention, was developed and tested on Spanish adolescents aged 15-18. Participants included 827 adolescents from central, east and north Spain. Six hundred and seven students (M = 15.71 years) received the…

  2. "I Can't Go to School and Leave Her in so Much Pain": Educational Shortfalls among Adolescent "Young Carers" in the South African AIDS Epidemic

    ERIC Educational Resources Information Center

    Cluver, L.; Operario, D.; Lane, T.; Kganakga, M.

    2012-01-01

    "I go to the hospital with my mother when she is sick. I can't go to school and leave her in so much pain. I won't concentrate." Millions of adolescents live with AIDS-affected parents or primary caregivers. Little is known about educational impacts of living in an AIDS-affected home, or of acting as a "young carer" in the context of AIDS. This…

  3. A balance beam aid for instruction in clinical diagnostic reasoning.

    PubMed

    Hamm, Robert M; Beasley, William Howard; Johnson, William Jay

    2014-10-01

    We describe a balance beam aid for instruction in diagnosis (BBAID) and demonstrate its potential use in supplementing the training of medical students to diagnose acute chest pain. We suggest the BBAID helps students understand the process of diagnosis because the impact of tokens (weights and helium balloons) attached to a beam at different distances from the fulcrum is analogous to the impact of evidence to the relative support for 2 diseases. The BBAID presents a list of potential findings and allows students to specify whether each is present, absent, or unknown. It displays the likelihood ratios corresponding to a positive (LR+) or negative (LR-) observation for each symptom, for any pair of diseases. For each specified finding, a token is placed on the beam at a location whose distance from the fulcrum is proportional to the finding's log(LR): a downward force (a weight) if the finding is present and a lifting force (a balloon) if it is absent. Combining the physical torques of multiple tokens is mathematically identical to applying Bayes' theorem to multiple independent findings, so the balance beam is a high-fidelity metaphor. Seven first-year medical students and 3 faculty members consulted the BBAID while diagnosing brief patient case vignettes. Student comments indicated the program is usable, helpful for understanding pertinent positive and negative findings' usefulness in particular situations, and welcome as a reference or self-test. All students attended the effect of the tokens on the beam, although some stated they did not use the numerical statistics. Faculty noted the BBAID might be particularly helpful in reminding students of diseases that should not be missed and identifying pertinent findings to ask for. PMID:24739532

  4. Cognitive-Behavioral Therapy for ADHD in Adolescents: Clinical Considerations and a Case Series

    PubMed Central

    Sprich, Susan E.; Burbridge, Jennifer; Lerner, Jonathan A.; Safren, Steven A.

    2016-01-01

    Although ADHD in adolescents is an impairing and prevalent condition, with community prevalence estimates between 2% and 6%, psychosocial treatments for adolescents compared to younger children are relatively understudied. Our group has successfully developed an evidence base for cognitive-behavioral therapy (CBT) for ADHD in medication-treated adults with ADHD with clinically significant symptoms. In the current paper, we describe an adaptation of this treatment to adolescents, and provide case reports on 3 adolescents who participated in an open pilot trial. The results suggest that the treatment approach was well tolerated by the adolescents and that they experienced clinical benefit. This early report of the approach in adolescents is promising and requires further efficacy testing. PMID:27616874

  5. Cognitive-Behavioral Therapy for ADHD in Adolescents: Clinical Considerations and a Case Series

    PubMed Central

    Sprich, Susan E.; Burbridge, Jennifer; Lerner, Jonathan A.; Safren, Steven A.

    2016-01-01

    Although ADHD in adolescents is an impairing and prevalent condition, with community prevalence estimates between 2% and 6%, psychosocial treatments for adolescents compared to younger children are relatively understudied. Our group has successfully developed an evidence base for cognitive-behavioral therapy (CBT) for ADHD in medication-treated adults with ADHD with clinically significant symptoms. In the current paper, we describe an adaptation of this treatment to adolescents, and provide case reports on 3 adolescents who participated in an open pilot trial. The results suggest that the treatment approach was well tolerated by the adolescents and that they experienced clinical benefit. This early report of the approach in adolescents is promising and requires further efficacy testing.

  6. "Youth friendly" clinics: considerations for linking and engaging HIV-infected adolescents into care.

    PubMed

    Tanner, Amanda E; Philbin, Morgan M; Duval, Anna; Ellen, Jonathan; Kapogiannis, Bill; Fortenberry, J Dennis

    2014-02-01

    Linkage and engagement in care are critical corollaries to the health of HIV-infected adolescents. The adolescent HIV epidemic and adolescents' unique barriers to care necessitates innovation in the provision of care, including the consideration of the clinical experience. Little research has addressed how "youth friendly" clinics may influence care retention for HIV-infected youth. We conducted 124 interviews with providers, outreach workers, and case managers, at 15 Adolescent Medicine Trials Network clinics. Photographs of each clinic documented the characteristics of the physical space. Constant comparison and content and visual narrative methods were utilized for data analysis. Three elements of youth friendliness were identified for clinics serving HIV-infected youth, including: (1) role of target population (e.g., pediatric, adolescent, HIV); (2) clinics' physical environment; and (3) clinics' social environment. Working to create 'youth friendly' clinics through changes in physical (e.g., space, entertainment, and educational materials) and social (e.g., staff training related to development, gender, sexual orientation) environments may help reduce HIV-infected adolescents' unique barriers to care engagement. The integration of clinic design and staff training within the organization of a clinical program is helpful in meeting the specialized needs of HIV-infected youth.

  7. Hepatitis B Vaccine Antibody Response and the Risk of Clinical AIDS or Death

    PubMed Central

    Landrum, Michael L.; Hullsiek, Katherine Huppler; O'Connell, Robert J.; Chun, Helen M.; Ganesan, Anuradha; Okulicz, Jason F.; Lalani, Tahaniyat; Weintrob, Amy C.; Crum-Cianflone, Nancy F.; Agan, Brian K.

    2012-01-01

    Background Whether seroresponse to a vaccine such as hepatitis B virus (HBV) vaccine can provide a measure of the functional immune status of HIV-infected persons is unknown.This study evaluated the relationship between HBV vaccine seroresponses and progression to clinical AIDS or death. Methods and Findings From a large HIV cohort, we evaluated those who received HBV vaccine only after HIV diagnosis and had anti-HBs determination 1–12 months after the last vaccine dose. Non-response and positive response were defined as anti-HBs <10 and ≥10 IU/L, respectively. Participants were followed from date of last vaccination to clinical AIDS, death, or last visit. Univariate and multivariable risk of progression to clinical AIDS or death were evaluated with Cox regression models. A total of 795 participants vaccinated from 1986–2010 were included, of which 41% were responders. During 3,872 person-years of observation, 122 AIDS or death events occurred (53% after 1995). Twenty-two percent of non-responders experienced clinical AIDS or death compared with 5% of responders (p<0.001). Non-response to HBV vaccine was associated with a greater than 2-fold increased risk of clinical AIDS or death (HR 2.47; 95% CI, 1.38–4.43) compared with a positive response, after adjusting for CD4 count, HIV viral load, HAART use, and delayed type hypersensitivity skin test responses (an in vivo marker of cell-mediated immunity). This association remained evident among those with CD4 count ≥500 cells/mm3 (HR 3.40; 95% CI, 1.39–8.32). Conclusions HBV vaccine responses may have utility in assessing functional immune status and risk stratificating HIV-infected individuals, including those with CD4 count ≥500 cells/mm3. PMID:22457767

  8. Clinical aspects of obesity in childhood and adolescence.

    PubMed

    Kiess, W; Galler, A; Reich, A; Müller, G; Kapellen, T; Deutscher, J; Raile, K; Kratzsch, J

    2001-02-01

    The level of fatness of a child at which morbidity acutely and/or later in life increases is determined on an acturial basis. Direct measurements of body fat content, e.g. hydrodensitometry, bioimpedance, or DEXA, are useful tools in scientific studies. However, body mass index (BMI) is easy to calculate and is generally accepted now to be used to define obesity in children and adolescents clinically. An increased risk of death from cardiovascular disease in adults has been found in subjects whose BMI had been greater than the 75th percentile as adolescents. Childhood obesity seems to substantially increase the risk of subsequent morbidity whether or not obesity persists into adulthood. The genetic basis of childhood obesity has been elucidated to some extent through the discovery of leptin, the ob gene product, and the increasing knowledge on the role of neuropeptides such as POMC, neuropeptide Y (NPY) and the melanocyte concentrating hormone receptors (for example, MC4R). Environmental/exogenous factors largely contribute to the development of a high degree of body fatness early in life. Twin studies suggest that approximately 50% of the tendency toward obesity is inherited. There are numerous disorders including a number of endocrine disorders (Cushing's syndrome, hypothyroidism, etc.) and genetic syndromes (Prader-Labhard-Willi syndrome, Bardet Biedl syndrome, etc.) that can present with obesity. A simple diagnostic algorithm allows for the differentiation between primary or secondary obesity. Among the most common sequelae of primary childhood obesity are hypertension, dyslipidemia, back pain and psychosocial problems. Therapeutic strategies include psychological and family therapy, lifestyle/behaviour modification and nutrition education. The role of regular exercise and exercise programmes is emphasized. Surgical procedures and drugs used in adult obesity are still not generally recommended in children and adolescents with obesity. As obesity is the most

  9. Low Back Pain in Children and Adolescents: an Algorithmic Clinical Approach

    PubMed Central

    Kordi, Ramin; Rostami, Mohsen

    2011-01-01

    Low back pain (LBP) is common among children and adolescents. In younger children particularly those under 3, LBP should be considered as an alarming sign for more serious underlying pathologies. However, similar to adults, non specific low back pain is the most common type of LBP among children and adolescents. In this article, a clinical algorithmic approach to LBP in children and adolescents is presented. PMID:23056800

  10. Familial cancer database: a clinical aide-mémoire.

    PubMed

    Sijmons, R H; Burger, G T

    2001-01-01

    Cancer is associated with a wide range of hereditary disorders. Recognizing these disorders in cancer patients may be of great importance for the medical management of both patients and their relatives. Conversely, recognizing the fact that cancer may develop in patients already diagnosed with a particular hereditary disorder may be important for the same reason. We have developed a stand-alone interactive computer program, Familial Cancer Database (FaCD), to assist the clinician in making a genetic differential diagnosis in cancer patients as well as in becoming aware of the tumour spectrum associated with a particular hereditary disorder. The program tries to match tumour and non-tumour features observed in patients and their families with any of the more than 300 disorders presently contained in its database and provides a clinical synopsis with literature references for each of these disorders. FaCD is offered free of charge in support of the Familial Cancer and Prevention project of the UICC Cancer Epidemiology and Prevention program. The software is primarily aimed at health care professionals with at least a basic knowledge of clinical cancer genetics, and can be downloaded from the internet at http://facd.uicc.org.

  11. Attributional Style in Clinically Depressed and Conduct Disordered Adolescents.

    ERIC Educational Resources Information Center

    Curry, John F.; Craighead, W. Edward

    1990-01-01

    Tested reformulated learned helplessness theory of depression with adolescent inpatients (N=63) diagnosed as depressed, conduct disordered, or both. Adolescents with major depressive diagnosis differed from nondepressed adolescents with significantly lower attributional style scores for positive events. Subjects who reported more severe depression…

  12. Interpersonal Theory and Adolescents with Depression: Clinical Update.

    ERIC Educational Resources Information Center

    Mellin, Elizabeth A.; Beamish, Patricia M.

    2002-01-01

    This article provides mental health counselors with information about the prevalence and course of adolescent depression, other empirically tested treatments for adolescent depression, an explanation of Interpersonal psychotherapy for adolescents (IPT-A) treatment protocol, and results of outcome studies on the effectiveness of IPT-A. Suggestions…

  13. The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

    PubMed Central

    Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-01-01

    The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

  14. The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs.

    PubMed

    Kagan, Jonathan M; Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-12-01

    The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs.

  15. Self-competence Among Early and Middle Adolescents Affected by Maternal HIV/AIDS

    PubMed Central

    Marelich, William D.; Murphy, Debra A.; Payne, Diana L.; Herbeck, Diane M.; Schuster, Mark A.

    2012-01-01

    Adolescent children of mothers with HIV face a host of stressors that place them at increased risk for poor outcomes. Using covariance structure analysis, this study examines adolescent risk outcomes and their relationships to maternal health, as well as the potentially protective factors of family environment and self-competence. The final model indicated that poor maternal health was negatively related to a protective family environment, which in turn was negatively related to adolescent risk outcomes. A protective family environment was also positively related to adolescent self-competence, which was negatively related to adolescent risk outcomes. Implications of the study are discussed, including how these findings can influence interventions aimed at reducing the risk for poor outcomes among adolescent youth with HIV-infected mothers. PMID:22485061

  16. Computer-Simulated Psychotherapy as an Aid in Teaching Clinical Psychology.

    ERIC Educational Resources Information Center

    Suler, John R.

    1987-01-01

    Describes how Elisa, a widely known computer program which simulates the responses of a psychotherapist, can be used as a teaching aid in undergraduate clinical psychology classes. Provides information on conducting the exercise, integrating it into the course syllabus, and evaluating its impact on students. (JDH)

  17. Predictors of Medication Adherence in an AIDS Clinical Trial: Patient and Clinician Perceptions

    ERIC Educational Resources Information Center

    Cox, Lisa E.

    2009-01-01

    This article presents data from an AIDS clinical trial that evaluated 238 (60 percent nonwhite) patients infected with HIV and their clinician's perceptions of medication adherence and visit attendance in relationship to lifestyle, psychosocial, and health belief model (HBM) variables. Twelve sites collected data via a prospective, multisite…

  18. A case study of school support and the psychological, emotional and behavioural consequences of HIV and AIDS on adolescents.

    PubMed

    Asikhia, Olubusayo Aduke; Mohangi, Kesh

    2015-01-01

    Various studies have reported a huge increase in the numbers of orphaned adolescents in Sub-Saharan Africa and its effects on their psychological, emotional and behavioural development. Yet, their needs are seldom recognised or adequately addressed in policy and programmes.This article uses a qualitative study to report the experiences of 11 orphaned adolescents (5 boys and 6 girls aged between 15 and 18 years) affected by HIV and AIDS in a secondary school (in Atteridgeville, Pretoria, South Africa) and the school support provided by them. The primary data-generation strategies were informal interviews and the Beck Youth Inventories-II (BYI-II) (adopted to measure the participants' level of emotional, behavioural and psychological problems). All interview transcriptions with the participants were thematically analysed. BYI-II data were subjected to T scores (in percentages) to know the participant's psychological, behavioural and emotional problems in order to compare it with their perceptions on the degree of support provided by the school. Result shows that participants have a high prevalence of psychological, behavioural and emotional problems and that the school support provided to them (teachers' support, the general school environment and the degree of discrimination, labelling and bullying that exists in the school) was not sufficient. The participants, however, reported a high level of support from the principal. In conclusion, we have suggested the urgent need for teachers to acquire and possess basic knowledge and skills in caring and paying attention to learners affected by HIV and AIDS and for government agencies and NGOs working with HIV-and AIDS-affected children, to focus on proposals that address the psychological, behavioural and emotional problems in such affected adolescents. PMID:26771076

  19. A case study of school support and the psychological, emotional and behavioural consequences of HIV and AIDS on adolescents.

    PubMed

    Asikhia, Olubusayo Aduke; Mohangi, Kesh

    2015-01-01

    Various studies have reported a huge increase in the numbers of orphaned adolescents in Sub-Saharan Africa and its effects on their psychological, emotional and behavioural development. Yet, their needs are seldom recognised or adequately addressed in policy and programmes.This article uses a qualitative study to report the experiences of 11 orphaned adolescents (5 boys and 6 girls aged between 15 and 18 years) affected by HIV and AIDS in a secondary school (in Atteridgeville, Pretoria, South Africa) and the school support provided by them. The primary data-generation strategies were informal interviews and the Beck Youth Inventories-II (BYI-II) (adopted to measure the participants' level of emotional, behavioural and psychological problems). All interview transcriptions with the participants were thematically analysed. BYI-II data were subjected to T scores (in percentages) to know the participant's psychological, behavioural and emotional problems in order to compare it with their perceptions on the degree of support provided by the school. Result shows that participants have a high prevalence of psychological, behavioural and emotional problems and that the school support provided to them (teachers' support, the general school environment and the degree of discrimination, labelling and bullying that exists in the school) was not sufficient. The participants, however, reported a high level of support from the principal. In conclusion, we have suggested the urgent need for teachers to acquire and possess basic knowledge and skills in caring and paying attention to learners affected by HIV and AIDS and for government agencies and NGOs working with HIV-and AIDS-affected children, to focus on proposals that address the psychological, behavioural and emotional problems in such affected adolescents.

  20. Characteristics of Pregnant Adolescents Receiving Prenatal Care at School-Based or Hospital-Based Clinics.

    ERIC Educational Resources Information Center

    Smith, Peggy B.; Gingiss, Phyllis L.

    1996-01-01

    A survey of pregnant inner-city adolescents at school-based and public hospitals examined relationships between demographics, psychosocial and behavioral characteristics, and tobacco and alcohol behaviors. Results highlighted the heterogeneity of pregnant adolescents served in different clinical settings and indicated a need to tailor educational…

  1. Clinical Correlates and Repetition of Self-Harming Behaviors among Female Adolescent Victims of Sexual Abuse

    ERIC Educational Resources Information Center

    Cyr, Mireille; McDuff, Pierre; Wright, John; Theriault, Chantal; Cinq-Mars, Caroline

    2005-01-01

    This study investigated self-harming behaviors in 149 female adolescent victims of sexual abuse, first, by determining the rates of nine types of self-mutilating behavior at intake and nine months later and, second, by investigating comorbidity of clinical correlates associated with these behaviors. The adolescents were divided into three groups…

  2. The Treatment for Adolescents with Depression Study (TADS): Demographic and Clinical Characteristics

    ERIC Educational Resources Information Center

    n/a; n/a

    2005-01-01

    Objective: The Treatment for Adolescents With Depression Study is a multicenter, randomized clinical trial sponsored by the NIMH. This study is designed to evaluate the short- and long-term effectiveness of four treatments for adolescents with major depressive disorder: fluoxetine, cognitive-behavioral therapy, their combination, and, acutely,…

  3. Prevalence and Clinical Correlates of Deliberate Self-Harm among a Community Sample of Italian Adolescents

    ERIC Educational Resources Information Center

    Cerutti, R.; Manca, M.; Presaghi, F.; Gratz, Kim L.

    2011-01-01

    The aims of this study were to investigate the rates of deliberate self-harm (DSH) behavior among an Italian adolescent sample, as well as to explore its clinical correlates. On a sample of 234 adolescents in Italian secondary schools (Mean age = 16.47; SD = 1.7) were assessed the DSH as well as externalizing symptoms (including both conduct…

  4. Clinical manifestations in children and adolescents with corpus callosum abnormalities.

    PubMed

    Margari, Lucia; Palumbi, Roberto; Campa, Maria Gloria; Operto, Francesca Felicia; Buttiglione, Maura; Craig, Francesco; Matricardi, Sara; Verrotti, Alberto

    2016-10-01

    Corpus callosum abnormality (CCA) outcomes are quite unpredictable and variable, from asymptomatic forms to mild or severe neurodevelopment disorders. The aim of this study was to examine clinical outcomes in CCA patients. The study included 61 children and adolescents in whom brain magnetic resonance imaging (MRI) scans showed CCA, isolated or associated to other central nervous system lesions. All patients underwent anamnesis, physical and neurological examination, routine laboratory tests, electroencephalogram (EEG), and MRI scans. In all participants, the intelligence quotient (IQ) was determined. We divided the participants into two subgroups: the first subgroup included patients with an isolated CCA, and the second subgroup included patients with CCA associated with extra-callosal brain lesions (complex CCA). We found that CCA were associated with elevated frequency to intellectual disability (ID), other neurodevelopment disorders, epilepsy, and isolated EEG anomalies. Mild ID (p = 0.003) was more frequent in the isolated subgroup, while epilepsy (p = 0.036) and pre-perinatal risk factors (p = 0.023) were more frequent in the complex CCA subgroup. Although the role of the CC in the interhemispheric communication is known, neurological and neurodevelopment outcomes of CCA are extremely variable and unpredictable. The presence of extra-callosal brain anomalies is one of the major prognostic factor, and probably, they have an important impact on the clinical outcome.

  5. Assessing the Challenges of Multi-Scope Clinical Research Sites: An Example from NIH HIV/AIDS Clinical Trials Networks

    PubMed Central

    Rosas, Scott R.; Cope, Marie T.; Villa, Christie; Motevalli, Mahnaz; Utech, Jill; Schouten, Jeffrey T.

    2013-01-01

    Rationale, aims, and objectives Large-scale, multi-network clinical trials are seen as a means for efficient and effective utilization of resources with greater responsiveness to new discoveries. Formal structures instituted within the National Institutes of Health (NIH) HIV/AIDS Clinical Trials facilitate collaboration and coordination across networks and emphasize an integrated approach to HIV/AIDS vaccine, prevention, and therapeutics clinical trials. This study examines the joint usage of clinical research sites as means of gaining efficiency, extending capacity, and adding scientific value to the networks. Methods A semi-structured questionnaire covering 8 clinical management domains was administered to 74 (62% of sites) clinical site coordinators at single- and multi-network sites to identify challenges and efficiencies related to clinical trials management activities and coordination with multi-network units. Results Overall, respondents at multi-network sites did not report more challenges than single-network sites, but did report unique challenges to overcome including in the areas of study prioritization, community engagement, staff education and training, and policies and procedures. The majority of multi-network sites reported that such affiliations do allow for the consolidation and cost-sharing of research functions. Suggestions for increasing the efficiency or performance of multi-network sites included streamlining standards and requirements, consolidating protocol activation methods, using a single cross-network coordinating center, and creating common budget and payment mechanisms. Conclusions The results of this assessment provide important information to consider in the design and management of multi-network configurations for the NIH HIV/AIDS Clinical Trials Networks, as well as others contemplating and promoting the concept of multi-network settings. PMID:24219425

  6. Experiences of stigma and access to HAART in children and adolescents living with HIV/AIDS in Brazil.

    PubMed

    Abadía-Barrero, César Ernesto; Castro, Arachu

    2006-03-01

    This study describes and conceptualizes the experiences of stigma in a group of children living with HIV in São Paulo, Brazil, and evaluates the impact of access to highly active antiretroviral therapy (HAART) over the social course of AIDS and over the children's experiences of stigma. Through ethnographic research in São Paulo from 1999 to 2001, the life trajectories of 50 children ages 1-15 living with or affected by HIV were studied. Data were collected via participant observation and semi-structured informal interviews and analyzed using social theories on illness experience and social inequality. Our results demonstrate that AIDS-related stigma occurs within complex discrimination processes that change as children reach adolescence. We found that structural violence in the forms of poverty, racism, and inequalities in social status, gender, and age fuels children's experiences of stigma. We also describe how access to HAART changes the lived experience of children, reduces stigma, and brings new challenges in AIDS care such as adolescents' sexuality and treatment adherence. Based on these results, we propose structural violence as the framework to study stigma and argue that interventions to reduce stigma that solely target the perception and attitudes toward people living with HIV are limited. In contrast universal access to HAART in Brazil is a powerful intervention that reduces stigma, in that it transforms AIDS from a debilitating and fatal disease to a chronic and manageable one, belongs to a broader mechanism to assure citizens' rights, and reduces social inequalities in access to health care.

  7. The Perception of Family Conflict by Parents Living with HIV/AIDS and Their Adolescent Children

    ERIC Educational Resources Information Center

    Li, Li; Jiang, Luohua; Lord, Lynwood; Rotheram-Borus, Mary Jane

    2007-01-01

    This study explores discrepancies in perceiving family conflict between HIV-infected parents and their adolescent children aged 12 to 22. A representative sample of 382 adolescent children and their HIV+ parents were recruited and assessed over 4 years. Relationships between discrepancies in perception and family demographics and the impact of…

  8. The Vancouver Lymphadenopathy-AIDS Study: 5. Antecedent behavioural, clinical and laboratory findings in patients with AIDS and HIV-seropositive controls.

    PubMed

    Boyko, W J; Schechter, M T; Craib, K J; Constance, P; Nitz, R; Fay, S; McLeod, A; O'Shaughnessy, M

    1986-10-15

    In a group of homosexual men in Vancouver studied prospectively since November 1982, 26 cases of acquired immune deficiency syndrome (AIDS) have arisen. To identify behavioural, clinical and laboratory findings that might predict the development of AIDS in people with antibody to human immunodeficiency virus (HIV), we compared data for 25 patients with AIDS with corresponding data for 80 controls serologically positive for HIV selected from the cohort. The clinical and laboratory data for the patients with AIDS preceded the diagnosis of the syndrome by a mean of 17.5 months. The controls had been both seropositive and AIDS-free for a mean of 16.7 months after acquisition of their data. We detected significant differences between the patients with AIDS and the controls in IgG and IgA levels, absolute number of helper T cells and ratio of helper to suppressor T cells but not in lifetime number of male sexual partners, frequency of receptive anal intercourse or receptive fisting, illicit drug use or history of infectious disease. We also detected an increased risk of AIDS among those who had an elevated number of sexual contacts in AIDS-endemic areas in the 5 years before enrollment. A history of increased early sexual contact in AIDS-endemic areas is likely to be associated with early infection and with an increased risk of AIDS among men with HIV infection of unknown duration. Thus, although our analysis had limited statistical power, we conclude that most lifestyle variables appear to act as exposure factors in HIV infection but not as cofactors in the development of AIDS.

  9. Pilot clinical trial of a robot-aided neuro-rehabilitation workstation with stroke patients

    NASA Astrophysics Data System (ADS)

    Krebs, Hermano I.; Hogan, Neville; Aisen, Mindy L.; Volpe, Bruce T.

    1996-12-01

    This paper summarizes our efforts to apply robotics and automation technology to assist, enhance, quantify, and document neuro-rehabilitation. It reviews a pilot clinical trial involving twenty stroke patients with a prototype robot-aided rehabilitation facility developed at MIT and tested at Burke Rehabilitation Hospital. In particular, we present a few results: (a) on the patient's tolerance of the procedure, (b) whether peripheral manipulation of the impaired limb influences brain recovery, (c) on the development of a robot-aided assessment procedure.

  10. Prevalence and clinical management of cytomegalovirus retinitis in AIDS patients in shanghai, china

    PubMed Central

    2011-01-01

    Background Cytomegalovirus retinitis is a common AIDS-associated illness, leading to blindness in up to 30% of patients. This study was to investigate the prevalence and clinical management of the cytomegalovirus retinitis associated with AIDS in a large municipality of China. Methods Clinical and laboratory data from 23 cytomegalovirus retinitis patients (35 eyes) out of 303 hospitalized AIDS individuals in a single medical center were analyzed retrospectively. Two of 23 patients were diagnosed cytomegalovirus retinitis just before hospitalization without anti-CMV therapy. Ganciclovir combined with the high active anti-retroviral therapy was installed for treatment of cytomegalovirus retinitis after diagnosis was confirmed. The data were analyzed by specialists and statistics was also applied. Results The prevalence of cytomegalovirus retinitis in hospitalized AIDS patients was 7.6% in this study. The level of CD4+ T lymphocytes was correlated well with the occurrence of cytomegalovirus retinitis, showing 16.8% (19/113) (95% confidence interval: 10.4,25.0), 5.4% (3/56) (95% confidence interval: 1.1,14.9), and 1.4% (1/69) (95% confidence interval: 0.0,7.8) occurrence in the patients with CD4+ T lymphocyte counts < 50, 50~99, and 100~199 cells/μl, respectively. The mean CD4+ T lymphocyte counts was 31.7 ± 38.6 cells/μl in 23 AIDS patients with cytomegalovirus retinitis. Median CD4+ T lymphocyte count is 20 cells/μl with inter-quartile range as (5, 36). Seven patients died (11 eyes) and 16 patients (24 eyes) survived. The proportion of blindness and low vision in eyes infected with cytomegalovirus retinitis respectively was 20.8% (5/24) and 29.2% (7/24) when they were diagnosed in survivors. The ganciclovir therapy was effective in 16 patients (24 eyes). Clinical recovery of cytomegalovirus retinitis was 41.7% (10/24) and clinical improvement 58.3% (14/24). After anti-CMV treatment, the proportion of blindness or low vision was 16.7% (4/24). Conclusions The AIDS

  11. Clinical analysis of HIV/AIDS patients with drug eruption in Yunnan, China

    PubMed Central

    Li, Yu-Ye; Jin, Yong-Mei; He, Li-Ping; Bai, Jin-Song; Liu, Jun; Yu, Min; Chen, Jian-Hua; Wen, Jing; Kuang, Yi-Qun

    2016-01-01

    Drug eruption is the most common clinical presentation in patients with HIV/AIDS. The systemic clinical and risk factors associated with drug eruption remain unknown. A retrospective analysis in HIV/AIDS patients with drug eruption was carried out with demographic data, epidemiological data, clinical characteristics, laboratory data and follow-up data. The risk factors correlated with prognosis were assessed by case control analysis. A total of 134 out of 1817 HIV/AIDS patients (7.4%) presented drug eruptions. The major class of sensitizing drug was HAART drugs (47.7%), followed by antibiotics (47.0%). Nevirapine (39.6%) was the most common sensitizing drug in the HAART regimens. The patients received HAART or had allergic history were prone to develop drug eruption. The alanine aminotransferase, albumin, globulin, creatinine, blood urea nitrogen (BUN), lymphocytes, red blood cells (RBC) and eosinophils of the drug eruption patients were significantly different the control patients. The allergic history, opportunistic infection, viral load, CD4 cell count, high globulin and low albumin were the risk factors correlated with death in HIV/AIDS patients with drug eruption. It is proposed that patients with higher viral loads, higher globulin levels and lower white blood cells (WBC) should be given special attention for the prevention of complications and death. PMID:27796328

  12. Attachment and family therapy: clinical utility of adolescent-family attachment research.

    PubMed

    Liddle, Howard A; Schwartz, Seth J

    2002-01-01

    The divide separating research and clinical work is narrowing. New therapies have been informed by research from specialties such as developmental psychology and developmental psychopathology. In this article, we attempt to illustrate the usefulness of research on attachment relations for family-based therapy with adolescents. We examine the clinical utility of adolescent attachment research within the context of multidimensional family therapy, an empirically supported treatment model that has incorporated developmental research, including basic research on attachment, in its assessment and intervention framework.

  13. Mobile phone-based asthma self-management aid for adolescents (mASMAA): a feasibility study

    PubMed Central

    Rhee, Hyekyun; Allen, James; Mammen, Jennifer; Swift, Mary

    2014-01-01

    Purpose Adolescents report high asthma-related morbidity that can be prevented by adequate self-management of the disease. Therefore, there is a need for a developmentally appropriate strategy to promote effective asthma self-management. Mobile phone-based technology is portable, commonly accessible, and well received by adolescents. The purpose of this study was to develop and evaluate the feasibility and acceptability of a comprehensive mobile phone-based asthma self-management aid for adolescents (mASMAA) that was designed to facilitate symptom monitoring, treatment adherence, and adolescent–parent partnership. The system used state-of-the-art natural language-understanding technology that allowed teens to use unconstrained English in their texts, and to self-initiate interactions with the system. Materials and methods mASMAA was developed based on an existing natural dialogue system that supports broad coverage of everyday natural conversation in English. Fifteen adolescent–parent dyads participated in a 2-week trial that involved adolescents’ daily scheduled and unscheduled interactions with mASMAA and parents responding to daily reports on adolescents’ asthma condition automatically generated by mASMAA. Subsequently, four focus groups were conducted to systematically obtain user feedback on the system. Frequency data on the daily usage of mASMAA over the 2-week period were tabulated, and content analysis was conducted for focus group interview data. Results Response rates for daily text messages were 81%–97% in adolescents. The average number of self-initiated messages to mASMAA was 19 per adolescent. Symptoms were the most common topic of teen-initiated messages. Participants concurred that use of mASMAA improved awareness of symptoms and triggers, promoted treatment adherence and sense of control, and facilitated adolescent–parent partnerships. Conclusion This study demonstrates the utility and user acceptability of mASMAA as a potential asthma

  14. The role of parents in pre-adolescent and adolescent overweight and obesity treatment: a systematic review of clinical recommendations.

    PubMed

    Shrewsbury, V A; Steinbeck, K S; Torvaldsen, S; Baur, L A

    2011-10-01

    The study aims to describe clinical recommendations (i) on the role of parents in both pre-adolescent and adolescent overweight and obesity treatment; (ii) to health professionals on how to involve parents in paediatric overweight and obesity treatment and (iii) to identify deficiencies in the associated literature. A systematic literature review was conducted in March 2010 to identify clinical practice guidelines, position or consensus statements on clinical management of paediatric overweight or obesity, developed by a national or international health professional association or government agency, and endorsed for current use. Relevant clinical recommendations in these documents were identified via a screen for the words 'parent', 'family' and synonyms. Twenty documents were included. Most documents emphasized the importance of involving parents or the family in paediatric overweight and obesity treatment with approximately a third of documents providing separate recommendations on the role of parents/family for pre-adolescents and adolescents. The documents varied markedly with regard to the presence of recommendations on parent/family involvement in the various components of lifestyle interventions or bariatric surgery. Almost half of the documents contained recommendations to health professionals regarding interactions with parents. High-quality research is needed on age-specific techniques to optimize the involvement of parents and family members in paediatric overweight and obesity treatment.

  15. Healthy Minds in Healthy Bodies: Adolescent Clinics and Middle Schools in Collaboration.

    ERIC Educational Resources Information Center

    Reyes, Augustina H.; Fowler, Michelle

    1999-01-01

    Explores the development of a collaboration between a clinic and an urban middle school in a high-poverty, language minority community in Texas. Considers the need for an adolescent clinic and issues of community support, funding, clinic objectives, and problems. (JPB)

  16. CLINICAL EXPERIENCE OF LONG-TERM TREATMENT WITH ARIPIPRAZOLE (ABILIFY) IN CHILDREN AND ADOLESCENTS AT THE CHILD AND ADOLESCENT PSYCHIATRIC CLINIC 1 IN ROSKILDE, DENMARK.

    PubMed

    Diomšina, Beata; Rasmussen, Pernille Darling; Danilevičiütė, Vita

    2015-01-01

    The aim of this paper is to share the clinical experience of the treatment of aripiprazole (Abilify) in children and adolescents. The authors have done a cross-sectional study about Abilify's treatment in children and adolescents with severe conduct problems (high impulsivity, aggression, outward reaction, physical cross-border behavior), high restlessness with ADHD, psychotic and psychosis-like symptoms with autistic disorders, psychosis, and intensive tics with Tourette's syndrome. The authors studied and described patients at the Child and Adolescent Psychiatric Clinic 1 in Roskilde, Denmark, who were treated with Abilify and were patients of the clinic in June 2013. The target group consisted of 33 patients, aged 9-18 years, which were in Abilify treatment during this time. Indications for the treatment and effectiveness of Abilify, Abilify's common doses used in children and adolescents, and the most common adverse effects of Abilify are presented. Abilify was found to be effective, well tolerated and safe for children and adolescents. The dose depends on the complexity of diagnosis (higher doses used in cases of complex diagnosis), on the age (higher doses used in older children, but only in the case of noncomplex diagnoses). Statistical analysis shows that in cases of complex diagnoses, dosage does not depend on age but depends on other factors. It also shows that the effect of treatment is better for those who did not gain weight.

  17. Managing Chronic Pain in Children and Adolescents: A Clinical Review.

    PubMed

    Landry, Bradford W; Fischer, Philip R; Driscoll, Sherilyn W; Koch, Krista M; Harbeck-Weber, Cynthia; Mack, Kenneth J; Wilder, Robert T; Bauer, Brent A; Brandenburg, Joline E

    2015-11-01

    Chronic pain in children and adolescents can be difficult for a single provider to manage in a busy clinical setting. Part of this difficulty is that pediatric chronic pain not only impacts the child but also the families of these children. In this review article, we discuss etiology and pathophysiology of chronic pain, along with variables that impact the severity of chronic pain and functional loss. We review diagnosis and management of selected chronic pain conditions in pediatric patients, including headache, low back pain, hypermobility, chronic fatigue, postural orthostatic tachycardia syndrome, abdominal pain, fibromyalgia, and complex regional pain syndrome. For each condition, we create a road map that contains therapy prescriptions, exercise recommendations, and variables that may influence pain severity. Potential medications for these pain conditions and associated symptoms are reviewed. A multidisciplinary approach for managing children with these conditions, including pediatric pain rehabilitation programs, is emphasized. Lastly, we discuss psychological factors and interventions for pediatric chronic pain and potential complementary and alternative natural products and interventions. PMID:26568508

  18. [Diabetes mellitus in childhood and adolescence. Clinical types].

    PubMed

    Sires, J M

    1979-01-01

    It is today's general medical opinion that children's diabetes mellitus was uncommon in the past. It was generally admitted at that time the initail stages were so sudden as to make difficut its early diagnosis. It's increased incidence is at present an alarming truth; however, a parallel increase of diabetic coma or of mulminant types has rather dropped. Diabetes may be diagnosed by just considering the main symptoms at the onset which are polydipsia, polyuria and weight loss. If an early diagnosis is not made, acidosis (abdominal pain, nausea, vomiting) may appear within a few days or weeks followed by coma (Kussamul's acidotic respiration and dehydration). Coma may be avoided by an early diagnosis and a life may be saved. It must be stressed that an important percentage of children and adolescents show a slow and gradual evolution (week or months) of their diabetes: gradual weight loss, sometimes with noticeable polyphagia, occasional enuresis, but without other associated symptoms. Asymptomatic, intermittent glucosurias are also frequent; they vary in magnitude an almost always they appear without ketonuria and with fasting normal glycemia. According to our experience they may precede in weeks or months the clinical manifestations of the disease. Postprandial glycemia is a sure diagnostic resource; it is of greater trustworthines than fasting glycemia; therefore we advise it as a routine diagnostic procedure which we recommend widely. In uncertain situations, the oral glucose tolerance test is advisable. PMID:486258

  19. Neural imaginaries and clinical epistemology: Rhetorically mapping the adolescent brain in the clinical encounter.

    PubMed

    Buchbinder, Mara

    2015-10-01

    The social work of brain images has taken center stage in recent theorizing of the intersections between neuroscience and society. However, neuroimaging is only one of the discursive modes through which public representations of neurobiology travel. This article adopts an expanded view toward the social implications of neuroscientific thinking to examine how neural imaginaries are constructed in the absence of visual evidence. Drawing on ethnographic fieldwork conducted over 18 months (2008-2009) in a United States multidisciplinary pediatric pain clinic, I examine the pragmatic clinical work undertaken to represent ambiguous symptoms in neurobiological form. Focusing on one physician, I illustrate how, by rhetorically mapping the brain as a therapeutic tool, she engaged in a distinctive form of representation that I call neural imagining. In shifting my focus away from the purely material dimensions of brain images, I juxtapose the cultural work of brain scanning technologies with clinical neural imaginaries in which the teenage brain becomes a space of possibility, not to map things as they are, but rather, things as we hope they might be. These neural imaginaries rely upon a distinctive clinical epistemology that privileges the creative work of the imagination over visualization technologies in revealing the truths of the body. By creating a therapeutic space for adolescents to exercise their imaginative faculties and a discursive template for doing so, neural imagining relocates adolescents' agency with respect to epistemologies of bodily knowledge and the role of visualization practices therein. In doing so, it provides a more hopeful alternative to the dominant popular and scientific representations of the teenage brain that view it primarily through the lens of pathology.

  20. Relationships between familial HIV/AIDS and symptoms of anxiety and depression: the mediating effect of bullying victimization in a prospective sample of South African children and adolescents.

    PubMed

    Boyes, Mark E; Cluver, Lucie D

    2015-04-01

    South African children and adolescents living in HIV/AIDS-affected families are at elevated risk of both symptoms of anxiety and depressive symptoms. Poverty and HIV/AIDS-related stigma are additional risk factors for these negative mental health outcomes. Community level factors, such as poverty and stigma, are difficult to change in the short term and identifying additional potentially malleable mechanisms linking familial HIV/AIDS with mental health is important from an intervention perspective. HIV/AIDS-affected children are also at increased risk of bullying victimization. This longitudinal study aimed to determine whether prospective relationships between familial HIV/AIDS and both anxiety symptoms and depressive symptoms operate indirectly via bullying victimization. Adolescents (M = 13.45 years, 56.67 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up one year later (n = 3,401, 96.70 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces, and door-to-door sampling included all households with a resident child/adolescent. Familial HIV/AIDS at baseline assessment was not directly associated with mental health outcomes 1 year later. However, significant indirect effects operating via bullying victimization were obtained for both anxiety and depression scores. Importantly, these effects were independent of poverty, HIV/AIDS-related stigma, and baseline mental health, which highlight bullying victimization as a potential target for future intervention efforts. The implementation and rigorous evaluation of bullying prevention programs in South African communities may improve mental health outcomes for HIV/AIDS-affected children and adolescents and this should be a focus of future research and intervention. PMID:24996836

  1. Relationships between familial HIV/AIDS and symptoms of anxiety and depression: the mediating effect of bullying victimization in a prospective sample of South African children and adolescents.

    PubMed

    Boyes, Mark E; Cluver, Lucie D

    2015-04-01

    South African children and adolescents living in HIV/AIDS-affected families are at elevated risk of both symptoms of anxiety and depressive symptoms. Poverty and HIV/AIDS-related stigma are additional risk factors for these negative mental health outcomes. Community level factors, such as poverty and stigma, are difficult to change in the short term and identifying additional potentially malleable mechanisms linking familial HIV/AIDS with mental health is important from an intervention perspective. HIV/AIDS-affected children are also at increased risk of bullying victimization. This longitudinal study aimed to determine whether prospective relationships between familial HIV/AIDS and both anxiety symptoms and depressive symptoms operate indirectly via bullying victimization. Adolescents (M = 13.45 years, 56.67 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up one year later (n = 3,401, 96.70 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces, and door-to-door sampling included all households with a resident child/adolescent. Familial HIV/AIDS at baseline assessment was not directly associated with mental health outcomes 1 year later. However, significant indirect effects operating via bullying victimization were obtained for both anxiety and depression scores. Importantly, these effects were independent of poverty, HIV/AIDS-related stigma, and baseline mental health, which highlight bullying victimization as a potential target for future intervention efforts. The implementation and rigorous evaluation of bullying prevention programs in South African communities may improve mental health outcomes for HIV/AIDS-affected children and adolescents and this should be a focus of future research and intervention.

  2. Screening and Assessing Adolescent Substance Use Disorders in Clinical Populations

    ERIC Educational Resources Information Center

    Winters, Ken C.; Kaminer, Yifrah

    2008-01-01

    The different established screening methodologies and comprehensive assessment techniques used in evaluating adolescents suspected of or known to have substance abuse disorders are discussed. Recommendations and suggestions for establishing standards of training and professional efficiency are also highlighted to treat adolescents with substance…

  3. Clinical Issues in the Assessment of Adolescent Defendants.

    ERIC Educational Resources Information Center

    Cornell, Dewey G.

    There are many practical difficulties in conducting forensic evaluations of adolescents charged with serious crimes. This paper addresses some of the reasons why adolescent forensic evaluations are problematic and suggests four strategies for establishing and maintaining rapport, based on a practitioner's experience in evaluating adolescents…

  4. [Loneliness and adolescence: clinical implications and outlook. Literature review].

    PubMed

    Van Rode, V; Rotsaert, M; Delhaye, M

    2015-01-01

    Loneliness is particularly prevalent during adolescence, a time also associated with the appearance of psychiatric illnesses. Loneliness has been linked to a number of mental health indicators such as depressive symptoms, self-esteem, anxiety, and perceived stress. During adolescence, the individual undergoes major social and personal transformations through redefining their social network thus making them more susceptible to developing mental health problems. Some studies suggest that the risk of mental health problems arises when an adolescent is repeatedly faced with loneliness. Mental health workers should therefore focus on any given adolescent's inability to establish satisfactory interpersonal relationships as a predictive element of loneliness. Thus, it would seem that the development of loneliness prevention and intervention programs aimed at adolescents who are unable to establish satisfactory interpersonal relationships could be of benefit to many.

  5. [Loneliness and adolescence: clinical implications and outlook. Literature review].

    PubMed

    Van Rode, V; Rotsaert, M; Delhaye, M

    2015-01-01

    Loneliness is particularly prevalent during adolescence, a time also associated with the appearance of psychiatric illnesses. Loneliness has been linked to a number of mental health indicators such as depressive symptoms, self-esteem, anxiety, and perceived stress. During adolescence, the individual undergoes major social and personal transformations through redefining their social network thus making them more susceptible to developing mental health problems. Some studies suggest that the risk of mental health problems arises when an adolescent is repeatedly faced with loneliness. Mental health workers should therefore focus on any given adolescent's inability to establish satisfactory interpersonal relationships as a predictive element of loneliness. Thus, it would seem that the development of loneliness prevention and intervention programs aimed at adolescents who are unable to establish satisfactory interpersonal relationships could be of benefit to many. PMID:26749631

  6. Relations of the Big-Five personality dimensions to autodestructive behavior in clinical and non-clinical adolescent populations

    PubMed Central

    Kotrla Topić, Marina; Perković Kovačević, Marina; Mlačić, Boris

    2012-01-01

    Aim To examine the relationship between the Big-Five personality model and autodestructive behavior symptoms, namely Autodestructiveness and Suicidal Depression in two groups of participants: clinical and non-clinical adolescents. Methods Two groups of participants, clinical (adolescents with diagnosis of psychiatric disorder based on clinical impression and according to valid diagnostic criteria, N = 92) and non-clinical (high-school students, N = 87), completed two sets of questionnaires: the Autodestructiveness Scale which provided data on Autodestructiveness and Suicidal Depression, and the International Personality Item Pool (IPIP), which provided data on the Big -Five personality dimensions. Results Clinical group showed significantly higher values on the Autodestructiveness scale in general, as well as on Suicidal Depression, Aggressiveness, and Borderline subscales than the non-clinical group. Some of the dimensions of the Big-Five personality model, ie, Emotional Stability, Conscientiousness, and Agreeableness showed significant relationship (hierarchical regression analyses, P values for β coefficients from <0.001 to 0.021) with Autodestructivness and Suicidal Depression, even after controlling for the sex and group effects or, when analyzing Suicidal Depression, after controlling the effect of other subscales. Conclusion The results indicate that dimensions of the Big-Five model are important when evaluating adolescent psychiatric patients and adolescents from general population at risk of self-destructive behavior. PMID:23100207

  7. Toward an Understanding of (EM)Power(Ment) for HIV/AIDS Prevention with Adolescent Women.

    ERIC Educational Resources Information Center

    Gutierrez, Lorraine; Oh, Hyun Joo; Gillmore, Mary Rogers

    Preventing the spread of Acquired Immune Deficiency Syndrome (AIDS) among women is a national priority. In the United States, AIDS is the sixth leading cause of death among young adult women, and their rate of infection is four times higher than men. This article was developed to help stimulate interest in the power dynamics of relationships and…

  8. Clinical neuropsychology within adolescent and young-adult psychiatry: conceptualizing theory and practice.

    PubMed

    Allott, Kelly; Proffitt, Tina-Marie; McGorry, Patrick D; Pantelis, Christos; Wood, Stephen J; Cumner, Marnie; Brewer, Warrick J

    2013-01-01

    Historically, clinical neuropsychology has made significant contributions to the understanding of brain-behavior relationships, particularly in neurological conditions. During the past several decades, neuropsychology has also become established as an important discipline in psychiatric settings. Cognition is increasingly recognized as being core to psychiatric illnesses and predictive of functional outcomes, augmenting theories regarding symptomatology and illness progression. Adult-type psychiatric disorders (including schizophrenia and other psychotic, mood, anxiety, eating, substance-related, and personality disorders) typically emerge during adolescence or young adulthood, a critical neurodevelopmental period. Clinical neuropsychological assessment in adolescent psychiatric patients is particularly valuable in informing clinical formulation and intervention and can be therapeutic across a number of levels. This article articulates the theoretical considerations and practical challenges and applications of clinical neuropsychology within adolescent and young-adult psychiatry. The importance of considering the neurodevelopmental context and its relationship to current theoretical models underpinning clinical practice are discussed.

  9. Spectrum of complicated migraine in children: A common profile in aid to clinical diagnosis

    PubMed Central

    Gupta, Surya N; Gupta, Vikash S; Fields, Dawn M

    2015-01-01

    Complicated migraine encompasses several individual clinical syndromes of migraine. Such a syndrome in children frequently presents with various neurological symptoms in the Emergency Department. An acute presentation in the absence of headache presents a diagnostic challenge. A delay in diagnosis and treatment may have medicolegal implication. To date, there are no reports of a common clinical profile proposed in making a clinical diagnosis for the complicated migraine. In this clinical review, we propose and describe: (1) A common clinical profile in aid to clinical diagnosis for spectrum of complicated migraine; (2) How it can be used in differentiating complicated migraine from migraine without aura, migraine with aura, and seizure; (3) We discuss the status of complicated migraine in the International Headache Society classification 2013; and (4) In addition, a common treatment strategy for the spectrum of migraine has been described. To diagnose complicated migraine clinically, it is imperative to adhere with the proposed profile. This will optimize the use of investigation and will also avoid a legal implication of delay in their management. The proposed common clinical profile is incongruent with the International Headache Society 2013. Future classification should minimize the dissociation from clinically encountered syndromes and coin a single word to address collectively this subtype of migraine with an acute presentation of a common clinical profile. PMID:25664241

  10. Clinical decision aids for chest pain in the emergency department: identifying low-risk patients

    PubMed Central

    Alley, William; Mahler, Simon A

    2015-01-01

    Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS). However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography. This review describes several of the chest pain decision aids developed and studied through the recent past, starting with the thrombolysis in myocardial infarction (TIMI) risk score and Global Registry of Acute Coronary Events (GRACE) scores, which were developed as prognostic aids for patients already diagnosed with ACS, then subsequently validated in the undifferentiated chest pain population. Asia-Pacific Evaluation of Chest Pain Trial (ASPECT); Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins (ADAPT); North American Chest Pain Rule (NACPR); and History, Electrocardiogram, Age, Risk factors, Troponin (HEART) score have been developed exclusively for use in the undifferentiated chest pain population as well, with improved performance compared to their predecessors. This review describes the relative merits and limitations of these decision aids so that providers can determine which tool fits the needs of their clinical practice setting. PMID:27147894

  11. Substance Use in Adolescent Psychiatric Outpatients: Self-Report, Health Care Providers' Clinical Impressions, and Urine Screening

    ERIC Educational Resources Information Center

    Holzer, Laurent; Pihet, Sandrine; Passini, Christina Moses; Feijo, Isabelle; Camus, Didier; Eap, Chin

    2014-01-01

    Purpose: To determine the prevalence of substance use among adolescent psychiatric outpatients using a variety of data sources. Method: Using a questionnaire, 3-month prevalence of substance use data were obtained from 50 adolescents and their health care providers. Adolescents' self-reports and providers' clinical impressions were…

  12. Where Do We Start? Using Collage to Explore Very Young Adolescents' Knowledge about HIV and AIDS in Four Senior Primary Classrooms in Kwazulu-Natal

    ERIC Educational Resources Information Center

    Norris, Greg; Mbokazi, Thembinkosi; Rorke, Francoise; Goba, Sylvia; Mitchell, Claudia

    2007-01-01

    This paper focuses specifically on the needs and concerns of "very young adolescents" who as defined by the Population Council are young people aged between 10 and 14 years. The title of this paper, "Where Do We Start?", acknowledges that attitudes towards and knowledge of HIV and AIDS are best looked at in a situated way. We look at classes of…

  13. Health-related quality of life in a clinical sample of obese children and adolescents

    PubMed Central

    2010-01-01

    Background Obesity affects ethnic minority groups disproportionately, especially in the pediatric population. However, little is known about the impact of obesity on health-related quality of life (HRQoL) in children and adolescents from mixed-ethnic samples. The purpose of this study was to: 1) measure HRQoL in a mixed-ethnic clinical sample of obese children and adolescents, 2) compare HRQoL assessments in obese participants and healthy controls, and 3) compare HRQoL in obese children and adolescents according to their pubertal status. Methods A clinical sample of children and adolescents with obesity (n = 96) and healthy children and adolescents attending local schools (n = 444) completed the Pediatric Quality of Life Inventory (PedsQL; UK version 4). Age-appropriate versions were self-administered by children and adolescents aged 8-18 years, and interview administered to children aged 5-7 years. Multiple regression analyses controlling for age, gender, pubertal status, and ethnicity were used to compare the PedsQL scores of the two samples. Results The clinical sample of obese children and adolescents had poorer HRQoL scores on all dimensions of the PedsQL compared to the healthy controls (p < 0.005). Subsequent analyses also demonstrated that in this sample of mixed-ethnic children and adolescents, prepubescent obese children achieved the poorest scores in the emotional functioning dimension. Conclusions Obesity significantly impacts on physical, emotional, social and school functioning of mixed-ethnic children and adolescents. Clinicians need to be aware of the significant impact of obesity on all aspects of functioning. More effort is required to target interventions to improve the quality of life of children with obesity. PMID:21078146

  14. Epidemiological observations in the AIDS clinic at the Hadassah University Hospital in Jerusalem.

    PubMed

    Maayan, S; Engelhard, D; Boger, S; Ganer, A; Morag, A; Shapiro, M; Sacks, T

    1989-06-01

    Of the first 395 attendees at the AIDS clinic in Jerusalem, 32% were homo/bisexuals, 4% i.v. drug abusers (IVDAs), 24% persons with minimal risk for AIDS and 38% were persons having no risk. Human immunodeficiency virus (HIV) antibody rates were 7% for homosexuals, 29% for IVDAs, 1% for persons with minimal risk and 0% for persons at no risk. Israeli homosexuals had a significantly greater risk for HIV infection (9 of 35) if they had sexual contact with non-Israelis as compared with homosexuals who had contact with local partners only (0/91, P less than 0.001). The mean number of attendees per month increased by 431% during the 4 months following the first prime-time television program on AIDS. The largest mean increases occurred among persons at no risk (1 to 27.2), those with minimal risk (2.5 to 16.5), and among women (1.25 to 20.0). This report indicates that HIV infection among Israeli homosexuals has not yet reached U.S. proportions. It also shows that the TV program raised anxiety concerning AIDS among the general public, and probably encouraged the public to use HIV testing as part of a general health screening program.

  15. Future directions in clinical child and adolescent psychology: a Delphi survey.

    PubMed

    James, Rochelle L; Roberts, Michael C

    2009-10-01

    This study sought to identify the future directions in three domains: clinical practice, research, and training of clinical child and adolescent psychologists in the upcoming decade. Doctoral-level active members in the field were surveyed via a two-round Delphi survey (45 in round 1; 35 in round 2). Evidence-based practice received the greatest consensus by the participants and highest rank in each of the three domains. Other highly ranked clinical practice directions included prevention and early diagnosis and treatment, and clinical services for specific psychological problems. Research directions focused on biological and social factors interactions in the etiology and treatment and specific child and adolescent disorders. In the training domain, major directions included the pursuit of specialty training in child and adolescent psychology and training emphasizing the biological basis of behavior. Implications of these future directions are discussed.

  16. An adolescent vampire cult in rural America: clinical issues and case study.

    PubMed

    Miller, T W; Veltkamp, L J; Kraus, R F; Lane, T; Heister, T

    1999-01-01

    The emergence of cult related activities in rural America are examined. Cults and their attraction to adolescents are addressed as are methods of cult indoctrination and a profile of cult members and their leader. Clinical management along with a rationale for the attraction of some adolescents to cults are discussed. A case study of a vampire cult and the psychopathology identified in the leader of the cult are provided. Import for clinicians is offered. PMID:10080963

  17. “Youth friendly” clinics: Considerations for linking and engaging HIV-infected adolescents into care

    PubMed Central

    Tanner, Amanda E.; Philbin, Morgan M.; Duval, Anna; Ellen, Jonathan; Kapogiannis, Bill; Fortenberry, J. Dennis

    2014-01-01

    Linkage and engagement in care are critical corollaries to the health of HIV-infected adolescents. The adolescent HIV epidemic and adolescents’ unique barriers to care necessitates innovation in the provision of care, including the consideration of the clinical experience. Little research has addressed how “youth friendly” clinics may influence care retention for HIV-infected youth. We conducted 124 interviews with providers, outreach workers, and case managers, at 15 Adolescent Medicine Trials Network clinics. Photographs of each clinic documented the characteristics of the physical space. Constant comparison and content and visual narrative methods were utilized for data analysis. Three elements of youth friendliness were identified for clinics serving HIV-infected youth, including: (1) role of target population (e.g., pediatric, adolescent, HIV); (2) clinics’ physical environment; and (3) clinics’ social environment. Working to create ‘youth friendly’ clinics through changes in physical (e.g., space, entertainment, and educational materials) and social (e.g., staff training related to development, gender, sexual orientation) environments may help reduce HIV-infected adolescents’ unique barriers to care engagement. The integration of clinic design and staff training within the organization of a clinical program is helpful in meeting the specialized needs of HIV-infected youth. PMID:23782040

  18. Bridging the Gap Between Laboratory and Clinic in Child and Adolescent Psychotherapy.

    ERIC Educational Resources Information Center

    Weisz, John R.; And Others

    1995-01-01

    In studies of the usefulness of psychotherapy with children and adolescents, clinical therapy has markedly poorer outcomes than laboratory studies. Proposals to bridge the gap include enriching the data base on treatment effects by clinical practitioners, identifying the features of research therapy that account for positive outcomes, and…

  19. The Adolescent Health Review: Test of a Computerized Screening Tool in School-Based Clinics.

    ERIC Educational Resources Information Center

    Harrison, Patricia A.; Beebe, Timothy J.; Funk, Eunkyung; Rancome, Jeanne

    2003-01-01

    Implemented a computerized screening instrument, the Adolescent Health Review, in urban school-based clinics to test the viability of a stand-alone screening process and its acceptance by patients and providers, examining the relationship between health risks and the stated purpose for the clinic visit. Patients and providers readily accepted the…

  20. Technology-Aided Interventions and Instruction for Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Odom, Samuel L.; Thompson, Julie L.; Hedges, Susan; Boyd, Brian A.; Dykstra, Jessica R.; Duda, Michelle A.; Szidon, Kathrine L.; Smith, Leann E.; Bord, Aimee

    2015-01-01

    The use of technology in intervention and instruction for adolescents with autism spectrum disorder (ASD) is increasing at a striking rate. The purpose of this paper is to examine the research literature underlying the use of technology in interventions and instruction for high school students with ASD. In this paper, authors propose a theoretical…

  1. The Adolescent Male Prostitute and Sexually Transmitted Diseases, HIV and AIDS.

    ERIC Educational Resources Information Center

    Markos, A. R.; And Others

    1994-01-01

    Adolescent male prostitutes have variable backgrounds; blend of different psychological, behavioral, social, and economic factors. Study of these factors forms basis for understanding potential risks they may be exposed to, including sexually transmitted diseases (STDs) and infection with human immunodeficiency virus (HIV). Reported high incidence…

  2. Clinical correlates of suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda.

    PubMed

    Rukundo, Godfrey Zari; Kinyanda, Eugene; Mishara, Brian

    2016-09-01

    The association between suicidality and HIV/AIDS has been demonstrated for three decades, but little is know about risk factors that can help understand this association and help identify who is most at risk. Few research studies have been conducted in sub-Saharan Africa, a region that accounts for more than 70% of the HIV global burden. This paper describes clinical risk factors for suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda. In this study, suicidality includes both suicidal ideation and suicidal attempts. A cross-sectional survey was conducted with 543 HIV-positive individuals aged 15 years and above, recruited from 2 HIV specialised clinics in Mbarara. Using logistic regression analysis, factors significantly associated with suicidality at 95% confidence interval were identified. The rate of suicidality was 10% (n = 54; 95% CI: 5.00-15.00). Risk factors for suicidality were: perception of poor physical health (OR 2.22, 95% CI 1.23-3.99, p = 0.007), physical pain (OR 1.83, 95% CI 1.01-3.30, p = 0.049), reducing work due to illness (OR = 2.22, 95% CI 1.23-3.99, p = 0.004) and recent HIV diagnosis (OR 1.02, 95% CI 1.01-1.03, p = 0.001). These findings suggest that HIV/AIDS in south-western Uganda is associated with a considerable burden of suicidality. HIV is associated with several clinical factors that increase vulnerability to suicidality. There is need for more appropriate interventions targeting these clinical risk factors, systematic suicide risk assessment and management of suicidal ideation and behaviours in HIV care. PMID:27681146

  3. Quality and predictors of adolescents' first aid intentions and actions towards a peer with a mental health problem.

    PubMed

    Mason, Robert J; Hart, Laura M; Rossetto, Alyssia; Jorm, Anthony F

    2015-07-30

    While peers are a common source of informal help for young people with a mental health problem, evidence suggests that the help they provide is inadequate. By examining predictors of the quality of mental health first aid provided by adolescents to their peers, future interventions can be targeted to adolescents most at risk of providing poor help. Students (n = 518) from Australian secondary schools were presented with two vignettes, depicting persons experiencing depression with suicidal thoughts, and social phobia. Participants were asked what they thought was wrong with the person, and how they would help them. Stigma towards the person was also assessed. Additionally, participants were asked if they had recently helped anyone in their own lives with a mental health problem, and, if so, what they did. The overall quality of help reported in response to the vignettes or an actual person was low; a particular inadequacy was the low rate of engaging the help of an adult. Being female, and believing that the person is sick rather than weak, consistently predicted better help-giving. PMID:25892257

  4. Development and assessment of a clinically viable system for breast ultrasound computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Gruszauskas, Nicholas Peter

    The chances of surviving a breast cancer diagnosis as well as the effectiveness of any potential treatments increase significantly with early detection of the disease. As such, a considerable amount of research is being conducted to augment the breast cancer detection and diagnosis process. One such area of research involves the investigation and application of sophisticated computer algorithms to assist clinicians in detecting and diagnosing breast cancer on medical images (termed generally as "computer-aided diagnosis" or CAD). This study investigated a previously-developed breast ultrasound CAD system with the intent of translating it into a clinically-viable system. While past studies have demonstrated that breast ultrasound CAD may be a beneficial aid during the diagnosis of breast cancer on ultrasound, there are no investigations concerning its potential clinical translation and there are currently no commercially-available implementations of such systems. This study "bridges the gap" between the laboratory-developed system and the steps necessary for clinical implementation. A novel observer study was conducted that mimicked the clinical use of the breast ultrasound CAD system in order to assess the impact it had on the diagnostic performance of the user. Several robustness studies were also performed: the sonographic features used by the system were evaluated and the databases used for calibration and testing were characterized, the effect of the user's input was assessed by evaluating the performance of the system with variations in lesion identification and image selection, and the performance of the system on different patient populations was investigated by evaluating its performance on a database consisting solely of patients with Asian ethnicity. The analyses performed here indicate that the breast ultrasound CAD system under investigation is robust and demonstrates only minor variability when subjected to "real-world" use. All of these results are

  5. Neural Imaginaries and Clinical Epistemology: Rhetorically Mapping the Adolescent Brain in the Clinical Encounter

    PubMed Central

    Buchbinder, Mara

    2014-01-01

    The social work of brain images has taken center stage in recent theorizing of the intersections between neuroscience and society. However, neuroimaging is only one of the discursive modes through which public representations of neurobiology travel. This article adopts an expanded view toward the social implications of neuroscientific thinking to examine how neural imaginaries are constructed in the absence of visual evidence. Drawing on ethnographic fieldwork conducted over 18 months (2008–2009) in a United States multidisciplinary pediatric pain clinic, I examine the pragmatic clinical work undertaken to represent ambiguous symptoms in neurobiological form. Focusing on one physician, I illustrate how, by rhetorically mapping the brain as a therapeutic tool, she engaged in a distinctive form of representation that I call neural imagining. In shifting my focus away from the purely material dimensions of brain images, I juxtapose the cultural work of brain scanning technologies with clinical neural imaginaries in which the teenage brain becomes a space of possibility, not to map things as they are, but rather, things as we hope they might be. These neural imaginaries rely upon a distinctive clinical epistemology that privileges the creative work of the imagination over visualization technologies in revealing the truths of the body. By creating a therapeutic space for adolescents to exercise their imaginative faculties and a discursive template for doing so, neural imagining relocates adolescents’ agency with respect to epistemologies of bodily knowledge and the role of visualization practices therein. In doing so, it provides a more hopeful alternative to the dominant popular and scientific representations of the teenage brain that view it primarily through the lens of pathology. PMID:24780561

  6. Clinical utility of dronabinol in the treatment of weight loss associated with HIV and AIDS

    PubMed Central

    Badowski, Melissa E; Perez, Sarah E

    2016-01-01

    Since the beginning of the HIV/AIDS epidemic, weight loss has been a common complaint for patients. The use of various definitions defining HIV wasting syndrome has made it difficult to determine its actual prevalence. Despite the use of highly active antiretroviral therapy, it is estimated that the prevalence of HIV wasting syndrome is between 14% and 38%. HIV wasting syndrome may stem from conditions affecting chewing, swallowing, or gastrointestinal motility, neurologic disease affecting food intake or the perception of hunger or ability to eat, psychiatric illness, food insecurity generated from psychosocial or economic concerns, or anorexia due to medications, malabsorption, infections, or tumors. Treatment of HIV wasting syndrome may be managed with appetite stimulants (megestrol acetate or dronabinol), anabolic agents (testosterone, testosterone analogs, or recombinant human growth hormone), or, rarely, cytokine production modulators (thalidomide). The goal of this review is to provide an in-depth evaluation based on existing clinical trials on the clinical utility of dronabinol in the treatment of weight loss associated with HIV/AIDS. Although total body weight gain varies with dronabinol use (–2.0 to 3.2 kg), dronabinol is a well-tolerated option to promote appetite stimulation. Further studies are needed with standardized definitions of HIV-associated weight loss and clinical outcomes, robust sample sizes, safety and efficacy data on chronic use of dronabinol beyond 52 weeks, and associated virologic and immunologic outcomes. PMID:26929669

  7. Clinical utility of dronabinol in the treatment of weight loss associated with HIV and AIDS.

    PubMed

    Badowski, Melissa E; Perez, Sarah E

    2016-01-01

    Since the beginning of the HIV/AIDS epidemic, weight loss has been a common complaint for patients. The use of various definitions defining HIV wasting syndrome has made it difficult to determine its actual prevalence. Despite the use of highly active antiretroviral therapy, it is estimated that the prevalence of HIV wasting syndrome is between 14% and 38%. HIV wasting syndrome may stem from conditions affecting chewing, swallowing, or gastrointestinal motility, neurologic disease affecting food intake or the perception of hunger or ability to eat, psychiatric illness, food insecurity generated from psychosocial or economic concerns, or anorexia due to medications, malabsorption, infections, or tumors. Treatment of HIV wasting syndrome may be managed with appetite stimulants (megestrol acetate or dronabinol), anabolic agents (testosterone, testosterone analogs, or recombinant human growth hormone), or, rarely, cytokine production modulators (thalidomide). The goal of this review is to provide an in-depth evaluation based on existing clinical trials on the clinical utility of dronabinol in the treatment of weight loss associated with HIV/AIDS. Although total body weight gain varies with dronabinol use (-2.0 to 3.2 kg), dronabinol is a well-tolerated option to promote appetite stimulation. Further studies are needed with standardized definitions of HIV-associated weight loss and clinical outcomes, robust sample sizes, safety and efficacy data on chronic use of dronabinol beyond 52 weeks, and associated virologic and immunologic outcomes. PMID:26929669

  8. Adolescents' Use of School-Based Health Clinics for Reproductive Health Services: Data from the National Longitudinal Study of Adolescent Health.

    ERIC Educational Resources Information Center

    Crosby, Richard A.; St. Lawrence, Janet

    2000-01-01

    Describes adolescents' use of school-based health clinics (SBCs) for family planning and sexually transmitted disease (STD)-related services, using data from the National Longitudinal Study of Adolescent Health. Results indicated that 13 percent received family planning and 8.9 percent received STD-related services from SBCs. Factors affecting the…

  9. Technology-Aided Interventions and Instruction for Adolescents with Autism Spectrum Disorder.

    PubMed

    Odom, Samuel L; Thompson, Julie L; Hedges, Susan; Boyd, Brian A; Dykstra, Jessica R; Duda, Michelle A; Szidon, Kathrine L; Smith, Leann E; Bord, Aimee

    2015-12-01

    The use of technology in intervention and instruction for adolescents with autism spectrum disorder (ASD) is increasing at a striking rate. The purpose of this paper is to examine the research literature underlying the use of technology in interventions and instruction for high school students with ASD. In this paper, authors propose a theoretical and conceptual framework for examining the use of technology by and for adolescents with ASD in school, home, and community settings. This framework is then used to describe the research literature on efficacy of intervention and instruction that utilizes technology. A review of the literature from 1990 to the end of 2013 identified 30 studies that documented efficacy of different forms of technology and their impact on academics, adaptive behavior, challenging behavior, communication, independence, social competence, and vocational skills. PMID:25468409

  10. Perceived Difficulty of Performing Selected HIV/AIDS Preventive Behaviors and Life Satisfaction: Is there a Relationship for African American Adolescents?

    PubMed

    Valois, Robert F; Kerr, Jelani C; Hennessy, Michael; DiClemente, Ralph J; Brown, Larry K; Carey, Michael P; Vanable, Peter A; Farber, Naomi B; Salazar, Laura F; Romer, Daniel

    2015-07-01

    Research on the relationship between adolescent health risk behaviors, sexual risk behaviors in particular, and perceived life satisfaction is emerging. Some researchers suggest that life satisfaction has been a neglected component of adolescent health research. African American adolescents aged 13-18 (n = 1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire via Audio Computer Assisted Self-Interview. Analyses were conducted to examine relationships between perceived difficulty in performing HIV/AIDS preventive behavior and perceived life satisfaction, while controlling for socioeconomic status. Results suggest that perceived life satisfaction is related to perceived difficulty in performing HIV/AIDS preventive behaviors, for both males and females, with variability in the magnitude of associations by gender. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived difficulty in performing HIV/AIDS preventive behavior to develop gender-appropriate and culturally-sensitive quality of life/health promotion programs.

  11. Perceived Difficulty of Performing Selected HIV/AIDS Preventive Behaviors and Life Satisfaction: Is there a Relationship for African American Adolescents?

    PubMed

    Valois, Robert F; Kerr, Jelani C; Hennessy, Michael; DiClemente, Ralph J; Brown, Larry K; Carey, Michael P; Vanable, Peter A; Farber, Naomi B; Salazar, Laura F; Romer, Daniel

    2015-07-01

    Research on the relationship between adolescent health risk behaviors, sexual risk behaviors in particular, and perceived life satisfaction is emerging. Some researchers suggest that life satisfaction has been a neglected component of adolescent health research. African American adolescents aged 13-18 (n = 1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire via Audio Computer Assisted Self-Interview. Analyses were conducted to examine relationships between perceived difficulty in performing HIV/AIDS preventive behavior and perceived life satisfaction, while controlling for socioeconomic status. Results suggest that perceived life satisfaction is related to perceived difficulty in performing HIV/AIDS preventive behaviors, for both males and females, with variability in the magnitude of associations by gender. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived difficulty in performing HIV/AIDS preventive behavior to develop gender-appropriate and culturally-sensitive quality of life/health promotion programs. PMID:25227680

  12. Addressing the Socio-Development Needs of Adolescents Living with HIV/AIDS in Nigeria: A call for action

    PubMed Central

    Folayan, Morenike O; Odetoyinbo, Morolake; Harrison, Abigail; Brown, Brandon

    2015-01-01

    The widespread use of antiretroviral therapy and remarkable success in the treatment of paediatric HIV infection has changed the face of the Human Immunodeficiency Virus (HIV) epidemic in children from a fatal disease to that of a chronic illness. Many children living with HIV are surviving into adolescence. This sub-population of people living with HIV is emerging as a public health challenge and burden in terms of healthcare management and service utilization than previously anticipated. This article provides an overview of the socio-developmental challenges facing adolescents living with HIV especially in a resource-limited setting like Nigeria. These include concerns about their healthy sexuality, safer sex and transition to adulthood, disclosure of their status and potential stigma, challenges faced in daily living, access and adherence to treatment, access to care and support, and clinic transition. Other issues include reality of death and implications for fertility intentions, mental health concerns and neurocognitive development. Coping strategies and needed support for adolescents living with HIV are also discussed, and the implications for policy formulation and programme design and implementation in Nigeria are highlighted. PMID:26050381

  13. Tailoring Clinical Services to Address the Unique Needs of Adolescents from the Pregnancy Test to Parenthood

    PubMed Central

    Daley, Alison Moriarty; Sadler, Lois S.; Reynolds, Heather Dawn

    2013-01-01

    Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15–19 year old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the health care system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood. PMID:23522339

  14. Recombinant alpha-2a interferon treatment in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC): clinical and immunological evaluation.

    PubMed

    Mezzaroma, I; Avella, A; Paganelli, R; Ensoli, B; d'Offizi, G; Sirianni, M C; Luzi, G; Valdarchi, C; Aiuti, F

    1991-01-01

    We evaluated clinical efficacy and tolerability of recombinant alpha 2a interferon (IFN), in a group of 16 patients with AIDS and ARC, including 3 children. All patients were followed up monthly for clinical and immunological studies. The frequency of oportunistic infections (OI) in AIDS, and the following symptoms in all patients were studied: fever, night sweats, fatigue, diarrhoea, weight loss. Immunological parameters (CD3+, CD4+, CD8+ lymphocytes, skin tests to recall antigens, NK activity, lymphoproliferative response to PHA) were also evaluated. Adult patients were treated with 3-6 million IU of r-alpha 2a IFN daily im for 3 months and the 3 times weekly up to 12 months. Pediatric cases were treated with lower doses of 0.5-1.5 million IU using the same time schedule. We observed clinical improvement and reduction of severe infections in 10/15 evaluable patients (4/4 ARC and 6/11 AIDS). Immunological parameters were transiently improved in one third of cases. We observed only mild side effects in r-alpha IFN treatment. We suggest therapy with r-alpha 2a IFN at low dosage should be tried in patients with AIDS for its beneficial effects on OI development.

  15. Reading and Spelling Abilities of Deaf Adolescents with Cochlear Implants and Hearing Aids

    ERIC Educational Resources Information Center

    Harris, Margaret; Terlektsi, Emmanouela

    2011-01-01

    A total of 86 deaf children aged between 12 and 16 years were recruited from schools for the deaf, specialist units attached to a school, and mainstream schools. Approximately one-third used hearing aids, one-third had received a cochlear implant before 42 months, and one-third had been implanted later. The 3 subgroups were matched for age and…

  16. Evaluation of a School-Based Intervention for HIV/AIDS Prevention among Belizean Adolescents

    ERIC Educational Resources Information Center

    Kinsler, Janni; Sneed, Carl D.; Morisky, Donald E.; Ang, Alfonso

    2004-01-01

    The purpose of this study was to evaluate the impact of a cognitive-behavioral peer-facilitated school-based HIV/AIDS education program on knowledge, attitudes and behavior among primary and secondary students in Belize. Students (N = 150) were recruited from six schools in Belize City. A quasi-experimental research design was used to assess the…

  17. HIV/AIDS Knowledge, Attitudes, and Opinions among Adolescents in the River States of Nigeria

    ERIC Educational Resources Information Center

    Wodi, Ben E.

    2005-01-01

    Sub-Saharan Africa remains the epicenter of the global HIV/AIDS pandemic (Taylor et al., 2003; UNAIDS/UNICEF/WHO, 2000; Eaton, Flishera and Arob, 2002; Prat, et al., 2000). Nigeria is one of the most afflicted sub-Saharan nations (UNAIDS, 2002). Rivers State, a major industrial area of Nigeria and the nerve center of the oil industry, represents a…

  18. Adolescent Activism for Postmodern HIV/AIDS Education: A New Social Movement.

    ERIC Educational Resources Information Center

    Elbaz, Gilbert

    1997-01-01

    Argues that Youth Education Life Line faces limitations in its effort to pressure for frank HIV/AIDS education because of its postmodern approach to education and lack of political and economic resources. It supports the notion that sometimes lack of resources rather than "identity infighting" can significantly undermine a new social movement's…

  19. Helping People with HIV/AIDS Return to Work: A Randomized Clinical Trial

    PubMed Central

    Martin, David J.; Chernoff, Robert A.; Buitron, Michael; Comulada, W. Scott; Liang, Li-Jung; Wong, F. Lennie

    2013-01-01

    Objective New treatments introduced in the mid 1990s led many people with HIV/AIDS who previously had been disabled by their disease to contemplate workforce reentry; many remain unemployed, and little is known concerning interventions that might help them return to work. We report the results of a randomized clinical trial (RCT) of an intervention designed to help people with HIV/AIDS reenter the workforce. Design We tested a mixed (group – individual) modality intervention that incorporated elements of Motivational Interviewing (Miller & Rollnick, 2002), skills building from Dialectical Behavior Therapy (Linehan, 1993), and job-related skills (Price & Vinokur, 1995). A total of 174 individuals participated in either the intervention or in standard of care and were followed for 24 months. Results Compared to individuals referred for standard of care, participants in the intervention engaged in more workforce-reentry activities over time and, once employed, were more likely to remain employed. Dose-response analyses revealed that among intervention participants, participants who attended more than one individual session engaged in more workforce-reentry activities than did individual who attended one or fewer individual sessions, whereas frequency of group session participation did not effect a difference between participants who attended more than six group sessions and participants who attended six or fewer group sessions. Conclusion Theoretically-based workforce-reentry assistance programs can assist disabled people with HIV/AIDS in their return-to-work efforts. PMID:23148715

  20. Clinical predictors of psychopathology in children and adolescents with Tourette Syndrome.

    PubMed

    de Groot, C M; Janus, M D; Bornstein, R A

    1995-01-01

    Tourette Syndrome (TS) is a neuropsychiatric disorder of childhood onset characterized by vocal and motor tics and associated psychopathologies. The current study was undertaken to explore the associations between tic symptomatology, related clinical variables and behavioral dysfunction within a cohort of TS subjects. Ninety-two child and adolescent TS subjects were rated through self-measure, and by parents on measures of tic symptomatology, OC characteristics, and dysfunctional behaviors including learning difficulties and attention deficits. Statistical modeling revealed associations among tic clusters, clinical items and behavioral measures, which were unique for the child and adolescent subgroups.

  1. [Profile of adolescents with repeated pregnancies attended at a prenatal clinic].

    PubMed

    Persona, Lia; Shimo, Antonieta Keiko Kakuda; Tarallo, Maria Celina

    2004-01-01

    This study identified the biopsychosocial profile of adolescent with repeated pregnancies, who were attended at a prenatal clinic. Data were collected through patient records and interviews and were subject to quantitative analysis. Based on the obtained results and in accordance with literature, factors that are strongly associated with the occurrence of pregnancy repetition were selected in the adolescents' profiles. These are: early menarche; first sexual intercourse shortly after menarche; school repetition; school dropout; non remunerated occupation; low family income; involvement with older partners; living with the partner; consensual union with the partner; one partner; low condom use; family history of adolescent pregnancy; father's absence because of death or abandonment; positive family reaction to previous pregnancy; previous abortion; adolescent's positive concepts about previous delivery; and absence from previous postpartum consultations.

  2. Balanced intervention for adolescents and adults with language impairment: a clinical framework.

    PubMed

    Fallon, Karen A; Katz, Lauren A; Carlberg, Rachel

    2015-02-01

    Providing effective intervention services for adolescents and adults who struggle with spoken and written language presents a variety of unique challenges. This article discusses the 5S Framework (skills, strategies, school, student buy-in, and stakeholders) for designing and implementing balanced spoken and written language interventions for adolescents and adults. An in-depth case illustration highlights the usefulness of the framework for targeting the language and literacy skills of adolescents and young adults. By describing and illustrating the five key components of the intervention framework, the article provides a useful clinical tool to help guide clinicians and educators who serve the needs of adolescents and adults who struggle with spoken and written language. PMID:25633140

  3. Clinical Assessment of Child and Adolescent Sleep Disturbance.

    ERIC Educational Resources Information Center

    Kuhn, Brett R.; Mayfield, Joan W.; Kuhn, Robert H.

    1999-01-01

    Provides guidelines for counselors interested in developing their own assessment procedure to evaluate child and adolescent sleep disturbance. Guidelines include reviewing the developmental and medical history, screening for parental psychopathology, obtaining a child behavior rating scale and sleep diary, and conducting a semistructured clinical…

  4. Intimate Partner Violence and Health Care-Seeking Patterns Among Female Users of Urban Adolescent Clinics

    PubMed Central

    Decker, Michele R.; Raj, Anita; Reed, Elizabeth; Marable, Danelle; Silverman, Jay G.

    2009-01-01

    To assess the prevalence of intimate partner violence (IPV) and associations with health care-seeking patterns among female patients of adolescent clinics, and to examine screening for IPV and IPV disclosure patterns within these clinics. A self-administered, anonymous, computerized survey was administered to female clients ages 14–20 years (N = 448) seeking care in five urban adolescent clinics, inquiring about IPV history, reasons for seeking care, and IPV screening by and IPV disclosure to providers. Two in five (40%) female urban adolescent clinic patients had experienced IPV, with 32% reporting physical and 21% reporting sexual victimization. Among IPV survivors, 45% reported abuse in their current or most recent relationship. IPV prevalence was equally high among those visiting clinics for reproductive health concerns as among those seeking care for other reasons. IPV victimization was associated with both poor current health status (AOR 1.57, 95% CI 1.03–2.40) and having foregone care in the past year (AOR 2.59, 95% CI 1.20–5.58). Recent IPV victimization was associated only with past 12 month foregone care (AOR 2.02, 95% CI 1.18–3.46). A minority (30%) reported ever being screened for IPV in a clinical setting. IPV victimization is pervasive among female adolescent clinic attendees regardless of visit type, yet IPV screening by providers appears low. Patients reporting poor health status and foregone care are more likely to have experienced IPV. IPV screening and interventions tailored for female patients of adolescent clinics are needed. PMID:19760162

  5. A collaborative outreach clinic for pregnant youth and adolescent mothers: Description of a pilot clinic and its patients

    PubMed Central

    Harrison, Megan E; Weinstangel, Hannah; Dalziel, Nancy; Moreau, Katherine A

    2014-01-01

    OBJECTIVE: To describe the pregnant youth and adolescent parents seen at an adolescent health outreach clinic in an urban community setting during a two-year pilot project. METHODS: A retrospective chart review of all adolescents who presented at the monthly half-day clinics from January 2008 through January 2010 (n=36) was performed. Measures extracted from charts included demographic information, reason for referral, social history, mental health history and outcome of assessment. RESULTS: All participants were female (mean age 17 years). Forty-two percent were pregnant at initial assessment, while the remainder had one or two children, or a recent pregnancy loss. Sixty-one percent had no primary care physician. The primary reason for referral was mental health concerns, most commonly depression. Almost one-half of patients relied on social assistance and almost one-third were living in shelters. At the time of first visit, 42% of patients were not attending school; the highest level of school completed for most patients was grade 8. The majority had a history of mental health issues and previous drug and/or alcohol use. CONCLUSIONS: Adolescents presenting to the clinic had a history of disadvantage in terms of income, educational attainment, living arrangements and mental health background, and are in need of various health services including primary care practitioners. These findings will help to inform future program development for these vulnerable youth, and have implications for practitioners caring for this population. PMID:24855427

  6. Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care.

    PubMed

    Michaud, Pierre-André; Blum, Robert Wm; Benaroyo, Lazare; Zermatten, Jean; Baltag, Valentina

    2015-10-01

    The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, working in the field of adolescent medicine, neurosciences, developmental and clinical psychology, sociology, ethics, and law. Formal presentations and discussions were based on a literature search and the participants' experience. The assessment of adolescent decision-making capacity includes the following: (1) a review of the legal context consistent with the principles of the Convention on the Rights of the Child; (2) an empathetic relationship between the adolescent and the health care professional/team; (3) the respect of the adolescent's developmental stage and capacities; (4) the inclusion, if relevant, of relatives, peers, teachers, or social and mental health providers with the adolescent's consent; (5) the control of coercion and other social forces that influence decision-making; and (6) a deliberative stepwise appraisal of the adolescent's decision-making process. This stepwise approach, already used among adults with psychiatric disorders, includes understanding the different facets of the given situation, reasoning on the involved issues, appreciating the outcomes linked with the decision(s), and expressing a choice. Contextual and psychosocial factors play pivotal roles in the assessment of adolescents' decision-making capacity. The evaluation must be guided by a well-established procedure, and health professionals should be trained accordingly. These proposals are the first to have been developed by a multicultural, multidisciplinary expert panel. PMID:26281798

  7. Using the theory of planned behaviour to understand the motivation to learn about HIV/AIDS prevention among adolescents in Tigray, Ethiopia.

    PubMed

    Gebreeyesus Hadera, H; Boer, H; Kuiper, W A J M

    2007-08-01

    Various studies indicate that school- or university-based HIV prevention curricula can reduce the prevalence of sexual risk behaviour among adolescent youth in Sub-Saharan Africa. However, effective HIV/AIDS prevention education may be problematic, if the needs of youth are not served adequately. To date, little attention has been given to the motivation of youth to learn about HIV/AIDS and about their preferences for HIV/AIDS curriculum design options. The aim of this study was to get insight into the determinants of the motivation of youth to learn about HIV/AIDS prevention and to assess their curriculum design preferences. Students from a university in Tigray, Ethiopia, filled out a structured questionnaire, which assessed demographics, variables that according to the Theory of Planned Behaviour are related to the motivation to learn, and their preferences for independent, carrier and integrated HIV/AIDS curriculum designs. On average, participants were highly motivated to learn about HIV/AIDS. Motivation to learn was primarily related to social norms and was not related to self-efficacy to discuss HIV/AIDS in class. The often discussed reluctance to discuss sexuality and condom use in curricula in Sub-Saharan Africa, seems to be more related to existing negative social norms, than to lack of self-efficacy. Participants revealed a high preference for the independent, carrier and integrated curriculum design options. However, students with a higher motivation to learn about HIV/AIDS were more attracted to the independent course design.

  8. Low Back Pain in Adolescents: A Comparison of Clinical Outcomes in Sports Participants and Nonparticipants

    PubMed Central

    Fritz, Julie M.; Clifford, Shannon N.

    2010-01-01

    Abstract Context: Back pain is common in adolescents. Participation in sports has been identified as a risk factor for the development of back pain in adolescents, but the influence of sports participation on treatment outcomes in adolescents has not been adequately examined. Objective: To examine the clinical outcomes of rehabilitation for adolescents with low back pain (LBP) and to evaluate the influence of sports participation on outcomes. Design: Observational study. Setting: Outpatient physical therapy clinics. Patients or Other Participants: Fifty-eight adolescents (age  =  15.40 ± 1.44 years; 56.90% female) with LBP referred for treatment. Twenty-three patients (39.66%) had developed back pain from sports participation. Intervention(s): Patients completed the Modified Oswestry Disability Questionnaire and numeric pain rating before and after treatment. Treatment duration and content were at the clinician's discretion. Adolescents were categorized as sports participants if the onset of back pain was linked to organized sports. Additional data collected included diagnostic imaging before referral, clinical characteristics, and medical diagnosis. Main Outcome Measure(s): Baseline characteristics were compared based on sports participation. The influence of sports participation on outcomes was examined using a repeated-measures analysis of covariance with the Oswestry and pain scores as dependent variables. The number of sessions and duration of care were compared using t tests. Results: Many adolescents with LBP receiving outpatient physical therapy treatment were involved in sports and cited sports participation as a causative factor for their LBP. Some differences in baseline characteristics and clinical treatment outcomes were noted between sports participants and nonparticipants. Sports participants were more likely to undergo magnetic resonance imaging before referral (P  =  .013), attended more sessions (mean difference  =  1.40, 95

  9. Sluggish Cognitive Tempo in a Child and Adolescent Clinical Outpatient Setting.

    PubMed

    Camprodon-Rosanas, Ester; Batlle, Santiago; Estrada-Prat, Xavier; Aceña-Díaz, Marta; Petrizan-Aleman, Araitz; Pujals, Elena; Martin-López, Luis M; Pérez-Solá, Víctor; Ribas-Fitó, Núria

    2016-09-01

    Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the relevance of SCT symptoms in the field of clinical child and adolescent psychiatry. The goal of this research was to study the symptoms of SCT in a clinical child and adolescent sample and to define its features and comorbid conditions. We reviewed 834 clinical records of patients referred to Child and Adolescent Mental Health Services and examined SCT symptoms and their relation with sociodemographic data, clinical diagnosis, comorbid conditions, Child Behavior Checklist dimensions, and intelligence quotient. Of the 515 patients (age range, 4 to 17 y, 62.5% male) for whom a fully completed Child Behavior Checklist for Children and Adolescents was available, 20.8% showed high levels of SCT symptoms. SCT symptoms were strongly associated with age, internalizing symptoms, learning disabilities, and ADHD inattentive subtype (ADHD-I). No significant correlations with intelligence quotient were found. We concluded that SCT symptoms are highly prevalent in a clinical sample, and that these symptoms might be related to the difficulties that some individuals have in responding to demands in their environments, such as academic or social demands, as they increase over time. PMID:27648500

  10. Development of computer-aided functions in clinical neurosurgery with PACS

    NASA Astrophysics Data System (ADS)

    Mukasa, Minoru; Aoki, Makoto; Satoh, Minoru; Kowada, Masayoshi; Kikuchi, K.

    1991-07-01

    The introduction of the "Picture Archiving and Communications System (known as PACS)," provides many benefits, including the application of C.A.D., (Computer Aided Diagnosis). Clinically, this allows for the measurement and design of an operation to be easily completed with the CRT monitors of PACS rather than with film, as has been customary in the past. Under the leadership of the Department of Neurosurgery, Akita University School of Medicine, and Southern Tohoku Research Institute for Neuroscience, Koriyama, new computer aided functions with EFPACS (Fuji Electric's PACS) have been developed for use in clinical neurosurgery. This image processing is composed of three parts as follows: (1) Automatic mapping of small lesions depicted on Magnetic Resonance (or MR) images on the brain atlas. (2) Superimposition of two angiographic films onto a single synthesized image. (3) Automatic mapping of the lesion's position (as shown on the. CT images) on the processing image referred to in the foregoing clause 2. The processing in the clause (1) provides a reference for anatomical estimation. The processing in the clause (2) is used for general analysis of the condition of a disease. The processing in the clause (3) is used to design the operation. This image processing is currently being used with good results.

  11. Adolescent parricide as a clinical and legal problem.

    PubMed

    Malmquist, Carl P

    2010-01-01

    Criminologists contribute to the knowledge regarding the continuing problem of parricide by way of macrostudies, utilizing large samples that reveal patterns of how such acts are carried out, gender differences, and other aspects. Clinicians have the opportunity to pursue microinvestigations into the details of how cognitive processes and emotions operate in the adolescent who engages in such behavior. Such investigations entail pursuing specifics in the psychosocial realm, such as earlier maltreatments and ongoing psychological conflicts, and also being alert to the neurobiological differences between adolescents and adults. The use of battered child syndrome as a legal defense is discussed, with contrasts made between relying on a posttraumatic stress disorder (PTSD) approach and a duress defense, based on explanations related to shame and humiliation.

  12. Are patient decision aids the best way to improve clinical decision making? Report of the IPDAS Symposium.

    PubMed

    Holmes-Rovner, Margaret; Nelson, Wendy L; Pignone, Michael; Elwyn, Glyn; Rovner, David R; O'Connor, Annette M; Coulter, Angela; Correa-de-Araujo, Rosaly

    2007-01-01

    This article reports on the International Patient Decision Aid Standards Symposium held in 2006 at the annual meeting of the Society for Medical Decision Making in Cambridge, Massachusetts. The symposium featured a debate regarding the proposition that "decision aids are the best way to improve clinical decision making.'' The formal debate addressed the theoretical problem of the appropriate gold standard for an improved decision, efficacy of decision aids, and prospects for implementation. Audience comments and questions focused on both theory and practice: the often unacknowledged roots of decision aids in expected utility theory and the practical problems of limited patient decision aid implementation in health care. The participants' vote on the proposition was approximately half for and half against. PMID:17873257

  13. Relationship between clozapine dose, serum concentration, and clinical outcome in children and adolescents in clinical practice.

    PubMed

    Wohkittel, Christopher; Gerlach, Manfred; Taurines, Regina; Wewetzer, Christoph; Unterecker, Stefan; Burger, Rainer; Schreck, Diana; Mehler-Wex, Claudia; Romanos, Marcel; Egberts, Karin

    2016-08-01

    Information on dose- and concentration-related clinical effects of clozapine treatment in children and adolescents is scarce. This study aimed to examine the relationship between dose, serum concentration, and clinical outcome as well as the influencing factors thereof in paediatric patients treated with clozapine. Data from a routine Therapeutic Drug Monitoring (TDM) service between 2004 and 2014 were studied in 68 patients, aged 11-18 years. Severity of illness, therapeutic effectiveness and adverse drug reactions (ADRs) were assessed by standardized means. A relationship between the daily dose (mean 319 mg, 4.9 mg/kg) and serum concentration (mean 387 ng/ml) of clozapine was found with the variation in dose explaining 30 % of the variability in clozapine serum concentrations. Also gender contributed to the variability, however, no influence of age or concomitant medications was detected. Furthermore, a significant association was found between clozapine serum concentration and the occurrence of ADRs. Patients without ADRs had a lower mean serum concentration than those with mild (261.4 vs 407.3 ng/ml, P = 0.018) and moderate ADRs (261.4 vs 416.3 ng/ml, P = 0.028). As clozapine was estimated to be effective in lower blood concentrations, guidance on a possibly lower therapeutic range of clozapine serum levels in paediatric patients is provided. With ADRs increasing under higher concentrations, TDM is strongly recommended in paediatric clozapine therapy for individualized dosing. Dose adjustment in females also might be reasonable according to gender-related differences in serum concentrations. However, regarding the limitations of this study results should be validated in larger studies with more standardized designs. PMID:27221285

  14. THE CHALLENGE OF SEDATION WITH ADOLESCENTS: CASE STUDIES AND CLINICAL RECOMMENDATIONS

    PubMed Central

    Coolidge, Trilby; Heaton, Lisa J.; Milgrom, Peter

    2010-01-01

    Adolescent dental patients pose a unique challenge to providers, particularly when intravenous sedation is introduced to the treatment plan. Surveys show many adolescents are afraid of the dentist. Five to six per cent overall are fearful of dental injections and may avoid care or have irregular attendance. At the same time, adolescents may assert their independence by refusing to cooperate with providers’ and parents’ requests even while accepting that the goal of better health is reasonable. Successful treatment of – and rapport with – the adolescent dental patient, however, can ensure that adolescents’ oral needs are met. Successful providers recognise that adolescents alternate between childlike and mature coping strategies during the course of dental treatment. Identifying an adolescent’s current coping style can help the dental team select appropriate strategies to help treatment proceed more smoothly for the adolescent and clinical team. Working with adolescents’ individual coping styles, rather than expecting consistently adult behaviour, will ideally help decrease frustration and improve treatment outcome. PMID:19267138

  15. Mindfulness-Based Stress Reduction for the Treatment of Adolescent Psychiatric Outpatients: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Biegel, Gina M.; Brown, Kirk Warren; Shapiro, Shauna L.; Schubert, Christine M.

    2009-01-01

    Research has shown that mindfulness-based treatment interventions may be effective for a range of mental and physical health disorders in adult populations, but little is known about the effectiveness of such interventions for treating adolescent conditions. The present randomized clinical trial was designed to assess the effect of the…

  16. Maternal Control and Adolescent Depression: Ethnic Differences among Clinically Referred Girls.

    ERIC Educational Resources Information Center

    Finkelstein, Jo-Ann S.; Donenberg, Geri R.; Martinovich, Zoran

    2001-01-01

    Examined the relationship between perceived maternal control and depression for 11 urban adolescent girls seeking psychological services at an outpatient clinic. No relation between control and depression was found for Caucasian and Latina girls, but high control was linked to less depression among African American girls. Findings highlight the…

  17. Evidence-Based Assessment for Children and Adolescents: Issues in Measurement Development and Clinical Application

    ERIC Educational Resources Information Center

    Kazdin, Alan E.

    2005-01-01

    Advances in measurement of child and adolescent social, emotional, and behavioral functioning and clinical disorders have been remarkable and remarkably reviewed in the prior articles. This commentary identifies common themes that emerge from the articles, discusses the proliferation of measures, and raises considerations regarding how one might…

  18. Preliminary Validation of a Screening Tool for Adolescent Panic Disorder in Pediatric Primary Care Clinics

    ERIC Educational Resources Information Center

    Queen, Alexander H.; Ehrenreich-May, Jill; Hershorin, Eugene R.

    2012-01-01

    This study examines the validity of a brief screening tool for adolescent panic disorder (PD) in a primary care setting. A total of 165 participants (ages 12-17 years) seen in two pediatric primary care clinics completed the Autonomic Nervous System Questionnaire (ANS; Stein et al. in Psychosomatic Med 61:359-364, 40). A subset of those screening…

  19. Clinical Precursors of Adolescent Conduct Disorder in Children with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Whittinger, Naureen S.; Langley, Kate; Fowler, Tom A.; Thomas, Hollie V.; Thapar, Anita

    2007-01-01

    Objective: To examine precursors of adolescent conduct disorder (CD) in children with attention-deficit/hyperactivity disorder (ADHD), investigating the significance of childhood oppositional defiant disorder (ODD) and ADHD. Method: A total of 151 children with ADHD recruited from child psychiatric and pediatric clinics were assessed through…

  20. Clinical Profile of Childhood Onset Depression Presenting to Child Adolescent and Family Services in Northampton

    ERIC Educational Resources Information Center

    Majumder, Pallab; Hammad, Hala

    2006-01-01

    Background: The clinical profile of depressive disorder in children and young people in Child Adolescent and Family Services (CAFS), Northampton was studied. Methods: Twenty-five patients who had attended the CAFS over a period of 2 years were analysed retrospectively. Results: The age range of subjects was 8 to 19 years. Majority of patients were…

  1. Mental Health Problems and Symptoms among Male Adolescents Attending a Teen Health Clinic.

    ERIC Educational Resources Information Center

    Smith, Peggy B.; Buzi, Ruth S.; Weinman, Maxine L.

    2001-01-01

    Examined the frequency and nature of mental health problems and symptoms among a group of 51 inner city male adolescents attending a teen health clinic. Results indicated participants experienced significant mental health problems and symptoms, such as relationship problems, problems with time and money, and symptoms of anger, depression, and…

  2. A Comparative Study of Clinical Correlates in Schizophrenia with Onset in Childhood, Adolescence and Adulthood

    ERIC Educational Resources Information Center

    Biswas, Parthasarathy; Malhotra, Savita; Malhotra, Anil; Gupta, Nitin

    2006-01-01

    Background: Childhood onset schizophrenia (COS) is a rare disorder. Comparative data on the effect of differential age of onset on clinical profile in schizophrenia are very few. Method: Subjects with COS (n = 15), adolescence onset schizophrenia (AdOS, n = 20) and adulthood onset schizophrenia (AOS, n = 20) were compared on socio-demographic,…

  3. Suicidal Behaviors among Adolescents in Puerto Rico: Rates and Correlates in Clinical and Community Samples

    ERIC Educational Resources Information Center

    Jones, Jennifer; Ramirez, Rafael Roberto; Davies, Mark; Canino, Glorisa; Goodwin, Renee D.

    2008-01-01

    This study examined rates and correlates of suicidal behavior among youth on the island of Puerto Rico. Data were drawn from two probability samples, one clinical (n = 736) and one community-based sample (n = 1,896), of youth ages 12 to 17. Consistent with previous studies in U.S. mainland adolescent populations, our results demonstrate that most…

  4. Medically important venomous animals: biology, prevention, first aid, and clinical management.

    PubMed

    Junghanss, Thomas; Bodio, Mauro

    2006-11-15

    Venomous animals are a significant health problem for rural populations in many parts of the world. Given the current level of the international mobility of individuals and the inquisitiveness of travelers, clinicians and travel clinics need to be able to give advice on the prevention, first aid, and clinical management of envenoming. Health professionals often feel overwhelmed by the taxonomy of venomous animals; however, venomous animals can be grouped, using a simple set of criteria, into cnidarians, venomous fish, sea snakes, scorpions, spiders, hymenoterans, and venomous terrestrial snakes. Geographic distribution, habitats, and circumstances of accidents further reduce the range of culprits that need to be considered in any single event. Clinical management of envenomed patients relies on supportive therapy and, if available, specific antivenoms. Supplies of life-saving antivenoms are scarce, and this scarcity particularly affects rural populations in resource-poor settings. Travel clinics and hospitals in highly industrialized areas predominantly see patients with injuries caused by accidents involving marine animals: in particular, stings by venomous fish and skin damage caused by jellyfish. However, globally, terrestrial venomous snakes are the most important group of venomous animals.

  5. Quality Assessment for Therapeutic Drug Monitoring in AIDS Clinical Trials Group (ACTG 5146): A Multicenter Clinical Trial

    PubMed Central

    DiFrancesco, Robin; Rosenkranz, Susan; Mukherjee, A. Lisa; Demeter, Lisa M.; Jiang, Hongyu; DiCenzo, Robert; Dykes, Carrie; Rinehart, Alex; Albrecht, Mary; Morse, Gene D.

    2010-01-01

    In a randomized trial, AIDS Clinical Trials Group (ACTG) protocol 5146 (A5146) investigated the use of TDM to adjust doses of HIV-1 protease inhibitors (PIs) in patients with prior virologic failure on PI-based therapy who were starting a new PI-based regimen. The overall percentage of “PI trough repeats”, such as rescheduled visits or redrawn PI trough specimens, increased from 2% to 5% to 10% as the process progressed from the clinical sites, the PSL, and the study team, respectively. Cumulatively, this represents a 17% rate of failure to obtain adequate PI trough sample. While targeting a turn-around of ≤ 7 days from sample receipt to a drug concentration report, 12% of the received specimens required a longer period to report concentrations. The implementation of dosing changes in the TDM arm were achieved within ≤7 days for 56% of the dose change events, and within ≤14 days for 77% of dose change events. This quality assurance analysis provides a valuable summary of the specific points in the TDM process that could be improved during a multicenter clinical trial including: [1] shortening the timeline of sample shipment from clinical site to the lab, [2] performing the collection of PI trough specimen within the targeted sampling window by careful monitoring of the last dose times and collection times by the clinicians [3] increasing patient adherence counseling to reduce the number of samples that are redrawn due to suspecting inconsistent adherence, and [4] decreasing the time to successful TDM-based dose adjustment. The application of some of these findings may also be relevant to single center studies or clinical TDM programs within a hospital. PMID:20592644

  6. Screening for Spiritual Struggle in an Adolescent Transgender Clinic: Feasibility and Acceptability.

    PubMed

    Grossoehme, Daniel H; Teeters, Alexis; Jelinek, Sue; Dimitriou, Sophia M; Conard, Lee Ann E

    2016-01-01

    Spiritual struggles are associated with poorer health outcomes, including depression, which has higher prevalence among transgender individuals than the general population. This study's objective was to improve the quality of care in an outpatient transgender clinic by screening patients and caregivers for spiritual struggle and future intervention. The quality improvement questions addressed were whether screening for spiritual struggle was feasible and acceptable; and whether the sensitivity and specificity of the Rush Protocol were acceptable. Revision of the screening was based on cognitive interviews with the 115 adolescents and caregivers who were screened. Prevalence of spiritual struggle was 38-47%. Compared to the Negative R-COPE, the Rush Protocol screener had sensitivities of 44-80% and specificities of 60-74%. The Rush Protocol was acceptable to adolescents seen in a transgender clinic, caregivers, and clinic staff; was feasible to deliver during outpatient clinic visits, and offers a straightforward means of identifying transgender persons and caregivers experiencing spiritual struggle.

  7. Outcomes of antiretroviral therapy among younger versus older adolescents and adults in an urban clinic, Zimbabwe

    PubMed Central

    Takarinda, K. C.; Owiti, P.; Mutasa-Apollo, T.; Mugurungi, O.; Buruwe, L.; Reid, A. J.

    2016-01-01

    Setting: A non-governmental organisation-supported clinic offering health services including antiretroviral therapy (ART). Objective: To compare ART retention between younger (age 10–14 years) vs. older (age 15–19 years) adolescents and younger (age 20–29 years) vs. older (age ⩾30 years) adults and determine adolescent- and adult-specific attrition-associated factors among those initiated on ART between 2010 and 2011. Design: Retrospective cohort study. Results: Of 110 (7%) adolescents and 1484 (93%) adults included in the study, no differences in retention were observed between younger vs. older adolescents at 6, 12 and 24 months. More younger adolescents were initiated with body mass index <16 kg/m2 compared with older adolescents (64% vs. 47%; P = 0.04). There were more females (74% vs. 52%, P < 0.001) and fewer patients initiating ART with CD4 count ⩽350 cells/mm3 (77% vs. 81%, P = 0.007) among younger vs. older adults. Younger adults demonstrated more attrition than older adults at all time-points. No attrition risk factors were observed among adolescents. Attrition-associated factors among adults included being younger, having a lower CD4 count and advanced human immunodeficiency virus disease at initiation, and initiation on a stavudine-based regimen. Conclusion: Younger adults demonstrated greater attrition and may require more attention. We were unable to demonstrate differences in attrition among younger vs. older adolescents. Loss to follow-up was the main reason for attrition across all age groups. Overall, earlier presentation for ART care appears important for improved ART retention among adults. PMID:27358802

  8. Self-image and eating disorder symptoms in normal and clinical adolescents.

    PubMed

    Forsén Mantilla, Emma; Bergsten, Katja; Birgegård, Andreas

    2014-01-01

    Eating disorders (ED) are psychiatric disorders of multifactorial origin, predominantly appearing in adolescence. Negative self-image is identified as risk factor, but the association between self-image and ED in adolescents or sex differences regarding such associations remains unclear. The study aimed to investigate the relationship between specific self-image aspects and ED symptoms in normal and clinical adolescents, including sex differences. Participants included 855 ED patients (girls=813, boys=42) and 482 normal adolescents (girls=238, boys=244), 13-15 years. Stepwise regression demonstrated strong associations between self-image and ED in normal adolescents (girls: R(2)=.31, boys: R(2)=.08), and stronger associations in patients (girls: R(2)=.64, boys: R(2)=.69). Qualitative sex differences were observed in patients. Connections between specific self-image aspects and ED have implications for clinical management of ED. The strong link between self-image variables and ED symptoms in normal girls, but not boys, is discussed in terms of the continuity-discontinuity hypothesis.

  9. Do you believe in magic? The impact of "Magic" Johnson on adolescents' AIDS knowledge and attitudes.

    PubMed

    Sigelman, C K; Miller, A B; Derenowski, E B

    1993-01-01

    A group of young people ages 10 to 18, interviewed after basketball star Earvin "Magic" Johnson announced that he had tested positive for the human immunodeficiency virus (HIV), were asked for their reactions to the news. Their knowledge of and attitudes regarding AIDS were also compared to those of similar young people interviewed before the announcement. Reactions to the announcement were varied and were accompanied by only isolated changes in knowledge and attitudes, suggesting that news of this celebrity's HIV infection served primarily to reinforce or make temporarily more salient knowledge and attitudes that predated the announcement.

  10. [Clinical aspects and treatment of tuberculosis of respiratory organs in adolescents under present epidemiological conditions].

    PubMed

    Stoiunin, M B; Chebotareva, T V; Repina, E S; Kosina, A M; Tochilova, T P; Kolotilova, O N

    1999-01-01

    The paper summarizes the results of clinical observations of 55 teenagers suffering from active respiratory tuberculosis. It defines risk factors for this disease in adolescents. Emphasis is laid on the current pathomorphology and a great variety of clinical types of tuberculosis. Treatment of tuberculosis is ascertained to be preferred by using the short-term intensive chemotherapy regimen recommended by the World Health Organization, which is intended to cure most patients in the shortest period as compared with existing routine regimens.

  11. AIDS Fact Pack.

    ERIC Educational Resources Information Center

    Center for Population Options, Washington, DC.

    The three fact sheets presented in this document address issues surrounding adolescent sexuality and sexually transmitted diseases (STDs), especially the Acquired Immune Deficiency Syndrome (AIDS). The first fact sheet, "Young Women and AIDS: A Worldwide Perspective," suggests that since open discussions of adolescent sexuality have long been…

  12. Understanding the psychosocial aspects of HIV / AIDS prevention for northern Thai single adolescent migratory women workers.

    PubMed

    Cash, K; Anansuchatkul, B; Busayawong, W

    1999-04-01

    This study describes formative research about sex, sexuality, and sexual relationships of northern Thai single female migratory laborers. Methodologies included focus group discussions, observation, and in-depth individual interviews. Findings revealed that these women were sexually active, although the actual number of girls who were or had been sexually active could not be determined. It was also found that serial partners were much common than multiple partner relationships. And that these young women did not practice safe sex which can be considered as a potential social consequences of negotiating safe sex often outweigh health consequences. Furthermore, respondents reported that condoms were "men's business" and that there are irreconcilable social costs if a single woman talks about condoms or AIDS. From these findings, it is suggested that these young women and girls, regardless of their occupation or marital status or age, need HIV/AIDS education. Condoms need to be brought out of the disease spectrum and into the family planning and contraceptive spectrum. Educational interventions and material should address young people's emotional and relational needs including their desire to be modern and acceptable to peers. PMID:12295350

  13. Parents who hit and scream: interactive effects of verbal and severe physical aggression on clinic-referred adolescents' adjustment.

    PubMed

    LeRoy, Michelle; Mahoney, Annette; Boxer, Paul; Gullan, Rebecca Lakin; Fang, Qijuan

    2014-05-01

    The goals of this study were first, to delineate the co-occurrence of parental severe physical aggression and verbal aggression toward clinic-referred adolescents, and second, to examine the interactive effects of parental severe physical aggression and verbal aggression on adolescent externalizing and internalizing behavior problems. This research involved 239 referrals of 11- to 18-year-old youth and their dual-parent families to a non-profit, private community mental health center in a semi-rural Midwest community. Multiple informants (i.e., adolescents and mothers) were used to assess parental aggression and adolescent behavior problems. More than half of clinic-referred adolescents (51%) experienced severe physical aggression and/or high verbal aggression from one or both parents. A pattern of interactive effects of mother-to-adolescent severe physical aggression and verbal aggression on adolescent behavior problems emerged, indicating that when severe physical aggression was present, mother-to-adolescent verbal aggression was positively associated with greater adolescent behavior problems whereas when severe physical aggression was not present, the links between verbal aggression and behavior problems was no longer significant. No interactive effects were found for father-to-adolescent severe physical aggression and verbal aggression on adolescent adjustment; however, higher father-to-adolescent verbal aggression was consistently linked to behavior problems above and beyond the influence of severe physical aggression. The results of this study should promote the practice of routinely assessing clinic-referred adolescents and their parents about their experiences of verbal aggression in addition to severe physical aggression and other forms of abuse.

  14. Cryptosporidiosis in HIV/AIDS patients in Kenya: clinical features, epidemiology, molecular characterization and antibody responses.

    PubMed

    Wanyiri, Jane W; Kanyi, Henry; Maina, Samuel; Wang, David E; Steen, Aaron; Ngugi, Paul; Kamau, Timothy; Waithera, Tabitha; O'Connor, Roberta; Gachuhi, Kimani; Wamae, Claire N; Mwamburi, Mkaya; Ward, Honorine D

    2014-08-01

    We investigated the epidemiological and clinical features of cryptosporidiosis, the molecular characteristics of infecting species and serum antibody responses to three Cryptosporidium-specific antigens in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Kenya. Cryptosporidium was the most prevalent enteric pathogen and was identified in 56 of 164 (34%) of HIV/AIDS patients, including 25 of 70 (36%) with diarrhea and 31 of 94 (33%) without diarrhea. Diarrhea in patients exclusively infected with Cryptosporidium was significantly associated with the number of children per household, contact with animals, and water treatment. Cryptosporidium hominis was the most prevalent species and the most prevalent subtype family was Ib. Patients without diarrhea had significantly higher serum IgG levels to Chgp15, Chgp40 and Cp23, and higher fecal IgA levels to Chgp15 and Chgp40 than those with diarrhea suggesting that antibody responses to these antigens may be associated with protection from diarrhea and supporting further investigation of these antigens as vaccine candidates.

  15. Effects of Computer-Aided Manufacturing Technology on Precision of Clinical Metal-Free Restorations

    PubMed Central

    Lee, Ki-Hong; Yeo, In-Sung; Wu, Benjamin M.; Yang, Jae-Ho; Han, Jung-Suk; Kim, Sung-Hun; Yi, Yang-Jin; Kwon, Taek-Ka

    2015-01-01

    Purpose. The purpose of this study was to investigate the marginal fit of metal-free crowns made by three different computer-aided design/computer-aided manufacturing (CAD/CAM) systems. Materials and Methods. The maxillary left first premolar of a dentiform was prepared for all-ceramic crown restoration. Thirty all-ceramic premolar crowns were made, ten each manufactured by the Lava system, Cercon, and Cerec. Ten metal ceramic gold (MCG) crowns served as control. The marginal gap of each sample was measured under a stereoscopic microscope at 75x magnification after cementation. One-way ANOVA and the Duncan's post hoc test were used for data analysis at the significance level of 0.05. Results. The mean (standard deviation) marginal gaps were 70.5 (34.4) μm for the MCG crowns, 87.2 (22.8) μm for Lava, 58.5 (17.6) μm for Cercon, and 72.3 (30.8) μm for Cerec. There were no significant differences in the marginal fit among the groups except that the Cercon crowns had significantly smaller marginal gaps than the Lava crowns (P < 0.001).  Conclusions. Within the limitation of this study, all the metal-free restorations made by the digital CAD/CAM systems had clinically acceptable marginal accuracy. PMID:26557681

  16. Classroom to clinic: incorporating adolescent spiritual/faith assessment into nurse practitioner education & practice.

    PubMed

    Haley, Janice M

    2014-01-01

    Although nursing is well grounded in the conceptualization of person as body-mind-spirit, there is little evidence that advanced practice nurses routinely address the spirit in giving patient care, especially with adolescents in the outpatient setting. The neglect of spiritual aspects of care may be related to lack of a framework, or education/incorporation into nurse practitioner preparation. This article describes one method of integrating adolescent spiritual/faith assessment into a nurse practitioner clinical course. Readings, assignments, and a grading rubric are offered.

  17. Text Messages as a Reminder Aid and Educational Tool in Adults and Adolescents with Atopic Dermatitis: A Pilot Study

    PubMed Central

    Pena-Robichaux, Venessa; Kvedar, Joseph C.; Watson, Alice J.

    2010-01-01

    Optimal management of atopic dermatitis (AD) requires patients to adhere to self-care behaviors. Technologies, such as cell phones, have been widely adopted in the USA and have potential to reinforce positive health behaviors. We conducted a pilot study with 25 adolescents and adults age 14 years and older [mean 30.5 yrs, SD 13.4] with AD. Daily text messages (TMs) that provided medication reminders and AD education were sent for six weeks to participants. Our goals were to (1) measure changes in pre- and posttest scores in treatment adherence, self-care behaviors, disease severity, and quality of life and (2) assess the usability and satisfaction of the TM system. Significant improvements in treatment adherence, self-care behaviors, skin severity, and quality of life (P ≤ .001, .002, <.001, and .014, resp.) were noted postintervention. User feedback on the TM system was positive with 88% and 92% of participants reporting that the reminder TMs and educational TMs were helpful, respectively. In conclusion, study participants were receptive to using TMs as a reminder aid and educational tool. The positive trends observed are promising and lay the ground work for further studies needed to elucidate the full potential of this simple and cost-effective intervention. PMID:20885940

  18. [Relationship between the courses of clinical Features of patients with schizophrenia in adolescents and admission to psychiatric clinic].

    PubMed

    Hattori, Isao; Miyauchi, Toshiro

    2005-01-01

    In order to improve diagnosis of schizophrenia with onset in adolescents at an early stage, we investigated in detail the clinical features of 74 patients with schizophrenia, (23 males) at adolescents psychiatric clinic. Many of the subjects had been suffering from the illness about 14 years old but had not undergone their first psychiatric examination until a few years later. A high percentage (more than 80%) of our subjects presented psychiatric symptoms such as delusional remembrance, delusional moods, delusions of persecution and hypobulia. Additionally, more than 60% of our subjects presented auditory hallucinations. In general, teenage patients with schizophrenia onset show vague symptoms such as anxiety, embarrassment and strange moods rather than obvious hallucinations. Nevertheless, it was possible to identify certain clinical features of this disorder in adolescents: many patients suffer delusional remembrance, delusional moods and delusions of persecution immediately after the onset of the illness. Gradually, problematic behaviors such as anorexia, self injury, offences against their families, voluntary vomiting, etc., develop, but patients do not always receive psychiatric examination at this stage. After socially obvious problems such as school refusal, withdrawal from social activities and lowering of school record develop over a period of time, patients may be urged to undergo psychiatric examination. Our research again underlines the difficulty of achieving diagnosis of schizophrenia at an early stage. The key to early diagnosis appears to be the accurate identification of psychiatric symptoms in the early stages of the illness at school, or at home if possible, before socially problematic behaviors arise.

  19. Targeting HIV clinical training with maps: lessons from the Pacific AIDS Education and Training Center.

    PubMed

    Myers, Janet; Bernstein, Mona; Morin, Stephen F; Reyes, Michael

    2007-12-01

    Public health providers are increasingly called on to do more with fewer resources. Aiming to help HIV clinical training providers in 15 local sites to better target their efforts, the Pacific AIDS Education and Training Center (PAETC) implemented a method for integrating disparate information, such as program-level evaluation and publicly available health services data, into one combined and useful format. The resulting local area profiles were distributed to each training site and were updated annually for 2 years. As a result, local training teams adopted data-based approaches to doing their work. Training managers and faculty reported that data presented in spatial formats (i.e., maps) were most helpful for targeting their outreach and training. In addition to achieving the aim of supporting better programs, the project increased capacity for using data to support all aspects of training and education, from grant writing to strategic planning.

  20. A needs analysis for computer-based telephone triage in a community AIDS clinic.

    PubMed Central

    Henry, S. B.; Schreiner, J. G.; Borchelt, D.; Musen, M. A.

    1992-01-01

    This study describes the complexity of the telephone-triage task in a community-based AIDS clinic. We identify deficiencies related to the data management for and documentation of the telephone-triage encounter, including inaccessibility of the medical record and failure to document required data elements. Our needs analysis suggests five design criteria for a computer-based system that assists nurses with the telephone-triage task: (1) online accessibility of the medical record, (2) ability to move among modules of the medical record and the triage-encounter module, (3) ease of data entry, (4) compliance with standards for documentation, and (5) notification of the primary-care physician in an appropriate and timely manner. PMID:1482941

  1. AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT): Rationale, Design, and Baseline Characteristics

    PubMed Central

    Smurzynski, Marlene; Collier, Ann C.; Koletar, Susan L.; Bosch, Ronald J.; Wu, Kunling; Bastow, Barbara; Benson, Constance A.

    2009-01-01

    Purpose ALLRT is a longitudinal cohort study of HIV-infected subjects prospectively randomized into selected clinical trials for antiretroviral (ARV) treatment-naïve and ARV treatment-experienced individuals conducted by the AIDS Clinical Trials Group (ACTG). We describe the rationale, design, and baseline characteristics of the ALLRT cohort and its potential to address important research questions related to ARV therapy. Method Standardized visits occur every 16 weeks to evaluate long-term clinical, virologic, and immunologic outcomes associated with ARV treatment. Results A total of 4,371 subjects enrolled in ALLRT from January 2000 through June 2007. Of these, 3,146 (72%) were ARV naïve at parent study entry (18% female, 44% white, 32% black, 21% Hispanic; median age 37 years, CD4 count 218 cells/μL, follow-up 3.6 years; 343 [11%] followed ≥8 years) and 1,225 (28%) were treatment experienced (13% female, 59% white, 20% black, 17% Hispanic; median age 42 years, CD4 count 325 cells/μL, follow-up 5.7 years). Conclusions ALLRT provides the opportunity to understand long-term ramifications of therapeutic ARV choices and determine whether these vary by treatment regimen, timing of treatment initiation, or treatment changes over long-term follow-up. Investigations based on uniform data and specimen collection in the context of randomized ARV treatments will be critical to developing more successful long-term therapeutic strategies for HIV treatment. PMID:18753121

  2. Quality of life, clinical characteristics and treatment adherence of people living with HIV/AIDS1

    PubMed Central

    Silva, Ana Cristina de Oliveira e; Reis, Renata Karina; Nogueira, Jordana Almeida; Gir, Elucir

    2014-01-01

    OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence. METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used. RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends. PMID:25591095

  3. Definition of a core set of quality indicators for the assessment of HIV/AIDS clinical care: a systematic review

    PubMed Central

    2013-01-01

    Background Several organizations and individual authors have been proposing quality indicators for the assessment of clinical care in HIV/AIDS patients. Nevertheless, the definition of a consensual core set of indicators remains controversial and its practical use is largely limited. This study aims not only to identify and characterize these indicators through a systematic literature review but also to propose a parsimonious model based on those most used. Methods MEDLINE, SCOPUS, Cochrane databases and ISI Web of Knowledge, as well as official websites of organizations dealing with HIV/AIDS care, were searched for articles and information proposing HIV/AIDS clinical care quality indicators. The ones that are on patient’s perspective and based on services set were excluded. Data extraction, using a predefined data sheet based on Cochrane recommendations, was done by one of the authors while a second author rechecked the extracted data for any inconsistency. Results A total of 360 articles were identified in our search query but only 12 of them met the inclusion criteria. We also identified one relevant site. Overall, we identified 65 quality indicators for HIV/AIDS clinical care distributed as following: outcome (n=15) and process-related (n=50) indicators; generic (n=36) and HIV/AIDS disease-specific (n=29) indicators; baseline examinations (n=19), screening (n=9), immunization (n=4), prophylaxis (n=5), HIV monitoring (n=16), and therapy (=12) indicators. Conclusions There are several studies that set up HIV clinical care indicators, with only a part of them useful to assess the HIV clinical care. More importantly, HIV/AIDS clinical care indicators need to be valid, reliable and most of all feasible. PMID:23809537

  4. Working Memory and Hearing Aid Processing: Literature Findings, Future Directions, and Clinical Applications

    PubMed Central

    Souza, Pamela; Arehart, Kathryn; Neher, Tobias

    2015-01-01

    Working memory—the ability to process and store information—has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This “mismatch” is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how) working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with “low alteration” processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges) in translating information on individual working memory into clinical treatment, including clinically feasible measures of working memory. PMID:26733899

  5. Working Memory and Hearing Aid Processing: Literature Findings, Future Directions, and Clinical Applications.

    PubMed

    Souza, Pamela; Arehart, Kathryn; Neher, Tobias

    2015-01-01

    Working memory-the ability to process and store information-has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This "mismatch" is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how) working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with "low alteration" processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges) in translating information on individual working memory into clinical treatment, including clinically feasible measures of working memory. PMID:26733899

  6. Distribution and Clinical Manifestations of Cryptosporidium Species and Subtypes in HIV/AIDS Patients in Ethiopia

    PubMed Central

    Adamu, Haileeyesus; Petros, Beyene; Zhang, Guoqing; Kassa, Hailu; Amer, Said; Ye, Jianbin; Feng, Yaoyu; Xiao, Lihua

    2014-01-01

    Background Cryptosporidiosis is an important cause for chronic diarrhea and death in HIV/AIDS patients. Among common Cryptosporidium species in humans, C. parvum is responsible for most zoonotic infections in industrialized nations. Nevertheless, the clinical significance of C. parvum and role of zoonotic transmission in cryptosporidiosis epidemiology in developing countries remain unclear. Methodology/Principal Findings In this cross-sectional study, 520 HIV/AIDS patients were examined for Cryptosporidium presence in stool samples using genotyping and subtyping techniques. Altogether, 140 (26.9%) patients were positive for Cryptosporidium spp. by PCR-RFLP analysis of the small subunit rRNA gene, belonging to C. parvum (92 patients), C. hominis (25 patients), C. viatorum (10 patients), C. felis (5 patients), C. meleagridis (3 patients), C. canis (2 patients), C. xiaoi (2 patients), and mixture of C. parvum and C. hominis (1 patient). Sequence analyses of the 60 kDa glycoprotein gene revealed a high genetic diversity within the 82 C. parvum and 19 C. hominis specimens subtyped, including C. parvum zoonotic subtype families IIa (71) and IId (5) and anthroponotic subtype families IIc (2), IIb (1), IIe (1) and If-like (2), and C. hominis subtype families Id (13), Ie (5), and Ib (1). Overall, Cryptosporidium infection was associated with the occurrence of diarrhea and vomiting. Diarrhea was attributable mostly to C. parvum subtype family IIa and C. hominis, whereas vomiting was largely attributable to C. hominis and rare Cryptosporidium species. Calf contact was identified as a significant risk factor for infection with Cryptosporidium spp., especially C. parvum subtype family IIa. Conclusions/Significance Results of the study indicate that C. parvum is a major cause of cryptosporidiosis in HIV-positive patients and zoonotic transmission is important in cryptosporidiosis epidemiology in Ethiopia. In addition, they confirm that different Cryptosporidium species and

  7. Patient Access to Online Visit Notes: Perceptions of Doctors and Patients at an Urban HIV/AIDS Clinic

    PubMed Central

    Oster, Natalia V.; Jackson, Sara L.; Dhanireddy, Shireesha; Mejilla, Roanne; Ralston, James D.; Leveille, Suzanne; Delbanco, Tom; Walker, Janice D.; Bell, Sigall K.; Elmore, Joann G.

    2014-01-01

    Patients living with HIV/AIDS face large societal and medical challenges. Inviting patients to read their doctors’ visit notes via secure electronic portals may empower patients and improve health. We investigated whether utilization and perceptions about access to doctors’ notes differed among doctors and patients in an HIV/AIDS clinic versus primary care setting. We analyzed pre- and 1-year postintervention data from 99 doctors and 3819 patients. HIV clinic patients did not report differences in perceived risks and benefits compared to primary care clinic patients, however, they were more likely to share notes with friends (33% versus 9%, P = .002), other health professionals (24% versus 8%, P = .03), or another doctor (38% versus 9%, P < .0001). HIV clinic doctors were less likely than primary care doctors to change=the level of candor in visit notes (P < .04). Our findings suggest that HIV clinic patients and doctors are ready to share visit notes online. PMID:24729072

  8. Dysfunctional Attitudes Scale Perfectionism: A Predictor and Partial Mediator of Acute Treatment Outcome among Clinically Depressed Adolescents

    ERIC Educational Resources Information Center

    Jacobs, Rachel H.; Silva, Susan G.; Reinecke, Mark A.; Curry, John F.; Ginsburg, Golda S.; Kratochvil, Christopher J.; March, John S.

    2009-01-01

    The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures…

  9. Randomized Clinical Trial of Motivational Enhancement of Substance Use Treatment among Incarcerated Adolescents: Post-Release Condom Non-Use

    ERIC Educational Resources Information Center

    Rosengard, Cynthia; Stein, L. A. R.; Barnett, Nancy P.; Monti, Peter M.; Golembeske, Charles; Lebeau-Craven, Rebecca; Miranda, Robert

    2007-01-01

    Evaluated impact of motivational enhancement (ME) of substance abuse treatment compared to relaxation training (RT) on sex without condoms (overall and involving substance use) 3 months following release among incarcerated adolescents. This randomized clinical trial involved 114 incarcerated adolescents from the Northeast. Regression analyses…

  10. The mental health of asylum-seeking and refugee children and adolescents attending a clinic in the Netherlands.

    PubMed

    Wiese, Elizabeth Batista Pinto; Burhorst, Ingrid

    2007-12-01

    We investigated the sociodemographic and clinical characteristics of asylum-seeking and refugee children and adolescents referred to a child and adolescent psychiatry service in the Netherlands. Children with families and unaccompanied minors were compared. Unaccompanied minors had significantly higher frequencies of symptoms and psychiatric disorders than the children with families, both considered a high-risk population for mental health problems. PMID:18089641

  11. Attachment Representations in Mothers, Fathers, Adolescents, and Clinical Groups: A Meta-analytic Search for Normative Data.

    ERIC Educational Resources Information Center

    van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J.

    1996-01-01

    This meta-analysis on 33 studies, including more than 2,000 Adult Attachment Interview (AAI) classifications, presents distributions of AAI classifications in samples of nonclinical fathers and mothers, in adolescents, in samples from different cultures, and in clinical groups. Fathers, adolescents, and participants from different countries show…

  12. Sex differences in atazanavir pharmacokinetics and associations with time to clinical events: AIDS Clinical Trials Group Study A5202

    PubMed Central

    Venuto, Charles S.; Mollan, Katie; Ma, Qing; Daar, Eric S.; Sax, Paul E.; Fischl, Margaret; Collier, Ann C.; Smith, Kimberly Y.; Tierney, Camlin; Morse, Gene D.

    2014-01-01

    Objectives It is uncertain whether HIV-1 antiretroviral exposure and clinical response varies between males and females or different race/ethnic groups. We describe ritonavir-enhanced atazanavir pharmacokinetics in relation to virological failure, safety and tolerability in treatment-naive individuals to investigate potential differences. Methods Plasma samples were collected from participants in AIDS Clinical Trials Group Study A5202 for measurement of antiretroviral concentrations. Individual estimates of apparent oral clearance of atazanavir (L/h) were calculated from a one-compartment model and divided into tertiles as slow (<7), middle (7 to <9; reference group) and fast (≥9). Associations between atazanavir clearance and clinical outcomes were estimated with a hazard ratio (HR) from Cox proportional hazards models. Interactions between atazanavir clearance and sex, race/ethnicity and NRTIs were investigated for each of the outcomes. Results Among 786 participants, average atazanavir clearance was slower in females (n = 131) than males (n = 655). Atazanavir clearance was associated with time to virological failure (P = 0.053) and this relationship differed significantly by sex (P = 0.003). Females in the fast atazanavir clearance group had shorter time to virological failure (HR 3.49; 95% CI 1.24–9.84) compared with the middle (reference) atazanavir clearance group. Among males, the slow atazanavir clearance group had a higher risk of virological failure (HR 2.10; 95% CI 1.16–3.77). Conclusions Atazanavir clearance differed by sex. Females with fast clearance and males with slow clearance had increased risk of virological failure. PMID:25159623

  13. Cortical Auditory Evoked Potentials Reveal Changes in Audibility with Nonlinear Frequency Compression in Hearing Aids for Children: Clinical Implications.

    PubMed

    Ching, Teresa Y C; Zhang, Vicky W; Hou, Sanna; Van Buynder, Patricia

    2016-02-01

    Hearing loss in children is detected soon after birth via newborn hearing screening. Procedures for early hearing assessment and hearing aid fitting are well established, but methods for evaluating the effectiveness of amplification for young children are limited. One promising approach to validating hearing aid fittings is to measure cortical auditory evoked potentials (CAEPs). This article provides first a brief overview of reports on the use of CAEPs for evaluation of hearing aids. Second, a study that measured CAEPs to evaluate nonlinear frequency compression (NLFC) in hearing aids for 27 children (between 6.1 and 16.8 years old) who have mild to severe hearing loss is reported. There was no significant difference in aided sensation level or the detection of CAEPs for /g/ between NLFC on and off conditions. The activation of NLFC was associated with a significant increase in aided sensation levels for /t/ and /s/. It also was associated with an increase in detection of CAEPs for /t/ and /s/. The findings support the use of CAEPs for checking audibility provided by hearing aids. Based on the current data, a clinical protocol for using CAEPs to validate audibility with amplification is presented. PMID:27587920

  14. Automatic Evaluations in Clinically Anxious and Nonanxious Children and Adolescents

    ERIC Educational Resources Information Center

    Vervoort, Leentje; Wolters, Lidewij H.; Hogendoorn, Sanne M.; Prins, Pier J. M.; de Haan, Else; Nauta, Maaike H.; Boer, Frits

    2010-01-01

    Automatic evaluations of clinically anxious and nonanxious children (n = 40, aged 8-16, 18 girls) were compared using a pictorial performance-based measure of automatic affective associations. Results showed a threat-related evaluation bias in clinically anxious but not in nonanxious children. In anxious participants, automatic evaluations of…

  15. Considering justice: an exploratory study of family therapy with adolescents.

    PubMed

    Bowling, Stephanie Weiland; Kearney, Lisa K; Lumadue, Christine A; Germain, Noelle R St

    2002-04-01

    Feminist approaches to therapy with adolescents emphasize an empowering focus on the strengths of adolescents while simultaneously insisting that therapists become aware of their own biases toward today's adolescents. However, a review of the family therapy literature finds little mention of feminist approaches for addressing injustices (e.g., family scapegoating, negative societal views of adolescents, and gender oppression) that arise in family therapy with adolescents. Therefore, this study explores clinical approaches and resources suggested by a surveyed group of self-identified feminist family therapists. In addition, we also recommend several approaches and resources that will aid family therapists in creating a more just climate for family therapy with youth.

  16. Child Maltreatment and the Adolescent Patient With Severe Obesity: Implications for Clinical Care

    PubMed Central

    Noll, Jennie G.; Sarwer, David B.; Reiter-Purtill, Jennifer; Rofey, Dana L.; Baughcum, Amy E.; Peugh, James; Courcoulas, Anita P.; Michalsky, Marc P.; Jenkins, Todd M; Becnel, Jennifer N.

    2015-01-01

    Objective To characterize prevalence and correlates of child maltreatment (CM) in a clinical sample of adolescents with severe obesity. Method Multicenter baseline data from 139 adolescents undergoing weight loss surgery (Mage = 16.9; 79.9% female, 66.2% White; Mbody mass index [BMI] = 51.5 kg/m2) and 83 nonsurgical comparisons (Mage = 16.1; 81.9% female, 54.2% White; MBMI = 46.9 kg/m2) documented self-reported CM (Childhood Trauma Questionnaire) and associations with psychopathology, quality of life, self-esteem and body image, high-risk behaviors, and family dysfunction. Results CM prevalence (females: 29%; males: 12%) was similar to national adolescent base rates. Emotional abuse was most prevalent. One in 10 females reported sexual abuse. For females, CM rates were higher in comparisons, yet correlates were similar for both cohorts: greater psychopathology, substance use, and family dysfunction, and lower quality of life. Conclusion While a minority of adolescents with severe obesity reported a CM history, they carry greater psychosocial burden into the clinical setting. PMID:25774054

  17. Involving parents in their adolescents' health: a role for school clinics.

    PubMed

    Dryfoos, J; Santelli, J

    1992-06-01

    School clinics are rapidly becoming effective in adolescent health care and health promotion; viability would be increased with increased efforts to reach and involve parents in the health of their children. Schools can act as catalysts for family communication, catalysts for school and parent communication, and promoting consistent contraceptive use. Parents report a desire for more information on health topics, although parental attendance is low for parents of "high risk" children in disadvantaged communities. Family communication is reported to have an effect on the likelihood that an adolescent will use contraception, rather than on the initiation of sexual activity. Parental supervision of dating, however, is an important regulator of adolescent sexual activity. Studies show that children of authoritative parents are the most successful in school and in avoiding the consequences of high risk behavior. Findings also indicate that the majority of parents favor programs on preventing teen pregnancy, sexually transmitted diseases, and HIV infections. Many parents find it difficult to communicate with their children. National surveys report strong support for sex education, school-based clinics and school-based reproductive health care. Harassment has come from a minority of conservative fundamentalist pressure group who have a louder voice in expressing opposition. Agreement is only on the importance of parents in adolescent health.

  18. Co-infection by Cryptococcus neoformans and Mycobacterium avium intracellulare in AIDS. Clinical and epidemiological aspects.

    PubMed

    Arastéh, K; Cordes, C; Futh, U; Grosse, G; Dietz, E; Staib, F

    In the observation of various opportunistic pathogens in HIV-positive persons, co-infection by Cryptococcus neoformans together with Mycobacterium avium intracellulare was found if there was a CD4 lymphocyte count as low as 3-20/microliters. In 1540 HIV-positive patients under treatment at a Berlin hospital (Auguste-Viktoria-Krankenhaus) during 1985-1994, all AIDS-relevant diseases were examined in a multivariate analysis as variables of influence on the manifestation of a systemic Mycobacterium avium complex (MAC) infection. The analysis involved data on 36 cases of cryptococcosis and 202 cases with a typical clinical course in whom MAC had been detected at sterile body sites. As significant and independent factors of influence, the following were identified: C. neoformans infection, wasting syndrome, lower age, low CD4 lymphocyte count and preceding Pneumocystis carinii pneumonia (PcP) prophylaxis. Cryptococcosis ranged first with an ods ratio of 2.75. The concomitant manifestation of cryptococcosis and systemic MAC infection in six patients is shown. Because both opportunists, C. neoformans and avian mycobacteria, may have their common habitat in droppings of defined species of pet birds, a common source of infection deserves further clinical and epidemiological attention.

  19. Bridging the gap between laboratory and clinic in child and adolescent psychotherapy.

    PubMed

    Weisz, J R; Donenberg, G R; Han, S S; Weiss, B

    1995-10-01

    Meta-analyses of laboratory outcome studies reveal beneficial effects of psychotherapy with children and adolescents. However, the research therapy in most of those lab studies differs from everyday clinic therapy in several ways, and the 9 studies of clinic therapy the authors have found show markedly poorer outcomes than research therapy studies. These findings suggest a need to bridge the long-standing gap between outcome researchers and clinicians. Three kinds of bridging research are proposed and illustrated: (a) enriching the research data base on treatment effects by practitioners in clinical settings--including private practice and health maintenance organizations, (b) identifying features of research therapy that account for positive outcomes and applying those features to clinical practice, and (c) exporting lab-tested treatments to clinics and assessing their effects with referred youths. If these bridging strategies were widely adopted, despite the numerous obstacles described herein, real progress might be made toward more effective treatment in clinical practice. PMID:7593861

  20. Clinical trials with a programmable hearing aid set for various listening environments.

    PubMed

    Ringdahl, A; Eriksson-Mangold, M; Israelsson, B; Lindkvist, A; Mangold, S

    1990-08-01

    A conventional hearing aid has a frequency response that does not change much at normal listening levels. It is therefore unlikely that optimal speech intelligibility and optimal listening comfort can be obtained simultaneously, or in different listening environments. With a programmable hearing aid with multiple memories the listener can choose between a range of sound pictures, which increases the chance of finding a suitable frequency curve for each listening situation. The programmable hearing aid with eight separate settings stored in eight memories, was compared with personal hearing aids fitted according to the recommendations of the National Acoustic Laboratories (NAL) by 22 experienced hearing aid users. One memory of the programmable hearing aid was initially fitted according to the NAL recommendation. The other memories were programmed to give variations around that recommendation. One aim was to investigate whether the hearing-impaired user took advantage of different frequency responses to achieve listening improvements in acoustically different environments. Another aim was to evaluate the ergonomic and acoustical features of the programmable hearing aid, compared with other well fitted hearing aids. The evaluations were based on comparisons of the test hearing aid to the personal aid for each subject, looking at speech tests, direct paired comparison judgements, sound quality judgements and interviews. A majority of the subjects experienced substantial benefit from being able to use different frequency response curves in different environments. With the test hearing aid the subjects performed better in speech discrimination tests in noise.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Healthcare Reform and Preparing the Future Clinical Child and Adolescent Psychology Workforce.

    PubMed

    Janicke, David M; Fritz, Alyssa M; Rozensky, Ronald H

    2015-01-01

    The healthcare environment is undergoing important changes for both patients and providers, in part due to the Patient Protection and Affordable Care Act (ACA). Ultimately the healthcare delivery system will function very differently by the end of this decade. These changes will have important implications for the education, training, scientific inquiry, and practice of clinical child and adolescent psychologists. In this article we provide a brief description of the fundamental features of the ACA, with a specific focus on critical components of the act that have important, specific implications for clinical child and adolescents psychologists. We then provide recommendations to help position our field to thrive in the evolving healthcare environment to help facilitate further awareness and promote discussion of both challenges and opportunities that face our field in this evolving health care environment. PMID:26158589

  2. Healthcare Reform and Preparing the Future Clinical Child and Adolescent Psychology Workforce.

    PubMed

    Janicke, David M; Fritz, Alyssa M; Rozensky, Ronald H

    2015-01-01

    The healthcare environment is undergoing important changes for both patients and providers, in part due to the Patient Protection and Affordable Care Act (ACA). Ultimately the healthcare delivery system will function very differently by the end of this decade. These changes will have important implications for the education, training, scientific inquiry, and practice of clinical child and adolescent psychologists. In this article we provide a brief description of the fundamental features of the ACA, with a specific focus on critical components of the act that have important, specific implications for clinical child and adolescents psychologists. We then provide recommendations to help position our field to thrive in the evolving healthcare environment to help facilitate further awareness and promote discussion of both challenges and opportunities that face our field in this evolving health care environment.

  3. AIDS Education Curriculum Guide.

    ERIC Educational Resources Information Center

    Horry County Board of Education, Conway, SC.

    This curriculum guide was developed, based on sound principles of human growth and development, to present the most recently available information on AIDS (Acquired Immune Deficiency Syndrome). The curriculum presents information on the known facts about AIDS and the AIDS virus infection. It also addresses the potential for adolescents and adults…

  4. The Adolescent Substance Abuse Goal Commitment (ASAGC) Questionnaire: An Examination of Clinical Utility and Psychometric Properties.

    PubMed

    Kaminer, Yifrah; Ohannessian, Christine McCauley; McKay, James R; Burke, Rebecca H

    2016-02-01

    Commitment to change is an innovative potential mediator or mechanism of behavior change that has not been examined in adolescents with substance use disorders (SUD). The Adolescent Substance Abuse Goal Commitment (ASAGC) questionnaire is a 16-item measure developed to assess an individual's commitment to his/her stated treatment goal. The objectives of this study are to explore the research and clinical utility of the commitment construct as measured by the ASAGC. During sessions 3 and 9 of a 10-week SUD treatment, therapists completed the ASAGC for 170 13-18 year-old adolescents. An exploratory factor analysis was conducted on the ATAGC items. Concurrent validity with related constructs, self-efficacy and motivation for change, was examined as well. At both sessions, the factor analysis resulted in two scales--Commitment to Recovery and Commitment to Harm Reduction. The ASAGC scales were found to demonstrate a high level of internal consistency (alpha coefficients ranged from .92 to .96 over time). In contrast to the Commitment to Harm Reduction scale, the Commitment to Recovery scale consistently correlated with scales from the Situational Confidence Questionnaire assessing self-efficacy, evidencing concurrent validity. Similarly, the Commitment to Recovery scale was related to the Problem Recognition Questionnaire, providing further evidence of the validity of the ASAGC. The ASAGC is a reliable and valid clinical research instrument for the assessment of adolescents' commitment to their substance abuse treatment goal. Clinical researchers may take advantage of the clinical utility of the ASAGC including its ability to differentiate between commitment to abstinence versus commitment to harm reduction.

  5. An Exploratory Survey of End-of-Life Attitudes, Beliefs and Experiences of Adolescents With HIV/AIDS and Their Families

    PubMed Central

    Garvie, Patricia A.; He, Jianping; Wang, Jichuan; D'Angelo, Lawrence J.; Lyon, Maureen E.

    2012-01-01

    Context For youths with life-limiting conditions, little is known regarding families’ understanding of their adolescent’s wishes for end-of-life care. Objectives To examine congruence in HIV positive adolescents’ and their families’ thoughts about death and dying. Methods The Lyon Advance Care Planning Survey-Adolescent and Surrogate versions were administered within a randomized controlled trial. Participants (n =48) were medically stable adolescents aged 14 to 21 years with HIV/AIDS and their families. Congruence was measured by intraclass correlation coefficients (ICC) for continuous variables and by kappa for ordinal or dichotomous responses. Results Adolescent participants were: mean age 16.6 years (range 14–21); 37.5% males; 92% African American; 38% CD4 count <200 and viral load mean=32,079 copies/mL (range <400–91,863 copies/mL). Adolescent/family dyads agreed it is important to complete an advance directive to let loved ones know their wishes (21/24 dyads), yet no dyads agreed an advance directive had been completed. Dyads endorsed incongruent thoughts about the adolescent being afraid of dying in pain (64%; congruent afraid=8 dyads, kappa=−0.0769) and being off life support machines (congruent important=9 dyads, ICC=−0.133, 95% confidence interval=−0.540 to 0.302, P=0.721). Families’ knowledge of teens’ preferences for the timing of end-of-life (EOL) conversations (early vs. late in course of illness) was poor (kappa=−0.1186). Adolescents (90%) wanted to talk about EOL issues before they entered the dying phase. Conclusion Although important areas of congruence emerged, equally important areas, such as the timing of these conversations and adolescents’ EOL needs and wishes, are not known by their families. Families need help initiating conversations to assure their adolescents’ EOL wishes are known to them. PMID:22771129

  6. Reducing HIV and AIDS through Prevention (RHAP): a theoretically based approach for teaching HIV prevention to adolescents through an exploration of popular music.

    PubMed

    Boutin-Foster, Carla; McLaughlin, Nadine; Gray, Angela; Ogedegbe, Anthony; Hageman, Ivan; Knowlton, Courtney; Rodriguez, Anna; Beeder, Ann

    2010-05-01

    Using popular culture to engage students in discussions of HIV prevention is a nontraditional approach that may complement current prevention efforts and enhance the ability to reach youth who are at high risk of contracting HIV and other sexually transmitted infections. Hip-hop or rap music is the dominant genre of music among adolescents, especially Black and Latino youth who are disproportionately impacted by HIV and AIDS. This paper describes the rationale and development of the Reducing HIV and AIDS through Prevention (RHAP) program, a school-based program that uses hip-hop/rap music as a vehicle for raising awareness among adolescents about HIV/AIDS. Constructs from the Social Cognitive Theory and the Sexual Script Theory were used in developing the program. It was piloted and evaluated among 26 middle school students in East Harlem, New York. The lessons learned from a formative evaluation of the program and the implications for developing other programs targeting public health problems are discussed. The RHAP program challenges the traditional pedagogue-student paradigm and provides an alternative approach to teaching about HIV prevention and awareness.

  7. Reducing HIV and AIDS through Prevention (RHAP): A Theoretically Based Approach for Teaching HIV Prevention to Adolescents through an Exploration of Popular Music

    PubMed Central

    McLaughlin, Nadine; Gray, Angela; Ogedegbe, Anthony; Hageman, Ivan; Knowlton, Courtney; Rodriguez, Anna; Beeder, Ann

    2010-01-01

    Using popular culture to engage students in discussions of HIV prevention is a nontraditional approach that may complement current prevention efforts and enhance the ability to reach youth who are at high risk of contracting HIV and other sexually transmitted infections. Hip-hop or rap music is the dominant genre of music among adolescents, especially Black and Latino youth who are disproportionately impacted by HIV and AIDS. This paper describes the rationale and development of the Reducing HIV and AIDS through Prevention (RHAP) program, a school-based program that uses hip-hop/rap music as a vehicle for raising awareness among adolescents about HIV/AIDS. Constructs from the Social Cognitive Theory and the Sexual Script Theory were used in developing the program. It was piloted and evaluated among 26 middle school students in East Harlem, New York. The lessons learned from a formative evaluation of the program and the implications for developing other programs targeting public health problems are discussed. The RHAP program challenges the traditional pedagogue–student paradigm and provides an alternative approach to teaching about HIV prevention and awareness. PMID:20195778

  8. [Computer-aided reconstruction of the facial skeleton : Planning and implementation in clinical routine].

    PubMed

    Wilde, F; Schramm, A

    2016-09-01

    In computer-aided reconstruction of the facial skeleton, a workflow has been established involving the following steps: > diagnosis → planning and simulation → surgical procedure → validation and quality control <. In addition to clinical findings, the focus of diagnosis is on three-dimensional (3D) imaging, particularly computed tomography. Planning and simulation involves creation of a virtual model of the desired surgical outcome using special planning software. The accuracy of implant fit can be virtually verified before surgery. 3D models and virtual reconstructions can be used for manufacturing patient-specific implants. During the surgical procedure, planning must be transferred to the surgical site as accurately as possible. A number of techniques are available for this purpose, e. g., closed reduction, open reduction with the placement of anatomically preformed or patient-specific implants in combination with surgical guides, and the additional use of navigation. Validation and quality control require postprocedural 3D imaging. After reconstructions of the midface, 3D imaging should be performed even before surgery is completed. Malpositions can thus be directly corrected and unnecessary open reconstructions avoided. Mobile 3D c-arms are particularly useful for intraoperative 3D imaging. Whereas intraoperative imaging makes postoperative imaging after midface reconstruction unnecessary in many cases, postoperative 3D imaging in addition to intraoperative imaging may still be recommended after complex reconstructions of the facial skeleton. PMID:27525666

  9. [Computer-aided reconstruction of the facial skeleton : Planning and implementation in clinical routine].

    PubMed

    Wilde, F; Schramm, A

    2016-09-01

    In computer-aided reconstruction of the facial skeleton, a workflow has been established involving the following steps: > diagnosis → planning and simulation → surgical procedure → validation and quality control <. In addition to clinical findings, the focus of diagnosis is on three-dimensional (3D) imaging, particularly computed tomography. Planning and simulation involves creation of a virtual model of the desired surgical outcome using special planning software. The accuracy of implant fit can be virtually verified before surgery. 3D models and virtual reconstructions can be used for manufacturing patient-specific implants. During the surgical procedure, planning must be transferred to the surgical site as accurately as possible. A number of techniques are available for this purpose, e. g., closed reduction, open reduction with the placement of anatomically preformed or patient-specific implants in combination with surgical guides, and the additional use of navigation. Validation and quality control require postprocedural 3D imaging. After reconstructions of the midface, 3D imaging should be performed even before surgery is completed. Malpositions can thus be directly corrected and unnecessary open reconstructions avoided. Mobile 3D c-arms are particularly useful for intraoperative 3D imaging. Whereas intraoperative imaging makes postoperative imaging after midface reconstruction unnecessary in many cases, postoperative 3D imaging in addition to intraoperative imaging may still be recommended after complex reconstructions of the facial skeleton.

  10. First clinical results with a real time, electronic imager as an aid to colonoscopy.

    PubMed Central

    Saunders, B P; Bell, G D; Williams, C B; Bladen, J S; Anderson, A P

    1995-01-01

    The early clinical results are described of a real time, electromagnetic imaging system as an aid to colonoscopy. After gaining experience with the use of the system, one experienced endoscopist was randomised to perform consecutive colonoscopies either with (n = 29) or without (n = 26) the imager view. All procedures were recorded on computer disk and replayed for retrospective analysis. Total colonoscopy was achieved in all patients except one (imager view not available). Comparing intubation time and duration of loop formation per patient, there was no significant difference between the two study groups. The number of attempts taken to straighten the colonoscope pre patient, however, was less when the endoscopist was able to see the imager view, p = 0.03. Hand pressure was also more effective when the endoscopist and endoscopy assistant could see the imager display, p = 0.02. Preliminary experience suggests that real time, electronic imaging of colonoscopy is safe, effective, and will improve the accuracy of the procedure. Images Figure 1 PMID:7615283

  11. Prospective evaluation of the value of direct referral hearing aid clinic in management of young patients with bilateral hearing loss.

    PubMed

    Abdelkader, M; McEwan, M; Cooke, L

    2004-06-01

    The purpose of this study was to evaluate the value and effectiveness of a direct referral hearing aid clinic (DRHAC) in providing appropriate hearing aids to young patients aged 18-60 years while at the same time identifying patients with significant ear disease who need an otologist's opinion. The patients were referred to a tertiary referral hearing assessment clinic. A total of 137 patients (18-60 years) met the criteria to be included in the study to be assessed in the clinic by both an audiometrician and an otologist. The main outcome measures were hearing evaluation and audiometrician's management. Of them, 114 patients attended the research clinic (83%), 23 patients (17%) did not attend the clinic and 57 patients (51%) did not need any treatment or further investigation as their hearing was normal or near normal. Thirty patients (27%) were given hearing aids. Twenty-five patients (22%) failed the audiometrician assessment and were referred to the otologist. Only 13 (18%) of the 25 patients referred for an otological opinion actually required further investigations, medical or surgical treatment. DRHAC is as viable a system in the younger as in the elderly population.

  12. Suicidal behaviors among adolescents in puerto rico: rates and correlates in clinical and community samples.

    PubMed

    Jones, Jennifer; Ramirez, Rafael Roberto; Davies, Mark; Canino, Glorisa; Goodwin, Renee D

    2008-04-01

    This study examined rates and correlates of suicidal behavior among youth on the island of Puerto Rico. Data were drawn from two probability samples, one clinical (n = 736) and one community-based sample (n = 1,896), of youth ages 12 to 17. Consistent with previous studies in U.S. mainland adolescent populations, our results demonstrate that most psychiatric disorders are associated with significantly increased likelihood of suicidal behaviors. These findings provide critical new information by demonstrating specificity in the link between psychiatric disorders and suicidal behaviors. These data also suggest consistency in the links in both clinical and community samples, and by gender. PMID:18470780

  13. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    PubMed Central

    Schmid, Marc

    2013-01-01

    Nonsuicidal self-injury (NSSI) is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years) was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls). Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity. PMID:24236273

  14. Prosthetic rehabilitation with an implant-supported fixed prosthesis using computer-aided design and computer-aided manufacturing dental technology for a patient with a mandibulectomy: A clinical report.

    PubMed

    Yoon, Hyung-In; Han, Jung-Suk

    2016-02-01

    The fabrication of dental prostheses with computer-aided design and computer-aided manufacturing shows acceptable marginal fits and favorable treatment outcomes. This clinical report describes the management of a patient who had undergone a mandibulectomy and received an implant-supported fixed prosthesis by using additive manufacturing for the framework and subtractive manufacturing for the monolithic zirconia restorations.

  15. [Decline of speech understanding in the hearing impaired elderly listeners who visited our hearing aid clinic].

    PubMed

    Yasue, Minori; Sugiura, Saiko; Uchida, Yasue; Nakashima, Tsutomu

    2014-08-01

    The aim of this study was to investigate distinctive change in the hearing impaired elderly listeners, especially about speech recognition. Subjects were 525 patients (235 males, 290 females), from 60 to 98 years of age who had visited the Hearing Aid Clinic of Otorhinolaryngology, National Center for Geriatrics and Gerontology Hospital, between June 2001 and December 2012. Pure-tone air conduction threshold determination was administered to each subject. The speech audiometry materials used to define speech discrimination ability were Japanese monosyllabic word lists, 67S word lists. Sex- and age-specific trends in maximum discrimination score (MDS) and rollover index (RI) were shown in this study. RI was computed by the formula (PBmax-PBmin)/PBmax. PBmax has almost the same meaning as MDS in Japan. PBmin represented the lowest PB score above the test intensity level of PBmax. Mean MDSs were 80.8% in their sixties, 75.3% in their seventies, 60.7% in their eighties, and 45.5% in their nineties. The rate of decrease in mean MDS per decade accelerated in the older generation. Mean RIs were 0.18 in patients in their sixties, 0.24 in their seventies, 0.30 in their eighties, and 0.30 in their nineties. It increased until the age of eighties. In the model 1, multiple logistic analyses were performed to examine the effect of age (in 10-year increments), sex and mean hearing levels in pure tone average of values at 500, 1000, 2000, 4000 Hz (in 10 dB increments) on the MDS < 60%. Significant associations were observed between MDS < 60% and age (odds ratio, 3.03; 95% confidence interval, 2.38 to 3.85), and mean hearing levels in pure tone average of values at 500, 1000, 2000, 4000 Hz (2.33; 2.03 to 2.68). Sex was not associated with MDS < 60%. In the model 2, multiple logistic analyses adjusted for age and sex were performed to examine the effect of hearing level at test frequencies of 125, 250, 500, 1000, 2000, 4000, and 8000 Hz (in 10 dB increments)on the MDS < 60

  16. An effective strategy for intervention with children and adolescents affected by HIV and AIDS.

    PubMed

    Gossart-Walker, S; Moss, N E

    2000-04-01

    With John's deep sorrow and grief and inability to express it adaptively, the authors thought again about the children's therapeutic needs in group. What is planned and expected from group often turns itself over to what children expect and need. The program's wish for the children to verbally work out their conflicts was idealistic and unrealistic. Instead, the authors needed to use clinical skills creatively to re-establish safety for all the children and to help John cope with his sorrow and anger. It was obvious to the leaders that his anger regarding his mother's illness and death were escalated by the leader's pregnancy. Support needed to be provided to John and the group as a whole by understanding this psychologic struggle, and by providing a safe environment for him to establish a language to express his rage and develop more adaptive coping mechanisms. The example of John exemplifies many of the points made in this article. Although John's experiences only speak of one member's experience within a group, the power of the group is certain to be healing, not only for the individual but also for all of its members. While John's healing is made clear in the example, the other children also gained from these group experiences. They all had their anger and resentment of loss of a leader (and metaphorically of their mothers) expressed for them with a growing sense of safety in the demonstration of pain and anger. They witnessed concretely that their rage and sadness could be articulated and could not cause harm to others. Most interestingly, they all began to talk about their mothers and their early childhoods calmly, with a profound sense of connection with each other, even with silliness and age-appropriate fun. They began to use each other as sources of comfort in their sharing of their stories. The letters to and from John after his departure from group allowed the group members to continue their powerful bond. The current members remember John fondly. His

  17. Plasma HIV-1 tropism and risk of short-term clinical progression to AIDS or death

    PubMed Central

    Casadellà Fontdevila, Maria; Cozzi-Lepri, Alessandro; Phillips, Andrew; Noguera Julian, Marc; Bickel, Marcus; Sedlacek, Dalibor; Kronborg, Gitte; Lazzarin, Adriano; Zilmer, Kai; Clotet, Bonaventura; Lundgren, Jens D; Paredes, Roger

    2014-01-01

    Introduction It is uncertain if plasma HIV-1 tropism is an independent predictor of short-term risk of clinical progression / death, in addition to the CD4 count and HIV RNA level. We conducted a nested case-control study within EuroSIDA to assess this question amongst people with current HIV RNA level >1000 copies/mL, including both people on ART and those ART naïve. Methods People with an AIDS diagnosis or who died from any causes for whom there was a stored plasma sample with HIV-1 RNA (VL)≥1,000 copies/mL available in the time window of 3–12 months prior to the event were identified. At least one control was selected for each case matched for age, VL and HCV status at the time of sampling. Controls were event-free after a matched duration of time from the date of sampling. Plasma HIV tropism was estimated using 454 and population sequencing (PS). Non-R5 HIV was defined as: (a) ≥2% of sequences with a Geno2Pheno (G2P) FPR≤3.75% by 454, and (b) a G2P FPR≤10% by PS. We also compared CD4 slopes over the 12 months following the date of sampling using a linear mixed model with random intercept according to HIV tropism and ART status. Results The study included 266 subjects, 100 cases and 166 controls, with sample taken on average in 2006; 23% and 24% had non-R5 HIV by 454 and PS respectively. There were 19% women, 25% MSM, 92% Caucasians, 22% HCV+. At the time of sampling, 26% were ART-naïve, 25% had started but were off ART and 49% were receiving ART. The median age, CD4 and viral load was 41 years, 350 cells/mm3 and 4.81 log c/mL, respectively. Baseline characteristics were well balanced by tropism. Factors independently associated with clinical progression or death were female gender (OR=2.12; 95% CI=1.04, 4.36; p=0.038), CD4+ count (OR=0.90 per 100 cells/mm3 higher; 95% CI 0.80, 1.00; p=0.058), being on ART (OR=2.72; 95% CI 1.15, 6.41; p=0.022) and calendar year of sample (OR=0.84 per more recent year; 95% CI=0.77, 0.91; p<0.001). Baseline plasma

  18. Splinter, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Splinter, First Aid A A A First Aid for Splinter: View ... wet, it makes the area prone to infection. First Aid Guide Self-care measures to remove a splinter ...

  19. Distinctive clinical course and pattern of relapse in adolescents with medulloblastoma

    SciTech Connect

    Tabori, Uri . E-mail: uri.tabori@sickkids.ca; Sung, Lillian; Laperriere, Normand; Crooks, Bruce; Wilson, Beverly

    2006-02-01

    Purpose: To report the clinical course of adolescents with medulloblastoma, with specific emphasis on prognosis and pattern of relapse. Methods and Materials: We retrospectively studied the clinical course and outcomes of children aged 10-20 years with medulloblastoma, treated at centers throughout Canada between 1986 and 2003. To better assess time to relapse, a cohort of patients aged 3-20 years at diagnosis was generated. Results: A total of 72 adolescents were analyzed. Five-year overall survival and event-free survival rates were 78.3% {+-} 5.4% and 68.0% {+-} 6.2%, respectively. Late relapses occurred at a median of 3.0 years (range, 0.3-6.8 years). In univariate analysis, conventional risk stratification and the addition of chemotherapy to craniospinal radiation did not have prognostic significance. Female patients had improved overall survival (p = 0.007). Time to relapse increased with age in a linear fashion. After relapse, patients faired poorly regardless of treatment modality. Patients who did not receive chemotherapy initially had improved progression-free survival at relapse (p 0.05). Conclusions: Our study suggests that adolescents with medulloblastoma might have a unique prognosis and pattern of relapse, dissimilar to those in younger children. They might benefit from different risk stratifications and prolonged follow-up. These issues should be addressed in future prospective trials.

  20. Repetitive Concussions in Adolescent Athletes – Translating Clinical and Experimental Research into Perspectives on Rehabilitation Strategies

    PubMed Central

    Semple, Bridgette D.; Lee, Sangmi; Sadjadi, Raha; Fritz, Nora; Carlson, Jaclyn; Griep, Carrie; Ho, Vanessa; Jang, Patrice; Lamb, Annick; Popolizio, Beth; Saini, Sonia; Bazarian, Jeffrey J.; Prins, Mayumi L.; Ferriero, Donna M.; Basso, D. Michele; Noble-Haeusslein, Linda J.

    2015-01-01

    Sports-related concussions are particularly common during adolescence, a time when even mild brain injuries may disrupt ongoing brain maturation and result in long-term complications. A recent focus on the consequences of repetitive concussions among professional athletes has prompted the development of several new experimental models in rodents, as well as the revision of guidelines for best management of sports concussions. Here, we consider the utility of rodent models to understand the functional consequences and pathobiology of concussions in the developing brain, identifying the unique behavioral and pathological signatures of concussive brain injuries. The impact of repetitive concussions on behavioral consequences and injury progression is also addressed. In particular, we focus on the epidemiological, clinical, and experimental evidence underlying current recommendations for physical and cognitive rest after concussion, and highlight key areas in which further research is needed. Lastly, we consider how best to promote recovery after injury, recognizing that optimally timed, activity-based rehabilitative strategies may hold promise for the adolescent athlete who has sustained single or repetitive concussions. The purpose of this review is to inform the clinical research community as it strives to develop and optimize evidence-based guidelines for the concussed adolescent, in terms of both acute and long-term management. PMID:25883586

  1. Improving balance in regulatory oversight of research in children and adolescents: a clinical investigator's perspective.

    PubMed

    Rosenfield, Robert L

    2008-01-01

    The current regulatory environment, designed to protect children, imposes barriers to research in children that are a deterrent to high-quality clinical research in minors. This article summarizes the special procedures necessary to obtain approval for research in healthy children that poses more than minimal risk according to the code of federal regulations (45 CFR 46.407 and 21 CFR 50.54). The operational realities of the process are illustrated by the case of the most recent research protocol to be reviewed under these rules. The current process poses obstacles to future studies of complex research questions in children and adolescents that require unaffected controls, such as the relationship of adolescent anovulatory disorders to adult illness. It is concluded that current regulatory procedures, while protecting children, increase the potential for the neglect of important research needs of children and are a disincentive to pursuit of a career in clinical research for young clinicians. Suggestions are made for improving the balance between the need for research in children and adolescents and its regulation.

  2. Clinical epidemiology of HIV/AIDS in China from 2004-2011.

    PubMed

    Li, Min; Shen, Yinzhong; Jiang, Xiaofei; Li, Qi; Zhou, Xiaoming; Lu, Hongzhou

    2014-02-01

    This study retrospectively analyzed Chinese publicly reported data on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). The HIV/AIDS morbidity (1/100,000) and mortality (1/100,000) rates in China continually increased from 0.23 and 0.06 in 2004 to 1.53 and 0.69 in 2011, respectively. The AIDS case fatality rate decreased yearly from 53.57% in 2008 to 45.11% in 2011, and the fatality rate in rural areas (0.25-0.42%) was higher than that in cities (0.13-0.22%). The number of HIV/AIDS patients discharged from city-level hospitals increased from 329 in 2004 to 7,266 in 2011, and this number was higher than the number of similar patients discharged from county-level (rural) hospitals (the number of HIV/AIDS patients increased from 252 in 2004 to 5,957 in 2011). The factors contributing to these trends include: enhanced physician HIV/AIDS education regarding diagnosis, intervention, monitoring, testing, and treatment; improved safety of blood collection and use; and improved management of HIV/AIDS patients. Therefore, HIV/AIDS prevention and control in rural areas of China is the key to reducing HIV transmission and mortality in China. PMID:24647113

  3. MR urography in children and adolescents: techniques and clinical applications.

    PubMed

    Dillman, Jonathan R; Trout, Andrew T; Smith, Ethan A

    2016-06-01

    Renal and urinary tract imaging is commonly performed in the pediatric population, particularly in the setting of suspected or known congenital anomalies. In most cases, adequate anatomic assessment can be achieved using ultrasound and fluoroscopic techniques, and evaluation of differential renal function and urinary tract drainage can be accomplished with renal scintigraphy. However, in a subset of children, anatomic or functional questions may remain after this routine evaluation. In this setting, magnetic resonance imaging (MRI) tailored to evaluate the kidneys and urinary tract, known as MR urography (MRU), can be used to depict the kidneys, ureters, and urinary bladder in detail and to determine differential renal function and assess urinary tract drainage. The objectives of this review article are to (1) describe pediatric-specific MRI techniques for assessment of the kidneys and urinary tract and (2) present common clinical applications for pediatric MRU where imaging can "add value" in terms of diagnosis and patient management. PMID:26915088

  4. Factor structure of the SOCRATES in a clinical sample of adolescents.

    PubMed

    Maisto, Stephen A; Chung, Tammy A; Cornelius, Jack R; Martin, Christopher S

    2003-06-01

    This study investigated the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES; W. R. Miller & J. S. Tonigan, 1996) in adolescents presenting for treatment of alcohol use disorder (AUD). The participants were 80 males and 43 females (mean age = 16.8 years) who presented for AUD treatment (95.1% outpatient, 4.9% inpatient). Participants completed assessments at baseline and 1 year and provided information on alcohol use and related variables monthly between these 2 assessments. Principal-components and confirmatory factor analyses of the baseline SOCRATES identified 2 factors, Taking Steps and Recognition, which showed good internal consistency and concurrent and predictive evidence of validity. The results were interpreted as supporting the use of the SOCRATES with clinical samples of adolescents.

  5. The clinical course of childhood and adolescent adrenoleukodystrophy before and after Lorenzo's oil.

    PubMed

    Suzuki, Y; Imamura, A; Shimozawa, N; Kondo, N

    2001-03-01

    The clinical course of Japanese patients with childhood and adolescent adrenoleukodystrophy (ALD) who were treated with Lorenzo's oil after the progression of early symptoms was investigated by Kaplan-Meier analyses. Many of the early symptoms, including visual, personality, hearing, mental and speech disturbances, had already appeared when the oil therapy was started. These early symptoms appeared significantly faster than bed-ridden state or dysphagia (P<0.01). Gait disturbance appeared faster than bed-ridden state and dysphagia (P<0.05), and tended to appear later than the early symptoms. These results would reflect the early natural course of childhood and adolescent ALD before treatment, and provide a basis for the evaluation of therapeutic trials for ALD.

  6. Applications of generalizability theory to clinical child and adolescent psychology research.

    PubMed

    Lakes, Kimberley D; Hoyt, William T

    2009-01-01

    Using generalizability theory to evaluate the reliability of child and adolescent measures enables researchers to enhance precision of measurement and consequently increase confidence in research findings. With an observer-rated measure of child self-regulation, we illustrate how multiple sources of error variance (e.g., raters, items) affect the dependability (replicability) of scores and demonstrate methods for enhancing dependability of observer ratings. Using ratings of 181 children, we illustrate the use of two-facet (i.e., raters and items as sources of error) and three-facet (i.e., raters, items and occasions) analyses to optimize design features of future studies using this measure. In addition, we show how generalizability theory provides a useful conceptual framework for thinking about determinants of scores on acquaintance (e.g., teacher or parent) ratings, as well as observer ratings, and sheds light on the strengths and limitations of both types of data for child and adolescent clinical research. PMID:19130364

  7. Sexual behavior of female adolescents on the spread of HIV/AIDS and other STDs in Carriacou.

    PubMed

    Patrice-Coy, Celestine; Johnson, Emmanuel Janagan; Boodram, Cheryl Ann Sarita

    2016-09-01

    This article explores information relating to female adolescents knowledge, attitudes, and behaviors toward human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) in Carriacou. The authors aimed at finding out whether adolescent females in Carriacou receive adequate information about HIV and other STDs. Where did students receive most of their information about HIV/STDs and whether the knowledge has influenced their sexual behaviors? Furthermore, this study focused on how female adolescents feel toward people living with HIV/STDs.Focus group method was employed with 2 age groups of female adolescent students. Content analysis was carried out by the researcher to analyze the data. Themes were developed using coding and thematic analysis.The findings revealed that female adolescents were highly aware of HIV/STDs-related facts. They were knowledgeable and have received adequate information about HIV/STDs. PMID:27603390

  8. Sexual behavior of female adolescents on the spread of HIV/AIDS and other STDs in Carriacou

    PubMed Central

    Patrice-Coy, Celestine; Johnson, Emmanuel Janagan; Boodram, Cheryl Ann Sarita

    2016-01-01

    Abstract This article explores information relating to female adolescents knowledge, attitudes, and behaviors toward human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) in Carriacou. The authors aimed at finding out whether adolescent females in Carriacou receive adequate information about HIV and other STDs. Where did students receive most of their information about HIV/STDs and whether the knowledge has influenced their sexual behaviors? Furthermore, this study focused on how female adolescents feel toward people living with HIV/STDs. Focus group method was employed with 2 age groups of female adolescent students. Content analysis was carried out by the researcher to analyze the data. Themes were developed using coding and thematic analysis. The findings revealed that female adolescents were highly aware of HIV/STDs-related facts. They were knowledgeable and have received adequate information about HIV/STDs. PMID:27603390

  9. A review of technological and clinical aspects of robot-aided rehabilitation of upper-extremity after stroke.

    PubMed

    Babaiasl, Mahdieh; Mahdioun, Seyyed Hamed; Jaryani, Poorya; Yazdani, Mojtaba

    2016-01-01

    Cerebrovascular accident (CVA) or stroke is one of the leading causes of disability and loss of motor function. Millions of people around the world are effected by it each year. Stroke results in disabled arm function. Restoration of arm function is essential to regaining activities of daily living (ADL). Along with traditional rehabilitation methods, robot-aided therapy has emerged in recent years. Robot-aided rehabilitation is more intensive, of longer duration and more repetitive. Using robots, repetitive dull exercises can turn into a more challenging and motivating tasks such as games. Besides, robots can provide a quantitative measure of the rehabilitation progress. This article overviews the terms used in robot-aided upper-limb rehabilitation. It continues by investigating the requirements for rehabilitation robots. Then the most outstanding works in robot-aided upper-limb rehabilitation and their control schemes have been investigated. The clinical outcomes of the built robots are also given that demonstrates the usability of these robots in real-life applications and their acceptance. This article summarizes a review done along with a research on the design, simulation and control of a robot for use in upper-limb rehabilitation after stroke. Implications for Rehabilitation Reviewing common terms in rehabilitation of upper limb using robots Reviewing rehabilitation robots built up to date Reviewing clinical outcomes of the mentioned rehabilitation robots.

  10. The Impact of Perceived Interpersonal Functioning on Treatment for Adolescent Depression: IPT-A versus Treatment as Usual in School-Based Health Clinics

    ERIC Educational Resources Information Center

    Gunlicks-Stoessel, Meredith; Mufson, Laura; Jekal, Angela; Turner, J. Blake

    2010-01-01

    Objective: Aspects of depressed adolescents' perceived interpersonal functioning were examined as moderators of response to treatment among adolescents treated with interpersonal psychotherapy for depressed adolescents (IPT-A; Mufson, Dorta, Moreau, & Weissman, 2004) or treatment as usual (TAU) in school-based health clinics. Method: Sixty-three…

  11. Latent Class Analysis of Substance Use among Adolescents Presenting to Urban Primary Care Clinics

    PubMed Central

    Bohnert, Kipling M.; Walton, Maureen A.; Resko, Stella; Barry, Kristen T.; Chermack, Stephen T.; Zucker, Robert A.; Zimmerman, Marc A.; Booth, Brenda M.; Blow, Frederic C.

    2015-01-01

    Background Polysubstance use during adolescence is a significant public health concern; however, few studies have investigated patterns of use during this developmental window within the primary care setting. Objectives This study uses an empirical method to classify adolescents into polysubstance use groups, and examines correlates of the empirically-defined groups. Methods Data come from patients, ages 12-18 years, presenting to urban, primary care community health clinics (Federally Qualified Health Centers) in two cities in the Midwestern United States (n=1664). Latent class analysis (LCA) was used to identify classes of substance users. Multinomial logistic regression was used to examine variables associated with class membership. Results LCA identified three classes: Class 1 (64.5%) exhibited low probabilities of all types of substance use; Class 2 (24.6%) was characterized by high probabilities of cannabis use and consequences; Class 3 (10.9%) had the highest probabilities of polysubstance use, including heavy episodic drinking and misuse of prescription drugs. Those in Class 2 and Class 3 were more likely to be older, and have poorer grades, poorer health, higher levels of psychological distress, and more sexual partners than those in Class 1. Individuals in Class 3 were also less likely to be African-American than those in Class 1. Conclusion Findings provide novel insight into the patterns of polysubstance use among adolescents presenting to low-income urban primary care clinics. Future research should examine the efficacy of interventions that address the complex patterns of substance use and concomitant health concerns among adolescents. PMID:24219231

  12. Counselling sessions increased duration of exclusive breastfeeding: a randomized clinical trial with adolescent mothers and grandmothers

    PubMed Central

    2014-01-01

    Background Considering that adolescent mothers may be more vulnerable to discontinuing exclusive breastfeeding (EBF) before 6 months and that their mothers may exert a negative influence on this practice, this study was conducted with the objective of evaluating the efficacy of breastfeeding counselling for adolescent mothers and their mothers in increasing EBF duration. Methods A clinical trial was performed in 323 adolescent mothers with newborns and their mothers randomized in four groups: (1) not living with mother, without intervention; (2) not living with mother, with intervention; (3) living with mother, without intervention, (4) living with mother, with intervention. The intervention consisted of five counselling sessions directed to mother and grandmother, in the maternity hospital and on follow-up. Information about feeding practices during the newborn’s first six months of life was collected monthly by telephone. Intervention’s efficacy was measured through Cox regression and comparison of exclusive breastfeeding medians and survival curves for the different groups. Results The intervention increased the duration of EBF by67 days for the group which included grandmothers (HR = 0.64; CI 95% = 0.46-0.90) and 46 days for the group which did not include grandmothers (HR = 0.52; CI 95% = 0.36-0.76). Conclusions Counselling sessions in the first four months of children’s lives proved to be effective in increasing EBF duration among adolescent mothers. Trial registration ClinicalTrials.gov NCT00910377. PMID:25033743

  13. Altered relationships between age and functional brain activation in adolescents at clinical high risk for psychosis

    PubMed Central

    Karlsgodt, Katherine H.; van Erp, Theo G.M.; Bearden, Carrie E.; Cannon, Tyrone D.

    2014-01-01

    Schizophrenia is considered a neurodevelopmental disorder, but whether the adolescent period, proximal to onset, is associated with aberrant development in individuals at clinical high risk (CHR) for psychosis is incompletely understood. While abnormal gray and white matter development has been observed, alterations in functional neuroimaging (fMRI) parameters during adolescence as related to conversion to psychosis have not yet been investigated. Twenty CHR individuals and 19 typically developing controls (TDC), (ages 14-21), were recruited from the Center for Assessment and Prevention of Prodromal States (CAPPS) at UCLA. Participants performed a Sternberg-style verbal working memory (WMem) task during fMRI and data were analyzed using a cross-sectional design to test the hypothesis that there is a deviant developmental trajectory in WMem associated neural circuitry in those at risk for psychosis. Eight of the CHR adolescents converted to psychosis within 2 years of initial assessment. A voxel-wise regression examining the relationship between age and activation revealed a significant group-by-age interaction. TDC showed a negative association between age and functional activation in the WMem circuitry while CHR adolescents showed a positive association. Moreover, CHR patients who later converted to overt psychosis showed a distinct pattern of abnormal age-associated activation in the frontal cortex relative to controls, while non-converters showed a more diffuse posterior pattern. Finding that age related variation in baseline patterns of neural activity differentiate individuals who subsequently convert to psychosis from healthy subjects suggests that these differences are likely to be clinically relevant. PMID:24144510

  14. Altered relationships between age and functional brain activation in adolescents at clinical high risk for psychosis.

    PubMed

    Karlsgodt, Katherine H; van Erp, Theo G M; Bearden, Carrie E; Cannon, Tyrone D

    2014-01-30

    Schizophrenia is considered a neurodevelopmental disorder, but whether the adolescent period, proximal to onset, is associated with aberrant development in individuals at clinical high risk (CHR) for psychosis is incompletely understood. While abnormal gray and white matter development has been observed, alterations in functional neuroimaging (fMRI) parameters during adolescence as related to conversion to psychosis have not yet been investigated. Twenty CHR individuals and 19 typically developing controls (TDC), (ages 14-21), were recruited from the Center for Assessment and Prevention of Prodromal States (CAPPS) at UCLA. Participants performed a Sternberg-style verbal working memory (WMem) task during fMRI and data were analyzed using a cross-sectional design to test the hypothesis that there is a deviant developmental trajectory in WMem associated neural circuitry in those at risk for psychosis. Eight of the CHR adolescents converted to psychosis within 2 years of initial assessment. A voxel-wise regression examining the relationship between age and activation revealed a significant group-by-age interaction. TDC showed a negative association between age and functional activation in the WMem circuitry while CHR adolescents showed a positive association. Moreover, CHR patients who later converted to overt psychosis showed a distinct pattern of abnormal age-associated activation in the frontal cortex relative to controls, while non-converters showed a more diffuse posterior pattern. Finding that age related variation in baseline patterns of neural activity differentiate individuals who subsequently convert to psychosis from healthy subjects suggests that these differences are likely to be clinically relevant. PMID:24144510

  15. Contributions of a specialty clinic for children and adolescents with Down syndrome.

    PubMed

    Skotko, Brian G; Davidson, Emily Jean; Weintraub, Gil S

    2013-03-01

    We investigated what added value, if any, a Down syndrome specialty clinic brings to the healthcare needs of children and adolescents with Down syndrome. For this quality improvement study, we performed a retrospective chart review of 105 new patients with Down syndrome, ages 3 and older, seen during the inaugural year of our specialty clinic. We asked how many of our patients were already up-to-date on the healthcare screenings recommended for people with Down syndrome. We further analyzed what tests we ordered, which referrals we suggested, and, ultimately, what new diagnoses of co-occurring medical conditions were made. Only 9.8% of our patients were current on all of the recommended Down syndrome healthcare screenings. Parents came to clinic with a variety of concerns, and after laboratory tests, radiologic studies, and subspecialty referrals, we made many new diagnoses of gastrointestinal conditions (e.g., constipation and celiac disease), seasonal allergies, dermatologic conditions (e.g., xerosis), behavioral diagnoses (e.g., autism spectrum disorder and disruptive behavior not otherwise specified), and clarifications of neurologic conditions. A Down syndrome specialty clinic can identify and address many healthcare needs of children and adolescents with Down syndrome beyond that which is provided in primary care settings. PMID:23401090

  16. [Characteristics of children and adolescents with gender dysphoria referred to the Hamburg Gender Identity Clinic].

    PubMed

    Becker, Inga; Gjergji-Lama, Voltisa; Romer, Georg; Möller, Birgit

    2014-01-01

    Given the increasing demand for counselling in gender dysphoria in childhood in Germany, there is a definite need for empirical data on characteristics and developmental trajectories of this clinical group. This study aimed to provide a first overview by assessing demographic characteristics and developmental trajectories of a group of gender variant boys and girls referred to the specialised Gender Identity Clinic in Hamburg. Data were extracted from medical charts, transcribed and analysed using qualitative content analysis methods. Categories were set up by inductive-deductive reasoning based on the patients' parents' and clinicians' information in the files. Between 2006 and 2010, 45 gender variant children and adolescents were seen by clinicians; 88.9% (n = 40) of these were diagnosed with gender identity disorder (ICD-10). Within this group, the referral rates for girls were higher than for boys (1:1.5). Gender dysphoric girls were on average older than the boys and a higher percentage of girls was referred to the clinic at the beginning of adolescence (> 12 years of age). At the same time, more girls reported an early onset age. More girls made statements about their (same-sex) sexual orientation during adolescence and wishes for gender confirming medical interventions. More girls than boys revealed self-mutilation in the past or present as well as suicidal thoughts and/or attempts. Results indicate that the presentation of clinically referred gender dysphoric girls differs from the characteristics boys present in Germany; especially with respect to the most salient age differences. Therefore, these two groups require different awareness and individual treatment approaches.

  17. Social Responsiveness Scale-aided analysis of the clinical impact of copy number variations in autism.

    PubMed

    van Daalen, Emma; Kemner, Chantal; Verbeek, Nienke E; van der Zwaag, Bert; Dijkhuizen, Trijnie; Rump, Patrick; Houben, Renske; van 't Slot, Ruben; de Jonge, Maretha V; Staal, Wouter G; Beemer, Frits A; Vorstman, Jacob A S; Burbach, J Peter H; van Amstel, Hans Kristian Ploos; Hochstenbach, Ron; Brilstra, Eva H; Poot, Martin

    2011-11-01

    Recent array-based studies have detected a wealth of copy number variations (CNVs) in patients with autism spectrum disorders (ASD). Since CNVs also occur in healthy individuals, their contributions to the patient's phenotype remain largely unclear. In a cohort of children with symptoms of ASD, diagnosis of the index patient using ADOS-G and ADI-R was performed, and the Social Responsiveness Scale (SRS) was administered to the index patients, both parents, and all available siblings. CNVs were identified using SNP arrays and confirmed by FISH or array CGH. To evaluate the clinical significance of CNVs, we analyzed three families with multiple affected children (multiplex) and six families with a single affected child (simplex) in which at least one child carried a CNV with a brain-transcribed gene. CNVs containing genes that participate in pathways previously implicated in ASD, such as the phosphoinositol signaling pathway (PIK3CA, GIRDIN), contactin-based networks of cell communication (CNTN6), and microcephalin (MCPH1) were found not to co-segregate with ASD phenotypes. In one family, a loss of CNTN5 co-segregated with disease. This indicates that most CNVs may by themselves not be sufficient to cause ASD, but still may contribute to the phenotype by additive or epistatic interactions with inherited (transmitted) mutations or non-genetic factors. Our study extends the scope of genome-wide CNV profiling beyond de novo CNVs in sporadic patients and may aid in uncovering missing heritability in genome-wide screening studies of complex psychiatric disorders. PMID:21837366

  18. Effectiveness of Shared Medical Appointments Versus Traditional Clinic Visits for Adolescents With Type 1 Diabetes.

    PubMed

    Everest, Erica; Akhtar, Sara; Sumego, Marianne; Zeizoun, Alaa; Worley, Sarah; Tang, Anne S; Dorsey, Allison; Smith, Ann; Schweiger, Bahareh

    2016-01-01

    Shared medical appointments began in the United States in 1996 to advance quality of care and enhance patients' ability to self-manage. Group visits gather patients with the same diagnosis for individual examinations followed by group education sessions taught by the provider. This leads to the opportunity to learn from the experiences of others. The Cleveland Clinic Department of Pediatric Endocrinology offers a shared medical appointment group for pediatric patients with type 1 diabetes called the ESCALAIT clinic (Enrichment Services and Care for Adolescents Living with Autoimmune Insulin Dependent Type 1 Diabetes). The objective of this study was to compare the effectiveness of traditional clinic visits with shared medical appointments for adolescents with type 1 diabetes in terms of hemoglobin A1c (HbA1c) improvement. Eighty ESCALAIT patients, aged 11 to 19 years were compared with 516 clinic controls of the same age. Visits were approximately 3 months apart for both patient groups. Changes in HbA1c between groups were calculated from the first to fourth visits. There was a statistically significant difference between the ESCALAIT clinic patients and the control patients. Our results revealed that the group visit patients had less improvement in HbA1c values at the last visit approximately 1 year later, but we would argue that the difference is not clinically significant. However, there were many benefits to shared medical appointment visits including increased access to care as well as peer support. Shared medical appointments are therefore a valid alternative to traditional clinic visits in this patient population. PMID:27367219

  19. Effectiveness of Shared Medical Appointments Versus Traditional Clinic Visits for Adolescents With Type 1 Diabetes.

    PubMed

    Everest, Erica; Akhtar, Sara; Sumego, Marianne; Zeizoun, Alaa; Worley, Sarah; Tang, Anne S; Dorsey, Allison; Smith, Ann; Schweiger, Bahareh

    2016-01-01

    Shared medical appointments began in the United States in 1996 to advance quality of care and enhance patients' ability to self-manage. Group visits gather patients with the same diagnosis for individual examinations followed by group education sessions taught by the provider. This leads to the opportunity to learn from the experiences of others. The Cleveland Clinic Department of Pediatric Endocrinology offers a shared medical appointment group for pediatric patients with type 1 diabetes called the ESCALAIT clinic (Enrichment Services and Care for Adolescents Living with Autoimmune Insulin Dependent Type 1 Diabetes). The objective of this study was to compare the effectiveness of traditional clinic visits with shared medical appointments for adolescents with type 1 diabetes in terms of hemoglobin A1c (HbA1c) improvement. Eighty ESCALAIT patients, aged 11 to 19 years were compared with 516 clinic controls of the same age. Visits were approximately 3 months apart for both patient groups. Changes in HbA1c between groups were calculated from the first to fourth visits. There was a statistically significant difference between the ESCALAIT clinic patients and the control patients. Our results revealed that the group visit patients had less improvement in HbA1c values at the last visit approximately 1 year later, but we would argue that the difference is not clinically significant. However, there were many benefits to shared medical appointment visits including increased access to care as well as peer support. Shared medical appointments are therefore a valid alternative to traditional clinic visits in this patient population.

  20. AIDS and family planning counseling of psychiatrically ill women in community mental health clinics.

    PubMed

    Coverdale, J H; Aruffo, J F

    1992-02-01

    Eighty-two of 83 mental health professionals, including psychiatrists, were surveyed to determine their attitudes and behaviors toward AIDS prevention and family planning counseling with psychiatrically ill female outpatients. Nearly all reported that information should be provided on AIDS and family planning. However, they reported that they had raised topics of AIDS with only 19% of patients and family planning with only 25% of patients. This lack of communication was confirmed by patients' own reports. Factors which might relate to this lack of communication are explored.

  1. HIV/AIDS and lipodystrophy: Implications for clinical management in resource-limited settings

    PubMed Central

    Finkelstein, Julia L; Gala, Pooja; Rochford, Rosemary; Glesby, Marshall J; Mehta, Saurabh

    2015-01-01

    Introduction Lipodystrophy is a term used to describe a metabolic complication of fat loss, fat gain, or a combination of fat loss and gain, which is associated with some antiretroviral (ARV) therapies given to HIV-infected individuals. There is limited research on lipodystrophy in low- and middle-income countries, despite accounting for more than 95% of the burden of HIV/AIDS. The objective of this review was to evaluate the prevalence, pathogenesis and prognosis of HIV-related lipoatrophy, lipohypertrophy and mixed syndrome, to inform clinical management in resource-limited settings. Methods We conducted a structured literature search using MEDLINE electronic databases. Relevant MeSH terms were used to identify published human studies on HIV and lipoatrophy, lipohypertrophy, or mixed syndrome in low-, low-middle- and upper-middle-income countries through 31 March 2014. The search resulted in 5296 articles; after 1599 studies were excluded (958 reviews, 641 non-human), 3697 studies were extracted for further review. After excluding studies conducted in high-income settings (n=2808), and studies that did not meet inclusion criteria (n=799), 90 studies were included in this review. Results and Discussion Of the 90 studies included in this review, only six were from low-income countries and eight were from lower middle-income economies. These studies focused on lipodystrophy prevalence, risk factors and side effects of antiretroviral therapy (ART). In most studies, lipodystrophy developed after the first six months of therapy, particularly with the use of stavudine. Lipodystrophy is associated with increased risk of cardiometabolic complications. This is disconcerting and anticipated to increase, given the rapid scale-up of ART worldwide, the increasing number and lifespan of HIV-infected patients on long-term therapy, and the emergence of obesity and non-communicable diseases in settings with extensive HIV burden. Conclusions Lipodystrophy is common in resource

  2. The metacognitions questionnaire for children: development and validation in a clinical sample of children and adolescents with anxiety disorders.

    PubMed

    Bacow, Terri Landon; Pincus, Donna B; Ehrenreich, Jill T; Brody, Leslie R

    2009-08-01

    A self-report measure of metacognition for both children and adolescents (ages 7-17) (Metacognitions Questionnaire for Children; MCQ-C) was adapted from a previous measure, the MCQ-A (Metacognitions Questionnaire for Adolescents) and was administered to a sample of 78 children and adolescents with clinical anxiety disorders and 20 non-clinical youth. The metacognitive processes included were (1) positive beliefs about worry (positive meta-worry); (2) negative beliefs about worry (negative meta-worry); (3) superstitious, punishment and responsibility beliefs (SPR beliefs) and (4) cognitive monitoring (awareness of one's own thoughts). The MCQ-C demonstrated good internal-consistency reliability, as well as concurrent and criterion validity, and four valid factors. In line with predictions, negative meta-worry was significantly associated with self-reports of internalizing symptoms (excessive worry and depression). Age-based differences on the MCQ-C were found for only one subscale, with adolescents reporting greater awareness of their thoughts than children. Adolescent girls scored higher on the total index of metacognitive processes than adolescent boys. Overall, these results provide preliminary support for the use of the MCQ-C with a broader age range as well as an association between metacognitive processes and anxiety symptomatology in both children and adolescents, with implications for cognitive behavioral interventions with anxious youth.

  3. One Size Does Not Fit All: Improving Clinical Practice in Older Children and Adolescents with Language and Learning Disorders

    ERIC Educational Resources Information Center

    Scott, Cheryl M.

    2014-01-01

    Purpose: In the lead article for this clinical forum, Kamhi (2014) suggests ways that current knowledge on instructional practices in learning and language can be applied to clinical practice in language disorders. I propose that Kamhi's suggestions are in need of fine-tuning for older children and adolescents with language disorders. A…

  4. Syphilis and HIV co-infection in patients who attend an AIDS outpatient clinic in Vitoria, Brazil

    PubMed Central

    Callegari, Fabiola Mesquita; Pinto-Neto, Lauro Ferreira da Silva; Medeiros, Charlla Jezus; Scopel, Camila Binsi; Page, Kimberly; Miranda

    2013-01-01

    Our goal was to determine the prevalence of, and risk factors associated with, syphilis in HIV-infected patients who attend an AIDS outpatient clinic in Vitoria, Brazil. We conducted a cross-sectional study—including interviews for demographic, behavioral, and clinical characteristics—and blood collection (venipuncture and fingerstick) for VDRL and treponemal tests (rapid test) in a total of 438 patients. The mean age was 43.0 years (SD = 11), and mean years of school was 8.1 (SD = 4.2). The prevalence of syphilis was 5.3% (95% CI, 3.3%–7.3%). The treponemal test was positive in 18.9% of participants. In multivariate analysis, prevalent syphilis infection was independently associated with male gender (AOR 4.6, 95% CI, 1.1–20.0), a history of male-male sex (AOR 1.8, 95% CI, 1.6–4.1), current use of antiretroviral therapy (AOR 5.5, 95% CI, 1.7–16.7), and history of treated syphilis infection (AOR 5.5, 95% CI, 2.0–15.8). Syphilis prevalence was high in patients living with HIV/AIDS who attend an AIDS clinic; therefore, routine STI counseling and screening should be included in their care. PMID:23732958

  5. Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide.

    PubMed

    Dougherty, Donald M; Mathias, Charles W; Marsh-Richard, Dawn M; Prevette, Kristen N; Dawes, Michael A; Hatzis, Erin S; Palmes, Guy; Nouvion, Sylvain O

    2009-08-30

    This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI+SA; n=25) or without (NSSI-Only; n=31) suicide attempts. We hypothesized that adolescent with NSSI+SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, self-reported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4-6 weeks after discharge. During hospitalization, NSSI+SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI+SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI+SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well.

  6. Clinical and biochemical determinants of bone metabolism and bone mass in adolescent female patients with anorexia nervosa.

    PubMed

    Audí, Laura; Vargas, Deisi M; Gussinyé, Miquel; Yeste, Diego; Martí, Gertrudis; Carrascosa, Antonio

    2002-04-01

    Among pathologies prevalent in western societies, anorexia nervosa has increased over the last decade. Its effects on bone mass need to be defined, and prognostic factors, either clinical or biochemical, could aid clinicians in individual patient management. To determine which clinical and/or biochemical parameters could be related to bone mass status in adolescent female anorexia nervosa patients, 73 female patients were classified according to different stages of their illness and studied in terms of clinical and biochemical parameters and bone densitometric mineral content at lumbar spine. Patients (age 17.2 +/- 1.7 y, mean +/- SD) with Tanner pubertal stage 5, regular menstruation for more than 3 mo before the onset of secondary amenorrhea, and diagnosed with anorexia nervosa were consecutively studied and classified in three clinical situations: I) active phase (34 patients): undernourished and amenorrheic; II) weight recovered but still amenorrheic (20 patients); III) fully recovered (19 patients). Clinical data were recorded at the time of bone density measurement, concomitant with blood sample extraction for study of IGF-I, IGF-binding protein 3 (IGFBP-3), IGFBP-1, estradiol, sex hormone-binding globulin, dehydroepiandrosterone sulfate, prealbumin, amino-terminal propeptide of procollagen III, osteocalcin, bone alkaline phosphatase, carboxy-terminal propeptide of procollagen I, amino-terminal propeptide of procollagen I, carboxy-terminal telopeptide of collagen I, 25-OH-vitamin D, 1,25(OH)(2)-vitamin D, and parathormone. In addition, a 24-h urine collection was made for cortisol, GH, deoxypyridinoline, amino-terminal telopeptide of collagen I, and calcium and creatinine content analysis. IGF-I, estradiol, and biochemical bone formation markers were higher and IGFBP-1, sex hormone-binding globulin, and biochemical bone resorption markers were lower in the weight-recovered stages (stages II and III) compared with the active phase (stage I). Bone formation

  7. Clinical Correlates of Non-Suicidal Self-Injury (NSSI) in an Outpatient Sample of Adolescents.

    PubMed

    García-Nieto, Rebeca; Carballo, Juan J; Díaz de Neira Hernando, Mónica; de León-Martinez, Victoria; Baca-García, Enrique

    2015-01-01

    Non-suicidal self-injury (NSSI) in adolescents is a major public health concern. The first goal of our study was to describe the characteristics and functions of NSSI and NSSI thoughts in an adolescent outpatient sample. The second goal was to examine which clinical factors discriminate between these two groups of patients. A group of 267 subjects was recruited from the Adolescent Outpatient Psychiatric Services, Jiménez Díaz Foundation (Madrid, Spain) from November 2011 to October 2012. All participants were administered the Spanish version of the Self-Injurious Thoughts and Behaviors Interview (SITBI). A total of 21.7% of patients reported having engaged in NSSI at least once in their lifetime. The most strongly endorsed function for NSSI was automatic negative reinforcement. In comparison with patients in the NSSI Thoughts group and the control group, patients in the NSSI group scored higher in Internalization of Anger and in all the scales comprising the Children's Depression Inventory. Our findings on the prevalence and functions of NSSI are consistent with the literature. NSSI was mainly performed for emotion regulation purposes; specifically, NSSI seems to be used to cope with anger and depression. In addition, internalization of anger might play a significant role in the maintenance of this behavior.

  8. [A case of adolescent adrenoleukodystrophy with clinical improvement after allogeneic bone marrow transplantation (allo-BMT)].

    PubMed

    Tsujii, Tomomi; Kinoshita, Masako; Tomimoto, Hidekazu; Hitomi, Takefumi; Okazaki, Toshirou; Uchiyama, Taku; Shibasaki, Hiroshi

    2004-10-01

    We reported a case of adolescent type adrenoleukodystrophy. A 20-year old man noticed slight hemiparesis on his right side. After admission, high level of serum VCLFA and ACTH and a point mutation in ALDP codon 606 were recognized along with white matter lesions in the left medulla, basal ganglia, splenium of the corpus callosum on brain MRI. Then we diagnosed the patient as having adolescent type adrenoleukodystrophy. We started Lorenzo's oil and seaching for BMT donor. Six months later, he received allo-BMT at our hospital. His clinical symptoms gradually deteriorated during waiting allo-BMT, and just before allo-BMT, right hemiparesis, gait disturbance, exaggerated deep tendon reflexes on his right side, right lower quadrantanopia and mild cognitive deterioration. Two months after allo-BMT, gait disturbance and right hemiparesis were alleviated. We also observed improvement of abnormal findings on brain MRI and magnetic stimulation. We believed that allo-BMT is effective for the treatment of adolescent type adrenoleukodystrophy.

  9. To Study the Clinical, Biochemical and Radiological Features of Acute Pancreatitis in HIV and AIDS

    PubMed Central

    Raza, Shahzad; Chaudhry, Naueen A.; Brown, Jordan D.; Aghaie, Sina; Rezai, Damoun; Khan, Areej; Tan, Paul De Leon; Berger, Barbara J.

    2013-01-01

    Background Pancreatitis complicating HIV infection, even in the Highly Active Antiretroviral Therapy (HAART) era, remains a management challenge. We felt there is a need to discern patterns in the biochemical markers, radiological studies, co-infections, length of stay (LOS) in patients with HIV or AIDS AND pancreatitis. Methods This is a retrospective study conducted from June, 2008 to August, 2010 on patients admitted with acute pancreatitis to our hospital. We extracted and compared the following parameters: biochemical markers, HBV markers (surface antigen, core antibody and surface antibody), HCV antibody, radiological studies, and length of stay (LOS). The Balthazar Grade score was used to assess radiological severity of disease. We stratified the cohort into comparison subsets according to CD4 count. Results Ninety-four admissions met the criteria for HIV or AIDS AND pancreatitis; 67 unique patients comprised the cohort. Median age was 48 years (range, 23 to 60 years). Thirty seven (55%) were male, 30 (45%), female. Two third (n = 51) (76%) were African American. Known risk factors included a history of pancreatitis, 17 (25%); cholecystitis, 13 (19%); alcohol abuse, 25 (37%); Intravenous drug abuse, 18 (27%). Only 36 (38%) admissions were on HAART regimen. Biochemical features on admission were: WBC, 6,100/mm3 (900 - 25,700); amylase, 152 U/L (30 - 1,344); lipase, 702.5 U/L (30 - 5,766), triglyceride, 65 mg/dL (57 - 400); glucose, 94 mg/dL (60 - 1,670); lactate, 2.3 mmol/L (1.09 - 5.49); AST, 61.5 U/L (9 - 1,950); LDH, 762 U/L (394 - 5,500); bicarbonate 19.5 mEq/L (3.3 - 82.7). Interestingly, 62% patients had normal pancreas on CT scan on admission. Of 67 individuals, hepatitis profile was available in 43, 21 (49%) were positive for HCV, 11 (26%) had markers for HBV. Four of 11 patients (36) with CD4 < 50 had evidence of persistent HBV (+core, -surface ab). Patients with CD4 < 200 have a median time for hospital course of 8 days (range 4 - 61 days) compare

  10. [Decline of speech understanding in the hearing impaired elderly listeners who visited our hearing aid clinic].

    PubMed

    Yasue, Minori; Sugiura, Saiko; Uchida, Yasue; Nakashima, Tsutomu

    2014-08-01

    The aim of this study was to investigate distinctive change in the hearing impaired elderly listeners, especially about speech recognition. Subjects were 525 patients (235 males, 290 females), from 60 to 98 years of age who had visited the Hearing Aid Clinic of Otorhinolaryngology, National Center for Geriatrics and Gerontology Hospital, between June 2001 and December 2012. Pure-tone air conduction threshold determination was administered to each subject. The speech audiometry materials used to define speech discrimination ability were Japanese monosyllabic word lists, 67S word lists. Sex- and age-specific trends in maximum discrimination score (MDS) and rollover index (RI) were shown in this study. RI was computed by the formula (PBmax-PBmin)/PBmax. PBmax has almost the same meaning as MDS in Japan. PBmin represented the lowest PB score above the test intensity level of PBmax. Mean MDSs were 80.8% in their sixties, 75.3% in their seventies, 60.7% in their eighties, and 45.5% in their nineties. The rate of decrease in mean MDS per decade accelerated in the older generation. Mean RIs were 0.18 in patients in their sixties, 0.24 in their seventies, 0.30 in their eighties, and 0.30 in their nineties. It increased until the age of eighties. In the model 1, multiple logistic analyses were performed to examine the effect of age (in 10-year increments), sex and mean hearing levels in pure tone average of values at 500, 1000, 2000, 4000 Hz (in 10 dB increments) on the MDS < 60%. Significant associations were observed between MDS < 60% and age (odds ratio, 3.03; 95% confidence interval, 2.38 to 3.85), and mean hearing levels in pure tone average of values at 500, 1000, 2000, 4000 Hz (2.33; 2.03 to 2.68). Sex was not associated with MDS < 60%. In the model 2, multiple logistic analyses adjusted for age and sex were performed to examine the effect of hearing level at test frequencies of 125, 250, 500, 1000, 2000, 4000, and 8000 Hz (in 10 dB increments)on the MDS < 60

  11. Relationships of the WISC-R and K-BIT for an adolescent clinical sample.

    PubMed

    Slate, J R; Graham, L S; Bower, J

    1996-01-01

    Correlations between the Wechsler Intelligence Scale for Children-Revised IQs and the Kaufman Brief Intelligence Test were determined for a clinical sample of 44 adolescents (35 with learning disabilities, 9 with mental retardation) who underwent routine three-year reevaluations. Even though three years had elapsed between the WISC-R and K-BIT scores, the correlations among the total and subscale scores of these measures were high and were all statistically significant. A significant mean difference was found between the WISC-R Verbal IQ and its K-Bit counterpart, the Vocabulary subscales. Implications of findings for assessment specialists are discussed. PMID:8970652

  12. Direct and indirect effects of caregiver social support on adolescent psychological outcomes in two South African AIDS-affected communities

    PubMed Central

    Casale, Marisa; Cluver, Lucie; Crankshaw, Tamaryn; Kuo, Caroline; Lachman, Jamie M.; Wild, Lauren G.

    2015-01-01

    Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV-endemic, resource-scarce Southern African communities. A cross-sectional household survey was conducted over 2009-2010 with 2477 South African adolescents aged 10-17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu-Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (p<.001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network. PMID:25623784

  13. Model for using hip-hop music for small group HIV/AIDS prevention counseling with African American adolescents and young adults.

    PubMed

    Stephens, T; Braithwaite, R L; Taylor, S E

    1998-10-01

    Currently little attention has been directed, with the exception of peer education efforts, to constructively develop new and innovative ways to promote HIV/AIDS primary prevention among African American (AA) adolescents and young adults. With this in mind, the aim of this conceptual effort is to present a HIV/AIDS preventive counseling protocol developed for use with AA young adults that makes use of hip-hop music, a form of music popularized by young AAs. The author contend that an increased understanding of the relationships that many AA young adults have with hip-hop music may be used by disease prevention personnel to educate these populations about protective factors for HIV. Making use of hip-hop music is one strategy for integrating counseling in prevention and health maintenance. The overall implications of using hip-hop music in health promotion are unlimited. First, this method makes use of cultural relevant materials to address the educational and health needs of the target community. Second, it is grounded in an approach that serves to stimulate cooperative learning based on peer developed content. Moreover, the use of this medium can be applied to other health promotion activities such as violence/harm reduction and substance abuse prevention, upon reviews of songs for appropriate content. The authors contend that such an approach holds heuristic value in dealing with HIV/AIDS prevention among AA young adults. Additional testing of the intervention is warranted in the refinement of this innovative intervention.

  14. Understanding and Addressing AIDS-Related Stigma: From Anthropological Theory to Clinical Practice in Haiti

    PubMed Central

    Castro, Arachu; Farmer, Paul

    2005-01-01

    For the past several years, diverse and often confused concepts of stigma have been invoked in discussions on AIDS. Many have argued compellingly that AIDS-related stigma acts as a barrier to voluntary counseling and testing. Less compelling are observations regarding the source of stigma or its role in decreasing interest in HIV care. We reviewed these claims as well as literature from anthropology, sociology, and public health. Preliminary data from research in rural Haiti suggest that the introduction of quality HIV care can lead to a rapid reduction in stigma, with resulting increased uptake of testing. Rather than stigma, logistic and economic barriers determine who will access such services. Implications for scale-up of integrated AIDS prevention and care are explored. PMID:15623859

  15. Understanding and addressing AIDS-related stigma: from anthropological theory to clinical practice in Haiti.

    PubMed

    Castro, Arachu; Farmer, Paul

    2005-01-01

    For the past several years, diverse and often confused concepts of stigma have been invoked in discussions on AIDS. Many have argued compellingly that AIDS-related stigma acts as a barrier to voluntary counseling and testing. Less compelling are observations regarding the source of stigma or its role in decreasing interest in HIV care. We reviewed these claims as well as literature from anthropology, sociology, and public health. Preliminary data from research in rural Haiti suggest that the introduction of quality HIV care can lead to a rapid reduction in stigma, with resulting increased uptake of testing. Rather than stigma, logistic and economic barriers determine who will access such services. Implications for scale-up of integrated AIDS prevention and care are explored.

  16. Psychometric properties of the Dutch version of the Meta-Cognitions Questionnaire-Adolescent Version (MCQ-A) in non-clinical adolescents and adolescents with obsessive-compulsive disorder.

    PubMed

    Wolters, Lidewij H; Hogendoorn, Sanne M; Oudega, Michiel; Vervoort, Leentje; de Haan, Else; Prins, Pier J M; Boer, Frits

    2012-03-01

    Although the meta-cognitive model (Wells, 1997, 2000) for obsessive-compulsive disorder (OCD) has clearly influenced research and treatment of OCD, little research has been performed in youth samples. In the present study the psychometric properties of the Dutch Meta-Cognitions Questionnaire-Adolescent Version (MCQ-A; Cartwright-Hatton et al., 2004) were examined in a clinical sample of adolescents with OCD (N = 40, 12-18 years) and a non-clinical sample (N = 317; 12-18 years). Results provided support for the 5-factor structure, and showed fair to good internal consistency and generally good retest reliability. Overall, adolescents with OCD reported more meta-cognitive beliefs than non-clinical adolescents. Several subscales were associated with self-reported obsessive-compulsive symptoms, anxiety and depression, but not with clinician-rated OCD severity. In conclusion, results suggest that the Dutch MCQ-A is a reliable and valid questionnaire to examine meta-cognitive beliefs in adolescents.

  17. Comorbid psychopathology and clinical symptomatology in children and adolescents with obsessive-compulsive disorder.

    PubMed

    Anagnostopoulos, D C; Korlou, S; Sakellariou, K; Kondyli, V; Sarafidou, J; Tsakanikos, E; Giannakopoulos, G; Liakopoulou, M

    2016-01-01

    Revised Children's Manifest Anxiety Scale (RCMAS). In the OCD group, 48% had contamination obsessions, 42% aggressive obsessions and 52% had washing and cleaning compulsions. Moreover, 32% had one additional disorder and 16.1% had two additional disorders. In comparison, only 17.2% of the control group children had one comorbid disorder. The OCD proband group had higher Total Problems score, as well as higher Anxiety/Depression, Thought Problems and Externalizing scores on the CBCL. When proband parents and control parents (29 mothers and 21 fathers) were compared, the percentage of fathers in the clinical range was significantly higher in the study group (Fisher's exact test: p=0.011, two tailed), whereas for mothers the difference did not attain significance (Fisher's exact test: p=0.106, two tailed). The fathers and mothers of children with OCD were more clinically affected than those of controls. Mothers of probands differed from controls in compulsions, compared to fathers, who differed in both obsessions and compulsions. Comorbidity rate was higher to children and adolescents with OCD. A considerable number of children and adolescents with OCD had higher symptomatology of anxiety and depression than controls, as well as higher rates of thought problems. Children and adolescents with OCD also exhibited higher rates of externalizing problems. This latter finding is considered as important and needs to be highlighted in terms of case management and treatment. Moreover, the parents of children and adolescents with OCD had more OCD symptomatology than the parents of children and adolescents with learning disorders. The symptomatology of the parents may create difficulties in interactions within the family and become burdensome for a vulnerable child. In turn, the child's symptomatology may create or increase some of the symptoms in the parents i.e. anxiety and depression. These findings suggest that at least for a percentage of children and adolescents with OCD, parental

  18. Gender dysphoria in adolescence.

    PubMed

    Leibowitz, Scott; de Vries, Annelou L C

    2016-01-01

    Adolescents presenting with gender-related concerns are increasingly seeking support from providers from a variety of disciplines within health care settings across the world. For those treating young people who meet the criteria for the DSM 5 diagnosis of gender dysphoria (GD), complex decisions in clinical care are common. Defining best practice with this population with respect to interventions that span mental health, physical, and surgical domains can be challenging, given a relative dearth of empirical data available; yet practice guidelines have emerged from different professional organizations which can aid with this. For this review paper, a broad literature search was performed to identify relevant studies pertaining to the care of adolescents with GD. In addition, an overview of trends in clinical practice, including shifts in conceptualization of how clinicians and patients define care that is considered affirming when working with this population, is described. This paper explores the characteristics of referral patterns to specialized clinics, provides a brief overview of gender identity development in adolescence, and then describes the phenomenology of known aetiological factors and co-occurring psychiatric issues in adolescents with GD. Additionally, clinical management considerations that detail assessment aims and common treatment interventions across disciplines will be explored. PMID:26828376

  19. Classifying risk status of non-clinical adolescents using psychometric indicators for psychosis spectrum disorders.

    PubMed

    Fonseca-Pedrero, Eduardo; Gooding, Diane C; Ortuño-Sierra, Javier; Pflum, Madeline; Paino, Mercedes; Muñiz, José

    2016-09-30

    This study is an attempt to evaluate extant psychometric indicators using latent profile analysis for classifying community-derived individuals based on a set of clinical, behavioural, and personality traits considered risk markers for psychosis spectrum disorders. The present investigation included four hundred and forty-nine high-school students between the ages of 12 and 19. We used the following to assess risk: the Prodromal Questionnaire-Brief (PQ-B), Oviedo Schizotypy Assessment Questionnaire (ESQUIZO-Q), Anticipatory and Consummatory Interpersonal Pleasure Scale-Adolescent version (ACIPS-A), and General Health Questionnaire 12 (GHQ-12). Using Latent profile analysis six latent classes (LC) were identified: participants in class 1 (LC1) displayed little or no symptoms and accounted for 38.53% of the sample; class 2 (LC2), who accounted for 28.06%, also produced low mean scores across most measures though they expressed somewhat higher levels of subjective distress; LC3, a positive schizotypy group (10.24%); LC4 (13.36%), a psychosis high-risk group; LC5, a high positive and negative schizotypy group (4.45%); and LC6, a very high distress, severe clinical high-risk group, comprised 5.34% of the sample. The current research indicates that different latent classes of early individuals at risk can be empirically defined in adolescent community samples using psychometric indicators for psychosis spectrum disorders. These findings may have implications for early detection and prevention strategies in psychosis spectrum disorders. PMID:27423122

  20. Clinical validity of a dimensional assessment of self- and interpersonal functioning in adolescent inpatients

    PubMed Central

    Haggerty, Greg; Blanchard, Mark; Baity, Matthew R.; Defife, Jared A; Stein, Michelle B.; Siefert, Caleb J.; Sinclair, Samuel J.; Zodan, Jennifer

    2014-01-01

    The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a clinical rating system assessing eight domains of self and interpersonal relational experience which can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943]; early memories narratives) or oral data (e.g., psychotherapy narratives, Relationship Anecdotal Paradigms). In the current study, seventy-two psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS-G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating disordered behavior and history of nonsuicidal self-injury. SCORS-G composite ratings achieved an acceptable level of inter-rater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy; history of nonsuicidal self-injury). SCORS-G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS-G with adolescents. PMID:25010080

  1. Impact of a youth-friendly HIV clinic: 10 years of adolescent outcomes in Port-au-Prince, Haiti

    PubMed Central

    Reif, Lindsey K; Bertrand, Rachel; Benedict, Charles; Lamb, Matthew R; Rouzier, Vanessa; Verdier, Rose; Johnson, Warren D; Pape, Jean W; Fitzgerald, Daniel W; Kuhn, Louise; McNairy, Margaret L

    2016-01-01

    Introduction Adolescents account for over 40% of new HIV infections in Haiti. This analysis compares outcomes among HIV-positive adolescents before and after implementation of an adolescent HIV clinic in Port-au-Prince, Haiti. Methods We conducted a cohort study using programmatic data among HIV-positive adolescents aged 13 to 19. Data from 41,218 adolescents who were HIV tested from January 2003 to December 2012 were included. Outcomes across the HIV care cascade were assessed before and after implementation of an adolescent clinic (2009), including HIV testing, enrolment in care, assessment for antiretroviral therapy (ART) eligibility, ART initiation and 12-month retention. Pre-ART outcomes were assessed 12 months after HIV testing. Factors associated with pre-ART and ART attrition were identified through multivariable competing risk and Cox proportional hazards regression modelling. Results Cumulatively, 1672 (4.1%) adolescents tested HIV positive (80% female, median age 16 years). Retention by cascade step comparing pre- and post-clinic included the following: 86% versus 87% of patients enrolled in care, 61% versus 79% were assessed for ART eligibility, 85% versus 92% initiated ART and 68% versus 66% were retained 12 months after ART initiation. Pre-ART attrition decreased from 61% pre-clinic to 50% post-clinic (p<0.001). Pre-ART attrition was associated with being female (sub-distributional hazard ratio (sHR): 1.59; CI: 1.31–1.93), syphilis diagnosis (sHR: 1.47; CI: 1.16–1.85) and slum residence (sHR: 0.84; CI: 0.72–0.97). ART attrition was associated with syphilis diagnosis (hazard ratio (HR): 2.23; CI: 1.35–3.68) and CD4 <50 cells/µL (HR: 1.88; CI: 1.15–3.06). Conclusions Implementation of a youth-friendly adolescent clinic improved retention in HIV care among adolescents, particularly in the assessment of ART eligibility and ART initiation. Additional interventions are needed to improve retention among pre-ART patients and support long

  2. Informed consent and clinical research involving children and adolescents: implications of the revised APA ethics code and HIPAA.

    PubMed

    Fisher, Celia B

    2004-12-01

    In 2003, 2 new sets of rules and regulations affecting the conduct of clinical research involving children and adolescents went into effect: the revised American Psychological Association's (APA) Ethical Principles of Psychologists and Code of Conduct (APA, 2002; effective June 1, 2003) and the Privacy Rule (45 CFR Part 160 and A and E of Part 164; effective April; 14, 2003) of the Health Insurance Portability and Accountability Act (HIPAA: Public Law 104-191). This article highlights those APA ethical standards and HIPAA regulations relevant to clinical research involving children and adolescents and discusses how psychologists can apply these rules in ways that will ensure ethical and legal compliance.

  3. Lack of attentional bias for emotional information in clinically depressed children and adolescents on the dot probe task.

    PubMed

    Neshat-Doost, H T; Moradi, A R; Taghavi, M R; Yule, W; Dalgleish, T

    2000-03-01

    The present study utilised a cognitive paradigm to investigate attentional biases in clinically depressed children and adolescents. Two groups of children and adolescents--clinically depressed (N = 19) and normal controls (N = 26)--were asked to complete a computerised version of the attentional dot probe paradigm similar to that used by MacLeod, Mathews, and Tata (1986). Results provided no support for an attentional bias, either toward depression-related words or threat words, in the depressed group. This finding is discussed in the context of cognitive theories of anxiety and depression.

  4. [Factors influencing the course and duration of inpatient child and adolescent psychiatric treatment: between empiricism and clinical reality].

    PubMed

    Branik, Emil

    2003-09-01

    In the last two decades considerable changes influenced the scope of inpatient treatment in child and adolescent psychiatry. Proceeding from a literature review dilemmas between available research data and clinical practice will be pointed out. Proposals will be made to take into account the complex developmental processes, the individuality and the social context by psychic impaired children and adolescents requiring hospitalisation. This could improve the transfer of research findings into the clinical practice. It will be argued against a confusion of economical interests with research findings.

  5. Autonomous thyroid nodules in adolescents: clinical characteristics and results of TRH testing

    SciTech Connect

    Osburne, R.C.; Goren, E.N.; Bybee, D.E.; Johnsonbaugh, R.E.

    1982-03-01

    Seven adolescents with autonomous thyroid nodules were evaluated over a three-year period. They had hyperfunctioning nodules on radionuclide scan which failed to suppress with exogenous administration of thyroid hormone. They were clinically euthyroid and had normal T4, free T4, and basal TSH values. However, as a group they had elevated total serum T3 concentrations, blunted TSH response to TRH, and accelerated closure of cranial sutures, all of which suggested subtle hyperthyroidism. These patients have been followed for one to five years. Four have undergone partial thyroidectomy because of persistent elevation in the serum T3 concentration or enlargement of the nodule. The clinical presentation and laboratory findings in this group are similar to those found in adults with autonomous nodules.

  6. Integration of a token economy into a child and adolescent psychiatry training clinic.

    PubMed

    Dulcan, M K; Mannarino, A P; Borcherding, B G

    1991-12-01

    We developed a token economy pilot program in which reinforcers were provided by a university outpatient child and adolescent psychiatry clinic to address two problems common to psychiatry training programs: 1) psychiatric residents have insufficient opportunity to learn to use behavior modification techniques with outpatients, and 2) many patients and their parents seen in training clinics are poorly motivated and noncompliant with treatment, which leads to psychiatry resident discouragement and frustration. The rationale for the program is presented from the perspective of both the resident and the patient. The implementation of the program with 25 cases is described, including potential and actual difficulties. One case treated by a psychiatry resident is presented in more detail.

  7. An Assessment of the Level of Influence of Family Life and HIV/AIDS Education on Knowledge, Attitude and Decision Making among Adolescents with Hearing Impairment in Some States in Nigeria

    ERIC Educational Resources Information Center

    Adeniyi, S. O.; Oyewumi, A. M.; Fakolade, O. A.

    2011-01-01

    This study investigated knowledge, attitude and decision making on HIV/AIDS among adolescents with hearing impairment in Oyo, Lagos and Kwara States. Seventy-six respondents participated in the study with age range between 16 and 20. The research adopted a descriptive survey research design. Seventy-six students with hearing impairment…

  8. Health Services: Clinical. Respiratory Therapy Aide. Instructor's Manual. Competency-Based Education.

    ERIC Educational Resources Information Center

    Cave, Julie; And Others

    This instructor's manual consists of materials for use in presenting a course in the occupational area of respiratory therapy aide. Included in the first part of the guide are a program master sequence; a master listing of instructional materials, equipment, and supplies; an overview of the competency-based vocational education (CBVE) system; and…

  9. Health Services: Clinical. Dietary Aide. Instructor's Manual. Competency-Based Education.

    ERIC Educational Resources Information Center

    Cave, Julie; And Others

    This instructor's manual consists of materials for use in presenting a course in the occupational area of dietary aide. Included in the first part of the guide are a program master sequence; a master listing of instructional materials, equipment, and supplies; an overview of the competency-based vocational education (CBVE) system; and guidelines…

  10. Health Services: Clinical. Radiographic Aide. Instructor's Manual. Competency-Based Education.

    ERIC Educational Resources Information Center

    Cave, Julie; And Others

    This instructor's manual consists of materials for use in presenting a course in the occupational area of radiographic aide. Included in the first part of the guide are a program master sequence; a master listing of instructional materials, equipment, and supplies; an overview of the competency-based vocational education (CBVE) system; and…

  11. Graphical and Normative Analysis of Binocular Vision by Mini Computer: A Teaching Aid and Clinical Tool.

    ERIC Educational Resources Information Center

    Kees, Martin; Schor, Clifton

    1981-01-01

    An inexpensive computer graphics systems (Commodore PET), used as a video aid for teaching students advanced case analysis, is described. The course provides students with the analytical tools for evaluating with graphical and statistical techniques and treating with lenses, prisms, and orthoptics various anomalies of binocular vision. (MLW)

  12. Health Services: Clinical. Medical Laboratory Aide. Instructor's Manual. Competency-Based Education.

    ERIC Educational Resources Information Center

    Cave, Julie; And Others

    This instructors manual consists of materials for use in presenting a course in the occupational area of medical laboratory aide. Included in the first part of the guide are a program master sequence; a master listing of instructional materials, equipment, and supplies; an overview of the competency-based vocational education (CBVE) system; and…

  13. Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics.

    PubMed Central

    Salomon, J. A.; Murray, C. J.

    2001-01-01

    OBJECTIVE: To improve the methodological basis for modelling the HIV/AIDS epidemics in adults in sub-Saharan Africa, with examples from Botswana, Central African Republic, Ethiopia, and Zimbabwe. Understanding the magnitude and trajectory of the HIV/AIDS epidemic is essential for planning and evaluating control strategies. METHODS: Previous mathematical models were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women. In this project, we have extended these models in order to take full advantage of the available data. We developed a maximum likelihood approach for the estimation of model parameters and used numerical simulation methods to compute uncertainty intervals around the estimates. FINDINGS: In the four countries analysed, there were an estimated half a million new adult HIV infections in 1999 (range: 260 to 960 thousand), 4.7 million prevalent infections (range: 3.0 to 6.6 million), and 370 thousand adult deaths from AIDS (range: 266 to 492 thousand). CONCLUSION: While this project addresses some of the limitations of previous modelling efforts, an important research agenda remains, including the need to clarify the relationship between sentinel data from pregnant women and the epidemiology of HIV and AIDS in the general population. PMID:11477962

  14. Does Interpersonal Psychotherapy improve clinical care for adolescents with depression attending a rural child and adolescent mental health service? Study protocol for a cluster randomised feasibility trial

    PubMed Central

    Bearsley-Smith, Cate; Browne, Mark Oakley; Sellick, Ken; Villanueva, Elmer V; Chesters, Janice; Francis, Karen; Reddy, Prasuna

    2007-01-01

    Background Depression amongst adolescents is a costly societal problem. Little research documents the effectiveness of public mental health services in mapping this problem. Further, it is not clear whether usual care in such services can be improved via clinician training in a relevant evidence based intervention. One such intervention, found to be effective and easily learned amongst novice clinicians, is Interpersonal Psychotherapy (IPT). The study described in the current paper has two main objectives. First, it aims to investigate the impact on clinical care of implementing Interpersonal Psychotherapy for Adolescents for the treatment of adolescent depression within a rural mental health service compared with Treatment as Usual (TAU). The second objective is to record the process and challenges (i.e. feasibility, acceptability, sustainability) associated with implementing and evaluating an evidence-based intervention within a community service. This paper outlines the study rationale and design for this community based research trial. Methods/design The study involves a cluster randomisation trial to be conducted within a Child and Adolescent Mental Health Service in rural Australia. All clinicians in the service will be invited to participate. Participating clinicians will be randomised via block design at each of four sites to (a) training and delivery of IPT, or (b) TAU. The primary measure of impact on care will be a clinically significant change in depressive symptomatology, with secondary outcomes involving treatment satisfaction and changes in other symptomatology. Participating adolescents with significant depressive symptomatology, aged 12 to 18 years, will complete assessment measures at Weeks 0, 12 and 24 of treatment. They will also complete a depression inventory once a month during that period. This study aims to recruit 60 adolescent participants and their parent/guardian/s. A power analysis is not indicated as an intra-class correlation

  15. Predictors of Sexual Risk Behavior among Zimbabwean Adolescents With and Without Disabilities: Implications for HIV/AIDS Prevention

    ERIC Educational Resources Information Center

    Magaya, Lindiwe

    2010-01-01

    The purpose of this study was to determine sexual risk behaviors among Zimbabwean adolescents with and without disabilities. Participants included 456 Zimbabwean high school students. Results indicated that more males than females engaged in sexual activities as early as nine years of age or younger. Females who reported having had sex, also…

  16. Incidence of Pancreatitis in HIV-1–Infected Individuals Enrolled in 20 Adult AIDS Clinical Trials Group Studies

    PubMed Central

    Reisler, Ronald B.; Murphy, Robert L.; Redfield, Robert R.; Parker, Robert A.

    2005-01-01

    Objective To report on the incidence of clinical- and laboratory-defined pancreatitis in HIV-1–infected individuals treated with antiretrovirals (ARVs). Methods Pancreatitis incidence rates were calculated based on a Poisson distribution for subjects enrolled in 1 or more of 20 Adult AIDS Clinical Trials Group studies from October 1989 through July 1999. Results A total of 8451 subjects were enrolled. The overall pancreatitis rates were 0.61 per 100 person-years (PYs) clinical and 2.23 per 100 PYs clinical/laboratory. Pancreatitis rates for single, dual, and triple nucleoside reverse transcriptase inhibitors (NRTIs) were similar. Rates of pancreatitis in didanosine (ddI) arms seemed to be dose dependent. Pancreatitis rates in ddI/hydroxyurea (HU) arms were not significantly different from the rates for ddI alone. Overall pancreatitis rates for ddI/stavudine (d4T) trials were high at 4.16 per 100 PYs clinical and 6.25 per 100 PYs clinical/laboratory. The highest rates were seen with the combination of indinavir (IDV)/ddI/d4Twith or without HU. Conclusions The combination of NRTIs and definition has an impact on the incidence of pancreatitis. Standardization of definition and more comprehensive evaluations are needed to determine how much of this pancreatitis is directly caused by ARVs and how much is attributable to preexisting comorbidities and other known risk factors. PMID:15905731

  17. Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic.

    PubMed

    Nielsen, Eva Skovslund; Hellfritzsch, Maja; Sørensen, Merete Juul; Rasmussen, Helle; Thomsen, Per Hove; Laursen, Torben

    2016-01-01

    This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent psychiatric ward, on 1 day in 2014. Prescriptions of drugs from ATC group N05-N06 were classified according to label status. Six hundred and fifteen drug prescriptions distributed on nine different drugs were prescribed to 503 children eligible for this study. Overall results showed that 170 of the 615 prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106 prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs is usually off-label. ADHD drugs were, as the only drug group, primarily prescribed on-label. Although off-label prescription may be rational and even evidence based, the responsibility in case of, e.g. adverse drug reactions is a challenge, and clinical trials in children should be incited.

  18. Clinical characteristics of children and adolescents with severe therapy-resistant asthma in Brazil *

    PubMed Central

    Rodrigues, Andrea Mendonça; Roncada, Cristian; Santos, Giovana; Heinzmann-Filho, João Paulo; de Souza, Rodrigo Godinho; Vargas, Mauro Henrique Moraes; Pinto, Leonardo Araújo; Jones, Marcus Herbert; Stein, Renato Tetelbom; Pitrez, Paulo Márcio

    2015-01-01

    Abstract Objective: To describe the clinical characteristics, lung function, radiological findings, and the inflammatory cell profile in induced sputum in children and adolescents with severe therapy-resistant asthma (STRA) treated at a referral center in southern Brazil. Methods: We retrospectively analyzed children and adolescents (3-18 years of age) with uncontrolled STRA treated with high-dose inhaled corticosteroids and long-acting ß2 agonists. We prospectively collected data on disease control, lung function, skin test reactivity to allergens, the inflammatory cell profile in induced sputum, chest CT findings, and esophageal pH monitoring results. Results: We analyzed 21 patients (mean age, 9.2 ± 2.98 years). Of those, 18 (86%) were atopic. Most had uncontrolled asthma and near-normal baseline lung function. In 4 and 7, induced sputum was found to be eosinophilic and neutrophilic, respectively; the inflammatory cell profile in induced sputum having changed in 67% of those in whom induced sputum analysis was repeated. Of the 8 patients receiving treatment with omalizumab (an anti-IgE antibody), 7 (87.5%) showed significant improvement in quality of life, as well as significant reductions in the numbers of exacerbations and hospitalizations. Conclusions: Children with STRA present with near-normal lung function and a variable airway inflammatory pattern during clinical follow-up, showing a significant clinical response to omalizumab. In children, STRA differs from that seen in adults, further studies being required in order to gain a better understanding of the disease mechanisms. PMID:26398754

  19. Accuracy of computer-aided template-guided oral implant placement: a prospective clinical study

    PubMed Central

    2014-01-01

    Purpose The aim of the present study was to evaluate the in vivo accuracy of flapless, computer-aided implant placement by comparing the three-dimensional (3D) position of planned and placed implants through an analysis of linear and angular deviations. Methods Implant position was virtually planned using 3D planning software based on the functional and aesthetic requirements of the final restorations. Computer-aided design/computer-assisted manufacture technology was used to transfer the virtual plan to the surgical environment. The 3D position of the planned and placed implants, in terms of the linear deviations of the implant head and apex and the angular deviations of the implant axis, was compared by overlapping the pre- and postoperative computed tomography scans using dedicated software. Results The comparison of 14 implants showed a mean linear deviation of the implant head of 0.56 mm (standard deviation [SD], 0.23), a mean linear deviation of the implant apex of 0.64 mm (SD, 0.29), and a mean angular deviation of the long axis of 2.42° (SD, 1.02). Conclusions In the present study, computer-aided flapless implant surgery seemed to provide several advantages to the clinicians as compared to the standard procedure; however, linear and angular deviations are to be expected. Therefore, accurate presurgical planning taking into account anatomical limitations and prosthetic demands is mandatory to ensure a predictable treatment, without incurring possible intra- and postoperative complications. Graphical Abstract PMID:25177520

  20. Parental emotion socialization in clinically depressed adolescents: Enhancing, and dampening positive affect

    PubMed Central

    Katz, Lynn Fainsilber; Shortt, Joann Wu; Allen, Nicholas B.; Davis, Betsy; Hunter, Erin; Leve, Craig; Sheeber, Lisa

    2013-01-01

    This study compared parental socialization of adolescent positive affect in families of depressed and healthy adolescents. Participants were 107 adolescents (42 boys) aged 14 - 18 years and their parents. Half of the participants met criteria for major depressive disorder and the others were demographically matched adolescents without emotional or behavioral disorders. Results based on multi-source questionnaire and interview data indicated that mothers and fathers of depressed adolescents were less accepting of adolescents’ positive affect and more likely to use strategies that dampen adolescents’ positive affect than were parents of healthy adolescents. Additionally, fathers of depressed adolescents exhibited fewer responses likely to enhance the adolescents’ positive affect than were fathers of healthy adolescents. These findings build on those of previous work in examining parental responses to adolescent emotions, focusing on positive emotions and including both mothers and fathers. PMID:23942826

  1. Eating disorder examination questionnaire: Norms and clinical reference data from adolescent boys and girls in Sweden.

    PubMed

    Mantilla, Emma Forsén; Birgegård, Andreas

    2016-05-30

    The study investigated norms and clinical reference values for the 14-day time frame version of the Eating Disorders Examination Questionnaire (EDE-Q) specifically developed to suit adolescent populations. The EDE-Q is a self-report instrument measuring problematic eating behaviors and attitudes. A general population sample (N=487, 239 girls and 248 boys) and a clinical sample (N=1051, 989 girls and 62 boys) aged 12-14 years were analyzed. Descriptive statistics for EDE-Q subscales and Global scale, as well as key behaviors, are presented, along with sex differences and diagnostic differences (clinical sample). General population sample sex differences were consistent and medium to large, with some evidence of floor effects for boys. In the clinical sample there was a main effect of gender, with girls scoring higher overall. The covariate age accounted for more variance in EDE-Q subscale scores than did diagnostic group. Results are discussed in terms of the appropriateness of the EDE-Q for boys, and possible denial of illness among patients.

  2. Active multimodal psychotherapy in children and adolescents with suicidality: description, evaluation and clinical profile.

    PubMed

    Högberg, Goran; Hällström, Tore

    2008-07-01

    The aim of this study was to describe and evaluate the clinical pattern of 14 youths with presenting suicidality, to describe an integrative treatment approach, and to estimate therapy effectiveness. Fourteen patients aged 10 to 18 years from a child and adolescent outpatient clinic in Stockholm were followed in a case series. The patients were treated with active multimodal psychotherapy. This consisted of mood charting by mood-maps, psycho-education, wellbeing practice and trauma resolution. Active techniques were psychodrama and body-mind focused techniques including eye movement desensitization and reprocessing. The patients were assessed before treatment, immediately after treatment and at 22 months post treatment with the Global Assessment of Functioning Scale. The clinical pattern of the group was observed. After treatment there was a significant change towards normality in the Global Assessment of Functioning scale both immediately post-treatment and at 22 months. A clinical pattern, post trauma suicidal reaction, was observed with a combination of suicidality, insomnia, bodily symptoms and disturbed mood regulation. We conclude that in the post trauma reaction suicidality might be a presenting symptom in young people. Despite the shortcomings of a case series the results of this study suggest that a mood-map-based multimodal treatment approach with active techniques might be of value in the treatment of children and youth with suicidality.

  3. Eating disorder examination questionnaire: Norms and clinical reference data from adolescent boys and girls in Sweden.

    PubMed

    Mantilla, Emma Forsén; Birgegård, Andreas

    2016-05-30

    The study investigated norms and clinical reference values for the 14-day time frame version of the Eating Disorders Examination Questionnaire (EDE-Q) specifically developed to suit adolescent populations. The EDE-Q is a self-report instrument measuring problematic eating behaviors and attitudes. A general population sample (N=487, 239 girls and 248 boys) and a clinical sample (N=1051, 989 girls and 62 boys) aged 12-14 years were analyzed. Descriptive statistics for EDE-Q subscales and Global scale, as well as key behaviors, are presented, along with sex differences and diagnostic differences (clinical sample). General population sample sex differences were consistent and medium to large, with some evidence of floor effects for boys. In the clinical sample there was a main effect of gender, with girls scoring higher overall. The covariate age accounted for more variance in EDE-Q subscale scores than did diagnostic group. Results are discussed in terms of the appropriateness of the EDE-Q for boys, and possible denial of illness among patients. PMID:27137979

  4. Treatment of Adolescent Marijuana Abuse: A Randomized Clinical Trial. Presentation 1: Structure of the Cannabis Youth Treatment Study.

    ERIC Educational Resources Information Center

    Titus, Janet C.; Dennis, Michael L.; Diamond, Guy; Godley, Susan H.; Babor, Thomas; Donaldson, Jean; Herrell, James; Tims, Frank; Webb, Charles

    The Cannabis Youth Treatment (CYT) study is a multi-site randomized field experiment examining five outpatient treatment protocols for adolescents who abuse or are dependent on marijuana. The purpose of the CYT project is twofold: (a) to test the relative clinical effectiveness and cost-effectiveness of five promising interventions targeted at…

  5. The Effects of Wilderness Therapy on the Clinical Concerns (on Axes I, II, and IV) of Troubled Adolescents

    ERIC Educational Resources Information Center

    Clark, Jeffrey R; Marmol, Leonardo M.; Cooley, Robert; Gathercoal, Kathleen

    2004-01-01

    The purpose of this study was twofold: (a) to empirically evaluate the effects of a 21-day wilderness therapy program (WT) on the defense styles, perceived psychosocial stressors (expressed concerns), dysfunctional personality patterns, clinical syndromes, and maladaptive behaviors of 109 troubled adolescents, as measured by the Defense Style…

  6. The Relationship between Substance Use and Clinical Characteristics among Adolescent Girls with Anorexia Nervosa or Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Wiederman, Michael W.; Pryor, Tamara

    1997-01-01

    Explores clinical characteristics associated with adolescent girls (N=110) diagnosed with an eating disorder and increased exposure to illicit drugs. Results indicate substance use was unrelated to scores on several scales of eating disorder symptomatology. One scale, though, predicted substance use regardless of age or eating disorder diagnosis.…

  7. Informed Consent and Clinical Research Involving Children and Adolescents: Implications of the Revised APA Ethics Code and HIPAA

    ERIC Educational Resources Information Center

    Fisher, Celia B.

    2004-01-01

    In 2003, 2 new sets of rules and regulations affecting the conduct of clinical research involving children and adolescents went into effect: the revised American Psychological Association's (APA) Ethical Principles of Psychologists and Code of Conduct (APA, 2002; effective June 1, 2003) and the Privacy Rule (45 CFR Part 160 and A and E of Part…

  8. Effectiveness Research: Transporting Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) From the Lab to School-Based Health Clinics

    ERIC Educational Resources Information Center

    Mufson, Laura H.; Dorta, Kristen Pollack; Olfson, Mark; Weissman, Myrna M.; Hoagwood, Kimberly

    2004-01-01

    This paper describes the process of modifying and transporting an evidence-based treatment, Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), from a university setting to school-based health clinics. It addresses conceptual issues involved in the shift from efficacy to effectiveness research as well as operational issues specific to…

  9. Group-Based Preference Assessment for Children and Adolescents in a Residential Setting: Examining Developmental, Clinical, Gender, and Ethnic Differences

    ERIC Educational Resources Information Center

    Volz, Jennifer L. Resetar; Cook, Clayton R.

    2009-01-01

    This study examines developmental, clinical, gender, and ethnic group differences in preference in residentially placed children and adolescents. In addition, this study considers whether residentially placed youth prefer stimuli currently being used as rewards as part of a campuswide token economy system and whether youth would identify preferred…

  10. Circadian rhythm sleep disorders in adolescents: clinical trials of combined treatments based on chronobiology.

    PubMed

    Okawa, M; Uchiyama, M; Ozaki, S; Shibui, K; Ichikawa, H

    1998-10-01

    Delayed sleep phase syndrome (DSPS) and non-24-h sleep-wake rhythm are circadian rhythm sleep disorders that are common in adolescents. Most patients have difficulty adjusting to school life, poor class attendance or refuse to go to school. Since a treatment has not been established, the present paper is presented to propose a strategy for treating circadian rhythm sleep disorders in adolescents, based on our clinical studies. Twenty subjects (12 males and eight females, mean age 16.2+/-1.7 years) participated in the study. The onset of sleep disorder occurred between the ages of 11 and 17. The most common factors affecting the onset of disorders were changes in social environment. The subjects kept a sleep-log for the periods before and during treatments. The treatments were based on chronobiology: resetting the daily life schedule, chronotherapy, regulation of the lighting environment, methylcobalamin, and/or melatonin. Bright light exposure was successful in 10 patients, of whom four were treated with methylcobalamin. Melatonin treatment was successful in two patients (one with and one without chronotherapy). Thirteen of the 20 patients were successfully, treated with therapies based on chronobiology. After consideration of these results, a step-by-step procedure of combined treatments for the circadian rhythm sleep disorders is proposed.

  11. Clinical ethics for the treatment of children and adolescents: a guide for general psychiatrists.

    PubMed

    Belitz, Jerald; Bailey, Robert A

    2009-06-01

    Clinical work--psychotherapy, assessment, consultation, or research--with emotionally ill children and adolescents is challenging, complex, and exceedingly rewarding. Psychiatrists must remain mindful of children's vulnerabilities but also remain respectful of their rights, regardless of any legal barriers or developmental limitations that exist. To varying degrees, youths are afforded the rights of integrity, autonomy, informed consent or assent, protection of health care information, and participation in research. All physicians who work with children and adolescents are obliged to possess the requisite skills necessary for the provision of beneficial assessments, psychotherapy and psychopharmacology, the protection and advocacy that vulnerable children may require, and the ability to collaborate with families, schools, and other systems in which children regularly function. This work requires self-examination and awareness of one's values and attitudes about children and families and self-monitoring of one's motivations and intents during therapeutic interactions. Additionally, psychiatrists are reminded to seek consultation from valued colleagues whenever an ethical quandary presents itself. Finally, while negotiating the multiple requirements of children, families, communities, legal statutes, and professional ethics and standards, psychiatrists must maintain an ardent commitment to the safety and well-being of their young patients. PMID:19486811

  12. A cultural approach to conducting HIV/AIDS and hepatitis C virus education among native American adolescents.

    PubMed

    Lowe, John

    2008-08-01

    This pilot study tests the feasibility of using a Talking Circle approach and measures cultural values and beliefs within a HIV/AIDS and hepatitis C virus (HCV) prevention program conducted among a Native American (Cherokee) youth population. A descriptive correlation design was used to examine the relationship between Cherokee self-reliance and HIV/AIDS and HCV knowledge, attitudes, and behaviors. The study used three questionnaires that were administered before and after the prevention program to collect data from a convenience sample of 41 students at a public high school within the boundaries of the Cherokee Nation in Oklahoma. Statistical analysis revealed immediate differences between pretests and posttests related to knowledge, attitudes, and behavioral intentions concerning HIV/AIDS and HCV and the cultural dynamic of Cherokee self-reliance. PMID:18757356

  13. A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney

    PubMed Central

    Patzer, Rachel E.; Basu, Mohua; Mohan, Sumit; Smith, Kayla D.; Wolf, Michael; Ladner, Daniela; Friedewald, John J.; Chiles, Mariana; Russell, Allison; McPherson, Laura; Gander, Jennifer; Pastan, Stephen

    2016-01-01

    Kidney transplantation is the preferred treatment for patients with end-stage renal disease, as it substantially increases a patient's survival and is cost saving compared to a lifetime of dialysis. However, transplantation is not universally chosen by patients with renal failure, and limited knowledge about the survival benefit of transplantation vs. dialysis may play a role. We created a mobile application clinical decision aid called iChoose Kidney to improve access to individualized prognosis information comparing dialysis and transplantation outcomes. We describe the iChoose Kidney study, a randomized controlled trial designed to test the clinical efficacy of a mobile health decision aid among end-stage renal disease patients referred for kidney transplantation at three large, diverse transplant centers across the U.S. Approximately 450 patients will be randomized to receive either: (1) standard of care or “usual” transplantation education, or (2) standard of care plus iChoose Kidney. The primary outcome is change in knowledge about the survival benefit of kidney transplantation vs. dialysis from baseline to immediate follow-up; secondary outcomes include change in treatment preferences, improved decisional conflict, and increased access to kidney transplantation. Analyses are also planned to examine effectiveness across subgroups of race, socioeconomic status, health literacy and health numeracy. Engaging patients in health care choices can increase patient empowerment and improve knowledge and understanding of treatment choices. If the effectiveness of iChoose Kidney has a greater impact on patients with low health literacy, lower socioeconomic status, and minority race, this decision aid could help reduce disparities in access to kidney transplantation. PMID:27610423

  14. Manufacturing mistrust: issues in the controversy regarding foster children in the pediatric HIV/AIDS clinical trials.

    PubMed

    Slomka, Jacquelyn

    2009-12-01

    The use of foster children as subjects in the pediatric HIV/AIDS clinical trials has been the subject of media controversy, raising a range of ethical and social dimensions. Several unsettled issues and debates in research ethics underlie the controversy and the lack of consensus among professional researchers on these issues was neither adequately appreciated nor presented in media reports. These issues include (1) the tension between protecting subjects from research risk while allowing them access to the possible benefits of research; (2) the blurring of the potentially conflicting roles of investigator and physician and the boundaries between research and therapy; (3) the adequacy of Institutional Review Board oversight; and (4) trust and the relationships among physicians, investigators and industry. The media controversy about the pediatric HIV/AIDS clinical trials can be seen as a means of "manufacturing mistrust" in health care, research and social services that have not always met the needs and expectations of the public. In an era of emerging infections, it is critical to the public's health that people understand the role of rigorous and ethical research in the development of safe and effective care. Investigators, journalists and the public need to become knowledgeable about major ethical issues in the conduct of research in order to engage in dialogue about balancing research risks and benefits and to be able to distinguish fact from distortion in an era of multiple and rapid transmission of information.

  15. Improving diagnostic capability for HPV disease internationally within the NIH-NIAID-Division of AIDS Clinical Trial Networks

    PubMed Central

    Godfrey, Catherine C.; Michelow, Pamela M.; Godard, Mandana; Sahasrabuddhe, Vikrant V.; Darden, Janice; Firnhaber, Cynthia S.; Wetherall, Neal T.; Bremer, James; Coombs, Robert W.; Wilkin, Timothy

    2014-01-01

    Objectives To evaluate an external quality assurance (EQA) program for the laboratory diagnosis of human papillomavirus (HPV) disease that was established to improve international research capability within the Division of AIDS at the National Institute of Allergy and Infectious Disease–supported Adult AIDS Clinical Trials Group network. Methods A three-component EQA scheme was devised comprising assessments of diagnostic accuracy of cytotechnologists and pathologists using available EQA packages, review of quality and accuracy of clinical slides from local sites by an outside expert, and HPV DNA detection using the commercially available HPV test kit. Results Seven laboratories and 17 pathologists in Africa, India, and South America participated. EQA scores were suboptimal for standard packages in three of seven laboratories. There was good agreement between the local laboratory and the central reader 70% of the time (90% confidence interval, 42%-98%). Performance on the College of American Pathologists’ HPV DNA testing panel was successful in all laboratories tested. Conclusions The prequalifying EQA round identified correctable issues that will improve the laboratory diagnosis of HPV related cervical disease at the international sites and will provide a mechanism for ongoing education and continuous quality improvement. PMID:24225757

  16. [Clinical and bacteriological profiles of the urinary infections associated the VIH/AIDS in hospital area of Bamako, Mali].

    PubMed

    Dao, S; Oumar, A A; Dembele, J P; Noutache, J L; Fongoro, S; Maiga, I; Bougoudogo, F

    2007-01-01

    The syndrome of immunodepression is the bed of multiple infections of which urinary infections. The goal of this study was to determine the aspects clinical and bacteriological urinary infections during the AIDS with the service of the infectious diseases of the hospital of the Point G of February 1, 2003 to June 30 2005. The diagnosis of the urinary infection was retained on the basis of bacteria number > or =10(4) bacteriury and or leucocytes count > or =10(5)/mm3. The prevalence of the urinary infection was estimated at 8.85%. The principal clinical aspects were a symptomatic pyelonephritis 73.5%, the leucocytiury 11.8%, the cystitis 8.8%, and acute prostatitis 5.9%. Escherichia coli was the most frequent bacterium (46.7%). The sensitivity of the germs was 91.7% with the aminosides, 90.9% with the fluoroquinolones, from 63.6 to 80% respectively with the cephalosporines of first and second generation. Resistance to ampicilline, chloramphenicol and sulfamides was about 72 and 80%. The systematic research of the urinary infection is necessary during the AIDS and the antibiotherapy of choice in first intention in absence of etiologic possibility of diagnosis should be the aminosides and or the fluoroquinolones.

  17. Pharmacogenetics informed decision making in adolescent psychiatric treatment: a clinical case report.

    PubMed

    Smith, Teri; Sharp, Susan; Manzardo, Ann M; Butler, Merlin G

    2015-01-01

    Advances made in genetic testing and tools applied to pharmacogenetics are increasingly being used to inform clinicians in fields such as oncology, hematology, diabetes (endocrinology), cardiology and expanding into psychiatry by examining the influences of genetics on drug efficacy and metabolism. We present a clinical case example of an adolescent male with anxiety, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder who did not tolerate numerous medications and dosages over several years in attempts to manage his symptoms. Pharmacogenetics testing was performed and DNA results on this individual elucidated the potential pitfalls in medication use because of specific pharmacodynamic and pharmacokinetic differences specifically involving polymorphisms of genes in the cytochrome p450 enzyme system. Future studies and reports are needed to further illustrate and determine the type of individualized medicine approach required to treat individuals based on their specific gene patterns. Growing evidence supports this biological approach for standard of care in psychiatry. PMID:25710722

  18. [Rare malignant tumors of the ovaries in adolescents--clinical aspects in deciding therapeutic aggressiveness].

    PubMed

    Schröder, W; Bau, O

    1990-01-01

    4 patients below the age of 20 years have been treated for a malignant tumor of the ovary during the period November 1, 1984 until April 30, 1988. Dysgerminoma was the diagnosis in two cases, as the third patient suffered from a bilateral malignant teratoma. Burkitt's Lymphoma involved both ovaries primarily in an 17-year-old girl. Retrospectively we analyzed diagnosis, therapy and clinical course of these young patients. Regarding the different histological types of the tumors that have been found we discuss critically current recommendations in therapeutic managements referring chemotherapy and/or radiotherapy. Defined conditions provided surgical treatment, that preserves fertility in early stages of malignant germ cell tumors of adolescent women, may be justified, especially for dysgerminomas. A real benefit relate to survival and quality of life by using chemotherapeutic agents can only be expected, if all prognostic factors are regarded.

  19. Pharmacogenetics Informed Decision Making in Adolescent Psychiatric Treatment: A Clinical Case Report

    PubMed Central

    Smith, Teri; Sharp, Susan; Manzardo, Ann M.; Butler, Merlin G.

    2015-01-01

    Advances made in genetic testing and tools applied to pharmacogenetics are increasingly being used to inform clinicians in fields such as oncology, hematology, diabetes (endocrinology), cardiology and expanding into psychiatry by examining the influences of genetics on drug efficacy and metabolism. We present a clinical case example of an adolescent male with anxiety, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder who did not tolerate numerous medications and dosages over several years in attempts to manage his symptoms. Pharmacogenetics testing was performed and DNA results on this individual elucidated the potential pitfalls in medication use because of specific pharmacodynamic and pharmacokinetic differences specifically involving polymorphisms of genes in the cytochrome p450 enzyme system. Future studies and reports are needed to further illustrate and determine the type of individualized medicine approach required to treat individuals based on their specific gene patterns. Growing evidence supports this biological approach for standard of care in psychiatry. PMID:25710722

  20. Clinical outcomes in breast cancer patients with HIV/AIDS: a retrospective study.

    PubMed

    Gomez, Alexandra; Montero, Alberto J; Hurley, Judith

    2015-02-01

    The purpose of the study is to describe what is the presentation of breast cancer in women with HIV, their tolerance to therapy, the most common complications of treatment and their outcomes. Retrospective chart review of patients with HIV diagnosed with breast cancer between January 1, 1989 and December 31, 2013 at the University of Miami/Jackson Memorial Hospital (UM/JMH) 47 females and 1 male were included in the analysis. The median age of diagnosis was 46 years (IQR 41-52) and 64% of the women were premenopausal. Median CD4(+) count was 330 cells/µL (IQR 131-589 cells/µL). 41% had AIDS at time of diagnosis. 94% of patients presented with locoregional disease and 6% with late stage breast cancer. 52% had ER(+) tumors. 6% had HER-2/neu tumor expression and 21 % had triple negative disease. The 5 year PFS was 50% (95% CI 34-64%), the 5 year OS was 44% (95% CI 29-58%), and the Breast cancer-specific survival was 57% (95% CI 40-70%). Death was attributed to breast cancer in 22 patients, AIDS progression in 6 patients, other medical condition in 1, and for 4, the cause was unknown. Serious adverse events were documented in 46% of patients treated with chemotherapy. Targeted therapy was well tolerated. Patients with HIV/AIDS and breast cancer pose a major challenge for oncologists. Surgery, radiation, and endocrine therapy are well tolerated. Standard dose chemotherapy can have life-threatening side effects which can be managed with growth factor support and antimicrobial prophylaxis. All cancer therapy can be given while continuing with antiviral therapy at full dose.

  1. A Cultural Approach to Conducting HIV/AIDS and Hepatitis C Virus Education among Native American Adolescents

    ERIC Educational Resources Information Center

    Lowe, John

    2008-01-01

    This pilot study tests the feasibility of using a Talking Circle approach and measures cultural values and beliefs within a HIV/AIDS and hepatitis C virus (HCV) prevention program conducted among a Native American (Cherokee) youth population. A descriptive correlation design was used to examine the relationship between Cherokee self-reliance and…

  2. Evaluation of an Intervention among Adolescents to Reduce Preventive Misconception in HIV Vaccine Clinical Trials

    PubMed Central

    Lally, Michelle; Goldsworthy, Richard; Sarr, Moussa; Kahn, Jessica; Brown, Larry; Peralta, Ligia; Zimet, Greg

    2014-01-01

    Purpose Placebo and randomization are important concepts that must be understood before youth can safely participate in HIV vaccine studies or other biomedical trials for HIV prevention. These concepts are central to the phenomenon of preventive misconception which may be associated with an increase in risk behavior among study participants related to mistaken beliefs. Persuasive messaging, traditionally used in the field of marketing, could enhance educational efforts associated with randomized clinical trials. Methods Two educational brochures were designed to increase knowledge about HIV vaccine clinical trials via 1 and 2-sided persuasive messaging. Through the Adolescent Medicine Trials Network, 120 youth were enrolled, administered a mock HIV vaccine trial consent, and then randomized to receive either no supplemental information or one of the two brochures. Results The 2-sided brochure group in which common clinical trial misconceptions were acknowledgedand then refuted had significantly higher scores on knowledge of randomization and interpretation of side effects than the consent-only control group, and willingness to participate in an HIV vaccine trial was not decreased with the use of this brochure. Conclusion Two sided persuasive messaging improves understanding of the concepts of randomization and placebo among youth who would consider participating in an HIV vaccine trial. Further evaluation of this approach should be considered for at-risk youth participating in an actual trial of a biomedical intervention for HIV prevention. PMID:24613097

  3. Clinical profiles, occurrence, and management of adolescent patients with HAIR-AN syndrome.

    PubMed

    Omar, Hatim A; Logsdon, Stephanie; Richards, Jessica

    2004-07-08

    The syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) is a subphenotype of the polycystic ovary syndrome. It is one of the most common causes of menstrual problems, hyperandrogenic symptoms, and insulin resistance among young women. Review of clinical data in an outpatient adolescent clinic showed that of the 1,002 young women (ages 10-21 years) attending the clinic over a 2-year period, 50 (5%) were diagnosed with HAIR-AN syndrome. Mean age of the patients was 15.5, initial mean weight at diagnosis was 94.5 kg, and the mean BMI was 33.33 kg/m2. Patients were treated with a weight-stabilization and -reduction program, oral contraceptive pills, and in most cases metformin. Of the patients, 80% were compliant with the follow-up and treatment regimen, 60% maintained or reduced their weight, 95% had regular menstrual cycles, and in most patients, the acne and/or hirsutism were the same or better than at the start of treatment. We conclude that HAIR-AN syndrome is a common disease in young women and multifaceted, aggressive treatment appears to be effective in reducing the severity of symptoms and preventing further consequences.

  4. Cognitive Behavioral Therapy for Early Adolescents with Autism Spectrum Disorders and Clinical Anxiety: A Randomized, Controlled Trial

    PubMed Central

    Wood, Jeffrey J.; Ehrenreich-May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth; Piacentini, John C.; De Nadai, Alessandro S.; Arnold, Elysse; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2014-01-01

    Background Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009), was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Method Thirty-three adolescents (11–15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and post-treatment/post-waitlist. Results In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators’ ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. Conclusions The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed. PMID:25526831

  5. Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial.

    PubMed

    Wood, Jeffrey J; Ehrenreich-May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth; Piacentini, John C; De Nadai, Alessandro S; Arnold, Elysse; Lewin, Adam B; Murphy, Tanya K; Storch, Eric A

    2015-01-01

    Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009) was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Thirty-three adolescents (11-15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and posttreatment/postwaitlist. In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators' ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed.

  6. Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial.

    PubMed

    Wood, Jeffrey J; Ehrenreich-May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth; Piacentini, John C; De Nadai, Alessandro S; Arnold, Elysse; Lewin, Adam B; Murphy, Tanya K; Storch, Eric A

    2015-01-01

    Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009) was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Thirty-three adolescents (11-15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and posttreatment/postwaitlist. In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators' ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed. PMID:25526831

  7. fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behavior in adolescents

    PubMed Central

    Brown, Matthew R. G.; Benoit, James R. A.; Juhás, Michal; Dametto, Ericson; Tse, Tiffanie T.; MacKay, Marnie; Sen, Bhaskar; Carroll, Alan M.; Hodlevskyy, Oleksandr; Silverstone, Peter H.; Dolcos, Florin; Dursun, Serdar M.; Greenshaw, Andrew J.

    2015-01-01

    High-risk behavior in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behavior and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behavior. We recruited 21 adolescents (age 14–17) with a wide range of high-risk behavior tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behavior Screen (ARBS). ARBS risk scores correlated highly (0.78) with impulsivity scores from the Barratt Impulsivity scale (BIS). Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI) while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behavior and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behavior tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents. PMID:26483645

  8. Mapping the Clinical Complexities of Adolescents with Substance Use Disorders: A Typological Study

    ERIC Educational Resources Information Center

    Meyers, Kathleen; McDermott, Paul A.; Webb, Alicia; Hagan, Teresa Ann

    2006-01-01

    Because of the vast improvements in adolescent substance use assessment, it is widely recognized that adolescent substance use disorders (SUD) encompasses diverse drugs, patterns and etiologies and are characterized by extensive heterogeneity in other life domains. The next step in advancing adolescent SUD assessment is to classify adolescents…

  9. Empirically Derived Subtypes of Lifetime Anxiety Disorders: Developmental and Clinical Correlates in U.S. Adolescents

    ERIC Educational Resources Information Center

    Burstein, Marcy; Georgiades, Katholiki; Lamers, Femke; Swanson, Sonja A.; Cui, Lihong; He, Jian-Ping; Avenevoli, Shelli; Merikangas, Kathleen R.

    2012-01-01

    Objective: The current study examined the sex- and age-specific structure and comorbidity of lifetime anxiety disorders among U.S. adolescents. Method: The sample consisted of 2,539 adolescents (1,505 females and 1,034 males) from the National Comorbidity Survey-Adolescent Supplement who met criteria for "Diagnostic and Statistical Manual of…

  10. Clinical application of a novel computer-aided detection system based on three-dimensional CT images on pulmonary nodule

    PubMed Central

    Zeng, Jian-Ye; Ye, Hai-Hong; Yang, Shi-Xiong; Jin, Ren-Chao; Huang, Qi-Liang; Wei, Yong-Chu; Huang, Si-Guang; Wang, Bin-Qiang; Ye, Jia-Zhou; Qin, Jian-Ying

    2015-01-01

    The aim of this study was to investigate the clinical application effects of a novel computer-aided detection (CAD) system based on three-dimensional computed tomography (CT) images on pulmonary nodule. 98 cases with pulmonary nodule (PN) in our hospital from Jun, 2009 to Jun, 2013 were analysed in this study. All cases underwent PN detection both by the simple spiral CT scan and by the computer-aided system based on 3D CT images, respectively. Postoperative pathological results were considered as the “gold standard”, for both two checking methods, the diagnostic accuracies for determining benign and malignant PN were calculated. Under simple spiral CT scan method, 63 cases is malignant, including 50 true positive cases and 13 false positive cases from the “gold standard”; 35 cases is benign, 16 true negative case and 19 false negative cases, the Sensitivity 1 (Se1)=0.725, Specificity1 (Sp1)=0.448, Agreement rate1 (Kappa 1)=0.673, J1 (Youden’s index 1)=0.173, LR(+)1=1.616, LR(-)1=0.499. Kappa 1=0.673 between the 0.4 and 0.75, has a moderate consistency. Underwent computer-aided detection (CAD) based on 3D CT method, 67cases is malignant, including 62 true positive cases and 7 false positive cases; 31 cases is benign, 24 true negative case and 7 false negative cases, Sensitivity 2 (Se2)=0.899, Specificity2 (Sp2)=0.828, Agreement rate (Kappa 2)=0.877, J2 (Youden’s index 2)=0.727, LR(+)2=5.212, LR(-)2=0.123. Kappa 2=0.877 >0.75, has a good consistency. Computer-aided PN detecting system based on 3D CT images has better clinical application value, and can help doctor carry out early diagnosis of lung disease (such as cancer, etc.) through CT images. PMID:26629115

  11. An automated tuberculosis screening strategy combining X-ray-based computer-aided detection and clinical information

    PubMed Central

    Melendez, Jaime; Sánchez, Clara I.; Philipsen, Rick H. H. M.; Maduskar, Pragnya; Dawson, Rodney; Theron, Grant; Dheda, Keertan; van Ginneken, Bram

    2016-01-01

    Lack of human resources and radiological interpretation expertise impair tuberculosis (TB) screening programmes in TB-endemic countries. Computer-aided detection (CAD) constitutes a viable alternative for chest radiograph (CXR) reading. However, no automated techniques that exploit the additional clinical information typically available during screening exist. To address this issue and optimally exploit this information, a machine learning-based combination framework is introduced. We have evaluated this framework on a database containing 392 patient records from suspected TB subjects prospectively recruited in Cape Town, South Africa. Each record comprised a CAD score, automatically computed from a CXR, and 12 clinical features. Comparisons with strategies relying on either CAD scores or clinical information alone were performed. Our results indicate that the combination framework outperforms the individual strategies in terms of the area under the receiving operating characteristic curve (0.84 versus 0.78 and 0.72), specificity at 95% sensitivity (49% versus 24% and 31%) and negative predictive value (98% versus 95% and 96%). Thus, it is believed that combining CAD and clinical information to estimate the risk of active disease is a promising tool for TB screening. PMID:27126741

  12. Implementing Psychophysiology in Clinical Assessments of Adolescent Social Anxiety: Use of Rater Judgments Based on Graphical Representations of Psychophysiology

    PubMed Central

    De Los Reyes, Andres; Augenstein, Tara M.; Aldao, Amelia; Thomas, Sarah A.; Daruwala, Samantha; Kline, Kathryn; Regan, Timothy

    2014-01-01

    OBJECTIVE Social stressor tasks induce adolescents’ social distress as indexed by low-cost psychophysiological methods. Unknown is how to incorporate these methods within clinical assessments. Having assessors judge graphical depictions of psychophysiological data may facilitate detections of data patterns that may be difficult to identify using judgments about numerical depictions of psychophysiological data. Specifically, the Chernoff Face method involves graphically representing data using features on the human face (eyes, nose, mouth, and face shape). This method capitalizes on humans’ abilities to discern subtle variations in facial features. Using adolescent heart rate norms and Chernoff Faces, we illustrated a method for implementing psychophysiology within clinical assessments of adolescent social anxiety. METHOD Twenty-two clinic-referred adolescents completed a social anxiety self-report and provided psychophysiological data using wireless heart rate monitors during a social stressor task. We graphically represented participants’ psychophysiological data and normative adolescent heart rates. For each participant, two undergraduate coders made comparative judgments between the dimensions (eyes, nose, mouth, and face shape) of two Chernoff Faces. One Chernoff Face represented a participant’s heart rate within a context (baseline, speech preparation, or speech-giving). The second Chernoff Face represented normative heart rate data matched to the participant’s age. RESULTS Using Chernoff faces, coders reliably and accurately identified contextual variation in participants’ heart rate responses to social stress. Further, adolescents’ self-reported social anxiety symptoms predicted Chernoff Face judgments, and judgments could be differentiated by social stress context. CONCLUSIONS Our findings have important implications for implementing psychophysiology within clinical assessments of adolescent social anxiety. PMID:24320027

  13. Frostbite, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Frostbite, First Aid A A A Severe frostbite can result in ... became frozen). Frostbite is often associated with hypothermia. First Aid Guide In the case of mild frostbite, the ...

  14. Heat Exhaustion, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Heat Exhaustion, First Aid A A A Heat exhaustion signs and symptoms ... specific to the other stages of heat illness. First Aid Guide Use a combination of the following measures ...

  15. Heat Cramps, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Heat Cramps, First Aid A A A Heat cramp signs and symptoms ... if later stages of heat illness are suspected. First Aid Guide Use a combination of the following measures, ...

  16. Heatstroke, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Heatstroke, First Aid A A A Heatstroke signs and symptoms can ... specific to the earlier stages of heat illness. First Aid Guide When heatstroke is suspected, seek emergency medical ...

  17. Bruises, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Bruises, First Aid A A A Bruises lighten and change color ... Bruises can be a sign of internal bleeding. First Aid Guide If there is external bleeding in addition ...

  18. Tick Bites, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Tick Bites, First Aid A A A It is important to inspect ... temporary paralysis in their host (called tick paralysis). First Aid Guide To remove an embedded tick: Wash your ...

  19. Evaluation of Computer-aided Diagnosis on a Large Clinical Full-Field Digital Mammographic Dataset

    PubMed Central

    Li, Hui; Giger, Maryellen L.; Yuan, Yading; Chen, Weijie; Horsch, Karla; Lan, Li; Jamieson, Andrew R.; Sennett, Charlene A.; Jansen, Sanaz A.

    2008-01-01

    Rationale and Objectives: To convert and optimize our previously developed computerized analysis methods for use with images from full-field digital mammography (FFDM) for breast mass classification in order to aid in the diagnosis of breast cancer. Materials and Methods: An institutional review board approved protocol was obtained, with waiver of consent for retrospective use of mammograms and pathology data. Seven hundreds and thirty-nine full-field digital mammographic images, which contained 287 biopsy-proven breast mass lesions, of which 148 lesions were malignant and 139 lesions were benign, were retrospectively collected. Lesion margins were delineated by an expert breast radiologist and were used as the truth for lesion-segmentation evaluation. Our computerized image analysis method consisted of several steps: 1) identified lesions were automatically extracted from the parenchymal background using computerized segmentation methods; 2) a set of image characteristics (mathematical descriptors) were automatically extracted from image data of the lesions and surrounding tissues; and 3) selected features were merged into an estimate of the probability of malignancy using a Bayesian artificial neural network classifier. Performance of the analyses was evaluated at various stages of the conversion using receiver operating characteristic (ROC) analysis. Results: An AUC value of 0.81 was obtained in the task of distinguishing between malignant and benign mass lesions in a round-robin by case evaluation on the entire FFDM dataset. We failed to show a statistically significant difference (P value=0.83) as compared with results from our previous study in which the computerized classification was performed on digitized screen-film mammograms (SFMD). Conclusion: Our computerized analysis methods developed on digitized screen-film mammography can be converted for use with FFDM. Results show that the computerized analysis methods for the diagnosis of breast mass lesions on

  20. A Comparison of the Concurrent and Predictive Validity of Three Measures of Readiness to Change Alcohol Use in a Clinical Sample of Adolescents

    ERIC Educational Resources Information Center

    Maisto, Stephen A.; Krenek, Marketa; Chung, Tammy; Martin, Christopher S.; Clark, Duncan; Cornelius, Jack

    2011-01-01

    The authors compared 3 measures of readiness to change alcohol use commonly used in clinical research and practice with adolescents: the Readiness Ruler, the SOCRATES (subscales of Recognition and Taking Steps), and a Staging Algorithm. The analysis sample consisted of 161 male and female adolescents presenting for intensive outpatient…

  1. Poor peer relations predict parent- and self-reported behavioral and emotional problems of adolescents with gender dysphoria: a cross-national, cross-clinic comparative analysis.

    PubMed

    de Vries, Annelou L C; Steensma, Thomas D; Cohen-Kettenis, Peggy T; VanderLaan, Doug P; Zucker, Kenneth J

    2016-06-01

    This study is the third in a series to examine behavioral and emotional problems in children and adolescents with gender dysphoria in a comparative analysis between two clinics in Toronto, Ontario, Canada and Amsterdam, the Netherlands. In the present study, we report Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) data on adolescents assessed in the Toronto clinic (n = 177) and the Amsterdam clinic (n = 139). On the CBCL and the YSR, we found that the percentage of adolescents with clinical range behavioral and emotional problems was higher when compared to the non-referred standardization samples but similar to the referred adolescents. On both the CBCL and the YSR, the Toronto adolescents had a significantly higher Total Problem score than the Amsterdam adolescents. Like our earlier studies of CBCL data of children and Teacher's Report Form data of children and adolescents, a measure of poor peer relations was the strongest predictor of CBCL and YSR behavioral and emotional problems in gender dysphoric adolescents. PMID:26373289

  2. A Manual-Based Intervention to Address Clinical Crises and Retain Patients in the Treatment of Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    May, Diane E.; Kratochvil, Christopher J.; Puumala, Susan E.; Silva, Susan G.; Rezac, Amy J.; Hallin, Mary J.; Reinecke, Mark A.; Vitiello, Benedetto; Weller, Elizabeth B.; Pathak, Sanjeev; Simons, Anne D.; March, John S.

    2007-01-01

    Objective: To describe a manual-based intervention to address clinical crises and retain participants in the Treatment for Adolescents with Depression Study (TADS). Method: The use of adjunct services for attrition prevention (ASAP) is described for adolescents (ages 12-17 years) during the 12-week acute treatment in TADS, from 2000 to 2003.…

  3. Alterations in left ventricular, left atrial, and right ventricular structure and function to cardiovascular risk factors in adolescents with type 2 diabetes participating in the TODAY clinical trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Data on cardiovascular disease (CVD) risk in adolescents with type 2 diabetes (T2D) are limited. Echocardiography was performed in the last year of the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial (median 4.5 yr from diagnosis of T2D, average age 18 yr), incl...

  4. Clinical and pathological correlates of severity classifications in trigger fingers based on computer-aided image analysis

    PubMed Central

    2014-01-01

    Background The treatment of trigger finger so far has heavily relied on clinicians’ evaluations for the severity of patients’ symptoms and the functionality of affected fingers. However, there is still a lack of pathological evidence supporting the criteria of clinical evaluations. This study’s aim was to correlate clinical classification and pathological changes for trigger finger based on the tissue abnormality observed from microscopic images. Methods Tissue samples were acquired, and microscopic images were randomly selected and then graded by three pathologists and two physicians, respectively. Moreover, the acquired images were automatically analyzed to derive two quantitative parameters, the size ratio of the abnormal tissue region and the number ratio of the abnormal nuclei, which can reflect tissue abnormality caused by trigger finger. A self-developed image analysis system was used to avoid human subjectivity during the quantification process. Finally, correlations between the quantitative image parameters, pathological grading, and clinical severity classification were assessed. Results One-way ANOVA tests revealed significant correlations between the image quantification and pathological grading as well as between the image quantification and clinical severity classification. The Cohen’s kappa coefficient test also depicted good consistency between pathological grading and clinical severity classification. Conclusions The criteria of clinical classification were found to be highly associated with the pathological changes of affected tissues. The correlations serve as explicit evidence supporting clinicians in making a treatment strategy of trigger finger. In addition, our proposed computer-aided image analysis system was considered to be a promising and objective approach to determining trigger finger severity at the microscopic level. PMID:25055721

  5. Theories of AIDS Transmission: Their Development and Implications.

    ERIC Educational Resources Information Center

    Sigelman, Carol; And Others

    This study examined knowledge of AIDS transmission, attitudes toward interacting with people who have AIDS, and concerns about being personally affected by AIDS in childhood and adolescence. Subjects were 188 children and adolescents ranging from 6 to 18 years old. An open-ended interview covering a wide range of AIDS-related topics was conducted…

  6. Strategies for Overcoming Obstacles in AIDS Education for Preteens.

    ERIC Educational Resources Information Center

    Rodrick-Athans, Linda; Bhavnagri, Navaz Peshotan

    1997-01-01

    Points out that every four months the number of reported AIDS cases among adolescents doubles. Describes and evaluates a comprehensive AIDS prevention education program for preteens. Identifies adolescent attitudes as barriers to effective AIDS education. Presents strategies to break down barriers and promote acceptance of AIDS education,…

  7. Information needs of health care professionals in an AIDS outpatient clinic as determined by chart review.

    PubMed Central

    Giuse, N B; Huber, J T; Giuse, D A; Brown, C W; Bankowitz, R A; Hunt, S

    1994-01-01

    OBJECTIVE: To examine the information needs of health care professionals in HIV-related clinical encounters, and to determine the suitability of existing information sources to address those needs. SETTING: HIV outpatient clinic. PARTICIPANTS: Seven health care professionals with diverse training and patient care involvement. METHODS: Based on patient charts describing 120 patient encounters, participants generated 266 clinical questions. Printed and on-line information sources were used to answer questions in two phases: using commonly available sources and using all available medical library sources. MEASUREMENTS: The questions were divided into 16 categories by subject. The number of questions answered, their categories, the information source(s) providing answers, and the time required to answer questions were recorded for each phase. RESULTS: Each participant generated an average of 3.8 clinical questions per chart. Five categories accounted for almost 75% of all questions; the treatment protocols/regimens category was most frequent (24%). A total of 245 questions (92%) were answered, requiring an average of 15 minutes per question. Most (87%) of the questions were answered via electronic sources, even though paper sources were consulted first. CONCLUSIONS: The participating professionals showed considerable information needs. A combination of on-line and paper sources was necessary to provide the answers. The study suggests that present-day information sources are not entirely satisfactory for answering clinical questions generated by examining charts of HIV-infected patients. PMID:7850563

  8. Clinical correlates of the weight bias internalization scale in a sample of obese adolescents seeking bariatric surgery.

    PubMed

    Roberto, Christina A; Sysko, Robyn; Bush, Jennifer; Pearl, Rebecca; Puhl, Rebecca M; Schvey, Natasha A; Dovidio, John F

    2012-03-01

    The aim of this study was to evaluate psychometric properties and clinical correlates of the Weight Bias Internalization Scale (WBIS) in a sample of obese adolescents seeking bariatric surgery. Sixty five adolescents enrolled in a bariatric surgery program at a large, urban medical center completed psychiatric evaluations, self-report questionnaires including the WBIS and other measures of psychopathology and physical assessments. The WBIS had high internal consistency (Cronbach's α = 0.92). As in previous research with adults, the one underlying factor structure was replicated and 10 of the original 11 items were retained. The scale had significant partial correlations with depression (r = 0.19), anxiety (r = 0.465), social, and behavioral problems (r = 0.364), quality of life (r = -0.480), and eating (r = 0.579), shape (r = 0.815), and weight concerns (r = 0.545), controlling for BMI. However, WBIS scores did not predict current or past psychiatric diagnosis or treatment or past suicidal ideation. Overall, the WBIS had excellent psychometric properties in a sample of obese treatment-seeking adolescents and correlated significantly with levels of psychopathology. These findings suggest that the WBIS could be a useful tool for healthcare providers to assess internalized weight bias among treatment-seeking obese youth. Assessment of internalized weight bias among this clinical population has the potential to identify adolescents who might benefit from information on coping with weight stigma, which in turn may augment weight loss efforts. PMID:21593805

  9. Developing a conceptual framework for an evaluation system for the NIAID HIV/AIDS clinical trials networks.

    PubMed

    Kagan, Jonathan M; Kane, Mary; Quinlan, Kathleen M; Rosas, Scott; Trochim, William M K

    2009-01-01

    Globally, health research organizations are called upon to re-examine their policies and practices to more efficiently and effectively address current scientific and social needs, as well as increasing public demands for accountability.Through a case study approach, the authors examine an effort undertaken by the National Institute of Allergy & Infectious Diseases (part of the National Institutes of Health, Department of Health & Human Services, United States Government) to develop an evaluation system for its recently restructured HIV/AIDS clinical trials program. The challenges in designing, operationalizing, and managing global clinical trials programs are considered in the context of large scale scientific research initiatives.Through a process of extensive stakeholder input, a framework of success factors was developed that enables both a prospective view of the elements that must be addressed in an evaluation of this research and a current state assessment of the extent to which the goals of the restructuring are understood by stakeholders across the DAIDS clinical research networks. PMID:19460164

  10. Developing a conceptual framework for an evaluation system for the NIAID HIV/AIDS clinical trials networks.

    PubMed

    Kagan, Jonathan M; Kane, Mary; Quinlan, Kathleen M; Rosas, Scott; Trochim, William M K

    2009-05-21

    Globally, health research organizations are called upon to re-examine their policies and practices to more efficiently and effectively address current scientific and social needs, as well as increasing public demands for accountability.Through a case study approach, the authors examine an effort undertaken by the National Institute of Allergy & Infectious Diseases (part of the National Institutes of Health, Department of Health & Human Services, United States Government) to develop an evaluation system for its recently restructured HIV/AIDS clinical trials program. The challenges in designing, operationalizing, and managing global clinical trials programs are considered in the context of large scale scientific research initiatives.Through a process of extensive stakeholder input, a framework of success factors was developed that enables both a prospective view of the elements that must be addressed in an evaluation of this research and a current state assessment of the extent to which the goals of the restructuring are understood by stakeholders across the DAIDS clinical research networks.

  11. Instant Experience in Clinical Trials: A Computer-Aided Simulation Technique

    ERIC Educational Resources Information Center

    Simpson, Michael A.

    1976-01-01

    Describes "Instant Experience," a simulation and game method in which students are given information about a promising new drug and asked to design a protocol for a clinical trial of the drug. Evaluation of a trial workshop showed positive response to the method. Educational goals to be achieved through its use are noted. (JT)

  12. Orphans of the AIDS Epidemic: An Examination of Clinical Level Problems of Children

    ERIC Educational Resources Information Center

    Pelton, Jennifer; Forehand, Rex

    2005-01-01

    Objective: The percentage of children with clinical levels of internalizing and externalizing problems before and after maternal death from acquired immunodeficiency syndrome was contrasted with two comparison groups: children whose mothers were human immunodeficiency virus infected but continued to live and children whose mothers were not…

  13. Computer-aided clinical laboratory diagnosis in conjunction with the electronic medical textbook.

    PubMed

    Kawamata, F; Kondoh, M; Mori, C; Endoh, J; Takahashi, T

    1995-01-01

    1. INTRODUCTION. Medical knowledge has been increasing and diversifying on a worldwide scale, while the specialization of physicians has been extended vigorously. Under this environment, it may be natural that mistakes are made in a comprehensive diagnosis, as the physician cannot master all of this dramatically increasing volume of knowledge. The knowledge has extended beyond the memory of human beings, thereby causing the deterioration of service; this is called the "Knowledge crisis." To tackle this problem, the Electronic Medical Textbook (EMT) has been conceived and set up as a medical knowledge base for physicians to optimize both their specialties and activities in clinical practice. Meanwhile, laboratory information systems were widely introduced. However, there are few systems which allow interpretation of the findings obtained. With this in mind, we have improved the utility of the EMT by enhancing its function with laboratory information follow-up, thesaurus back-up, Japanese language support, and online access. 2. SYSTEM DESCRIPTION. The knowledge database for medical decision-making consists of three categories: 1) Medical domain knowledge (including approximately 3500 diseases) from the AMA's "The Current Medical Information & Terminology (CMIT)"; 2) Knowledge on relationship between laboratory testing results and diseases from "The Effects of Disease on Clinical Laboratory," compiled by the AACC; and 3) Clinical testing knowledge from Otsuka's laboratory test handbook "Kensa-Kojien." These categories are connected by links in the process of cross-reference. In actual use, the first is to select the supporting system bringing up clinical signs and findings on CRT from which users can then choose any representations corresponding to the patient's clinical state. Once the relevant objects have been selected, the system presents the correlated investigative tests to be performed, along with a scope of laboratory tests ordering for its initial

  14. Association of X4 tropism with disease progression in antiretroviral-treated children and adolescents living with HIV/AIDS in São Paulo, Brazil.

    PubMed

    Almeida, Flávia Jacqueline; Zaparoli, Mayra Simioni; Moreira, Denise Helena; Cavalcanti, Jaqueline de Souza; Rodrigues, Rosangela; Berezin, Eitan Naaman; Ferreira, João Leandro de Paula; Sáfadi, Marco Aurélio Palazzi; Brígido, Luis Fernando de Macedo

    2014-01-01

    Management of children with HIV/AIDS is specially challenging. Age-related issues do not allow for direct transposition of adult observations to this population. CXCR4 tropism has been associated with disease progression in adults. The geno2pheno web-base is a friendly tool to predict viral tropism on envelope V3 sequences, generating a false positive rate for a CXCR4 prediction. We evaluated the association of HIV-1 tropism prediction with clinical and laboratory outcome of 73 children with HIV/AIDS in São Paulo, Brazil. The CXCR4 tropism was strongly associated with a lower (nadir) CD4 documented during follow-up (p<0.0001) and with disease severity (clinical event and/or CD4 below 200cells/mm(3)) at the last observation, using commonly applied clinical cutoffs, such as (10%)FPRclonal (p=0.001). When variables obtained during follow-up are included, both treatment adherence and viral tropism show a significant association with disease severity. As for viremia suppression, 30% (22/73) were undetectable at the last observation, with only adherence strongly associated with suppression after adjustment. The study brings further support to the notion that antiretroviral treatment adherence is pivotal to management of HIV disease, but suggests that tropism prediction may provide an additional prognostic marker to monitor HIV disease in children.

  15. Incomplete Reconstitution of T Cell Subsets on Combination Antiretroviral Therapy in the AIDS Clinical Trials Group Protocol 384

    PubMed Central

    Robbins, Gregory K.; Spritzler, John G.; Chan, Ellen S.; Asmuth, David M.; Gandhi, Rajesh T.; Rodriguez, Benigno A.; Skowron, Gail; Skolnik, Paul R.; Shafer, Robert W.; Pollard, Richard B.

    2009-01-01

    Background Initiation of combination antiretroviral therapy (ART) results in higher total CD4 cell counts, a surrogate for immune reconstitution. Whether the baseline CD4 cell count affects reconstitution of immune cell subsets has not been well characterized. Methods Using data from 978 patients (621 with comprehensive immunological assessments) from the AIDS [Acquired Immunodeficiency Syndrome] Clinical Trials Group protocol 384, a randomized trial of initial ART, we compared reconstitution of CD4+, CD4+ naive and memory, CD4+ activation, CD8+, CD8+ activation, B, and natural killer cells among patients in different baseline CD4+ strata. Reference ranges for T cell populations in control patients negative for human immunodeficiency virus (HIV) infection were calculated using data from AIDS Clinical Trials Group protocol A5113. Results Patients in the lower baseline CD4+ strata did not achieve total CD4+ cell counts similar to those of patients in the higher strata during 144 weeks of ART, although CD4+ cell count increases were similar. Ratios of CD4+ naive-memory cell counts and CD4+:CD8+ cell counts remained significantly reduced in patients with lower baseline CD4+ cell counts (≤350 cells/mm3). These immune imbalances were most notable for those initiating ART with a baseline CD4+ cell count ≤200 cells/mm3, even after adjustment for baseline plasma HIV RNA levels. Conclusions After nearly 3 years of ART, T cell subsets in patients with baseline CD4+ cell counts >350 cells/mm3 achieved or approached the reference range those of control individuals without HIV infection. In contrast, patients who began ART with ≤350 CD4+ cells/mm3 generally did not regain normal CD4+ naive-memory cell ratios. These results support current guidelines to start ART at a threshold of 350 cells/mm3 and suggest that there may be immunological benefits associated with initiating therapy at even higher CD4+ cell counts. PMID:19123865

  16. Adherence to antiretroviral therapy among HIV and AIDS patients at the Kwa-Thema clinic in Gauteng Province, South Africa

    PubMed Central

    Eyassu, Melaku A.; Mbambo-Kekana, Nonceba P.

    2016-01-01

    Background Introduction of antiretroviral therapy (ART) has shown reduction in HIV-related mortality and morbidity in people living with HIV and AIDS. Since high levels of adherence of more than 95.0% is required to achieve effective suppression of viral load, researchers found it important to establish whether people are pursuing what is expected of them. Aim and setting The study was aimed at determining adherence to ART among HIV and AIDS patients at the Kwa-Thema clinic in Gauteng Province Methods Quantitative cross-sectional descriptive design was used. Ethical clearance was sort from MEDUNSA Research Ethics Committee. Validity and reliability were maintained throughout the study. A non-probability systematic sampling was used. Data were collected using administered structured questionnaire, and a total of 290 respondents were involved. Data were analysed using SPSS software version 22. Results The findings indicated that the adherence to ART was 77.0%. Factors that were significantly associated with adherence were gender (χ2 = 3.78, df = 1, p < 0.05), level of education (χ2 = 3.52, df = 3, p = 0.032), co-treatment of HIV and other infections (χ2 = 5.46, df = 4, p = 0.019), ability to follow ART (χ2 = 12.82, df = 1, p = 0.000 < 0.05), and types of antiretroviral drugs. Recommendation The study recommends intensification of health education campaign against stigma and gender discrimination. Providing feedback to patients regarding benefits of ART is important. Conclusion The study concluded that adherence to ART at the Kwa-Thema clinic was sub-optimal (less than 95%) at 77%, but comparable with the adherence levels in other developing countries. PMID:27380858

  17. Are adolescents with internet addiction prone to aggressive behavior? The mediating effect of clinical comorbidities on the predictability of aggression in adolescents with internet addiction.

    PubMed

    Lim, Jae-A; Gwak, Ah Reum; Park, Su Mi; Kwon, Jun-Gun; Lee, Jun-Young; Jung, Hee Yeon; Sohn, Bo Kyung; Kim, Jae-Won; Kim, Dai Jin; Choi, Jung-Seok

    2015-05-01

    Previous studies have reported associations between aggression and Internet addiction disorder (IAD), which has also been linked with anxiety, depression, and impulsiveness. However, the causal relationship between aggression and IAD has thus far not been clearly demonstrated. This study was designed to (a) examine the association between aggression and IAD and (b) investigate the mediating effects of anxiety, depression, and impulsivity in cases in which IAD predicts aggression or aggression predicts IAD. A total of 714 middle school students in Seoul, South Korea, were asked to provide demographic information and complete the Young's Internet Addiction Test (Y-IAT), the Buss-Perry Aggression Questionnaire, the Barratt Impulsiveness Scale-11, the State-Trait Anger Expression Inventory-2, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Conners-Wells Adolescent Self-Report Scale. Three groups were identified based on the Y-IAT: the usual user group (n=487, 68.2%), the high-risk group (n=191, 26.8%), and the Internet addiction group (n=13, 1.8%). The data revealed a linear association between aggression and IAD such that one variable could be predicted by the other. According to the path analysis, the clinical scales (BAI, BDI, and CASS) had partial or full mediating effects on the ability of aggression to predict IAD, but the clinical scales had no mediating effect on the ability of IAD to predict aggression. The current findings suggest that adolescents with IAD seem to have more aggressive dispositions than do normal adolescents. If more aggressive individuals are clinically prone to Internet addiction, early psychiatric intervention may contribute to the prevention of IAD.

  18. Are adolescents with internet addiction prone to aggressive behavior? The mediating effect of clinical comorbidities on the predictability of aggression in adolescents with internet addiction.

    PubMed

    Lim, Jae-A; Gwak, Ah Reum; Park, Su Mi; Kwon, Jun-Gun; Lee, Jun-Young; Jung, Hee Yeon; Sohn, Bo Kyung; Kim, Jae-Won; Kim, Dai Jin; Choi, Jung-Seok

    2015-05-01

    Previous studies have reported associations between aggression and Internet addiction disorder (IAD), which has also been linked with anxiety, depression, and impulsiveness. However, the causal relationship between aggression and IAD has thus far not been clearly demonstrated. This study was designed to (a) examine the association between aggression and IAD and (b) investigate the mediating effects of anxiety, depression, and impulsivity in cases in which IAD predicts aggression or aggression predicts IAD. A total of 714 middle school students in Seoul, South Korea, were asked to provide demographic information and complete the Young's Internet Addiction Test (Y-IAT), the Buss-Perry Aggression Questionnaire, the Barratt Impulsiveness Scale-11, the State-Trait Anger Expression Inventory-2, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Conners-Wells Adolescent Self-Report Scale. Three groups were identified based on the Y-IAT: the usual user group (n=487, 68.2%), the high-risk group (n=191, 26.8%), and the Internet addiction group (n=13, 1.8%). The data revealed a linear association between aggression and IAD such that one variable could be predicted by the other. According to the path analysis, the clinical scales (BAI, BDI, and CASS) had partial or full mediating effects on the ability of aggression to predict IAD, but the clinical scales had no mediating effect on the ability of IAD to predict aggression. The current findings suggest that adolescents with IAD seem to have more aggressive dispositions than do normal adolescents. If more aggressive individuals are clinically prone to Internet addiction, early psychiatric intervention may contribute to the prevention of IAD. PMID:25902276

  19. Are Adolescents with Internet Addiction Prone to Aggressive Behavior? The Mediating Effect of Clinical Comorbidities on the Predictability of Aggression in Adolescents with Internet Addiction

    PubMed Central

    Lim, Jae-A; Gwak, Ah Reum; Park, Su Mi; Kwon, Jun-Gun; Lee, Jun-Young; Jung, Hee Yeon; Sohn, Bo Kyung; Kim, Jae-Won

    2015-01-01

    Abstract Previous studies have reported associations between aggression and Internet addiction disorder (IAD), which has also been linked with anxiety, depression, and impulsiveness. However, the causal relationship between aggression and IAD has thus far not been clearly demonstrated. This study was designed to (a) examine the association between aggression and IAD and (b) investigate the mediating effects of anxiety, depression, and impulsivity in cases in which IAD predicts aggression or aggression predicts IAD. A total of 714 middle school students in Seoul, South Korea, were asked to provide demographic information and complete the Young's Internet Addiction Test (Y-IAT), the Buss–Perry Aggression Questionnaire, the Barratt Impulsiveness Scale-11, the State–Trait Anger Expression Inventory-2, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Conners–Wells Adolescent Self-Report Scale. Three groups were identified based on the Y-IAT: the usual user group (n=487, 68.2%), the high-risk group (n=191, 26.8%), and the Internet addiction group (n=13, 1.8%). The data revealed a linear association between aggression and IAD such that one variable could be predicted by the other. According to the path analysis, the clinical scales (BAI, BDI, and CASS) had partial or full mediating effects on the ability of aggression to predict IAD, but the clinical scales had no mediating effect on the ability of IAD to predict aggression. The current findings suggest that adolescents with IAD seem to have more aggressive dispositions than do normal adolescents. If more aggressive individuals are clinically prone to Internet addiction, early psychiatric intervention may contribute to the prevention of IAD. PMID:25902276

  20. HIV infection and AIDS: new biology, therapeutic advances, and clinical implications. Introduction.

    PubMed

    Miles, S A

    1997-01-01

    Recent advances in our understanding of the pathogenesis of human immunodeficiency virus (HIV) disease and the important role that viral load plays in the initial selection of antiretroviral therapy significantly alters our management of this disease. Guidelines from the British HIV Association, International AIDS Society-USA, and United States Public Health Service panels regarding the selection of appropriate antiretroviral therapy, and from the Centers for Disease Control and Prevention on prophylaxis for opportunistic infections, have recently been published. Despite tremendous advances in treating the disease and its related complications, a comprehensive, long-term disease management plan that includes recognition of patient concerns about quality of life is lacking. New approaches to managing HIV disease must now include strategies that address patient concerns about fatigue, gastrointestinal distress, malnutrition, and weight loss. Patients must become more involved in decisions about selection of specific drugs and drug regimens and must be consulted about their expectations and needs. We have made significant strides in the treatment of HIV disease. We can readily reduce the viral burden to virtually undetectable levels, and we must continue to develop even more potent and tolerable treatment regimens. We can make patients live longer. Helping patients live better quality lives deserves further study. PMID:9389309

  1. Clinical Management and Patient Outcomes Among Children and Adolescents Receiving Telemedicine Consultations for Obesity

    PubMed Central

    Cole, Stacey L.; Marcin, James P.; Nesbitt, Thomas S.

    2008-01-01

    Abstract Rural residents report lower likelihood of exercising, and higher rates of obesity, heart disease, and diabetes compared to their urban counterparts. Our goals were to (1) investigate the outcomes of telemedicine consultations for pediatric obesity on changes/additions to diagnoses, diagnostic evaluation or treatment, and (2) determine whether changes in diagnostic and management recommendations made by the consultant were associated with improvements in patient nutrition, activity level, and weight. We conducted a retrospective medical record review of patients referred to a University-affiliated Children's Hospital Pediatric Telemedicine Weight Management Clinic for a diagnosis of obesity. Of the 139 children and adolescents who received pediatric weight management consultations during the study period, 99 patients met inclusion criteria. Weight management consultations resulted in changes/additions to diagnoses in 77.8% of patients and changes/additions to diagnostic evaluation in 79.8% of patients. Of patients seen more than once, 80.7% showed improvement in clinical outcomes. Of patients seen more than once, 80.6% improved their diet, 69.4% increased activity levels, 21.0% showed slowing of weight gain or weight maintenance, and 22.6% showed weight reduction. Improvements in clinical outcomes were not associated with changes/additions to diagnoses (Odds Ratio [OR] = 0.98; 95% Confidence Interval [CI] = 0.25–3.98) and were weakly associated with changes/additions to diagnostic evaluations (OR = 2.23; 95% CI = 0.58–8.73). However, changes/additions to treatment were associated with improvement in weight status (OR = 9.0; 95% CI = 1.34–76.21). Obesity consultations were associated with changes/additions to diagnoses, diagnostic evaluation, and treatment. Treatment changes were associated with improvement in weight status. Telemedicine weight management consultations have the potential to result in modifications in patient

  2. Empirical Derivation and Validation of a Clinical Case Definition for Neuropsychological Impairment in Children and Adolescents.

    PubMed

    Beauchamp, Miriam H; Brooks, Brian L; Barrowman, Nick; Aglipay, Mary; Keightley, Michelle; Anderson, Peter; Yeates, Keith O; Osmond, Martin H; Zemek, Roger

    2015-09-01

    Neuropsychological assessment aims to identify individual performance profiles in multiple domains of cognitive functioning; however, substantial variation exists in how deficits are defined and what cutoffs are used, and there is no universally accepted definition of neuropsychological impairment. The aim of this study was to derive and validate a clinical case definition rule to identify neuropsychological impairment in children and adolescents. An existing normative pediatric sample was used to calculate base rates of abnormal functioning on eight measures covering six domains of neuropsychological functioning. The dataset was analyzed by varying the range of cutoff levels [1, 1.5, and 2 standard deviations (SDs) below the mean] and number of indicators of impairment. The derived rule was evaluated by bootstrap, internal and external clinical validation (orthopedic and traumatic brain injury). Our neuropsychological impairment (NPI) rule was defined as "two or more test scores that fall 1.5 SDs below the mean." The rule identifies 5.1% of the total sample as impaired in the assessment battery and consistently targets between 3 and 7% of the population as impaired even when age, domains, and number of tests are varied. The NPI rate increases in groups known to exhibit cognitive deficits. The NPI rule provides a psychometrically derived method for interpreting performance across multiple tests and may be used in children 6-18 years. The rule may be useful to clinicians and scientists who wish to establish whether specific individuals or clinical populations present within expected norms versus impaired function across a battery of neuropsychological tests.

  3. Clinical evolution and nutritional status in asthmatic children and adolescents enrolled in Primary Health Care

    PubMed Central

    Morishita, Rosinha Yoko Matsubayaci; Strufaldi, Maria Wany Louzada; Puccini, Rosana Fiorini

    2015-01-01

    Objective: To evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care. Methods: A retrospective cohort study of 219 asthmatic patients (3-17 years old) enrolled in Primary Care Services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level. Results: 50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (p=0.409). After 1 year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids. Conclusions: The monitoring of asthmatic patients in Primary Care Services showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study. PMID:26316387

  4. Increase in clinical prevalence of AIDS implies increase in unsafe medical injections.

    PubMed

    Reid, S

    2009-05-01

    A mass action model developed by the World Health Organization (WHO) estimates that the re-use of contaminated syringes for medical care accounted for 2.5% of HIV infections in sub-Saharan Africa in 2000. The WHO's model applies the population prevalence of HIV infection rather than the clinical prevalence to calculate patients' frequency of exposure to contaminated injections. This approach underestimates iatrogenic exposure risks when progression to advanced HIV disease is widespread. This sensitivity analysis applies the clinical prevalence of HIV to the model and re-evaluates the transmission efficiency of HIV in injections. These adjustments show that no less than 12-17%, and up to 34-47%, of new HIV infections in sub-Saharan Africa may be attributed to medical injections. The present estimates undermine persistent claims that injection safety improvements would have only a minor impact on HIV incidence in Africa. PMID:19386964

  5. Metaphrase: an aid to the clinical conceptualization and formalization of patient problems in healthcare enterprises.

    PubMed

    Tuttle, M S; Olson, N E; Keck, K D; Cole, W G; Erlbaum, M S; Sherertz, D D; Chute, C G; Elkin, P L; Atkin, G E; Kaihoi, B H; Safran, C; Rind, D; Law, V

    1998-11-01

    Patient descriptors, or "problems," such as "brain metastases of melanoma" are an effective way for caregivers to describe patients. But most problems, e.g., "cubital tunnel syndrome" or "ulnar nerve compression," found in problem lists in an Electronic Medical Record (EMR) are not comparable computationally--in general, a computer cannot determine whether they describe the same or a related problem, or whether the user would have preferred "ulnar nerve compression syndrome." Metaphrase is a scalable, middleware component designed to be accessed from problem-manager applications in EMR systems. In response to caregivers' informal descriptors it suggests potentially equivalent, authoritative, and more formally comparable descriptors. Metaphrase contains a clinical subset of the 1997 UMLS Metathesaurus and some 10,000 "problems" from the Mayo Clinic and Harvard Beth Israel Hospital. Word and term completion, spelling correction, and semantic navigation, all combine to ease the burden of problem conceptualization, entry and formalization.

  6. Randomized clinical trial of musical distraction with and without headphones for adolescents' immunization pain.

    PubMed

    Kristjánsdóttir, Ólöf; Kristjánsdóttir, Guðrún

    2011-03-01

    Distraction has shown to be a helpful pain intervention for children; however, few investigations have studied the effectiveness of this method with adolescents. The aim of this study was to evaluate the usefulness of an easy and practical musical distraction in reducing adolescents' immunization pain. Furthermore, to examine whether musical distraction techniques (with or without headphones) used influenced the pain outcome. Hundred and eighteen 14-year-old adolescents, scheduled for polio immunization, participated. Adolescents were randomly assigned to one of three research groups; musical distraction with headphones (n=38), musical distraction without headphones (n=41) and standard care control (n=39). Results showed adolescents receiving musical distraction were less likely to report pain compared to the control group, controlling for covariates. Comparing musical distraction techniques, eliminating headphone emerged as a significant predictor of no pain. Results suggest that an easy and practical musical distraction intervention, implemented without headphones, can give some pain relief to adolescents during routine vaccination.

  7. FAMILIES' RESPONSE TO AIDS: NEW INSIGHTS INTO PARENTAL ROLES IN FOSTERING HIV/AIDS KNOWLEDGE.

    PubMed

    Dimbuene, Zacharie Tsala

    2015-11-01

    Worldwide, there is a consensus that parents must be involved in children's HIV/AIDS education. However, there is little evidence that speaks to this advocacy for improving adolescent health. This study developed and tested four hypotheses about (i) the relationship between parents' and adolescents' knowledge of HIV/AIDS transmission routes and prevention strategies conditional upon (ii) parents' gender, (iii) communication about sexuality, and (iv) the parent-adolescent education gap. The sample consisted of 306 parent-adolescent dyads from the 2002 Cameroon Family and Health Survey. Adolescents were aged 12-19 years. Overall, fifteen items about HIV/AIDS transmission routes and prevention strategies were analysed. Descriptive results showed that parents fared better than adolescents regardless of the AIDS fact considered. An exception was the correct use of condoms (parents 57% vs adolescents 61%). The generation gap probably explains this result: parents are more conservative, reluctant and distant from condoms compared with adolescents, who are more receptive and open to discussing sex with peers. Multivariate ordered logistic regressions showed a significant positive effect of parents' HIV/AIDS knowledge on adolescents' HIV/AIDS knowledge, thus supporting the main hypothesis of direct parental influences. Parent-adolescent communication about sexuality showed positive and significant effects on adolescents' HIV/AIDS knowledge, suggesting an 'enhancing effect' when combined with the effect of parents' HIV/AIDS knowledge. Against the background that parents in sub-Saharan Africa do not teach their children about sexuality, the study demonstrated that families can play an important role in HIV/AIDS education. These findings have major implications for HIV/AIDS interventions involving adolescents, parents or both, in fostering accurate HIV/AIDS knowledge among adolescents, which could lead to protective sexual behaviours. PMID:25268460

  8. Clinical aspects of obesity in childhood and adolescence--diagnosis, treatment and prevention.

    PubMed

    Kiess, W; Reich, A; Müller, G; Meyer, K; Galler, A; Bennek, J; Kratzsch, J

    2001-05-01

    The level of fatness at which morbidity increases is determined on an acturial basis. Direct measurements of body fat content, eg hydrodensitometry, bioimpedance or DEXA, are useful tools in scientific studies. However, body mass index (BMI) is easy to calculate and is frequently used to define obesity clinically. An increased risk of death from cardiovascular disease in adults has been found in subjects whose BMI had been greater than the 75th percentile as adolescents. Childhood obesity seems to increase the risk of subsequent morbidity whether or not obesity persists into adulthood. The genetic basis of childhood obesity has been elucidated to some extent through the discovery of leptin, the ob gene product, and the increasing knowledge on the role of neuropeptides such as POMC, neuropeptide Y (NPY) and the melanocyte concentrating hormone receptors (MC4R). Environmental/exogenous factors contribute to the development of a high degree of body fatness early in life. Twin studies suggest that approximately 50% of the tendency toward obesity is inherited. There are numerous disorders including a number of endocrine disorders (Cushing's syndrome, hypothyroidism, etc) and genetic syndromes (Prader-Labhard-Willi syndrome, Bardet-Biedl syndrome etc) that can present with obesity. A simple diagnostic algorithm allows for the differentiation between primary or secondary obesity. Among the most common sequelae of primary childhood obesity are hypertension, dyslipidemia and psychosocial problems. Therapeutic strategies include psychological and family therapy, lifestyle/behavior modification and nutrition education. The role of regular exercise and exercise programs is emphasized. Surgical procedures and drugs used as treatments for adult obesity are still not recommended for children and adolescents with obesity. As obesity is the most common chronic disorder in the industrialized societies, its impact on individual lives as well as on health economics has to be

  9. Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms

    PubMed Central

    2012-01-01

    Background The pathophysiology of chronic fatigue syndrome (CFS) in adolescents is unknown, and the clinical course and prognosis is still questioned. Recent research indicates that abnormalities of autonomic cardiovascular control may play an important role. The aim of this research project was to perform a follow-up study of adolescents with chronic fatigue syndrome, focusing on clinical symptoms and autonomic cardiovascular control. Methods 47 adolescents (12-18 years old) with CFS were recruited from the outpatient clinic at the Department of Pediatrics, Oslo University Hospital. In a primary visit and a follow-up visit (3-17 months later), we evaluated: a) a wide range of complaints and symptoms and b) cardiovascular variables at baseline and during a 20° head-up tilt-test (HUT). Results At the second visit, patients reported significant improvement regarding functional impairments, fatigue severity, muscular pain, concentration problems, post-exertional malaise and the problem of non-relieving rest. Also, at the second visit, baseline heart rate (HR), blood pressure, total peripheral resistance index (TPRI) and LF/HF (low-frequency:high-frequency heart rate variability ratio, an index of sinus node sympathovagal balance derived from spectral analyses of heart rate) were significant lower, and the increases in HR, mean blood pressure (MBP), diastolic blood pressure (DBP) and TPRI during tilt were significantly less pronounced as compared to the first visit. There was a significant correlation between changes in autonomic symptom score, fatigue severity score and functional impairment score from the first to the second visit. Conclusions The majority of adolescents with CFS experienced an improvement over time in functional impairment, self-reported fatigue and additional symptoms, and a concurrent improvement of autonomic cardiovascular control. A possible connection between clinical symptoms and abnormal autonomic control in CFS might represent a focus for

  10. The Clinical Impact of Continuing to Prescribe Antiretroviral Therapy in Patients with Advanced AIDS Who Manifest No Virologic or Immunologic Benefit

    PubMed Central

    Wohl, David A.; Kendall, Michelle A.; Feinberg, Judith; Alston-Smith, Beverly; Owens, Susan; Chafey, Suzette; Marco, Michael; Maxwell, Sharon; Benson, Constance; Keiser, Philip; van der Horst, Charles; Jacobson, Mark A.

    2013-01-01

    Introduction Despite the efficacy and tolerability of modern antiretroviral therapy (ART), many patients with advanced AIDS prescribed these regimens do not achieve viral suppression or immune reconstitution as a result of poor adherence, drug resistance, or both. The clinical outcomes of continued ART prescription for such patients have not been well characterized. Methods We examined the causes and predictors of all-cause mortality, AIDS-defining conditions, and serious non-AIDS-defining events among a cohort of participants in a clinical trial of pre-emptive therapy for CMV disease. We focused on participants who, despite ART had failed to achieve virologic suppression and substantive immune reconstitution. Results 233 ART-receiving participants entered with a median baseline CD4+ T cell count of 30/mm3 and plasma HIV RNA of 5 log10 copies/mL. During a median 96 weeks of follow-up, 24.0% died (a mortality rate of 10.7/100 patient-years); 27.5% reported a new AIDS-defining condition, and 22.3% a new serious non-AIDS event. Of the deaths, 42.8% were due to an AIDS-defining condition, 44.6% were due to a non-AIDS-defining condition, and 12.5% were of unknown etiology. Decreased risk of mortality was associated with baseline CD4+ T cell count ≥25/mm3 and lower baseline HIV RNA. Conclusions Among patients with advanced AIDS prescribed modern ART who achieve neither virologic suppression nor immune reconstitution, crude mortality percentages appear to be lower than reported in cohorts of patients studied a decade earlier. Also, in contrast to the era before modern ART became available, nearly half of the deaths in our modern-era study were caused by serious non-AIDS-defining events. Even among the most advanced AIDS patients who were not obtaining apparent immunologic and virologic benefit from ART, continued prescription of these medications appears to alter the natural history of AIDS—improving survival and shifting the causes of death from AIDS- to non-AIDS

  11. Clinical use of vaginal or rectally applied microbicides in patients suffering from HIV/AIDS.

    PubMed

    Gupta, Satish Kumar; Nutan

    2013-01-01

    Microbicides, primarily used as topical pre-exposure prophylaxis, have been proposed to prevent sexual transmission of HIV. This review covers the trends and challenges in the development of safe and effective microbicides to prevent sexual transmission of HIV Initial phases of microbicide development used such surfactants as nonoxynol-9 (N-9), C13G, and sodium lauryl sulfate, aiming to inactivate the virus. Clinical trials of microbicides based on N-9 and C31G failed to inhibit sexual transmission of HIV. On the contrary, N-9 enhanced susceptibility to sexual transmission of HIV-1. Subsequently, microbicides based on polyanions and a variety of other compounds that inhibit the binding, fusion, or entry of virus to the host cells were evaluated for their efficacy in different clinical setups. Most of these trials failed to show either safety or efficacy for prevention of HIV transmission. The next phase of microbicide development involved antiretroviral drugs. Microbicide in the form of 1% tenofovir vaginal gel when tested in a Phase IIb trial (CAPRISA 004) in a coitally dependent manner revealed that tenofovir gel users were 39% less likely to become HIV-infected compared to placebo control. However, in another trial (VOICE MTN 003), tenofovir gel used once daily in a coitally independent mode failed to show any efficacy to prevent HIV infection. Tenofovir gel is currently in a Phase III safety and efficacy trial in South Africa (FACTS 001) employing a coitally dependent dosing regimen. Further, long-acting microbicide-delivery systems (vaginal ring) for slow release of such antiretroviral drugs as dapivirine are also undergoing clinical trials. Discovering new markers as correlates of protective efficacy, novel long-acting delivery systems with improved adherence in the use of microbicides, discovering new compounds effective against a broad spectrum of HIV strains, developing multipurpose technologies incorporating additional features of efficacy against other

  12. Towards the routine use of brain imaging to aid the clinical diagnosis of disorders of consciousness.

    PubMed

    Coleman, M R; Davis, M H; Rodd, J M; Robson, T; Ali, A; Owen, A M; Pickard, J D

    2009-09-01

    Clinical audits have highlighted the many challenges and dilemmas faced by clinicians assessing persons with disorders of consciousness (vegetative state and minimally conscious state). The diagnostic decision-making process is highly subjective, dependent upon the skills of the examiner and invariably dictated by the patients' ability to move or speak. Whilst a considerable amount has been learnt since Jennett and Plum coined the term 'vegetative state', the assessment process remains largely unchanged; conducted at the bedside, using behavioural assessment tools, which are susceptible to environmental and physiological factors. This has created a situation where the rate of misdiagnosis is unacceptably high (up to 43%). In order to address these problems, various functional brain imaging paradigms, which do not rely upon the patient's ability to move or speak, have been proposed as a source of additional information to inform the diagnostic decision making process. Although accumulated evidence from brain imaging, particularly functional magnetic resonance imaging (fMRI), has been encouraging, the empirical evidence is still based on relatively small numbers of patients. It remains unclear whether brain imaging is capable of informing the diagnosis beyond the behavioural assessment and whether brain imaging has any prognostic utility. In this study, we describe the functional brain imaging findings from a group of 41 patients with disorders of consciousness, who undertook a hierarchical speech processing task. We found, contrary to the clinical impression of a specialist team using behavioural assessment tools, that two patients referred to the study with a diagnosis of vegetative state did in fact demonstrate neural correlates of speech comprehension when assessed using functional brain imaging. These fMRI findings were found to have no association with the patient's behavioural presentation at the time of investigation and thus provided additional diagnostic

  13. Traditional complementary and alternative medicine: knowledge, attitudes and practices of health care workers in HIV and AIDS clinics in Durban hospitals.

    PubMed

    Mbutho, Nozuko P; Gqaleni, Nceba; Korporaal, Charmaine M

    2012-01-01

    Traditional complementary and alternative medicine (TCAM) has been reported to be commonly used among individuals with HIV and AIDS disease. However a lack of communication between health care workers (HCWs) and patients as well as between HCWs and TCAM practitioners has been identified as one of the challenges that may adversely affect treatment of HIV and AIDS patients. With improved and sustained communication HCWs, patients and TCAM practitioners would be able to make informed decisions with regards to best treatment practices based on the knowledge of what is safe, effective and what is not. In order to establish a baseline understanding of the current status of interaction and communication between HCWs and TCAM profession in Durban, South Africa, the purpose of the study was to investigate the knowledge, attitudes and practices of HCWs in the HIV and AIDS clinics towards TCAM professions. Data was collected by means of anonymous self-administered questionnaire which was distributed to HCWs in the HIV and AIDS clinics. Out of 161 HCWs in the HIV and AIDS clinics 81 HCWs returned the questionnaires resulting in 50% response rate. The results showed that participants did not possess a basic knowledge of TCAM. Out of 81 participants 23 (28%) scored zero in a true or false knowledge assessment question. PMID:23983356

  14. Sensitivity of Noncommercial Computer-aided Detection System for Mammographic Breast Cancer Detection: Pilot Clinical Trial

    PubMed Central

    Helvie, Mark A.; Hadjiiski, Lubomir; Makariou, Erini; Chan, Heang-Ping; Petrick, Nicholas; Sahiner, Berkman; Lo, Shih-Chung B.; Freedman, Matthew; Adler, Dorit; Bailey, Janet; Blane, Caroline; Hoff, Donna; Hunt, Karen; Joynt, Lynn; Klein, Katherine; Paramagul, Chintana; Patterson, Stephanie K.; Roubidoux, Marilyn A.

    2009-01-01

    PURPOSE To evaluate a noncommercial computer-aided detection (CAD) program for breast cancer detection with screening mammography. MATERIALS AND METHODS A CAD program was developed for mammographic breast cancer detection. The program was applied to 2,389 patients’ screening mammograms at two geographically remote academic institutions (institutions A and B). Thirteen radiologists who specialized in breast imaging participated in this pilot study. For each case, the individual radiologist performed a prospective Breast Imaging Reporting and Data System (BI-RADS) assessment after viewing of the screening mammogram. Subsequently, the radiologist was shown CAD results and rendered a second BI-RADS assessment by using knowledge of both mammographic appearance and CAD results. Outcome analysis of results of examination in patients recalled for a repeat examination, of biopsy, and of 1-year follow-up examination was recorded. Correct detection with CAD included a computer-generated mark indicating a possible malignancy on craniocaudal or mediolateral oblique views or both. RESULTS Eleven (0.46%) of 2,389 patients had mammographically detected nonpalpable breast cancers. Ten (91%) of 11 (95% CI: 74%, 100%) cancers were correctly identified with CAD. Radiologist sensitivity without CAD was 91% (10 of 11; 95% CI: 74%, 100%). In 1,077 patients, follow-up findings were documented at 1 year. Five (0.46%) patients developed cancers, which were found on subsequent screening mammograms. The area where the cancers developed in two (40%) of these five patients was marked (true-positive finding) by the computer in the preceding year. Because of CAD results, a 9.7% increase in recall rate from 14.4% (344 of 2,389) to 15.8% (378 of 2,389) occurred. Radiologists’ recall rate of study patients prior to use of CAD was 31% higher than the average rate for nonstudy cases (10.3%) during the same time period at institution A. CONCLUSION Performance of the CAD program had a very high

  15. High-definition optical coherence tomography - an aid to clinical practice and research in dermatology.

    PubMed

    Cao, Taige; Tey, Hong Liang

    2015-09-01

    At present, beyond clinical assessment, the diagnosis of skin diseases is primarily made histologically. However, skin biopsies have many disadvantages, including pain, scarring, risk of infection, and sampling error. With recent advances in skin imaging technology, the clinical use of imaging methods for the practical management of skin diseases has become an option. The in vivo high-definition optical coherence tomography (HD-OCT) has recently been developed and commercialized (Skintell; Agfa, Belgium). Compared with conventional OCT, it has a higher resolution; compared with reflectance confocal microscopy, it has a shorter time for image acquisition as well as a greater penetration depth and a larger field of view. HD-OCT is promising but much work is still required to develop it from a research tool to a valuable adjunct for the noninvasive diagnosis of skin lesions. Substantial work has been done to identify HD-OCT features in various diseases but interpretation can be time-consuming and tedious. Projects aimed at automating these processes and improving image quality are currently under way.

  16. Clinical effectiveness of dolutegravir in the treatment of HIV/AIDS

    PubMed Central

    Taha, Huda; Das, Archik; Das, Satyajit

    2015-01-01

    Dolutegravir (DTG) is a second-generation integrase strand transfer inhibitor (INSTI), which has now been licensed to be used in different countries including the UK. Earlier studies have demonstrated that DTG when used with nucleoside backbone in treatment-naïve and - experienced patients has been well tolerated and demonstrated virological suppression comparable to other INSTIs and superiority against other first-line agents, including efavirenz and boosted protease inhibitors. Like other INSTIs, DTG uses separate metabolic pathways compared to other antiretrovirals and is a minor substrate for CYP-450. It does not appear to have a significant interaction with drugs, which uses the CYP-450 system. Nonetheless, it uses renal solute transporters that may potentially inhibit the transport of other drugs and can have an effect on the elimination of other drugs. However, the impact of this mechanism appears to be very minimal and insignificant clinically. The side effect profiles of DTG are similar to raltegravir and have been found to be well tolerated. DTG has a long plasma half-life and is suitable for once daily use without the need for a boosting agent. DTG has all the potential to be used as a first-line drug in combination with other nucleoside backbones, especially in the form of a single tablet in combination with abacavir and lamivudine. The purpose of this review article is to present the summary of the available key information about the clinical usefulness of DTG in the treatment of HIV infection. PMID:26491363

  17. Locomotion studies as an aid in clinical assessment of childhood gait.

    PubMed Central

    Letts, R. M.; Winter, D. A.; Quanbury, A. O.

    1975-01-01

    A clinical locomotion laboratory has been developed to provide quantitative information in the management of gait disorders. The biomedical engineering development of this system identified two major clinical constraints: (a) the need for instrumentation that would not alter the natural gait of the patient and (b) the need for data-processing techniques that would permit analysis and correlation of the large volume of electromyographic (EMg) and kinematic information. The net result has been a unit that incorporates a multichannel telemetry system to capture the EMG and foot-switch information and a television computer system to handle the kinematic information. Gait studies on children with hemiparesis, muscular dystrophy and cerebral palsy have yielded quantitative EMG and kinematic information on the pathomechanics of ambulation in these disorders. Because the information obtained is quantitative, an accurate measure of improvement (or lack of it) after treatment can be documented. Therefore, the locomotion laboratory may have an important role in the preoperative and postoperative evaluation of children whose abnormal gait may require surgical corrective procedures or rehabilitative treatment including the use of prostheses or orthoses. Images FIG. 2 FIG. 4 FIG. 6 FIG. 7 FIG. 8A FIG. 8B PMID:1168537

  18. Rapid Identification of Mycobacterium Species with the Aid of Multiplex Polymerase Chain Reaction (PCR) From Clinical Isolates

    PubMed Central

    Gupta, Siddhartha; Bandyopadhyay, Debasis; Paine, Suman Kalyan; Gupta, Soma; Banerjee, Surajita; Bhattacharya, Sujata; Gachhui, Ratan; Bhattacharya, Basudev

    2010-01-01

    Mycobacteria are aerobic, nonspore forming, non-motile,single-cell bacteria.Of more than 40 currently recognized species of mycobacteria, Mycobacterium tuberculosis, the causative agent of human TB is the commonest pathogen for pulmonary and extra pulmonary tuberculosis cases. The other members of the Mycobacterium tuberculosis complex (MTC) or the nontubercular mycobacterium (NTM) produces similar diseases which cannot be differentiated from tuberculosis by clinical symptoms and signs. But this differentiation is important as the chemotherapy varies widely according to the strain of mycobacterium. The burden of morbidity and mortality of tuberculosis is rapidly growing worldwide, particularly with the HIV/AIDS epidemic. The strain identification of Mycobacterium remains a cumbersome, labor intensive and expensive procedure, which requires 3 to 12 weeks of time. The conventional methods of strain identification lack proper standardization and precise diagnosis. The prime objective of this study is to overcome these problems. A multiplex PCR using 3 amplicons of 165,365, and 541 base pair target sequences was done with a total number of 165 clinical isolates of suspected Koch’s patients. Strain identification was compared both by conventional methods and multiplex PCR. The results of the study show that this multiplex PCR is supposed to be less complicated, less time consuming, cost-effective and superior to the conventional methods. It is also applicable for culture negative samples where strain identification is not possible by conventional approach. PMID:21258579

  19. "Teens Talk Healthy Weight": the impact of a motivational digital video disc on parental knowledge of obesity-related diseases in an adolescent clinic.

    PubMed

    Windham, Meghan E; Hastings, Elisabeth S; Anding, Roberta; Hergenroeder, Albert C; Escobar-Chaves, Soledad Liliana; Wiemann, Constance M

    2014-10-01

    The purpose of the study was to investigate the impact of a 7-minute educational and motivational weight-management digital video disc (DVD) that uses real patient/parent testimonials and provider-patient interactions, on adolescent and parent knowledge of obesity-related diseases; readiness, motivation, and self-efficacy to lose weight; connectedness to care provider; and likelihood of return to clinic for follow-up care. A randomized controlled trial was conducted among 40 overweight/obese adolescent participants (22.5% male, 77.5% female, mean age=15.43 years) and their parents (n=38) who visited a referral-only adolescent clinic for the first time from October 2009 to March 2010. Adolescents were randomly assigned by a research assistant to standard care alone or standard care plus DVD. Standard care (protocol-driven medical and nutritional assessment and counseling) was provided to all adolescents by a registered dietitian nutritionist and physician or nurse practitioner. Adolescents in the intervention group also viewed the DVD. Adolescents and parents completed assessments pre- and post-clinic visit. Repeated measures analysis of covariance was used to evaluate group differences, while controlling for race/ethnicity and age. Parents who viewed the DVD experienced greater improvements in obesity-related disease knowledge than parents who did not view the DVD. Adolescents in both groups improved on measures of motivation to lose weight and dieting self-efficacy, based on pre and post-test questionnaires. A 7-minute educational and motivational DVD helped improve parent knowledge, but was not more powerful than standard care alone in changing other weight-related outcomes in this adolescent clinic. Because it led to increased parental knowledge, incorporating the DVD into clinical practice could also allow more time for health providers to focus on specific obesity-related treatment/education. Future research might examine whether the DVD has more utility in

  20. "Teens Talk Healthy Weight": the impact of a motivational digital video disc on parental knowledge of obesity-related diseases in an adolescent clinic.

    PubMed

    Windham, Meghan E; Hastings, Elisabeth S; Anding, Roberta; Hergenroeder, Albert C; Escobar-Chaves, Soledad Liliana; Wiemann, Constance M

    2014-10-01

    The purpose of the study was to investigate the impact of a 7-minute educational and motivational weight-management digital video disc (DVD) that uses real patient/parent testimonials and provider-patient interactions, on adolescent and parent knowledge of obesity-related diseases; readiness, motivation, and self-efficacy to lose weight; connectedness to care provider; and likelihood of return to clinic for follow-up care. A randomized controlled trial was conducted among 40 overweight/obese adolescent participants (22.5% male, 77.5% female, mean age=15.43 years) and their parents (n=38) who visited a referral-only adolescent clinic for the first time from October 2009 to March 2010. Adolescents were randomly assigned by a research assistant to standard care alone or standard care plus DVD. Standard care (protocol-driven medical and nutritional assessment and counseling) was provided to all adolescents by a registered dietitian nutritionist and physician or nurse practitioner. Adolescents in the intervention group also viewed the DVD. Adolescents and parents completed assessments pre- and post-clinic visit. Repeated measures analysis of covariance was used to evaluate group differences, while controlling for race/ethnicity and age. Parents who viewed the DVD experienced greater improvements in obesity-related disease knowledge than parents who did not view the DVD. Adolescents in both groups improved on measures of motivation to lose weight and dieting self-efficacy, based on pre and post-test questionnaires. A 7-minute educational and motivational DVD helped improve parent knowledge, but was not more powerful than standard care alone in changing other weight-related outcomes in this adolescent clinic. Because it led to increased parental knowledge, incorporating the DVD into clinical practice could also allow more time for health providers to focus on specific obesity-related treatment/education. Future research might examine whether the DVD has more utility in

  1. Typical Versus Atypical Anorexia Nervosa Among Adolescents: Clinical Characteristics and Implications for ICD-11.

    PubMed

    Silén, Yasmina; Raevuori, Anu; Jüriloo, Elisabeth; Tainio, Veli-Matti; Marttunen, Mauri; Keski-Rahkonen, Anna

    2015-09-01

    There is scant research on the clinical utility of differentiating International Classification of Diseases (ICD) 10 diagnoses F50.0 anorexia nervosa (typical AN) and F50.1 atypical anorexia. We reviewed systematically records of 47 adolescents who fulfilled criteria for ICD-10 F50.0 (n = 34) or F50.1 (n = 13), assessing the impact of diagnostic subtype, comorbidity, background factors and treatment choices on recovery. Atypical AN patients were significantly older (p = 0.03), heavier (minimum body mass index 16.7 vs 15.1 kg/m(2) , p = 0.003) and less prone to comorbidities (38% vs 71%, p = 0.04) and had shorter, less intensive and less costly treatments than typical AN patients. The diagnosis of typical versus atypical AN was the sole significant predictor of treatment success: recovery from atypical AN was 4.3 times (95% confidence interval [1.1, 17.5]) as likely as recovery from typical AN. Overall, our findings indicate that a broader definition of AN may dilute the prognostic value of the diagnosis, and therefore, ICD-11 should retain its distinction between typical and atypical AN.

  2. Clinical utility of reliable digit span in assessing effort in children and adolescents with epilepsy.

    PubMed

    Welsh, Antoinette J; Bender, H Allison; Whitman, Lindsay A; Vasserman, Marsha; Macallister, William S

    2012-11-01

    The assessment of effort is an important aspect of a comprehensive neuropsychological evaluation, as this can significantly impact data interpretation. While recent work has validated the appropriateness of adult-derived cutoffs for standalone effort measures in younger populations, little research has focused on embedded effort measures in children. The present study includes 54 clinically referred children and adolescents (32 males/22 females; aged 6-17) with a confirmed diagnosis of epilepsy. Reliable Digit Spans (RDSs) were calculated and the Test of Memory Malingering (TOMM) was administered in the context of a comprehensive neuropsychological evaluation. Using a previously published RDS cutoff of ≤6, a pass rate of only 65% was obtained, well below the recommended 90% pass rate for an effective effort index. In contrast, when adult criteria were used on TOMM Trial 2, a 90% pass rate was observed. RDS scores were significantly correlated with IQ estimates (r = .59, p < .001) and age (r = .61, p < .001). The difference between RDS and the TOMM on the participant outcome was statistically significant (χ(2) = 9.05, p = .003). These results suggest that RDS appears to yield a large number of false positives and, therefore, may be of limited utility in detecting poor effort in a pediatric epilepsy population. These findings likely extend to other pediatric populations that are known to have significant cognitive loss.

  3. Clinical and Cognitive Characteristics Associated with Mathematics Problem Solving in Adolescents with Autism Spectrum Disorder.

    PubMed

    Oswald, Tasha M; Beck, Jonathan S; Iosif, Ana-Maria; McCauley, James B; Gilhooly, Leslie J; Matter, John C; Solomon, Marjorie

    2016-04-01

    Mathematics achievement in autism spectrum disorder (ASD) has been understudied. However, the ability to solve applied math problems is associated with academic achievement, everyday problem-solving abilities, and vocational outcomes. The paucity of research on math achievement in ASD may be partly explained by the widely-held belief that most individuals with ASD are mathematically gifted, despite emerging evidence to the contrary. The purpose of the study was twofold: to assess the relative proportions of youth with ASD who demonstrate giftedness versus disability on applied math problems, and to examine which cognitive (i.e., perceptual reasoning, verbal ability, working memory) and clinical (i.e., test anxiety) characteristics best predict achievement on applied math problems in ASD relative to typically developing peers. Twenty-seven high-functioning adolescents with ASD and 27 age- and Full Scale IQ-matched typically developing controls were assessed on standardized measures of math problem solving, perceptual reasoning, verbal ability, and test anxiety. Results indicated that 22% of the ASD sample evidenced a mathematics learning disability, while only 4% exhibited mathematical giftedness. The parsimonious linear regression model revealed that the strongest predictor of math problem solving was perceptual reasoning, followed by verbal ability and test anxiety, then diagnosis of ASD. These results inform our theories of math ability in ASD and highlight possible targets of intervention for students with ASD struggling with mathematics.

  4. Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents

    PubMed Central

    Bello, Nicholas T

    2015-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR). As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is “added on” to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD. PMID:26170637

  5. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

    PubMed Central

    Di Lorenzo, Rosaria; Cimino, Nina; Di Pietro, Elena; Pollutri, Gabriella; Neviani, Vittoria; Ferri, Paola

    2016-01-01

    Background Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT), and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18) who had acute hospitalizations (n=140) in SPDT and had been successively transferred to “The Medlar” (n=83), from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient −2.28, 95% confidence interval [CI]: −3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic regression). The most frequent reasons for admission were aggressive behavior in males and suicide risk in females (P=0.002). The most frequent psychiatric diagnosis at SPDT discharge was “conduct disorder”, more frequent in males, followed by “adjustment disorder”, more frequent in females (P=0.001). In SPDT, the adolescent hospitalizations progressively increased fivefold at the end of the observation period

  6. SeDeLo: using semantics and description logics to support aided clinical diagnosis.

    PubMed

    Rodríguez-González, Alejandro; Labra-Gayo, Jose Emilio; Colomo-Palacios, Ricardo; Mayer, Miguel A; Gómez-Berbís, Juan Miguel; García-Crespo, Angel

    2012-08-01

    Automated medical diagnosis systems based on knowledge-oriented descriptions have gained momentum with the emergence of semantic descriptions. The objective of this paper is to propose a normalized design that solves some of the problems which have been detected by authors in previous tools. The authors bring together two different technologies to develop a new clinical decision support system: description logics aimed at developing inference systems to improve decision support for the prevention, treatment and management of illness and semantic technologies. Because of its new design, the system is capable of obtaining improved diagnostics compared with previous efforts. However, this evaluation is more focused in the computational performance, giving as result that description logics is a good solution with small data sets. In this paper, we provide a well-structured ontology for automated diagnosis in the medical field and a three-fold formalization based on Description Logics with the use of Semantic Web technologies.

  7. Computer-aided assessment of transient ischemic attacks. A clinical evaluation.

    PubMed

    Reggia, J A; Tabb, D R; Price, T R; Banko, M; Hebel, R

    1984-12-01

    We developed and evaluated a computer-based system to assist with the difficult problem of assessing the conditions of patients with transient ischemic attacks (TIAs). The program used criteria to classify a patient's illness localize the neurologic deficit, screen for 46 causative or mimicking disorders, recommend additional tests, and suggest management steps. We evaluated this program in 103 patients with TIAs. The TIA program's localization and classification of patients generally agreed with those made by stroke specialists at our institution, demonstrating that computer programs can reproduce the decision criteria of stroke specialists. With revisions, the TIA program or similar systems could be useful for objective disease classification in clinical trials or epidemiologic studies. In contrast, the TIA program's treatment recommendations were often found to differ significantly from the actual treatments administered by non-stroke specialists.

  8. ESCAP Expert Article: borderline personality disorder in adolescence: an expert research review with implications for clinical practice.

    PubMed

    Fonagy, Peter; Speranza, Mario; Luyten, Patrick; Kaess, Michael; Hessels, Christel; Bohus, Martin

    2015-11-01

    Borderline personality disorder (BPD) has onset in adolescence, but is typically first diagnosed in young adulthood. This paper provides a narrative review of the current evidence on diagnosis, comorbidity, phenomenology and treatment of BPD in adolescence. Instruments available for diagnosis are reviewed and their strengths and limitations discussed. Having confirmed the robustness of the diagnosis and the potential for its reliable clinical assessment, we then explore current understandings of the mechanisms of the disorder and focus on neurobiological underpinnings and research on psychological mechanisms. Findings are accumulating to suggest that adolescent BPD has an underpinning biology that is similar in some ways to adult BPD but differs in some critical features. Evidence for interventions focuses on psychological therapies. Several encouraging research studies suggest that early effective treatment is possible. Treatment development has just begun, and while adolescent-specific interventions are still in the process of evolution, most existing therapies represent adaptations of adult models to this developmental phase. There is also a significant opportunity for prevention, albeit there are few data to date to support such initiatives. This review emphasizes that there can be no justification for failing to make an early diagnosis of this enduring and pervasive problem.

  9. Clinical status in adolescents: is its impact on oral health-related quality of life influenced by psychological characteristics?

    PubMed

    Foster Page, Lyndie A; Thomson, W Murray; Ukra, Ali; Baker, Sarah R

    2013-06-01

    The objective of this study was to examine, using structural equation modelling, the relationships among clinical characteristics (such as caries experience and malocclusion), oral health-related quality of life (OHRQoL), and psychological characteristics (mental health, self-esteem, somatisation, and social perception of body image) in adolescents in New Zealand. Adolescents were examined for malocclusion using the Dental Aesthetic Index (DAI) and for dental caries. Among the 353 (58.8%) 12- and 13-yr-old adolescents who took part in this cross-sectional study, the overall mean ± SD decayed, missing, or filled surfaces (DMFS) value was 1.6 ± 3.0, with slightly more than 50% of being caries-free; the mean ± SD DAI was 31.5 ± 7.6, with one-quarter of subjects having a 'handicapping' malocclusion. The structural equation modelling analysis showed that the structural model was a good fit to the data. As hypothesized, the DAI score significantly predicted OHRQoL. There was no direct relationship between caries experience (DMFS) and OHRQoL, but there was an indirect effect of DMFS on OHRQoL mediated through psychological characteristics. The amount of OHRQoL variance accounted for in the model was substantial, at 62%. It appears that investigating OHRQoL in adolescents is not straightforward; while malocclusion directly affects OHRQoL, the influence of dental caries experience is less direct.

  10. Compensation for research-related injury in NIH-sponsored HIV/AIDS clinical trials in Africa.

    PubMed

    Mamotte, Nicole; Wassenaar, Douglas; Singh, Nivedhna

    2013-02-01

    Concern has been voiced in the research ethics literature that under U.S. federal regulations U.S. sponsors, particularly the NIH, are not required to provide compensation for the treatment of research-related injury for trial participants or to allow grant funds to be used by investigators for appropriate insurance. This is problematic in developing country contexts because most participants are unlikely to have health insurance, resulting in overburdened and under-resourced health systems in many developing countries being responsible for providing care and treatment for research-related injury. This study provides preliminary insight into how respondent principal investigators of NIH-sponsored HIV/AIDS clinical trials in Africa and African research ethics committees deal with compensation for research-related injury. The majority of PIs surveyed provided free treatment for research-related injury, but few provided other forms of financial reparation to participants. The study also found that half of the PIs surveyed indicated that NIH funds were used for compensation, highlighting a contradiction between literature and practice. The majority of REC chairs surveyed indicated that their RECs routinely reviewed compensation plans for research-related injury and that their ethics application forms specifically requested information on compensation. Findings from one southern African country revealed that NIH funds were not used to provide treatment and/or financial reparation for research-related injury. Instead, PIs from this country relied on the government or the individual research participant (and/or their medical aid/health insurer) to cover the costs of research-related injury. The findings are discussed in the light of the recent (December 2011) U.S. Presidential Commission for the Study of Bioethics report which recommends that research participants are morally entitled to compensation for research-related injury.

  11. Association of Educational Attainment and Adolescent Substance Use Disorder in a Clinical Sample

    ERIC Educational Resources Information Center

    Apantaku-Olajide, Tunde; James, Philip D.; Smyth, Bobby P.

    2014-01-01

    This study explores substance use, psychosocial problems, and the relationships to educational status in 193 adolescents (school dropouts, 63; alternative education, 46; mainstream students, 84) who attended a substance abuse treatment facility in Dublin, Ireland, within a 42-month period. For each adolescent, data on demographics, family…

  12. Capoeira as a Clinical Intervention: Addressing Adolescent Aggression with Brazilian Martial Arts

    ERIC Educational Resources Information Center

    Burt, Isaac; Butler, S. Kent

    2011-01-01

    Aggression in adolescents is harmful and emotionally devastating to youth and surrounding communities. This article integrates martial arts and therapeutic principles into a culturally sensitive model that cultivates change in the aggressive behaviors of disenfranchised adolescents. The art form of Capoeira is proposed for promoting positive…

  13. Depressive Symptoms and Clinical Status during the Treatment of Adolescent Suicide Attempters (TASA) Study

    ERIC Educational Resources Information Center

    Vitiello, Benedetto; Brent, David A.; Greenhill, Laurence L.; Emslie, Graham; Wells, Karen; Walkup, John T.; Stanley, Barbara; Bukstein, Oscar; Kennard, Betsy D.; Compton, Scott; Coffey, Barbara; Cwik, Mary F.; Posner, Kelly; Wagner, Ann; March, John S.; Riddle, Mark; Goldstein, Tina; Curry, John; Capasso, Lisa; Mayes, Taryn; Shen, Sa; Gugga, S. Sonia; Turner, J. Blake; Barnett, Shannon; Zelazny, Jamie

    2009-01-01

    Objective: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. Method: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating…

  14. Adolescents and the Media: Medical and Psychological Impact. Developmental Clinical Psychology and Psychiatry, Volume 33.

    ERIC Educational Resources Information Center

    Strasburger, Victor C.

    Aimed at primary care physicians and nurses, educators, and parents, this book reviews media effects on adolescent behavior and psychology. The book notes that television is a powerful medium to which adolescents are uniquely susceptible and how studies have shown television's ability to shape social attitudes. Theories of how television affects…

  15. The clinical usefulness of the new LPE specifier for subtyping adolescents with conduct disorder in the DSM 5.

    PubMed

    Jambroes, Tijs; Jansen, Lucres M C; Vermeiren, Robert R J M; Doreleijers, Theo A H; Colins, Olivier F; Popma, Arne

    2016-08-01

    In DSM 5, conduct disorder (CD) has been expanded with a new specifier 'with Limited Prosocial Emotions' (LPE) in addition to the age-of-onset (AoO) subtyping, and is thought to identify a severe antisocial subgroup of CD. However, research in clinical practice has been scarce. Therefore, the current study will examine differences in clinical symptoms between subtypes of CD, based on both subtyping schemes. Subsequently, it will investigate whether the LPE specifier explains unique variance in aggression, added to the AoO subtyping. A sample of 145 adolescents with CD (51 % male, mean age 15.0) from a closed treatment institution participated in this study. CD diagnoses and AoO subtype were assessed using a structured diagnostic interview. The LPE specifier was assessed using the callous-unemotional dimension of the Youth Psychopathy Traits Inventory (YPI). Self-reported proactive and reactive aggression, rule-breaking behavior and internalizing problems within the subtypes were compared. Youth with childhood-onset CD and LPE showed significantly more aggression than adolescent-onset CD without LPE (proactive aggression: F = 3.1, p < 0.05, reactive aggression: F = 3.7, p < 0.05). Hierarchical regression revealed that the LPE specifier uniquely explained 7 % of the variance in reactive aggression, additionally to the AoO subtyping. For proactive aggression, the interaction between AoO and the LPE added 4.5 % to the explained variance. Although the LPE specifier may help to identify a more aggressive subtype of CD in adolescents, the incremental utility seems to be limited. Therefore, clinical relevance of the LPE specifier in high-risk adolescent samples still needs to be investigated thoroughly. PMID:26725044

  16. The use of laser Doppler imaging as an aid in clinical management decision making in the treatment of vesicant burns.

    PubMed

    Brown, R F; Rice, P; Bennett, N J

    1998-12-01

    Vesicants are a group of chemicals recognised, under the terms of the Chemical Weapons Convention, as potential chemical warfare agents whose prime effect on the skin is to cause burns and blistering. Experience of the clinical management of these injuries is not readily available and therefore an accurate assessment of the severity of the lesion and extent of tissue involvement is an important factor when determining the subsequent clinical management strategy for such lesions. This study was performed to assess the use of laser Doppler imaging (LDI) as a noninvasive means of assessing wound microvascular perfusion following challenge with the vesicant agents (sulphur mustard or lewisite) by comparing the images obtained with histopathological analysis of the lesion. Large white pigs were challenged with sulphur mustard (1.91 mg cm(-2)) or lewisite (0.3 mg.cm(-2)) vapour for periods of up to 6 h At intervals of between 1 h and 7 days following vesicant challenge, LDI images were acquired and samples for routine histopathology were taken. The results from this study suggest that LDI was: (i) a simple, reproducible and noninvasive means of assessing changes in tissue perfusion, and hence tissue viability, in developing and healing vesicant burns; (ii) the LDI images correlates well with histopathological assessment of the resulting lesions and the technique was sufficiently sensitive enough to discriminate between skin lesions of different aetiology. These attributes suggest that LDI would be a useful investigative tool that could aid clinical management decision making in the early treatment of vesicant agent-induced skin burns.

  17. Image-aided Suicide Gene Therapy Utilizing Multifunctional hTERT-targeting Adenovirus for Clinical Translation in Hepatocellular Carcinoma

    PubMed Central

    Kim, Yun-Hee; Kim, Kyung Tae; Lee, Sang-Jin; Hong, Seung-Hee; Moon, Ju Young; Yoon, Eun Kyung; Kim, Sukyoung; Kim, Eun Ok; Kang, Se Hun; Kim, Seok Ki; Choi, Sun Il; Goh, Sung Ho; Kim, Daehong; Lee, Seong-Wook; Ju, Mi Ha; Jeong, Jin Sook; Kim, In-Hoo

    2016-01-01

    Trans-splicing ribozyme enables to sense and reprogram target RNA into therapeutic transgene and thereby becomes a good sensing device for detection of cancer cells, judging from transgene expression. Previously we proposed PEPCK-Rz-HSVtk (PRT), hTERT targeting trans-splicing ribozyme (Rz) driven by liver-specific promoter phosphoenolpyruvate carboxykinase (PEPCK) with downstream suicide gene, herpes simplex virus thymidine kinase (HSVtk) for hepatocellular carcinoma (HCC) gene therapy. Here, we describe success of a re-engineered adenoviral vector harboring PRT in obtaining greater antitumor activity with less off-target effect for clinical application as a theranostics. We introduced liver-selective apolipoprotein E (ApoE) enhancer to the distal region of PRT unit to augment activity and liver selectivity of PEPCK promoter, and achieved better transduction into liver cancer cells by replacement of serotype 35 fiber knob on additional E4orf1-4 deletion of E1&E3-deleted serotype 5 back bone. We demonstrated that our refined adenovirus harboring PEPCK/ApoE-Rz-HSVtk (Ad-PRT-E) achieved great anti-tumor efficacy and improved ability to specifically target HCC without damaging normal hepatocytes. We also showed noninvasive imaging modalities were successfully employed to monitor both how well a therapeutic gene (HSVtk) was expressed inside tumor and how effectively a gene therapy took an action in terms of tumor growth. Collectively, this study suggests that the advanced therapeutic adenoviruses Ad-PRT-E and its image-aided evaluation system may lead to the powerful strategy for successful clinical translation and the development of clinical protocols for HCC therapy. PMID:26909111

  18. The Impact of a Culturally Appropriate, STD/AIDS Education Intervention on Black Male Adolescents' Sexual and Condom Use Behavior.

    ERIC Educational Resources Information Center

    DeLamater, John; Wagstaff, David A.; Havens, Kayt Klein

    A culturally appropriate, theoretically based videotape was developed in collaboration with local African American producers to promote condom use among 15-to-19-year-old black males seeking treatment at a municipal sexually transmitted disease (STD) clinic. The videotape's immediate, short-term (30-day), and long-term (6-month) impacts were…

  19. A qualitative exploration of resilience in pre-adolescent AIDS orphans living in a residential care facility.

    PubMed

    Pienaar, Anja; Swanepoel, Zendré; van Rensburg, Hendrik; Heunis, Christo

    2011-01-01

    This article presents the findings of a study among a small group of South African AIDS orphans living in a residential care facility, Lebone Land. The research was conducted between June and September 2006. A qualitative, exploratory study consisting of in-depth, semistructured interviews with eight children and seven key informants aimed to identify and investigate developmental assets operating in the children's lives to help them cope amid exposure to adversities. The findings indicate that the developmental assets that facilitate coping and foster resilience in these children relate to four main components: external stressors and challenges, external supports, inner strengths and interpersonal and problem-solving skills. Emerging key themes relate to the experience of illness, death, poverty and violence, as well as the important roles of morality, social values, resistance skills, religion and faith in assisting these children in defining their purpose in life. To this end, constructive use of time, commitment to learning, goal-setting, problem-solving ability and self-efficacy are fundamental in the children's attainment of their future projections. Therefore, qualities such as optimism, perseverance and hope seem to permeate the children's process of recovery. Strong networks of support, particularly friendships with other children, also seem to contribute to developing and sustaining resilience. PMID:23237727

  20. Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis

    PubMed Central

    Wang, Q.; Li, M.; Lou, Edmond H. M.; Wong, M. S.

    2015-01-01

    Background Non-ionizing radiation imaging assessment has been advocated for the patients with adolescent idiopathic scoliosis (AIS). As one of the radiation-free methods, ultrasound imaging has gained growing attention in scoliosis assessment over the past decade. The center of laminae (COL) method has been proposed to measure the spinal curvature in the coronal plane of ultrasound image. However, the reliability and validity of this ultrasound method have not been validated in the clinical setting. Objectives To evaluate the reliability and validity of clinical ultrasound imaging on lateral curvature measurements of AIS with their corresponding magnetic resonance imaging (MRI) measurements. Methods Thirty curves (ranged 10.2°–68.2°) from sixteen patients with AIS were eligible for this study. The ultrasound scan was performed using a 3-D ultrasound unit within the same morning of MRI examination. Two researchers were involved in data collection of these two examinations. The COL method was used to measure the coronal curvature in ultrasound image, compared with the Cobb method in MRI. The intra- and inter-rater reliability of the COL method was evaluated by intra-class correlation coefficient (ICC). The validity of this method was analyzed by paired Student’s t-test, Bland–Altman statistics and Pearson correlation coefficient. The level of significance was set as 0.05. Results The COL method showed high intra- and inter-rater reliabilities (both with ICC (2, K) >0.9, p<0.05) to measure the coronal curvature. Compared with Cobb method, COL method showed no significant difference (p<0.05) when measuring coronal curvature. Furthermore, Bland-Altman method demonstrated an agreement between these two methods, and Pearson’s correlation coefficient (r) was high (r>0.9, p<0.05). Conclusion The ultrasound imaging could provide a reliable and valid measurement of spinal curvature in the coronal plane using the COL method. Further research is needed to validate the

  1. [Consensus document on the clinical use of melatonin in children and adolescents with sleep-onset insomnia].

    PubMed

    Pin Arboledas, G; Merino Andreu, M; de la Calle Cabrera, T; Hidalgo Vicario, M I; Rodríguez Hernández, P J; Soto Insuga, V; Madrid Pérez, J A

    2014-11-01

    Sleep problems are highly prevalent among our children and adolescents. Its treatment is mainly based on cognitive behavioural therapies and habit modification procedures. However, the use of sleep promoting drugs and substances is widespread without being supported by clinical guidelines. Exogenous melatonin is a neurohormone marketed as a nutritional supplement that is being increasingly used in the management of sleep problems, and with no control over its use. The consensus document is presented on the use of melatonin in sleep-onset insomnia prepared by representatives of the Spanish Paediatric Association, the Spanish Society of Sleep, the Spanish Society of Paediatric Outpatients and Primary Care, the Spanish Society for Adolescent Medicine, the Spanish Society of Child Psychiatry, and the Spanish Society of Paediatric Neurology.

  2. [Consensus document on the clinical use of melatonin in children and adolescents with sleep-onset insomnia].

    PubMed

    Pin Arboledas, G; Merino Andreu, M; de la Calle Cabrera, T; Hidalgo Vicario, M I; Rodríguez Hernández, P J; Soto Insuga, V; Madrid Pérez, J A

    2014-11-01

    Sleep problems are highly prevalent among our children and adolescents. Its treatment is mainly based on cognitive behavioural therapies and habit modification procedures. However, the use of sleep promoting drugs and substances is widespread without being supported by clinical guidelines. Exogenous melatonin is a neurohormone marketed as a nutritional supplement that is being increasingly used in the management of sleep problems, and with no control over its use. The consensus document is presented on the use of melatonin in sleep-onset insomnia prepared by representatives of the Spanish Paediatric Association, the Spanish Society of Sleep, the Spanish Society of Paediatric Outpatients and Primary Care, the Spanish Society for Adolescent Medicine, the Spanish Society of Child Psychiatry, and the Spanish Society of Paediatric Neurology. PMID:24768501

  3. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis.

    PubMed

    Bousquet, Jean; Schünemann, Holger J; Hellings, Peter W; Arnavielhe, Sylvie; Bachert, Claus; Bedbrook, Anna; Bergmann, Karl-Christian; Bosnic-Anticevich, Sinthia; Brozek, Jan; Calderon, Moises; Canonica, G Walter; Casale, Thomas B; Chavannes, Niels H; Cox, Linda; Chrystyn, Henry; Cruz, Alvaro A; Dahl, Ronald; De Carlo, Giuseppe; Demoly, Pascal; Devillier, Phillipe; Dray, Gérard; Fletcher, Monica; Fokkens, Wytske J; Fonseca, Joao; Gonzalez-Diaz, Sandra N; Grouse, Lawrence; Keil, Thomas; Kuna, Piotr; Larenas-Linnemann, Désirée; Lodrup Carlsen, Karin C; Meltzer, Eli O; Mullol, Jaoquim; Muraro, Antonella; Naclerio, Robert N; Palkonen, Susanna; Papadopoulos, Nikolaos G; Passalacqua, Giovanni; Price, David; Ryan, Dermot; Samolinski, Boleslaw; Scadding, Glenis K; Sheikh, Aziz; Spertini, François; Valiulis, Arunas; Valovirta, Erkka; Walker, Samantha; Wickman, Magnus; Yorgancioglu, Arzu; Haahtela, Tari; Zuberbier, Torsten

    2016-08-01

    The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials.

  4. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis.

    PubMed

    Bousquet, Jean; Schünemann, Holger J; Hellings, Peter W; Arnavielhe, Sylvie; Bachert, Claus; Bedbrook, Anna; Bergmann, Karl-Christian; Bosnic-Anticevich, Sinthia; Brozek, Jan; Calderon, Moises; Canonica, G Walter; Casale, Thomas B; Chavannes, Niels H; Cox, Linda; Chrystyn, Henry; Cruz, Alvaro A; Dahl, Ronald; De Carlo, Giuseppe; Demoly, Pascal; Devillier, Phillipe; Dray, Gérard; Fletcher, Monica; Fokkens, Wytske J; Fonseca, Joao; Gonzalez-Diaz, Sandra N; Grouse, Lawrence; Keil, Thomas; Kuna, Piotr; Larenas-Linnemann, Désirée; Lodrup Carlsen, Karin C; Meltzer, Eli O; Mullol, Jaoquim; Muraro, Antonella; Naclerio, Robert N; Palkonen, Susanna; Papadopoulos, Nikolaos G; Passalacqua, Giovanni; Price, David; Ryan, Dermot; Samolinski, Boleslaw; Scadding, Glenis K; Sheikh, Aziz; Spertini, François; Valiulis, Arunas; Valovirta, Erkka; Walker, Samantha; Wickman, Magnus; Yorgancioglu, Arzu; Haahtela, Tari; Zuberbier, Torsten

    2016-08-01

    The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials. PMID:27260321

  5. Linking HIV-positive adolescents to care in 15 different clinics across the United States: Creating solutions to address structural barriers for linkage to care

    PubMed Central

    Philbin, Morgan M.; Tanner, Amanda E.; DuVal, Anna; Ellen, Jonathan; Kapogiannis, Bill; Fortenberry, J. Dennis

    2013-01-01

    Linkage to care is a critical corollary to expanded HIV testing, but many adolescents are not successfully linked to care, in part due to fragmented care systems. Through a collaboration of the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and the Adolescent Trials Network (ATN), a linkage to care outreach worker was provided to ATN clinics. Factors related to linkage were explored to better understand how to improve retention rates and health outcomes for HIV-positive adolescents. We conducted 124 interviews with staff at 15 Adolescent Trials Network clinics to better understand linkage to care processes, barriers, and facilitators. Content analysis was conducted focusing on structural barriers to care and potential solutions, specifically at the macro-, meso-, and micro-levels. Macro-level barriers included navigating health insurance policies, transportation to appointments, and ease of collecting and sharing client-level contact information between testing agencies, local health departments and clinics; meso-level barriers included lack of youth friendliness within clinic space and staff, and duplication of linkage services; micro-level barriers included adolescents’ readiness for care and adolescent developmental capacity. Staff initiated solutions included providing transportation for appointments and funding clinic visits and tests with a range of grants and clinic funds while waiting for insurance approval. However, such solutions were often ad hoc and partial, using micro-level solutions to address macro-level barriers. Comprehensive initiatives to improve linkage to care are needed to address barriers to HIV-care for adolescents, whose unique developmental needs make accessing care particularly challenging. Matching the level of structural solution to the level of structural barriers (i.e., macro-level with macro-level), such as creating policy to address needed youth healthcare entitlements versus covering

  6. Evaluating Research and Impact: A Bibliometric Analysis of Research by the NIH/NIAID HIV/AIDS Clinical Trials Networks

    PubMed Central

    Rosas, Scott R.; Kagan, Jonathan M.; Schouten, Jeffrey T.; Slack, Perry A.; Trochim, William M. K.

    2011-01-01

    Evaluative bibliometrics uses advanced techniques to assess the impact of scholarly work in the context of other scientific work and usually compares the relative scientific contributions of research groups or institutions. Using publications from the National Institute of Allergy and Infectious Diseases (NIAID) HIV/AIDS extramural clinical trials networks, we assessed the presence, performance, and impact of papers published in 2006–2008. Through this approach, we sought to expand traditional bibliometric analyses beyond citation counts to include normative comparisons across journals and fields, visualization of co-authorship across the networks, and assess the inclusion of publications in reviews and syntheses. Specifically, we examined the research output of the networks in terms of the a) presence of papers in the scientific journal hierarchy ranked on the basis of journal influence measures, b) performance of publications on traditional bibliometric measures, and c) impact of publications in comparisons with similar publications worldwide, adjusted for journals and fields. We also examined collaboration and interdisciplinarity across the initiative, through network analysis and modeling of co-authorship patterns. Finally, we explored the uptake of network produced publications in research reviews and syntheses. Overall, the results suggest the networks are producing highly recognized work, engaging in extensive interdisciplinary collaborations, and having an impact across several areas of HIV-related science. The strengths and limitations of the approach for evaluation and monitoring research initiatives are discussed. PMID:21394198

  7. Associating Drugs, Targets and Clinical Outcomes into an Integrated Network Affords a New Platform for Computer-Aided Drug Repurposing

    PubMed Central

    Oprea, Tudor I.; Nielsen, Sonny Kim; Ursu, Oleg; Yang, Jeremy J.; Taboureau, Olivier; Mathias, Stephen L.; Kouskoumvekaki, lrene; Sklar, Larry A.; Bologa, Cristian G.

    2012-01-01

    Finding new uses for old drugs is a strategy embraced by the pharmaceutical industry, with increasing participation from the academic sector. Drug repurposing efforts focus on identifying novel modes of action, but not in a systematic manner. With intensive data mining and curation, we aim to apply bio- and cheminformatics tools using the DRUGS database, containing 3,837 unique small molecules annotated on 1,750 proteins. These are likely to serve as drug targets and antitargets (i.e., associated with side effects, SE). The academic community, the pharmaceutical sector and clinicians alike could benefit from an integrated, semantic-web compliant computer-aided drug repurposing (CADR) effort, one that would enable deep data mining of associations between approved drugs (D), targets (T), clinical outcomes (CO) and SE. We report preliminary results from text mining and multivariate statistics, based on 7,684 approved drug labels, ADL (Dailymed) via text mining. From the ADL corresponding to 988 unique drugs, the “adverse reactions” section was mapped onto 174 SE, then clustered via principal component analysis into a 5x5 self-organizing map that was integrated into a Cytoscape network of SE-D-T-CO. This type of data can be used to streamline drug repurposing and may result in novel insights that can lead to the identification of novel drug actions. PMID:22287994

  8. Addressing adolescent pregnancy with legislation.

    PubMed

    Montgomery, Tiffany M; Folken, Lori; Seitz, Melody A

    2014-01-01

    Adolescent pregnancy is a concern among many women's health practitioners. While it is practical and appropriate to work to prevent adolescent pregnancy by educating adolescents in health care clinics, schools and adolescent-friendly community-based organizations, suggesting and supporting legislative efforts to reduce adolescent pregnancy can help address the issue on an even larger scale. This article aims to help nurses better understand current legislation that addresses adolescent pregnancy, and to encourage support of future adolescent pregnancy prevention legislation. PMID:25145716

  9. Addressing adolescent pregnancy with legislation.

    PubMed

    Montgomery, Tiffany M; Folken, Lori; Seitz, Melody A

    2014-01-01

    Adolescent pregnancy is a concern among many women's health practitioners. While it is practical and appropriate to work to prevent adolescent pregnancy by educating adolescents in health care clinics, schools and adolescent-friendly community-based organizations, suggesting and supporting legislative efforts to reduce adolescent pregnancy can help address the issue on an even larger scale. This article aims to help nurses better understand current legislation that addresses adolescent pregnancy, and to encourage support of future adolescent pregnancy prevention legislation.

  10. Computer-aided detection in full-field digital mammography in a clinical population: performance of radiologist and technologists.

    PubMed

    van den Biggelaar, Frank J H M; Kessels, Alphons G H; van Engelshoven, Jos M A; Boetes, Carla; Flobbe, Karin

    2010-04-01

    The purpose of the study was to evaluate the impact of a computer-aided detection (CAD) system on the performance of mammogram readers in interpreting digital mammograms in a clinical population. Furthermore, the ability of a CAD system to detect breast cancer in digital mammography was studied in comparison to the performance of radiologists and technologists as mammogram readers. Digital mammograms of 1,048 consecutive patients were evaluated by a radiologist and three technologists. Abnormalities were recorded and an imaging conclusion was given as a BI-RADS score before and after CAD analysis. Pathology results during 12 months follow up were used as a reference standard for breast cancer. Fifty-one malignancies were found in 50 patients. Sensitivity and specificity were computed before and after CAD analysis and provided with 95% CIs. In order to assess the detection rate of malignancies by CAD and the observers, the pathological locations of these 51 breast cancers were matched with the locations of the CAD marks and the mammographic locations that were considered to be suspicious by the observers. For all observers, the sensitivity rates did not change after application of CAD. A mean sensitivity of 92% was found for all technologists and 84% for the radiologist. For two technologists, the specificity decreased (from 84 to 83% and from 77 to 75%). For the radiologist and one technologist, the application of CAD did not have any impact on the specificity rates (95 and 83%, respectively). CAD detected 78% of all malignancies. Five malignancies were indicated by CAD without being noticed as suspicious by the observers. In conclusion, the results show that systematic application of CAD in a clinical patient population failed to improve the overall sensitivity of mammogram interpretation by the readers and was associated with an increase in false-positive results. However, CAD marked five malignancies that were missed by the different readers. PMID:19418215

  11. Coblation vs. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults

    PubMed Central

    Hong, Sung-Moon; Cho, Jae-Gu; Chae, Sung Won; Lee, Heung-Man

    2013-01-01

    Objectives Coblation is operated in low temperature, so it is proposed that tonsillectomy with coblation involves less postoperative pain and allows accelerated healing of the tonsillar fossae compared with other methods involving heat driven processes. However, the results of the previous studies showed that the effect of coblation tonsillectomy has been equivocal in terms of postoperative pain and hemorrhage. Though, most of the previous studies which evaluated coblation tonsillectomy were performed in children. Recently, electrocautery tonsillectomy has been used most widely because of the reduced intraoperative blood loss and shorter operative time compared to other techniques. This prospective study compared intraoperative records and postoperative clinical outcomes in adolescents and adults following coblation and electrocautery tonsillectomies. Methods Eighty patients over 16 years of age with histories of recurrent tonsillitis were enrolled. The patients were randomly allocated into coblation (n=40) and electrocautery tonsillectomy groups (n=40). All operations were performed by one surgeon who was skilled in both surgical techniques. Intraoperative parameters and postoperative outcomes were checked. Results Postoperative pain and otalgia were not significantly different between the two groups; however, there was a tendency towards reduced pain and otalgia in the coblation group. More cotton balls for swabbing the operative field were used introoperatively in the electrocautery group (P=0.00). There was no significant difference in postoperative hemorrhage, wound healing, commencement of a regular diet, and foreign body sensation between the groups. Conclusion Only cotton use, which represented the amount of blood loss, was less in the coblation tonsillectomy group. Coblation tonsillectomy warrants further study with respect to the decreased postoperative pain and otalgia. PMID:23799166

  12. Attention-deficit/hyperactivity disorder in children and adolescents: interventions for a complex costly clinical conundrum.

    PubMed

    Greydanus, Donald E; Pratt, Helen D; Sloane, Mark A; Rappley, Marsha D

    2003-10-01

    Management of a child or adolescent with attention-deficit/hyperactivity disorder (ADHD) is reviewed, including psychological and pharmacologic approaches. Psychological treatment includes psychotherapy, cognitive-behavior therapy, support groups, parent training, educator/teacher training, biofeedback, meditation, and social skills training. Medications are reviewed that research has revealed can improve the core symptomatology of a child or adolescent with ADHD. These medications include stimulants, antidepressants, alpha-2 agonists, and a norepinephrine reuptake inhibitor. Management of ADHD should include a multi-modal approach, involving appropriate educational interventions, appropriate psychological management of the patient (child or adolescent), and judicious use of medications. Parents, school officials, and clinicians must work together to help all children and adolescents with ADHD achieve their maximum potential.

  13. Substance Abuse Prevention Program for Children and Adolescents in a Community-Based Clinic

    ERIC Educational Resources Information Center

    Shelton, Andrea; Harvin, Sheila; White, Janeana

    2006-01-01

    This paper describes a community-based substance abuse prevention program utilizing a cognitive-behavioral curriculum to children and adolescents affected by a substance use disorder in a parent or caretaker.

  14. Intervention with Substance Abusing Runaway Adolescents and their Families: Results of a Randomized Clinical Trial

    PubMed Central

    Slesnick, Natasha; Erdem, Gizem; Bartle-Haring, Suzanne; Brigham, Gregory S.

    2013-01-01

    Objectives To examine the efficacy of three theoretically distinct interventions among substance-abusing runaway adolescents and to explore individual differences in trajectories of change. Methods Adolescents (N=179) between the ages of 12–17 were recruited from a runaway shelter in a Midwestern city. The sample included 94 females (52.5%) and 85 males (47.5%), the majority of the adolescents were African American (n= 118, 65.9%). Adolescents were randomly assigned to the Community Reinforcement Approach (CRA, n = 57), Motivational Interviewing (MI, n = 61), or Ecologically-Based Family Therapy (EBFT, n = 61). Substance use was assessed at baseline, 3, 6, 9, 12, 18, and 24 months via Form 90 and urine screens. Results Hierarchical linear modeling revealed statistically significant improvement in frequency of substance use among runaways in all three treatment groups with a slight increase at post-treatment. Latent trajectory profile analysis explored individual differences in change trajectories and yielded a 3 class model. The majority of adolescents (n = 136, 76%) showed reductions in substance use over time with a slight increase at follow-up (Class 1: Decreasing). Twenty-four (13.4%) adolescents had shown high levels of substance use over time with patterns of increase and decrease (Class 2: Fluctuating high users), and 19 (10.6%) decreased but returned to baseline levels by two years post-baseline (Class 3: U shaped). Few differences among treatment conditions were noted; within the “decreasing” group, adolescents in MI treatment showed a quicker decline in their substance use but a faster relapse compared to those receiving EBFT. Conclusions These findings suggest that CRA, EBFT and MI are viable treatments for runaway substance-abusing adolescents. PMID:23895088

  15. Disentangling screening and diagnostic Chlamydia test positivity among females testing at title x-funded and adolescent health clinics, san francisco 2009.

    PubMed

    Stephens, Sally C; Snell, Ameera; Liska, Sally; Rauch, Leah; Philip, Susan S; Bernstein, Kyle T

    2011-07-01

    By using a reason-for-test code, we compared positivity for female chlamydia and gonorrhea. At family planning clinics, there were no statistically significant differences in screening versus diagnostic positivity for either chlamydia or gonorrhea among women. However, at adolescent health clinics, diagnostic positivity was higher than screening positivity for chlamydia and gonorrhea.

  16. How Setswana Cultural Beliefs and Practices on Sexuality Affect Teachers' and Adolescents' Sexual Decisions, Practices, and Experiences as well as HIV/AIDS and STI Prevention in Select Botswanan Secondary Schools.

    PubMed

    Nleya, Paul T; Segale, Emelda

    2015-01-01

    The article reports on the aspects of a Botswana Ministry of Education and Skills Development (MoE & SD) HIV/AIDS Instructional Television (ITV) project modeled on a similar HIV/AIDS program implemented in Brazil. This Teacher Capacity Building Project (TCBP) in Botswana is in its initial years of implementation. Its overall goal is to contribute to the prevention and mitigation of the impact of HIV and AIDS by strengthening the capacity of the education and communication sectors to deliver interactive, distance HIV/AIDS education primarily to teachers so that they act as agents of behavior change among the in-school youth. One of the components of the TCBP program is a live teacher education television HIV/AIDS program called Talk Back program. Talk Back is a collaborative effort of the MoE & SD and the Botswana national television station. The Talk Back program involves development and implementation of weekly 1 hour live HIV/AIDS education interactive TV broadcasts for teachers. The development of the live programs is guided by a curriculum that provides a wide range of themes related to HIV/AIDS and education. This article reports the results of a survey of a sample of teachers and students at junior secondary schools and senior secondary schools, first, on their views and opinions regarding the Talk Back program as a TCBP. Second, how Setswana cultural beliefs, myths, and practices on sexuality affect teachers' and adolescents' sexual decisions, practices, and experiences as well as HIV/AIDS and sexually transmitted infection prevention. A questionnaire survey and focus group interviews were used as data collection instruments in selected secondary schools. The findings of the study suggest that the Talk Back program has not met much success as a TCBP. The findings further suggest that several myths, beliefs, misconceptions, and attitudes about HIV/AIDS exist among Botswana teachers and students and thus make it difficult for the Talk Back program to impart

  17. Six-year outcomes in first admission adolescent inpatients: clinical and cognitive characteristics at admission as predictors.

    PubMed

    Pogge, David L; Insalaco, Brie; Bertisch, Hilary; Bilginer, Lale; Stokes, John; Cornblatt, Barbara A; Harvey, Philip D

    2008-07-15

    Persistent functional disability is common after even a single psychiatric admission in people with schizophrenia or bipolar disorder, but less is known about other conditions and about adolescent onset patients. This study examined clinical symptoms and cognitive performance at the time of the first admission for the prediction of 6-year outcomes. First admission adolescent patients with a variety of psychiatric diagnoses were assessed with comprehensive clinical ratings of psychopathology, a neuropsychological assessment, and received clinical diagnoses while experiencing their first psychiatric admission. They were contacted 6 years after discharge and examined with a structured assessment of psychiatric symptoms and functioning. Despite the low levels of overall impairment at follow-up, at least 20% of the variance in depression, psychosis, poor peer relationships and poor school attendance 6 years after the hospital admission were predicted by information collected during the hospitalization. Attentional deficits during admission predicted the presence of psychosis at follow-up more substantially than psychotic symptoms during admission, as well as predicting risk for relapse. Attentional deficits during a first psychiatric admission predicted risk for manifesting psychosis at 6-year follow-up to a more substantial degree than either a psychosis diagnosis or psychotic symptoms at admission. In contrast to psychosis, depression at follow-up was predicted by admission symptomatology, but not by cognitive deficits. PMID:18534688

  18. Distinguishing primary and secondary variants of callous-unemotional traits among adolescents in a clinic-referred sample.

    PubMed

    Kahn, Rachel E; Frick, Paul J; Youngstrom, Eric A; Kogos Youngstrom, Jennifer; Feeny, Norah C; Findling, Robert L

    2013-09-01

    The current study used model-based cluster analyses to determine if there are 2 distinct variants of adolescents (ages 11-18) high on callous-unemotional (CU) traits that differ on their level of anxiety and history of trauma. The sample (n = 272) consisted of clinic-referred youths who were primarily African American (90%) and who came from low-income families. Consistent with hypotheses, 3 clusters emerged, including a group low on CU traits, as well as 2 groups high on CU traits that differed in their level of anxiety and past trauma. Consistent with past research on incarcerated adults and adolescents, the group high on anxiety (i.e., secondary variant) was more likely to have histories of abuse and had higher levels of impulsivity, externalizing behaviors, aggression, and behavioral activation. In contrast, the group low on anxiety (i.e., primary variant) scored lower on a measure of behavioral inhibition. On measures of impulsivity and externalizing behavior, the higher scores for the secondary cluster were found only for self-report measures, not on parent-report measures. Youths in the primary cluster also were perceived as less credible reporters than youths in the secondary cluster (i.e., secondary variant) or cluster low on CU traits. These reporter and credibility differences suggest that adolescents within the primary variant may underreport their level of behavioral disturbance, which has important assessment implications. PMID:23647031

  19. Distinguishing Primary and Secondary Variants of Callous Unemotional Traits among Adolescents in a Clinic-referred Sample

    PubMed Central

    Kahn, Rachel E.; Frick, Paul J.; Youngstrom, Eric A.; Youngstrom, Jennifer Kogos; Feeny, Norah C.; Findling, Robert L.

    2013-01-01

    The current study used model-based cluster analyses to determine if there are two distinct variants of adolescents (ages 11 - 18) high on callous-unemotional (CU) traits that differ on their level of anxiety and history of trauma. The sample (n = 272) consisted of clinic-referred youths who were primarily African-American (90%) and from low income families. Consistent with hypotheses, three clusters emerged, including a group low on CU traits, as well as two groups high on CU traits that differed in their level of anxiety and past trauma. Consistent with past research on incarcerated adults and adolescents, the group high on anxiety (i.e., secondary variant) was more likely to have histories of abuse and had higher levels of impulsivity, externalizing behaviors, aggression, and behavioral activation. In contrast, the group low on anxiety (i.e., primary variant) scored lower on a measure of behavioral inhibition. On measures of impulsivity and externalizing behavior, the higher scores for the secondary cluster only were found for self-report measures, not on parent-report measures. Youths in the primary cluster also were perceived as less credible reporters than youth in the secondary or cluster low on CU traits. These reporter and credibility differences suggest that adolescents within the primary variant may underreport their level of behavioral disturbance, which has important assessment implications. PMID:23647031

  20. Parent-youth agreement on symptoms and diagnosis: assessment with a diagnostic interview in an adolescent inpatient clinical population.

    PubMed

    Lauth, Bertrand; Arnkelsson, Guðmundur B; Magnússon, Páll; Skarphéðinsson, Guðmundur Á; Ferrari, Pierre; Pétursson, Hannes

    2010-12-01

    Diagnostic information on adolescents may be elicited from both youths and their parents, especially for depressive and suicidal symptomatology. The objective of this study was to examine the degree of agreement between parent and adolescent reports of major psychiatric disorders, at the diagnostic and at the symptom level, in a severely affected inpatient clinical population. 64 parent-adolescent pairs were interviewed separately with the semi-structured diagnostic interview Kiddie-SADS-PL. Symptomatology was also assessed with 11 self-report and parent-report scales, all translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included to assess emotional dimensions such as depression or anxiety and cognitive dimensions such as attention deficit or self-concept. Good agreement was found for social phobia and fair agreement for generalized anxiety disorder. Although parent-youth agreement was poor in most cases at the symptoms level, significant correlations indicated consistency for most severity scores, except those related to depressive symptomatology, attention deficit, separation anxiety or conduct disorder. The low agreement between reports of suicidal ideation is in line with results from previous studies and suggests that parents might under- or over-estimate this symptomatology. The combination of data obtained with diagnostic interviews and rating-scales confirmed results from prior empirical work, giving greater weight to parents' reports of observable behavior and to adolescents' reports of subjective experiences, especially depressive symptomatology. Our findings suggest that both parent and child informants are necessary to obtain adequate assessments in adolescents. Further research should explore the correspondence between discrepant diagnoses and external criteria such as parental psychopathology or parent-child relationships and attachment. Psychoanalysis could benefit from cognitive neuroscience and use cognitive

  1. Parent-youth agreement on symptoms and diagnosis: assessment with a diagnostic interview in an adolescent inpatient clinical population.

    PubMed

    Lauth, Bertrand; Arnkelsson, Guðmundur B; Magnússon, Páll; Skarphéðinsson, Guðmundur Á; Ferrari, Pierre; Pétursson, Hannes

    2010-12-01

    Diagnostic information on adolescents may be elicited from both youths and their parents, especially for depressive and suicidal symptomatology. The objective of this study was to examine the degree of agreement between parent and adolescent reports of major psychiatric disorders, at the diagnostic and at the symptom level, in a severely affected inpatient clinical population. 64 parent-adolescent pairs were interviewed separately with the semi-structured diagnostic interview Kiddie-SADS-PL. Symptomatology was also assessed with 11 self-report and parent-report scales, all translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included to assess emotional dimensions such as depression or anxiety and cognitive dimensions such as attention deficit or self-concept. Good agreement was found for social phobia and fair agreement for generalized anxiety disorder. Although parent-youth agreement was poor in most cases at the symptoms level, significant correlations indicated consistency for most severity scores, except those related to depressive symptomatology, attention deficit, separation anxiety or conduct disorder. The low agreement between reports of suicidal ideation is in line with results from previous studies and suggests that parents might under- or over-estimate this symptomatology. The combination of data obtained with diagnostic interviews and rating-scales confirmed results from prior empirical work, giving greater weight to parents' reports of observable behavior and to adolescents' reports of subjective experiences, especially depressive symptomatology. Our findings suggest that both parent and child informants are necessary to obtain adequate assessments in adolescents. Further research should explore the correspondence between discrepant diagnoses and external criteria such as parental psychopathology or parent-child relationships and attachment. Psychoanalysis could benefit from cognitive neuroscience and use cognitive

  2. HIV / AIDS Network.

    PubMed

    1995-01-01

    The HIV/AIDS Network and the Philippines Department of Health (DOH) collaborated to produce the AIDS Candlelight Memorial at the Philippine International Convention Center (PICC), May 1995, and World AIDS Day activities on December 1, 1995. After the memorial, a fashion show, "Body Shots," provided a channel for information on acquired immunodeficiency syndrome (AIDS). On World AIDS Day, at the request of DOH, the Network provided speakers who lectured on human immunodeficiency virus (HIV) and AIDS in different government offices. Prior to World AIDS Day, the Network focused on strengthening its cohesiveness and building the capabilities of its member organizations through lectures and symposia during November. Network activities were coordinated by the Remedios AIDS Foundation with support from the other members of the Coordinating Council: Health Action Information Network (HAIN); Caritas; Kabalikat, Stop Trafficking of Pilopinos Foundation, Inc. (STOP);and the Library Foundation (TLF). The Coordinating Council elected for 1996 includes the Remedios AIDS Foundation, HAIN, Caritas, TLF, STOP, the Foundation for Adolescent Development (FAD), and the Salvation Army. PMID:12291699

  3. The eXtraordinarY Kids Clinic: an interdisciplinary model of care for children and adolescents with sex chromosome aneuploidy

    PubMed Central

    Tartaglia, Nicole; Howell, Susan; Wilson, Rebecca; Janusz, Jennifer; Boada, Richard; Martin, Sydney; Frazier, Jacqueline B; Pfeiffer, Michelle; Regan, Karen; McSwegin, Sarah; Zeitler, Philip

    2015-01-01

    Purpose Individuals with sex chromosome aneuploidies (SCAs) are born with an atypical number of X and/or Y chromosomes, and present with a range of medical, developmental, educational, behavioral, and psychological concerns. Rates of SCA diagnoses in infants and children are increasing, and there is a need for specialized interdisciplinary care to address associated risks. The eXtraordinarY Kids Clinic was established to provide comprehensive and experienced care for children and adolescents with SCA, with an interdisciplinary team composed of developmental–behavioral pediatrics, endocrinology, genetic counseling, child psychology, pediatric neuropsychology, speech–language pathology, occupational therapy, nursing, and social work. The clinic model includes an interdisciplinary approach to care, where assessment results by each discipline are integrated to develop unified diagnostic impressions and treatment plans individualized for each patient. Additional objectives of the eXtraordinarY Kids Clinic program include prenatal genetic counseling, research, education, family support, and advocacy. Methods Satisfaction surveys were distributed to 496 patients, and responses were received from 168 unique patients. Results Satisfaction with the overall clinic visit was ranked as “very satisfied” in 85%, and as “satisfied” in another 9.8%. Results further demonstrate specific benefits from the clinic experience, the importance of a knowledgeable clinic coordinator, and support the need for similar clinics across the country. Three case examples of the interdisciplinary approach to assessment and treatment are included. PMID:26229481

  4. Recurrent Intrathecal Methotrexate Induced Neurotoxicity in an Adolescent with Acute Lymphoblastic Leukemia: Serial Clinical and Radiologic Findings

    PubMed Central

    Brugnoletti, Fulvia; Morris, E. Brannon; Laningham, Fred H.; Patay, Zoltán; Pauley, Jennifer L; Pui, Ching-Hon; Jeha, Sima; Inaba, Hiroto

    2008-01-01

    Systemic and intrathecal methotrexate (MTX) are integral components of acute lymphoblastic leukemia (ALL) therapy, but can be associated with neurotoxicity. We describe here the case of an adolescent male with T-cell ALL who developed recurrent episodes of subacute neurotoxicity characterized by slurred speech, emotional lability, and hemiparesis after intrathecal MTX administration. Serial magnetic resonance imaging with diffusion-weighted imaging showed recurrent areas of restricted diffusion within cerebral hemispheric white matter, which correlated chronologically with the administration of intrathecal therapy and severity of clinical symptoms. Resolution of diffusion abnormalities did not preclude further toxicity and a large lesion could cause persisting symptoms. PMID:18831032

  5. [A clinic and pathway comorbidity aetiology of the somatoform disorder, abuse syndromes and addictions at adolescent age].

    PubMed

    Chernyshov, O V

    2014-01-01

    The clinical features of forming of komorbydnoho combination of vegetative disfunction are studied with the displays of chronic pain. It examined 82 adolescents--48 girls (58.5%) and 34 boys (41.5%) aged 16-17 years. All teenagers have noted the presence of the dual problems of stress in their lives. Girls feel a greater impact of stressful factors than boys. The largest number of connected stressful factors were found in the subgroup of women with the syndrome tsefalhiyi, and the lowest was observed among boys with abdominalhiyi syndrome.

  6. Case study of an adolescent Cambodian refugee: a clinical, developmental and cultural perspective.

    PubMed

    Bemak, F; Timm, J

    1994-01-01

    This paper presents a case study of Tu, a Cambodian man who came to the US as an unaccompanied war refugee when he was 15 years old after experiencing severe trauma. Tu was diagnosed with post traumatic stress disorder and underwent 2.5 years of therapy with a clinical consultant. At this point, Tu became somewhat acculturated and resolved but found the process of self-evaluation too painful to continue. The therapist moved away and lost track of Tu for 7 years until contacted by his current therapist for a conference because Tu's period of adjustment had ended and his serious mental health problems were causing problematic deviant behavior. Initial therapy had allowed Tu to replace aggressive behavior with a moderate depression caused by his inability to adjust to life in the US. During the 4 years between therapists, Tu moved from place to place and experienced increasingly severe problems, including arrests. The success of the early therapy was achieved by establishing a climate of trust and safety with a therapist who understood Tu's cultural background and allowed Tu to control the pace of therapy. Non-Western interventions, such as using Tu's Cambodian caseworker as a partner in the healing process and enlisting the aid of a Buddhist monk also proved of value. Tu's continuing difficulties occurred because his therapeutic sessions ended before he could achieve the developmental stage that would have allowed him to believe that his new world was safe and, perhaps, because his new therapist was a woman (as was the head of his foster home). Understanding of cultural issues, including the gender roles of women in patriarchal Cambodia, may have helped Tu's counselors succeed in providing the ongoing support needed by all patients suffering post-traumatic stress disorder.

  7. Case study of an adolescent Cambodian refugee: a clinical, developmental and cultural perspective.

    PubMed

    Bemak, F; Timm, J

    1994-01-01

    This paper presents a case study of Tu, a Cambodian man who came to the US as an unaccompanied war refugee when he was 15 years old after experiencing severe trauma. Tu was diagnosed with post traumatic stress disorder and underwent 2.5 years of therapy with a clinical consultant. At this point, Tu became somewhat acculturated and resolved but found the process of self-evaluation too painful to continue. The therapist moved away and lost track of Tu for 7 years until contacted by his current therapist for a conference because Tu's period of adjustment had ended and his serious mental health problems were causing problematic deviant behavior. Initial therapy had allowed Tu to replace aggressive behavior with a moderate depression caused by his inability to adjust to life in the US. During the 4 years between therapists, Tu moved from place to place and experienced increasingly severe problems, including arrests. The success of the early therapy was achieved by establishing a climate of trust and safety with a therapist who understood Tu's cultural background and allowed Tu to control the pace of therapy. Non-Western interventions, such as using Tu's Cambodian caseworker as a partner in the healing process and enlisting the aid of a Buddhist monk also proved of value. Tu's continuing difficulties occurred because his therapeutic sessions ended before he could achieve the developmental stage that would have allowed him to believe that his new world was safe and, perhaps, because his new therapist was a woman (as was the head of his foster home). Understanding of cultural issues, including the gender roles of women in patriarchal Cambodia, may have helped Tu's counselors succeed in providing the ongoing support needed by all patients suffering post-traumatic stress disorder. PMID:12293036

  8. Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

    PubMed Central

    Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

    2014-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

  9. Computer aided identification of sodium channel blockers in the clinical treatment of epilepsy using molecular docking tools

    PubMed Central

    Shaheen, Uzma; Akka, Jyothy; Hinore, Jitendra Singh; Girdhar, Amandeep; Bandaru, Srinivas; Sumithnath, Tharaparambil Gangadharan; Nayarisseri, Anuraj; Munshi, Anjana

    2015-01-01

    Phenytoin (PHT) and Carbamazepine (CBZ) are excellent sodium channel blockers administered in clinical treatment of epileptic seizures. However, the narrow therapeutic range and limited pharmacokinetics of these drugs have raised serious concerns in the proper management of epilepsy. To overcome this, the present study attempts to identify a candidate molecule with superior pharmacological profile than PHT and CBZ through In silico approaches. PHT and CBZ served as query small molecules for Tanimoto based similarity search with a threshold of 95% against PubChem database. Aided by MolDock algorithm, high affinity similar compound against each query was retrieved. PHT and CBZ and their respective similar were further tested for toxicity profiles, LC 50 values and biological activity. Compounds, NSC403438 and AGN-PC-0BPCBP respectively similar to PHT and CBZ demonstrated higher affinity to sodium channel protein than their respective leads. Of particular relevance, NSC403438 demonstrated highest binding affinity bestowed with least toxicity, better LC 50 values and optimal bioactivity. NSC403438 was further mapped for its structure based pharmacophoric features. In the study, we report NSC403438 as potential sodium channel blocker as a better candidate than PHT and CBZ which can be put forth for pharmacodynamic and pharmacokinetic studies. Abbreviations AEDs - Antiepileptic drugs, BLAST - Basic Local Alignment Search Tool, CBZ - Carbamazepine, GEFS+ - Generalized Epilepsy with Febrile Seizures Plus, GPCR - G Protein Coupled Receptor, Nav - Sodium channel with specific voltage conduction, PDB - Protein Data Bank, PHT - Phenytoin, PIR - Protein Information resources, SAVES - Structural Analysis and Verification Server, VGSC - Voltage-gated Sodium channels. PMID:25914447

  10. Troubled Adolescents and HIV Infection.

    ERIC Educational Resources Information Center

    Woodruff, John O., Ed.; And Others

    This report on adolescents, Acquired Immune Deficiency Syndrome (AIDS), and Human Immune Virus (HIV) infection had its beginning in the Knowledge Development Workshop "Issues in the Prevention and Treatment of AIDS Among Adolescents with Serious Emotional Disturbance," held June 9-10, 1988 in the District of Columbia. These papers are included:…

  11. Adolescent Behavior Change: A Review.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Educational Programs and Studies Information Service.

    This focus paper contains reprints of 11 articles intended to provide an overview of the key issues in the area of adolescent behavior change as it relates to Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) education. Included are: (1) "Preventing HIV Infection and AIDS in Children and Adolescents" (J.…

  12. Preventive health care among HIV positive women in a Utah HIV/AIDS clinic: a retrospective cohort study

    PubMed Central

    2014-01-01

    Background Despite evidence that HIV positive women may suffer higher rates of heart disease, diabetes, human papillomavirus infection, and some types of cancer, the provision of preventive health services to HIV positive women is unknown. Preventive health services recommended for such women include breast, colorectal and cervical cancer screening, sexually transmitted infection (STI) testing, vaccinations, and patient counseling on a number of issues including sexual behaviors. Methods This retrospective cohort study utilized medical record reviews of 192 HIV positive women who were patients at the University of Utah Infectious Diseases Clinic in 2009. Medical records were reviewed for all encounters during 2009 using a standardized data collection form; data were collected on patient demographics and a variety of preventive health services. Chi squared tests were used to assess receipt of preventive health services by demographic factors, and multivariable logistic regression was used to determine predictors of receiving select services. Results The most commonly recorded preventive services included blood pressure screening, screening for Hepatitis A and B, Tetanus-Diphtheria-Pertussis vaccination, Pneumococcal pneumonia vaccination, substance abuse screening, and mental health screening. STI testing and safe sex counseling were documented in the medical records of only 37% and 33.9% of women, respectively. Documentation of cancer screening was also low, with cervical cancer screening documented for 56.8% of women, mammography for 65% (N = 26/40) of women, and colorectal cancer screening for 10% (N = 4/40) of women, where indicated. In multivariable models, women with private health insurance were less likely to have documented STI testing (OR 0.20; 95% CI 0.08 - 0.52), and, Hispanic women were less likely to have documented safe-sex counseling (OR 0.26; 95% CI 0.07 - 0.94). Conclusions HIV/AIDS providers should focus on the needs of all women for

  13. Physical, clinical, and psychosocial parameters of adolescents with different degrees of excess weight☆

    PubMed Central

    Antonini, Vanessa Drieli Seron; da Silva, Danilo Fernandes; Bianchini, Josiane Aparecida Alves; Lopera, Carlos Andres; Moreira, Amanda Caroline Teles; Locateli, João Carlos; Nardo, Nelson

    2014-01-01

    OBJECTIVE: To compare body composition, hemodynamic parameters, health-related physical fitness, and health-related quality of life of adolescents with anthropometric diagnosis of overweight, obesity, and severe obesity. METHODS: 220 adolescents with excess body weight were enrolled. They were beginners in a intervention program that included patients based on age, availability, presence of excess body weight, place of residence, and agreement to participate in the study . This study collected anthropometric and hemodynamic variables, health-related physical fitness, and health-related quality of life of the adolescents. To compare the three groups according to nutritional status, parametric and non-parametric tests were applied. Significance level was set at p<0.05. RESULTS: There was no significant difference in resting heart rate, health-related physical fitness, relative body fat, absolute and relative lean mass, and health-related quality of life between overweight, obese, and severely obese adolescents (p>0.05). Body weight, body mass index, waist and hip circumference, and systolic blood pressure increased as degree of excess weightincreased (p<0.05). Dyastolic blood pressure of the severe obesity group was higher than the other groups (p<0.05). There was an association between the degree of excess weight and the prevalence of altered blood pressure (overweight: 12.1%; obesity: 28.1%; severe obesity: 45.5%; p<0.001). The results were similar when genders were analyzed separately. CONCLUSION: Results suggest that overweight adolescents presented similar results compared to obese and severely obese adolescents in most of the parameters analyzed. PMID:25510998

  14. Stress management techniques in childhood and adolescence. Relaxation training, meditation, hypnosis, and biofeedback: appropriate clinical applications.

    PubMed

    Smith, M S; Womack, W M

    1987-11-01

    Many childhood and adolescent stress-related symptoms have a psychophysiological component that involves muscular tension and/or autonomic nervous system dysfunction. Examples of this include recurrent headache, chest pain, abdominal pain, syncope, and dizziness. After a careful medical and psychosocial evaluation, the clinician may identify many patients who are appropriate for the application of stress reduction techniques such as progressive muscular relaxation, meditation, biofeedback, and relaxation/mental imagery (self-hypnosis). This review describes these techniques and their application with selected children and adolescents.

  15. Clinical concepts for treatment of the elbow in the adolescent overhead athlete.

    PubMed

    Ellenbecker, Todd S; Reinold, Michael; Nelson, Cory O

    2010-10-01

    Injuries to the adolescent elbow are common because of the repetitive overuse inherent in many overhead sport activities. The management of these patients is greatly facilitated through a greater understanding of the demands placed on the upper extremity kinetic chain during these overhead activities as well as a detailed examination and rehabilitation for the entire upper extremity kinetic chain. Particular emphasis on improving rotator cuff strength and muscular endurance, along with scapular stabilization, is a critical part of elbow rehabilitation in these patients. In addition, the use of a strategic and progressive interval sport return program is necessary to minimize reinjury and return the adolescent overhead athlete to full function.

  16. Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting.

    PubMed

    Johansen, Anders; Holm, Jens-Christian; Pearson, Seija; Kjærsgaard, Mimi; Larsen, Lone Marie; Højgaard, Birgitte; Cortes, Dina

    2015-05-01

    Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children and adolescents a chronic illness, which is in line with the American Medical Society. We summarize the evidence for the efficacy of a combination of diet, physical activity and behavior-focused interventions in a family-based setting. The present guidelines propose a multidisciplinary service implemented as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI corresponds to an isoBMI of minimum 30 or BMI corresponds to an isoBMI of 25 and complex obesity is suspected. Obtaining a thorough medical history is pivotal. We propose a structured interview to ensure collection of all relevant information. We recommend physical examination focused on BMI, waist circumference, growth, pubertal stage, blood pressure, neurology and skin and provide comprehensive paraclinical investigations for obesity and obesity related conditions. Treatment of obesity in children and adolescents is fully dependent on the combined effort of the entire family. This cannot be overemphasized! The main principle of the treatment is developing an individual detailed plan for every patient to reduce caloric intake whilst increasing physical activity, leaving no ambiguity with the recommendations.

  17. A Five Step Process for Interactive Parent-Adolescent Communication About HIV Prevention: Advice from Parents Living With HIV/AIDS

    PubMed Central

    Edwards, Laura L.; Reis, Janet S.

    2014-01-01

    AIM This study investigated how parents living with HIV communicated about HIV prevention with their 10–18 year old children. METHODS Interviews with 76 mothers and fathers were analyzed for (1) their experiences discussing HIV prevention with adolescents, and (2) advice on how to best broach HIV-related topics. RESULTS Interactive conversations, where both parents and adolescents participated, were regarded as effective. Parents emphasized that adolescents should have a “voice” (be able to voice their concerns) and a “choice” (have a variety of effective prevention strategies to choose from) during HIV-related talks. DISCUSSION A five step process for interactive communication emerged as a result of these discussions. IMPLICATIONS Health care professionals can facilitate adolescent sexual health by encouraging parents to actively involve their children in discussions about HIV prevention. CONCLUSION Future HIV prevention programs could benefit by providing parents with appropriate tools to foster interactive discussions about sexual health with adolescents. PMID:24683366

  18. Enhancing Adolescent and Young Adult Oncology Research Within the National Clinical Trials Network: Rationale, Progress, and Emerging Strategies.

    PubMed

    Weiss, Aaron R; Nichols, Craig R; Freyer, David R

    2015-10-01

    Adolescent and Young Adult Oncology (AYAO, including patients 15-39 years of age) is an emerging discipline in the field of cancer treatment and research. Poorer survival outcomes for this population and characteristic age-related challenges in care have called attention to the need for increased AYAO research. This chapter outlines pressing questions and reviews recent progress in AYAO research within the current organizational structure of the federal clinical trials enterprise, emphasizing how the United States National Cancer Institute's National Clinical Trials Network (NCTN) has created novel opportunities for collaborative AYAO research among the pediatric and adult NCTN groups. Potential strategies for expanding AYAO research, both within the NCTN and with other partners in the federal and advocacy domains are identified. PMID:26433555

  19. Disentangling Adolescent Substance Use and Problem Use within a Clinical Sample.

    ERIC Educational Resources Information Center

    Stice, Eric; Kirz, Josh; Borbely, Christina

    2002-01-01

    Tested whether psychosocial variables showed direct relations to substance use, and direct, indirect, and interactive relations to use-related negative consequences in adolescents. Found psychosocial variables relate to problem use beyond the simple indirect effect from consumption level. (Author/DLH)

  20. Clinical Assessment of Attachment Patterns and Personality Disorder in Adolescents and Adults

    ERIC Educational Resources Information Center

    Westen, Drew; Nakash, Ora; Thomas, Cannon; Bradley, Rebekah

    2006-01-01

    The relevance of attachment theory and research for practice has become increasingly clear. The authors describe a series of studies with 3 aims: (a) to validate measures of attachment for use by clinicians with adolescents and adults (b) to examine the relation between attachment and personality pathology, and (c) to ascertain whether factor…

  1. Readiness to Change in Adolescents Screening Positive for Substance Use in Urban Primary Care Clinics

    ERIC Educational Resources Information Center

    Stevens, Jack; McGeehan, Jennifer; Kelleher, Kelly J.

    2010-01-01

    Primary care physicians often perceive patients as unlikely to decrease their substance use and suggest this reluctance to change diminishes their willingness to screen and intervene. The literature on readiness to change has primarily focused on adults, and the available studies on adolescents have largely included hospitalized and/or…

  2. Adiposity in children and adolescents: Correlates and clinical consequences of fat stored in specific body depots

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The 2011 Pennington Biomedical Research Center's Scientific Symposium focused on adiposity in children and adolescents. The symposium was attended by 15 speakers and other invited experts. The specific objectives of the symposium were to (i) integrate the latest published and unpublished findings on...

  3. Peer Influence and Nonsuicidal Self Injury: Longitudinal Results in Community and Clinically-Referred Adolescent Samples

    ERIC Educational Resources Information Center

    Prinstein, Mitchell J.; Heilbron, Nicole; Guerry, John D.; Franklin, Joseph C.; Rancourt, Diana; Simon, Valerie; Spirito, Anthony

    2010-01-01

    Research suggests that adolescents' engagement in nonsuicidal self-injurious (NSSI) behaviors may be increasing over time, yet little is known regarding distal longitudinal factors that may promote engagement in these behaviors. Data from two longitudinal studies are presented to examine whether NSSI may be associated with peer influence…

  4. Adolescent Brain and Cognitive Developments: Implications for Clinical Assessment in Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Ciccia, Angela Hein; Meulenbroek, Peter; Turkstra, Lyn S.

    2009-01-01

    Adolescence is a time of significant physical, social, and emotional developments, accompanied by changes in cognitive and language skills. Underlying these are significant developments in brain structures and functions including changes in cortical and subcortical gray matter and white matter tracts. Among the brain regions that develop during…

  5. Treating Children and Adolescents in Residential and Inpatient Settings. Developmental Clinical Psychology and Psychiatry. Volume 36.

    ERIC Educational Resources Information Center

    Lyman, Robert D.; Campbell, Nancy R.

    This book examines the various components of hospital, residential, and outpatient treatments for children and adolescents with mental disorders. Options and settings for residential care are presented, including the principles and practical issues, such as providing continuing education, that underlie the decision making for placement of youth in…

  6. Early Onset Recurrent Subtype of Adolescent Depression: Clinical and Psychosocial Correlates

    ERIC Educational Resources Information Center

    Hammen, Constance; Brennan, Patricia A.; Keenan-Miller, Danielle; Herr, Nathaniel R.

    2008-01-01

    Background: Evaluated trajectories of adolescent depression and their correlates in a longitudinal study of a community sample: early onset (by age 15) with major depression (MDE) recurrence between 15 and 20; early onset with no recurrence; later onset of major depression after age 15 with and without recurrence by 20; and never-depressed.…

  7. Antisocial Behavior, Psychopathology and Functional Impairment: Association with Sex and Age in Clinical Children and Adolescents

    ERIC Educational Resources Information Center

    Vera, Juan; Ezpeleta, Lourdes; Granero, Roser; de la Osa, Nuria

    2010-01-01

    This study examined the prevalence, degree of association and differential effect, by sex and age, of conduct disorder symptoms on psychopathology and functioning. Participants included 680 Spanish children and adolescents between 8 and 17 years and their parents, attending to psychiatric outpatient consultation. Data were obtained through…

  8. Pursuit of Muscularity in Adolescent Boys: Relations among Biopsychosocial Variables and Clinical Outcomes

    ERIC Educational Resources Information Center

    Cafri, Guy; van den Berg, Patricia; Thompson, J. Kevin

    2006-01-01

    Adolescent boys (n = 269) were assessed for levels of several risky behaviors related to the pursuit of muscularity, including substance use (anabolic steroids, prohormones, and ephedrine) dieting to gain weight, and symptoms of muscle dysmorphia (MD). The association between these behaviors and a variety of putative biological, psychological, and…

  9. GABAergic contributions to alcohol responsivity during adolescence: insights from preclinical and clinical studies.

    PubMed

    Silveri, Marisa M

    2014-08-01

    There is a considerable body of literature demonstrating that adolescence is a unique age period, which includes rapid and dramatic maturation of behavioral, cognitive, hormonal and neurobiological systems. Most notably, adolescence is also a period of unique responsiveness to alcohol effects, with both hyposensitivity and hypersensitivity observed to the various effects of alcohol. Multiple neurotransmitter systems are undergoing fine-tuning during this critical period of brain development, including those that contribute to the rewarding effects of drugs of abuse. The role of developmental maturation of the γ-amino-butyric acid (GABA) system, however, has received less attention in contributing to age-specific alcohol sensitivities. This review integrates GABA findings from human magnetic resonance spectroscopy studies as they may translate to understanding adolescent-specific responsiveness to alcohol effects. Better understanding of the vulnerability of the GABA system both during adolescent development, and in psychiatric conditions that include alcohol dependence, could point to a putative mechanism, boosting brain GABA, that may have increased effectiveness for treating alcohol use disorders.

  10. Five-year results of a prospective randomised controlled clinical trial of posterior computer-aided design-computer-aided manufacturing ZrSiO4 -ceramic crowns.

    PubMed

    Passia, N; Stampf, S; Strub, J R

    2013-08-01

    The aim of this prospective randomised controlled clinical trial was to evaluate the clinical outcome of shrinkage-free ZrSiO4 -ceramic full-coverage crowns on premolars and molars in comparison with conventional gold crowns over a 5-year period. Two hundred and twenty-three patients were included and randomly divided into two treatment groups. One hundred and twenty-three patients were restored with 123 ZrSiO4 -ceramic crowns, and 100 patients received 100 gold crowns, which served as the control. All crowns were conventionally cemented with glass-ionomer cement. After an observation period of 6, 12, 24, 36, 48 and 60 months, the survival probability (Kaplan-Meier) for the shrinkage-free ZrSiO4 -ceramic crowns was 98·3%, 92·0%, 84·7%, 79% and 73·2% and for the gold crowns, 99%, 97·9%, 95·7%, 94·6% and 92·3%, respectively. The difference between the test and control group was statistically significant (P = 0·0027). The gold crowns showed a better marginal integrity with less marginal discoloration than the ceramic crowns. The most common failure in the ceramic crown group was fracture of the crown. The 60-month results of this prospective randomised controlled clinical trial suggest that the use of these shrinkage-free ZrSiO4 -ceramic crowns in posterior tooth restorations cannot be recommended.

  11. Clinical Experience of Weight Loss Surgery in Morbidly Obese Korean Adolescents

    PubMed Central

    Park, Ji Yeon; Song, Dan

    2014-01-01

    Purpose Comprehensive multidisciplinary weight management programs encompassing various conservative measures have shown only modest weight loss results in obese children and adolescents; therefore, bariatric surgery for this population has become a matter of discussion. This study aimed to present our experience with and outcomes for laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in morbidly obese Korean adolescents. Materials and Methods The prospectively established database of all patients undergoing bariatric surgery at Soonchunhyang University Seoul Hospital, Korea between January 2011 and January 2013 was retrospectively reviewed. Adolescents aged 14 to 20 years were included in the present analyses. Results Twenty-two adolescents underwent bariatric surgery during the study period; 14 underwent LSG and 8, LRYGB. Of these, 17 were female and 5 were male. The mean age was 19 years. Their mean body weight and body mass index (BMI) before surgery were 115 kg and 40.1 kg/m2. The only postoperative complication was intraluminal bleeding in 1 patient, which was managed conservatively. The mean BMI decreased to 29.1 kg/m2 after a mean follow-up of 10 months. The percent excess weight loss (%EWL) at 1, 3, 6, and 12 months postoperatively were 19.6, 39.9, 52.6, and 74.2%, respectively. Only 1 patient showed %EWL less than 30% at 12 months after surgery. All patients with diabetes and sleep apnea were cured of their disease, and other comorbidities also improved or resolved after surgery. Conclusion Bariatric surgery leads to significant short-term weight loss along with resolution of obesity-related comorbidities in obese children and adolescents. PMID:25048498

  12. Clinical findings and white matter abnormalities seen on diffusion tensor imaging in adolescents with very low birth weight.

    PubMed

    Skranes, J; Vangberg, T R; Kulseng, S; Indredavik, M S; Evensen, K A I; Martinussen, M; Dale, A M; Haraldseth, O; Brubakk, A-M

    2007-03-01

    Very low birth weight (VLBW) children are at high risk of perinatal white matter injury, which, when subtle, may not be seen using conventional magnetic resonance imaging. The relationship between clinical findings and fractional anisotropy (FA) measurements in white matter of adolescents born prematurely with VLBW was studied in 34 subjects (age = 15 years, birth weight clinically and with diffusion tensor imaging (DTI). Perceptual and cognitive functions were evaluated by visual motor integration (VMI) with supplementary tests and sub-tests from WISC-III, motor function by movement ABC and Grooved Pegboard test and psychiatric symptoms by the schedule for affective disorders and schizophrenia for school-age children semistructured interview, the Autism Spectrum Screening Questionnaire and attention deficit hyperactivity disorder (ADHD) rating scale IV. Overall functioning was scored on the children's global assessment scale. DTI scans were performed for calculation of FA maps and areas of significant differences in mean FA values between subjects and controls were compared with their clinical data. The VLBW children had reduced FA values in the internal and external capsule, corpus callosum and superior, middle superior and inferior fasciculus. Within this group of children, visual motor and visual perceptual deficits were associated with low FA values in the external capsule, posterior part of the internal capsule and in the inferior fasciculus. Children with low IQ had low FA values in the external capsule and inferior and middle superior fasciculus. Fine motor impairment was related to low FA values in the internal and external capsule and superior fasciculus. Eight VLBW children with inattention symptoms or a diagnosis of ADHD had significantly lower FA values in several areas. Mild social deficits correlated with reduced FA values in the external capsule and superior fasciculus. We

  13. Clinical findings and white matter abnormalities seen on diffusion tensor imaging in adolescents with very low birth weight.

    PubMed

    Skranes, J; Vangberg, T R; Kulseng, S; Indredavik, M S; Evensen, K A I; Martinussen, M; Dale, A M; Haraldseth, O; Brubakk, A-M

    2007-03-01

    Very low birth weight (VLBW) children are at high risk of perinatal white matter injury, which, when subtle, may not be seen using conventional magnetic resonance imaging. The relationship between clinical findings and fractional anisotropy (FA) measurements in white matter of adolescents born prematurely with VLBW was studied in 34 subjects (age = 15 years, birth weight clinically and with diffusion tensor imaging (DTI). Perceptual and cognitive functions were evaluated by visual motor integration (VMI) with supplementary tests and sub-tests from WISC-III, motor function by movement ABC and Grooved Pegboard test and psychiatric symptoms by the schedule for affective disorders and schizophrenia for school-age children semistructured interview, the Autism Spectrum Screening Questionnaire and attention deficit hyperactivity disorder (ADHD) rating scale IV. Overall functioning was scored on the children's global assessment scale. DTI scans were performed for calculation of FA maps and areas of significant differences in mean FA values between subjects and controls were compared with their clinical data. The VLBW children had reduced FA values in the internal and external capsule, corpus callosum and superior, middle superior and inferior fasciculus. Within this group of children, visual motor and visual perceptual deficits were associated with low FA values in the external capsule, posterior part of the internal capsule and in the inferior fasciculus. Children with low IQ had low FA values in the external capsule and inferior and middle superior fasciculus. Fine motor impairment was related to low FA values in the internal and external capsule and superior fasciculus. Eight VLBW children with inattention symptoms or a diagnosis of ADHD had significantly lower FA values in several areas. Mild social deficits correlated with reduced FA values in the external capsule and superior fasciculus. We

  14. Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

    PubMed Central

    2011-01-01

    Background Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus a barrier for health care providers (HCPs) to overcome in their attempts to involve both adolescents and parents in improvement of glycaemic control. Evidence-based interventions that involve all three parties (i.e., adolescents, parents and HCPs) and are integrated into routine outpatient clinic visits are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y)) for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic visits will reduce haemoglobin A1c (HbA1c) concentrations and improve adolescents' life skills compared with a control group. Methods/Design Using a mixed methods design comprising a randomised controlled trial and a nested qualitative evaluation, we will recruit 68 adolescents age 13 - 18 years with type 1 diabetes (HbA1c > 8.0%) and their parents from 2 Danish hospitals and randomise into GSD-Y or control groups. During an 8-12 month period, the GSD-Y group will complete 8 outpatient GSD-Y visits, and the control group will completes an equal number of standard visits. The primary outcome is HbA1c. Secondary outcomes include the following: number of self-monitored blood glucose values and levels of autonomous motivation, involvement and autonomy support from parents, autonomy support from HCPs, perceived competence in managing diabetes, well-being, and diabetes-related problems. Primary and secondary outcomes will be evaluated within and between groups by comparing data from baseline, after completion of the visits, and again after a 6-month follow-up. To illustrate how GSD

  15. A Brief, Low-Cost, Theory-Based Intervention to Promote Dual Method Use by Black and Latina Female Adolescents: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Roye, Carol; Perlmutter Silverman, Paula; Krauss, Beatrice

    2007-01-01

    HIV/AIDS disproportionately affects young women of color. Young women who use hormonal contraception are less likely to use condoms. Brief, inexpensive HIV-prevention interventions are needed for high-volume clinics. This study was a randomized clinical trial of two interventions: (a) a video made for this study and (b) an adaptation of Project…

  16. Now that you want to take your HIV/AIDS vaccine/biological product research concept into the clinic: what are the "cGMP"?

    PubMed

    Sheets, Rebecca L; Rangavajhula, Vijaya; Pullen, Jeffrey K; Butler, Chris; Mehra, Vijay; Shapiro, Stuart; Pensiero, Michael

    2015-04-01

    The Division of AIDS Vaccine Research Program funds the discovery and development of HIV/AIDS vaccine candidates. Basic researchers, having discovered a potential vaccine in the laboratory, next want to take that candidate into the clinic to test the concept in humans, to see if it translates. Many of them have heard of "cGMP" and know that they are supposed to make a "GMP product" to take into the clinic, but often they are not very familiar with what "cGMP" means and why these good practices are so important. As members of the Vaccine Translational Research Branch, we frequently get asked "can't we use the material we made in the lab in the clinic?" or "aren't Phase 1 studies exempt from cGMP?" Over the years, we have had many experiences where researchers or their selected contract manufacturing organizations have not applied an appropriate degree of compliance with cGMP suitable for the clinical phase of development. We share some of these experiences and the lessons learned, along with explaining the importance of cGMP, just what cGMP means, and what they can assure, in an effort to de-mystify this subject and facilitate the rapid and safe translational development of HIV vaccines. PMID:25698494

  17. Now That You Want to Take Your HIV/AIDS Vaccine/Biological Product Research Concept into the Clinic: What are “cGMP”?

    PubMed Central

    Sheets, Rebecca L.; Rangavajhula, Vijaya; Pullen, Jeffrey K.; Butler, Chris; Mehra, Vijay; Shapiro, Stuart

    2015-01-01

    The Division of AIDS Vaccine Research Program funds the discovery and development of HIV/AIDS vaccine candidates. Basic researchers, having discovered a potential vaccine in the laboratory, next want to take that candidate into the clinic to test the concept in humans, to see if it translates. Many of them have heard of “cGMP” and know that they are supposed to make a “GMP product” to take into the clinic, but often they are not very familiar with what “cGMP” means and why these good practices are so important. As members of the Vaccine Translational Research Branch, we frequently get asked “can’t we use the material we made in the lab in the clinic?” or “aren’t Phase 1 studies exempt from cGMP?” Over the years, we have had many experiences where researchers or their selected contract manufacturing organizations have not applied an appropriate degree of compliance with cGMP suitable for the clinical phase of development. We share some of these experiences and the lessons learned, along with explaining the importance of cGMP, just what cGMP means, and what they can assure, in an effort to de-mystify this subject and facilitate the rapid and safe translational development of HIV vaccines. PMID:25698494

  18. Outcomes of antiretroviral therapy among younger versus older adolescents and adults in an urban clinic, Zimbabwe.

    PubMed

    Matyanga, C M J; Takarinda, K C; Owiti, P; Mutasa-Apollo, T; Mugurungi, O; Buruwe, L; Reid, A J

    2016-06-21

    Contexte : Un centre de santé soutenu par une organisation non gouvernementale offrant des services de santé, notamment les services de traitement antirétroviral (TAR).Objectif : Comparer la rétention du TAR entre des adolescents plus jeunes (10–14 ans) et plus âgés (15–19 ans) et des adultes plus jeunes (20–29 ans) et plus âgés (⩾30 ans) et déterminer les facteurs associés à l'attrition et spécifiques des adolescents et des adultes parmi ceux qui ont mis en route du TAR en 2010–2011.Schéma : Etude rétrospective de cohorte.Résultats : L'étude a inclus 110 (7%) adolescents et 1484 (93%) adultes. Aucune différence en termes de rétention n'a été observée entre les adolescents plus jeunes et plus âgés à 6, 12 et 24 mois. Davantage des plus jeunes adolescents ont été initiés au traitement avec un index de masse corporelle <16 kg/m(2) comparé aux adolescents plus âgés (64% contre 47% ; P = 0,04). Il y avait plus de femmes (74% contre 52% ; P < 0,001) et moins de patients démarrant le TAR avec un comptage de CD4 ⩽ 350 cellules/mm(3) (77% contre 81% ; P = 0,007) parmi les adultes plus jeunes comparés aux plus âgés. Les adultes plus jeunes ont eu davantage d'attrition à tout moment que les plus âgés. Aucun facteur de risque d'attrition n'a été observé parmi les adolescents. Chez les adultes, les facteurs associés à l'attrition ont inclus l'âge plus jeune, un comptage de CD4 plus faible et une infection au virus de l'immunodéficience humaine plus avancée lors de la mise en route du traitement et son initiation dans le cadre d'un protocole basé sur la stavudine.Conclusion : Les adultes plus jeunes ont eu davantage d'attrition et devraient susciter davantage d'attention. Nous n'avons pas pu démontrer de différences d'attrition entre les adolescents plus jeunes et plus âgés. La perte de vue a été la cause principale d'attrition dans tous les groupes d'âge. Dans l'ensemble, un démarrage plus précoce du TAR parait

  19. Evaluating ego defense mechanisms using clinical interviews: an empirical study of adolescent diabetic and psychiatric patients.

    PubMed

    Jacobson, A M; Beardslee, W; Hauser, S T; Noam, G G; Powers, S I; Houlihan, J; Rider, E

    1986-12-01

    Ego defense mechanisms were studied in three groups of early adolescents: diabetic patients, non-psychotic psychiatric patients, and healthy high school students. Defenses were assessed from ratings of open-ended, in-depth interviews. High levels of denial and low levels of asceticism were found in all three groups. Comparisons between groups indicated that psychiatric patients had a distinctive profile of defense usage, in comparison to adolescents from the other two groups. An independent measure of ego development was positively correlated with the defenses of altruism, intellectualization, and suppression, while it was negatively correlated with acting out, avoidance, denial, displacement, projection, and repression. The findings of substantial differences in defense usage between the psychiatric and non-psychiatric samples, and the size and directions of the correlations with ego development level, lend support to the validity of the defense codes.

  20. Isotretinoin and mental health in adolescents: Australian consensus.

    PubMed

    Rowe, Casey; Spelman, Lynda; Oziemski, Margaret; Ryan, Alexander; Manoharan, Shobhan; Wilson, Perry; Daubney, Michael; Scott, James

    2014-05-01

    Acne is a common condition among adolescents and has the potential to negatively impact on the psychological well-being of those who suffer from it. In particular, depression and suicidal ideation are more common in adolescents with acne. Successful treatment of acne can improve the quality of life and reduce levels of anxiety and depression in these individuals. The current treatment of choice for severe or refractive acne is isotretinoin, a retinoid. While the possible causal association between isotretinoin and mental illness remains a controversial topic, a recent systematic review has presented evidence to support this relationship. In light of this evidence, a group of dermatologists and psychiatrists have collaborated to develop these recommendations to aid the safe prescribing of isotretinoin in adolescents. These clinical suggestions are aimed at practitioners in both disciplines to increase awareness of the current evidence in support of the association between isotretinoin and adolescent depression.