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Sample records for adolescent community cohort

  1. The Minnesota Adolescent Community Cohort Study: Design and Baseline Results

    PubMed Central

    Forster, Jean; Chen, Vincent; Perry, Cheryl; Oswald, John; Willmorth, Michael

    2014-01-01

    The Minnesota Adolescent Community Cohort (MACC) Study is a population-based, longitudinal study that enrolled 3636 youth from Minnesota and 605 youth from comparison states age 12 to 16 years in 2000–2001. Participants have been surveyed by telephone semi-annually about their tobacco-related attitudes and behaviors. The goals of the study are to evaluate the effects of the Minnesota Youth Tobacco Prevention Initiative and its shutdown on youth smoking patterns, and to better define the patterns of development of tobacco use in adolescents. A multilevel sample was constructed representing individuals, local jurisdictions and the entire state, and data are collected to characterize each of these levels. This paper presents the details of the multilevel study design. We also provide baseline information about MACC participants including demographics and tobacco-related attitudes and behaviors. This paper describes smoking prevalence at the local level, and compares MACC participants to the state as a whole. PMID:21360063

  2. Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study

    PubMed Central

    Reisner, Sari L.; Vetters, Ralph; Leclerc, M; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J.

    2014-01-01

    Purpose Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exists to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the current study aimed to fill this gap. Methods A retrospective cohort study of electronic health record (EHR) data from 180 transgender patients age 12–29 years seen between 2002–2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM to MTF youth on mental health outcomes. Results The sample (n=360) had a mean age of 19.6 (SD=3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared to cisgender matched controls, transgender youth had a two- to three-fold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p<0.05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Conclusions Transgender youth were found to have a disparity in negative mental health outcomes compared to cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. PMID:25577670

  3. Designing Deeply Engaging Online Communities for Adolescents

    ERIC Educational Resources Information Center

    Gurzick, David

    2009-01-01

    American adolescents have experienced growth in their use of online communities; yet, it was unknown whether the current understanding of online-community design applied to the design of communities specific to adolescents. This study bridged this gap, examining (a) How adolescents interact in an online community designed in accordance with…

  4. Building the Future with Cohorts: Communities of Inquiry

    ERIC Educational Resources Information Center

    Rausch, David W.; Crawford, Elizabeth

    2012-01-01

    With recent interest in communities of practice, learning communities, and critical inquiry theory, the University of Tennessee at Chattanooga (UTC) developed, implemented, and studied the relationship of community and the cohort model. This paper shares information about successes and opportunities for improvement. Cohort-based learners across a…

  5. TB Incidence in an Adolescent Cohort in South Africa

    PubMed Central

    Mahomed, Hassan; Ehrlich, Rodney; Hawkridge, Tony; Hatherill, Mark; Geiter, Lawrence; Kafaar, Fazlin; Abrahams, Deborah Ann; Mulenga, Humphrey; Tameris, Michele; Geldenhuys, Hennie; Hanekom, Willem Albert; Verver, Suzanne; Hussey, Gregory Dudley

    2013-01-01

    Background Tuberculosis (TB) is a major public health problem globally. Little is known about TB incidence in adolescents who are a proposed target group for new TB vaccines. We conducted a study to determine the TB incidence rates and risk factors for TB disease in a cohort of school-going adolescents in a high TB burden area in South Africa. Methods We recruited adolescents aged 12 to 18 years from high schools in Worcester, South Africa. Demographic and clinical information was collected, a tuberculin skin test (TST) performed and blood drawn for a QuantiFERON TB Gold assay at baseline. Screening for TB cases occurred at follow up visits and by surveillance of registers at public sector TB clinics over a period of up to 3.8 years after enrolment. Results A total of 6,363 adolescents were enrolled (58% of the school population targeted). During follow up, 67 cases of bacteriologically confirmed TB were detected giving an overall incidence rate of 0.45 per 100 person years (95% confidence interval 0.29–0.72). Black or mixed race, maternal education of primary school or less or unknown, a positive baseline QuantiFERON assay and a positive baseline TST were significant predictors of TB disease on adjusted analysis. Conclusion The adolescent TB incidence found in a high burden setting will help TB vaccine developers plan clinical trials in this population. Latent TB infection and low socio-economic status were predictors of TB disease. PMID:23533639

  6. Cohort Profile update: The 1993 Pelotas (Brazil) Birth Cohort follow-up visits in adolescence

    PubMed Central

    Gonçalves, Helen; Assunção, Maria CF; Wehrmeister, Fernando C; Oliveira, Isabel O; Barros, Fernando C; Victora, Cesar G; Hallal, Pedro C; Menezes, Ana MB

    2014-01-01

    In this paper we update the profile of the 1993 Pelotas (Brazil) Birth Cohort Study, with emphasis on a shift of priority from maternal and child health research topics to four main categories of outcome variables, collected throughout adolescence: (i) mental health; (ii) body composition; (iii) risk factors for non-communicable diseases (NCDs); (iv) human capital. We were able to trace 81.3% (n = 4106) of the original cohort at 18 years of age. For the first time, the 18-years visit took place entirely on the university premises, in a clinic equipped with state-of-the-art equipment for the assessment of body composition. We welcome requests for data analyses from outside scientists. For more information, refer to our website (http://www.epidemio-ufpel.org.projetos_de_pesquisas/estudos/coorte_1993) or e-mail the corresponding author. PMID:24729426

  7. Examining Hookah Smoking Among a Cohort of Adolescent Ever Smokers

    PubMed Central

    Mermelstein, Robin

    2011-01-01

    Introduction: Evidence suggests that hookah smoking is growing among adolescents, particularly among those with a history of cigarette smoking, and is an emerging public health concern. We examined hookah use and its correlates among a sample of adolescents who have ever smoked and may be considered high risk for hookah use. Methods: We examined differences between hookah users and nonusers among a cohort of 951 adolescents (75.3% of the baseline sample, mean age 17.6 years at 24 months), consisting exclusively of youth who reported ever smoking cigarettes who were participating in a longitudinal study of adolescent smoking predictors and patterns. Ever and 30-day hookah use were assessed at 24 months. Results: Of the 951 participants, 58.5% reported ever use and 30.2% reported smoking hookah at least 1 day in the past 30 days. Multivariate logistic regression analyses found that 30-day hookah use was associated with sex (p < .05); race (p < .001); current cigarette (p < .0001), cigar (p < .01), kretek (p < .05), and alcohol use (p < .01); and attending a hookah bar, lounge, or restaurant (p < .001). Participants who were male, White, and were concurrent users of multiple tobacco products and other substances had increased odds of 30-day hookah use. Conclusions: Prevalence of hookah use is high among youth who have already tried cigarette smoking and is associated with a variety of tobacco and other substance use behaviors. Evidence-based programs may be needed to prevent initiation of or reduce Hookah smoking, as well as address cooccurring problem behaviors, to lessen the health risks associated with use among adolescents. PMID:21896886

  8. Community violence concerns and adolescent sleep

    PubMed Central

    Bagley, Erika J.; Tu, Kelly M.; Buckhalt, Joseph A.; El-Sheikh, Mona

    2016-01-01

    Objective The goal of this study was to examine links between concerns about community violence and objective and subjective sleep parameters in an adolescent sample. Sex was considered as a moderator of effects. Design The study used a cross-sectional design. Participants The community-based sample included 252 adolescents (53% girls) with an average age of 15.79 years (SD = 0.81) from the Southeastern United States. The sample included 34% African American and 66% European American adolescents from a wide range of socioeconomic backgrounds. Measurements Adolescent-reported community violence concerns were assessed using a composite of 3 separate subscales that measured perceived community safety and threats of community and school violence. Sleep duration and quality were assessed using actigraphy, and subjective sleep problems and daytime sleepiness were measured with subscales of the School Sleep Habits Survey. Results Community violence predicted lower sleep efficiency, more long-wake episodes, and more sleep/wake problems and sleepiness. Sex-related moderation effects revealed that girls in the sample were more vulnerable to the effects of violence concerns on their objective sleep quality. Conclusions Findings highlight the role of community violence concerns on adolescents’ sleep, revealing that greater community violence concerns are linked with lower levels of actigraphy-based and subjective reports of sleep quality, particularly for adolescent girls. Consideration of the mechanisms by which violence concerns may affect sleep is discussed.

  9. Community violence concerns and adolescent sleep

    PubMed Central

    Bagley, Erika J.; Tu, Kelly M.; Buckhalt, Joseph A.; El-Sheikh, Mona

    2016-01-01

    Objective The goal of this study was to examine links between concerns about community violence and objective and subjective sleep parameters in an adolescent sample. Sex was considered as a moderator of effects. Design The study used a cross-sectional design. Participants The community-based sample included 252 adolescents (53% girls) with an average age of 15.79 years (SD = 0.81) from the Southeastern United States. The sample included 34% African American and 66% European American adolescents from a wide range of socioeconomic backgrounds. Measurements Adolescent-reported community violence concerns were assessed using a composite of 3 separate subscales that measured perceived community safety and threats of community and school violence. Sleep duration and quality were assessed using actigraphy, and subjective sleep problems and daytime sleepiness were measured with subscales of the School Sleep Habits Survey. Results Community violence predicted lower sleep efficiency, more long-wake episodes, and more sleep/wake problems and sleepiness. Sex-related moderation effects revealed that girls in the sample were more vulnerable to the effects of violence concerns on their objective sleep quality. Conclusions Findings highlight the role of community violence concerns on adolescents’ sleep, revealing that greater community violence concerns are linked with lower levels of actigraphy-based and subjective reports of sleep quality, particularly for adolescent girls. Consideration of the mechanisms by which violence concerns may affect sleep is discussed. PMID:27695706

  10. Could a brief assessment of negative emotions and self-esteem identify adolescents at current and future risk of self-harm in the community? A prospective cohort analysis

    PubMed Central

    2013-01-01

    Background Self-harm is common in adolescents, but it is often unreported and undetected. Available screening tools typically ask directly about self-harm and suicidal ideation. Although in an ideal world, direct enquiry and open discussion around self-harm would be advocated, non-psychiatric professionals in community settings are often reluctant to ask about this directly and disclosure can be met with feeling of intense anxiety. Training non-specialist staff to directly ask about self-harm has limited effects suggesting that alternative approaches are required. This study investigated whether a targeted analysis of negative emotions and self-esteem could identify young adolescents at risk of self-harm in community settings. Methods Data were collected as part of a clinical trial from young people in school years 8–11 (aged 12–16) at eight UK secondary schools (N = 4503 at baseline, N = 3263 in prospective analysis). The Short Mood and Feelings Questionnaire, Revised Child Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, personal failure (Children’s Automatic Thoughts Scale), and two items on self-harm were completed at baseline, 6 and 12 months. Results Following a process of Principal Components Analysis, item reduction, and logistic regression analysis, three internally reliable factors were identified from the original measures that were independently associated with current and future self-harm; personal failure (3 items), physical symptoms of depression/anxiety (6 items), positive self-esteem (5 items). The summed score of these 14 items had good accuracy in identifying current self-harm (AUC 0.87 girls, 0.81 boys) and at six months for girls (0.81), and fair accuracy at six months for boys (AUC 0.74) and 12 months for girls (AUC 0.77). Conclusions A brief and targeted assessment of negative emotions and self-esteem, focusing on factors that are strongly associated with current and future self-harm, could potentially be used to

  11. Long-Range Socioeconomic and Marital Consequences of Adolescent Marriage in Three Cohorts of Adult Males.

    ERIC Educational Resources Information Center

    Teti, Douglas M.; And Others

    1987-01-01

    Studied long-term consequences of adolescent marriage in three age cohorts of males. Found that Black and White males who married as adolescents completed less education, earned less, held lower-status occupations, and experienced more marital disruption than did peers who married as adults. (Author/NB)

  12. Relay Writing in an Adolescent Online Community

    ERIC Educational Resources Information Center

    Yi, Youngjoo

    2008-01-01

    "Welcome to Buckeye City" is an adolescent online community that was maintained by 25 Korean students who attended American schools. On the website, the students engaged in "relay writing"--a writing activity in which each person contributed a portion of an evolving story in a relayed manner. Relay writing offers teachers a new and valuable window…

  13. Building a Just Adolescent Community

    ERIC Educational Resources Information Center

    Enright, Mary Schaefer; Schaefer, Lawrence V.; Schaefer, Patricia S.; Schaefer, Kristin A.

    2008-01-01

    Lawrence Kohlberg, a psychologist, coined the term "Just Community" to describe a community built on trust and resolution, in which each member participates democratically in the development of the rules and regulations that govern their community life (Kohlberg, 1985). In a school, this means that students and teachers alike actively participate…

  14. Birth cohort effects on adolescent alcohol use: The influence of social norms from 1976-2007

    PubMed Central

    Keyes, Katherine M.; Schulenberg, John E.; O’Malley, Patrick M.; Johnston, Lloyd D.; Bachman, Jerald G.; Li, Guohua; Hasin, Deborah

    2012-01-01

    Context The substantial changes adolescent alcohol use prevalence over time suggests that population-level environmental factors are important determinants of use, yet the potential influence of such environmental factors is inadequately understood. Objective The present study investigated whether adolescents in birth cohorts and/or time periods characterized by restrictive social norms towards alcohol were at decreased risk for alcohol use and binge drinking, controlling for individual attitudes (disapproval) towards use. Design Aggregated data from thirty-two annual national surveys of U.S. high school students. Participants A total of 1,032,052 students contributed data from 1976 through 2007. Exposure The social norm was measured by creating scores for each time period and birth cohort indicating the proportion disapproving of weekend binge drinking. Outcomes Frequency of past-year alcohol use and any instance of binge drinking (5+ drinks) in the past two-weeks, analyzed using multi-level models clustering individuals within time periods and birth cohorts. Period- and cohort-specific social norm scores were modeled as predictors, controlling for individual attitudes and demographics. Results Individuals who matured in birth cohorts with more restrictive social norms were less likely to use alcohol compared to individuals who matured in cohorts with more permissive norms; each 5% increase in the cohort-specific disapproval was associated with a 12% decrease in the odds of past-year alcohol use (OR=0.88, 99% C.I. 0.87-0.89). The effects of cohort-specific disapproval were notably stronger among White than non-White adolescents. Conclusions The present study documents the importance of considering time-varying population-level risk factors in the study of adolescent alcohol use, and indicates that even after an individual’s personal attitudes are accounted for, risk is shaped by cohort effects whereby the norms within the cohort contribute to the risk of

  15. Community Influence on Adolescent Obesity: Race/Ethnic Differences

    ERIC Educational Resources Information Center

    Wickrama, K. A. Thulitha; Wickrama, K. A. S.; Bryant, Chalandra M.

    2006-01-01

    Using a sample of 20,000 adolescents (Add Health data), this study examined the influences of community poverty and race/ethnicity on adolescent obesity. Multilevel analyses revealed strong evidence for the unique influences of community poverty and race/ethnicity on adolescent obesity net of family characteristics. The prevalence of obesity is…

  16. Community Experiences: Contributions to Adolescent Learning and Intellectual Development.

    ERIC Educational Resources Information Center

    Hamilton, Stephen F.

    Unpaid community activities have been widely recommended as learning experiences for adolescents. An evaluation was conducted of two community action learning programs, one which placed adolescents one-to-one in adult-dominated settings and the other which gave adolescents a group project to plan and carry out with adult assistance. Both programs…

  17. Clustering of substance use and sexual risk behaviour in adolescence: analysis of two cohort studies

    PubMed Central

    Sweeting, Helen; Haw, Sally

    2012-01-01

    Objectives The authors aimed to examine whether changes in health risk behaviour rates alter the relationships between behaviours during adolescence, by comparing clustering of risk behaviours at different time points. Design Comparison of two cohort studies, the Twenty-07 Study (‘earlier cohort’, surveyed in 1987 and 1990) and the 11-16/16+ Study (‘later cohort’, surveyed 1999 and 2003). Setting Central Clydeside Conurbation around Glasgow City. Participants Young people who participated in the Twenty-07 and 11-16/16+ studies at ages 15 and 18–19. Primary and secondary outcomes measures The authors analysed data on risk behaviours in both early adolescence (started smoking prior to age 14, monthly drinking and ever used illicit drugs at age 15 and sexual intercourse prior to age 16) and late adolescence (age 18–19, current smoking, excessive drinking, ever used illicit drugs and multiple sexual partners) by gender and social class. Results Drinking, illicit drug use and risky sexual behaviour (but not smoking) increased between the earlier and later cohort, especially among girls. The authors found strong associations between substance use and sexual risk behaviour during early and late adolescence, with few differences between cohorts, or by gender or social class. Adjusted ORs for associations between each substance and sexual risk behaviour were around 2.00. The only significant between-cohort difference was a stronger association between female early adolescent smoking and early sexual initiation in the later cohort. Also, relationships between illicit drug use and both early sexual initiation and multiple sexual partners in late adolescence were significantly stronger among girls than boys in the later cohort. Conclusions Despite changes in rates, relationships between adolescent risk behaviours remain strong, irrespective of gender and social class. This indicates a need for improved risk behaviour prevention in young people, perhaps through a

  18. Sexual risk behaviors increasing among adolescents over time: comparison of two cohorts in Spain.

    PubMed

    Espada, José P; Escribano, Silvia; Orgilés, Mireia; Morales, Alexandra; Guillén-Riquelme, Alejandro

    2015-01-01

    Despite advances in treatment and prevention, HIV/AIDS remains a serious health and social problem. This study's objective is to examine sexual behavior, levels of knowledge, and attitudes toward HIV/AIDS between two cohorts in Spanish adolescents, and to analyze gender differences in these cohorts. Participants were 2132 adolescents between 15 and 18 years of age: 1222 in 2006 (43.2% boys) and 910 in 2012 (54.1% boys). The results indicate lower HIV knowledge and less favorable attitudes about HIV/AIDS in the 2012 cohort. In addition, adolescents from the 2012 cohort had their first sexual intercourse at an earlier age and have more sexual partners than those from the 2006 cohort. Compared to boys, girls engage in fewer risky behaviors, although they did not use condoms with their stable partner; girls tended to use condom less when they were in a stable relationship than boys. This study confirms the insufficiency of prevention campaigns as well as the need to improve the impact from programs that promote healthy sexual habits. Assuming comparability of cohorts, this study suggests increased risk of HIV/AIDS over time.

  19. Alcohol Prevalence and Attitudes among Adults and Adolescents: Their Relation to Early Adolescent Alcohol Use in Rural Communities

    ERIC Educational Resources Information Center

    DeHaan, Laura; Boljevac, Tina

    2010-01-01

    Although research has identified numerous neighborhood mechanisms influencing urban adolescent risk behaviors, less is known about how community contexts influence rural adolescents. This study explores perceived controls against adolescent drinking (i.e., tolerance of community adolescent alcohol use), adolescent perceptions of community…

  20. Cohort profile: the Boston Area Community Health (BACH) survey.

    PubMed

    Piccolo, Rebecca S; Araujo, Andre B; Pearce, Neil; McKinlay, John B

    2014-02-01

    The Boston Area Community Health (BACH) Survey is a community-based, random sample, epidemiologic cohort of n = 5502 Boston (MA) residents. The baseline BACH Survey (2002-05) was designed to explore the mechanisms conferring increased health risks on minority populations with a particular focus on urologic signs/symptoms and type 2 diabetes. To this end, the cohort was designed to include adequate numbers of US racial/ethnic minorities (Black, Hispanic, White), both men and women, across a broad age of distribution. Follow-up surveys were conducted ∼5 (BACH II, 2008) and 7 (BACH III, 2010) years later, which allows for both within- and between-person comparisons over time. The BACH Survey's measures were designed to cover the following seven broad categories: socio-demographics, health care access/utilization, lifestyles, psychosocial factors, health status, physical measures and biochemical parameters. The breadth of measures has allowed BACH researchers to identify disparities and quantify contributions to social disparities in a number of health conditions including urologic conditions (e.g. nocturia, lower urinary tract symptoms, prostatitis), type 2 diabetes, obesity, bone mineral content and density, and physical function. BACH I data are available through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repositories (www.niddkrepository.org). Further inquiries can be made through the New England Research Institutes Inc. website (www.neriscience.com/epidemiology).

  1. Child Maltreatment and Adolescent Mental Health Problems in a Large Birth Cohort

    ERIC Educational Resources Information Center

    Mills, Ryan; Scott, James; Alati, Rosa; O'Callaghan, Michael; Najman, Jake M.; Strathearn, Lane

    2013-01-01

    Objective: To examine whether notified child maltreatment is associated with adverse psychological outcomes in adolescence, and whether differing patterns of psychological outcome are seen depending on the type of maltreatment. Methods: The participants were 7,223 mother and child pairs enrolled in a population-based birth cohort study in…

  2. Fragmentary Cohorts, Full Cohorts, and the Placement/Course Level Match in Remedial Mathematics Courses among Urban Community College Students

    ERIC Educational Resources Information Center

    Maxwell, William; Hagedorn, Linda Serra; Cypers, Scott; Lester, Jaime; Moon, Hye

    2004-01-01

    This paper is an exploratory description of remedial coursetaking over several semesters. In attempting to characterize the introductory course classrooms of urban community colleges, it proposes a distinction between fragmentary and full cohorts. Also proposed is a concept little examined in community colleges, the placement/course level match,…

  3. Depressive symptomatology, weight status and obesogenic risk among Australian adolescents: a prospective cohort study

    PubMed Central

    Hoare, Erin; Millar, Lynne; Fuller-Tyszkiewicz, Matthew; Skouteris, Helen; Nichols, Melanie; Malakellis, Mary; Swinburn, Boyd; Allender, Steven

    2016-01-01

    Objectives Adolescence is a period of increased risk for mental health problems and development of associated lifestyle risk behaviours. This study examined cross-sectional and longitudinal associations between obesogenic risk factors, weight status, and depressive symptomatology in a cohort of Australian adolescents. Design Prospective cohort study. Setting The study used repeated measures data from the Australian Capital Territory (ACT) It's Your Move project, an Australian community-based obesity prevention intervention. Intervention effect was non-significant therefore intervention and comparison groups were combined in this study. Participants Total sample was 634 secondary school students (female n=338, male n=296) with mean age 13 years (SD=0.6) at baseline (2012) and 15 years (SD=0.6) at follow-up (2014) recruited from 6 government secondary schools in the ACT. Primary and secondary outcomes measures Primary outcome was depressive symptomatology measured by Short Mood and Feelings Questionnaire. Secondary outcomes were weight status, physical activity, screen time and diet related measures. Results Increased physical activity was associated to lower depressive symptomatology among males (OR=0.35, p<0.05). Sweet drink (OR=1.15, p<0.05) and takeaway consumption (OR=1.84, p<0.05) were associated with higher levels of depressive symptomatology among females at follow-up. Males who were classified as overweight or obese at baseline, and remained so over the study period, were at increased risk of depressive symptomatology at follow-up (b=1.63, 95% CI 0.33 to 2.92). Inactivity among males over the 2-year study period was predictive of higher depressive symptomatology scores at follow-up (b=2.55, 95% CI 0.78 to 4.32). For females, those who increased their consumption of takeaway foods during the study period were at increased risk for developing depressive symptomatology (b=1.82, 95% CI −0.05 to 3.71). Conclusions There are multiple, probably complex

  4. Childbearing in adolescence: intergenerational dejà-vu? Evidence from a Brazilian birth cohort

    PubMed Central

    2013-01-01

    Background Pregnancy in adolescence tends to repeat over generations. This event has been little studied in middle and low-income societies undergoing a rapid epidemiological transition. To assess this association it is important to adjust for socioeconomic conditions at different points in lifetime. Therefore, the aim of this study is to analyze the independent effect of adolescent childbearing in a generation on its recurrence in the subsequent generation, after adjusting for socioeconomic status at different points in life. Methods The study was conducted on a prospective cohort of singleton liveborn females from the city of Ribeirão Preto, Brazil, evaluated in 1978/79, and their daughters assessed in 2002/04. A total of 1059 mother-daughter pairs were evaluated. The women who had their first childbirth before 20 years of age were considered to be adolescent mothers. The risk of childbearing in adolescence for the daughter was modeled as a function of the occurrence of teenage childbearing in her mother, after adjustment for socio-demographic variables in a Poisson regression model. Results The rate of childbearing during adolescence was 31.4% in 1978/79 and 17.1% in 2002/04. Among the daughters of the 1st generation adolescent mothers, this rate was 26.7%, as opposed to 12.7% among the daughters of non adolescent mothers. After adjustments the risk of adolescent childbearing for the 2nd generation was 35% higher for women whose mothers had been pregnant during adolescence – RR = 1.35 (95% CI 1.04-1.74). Conclusion Adolescent childbearing in the 1st generation was a predictor of adolescent childbearing in the 2nd, regardless of socioeconomic factors determined at different points in lifetime. PMID:23855747

  5. Adolescent self-organization predicts midlife memory in a prospective birth cohort study.

    PubMed

    Xu, Man K; Jones, Peter B; Barnett, Jennifer H; Gaysina, Darya; Kuh, Diana; Croudace, Tim J; Richards, Marcus

    2013-12-01

    Childhood and adolescent mental health have a lasting impact on adult life chances, with strong implications for subsequent health, including cognitive aging. Using the British 1946 birth cohort, the authors tested associations between adolescent conduct problems, emotional problems and aspects of self-organization, and verbal memory at 43 years and rate of decline in verbal memory from 43 to 60-64 years. After controlling for childhood intelligence, adolescent self-organization was positively associated with verbal memory at 43 years, mainly through educational attainment, although not with rate of memory decline. Associations between adolescent conduct and emotional problems and future memory were of negligible magnitude. It has been suggested that interventions to improve self-organization may save a wide range of societal costs; this study also suggests that this might also benefit cognitive function in later life. PMID:24364401

  6. Longitudinal changes in adiposity during adolescence: a population-based cohort

    PubMed Central

    Araújo, Joana; Barros, Henrique; Severo, Milton; Lopes, Carla; Ramos, Elisabete

    2014-01-01

    Objective We aimed to assess the trends in body mass index (BMI) and body fat percentage (BF%) from the age of 13 to 17 years and to evaluate how sociodemographic and behavioural characteristics at the age of 13  impact changes in BMI and BF%. Setting Porto, Portugal. Participants We evaluated 1451 adolescents in a community-based cohort. Outcome measures BMI z-scores were calculated according to CDC references. BF% was assessed by bioelectrical impedance. Variables with a significant effect in adiposity changes were identified through linear regression models. In girls, estimates were controlled for duration of follow-up, parental education, baseline BMI z-score, age at menarche and the interaction term baseline BMI z-score×age at menarche; in boys, adjustments were performed for duration of follow-up, parental education, baseline BMI z-score and the interaction term baseline BMI z-score×duration of follow-up. Results On average, BMI z-score decreased from the age of 13 to 17 years (mean difference −0.20, 95% CI −0.23 to −0.16 among girls and −0.15, 95% CI −0.19 to −0.11 among boys). Accordingly, 12.4% of girls and 13% of boys moved to a lower BMI category and 2.2% of girls and 5.5% of boys to a higher category. There were sex differences in the significant determinants of adiposity trends. Among girls, BMI z-score significantly decreased with baseline BMI z-score (β=−0.163, 95% CI −0.204 to −0.122) and significantly increased with age at menarche (β=0.078, 95% CI 0.050 to 0.107). Results were similar for BF%. Among boys, BMI z-score significantly increased with higher parental BMI, and BF% decreased among those who wished to look larger at the age of 13 (β=−1.367, 95% CI −2.174 to −0.560), compared with those who were satisfied with their image. Conclusions In adolescents, ageing resulted in a decrease in BMI z-scores and BF%. BMI and BF% at the age of 13 were the major determinants of the observed trends. Our results suggest

  7. Community structural instability, anomie, imitation and adolescent suicidal behavior.

    PubMed

    Thorlindsson, Thorolfur; Bernburg, Jón Gunnar

    2009-04-01

    The current study examines the contextual effects of community structural characteristics, as well as the mediating role of key social mechanisms, on youth suicidal behavior in Iceland. We argue that the contextual influence of community structural instability on youth suicidal behavior should be mediated by weak attachment to social norms and values (anomie), and contact with suicidal others (suggestion-imitation). The data comes from a national survey of 14-16 years old adolescents. Valid questionnaires were obtained from 7018 students (response rate about 87%). The findings show that the community level of residential mobility has a positive, contextual effect on adolescent suicidal behavior. The findings also indicate that the contextual effect of residential mobility is mediated by both anomie and suggestion-imitation. The findings offer the possibility to identify communities that carry a substantial risk for adolescent suicide as well as the mechanisms that mediate the influence of community structural characteristics on adolescent risk behavior.

  8. Design and Analysis of the Community Youth Development Study Longitudinal Cohort Sample

    ERIC Educational Resources Information Center

    Brown, Eric C.; Graham, John W.; Hawkins, J. David; Arthur, Michael W.; Baldwin, Megan M.; Oesterle, Sabrina; Briney, John S.; Catalano, Richard F.; Abbott, Robert D.

    2009-01-01

    Communities That Care (CTC) is a prevention system designed to reduce adolescent substance use and delinquency through the selection of effective preventive interventions tailored to a community's specific profile of risk and protection. A community-randomized trial of CTC, the Community Youth Development Study, is currently being conducted in 24…

  9. Adult and Adolescent Perceptions of Their Community's Drug Use Patterns.

    ERIC Educational Resources Information Center

    Parker, Reese; And Others

    This study identified differences and similarities among the perceptions of adult and adolescent community members regarding drug use patterns and practices. A written questionnaire was administered to 5,128 adolescents from grades 7 through 12 in the rural inland northwest, and a similar questionnaire was administered to over 900 adults in the…

  10. Comorbid Depression and Heart Failure: A Community Cohort Study

    PubMed Central

    Mair, Frances S.; Roger, Véronique L.; Weston, Susan A.; Jiang, Ruoxiang; Chamberlain, Alanna M.

    2016-01-01

    Objective To examine the association between depression and clinical outcomes in heart failure (HF) in a community cohort. Patients and Methods HF patients in Minnesota, United States completed depression screening using the 9-item Patient Health Questionnaire (PHQ-9) between 1st Oct 2007 and 1st Dec 2011; patients with PHQ-9≥5 were labelled “depressed”. We calculated the risk of death and first hospitalization within 2 years using Cox regression. Results were adjusted for 10 commonly used prognostic factors (age, sex, systolic blood pressure, estimated glomerular filtration rate, serum sodium, ejection fraction, blood urea nitrogen, brain natriuretic peptide, presence of diabetes and ischaemic aetiology). Area under the curve (AUC), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) compared depression as a predictor against the aforementioned factors. Results 425 patients (mean age 74, 57.6% males) were included in the study; 179 (42.1%) had PHQ-9≥5. The adjusted hazard ratio of death was 2.02 (95% CI 1.34–3.04) and of hospitalization was 1.42 (95% CI 1.13–1.80) for those with compared to those without depression. Adding depression to the models did not appreciably change the AUC but led to statistically significant improvements in both the IDI (p = 0.001 and p = 0.005 for death and hospitalization, respectively) and NRI (for death and hospitalization, 35% (p = 0.002) and 27% (p = 0.007) were reclassified correctly, respectively). Conclusion Depression is frequent among community patients with HF and associated with increased risk of hospitalizations and death. Risk prediction for death and hospitalizations in HF patients can be improved by considering depression. PMID:27362359

  11. Role of parenting styles in adolescent substance use: results from a Swedish longitudinal cohort study

    PubMed Central

    Berge, J; Sundell, K; Öjehagen, A; Håkansson, A

    2016-01-01

    Objective Adolescent substance use is an area of concern because early substance use is associated with a higher risk of adverse outcomes. Parenting style, defined as the general style of parenting, as well as substance-specific parenting practices may influence children's substance use behaviour. The present study aims to probe the impact of parenting style on adolescent substance use. Method A cohort of 1268 adolescents (48% girls), aged 12–13 years at baseline, from 21 junior high schools was assessed in the first semester of junior high school, and then again in the last semester of the 9th grade, 32 months later. Parenting style, operationalised as a fourfold classification of parenting styles, including established risk factors for adolescent substance use, were measured at baseline. Results Neglectful parenting style was associated with worse substance use outcomes across all substances. After adjusting for other proximal risk factors in multivariate analyses, parenting style was found to be unrelated to substance use outcomes with one exception: authoritative parenting style was associated with less frequent drinking. Association with deviant peers, delinquent behaviour, provision of alcohol by parents, and previous use of other substances were associated with substance use outcomes at follow-up. Conclusions The results of the present study indicate that parenting style may be less important for adolescent substance use outcomes than what has previously been assumed, and that association with deviant peers and delinquent behaviour may be more important for adolescent substance use outcomes than general parenting style. PMID:26769781

  12. Cannabis Use in Adolescence and Young Adulthood: A Review of Findings from the Victorian Adolescent Health Cohort Study.

    PubMed

    Coffey, Carolyn; Patton, George C

    2016-06-01

    The Victorian Adolescent Health Cohort Study (VAHCS) is a long-term Australian cohort study that has documented cannabis use in young Australians from the mid-teens to the mid-30s. The study findings have described the natural history of early cannabis use, remission, and escalation and the social and mental health consequences of different patterns of use. The adverse consequences of cannabis use are most clear-cut in heavy early adolescent users. These consequences include educational failure, persisting mental health problems, and progression to other substance use. For later onset and occasional users, the risks are lower and appear to entail modest elevations in risk for other drug use compared with never users. With growing evidence of health consequences, there is a strong case for actions around early heavy adolescent users. Prevention of early use, identification and treatment of early heavy users, and harm reduction through diversion of early heavy users away from the custodial justice system into health care are all priority responses. PMID:27254840

  13. Cannabis Use in Adolescence and Young Adulthood: A Review of Findings from the Victorian Adolescent Health Cohort Study.

    PubMed

    Coffey, Carolyn; Patton, George C

    2016-06-01

    The Victorian Adolescent Health Cohort Study (VAHCS) is a long-term Australian cohort study that has documented cannabis use in young Australians from the mid-teens to the mid-30s. The study findings have described the natural history of early cannabis use, remission, and escalation and the social and mental health consequences of different patterns of use. The adverse consequences of cannabis use are most clear-cut in heavy early adolescent users. These consequences include educational failure, persisting mental health problems, and progression to other substance use. For later onset and occasional users, the risks are lower and appear to entail modest elevations in risk for other drug use compared with never users. With growing evidence of health consequences, there is a strong case for actions around early heavy adolescent users. Prevention of early use, identification and treatment of early heavy users, and harm reduction through diversion of early heavy users away from the custodial justice system into health care are all priority responses.

  14. The Adolescent Community of Engagement: A Framework for Research on Adolescent Online Learning

    ERIC Educational Resources Information Center

    Borup, Jered; West, Richard E.; Graham, Charles R.; Davies, Randall S.

    2014-01-01

    This paper describes the Adolescent Community of Engagement (ACE) framework as a lens to guide research and design in adolescent online learning environments. Several online learning frameworks have emerged from higher education contexts, but these frameworks do not explicitly address the unique student and environmental characteristics of the…

  15. Adolescent internet use and its relationship to cigarette smoking and alcohol use: a prospective cohort study.

    PubMed

    Chiao, Chi; Yi, Chin-Chun; Ksobiech, Kate

    2014-01-01

    The present study aims to investigate the longitudinal impact of situational Internet use on future cigarette smoking and alcohol use among male and female adolescents. A Northern Taiwanese cohort sample of adolescents with no prior use of cigarettes (n=1445) or alcohol (n=1468) was surveyed at age 16 and again 4 years later. Information regarding where, why, and length of time spent using the Internet was gathered from the 16-year-old participants. Outcome information regarding cigarette/alcohol use was gathered via a follow-up questionnaire at age 20. Multivariate regressions were used to incorporate peer, individual and family characteristics as measured at age 16 and create models of future cigarette and alcohol use at age 20. The analyses demonstrated that adolescent Internet use, particularly where such use took place, has a significant impact on future cigarette smoking and alcohol use, adjusted for conventional factors, and its relationship differs significantly by gender. Female adolescents with Internet café use appear to be especially likely to develop these two risky behaviors. The why of Internet use is also a predictor of future cigarette smoking. Finally, time spent using the Internet is significantly related to alcohol use; greater use of the Internet is associated with higher levels of drinking. The results revealed that different risky behaviors are differentially influenced by separate components of adolescent Internet use. These findings suggest that programs aimed at promoting adolescent health could potentially benefit Taiwanese adolescents by including components related to situational Internet use and taking gender into consideration.

  16. Engagement in School and Community Civic Activities among Rural Adolescents

    ERIC Educational Resources Information Center

    Ludden, Alison Bryant

    2011-01-01

    Involvement in civic and community activities is a core part of positive youth development. Adolescents involved in voluntary civic activities have greater academic engagement, enhanced well-being, less involvement in problem behaviors, and they are more likely to value connections to their community than those who are not involved. The current…

  17. Community Violence Exposure, Threat Appraisal, and Adjustment in Adolescents

    ERIC Educational Resources Information Center

    Kliewer, Wendy; Sullivan, Terri N.

    2008-01-01

    Validity data are presented for a new measure of threat appraisals in response to community violence. Adolescents (N = 358; 45% male; 91% African American, M = 12.10 years, SD = 1.63) and their maternal caregivers participated in two waves of a longitudinal interview study focused on the consequences of exposure to community violence. Structural…

  18. Factors Affecting Drug Abuse in Adolescent Females in Rural Communities

    ERIC Educational Resources Information Center

    Renes, Susan L.; Strange, Anthony T.

    2009-01-01

    This article explores factors influencing adolescent female substance use in rural communities. Self-reported data gathered from females 12 to 15 years of age in two northwestern communities in the United States showed an association among gender identity, peer and parental relationships, and substance use. Aggressive masculinity had the strongest…

  19. Protective factors in American Indian communities and adolescent violence.

    PubMed

    Pu, Jia; Chewning, Betty; St Clair, Iyekiyapiwin Darlene; Kokotailo, Patricia K; Lacourt, Jeanne; Wilson, Dale

    2013-09-01

    With their distinct cultural heritage and rural boundaries, American Indian reservation communities offer a unique opportunity to explore protective factors that help buffer adolescents from potential risk behaviors such as violence. Prior published research on Indian communities has not explored three potential protective factors for violence-parental monitoring of adolescents and friends, adolescents' self-efficacy to avoid fighting, and adolescents' interest in learning more about their traditional culture. This paper explores the relationship between these factors and reduced risk of reported violence. In 1998, 630 American Indian students in grades 6-12 were surveyed in five Midwestern, rural Indian reservation schools. Path analysis was used to identify the direct and indirect association of the three potential protective factors with reduced violence behavior. There were significant gender differences both in perceived parental monitoring and in adolescents' self-efficacy. For female adolescents, parental monitoring had the strongest inverse relationship with female adolescents' involvement in violence. Female adolescents' self-efficacy and their interest in learning more about their culture were also inversely associated with violence and therefore potentially important protectors. Male adolescents who reported more interest in learning the tribe's culture had better self-efficacy to avoid violence. However, self-efficacy did not successfully predict their reported involvement in peer violence. These findings support exploring gender differences, parental monitoring, self-efficacy training as well as cultural elements in future violence intervention studies. Further investigation is needed to identify protective factors for risk behaviors among male adolescents and test the generalizability to non-reservation based adolescents.

  20. Adolescent peer aggression and its association with mental health and substance use in an Australian cohort.

    PubMed

    Moore, Sophie E; Norman, Rosana E; Sly, Peter D; Whitehouse, Andrew J O; Zubrick, Stephen R; Scott, James

    2014-01-01

    Prospective longitudinal birth cohort data was used to examine the association between peer aggression at 14 years and mental health and substance use at 17 years. A sample of 1590 participants from the Western Australian Pregnancy Cohort (Raine) study were divided into mutually exclusive categories (victims, perpetrators, victim-perpetrators and uninvolved). Involvement in any type of peer aggression as a victim (10.1%), perpetrator (21.4%), or a victim-perpetrator (8.7%) was reported by 40.2% of participants. After adjusting for confounding factors, those who were a victim of peer aggression had increased odds of later depression and internalising symptoms whilst perpetrators of peer aggression were found to be at increased risk of depression and harmful alcohol use. Victim-perpetrators of peer aggression were more likely to have externalising behaviours at 17 years. These results show an independent temporal relationship between peer aggression and later mental health and substance use problems in adolescence.

  1. Tracking of physical activity during adolescence: the 1993 Pelotas Birth Cohort, Brazil

    PubMed Central

    Azevedo, Mario Renato; Menezes, Ana Maria; Assunção, Maria Cecília; Gonçalves, Helen; Arumi, Ignasi; Horta, Bernardo Lessa; Hallal, Pedro Curi

    2014-01-01

    OBJECTIVE To analyze physical activity during adolescence in participants of the 1993 Pelotas Birth Cohort Study, Brazil. METHODS Data on leisure time physical activity at 11, 15, and 18 years of age were analyzed. At each visit, a cut-off point of 300 min/week was used to classify adolescents as active or inactive. A total of 3,736 participants provided data on physical activity at each of the three age points. RESULTS A significant decline in the proportion of active adolescents was observed from 11 to 18 years of age, particularly among girls (from 32.9% to 21.7%). The proportions of girls and boys who were active at all three age points were 28.0% and 55.1%, respectively. After adjustment for sex, economic status, and skin color, participants who were active at 11 and 15 years of age were 58.0% more likely to be active at 18 years of age compared with those who were inactive at 11 and 15 years of age. CONCLUSIONS Physical activity declined during adolescence and inactivity tended to track over time. Our findings reinforce the need to promote physical activity at early stages of life, because active behavior established early tends to be maintained over time. PMID:26039395

  2. Childhood traumatic events and adolescent overgeneral autobiographical memory: Findings in a UK cohort

    PubMed Central

    Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J. Mark G.

    2014-01-01

    Background Overgeneral autobiographical memory has repeatedly been identified as a risk factor for adolescent and adult psychopathology but the factors that cause such over-generality remain unclear. This study examined the association between childhood exposure to traumatic events and early adolescent overgeneral autobiographical memory in a large population sample. Methods Thirteen-year-olds, n = 5,792, participating in an ongoing longitudinal cohort study (ALSPAC) completed a written version of the Autobiographical Memory Test. Performance on this task was examined in relation to experience of traumatic events, using data recorded by caregivers close to the time of exposure. Results Results indicated that experiencing a severe event in middle childhood increased the likelihood of an adolescent falling into the lowest quartile for autobiographical memory specificity (retrieving 0 or 1 specific memory) at age 13 by approximately 60%. The association persisted after controlling for a range of potential socio-demographic confounders. Limitations Data on the traumatic event exposures was limited by the relatively restricted range of traumas examined, and the lack of contextual details surrounding both the traumatic event exposures themselves and the severity of children's post-traumatic stress reactions. Conclusions This is the largest study to date of the association between childhood trauma exposure and overgeneral autobiographical memory in adolescence. Findings suggest a modest association between exposure to traumatic events and later overgeneral autobiographical memory, a psychological variable that has been linked to vulnerability to clinical depression. PMID:24657714

  3. Working Adults in Accelerated Cohorts: More than a Learning Community

    ERIC Educational Resources Information Center

    Spaid, Robin; Duff, Evan D.

    2009-01-01

    There are 54 million working adults in the United States without bachelor's degrees (Pusser et al., 2007). Many would like to obtain a college degree but need an educational program that fits their needs. A viable alternative to a traditional college program is an accelerated program in a cohort format. This article highlights best practices for…

  4. Criminal victimization in childhood and adolescence according to official records: the Pelotas (Brazil) birth cohort study

    PubMed Central

    Giraldo Gallo, Erika Alejandra; Menezes, Ana Maria B.; Murray, Joseph; Duarte da Silva, Luciana Anselmi; Wehrmeister, Fernando César; Gonçalves, Helen; Barros, Fernando

    2016-01-01

    This article describes different types of officially recorded victimization among 5,249 children in the 1993 birth cohort in the city of Pelotas, Rio Grande do Sul State, Brazil. Official data were obtained from the Secretariat for Public Security and the Special Court for Children and Youth. Victimization was registered for in 1,150 cohort members, with 1,396 incidents recorded as of December 31, 2012. The total incidence of victimization was 15.7 ocorrences per 1,000 person-years, with the majority involving violent victimization (12.7 per 1,000 person-years). Victimization increased gradually in childhood and rapidly throughout adolescence. The highest incidence rates were among females (p < 0.05), the poor (p < 0.05), children of adolescent mothers (p < 0.001), and children of single mothers (p < 0.05). The most common violent victimization types were physical injuries, robbery, and crimes against personal freedom; non-violent victimization mainly involved theft. Studies like this help identify lifetime risk and protective factors for victimization, highlighting the importance of surveillance and control measures against violence. PMID:27580232

  5. Criminal victimization in childhood and adolescence according to official records: the Pelotas (Brazil) birth cohort study.

    PubMed

    Gallo, Erika Alejandra Giraldo; Menezes, Ana Maria B; Murray, Joseph; Silva, Luciana Anselmi Duarte da; Wehrmeister, Fernando César; Gonçalves, Helen; Barros, Fernando

    2016-01-01

    This article describes different types of officially recorded victimization among 5,249 children in the 1993 birth cohort in the city of Pelotas, Rio Grande do Sul State, Brazil. Official data were obtained from the Secretariat for Public Security and the Special Court for Children and Youth. Victimization was registered for in 1,150 cohort members, with 1,396 incidents recorded as of December 31, 2012. The total incidence of victimization was 15.7 ocorrences per 1,000 person-years, with the majority involving violent victimization (12.7 per 1,000 person-years). Victimization increased gradually in childhood and rapidly throughout adolescence. The highest incidence rates were among females (p < 0.05), the poor (p < 0.05), children of adolescent mothers (p < 0.001), and children of single mothers (p < 0.05). The most common violent victimization types were physical injuries, robbery, and crimes against personal freedom; non-violent victimization mainly involved theft. Studies like this help identify lifetime risk and protective factors for victimization, highlighting the importance of surveillance and control measures against violence. PMID:27580232

  6. Comparing media and family predictors of alcohol use: a cohort study of US adolescents

    PubMed Central

    Stoolmiller, Mike; Wills, Thomas A; McClure, Auden C; Tanski, Susanne E; Worth, Keilah A; Gerrard, Meg

    2012-01-01

    Objective To compare media/marketing exposures and family factors in predicting adolescent alcohol use. Design Cohort study. Setting Confidential telephone survey of adolescents in their homes. Participants Representative sample of 6522 US adolescents, aged 10–14 years at baseline and surveyed four times over 2 years. Primary outcome measure Time to alcohol onset and progression to binge drinking were assessed with two survival models. Predictors were movie alcohol exposure (MAE), ownership of alcohol-branded merchandise and characteristics of the family (parental alcohol use, home availability of alcohol and parenting). Covariates included sociodemographics, peer drinking and personality factors. Results Over the study period, the prevalence of adolescent ever use and binge drinking increased from 11% to 25% and from 4% to 13%, respectively. At baseline, the median estimated MAE from a population of 532 movies was 4.5 h and 11% owned alcohol-branded merchandise at time 2. Parental alcohol use (greater than or equal to weekly) was reported by 23% and 29% of adolescents could obtain alcohol from home. Peer drinking, MAE, alcohol-branded merchandise, age and rebelliousness were associated with both alcohol onset and progression to binge drinking. The adjusted hazard ratios for alcohol onset and binge drinking transition for high versus low MAE exposure were 2.13 (95% CI 1.76 to 2.57) and 1.63 (1.20 to 2.21), respectively, and MAE accounted for 28% and 20% of these transitions, respectively. Characteristics of the family were associated with alcohol onset but not with progression. Conclusion The results suggest that family focused interventions would have a larger impact on alcohol onset while limiting media and marketing exposure could help prevent both onset and progression. PMID:22349939

  7. Engagement in school and community civic activities among rural adolescents.

    PubMed

    Ludden, Alison Bryant

    2011-09-01

    Involvement in civic and community activities is a core part of positive youth development. Adolescents involved in voluntary civic activities have greater academic engagement, enhanced well-being, less involvement in problem behaviors, and they are more likely to value connections to their community than those who are not involved. The current research examined involvement in school and community civic activities as well as religious youth groups among 8th and 9th graders (N = 679, 61.7% female, 85.9% White) from small, rural schools in the Midwest U.S. and linked involvement to religiosity, well-being, problem behavior, academic engagement, and perceptions of parents and peers. Half of the adolescents in the sample reported involvement in civic activities or, more commonly, in religious youth groups. Adolescents who participated in religious youth groups reported more extracurriculars, less problem behavior, higher grades and motivation, and more support from parents and friends than adolescents who did not. The most frequently reported school civic activities were student council and Future Farmers of America, and 4-H was the most popular community civic activity. Those who were involved in school- and community-based civic activities reported more religiosity, academic engagement, and positive perceptions of parents and peers than uninvolved youth. The results support and extend research on rural youth by documenting civic activities across contexts and examining how involvement is associated with positive youth development. PMID:20405186

  8. Engagement in school and community civic activities among rural adolescents.

    PubMed

    Ludden, Alison Bryant

    2011-09-01

    Involvement in civic and community activities is a core part of positive youth development. Adolescents involved in voluntary civic activities have greater academic engagement, enhanced well-being, less involvement in problem behaviors, and they are more likely to value connections to their community than those who are not involved. The current research examined involvement in school and community civic activities as well as religious youth groups among 8th and 9th graders (N = 679, 61.7% female, 85.9% White) from small, rural schools in the Midwest U.S. and linked involvement to religiosity, well-being, problem behavior, academic engagement, and perceptions of parents and peers. Half of the adolescents in the sample reported involvement in civic activities or, more commonly, in religious youth groups. Adolescents who participated in religious youth groups reported more extracurriculars, less problem behavior, higher grades and motivation, and more support from parents and friends than adolescents who did not. The most frequently reported school civic activities were student council and Future Farmers of America, and 4-H was the most popular community civic activity. Those who were involved in school- and community-based civic activities reported more religiosity, academic engagement, and positive perceptions of parents and peers than uninvolved youth. The results support and extend research on rural youth by documenting civic activities across contexts and examining how involvement is associated with positive youth development.

  9. Cervical Pap Screening Cytological Abnormalities among HIV-Infected Adolescents in the LEGACY Cohort

    PubMed Central

    Setse, Rosanna W.; Siberry, George K.; Moss, William J.; Gravitt, Patti; Wheeling, Travis; Bohannon, Beverly; Dominguez, Kenneth; Consortium, Legacy

    2014-01-01

    Objectives To determine the prevalence of cervical Pap screening (CPAP-S), identify factors associated with CPAP-S, and explore risk factors for abnormal cervical cytology in female adolescents with perinatally and behaviorally acquired HIV infection. Design Cross-sectional Setting LEGACY is a national observational cohort chart review study of 1478 HIV-infected persons (≤ age 24 years) managed in 22 HIV specialty clinics in the United States. Participants Sexually active females aged ≥13–24 years in the LEGACY cohort Main Outcome measures CPAP-S & abnormal cervical cytology. Results Of 231 sexually active female participants (>= 13 years) in 2006, 49% had CPAP-S documented since 2001. 58% of 113 cervical tests were abnormal (2% high-grade). In multivariable analysis, perinatal HIV infection and black race were associated with decreased likelihood of CPAP-S (adjusted prevalence ratio [APR] 0.66, 95% CI 0.45, 0.96 and APR 0.74, 95% CI 0.56, 0.96, respectively). Presence of any STI was independently associated with increased likelihood of CPAP-S (APR 1.56, 95% CI 1.21, 2.02). CD4+ T-lymphocyte count <200 cells/mL and previous STI were independently associated with increased likelihood of abnormal cervical cytology (APR 2.19, 95% CI 1.26, 3.78 & APR 1.94, 95% CI 1.29, 2.92, respectively). Conclusions Among sexually active HIV-infected adolescent females, prevalence of CPAP-S was low and cytology was abnormal in more than half of Pap smears. Perinatally HIV-infected, sexually active females were less likely to undergo CPAP-S than their behaviorally HIV-infected counterparts. Interventions targeted at HIV-infected adolescents and care providers are needed to improve CPAP-S in HIV-infected young women, especially those with perinatally acquired HIV infection. PMID:22088311

  10. Anger in Adolescent Communities: How Angry Are They?

    PubMed

    Pullen, Lisa; Modrcin, Mary Anne; McGuire, Sandra L; Lane, Karen; Kearnely, Melissa; Engle, Sonya

    2015-01-01

    Anger is a common factor in two causes of death in adolescence: homicide and suicide. This study looked at the level of anger in non-clinical convenience sample of adolescents (N = 139) between the ages of 12 and 19 years (early: 12 to 14 years, mid: 15 to 16 years, late: 17 to 19 years) from a large Southeastern Baptist church. Participants completed the State-Trait Anger Expression Inventory, Beck and Children's Depression Inventories, and Children of Alcoholics Screening Test (CAST). The level of self-reported anger was low. The difference in anger between the three age groups was not statistically significant. Differences in gender were generally not significant statistically. A strong correlation exists between stress and anger. A minor relationship between parental drinking behaviors, as measured by the CAST, and anger was found. A significant relationship between anger and depression, and frequency of participation in religious activity and decreased anger was established. By increasing the current knowledge of anger in adolescents, it may be possible to gain insight into risk factors or triggers that cause anger. Interventions must be implemented early to prevent juvenile detention and to help adolescents remain in the community. Public policies addressing anger in adolescents are essential. Health care providers must work together to identify adolescents with disorders or feelings of isolation or disconnect and provide treatment based in communities so adolescents can still function and not be isolated. It is relevant that a mentor or someone that can be trusted is provided to build a safe and secure environment. This greater knowledge may aid in assessment and treatment of adolescents with dysfunctional anger.

  11. Anger in Adolescent Communities: How Angry Are They?

    PubMed

    Pullen, Lisa; Modrcin, Mary Anne; McGuire, Sandra L; Lane, Karen; Kearnely, Melissa; Engle, Sonya

    2015-01-01

    Anger is a common factor in two causes of death in adolescence: homicide and suicide. This study looked at the level of anger in non-clinical convenience sample of adolescents (N = 139) between the ages of 12 and 19 years (early: 12 to 14 years, mid: 15 to 16 years, late: 17 to 19 years) from a large Southeastern Baptist church. Participants completed the State-Trait Anger Expression Inventory, Beck and Children's Depression Inventories, and Children of Alcoholics Screening Test (CAST). The level of self-reported anger was low. The difference in anger between the three age groups was not statistically significant. Differences in gender were generally not significant statistically. A strong correlation exists between stress and anger. A minor relationship between parental drinking behaviors, as measured by the CAST, and anger was found. A significant relationship between anger and depression, and frequency of participation in religious activity and decreased anger was established. By increasing the current knowledge of anger in adolescents, it may be possible to gain insight into risk factors or triggers that cause anger. Interventions must be implemented early to prevent juvenile detention and to help adolescents remain in the community. Public policies addressing anger in adolescents are essential. Health care providers must work together to identify adolescents with disorders or feelings of isolation or disconnect and provide treatment based in communities so adolescents can still function and not be isolated. It is relevant that a mentor or someone that can be trusted is provided to build a safe and secure environment. This greater knowledge may aid in assessment and treatment of adolescents with dysfunctional anger. PMID:26201172

  12. Adolescents' Exposure to Community Violence: Are Neighborhood Youth Organizations Protective?

    ERIC Educational Resources Information Center

    Gardner, Margo; Brooks-Gunn, Jeanne

    2009-01-01

    Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), we identified a significant inverse association between the variety of youth organizations available at the neighborhood level and adolescents' exposure to community violence. We examined two non-competing explanations for this finding. First, at the individual…

  13. Community Residential Treatment of MR Adolescent Offenders.

    ERIC Educational Resources Information Center

    Denkowski, George C.; And Others

    A model for habilitating mentally retarded adolescent offenders is described. Discussion of historical background indicates a lack of programs for this population. A data-based profile of the population covers range of developmental delay, adaptive behavior scores, social skill development, academic achievement, arrest history, racial composition,…

  14. Adolescent Impulsivity: Findings from a Community Sample

    ERIC Educational Resources Information Center

    d'Acremont, Mathieu; Van der Linden, Martial

    2005-01-01

    Impulsivity is central to several psychopathological states in adolescence. However, there is little consensus concerning the definition of impulsivity and its core dimensions. In response to this lack of consensus, Whiteside and Lynam (2001, "Pers. Individ. Differ." 30, 669-689) have developed the UPPS Impulsive Behavior Scale, which is able to…

  15. The Development of Multiple Domains of Child and Adolescent Self-Concept: A Cohort Sequential Longitudinal Design.

    ERIC Educational Resources Information Center

    Cole, David A.; Maxwell, Scott E.; Martin, Joan M.; Peeke, Lachlan G.; Seroczynski, A.D.; Tran, Jane M.; Hoffman, Kit B.; Ruiz, Mark D.; Jacquez, Farrah; Maschman, Tracy

    2001-01-01

    Examined development of child and adolescent self-concept in two overlapping age cohorts as a function of the self-concept domain, social/developmental/educational transitions, and gender. Structural equation modeling addressed questions about stability of individual differences over time. Multilevel modeling addressed questions about mean-level…

  16. Bone mineral density in a cohort of adolescent women using depot medroxyprogesterone acetate for one to two years.

    PubMed

    Busen, Nancy H; Britt, Robin B; Rianon, Nahid

    2003-04-01

    The purpose of this study was to examine estradiol and bone mineral density (BMD) in a cohort of adolescents using depot medroxyprogesterone acetate (DMPA) for one to two years. BMD was significantly decreased in the femoral neck and lumbar spine at year one. Estradiol levels suggested hypoestrogenization among subjects

  17. The social norms of birth cohorts and adolescent marijuana use in the United States, 1976–2007

    PubMed Central

    Keyes, Katherine M.; Schulenberg, John E.; O’Malley, Patrick M.; Johnston, Lloyd D.; Bachman, Jerald G.; Li, Guohua; Hasin, Deborah

    2011-01-01

    Aims Studies of the relationship between social norms and marijuana use have generally focused on individual attitudes, leaving the influence of larger societal-level attitudes unknown. The present study investigated societal-level disapproval of marijuana use defined by birth cohort or by time period. Design Combined analysis of nationally-representative annual surveys of secondary school students in the U.S. conducted 1976–2007 as part of the Monitoring the Future study. Setting In-school surveys completed by adolescents in the U.S. Participants 986,003 adolescents in grades 8, 10, and 12 Measurements Main predictors included the percentage of students who disapproved of marijuana in each birth cohort and time period. Multi-level models with individuals clustered in time periods of observation and birth cohorts were modeled, with past-year marijuana use as the outcome. Findings Results indicated a significant and strong effect of birth cohort disapproval of marijuana use in predicting individual risk of marijuana use, after controlling for individual-level disapproval, perceived norms towards marijuana, and other characteristics. For example, compared to birth cohorts in which most (87–90.9%) adolescents disapproved of marijuana use, odds of marijuana use were 3.53 times higher in cohorts where less than half (42–46.9%) disapproved (99% C.I. 2.75, 4.53). Conclusions Individuals in birth cohorts that are more disapproving of marijuana use are less likely to use, independent of their personal attitudes towards marijuana use. Social norms and attitudes regarding marijuana use cluster in birth cohorts, and this clustering has a direct effect on marijuana use even after controlling for individual attitudes and perceptions of norms. PMID:21545669

  18. Sleep Duration Trajectories and Body Composition in Adolescents: Prospective Birth Cohort Study

    PubMed Central

    Schäfer, Antônio Augusto; Domingues, Marlos Rodrigues; Dahly, Darren Lawrence; Meller, Fernanda Oliveira; Gonçalves, Helen; Wehrmeister, Fernando César; Assunção, Maria Cecília Formoso

    2016-01-01

    We aimed to estimate the association between sleep duration trajectories and body composition in adolescents. We used data from participants of the 1993 Pelotas (Brazil) Birth Cohort Study who were later followed up at age 18 years (response rate of 81.3%). At the time, 3974 adolescents had complete data on body composition, which was assessed by air displacement plethysmography. Sleep duration was self-reported by participants at ages 11 and 18 years. Analyses were sex-stratified. The mean sleep duration at 11 years was 9.7 (SD 1.4) and 8.4 (SD 1.9) at 18 years. Sleep duration was dichotomized as inadequate (<8 hours/day) or adequate (≥8 hours/day). Mean body mass, fat mass, and fat-free mass indices at 18 years were 23.4 kg/m2 (SD 4.5), 6.1 kg/m2 (SD 3.9) and 17.3 kg/m2 (SD 2.5), respectively. Girls who reported inadequate sleep duration at 11 years of age, but adequate sleep duration at 18, on average experienced an increase in body mass index (β = 0.39 z-scores; 95% CI 0.13, 0.65), fat mass index (β = 0.30 z-scores; 95% CI 0.07, 0.53), and fat-free mass index (β = 0.24 z-scores; 95% CI 0.08, 0.39) compared to those who had adequate sleep duration at both time points. The results suggest that changes in sleep duration across adolescence may impact body composition in later adolescence and that this may differ by sex. PMID:27010312

  19. Alcohol Use among Rural Middle School Students: Adolescents, Parents, Teachers, and Community Leaders' Perceptions

    ERIC Educational Resources Information Center

    de Haan, Laura; Boljevac, Tina

    2009-01-01

    Background: Although rural adolescents use of alcohol is at some of the highest rates nationally, rural adolescent alcohol use has not been studied extensively. This study examines how community attitudes and behaviors are related to adolescent drinking in rural environments. Methods: Data were gathered in 22 rural communities in the Upper Midwest…

  20. Undernutrition in early life and body composition of adolescent males from a birth cohort study.

    PubMed

    Gigante, Denise P; Victora, Cesar G; Horta, Bernardo L; Lima, Rosângela C

    2007-05-01

    The evidence for an association between poor nutrition in early life and subsequent obesity is inconclusive. In the present study, we investigated the associations between stunting, wasting and underweight at 2 and 4 years of age, and body composition in adolescence in male subjects studied since birth. The 1982 Pelotas Birth Cohort Study included all children born in maternity hospitals and living in the urban area of the city of Pelotas, Southern Brazil. All males born in 1982 were legally required to enlist in the army between January and April 2000. We were thus able to track 2250 subjects in 2000 (78.9% of the original cohort). Anthropometric measurements were collected in 1984 and 1986, and body composition was assessed in 2000. In the present analysis, we used as predictors the nutritional indices height-for-age, weight-for-height and weight-for-age presented in six categories. Outcomes included fat, lean and body mass indices and fat:lean mass ratio, derived from anthropometric and bioimpedance measurements. ANOVA and linear regression were used in the analyses to adjust for confounding. All predictors were positively associated with fat and body mass indices. Height-for-age Z score at age 2 or 4 years was not associated with lean mass index, but all other predictors were associated. Fat:lean mass ratio was associated only with weight-for-height Z score. Our results suggest that undernutrition is not a risk factor for overweight and obesity in our population and may partially protect against fatness in adolescence.

  1. The Adolescent Community Reinforcement Approach for Adolescent Cannabis Users, Cannabis Youth Treatment (CYT) Series, Volume 4.

    ERIC Educational Resources Information Center

    Godley, Susan Harrington; Meyers, Robert J.; Smith, Jane Ellen; Karvinen, Tracy; Titus, Janet C.; Godley, Mark D.; Dent, George; Passetti, Lora; Kelberg, Pamela

    This publication was written for therapists and their supervisors who may want to implement the adolescent community reinforcement approach intervention, which was one of the five interventions tested by the Center for Substance Abuse Treatment's (CSAT's) Cannabis Youth Treatment (CYT) Project. The CYT Project provided funding to support a study…

  2. Stuttering, Temperament, and Anxiety: Data from a Community Cohort Ages 2-4 Years

    ERIC Educational Resources Information Center

    Kefalianos, Elaina; Onslow, Mark; Ukoumunne, Obioha; Block, Susan; Reilly, Sheena

    2014-01-01

    Purpose: The purpose of this study was to ascertain whether and when temperament differences, including precursors of anxiety, emerge before onset and during stuttering development. Method: The authors prospectively studied temperament characteristics of a community cohort of children who stutter (N = 183) and children in the control group (N =…

  3. The Impact of a Cohort Model Learning Community on First-Year Engineering Student Success

    ERIC Educational Resources Information Center

    Doolen, Toni L.; Biddlecombe, Erin

    2014-01-01

    This study investigated the effect of cohort participation in a learning community and collaborative learning techniques on the success of first-year engineering students. Student success was measured as gains in knowledge, skills, and attitudes, student engagement, and persistence in engineering. The study group was comprised of students…

  4. Assessment of a Remedial Community College Cohort for Multiple Intelligences.

    ERIC Educational Resources Information Center

    Ksicinski, Joyce M.

    According to a 1996 study by the National Center for Education Statistics, 75% of America's colleges offer remedial courses and 29% of first-time freshmen take them. Community colleges typically spend more on remedial education than do four-year institutions, and they are anticipating increased demand for such programs. The study cites Howard…

  5. Protective Factors in American Indian Communities and Adolescent Violence

    PubMed Central

    Pu, Jia; Chewning, Betty; St. Clair, Iyekiyapiwin Darlene; Kokotailo, Patricia K; Lacourt, Jeanne; Wilson, Dale

    2014-01-01

    Purpose With their distinct cultural heritage and rural boundaries, American Indian reservation communities offer a unique opportunity to explore protective factors that help buffer adolescents from potential risk behaviors such as violence. Prior published research on Indian communities has not explored three potential protective factors for violence - parental monitoring of adolescents and friends, adolescents’ self-efficacy to avoid fighting, and adolescents’ interest in learning more about their traditional culture. This paper explores the relationship between these factors and reduced risk of reported violence. Methods In 1998, 630 American Indian students in grades 6–12 were surveyed in five Midwestern, rural Indian reservation schools. Path analysis was used to identify the direct and indirect association of the three potential protective factors with reduced violence behavior. Results There were significant gender differences both in perceived parental monitoring and in adolescents’ self-efficacy. For female adolescents, parental monitoring had the strongest inverse relationship with female adolescents’ involvement in violence. Female adolescents’ self-efficacy and their interest in learning more about their culture were also inversely associated with violence and therefore potentially important protectors. Male adolescents who reported more interest in learning the tribe’s culture had better self-efficacy to avoid violence. However, self-efficacy did not successfully predict their reported involvement in peer violence. Conclusions These findings support exploring gender differences, parental monitoring, self-efficacy training as well as cultural elements in future violence intervention studies. Further investigation is needed to identify protective factors for risk behaviors among male adolescents and test the generalizability to non-reservation based adolescents. PMID:22926269

  6. Early adolescent cocaine use as determined by hair analysis in a prenatal cocaine exposure cohort

    PubMed Central

    Warner, Tamara Duckworth; Behnke, Marylou; Eyler, Fonda Davis; Szabo, Nancy J.

    2010-01-01

    Background Preclinical and other research suggest that youth with prenatal cocaine exposure (PCE) may be at high risk for cocaine use due to both altered brain development and exposure to unhealthy environments. Methods Participants are early adolescents who were prospectively enrolled in a longitudinal study of PCE prior to or at birth. Hair samples were collected from the youth at ages 10½ and 12½ (N=263). Samples were analyzed for cocaine and its metabolites using ELISA screening with gas chromatography/mass spectroscopy (GC/MS) confirmation of positive samples. Statistical analyses included comparisons between the hair-positive and hair-negative groups on risk and protective factors chosen a priori as well as hierarchical logistical regression analyses to predict membership in the hair-positive group. Results Hair samples were positive for cocaine use for 14% (n=36) of the tested cohort. Exactly half of the hair-positive preteens had a history of PCE. Group comparisons revealed that hair-negative youth had significantly higher IQ scores at age 10½; the hair-positive youth had greater availability of cigarettes, alcohol, and other drugs in the home; caregivers with more alcohol problems and depressive symptoms; less nurturing home environments; and less positive attachment to their primary caregivers and peers. The caregivers of the hair-positive preteens reported that the youth displayed more externalizing and social problems, and the hair-positive youth endorsed more experimentation with cigarettes, alcohol, and/or other drugs. Mental health problems, peer drug use, exposure to violence, and neighborhood characteristics did not differ between the groups. Regression analyses showed that the availability of drugs in the home had the greatest predictive value for hair-positive group membership while higher IQ, more nurturing home environments, and positive attachment to caregivers or peers exerted some protective effect. Conclusion The results do not support a

  7. Rural Community Characteristics, Economic Hardship, and Peer and Parental Influences in Early Adolescent Alcohol Use

    ERIC Educational Resources Information Center

    De Haan, Laura; Boljevac, Tina; Schaefer, Kurt

    2010-01-01

    The study explores how differences in rural community contexts relate to early adolescent alcohol use. Data were gathered from 1,424 adolescents in the sixth through eighth grades in 22 rural Northern Plains communities, as well as 790 adults, parents, teachers, and community leaders. Multilevel modeling analyses revealed that community…

  8. Serial anthropometry predicts peripheral nerve dysfunction in a community cohort

    PubMed Central

    Ylitalo, Kelly R.; Herman, William H.; Harlow, Siobán D.

    2012-01-01

    Background Obesity is a risk factor for glucose intolerance, but the independent role of obesity in the development of peripheral neuropathy is unclear. This study assessed the impact of body size trajectories on prevalent nerve dysfunction in community-dwelling women with and without glucose intolerance. Methods Annual (1996–2008) anthropometric measures of weight, height, waist circumference, and body mass index (BMI, weight[kg]/height[m2]) were assessed in the Study of Women's Health Across the Nation – Michigan site. Glucose intolerance was defined annually based on current use of diabetes medications, self-reported diabetes diagnosis, and, when available, fasting glucose. Peripheral nerve dysfunction in 2008 was defined as abnormal monofilament testing or ≥4 symptoms or signs. Linear mixed models were used to determine trajectories of anthropometry by subsequently-identified nerve dysfunction status. Results Mean BMI was 32.4 kg/m2 at baseline and 27.8% of women had nerve dysfunction in 2008. BMI, weight, and waist circumference increased over time. Women who would have nerve dysfunction were significantly larger than women without dysfunction, independent of glucose intolerance. At mean baseline age of 46, BMI, weight, and waist circumference differed significantly (p-value<0.01) by subsequent nerve dysfunction status, independent of glucose intolerance and hypertension. These body size differences were maintained but not exacerbated over time. Conclusions Peripheral nerve dysfunction is prevalent among community-dwelling women. Twelve years before the nerve assessment, anthropometry differed between women who would and would not have nerve dysfunction, differences that were maintained over time. Obesity deserves attention as an important and potentially modifiable risk factor for peripheral nerve dysfunction. PMID:23161607

  9. Obesity and psychological traits associated with eating disorders among Cypriot adolescents: comparison of 2003 and 2010 cohorts.

    PubMed

    Hadjigeorgiou, C; Tornaritis, M; Savvas, S; Solea, A; Kafatos, A

    2012-08-01

    Increasing rates of overweight and eating disorders among young people are a concern. The aim of this study was to compare the prevalence of overweight/obesity among Cypriot adolescents between cohorts from 2003 and 2010 and to determine whether body mass index (BMI) was associated with psychological traits linked to eating disorders. Anthropometric measures were done on a representative sample of students aged 10-18 years and the Eating Disorder Inventory-3rd version (EDI-3) and 26-item Eating Attitudes Test (EAT-26) scales were completed by 13-18-year-olds. Mean waist circumference of the 2010 cohort of 10-18-year-olds was 3.6 cm higher in boys and 5.5 cm higher in girls than the 2003 cohort. Mean BMI was higher in 2010 only in the 16-18-year-old age group. More adolescents on the higher end of the weight spectrum had pathological scores n the eating disorder scales. Obesity and maladaptive eating attitudes are common in Cypriot adolescents.

  10. Adolescents' Civic Engagement and Alcohol Use: Longitudinal Evidence for Patterns of Engagement and Use in the Adult Lives of a British Cohort

    ERIC Educational Resources Information Center

    Finlay, Andrea K.; Flanagan, Constance

    2013-01-01

    Participation in discretionary activities during adolescence may facilitate the development of social networks that recruit youth into adult civic life or provide risky contexts that promote alcohol problems. Using data from the 1970 British Cohort Study, latent class analysis was used to identify adolescents' patterns of civic engagement, alcohol…

  11. Victimization of Peruvian adolescents and health risk behaviors: young lives cohort

    PubMed Central

    2014-01-01

    Background While extensive research has been conducted on bullying and victimization in western countries, research is lacking in low- and middle-income settings. This study focused on bullying victimization in Peru. It explored the relationship between the caregiver’s perception of child victimization and the child’s view of selected negative experiences occurring with other children their age. Also, the study examined the association between victimization and adolescent health risk behaviors. Methods This study used data from 675 children participating in the Peru cohort of the Young Lives study. Children and caregivers were interviewed in 2002 when children were 8 years of age and again in 2009 when children were 15 years of age. Measures of victimization included perceptions from children and caregivers while measures of health risk behaviors included cigarette smoking, alcohol drinking, and sexual relations among adolescents. Results Caregivers identified 85 (12.6%) children bullied at ages 8 and 15, 235 (34.8%) bullied at age 8 only, 61 (9.0%) bullied at age 15 only, and 294 (43.6%) not bullied at either age. Children who were bullied at both ages compared with all other children were 1.58 (95% CI 1.00-2.50) times more likely to smoke cigarettes, 1.57 (1.04-2.38) times more likely to drink alcohol, and 2.17 (1.41-3.33) times more likely to have ever had a sexual relationship, after adjusting for gender. The caregiver’s assessment of child victimization was significantly associated with child reported bullying from other children their age. Child reported victimization was significantly associated with increased risky behaviors in some cases. Conclusion Long-term victimization from bullying is more strongly associated than less frequent victimization with increased risk of cigarette smoking, alcohol drinking, and sexual relations at age 15. Hence, programs focused on helping children learn how to mitigate and prevent bullying consistently over time may

  12. Prevalence and Characteristics of Binge Eating in an Adolescent Community Sample

    ERIC Educational Resources Information Center

    Goossens, Lien; Soenens, Bart; Braet, Caroline

    2009-01-01

    The objective of this article was to investigate the prevalence and psychological correlates of binge eating among adolescents. Self-report questionnaires were administered to a community sample of 708 adolescents (M[subscript age] = 14 years). Adolescents reporting loss of control over eating (17% of the sample) reported more eating pathology and…

  13. Prospective Study of Adolescent Drug Use among Community Samples of ADHD and Non-ADHD Participants

    ERIC Educational Resources Information Center

    August, Gerald J.; Winters, Ken C.; Realmuto, George M.; Fahnhorst, Tamara; Botzet, Andria; Lee, Susanne

    2006-01-01

    Objective: To describe the late adolescent drug use outcomes from a relatively large, community-identified sample of children with attention-deficit/hyperactivity disorder (ADHD) who have been assessed longitudinally from childhood through late adolescence. Method: Adolescent drug use outcomes were compared between ADHD-only (n = 27),…

  14. Sample Design and Cohort Selection in the Hispanic Community Health Study/Study of Latinos

    PubMed Central

    LaVange, Lisa M.; Kalsbeek, William; Sorlie, Paul D.; Avilés-Santa, Larissa M.; Kaplan, Robert C.; Barnhart, Janice; Liu, Kiang; Giachello, Aida; Lee, David J.; Ryan, John; Criqui, Michael H.; Elder, John P.

    2010-01-01

    PURPOSE The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a multi-center, community based cohort study of Hispanic/Latino adults in the United States. A diverse participant sample is required that is both representative of the target population and likely to remain engaged throughout follow-up. The choice of sample design, its rationale, and benefits and challenges of design decisions are described in this paper. METHODS The study design calls for recruitment and follow-up of a cohort of 16,000 Hispanics/Latinos aged 18-74 years, with 62.5% (10,000) over 44 years of age and adequate subgroup sample sizes to support inference by Hispanic/Latino background. Participants are recruited in community areas surrounding four field centers in the Bronx, Chicago, Miami, and San Diego. A two-stage area probability sample of households is selected with stratification and over-sampling incorporated at each stage to provide a broadly diverse sample, offer efficiencies in field operations, and ensure that the target age distribution is obtained. CONCLUSIONS Embedding probability sampling within this traditional, multi-site cohort study design enables competing research objectives to be met. However, the use of probability sampling requires developing solutions to some unique challenges in both sample selection and recruitment, as described here. PMID:20609344

  15. Trajectories of gambling problems from mid-adolescence to age 30 in a general population cohort.

    PubMed

    Carbonneau, René; Vitaro, Frank; Brendgen, Mara; Tremblay, Richard E

    2015-12-01

    Studies of gambling starting before adulthood in the general population are either cross-sectional, based on the stability of these behaviors between 2 time points, or cover a short developmental period. The present study aimed at investigating the developmental trajectories of gambling problems across 3 key periods of development, mid-adolescence, early adulthood, and age 30, in a mixed-gender cohort from the general population. Using a semiparametric mixture model, trajectories were computed based on self-reports collected at ages 15 (N = 1,882), 22 (N = 1,785), and 30 (N = 1,358). Two distinct trajectories were identified: 1 trajectory including males and females who were unlikely to have experienced gambling problems across the 15-year period, and 1 trajectory including participants likely to have experienced at least 1 problem over the last 12 months at each time of assessment. Participants following a high trajectory were predominantly male, participated frequently in 3 to 4 different gambling activities, and were more likely to report substance use and problems related to their alcohol and drug consumption at age 30. Thus, gambling problems in the general population are already observable at age 15 in a small group of individuals, who maintain some level of these problems through early adulthood, before moderately but significantly desisting by age 30, while also experiencing other addictive behaviors and related problems. PMID:26168229

  16. PTSD in Children and Adolescents: The Aftermath of Parental Incarceration among Children and Adolescents within the African-American Community

    ERIC Educational Resources Information Center

    Smith, Angie J.

    2014-01-01

    Purpose: The purpose of this paper is to examine Posttraumatic Stress Disorder (PTSD) resulting from parental incarceration upon children and adolescents in an African-American community. Methodology: Much of the literature on posttraumatic stress disorder focuses on children and adolescents that have been exposed to a one-time event (e.g. school…

  17. The Power of Literature: Establishing and Enhancing the Young Adolescent Classroom Community

    ERIC Educational Resources Information Center

    Kent, Andrea M.; Simpson, Jennifer L.

    2012-01-01

    Teachers can use literature written for the young adolescent as a powerful tool for establishing and enhancing the community in the classroom that is arguably a necessity for learning to occur. In order for the young adolescent to be successful in the school classroom, a shared sense of community must exist. The students must feel connected to,…

  18. Measuring Community Risk and Protective Factors for Adolescent Problem Behaviors: Evidence from a Developing Nation

    ERIC Educational Resources Information Center

    Maguire, Edward R.; Wells, William; Katz, Charles M.

    2011-01-01

    Most published research on community risk and protective factors for adolescent problem behaviors has been carried out in developed nations. This article examines community risk and protective factors in a sample of more than 2,500 adolescents in Trinidad and Tobago, a developing Caribbean nation. The authors examine the construct and concurrent…

  19. Community Violence, Protective Factors, and Adolescent Mental Health: A Profile Analysis

    ERIC Educational Resources Information Center

    Copeland-Linder, Nikeea; Lambert, Sharon F.; Ialongo, Nicholas S.

    2010-01-01

    This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring,…

  20. Therapeutic Engagement as a Predictor of Retention in Adolescent Therapeutic Community Treatment

    ERIC Educational Resources Information Center

    Abdel-Salam, Sami; Gunter, Whitney D.

    2014-01-01

    The adolescent drug problem places a huge toll on society and a heavy burden on the criminal justice system. Research regarding the benefits of therapeutic community (TC) treatment for adolescents has shown it to be effective. Despite the ability of therapeutic communities to lower drug relapse and reduce criminality, a great deal remains unknown…

  1. Adolescent Self-control Predicts Midlife Hallucinatory Experiences: 40-Year Follow-up of a National Birth Cohort

    PubMed Central

    Nishida, Atsushi; Xu, Kate Man; Croudace, Tim; Jones, Peter B.; Barnett, Jenifer; Richards, Marcus

    2014-01-01

    Background: Associations between self-control in adolescence and adult mental health are unclear in the general population; to our knowledge, no study has investigated self-control in relation to psychotic-like symptoms. Aims: To investigate the relationship between adolescent self-control and the midlife mental health outcomes of anxiety and depression symptoms and psychotic-like experiences (PLEs), controlling for the effect of adolescent conduct and emotional problems and for parental occupational social class and childhood cognition. Methods: A population-based sample, the MRC National Survey of Health and Development (the British 1946 birth cohort) was contacted 23 times between ages 6 weeks and 53 years. Teachers completed rating scales to assess emotional adjustment and behaviors, from which factors measuring self-control, behavioral, and emotional problems were extracted. At age 53 years, PLEs were self-reported by 2918 participants using 4 items from the Psychosis Screening Questionnaire; symptoms of anxiety and depression were assessed using the scaled version of the General Health Questionnaire (GHQ-28). Results: After adjustment for the above covariates, poor adolescent self-control was associated with the presence of PLEs in adulthood, specifically hallucinatory experiences at age 53 years, even after adjustment for GHQ-28 scores. Conclusions: Lower self-control in adolescence is a risk factor for hallucinatory experiences in adulthood. PMID:24714378

  2. Bullying victimisation and risk of self harm in early adolescence: longitudinal cohort study

    PubMed Central

    Moffitt, Terrie E; Houts, Renate M; Belsky, Daniel W; Arseneault, Louise; Caspi, Avshalom

    2012-01-01

    Objectives To test whether frequent bullying victimisation in childhood increases the likelihood of self harming in early adolescence, and to identify which bullied children are at highest risk of self harm. Design The Environmental Risk (E-Risk) longitudinal study of a nationally representative UK cohort of 1116 twin pairs born in 1994-95 (2232 children). Setting England and Wales, United Kingdom. Participants Children assessed at 5, 7, 10, and 12 years of age. Main outcome measures Relative risks of children’s self harming behaviour in the six months before their 12th birthday. Results Self harm data were available for 2141 children. Among children aged 12 who had self harmed (2.9%; n=62), more than half were victims of frequent bullying (56%; n=35). Exposure to frequent bullying predicted higher rates of self harm even after children’s pre-morbid emotional and behavioural problems, low IQ, and family environmental risks were taken into account (bullying victimisation reported by mother: adjusted relative risk 1.92, 95% confidence interval 1.18 to 3.12; bullying victimisation reported by child: 2.44, 1.36 to 4.40). Victimised twins were more likely to self harm than were their non-victimised twin sibling (bullying victimisation reported by mother: 13/162 v 3/162, ratio=4.3, 95% confidence interval 1.3 to 14.0; bullying victimisation reported by child: 12/144 v 7/144, ratio=1.7, 0.71 to 4.1). Compared with bullied children who did not self harm, bullied children who self harmed were distinguished by a family history of attempted/completed suicide, concurrent mental health problems, and a history of physical maltreatment by an adult. Conclusions Prevention of non-suicidal self injury in young adolescents should focus on helping bullied children to cope more appropriately with their distress. Programmes should target children who have additional mental health problems, have a family history of attempted/completed suicide, or have been maltreated by an adult

  3. Changes in Eating Attitudes, Body Esteem and Weight Control Behaviours during Adolescence in a South African Cohort

    PubMed Central

    Gitau, Tabither M.; Micklesfield, Lisa K.; Pettifor, John M.; Norris, Shane A.

    2014-01-01

    Failure to consume an adequate diet or over consumption during adolescence can disrupt normal growth and development, resulting in undesirable weight change. This leads to an increase in unhealthy weight control practices related to eating and exercise among both adolescent girls and boys to meet the societal ‘ideal’ body shape. This study therefore aims to examine the longitudinal changes in eating attitudes, body-esteem and weight control behaviours among adolescents between 13 and 17 years; and, to describe perceptions around body shape at age 17 years. A total of 1435 urban South African black and mixed ancestry boys and girls, who had data at both age 13 and 17 years from the Birth to Twenty cohort were included. Data were collected through self-administered questionnaires on eating attitudes (EAT-26), body esteem and weight control behaviours for either weight loss or muscle gain attempts. Height and weight were measured at both time points and BMI was calculated. Black females had a higher BMI (p<0.001) and an increased risk of developing eating disorders as well as significant increase in the prevalence of weight loss practices between the ages 13 and 17 years. At age 17 years both Mixed ancestry adolescents had lower body-esteem compared to black adolescents. The prevalence of possible eating disorders was 11% and 13.1% in early and late adolescents respectively. Males and females shared similar opinions on normal silhouettes being the ‘best’, ‘getting respect’ and being the ‘happiest’, while the obese silhouette was associated with the ‘worst’ and the ‘unhappiest’, and the underweight silhouette with the “weakest”. Black females had a higher BMI and an increased risk of developing eating disorders. Adolescent females engaged more in weight loss practices whereas, males in muscle gain practices indicating that Western norms of thinness as the ideal are becoming more common in South Africa. PMID:25310343

  4. Changes in eating attitudes, body esteem and weight control behaviours during adolescence in a South African cohort.

    PubMed

    Gitau, Tabither M; Micklesfield, Lisa K; Pettifor, John M; Norris, Shane A

    2014-01-01

    Failure to consume an adequate diet or over consumption during adolescence can disrupt normal growth and development, resulting in undesirable weight change. This leads to an increase in unhealthy weight control practices related to eating and exercise among both adolescent girls and boys to meet the societal 'ideal' body shape. This study therefore aims to examine the longitudinal changes in eating attitudes, body-esteem and weight control behaviours among adolescents between 13 and 17 years; and, to describe perceptions around body shape at age 17 years. A total of 1435 urban South African black and mixed ancestry boys and girls, who had data at both age 13 and 17 years from the Birth to Twenty cohort were included. Data were collected through self-administered questionnaires on eating attitudes (EAT-26), body esteem and weight control behaviours for either weight loss or muscle gain attempts. Height and weight were measured at both time points and BMI was calculated. Black females had a higher BMI (p<0.001) and an increased risk of developing eating disorders as well as significant increase in the prevalence of weight loss practices between the ages 13 and 17 years. At age 17 years both Mixed ancestry adolescents had lower body-esteem compared to black adolescents. The prevalence of possible eating disorders was 11% and 13.1% in early and late adolescents respectively. Males and females shared similar opinions on normal silhouettes being the 'best', 'getting respect' and being the 'happiest', while the obese silhouette was associated with the 'worst' and the 'unhappiest', and the underweight silhouette with the "weakest". Black females had a higher BMI and an increased risk of developing eating disorders. Adolescent females engaged more in weight loss practices whereas, males in muscle gain practices indicating that Western norms of thinness as the ideal are becoming more common in South Africa. PMID:25310343

  5. Drinking patterns of adolescents who develop alcohol use disorders: results from the Victorian Adolescent Health Cohort Study

    PubMed Central

    Olsson, Craig A; Romaniuk, Helena; Salinger, Jodi; Staiger, Petra K; Bonomo, Yvonne; Hulbert, Carol; Patton, George C

    2016-01-01

    Objective We identify drinking styles that place teens at greatest risk of later alcohol use disorders (AUD). Design Population-based cohort study. Setting Victoria, Australia. Participants A representative sample of 1943 adolescents living in Victoria in 1992. Outcome measures Teen drinking was assessed at 6 monthly intervals (5 waves) between mean ages 14.9 and 17.4 years and summarised across waves as none, one, or two or more waves of: (1) frequent drinking (3+ days in the past week), (2) loss of control over drinking (difficulty stopping, amnesia), (3) binge drinking (5+ standard drinks in a day) and (4) heavy binge drinking (20+ and 11+ standard drinks in a day for males and females, respectively). Young Adult Alcohol Use Disorder (AUD) was assessed at 3 yearly intervals (3 waves) across the 20s (mean ages 20.7 through 29.1 years). Results We show that patterns of teen drinking characterised by loss of control increase risk for AUD across young adulthood: loss of control over drinking (one wave OR 1.4, 95% CI 1.1 to 1.8; two or more waves OR 1.9, CI 1.4 to 2.7); binge drinking (one wave OR 1.7, CI 1.3 to 2.3; two or more waves OR 2.0, CI 1.5 to 2.6), and heavy binge drinking (one wave OR 2.0, CI 1.4 to 2.8; two or more waves OR 2.3, CI 1.6 to 3.4). This is not so for frequent drinking, which was unrelated to later AUD. Although drinking was more common in males, there was no evidence of sex differences in risk relationships. Conclusions Our results extend previous work by showing that patterns of drinking that represent loss of control over alcohol consumption (however expressed) are important targets for intervention. In addition to current policies that may reduce overall consumption, emphasising prevention of more extreme teenage bouts of alcohol consumption appears warranted. PMID:26868948

  6. Suicide Method Runs in Families: A Birth Certificate Cohort Study of Adolescent Suicide in Taiwan

    ERIC Educational Resources Information Center

    Lu, Tsung-Hsueh; Chang, Wan-Ting; Lin, Jin-Jia; Li, Chung-Yi

    2011-01-01

    Suicide method used by adolescents was examined to determine if it was the same as that employed by their suicidal parents. Six hundred eighty adolescents completed suicide between 1997 and 2007, of whom 12 had parents who had previously died by suicide. The suicide method used by these adolescents was compared with that employed by their suicidal…

  7. Contingency Management in Community Programs Treating Adolescent Substance Abuse: A Feasibility Study

    PubMed Central

    Killeen, Therese K.; McRae-Clark, Aimee L.; Waldrop, Angela E.; Upadhyaya, Himanshu; Brady, Kathleen T.

    2012-01-01

    PROBLEM Adolescent substance abuse remains a public health problem, and more effective treatment approaches are needed. PURPOSE The study aims to determine the feasibility and preliminary effectiveness of implementing a cost-effective contingency management (CM) intervention in community substance abuse treatment for adolescents with marijuana use disorders. METHODS Thirty-one adolescents with primary marijuana use disorder enrolled in a community treatment program were randomized. FINDINGS There were no significant group differences in percent negative UDS, sustained negative UDS, or retention in treatment. CONCLUSIONS CM was difficult to integrate into community treatment programs and did not seem to be an effective adjunct to standard community substance abuse treatment for adolescents with marijuana use disorders. Modifying the CM procedure for adolescents, changing staff attitudes toward CM, and/or combining CM with other evidence-based psychosocial treatment may improve outcomes. PMID:22299805

  8. Drinking to Cope: a Latent Class Analysis of Coping Motives for Alcohol Use in a Large Cohort of Adolescents.

    PubMed

    Stapinski, Lexine A; Edwards, Alexis C; Hickman, Matthew; Araya, Ricardo; Teesson, Maree; Newton, Nicola C; Kendler, Kenneth S; Heron, Jon

    2016-07-01

    Alcohol consumption during adolescence is widespread, although there is considerable variation in patterns of use. The aim of this study was to identify patterns of coping-motivated alcohol use in a UK birth cohort and examine individual and family characteristics associated with the resulting drinker profiles. At age 17, participants (n = 3957; 56 % female) reported their alcohol and drug use, internalising symptoms and use of alcohol to cope with a range of emotions. Socio-demographic data were collected via maternal report. Latent class analysis identified drinker subtypes based on the coping motives reported. Association between these profiles and socio-demographic characteristics and internalising disorders was examined. The vast majority (92 %) of adolescents reported alcohol consumption in the past year, and 26 % of those drank weekly or more often. Four distinct motive profiles were identified. These profiles were associated with different socio-demographic characteristics: adolescents from higher socio-economic backgrounds drank primarily for increased confidence, whereas adolescents from low socio-economic backgrounds were more likely to drink to cope with low mood. Adolescents with an anxiety or depressive disorder were six times more likely to fall within the high-risk subtype, characterised by a generalised pattern of drinking to cope with emotions across the board. Coping motives for drinking vary with individual and family factors. Adolescents from low versus high socio-economic backgrounds were characterised by distinct drinking profiles; thus, prevention messages may need to be tailored accordingly. Internalising disorders were strongly associated with a high-risk profile of coping-motivated drinking. PMID:27129479

  9. Stress resilience in adolescence and subsequent antidepressant and anxiolytic medication in middle aged men: Swedish cohort study.

    PubMed

    Hiyoshi, Ayako; Udumyan, Ruzan; Osika, Walter; Bihagen, Erik; Fall, Katja; Montgomery, Scott

    2015-06-01

    It is unclear whether psychological resilience to stress in adolescence represents a persistent characteristic relevant to the subsequent risk for depression and anxiety in later adulthood. We aimed to test whether low psychological stress resilience assessed in adolescence is associated with an increased risk of receiving medication for depression and anxiety in middle age. We utilized Swedish register-based cohort study. Men born between 1952 and 1956 (n = 175,699), who underwent compulsory assessment for military conscription in late adolescence were followed to examine subsequent risk of pharmaceutically-treated depression and anxiety in middle age, from 2006 to 2009 corresponding to ages between 50 and 58 years, using Cox regression. The associations of stress resilience with prescription of antidepressant and anxiolytics medication through potential mediating factors cognitive and physical function and adult socioeconomic factors were calculated. Low stress resilience was associated with elevated risks for antidepressant (hazard ratio (HR):1.5 (95% CI 1.4 1.6)) and anxiolytics (HR:2.4 (CI 2.0 2.7)) medication. Adjustment for measures of childhood living circumstances attenuated the associations somewhat. Around a third of association with low stress resilience, and a half of that with moderate resilience, was mediated through cognitive and physical function in adolescence and adult socioeconomic factors. The magnitude of the inverse association of higher cognitive function with antidepressant medication was eliminated among those with low stress resilience. These results indicate that low stress resilience in adolescence is associated with an increased risk for antidepressant and anxiolytics medication over 30 years later, in part mediated through developmental factors in adolescence and socioeconomic circumstances in adulthood, and low stress resilience can diminish or eliminate the inverse association of higher cognitive function with antidepressant

  10. Inequality and adolescent violence: an exploration of community, family, and individual factors.

    PubMed Central

    Bruce, Marino A.

    2004-01-01

    PURPOSE: The study seeks to examine whether the relationships among community, family, individual factors, and violent behavior are parallel across race- and gender-specific segments of the adolescent population. METHODS: Data from the National Longitudinal Study of Adolescent Health are analyzed to highlight the complex relationships between inequality, community, family, individual behavior, and violence. RESULTS: The results from robust regression analysis provide evidence that social environmental factors can influence adolescent violence in race- and gender-specific ways. CONCLUSIONS: Findings from this study establish the plausibility of multidimensional models that specify a complex relationship between inequality and adolescent violence. PMID:15101669

  11. Maternal anthropometric characteristics in pregnancy and blood pressure among adolescents: 1993 live birth cohort, Pelotas, southern Brazil

    PubMed Central

    2010-01-01

    Background We investigated the association between maternal anthropometric measurements in prepregnancy and at the end of pregnancy and their children's systolic (SBP) and diastolic (DBP) blood pressure at 11 years of age, in a prospective cohort study. Methods All hospital births which took place in 1993 in the city of Pelotas - Brazil, were identified (5,249 live births). In 2004, the overall proportion of follow-up was 85% and we obtained arterial blood pressure measurements of 4,452 adolescents. Results Independent variables analyzed included maternal prepregnancy weight and body mass index (BMI) and maternal weight, and height at the end of pregnancy. Multiple linear regression analysis controlling for the following confounders were carried out: adolescent's skin color, family income at birth, smoking, alcohol intake during pregnancy, and gestational arterial hypertension. Mean SBP and DBP were 101.9 mmHg (SD 12.3) and 63.4 mmHg (SD 9.9), respectively. Maternal prepregnancy weight and BMI, and weight at the end of pregnancy were positively associated with both SBP and DBP in adolescent subjects of both sexes; maternal height was positively associated with SBP only among males. Conclusions Adequate evaluation of maternal anthropometric characteristics during pregnancy may prevent high levels of blood pressure among adolescent children. PMID:20653949

  12. Associations of family and neighborhood socioeconomic characteristics with longitudinal adiposity patterns in a biracial cohort of adolescent girls

    PubMed Central

    Crespi, Catherine M.; Wang, May C.; Seto, Edmund; Mare, Robert; Gee, Gilbert

    2014-01-01

    Although many studies have examined the relationship of adiposity with neighborhood socioeconomic context in adults, few studies have investigated this relationship during adolescence. Using 10-year annual measurements of body mass index, expressed as z-scores (BMIz), obtained from 775 Black and White participants of the NHLBI Growth and Health Study, a prospective cohort study of girls from pre- to post-adolescence, we used multilevel modeling to investigate whether family socioeconomic status (SES) and neighborhood socioeconomic characteristics (measured by census tract median family income) explain variation in BMIz trajectory parameters. Analyses controlled for pubertal maturation. We found that lower SES was associated with higher overall levels of BMIz for both White and Black girls. Additionally, lower SES Black girls had a more sustained increase in BMIz during early adolescence and reached a higher peak compared to higher SES Black girls and to White girls. Neighborhood income was associated with BMIz trajectory for Black girls only. Unexpectedly, among Black girls, living in higher income neighborhoods was associated with higher overall levels of BMIz, controlling for SES. Our findings suggest that neighborhood socioeconomic characteristics may affect adolescent BMIz trajectory differently in different racial/ethnic groups. PMID:25879263

  13. Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya

    PubMed Central

    Dellicour, Stephanie; Aol, George; Ouma, Peter; Yan, Nicole; Bigogo, Godfrey; Hamel, Mary J; Burton, Deron C; Oneko, Martina; Breiman, Robert F; Slutsker, Laurence; Feikin, Daniel; Kariuki, Simon; Odhiambo, Frank; Stergachis, Andreas; Laserson, Kayla F; ter Kuile, Feiko O; Desai, Meghna

    2016-01-01

    Objective Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya. Design This was a population-based prospective cohort. Participants and setting Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance. Outcome measure Miscarriage. Results Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed. Conclusions This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage. PMID:27084287

  14. Long-term effects of adolescent smoking on depression and socioeconomic status in adulthood in an urban African American cohort.

    PubMed

    Strong, Carol; Juon, Hee-Soon; Ensminger, Margaret E

    2014-06-01

    Despite known adverse causal effects of cigarette smoking on mental health, findings for the effects of adolescent cigarette smoking on later depression and socioeconomic status remain inconclusive. Previous studies have had shorter follow-up periods and did not have a representative portion of the African American population. Using an analytical method that matches adolescent smokers with nonsmokers on childhood and background variables, this study aims to provide evidence on the effects of adolescent regular smoking on adult depression and socioeconomic status. Our longitudinal study is from the Woodlawn Study that followed 1,242 African Americans in Chicago from 1966-1967 (at age 6-7) through 2002-2003 (at age 42-43). We used a propensity score matching method to find a regular and a non-regular adolescent smoking group with similar childhood socioeconomic and family background and first grade academic and behavioral performance. We compared the matched samples to assess the longitudinal effects of adolescent smoking on adult outcomes. Comparing the matched 199 adolescent regular smokers and 199 non-regular smokers, we found statistical support for the effects of adolescent cigarette smoking on later educational attainment (OR, 2.13; 95 % CI, 1.34, 3.39) and long-term unemployment (OR, 1.74; 95 % CI, 1.11, 2.75), but did not find support for the effects on adulthood major depressive disorders. With a community population of urban African Americans followed for 40 years, our study contributes to the understanding of the relationships between adolescent smoking and later educational attainment and employment.

  15. Bloodstream Infections in Community Hospitals in the 21st Century: A Multicenter Cohort Study

    PubMed Central

    Anderson, Deverick J.; Moehring, Rebekah W.; Sloane, Richard; Schmader, Kenneth E.; Weber, David J.; Fowler, Vance G.; Smathers, Emily; Sexton, Daniel J.

    2014-01-01

    Background While the majority of healthcare in the US is provided in community hospitals, the epidemiology and treatment of bloodstream infections in this setting is unknown. Methods and Findings We undertook this multicenter, retrospective cohort study to 1) describe the epidemiology of bloodstream infections (BSI) in a network of community hospitals and 2) determine risk factors for inappropriate therapy for bloodstream infections in community hospitals. 1,470 patients were identified as having a BSI in 9 community hospitals in the southeastern US from 2003 through 2006. The majority of BSIs were community-onset, healthcare associated (n = 823, 56%); 432 (29%) patients had community-acquired BSI, and 215 (15%) had hospital-onset, healthcare-associated BSI. BSIs due to multidrug-resistant pathogens occurred in 340 patients (23%). Overall, the three most common pathogens were S. aureus (n = 428, 28%), E. coli (n = 359, 24%), coagulase-negative Staphylococci (n = 148, 10%), though type of infecting organism varied by location of acquisition (e.g., community-acquired). Inappropriate empiric antimicrobial therapy was given to 542 (38%) patients. Proportions of inappropriate therapy varied by hospital (median = 33%, range 21–71%). Multivariate logistic regression identified the following factors independently associated with failure to receive appropriate empiric antimicrobial therapy: hospital where the patient received care (p<0.001), assistance with ≥3 ADLs (p = 0.005), Charlson score (p = 0.05), community-onset, healthcare-associated infection (p = 0.01), and hospital-onset, healthcare-associated infection (p = 0.02). Important interaction was observed between Charlson score and location of acquisition. Conclusions Our large, multicenter study provides the most complete picture of BSIs in community hospitals in the US to date. The epidemiology of BSIs in community hospitals has changed: community-onset, healthcare

  16. Adolescent self-harm and suicidal thoughts in the ALSPAC cohort: a self-report survey in England

    PubMed Central

    2012-01-01

    Background Substantial numbers of adolescents self-harm, but the majority of cases do not reach the attention of medical services, making community studies essential. The prevalence of suicidal thoughts and plans at this age, and the inter-relationships between suicidal thoughts, plans and self-harm remain largely unexplored. Method Cross-sectional analysis of self-reported questionnaire data collected from members of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England. Respondents (n = 4810) were aged 16–17 years old and have been followed up since birth. Results Altogether 905 (18.8%) respondents had ever self-harmed. The prevalence of lifetime self-harm was higher in females (25.6%) than males (9.1%). The most commonly used method was self-cutting: this was used alone or in combination in 73.5% of episodes, compared to 10.0% who took overdoses alone or in combination with other methods. Of those who reported self-harm, 25.3% wanted to die during the most recent episode. Concurrent depression was associated with a greatly increased risk of self-harm (OR 5.43). Only 12.4% of participants sought medical help following their most recent episode of self-harm, although this figure was higher (30.1%) where self-harm was carried out with desire to die. Of the whole sample, 15.8% had ever thought of killing themselves, and 4.3% had ever made plans to kill themselves. Compared to those who had never self-harmed, those who had self-harmed but not wanted to die during the most recent episode were at increased risk of ever having had suicidal thoughts (37.6% compared to 7.8% χ2 =102.3, p < 0.001) and ever making suicidal plans (8.7% compared to 0.7%, χ2 =166.9, p < 0.001). As the frequency of self-harm increased, so did the risk of suicidal thoughts and plans. Conclusions Self-harm and suicidal thoughts are common among 16/17 year olds. Although the majority of self-harm behaviour is not accompanied by a desire to die, all

  17. Achieving Synergy: Linking an Internet-Based Inflammatory Bowel Disease Cohort to a Community-Based Inception Cohort and Multicentered Cohort in Inflammatory Bowel Disease

    PubMed Central

    Aldridge, Molly; Cook, Suzanne Follan; Bright, Renee; Mallette, Meaghan; Moniz, Heather; Shah, Samir A; LeLeiko, Neal S; Shapiro, Jason; Sands, Bruce E; Chen, Wenli; Jaeger, Elizabeth; Galanko, Joseph; Long, Millie D; Martin, Christopher F; Sandler, Robert S; Kappelman, Michael D

    2016-01-01

    Background Traditional cohort studies are important contributors to our understanding of inflammatory bowel diseases, but they are labor intensive and often do not focus on patient-reported outcomes. Internet-based studies provide new opportunities to study patient-reported outcomes and can be efficiently implemented and scaled. If a traditional cohort study was linked to an Internet-based study, both studies could benefit from added synergy. Existing cohort studies provide an opportunity to develop and test processes for cohort linkage. The Crohn’s and Colitis Foundation of America’s (CCFA) Partners study is an Internet-based cohort of more than 14,000 participants. The Ocean State Crohn’s and Colitis Area Registry (OSCCAR) is an inception cohort. The Sinai-Helmsley Alliance for Research Excellence (SHARE) is a multicentered cohort of inflammatory bowel disease patients. Both the later cohorts include medical record abstraction, patient surveys, and biospecimen collection. Objective Given the complementary nature of these existing cohorts, we sought to corecruit and link data. Methods Eligible OSCCAR and SHARE participants were invited to join the CCFA Partners study and provide consent for data sharing between the 2 cohorts. After informed consent, participants were directed to the CCFA Partners website to complete enrollment and a baseline Web-based survey. Participants were linked across the 2 cohorts by the matching of an email address. We compared demographic and clinical characteristics between OSCCAR and SHARE participants who did and did not enroll in CCFA Partners and the data linkage. Results Of 408 participants in the OSCCAR cohort, 320 were eligible for participation in the CCFA Partners cohort. Of these participants, 243 consented to participation; however, only 44 enrolled in CCFA Partners and completed the linkage. OSCCAR participants who enrolled in CCFA Partners were better educated (17% with doctoral degrees) than those who did not (3% with

  18. Objectively measured physical activity and longitudinal changes in adolescent body fatness: an observational cohort study*

    PubMed Central

    Collings, P. J.; Wijndaele, K.; Corder, K.; Westgate, K.; Ridgway, C. L.; Sharp, S. J.; Atkin, A. J.; Stephen, A. M.; Bamber, D.; Goodyer, I.; Brage, S.

    2015-01-01

    Summary Background The data regarding prospective associations between physical activity (PA) and adiposity in youth are inconsistent. Objective The objective of this study was to investigate associations between baseline levels of objectively measured PA and changes in adiposity over 2.5 years from mid‐to‐late adolescence. Methods This was an observational cohort study in 728 school students (43% boys) from Cambridgeshire, United Kingdom. Fat mass index (FMI, kg m−2) was estimated at baseline (mean ± standard deviation age: 15 ± 0.3 years) and follow‐up (17.5 ± 0.3 years) by anthropometry and bioelectrical impedance. Habitual PA was assessed at baseline by ≥3 d combined heart rate and movement sensing. Average daily PA energy expenditure (PAEE) and the time (min d−1) spent in light, moderate and vigorous intensity PA (LPA, MPA and VPA, respectively) was estimated. Multilevel models were used to investigate associations between baseline PA and change in FMI (ΔFMI). Adjustment for baseline age, sex, follow‐up duration, area‐level socioeconomic status, season of PA assessment, sedentary time, energy intake and sleep duration was made; baseline FMI was also added in a second model. Results FMI increased significantly over follow‐up (0.6 ± 1.2 kg m−2, P < 0.001). Baseline PAEE and LPA positively predicted ΔFMI in overfat participants (P ≤ 0.030), as did VPA in initially normal fat participants (P ≤ 0.044). There were further positive associations between PAEE and ΔFMI in normal fat participants, and between MPA and ΔFMI in both fat groups, when adjusted for baseline FMI (P ≤ 0.024). Conclusions Baseline PAEE and its subcomponents were positively associated with small and unlikely clinically relevant increases in ΔFMI. These counter‐intuitive findings may be explained by behavioural changes during the course of study follow‐up. PMID:25919340

  19. The influence of birth order and number of siblings on adolescent body composition: evidence from a Brazilian birth cohort study.

    PubMed

    de Oliveira Meller, Fernanda; Assunção, M C F; Schäfer, A A; de Mola, C L; Barros, A J D; Dahly, D L; Barros, F C

    2015-07-14

    The aim of this study was to estimate the association between birth order and number of siblings with body composition in adolescents. Data are from a birth cohort study conducted in Pelotas, Brazil. At the age of 18 years, 4563 adolescents were located, of whom 4106 were interviewed (follow-up rate 81.3 %). Of these, 3974 had complete data and were thus included in our analysis. The variables used in the analysis were measured during the perinatal period, or at 11, 15 and/or 18 years of age. Body composition at 18 years was collected by air displacement plethysmography (BOD POD®). Crude and adjusted analyses of the association between birth order and number of siblings with body composition were performed using linear regression. All analyses were stratified by the adolescent sex. The means of BMI, fat mass index and fat-free mass index among adolescents were 23.4 (sd 4.5) kg/m², 6.1 (sd 3.9) kg/m² and 17.3 (sd 2.5) kg/m², respectively. In adjusted models, the total siblings remained inversely associated with fat mass index (β = - 0.37 z-scores, 95 % CI - 0.52, - 0.23) and BMI in boys (β = - 0.39 z-scores, 95 % CI - 0.55, - 0.22). Fat-free mass index was related to the total siblings in girls (β = 0.06 z-scores, 95 % CI - 0.04, 0.17). This research has found that number of total siblings, and not birth order, is related to the fat mass index, fat-free mass index and BMI in adolescents. It suggests the need for early prevention of obesity or fat mass accumulation in only children.

  20. The study design and methodology for the ARCHER study - adolescent rural cohort study of hormones, health, education, environments and relationships

    PubMed Central

    2012-01-01

    Background Adolescence is characterized by marked psychosocial, behavioural and biological changes and represents a critical life transition through which adult health and well-being are established. Substantial research confirms the role of psycho-social and environmental influences on this transition, but objective research examining the role of puberty hormones, testosterone in males and oestradiol in females (as biomarkers of puberty) on adolescent events is lacking. Neither has the tempo of puberty, the time from onset to completion of puberty within an individual been studied, nor the interaction between age of onset and tempo. This study has been designed to provide evidence on the relationship between reproductive hormones and the tempo of their rise to adult levels, and adolescent behaviour, health and wellbeing. Methods/Design The ARCHER study is a multidisciplinary, prospective, longitudinal cohort study in 400 adolescents to be conducted in two centres in regional Australia in the State of New South Wales. The overall aim is to determine how changes over time in puberty hormones independently affect the study endpoints which describe universal and risk behaviours, mental health and physical status in adolescents. Recruitment will commence in school grades 5, 6 and 7 (10–12 years of age). Data collection includes participant and parent questionnaires, anthropometry, blood and urine collection and geocoding. Data analysis will include testing the reliability and validity of the chosen measures of puberty for subsequent statistical modeling to assess the impact over time of tempo and onset of puberty (and their interaction) and mean-level repeated measures analyses to explore for significant upward and downward shifts on target outcomes as a function of main effects. Discussion The strengths of this study include enrollment starting in the earliest stages of puberty, the use of frequent urine samples in addition to annual blood samples to measure

  1. The economic costs of chronic pain among a cohort of treatment seeking adolescents in the United States

    PubMed Central

    Groenewald, Cornelius B.; Essner, Bonnie S.; Wright, Davene; Fesinmeyer, Megan D.; Palermo, Tonya M.

    2014-01-01

    The aim of this study was to assess the economic cost of chronic pain among adolescents receiving interdisciplinary pain treatment. Information was gathered from 149 adolescents (ages 10-17) presenting for evaluation and treatment at interdisciplinary pain clinics in the United States. Parents completed a validated measure of family economic attributes, the Client Service Receipt Inventory, to report on health service use and productivity losses due to their child's chronic pain retrospectively over 12 months. Health care costs were calculated by multiplying reported utilization estimates by unit visit costs from the 2010 Medical Expenditure Panel Survey. The estimated mean and median costs per participant were $11,787 and $6,770 respectively. Costs were concentrated in a small group of participants, the top 5 % of those patients incurring the highest costs accounted for 30 % of total costs while the lower 75 % of participants accounted for only 34 % of costs. Total costs to society for adolescents with moderate to severe chronic pain were extrapolated to $19.5 billion annually in the U.S. The cost of childhood chronic pain presents a substantial economic burden to families and society. Future research should focus on predictors of increased health services use and costs in adolescents with chronic pain. Perspective This cost of illness study comprehensively estimates the economic costs of chronic pain in a cohort of treatment-seeking adolescents. The primary driver of costs was direct medical costs followed by productivity losses. Because of its economic impact, policy makers should invest resources in the prevention, diagnosis, and treatment of chronic pediatric pain. PMID:24953887

  2. COMT Val(158)Met and 5HTTLPR functional loci interact to predict persistence of anxiety across adolescence: results from the Victorian Adolescent Health Cohort Study.

    PubMed

    Olsson, C A; Byrnes, G B; Anney, R J L; Collins, V; Hemphill, S A; Williamson, R; Patton, G C

    2007-10-01

    We investigated whether a composite genetic factor, based on the combined actions of catechol-O-methyltransferase (COMT) (Val(158)Met) and serotonin transporter (5HTTLPR) (Long-Short) functional loci, has a greater capacity to predict persistence of anxiety across adolescence than either locus in isolation. Analyses were performed on DNA collected from 962 young Australians participating in an eight-wave longitudinal study of mental health and well-being (Victorian Adolescent Health Cohort Study). When the effects of each locus were examined separately, small dose-response reductions in the odds of reporting persisting generalized (free-floating) anxiety across adolescence were observed for the COMT Met(158) [odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.76-0.95, P = 0.004] and 5HTTLPR Short alleles (OR = 0.88, CI = 0.79-0.99, P = 0.033). There was no evidence for a dose-response interaction effect between loci. However, there was a double-recessive interaction effect in which the odds of reporting persisting generalized anxiety were more than twofold reduced (OR = 0.45, CI = 0.29-0.70, P < 0.001) among carriers homozygous for both the COMT Met(158) and the 5HTTLPR Short alleles (Met(158)Met + Short-Short) compared with the remaining cohort. The double-recessive effect remained after multivariate adjustment for a range of psychosocial predictors of anxiety. Exploratory stratified analyses suggested that genetic protection may be more pronounced under conditions of high stress (insecure attachments and sexual abuse), although strata differences did not reach statistical significance. By describing the interaction between genetic loci, it may be possible to describe composite genetic factors that have a more substantial impact on psychosocial development than individual loci alone, and in doing so, enhance understanding of the contribution of constitutional processes in mental health outcomes. PMID:17504250

  3. Stability of Diagnosis: A 20-Year Retrospective Cohort Study of Israeli Psychiatric Adolescent Inpatients.

    ERIC Educational Resources Information Center

    Valevski, Avi; Ratzoni, Gideon; Sever, Jonathan; Apter, Alan; Zalsman, Gil; Shiloh, Roni; Weizman, Abraham; Tyano, Sam

    2001-01-01

    Outcome according to diagnosis and stability of diagnosis were investigated in a follow-back study, with a duration of 15-19 years, of 351 adolescents with various psychiatric disorders hospitalized in a closed psychiatric ward. Findings indicated that transient adolescent psychosis is associated with a relatively good prognosis and should…

  4. Practice Parameter on Child and Adolescent Mental Health Care in Community Systems of Care

    ERIC Educational Resources Information Center

    Journal of the American Academy of Child and Adolescent Psychiatry, 2007

    2007-01-01

    This parameter presents overarching principles and practices for child and adolescent mental health care in community systems of care. Community systems of care are defined broadly as comprising the wide array of child-serving agencies, programs, and practitioners (both public and private), in addition to natural community supports such as…

  5. Work, Community, and Parenting Resources and Demands as Predictors of Adolescent Problems and Grades

    ERIC Educational Resources Information Center

    Voydanoff, Patricia

    2004-01-01

    This article uses a resources and demands approach to examine the extent to which work, community, and parenting resources and demands are related to adolescents' internalizing and externalizing problems and grades in school. The analysis is based on data from 489 married two-earner couples and adolescents aged 10 to 17 interviewed for the…

  6. Dream Content of Schizophrenic, Nonschizophrenic Mentally Ill, and Community Control Adolescents.

    ERIC Educational Resources Information Center

    Hadjez, Jack; Stein, Daniel; Gabbay, Uri; Bruckner, Judith; Meged, Sorin; Barak, Yoram; Elizur, Avner; Weizman, Abraham; Rotenberg, Vadim S.

    2003-01-01

    Study compared dream content of schizophrenic adolescent inpatients, adolescent inpatient s with other mental disorders, and community controls. Results suggest that psychopathology per se, rather than the specific psychiatric disturbance, may be associated with impoverishment of dream content; and that negative, rather than positive,…

  7. The Relation of Family and School Attachment to Adolescent Deviance in Diverse Groups and Communities.

    ERIC Educational Resources Information Center

    Dornbusch, Sanford M.; Erickson, Kristan Glasgow; Laird, Jennifer; Wong, Carol A.

    2001-01-01

    Examined whether attachments to family and school reduced five forms of adolescent deviance (smoking, drinking, marijuana use, delinquency, and violent behavior). Found that adolescent attachments to family and school reduced overall frequency, prevalence, and intensity of deviant involvement, regardless of community context, gender, or ethnic…

  8. Brief Report: Do Delinquency and Community Violence Exposure Explain Internalizing Problems in Early Adolescent Gang Members?

    ERIC Educational Resources Information Center

    Madan, Anjana; Mrug, Sylvie; Windle, Michael

    2011-01-01

    Adolescent gang members are at higher risk for internalizing problems as well as exposure to community violence and delinquency. This study examined whether gang membership in early adolescence is associated with internalizing problems (depression, anxiety, and suicidal behavior) and whether these associations are mediated by delinquency and…

  9. Mother, Daughter, Teenager-Who Am I? Perceptions of Adolescent Maternity in a Navajo Reservation Community.

    ERIC Educational Resources Information Center

    Dalla, Rochelle L.; Gamble, Wendy C.

    2000-01-01

    Intensive interviews focusing on perceptions of teenage parenting were conducted with Navajo teenage mothers, their mothers, and community informants. Two central themes representing commitment to maternity or adolescence were found. Factors associated with the prevalence of adolescent parenting on the Navajo reservation are discussed, as are…

  10. Community Health Nurses' Knowledge of, Attitudes toward, and Involvement with Adolescent Contraceptive Services.

    ERIC Educational Resources Information Center

    Swenson, Ingrid; And Others

    1991-01-01

    Surveyed national sample of 844 community health nurses to assess their knowledge of, attitudes toward, involvement with reproductive health services. Slightly more than 50 percent of nurses provided or administered contraceptive services to adolescents. Ninety-five percent agreed that contraceptives should be available to adolescents; 90 percent…

  11. Pilot Study of Community-Based Cognitive Behavioral Group Therapy for Adolescents with Social Phobia.

    ERIC Educational Resources Information Center

    Baer, Susan; Garland, E. Jane

    2005-01-01

    Objective: A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric…

  12. 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…

  13. Eating Disorders among a Community-Based Sample of Chilean Female Adolescents

    ERIC Educational Resources Information Center

    Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela

    2011-01-01

    The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder.…

  14. Child Sexual Abuse Consequences in Community Samples of Latino and European American Adolescents

    ERIC Educational Resources Information Center

    Newcomb, Michael D.; Munoz, David T.; Carmona, Jennifer Vargas

    2009-01-01

    Objective: Research investigating the impact of child sexual abuse (CSA) in community samples of adolescents has been limited. This study aims to identify sexual abuse among ethnically diverse high school adolescents of both genders and evaluate their psycho-emotional consequences. Method: Through the use of self-report instruments, a sample of…

  15. Social Anxiety Disorder and Victimization in a Community Sample of Adolescents

    ERIC Educational Resources Information Center

    Gren-Landell, Malin; Aho, Nikolas; Andersson, Gerhard; Svedin, Carl Goran

    2011-01-01

    Despite high prevalence rates of social anxiety disorder (SAD) and high rates of victimization in adolescents, studies on the relationship between these phenomena are missing. In the present study we report associations between SAD and multiple victimization experiences in a community sample of adolescents. A cross-sectional study was conducted on…

  16. Potentially traumatic interpersonal events, psychological distress and recurrent headache in a population-based cohort of adolescents: the HUNT study

    PubMed Central

    Stensland, Synne Øien; Dyb, Grete; Thoresen, Siri; Wentzel-Larsen, Tore; Zwart, John-Anker

    2013-01-01

    Objectives Recurrent headache co-occurs commonly with psychological distress, such as anxiety or depression. Potentially traumatic interpersonal events (PTIEs) could represent important precursors of psychological distress and recurrent headache in adolescents. Our objective was to assess the hypothesised association between exposure to PTIEs and recurrent migraine and tension-type headache (TTH) in adolescents, and to further examine the potential impact of psychological distress on this relationship. Design Population-based, cross-sectional cohort study. The study includes self-reported data from youth on exposure to potentially traumatic events, psychological distress and a validated interview on headache. Setting The adolescent part of the Nord-Trøndelag Health Study 2006–2008 (HUNT), conducted in Norway. Participants A cohort of 10 464 adolescents were invited to the study. Age ranged from 12 to 20 years. The response rate was 73% (7620), of whom 50% (3832) were girls. Main outcome measures Data from the headache interview served as the outcome. Recurrent headache was defined as headache recurring at least monthly during the past year, and was subclassified into monthly, weekly and daily complaints. Subtypes were classified as TTH, migraine, migraine with TTH and/or non-classifiable headache, in accordance with the International Classification of Headache Disorders criteria, second edition. Results Multiple logistic regression analysis, adjusted for sociodemographics, showed consistently significant associations between exposure to PTIEs and recurrent headache, regardless of the frequency or subtype of headache. Increasing exposure to PTIEs was associated with higher prevalence of recurrent headache, indicating a dose–response relationship. The strength of associations between exposure to PTIEs and all recurrent headache disorders was significantly attenuated when psychological distress was entered into the regression equation. Conclusions The

  17. Effect of tobacco smoke exposure during pregnancy and preschool age on growth from birth to adolescence: a cohort study

    PubMed Central

    2014-01-01

    Background There is strong evidence of an association between maternal smoking during pregnancy and restriction of intrauterine growth, but the effects of this exposure on postnatal linear growth are not well defined. Furthermore, few studies have investigated the role of tobacco smoke exposure also after pregnancy on linear growth until adolescence. In this study we investigated the effect of maternal smoking exposure during pregnancy and preschool age on linear growth from birth to adolescence. Methods We evaluated a cohort of children born between 1994 and 1999 in Cuiabá, Brazil, who attended primary health clinics for vaccination between the years 1999 and 2000 (at preschool age) and followed-up after approximately ten years. Individuals were located in public and private schools throughout the country using the national school census. Height/length was measured, and length at birth was collected at maternity departments. Stature in childhood and adolescence was assessed using the height-for-age index sex-specific expressed as z-score from curves published by the World Health Organization. Linear mixed effects models were used to estimate the association between exposure to maternal smoking, during pregnancy and preschool age, and height of children assessed at birth, preschool and school age, adjusted for age of the children. Results We evaluated 2405 children in 1999–2000, length at birth was obtained from 2394 (99.5%), and 1716 at follow-up (71.4% of baseline), 50.7% of the adolescents were male. The z-score of height-for-age was lower among adolescents exposed to maternal smoking both during pregnancy and childhood (p < 0.01). Adjusting for age, sex, maternal height, maternal schooling, socioeconomic position at preschool age, and breastfeeding, children exposed to maternal smoking both during pregnancy and preschool age showed persistent lower height-for-age since birth to adolescence (coefficient: −0.32, p < 0.001) compared to non

  18. 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.

  19. Repeat suicide attempts in Hong Kong community adolescents.

    PubMed

    Wong, Joy P S; Stewart, Sunita M; Claassen, Cindy; Lee, Peter W H; Rao, Uma; Lam, T H

    2008-01-01

    It has been well documented that a history of suicide attempts confers risk for subsequent attempts; however, efforts to explain how variables may change after a previous attempt and in turn relate to future suicide attempts are rare in the literature. This study presents longitudinal data on adolescent suicide attempts in Hong Kong, and examines whether the data support the "crescendo" model to explain repeat suicide attempts. One thousand and ninety-nine community adolescents aged 12-18 years were evaluated at two assessment points 12 months apart (T1 and T2). The study assessed (1) risk factors at T1 for a suicide attempt between T1 and T2, (2) whether a suicide attempt during the 12 months prior to T1 predicted an attempt between the two assessment points, and (3) whether the indicators of distress worsened from T1 to T2 if an attempt had taken place in the interim. The results indicated that: (1) depressive symptoms, substance use, and suicidal ideation measured at T1 were independent predictors of a suicide attempt between T1 and T2; (2) suicide attempt in the year prior to T1 predicted suicide attempt between T1 and T2 after controlling for other predictors; and (3) suicide attempt between T1 and T2 was a predictive factor for a negative change from T1 to T2 in substance use, suicidal ideation, family relationships, depression, anxiety, and life stress. These findings are consistent with the "crescendo" model proposing that the risk of repeat attempts is enhanced following a previous suicide attempt.

  20. Obesity Alters the Microbial Community Profile in Korean Adolescents

    PubMed Central

    Jang, Han Byul; Choi, Min-Gyu; Park, Kyung-Hee; Kang, Jae Heon; Park, Sang Ick; Lee, Hye-Ja; Cho, Seung-Hak

    2015-01-01

    Obesity is an increasing public health concern worldwide. According to the latest Organization for Economic Co-operation and Development (OECD) report (2014), the incidence of child obesity in Korea has exceeded the OECD average. To better understand and control this condition, the present study examined the composition of the gut microbial community in normal and obese adolescents. Fecal samples were collected from 67 obese (body mass index [BMI] ≥ 30 kg/m2, or ≥ 99th BMI percentile) and 67 normal (BMI < 25 kg/m2 or < 85th BMI percentile) Korean adolescents aged 13–16 years and subjected to 16S rRNA gene sequencing. Analysis of bacterial composition according to taxonomic rank (genus, family, and phylum) revealed marked differences in the Bacteroides and Prevotella populations in normal and obese samples (p < 0.005) at the genus and family levels; however, there was no difference in the Firmicutes-to-Bacteroidetes (F/B) ratio between normal and obese adolescents samples at the phylum level (F/B normal = 0.50 ± 0.53; F/B obese = 0.56 ± 0.86; p = 0.384). Statistical analysis revealed a significant association between the compositions of several bacterial taxa and child obesity. Among these, Bacteroides and Prevotella showed the most significant association with BMI (p < 0.0001 and 0.0001, respectively). We also found that the composition of Bacteroides was negatively associated with triglycerides (TG), total cholesterol, and high-sensitive C-reactive protein (hs-crp) (p = 0.0049, 0.0023, and 0.0038, respectively) levels, whereas that of Prevotella was positively associated with TG and hs-crp levels (p = 0.0394 and 0.0150, respectively). We then applied the association rule mining algorithm to generate “rules” to identify the association between the populations of multiple bacterial taxa and obesity; these rules were able to discriminate obese from normal states. Therefore, the present study describes a systemic approach to identify the association

  1. Obesity Alters the Microbial Community Profile in Korean Adolescents.

    PubMed

    Hu, Hae-Jin; Park, Sin-Gi; Jang, Han Byul; Choi, Min-Kyu; Choi, Min-Gyu; Park, Kyung-Hee; Kang, Jae Heon; Park, Sang Ick; Lee, Hye-Ja; Cho, Seung-Hak

    2015-01-01

    Obesity is an increasing public health concern worldwide. According to the latest Organization for Economic Co-operation and Development (OECD) report (2014), the incidence of child obesity in Korea has exceeded the OECD average. To better understand and control this condition, the present study examined the composition of the gut microbial community in normal and obese adolescents. Fecal samples were collected from 67 obese (body mass index [BMI] ≥ 30 kg/m2, or ≥ 99th BMI percentile) and 67 normal (BMI < 25 kg/m2 or < 85th BMI percentile) Korean adolescents aged 13-16 years and subjected to 16S rRNA gene sequencing. Analysis of bacterial composition according to taxonomic rank (genus, family, and phylum) revealed marked differences in the Bacteroides and Prevotella populations in normal and obese samples (p < 0.005) at the genus and family levels; however, there was no difference in the Firmicutes-to-Bacteroidetes (F/B) ratio between normal and obese adolescents samples at the phylum level (F/B normal = 0.50 ± 0.53; F/B obese = 0.56 ± 0.86; p = 0.384). Statistical analysis revealed a significant association between the compositions of several bacterial taxa and child obesity. Among these, Bacteroides and Prevotella showed the most significant association with BMI (p < 0.0001 and 0.0001, respectively). We also found that the composition of Bacteroides was negatively associated with triglycerides (TG), total cholesterol, and high-sensitive C-reactive protein (hs-crp) (p = 0.0049, 0.0023, and 0.0038, respectively) levels, whereas that of Prevotella was positively associated with TG and hs-crp levels (p = 0.0394 and 0.0150, respectively). We then applied the association rule mining algorithm to generate "rules" to identify the association between the populations of multiple bacterial taxa and obesity; these rules were able to discriminate obese from normal states. Therefore, the present study describes a systemic approach to identify the association between

  2. Predictors of Suicidal Ideation in Late Childhood and Adolescence: A 5-Year Follow-Up of Two Nationally Representative Cohorts in the Republic of Korea

    ERIC Educational Resources Information Center

    Park, Sunhee

    2013-01-01

    This study explores the trajectory of suicidal ideation in childhood and adolescence and identifies its strong predictors. Secondary data obtained from two nationally representative cohorts of South Korean youth were longitudinally analyzed using frequencies, percentages, and discrete time survival analysis. This study revealed an increase in the…

  3. Gene–environment interaction in externalizing problems among adolescents: evidence from the Pelotas 1993 Birth Cohort Study

    PubMed Central

    Kieling, Christian; Hutz, Mara H; Genro, Júlia P; Polanczyk, Guilherme V; Anselmi, Luciana; Camey, Suzi; Hallal, Pedro C; Barros, Fernando C; Victora, Cesar G; Menezes, Ana M B; Rohde, Luis Augusto

    2013-01-01

    Background The study of gene–environment interactions (G × E) is one of the most promising strategies to uncover the origins of mental disorders. Replication of initial findings, however, is essential because there is a strong possibility of publication bias in the literature. In addition, there is a scarcity of research on the topic originated from low- and middle-income countries (LMIC). The aim of this study was to replicate G × E hypotheses for externalizing problems among adolescents in a middle-income country. Methods As part of the Pelotas 1993 Birth Cohort Study, 5,249 children were enrolled at birth and followed up to the age of 15 years, with an 85.7% retention rate. We sought an interaction between the homozygosity of the 10-repeat allele at the dopamine transporter (DAT1) gene and prenatal maternal smoking in the development of hyperactivity problems during adolescence assessed by the Strengths and Difficulties Questionnaire. We also tested for an interaction between the uVNTR polymorphism at the monoamine oxidase A (MAOA) and the experience of childhood maltreatment in the occurrence of conduct problems among adolescent boys. Results Although there was a clear association between prenatal maternal smoking and hyperactivity scores in adolescence (p < 0.001), no main genetic or interaction effects for the DAT1 gene were detected. Similarly, childhood maltreatment showed to be associated with conduct problems among boys (p < 0.001), with no observable main genetic or interaction effects for the MAOA gene. Conclusions In the largest mental health G × E study performed in a LMIC to date, we did not replicate previous positive findings from the literature. Despite the presence of main environmental effects, there was no evidence of effect modification by genotype status. Additional replication efforts to measure G × E are needed to better understand the origins of mental health and illness, especially in LMIC. PMID:23215821

  4. The relative impact of a vegetable-rich diet on key markers of health in a cohort of Australian adolescents.

    PubMed

    Grant, Ross; Bilgin, Ayse; Zeuschner, Carol; Guy, Trish; Pearce, Robyn; Hokin, Bevan; Ashton, John

    2008-01-01

    Childhood obesity is a widespread health problem in Australia. Overweight in childhood can lead to adult overweight and the development of risk factors for cardiovascular disease (CVD). Effective strategies for reducing childhood obesity are urgently required. A vegetarian diet has been shown to be an effective prophylactic to many lifestyle diseases in the adult population and may therefore be beneficial in children. However the metabolic demands of adolescents are different to adults and the impact of a vegetarian diet on CVD markers in this demographic is not certain. We compared key physiological and biochemical markers of health against responses to a modified, Schools Physical Activity and Nutrition Survey (SPANS) using one-way and two-way Analysis of Variance. 215 adolescents (14-15 yrs) from 5 Adventist secondary schools in the Sydney and Hunter regions of New South Wales, Australia, participated in this study. Adolescents consuming predominantly vegetarian foods showed significantly better scores on markers of cardiovascular health, including, body mass index (BMI), waist circumference, Cholesterol/High density lipoprotein ratio and low density lipoprotein. Adolescents consuming nuts more than once per week, also showed lower scores for BMI and serum glucose irrespective of their vegetarian status. Markers of general health including haemoglobin and average height were not different between groups; however a lower serum level of vitamin B12 was apparent in the vegetarian cohort. Surprisingly, exercise on its own was not statistically associated with any of the risk factors tested suggesting that diet may be the most significant factor in promoting health in this age group.

  5. Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol

    PubMed Central

    Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

    2016-01-01

    Introduction Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. Methods and analysis This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. Ethics and dissemination The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments

  6. Personality psychopathology, drug use and psychological symptoms in adolescents with substance use disorders and community controls

    PubMed Central

    Forns, Maria; Goti, Javier; Castro-Fornieles, Josefina

    2015-01-01

    Substance use is a risk behavior that tends to increase during adolescence, a time when part of the personality is still in development. Traditionally, personality psychopathology has been measured in terms of categories, although dimensional models have demonstrated better consistency. This study aimed to analyze differences in personality profiles between adolescents with substance use disorders (SUD n = 74) and matched community controls (MCC n = 74) using the Personality Psychopathology Five (PSY-5) dimensional model. Additionally, we compared age at first drug use, level of drug use and internalizing and externalizing symptoms between the groups. In this study, the PSY-5 model has proved to be useful for differentiating specific personality disturbances in adolescents with SUD and community adolescents. The Disconstraint scale was particularly useful for discriminating adolescents with substance use problems and the Delinquent Attitudes facet offered the best differentiation. PMID:26082873

  7. A systematic review of community-based parenting interventions for adolescents with challenging behaviours.

    PubMed

    Medlow, Sharon; Klineberg, Emily; Jarrett, Carmen; Steinbeck, Katharine

    2016-10-01

    Parenting skills training is an established means of treating challenging behaviours among young children, but there has been limited research on its efficacy when used to treat challenging adolescent behaviour. The aim of this systematic review was to evaluate the efficacy and effectiveness of community-based parenting interventions designed for families with adolescents, as judged in terms of increased knowledge and skills among parents, improvements in adolescent behaviour, and program feasibility within community settings. Results indicated that intervention group parents typically made greater gains than did control group parents on measures of good parenting, with positive flow-on effects to some aspects of challenging adolescent behaviours. Limited evidence suggests that group and individual intervention formats may be equally effective and that there is no advantage to the participation of the target adolescent in the intervention.

  8. A systematic review of community-based parenting interventions for adolescents with challenging behaviours.

    PubMed

    Medlow, Sharon; Klineberg, Emily; Jarrett, Carmen; Steinbeck, Katharine

    2016-10-01

    Parenting skills training is an established means of treating challenging behaviours among young children, but there has been limited research on its efficacy when used to treat challenging adolescent behaviour. The aim of this systematic review was to evaluate the efficacy and effectiveness of community-based parenting interventions designed for families with adolescents, as judged in terms of increased knowledge and skills among parents, improvements in adolescent behaviour, and program feasibility within community settings. Results indicated that intervention group parents typically made greater gains than did control group parents on measures of good parenting, with positive flow-on effects to some aspects of challenging adolescent behaviours. Limited evidence suggests that group and individual intervention formats may be equally effective and that there is no advantage to the participation of the target adolescent in the intervention. PMID:27497999

  9. Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia

    PubMed Central

    Allotey, Pascale; Reidpath, Daniel D.; Devarajan, Nirmala; Rajagobal, Kanason; Yasin, Shajahan; Arunachalam, Dharmalingam; Imelda, Johanna Debora; Soyiri, Ireneous; Davey, Tamzyn; Jahan, Nowrozy

    2014-01-01

    Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement. PMID:24804983

  10. Engaging and sustaining adolescents in community-based participatory research: structuring a youth-friendly community-based participatory research environment.

    PubMed

    LoIacono Merves, Marni; Rodgers, Caryn R R; Silver, Ellen Johnson; Sclafane, Jamie Heather; Bauman, Laurie J

    2015-01-01

    Community-Based Participatory Research partnerships typically do not include adolescents as full community partners. However, partnering with adolescents can enhance the success and sustainability of adolescent health interventions. We partnered with adolescents to address health disparities in a low-income urban community. In partnering with youth, it is important to consider their developmental stage and needs to better engage and sustain their involvement. We also learned the value of a Youth Development framework and intentionally structuring a youth-friendly Community-Based Participatory Research environment. Finally, we will raise some ethical responsibilities to consider when working with youth partners.

  11. Childhood, Adolescent, and Teenage Obesity: Recommendations for Community Initiatives in Central Harlem.

    PubMed

    Maidenberg, Michelle P

    2016-05-01

    Because ofpoverty, the high prevalence of obesity, and the lack of adequate supports, Central Harlem's children, adolescents, and teenagers are at risk for major physiological, psychological, and social issues. This article discusses the public health concerns related to this population, especially the prevalence of obesity. This article identifies the prevalence of illness and obesity in the inner city and stipulates the causes and consequences of obesity among children, adolescents, and teenagers. In addition, it reports on the appropriate community intervention, using a coalition and a community collaborative organization that serve as models to build support for Central Harlem. A proposal is offered for reducing obesity among youths in the community. The intervention outlines a logic model that identifies a multisystemic approach at the micro and macro level for community intervention and policy initiatives to advocate for fundamental change. Further research recommendations are described to reduce the prevalence of childhood, adolescent, and teenage obesity in urban communities.

  12. Childhood, Adolescent, and Teenage Obesity: Recommendations for Community Initiatives in Central Harlem.

    PubMed

    Maidenberg, Michelle P

    2016-05-01

    Because ofpoverty, the high prevalence of obesity, and the lack of adequate supports, Central Harlem's children, adolescents, and teenagers are at risk for major physiological, psychological, and social issues. This article discusses the public health concerns related to this population, especially the prevalence of obesity. This article identifies the prevalence of illness and obesity in the inner city and stipulates the causes and consequences of obesity among children, adolescents, and teenagers. In addition, it reports on the appropriate community intervention, using a coalition and a community collaborative organization that serve as models to build support for Central Harlem. A proposal is offered for reducing obesity among youths in the community. The intervention outlines a logic model that identifies a multisystemic approach at the micro and macro level for community intervention and policy initiatives to advocate for fundamental change. Further research recommendations are described to reduce the prevalence of childhood, adolescent, and teenage obesity in urban communities. PMID:27263198

  13. Identifying Patients with Bacteremia in Community-Hospital Emergency Rooms: A Retrospective Cohort Study

    PubMed Central

    Takeshima, Taro; Yamamoto, Yosuke; Noguchi, Yoshinori; Maki, Nobuyuki; Gibo, Koichiro; Tsugihashi, Yukio; Doi, Asako; Fukuma, Shingo; Yamazaki, Shin; Kajii, Eiji; Fukuhara, Shunichi

    2016-01-01

    Objectives (1) To develop a clinical prediction rule to identify patients with bacteremia, using only information that is readily available in the emergency room (ER) of community hospitals, and (2) to test the validity of that rule with a separate, independent set of data. Design Multicenter retrospective cohort study. Setting To derive the clinical prediction rule we used data from 3 community hospitals in Japan (derivation). We tested the rule using data from one other community hospital (validation), which was not among the three “derivation” hospitals. Participants Adults (age ≥ 16 years old) who had undergone blood-culture testing while in the ER between April 2011 and March 2012. For the derivation data, n = 1515 (randomly sampled from 7026 patients), and for the validation data n = 467 (from 823 patients). Analysis We analyzed 28 candidate predictors of bacteremia, including demographic data, signs and symptoms, comorbid conditions, and basic laboratory data. Chi-square tests and multiple logistic regression were used to derive an integer risk score (the “ID-BactER” score). Sensitivity, specificity, likelihood ratios, and the area under the receiver operating characteristic curve (i.e., the AUC) were computed. Results There were 241 cases of bacteremia in the derivation data. Eleven candidate predictors were used in the ID-BactER score: age, chills, vomiting, mental status, temperature, systolic blood pressure, abdominal sign, white blood-cell count, platelets, blood urea nitrogen, and C-reactive protein. The AUCs was 0.80 (derivation) and 0.74 (validation). For ID-BactER scores ≥ 2, the sensitivities for derivation and validation data were 98% and 97%, and specificities were 20% and 14%, respectively. Conclusions The ID-BactER score can be computed from information that is readily available in the ERs of community hospitals. Future studies should focus on developing a score with a higher specificity while maintaining the desired sensitivity

  14. Cohorts and Relatedness: Self-Determination Theory as an Explanation of How Learning Communities Affect Educational Outcomes

    ERIC Educational Resources Information Center

    Beachboard, Martine Robinson; Beachboard, John C.; Li, Wenling; Adkison, Stephen R.

    2011-01-01

    This study examines whether feelings of relatedness constitute a substantial means by which learning communities (cohorts) improve learning outcomes in higher education. It applies Ryan and Deci's Self-Determination Theory to an analysis of the National Survey of Student Engagement. The SDT hypothesizes that environments that support perceptions…

  15. Distribution of Glycated Haemoglobin According to Early-Life and Contemporary Characteristics in Adolescents and Adults without Diabetes: The 1982 and 1993 Pelotas Birth Cohorts

    PubMed Central

    Restrepo-Méndez, María Clara; Silveira, Vera M.; Miranda, Jaime J.; Gonçalves, Helen D.; Oliveira, Isabel O.; Horta, Bernardo L.; Gigante, Denise P.; Menezes, Ana Maria; Assunção, Maria Cecília F.

    2016-01-01

    Aim Glycated haemoglobin (HbA1c), a marker of glucose control in individuals with diabetes mellitus, is also related with the incidence of cardiometabolic risk in populations free of disease. The aim of this study was to describe the distribution of HbA1c levels according to early-life and contemporary factors in adolescents and adults without diabetes mellitus. Methods HbA1c was measured in adults aged 30 years and adolescents aged 18 years who are participants in the 1982 and 1993 Pelotas Birth Cohorts, respectively. Bivariate and multivariate analyses were performed to describe the HbA1c mean values according to early-life and contemporary characteristics collected prospectively since birth. Results The distribution of the HbA1c was approximately normal in both cohorts, with a mean (SD) 5.10% (0.43) in the 1982 cohort, and 4.89% (0.50) in the 1993 cohort. HbA1c mean levels were significantly higher in individuals self-reported as black/brown skin color compared to those self-reported as white in both cohorts. Parental history of diabetes was associated with higher HbA1c mean in adults, while stunting at one year old presented an inverse relation with the outcome in adolescents. No other early and contemporary factors were associated with HbA1c levels in adults or adolescents. Conclusions We found a consistent relationship between HbA1c and skin color in both cohorts. Further research is needed to understand the role of genomic ancestry on levels of HbA1c concentrations which may inform policies and preventive actions for diabetes mellitus and cardiometabolic risk. PMID:27626274

  16. Adolescent Self-Organization and Adult Smoking and Drinking over Fifty Years of Follow-Up: The British 1946 Birth Cohort.

    PubMed

    Nishida, Atsushi; Cadar, Dorina; Xu, Man K; Croudace, Timothy; Jones, Peter B; Kuh, Diana; Richards, Marcus

    2016-01-01

    Variations in markers of adolescent self-organization predict a range of economic and health-related outcomes in general population studies. Using a population-based birth cohort study we investigated associations between adolescent self-organization and two common factors over adulthood influencing health, smoking and alcohol consumption. The MRC National Survey of Health and Development (the British 1946 birth cohort) was used to test associations between a dimensional measure of adolescent self-organization derived from teacher ratings, and summary longitudinal measures of smoking and alcohol consumption over the ensuing five decades. Multinomial regression models were adjusted for sex, adolescent emotional and conduct problems, occupational social class of origin, childhood cognition, educational attainment and adult occupational social class. With all covariates adjusted, higher adolescent self-organization was associated with fewer smoking pack years, although not with quitting; there was no association with alcohol consumption across adulthood (none or heavy compared with light to moderate). Adolescent self-organization appears to be protective against smoking, but not against heavy alcohol consumption. Interpretation of this differential effect should be embedded in an understanding of the social and sociodemographic context in which these health behaviours occur over time.

  17. Adolescent Self-Organization and Adult Smoking and Drinking over Fifty Years of Follow-Up: The British 1946 Birth Cohort

    PubMed Central

    2016-01-01

    Variations in markers of adolescent self-organization predict a range of economic and health-related outcomes in general population studies. Using a population-based birth cohort study we investigated associations between adolescent self-organization and two common factors over adulthood influencing health, smoking and alcohol consumption. The MRC National Survey of Health and Development (the British 1946 birth cohort) was used to test associations between a dimensional measure of adolescent self-organization derived from teacher ratings, and summary longitudinal measures of smoking and alcohol consumption over the ensuing five decades. Multinomial regression models were adjusted for sex, adolescent emotional and conduct problems, occupational social class of origin, childhood cognition, educational attainment and adult occupational social class. With all covariates adjusted, higher adolescent self-organization was associated with fewer smoking pack years, although not with quitting; there was no association with alcohol consumption across adulthood (none or heavy compared with light to moderate). Adolescent self-organization appears to be protective against smoking, but not against heavy alcohol consumption. Interpretation of this differential effect should be embedded in an understanding of the social and sociodemographic context in which these health behaviours occur over time. PMID:26752724

  18. Adolescent Self-Organization and Adult Smoking and Drinking over Fifty Years of Follow-Up: The British 1946 Birth Cohort.

    PubMed

    Nishida, Atsushi; Cadar, Dorina; Xu, Man K; Croudace, Timothy; Jones, Peter B; Kuh, Diana; Richards, Marcus

    2016-01-01

    Variations in markers of adolescent self-organization predict a range of economic and health-related outcomes in general population studies. Using a population-based birth cohort study we investigated associations between adolescent self-organization and two common factors over adulthood influencing health, smoking and alcohol consumption. The MRC National Survey of Health and Development (the British 1946 birth cohort) was used to test associations between a dimensional measure of adolescent self-organization derived from teacher ratings, and summary longitudinal measures of smoking and alcohol consumption over the ensuing five decades. Multinomial regression models were adjusted for sex, adolescent emotional and conduct problems, occupational social class of origin, childhood cognition, educational attainment and adult occupational social class. With all covariates adjusted, higher adolescent self-organization was associated with fewer smoking pack years, although not with quitting; there was no association with alcohol consumption across adulthood (none or heavy compared with light to moderate). Adolescent self-organization appears to be protective against smoking, but not against heavy alcohol consumption. Interpretation of this differential effect should be embedded in an understanding of the social and sociodemographic context in which these health behaviours occur over time. PMID:26752724

  19. The association between the angiotensin-converting enzyme-2 gene and blood pressure in a cohort study of adolescents

    PubMed Central

    2013-01-01

    Background The Angiotensin-Converting Enzyme-2 (ACE2) gene, located on chromosome X, is believed to be implicated in blood pressure regulation. However the few studies that have examined this association have yielded mixed results. The objective of this study was to assess the association between tag single nucleotide polymorphisms (SNPs) in the angiotensin-converting enzyme-2 gene with blood pressure and blood pressure change in adolescents. Methods Participants in the Nicotine Dependence in Teens (NDIT) cohort study with blood or saliva samples and at least 3 blood pressure measurements over 5 years were included in the analytic sample (n = 555). Linear growth curve models stratified on sex and ethnicity were used to assess the association between four tag SNPs in the ACE2 gene and systolic (SBP) and diastolic blood pressure (DBP), and blood pressure change. Results In males of European descent, rs2074192 and rs233575 were significantly associated with SBP and DBP, and rs2158083 was associated with SBP. In French Canadian males, rs233575 and rs2158083 were significantly associated with DBP. Among females of European descent, rs2074192, rs233575, and rs2158083 were significantly associated with change in SBP over 5 years. Conclusions This is the first study to assess the association between the ACE2 gene with blood pressure and blood pressure change in a cohort of adolescents. Results indicate that several ACE2 gene SNPs are associated with blood pressure or blood pressure change in persons of European descent. However the therapeutic potential of these SNPs should be explored. PMID:24191856

  20. Community Conversations: An Approach for Expanding and Connecting Opportunities for Employment for Adolescents with Disabilities

    ERIC Educational Resources Information Center

    Trainor, Audrey A.; Carter, Erik W.; Swedeen, Beth; Pickett, Kelly

    2012-01-01

    Although early work experiences can impart a number of benefits to adolescents with disabilities, few students have meaningful access to these opportunities. The authors examined "community conversations" to build capacity and interest in expanding employment opportunities. Events were held in seven different communities and used the World Cafe…

  1. Community Involvement and Adolescent Mental Health: Moderating Effects of Race/Ethnicity and Neighborhood Disadvantage

    ERIC Educational Resources Information Center

    Hull, Pamela; Kilbourne, Barbara; Reece, Michelle; Husaini, Baqar

    2008-01-01

    Social development and stress process theories suggest that participation in one's community can function as a protective factor for mental health, especially for youth from socioeconomically disadvantaged areas. However, the effects of community involvement on adolescent mental health could vary across racial/ethnic groups and levels of…

  2. Adolescent Dating Violence Prevention and Intervention in a Community Setting: Perspectives of Young Adults and Professionals

    ERIC Educational Resources Information Center

    Martsolf, Donna S.; Colbert, Crystal; Draucker, Claire B.

    2012-01-01

    Adolescent dating violence (ADV) is a significant community problem. In this study, we examine the perspectives of two groups (young adults who experienced ADV as teens and professionals who work with teens) on ADV prevention/intervention in a community context. We interviewed 88 young adults and 20 professionals. Our research team used Thorne's…

  3. Community-Based Participatory Research to Improve Preconception Health among Northern Plains American Indian Adolescent Women

    ERIC Educational Resources Information Center

    Richards, Jennifer; Mousseau, Alicia

    2012-01-01

    Background: Sacred Beginnings is a community-based participatory research project that examines the effectiveness of a culturally appropriate preconception health educational intervention developed by tribal community members and elders. The primary goal is to increase knowledge of preconception health and its benefits among adolescent females and…

  4. Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

    ERIC Educational Resources Information Center

    Kirby, Kimberly C.; Versek, Brian; Kerwin, MaryLouise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia; Meyers, Robert J.

    2015-01-01

    We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however,…

  5. Associations between Sugar Intake from Different Food Sources and Adiposity or Cardio-Metabolic Risk in Childhood and Adolescence: The Korean Child-Adolescent Cohort Study.

    PubMed

    Hur, Yang-Im; Park, Hyesook; Kang, Jae-Heon; Lee, Hye-Ah; Song, Hong Ji; Lee, Hae-Jeung; Kim, Ok-Hyun

    2015-12-31

    The increasing prevalence of childhood obesity is a serious public health problem associated with co-morbidities in adulthood, as well as childhood. This study was conducted to identify associations between total sugar intake and sugar intake from different foods (fruit, milk, and sugar-sweetened beverages (SSBs)), and adiposity and continuous metabolic syndrome scores (cMetS) among Korean children and adolescents using cohort data. The study subjects were children (n = 770) who participated in the 4th year (2008) of the Korean Child-Adolescent Cohort Study (KoCAS). Dietary intake data were collected via three-day 24-h food records, and sugar intake was calculated for the total sugar content of foods using our database compiled from various sources. Anthropometric measurements, assessments of body composition, and blood sample analysis were performed at baseline and at follow-up four years later. The cMetS was calculated based on waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and mean arterial blood pressure. According to multiple linear regression analysis, there were no significant associations between total sugar intake and adiposity and cMetS. However, higher intake of fruit sugar at baseline was significantly associated with lower body mass index (BMI) z-scores and body fat percentages at baseline (β = -0.10, p = 0.02 and β = -0.78, p < 0.01, respectively). At follow-up, sugar intake from fruit at baseline was still negatively associated with the above outcomes, but only the relationship with BMI z-scores retained statistical significance (β = -0.08, p < 0.05). There was a significant positive relationship between consumption of sugar from SSBs and cMetS at baseline (β = 0.04, p = 0.02), but that relationship was not observed at follow-up (p = 0.83). Differences in consumption sugars from fruit and SSBs might play an important role in the risk of adiposity and metabolic disease in children and adolescents. Our results

  6. Associations between Sugar Intake from Different Food Sources and Adiposity or Cardio-Metabolic Risk in Childhood and Adolescence: The Korean Child–Adolescent Cohort Study

    PubMed Central

    Hur, Yang-Im; Park, Hyesook; Kang, Jae-Heon; Lee, Hye-Ah; Song, Hong Ji; Lee, Hae-Jeung; Kim, Ok-Hyun

    2015-01-01

    The increasing prevalence of childhood obesity is a serious public health problem associated with co-morbidities in adulthood, as well as childhood. This study was conducted to identify associations between total sugar intake and sugar intake from different foods (fruit, milk, and sugar-sweetened beverages (SSBs)), and adiposity and continuous metabolic syndrome scores (cMetS) among Korean children and adolescents using cohort data. The study subjects were children (n = 770) who participated in the 4th year (2008) of the Korean Child–Adolescent Cohort Study (KoCAS). Dietary intake data were collected via three-day 24-h food records, and sugar intake was calculated for the total sugar content of foods using our database compiled from various sources. Anthropometric measurements, assessments of body composition, and blood sample analysis were performed at baseline and at follow-up four years later. The cMetS was calculated based on waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and mean arterial blood pressure. According to multiple linear regression analysis, there were no significant associations between total sugar intake and adiposity and cMetS. However, higher intake of fruit sugar at baseline was significantly associated with lower body mass index (BMI) z-scores and body fat percentages at baseline (β = −0.10, p = 0.02 and β = −0.78, p < 0.01, respectively). At follow-up, sugar intake from fruit at baseline was still negatively associated with the above outcomes, but only the relationship with BMI z-scores retained statistical significance (β = −0.08, p < 0.05). There was a significant positive relationship between consumption of sugar from SSBs and cMetS at baseline (β = 0.04, p = 0.02), but that relationship was not observed at follow-up (p = 0.83). Differences in consumption sugars from fruit and SSBs might play an important role in the risk of adiposity and metabolic disease in children and adolescents. Our

  7. Risk of Cigarette Smoking Initiation During Adolescence Among US-Born and Non–US-Born Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Parrinello, Christina M.; Isasi, Carmen R.; Xue, Xiaonan; Bandiera, Frank C.; Cai, Jianwen; Lee, David J.; Navas-Nacher, Elena L.; Perreira, Krista M.; Salgado, Hugo

    2015-01-01

    Objectives. We assessed risk of cigarette smoking initiation among Hispanics/Latinos during adolescence by migration status and gender. Methods. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) surveyed persons aged 18 to 74 years in 2008 to 2011. Our cohort analysis (n = 2801 US-born, 13 200 non–US-born) reconstructed participants’ adolescence from 10 to 18 years of age. We assessed the association between migration status and length of US residence and risk of cigarette smoking initiation during adolescence, along with effects of gender and Hispanic/Latino background. Results. Among individuals who migrated by 18 years of age, median age and year of arrival were 13 years and 1980, respectively. Among women, but not men, risk of smoking initiation during adolescence was higher among the US-born (hazard ratio [HR] = 2.10; 95% confidence interval [CI] = 1.73, 2.57; P < .001), and those who had resided in the United States for 2 or more years (HR = 1.47; 95% CI = 1.11, 1.96; P = .01) than among persons who lived outside the United States. Conclusions. Research examining why some adolescents begin smoking after moving to the United States could inform targeted interventions. PMID:25322293

  8. Community factors shaping early age at first sex among adolescents in Burkina Faso, Ghana, Malawi, and Uganda.

    PubMed

    Stephenson, Rob; Simon, Calleen; Finneran, Catherine

    2014-06-01

    Using data from the National Survey of Adolescents (2004), we examine the community-level factors associated with early age at first sex among adolescents 14-19 years old in four African countries. Regression models are fitted separately by sex for each country for an outcome measuring early age at first sex, with a focus on community-level factors as potential influences of age on sexual debut. The community-level factors associated with adolescents' sexual debut vary widely by both country and gender. Community influences that emerge as risk or protective factors of early sexual debut include community levels of adolescent marriage, wealth, religious group affiliation, sex education, parental monitoring, reproductive health knowledge, media exposure, membership in adolescent social group, and use of alcohol. Results indicate the importance of context-specific understanding of adolescents' sexual behaviour and suggest how elements of place should be harnessed in the development of effective HIV and sexual health interventions.

  9. Perceived Neighborhood Partner Availability, Partner Selection And Risk For Sexually Transmitted Infections Within A Cohort Of Adolescent Females

    PubMed Central

    Matson, Pamela A.; Chung, Shang-en; Ellen, Jonathan M.

    2014-01-01

    Purpose This research examined the association between a novel measure of perceived partner availability and discordance between ideal and actual partner characteristics as well as trajectories of ideal partner preferences and perceptions of partner availability over time. Methods A clinic recruited cohort of adolescent females (N = 92), aged 16 -19, were interviewed quarterly for 12 months using audio computer-assisted self-interview. Participants ranked the importance of characteristics for their ideal main sex partner and then reported on these characteristics for their current main partner. Participants reported on perceptions of availability of ideal sex partners in their neighborhood. Paired t-tests examined discordance between ideal and actual partner characteristics. Random-intercept regression models examined repeated measures. Results Actual partner ratings were lower than ideal partner preferences for fidelity, equaled ideal preferences for emotional support and exceed ideal preferences for social/economic status and physical attractiveness. Discordance on emotional support and social/economic status was associated with sex partner concurrency. Participants perceived low availability of ideal sex partners. Those who perceived more availability were less likely to be ideal/actual discordant on fidelity [OR = 0.88, 95%CI: 0.78,1.0]. Neither ideal partner preferences nor perceptions of partner availability changed over 12 months. Conclusions Current main sex partners met or exceeded ideal partner preferences in all domains except fidelity. If emotional needs are met, adolescents may tolerate partner concurrency in areas of limited partner pools. Urban adolescent females who perceive low availability may be at increased risk for STI as they may be more likely to have non-monogamous partners. PMID:24393545

  10. Stunted at 10 Years. Linear Growth Trajectories and Stunting from Birth to Pre-Adolescence in a Rural Bangladeshi Cohort

    PubMed Central

    Svefors, Pernilla; Rahman, Anisur; Ekström, Eva-Charlotte; Khan, Ashraful Islam; Lindström, Emma; Persson, Lars Åke; Ekholm Selling, Katarina

    2016-01-01

    Background Few studies in low-income settings analyse linear growth trajectories from foetal life to pre-adolescence. The aim of this study is to describe linear growth and stunting from birth to 10 years in rural Bangladesh and to analyse whether maternal and environmental determinants at conception are associated with linear growth throughout childhood and stunting at 10 years. Methods and Findings Pregnant women participating in the MINIMat trial were identified in early pregnancy and a birth cohort (n = 1054) was followed with 19 growth measurements from birth to 10 years. Analyses of baseline predictors and mean height-for-age Z-scores (HAZ) over time were modelled using GLMM. Logistic regression analysis was used to investigate the associations between baseline predictors and stunting (HAZ<-2) at 10 years. HAZ decreased to 2 years, followed by an increase up to 10 years, while the average height-for-age difference in cm (HAD) to the WHO reference median continued to increase up to 10 years. Prevalence of stunting was highest at 2 years (50%) decreasing to 29% at 10 years. Maternal height, maternal educational level and season of conception were all independent predictors of HAZ from birth to pre-adolescence (p<0.001) and stunting at 10 years. The highest probability to be stunted at 10 years was for children born by short mothers (<147.5 cm) (ORadj 2.93, 95% CI: 2.06–4.20), mothers with no education (ORadj 1.74, 95% CI 1.17–2.81) or those conceived in the pre-monsoon season (ORadj 1.94, 95% CI 1.37–2.77). Conclusions Height growth trajectories and prevalence of stunting in pre-adolescence showed strong intergenerational associations, social differentials, and environmental influence from foetal life. Targeting women before and during pregnancy is needed for the prevention of impaired child growth. PMID:26934484

  11. Preference for spirituality and twelve-step-oriented approaches among adolescents in a residential therapeutic community.

    PubMed

    Aromin, Romulo A; Galanter, Marc; Solhkhah, Ramon; Bunt, Gregory; Dermatis, Helen

    2006-01-01

    This study sought to determine which adolescents being treated for substance use in a residential Therapeutic Community (TC) would endorse spirituality and Twelve Step oriented approaches as part of their treatment. By identifying individual difference characteristics associated with preference for spirituality and Twelve Step oriented approaches, integrated substance abuse treatments can be targeted to appropriate subgroups of adolescents. A total of 181 adolescents completed a survey assessing their substance use and attitudes toward spirituality and Twelve Step oriented approaches that was similar to a survey completed by 322 adults in the same residential TC program. In the adolescent sample, three spirituality related characteristics: perceived connectedness to others, frequency of prayer, and spiritual orientation to life were associated with preference for both spirituality and twelve step oriented approaches being featured more in TC treatment. Adolescents were less likely than adults to express a preference that both approaches be featured more in TC treatment.

  12. The association between early cannabis use and psychotic-like experiences in a community adolescent sample.

    PubMed

    Hides, Leanne; Lubman, Dan I; Buckby, Joe; Yuen, Hok Pan; Cosgrave, Elizabeth; Baker, Kathryn; Yung, Alison R

    2009-07-01

    Cannabis use has been associated with greater risk of developing psychotic-like experiences (PLEs) and psychosis. This paper aims to determine if different levels of cannabis (lifetime, regular, recent) exposure are associated with PLEs and specific PLE subscales among adolescents. Participants consisted of a community sample of 880 adolescents in Melbourne, Australia. Adolescents were administered the positive symptom scale of the Community Assessment of Psychic Experiences (CAPE) and measures of substance use and depression. Lifetime cannabis use and the frequency of cannabis use in the last year (recent use) were associated with PLEs, primarily the experience of auditory and visual hallucinations (perceptual abnormalities). Low levels of recent cannabis use were more strongly associated with PLEs than more frequent use. These findings indicate that different levels of cannabis exposure were differentially associated with PLEs and highlight the need for early detection and treatment strategies for PLEs and cannabis use in adolescents.

  13. A Behaviorally-Anchored Rating System to Monitor Treatment Integrity for Community Clinicians Using the Adolescent Community Reinforcement Approach

    ERIC Educational Resources Information Center

    Smith, Jane Ellen; Gianini, Loren M.; Garner, Bryan R.; Malek, Karen L.; Godley, Susan H.

    2014-01-01

    This study evaluated a process for training raters to reliably rate clinicians delivering the Adolescent Community Reinforcement Approach (A-CRA) in a national dissemination project. The unique A-CRA coding system uses specific behavioral anchors throughout its 73 procedure components. Five randomly selected raters each rated "passing"…

  14. Eating Disorders Among a Community-based Sample of Chilean Female Adolescents.

    PubMed

    Granillo, M Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela

    2011-12-01

    The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder. Multivariate logistic regression analyses revealed that those with higher symptoms of anxiety and who had tried cigarettes were significantly more likely to have been diagnosed with an eating disorder. Findings indicate that Chilean female adolescents are at risk of eating disorders and that eating disorders, albeit maladaptive, may be a means to cope with negative affect, specifically anxiety.

  15. The association between negative attention biases and symptoms of depression in a community sample of adolescents

    PubMed Central

    Murphy, Susannah E.; Lau, Jennifer Y.F.

    2015-01-01

    Adolescence is a vulnerable time for the onset of depression. Recent evidence from adult studies suggests not only that negative attention biases are correlated with symptoms of depression, but that reducing negative attention biases through training can in turn reduce symptomology. The role and plasticity of attention biases in adolescent depression, however, remains unclear. This study examines the association between symptoms of depression and attention biases, and whether such biases are modifiable, in a community sample of adolescents. We report data from 105 adolescents aged 13–17 who completed a dot-probe measure of attention bias before and after a single session of visual search-based cognitive bias modification training. This is the first study to find a significant association between negative attention biases and increased symptoms of depression in a community sample of adolescents. Contrary to expectations, we were unable to manipulate attention biases using a previously successful cognitive bias modification task. There were no significant effects of the training on positive affect and only modest effects of the training, identified in post-hoc analyses, were observed on negative affect. Our data replicate those from the adult literature, which suggest that adolescent depression is a disorder associated with negative attention biases, although we were unable to modify attention biases in our study. We identify numerous parameters of our methodology which may explain these null training effects, and which could be addressed in future cognitive bias modification studies of adolescent depression. PMID:26539335

  16. Community paediatric respiratory infection surveillance study protocol: a feasibility, prospective inception cohort study

    PubMed Central

    Anderson, Emma C; Ingle, Suzanne Marie; Muir, Peter; Beck, Charles; Finn, Adam; Leeming, John Peter; Cabral, Christie; Kesten, Joanna May; Hay, Alastair D

    2016-01-01

    Introduction Paediatric respiratory tract infections (RTIs) are common reasons for primary care consultations and antibiotic prescribing. Locally relevant syndromic and microbiological surveillance information has the potential to improve the care of children with RTIs by normalising illness (parents) and reducing uncertainty (clinicians). Currently, most RTI studies are conducted at the point of healthcare service consultation, leaving the community burden, microbiology, symptom duration and proportion consulting largely unknown. This study seeks to establish the feasibility of (mainly online) participant recruitment and retention, and the acceptability/comparability of parent versus nurse-collected microbiological sampling, to inform the design of a future surveillance intervention study. Evidence regarding consultation rates and symptom duration is also sought. Methods and analysis A community-based, feasibility prospective inception cohort study, recruiting children aged ≥3 months and <16 years and their parents via general practitioner surgery invitation letter, aiming to collect data on 300 incident RTIs by July 2016. Following informed consent, parents provide baseline (demographic) data online, and respond to weekly emails to confirm the absence/presence of new RTI symptoms. Once symptomatic, parents provide daily data online (RTI symptoms, school/day-care attendance, time off work, health service use, medication), and a research nurse visits to collect clinical examination data and microbiological (nasal and saliva) swabs. Parents are invited to provide symptomatic (at nurse visit, but without nurse assistance) and asymptomatic (alone) swabs on recovery. A review of primary care medical notes will gather medical history, health service utilisation, referral and antibiotic prescribing rates. Feasibility will be assessed using recruitment and retention rates, data completeness; and acceptability by quantitative survey and qualitative interviews

  17. Multiple Norovirus Infections in a Birth Cohort in a Peruvian Periurban Community

    PubMed Central

    Saito, Mayuko; Goel-Apaza, Sonia; Espetia, Susan; Velasquez, Daniel; Cabrera, Lilia; Loli, Sebastian; Crabtree, Jean E.; Black, Robert E.; Kosek, Margaret; Checkley, William; Zimic, Mirko; Bern, Caryn; Cama, Vitaliano; Gilman, Robert H.; Xiao, L.; Kelleher, D.; Windle, H. J.; van Doorn, L. J.; Varela, M.; Verastegui, M.; Calderon, M.; Alva, A.; Roman, K.

    2014-01-01

    Background. Human noroviruses are among the most common enteropathogens globally, and are a leading cause of infant diarrhea in developing countries. However, data measuring the impact of norovirus at the community level are sparse. Methods. We followed a birth cohort of children to estimate norovirus infection and diarrhea incidence in a Peruvian community. Stool samples from diarrheal episodes and randomly selected nondiarrheal samples were tested by polymerase chain reaction for norovirus genogroup and genotype. Excretion duration and rotavirus coinfection were evaluated in a subset of episodes. Results. Two hundred twenty and 189 children were followed to 1 and 2 years of age, respectively. By 1 year, 80% (95% confidence interval [CI], 75%–85%) experienced at least 1 norovirus infection and by 2 years, 71% (95% CI, 65%–77%) had at least 1 episode of norovirus-associated diarrhea. Genogroup II (GII) infections were 3 times more frequent than genogroup 1 (GI) infections. Eighteen genotypes were found; GII genotype 4 accounted for 41%. Median excretion duration was 34.5 days for GII vs 8.5 days for GI infection (P = .0006). Repeat infections by the same genogroup were common, but repeat infections by the same genotype were rare. Mean length-for-age z score at 12 months was lower among children with prior norovirus infection compared to uninfected children (coefficient: −0.33 [95% CI, −.65 to −.01]; P = .04); the effect persisted at 24 months. Conclusions. Norovirus infection occurs early in life and children experience serial infections with multiple genotypes, suggesting genotype-specific immunity. An effective vaccine would have a substantial impact on morbidity, but may need to target multiple genotypes. PMID:24300042

  18. Stress-related eating, obesity and associated behavioural traits in adolescents: a prospective population-based cohort study

    PubMed Central

    2014-01-01

    Background Stress-related eating is associated with unhealthy eating and drinking habits and an increased risk of obesity among adults, but less is known about factors related to stress-driven eating behaviour among children and adolescents. We studied the prevalence of stress-related eating and its association with overweight, obesity, abdominal obesity, dietary and other health behaviours at the age of 16. Furthermore, we examined whether stress-related eating is predicted by early-life factors including birth size and maternal gestational health. Methods The study population comprised 3598 girls and 3347 boys from the Northern Finland Birth Cohort 1986 (NFBC1986). Followed up since their antenatal period, adolescents underwent a clinical examination, and their stress-related eating behaviour, dietary habits and other health behaviours were assessed using a postal questionnaire. We examined associations using cross-tabulations followed by latent class analysis and logistic regression to profile the adolescents and explain the risk of obesity with behavioural traits. Results Stress-related eating behaviour was more common among girls (43%) than among boys (15%). Compared with non-stress-driven eaters, stress-driven eaters had a higher prevalence of overweight, obesity and abdominal obesity. We found no significant associations between stress-eating and early-life factors. Among girls, tobacco use, shorter sleep, infrequent family meals and frequent consumption of chocolate, sweets, light sodas and alcohol were more prevalent among stress-driven eaters. Among boys, the proportions of those with frequent consumption of sausages, chocolate, sweets, hamburgers and pizza were greater among stress-driven eaters. For both genders, the proportions of those bingeing and using heavy exercise and strict diet for weight control were higher among stress-eaters. Besides a ‘healthy lifestyle’ cluster, latent class analysis revealed two other patterns (‘adverse habits’,

  19. Romantic and Sexual Behavior in Young Adolescents: Repeated Surveys in a Population-Based Cohort

    ERIC Educational Resources Information Center

    Waylen, Andrea E.; Ness, Andrew; McGovern, Phil; Wolke, Dieter; Low, Nicola

    2010-01-01

    Adverse outcomes of teenage sexual activity are common in the United Kingdom. The authors used a computer-assisted interview to ask young adolescents aged 11 to 12 years (N = 6,856) and 12 to 13 years (N = 6,801) who were part of the Avon Longitudinal Study of Parents and Children about romantic and intimate behaviors. A total of 24% of 11- to…

  20. Smoking behaviors in a community-based cohort of HIV-infected indigent adults

    PubMed Central

    Vijayaraghavan, Maya; Penko, Joanne; Vittinghoff, Eric; Bangsberg, David R.; Miaskowski, Christine; Kushel, Margot B.

    2014-01-01

    We conducted a longitudinal study of a community-based cohort of HIV-infected indigent adults to examine smoking behaviors and factors associated with quitting. We assessed “hardcore” smoking behaviors associated with a low probability of quitting. Of the 296 participants, 218 were current smokers (73.6%). The prevalence of “hardcore” smoking was high: 59.6% smoked ≥ 15 cigarettes per day, and 67.3% were daily smokers. During the study interval, 20.6% made at least one quit attempt. Of these, 53.3% were abstinent at 6 months. The successful quit rate over two years was 4.6%. Illegal substance use (adjusted odds ratio, AOR 0.2, 95% CI 0.1-0.6) and smoking within 30 minutes of waking (AOR 0.2, 95% CI 0.1-0.7) were associated with lower likelihood of making a quit attempt. Interventions that reduce nicotine dependence prior to smoking cessation and those that are integrated with substance use treatment may be effective for this population. PMID:23918243

  1. Determinants of Disability in Rheumatoid Arthritis: A Community-Based Cohort Study

    PubMed Central

    Krause, Megan L.; Crowson, Cynthia S.; Bongartz, Tim; Matteson, Eric L.; Michet, Clement J.; Mason, Thomas G.; Persellin, Scott T.; Gabriel, Sherine E.; Davis, John M.

    2015-01-01

    Longitudinal care of a community-based cohort of patients with rheumatoid arthritis (RA) was evaluated retrospectively. Candidate determinants of disability included visual analog scales (VAS) for patient global assessment and pain, comorbidities, and medications. The outcome was the ‘patient-acceptable symptom state’ for disability as defined by the Health Assessment Questionnaire (HAQ) disability index, using a cutoff of <1.04. Two-sample t tests and multivariable logistic regression were used to determine odds ratios (OR) for associations between predictor variables and disability. Out of a total of 99 patients, 28 (28%) patients had HAQ ≥1.04 at their last visit. The greatest odds of not attaining the patient-acceptable symptom state in a multivariable model was associated with corticosteroids (OR: 5.1; p=0.02), antidepressants (OR: 5.3; p=0.02), and female sex (OR: 6.5; p=0.05). In the era of biologic therapy, female sex, corticosteroids, and antidepressants remain profound determinants of disability highlighting the need to understand the underlying mechanisms. PMID:26862353

  2. Risky Health Behavior Among Adolescents in the Childhood Cancer Survivor Study Cohort

    PubMed Central

    Howell, Carrie R.; Li, Zhenghong; Foster, Rebecca H.; Mertens, Ann C.; Robison, Leslie L.; Ness, Kirsten K.

    2012-01-01

    Objective To report the prevalence and comparison of cancer-linked health behaviors and identify risk factors associated with unhealthy behavior among adolescent siblings and cancer survivors. Methods The Child Health and Illness Profile—Adolescent Edition (CHIP—AE) was completed by 307 survivors and 97 sibling controls 14–20 years of age. Results Risky behavior ranged from 0.7% to 35.8% for survivors and 1.0% to 41.2% for siblings. Comparisons of sexual behavior, tobacco, alcohol, or illicit drug use utilizing continuous data revealed no differences between groups. Categorically, survivors were less likely to report past smokeless tobacco use or current use of beer/wine or binge drinking (p-values range from .01 to .04). Survivors with better mental health were at lower risk for poor behavioral outcomes. Conclusions Adolescent survivors engage in risky health behaviors at rates generally equivalent to their siblings. Aggressive health education efforts should be directed toward this high-risk population. PMID:22427699

  3. Community-Based HIV and Health Testing for High-Risk Adolescents and Youth.

    PubMed

    Reif, Lindsey K; Rivera, Vanessa; Louis, Bianca; Bertrand, Rachel; Peck, Mireille; Anglade, Benedict; Seo, Grace; Abrams, Elaine J; Pape, Jean W; Fitzgerald, Daniel W; McNairy, Margaret L

    2016-08-01

    Adolescents account for 40% of new HIV infections, and HIV testing strategies to increase uptake of testing are needed. A community-based adolescent and youth HIV and health testing campaign was conducted in seven slum neighborhoods of Port-au-Prince, Haiti, from December 2014 to September 2015. Community health workers provided community sensitization and recruited 10- to 24-year-olds to test for HIV, syphilis, gonorrhea/chlamydia, and to screen for tuberculosis (TB) and pregnancy. HIV-infected individuals were escorted to the GHESKIO HIV clinic for same-day enrollment in care. Among 3425 individuals eligible for testing, 3348 (98%) accepted an HIV test. HIV prevalence was 2.65% (n = 89). Median age was 19 [interquartile range (IQR) 17-20]; 73% were female. HIV prevalence was 0.6-7.4% across slum neighborhoods. All HIV-infected individuals enrolled in care the same day as testing; median CD4 was 529 cells/μL [IQR 363-761]. Syphilis prevalence was 2.60% (65/2536) and gonorrhea/chlamydia prevalence was 6.25% (96/1536). Among 168 (5%) individuals who reported TB symptoms, 7.7% (13/168) had microbiologically confirmed disease. One hundred twenty-nine females (5% of all females) were pregnant. This community-based testing campaign identified an adolescent and youth population with an HIV prevalence six times higher than the estimated national adolescent HIV prevalence (0.4%) in Haiti, including perinatally infected adolescents. This type of community-based campaign for HIV testing within a package of services can serve as a model for other resource-poor settings to identify high-risk adolescents and youth, and curb the global HIV epidemic among adolescents. PMID:27509237

  4. Engaging and sustaining adolescents in Community-Based Participatory Research: Structuring a youth-friendly CBPR environment

    PubMed Central

    Merves, Marni LoIacono; Rodgers, Caryn R. R.; Silver, Ellen Johnson; Sclafane, Jamie Heather; Bauman, Laurie J.

    2014-01-01

    Community-Based Participatory Research (CBPR) partnerships typically do not include adolescents as full community partners. However, partnering with adolescents can enhance the success and sustainability of adolescent health interventions. We partnered with adolescents to address health disparities in a low income urban community. In partnering with youth, it is important to consider their developmental stage and needs in order to better engage and sustain their involvement. We also learned the value of a Youth Development (YD) framework and intentionally structuring a youth-friendly CBPR environment. Finally, we will raise some ethical responsibilities to consider when working with youth partners. PMID:25423241

  5. Cohorts, Communities of Inquiry, and Course Delivery Methods: UTC Best Practices in Learning--The Hybrid Learning Community Model

    ERIC Educational Resources Information Center

    Rausch, David W.; Crawford, Elizabeth K.

    2012-01-01

    From the early 1990s to present, the practice of cohort-based learning has been on the rise in colleges, universities, organizations, and even some K-12 programs across the nation. This type of learning model uses the power of the interpersonal relationships to enhance the learning process and provide additional support to the cohort members as…

  6. Improving Care for Depression & Suicide Risk in Adolescents: Innovative Strategies for Bringing Treatments to Community Settings

    PubMed Central

    Asarnow, Joan Rosenbaum; Miranda, Jeanne

    2015-01-01

    This article reviews the literature on interventions and services for depression and suicide prevention among adolescents, with the goals of placing this science within the context of current changing health care environments and highlighting innovative models for improving health and mental health. We examine the: challenges and opportunities offered by new initiatives and legislation designed to transform the U.S. health and mental healthcare systems; summarize knowledge regarding the treatment of depression and suicidality/self-harm in adolescents; and describe innovative models for partnering with health systems and communities. This review demonstrates that treatment models and service delivery strategies are currently available for increasing evidence-based care, particularly for depression, and concludes with recommendations for future research and quality improvement initiatives aimed at inspiring additional efforts to put science to work, bridge science and community practice, and develop strategies for partnering with communities to improve care, mental health, and well-being among adolescents. PMID:24437432

  7. Communities advancing the studies of Tribal nations across their lifespan: Design, methods, and baseline of the CoASTAL cohort

    PubMed Central

    Tracy, Kate; Boushey, Carol; Roberts, Sparkle M.; Morris, J.Glenn; Grattan, Lynn M.

    2015-01-01

    The CoASTAL cohort represents the first community cohort assembled to study a HAB related illness. It is comprised of three Native American tribes in the Pacific NW for the purpose of studying the health impacts of chronic, low level domoic acid (DA) exposure through razor clam consumption. This cohort is at risk of domoic acid (DA) toxicity by virtue of their geographic location (access to beaches with a history of elevated DA levels in razor clams) and the cultural and traditional significance of razor clams in their diet. In this prospective, longitudinal study, Wave 1 of the cohort is comprised of 678 members across the lifespan with both sexes represented within child, adult and geriatric age groups. All participants are followed annually with standard measures of medical and social history; neuropsychological functions, psychological status, and dietary exposure. DA concentration levels are measured at both public and reservation beaches where razor clams are sourced and multiple metrics have been piloted to further determine exposure. Baseline data indicates that all cognitive and psychological functions are within normal limits. In addition there is considerable variability in razor clam exposure. Therefore, the CoASTAL cohort offers a unique opportunity to investigate the potential health effects of chronic, low level exposure to DA over time. PMID:27616972

  8. Communities advancing the studies of Tribal nations across their lifespan: Design, methods, and baseline of the CoASTAL cohort

    PubMed Central

    Tracy, Kate; Boushey, Carol; Roberts, Sparkle M.; Morris, J.Glenn; Grattan, Lynn M.

    2015-01-01

    The CoASTAL cohort represents the first community cohort assembled to study a HAB related illness. It is comprised of three Native American tribes in the Pacific NW for the purpose of studying the health impacts of chronic, low level domoic acid (DA) exposure through razor clam consumption. This cohort is at risk of domoic acid (DA) toxicity by virtue of their geographic location (access to beaches with a history of elevated DA levels in razor clams) and the cultural and traditional significance of razor clams in their diet. In this prospective, longitudinal study, Wave 1 of the cohort is comprised of 678 members across the lifespan with both sexes represented within child, adult and geriatric age groups. All participants are followed annually with standard measures of medical and social history; neuropsychological functions, psychological status, and dietary exposure. DA concentration levels are measured at both public and reservation beaches where razor clams are sourced and multiple metrics have been piloted to further determine exposure. Baseline data indicates that all cognitive and psychological functions are within normal limits. In addition there is considerable variability in razor clam exposure. Therefore, the CoASTAL cohort offers a unique opportunity to investigate the potential health effects of chronic, low level exposure to DA over time.

  9. From Amateur to Framauteur: Art Development of Adolescents and Young Adults within an Interest-Based Community

    ERIC Educational Resources Information Center

    Manifold, Marjorie Cohee

    2012-01-01

    In this article, the art developmental progression of adolescents and young adults within the cultural context of an interest-based community is described; the role of narrative and sociocultural community to the art development of adolescents and young adults is highlighted. Artistic development begins in response to an aesthetic phenomenon, is…

  10. The protective role of maternal racial socialization for African American adolescents exposed to community violence.

    PubMed

    Henry, Jessica S; Lambert, Sharon F; Smith Bynum, Mia

    2015-08-01

    Urban African American youth's disproportionate exposure to community violence and increased risk for its adverse consequences have heightened interest in identifying protective factors that mitigate the effects of community violence exposure for these youth. Thus, the present study examined whether maternal racial socialization messages protect African American adolescents against the adverse effects of community violence exposure. Participants were a community sample of African American adolescents (N = 106; mean age = 15.41 years) and their female guardians. For community-violence-exposed youth, maternal racial socialization messages protected against aggressive behaviors and depressive symptoms, such that maternal messages about cultural pride attenuated the association between community violence exposure and parent-reported aggressive behaviors, and cultural appreciation of legacy messages attenuated the association between community violence exposure and adolescent-reported depressive symptoms. Findings highlight the need to integrate race-relevant factors into preventive interventions targeting African American youth at risk for or exposed to community violence, and suggest that family interventions promoting parents' efficacy to implement racial socialization practices are useful for youth exposed to violence.

  11. Obesity impairs academic attainment in adolescence: findings from ALSPAC, a UK cohort

    PubMed Central

    Booth, J N; Tomporowski, P D; Boyle, J M E; Ness, A R; Joinson, C; Leary, S D; Reilly, J J

    2014-01-01

    Objective: While being overweight or obese in adolescence may have detrimental effects on academic attainment, the evidence base is limited by reliance on cross-sectional studies with small sample sizes, failure to take account of confounders and lack of consideration of potential mediators. The present study aimed to address these limitations and examine longitudinal associations between obesity in adolescence and academic attainment. Design: Associations between weight status at 11 years old and academic attainment assessed by national tests at 11, 13 and 16 years were examined in the Avon Longitudinal Study of Parents and Children. Healthy weight was defined as body mass index (BMI) Z-score <1.04; overweight as BMI Z-score 1.04–1.63; obesity as BMI Z-score ⩾1.64. Participants: Data from 5966 participants with objectively measured weight status were examined: 71.4% were healthy weight (1935 males; 2325 females), 13.3% overweight (372 males; 420 females) and 15.3% obese (448 males; 466 females). Results: Girls obese at 11 years had lower academic attainment at 11, 13 and 16 years compared with those of a healthy weight, even after controlling for a wide range of confounders. Associations between obesity and academic attainment were less clear in boys. The potential mediating effects of depressive symptoms, intelligence quotient (IQ) and age of menarche in girls were explored, but when confounders were included, there was no strong evidence for mediation. Conclusions: For girls, obesity in adolescence has a detrimental impact on academic attainment 5 years later. Mental health, IQ and age of menarche did not mediate this relationship, suggesting that further work is required to understand the underlying mechanisms. Parents, education and public health policy makers should consider the wide reaching detrimental impact of obesity on educational outcomes in this age group. PMID:24614099

  12. Telephone-based guided self-help for adolescents with chronic fatigue syndrome: A non-randomised cohort study.

    PubMed

    Lloyd, Samantha; Chalder, Trudie; Sallis, Hannah M; Rimes, Katharine A

    2012-05-01

    The aim of this study was to gain preliminary evidence about the efficacy of a new telephone-based guided self-help intervention, based on cognitive-behavioural principles, which aimed to reduce fatigue and improve school attendance in adolescents with chronic fatigue syndrome (CFS). A non-randomised cohort design was used, with a two-month baseline period. Sixty-three 11-18 year-old participants recruited from a specialist CFS unit received the intervention. Participants received six half-hour fortnightly telephone sessions and two follow-up sessions. Fatigue and school attendance were the main outcomes and the main time point for assessing outcome was 6 months post-treatment. Using multi-level modelling, a significant decrease in fatigue was found between pre-treatment and 6 month follow-up, treatment effect estimate = - 5.68 (-7.63, -3.72), a large effect size (Cohen's d = 0.79). The decrease in fatigue between pre and post-treatment was significantly larger than between baseline and pre-treatment. A significant increase in school attendance was found between pre-treatment and 6 month follow-up, effect estimate = 1.38 (0.76, 2.00), a medium effect size (d = -0.48). univariate logistic regression found baseline perfectionism to be associated with better [corrected] school attendance at six-month follow-up. In conclusion, telephone-based guided self-help is an acceptable minimal intervention which is efficacious in reducing fatigue in adolescents with CFS.

  13. Vitamin D status in a Brazilian cohort of adolescents and young adults with perinatally acquired human immunodeficiency virus infection.

    PubMed

    Schtscherbyna, Annie; Gouveia, Carla; Pinheiro, Maria Fernanda Miguens Castelar; Luiz, Ronir Raggio; Farias, Maria Lucia Fleiuss; Machado, Elizabeth Stankiewicz

    2016-02-01

    The purpose was to determine the prevalence and related factors of vitamin D (VitD) insufficiency in adolescents and young adults with perinatally acquired human immunodeficiency virus. A cohort of 65 patients (17.6 ± 2 years) at the Federal University of Rio de Janeiro, Brazil, were examined for pubertal development, nutrition, serum parathormone and serum 25-hydroxyvitamin D [s25(OH)D]. s25(OH)D levels < 30 ng/mL (< 75 nmol/L) were defined as VitD insufficiency. CD4+ T-cell counts and viral load, history of worst clinical status, immunologic status as nadir, current immunologic status, and antiretroviral (ART) regimen were also evaluated as risk factors for VitD insufficiency. Mean s25(OH)D was 37.7 ± 13.9 ng/mL and 29.2% had VitD insufficiency. There was no difference between VitD status and gender, age, nutritional status, clinical and immunological classification, and type of ART. Only VitD consumption showed tendency of association with s25(OH)D (p = 0.064). Individuals analysed in summer/autumn season had a higher s25(OH)D compared to the ones analysed in winter/spring (42.6 ± 14.9 vs. 34.0 ± 11.9, p = 0.011). Although, the frequency of VitD insufficiency did not differ statistically between the groups (summer/autumn 17.9% vs. winter/spring 37.8%, p = 0.102), we suggest to monitor s25(OH)D in seropositive adolescents and young adults, especially during winter/spring months, even in sunny regions.

  14. Vitamin D status in a Brazilian cohort of adolescents and young adults with perinatally acquired human immunodeficiency virus infection

    PubMed Central

    Schtscherbyna, Annie; Gouveia, Carla; Pinheiro, Maria Fernanda Miguens Castelar; Luiz, Ronir Raggio; Farias, Maria Lucia Fleiuss; Machado, Elizabeth Stankiewicz

    2016-01-01

    The purpose was to determine the prevalence and related factors of vitamin D (VitD) insufficiency in adolescents and young adults with perinatally acquired human immunodeficiency virus. A cohort of 65 patients (17.6 ± 2 years) at the Federal University of Rio de Janeiro, Brazil, were examined for pubertal development, nutrition, serum parathormone and serum 25-hydroxyvitamin D [s25(OH)D]. s25(OH)D levels < 30 ng/mL (< 75 nmol/L) were defined as VitD insufficiency. CD4+ T-cell counts and viral load, history of worst clinical status, immunologic status as nadir, current immunologic status, and antiretroviral (ART) regimen were also evaluated as risk factors for VitD insufficiency. Mean s25(OH)D was 37.7 ± 13.9 ng/mL and 29.2% had VitD insufficiency. There was no difference between VitD status and gender, age, nutritional status, clinical and immunological classification, and type of ART. Only VitD consumption showed tendency of association with s25(OH)D (p = 0.064). Individuals analysed in summer/autumn season had a higher s25(OH)D compared to the ones analysed in winter/spring (42.6 ± 14.9 vs. 34.0 ± 11.9, p = 0.011). Although, the frequency of VitD insufficiency did not differ statistically between the groups (summer/autumn 17.9% vs. winter/spring 37.8%, p = 0.102), we suggest to monitor s25(OH)D in seropositive adolescents and young adults, especially during winter/spring months, even in sunny regions. PMID:26872341

  15. Experiences with community engagement and informed consent in a genetic cohort study of severe childhood diseases in Kenya

    PubMed Central

    2010-01-01

    Background The potential contribution of community engagement to addressing ethical challenges for international biomedical research is well described, but there is relatively little documented experience of community engagement to inform its development in practice. This paper draws on experiences around community engagement and informed consent during a genetic cohort study in Kenya to contribute to understanding the strengths and challenges of community engagement in supporting ethical research practice, focusing on issues of communication, the role of field workers in 'doing ethics' on the ground and the challenges of community consultation. Methods The findings are based on action research methods, including analysis of community engagement documentation and the observations of the authors closely involved in their development and implementation. Qualitative and quantitative content analysis has been used for documentation of staff meetings and trainings, a meeting with 24 community leaders, and 40 large public and 70 small community group meetings. Meeting minutes from a purposive sample of six community representative groups have been analysed using a thematic framework approach. Results Field workers described challenges around misunderstandings about research, perceived pressure for recruitment and challenges in explaining the study. During consultation, leaders expressed support for the study and screening for sickle cell disease. In community meetings, there was a common interpretation of research as medical care. Concerns centred on unfamiliar procedures. After explanations of study procedures to leaders and community members, few questions were asked about export of samples or the archiving of samples for future research. Conclusions Community engagement enabled researchers to take account of staff and community opinions and issues during the study and adapt messages and methods to address emerging ethical challenges. Field workers conducting informed

  16. Culturally Diverse Cohorts: The Exploration of Learning in Context and Community

    ERIC Educational Resources Information Center

    Callaghan, Carolyn M.

    2012-01-01

    This dissertation explores the experiences of culturally diverse interactions and learning in adult cohorts. A cohort is defined as a group of students who enter a program of study together and complete a series of common learning experiences during a specified period of time (Saltiel & Russo, 2001). There is much research on the general use,…

  17. Academic Cohorts: Benefits and Drawbacks of Being a Member of a Community of Learners

    ERIC Educational Resources Information Center

    Lei, Simon; Gorelick, Denise; Short, Keily; Smallwood, Lauren; Wright-Porter, Karen

    2011-01-01

    In response to the increasing rate of students failing to complete their bachelor, master, and doctoral programs, many colleges and universities are now offering cohort education models of study. The goals of cohort education are to promote retention, graduation, and success rates of students. This non-traditional approach to education places…

  18. Impact of adolescent peer aggression on later educational and employment outcomes in an Australian cohort.

    PubMed

    Moore, Sophie E; Scott, James G; Thomas, Hannah J; Sly, Peter D; Whitehouse, Andrew J O; Zubrick, Stephen R; Norman, Rosana E

    2015-08-01

    This study used prospective birth cohort data to analyse the relationship between peer aggression at 14 years of age and educational and employment outcomes at 17 years (N = 1091) and 20 years (N = 1003). Participants from the Western Australian Pregnancy Cohort (Raine) study were divided into mutually exclusive categories of peer aggression. Involvement in peer aggression was reported by 40.2% (10.1% victims; 21.4% perpetrators; 8.7% victim-perpetrators) of participants. Participants involved in any form of peer aggression were less likely to complete secondary school. Perpetrators and victim-perpetrators of peer aggression were more likely to be in the 'No Education, Employment or Training' group at 20 years of age. This association was explained by non-completion of secondary school. These findings demonstrate a robust association between involvement in peer aggression and non-completion of secondary school, which in turn was associated with an increased risk of poor educational and employment outcomes in early adulthood. PMID:26057874

  19. Impact of adolescent peer aggression on later educational and employment outcomes in an Australian cohort.

    PubMed

    Moore, Sophie E; Scott, James G; Thomas, Hannah J; Sly, Peter D; Whitehouse, Andrew J O; Zubrick, Stephen R; Norman, Rosana E

    2015-08-01

    This study used prospective birth cohort data to analyse the relationship between peer aggression at 14 years of age and educational and employment outcomes at 17 years (N = 1091) and 20 years (N = 1003). Participants from the Western Australian Pregnancy Cohort (Raine) study were divided into mutually exclusive categories of peer aggression. Involvement in peer aggression was reported by 40.2% (10.1% victims; 21.4% perpetrators; 8.7% victim-perpetrators) of participants. Participants involved in any form of peer aggression were less likely to complete secondary school. Perpetrators and victim-perpetrators of peer aggression were more likely to be in the 'No Education, Employment or Training' group at 20 years of age. This association was explained by non-completion of secondary school. These findings demonstrate a robust association between involvement in peer aggression and non-completion of secondary school, which in turn was associated with an increased risk of poor educational and employment outcomes in early adulthood.

  20. Associations between objectively measured physical activity and academic attainment in adolescents from a UK cohort

    PubMed Central

    Booth, J N; Leary, S D; Joinson, C; Ness, A R; Tomporowski, P D; Boyle, J M; Reilly, J J

    2014-01-01

    Background To test for cross-sectional (at age 11) and longitudinal associations between objectively measured free-living physical activity (PA) and academic attainment in adolescents.Method Data from 4755 participants (45% male) with valid measurement of PA (total volume and intensity) by accelerometry at age 11 from the Avon Longitudinal Study of Parents and Children (ALSPAC) was examined. Data linkage was performed with nationally administered school assessments in English, Maths and Science at ages 11, 13 and 16. Results In unadjusted models, total volume of PA predicted decreased academic attainment. After controlling for total volume of PA, percentage of time spent in moderate-vigorous intensity PA (MVPA) predicted increased performance in English assessments in both sexes, taking into account confounding variables. In Maths at 16 years, percentage of time in MVPA predicted increased performance for males (standardised β=0.11, 95% CI 0.00 to 0.22) and females (β=0.08, 95% CI 0.00 to 0.16). For females the percentage of time spent in MVPA at 11 years predicted increased Science scores at 11 and 16 years (β=0.14 (95% CI 0.03 to 0.25) and 0.14 (0.07 to 0.21), respectively). The correction for regression dilution approximately doubled the standardised β coefficients. Conclusions Findings suggest a long-term positive impact of MVPA on academic attainment in adolescence. PMID:24149097

  1. Community resilience factors among indigenous Sámi adolescents: a qualitative study in Northern Norway.

    PubMed

    Nystad, Kristine; Spein, Anna Rita; Ingstad, Benedicte

    2014-10-01

    This qualitative study explores community resilience factors within an indigenous Sámi community in Northern Norway. Semistructured interviews were conducted with 22 informants, 12 females and 10 males, ranging in age from 13 to 19 years old, 12 of whom had reindeer husbandry affiliation. Data analysis used a modified grounded theory approach and narrative analysis. Interpretation of the data was based on ecological perspectives theory and the identification of possible community resilience factors including Sámi language competence, use of recreational and natural resources, and traditional ecological knowledge, such as reindeer husbandry related activities. These cultural factors appear to strengthen adolescents' ethnic identity and pride, which in turn act as potential resilience mechanisms. Land was a significant arena for traditional practices and recreation. The majority of the youth reported support from relationships with extended godparents (fáddarat) and extended family (sohka) networks. The fáttar network was particularly strong among adolescents with reindeer husbandry affiliations. Native language competence and reindeer husbandry were key components in adolescent social networks. Interconnectedness among the community members and with the environment seemed to promote resilience and well-being. Two factors that excluded adolescents from full community membership and participation were being a nonnative Sámi language speaker and the absence of extended Sámi family networks.

  2. Social capital and adolescent smoking in schools and communities: a cross-classified multilevel analysis.

    PubMed

    De Clercq, Bart; Pfoertner, Timo-Kolja; Elgar, Frank J; Hublet, Anne; Maes, Lea

    2014-10-01

    We sought to determine whether social capital at the individual-, school- and community-level can explain variance in adolescent smoking and accounts for social inequalities in smoking. We collected data as part of the 2005/6 Health Behavior in School-aged Children survey, a nationally representative survey of the health and well-being of high school pupils in Belgium (Flanders). Social capital was assessed by structural and cognitive components of family social capital, a four-factor school social capital scale and a cognitive community social capital scale. We fitted non-hierarchical multilevel models to the data, with 8453 adolescents nested within a cross-classification of 167 schools and 570 communities. Significant variation in adolescent regular smoking was found between schools, but not between communities. Only structural family social capital and cognitive school social capital variables negatively related to regular smoking. No interactions between socio-economic status and social capital variables were found. Our findings suggest that previously observed community-level associations with adolescent smoking may be a consequence of unmeasured confounding. Distinguishing nested contexts of social capital is important because their associations with smoking differ.

  3. Protein Biomarkers for Insulin Resistance and Type 2 Diabetes Risk in Two Large Community Cohorts.

    PubMed

    Nowak, Christoph; Sundström, Johan; Gustafsson, Stefan; Giedraitis, Vilmantas; Lind, Lars; Ingelsson, Erik; Fall, Tove

    2016-01-01

    Insulin resistance (IR) is a precursor of type 2 diabetes (T2D), and improved risk prediction and understanding of the pathogenesis are needed. We used a novel high-throughput 92-protein assay to identify circulating biomarkers for HOMA of IR in two cohorts of community residents without diabetes (n = 1,367) (mean age 73 ± 3.6 years). Adjusted linear regression identified cathepsin D and confirmed six proteins (leptin, renin, interleukin-1 receptor antagonist [IL-1ra], hepatocyte growth factor, fatty acid-binding protein 4, and tissue plasminogen activator [t-PA]) as IR biomarkers. Mendelian randomization analysis indicated a positive causal effect of IR on t-PA concentrations. Two biomarkers, IL-1ra (hazard ratio [HR] 1.28, 95% CI 1.03-1.59) and t-PA (HR 1.30, 1.02-1.65) were associated with incident T2D, and t-PA predicted 5-year transition to hyperglycemia (odds ratio 1.30, 95% CI 1.02-1.65). Additional adjustment for fasting glucose rendered both coefficients insignificant and revealed an association between renin and T2D (HR 0.79, 0.62-0.99). LASSO regression suggested a risk model including IL-1ra, t-PA, and the Framingham Offspring Study T2D score, but prediction improvement was nonsignificant (difference in C-index 0.02, 95% CI -0.08 to 0.12) over the T2D score only. In conclusion, proteomic blood profiling indicated cathepsin D as a new IR biomarker and suggested a causal effect of IR on t-PA. PMID:26420861

  4. Do Executive Function and Impulsivity Predict Adolescent Health Behaviour after Accounting for Intelligence? Findings from the ALSPAC Cohort

    PubMed Central

    Pechey, Rachel; Couturier, Dominique-Laurent; Deary, Ian J.; Marteau, Theresa M.

    2016-01-01

    Objective Executive function, impulsivity, and intelligence are correlated markers of cognitive resource that predict health-related behaviours. It is unknown whether executive function and impulsivity are unique predictors of these behaviours after accounting for intelligence. Methods Data from 6069 participants from the Avon Longitudinal Study of Parents and Children were analysed to investigate whether components of executive function (selective attention, attentional control, working memory, and response inhibition) and impulsivity (parent-rated) measured between ages 8 and 10, predicted having ever drunk alcohol, having ever smoked, fruit and vegetable consumption, physical activity, and overweight at age 13, after accounting for intelligence at age 8 and childhood socioeconomic characteristics. Results Higher intelligence predicted having drunk alcohol, not smoking, greater fruit and vegetable consumption, and not being overweight. After accounting for intelligence, impulsivity predicted alcohol use (odds ratio = 1.10; 99% confidence interval = 1.02, 1.19) and smoking (1.22; 1.11, 1.34). Working memory predicted not being overweight (0.90; 0.81, 0.99). Conclusions After accounting for intelligence, executive function predicts overweight status but not health-related behaviours in early adolescence, whilst impulsivity predicts the onset of alcohol and cigarette use, all with small effects. This suggests overlap between executive function and intelligence as predictors of health behaviour in this cohort, with trait impulsivity accounting for additional variance. PMID:27479488

  5. Cognitive ability, parental socioeconomic position and internalising and externalising problems in adolescence: Findings from two European cohort studies

    PubMed Central

    Araya, Ricardo; Lawlor, Debbie A.; Ormel, Johan; Verhulst, Frank C.; Oldehinkel, Albertine J.

    2010-01-01

    We investigated whether cognitive ability (CA) may be a moderator of the relationship of parental socioeconomic position (SEP) with internalising and externalising problems in adolescents. We used data from two longitudinal cohort studies; the Avon Longitudinal Study of Parents and Children (ALSPAC) and the Tracking Adolescents’ Individual Lives Survey (TRAILS). Indicators of SEP were mother’s education and household income. CA was estimated with IQ scores, derived from the Wechsler Intelligence Scale for Children. Internalising and externalising problems were measured with the Strengths and Difficulties Questionnaire in ALSPAC and with the Child Behavior Checklist in TRAILS. Logistic regression analyses were used to estimate the relative index of inequality (RII) for each outcome; the RII provides the odds ratio comparing the most to least deprived for each measure of SEP. In fully adjusted models an association of mother’s education with externalising problems was observed [ALSPAC RII 1.42 (95%CI: 1.01–1.99); TRAILS RII 2.21 (95%CI: 1.37–3.54)], and of household income with internalising and externalising problems [pooled ALSPAC & TRAILS internalising RII 1.30 (95%CI: 0.99–1.71); pooled ALSPAC & TRAILS externalising RII 1.38 (95%CI: 1.03–1.84)]. No consistent associations were observed between mother’s education and internalising problems. Results of stratified analyses and interaction-terms showed no evidence that CA moderated the association of SEP with internalising or externalising problems. PMID:20535529

  6. Impact of the Jamaican birth cohort study on maternal, child and adolescent health policy and practice.

    PubMed

    McCaw-Binns, A; Ashley, D; Samms-Vaughan, M

    2010-01-01

    The Jamaica Perinatal Morbidity and Mortality Survey (JPMMS) was a national study designed to identify modifiable risk factors associated with poor maternal and perinatal outcome. Needing to better understand factors that promote or retard child development, behaviour and academic achievement, we conducted follow-up studies of the birth cohort. The paper describes the policy developments from the JPMMS and two follow-up rounds. The initial study (1986-87) documented 94% of all births and their outcomes on the island over 2 months (n = 10 508), and perinatal (n = 2175) and maternal deaths (n = 62) for a further 10 months. A subset of the birth cohort, identified by their date of birth through school records, was seen at ages 11-12 (n = 1715) and 15-16 years (n = 1563). Findings from the initial survey led to, inter alia, clinic-based screening for syphilis, referral high-risk clinics run by visiting obstetricians, and the redesign and construction of new labour wards at referral hospitals. The follow-up studies documented inadequate academic achievement among boys and children attending public schools, and associations between under- and over-nutrition, excessive television viewing (>20 h/week), inadequate parental supervision and behavioural problems. These contributed to the development of a television programming code for children, a National Parenting Policy, policies aimed at improving inter-sectoral services to children from birth to 5 years (Early Childhood Commission) and behavioural interventions of the Violence Prevention Alliance (an inter-sectoral NGO) and the Healthy Lifestyles project (Ministry of Health). Indigenous maternal and child health research provided a local evidence base that informed public policy. Collaboration, good communication, being vigilant to opportunities to influence policy, and patience has contributed to our success.

  7. Obesity-associated distress in Lebanese adolescents: an exploratory look at a large cohort of students.

    PubMed

    Salameh, P; Barbour, B

    2011-12-01

    Childhood obesity has beome an international concern. Our objective was to construct a scale for assessing obesity-related distress among Lebanese boys and girls and to study the relationship between obesity-associated behaviours and distress. A cross-sectional study was conducted in 2009 on a sample of 1933 adolescents aged 12-18 years. Questions were asked about personal and family characteristics, satisfaction with weight, frequency of consumption of selected food groups, eating and dieting habits, physical activity behaviour (current and during childhood), attitudes towards obesity, and obesity-related distress. In the factor analysis, all 8 items of the obesity distress scale loaded onto 1 factor. Boys were significantly less likely than girls to be distressed by their obesity. Obesity-related distress, particularly when related to family and media pressure to lose weight, increased the risk of using weight-loss diets and drugs but was not associated with healthy dietary habits or participation in physical activity.

  8. Acute bronchitis and volcanic air pollution: a community-based cohort study at Kilauea Volcano, Hawai'i, USA.

    PubMed

    Longo, Bernadette M; Yang, Wei

    2008-01-01

    Eruption at Kilauea Volcano, Hawai'i, has continued since 1983, emitting sulfurous air pollution into nearby communities. The purpose of this cohort study was to estimate the relative risk (RR) of acute bronchitis over a period from January 2004 to December 2006 in communities exposed to the volcanic air pollution. A community-based case review was conducted using medical records from clinics and emergency rooms in exposed and unexposed study areas. Initial visits by local residents for diagnosed acute bronchitis were clinically reviewed. The cumulative incidence rate for the 3-yr period was 117.74 per 1000 in unexposed communities and 184.63 per 1000 in exposed communities. RR estimates were standardized for age and gender, revealing an elevated cumulative incidence ratio (CIR) of 1.57 (95% CI = 1.36-1.81) for acute bronchitis in the exposed communities. Highest risk [CIR: 6.56 (95% CI = 3.16-13.6)] was observed in children aged 0-14 yr who resided in the exposed communities. Exposed middle-aged females aged 45-64 yr had double the risk for acute bronchitis than their unexposed counterparts. These findings suggest that communities continuously exposed to sulfurous volcanic air pollution may have a higher risk of acute bronchitis across the life span. PMID:18850456

  9. The wider social environment and changes in self-reported quality of life in the transition from late childhood to early adolescence: a cohort study

    PubMed Central

    Drukker, Marjan; Kaplan, Charles; Schneiders, Josien; Feron, Frans JM; van Os, Jim

    2006-01-01

    Background Neighbourhood socioeconomic disadvantage and social capital have been associated with adolescent well-being, but the majority of studies were cross-sectional, and the time window over which the neighbourhood may impact on development is unknown. Therefore, the contribution of the neighbourhood environment to adolescents' quality of life and the course of these effects during the period of transition from childhood to early adolescence was examined. Methods A cohort of adolescents living in Maastricht (The Netherlands), with a mean age of 11.2 years at baseline and of 13.5 years at follow-up was followed. Adolescents who responded both at baseline and at follow-up were included in the analysis (n = 475). Multilevel regression analyses estimated neighbourhood effects while controlling for individual-level effects. Neighbourhood-level socioeconomic and social capital variables, individual-level confounders, and baseline values of the outcome measures were included in the models. Results None of the neighbourhood factors was associated with changes in general health or mental health over the two-year period. However, two-year exposure to greater disparity between individual level socioeconomic status on the one hand and neighbourhood level of socioeconomic status on the other (e.g. high socioeconomic status adolescents living in deprived neighbourhoods and vice versa) negatively impacted on self-esteem and satisfaction. Conclusion The neighbourhood environment per se does not contribute to change in quality of life during the transition to early adolescence. However, adolescents living in families whose socioeconomic status deviates from the mean level of neighbourhood socioeconomic deprivation may be negatively affected. PMID:16707015

  10. Psychological Symptoms Linking Exposure to Community Violence and Academic Functioning in African American Adolescents

    ERIC Educational Resources Information Center

    Busby, Danielle R.; Lambert, Sharon F.; Ialongo, Nicholas S.

    2013-01-01

    African American adolescents are exposed disproportionately to community violence, increasing their risk for emotional and behavioral symptoms that can detract from learning and undermine academic outcomes. The present study examined whether aggressive behavior and depressive and anxious symptoms mediated the association between exposure to…

  11. Addressing the Spectrum of Adolescent Weight-Related Problems: Engaging Parents and Communities

    ERIC Educational Resources Information Center

    Neumark-Sztainer, Dianne

    2007-01-01

    Weight-related problems, including eating disorders, disordered eating, and obesity, are prevalent among adolescents. School and community-based educators and health care providers have an important role to play in the prevention of weight-related problems in youth. This article includes: 1) a brief overview of weight-related problems in…

  12. Community-Based Summer Work Experiences of Adolescents with High-Incidence Disabilities

    ERIC Educational Resources Information Center

    Carter, Erik W.; Trainor, Audrey A.; Ditchman, Nicole; Swedeen, Beth; Owens, Laura

    2011-01-01

    Although summer offers a natural context for adolescents to gain community-based work experience, little is known about the extent to which youth with disabilities are accessing these transition-related opportunities. We examined the summer employment experiences of 220 youth with high-incidence disabilities at two time points. Although more than…

  13. Nonsuicidal Self-Harm among Community Adolescents: Understanding the "Whats" and "Whys" of Self-Harm

    ERIC Educational Resources Information Center

    Laye-Gindhu, Aviva; Schonert-Reichl, Kimberly A.

    2005-01-01

    This study examines self-harm in a community sample of adolescents. More specifically, the study identifies the prevalence and types of self-harm, elucidates the nature and underlying function of self-harm, and evaluates the relation of psychological adjustment, sociodemographic, and health-risk variables to self-harm. Self-report questionnaires…

  14. Community Food Environment, Home Food Environment, and Fruit and Vegetable Intake of Children and Adolescents

    ERIC Educational Resources Information Center

    Ding, Ding; Sallis, James F.; Norman, Gregory J.; Saelens, Brian E.; Harris, Sion Kim; Kerr, Jacqueline; Rosenberg, Dori; Durant, Nefertiti; Glanz, Karen

    2012-01-01

    Objectives: To determine (1) reliability of new food environment measures; (2) association between home food environment and fruit and vegetable (FV) intake; and (3) association between community and home food environment. Methods: In 2005, a cross-sectional survey was conducted with readministration to assess test-retest reliability. Adolescents,…

  15. Validating the Beck Depression Inventory-II for Hong Kong Community Adolescents

    ERIC Educational Resources Information Center

    Byrne, Barbara M.; Stewart, Sunita M.; Lee, Peter W. H.

    2004-01-01

    The primary purpose of this study was to test for the validity of a Chinese version of the Beck Depression Inventory-II (C-BDI-II) for use with Hong Kong community (i.e., nonclinical) adolescents. Based on a randomized triadic split of the data (N = 1460), we conducted exploratory factor analysis on Group1 (n = 486) and confirmatory factor…

  16. Dimensions of Adolescent Subjective Social Status within the School Community: Description and Correlates

    ERIC Educational Resources Information Center

    Sweeting, Helen; West, Patrick; Young, Robert; Kelly, Shona

    2011-01-01

    School pupils strive to meet both school-defined and social goals, and the structure of adolescent self-concept is multidimensional, including both academic and non-academic self-perceptions. However, subjective social status within the school community has been represented as a single dimension. Scottish 15-year olds participating in a…

  17. Exposure to Community Violence and Political Socialization among Adolescents in Northern Ireland

    ERIC Educational Resources Information Center

    Shepherd, Linda

    2007-01-01

    This study evaluates the effects of adolescent exposure to cross-community violence, intense paramilitary operations, aggression, and intimidation in Northern Ireland. Using publicly available survey data gathered by agencies in Northern Ireland, the research examines the effects of exposure to political violence with focus upon the manner by…

  18. African American Adolescents Living and Coping with Community Violence on Chicago's Southside

    ERIC Educational Resources Information Center

    Voisin, Dexter R.; Bird, Jason D. P.; Hardestry, Melissa; Shiu, Cheng Shi

    2011-01-01

    This study explores community violence exposures among African American adolescents and whether coping strategies were gendered. In-depth interviews are conducted with a sample of 32 African American high school students. Data are analyzed using a thematic analysis. The primary forms of violence exposures are physical attacks, fighting, and…

  19. A Collaborative Model for Community-Based Health Care Screening of Homeless Adolescents.

    ERIC Educational Resources Information Center

    Busen, Nancy H.; Beech, Bettina

    1997-01-01

    A multidisciplinary team from community organizations serving the homeless and from universities collaborated in screening 150 homeless adolescents for psychosocial and physical risks. The population had a history of physical, sexual, and substance abuse as well as high rates of HIV and hepatitis B. Case management by advanced practice nurses was…

  20. Israeli Adolescents Exposed to Community and Terror Violence: The Protective Role of Social Support

    ERIC Educational Resources Information Center

    Brookmeyer, Kathryn A.; Henrich, Christopher C.; Cohen, Guina; Shahar, Golan

    2011-01-01

    This study investigates how social support may protect Israeli early adolescents who have witnessed community violence from engaging in violent behavior when they have also witnessed terror violence. The study examines how support from parents, school, and friends could serve as protective, despite the interactive risk effects of witnessing…

  1. Interpersonal Competence Configurations, Attachment to Community, and Residential Aspirations of Rural Adolescents

    ERIC Educational Resources Information Center

    Petrin, Robert A.; Farmer, Thomas W.; Meece, Judith L.; Byun, Soo-yong

    2011-01-01

    Adolescents who grow-up in rural areas often experience a tension between their attachment to the rural lifestyle afforded by their home community and a competing desire to gain educational, social, and occupational experiences that are only available in metropolitan areas. While these diverging pressures are well-documented, there is little…

  2. Promoting Academic Engagement among Immigrant Adolescents through School-Family-Community Collaboration

    ERIC Educational Resources Information Center

    Suarez-Orozco, Carola; Onaga, Marie; de Lardemelle, Cecile

    2010-01-01

    Schools are receiving students of immigrant origin in unprecedented numbers. Using an ecological framework, the authors reviewed the community, school, familial, and individual challenges that immigrant adolescent students encounter. They examined cognitive, relational, and behavioral dimensions of student engagement as well as culturally…

  3. The Role of Parent and Peer Support in Predicting Adolescent Depression: A Longitudinal Community Study

    ERIC Educational Resources Information Center

    Young, Jami F.; Berenson, Kathy; Cohen, Patricia; Garcia, Jesenia

    2005-01-01

    This study examines whether perceived parent support, peer support, and the interaction between them predict depression symptoms and depression diagnosis 2 years later in a community sample of 389 adolescents. Controlling for Time 1 depression, parent support and anticipated peer support were not independently related to Time 2 depression in…

  4. Adolescent Outcomes of Childhood Attention-Deficit/Hyperactivity Disorder in a Diverse Community Sample

    ERIC Educational Resources Information Center

    Bussing, Regina; Mason, Dana M.; Bell, Lindsay; Porter, Phillip; Garvan, Cynthia

    2010-01-01

    Objective: To describe adolescent outcomes of childhood attention-deficit/hyperactivity disorder (ADHD) in a diverse community sample. Method: ADHD screening of a school district sample of 1,615 students aged 5 to 11 years was followed by a case-control study 8 years later. High-risk youths meeting full (n = 94) and subthreshold (n = 75) DSM-IV…

  5. 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…

  6. Imaginary Community of the Mainstream Classroom: Adolescent Immigrants' Perspectives

    ERIC Educational Resources Information Center

    Cohen, James

    2012-01-01

    In this paper, I explore the perspectives of three adolescent Mexican English language Learners regarding their high school English as a Second Language (ESL) classroom experiences within an urban city in the southwestern part of the U.S. An additional purpose is to demonstrate how the three student participants did or did not invest their…

  7. Adolescent Fertility: Selected, Annotated Resources for the International Community.

    ERIC Educational Resources Information Center

    Ogden, Celia

    This bibliography on adolescent fertility contains over 300 annotations of articles, audiovisual materials, books, charts, comic books, games, journals, papers, pamphlets, and packets. With a few exceptions entries were published from 1974 through 1978; they are categorized according to geographic section: World, Africa, Asia, Europe, Latin…

  8. New Roles for Early Adolescents in Schools and Communities.

    ERIC Educational Resources Information Center

    Schine, Joan; And Others

    This booklet is intended to stimulate new interest in the need of young adolescents to take on meaningful roles and to help planners and practitioneers to translate that interest into youth participation programs. There are three major sections. Section I examines the special needs and characteristics of youth in the 10 to 14 age group. Discussed…

  9. Assessing community readiness for overweight and obesity prevention in pre-adolescent girls: a case study

    PubMed Central

    2013-01-01

    Background Childhood overweight and obesity is a global public health concern. For girls in particular, being overweight or obese during pre-adolescence (aged 7–11 years) has intergenerational implications for both the mother and her future offspring. In the United Kingdom (UK) there is increasing interest in community targeted interventions but less is known about how to tailor these approaches to the needs of the community. This study applied the Community Readiness Model (CRM), for the first time in the UK, to demonstrate its applicability in designing tailored interventions. Methods Community readiness assessment was conducted using semi-structured key informant interviews. The community’s key informants were identified through focus groups with pre-adolescent girls. The interviews addressed the community’s efforts; community knowledge of the efforts; leadership; community climate; community knowledge of the issue and resources available to support the issue. Interviews were conducted until the point of theoretical saturation and questions were asked separately regarding physical activity (PA) and healthy eating and drinking (HED) behaviours. The interviews were transcribed verbatim and were firstly analysed thematically and then scored using the assessment guidelines produced by the CRM authors. Results Readiness in this community was higher for PA than for HED behaviours. The lowest scores related to the community’s ’resources’ and the ’community knowledge of the issue’; affirming these two issues as the most appropriate initial targets for intervention. In terms of resources, there is also a need for resources to support the development of HED efforts beyond the school. Investment in greater physical education training for primary school teachers was also identified as an intervention priority. To address the community’s knowledge of the issue, raising the awareness of the prevalence of pre-adolescent girls’ health behaviours is a

  10. Community Factors Shaping Early Age at First Sex among Adolescents in Burkina Faso, Ghana, Malawi, and Uganda

    PubMed Central

    Simon, Calleen; Finneran, Catherine

    2014-01-01

    ABSTRACT Using data from the National Survey of Adolescents (2004), we examine the community-level factors associated with early age at first sex among adolescents 14-19 years old in four African countries. Regression models are fitted separately by sex for each country for an outcome measuring early age at first sex, with a focus on community-level factors as potential influences of age on sexual debut. The community-level factors associated with adolescents’ sexual debut vary widely by both country and gender. Community influences that emerge as risk or protective factors of early sexual debut include community levels of adolescent marriage, wealth, religious group affiliation, sex education, parental monitoring, reproductive health knowledge, media exposure, membership in adolescent social group, and use of alcohol. Results indicate the importance of context-specific understanding of adolescents’ sexual behaviour and suggest how elements of place should be harnessed in the development of effective HIV and sexual health interventions. PMID:25076654

  11. Growing up in violent communities: do family conflict and gender moderate impacts on adolescents' psychosocial development?

    PubMed

    McKelvey, Lorraine M; Whiteside-Mansell, Leanne; Bradley, Robert H; Casey, Patrick H; Conners-Burrow, Nicola A; Barrett, Kathleen W

    2011-01-01

    This study examined the moderating effects of family conflict and gender on the relationship between community violence and psychosocial development at age 18. The study sample consisted of 728 children and families who were part of the Infant Health and Development Program study of low-birth-weight, pre-term infants. In this sample, adolescent psychosocial outcomes were predicted by community violence differently for male and female children and based on their experiences of conflict at home. For male children, being in a high conflict family as a child exacerbated the negative effects of community violence such that internalizing problems (depression and anxiety) and risk-taking behaviors increased as community violence increased, while being in a low conflict family protected the child against the negative impacts of the community. For female adolescents, there were no moderating effects of family conflict on the relationship between community violence and externalizing problems. Moderating effects for internalizing problems demonstrated that being in low conflict families did not serve as protection against community violence for girls as was demonstrated for boys. These findings demonstrate the long-term effects of community violence on child development, highlighting the importance of gender and family context in the development of internalizing and externalizing problems.

  12. The Role of Community Resource Assessments in the Development of 15 Adolescent Health Community-Researcher Partnerships

    PubMed Central

    Deeds, Bethany Griffin; Straub, Diane M.; Willard, Nancy; Castor, Judith; Ellen, Jonathan; Peralta, Ligia

    2009-01-01

    Background Connect to Protect (C2P): Partnerships for Youth Prevention Interventions is an initiative that alters the community’s structural elements to reduce youth HIV rates. Objectives This study details a community resource assessment and describes how resources were evaluated in the context of local needs. Methods Fifteen sites developed a community resource list, conducted a brief survey, created a youth service directory, and mapped where disease prevalence and community resources intersected. Sites also completed a survey to review and verify local site findings. Results On average, sites identified 267 potential community resources. Sites narrowed their resource list to conduct a brief survey with 1,162 agencies; the site average was 78. Final products of this process included maps comparing resources with risk data. Conclusions The evaluation of local resources is an important initial step in partnership development and is essential for the success of health promotion and disease prevention interventions that target adolescents. PMID:20208189

  13. Comparison of Commercial Wrist-Based and Smartphone Accelerometers, Actigraphy, and PSG in a Clinical Cohort of Children and Adolescents

    PubMed Central

    Toon, Elicia; Davey, Margot J.; Hollis, Samantha L.; Nixon, Gillian M.; Horne, Rosemary S.C.; Biggs, Sarah N.

    2016-01-01

    Study Objectives: To compare two commercial sleep devices, an accelerometer worn as a wristband (UP by Jawbone) and a smartphone application (MotionX 24/7), against polysomnography (PSG) and actigraphy (Actiwatch2) in a clinical pediatric sample. Methods: Children and adolescents (n = 78, 65% male, mean age 8.4 ± 4.0 y) with suspected sleep disordered breathing (SDB), simultaneously wore an actiwatch, a commercial wrist-based device and had a smartphone with a sleep application activated placed near their right shoulder, during their diagnostic PSG. Outcome variables were sleep onset latency (SOL), total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE). Paired comparisons were made between PSG, actigraphy, UP, and MotionX 24/7. Epoch-by-epoch comparisons determined sensitivity, specificity, and accuracy between PSG, actigraphy, and UP. Bland-Altman plots determined level of agreement. Differences in bias between SDB severity and developmental age were assessed. Results: No differences in mean TST, WASO, or SE between PSG and actigraphy or PSG and UP were found. Actigraphy overestimated SOL (21 min). MotionX 24/7 underestimated SOL (12 min) and WASO (63 min), and overestimated TST (106 min) and SE (17%). UP showed good sensitivity (0.92) and accuracy (0.86) but poor specificity (0.66) when compared to PSG. Bland-Altman plots showed similar levels of bias in both actigraphy and UP. Bias did not differ by SDB severity, however was affected by age. Conclusions: When compared to PSG, UP was analogous to Actiwatch2 and may have some clinical utility in children with sleep disordered breathing. MotionX 24/7 did not accurately reflect sleep or wake and should be used with caution. Citation: Toon E, Davey MJ, Hollis SL, Nixon GM, Horne RS, Biggs SN. Comparison of commercial wrist-based and smartphone accelerometers, actigraphy, and PSG in a clinical cohort of children and adolescents. J Clin Sleep Med 2016;12(3):343–350. PMID:26446248

  14. Relationships of physical fitness and obesity with metabolic risk factors in children and adolescents: Chungju city cohort study

    PubMed Central

    Kim, Hyo Jin; Lee, Kyu-Jin; Jeon, Yeon Jin; Ahn, Moon Bae; Jung, In Ah; Kim, Shin Hee; Cho, Won-Kyoung; Cho, Kyoung Soon; Park, So Hyun; Jung, Min Ho

    2016-01-01

    Purpose The purpose of this study was to investigate the relationships of physical fitness and obesity with metabolic risk factors in children and adolescents. Methods This cohort study was conducted in Chungju city, South Korea. Total 843 subjects were enrolled, including 193 elementary school 4th grade male (E4M), 189 elementary school 4th grade female (E4F) and 461 male-middle school students (M1M). The subjects were also classified into 2 groups by body mass index; normal weight (NW) group and overweight included obesity (OW/OB) group. Physical fitness was measured by shuttle run (cardiorespiratory fitness, CRF), sit and reach (flexibility), handgrip strength (muscular strength) and stand long jump (agility). Results The prevalence of OW/OB was respectively 33.7% (65 of 193) among E4M, 28.6% (54 of 189) among E4F, and 28.0% (129 of 461) among M1M. Hematocrit, white blood cell, triglyceride, low-density lipoprotein, insulin, homeostasis model assessment of insulin resistance, systolic and diastolic blood pressure were higher, while high-density lipoprotein were lower in the OW/OB group than in the NW group. The OW/OB group presented significantly lower CRF (P<0.01) and lower agility, but higher muscular strength compared with NW group. CRF was negatively correlated with obesity indices and metabolic risk factors. After adjustments for potential confounders, odds ratios for 4th–5th grade CRF of OW/OB compared NW in the E4M, E4F, M1M, were 7.38 (95 % CI, 3.24–16.83), 4.10 (95% CI, 1.83–9.18), 16.06 (95% CI, 8.23–31.00) (P<0.01). Conclusion Our study has shown that CRF has negative correlation with OW/OB in children and adolescents of Chungju city. We suggest that improvement of CRF through regular physical activity would be an important method for reducing the metabolic risks of childhood obesity. PMID:27104177

  15. Exploring risk and protective factors with a community sample of American Indian adolescents who attempted suicide.

    PubMed

    Cwik, Mary; Barlow, Allison; Tingey, Lauren; Goklish, Novalene; Larzelere-Hinton, Francene; Craig, Mariddie; Walkup, John T

    2015-01-01

    American Indian adolescents are at disproportionate risk for suicide, and community-based studies of this population, which allow a deeper understanding of risks and resilience to inform interventions, are rare. This is a cross-sectional study of N = 71 Apache adolescents. Strengths include the role of the community and American Indian paraprofessionals in the design, implementation, and interpretation of findings. Participants were M = 16.0 years old, 65% female, and 69% multiple attempters. Risks included suicidal behavior among peers and family (68%), caregivers with substance problems (62%), and participant substance use history, namely alcohol (91%) and marijuana (88%). Areas of resiliency included lower depression scores (M = 23.1) and cultural activity participation. A multi-tiered intervention at individual, family, and community levels is needed.

  16. Exploring risk and protective factors with a community sample of American Indian adolescents who attempted suicide.

    PubMed

    Cwik, Mary; Barlow, Allison; Tingey, Lauren; Goklish, Novalene; Larzelere-Hinton, Francene; Craig, Mariddie; Walkup, John T

    2015-01-01

    American Indian adolescents are at disproportionate risk for suicide, and community-based studies of this population, which allow a deeper understanding of risks and resilience to inform interventions, are rare. This is a cross-sectional study of N = 71 Apache adolescents. Strengths include the role of the community and American Indian paraprofessionals in the design, implementation, and interpretation of findings. Participants were M = 16.0 years old, 65% female, and 69% multiple attempters. Risks included suicidal behavior among peers and family (68%), caregivers with substance problems (62%), and participant substance use history, namely alcohol (91%) and marijuana (88%). Areas of resiliency included lower depression scores (M = 23.1) and cultural activity participation. A multi-tiered intervention at individual, family, and community levels is needed. PMID:25909321

  17. Community-level adult daily smoking prevalence moderates the association between adolescents' cigarette smoking and perceived smoking by friends.

    PubMed

    Thrul, Johannes; Lipperman-Kreda, Sharon; Grube, Joel W; Friend, Karen B

    2014-09-01

    Few studies have investigated the complex interactions among the individual- and community-level social risk factors that underlie adolescents' smoking behaviors. This study investigated whether community-level adult daily smoking prevalence is associated with adolescents' smoking and whether it moderates the associations between perceived friends' smoking approval and smoking behavior and adolescents' own smoking. Self-reported data from 1,190 youths (50.3% female; 13-18 years old) in 50 midsized Californian cities were obtained through telephone interviews. Community characteristics were obtained from 2010 GeoLytics data. Community adult daily smoking prevalence was ascertained from telephone interviews with 8,918 adults conducted in the same 50 cities. Multilevel analyses, controlling for individual and city characteristics, were used to predict adolescents' past 12-month smoking from perceived friends' smoking approval and smoking behavior and from community adult daily smoking prevalence. Results showed that perceived friends' smoking approval and behavior were associated positively with adolescents' smoking, as was the community-level prevalence of adult daily smoking. Furthermore, the association between perceived friends' smoking behavior and adolescents' own smoking was moderated by the prevalence of adult daily smokers in the community. Specifically, the association was stronger in cities with higher prevalence of adult smokers. These results suggest that adult community norms that are more supportive of smoking may enhance the influence of friends' smoking behavior. Therefore, interventions designed to prevent or reduce youths' smoking should also focus on reducing smoking by adults.

  18. Fertility treatment and risk of childhood and adolescent mental disorders: register based cohort study

    PubMed Central

    Mortensen, Erik Lykke; Hvidtjørn, Dorte; Kesmodel, Ulrik Schiøler

    2013-01-01

    Objective To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children. Design Prospective register based cohort study. Setting Nationwide register based information from Danish National Health Registers cross linked by a unique personal identification number assigned to all citizens in Denmark. Participants All children born in Denmark in 1995-2003 with follow-up in 2012 when the children were aged 8-17; 33 139 children were conceived after fertility treatment and 555 828 children were born after spontaneous conception. Main outcome measures Absolute risks and hazard ratios for overall and specific mental disorders estimated with adjustment for potential confounding variables. Estimated association between the risk of mental disorders and subtypes of procedures, hormone treatments, gamete types, and cause of infertility. Results The risk of mental disorders in children born after in vitro fertilisation or intracytoplasmic sperm injection was low, and was no higher than in spontaneously conceived children, except for a borderline significant increased risk of tic disorders (hazard ratio 1.40, 95% confidence interval 1.01 to 1.95; absolute risk 0.3%). In contrast, children born after ovulation induction with or without insemination had low but significantly increased risks of any mental disorder (1.20, 1.11 to 1.31; absolute risk 4.1%), autism spectrum disorders (1.20, 1.05 to 1.37; 1.5%), hyperkinetic disorders (1.23, 1.08 to 1.40; 1.7%), conduct, emotional, or social disorder (1.21, 1.02 to 1.45; 0.8%), and tic disorders (1.51, 1.16 to 1.96; 0.4%). There was no risk systematically related to any specific type of hormone drug treatment. Conclusions There was a small increase in the incidence of mental disorders in children born after ovulation induction/intrauterine insemination. Children born after in vitro fertilisation/intracytoplasmic sperm injection were

  19. Prenatal Exposure to Maternal Cigarette Smoking and DNA Methylation: Epigenome-Wide Association in a Discovery Sample of Adolescents and Replication in an Independent Cohort at Birth through 17 Years of Age

    PubMed Central

    Lee, Ken W.K.; Richmond, Rebecca; Hu, Pingzhao; French, Leon; Shin, Jean; Bourdon, Celine; Reischl, Eva; Waldenberger, Melanie; Zeilinger, Sonja; Gaunt, Tom; McArdle, Wendy; Ring, Susan; Woodward, Geoff; Bouchard, Luigi; Gaudet, Daniel; Smith, George Davey; Relton, Caroline; Paus, Tomas

    2014-01-01

    Background: Prenatal exposure to maternal cigarette smoking (prenatal smoke exposure) had been associated with altered DNA methylation (DNAm) at birth. Objective: We examined whether such alterations are present from birth through adolescence. Methods: We used the Infinium HumanMethylation450K BeadChip to search across 473,395 CpGs for differential DNAm associated with prenatal smoke exposure during adolescence in a discovery cohort (n = 132) and at birth, during childhood, and during adolescence in a replication cohort (n = 447). Results: In the discovery cohort, we found five CpGs in MYO1G (top-ranking CpG: cg12803068, p = 3.3 × 10–11) and CNTNAP2 (cg25949550, p = 4.0 × 10–9) to be differentially methylated between exposed and nonexposed individuals during adolescence. The CpGs in MYO1G and CNTNAP2 were associated, respectively, with higher and lower DNAm in exposed versus nonexposed adolescents. The same CpGs were differentially methylated at birth, during childhood, and during adolescence in the replication cohort. In both cohorts and at all developmental time points, the differential DNAm was in the same direction and of a similar magnitude, and was not altered appreciably by adjustment for current smoking by the participants or their parents. In addition, four of the five EWAS (epigenome-wide association study)–significant CpGs in the adolescent discovery cohort were also among the top sites of differential methylation in a previous birth cohort, and differential methylation of CpGs in CYP1A1, AHRR, and GFI1 observed in that study was also evident in our discovery cohort. Conclusions: Our findings suggest that modifications of DNAm associated with prenatal maternal smoking may persist in exposed offspring for many years—at least until adolescence. Citation: Lee KW, Richmond R, Hu P, French L, Shin J, Bourdon C, Reischl E, Waldenberger M, Zeilinger S, Gaunt T, McArdle W, Ring S, Woodward G, Bouchard L, Gaudet D, Davey Smith G, Relton C, Paus T

  20. Prevalence of purging at age 16 and associations with negative outcomes among girls in three community-based cohorts

    PubMed Central

    Solmi, Francesca; Sonneville, Kendrin R; Easter, Abigail; Horton, Nicholas J; Crosby, Ross D; Treasure, Janet; Rodriguez, Alina; Jarvelin, Marjo-Riitta; Field, Alison E; Micali, Nadia

    2015-01-01

    Background The comorbidity of purging behaviours, such as vomiting, inappropriate use of laxatives, diuretics or slimming medications, has been examined in literature. However, most studies do not include adolescents, individuals who purge in the absence of binge eating, or those purging at subclinical frequency. This study examines the prevalence of purging among 16-year-old girls across three countries and their association with substance use and psychological comorbidity. Methods Data were obtained by questionnaire in 3 population-based cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), United Kingdom, n = 1,608; Growing Up Today Study (GUTS), USA, n = 3,504; North Finland Birth Cohort (NFBC85/86), Finland, n = 2,306). Multivariate logistic regressions were employed to estimate associations between purging and outcomes. Four models were fit adjusting for binge eating and potential confounders of these associations. Results In ALSPAC, 9.7% of girls reported purging in the 12-months prior to assessment, 7.3% in GUTS, and 3.5% in NFBC. In all 3 cohorts, purging was associated with adverse outcomes such as binge drinking (ALSPAC: odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4–2.9; GUTS: OR = 2.5, 95% CI = 1.5–4.0; NFBC: OR = 1.7, 95% CI = 1.0–2.8), drug use (ALSPAC: OR = 2.9, 95% CI = 1.8–4.7; GUTS: OR = 4.5, 95% CI = 2.8–7.3; NFBC: OR = 4.1, 95% CI = 2.6–6.6), depressive symptoms in ALSPAC (OR = 2.2, 95% CI = 1.5–3.1) and GUTS(OR = 3.7, 95% CI = 2.2–6.3), and several psychopathology measures including clinical anxiety/depression in NFBC (OR = 11.2, 95% CI = 3.9, 31.7). Conclusions Results show a higher prevalence of purging behaviours among girls in the United Kingdom compared to those in the United States and Finland. Our findings support evidence highlighting that purging in adolescence is associated with negative outcomes, independent of its frequency and binge eating. PMID:24975817

  1. Community Structural Instability, Anomie, Imitation and Adolescent Suicidal Behavior

    ERIC Educational Resources Information Center

    Thorlindsson, Thorolfur; Bernburg, Jon Gunnar

    2009-01-01

    The current study examines the contextual effects of community structural characteristics, as well as the mediating role of key social mechanisms, on youth suicidal behavior in Iceland. We argue that the contextual influence of community structural instability on youth suicidal behavior should be mediated by weak attachment to social norms and…

  2. Religious Education and Community Involvement among Jewish Adolescents

    ERIC Educational Resources Information Center

    Sasson, Uzi; Sasson, Ayelet

    2009-01-01

    Religious Education is one way to increase and maintain community involvement among teenagers. In many Jewish communities across the United States, participation in religious activities and religious youth movements have decreased. As research in this area is limited, this study sets out to identify the curricula that are more effective in…

  3. Exposure to Community Violence in Adolescence: Trauma Symptoms.

    ERIC Educational Resources Information Center

    Rosenthal, Beth Spenciner

    2000-01-01

    Considerable exposure to recurring community violence with considerable variation in the amount of exposure was found in a sample of 455 first-year students at an urban college. Exposure to recurring community violence was moderately correlated with the manifestation of psychological trauma symptoms. Further, being victimized and witnessing…

  4. Psychological Distress for African-American Adolescent Males: Exposure to Community Violence and Social Support as Factors

    ERIC Educational Resources Information Center

    Paxton, Keisha Carr; Robinson, W. LaVome; Shah, Seema; Schoeny, Michael E.

    2004-01-01

    This study examined exposure to community violence and depressive and post-traumatic stress disorder (PTSD) symptoms within a non-random sample of low-income, African-American male adolescents. The moderating effect of social support on these relationships was also examined. Seventy-seven African-American adolescent males were recruited from an…

  5. Brief Report: The Impact of Attention Deficit Hyperactivity Disorder (ADHD) Symptoms on Academic Performance in an Adolescent Community Sample

    ERIC Educational Resources Information Center

    Birchwood, James; Daley, Dave

    2012-01-01

    Less is understood about the relationship between ADHD symptoms and academic performance in adolescents than the relationship in younger children. As such, the aim of the present study was to investigate the prospective relationship between ADHD symptoms and academic performance in a community adolescent sample. Three hundred and twenty-four…

  6. Effects of Parental Monitoring and Exposure to Community Violence on Antisocial Behavior and Anxiety/Depression among Adolescents

    ERIC Educational Resources Information Center

    Bacchini, Dario; Miranda, Maria Concetta; Affuso, Gaetana

    2011-01-01

    The aim of the research was to investigate the influence of gender, exposure to community violence, and parental monitoring upon antisocial behavior and anxiety/depression in adolescence. Involved in the study were 489 adolescents (290 males and 189 females) from 4 secondary schools in the city of Naples, Italy. The age of participants ranged from…

  7. The Relationship between Anxiety Disorders and Substance Use among Adolescents in the Community: Specificity and Gender Differences

    ERIC Educational Resources Information Center

    Wu, Ping; Goodwin, Renee D.; Fuller, Cordelia; Liu, Xinhua; Comer, Jonathan S.; Cohen, Patricia; Hoven, Christina W.

    2010-01-01

    Using a sample of 781 adolescents (ages 13-17, 52.8% male) from a community survey, this study examined gender differences in the co-occurrence of specific anxiety disorders with substance use in adolescents. The associations between anxiety disorders and substance use differed according to the particular anxiety disorders and forms of substance…

  8. Urban adolescent mothers exposed to community, family, and partner violence: prevalence, outcomes, and welfare policy implications.

    PubMed

    Kennedy, Angie C

    2006-01-01

    The federal welfare reforms of 1996 mandated that all minor adolescent mothers receiving cash assistance must attend school and live at home to receive their cash grant. Though this law has been in place for over 8 years, little research has been done that explores the barriers facing adolescent mothers who try to attend school and live at home. Anecdotal and qualitative evidence from welfare reform evaluation studies suggests that violence may be just such a barrier. This article reviews the recent empirical literature on urban adolescent mothers' exposure to multiple forms of violence. The author delineates and critiques the existing research on the prevalence of and outcomes linked with exposure to community violence, witnessed parental violence, physical abuse within the family, and partner violence among this population. The article concludes with recommendations for researchers, practitioners, and policy makers in light of the reviewed findings.

  9. Population-based cohort study of anti-infective medication use before and after the onset of type 1 diabetes in children and adolescents.

    PubMed

    Fazeli Farsani, Soulmaz; Souverein, Patrick C; van der Vorst, Marja M J; Knibbe, Catherijne A J; de Boer, Anthonius; Mantel-Teeuwisse, Aukje K

    2014-08-01

    A population-based cohort study was conducted in the Dutch PHARMO database to investigate prevalence and patterns of anti-infective medication use in children and adolescents with type 1 diabetes (T1D) before and after the onset of this disease. All patients <19 years with at least 2 insulin prescriptions (1999 to 2009) were identified (T1D cohort) and compared with an age- and sex-matched (ratio: 1 up to 4) diabetes-free reference group. The prevalence and average number of anti-infective use was studied from (up to) 8 years before until a maximum of 4 years after the onset of T1D. A total of 925 patients with T1D and 3,591 children and adolescents in the reference cohort (51% boys, mean age of 10.1 [standard deviation, 4.5] years) were included. The overall prevalence of anti-infective use (62.6 compared to 52.6%, P < 0.001) and average number of prescriptions (2.71 compared to 1.42 per child, P < 0.001) in the T1D cohort were significantly higher than those in the reference cohort after the onset of diabetes. This pattern was consistent across sex and age categories and already observed in the year before the onset of type 1 diabetes. Patients in the T1D cohort received more antibacterials (49.8 compared to 40%, P < 0.001), antimycotics (4.0 compared to 1.3%, P < 0.001), antivirals (2.5 compared to 0.4%, P < 0.001), and second-line antibiotics, such as aminoglycosides, quinolones, and third-generation cephalosporins and carbapenems. Our findings that elevated anti-infective use in the T1D cohort exists in the period before the onset of type 1 diabetes and the consumption of more second-line anti-infective compounds in this time period warrant further research.

  10. Exposure to Violence in the Community Predicts Friendships with Academically Disengaged Peers During Middle Adolescence.

    PubMed

    Schwartz, David; Kelly, Brynn M; Mali, Luiza V; Duong, Mylien T

    2016-09-01

    Adolescents who have been exposed to violence in the community often experience subsequent difficulties with academic achievement. Because competence in the classroom is a salient developmental task during the adolescent years, outcomes in this critical context can then have broader implications for social and psychological functioning. In the current study, we tested a hypothesized progression in which the association between violence exposure and deficient achievement is presumed to potentiate friendships with academically disengaged peers. We followed 415 urban adolescents (53 % girls; average age of 14.6 years) for a one-year period, with two annual assessment of psychosocial functioning. Exposure to violence in the community and academic engagement were assessed with a self-report inventory; reciprocated friendships were assessed with a peer interview; and achievement was indexed based on a review of school records. Consistent with our hypotheses, neighborhood violence was associated with deficient classroom achievement. Poor achievement, in turn, mediated associations between community violence exposure and low academic engagement among friends. Our findings highlight pathways though which exposure to community violence potentially predicts later dysfunction. PMID:27138174

  11. In response to community violence: coping strategies and involuntary stress responses among Latino adolescents.

    PubMed

    Epstein-Ngo, Quyen; Maurizi, Laura K; Bregman, Allyson; Ceballo, Rosario

    2013-01-01

    Among poor, urban adolescents, high rates of community violence are a pressing public health concern. This study relies on a contextual framework of stress and coping to investigate how coping strategies and involuntary stress responses may both mediate and moderate the relation between exposure to community violence and psychological well-being. Our sample consists of 223 ninth grade Latino adolescents from poor, urban families. In response to community violence, these adolescents reported using an array of coping strategies as well as experiencing a number of involuntary stress responses; the most frequent coping responses were turning to religion and seeking social support. Hierarchical regression analyses demonstrated that involuntary stress responses mediated the relations between both witnessing or being victimized by violence and poorer psychological functioning, while coping strategies moderated these relations. These findings suggest that the negative psychological effects of exposure to community violence may, in part, be explained by involuntary stress responses, while religious-based coping may serve as a protective factor.

  12. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents

    PubMed Central

    Bråbäck, Lennart; Åström, Daniel Oudin; Strömgren, Magnus; Forsberg, Bertil

    2016-01-01

    Objective To investigate associations between exposure to air pollution and child and adolescent mental health. Design Observational study. Setting Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. Participants The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221. Main outcome measures Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics. Results The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m3. Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m3 increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected. Conclusion There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others. PMID:27259522

  13. Multiple online victimization of Spanish adolescents: Results from a community sample.

    PubMed

    Montiel, Irene; Carbonell, Enrique; Pereda, Noemí

    2016-02-01

    Little is known about online victimization of Spanish adolescents. The present study aims to determine the past-year prevalence of online victimization in a community sample of Spanish adolescents. The final sample consisted of 3,897 adolescents between 12 and 17 years old (M=14.45, SD=1.59), 1,836 males and 2,049 females, recruited from 39 secondary schools in the east of Spain. The Cuestionario de victimización juvenil mediante internet y/o teléfono móvil (hereinafter, Juvenile Online Victimization Questionnaire, JOV-Q, Montiel & Carbonell, 2012) was applied for the assessment of eight types of online victimization grouped in two major domains: sexual (sexual coercion, sexual pressure, online grooming by an adult, unwanted exposure to sexual content and violation of privacy); and nonsexual victimization (online harassment, happy slapping, pressure to obtain personal information). Sixty-one percent of adolescents reported online victimization during the last year. Online sexual victimization was reported by 39.5% of adolescents and nonsexual victimization by 53.4% of them, whereas 31% of youth reported having experienced online victimization in both domains. The highest prevalence rates were recorded for online harassment (50%), unwanted exposure to sexual content (24.4%), pressure to obtain personal information (18.4%) and online grooming by an adult (17.2%), and the lowest for sexual coercion (6.7%) and happy slapping (2.2%). Thirty-five percent of the adolescents were considered online polyvictims and most of them experienced victimization in both sexual and nonsexual domains (88%). This study illustrates that Spanish adolescents experience high levels of online victimization and that multiple online victimization appears to be the norm among cybervictims. PMID:26724825

  14. Multiple online victimization of Spanish adolescents: Results from a community sample.

    PubMed

    Montiel, Irene; Carbonell, Enrique; Pereda, Noemí

    2016-02-01

    Little is known about online victimization of Spanish adolescents. The present study aims to determine the past-year prevalence of online victimization in a community sample of Spanish adolescents. The final sample consisted of 3,897 adolescents between 12 and 17 years old (M=14.45, SD=1.59), 1,836 males and 2,049 females, recruited from 39 secondary schools in the east of Spain. The Cuestionario de victimización juvenil mediante internet y/o teléfono móvil (hereinafter, Juvenile Online Victimization Questionnaire, JOV-Q, Montiel & Carbonell, 2012) was applied for the assessment of eight types of online victimization grouped in two major domains: sexual (sexual coercion, sexual pressure, online grooming by an adult, unwanted exposure to sexual content and violation of privacy); and nonsexual victimization (online harassment, happy slapping, pressure to obtain personal information). Sixty-one percent of adolescents reported online victimization during the last year. Online sexual victimization was reported by 39.5% of adolescents and nonsexual victimization by 53.4% of them, whereas 31% of youth reported having experienced online victimization in both domains. The highest prevalence rates were recorded for online harassment (50%), unwanted exposure to sexual content (24.4%), pressure to obtain personal information (18.4%) and online grooming by an adult (17.2%), and the lowest for sexual coercion (6.7%) and happy slapping (2.2%). Thirty-five percent of the adolescents were considered online polyvictims and most of them experienced victimization in both sexual and nonsexual domains (88%). This study illustrates that Spanish adolescents experience high levels of online victimization and that multiple online victimization appears to be the norm among cybervictims.

  15. Association of Smoking in Adolescence With Abdominal Obesity in Adulthood: A Follow-Up Study of 5 Birth Cohorts of Finnish Twins

    PubMed Central

    Pietiläinen, Kirsi; Kantonen, Suvi; Rissanen, Aila; Kaprio, Jaakko

    2009-01-01

    Objectives. We studied the association of adolescent smoking with overweight and abdominal obesity in adulthood. Methods. We used the FinnTwin16, a prospective, population-based questionnaire study of 5 consecutive and complete birth cohorts of Finnish twins born between 1975 and 1979 (N = 4296) and studied at four points between the ages of 16 and 27 years to analyze the effect of adolescent smoking on abdominal obesity and overweight in early adulthood. Results. Smoking at least 10 cigarettes daily when aged 16 to 18 years increased the risk of adult abdominal obesity (odds ratio [OR]=1.77; 95% confidence interval [CI] = 1.39, 2.26). After we adjusted for confounders, the OR was 1.44 (95% CI = 1.11, 1.88), and after further adjustment for current body mass index (BMI), the OR was 1.34 (95% CI = 0.95, 1.88). Adolescent smoking significantly increased the risk of becoming overweight among women even after adjustment for possible confounders, including baseline BMI (OR = 1.74; 95% CI = 1.06, 2.88). Conclusions. Smoking is a risk factor for abdominal obesity among both genders and for overweight in women. The prevention of smoking during adolescence may play an important role in promoting healthy weight and in decreasing the morbidity related to abdominal obesity. PMID:19059868

  16. Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study

    PubMed Central

    2013-01-01

    Background Healthcare-associated (HCA) bloodstream infections (BSI) have been associated with worse outcomes, in terms of higher frequencies of antibiotic-resistant microorganisms and inappropriate therapy than strict community-acquired (CA) BSI. Recent changes in the epidemiology of community (CO)-BSI and treatment protocols may have modified this association. The objective of this study was to analyse the etiology, therapy and outcomes for CA and HCA BSI in our area. Methods A prospective multicentre cohort including all CO-BSI episodes in adult patients was performed over a 3-month period in 2006–2007. Outcome variables were mortality and inappropriate empirical therapy. Adjusted analyses were performed by logistic regression. Results 341 episodes of CO-BSI were included in the study. Acquisition was HCA in 56% (192 episodes) of them. Inappropriate empirical therapy was administered in 16.7% (57 episodes). All-cause mortality was 16.4% (56 patients) at day 14 and 20% (71 patients) at day 30. After controlling for age, Charlson index, source, etiology, presentation with severe sepsis or shock and inappropriate empirical treatment, acquisition type was not associated with an increase in 14-day or 30-day mortality. Only an stratified analysis of 14th-day mortality for Gram negatives BSI showed a statically significant difference (7% in CA vs 17% in HCA, p = 0,05). Factors independently related to inadequate empirical treatment in the community were: catheter source, cancer, and previous antimicrobial use; no association with HCA acquisition was found. Conclusion HCA acquisition in our cohort was not a predictor for either inappropriate empirical treatment or increased mortality. These results might reflect recent changes in therapeutic protocols and epidemiological changes in community pathogens. Further studies should focus on recognising CA BSI due to resistant organisms facilitating an early and adequate treatment in patients with CA resistant BSI. PMID

  17. 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

  18. The Music Experiences and Attitudes Of A First Cohort of Prelingually-Deaf Adolescents and Young Adults CI Recipients.

    PubMed

    Gfeller, Kate; Driscoll, Virginia; Smith, Rachel See; Scheperle, Christina

    2012-11-01

    The purpose of this study was to examine the musical engagement (participation and attitude) of pediatric CI recipients who were implanted during early childhood and who have reached age 15 or older. A questionnaire was administered to a group of 31 prelingually deaf CI users who receive annual follow up services and assessment in a clinical research center. The questionnaire was used to examine involvement in and attitudes toward music in school, the community, and in the home; social affiliation (hearing, Deaf, both) and mode of communication (oral, manual, both) were also examined. Despite the technical limitations of cochlear implants in transmitting pitch, melody, and tone quality, over two thirds of this sample described music as being important or very important in their lives. A high level of past and present familial involvement in music was associated with higher levels of current involvement and importance of music in the lives of adolescent and young adult CI users. Comparisons were noted with data from prior studies of persons with hearing loss who were non-CI users. PMID:23565029

  19. The Music Experiences and Attitudes Of A First Cohort of Prelingually-Deaf Adolescents and Young Adults CI Recipients

    PubMed Central

    Gfeller, Kate; Driscoll, Virginia; Smith, Rachel See; Scheperle, Christina

    2012-01-01

    The purpose of this study was to examine the musical engagement (participation and attitude) of pediatric CI recipients who were implanted during early childhood and who have reached age 15 or older. A questionnaire was administered to a group of 31 prelingually deaf CI users who receive annual follow up services and assessment in a clinical research center. The questionnaire was used to examine involvement in and attitudes toward music in school, the community, and in the home; social affiliation (hearing, Deaf, both) and mode of communication (oral, manual, both) were also examined. Despite the technical limitations of cochlear implants in transmitting pitch, melody, and tone quality, over two thirds of this sample described music as being important or very important in their lives. A high level of past and present familial involvement in music was associated with higher levels of current involvement and importance of music in the lives of adolescent and young adult CI users. Comparisons were noted with data from prior studies of persons with hearing loss who were non-CI users. PMID:23565029

  20. Physical Activity Among Adolescents in an East Malaysian Rural Indigenous Community: Exploring the Influence of Neighborhood Environmental Factors.

    PubMed

    Saimon, Rosalia; Choo, Wan Yuen; Chang, Kam Hock; Ng, Chirk Jenn; Bulgiba, Awang

    2015-11-01

    This study explores the rural environmental factors that influence adolescents' participation in physical activities (PA). Thirty-six indigenous adolescents, aged 13 to 17 years from rural communities of East Malaysia were involved in the photovoice procedures: photo-taking, selecting, contextualizing, and codifying themes. Despite being endowed with natural resources such as river, forest, hills, and so on, the adolescents and the community did not capitalize on these rich resources to promote and engage in PA. Poor maintenance of natural resources, the lack of pedestrian infrastructures and road safety, the lack of PA facilities, and negative perception of ancestors' agricultural activities were among factors that constrained adolescents' PA. Although basic amenities such as play spaces and pedestrian infrastructures are necessary to increase adolescents' PA, any intervention should make the most of the natural resources, which are cheaper, environment friendly, and sustainable.

  1. 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

  2. Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

    PubMed Central

    Kirby, Kimberly C.; Versek, Brian; Kerwin, MaryLouise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia; Meyers, Robert J.

    2013-01-01

    We describe a project focused on training parents to facilitate their treatment-resistant adolescent’s treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however, there are no controlled trials for parents with a substance-abusing child. We examined the behavioral parent training literature to guide us in tailoring CRAFT for parents of adolescents. We discuss adaptations to CRAFT, outcomes and experiences gained from a brief pilot of the revised CRAFT program, and the future directions of this work. PMID:25883523

  3. Adolescents' Views of Guns in a High-Violence Community

    ERIC Educational Resources Information Center

    Black, Sally; Hausman, Alice

    2008-01-01

    Firearms account for the majority of deaths among young Black men in America. This article presents a qualitative investigation of youth temptations, emotional reactions, and subsequent behavior with respect to guns. Twenty-three youth enrolled in a community-based firearm reduction program have participated in interviews on retrospective…

  4. An assessment of community capacity to prevent adolescent alcohol consumption.

    PubMed

    Williams, Rebecca J; Kittinger, Daniela Spoto; Ta, Van M; Nihoa, Wendy K; Payne, Christine; Nigg, Claudio R

    2012-09-01

    To effectively address the issue of youth alcohol use, communities need to have sufficient infrastructure and capacity in place to operate effective prevention programs. This study evaluates community capacity in the state of Hawai'i, using the Capacity Assessment Survey administered to stakeholders in the youth alcohol prevention system. Capacity is quantified with gap scores, which measure the discrepancy between an agency's performance of an attribute and the attribute's relative importance. Six assessment areas, termed capacity domains, are defined. Results are given for each county and the state overall. Based on these results, communities need to prioritize capacity-building efforts specifically in the domains of effectiveness, funding/resource availability, and sustainability. Organization, workforce skills/knowledge, and cultural competency were categorized as relative strengths in comparison, but gap scores are nevertheless significantly greater than 0 ("ideal"; p < .001), indicating these areas need improvement as well. Suggestions for improvement in each capacity domain are given. This assessment is the first step in a five-step planning process to implement youth alcohol prevention programs in communities in Hawai'i. PMID:22467663

  5. Teacher Efficacy and Rural Community Transition for Adolescents with Disabilities.

    ERIC Educational Resources Information Center

    Gold, Veronica

    In the past decade, disappointing national outcomes have been reported regarding the transition of youth with disabilities to community and work environments. The transition outlook is even more dismal for rural youth with disabilities, in light of geographic barriers to special education service delivery, lack of jobs in rural areas, and rural…

  6. Adolescent self-control behavior predicts body weight through the life course: a prospective birth cohort study

    PubMed Central

    Koike, S; Hardy, R; Richards, M

    2016-01-01

    Background: Weight gain has become one of the biggest issues for healthy aging in middle- and high-income countries. Self-control of emotional reward cues is an important behavioral factor for regulation of weight gain through voluntary diet control and physical activity. Methods: We tested the associations between teacher-rated self-control at ages 13 and 15 years, and measured body mass index (BMI) between ages 15 and 60–64 years, controlling for confounding factors such as affective symptoms and cognition, using 3873 study members in the Medical Research Council National Survey of Health and Development, also known as the British 1946 birth cohort. Results: Multivariable regression analysis after adjustment for all covariates showed that lower self-control was associated with higher BMI in all measure points (P<0.05). Multilevel modeling using a cubic model showed that there was an association between self-control and BMI at 15 years in females (male: BMI=−0.00 kg m−2 per 1 s.d. on the self-control score (95% confidence interval (CI): −0.12 to 0.11), P =0.94; female: BMI=−0.27 (−0.42 to −0.11), P<0.001). The association became stronger with age in both sexes (BMI=−0.065 (−0.082 to −0.048), P<0.001; BMI=−0.036 (−0.057 to −0.015), P<0.001). By age 60–64 years, the association between self-control and BMI in men had increased to −0.70 (−0.96 to −0.44) and −0.67 (−1.04 to −0.30) in women. Conclusions: Lower adolescent self-control was associated with higher BMI through the life course, and this becomes stronger with age. Investigations to test whether intervention to self-control improves obesity are recommended. PMID:26449420

  7. Linking physical education with community sport and recreation: a program for adolescent girls.

    PubMed

    Casey, Meghan; Mooney, Amanda; Eime, Rochelle; Harvey, Jack; Smyth, John; Telford, Amanda; Payne, Warren

    2013-09-01

    The engagement of adolescent girls in physical activity (PA) is a persistent challenge. School-based PA programs have often met with little success because of the lack of linkages between school and community PA settings. The Triple G program aimed to improve PA levels of secondary school girls (12-15 years) in regional Victoria, Australia. The program included a school-based physical education (PE) component that uniquely incorporated student-centered teaching and behavioral skill development. The school component was conceptually and practically linked to a community component that emphasized appropriate structures for participation. The program was informed by ethnographic fieldwork to understand the contextual factors that affect girls' participation in PA. A collaborative intervention design was undertaken to align with PE curriculum and coaching and instructional approaches in community PA settings. The theoretical framework for the intervention was the socioecological model that was underpinned by both individual-level (social cognitive theory) and organizational-level (building organizational/community capacity) strategies. The program model provides an innovative conceptual framework for linking school PE with community sport and recreation and may benefit other PA programs seeking to engage adolescent girls. The objective of this article is to describe program development and the unique theoretical framework and curriculum approaches.

  8. Sports, smoking, and overweight during adolescence as predictors of sciatica in adulthood: a 28-year follow-up study of a birth cohort.

    PubMed

    Rivinoja, Anni E; Paananen, Markus V; Taimela, Simo P; Solovieva, Svetlana; Okuloff, Annaleena; Zitting, Paavo; Järvelin, Marjo-Riitta; Leino-Arjas, Päivi; Karppinen, Jaro I

    2011-04-15

    Lifestyle factors such as smoking, obesity, and level of physical activity predict low back pain (LBP) and sciatica. The authors investigated whether participating in sports, smoking, and being overweight or obese at 14 years of age predicted hospitalizations due to LBP or sciatica in adulthood. In 1980, at the age of 14 years, a total of 11,399 members of the 1966 Northern Finland Birth Cohort returned the postal questionnaire. Patients from the 1966 Northern Finland Birth Cohort who were hospitalized because of LBP or sciatica were followed to the end of 2008 through the Finnish Hospital Discharge Register. Data were analyzed using Cox's proportional hazards multistate model with the Markov clock forward time scale. During follow-up, 119 females (2.7%) and 254 males (5.6%) had been hospitalized at least once because of LBP or sciatica. Among females, overweight was associated with an increased risk of second-time hospitalization for surgical treatment for sciatica (hazard ratio = 7.1, 95% confidence interval: 1.5, 34.4). Among males, smoking was associated with an increased risk of first-time nonsurgical hospitalization (hazard ratio = 1.8, 95% confidence interval: 1.2, 2.7) and second-time surgical hospitalization (hazard ratio = 3.2, 95% confidence interval: 1.2, 8.2). The authors found potentially modifiable risk factors in adolescence that predicted hospital treatments for low back disorders during adolescence and young adulthood.

  9. Methods for a longitudinal cohort of refugee children in a regional community in Australia

    PubMed Central

    Zwi, Karen; Rungan, Santuri; Woolfenden, Susan; Williams, Katrina; Woodland, Lisa

    2016-01-01

    Purpose Few studies explore the long-term health and well-being of refugee children. A longitudinal cohort of refugee children was created to determine health and well-being outcomes over time. This article describes the methodology used to conduct this study, including sample characteristics and effectiveness of recruitment and retention strategies. Participants Newly arrived refugee children settling in a regional part of Australia aged 6 months to 15 years were recruited between 2009 and 2013 and 85% were followed for an average of 31 months. Method and design General practitioners conducted health and pathology examinations shortly after arrival. Additional follow-up assessments were conducted by the research team at an average of 13 months after arrival for the first (year 2) and 31 months for the second (year 3) assessment. Children under 5 years had developmental and children aged 4–17 years had social–emotional screening. Families were assessed for risk and protective factors using a structured interview and the Social Readjustment Ratings Scale. Parent experience of the research was explored. Findings to date Eligibility criteria were met by 158 of 228 (69%) newly arrived children, 61 of whom (39%) were enrolled. Retention was 100% (n=61) at year 2 and 85% at year 3. The study sample was younger than and had an over-representation of African refugees as compared to the eligible population. Parents reported that the research was respectful. Future plans This study demonstrates that a longitudinal cohort study in refugee children is feasible and acceptable, and retention rates can be high. The establishment of this cohort provides the opportunity to analyse valuable data about the early settlement experience, risk and protective factors and long-term health and well-being outcomes in refugee children. These are necessary to identify refugee children in need of additional support and to guide future service delivery. PMID:27558902

  10. Community variation in adolescent access to indoor tanning facilities.

    PubMed

    Olson, Ardis L; Carlos, Heather A; Sarnoff, Rachel A

    2013-04-01

    Melanoma rates among younger women in New Hampshire (NH) are rising. In urban studies, youth proximity to tanning facilities has been linked to indoor tanning, a proven cause of melanoma. Youth access has not been examined in rural settings. To determine on a statewide basis the influence of rurality and community income level on female students' ease of access to tanning facilities, all NH tanning facilities (N = 261) and high schools (N = 77) in 2011 were spatially and statistically analyzed to determine schools with more facilities within 2 miles of the school and greater capacity (fewer female students per facility), for indoor tanning. Schools above the state-wide average for both measures were classified as "Easy Access" to indoor tanning. Among NH high schools, 74 % have 1 or more tanning facility within two miles and 22 % have "Easy Access" to tanning facilities. Ease of access did not differ by rurality. Lower-income school status was an independent predictor of both greater capacity and "Easy Access". While urban and rural teens have similar access to indoor tanning, female students in lower-income communities have easier access. Variations in access by community size and income must be considered in planning interventions to address youth indoor tanning.

  11. Evaluation of the Environmental Supports Scale with a Community Sample of Adolescents.

    PubMed

    Risco, Cristina M; Collado, Anahi D; Reynolds, Elizabeth K; Lejuez, Carl W; MacPherson, Laura

    2016-05-01

    Environmental sources of psychosocial support have been found to modulate or protect against the development of psychopathology and risk behavior among adolescents. Capturing sources of environmental support across multiple developmental contexts requires the availability of well-validated, concise assessments-of which there are few in the existing literature. In order to address this need, the current study explored the factor structure, concurrent and convergent validity of the Environmental Supports Scale (ESS; Genetic, Social, and General Psychology Monographs, 117; 395-417, 1991) with a community sample of adolescents. An unconstrained exploratory factor analysis revealed a separate factor for home, school, and neighborhood settings. Internal consistency and test-retest reliability were evaluated for each factor. Concurrent and predictive validity analyses revealed that the ESS was associated in the expected directions across a range of constructs relevant to adolescent development including internalizing symptoms, well-being, external influences, and engagement in risk behavior. Convergent validity for the neighborhood context was established with an assessment of neighborhood environmental adversity. A brief assessment of perceived environmental support across key developmental contexts provides an important tool for research on resilience processes during adolescence and may help illuminate key protective factors and inform intervention and prevention efforts.

  12. Early intervention in pertussis outbreak with high attack rate in cohort of adolescents with complete acellular pertussis vaccination in Valencia, Spain, April to May 2015.

    PubMed

    Miguez Santiyan, A; Ferrer Estrems, R; Chover Lara, J L; Alberola Enguidanos, J; Nogueira Coito, J M; Salazar Cifre, A

    2015-07-09

    Forty-three pertussis cases reported in May 2015 in Valencia were linked to a school outbreak where 90% of the students had been vaccinated. Cases were diagnosed upon paediatrician consultation and in hospital emergency units. Approximately half of the cases were students born in 2002, the first age cohort with complete shift to acellular pertussis vaccine. Public health intervention, visiting school premises to conduct interviews, sample collection and early antibiotic prophylaxis stopped further spread in the community.

  13. Linking community, parenting, and depressive symptom trajectories: testing resilience models of adolescent agency based on race/ethnicity and gender.

    PubMed

    Williams, Amanda L; Merten, Michael J

    2014-09-01

    Family stress models illustrate how communities affect youth outcomes through effects on parents and studies consistently show the enduring effects of early community context. The present study takes a different approach identifying human agency during adolescence as a potentially significant promotive factor mediating the relationship between community, parenting, and mental health. While agency is an important part of resilience, its longitudinal effects are unknown, particularly based on gender and race/ethnicity. The purpose of this research was to model the long-term effects of community structural adversity and social resources as predictors of adolescent depressive symptom trajectories via indirect effects of parental happiness, parent-child relationships, and human agency. Latent growth analyses were conducted with 1,796 participants (53% female; 56% White) across four waves of the National Longitudinal Study of Adolescent Health spanning adolescence (Wave 1) through adulthood (Wave 4). The results identified agency as an important promotive factor during adolescence with long-term mental health benefits, but only for White and male participants. For these individuals, community social resources and the quality of the parent-child relationship were related to higher levels of agency and more positive mental health trajectories. Although community social resources similarly benefitted parenting and agency among females and non-White participants, there were no significant links between agency and depressive symptoms for these youth. The results suggest that agency remains an important, but poorly understood concept and additional work is necessary to continue unpacking its meaning for diverse groups of youth. PMID:24907892

  14. Linking community, parenting, and depressive symptom trajectories: testing resilience models of adolescent agency based on race/ethnicity and gender.

    PubMed

    Williams, Amanda L; Merten, Michael J

    2014-09-01

    Family stress models illustrate how communities affect youth outcomes through effects on parents and studies consistently show the enduring effects of early community context. The present study takes a different approach identifying human agency during adolescence as a potentially significant promotive factor mediating the relationship between community, parenting, and mental health. While agency is an important part of resilience, its longitudinal effects are unknown, particularly based on gender and race/ethnicity. The purpose of this research was to model the long-term effects of community structural adversity and social resources as predictors of adolescent depressive symptom trajectories via indirect effects of parental happiness, parent-child relationships, and human agency. Latent growth analyses were conducted with 1,796 participants (53% female; 56% White) across four waves of the National Longitudinal Study of Adolescent Health spanning adolescence (Wave 1) through adulthood (Wave 4). The results identified agency as an important promotive factor during adolescence with long-term mental health benefits, but only for White and male participants. For these individuals, community social resources and the quality of the parent-child relationship were related to higher levels of agency and more positive mental health trajectories. Although community social resources similarly benefitted parenting and agency among females and non-White participants, there were no significant links between agency and depressive symptoms for these youth. The results suggest that agency remains an important, but poorly understood concept and additional work is necessary to continue unpacking its meaning for diverse groups of youth.

  15. Iron status and dietary iron intake of adolescents from a rural community in Sabah, Malaysia.

    PubMed

    Foo, Leng Huat; Khor, Geok Lin; Tee, E-Siong; Prabakaran, Dhanaraj

    2004-01-01

    Iron deficiency anaemia (IDA) is the most prevalent micronutrient deficiency in the world affecting the general health and wellbeing of millions. In Malaysia, moderately high prevalences of anaemia have been reported amongst infants, young children and women of childbearing age. Data is scant for the adolescents. This study was undertaken to assess the iron status and dietary intake of 165 adolescents, comprising 74 male and 91 female subjects, aged 12 to 19 years, from the rural communities in Tuaran District of Sabah, Malaysia. Convenience sampling was used for the selection of study subjects. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV) and haemoglobin (Hb) were determined for the study. The mean age of the subjects was 15.2 +/-2.1 years. While the majority of the subjects (77.6%) had normal body mass index (BMI) values, 17.6% were underweight and 4.8% overweight. About 35% to 40% of the subjects showed deficient values for haematocrit, serum ferritin, serum iron, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and transferrin saturation (TS), and 20% were anaemic (Hb <12 g/L). Using the multiple criteria of iron status indicators, the prevalence of iron depletion, iron deficiency and IDA in the male and female adolescents were 5.4% vs. 6.6%, 18.9% vs. 26.4% and 5.4% vs. 26.4%, respectively. Iron deficiency anaemia (85.0%) contributed largely to the prevalence of anaemia. The dietary iron intake of the adolescents was unsatisfactory, with approximately 98% of subjects failing to meet the Malaysian RDA level. Almost all the female subjects (91%) had dietary iron intake below two-thirds of the RDA level compared with a much smaller proportion for the male adolescents (68%). The prevalence of IDA in the present study population, especially in the female adolescents, appears to be a significant public health problem. Priority should therefore be given to the eradication of

  16. Community-based palliative care is associated with reduced emergency department use by people with dementia in their last year of life: A retrospective cohort study

    PubMed Central

    Spilsbury, Katrina; Arendts, Glenn; McNamara, Bev; Semmens, James

    2015-01-01

    Objective: To describe patterns in the use of hospital emergency departments in the last year of life by people who died with dementia and whether this was modified by use of community-based palliative care. Design: Retrospective population-based cohort study of people in their last year of life. Time-to-event analyses were performed using cumulative hazard functions and flexible parametric proportional hazards regression models. Setting/participants: All people living in Western Australia who died with dementia in the 2-year period 1 January 2009 to 31 December 2010 (dementia cohort; N = 5261). A comparative cohort of decedents without dementia who died from other conditions amenable to palliative care (N = 2685). Results: More than 70% of both the dementia and comparative cohorts attended hospital emergency departments in the last year of life. Only 6% of the dementia cohort used community-based palliative care compared to 26% of the comparative cohort. Decedents with dementia who were not receiving community-based palliative care attended hospital emergency departments more frequently than people receiving community-based palliative care. The magnitude of the increased rate of emergency department visits varied over the last year of life from 1.4 (95% confidence interval: 1.1–1.9) times more often in the first 3 months of follow-up to 6.7 (95% confidence interval: 4.7–9.6) times more frequently in the weeks immediately preceding death. Conclusions: Community-based palliative care of people who die with or of dementia is relatively infrequent but associated with significant reductions in hospital emergency department use in the last year of life. PMID:25783598

  17. All Kids Are Our Kids: What Communities Must Do To Raise Caring and Responsible Children and Adolescents.

    ERIC Educational Resources Information Center

    Benson, Peter L.

    This book challenges American communities to reclaim their responsibility for raising healthy, successful, and caring children and adolescents. The book also offers a critique of American culture along with practical strategies for uniting and mobilizing communities around a shared vision of healthy development. The book argues that three…

  18. A Healthy Harvest: Adolescents Grow Food and Well-Being with Policy Implications for Education, Health and Community Planning

    ERIC Educational Resources Information Center

    Pevec, Illene Susan

    2011-01-01

    The severe youth health crisis involving overweight and obesity requires a complex policy response involving multiple domains: education, agriculture, health services, and community planning. This research examines gardening's affective benefits for adolescents and the potential school and youth gardens have to support healthy communities.…

  19. Social Support Factors as Moderators of Community Violence Exposure Among Inner-City African American Young Adolescents

    ERIC Educational Resources Information Center

    Hammack, Phillip L.; Richards, Maryse H.; Luo, Zupei; Edlynn, Emily S.; Roy, Kevin

    2004-01-01

    Using both surveys and the experience sampling method (ESM), community violence exposure, social support factors, and depressive and anxiety symptoms were assessed longitudinally among inner-city African American adolescents. Moderator models were tested to determine protective factors for youth exposed to community violence. Several social…

  20. Two-Year Community: The Impact of the Clinical Social Worker in a Community College Biotech Program: A Cohort Study

    ERIC Educational Resources Information Center

    Tanski, Anne E.; Bobick, Sandra; Mosley-Turner, Katherine; Garofalo, Giovanni

    2016-01-01

    Given biotechnology's emergence as a major competitor in the Pittsburgh region, critically linking education to industry through the Community College of Allegheny County's Biotechnology Workforce Collaborative (BWC) provided a well-trained workforce. The collaborative also sought to increase the number of women in the sciences, specifically…

  1. Intergenerational concepts of adolescent sexuality: implications for community-based reproductive health care with Haitian immigrants.

    PubMed

    DeSantis, L; Thomas, J T; Sinnett, K

    1999-04-01

    Intergenerational conflict occurs when immigrant parents hold different values from those of their more rapidly acculturating offspring. These conflicts frequently involve disparate views related to sex roles and reproduction. A community-based study of 19 immigrant Haitian parent-adolescent pairs in South Florida compared their attitudes and values about sexuality and reproduction. Data were obtained through focused, open-ended interviews. Content analysis procedures at the level of words and phrases facilitated the categorization of responses. Data revealed considerable differences between parents and adolescents about the sources and types of information learned about reproduction and contraception, when such information is learned, and expectations regarding premarital sexual intercourse. Both parents and adolescents lacked accurate biomedical information about contraception, placed responsibility for contraceptive use primarily on the female partner, considered reproduction a natural rather than a medical event, and believed parents have the major responsibility for educating children about reproduction and contraception. Implications for culturally-appropriate health care center on increasing the role of the public health nurse in health education, minimizing intergenerational and intercultural conflict, and engaging the Haitian immigrant community in the promotion of reproductive health. PMID:10319660

  2. Adolescent Family Factors Promoting Healthy Adult Functioning: A Longitudinal Community Study

    PubMed Central

    Paradis, Angela D.; Giaconia, Rose M.; Reinherz, Helen Z.; Beardslee, William R.; Ward, Kirsten E.; Fitzmaurice, Garrett M.

    2010-01-01

    Background Although long-held wisdom and current research suggests that accepting and supportive family relationships may positively influence adult psychosocial functioning, few studies have prospectively investigated these associations. This study examined whether positive family factors during adolescence are associated with healthy adult functioning. Method The 353 participants were part of a single-age cohort whose psychosocial development has been prospectively traced. Two aspects of family functioning - feeling highly valued as a family member and having a family confidant - were measured at age 15. Developmentally-relevant areas of functioning were assessed at age 30. Results Both positive family factors were predictive of adaptive adult functioning across several domains, including mental health and social/interpersonal functioning. Conclusions Findings provide evidence about the salient relationships between positive family relationships and later healthy functioning. PMID:21532965

  3. The impact of multimorbidity on short-term events in patients with community-acquired pneumonia: prospective cohort study.

    PubMed

    Weir, D L; Majumdar, S R; McAlister, F A; Marrie, T J; Eurich, D T

    2015-03-01

    The impact of multimorbidity on patients with community-acquired pneumonia has not been well characterised. Thus, our aim was to explore the relationship between multimorbidity and adverse events within 90 days of discharge. Data were prospectively collected for a population-based cohort of all adults discharged from any of the seven emergency departments (ED) or six hospitals in Edmonton (Alberta, Canada) with community-acquired pneumonia. Multivariable Cox regression models were used to examine the independent association between multimorbidity (defined as two or more chronic conditions) and subsequent 90-day mortality, hospitalisation, or ED visits after treatment of pneumonia. The cohort included 5565 patients, mean age was 57 years (SD 20), 54% were male, and 59% were treated as outpatients; 1602 (29%) patients had multimorbidity. Within 90 days, 255 (5%) patients died, 1205 (22%) were hospitalised, 1280 (23%) died or were hospitalised, and 2049 (37%) were admitted to the ED. The presence of multimorbidity was independently associated with an increased risk of death or hospitalisation within 90 days (37% vs. 17% for those without multimorbidity, adjusted hazard ratio: 1.43, 95% confidence interval: 1.26 to 1.62) as well as ED visits (45% vs. 34%, adjusted hazard ratio: 1.40, 95% confidence interval: 1.26 to 1.56). Multimorbidity was present in one-third of all patients with pneumonia in our study, and it was independently associated with death, hospitalisation, or return to ED within 90 days of discharge. Our findings suggest that multimorbidity is strongly related to prognosis and should be considered when making site-of-care decisions in the ED or deciding upon readiness for discharge.

  4. Cohort study of smoke-free homes in economically disadvantaged communities in the Dominican Republic

    PubMed Central

    Dozier, Ann M.; Diaz, Sergio; Guido, Joseph; de Monegro, Zahira Quiñones; McIntosh, Scott; Fisher, Susan G.; Ossip, Deborah J.

    2015-01-01

    Objective To analyze household smoking bans over time and predictors of bans among communities in the Dominican Republic, historically a significant tobacco-growing country with few tobacco control regulations. Methods Baseline (2004) and follow-up surveillance surveys (2006, 2007) (each n > 1 000 randomly selected households) conducted in six economically disadvantaged communities (three tobacco-growing and two each urban, peri-urban, and rural) assessed household members’ demographics, health status, and household characteristics, including smoking restrictions. Results Between 2004 and 2007, household smoking-ban prevalence increased in all communities (24%–45%). Households with smokers (versus those without) adopted bans at lower rates (6%–17%; 35%–58%). Logistic regression models demonstrated that allowing smoking in nonsmoking households was more likely in tobacco-growing communities, Catholic households, and those with a member with a cardiovascular problem. Having a child under age 5 or a member with a respiratory condition was not significantly related to establishing smoking bans. Conclusions Prevalence of households banning smoking increased in all communities but remained well below rates in industrialized countries. For low- and middle-income countries or those early in tobacco control, small awareness-raising measures (including surveillance activities) may lead to significant increases in household-ban adoption, particularly among nonsmoking households. Increasing household-ban prevalence may affect community norms that can lead to greater adoption. Having household members who smoke and being in a tobacco-growing community may mitigate the establishment of household bans. Increasing individuals’ knowledge about the far-reaching health effects of secondhand smoke exposure on children and nonsmoking adults (healthy or unhealthy) may help overcome these obstacles. PMID:24626445

  5. Variation in Sexual Behaviors in a Cohort of Adolescent Females: The Role of Personal, Perceived Peer and Family Attitudes

    PubMed Central

    Gold, Melanie A.; Bost, James E.; Adimora, Ada A.; Orr, Donald P.; Fortenberry, J. Dennis

    2010-01-01

    Purpose Little is known about how adolescent sexual behaviors develop and the influence of personal or perceived social attitudes. We sought to describe how personal, perceived peer and perceived family attitudes towards adolescent sexual activity influences adolescent females’ sexual behaviors over time. Methods Between 1999–2006, 358 English-speaking females, aged 14–17 were recruited from three urban adolescent clinics. Participants completed quarterly and annual questionnaires over 4 years. Primary outcomes were engagement in eight sexual behaviors: kissing, having breasts or genitals touched, touching partners’ genitals, and oral (giving or receiving), anal, or vaginal sex. Three attitudinal scales assessed personal importance of abstinence, perceived peer beliefs about when to have sex and perceived family beliefs that adolescent sex is negative.. We used generalized estimating equations to identify predictors of each sexual behavior and compared whether personal, perceived peer or perceived family attitudes predicted sexual behaviors over time. Results The odds of reporting each sexual behavior increased with age but were lower among those whose personal or perceived family attitudes were less positive. Participants’ personal attitudes towards adolescent sex were the strongest predictor of engagement in all eight sexual behaviors even after controlling for perceived peer and perceived family attitudes. Conclusions Female adolescent’s personal attitudes towards abstinence appear to be the strongest predictor of engagement in a variety of sexual behaviors. Efforts to influence adolescent attitudes towards abstinence may be an important approach to reducing sexual behaviors that increase the risk for pregnancy and sexually transmitted infections. PMID:21185529

  6. Submaximal fitness and mortality risk reduction in coronary heart disease: a retrospective cohort study of community-based exercise rehabilitation

    PubMed Central

    Taylor, Claire; Tsakirides, Costas; Moxon, James; Moxon, James William; Dudfield, Michael; Witte, Klaus K; Ingle, Lee; Carroll, Sean

    2016-01-01

    Objectives To examine the association between submaximal cardiorespiratory fitness (sCRF) and all-cause mortality in a cardiac rehabilitation (CR) cohort. Design Retrospective cohort study of participants entering CR between 26 May 1993 and 16 October 2006, followed up to 1 November 2013 (median 14 years, range 1.2–19.4 years). Setting A community-based CR exercise programme in Leeds, West Yorkshire, UK. Participants A cohort of 534 men (76%) and 136 women with a clinical diagnosis of coronary heart disease (CHD), aged 22–82 years, attending CR were evaluated for the association between baseline sCRF and all-cause mortality. 416 participants with an exercise test following CR (median 14 weeks) were examined for changes in sCRF and all-cause mortality. Main outcome measures All-cause mortality and change in sCRF expressed in estimated metabolic equivalents (METs). Results Baseline sCRF was a strong predictor of all-cause mortality; compared to the lowest sCRF group (<5 METs for women and <6 METs for men), mortality risk was 41% lower in those with moderate sCRF (HR 0.59; 95% CI 0.42 to 0.83) and 60% lower (HR 0.40; 95% CI 0.25 to 0.64) in those with higher sCRF levels (≥7 METs women and ≥8 METs for men). Although improvement in sCRF at 14 weeks was not associated with a significant mortality risk reduction (HR 0.91; 95% CI 0.79 to 1.06) for the whole cohort, in those with the lowest sCRF (and highest all-cause mortality) at baseline, each 1-MET improvement was associated with a 27% age-adjusted reduction in mortality risk (HR 0.73; 95% CI 0.57 to 0.94). Conclusions Higher baseline sCRF is associated with a reduced risk of all-cause mortality over 14 years in adults with CHD. Improving fitness through exercise-based CR is associated with significant risk reduction for the least fit. PMID:27363816

  7. The experience of adolescent inpatient care and the anticipated transition to the community: Young people's perspectives.

    PubMed

    Gill, Freya; Butler, Stephen; Pistrang, Nancy

    2016-01-01

    This study explored adolescents' perspectives of inpatient mental health care, focussing on aspects of the inpatient environment they anticipated would help or hinder their transition back home. Semi-structured interviews were conducted with 12 adolescent inpatients; transcripts were analysed thematically. Participants experienced inpatient treatment as offering a mix of benefits (e.g., supportive relationships) and drawbacks (e.g., living in a "fake world"). They anticipated the transition home as providing opportunities for personal growth and consolidation of new coping skills, but also posing challenges concerning re-entering the "real world" after the experience of being "wrapped in cotton wool". Self-determination theory and attachment theory offer two potential frameworks for understanding these opportunities and challenges. Inpatient care has the potential to foster key mechanisms for adaptive development, creating a platform for developing positive future behaviours. Community teams should work closely with inpatient units to support the generalisation of the young person's newly acquired coping skills. PMID:26599528

  8. 3:00 TO 6:00 P.M.: Young Adolescents at Home and in the Community. [With] an Annotated Bibliography.

    ERIC Educational Resources Information Center

    Lefstein, Leah M.; And Others

    This collection of four articles focuses on the needs of and services for young adolescents in the after-school hours. In "Young Adolescents and Their Communities: A Shared Responsibility," William Kerewsky and Leah M. Lefstein discuss the physical, intellectual, emotional, and social development of young adolescents. Elliot A. Medrich, in "Time…

  9. Medically Significant Infections Are Increased in Patients With Juvenile Idiopathic Arthritis Treated With Etanercept: Results From the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study

    PubMed Central

    Davies, Rebecca; Southwood, Taunton R.; Kearsley‐Fleet, Lianne; Lunt, Mark

    2015-01-01

    Objective The association between anti–tumor necrosis factor therapy and increased rates of infection is widely documented in adults with rheumatoid arthritis. Findings in children with juvenile idiopathic arthritis (JIA) have been less well documented. The aims of this analysis were to compare the rates of medically significant infections (MSIs) in children with JIA treated with etanercept (ETN) versus methotrexate (MTX) and to compare the rates between combination therapy with ETN plus MTX and monotherapy with ETN. Methods A total of 852 ETN‐treated children and 260 MTX‐treated children had been recruited to the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR‐ETN). MSIs included infections that resulted in death or hospitalization or were deemed medically significant by the clinician. This on‐drug analysis followed the patients until the first MSI, treatment discontinuation, the last followup, or death. Cox proportional hazards models, which were adjusted using propensity deciles, were used to compare rates of MSI between cohorts. Sensitivity analyses were conducted specifically with regard to serious infections (SIs), which were defined as those requiring hospitalization or treatment with intravenous antibiotics/antivirals. Results The ETN‐treated cohort was older and had a longer disease duration, but the disease activity was similar between the cohorts. A total of 133 first MSIs were reported (109 with ETN and 24 with MTX). Patients receiving ETN had higher rates of MSI than did the controls (propensity decile adjusted hazard ratio 2.13 [95% confidence interval 1.22–3.74]). The risk of MSI was higher whether patients were receiving combination or monotherapy. Sensitivity analysis showed no between‐group difference in the rate of SIs, which were much less common. Conclusion ETN therapy is associated with an increased risk of MSI; however, this increased risk disappears when considering only SIs, which

  10. Why do Families of Sick Newborns Accept Hospital Care? A Community-Based Cohort Study in Karachi, Pakistan

    PubMed Central

    Owais, Aatekah; Sultana, Shazia; Stein, Aryeh D.; Bashir, Nasira H.; Awaldad, Razia; Zaidi, Anita K M

    2011-01-01

    Objective Sick young infants are at high risk of mortality in developing countries but families often decline hospital referral. Our objective was to identify the predictors of acceptance of referral for hospital care among families of severely ill newborns and infants <59 days old in three low-income communities of Karachi, Pakistan. Study design A cohort of 541 newborns and infants referred from home by community health workers doing household surveillance, and diagnosed with a serious illness at local community clinics between January 1 and December 31, 2007, was followed-up within 1 month of referral to the public hospital. Results Only 24% of families accepted hospital referral. Major reasons for refusal were financial difficulties (67%) and father/elder denying permission (65%). Religious/cultural beliefs were cited by 20% of families. Referral acceptance was higher with recognition of severity of the illness by mother (OR=12.7; 95% CI=4.6–35.2), family’s ability to speak the dominant language at hospital (OR=2.0; 95% CI=1.3–3.1), presence of grunting in the infant (OR=3.3; 95% CI=1.2–9.0), and infant temperature <35.5°C (OR=4.1; 95% CI=2.3–7.4). No gender differential was observed. Conclusion Refusal of hospital referral for sick young infants is very common. Interventions that encourage appropriate care seeking, as well as community-based management of young infant illnesses when referral is not feasible are needed to improve neonatal survival in low-income countries. PMID:21273989

  11. Long-term outcomes in adolescents perinatally infected with HIV-1 and followed up since birth in the French perinatal cohort (EPF/ANRS CO10).

    PubMed

    Dollfus, C; Le Chenadec, J; Faye, A; Blanche, S; Briand, N; Rouzioux, C; Warszawski, J

    2010-07-15

    BACKGROUND. Increasing numbers of children perinatally infected with human immunodeficiency virus (HIV) are reaching adolescence, largely because of advances in treatment over the past 10 years, but little is known about their current health status. We describe here the living conditions and clinical and immunovirologic outcomes at last evaluation among this pioneering generation of adolescents who were born before the introduction of prophylaxis for vertical transmission and whose infections were diagnosed at a time when treatment options were limited. METHODS. The eligible population consisted of HIV-1-infected children who were born before December 1993 and who were included at birth in the prospective national French Perinatal Cohort (EPF/ANRS CO10). RESULTS. Of the 348 eligible children, 210 (60%; median age, 15 years) were still alive and regularly followed up. Current treatment was highly active antiretroviral therapy (HAART) in 77% and 2 nucleoside analogues in 5.0%; 16% had stopped treatment, and 2% had never been treated. The median CD4 cell count was 557 cells/microL, and 200 cells/microL was exceeded in 94% of patients. The median viral load was 200 copies/mL. Viral load was undetectable in 43% of the adolescents and in 54.5% of those receiving HAART. Median height, weight, and body mass index were similar to French reference values for age, and school achievement was similar to nationwide statistics. Better immunologic status was associated with being younger and with having begun HAART earlier. Undetectable viral load was associated with maternal geographic origin and current HAART. CONCLUSIONS. Given the limited therapeutic options available during the early years of these patients' lives and the challenge presented by treatment adherence during adolescence, the long-term outcomes among this population are encouraging. PMID:20536367

  12. Adolescents' health and health behaviour as predictors of injury death. A prospective cohort follow-up of 652,530 person-years

    PubMed Central

    Mattila, Ville M; Parkkari, Jari; Koivusilta, Leena; Nummi, Tapio; Kannus, Pekka; Rimpelä, Arja

    2008-01-01

    Background Injuries represent an important cause of mortality among young adults. Longitudinal studies on risk factors are scarce. We studied associations between adolescents' perceived health and health behaviour and injury death. Methods A prospective cohort of 57,407 Finns aged 14 to 18 years was followed for an average of 11.4 years. The end-point of study was injury death or termination of follow-up in 2001. The relationships of eight health and health behaviour characteristics with injury death were studied with adjusted Cox's proportional hazard model. Results We identified 298 (0.5%) injury deaths, 232 (0.9%) in men and 66 (0.2%) in women. The mean age at death was 23.8 years. In the models adjusted for age, sex and socioeconomic background, the strongest risk factors for injury death were recurring drunkenness (HR 2.1; 95% CI: 1.4–3.1) and daily smoking (HR 1.7; 95% CI: 1.3–2.2). Poor health did not predict injury death. Unintentional and intentional injury deaths had similar health and health behavioural risk factors. Conclusion Health compromising behaviour adopted at adolescence has a clear impact on the risk of injury death in adulthood independent from socioeconomic background. On the other hand, poor health as such is not a significant predictor of injury death. Promotion of healthy lifestyle among adolescents as part of public health programmes would seem an appropriate way to contribute to adolescent injury prevention. PMID:18366651

  13. Predictive ability and stability of adolescents' pregnancy intentions in a predominantly Latino community.

    PubMed

    Rocca, Corinne H; Hubbard, Alan E; Johnson-Hanks, Jennifer; Padian, Nancy S; Minnis, Alexandra M

    2010-09-01

    Using data from a prospective cohort of 555 adolescent girls and boys from a predominantly Latino neighborhood of San Francisco, we examined how well four survey questionnaire items measuring pregnancy intentions predicted the incidence of pregnancy. We also compared consistency of responses among items and assessed how intentions fluctuated over time. Girls experienced 72 pregnancies over two years (six-month cumulative incidence = 8 percent), and boys reported being responsible for 50 pregnancies (six-month cumulative incidence = 10 percent). Although the probability of becoming pregnant generally increased with higher intention to do so, the risk of becoming pregnant was elevated only at the highest response categories for each item. Most pregnancies occurred among teenagers reporting the lowest levels of intention: for instance, 73 percent of pregnancies occurred among girls who reported that they definitely did not want to become pregnant. Considerable change in respondents' intentions were found over short periods of time: 18 percent and 41 percent of responses to the wantedness and happiness items, respectively, changed between six-month survey visits. The development of appropriate strategies to reduce pregnancy among adolescents would benefit from a more nuanced understanding of how teenagers view the prospect of pregnancy and what determines whether they actively protect themselves from unintended pregnancy. PMID:21469271

  14. How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment

    PubMed Central

    2014-01-01

    Background The Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health. A preliminary analysis of the data, unexpectedly, revealed that the influence of the physical environment on adolescent health was a dominant theme across every site examined. To explore this further, this paper analyzed the specific components of the physical environment that were perceived to influence health, and how they contributed to various health outcomes across sites. Methods Researchers in each site conducted in-depth interviews among adolescents; community mapping and focus groups among adolescents; a Photovoice methodology, in which adolescents were trained in photography and took photos of the meaning of ‘health’ in their communities; and key informant interviews among adults who work with young people. A total 529 participants from across the sites were included in the analysis. Results Findings showed that while there was surprising uniformity in how adolescents characterized their physical environment, perceived health outcomes related to the physical environment varied by site and gender. In Baltimore and Johannesburg, vacant homes and the lack of recreation facilities were perceived to impact on sexual and reproductive health problems for girls, while among boys they contributed to drugs and violence. In Shanghai, New Delhi, and Ibadan, garbage and trash observed in their communities were perceived to have a higher impact on infectious and chronic diseases. Conclusions As the world continues to urbanize, our study points to a strong need to examine how the physical aspects of a living environment contribute to the health of adolescents. Specific aspects, such as housing, safety, garbage, and recreational spaces must all be examined as possible pathways for making improvements to health of adolescents

  15. Social Media Use in Research: Engaging Communities in Cohort Studies to Support Recruitment and Retention

    PubMed Central

    Farina-Henry, Eva; Blaisdell, Laura L

    2015-01-01

    Background This paper presents the first formal evaluation of social media (SM) use in the National Children’s Study (NCS). The NCS is a prospective, longitudinal study of the effects of environment and genetics on children’s health, growth and development. The Study employed a multifaceted community outreach campaign in combination with a SM campaign to educate participants and their communities about the Study. SM essentially erases geographic differences between people due to its omnipresence, which was an important consideration in this multi-site national study. Using SM in the research setting requires an understanding of potential threats to confidentiality and privacy and the role that posted content plays as an extension of the informed consent process. Objective This pilot demonstrates the feasibility of creating linkages and databases to measure and compare SM with new content and engagement metrics. Methods Metrics presented include basic use metrics for Facebook as well as newly created metrics to assist with Facebook content and engagement analyses. Results Increasing Likes per month demonstrates that online communities can be quickly generated. Content and Engagement analyses describe what content of posts NCS Study Centers were using, what content they were posting about, and what the online NCS communities found most engaging. Conclusions These metrics highlight opportunities to optimize time and effort while determining the content of future posts. Further research about content analysis, optimal metrics to describe engagement in research, the role of localized content and stakeholders, and social media use in participant recruitment is warranted. PMID:26201259

  16. Signs or Symptoms of Acute HIV Infection in a Cohort Undergoing Community-Based Screening.

    PubMed

    Hoenigl, Martin; Green, Nella; Camacho, Martha; Gianella, Sara; Mehta, Sanjay R; Smith, Davey M; Little, Susan J

    2016-03-01

    We analyzed signs and symptoms in 90 patients diagnosed with acute HIV infection in a community-based program that offered universal HIV-1 nucleic acid amplification testing. Forty-seven (52%) patients reported ongoing signs or symptoms at the time of testing. Another 25 (28%) reported signs or symptoms that had occurred during the 14 days before testing.

  17. Macrolide-resistant Mycoplasma pneumoniae in adolescents with community-acquired pneumonia

    PubMed Central

    2012-01-01

    Background Although the prevalence of macrolide-resistant Mycoplasma pneumoniae isolates in Japanese pediatric patients has increased rapidly, there have been no reports concerning macrolide-resistant M. pneumoniae infection in adolescents aged 16 to 19 years old. The purpose of this study was to clarify the prevalence and clinical characteristics of macrolide-resistant M. pneumoniae in adolescent patients with community-acquired pneumonia. Methods A total of 99 cases with M. pneumoniae pneumonia confirmed by polymerase chain reaction (PCR) and culture were analyzed. Forty-five cases were pediatric patients less than 16 years old, 26 cases were 16 to 19-year-old adolescent patients and 28 cases were adult patients. Primers for domain V of 23S rRNA were used and DNA sequences of the PCR products were compared with the sequence of an M. pneumoniae reference strain. Results Thirty of 45 pediatric patients (66%), 12 of 26 adolescent patients (46%) and seven of 28 adult patients (25%) with M. pneumoniae pneumonia were found to be infected with macrolide-resistant M. pneumoniae (MR patients). Although the prevalence of resistant strains was similar in pediatric patients between 2008 and 2011, an increase in the prevalence of resistant strains was observed in adolescent patients. Among 30 pediatric MR patients, 26 had an A-to-G transition at position 2063 (A2063G) and four had an A-to-G transition at position 2064 (A2064G). In 12 adolescent MR patients, 10 showed an A2063G transition and two showed an A2064G transition, and in seven adult MR patients, six showed an A2063G transition and one showed an A2064G transition. Conclusions The prevalence of macrolide-resistant M. pneumoniae is high among adolescent patients as well as pediatric patients less than 16-years old. To prevent outbreaks of M. pneumoniae infection, especially macrolide-resistant M. pneumoniae, in closed populations including among families, in schools and in university students, physicians should pay

  18. Interruptions of antiretroviral therapy in children and adolescents with HIV infection in clinical practice: a retrospective cohort study in the USA

    PubMed Central

    Rakhmanina, Natella; Lam, Kam S; Hern, Jaclyn; Young, Heather A; Walters, Alex; Castel, Amanda D

    2016-01-01

    Introduction Changes in combination antiretroviral therapy (cART) throughout childhood challenge the continuity of paediatric HIV treatment. This study aimed to evaluate the prevalence of treatment interruption (TI), including lamivudine (3TC) monotherapy, and the relationship of TI to virologic and immunologic parameters in HIV-infected paediatric patients. Methods Nested within a prospective observational study of a city-wide cohort of HIV-infected persons in the District of Columbia, this sub-study collected retrospective data on antiretroviral therapy, enrolment (endpoint) and historic (lifelong) CD4 counts and HIV RNA viral load (VL) of the paediatric cohort. TI was defined as interruption of cART ≥4 consecutive weeks. Data on TI, including 3TC monotherapy TI (MTI), were collected. Descriptive statistics and univariate testing were used to compare children with TI and MTI to children on continuous treatment (CT). Results Thirty-eight (28%) out of 136 enrolled children (median age=12.9 years) experienced TI, with 14 (37%) of those placed on 3TC MTI. Significantly lower endpoint median CD4 counts (598 cells/mm3 vs. 815 cells/mm3; p=0.003) and CD4% (27.5% vs. 33%; p=0.006) were observed in the TI cohort as compared to the CT cohort. The median endpoint VL in the overall TI cohort was ~4 times higher than among the CT cohort (1427 copies/mL vs. 5581 copies/mL; p<0.0001). After a median TI duration of one year, a majority (n=31; 82%) of patients with TI restarted cART, including 100% of those with total TI and 53% of those on MTI, respectively. Conclusions In our study, we observed high frequency of the TI in HIV in paediatric HIV clinical practice. All TIs, including 3TC MTI, were associated with significantly lower endpoint median CD4 counts and higher median VLs, as compared to CT in paediatric patients. The high frequency of TI and associated poor outcomes suggest a need for a better strategy in managing the course of the paediatric and adolescent cART. PMID

  19. Community participation for transformative action on women's, children's and adolescents' health.

    PubMed

    Marston, Cicely; Hinton, Rachael; Kean, Stuart; Baral, Sushil; Ahuja, Arti; Costello, Anthony; Portela, Anayda

    2016-05-01

    The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. We outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals.

  20. Adolescents' Educational Outcomes in a Social Ecology of Parenting, Family, and Community Risks in Northern Ireland

    PubMed Central

    Goeke-Morey, Marcie C.; Taylor, Laura K.; Cairns, Ed; Merrilees, Christine E.; Shirlow, Peter; Cummings, E. Mark

    2015-01-01

    This study examines the influence of social ecological risks within the domains of parenting, family environment, and community in the prediction of educational outcomes for 770 adolescents (49% boys, 51% girls, M = 13.6 years, SD = 2.0) living in a setting of protracted political conflict, specifically working class areas of Belfast, Northern Ireland. Controlling for religious community, age, and gender, youths' lower academic achievement was associated with family environments characterized by high conflict and low cohesion. School ehaviour problems were related to greater exposure to community violence, or sectarian and nonsectarian antisocial behaviour. Youths' expectations about educational attainment were undermined by conflict in the family environment and antisocial behaviour in the community, as well as parenting low in warmth and behavioural control. Findings underscore the importance of considering family and community contributions to youths' educational outcomes. Suggestions regarding targeted interventions toward promoting resilience are discussed, such as assessing both child and family functioning, developing multidimensional interventions for parents, and building community partnerships, among others. PMID:26834298

  1. Neck circumference predicts renal function decline in overweight women: A community-based prospective cohort study.

    PubMed

    Yoon, Chang-Yun; Park, Jung Tak; Jhee, Jong Hyun; Kee, Youn Kyung; Seo, Changhwan; Lee, Misol; Cha, Min-Uk; Jung, Su-Young; Park, Seohyun; Yun, Hae-Ryong; Kwon, Young Eun; Oh, Hyung Jung; Han, Seung Hyeok; Yoo, Tae-Hyun; Kang, Shin-Wook

    2016-09-01

    Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated.The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ≥23 kg/m. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m or the development of proteinuria.The mean patient age was 36.3 ± 3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P < 0.001; women, P = 0.009) and diabetes (men, P = 0.002; women, P < 0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, eGFR was significantly lower only in male subjects of the big NC group (P < 0.001), whereas it was comparable between the small and big NC groups (P = 0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1 cm increase, hazard ratio [95% confidence interval] = 1.159 [1.024-1.310], P = 0.019) but not in male subjects.NC is independently associated with the development of CKD in overweight female subjects, suggesting

  2. Preventing adolescent tobacco use and assisting young people to quit: population-, community-, and individually focused evidence-based interventions.

    PubMed

    Hackbarth, Diana P

    2012-03-01

    Tobacco use among adolescents is declining in the United States but remains a major public health problem in the United States and globally. The Healthy People 2020 model of determinants of health is useful in understanding the complex interaction of factors that help explain adolescent smoking-related behaviors. Nurses are well positioned to take leadership roles in health care settings, schools, and their own communities as well as at the state, national, and global levels in advocating for policies that prevent and treat adolescent tobacco use and the subsequent burden of disease in future populations.

  3. Behavioral and community correlates of adolescent pregnancy and Chlamydia rates in rural counties in Minnesota.

    PubMed

    Kozhimannil, Katy B; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

    2015-06-01

    Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Pregnancy and chlamydia infection rates among 15-19 year-old females were compared across Minnesota's 87 counties, stratified by rural/urban designations. Regression models for rural counties (n = 66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study. PMID:25344773

  4. Behavioral and community correlates of adolescent pregnancy and Chlamydia rates in rural counties in Minnesota.

    PubMed

    Kozhimannil, Katy B; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

    2015-06-01

    Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Pregnancy and chlamydia infection rates among 15-19 year-old females were compared across Minnesota's 87 counties, stratified by rural/urban designations. Regression models for rural counties (n = 66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study.

  5. Attachment as a mediator between community violence and posttraumatic stress symptoms among adolescents with a history of maltreatment.

    PubMed

    London, Melissa J; Lilly, Michelle M; Pittman, Laura

    2015-04-01

    Experiences that are detrimental to the attachment relationship, such as childhood maltreatment, may reduce feelings of safety among survivors and exacerbate the effects of exposure to subsequent violence, such as witnessing community violence. Though attachment style has been examined in regard to posttraumatic stress in adults who have a history of exposure to violence in childhood, less is known about the influence of attachment on the relationship between exposure to violence and posttraumatic stress symptoms in children and adolescents. The current study aimed to explore the role of attachment in the link between exposure to community violence and posttraumatic stress symptoms in adolescents with a history of childhood abuse. Participants included adolescents (aged 15-18 years) who had a history of maltreatment (N=75) and a matched sample without a childhood abuse history (N=78) from the National Data Archive on Child Abuse and Neglect (Salzinger, Feldman, & Ng-Mak, 2008). A conditional process model using bootstrapping to estimate indirect effects showed a significant indirect effect of insecure attachment on the relationship between exposure to community violence and posttraumatic stress symptoms for adolescents with a history of childhood physical abuse, but not for adolescents without this history. Implications for a cumulative risk model for post-trauma pathology starting in adolescence are discussed.

  6. Neuropathological associates of multiple cognitive functions in two community-based cohorts of older adults.

    PubMed

    Dowling, N Maritza; Tomaszewski Farias, Sarah; Reed, Bruce R; Sonnen, Joshua A; Strauss, Milton E; Schneider, Julie A; Bennett, David A; Mungas, Dan

    2011-07-01

    Studies of neuropathology-cognition associations are not common and have been limited by small sample sizes, long intervals between autopsy and cognitive testing, and lack of breadth of neuropathology and cognition variables. This study examined domain-specific effects of common neuropathologies on cognition using data (N = 652) from two large cohort studies of older adults. We first identified dimensions of a battery of 17 neuropsychological tests, and regional measures of Alzheimer's disease (AD) neuropathology. We then evaluated how cognitive factors were related to dimensions of AD and additional measures of cerebrovascular and Lewy Body disease, and also examined independent effects of brain weight. All cognitive domains had multiple neuropathology determinants that differed by domain. Neocortical neurofibrillary tangles were the strongest predictors of most domains, while medial temporal tangles showed a weaker relationship with episodic memory. Neuritic plaques had relatively strong effects on multiple domains. Lewy bodies and macroscopic infarcts were associated with all domains, while microscopic infarcts had more limited associations. Brain weight was related to all domains independent of specific neuropathologies. Results show that cognition is complexly determined by multiple disease substrates. Neuropathological variables and brain weight contributed approximately a third to half of the explained variance in different cognitive domains. PMID:21092373

  7. The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged children

    PubMed Central

    Lambert, Stephen B; Allen, Kelly M; Carter, Robert C; Nolan, Terence M

    2008-01-01

    Background Acute respiratory illnesses (ARIs) during childhood are often caused by respiratory viruses, result in significant morbidity, and have associated costs for families and society. Despite their ubiquity, there is a lack of interdisciplinary epidemiologic and economic research that has collected primary impact data, particularly associated with indirect costs, from families during ARIs in children. Methods We conducted a 12-month cohort study in 234 preschool children with impact diary recording and PCR testing of nose-throat swabs for viruses during an ARI. We used applied values to estimate a virus-specific mean cost of ARIs. Results Impact diaries were available for 72% (523/725) of community-managed illnesses between January 2003 and January 2004. The mean cost of ARIs was AU$309 (95% confidence interval $263 to $354). Influenza illnesses had a mean cost of $904, compared with RSV, $304, the next most expensive single-virus illness, although confidence intervals overlapped. Mean carer time away from usual activity per day was two hours for influenza ARIs and between 30 and 45 minutes for all other ARI categories. Conclusion From a societal perspective, community-managed ARIs are a significant cost burden on families and society. The point estimate of the mean cost of community-managed influenza illnesses in healthy preschool aged children is three times greater than those illnesses caused by RSV and other respiratory viruses. Indirect costs, particularly carer time away from usual activity, are the key cost drivers for ARIs in children. The use of parent-collected specimens may enhance ARI surveillance and reduce any potential Hawthorne effect caused by compliance with study procedures. These findings reinforce the need for further integrated epidemiologic and economic research of ARIs in children to allow for comprehensive cost-effectiveness assessments of preventive and therapeutic options. PMID:18215329

  8. Incident sexually transmitted infections and their risk factors in an Aboriginal community in Australia: a population based cohort study

    PubMed Central

    Miller, P; Law, M; Torzillo, P; Kaldor, J

    2001-01-01

    website extra Extended tables can be found on the STI website www.sextransinf.com Objective: To identify risk factors for incident sexually transmitted infections (STI) in a remote Aboriginal community in Australia. Design: A population based cohort study. Setting: An Aboriginal community in central Australia. Participants: 1034 Aboriginal people aged 12–40 years, resident in the study region, seen during the period 1 January 1996 to 30 June 1998 for STI diagnosis. Main outcome measures: Incident rate of gonorrhoea, chlamydia, and syphilis per 100 person years. Results: There were 313 episodes of incident gonorrhoea, 240 of incident chlamydial infection, and 17 of incident syphilis. For gonorrhoea, risk factors were age, substance abuse, and previous prevalent chlamydial infection with a rate ratio (RR) of 3.2 in people aged 15–19 years, 1.6 in people who abused alcohol, and 3.2 in women who had sniffed petrol on a regular basis. For chlamydia, risk factors were sex, age, and a previous history of STI with a RR of 2.7 in people aged 15–19 years. Similar factors were associated with an increased risk of syphilis but the associations were not statistically significant. Conclusion: This study identified objective predictors of incident STI which can be used to target interventions and maximise their impact. The results of this study may well have relevance to indigenous communities in other countries that are faced with high levels of STI and substance abuse. Key Words: Aborigines; sexually transmitted infections; risk factors; Australia PMID:11158687

  9. Factors associated with cell phone use in adolescents in the community of Madrid (Spain).

    PubMed

    Sánchez-Martínez, Mercedes; Otero, Angel

    2009-04-01

    The purpose of this research is to measure cell phone use among high school adolescents and the factors associated with intensive cell phone use (depressive symptoms, social isolation, drug and alcohol use, school failure, and cell phone dependence). We conducted a cross-sectional survey study of 1,328 adolescents aged 13 to 20 years in nine secondary schools of the Community of Madrid between January to April 2007. The mean age of sample participants was 15.7 years. Almost all (96.5%) had their own cell phone (80.5% had one, and 15.9% had two or more). Some 54.8% take it to school and 46.1% keep it on during class; 41.7% use it intensively. The estimated prevalence of cell phone dependence was 20% (26.1% in females, 13% in males). Intensive cell phone use was associated with female sex, rural school location, good family economy, smoking tobacco, excessive alcohol consumption, depression, cell phone dependence, and school failure. More health education is needed to promote correct and effective cell phone use among adolescents. Factors associated with intensive use and dependence should be considered for possible intervention activities. PMID:19072078

  10. Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

    PubMed Central

    2010-01-01

    Background There is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso. Study objectives To measure the perinatal mortality rate (PNMR) in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death. Methods We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR) and early neonatal mortality rate (ENMR). We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death. Results 895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99), 54 per 1000 (95% CI: 38-69) and 27 per 1000 (95% CI: 9-44), respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0), primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9), twins (RR = 4.0, 95% CI: 2.3-6.9) and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3) were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre Conclusion Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country. PMID:20716352

  11. Relation of QRS duration to mortality in a community-based cohort with hypertrophic cardiomyopathy.

    PubMed

    Bongioanni, Sergio; Bianchi, Francesca; Migliardi, Alessandro; Gnavi, Roberto; Pron, Paolo Giay; Casetta, Marzia; Conte, Maria Rosa

    2007-08-01

    A prolonged QRS duration on the standard electrocardiogram is associated with an increased risk of cardiovascular death in cardiomyopathies of different origin. However, the relation between QRS duration and prognosis in hypertrophic cardiomyopathy (HC) remains undefined. We assessed the relation between QRS duration and cardiovascular death in 241 consecutive patients with HC. The study cohort was divided into 2 groups according to QRS duration: <120 and > or =120 ms. Of the 241 patients, 191 (79%) had a QRS duration <120 ms and 50 (21%) a QRS duration > or =120 ms. During a mean follow-up of 7.9 +/- 5.1 years, 35 patients died of cardiovascular causes related to HC. Of these 35 patients, 13 (6%) had a QRS duration <120 ms and 22 (43%) had a QRS duration > or =120 ms (p <0.01). Risk of cardiovascular death was significantly higher in patients with a QRS duration > or =120 ms than in those with a QRS duration <120 ms (relative risk 5.2, p <0.0001). At 8-year follow-up, cumulative risks of HC-related death were 7.1% in patients with a QRS duration <120 ms and 55% in those with a QRS duration > or =120 ms. Multivariate analysis confirmed that a QRS duration > or =120 ms was independently associated with an increased risk of cardiovascular death (hazard ratio 3.2, p = 0.007). New York Heart Association functional class III/IV was the only other clinical variable significantly and independently associated with an increased risk of cardiovascular death. In conclusion, in patients with HC, QRS duration on standard electrocardiogram is directly related to cardiovascular mortality, and a QRS duration > or =120 ms is a strong and independent predictor of prognosis.

  12. Following young people with perinatal HIV infection from adolescence into adulthood: the protocol for PHACS AMP Up, a prospective cohort study

    PubMed Central

    Tassiopoulos, Katherine; Patel, Kunjal; Alperen, Julie; Kacanek, Deborah; Ellis, Angela; Berman, Claire; Allison, Susannah M; Hazra, Rohan; Barr, Emily; Cantos, Krystal; Siminski, Suzanne; Massagli, Michael; Bauermeister, Jose; Siddiqui, Danish Q; Puga, Ana; Van Dyke, Russell; Seage, George R

    2016-01-01

    Introduction The first generation of adolescents born with HIV infection has reached young adulthood due to advances in treatment. It is important to continue follow-up of these individuals to assess their long-term medical, behavioural and mental health and ability to successfully transition to adulthood while coping with a chronic, potentially stigmatising condition. To accomplish this, and to maintain their interest in long-term research participation, we need to accommodate the changing lifestyles and interests of young adult study participants while ensuring valid data collection. We report the protocol for Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) Up, a prospective cohort study enrolling young adult participants for long-term follow-up. Methods and analysis AMP Up is recruiting 850 young men and women 18 years of age and older—600 perinatally HIV-infected and a comparison group of 250 perinatally HIV-exposed, uninfected—at 14 clinical research sites in the USA and Puerto Rico. Recruitment began in April 2014 and is ongoing, with 305 participants currently enrolled. Planned follow-up is ≥6 years. Data are collected with a flexible hybrid of online and in-person methods. Outcomes include: transition to adult clinical care and retention in care; end-organ diseases; malignancies; metabolic complications; sexually transmitted infections; reproductive health; mental health and neurocognitive functioning; adherence to antiretroviral treatment; sexual behaviour and substance use; hearing and language impairments; and employment and educational achievement. Ethics and dissemination The study received ethical approval from the Harvard T.H. Chan School of Public Health's institutional review board (IRB), and from the IRBs of each clinical research site. All participants provide written informed consent; for cognitively impaired individuals with legally authorised representatives, legal guardian permission and participant assent

  13. Process and outcome evaluation of a community intervention for orphan adolescents in western Kenya.

    PubMed

    Hallfors, Denise D; Cho, Hyunsan; Mbai, Isabella; Milimo, Benson; Itindi, Janet

    2012-10-01

    We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area in rural western Kenya to test whether providing young orphan adolescents with uniforms, school fees, and community visitors improves school retention and reduces HIV risk factors. The trial was a community intervention, limited to one community. In this paper, we examined intervention implementation and its association with outcomes using longitudinal data. We used both quantitative and qualitative methods to evaluate the community-based model for orphan HIV prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE analyses showed null effects after 2 years. Volunteer community visitors, a key element of the intervention, showed little of the expected effect although qualitative reports documented active assistance to prevent orphans' school absence. For future research, we recommend capturing the transition to high school, a larger sample size, and biomarker data to add strength to the research design. We also recommend a school-based intervention approach to improve implementation and reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving school attendance and preventing dropout because of their unique ability to address critical biopsychosocial problems. PMID:22350730

  14. The burden of severe asthma in childhood and adolescence: results from the paediatric U-BIOPRED cohorts.

    PubMed

    Fleming, Louise; Murray, Clare; Bansal, Aruna T; Hashimoto, Simone; Bisgaard, Hans; Bush, Andrew; Frey, Urs; Hedlin, Gunilla; Singer, Florian; van Aalderen, Wim M; Vissing, Nadja H; Zolkipli, Zaraquiza; Selby, Anna; Fowler, Stephen; Shaw, Dominick; Chung, Kian Fan; Sousa, Ana R; Wagers, Scott; Corfield, Julie; Pandis, Ioannis; Rowe, Anthony; Formaggio, Elena; Sterk, Peter J; Roberts, Graham

    2015-11-01

    U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches. A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53 preschoolers with mild/moderate wheeze in a cross-sectional study. Despite high-dose treatment, the severe cohorts had more severe exacerbations compared with the mild/moderate ones (annual medians: school-aged 3.0 versus 1.1, preschool 3.9 versus 1.8; p<0.001). Exhaled tobacco exposure was common in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), was worse in the severe cohorts (mean±se school-age PAQLQ: 4.77±0.15 versus 5.80±0.19; preschool PACQLQ: 4.27±0.18 versus 6.04±0.18; both p≤0.001); however, mild/moderate cohorts also had significant morbidity. Impaired quality of life was associated with poor control and airway obstruction. Otherwise, the severe and mild/moderate cohorts were clinically very similar. Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life that is associated with poor control and airflow limitation: a very different phenotype from adult severe asthma. In-depth phenotyping of these children, integrating clinical data with high-dimensional biomarkers, may help to improve and tailor their clinical management.

  15. Expanding the vision: the strengths-based, community-oriented child and adolescent psychiatrist working in schools.

    PubMed

    Kriechman, Avron; Salvador, Melina; Adelsheim, Steven

    2010-01-01

    Because the majority of children with mental health needs are most likely to receive treatment in a school setting, there is a long history of linking child and adolescent psychiatrists to schools. Psychiatrists traditionally have been involved in assessing, diagnosing, and treating the severely mentally ill or consulting with school-based providers. With no end in sight to the dearth of child and adolescent psychiatrists, not to mention child and adolescent behavioral health providers in other disciplines, this role has been broadened in recent years by several programs in which the child and adolescent psychiatrist provides flexible, population-based, systemic, and context-specific approaches to working in schools. In this article, the authors first review some of the traditional roles for child and adolescent psychiatrists working in school mental health settings. Then 2 national programs are highlighted, which successfully integrate psychiatrist trainees into comprehensive school mental health programs. The theoretical approach to a specific community-oriented, strengths-based model for school mental health support used in New Mexico by the University of New Mexico (UNM) Psychiatry Department's Center for Rural and Community Behavioral Health school telepsychiatry program, which supports rural and frontier school mental health programs and school-based health centers, is discussed in detail. The UNM model involves a strength-and resiliency-based collaboration between the child and adolescent psychiatrist, students, families, educators, and those who support them. The psychiatrist co-creates a "community of concern" and support for students, including not only customary participants such as parents, educators, and health care providers but also peers, families of choice, lay professionals, community gatekeepers, and others identified by the student as critical to his or her well-being. The advantages for child and adolescent psychiatry trainees being exposed to

  16. Barriers and enablers for participation in healthy lifestyle programs by adolescents who are overweight: a qualitative study of the opinions of adolescents, their parents and community stakeholders

    PubMed Central

    2014-01-01

    Background Overweight or obesity during adolescence affects almost 25% of Australian youth, yet limited research exists regarding recruitment and engagement of adolescents in weight-management or healthy lifestyle interventions, or best-practice for encouraging long-term healthy behaviour change. A sound understanding of community perceptions, including views from adolescents, parents and community stakeholders, regarding barriers and enablers to entering and engaging meaningfully in an intervention is critical to improve the design of such programs. Methods This paper reports findings from focus groups and semi-structured interviews conducted with adolescents (n?=?44), parents (n?=?12) and community stakeholders (n?=?39) in Western Australia. Three major topics were discussed to inform the design of more feasible and effective interventions: recruitment, retention in the program and maintenance of healthy change. Data were analysed using content and thematic analyses. Results Data were categorised into barriers and enablers across the three main topics. For recruitment, identified barriers included: the stigma associated with overweight, difficulty defining overweight, a lack of current health services and broader social barriers. The enablers for recruitment included: strategic marketing, a positive approach and subsidising program costs. For retention, identified barriers included: location, timing, high level of commitment needed and social barriers. Enablers for retention included: making it fun and enjoyable for adolescents, involving the family, having an on-line component, recruiting good staff and making it easy for parents to attend. For maintenance, identified barriers included: the high degree of difficulty in sustaining change and limited services to support change. Enablers for maintenance included: on-going follow up, focusing on positive change, utilisation of electronic media and transition back to community services. Conclusions This study

  17. Association of socioeconomic status change between infancy and adolescence, and blood pressure, in South African young adults: Birth to Twenty Cohort

    PubMed Central

    Adair, Linda S; Pisa, Pedro T; Griffiths, Paula L; Pettifor, John M; Norris, Shane A

    2016-01-01

    Objective Social epidemiology models suggest that socioeconomic status (SES) mobility across the life course affects blood pressure. The aim of this study was to investigate the association between SES change between infancy and adolescence, and blood pressure, in young adults, and the impact of early growth on this relationship. Setting Data for this study were obtained from a ‘Birth to Twenty’ cohort in Soweto, Johannesburg, in South Africa. Participants The study included 838 Black participants aged 18 years who had household SES measures in infancy and at adolescence, anthropometry at 0, 2, 4 and 18 years of age and blood pressure at the age of 18 years. Methods We computed SES change using asset-based household SES in infancy and during adolescence as an exposure variable, and blood pressure and hypertension status as outcomes. Multivariate linear and logistic regressions were used to investigate the associations between SES change from infancy to adolescence, and age, height and sex-specific blood pressure and hypertension prevalence after adjusting for confounders. Results Compared to a persistent low SES, an upward SES change from low to high SES tertile between infancy and adolescence was significantly associated with lower systolic blood pressure (SBP) at the age of 18 years (β=−4.85; 95% CI −8.22 to −1.48; p<0.01; r2=0.1804) after adjusting for SES in infancy, small-for-gestational-age (SGA) and weight gain. Associations between SES change and SBP were partly explained by weight gain between birth and the age of 18 years. There was no association between SES mobility and diastolic blood pressure, mean arterial pressure or hypertension status. Conclusions Our study confirms that upward SES change has a protective effect on SBP by the time participants reach young adulthood. Socioeconomic policies and interventions that address inequality may have the potential to reduce cardiovascular disease burden related to BP in later life. PMID

  18. Bullying behavior in relation to psychiatric disorders and physical health among adolescents: a clinical cohort of 508 underage inpatient adolescents in Northern Finland.

    PubMed

    Luukkonen, Anu-Helmi; Räsänen, Pirkko; Hakko, Helinä; Riala, Kaisa

    2010-06-30

    The aim was to investigate the association of bullying behavior with psychiatric disorders and physical health in a sample of adolescent psychiatric patients, as there have to our knowledge been no previous studies using actual psychiatric diagnoses examining this relationship in boys and girls. We studied 508 Finnish adolescents (age 12-17) admitted to psychiatric inpatient care between April 2001 and March 2006 from the geographically large area of Northern Finland. The Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime (K-SADS-PL) was used to obtain psychiatric diagnoses of adolescents according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and information on bullying behavior. Logistic regression analyses showed that having an externalizing disorder increased the likelihood of being a bully or a bully-victim (i.e. a person who is both a bully and a victim of bullying) among both the boys (odds ratio, OR=14.4, P=0.001) and the girls (OR=10.0, P<0.001). In addition, having an internalizing disorder increased the likelihood of being a victim of bullying among the boys (OR=3.4, P=0.008), but not the girls. Chronic somatic diseases were also significantly associated with being bullied among the boys (OR=2.5, P=0.041). Our results suggest that adolescents who are involved in bullying behavior should be evaluated psychiatrically, as this might be an early marker of psychiatric disorders.

  19. Maternal Age of Menarche and Blood Pressure in Adolescence: Evidence from Hong Kong’s “Children of 1997” Birth Cohort

    PubMed Central

    Lai, Tsz Chun; Leung, Gabriel Matthew; Schooling, C. Mary

    2016-01-01

    Background Age of puberty has declined substantially in developed settings and is now declining in the rest of the world with economic development. Early age of puberty is associated with non-communicable diseases in adulthood, and may be a long-term driver of population health with effects over generations. In a non-Western setting, we examined the association of maternal age of menarche with blood pressure in late childhood/adolescence. Methods We used generalised estimating equations to estimate the adjusted association of maternal age of menarche with age-, sex- and height-adjusted blood pressure z-score from 10 to 16 years in Hong Kong’s population-representative birth cohort, “Children of 1997” (n = 8327). We also assessed whether associations were mediated by body mass index (BMI) or pubertal stage. Results Earlier maternal age of menarche was associated with higher systolic blood pressure in adolescence [-0.02 z-score per year older maternal age of menarche, 95% confidence interval (CI) -0.04 to -0.003]. The association of maternal age of menarche with systolic blood pressure was mediated by adiposity and/or pubertal stage at 11 years. Maternal age of menarche was not associated with diastolic blood pressure. Conclusion Earlier maternal age of puberty was associated with higher systolic blood pressure, largely mediated by adiposity, highlighting the importance of tackling childhood obesity as a public health priority in view of the secular trend of declining age of puberty. PMID:27454175

  20. A collaborative model for community-based health care screening of homeless adolescents.

    PubMed

    Busen, N H; Beech, B

    1997-01-01

    Because of their survival life-style, homeless youth are at extremely high risk for contracting life-threatening and debilitating diseases, such as acquired immunodeficiency syndrome and hepatitis B, and for engaging in chronic substance abuse; yet health services are often limited and not easily accessed. This article describes an innovative health-screening project for 150 homeless youth between the ages of 11 and 23 years in an urban metroplex. The Homeless Youth Services Project was the initial phase of a multiphase project to investigate the social and health services available to homeless youth. The study project was a collaborative effort between several community agencies that shared the multiple goals of identifying the homeless adolescent population, documenting the rate of human immunodeficiency virus (HIV) seroprevalence and level of risk, and identifying community services and resources. Results of the screening project included the psychosocial and physical risks associated with homeless adolescents as well as the laboratory results of blood and urine screens. Consistent with the literature, the study population had a history of runaway behavior; physical, sexual, and substance abuse; and high rates of HIV seroprevalence and hepatitis B. Implications for advanced practice nurses working with homeless youth are also addressed.

  1. Effects of a Culturally Grounded Community-Based Diabetes Prevention Program for Obese Latino Adolescents

    PubMed Central

    Shaibi, Gabriel Q.; Konopken, Yolanda; Hoppin, Erica; Keller, Colleen S.; Ortega, Rocio; Castro, Felipe González

    2012-01-01

    Purpose The purpose of this study was to test the feasibility and preliminary effects of a culturally grounded, community-based diabetes prevention program among obese Latino adolescents. Methods Fifteen obese Latino adolescents (body mass index [BMI] percentile = 96.3 ± 1.1, age = 15.0 ± 0.9 years) completed a 12-week intervention that included weekly lifestyle education classes delivered by bilingual/bicultural promotoras and three, 60-minute physical activity sessions per week. Participants were assessed for anthropometrics (height, weight, BMI, and waist circumference), cardiorespiratory fitness, physical activity/inactivity, nutrition behaviors, and insulin sensitivity and glucose tolerance by a 2-hour oral glucose tolerance test. Results The intervention resulted in significant decreases in BMI z score, BMI percentile, and waist circumference; increases in cardiorespiratory fitness; and decreases in physical inactivity and dietary fat consumption. In addition to these changes, the intervention led to significant improvements in insulin sensitivity and reductions in 2-hour glucose levels. Conclusions These results support the feasibility and efficacy of a community-based diabetes prevention program for high-risk Latino youth. Translational approaches that are both culturally grounded and biologically meaningful represent a novel and innovative strategy for closing the obesity-related health disparities gap. PMID:22585870

  2. From the macro to the micro: a geographic examination of the community context and early adolescent problem behaviors.

    PubMed

    Chilenski, Sarah M

    2011-12-01

    This study examined how multiple dimensions and levels of the community context associated with early adolescent problem behaviors in rural communities. Four thousand, five hundred and nine eighth-grade students in 28 rural and small town school districts in two states participated in surveys regarding substance use and delinquency in 2005. Locations of alcohol retailers, tobacco retailers, youth-serving organizations, and student residences were geocoded. Associations of the number of proximal alcohol and tobacco retailers, and youth-serving organizations with an early-adolescent problem behavior index were tested in Nonlinear Mixed Models that controlled for multiple district-level and individual characteristics. Multi-level model results demonstrated that the number of alcohol and tobacco retail locations within a one-mile radius of each adolescent's home positively associated with student-reported problem behaviors above and beyond the influence of school district and individual characteristics. Results suggest that the proximal community context added significantly to the district context when understanding the occurrence of early adolescent problem behaviors. Recognizing this variability in geographically determined risk within a community will likely enhance the effectiveness of community prevention activities.

  3. Self-Reported Speech Problems in Adolescents and Young Adults with 22q11.2 Deletion Syndrome: A Cross-Sectional Cohort Study

    PubMed Central

    Vorstman, Jacob AS; Kon, Moshe; Mink van der Molen, Aebele B

    2014-01-01

    Background Speech problems are a common clinical feature of the 22q11.2 deletion syndrome. The objectives of this study were to inventory the speech history and current self-reported speech rating of adolescents and young adults, and examine the possible variables influencing the current speech ratings, including cleft palate, surgery, speech and language therapy, intelligence quotient, and age at assessment. Methods In this cross-sectional cohort study, 50 adolescents and young adults with the 22q11.2 deletion syndrome (ages, 12-26 years, 67% female) filled out questionnaires. A neuropsychologist administered an age-appropriate intelligence quotient test. The demographics, histories, and intelligence of patients with normal speech (speech rating=1) were compared to those of patients with different speech (speech rating>1). Results Of the 50 patients, a minority (26%) had a cleft palate, nearly half (46%) underwent a pharyngoplasty, and all (100%) had speech and language therapy. Poorer speech ratings were correlated with more years of speech and language therapy (Spearman's correlation= 0.418, P=0.004; 95% confidence interval, 0.145-0.632). Only 34% had normal speech ratings. The groups with normal and different speech were not significantly different with respect to the demographic variables; a history of cleft palate, surgery, or speech and language therapy; and the intelligence quotient. Conclusions All adolescents and young adults with the 22q11.2 deletion syndrome had undergone speech and language therapy, and nearly half of them underwent pharyngoplasty. Only 34% attained normal speech ratings. Those with poorer speech ratings had speech and language therapy for more years. PMID:25276637

  4. Associations between Intelligence in Adolescence and Indicators of Health and Health Behaviors in Midlife in a Cohort of Swedish Women

    ERIC Educational Resources Information Center

    Modig, Karin; Bergman, Lars R.

    2012-01-01

    The objective of this study was to investigate associations between intelligence and indicators of health status and health behaviors at age 43 in a cohort of Swedish women (n = 682). Intelligence was measured by standard IQ tests given at ages 10, 13, and 15. At the age of 43, 479 of the women were sampled for a medical examination in which 369…

  5. 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

  6. The Decline of Academic Motivation during Adolescence: An Accelerated Longitudinal Cohort Analysis on the Effect of Psychological Need Satisfaction

    ERIC Educational Resources Information Center

    Gnambs, Timo; Hanfstingl, Barbara

    2016-01-01

    Adolescents typically exhibit a marked decline in academic intrinsic motivation throughout their school careers. Following self-determination theory, it is hypothesised that traditional school environments insufficiently satisfy three basic psychological needs of youths during maturation, namely the needs for autonomy, competence and relatedness.…

  7. Salient Environmental and Perceptual Correlates of Current and Established Smoking for 2 Representative Cohorts of Indiana Adolescents

    ERIC Educational Resources Information Center

    Seo, Dong-Chul; Bodde, Amy E.; Torabi, Mohammad R.

    2009-01-01

    Purpose: A secondary analysis of 2000 and 2004 Indiana Youth Tobacco Survey (IYTS) data was conducted to investigate salient environmental and perceptual correlates of adolescents' current and established smoking while controlling for demographic variables such as gender, grade, and race/ethnicity and to compare the pattern of significant…

  8. Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support.

    PubMed

    Denno, Donna M; Hoopes, Andrea J; Chandra-Mouli, Venkatraman

    2015-01-01

    Access to youth friendly health services is vital for ensuring sexual and reproductive health (SRH) and well-being of adolescents. This study is a descriptive review of the effectiveness of initiatives to improve adolescent access to and utilization of sexual and reproductive health services (SRHS) in low- and middle-income countries. We examined four SRHS intervention types: (1) facility based, (2) out-of-facility based, (3) interventions to reach marginalized or vulnerable populations, (4) interventions to generate demand and/or community acceptance. Outcomes assessed across the four questions included uptake of SRHS or sexual and reproductive health commodities and sexual and reproductive health biologic outcomes. There is limited evidence to support the effectiveness of initiatives that simply provide adolescent friendliness training for health workers. Data are most ample (10 initiatives demonstrating weak but positive effects and one randomized controlled trial demonstrating strong positive results on some outcome measures) for approaches that use a combination of health worker training, adolescent-friendly facility improvements, and broad information dissemination via the community, schools, and mass media. We found a paucity of evidence on out-of-facility-based strategies, except for those delivered through mixed-use youth centers that demonstrated that SRHS in these centers are neither well used nor effective at improving SRH outcomes. There was an absence of studies or evaluations examining outcomes among vulnerable or marginalized adolescents. Findings from 17 of 21 initiatives assessing demand-generation activities demonstrated at least some association with adolescent SRHS use. Of 15 studies on parental and other community gatekeepers' approval of SRHS for adolescents, which assessed SRHS/commodity uptake and/or biologic outcomes, 11 showed positive results. Packages of interventions that train health workers, improve facility adolescent friendliness

  9. Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support.

    PubMed

    Denno, Donna M; Hoopes, Andrea J; Chandra-Mouli, Venkatraman

    2015-01-01

    Access to youth friendly health services is vital for ensuring sexual and reproductive health (SRH) and well-being of adolescents. This study is a descriptive review of the effectiveness of initiatives to improve adolescent access to and utilization of sexual and reproductive health services (SRHS) in low- and middle-income countries. We examined four SRHS intervention types: (1) facility based, (2) out-of-facility based, (3) interventions to reach marginalized or vulnerable populations, (4) interventions to generate demand and/or community acceptance. Outcomes assessed across the four questions included uptake of SRHS or sexual and reproductive health commodities and sexual and reproductive health biologic outcomes. There is limited evidence to support the effectiveness of initiatives that simply provide adolescent friendliness training for health workers. Data are most ample (10 initiatives demonstrating weak but positive effects and one randomized controlled trial demonstrating strong positive results on some outcome measures) for approaches that use a combination of health worker training, adolescent-friendly facility improvements, and broad information dissemination via the community, schools, and mass media. We found a paucity of evidence on out-of-facility-based strategies, except for those delivered through mixed-use youth centers that demonstrated that SRHS in these centers are neither well used nor effective at improving SRH outcomes. There was an absence of studies or evaluations examining outcomes among vulnerable or marginalized adolescents. Findings from 17 of 21 initiatives assessing demand-generation activities demonstrated at least some association with adolescent SRHS use. Of 15 studies on parental and other community gatekeepers' approval of SRHS for adolescents, which assessed SRHS/commodity uptake and/or biologic outcomes, 11 showed positive results. Packages of interventions that train health workers, improve facility adolescent friendliness

  10. Outcome of Community-Acquired Staphylococcus aureus Bacteraemia in Patients with Diabetes: A Historical Population-Based Cohort Study

    PubMed Central

    Smit, Jesper; Thomsen, Reimar Wernich; Schønheyder, Henrik Carl; Nielsen, Henrik; Frøslev, Trine; Søgaard, Mette

    2016-01-01

    Background Patients with diabetes (DM) experience increased risk of Staphylococcus aureus bacteraemia (SAB), but the prognostic impact of diabetes in patients with SAB remain unclear. Therefore, we investigated 30-day all-cause mortality in patients with and without DM. Methods Population-based medical databases were used to conduct a cohort study of all adult patients with community-acquired SAB in Northern Denmark, 2000–2011. Using Cox proportional hazards regression, we computed hazard ratios as estimates of 30-day mortality rate ratios (MRRs) among patients with and without DM. We further investigated whether the prognostic impact of DM differed among patients with and without recent preadmission healthcare contacts (within 30 days of the current hospitalization) and by age, sex, marital status, level of comorbidity, and DM-related characteristics (e.g., duration of DM and presence of DM complications). Results Among 2638 SAB patients, 713 (27.0%) had DM. Thirty-day cumulative mortality was 25.8% in patients with DM and 24.3% in patients without DM, for an adjusted MRR (aMRR) of 1.01 (95% confidence interval (CI), 0.84–1.20). In analyses with and without recent healthcare contacts, the corresponding aMRRs were 0.84 (95% CI, 0.62–1.14) and 1.13 (95% CI, 0.91–1.41), respectively. Compared to patients without DM, the aMRR was 0.94 (95% CI, 0.74–1.20) for male patients with DM and 1.13 (95% CI, 0.87–1.47) for female patients with DM. The prognostic influence of DM on mortality did not differ notably with age, level of comorbidity, or characteristics of patients with DM. Conclusion Patients with DM and community-acquired SAB did not experience higher 30-day mortality than patients without DM. PMID:27082873

  11. Lactate and Risk of Incident Diabetes in a Case-Cohort of the Atherosclerosis Risk in Communities (ARIC) Study

    PubMed Central

    Juraschek, Stephen P.; Shantha, Ghanshyam Palamaner Subash; Chu, Audrey Y.; Miller, Edgar R.; Guallar, Eliseo; Hoogeveen, Ron C.; Ballantyne, Christie M.; Brancati, Frederick L.; Schmidt, Maria Inês; Pankow, James S.; Young, J. Hunter

    2013-01-01

    Background Oxidative capacity is decreased in type 2 diabetes. Whether decreased oxidative capacity is a cause or consequence of diabetes is unknown. Our purpose is to evaluate whether lactate, a marker of oxidative capacity, is associated with incident diabetes. Methods and Findings We conducted a case-cohort study in the Atherosclerosis Risk in Communities (ARIC) study at year 9 of follow-up. We evaluated lactate’s association with diabetes risk factors at baseline and estimated the hazard ratio for incident diabetes by quartiles of plasma lactate in 544 incident diabetic cases and 533 non-cases. Plasma lactate showed a graded positive relationship with fasting glucose and insulin (P<0.001). The relative hazard for incident diabetes increased across lactate quartiles (P-trend ≤0.001). Following adjustment for demographic factors, medical history, physical activity, adiposity, and serum lipids, the hazard ratio in the highest quartile was 2.05 times the hazard in the lowest quartile (95% CI: 1.28, 3.28). After including fasting glucose and insulin the association became non-significant. Conclusions Lactate, an indicator of oxidative capacity, predicts incident diabetes independent of many other risk factors and is strongly related to markers of insulin resistance. Future studies should evaluate the temporal relationship between elevated lactate and impaired fasting glucose and insulin resistance. PMID:23383072

  12. Acute Otitis Media during the First Two Years of Life in a Rural Community in Bangladesh: A Prospective Cohort Study

    PubMed Central

    Roy, Eliza; Hasan, Zahid; Haque, Fazlul; Siddique, A.K.M.; Sack, Richard Bradley

    2007-01-01

    The study investigated the burden of acute otitis media (AOM) during the first two years of life in a cohort of 252 newborns in rural Bangladesh using data collected on occurrences of AOM. Trained community health workers (CHWs) conducted household surveillance and picked up cases of AOM using the study algorithm. The incidence rate was 0.9 episodes per child-year observed. Forty-six percent (n=115) of the 252 subjects developed AOM: 36% (n=91) during the first year of life and 10% (n=24) during the second year of life (p<0.001). The age-specific incidence rates of AOM varied; peaks occurred in the 6-12-month age-group and the lowest in the first three months of life. In total, 20% (n=49) of the study subjects had single, 26% (n=66) recurrent, and 54% (n=137) no episode of AOM. Perforation with discharge developed in 85% (n=322) of 375 episodes. The duration of discharge from the ears was ≤6 weeks in 95% of the episodes, but in 5% of the episodes, discharge from the ears continued for >6 weeks. The incidence of AOM was higher in the monsoon season compared to the summer season (p<0.003). The study documented AOM as an important cause of morbidity among rural children up to two years of age in Bangladesh and should be addressed with strategies to overcome the burden of disease. PMID:18402184

  13. Thoughts of Death and Suicide in Early Adolescence

    ERIC Educational Resources Information Center

    Vander Stoep, Ann; McCauley, Elizabeth; Flynn, Cynthia; Stone, Andrea

    2009-01-01

    The prevalence and persistence of thoughts of death and suicide during early adolescence were estimated in a community-based cohort. A latent class approach was used to identify distinct subgroups based on endorsements to depression items administered repeatedly over 24 months. Two classes emerged, with 75% in a low ideation class across four…

  14. Measured adolescent body mass index and adult breast cancer in a cohort of 951,480 women.

    PubMed

    Keinan-Boker, Lital; Levine, Hagai; Derazne, Estela; Molina-Hazan, Vered; Kark, Jeremy D

    2016-07-01

    Body mass index (BMI) in adolescence, studied predominantly as a self-reported risk factor for breast cancer (BC), may have been subjected to recall bias. We examined the association between measured BMI in adolescence and the incidence of BC by menopausal status. 951,480 Jewish Israeli females aged 16-19 who underwent anthropometric measurements in 1967-2011 were followed up to 31.12.2012 for BC incidence. Cox proportional hazards models assessed the association between adolescent BMI (as age-specific CDC percentiles) and time to BC diagnosis, adjusting for sociodemographic covariates. The analysis was also subdivided by age at diagnosis. 9619 BC cases diagnosed during 18,078,941 person-years of follow-up were included in multivariable analyses: 4901 premenopausal, 3809 perimenopausal, and 909 postmenopausal. Compared with 'healthy' BMI (5th-<85th percentiles) and adjusted for country of origin, education, and height, adolescent BMI was largely negatively associated with BC: hazard ratio (HR) = 1.057 (95 % confidence interval (CI) 0.955-1.169, p = 0.286) in underweight (<5th percentile); HR = 0.918 (95 % CI 0.849-0.993, p = 0.032) in overweight (85th-<95th percentiles); and HR = 0.682 (95 % CI 0.552-0.843, p = 0.00004) in obese (≥95th percentile) women. In premenopausal, but not peri- and postmenopausal BC, associations were statistically significant; underweight was associated with increased risk of premenopausal BC (HR = 1.15, 95 % CI 1.01-1.31, p = 0.037), and overweight and obesity with significantly lower risk. Adolescent thinness was associated with increased risk for early BC. Overweight and obesity were protectively associated with premenopausal but not postmenopausal BC. The lack of an association of adolescent overweight/obesity with increased peri- and postmenopausal BC suggests a causal role for adult weight gain. PMID:27306419

  15. Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji.

    PubMed

    Waqa, Gade; Moodie, Marj; Schultz, Jimaima; Swinburn, Boyd

    2013-12-01

    Nearly one-half of the adult population in Fiji between the ages of 15-64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13-18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups. PMID:24469301

  16. Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji.

    PubMed

    Waqa, Gade; Moodie, Marj; Schultz, Jimaima; Swinburn, Boyd

    2013-12-01

    Nearly one-half of the adult population in Fiji between the ages of 15-64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13-18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups.

  17. COBA-Cohort: a prospective cohort of HIV-negative men who have sex with men, attending community-based HIV testing services in five European countries (a study protocol)

    PubMed Central

    Fernàndez-López, Laura; Fuertes, Ricardo; Rojas Castro, Daniela; Pichon, François; Cigan, Bojan; Chanos, Sophocles; Meireles, Paula; Morel, Stéphane; Slaaen Kaye, Per; Agustí, Cristina; Klavs, Irena; Casabona, Jordi

    2016-01-01

    Introduction Community-based voluntary counselling and testing (CBVCT) services for men who have sex with men (MSM) can reach those most-at-risk and provide an environment for gay men that is likely to be non-stigmatising. Longitudinal data on the behaviour of HIV-negative MSM are scarce in Europe. The aim of this protocol, developed during the Euro HIV Early Diagnosis And Treatment (EDAT) project, is to implement a multicentre community-based cohort of HIV-negative MSM attending 15 CBVCT services in 5 European countries. Research objectives (1) To describe the patterns of CBVCT use, (2) to estimate HIV incidence, and to identify determinants of (3) HIV seroconversion and (4) HIV and/or sexually transmitted infection (STI) test-seeking behaviour. Methods and analysis All MSM aged 18 years or over and who had a negative HIV test result are invited to participate in the COmmunity-BAsed Cohort (COBA-Cohort). Study enrolment started in February 2015, and is due to continue for at least 12 months at each study site. Follow-up frequency depends on the testing recommendations in each country (at least 1 test per year). Sociodemographic data are collected at baseline; baseline and follow-up questionnaires both gather data on attitudes and perceptions, discrimination, HIV/STI testing history, sexual behaviour, condom use, and pre- and post-exposure prophylaxis. Descriptive, exploratory and multivariate analyses will be performed to address the main research objectives of this study, using appropriate statistical tests and models. These analyses will be performed on the whole cohort data and stratified by study site or country. Ethics and dissemination The study was approved by the Public Health authorities of each country where the study is being implemented. Findings from the COBA-Cohort study will be summarised in a report to the European Commission, and in leaflets to be distributed to study participants. Articles and conference abstracts will be submitted to peer

  18. When a girl's decision involves the community: the realities of adolescent Maya girls' lives in rural indigenous Guatemala.

    PubMed

    Wehr, Heather; Tum, Silvia Ester

    2013-05-01

    Adolescent Maya girls are among the most vulnerable, marginalized sub-populations in Guatemala, a country that is largely young, indigenous and poor. Adolescent Maya girls have limited access to secondary schooling, opportunities to work or earn an income, and sexual and reproductive health information and services. This article explores the extent to which adolescent Maya girls are able to adopt what they have learned in a community-based skills-building and sex education programme in isolated rural, indigenous Guatemalan communities. This is presented through an interview between the authors, who met and worked together in the Population Council's programme Abriendo Oportunidades (Opening Opportunities) for girls aged 8-19 years. The interview discusses what can be done so that indigenous adolescents not only obtain the sexual health information they need, but develop the skills to make decisions, communicate with their peers and parents, and exercise their rights. Much culturally and linguistically sensitive work must be done, using a community-based participatory approach, so that young people who do want to use condoms for protection or contraceptive methods not only have access to the methods, but the support of their families and communities, and government-sponsored sex education programmes, to use them. PMID:23684196

  19. Nonsuicidal Self-Injury in a Community Sample of Adolescents: Subgroups, Stability, and Associations with Psychological Difficulties

    ERIC Educational Resources Information Center

    Bjarehed, Jonas; Wangby-Lundh, Margit; Lundh, Lars-Gunnar

    2012-01-01

    Patterns of nonsuicidal self-injury (NSSI) and their association with other psychological difficulties were studied in a community sample of young Swedish adolescents, by a two-wave longitudinal design with a 1-year interval. Hierarchical cluster analysis at T1 identified eight NSSI subgroups in each gender, of which five were clearly replicated…

  20. Adolescents' Psychological Response to the Experience of Community Interpersonal Violence: A Cross-National and a Cross-Cultural Comparison

    ERIC Educational Resources Information Center

    Rosenthal, Beth Spenciner; Wilson, W. Cody

    2006-01-01

    A comparative cross-national study investigating the level of experience with community interpersonal violence, level of psychological distress, and the relationship between exposure and distress among adolescents is presented. Participants were 617 first-year college students comprising African Americans and Jamaican Americans living in New York…

  1. A Qualitative Exploration of Community-Based Organization Programs, Resources, and Training to Promote Adolescent Sexual Health

    ERIC Educational Resources Information Center

    McCarthy, Molly A.; Fisher, Christopher M.; Zhou, Junmin; Zhu, He; Pelster, Aja Kneip; Schober, Daniel J.; Baldwin, Kathleen; Fortenberry, J. Dennis; Goldsworthy, Richard

    2015-01-01

    Youth development professionals (YDPs) working at community-based organizations (CBOs) can promote adolescent sexual health through programs. This study explored the programs and resources that youth access at CBOs and training YDPs receive. Twenty-one semi-structured interviews were conducted with YDPs. Qualitative content analyses were conducted…

  2. "Passing It On" during a "Day in the Life" of Resilient Adolescents in Diverse Communities around the Globe

    ERIC Educational Resources Information Center

    Cameron, Catherine Ann; Lau, Cindy; Tapanya, Sombat

    2009-01-01

    This social-ecological inquiry explores youth resiliency in diverse communities using innovative qualitative visual methodologies. It engages adolescents in a process of sharing their daily experiences and reflecting on the resources they bring to bear to thrive in the face of geographic and social relocations. The four youth participants were…

  3. Community Violence and Psychological Distress: The Protective Effects of Emotional Social Support and Sense of Personal Control among Older Adolescents

    ERIC Educational Resources Information Center

    Rosenthal, Beth Spenciner; Wilson, W. Cody

    2008-01-01

    This empirical study investigated three mechanisms of protection (preventive, compensatory, buffering) for two factors (emotional social support, sense of personal control) in the relationship between exposure to community violence and psychological distress among 947 diverse, older adolescents. Findings indicate that social support and sense of…

  4. Beyond the Primary Influences of Parents and Peers on Very Young Adolescent Alcohol Use: Evidence of Independent Community Associations

    ERIC Educational Resources Information Center

    Smith, Dayna T.; Kelly, Adrian B.; Chan, Gary C. K.; Toumbourou, John W.; Patton, George C.; Williams, Joanne W.

    2014-01-01

    This study examined the extent to which young adolescent alcohol use was related to alcohol-related norms and law enforcement of underage alcohol use, after accounting for known strong parent and peer correlates. Our sample consisted of 7,674 students (X-bar age = 12 years) from 30 Australian communities. Two-level (individuals nested within…

  5. Adaptive Coping Reduces the Impact of Community Violence Exposure on Violent Behavior among African American and Latino Male Adolescents

    ERIC Educational Resources Information Center

    Brady, Sonya S.; Gorman-Smith, Deborah; Henry, David B.; Tolan, Patrick H.

    2008-01-01

    This study examined whether coping moderated the impact of community violence exposure (CVE) on violent behavior among 285 urban African American and Latino adolescent males assessed annually across 5 years. Composites indicating overall CVE (having knowledge of others' victimization, witnessing violence, direct victimization) and approach to…

  6. Expressive Art for the Social and Community Integration of Adolescents with Acquired Brain Injuries: A Systematic Review

    ERIC Educational Resources Information Center

    Goyal, Anita; Keightley, Michelle L.

    2008-01-01

    Adolescents with acquired brain injuries suffer from social and community withdrawal that result in isolation from their peer groups. The review highlights the evidence of effectiveness of expressive art interventions in the form of theatre for populations with difficulties in physical, emotional, cognitive, or social functioning. A systematic…

  7. 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.

  8. Structural determinants of adolescent girls' vulnerability to HIV: views from community members in Botswana, Malawi, and Mozambique.

    PubMed

    Underwood, Carol; Skinner, Joanna; Osman, Nadia; Schwandt, Hilary

    2011-07-01

    In sub-Saharan Africa, adolescent girls are three to four times more likely than adolescent boys to be living with HIV/AIDS. A literature review revealed only four studies that had examined HIV vulnerability from the perspective of community members. None of the studies focused specifically on adolescent girls. To fill this gap, in 2008 12 focus group discussions were held in selected peri-urban and rural sites in Botswana, 12 in Malawi, and 11 in Mozambique to identify factors that render girls vulnerable to HIV infection from the community members' perspective. The preponderance of comments identified structural factors--insufficient economic, educational, socio-cultural, and legal support for adolescent girls--as the root causes of girls' vulnerability to HIV through exposure to unprotected sexual relationships, primarily relationships that are transactional and age-disparate. Community members explicitly called for policies and interventions to strengthen cultural, economic, educational, and legal structures to protect girls, recognized community members' responsibility to take action, and requested programs to enhance adult-child communication, thus revealing an understanding that girls' vulnerability is multi-level and multi-faceted, so must be addressed through a comprehensive approach to HIV prevention.

  9. Adolescents' Educational Outcomes in a Social Ecology of Parenting, Family, and Community Risks in Northern Ireland

    ERIC Educational Resources Information Center

    Goeke-Morey, Marcie C.; Taylor, Laura K.; Merrilees, Christine E.; Cummings, E. Mark; Cairns, Ed; Shirlow, Peter

    2013-01-01

    This study examines the influence of social ecological risks within the domains of parenting, family environment, and community in the prediction of educational outcomes for 770 adolescents (49% boys, 51% girls, "M"?=?13.6 years, "SD"?=?2.0) living in a setting of protracted political conflict, specifically working class areas…

  10. Exposure to Community Violence and Protective and Risky Contexts among Low Income Urban African American Adolescents: A Prospective Study

    ERIC Educational Resources Information Center

    Goldner, Jonathan; Peters, Tracy L.; Richards, Maryse H.; Pearce, Steven

    2011-01-01

    This study examined protective and risky companionship and locations for exposure to community violence among African American young adolescents living in high crime, urban areas. The Experience Sampling Method (ESM), an in vivo data collection method, was employed to gather information from 233 students (62% female) over 3 years, beginning in the…

  11. When a girl's decision involves the community: the realities of adolescent Maya girls' lives in rural indigenous Guatemala.

    PubMed

    Wehr, Heather; Tum, Silvia Ester

    2013-05-01

    Adolescent Maya girls are among the most vulnerable, marginalized sub-populations in Guatemala, a country that is largely young, indigenous and poor. Adolescent Maya girls have limited access to secondary schooling, opportunities to work or earn an income, and sexual and reproductive health information and services. This article explores the extent to which adolescent Maya girls are able to adopt what they have learned in a community-based skills-building and sex education programme in isolated rural, indigenous Guatemalan communities. This is presented through an interview between the authors, who met and worked together in the Population Council's programme Abriendo Oportunidades (Opening Opportunities) for girls aged 8-19 years. The interview discusses what can be done so that indigenous adolescents not only obtain the sexual health information they need, but develop the skills to make decisions, communicate with their peers and parents, and exercise their rights. Much culturally and linguistically sensitive work must be done, using a community-based participatory approach, so that young people who do want to use condoms for protection or contraceptive methods not only have access to the methods, but the support of their families and communities, and government-sponsored sex education programmes, to use them.

  12. Body Mass Index and Mortality among Korean Elderly in Rural Communities: Kangwha Cohort Study

    PubMed Central

    Hong, Seri; Yi, Sang-Wook; Sull, Jae Woong; Hong, Jae-Seok; Jee, Sun Ha; Ohrr, Heechoul

    2015-01-01

    Background The relationship between body mass index (BMI) and mortality may differ by ethnicity, but its exact nature remains unclear among Koreans. The study aim was to prospectively examine the association between BMI and mortality in Korean. Methods 6166 residents (2636 men; 3530 women) of rural communities (Kangwha County, Republic of Korea) aged 55 and above were followed up for deaths from 1985–2008. The multivariable-adjusted hazard ratios were calculated using the Cox proportional hazards model. Results During the 23.8 years of follow-up (an average of 12.5 years in men and 15.7 years in women), 2174 men and 2372 women died. Men with BMI of 21.0–27.4 and women with BMI of 20.0–27.4 had a minimal risk for all-cause mortality. A lower BMI as well as a higher BMI increased the hazard ratio of death. For example, multivariable-adjusted hazard ratios associated with BMI below 16, and with BMI of 27.5 and above, were 2.4 (95% CI = 1.6–3.5) and 1.5 (95% CI = 1.1–1.9) respectively, in men, compared to those with BMI of 23.0–24.9. This reverse J-curve association was maintained among never smokers, and among people with no known chronic diseases. Higher BMI increased vascular mortality, while lower BMI increased deaths from vascular diseases, cancers, and, especially, respiratory diseases. Except for cancers, these associations were generally weaker in women than in men. Conclusions A reverse J-curve association between BMI and all-cause mortality may exist. BMI of 21–27.4 (rather than the range suggested by WHO of 18.5–23 for Asians) may be considered a normal range with acceptable risk in Koreans aged 55 and above, and may be used as cut points for interventions. More concern should be given to people with BMI above and below a BMI range with acceptable risk. Further studies are needed to determine ethnicity-specific associations. PMID:25719567

  13. Developmental Trajectories of Adaptive Behaviors from Early Childhood to Adolescence in a Cohort of 152 Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Baghdadli, Amaria; Assouline, Brigitte; Sonie, Sandrine; Pernon, Eric; Darrou, Celine; Michelon, Cecile; Picot, Marie-Christine; Aussilloux, Charles; Pry, Rene

    2012-01-01

    This study examines change in 152 children over an almost 10-year period (T1: 4.9 (plus or minus 1.3) years; T2: 8.1 (plus or minus 1.3) years; T3: 15(plus or minus 1.6) years) using a group-based, semi-parametric method in order to identify distinct developmental trajectories. Important deficits remain at adolescence in the adaptive abilities of…

  14. Adolescent over-general memory, life events and mental health outcomes: Findings from a UK cohort study

    PubMed Central

    Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J. Mark G.

    2016-01-01

    Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations. PMID:25716137

  15. Adolescent over-general memory, life events and mental health outcomes: Findings from a UK cohort study.

    PubMed

    Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J Mark G

    2016-01-01

    Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations.

  16. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program

    PubMed Central

    Marques, Andrea Horvath; Oliveira, Paula Approbato; Scomparini, Luciana Burim; Silva, Uiara Maria Rêgo e; Silva, Angelica Cristine; Doretto, Victoria; de Medeiros Filho, Mauro Victor; Scivoletto, Sandra

    2015-01-01

    The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries (“LMICs”). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program (“TEP”), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP’s implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP’s social impact, challenges, and limitations. The program’s goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program’s cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health. PMID

  17. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program.

    PubMed

    Marques, Andrea Horvath; Oliveira, Paula Approbato; Scomparini, Luciana Burim; Silva, Uiara Maria Rêgo E; Silva, Angelica Cristine; Doretto, Victoria; de Medeiros Filho, Mauro Victor; Scivoletto, Sandra

    2015-01-01

    The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries ("LMICs"). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program ("TEP"), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP's implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP's social impact, challenges, and limitations. The program's goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program's cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.

  18. Virtual cohorts and face-to-face recruitment: Strategies for cultivating the next generation of the IRIS Community

    NASA Astrophysics Data System (ADS)

    Hubenthal, M.; Wysession, M. E.; Aster, R. C.

    2009-12-01

    Since 1998, the IRIS Consortium REU program has facilitated research opportunities and career development for 71 undergraduate students to work with leaders in seismological research, travel to exciting locations for fieldwork, and engage in significant research for presentation and recognition at major professional conferences. A principal program goal is to encourage more students, representing a more diverse population, to choose careers in Earth science. Of the forty-six internship alumni that have completed their undergraduate degrees thus far, 85% have attained or are currently pursuing a graduate degree in a geoscience field and an additional 6% are working in a geoscience career with an undergraduate degree. The IRIS Consortium’s program differs from traditional REUs in that students are hosted at IRIS member institutions that are geographically distributed. To capture the sprit of a traditional REU cohort, IRIS has developed and refined a model that bonds students into a cohort. Key to the model are: a) research projects that have a common focus within seismology, b) a weeklong orientation where students get to know one another, share common experiences and establish a “social presence” with the other interns, c) a cyber infrastructure to maintain their connectedness in a way that enables both learning and collaboration, d) an alumni mentor that supports the interns and serves both as a role model and an unbiased and experienced third-party to the mentor/mentee relationship, and e) an alumni reception, and scientific presentation, at the annual Fall AGU Meeting to reconnect and share experiences. Through their virtual community interns offer each other assistance, share ideas, ask questions, and relate life experiences while conducting their own unique research. In addition to developing a model for encouraging virtual cohorts, IRIS has also carefully examined recruitment strategies to increase and diversify the applicant pool. Based on applicant

  19. Background for Community Level Work on Educational Adjustment in Adolescence: Reviewing the Literature on Contributing Factors.

    ERIC Educational Resources Information Center

    Redd, Zakia; Brooks, Jennifer; McGarvey, Ayelish M.

    Given the importance of adolescents' educational adjustment, a key question for those concerned with improving adolescent functioning is what can be done to increase adolescents' levels of educational functioning. This review addresses a number of broad facets of adolescents' educational functioning, including those in the psychological…

  20. The Role of Community Health Workers in Preventing Adolescent Repeat Pregnancies and Births.

    PubMed

    Maravilla, Joemer Calderon; Betts, Kim S; Abajobir, Amanuel Alemu; Couto E Cruz, Camila; Alati, Rosa

    2016-10-01

    Intervention by community health workers (CHWs) is believed to prevent repeated childbearing among teenagers. This review investigated the effectiveness of CHWs in reducing repeated pregnancies and births among adolescents aged <20 years, 2 years after the delivery of their first child. Through electronic database and hand searching, experimental and/or observational studies were screened with their results undergoing systematic review and meta-analyses. Subgroup analyses were performed to further assess how study characteristics affected the pooled estimates and heterogeneity. A total of 11 eligible articles, from January 1980 to May 2015, were included. Seven studies evaluated repeated births and eight measured repeated pregnancies. Studies showed relevant disparities in terms of selected methodological aspects and program characteristics. Although most studies (n = 9) were either of "strong" or of "moderate" quality, only two of five finding a significant reduction exhibited a high level of quality as the other three failed to adjust results for confounders. Random effects modeling revealed an overall 30% decrease in repeated adolescent births (odds ratio = .70, confidence interval = .49-.99) among CHW-visited areas relative to nonvisited sites. On the other hand, no significant association was detected in terms of repeated pregnancies (odds ratio = .96, confidence interval = .70-1.28). PMID:27474526

  1. The Role of Community Health Workers in Preventing Adolescent Repeat Pregnancies and Births.

    PubMed

    Maravilla, Joemer Calderon; Betts, Kim S; Abajobir, Amanuel Alemu; Couto E Cruz, Camila; Alati, Rosa

    2016-10-01

    Intervention by community health workers (CHWs) is believed to prevent repeated childbearing among teenagers. This review investigated the effectiveness of CHWs in reducing repeated pregnancies and births among adolescents aged <20 years, 2 years after the delivery of their first child. Through electronic database and hand searching, experimental and/or observational studies were screened with their results undergoing systematic review and meta-analyses. Subgroup analyses were performed to further assess how study characteristics affected the pooled estimates and heterogeneity. A total of 11 eligible articles, from January 1980 to May 2015, were included. Seven studies evaluated repeated births and eight measured repeated pregnancies. Studies showed relevant disparities in terms of selected methodological aspects and program characteristics. Although most studies (n = 9) were either of "strong" or of "moderate" quality, only two of five finding a significant reduction exhibited a high level of quality as the other three failed to adjust results for confounders. Random effects modeling revealed an overall 30% decrease in repeated adolescent births (odds ratio = .70, confidence interval = .49-.99) among CHW-visited areas relative to nonvisited sites. On the other hand, no significant association was detected in terms of repeated pregnancies (odds ratio = .96, confidence interval = .70-1.28).

  2. Features of Online Health Communities for Adolescents With Type 1 Diabetes

    PubMed Central

    Ho, Yun-Xian; O’Connor, Brendan H.; Mulvaney, Shelagh A.

    2014-01-01

    The aim of this exploratory study was to examine diabetes online health communities (OHCs) available to adolescents with type 1 diabetes (T1D). We sought to identify and classify site features and relate them to evidence-based processes for improving self-management. We reviewed 18 OHCs and identified the following five feature categories: social learning and networking, information, guidance, engagement, and personal health data sharing. While features that have been associated with improved self-management were present, such as social learning, results suggest that more guidance or structure would be helpful to ensure that those processes were focused on promoting positive beliefs and behaviors. Enhancing guidance-related features and structure to existing OHCs could provide greater opportunity for effective diabetes self-management support. To support clinical recommendations, more research is needed to quantitatively relate features and participation in OHCs to patient outcomes. PMID:24473058

  3. Features of online health communities for adolescents with type 1 diabetes.

    PubMed

    Ho, Yun-Xian; O'Connor, Brendan H; Mulvaney, Shelagh A

    2014-10-01

    The aim of this exploratory study was to examine diabetes online health communities (OHCs) available to adolescents with type 1 diabetes (T1D). We sought to identify and classify site features and relate them to evidence-based processes for improving self-management. We reviewed 18 OHCs and identified the following five feature categories: social learning and networking, information, guidance, engagement, and personal health data sharing. While features that have been associated with improved self-management were present, such as social learning, results suggest that more guidance or structure would be helpful to ensure that those processes were focused on promoting positive beliefs and behaviors. Enhancing guidance-related features and structure to existing OHCs could provide greater opportunity for effective diabetes self-management support. To support clinical recommendations, more research is needed to quantitatively relate features and participation in OHCs to patient outcomes. PMID:24473058

  4. Red Blood Cell Fatty Acids and Biomarkers of Inflammation: A Cross-sectional Study in a Community-based Cohort

    PubMed Central

    Fontes, João D.; Rahman, Faisal; Lacey, Sean; Larson, Martin G.; Vasan, Ramachandran S.; Benjamin, Emelia J.; Harris, William S.; Robins, Sander J.

    2015-01-01

    Introduction Inflammation and inflammatory biomarkers have emerged as integral components and predictors of incident cardiovascular (CV) disease. Omega-3 fatty acids, particularly eicosapentaenoic and docosahexaenoic acids (EPA and DHA) have anti-inflammatory properties, and have been variably associated with lower blood pressure, favorable blood lipid changes, and reduced CV events. Methods and Results We examined the cross-sectional association of red blood cell (RBC) fatty acids, representative of body membrane fatty acid composition, with 10 biomarkers active in multiple inflammatory pathways in 2724 participants (mean age 66±9 years, 54% women, 8% minorities) from the Framingham Offspring and minority Omni Cohorts. . After multivariable adjustment, the RBC EPA and DHA content was inversely correlated (all P≤0.001) with 8 markers of inflammation, receptors, or pathways: urinary isoprostanes (r=−0.16); and soluble interleukin-6 (r=−0.10); C-reactive protein (r=−0.08); tumor necrosis factor receptor 2 (r=−0.08); intercellular adhesion molecule-1 (r=−0.08); P-selectin (r=−0.06); lipoprotein-associated phospholipase-A2 mass (r=−0.11) and activity (r=−0.08). The correlations for monocyte chemoattractant protein-1 was −0.05, P=0.006 and osteoprotegerin (r= −0.06, P=0.002) were only nominally significant. Conclusion In our large community-based study, we observed modest inverse associations between several types of inflammatory biomarkers with RBC omega-3 fatty acid levels. Our findings are consistent with the hypothesis that omega-3 fatty acids have anti-inflammatory properties. PMID:25897795

  5. The Oxfordshire Community Stroke Project classification system predicts clinical outcomes following intravenous thrombolysis: a prospective cohort study

    PubMed Central

    Yang, Yuling; Wang, Anxin; Zhao, Xingquan; Wang, Chunxue; Liu, Liping; Zheng, Huaguang; Wang, Yongjun; Cao, Yibin; Wang, Yilong

    2016-01-01

    Background The Oxfordshire Community Stroke Project (OCSP) classification system is a simple stroke classification system that can be used to predict clinical outcomes. In this study, we compare the safety and efficacy of intravenous thrombolysis in Chinese stroke patients categorized using the OCSP classification system. Patients and methods We collected data from the Thrombolysis Implementation and Monitoring of Acute Ischemic Stroke in China registry. A total of 1,115 patients treated with intravenous thrombolysis with alteplase within 4.5 hours of stroke onset were included. Symptomatic intracranial hemorrhage (SICH), mortality, and 90-day functional outcomes were compared between the stroke patients with different stroke subtypes. Results Of the 1,115 patients included in the cohort, 197 (17.67%) were classified with total anterior circulation infarct (TACI), 700 (62.78%) with partial anterior circulation infarct, 153 (13.72%) with posterior circulation infarct, and 65 (5.83%) with lacunar infarct. After multivariable adjustment, compared to the patients with non-TACI, those with TACI had a significantly increased risk of SICH (odds ratio [OR] 8.80; 95% confidence interval [CI] 2.84–27.25, P<0.001), higher mortality (OR 5.24; 95% CI 3.19–8.62; P<0.001), and poor functional independence (OR 0.38; 95% CI 0.26–0.56; P<0.001) at 3-month follow-up. Conclusion After thrombolysis, the patients with TACI exhibited greater SICH, a higher mortality rate, and worse 3-month clinical outcomes compared with the patients with non-TACI. The OCSP classification system may help clinicians predict the safety and efficacy of thrombolysis. PMID:27418829

  6. Parity and Breastfeeding in Relation to Obesity among Black and White Women in the Southern Community Cohort Study

    PubMed Central

    Larson, Celia O.; Matthews, Charles E.; Buchowski, Maciej S.; Signorello, Lisa B.; Hargreaves, Margaret K.; Blot, William J.

    2009-01-01

    Abstract Objective This research sought to describe associations among parity, breastfeeding, and adult obesity in black and white women in the southeastern United States. Methods Cross-sectional data from 7,986 white women and 23,198 black women (age 40–79 years) living in the southeastern United States and enrolled in the Southern Community Cohort Study during 2002–2006 were used to examine self-reported body mass index (BMI) and weight change since age 21 in association with parity and breastfeeding. Multiple linear regression and logistic regression with adjustment for demographic and lifestyle factors were used. Results At all levels of parity and breastfeeding, black women had higher BMI and weight gain since age 21 than white women. Compared to nulliparity, five or more live births was associated with increased odds of obesity in white women (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.08–1.74) and, to a lesser extent, in black women (OR = 1.22, 95% CI = 1.07–1.38). In white women, breastfeeding for more than 12 months compared to none was associated with decreased odds of obesity (OR = 0.68, 95% CI = 0.56–0.82), whereas in black women, no association between obesity and breastfeeding was seen. Conclusions The associations between childbearing factors and measures of adult obesity appear to be larger in white women compared to black women but relatively small overall. However, when considered as part of the constellation of factors that lead to obesity, even these small associations may be important in an overall obesity prevention strategy. PMID:19743905

  7. Community-level successes and challenges to implementing adolescent sex education programs.

    PubMed

    Ott, Mary A; Rouse, Maura; Resseguie, Jamie; Smith, Hannah; Woodcox, Stephanie

    2011-02-01

    Best practices for adolescent sex education recommend science-based approaches. However, little is known about the capacity and needs of organizations who implement sex education programs on the local level. The purpose of this research was to describe successes and challenges of community organizations in implementing science-based sex education. Using qualitative methods, we interviewed program directors and educators in 17 state-funded adolescent pregnancy prevention/sex education programs as part of a larger mixed methods evaluation. Semi-structured interviews focused on success and challenges faced in implementing science-based approaches to program design, implementation and evaluation. Interviews were audio-recorded, transcribed and analyzed using a thematic approach. Grantees included a range of programs, from short programs on puberty and HIV for late elementary students, to skills-based curricular sex education programs for high schools, to year-long youth development programs. Key aspects of curricular choice included meeting the needs of the population, and working within time constraints of schools and other community partners. Populations presenting specific challenges included rural youth, youth in juvenile justice facilities, and working with Indiana's growing Latino population. Programs self-developing curricula described challenges related to assessment and evaluation of impact. Programs using commercial curricula described challenges related to curricular selection and adaptation, in particularly shortening curricula, and adapting to different cultural or social groups. A remarkable degree of innovation was observed. The use of qualitative methods permitted the identification of key challenges and successes in a state-sponsored small grants program. Information can be used to enhance program capacity and quality.

  8. Using social marketing to create communities for our children and adolescents that do not model and encourage drinking.

    PubMed

    Jones, Sandra C

    2014-11-01

    Our children and adolescents are growing up in environments that support, and even, encourage (excessive) drinking. Thus, if we are to address the problem of underage drinking our focus needs to move beyond eliciting behavior change among children and adolescents to changing underlying community attitudes, social norms, and the environment itself. This review sought to examine the evidence base surrounding 'community-based' interventions designed to address underage drinking; to determine the extent to which 'community' interventions have thus far targeted the broader community and gone beyond behavior-focused strategies and endeavored to change social and physical environments. The review found surprisingly few interventions that sought to comprehensively address social norms at a community level. We need to move (research and interventions) beyond narrowly-focused efforts targeting teens and their parents; it is only when we address alcohol consumption at a population level that we will be able to provide an environment for children and adolescents which does not model (excessive) drinking as a normative social behavior.

  9. Effect of human papillomavirus (HPV) vaccination on clinical indicators of sexual behaviour among adolescent girls: the Ontario Grade 8 HPV Vaccine Cohort Study

    PubMed Central

    Smith, Leah M.; Kaufman, Jay S.; Strumpf, Erin C.; Lévesque, Linda E.

    2015-01-01

    Background: Suboptimal human papillomavirus (HPV) vaccine coverage in some jurisdictions is partly attributed to fears that vaccination may increase risky sexual behaviour. We assessed the effect of HPV vaccination on clinical indicators of sexual behaviour among adolescent girls in Ontario. Methods: Using Ontario’s administrative health databases, we identified a population-based cohort of girls in grade 8 in the 2 years before (2005/06 and 2006/07) and after (2007/08 and 2008/09) implementation of Ontario’s grade 8 HPV vaccination program. For each girl, we then obtained data on vaccine receipt in grades 8 and 9 and data on indicators of sexual behaviour (pregnancy and non–HPV-related sexually transmitted infections) in grades 10–12. Using a quasi-experimental method known as regression discontinuity, we estimated, for each outcome, the risk difference (RD) and relative risk (RR) attributable to vaccination and to program eligibility. Results: The cohort comprised 260 493 girls, of whom 131 781 were ineligible for the program and 128 712 were eligible. We identified 15 441 (5.9%) cases of pregnancy and sexually transmitted infection and found no evidence that vaccination increased the risk of this composite outcome: RD per 1000 girls −0.61 (95% confidence interval [CI] −10.71 to 9.49) and RR 0.96 (95% CI 0.81 to 1.14). Similarly, we found no discernible effect of program eligibility: RD per 1000 girls −0.25 (95% CI −4.35 to 3.85) and RR 0.99 (95% CI 0.93 to 1.06). The findings were similar when outcomes were assessed separately. Interpretation: We present strong evidence that HPV vaccination does not have any significant effect on clinical indicators of sexual behaviour among adolescent girls. These results suggest that concerns over increased promiscuity following HPV vaccination are unwarranted and should not deter from vaccinating at a young age. PMID:25487660

  10. Clopidogrel treatment on the incidence and severity of community acquired pneumonia in a cohort study and meta-analysis of antiplatelet therapy in pneumonia and critical illness

    PubMed Central

    Gross, A. Kendall; Dunn, Steven P.; Feola, David J.; Martin, Craig A.; Charnigo, Richard; Li, Zhenyu; Abdel-Latif, Ahmed; Smyth, Susan S.

    2013-01-01

    Background Platelet activation results in the release and upregulation of mediators responsible for immune cell activation and recruitment, suggesting that platelets play an active role in immunity. Animal models and retrospective data have demonstrated benefit of antiplatelet therapy on inflammatory mediator expression and clinical outcomes. This study sought to characterize effects of clopidogrel on the incidence and severity of community-acquired pneumonia (CAP). Methods A retrospective cohort study was conducted of Kentucky Medicaid patients (2001-2005). The exposed cohort consisted of patients receiving at least six consecutive clopidogrel prescriptions; the non-exposed cohort was comprised of patients not prescribed clopidogrel. Primary endpoints included incidence of CAP and inpatient treatment. Secondary severity endpoints included mortality, intensive care unit admission, mechanical ventilation, sepsis, and acute respiratory distress syndrome/acute lung injury. Results CAP incidence was significantly greater in the exposed cohort (OR 3.39, 95% CI 3.27-3.51, p < 0.0001) that remained after adjustment (OR 1.48, 95% CI 1.41-1.55, p < 0.0001). Inpatient treatment was more common in the exposed cohort (OR 1.96, 95% CI 1.85-2.07, p < 0.0001), but no significant difference remained after adjustment. Trends favoring the exposed cohort were found for the secondary severity endpoints of mechanical ventilation (p = 0.07) and mortality (p = 0.10). Pooled analysis of published studies supports these findings. Conclusions While clopidogrel use may be associated with increased CAP incidence, clopidogrel does not appear to increase – and may reduce – its severity among inpatients. Because this study was retrospective and could not quantify all variables (e.g., aspirin use), these findings should be explored prospectively. PMID:23124575

  11. Birth Weight in Relation to Leisure Time Physical Activity in Adolescence and Adulthood: Meta-Analysis of Results from 13 Nordic Cohorts

    PubMed Central

    Andersen, Lise Geisler; Ängquist, Lars; Gamborg, Michael; Byberg, Liisa; Bengtsson, Calle; Canoy, Dexter; Eriksson, Johan G.; Eriksson, Marit; Järvelin, Marjo-Riitta; Lissner, Lauren; Nilsen, Tom I.; Osler, Merete; Overvad, Kim; Rasmussen, Finn; Salonen, Minna K.; Schack-Nielsen, Lene; Tammelin, Tuija H.; Tuomainen, Tomi-Pekka; Sørensen, Thorkild I. A.; Baker, Jennifer L.

    2009-01-01

    Background Prenatal life exposures, potentially manifested as altered birth size, may influence the later risk of major chronic diseases through direct biologic effects on disease processes, but also by modifying adult behaviors such as physical activity that may influence later disease risk. Methods/Principal Findings We investigated the association between birth weight and leisure time physical activity (LTPA) in 43,482 adolescents and adults from 13 Nordic cohorts. Random effects meta-analyses were performed on categorical estimates from cohort-, age-, sex- and birth weight specific analyses. Birth weight showed a reverse U-shaped association with later LTPA; within the range of normal weight the association was negligible but weights below and above this range were associated with a lower probability of undertaking LTPA. Compared with the reference category (3.26–3.75 kg), the birth weight categories of 1.26–1.75, 1.76–2.25, 2.26–2.75, and 4.76–5.25 kg, had odds ratios of 0.67 (95% confidence interval: 0.47, 0.94), 0.72 (0.59, 0.88), 0.89 (0.79, 0.99), and 0.65 (0.50, 0.86), respectively. The shape and strength of the birth weight-LTPA association was virtually independent of sex, age, gestational age, educational level, concurrent body mass index, and smoking. Conclusions/Significance The association between birth weight and undertaking LTPA is very weak within the normal birth weight range, but both low and high birth weights are associated with a lower probability of undertaking LTPA, which hence may be a mediator between prenatal influences and later disease risk. PMID:20016780

  12. Sensitivity Analysis of Weight Reduction Results of an Observational Cohort Study in Overweight and Obese Children and Adolescents in Germany: The Evakuj Study

    PubMed Central

    Böhler, Thomas; Goldapp, Cornelia; Mann, Reinhard; Reinehr, Thomas; Bullinger, Monika; Holl, Reinhard; Hoffmeister, Ulrike; van Egmond-Fröhlich, Andreas; Ravens-Sieberer, Ulrike; Wille, Nora; Westenhöfer, Joachim; Bengel, Jürgen

    2013-01-01

    In the German EvAKuJ observational cohort study, changes in the body mass index standard deviation score (BMI–SDS) of overweight and obese children and adolescents as primary outcome of multimodal (short, inpatient or long, outpatient) weight-loss interventions are difficult to interpret. Published intention-to-treat (ITT) and per protocol data obtained at the end of the intervention (T1), one year (T2), and two years (T3) after its end were used for sensitivity analysis of treatment success rates. The odds ratio and the number needed to treat (NNT) for BMI–SDS reduction of at least −0.2 (successful treatment) and at least −0.5 (good treatment success) were related to spontaneous BMI-SDS reduction rates in a hypothetical control group (control event rate, CER). At T1, treatment seems to be effective up to a CER of 10% in inpatients and of 5% in outpatients. ITT analysis, compromised by a loss to follow-up of 81 to 90% (inpatients) and 57 to 66% (outpatients), indicated that treatment may become less effective at a CER above 1% in inpatients (e.g., successful treatment at T2: NNT=106, at T3: NNT=51), and above 5% in outpatients (successful treatment at T2: NNT=7, at T3: NNT=8; good treatment success at T2 and T3: NNT=25). Positive short-term effects of inpatient treatment of overweight and obese children and adolescents may not be maintained in the long term. Long-term effectiveness of outpatient treatment may depend on age and the degree of overweight. PMID:24198928

  13. Effectiveness of community-based support for pregnant women living with HIV: a cohort study in South Africa

    PubMed Central

    Fatti, Geoffrey; Shaikh, Najma; Eley, Brian; Grimwood, Ashraf

    2016-01-01

    ABSTRACT Antiretroviral treatment (ART) initiation in HIV-infected pregnant women in sub-Saharan Africa (SSA) remains inadequate, and there is a severe shortage of professional healthcare workers in the region. The effectiveness of community support programmes for HIV-infected pregnant women and their infants in SSA is unclear. This study compared initiation of maternal antiretrovirals and infant outcomes amongst HIV-infected pregnant women and their infants who received and did not receive community-based support (CBS) in a high HIV-prevalence setting in South Africa. A cohort study, including HIV-infected pregnant women and their infants, was conducted at three sentinel surveillance facilities between January 2009 and June 2012, utilising enhanced routine clinical data. Through home visits, CBS workers encouraged uptake of interventions in the ART cascade, provided HIV-related education, ART initiation counselling and psychosocial support. Outcomes were compared using Kaplan–Meier analyses and multivariable Cox and log-binomial regression. Amongst 1105 mother–infant pairs included, 264 (23.9%) received CBS. Amongst women eligible to start ART antenatally, women who received CBS had a reduced risk of not initiating antenatal ART, 5.4% vs. 30.3%; adjusted risk ratio (aRR) = 0.18 (95% CI: 0.08–0.44; P < .0001). Women who received CBS initiated antenatal ART with less delay after the first antenatal visit, median 26 days vs. 39 days; adjusted hazard ratio (aHR) = 1.57 (95% CI: 1.15–2.14; P = .004). Amongst women who initiated antenatal zidovudine (ZDV) to prevent vertical transmission, women who received CBS initiated ZDV with less delay, aHR = 1.52 (95% CI: 1.18–2.01; P = .001). Women who received CBS had a lower risk of stillbirth, 1.5% vs. 5.4%; aRR = 0.24 (95% CI: 0.07–1.00; P = .050). Pregnant women living with HIV who received CBS had improved antenatal triple ART initiation in eligible women, women initiated ART and

  14. Social Participation and the Prevention of Decline in Effectance among Community-Dwelling Elderly: A Population-Based Cohort Study

    PubMed Central

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2015-01-01

    Background We examined the association between a decline in effectance and social participation (SP) from the perspective of the number and the type of SP in a prospective cohort study. Methods Included in this analysis were community-dwelling elderly aged ≥65 without dependency on the basic activities of daily living and reporting a perfect baseline effectance score (n = 4,588; mean age 72.8±5.7). SP was categorized into 5 types: neighborhood associations, hobby groups, local event groups, senior citizen clubs, and volunteer groups. Effectance was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Using logistic regression analysis, odds ratio (OR) and a 95% confidence interval (CI) for a decline in effectance were calculated. Age, family, BMI, pensions, medical history, medications, alcohol, smoking, cognitive function, depression, social support, ADL, and IADL were used as covariates. Results During the 3-year follow-up, 17.8% of eligible participants reported a decline in effectance. After adjustment for covariates, participation in various groups was associated with the preservation of effectance for both genders. Regarding the type of SP, among females, participation in neighborhood associations (OR: 0.62, 95%CI: 0.48–0.81), hobby groups (0.58, 0.43–0.77), local event groups (0.63, 0.47–0.86), and volunteer groups (0.53, 0.35–0.82) was inversely associated with a decline in effectance. Among males, the beneficial effect was more likely limited to hobby groups (0.59, 0.43–0.81) and volunteer groups (0.57, 0.39–0.83). Conclusions Our results suggest that participation in a variety of social groups is effective for maintenance of older people’s effectance, while the beneficial effect of each type of SP on effectance is stronger for females than for males. Recommending community-dwelling elderly to participate in social groups appropriate for their gender may be effective for successful aging. PMID:26406326

  15. Reproduction and marriage among male survivors of cancer in childhood, adolescence and young adulthood: a national cohort study

    PubMed Central

    Gunnes, M W; Lie, R T; Bjørge, T; Ghaderi, S; Ruud, E; Syse, A; Moster, D

    2016-01-01

    Background: Increased survival after cancer in young age has made long-term follow-up studies of high external validity important. In this national cohort study, we explored the impact of cancer in young age on reproduction and marital status in male survivors. Methods: Hazard ratios (HRs) and relative risks (RRs) of reproductive and marital outcomes were studied for male survivors of cancer in young age (<25 years) and cancer-free male comparisons, born during 1965–1985, by linking compulsory national registries in Norway. Results: Male cancer survivors (n=2687) had reduced paternity (HR: 0.72, 95% confidence interval (CI): 0.68–0.76). This was most apparent in survivors of testicular cancer, brain tumours, lymphoma, leukemia and bone tumours, and when diagnosed with cancer before 15 years of age. Male cancer survivors were more likely to avail of assisted reproduction (RR: 3.32, 95% CI: 2.68–4.11). There was no increased risk of perinatal death, congenital malformations, being small for gestational age, of low birth weight or preterm birth in their first offspring. Male cancer survivors were less likely to marry (HR: 0.93, 95% CI: 0.86–1.00), in particular brain tumour survivors. Conclusions: In this national cohort study, we demonstrated reduced paternity and increased use of assisted reproduction among male cancer survivors, but no adverse outcome for their first offspring at birth. PMID:26794280

  16. Relationships between community social capital and injury in Canadian adolescents: a multilevel analysis

    PubMed Central

    Vafaei, Afshin; Pickett, William; Alvarado, Beatriz E

    2015-01-01

    Background Characteristics of social environments are potential risk factors for adolescent injury. Impacts of social capital on the occurrence of such injuries have rarely been explored. Methods General health questionnaires were completed by 8910 youth aged 14 years and older as part of the 2010 Canadian Health Behaviour in School-Aged Children study. These were supplemented with community-level data from the 2006 Canada Census of Population. Multilevel logistic regression models with random intercepts were fit to examine associations of interest. The reliability and validity of variables used in this analysis had been established in past studies, or in new analyses that employed factor analysis. Results Between school differences explained 2% of the variance in the occurrence of injuries. After adjustment for all confounders, community social capital did not have any impact on the occurrence of injuries in boys: OR: 1.01, 95% CI 0.80 to 1.29. However, living in areas with low social capital was associated with lower occurrence of injuries in girls (OR 0.78, 95% CI 0.63 to 0.96). Other factors that were significantly related to injuries in both genders were younger age, engagement in more risky behaviours, and negative behavioural influences from peers. Conclusions After simultaneously taking into account the influence of community-level and individual-level factors, community levels of social capital remained a relatively strong predictor of injury among girls but not boys. Such gender effects provide important clues into the social aetiology of youth injury. PMID:26294708

  17. A Quasi-Experimental Evaluation of a Community-Based HIV Prevention Intervention for Mexican American Female Adolescents: The SHERO's Program

    ERIC Educational Resources Information Center

    Harper, Gary W.; Bangi, Audrey K.; Sanchez, Bernadette; Doll, Mimi; Pedraza, Ana

    2009-01-01

    This article describes a quasi-experimental evaluation of a community-based, culturally and ecologically tailored HIV prevention intervention for Mexican American female adolescents grounded in the AIDS risk reduction model. A total of 378 Mexican American female adolescents (mean age = 15.2) participated in either the nine-session SHERO's (a…

  18. Gender and ethnic differences in the prevalence of alcohol, cigarette, and illicit drug use over time in a cohort of young Hispanic adolescents in south Florida.

    PubMed

    Khoury, E L; Warheit, G J; Zimmerman, R S; Vega, W A; Gil, A G

    1996-01-01

    The purpose of this study was to describe patterns of substance use among young Hispanic adolescents of Cuban and Central/South American heritage, many of whom are recent immigrants to the U.S. At present there are very little epidemiologic data on these Hispanic ethnic subgroups, particularly for girls. A cohort of 848 middle school boys and girls in Miami, Florida completed questionnaires in 7th, 8th, and 9th grades concerning their use of alcohol, cigarettes, marijuana, and other illicit drugs. African Americans and White non-Hispanics were used as comparison groups. In general, White non-Hispanics and U.S.-born Hispanics had the highest lifetime and past year prevalence rates of substance use. While no statistically significant gender differences were found for any of the racial/ethnic groups, the use of substances among Hispanic girls often exceeded that of their male counterparts. A progressive increase in use of alcohol, cigarettes, marijuana, and other illicit drugs was evident over the two and one-half year duration of the study for both gender groups. PMID:8883369

  19. The Relationship Between Anxiety Disorders and Substance Use Among Adolescents in the Community: Specificity and Gender Differences

    PubMed Central

    Goodwin, Renee D.; Fuller, Cordelia; Liu, Xinhua; Comer, Jonathan S.; Cohen, Patricia; Hoven, Christina W.

    2009-01-01

    Using a sample of 781 adolescents (ages 13–17, 52.8% male) from a community survey, this study examined gender differences in the co-occurrence of specific anxiety disorders with substance use in adolescents. The associations between anxiety disorders and substance use differed according to the particular anxiety disorders and forms of substance use being examined, as well as by gender. Social phobia was associated with cigarette smoking among boys only. For girls, social phobia appeared to be negatively associated with drug use. For the other anxiety disorders, the associations with substance use tended to be stronger among girls. These findings highlight the need to improve clinical recognition of the anxiety disorders and to improve treatment access for afflicted adolescents. Future studies based on longitudinal data could further elucidate the relationships among anxiety disorders, gender, and substance use. PMID:20084563

  20. Positive aspects of the coping of mothers of adolescent children with developmental disability in the Bedouin community in Israel.

    PubMed

    Manor-Binyamini, Iris

    2014-06-01

    This research examines the positive aspects of coping experienced by 270 mothers of adolescent children with and without a developmental disability in the Bedouin community. The mothers completed the Sociodemographic Data Questionnaire, the Grandparents Functional Support Assessment, the Gratitude Questionnaire, and the Posttraumatic Growth Inventory. Mothers of adolescent children with developmental disability reported higher levels of social support, gratitude, and personal growth than did mothers of adolescent children without developmental disability. Additionally, mothers demonstrated a higher level of gratitude toward their spouse's parents. Positive correlation was also found between gratitude and personal growth and between gratitude and support from the husband's parents. The findings highlight the important need to develop awareness and culturally appropriate intervention programs based on these positive aspects, to enhance these mothers' coping abilities.

  1. A Qualitative Exploration of Community-Based Organization Programs, Resources, and Training to Promote Adolescent Sexual Health

    PubMed Central

    McCarthy, M.; Fisher, C.M.; Zhou, J.; Kneip Pelster, A.D.; Schober, D.; Baldwin, K.; Fortenberry, J.; Goldsworthy, R.

    2016-01-01

    Background Youth development professionals (YDPs) working at community-based organizations (CBOs) can promote adolescent sexual health through programs. This study explored the programs and resources that youth access at CBOs and training YDPs receive. Methods Twenty-one semi-structured interviews were conducted with YDPs. Qualitative content analyses were conducted using NVivo. Results Most YDPs (n = 15, 71.4%) described sexuality-related programs for youth. Some YDPs provided informal information (n = 11, 52.4%) and/or referrals for youth (n = 6, 28.6%). Few YDPs (n = 8, 38.1%) were trained to address adolescent sexuality, but some (n = 10, 47.6%) sought outside resources. Conclusions YDPs have a unique opportunity to improve adolescent sexual health and sexuality. Five considerations for organizations that develop programs and training for CBOs are suggested. PMID:27790077

  2. Intergenerational continuity of child abuse among adolescent mothers: authoritarian parenting, community violence, and race.

    PubMed

    Valentino, Kristin; Nuttall, Amy K; Comas, Michelle; Borkowski, John G; Akai, Carol E

    2012-05-01

    Among the negative sequelae of child maltreatment is increased risk for continuity of maltreatment into subsequent generations. Despite acknowledgment in the literature that the pathways toward breaking the cycle of maltreatment are likely the result of dynamic interactions of risk and protective factors across multiple ecological levels, few studies have followed high-risk samples of maltreated and nonmaltreated parents over time to evaluate such processes. In the current investigation, exposure to community violence and authoritarian parenting attitudes were evaluated as predictors of the intergenerational continuity of abuse, and the moderating effect of African American race was examined. The sample included 70 mothers and their 18-year-old children, who have been followed longitudinally since the third trimester of the adolescent mothers' pregnancy. Results revealed that among mothers with a child abuse history, higher exposure to community violence and lower authoritarian parenting attitudes were associated with increased risk for intergenerational continuity of abuse. The relation of authoritarian parenting attitudes to intergenerational continuity was moderated by race; the protective effects of authoritarian parenting were limited to the African American families only. The salience of multiple ecological levels in interrupting the intergenerational continuity of child abuse is discussed, and implications for preventive programs are highlighted.

  3. Educational-entertainment as an intervention with Black adolescents exposed to community violence.

    PubMed

    Allen, Valerie Dorsey; Solomon, Phyllis

    2012-01-01

    Witnessing violence is one adverse childhood experience (ACE) associated with living in impoverished Black urban communities. Youth with higher violence avoidance self-efficacy and positive coping are more likely to avoid violence. This study evaluates educational entertainment (edutainment) as an intervention with Black adolescents exposed to community violence. Edutainment has shown success in increasing self-efficacy and positive coping skills in other domains. Self-administered scales were used to measure stress, anxiety, violence avoidance self-efficacy, and coping strategies. Data were collected pre- and nine days post-interventions/no intervention from 20 subjects receiving the edutainment intervention, 19 subjects participating in a group discussion about violence, and 21 subjects receiving no intervention (N = 60). Edutainment and no intervention were more effective than group discussion alone in increasing violence avoidance self-efficacy. Violence avoidance self-efficacy was found to have an intervening relationship between edutainment and the outcome of stress. This study indicates limited but positive effects for edutainment.

  4. The association between characteristics of fathering in infancy and depressive symptoms in adolescence: A UK birth cohort study.

    PubMed

    Scourfield, Jonathan; Culpin, Iryna; Gunnell, David; Dale, Caroline; Joinson, Carol; Heron, Jon; Collin, Simon M

    2016-08-01

    Evidence suggests that the quality of fathers' parenting has an impact on psychological outcomes during adolescence, but less is known about which aspects of fathering have the strongest effects. This study, using the Avon Longitudinal Study of Parents and Children (ALSPAC), considers which paternal attitudes towards and experiences of child care in infancy are most strongly associated with depressive symptoms in adolescence, and whether father effects are independent of maternal influence and other risk factors. Primary exposures were fathers' attitudes to and experiences of child care at 8 weeks, 8 months and 21 months coded as continuous scores; the primary outcome was self-reported depressive symptoms at 16 years (Short Moods and Feelings Questionnaire score ≥11). Multivariable logistic regression models showed reasonably strong evidence that parental reports indicating potential paternal abuse when children were toddlers were associated with a 22% increased odds of depressive symptoms at age 16 (odds ratio [OR] 1.22 [95% CI 1.11, 1.34] per SD). There was some evidence for an interaction with social class (p=0.04): for children living in higher social class households (professional, managerial and technical classes), an increase in the potential abuse scale increased the odds of depressive symptoms by 31% (OR 1.31 [1.13, 1.53] per SD), whereas there was no effect in the lower social class categories. The potential paternal abuse measure needs to be validated and research is needed on what circumstances predict anger and frustration with child care. Effective interventions are needed to help fathers cope better with parenting stress. PMID:27376651

  5. The association between characteristics of fathering in infancy and depressive symptoms in adolescence: A UK birth cohort study.

    PubMed

    Scourfield, Jonathan; Culpin, Iryna; Gunnell, David; Dale, Caroline; Joinson, Carol; Heron, Jon; Collin, Simon M

    2016-08-01

    Evidence suggests that the quality of fathers' parenting has an impact on psychological outcomes during adolescence, but less is known about which aspects of fathering have the strongest effects. This study, using the Avon Longitudinal Study of Parents and Children (ALSPAC), considers which paternal attitudes towards and experiences of child care in infancy are most strongly associated with depressive symptoms in adolescence, and whether father effects are independent of maternal influence and other risk factors. Primary exposures were fathers' attitudes to and experiences of child care at 8 weeks, 8 months and 21 months coded as continuous scores; the primary outcome was self-reported depressive symptoms at 16 years (Short Moods and Feelings Questionnaire score ≥11). Multivariable logistic regression models showed reasonably strong evidence that parental reports indicating potential paternal abuse when children were toddlers were associated with a 22% increased odds of depressive symptoms at age 16 (odds ratio [OR] 1.22 [95% CI 1.11, 1.34] per SD). There was some evidence for an interaction with social class (p=0.04): for children living in higher social class households (professional, managerial and technical classes), an increase in the potential abuse scale increased the odds of depressive symptoms by 31% (OR 1.31 [1.13, 1.53] per SD), whereas there was no effect in the lower social class categories. The potential paternal abuse measure needs to be validated and research is needed on what circumstances predict anger and frustration with child care. Effective interventions are needed to help fathers cope better with parenting stress.

  6. Long-Term Fine Particulate Matter Exposure and Major Depressive Disorder in a Community-Based Urban Cohort

    PubMed Central

    Kim, Kyoung-Nam; Lim, Youn-Hee; Bae, Hyun Joo; Kim, Myounghee; Jung, Kweon; Hong, Yun-Chul

    2016-01-01

    Background: Previous studies have associated short-term air pollution exposure with depression. Although an animal study showed an association between long-term exposure to particulate matter ≤ 2.5 μm (PM2.5) and depression, epidemiological studies assessing the long-term association are scarce. Objective: We aimed to determine the association between long-term PM2.5 exposure and major depressive disorder (MDD). Methods: A total of 27,270 participants 15–79 years of age who maintained an address within the same districts in Seoul, Republic of Korea, throughout the entire study period (between 2002 and 2010) and without a previous MDD diagnosis were analyzed. We used three district-specific exposure indices as measures of long-term PM2.5 exposure. Cox proportional hazards models adjusted for potential confounding factors and measured at district and individual levels were constructed. We further conducted stratified analyses according to underlying chronic diseases such as diabetes mellitus, cardiovascular disease, and chronic obstructive pulmonary disease. Results: The risk of MDD during the follow-up period (2008–2010) increased with an increase of 10 μg/m3 in PM2.5 in 2007 [hazard ratio (HR) = 1.44; 95% CI: 1.17, 1.78], PM2.5 between 2007 and 2010 (HR = 1.59; 95% CI: 1.02, 2.49), and 12-month moving average of PM2.5 until an event or censor (HR = 1.47; 95% CI: 1.14, 1.90). The association between long-term PM2.5 exposure and MDD was greater in participants with underlying chronic diseases than in participants without these diseases. Conclusion: Long-term PM2.5 exposure increased the risk of MDD among the general population. Individuals with underlying chronic diseases are more vulnerable to long-term PM2.5 exposure. Citation: Kim KN, Lim YH, Bae HJ, Kim M, Jung K, Hong YC. 2016. Long-term fine particulate matter exposure and major depressive disorder in a community-based urban cohort. Environ Health Perspect 124:1547–1553; http://dx.doi.org/10

  7. Vitamin D Status and Long-Term Mortality in Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort

    PubMed Central

    Holter, Jan C.; Ueland, Thor; Norseth, Jon; Brunborg, Cathrine; Frøland, Stig S.; Husebye, Einar; Aukrust, Pål; Heggelund, Lars

    2016-01-01

    Background Low vitamin D status has been associated with short-term (30-day) mortality in hospitalized adults with community-acquired pneumonia (CAP). Data on its prevalence in these patients are scarce, and impact on long-term prognosis is unknown. We examined the prevalence of vitamin D deficiency and inadequacy and their effect on long-term mortality in hospitalized adults with CAP. Methods Secondary follow-up analysis of data from a prospectively recruited (January 2008–January 2011) well-defined cohort of 241 hospital survivors of CAP (Norway, latitude 60°N). Serum 25-hydroxyvitamin D levels, demographic, clinical, and laboratory data were measured within 48 hours of admission. The etiology of CAP was established in 63% of patients through extensive microbiological investigations. Mortality data were obtained from the national Cause of Death Registry. Explanatory strategy and Cox regression models were used to explore the association between vitamin D status and all-cause mortality. Results Median age was 66 years. Eighty-seven (36%) patients were vitamin D deficient (<30 nmol/L), 81 (34%) were inadequate (30–49 nmol/L), and 73 (30%) were sufficient (≥50 nmol/L). Seventy-two patients died over a median of 1839 days (range 1–2520 days), corresponding to cumulative 5-year survival rates of 66.2% (95% CI 56.2–76.2%), 77.0% (67.6–86.4%), and 77.8% (67.8–87.8%) for vitamin D deficient, inadequate, and sufficient patients, respectively. After adjusting for confounders (age, chronic obstructive pulmonary disease, immunocompromization and season), vitamin D deficiency, but not inadequacy, was significantly associated with higher mortality compared to patients with sufficiency (HR 1.91, 95% CI 1.06–3.45; P = .031). Conclusions There is a high prevalence of vitamin D deficiency and inadequacy among hospitalized adults with CAP. The results of this study also suggest that vitamin D deficiency is associated with an increased risk of mortality way beyond

  8. Long-term morbidity and mortality after hospitalization with community-acquired pneumonia: a population-based cohort study.

    PubMed

    Johnstone, Jennie; Eurich, Dean T; Majumdar, Sumit R; Jin, Yan; Marrie, Thomas J

    2008-11-01

    Little is known about the long-term sequelae of community-acquired pneumonia (CAP). Therefore, we describe the long-term morbidity and mortality of patients after pneumonia requiring hospitalization. We specifically hypothesized that the Pneumonia Severity Index (PSI), designed to predict 30-day pneumonia-related mortality, would also be associated with longer-term all-cause mortality. Between 2000 and 2002, 3415 adults with CAP admitted to 6 hospitals in Edmonton, Alberta, Canada, were prospectively enrolled in a population-based cohort. At the time of hospital admission, demographic, clinical, and laboratory data were collected and the PSI was calculated for each patient. Postdischarge outcomes through to 2006 were ascertained using multiple linked administrative databases. Outcomes included all-cause mortality, hospital admissions, and re-hospitalization for pneumonia over a maximum of 5.4 years of follow-up. Follow-up data were available for 3284 (96%) patients; 66%were > or =65 years of age, 53% were male, and according to the PSI fully 63% were predicted to have greater than 18% 30-day pneumonia-related mortality (that is, PSI class IV-V). Median follow-up was 3.8 years. The 30-day, 1-year, and end of study mortality rates were 12%, 28%, and 53%, respectively. Overall, 82(19%) patients aged <45 years died compared with 1456 (67%) patients aged > or =65 years (hazard ratio [HR], 5.07; 95% confidence interval [CI], 4.06-6.34). Male patients were more likely to die than female patients during follow-up (971 [56%] vs. 767 [49%], respectively; HR, 1.20; 95% CI, 1.13-1.37). Initial PSI classification predicted not only 30-day mortality, but also long-term postdischarge mortality, with 92 (15%) of PSI class I-II patients dying compared with 616 (82%) PSI class V patients (HR, 11.80; 95% CI, 4.70-14.70). Of 2950 patients who survived the initial CAP hospitalization, 72% were hospitalized again (median, 2 admissions over follow-up) and 16% were re-hospitalized with

  9. Measuring depression and stigma towards depression and mental health treatment among adolescents in an Arab-American community

    PubMed Central

    Jaber, R.M.; Farroukh, M.; Ismail, M.; Najda, J.; Sobh, H.; Hammad, A.; Dalack, G.W.

    2014-01-01

    There has been limited research that has examined the prevalence of depression and attitudes towards depression and mental health treatment in Arab-American adolescents; we sought to assess these in a predominantly Arab-American community in metro Detroit. A health survey of adolescents aged 12–17 years was conducted (n=98). Participants were recruited from two local community organizations in Dearborn, MI. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9) Depression Scale, and attitude towards depression and willingness to seek help for mental health conditions were assessed by the Self-Stigma of Depression Scale (SSDS). To assess whether attitudes might be affected by information about mental health treatment, adolescents were randomized to view either an educational video about mental health, or a control video before responding to questions about their willingness to seek help for mental health conditions. Overall, 14% of Arab-American adolescents in this study endorsed moderate or moderately severe depression (PHQ-9 ≥ 11), suggesting a need to increase awareness of and access to mental health services and screening for Arab-American youth. PMID:26257824

  10. Menstrual Hygiene Practices in Context of Schooling: A Community Study Among Rural Adolescent Girls in Varanasi

    PubMed Central

    Kansal, Sangeeta; Singh, Sweta; Kumar, Alok

    2016-01-01

    Introduction: Up until now, poor menstrual hygiene in developing countries has been an insufficiently acknowledged problem. The lack of attention to this issue is striking as we cannot achieve several Millennium Development Goals (MDGs), that is, 2, 3 4,5, and 5B. This study aimed to assess the level of awareness about menarche and hygienic practices during menstruation in context of schooling. Materials and Methods: Community-based cross-sectional study using a mix method approach (qualitative and quantitative). It was conducted among 650 adolescent girls in the field practice area of Rural Health and Training Centre, Chiraigaon block of district Varanasi between January and June2011. Pretested, semistructured interview schedule was used. Data were analyzed statistically by using Statistical Package for Social Sciences (SPSS) software. Results: Out of the total 650 respondents, 590 (90.78%) had attained menarche at the time of interview and only one-third of the respondents (29.4%) were aware of menstruation before menarche and sisters (55%) played the key role in providing information to them. Only 31% respondents were using sanitary pads during menstruation. Self-reported reproductive tract infection (RTI) was observed more in respondents not maintaining hygienic practices (6.6%) as compared to those maintaining hygiene (2.6%). Conclusion and Recommendations: From the Focus Group Discussions (FGDs) as well as quantitative survey it was observed that the awareness about menarche before its onset was still poor in rural areas. Significant association (P < 0.05) was observed between respondent education and their awareness about menarche before its onset. Therefore, it is recommended that teachers can play an influential role in informing them about changes during adolescence, especially about menarche and other issues related to menstruation. As per the present study, sisters and mothers were the major source of information. Therefore, there is a need for the

  11. Improving the Health of Adolescents & Young Adults: A Guide for States and Communities

    ERIC Educational Resources Information Center

    Brindis, Claire D.; Park, M. Jane; Valderrama, L. Teresa; Lee, Caron M.; Margolis, Rebecca; Kolbe, Lloyd J.; Achrekar, Angeli P.; Hannan, Casey; Anglin, Trina M.

    2004-01-01

    Adolescence represents a unique period in the life cycle. No longer children and not yet adults, adolescents make significant choices about their health and develop attitudes and health practices that impact their current safety and well-being. Those choices also often influence their risk for future serious chronic disease. Adolescence also…

  12. Ethnic Label Use in Adolescents from Traditional and Non-Traditional Immigrant Communities

    ERIC Educational Resources Information Center

    Kiang, Lisa; Perreira, Krista M.; Fuligni, Andrew J.

    2011-01-01

    Understanding adolescents' use of ethnic labels is a key developmental issue, particularly given the practical significance of identity and self-definition in adolescents' lives. Ethnic labeling was examined among adolescents in the traditional immigrant receiving area of Los Angeles (Asian n = 258, Latino n = 279) and the non-traditional…

  13. Cannabis use and quality of life of adolescents and young adults: findings from an Australian birth cohort.

    PubMed

    Fischer, Jane A; Clavarino, Alexandra M; Plotnikova, Maria; Najman, Jackob M

    2015-01-01

    Cannabis is generally used to enhance mood (quality of life), but it is not known whether it has this effect in the medium to longer term. Little is currently known about the temporal sequence between cannabis use and the quality of life (QOL). Data are taken from a prospective longitudinal study of pregnant women recruited at their first antenatal visit in Brisbane, Australia. Offspring data from the follow-ups with 14-year-olds and 21-year-olds are used here. Indicators of QOL, happiness, and satisfaction at 14 years are considered as predictors of subsequent cannabis use. The association between cannabis use and QOL at 21 years, adjusting for prior QOL (14 years), is also examined. Socio-demographic characteristics were included as potential confounders relevant to QOL assessments. In this cohort, lower QOL in the early teenage years predicted subsequent onset of cannabis use in young adulthood. After adjustment for socio-demographic characteristics and for QOL pre-cannabis use, participants who used cannabis more frequently had a lower QOL at the 21-years follow-up. Frequent use of cannabis does not appear to enhance the user's QOL and appears to be associated with a reduced QOL into young adulthood. PMID:25950590

  14. Cannabis use and quality of life of adolescents and young adults: findings from an Australian birth cohort.

    PubMed

    Fischer, Jane A; Clavarino, Alexandra M; Plotnikova, Maria; Najman, Jackob M

    2015-01-01

    Cannabis is generally used to enhance mood (quality of life), but it is not known whether it has this effect in the medium to longer term. Little is currently known about the temporal sequence between cannabis use and the quality of life (QOL). Data are taken from a prospective longitudinal study of pregnant women recruited at their first antenatal visit in Brisbane, Australia. Offspring data from the follow-ups with 14-year-olds and 21-year-olds are used here. Indicators of QOL, happiness, and satisfaction at 14 years are considered as predictors of subsequent cannabis use. The association between cannabis use and QOL at 21 years, adjusting for prior QOL (14 years), is also examined. Socio-demographic characteristics were included as potential confounders relevant to QOL assessments. In this cohort, lower QOL in the early teenage years predicted subsequent onset of cannabis use in young adulthood. After adjustment for socio-demographic characteristics and for QOL pre-cannabis use, participants who used cannabis more frequently had a lower QOL at the 21-years follow-up. Frequent use of cannabis does not appear to enhance the user's QOL and appears to be associated with a reduced QOL into young adulthood.

  15. Outcome results for the Ma'alahi Youth Project, a Tongan community-based obesity prevention programme for adolescents.

    PubMed

    Fotu, K F; Millar, L; Mavoa, H; Kremer, P; Moodie, M; Snowdon, W; Utter, J; Vivili, P; Schultz, J T; Malakellis, M; McCabe, M P; Roberts, G; Swinburn, B A

    2011-11-01

    Tonga has a very high prevalence of obesity with steep increases during youth, making adolescence a critical time for obesity prevention. The Ma'alahi Youth Project, the Tongan arm of the Pacific Obesity Prevention in Communities project, was a 3-year, quasi-experimental study of community-based interventions among adolescents in three districts on Tonga's main island (Tongatapu) compared to the island of Vava'u. Interventions focused mainly on capacity building, social marketing, education and activities promoting physical activity and local fruit and vegetables. The evaluation used a longitudinal design (mean follow-up duration 2.4 years). Both intervention and comparison groups showed similar large increases in overweight and obesity prevalence (10.1% points, n = 815; 12.6% points, n = 897 respectively). Apart from a small relative decrease in percentage body fat in the intervention group (-1.5%, P < 0.0001), there were no differences in outcomes for any anthropometric variables between groups and behavioural changes did not follow a clear positive pattern. In conclusion, the Ma'alahi Youth Project had no impact on the large increase in prevalence of overweight and obesity among Tongan adolescents. Community-based interventions in such populations with high obesity prevalence may require more intensive or longer interventions, as well as specific strategies targeting the substantial socio-cultural barriers to achieving a healthy weight.

  16. Mental health trajectories from adolescence to adulthood: Language disorder and other childhood and adolescent risk factors.

    PubMed

    Bao, Lin; Brownlie, E B; Beitchman, Joseph H

    2016-05-01

    Longitudinal research on mental health development beyond adolescence among nonclinical populations is lacking. This study reports on psychiatric disorder trajectories from late adolescence to young adulthood in relation to childhood and adolescent risk factors. Participants were recruited for a prospective longitudinal study tracing a community sample of 5-year-old children with communication disorders and a matched control cohort to age 31. Psychiatric disorders were measured at ages 19, 25, and 31. Known predictors of psychopathology and two school-related factors specifically associated with language disorder (LD) were measured by self-reports and semistructured interviews. The LD cohort was uniquely characterized by a significantly decreasing disorder trajectory in early adulthood. Special education was associated with differential disorder trajectories between LD and control cohorts, whereas maltreatment history, specific learning disorder, family structure, and maternal psychological distress were associated with consistent trajectories between cohorts. From late adolescence to young adulthood, childhood LD was characterized by a developmentally limited course of psychiatric disorder; maltreatment was consistently characterized by an elevated risk of psychiatric disorder regardless of LD history, whereas special education was associated with significantly decreasing risk of psychiatric disorder only in the presence of LD.

  17. Low resting heart rate is associated with violence in late adolescence: a prospective birth cohort study in Brazil

    PubMed Central

    Murray, Joseph; Hallal, Pedro C; Mielke, Gregore I; Raine, Adrian; Wehrmeister, Fernando C; Anselmi, Luciana; Barros, Fernando C

    2016-01-01

    Background: Youth violence is a major global public health problem. Three UK and Swedish studies suggest that low resting heart rate predicts male youth violence, but this has not been tested in other social settings nor for females. Methods: A prospective, population-based birth cohort study was conducted in Pelotas, Brazil. Heart rate was measured using a wrist monitor at ages 11, 15 and 18 years. Violent crime and non-violent crime were measured at age 18 in self-reports and official records (N = 3618). Confounding variables were assessed in the perinatal period and at age 11, in interviews with mothers and children. Logistic regression was used to estimate associations between quartiles of heart rate at each age, and violent and non-violent crime at age 18, separately for males and females. Results: Lower resting heart rate was a robust correlate of violent and non-violent crime for males. Comparing males in the lowest and top quartiles of heart rate at age 15 years, adjusted odds ratios were 1.9 for violent crime [95% confidence interval (CI) 1.4–2.7] and 1.7 for non-violent crime (95% CI 1.1–2.6). For females, crime outcomes were associated only with low resting heart rate at age 18. Associations were generally linear across the four heart rate quartiles. There was no evidence that associations differed according to socioeconomic status at age 15. Conclusions: Low resting heart rate predicted violent and non-violent crime for males, and was cross-sectionally associated with crime for females. Biological factors may contribute to individual propensity to commit crime, even in a middle-income setting with high rates of violence. PMID:26822937

  18. Academic performance of opposite-sex and same-sex twins in adolescence: A Danish national cohort study.

    PubMed

    Ahrenfeldt, Linda; Petersen, Inge; Johnson, Wendy; Christensen, Kaare

    2015-03-01

    Testosterone is an important hormone in the sexual differentiation of the brain, contributing to differences in cognitive abilities between males and females. For instance, studies in clinical populations such as females with congenital adrenal hyperplasia (CAH) who are exposed to high levels of androgens in utero support arguments for prenatal testosterone effects on characteristics such as visuospatial cognition and behaviour. The comparison of opposite-sex (OS) and same-sex (SS) twin pairs can be used to help establish the role of prenatal testosterone. However, although some twin studies confirm a masculinizing effect of a male co-twin regarding for instance perception and cognition it remains unclear whether intra-uterine hormone transfer exists in humans. Our aim was to test the potential influences of testosterone on academic performance in OS twins. We compared ninth-grade test scores and teacher ratings of OS (n=1812) and SS (n=4054) twins as well as of twins and singletons (n=13,900) in mathematics, physics/chemistry, Danish, and English. We found that males had significantly higher test scores in mathematics than females (.06-.15 SD), whereas females performed better in Danish (.33-.49 SD), English (.20 SD), and neatness (.45-.64 SD). However, we did not find that OS females performed better in mathematics than SS and singleton females, nor did they perform worse either in Danish or English. Scores for OS and SS males were similar in all topics. In conclusion, this study did not provide evidence for a masculinization of female twins with male co-twins with regard to academic performance in adolescence.

  19. Academic performance of opposite-sex and same-sex twins in adolescence: A Danish national cohort study

    PubMed Central

    Petersen, Inge; Johnson, Wendy; Christensen, Kaare

    2015-01-01

    Testosterone is an important hormone in the sexual differentiation of the brain, contributing to differences in cognitive abilities between males and females. For instance, studies in clinical populations such as females with congenital adrenal hyperplasia (CAH) who are exposed to high levels of androgens in utero support arguments for prenatal testosterone effects on characteristics such as visuospatial cognition and behaviour. The comparison of opposite-sex (OS) and same-sex (SS) twin pairs can be used to help establish the role of prenatal testosterone. However, although some twin studies confirm a masculinizing effect of a male co-twin regarding for instance perception and cognition it remains unclear whether intra-uterine hormone transfer exists in humans. Our aim was to test the potential influences of testosterone on academic performance in OS twins. We compared ninth-grade test scores and teacher ratings of OS (n = 1812) and SS (n = 4054) twins as well as of twins and singletons (n = 13,900) in mathematics, physics/chemistry, Danish, and English. We found that males had significantly higher test scores in mathematics than females (.06–.15 SD), whereas females performed better in Danish (.33–.49 SD), English (.20 SD), and neatness (.45–.64 SD). However, we did not find that OS females performed better in mathematics than SS and singleton females, nor did they perform worse either in Danish or English. Scores for OS and SS males were similar in all topics. In conclusion, this study did not provide evidence for a masculinization of female twins with male co-twins with regard to academic performance in adolescence. PMID:25655669

  20. Feasibility of Implementing the Adolescent Community Reinforcement Approach in School Settings for Adolescents with Substance Use Disorders

    ERIC Educational Resources Information Center

    Hunter, Brooke D.; Godley, Mark D.; Godley, Susan H.

    2014-01-01

    Nationally, approximately 10% of adolescents in need of treatment for a substance use (SU) disorder receive treatment. School-based treatment may provide an important opportunity to reduce the treatment gap by facilitating access to services. While some school-based SU treatment exists, little is known about whether newer, evidence-based…

  1. A cross-cultural examination of adolescent civic engagement: comparing Italian and American community-oriented and political involvement.

    PubMed

    Jahromi, Parissa; Crocetti, Elisabetta; Buchanan, Christy M

    2012-01-01

    The purpose of this study was to investigate community-oriented and political civic engagement activities and intentions among youth in Italy and the United States. Adolescents (N = 566) from academically rigorous schools in both countries completed surveys assessing frequency of civic activity participation, motivation for activity, evaluations of activity, and intentions for future civic engagement. Results suggest that youth in both countries were more likely to participate in community-oriented than political civic activities and that youth in both countries found their civic experiences to be meaningful. American youth reported more past civic activities of both types and higher intentions for future community-oriented civic engagement compared to Italian youth. Finally, a model was tested to examine links between peer and school contexts and civic activities and intentions. Findings highlighted that, in both countries, peer and school contexts had a stronger impact on community-oriented than on political civic activity.

  2. Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention

    PubMed Central

    2013-01-01

    Background Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and reproductive health information, services and counselling. To date, many adolescent health programmes have targeted a single determinant of sexual and reproductive health. However, recent evidence suggests that the complexity of sexual and reproductive health issues demands an equally multi-layered and comprehensive approach. Methods This article describes the development, implementation and evaluation design of the community-embedded reproductive health care for adolescents (CERCA) study in three Latin American cities: Cochabamba (Bolivia), Cuenca (Ecuador) and Managua (Nicaragua). Project CERCA’s research methodology builds on existing methodological frameworks, namely: action research, community based participatory research and intervention-mapping. The interventions in each country address distinct target groups (adolescents, parents, local authorities and health providers) and seek improvement of the following sexual health behaviours: communication about sexuality, sexual and reproductive health information-seeking, access to sexual and reproductive health care and safe sexual relationships. In Managua, we implemented a randomised controlled study, and in Cochabamba and Cuenca we adopted a non-randomised controlled study to evaluate the effectiveness of Project CERCA interventions, in addition to a process evaluation. Discussion This research will result in a methodological framework that will contribute to the improved design and implementation of future adolescent sexual and reproductive health interventions. Trial registration ClinicalTrials.gov (NCT01722084) PMID:23311647

  3. INTERIM REPORT, DEVELOP A COMMUNITY INVOLVEMENT STRATEGY: PREPARE TO IMPLEMENT A COHORT STUDY OF CHILDREN'S ENVIRONMENTAL HEALTH

    EPA Science Inventory

    Introduction

    The National Children's Study (NCS) is an ambitious undertaking: a 20-year prospective cohort

    study that will investigate the relationships between a broad range of environmental factors and the health

    and well-being of children. Approximately 10...

  4. The Relationship between Motor Skills, Perceived Social Support, and Internalizing Problems in a Community Adolescent Sample

    PubMed Central

    Mancini, Vincent O.; Rigoli, Daniela; Heritage, Brody; Roberts, Lynne D.; Piek, Jan P.

    2016-01-01

    Objectives: Poor motor skills are associated with a range of psychosocial consequences, including internalizing (anxious and depressive) symptoms. The Elaborated Environmental Stress Hypothesis provides a causal framework to explain this association. The framework posits that motor skills impact internalizing problems through an indirect effect via perceived social support. However, empirical evaluation is required. We examined whether motor skills had an indirect effect on anxious and depressive symptoms via perceived family support domains. Methods: This study used a community sample of 93 adolescents (12–16 years). Participants completed measures of motor skills, perceived social support across three dimensions (family, friend, and significant other), depressive symptoms, and anxious symptoms. Age, gender, verbal IQ, and ADHD symptoms were included as control variables. Results: Regression analysis using PROCESS revealed that motor skills had an indirect effect on depressive symptoms via perceived family support, but not by perceived friend support or significant other support. The negative association between motor skills and anxious symptoms was not mediated by any perceived social support domain. Conclusions: Findings are consistent with previous literature indicating an association between motor skills and internalizing problems. However, we identified a different pattern of relationships across anxious and depressive symptoms. While anxiety and depressive symptoms were highly correlated, motor skills had an indirect effect on depressive symptoms via perceived family support only. Our findings highlight the importance of family support as a potential protective factor in the onset of depressive symptoms. This study provides partial support for the Elaborated Environmental Stress Hypothesis, however further research is required. PMID:27148149

  5. Factors Associated with Physical Activity among Macedonian Adolescents in Albanian Ethnic Community

    PubMed Central

    GONTAREV, Seryozha; KALAC, Ruzdija; AMETI, Vullnet; REDJEPI, Agim

    2016-01-01

    Background: The purpose of this study was to determine the relationship of demographic, psychological, social and environmental factors with physical activity and to determine whether indicators of physical activity differ by gender among Macedonian adolescents from Albanian ethnic community from 11 to 14 yr (N = 886). Methods: Research were conducted in 2014 in several primary schools randomly selected from Tetovo and Gostivar region of the R. Macedonia. Students completed a questionnaire which examined their level of participation in physical activity and sedentary behavior along with a number of potential correlates. Hierarchical regression was used to explore the relationship between hypothesised factors and physical activity. Results: The boys unlike the girls showed significantly higher levels of physical activity (P=0.001). Respondents of both genders who perceive greater benefits from the physical activity (P=0.010). They have more confidence in their abilities (P=0.001), enjoy more in the physical activities (P=0.016), perceive greater social support from friends (P=0.008) and parents (P=0.001) and have higher levels of physical activity. Conclusions: The results indicate the importance of developing a national plan and program to promote physical activity in order to help young people to change unhealthy lifestyle habits and increase the physical activity, thus improving their health. PMID:27252917

  6. Zinc in plasma and breast milk in adolescents and adults in pregnancy and pospartum: a cohort study in Uruguay.

    PubMed

    Severi, Cecilia; Hambidge, Michael; Krebs, Nancy; Alonso, Rafael; Atalah, Eduardo

    2013-01-01

    Objetivo: Evaluar la edad como factor de riego para el déficit nutricional de zinc en el embarazo y en el posparto y la correlación entre la concentración de zinc plasmático y de la leche materna. Diseño: Estudio de cohorte de 151 embarazadas adolescentes y 161 adultas con < 14 semanas de gestación al primer control prenatal, seleccionadas en 16 centros públicos de salud de primer nivel de atención de Uruguay. Se obtuvieron datos socio demográficos y se determinó zinc plasmático al primer control prenatal y 4 meses posparto (± 1 mes). En el último control se midió también la concentración de zinc en la leche materna. Resultados: La media de concentración de zinc plasmático a las 14 semanas de gestación fue 84.4 ± 3.6 ug. /dl sin diferencias significativas con las adultas (85.2 ± 13.6 ug/dl). La prevalencia de hipozincemia fue relativamente baja, sin diferencias entre los grupos (14.6% en adolescentes y 12.3% en adultas). La concentración de zinc en la leche materna fue similar en adolescentes y adultas (1.2 CI 1.1-1.4 mg. /L en el grupo total). No se encontró correlación entre el nivel plasmático de zinc materno y la concentración en la leche en adultas y una débil correlación en el grupo de adolescentes (-0.27, P <0.05). Conclusión: La prevalencia de hipozincemia en el embarazo es relativamente baja y similar entre adultas y adolescentes. No se observó relación entre la edad materna y los niveles plasmáticos de zinc post parto en la madre ni en la leche materna. La concentración de zinc plasmático materno no se correlacionó con el zinc en la leche materna.

  7. Mediterranean Diet and Health-Related Quality of Life in Two Cohorts of Community-Dwelling Older Adults

    PubMed Central

    Pérez-Tasigchana, Raúl F; León-Muñoz, Luz M.; López-García, Esther; Banegas, José R.; Rodríguez-Artalejo, Fernando; Guallar-Castillón, Pilar

    2016-01-01

    Introduction In older adults, the Mediterranean diet is associated with lower risk of chronic diseases, but its association with health-related quality of life (HRQL) is still uncertain. This study assessed the association between the Mediterranean diet and HRQL in 2 prospective cohorts of individuals aged ≥60 years in Spain. Methods The UAM-cohort (n = 2376) was selected in 2000/2001 and followed-up through 2003. At baseline, diet was collected with a food frequency questionnaire, which was used to develop an 8-item index of Mediterranean diet (UAM-MDP). The Seniors-ENRICA cohort (n = 1911) was recruited in 2008/2010 and followed-up through 2012. At baseline, a diet history was used to obtain food consumption. Mediterranean diet adherence was measured with the PREDIMED score and the Trichopoulou’s Mediterranean Diet Score (MSD). HRQL was assessed, at baseline and at the end of follow-up, with the physical and mental component summaries (PCS and MCS) of the SF-36 questionnaire in the UAM-cohort, and the SF-12v.2 questionnaire in the Seniors-ENRICA cohort. Analyses were conducted with linear regression, and adjusted for the main confounders including baseline HRQL. Results In the UAM-cohort, no significant associations between the UAM-MDP and the PCS or the MCS were found. In the Seniors-ENRICA cohort, a higher PREDIMED score was associated with a slightly better PCS; when compared with the lowest tertile of PREDIMED score, the beta coefficient (95% confidence interval) for PCS was 0.55 (-0.48 to 1.59) in the second tertile, and 1.34 (0.21 to 2.47) in the highest tertile. However, the PREDIMED score was non-significantly associated with a better MCS score. The MSD did not show an association with either the PCS or the MCS. Conclusions No clinically relevant association was found between the Mediterranean diet and HRQL in older adults in Spain. PMID:27008160

  8. Associations of Birth Order with Early Adolescent Growth, Pubertal Onset, Blood Pressure and Size: Evidence from Hong Kong’s “Children of 1997” Birth Cohort

    PubMed Central

    Kwok, Man Ki; Leung, Gabriel M.; Schooling, C. Mary

    2016-01-01

    Background Birth order has been proposed as a cardiovascular risk factor, because the lower birth weight and greater infant weight gain typical of firstborns could programme metabolism detrimentally. Methods We examined the associations of birth order (firstborn or laterborn) with birth weight-for-gestational age, length/height and body mass index (BMI) z-scores during infancy, childhood, and puberty using generalized estimating equations, with age at pubertal onset using interval-censored regression and with age-, sex- and height-standardized blood pressure, height and BMI z-scores at 13 years using linear regression in a population-representative Chinese birth cohort: “Children of 1997” (n = 8,327). Results Compared with laterborns, firstborns had lower birth weight-for-gestational age (mean difference = -0.18 z-score, 95% confidence interval (CI) -0.23, -0.14), lower infant BMI (-0.09 z-score, 95% CI -0.14, -0.04), greater childhood height (0.10 z-score, 95% CI 0.05, 0.14) and BMI (0.08 z-score, 95% CI 0.03, 0.14), but not greater pubertal BMI (0.05 z-score, 95% CI -0.02, 0.11), adjusted for sex, parental age, birthplace, education and income. Firstborns had earlier onset of pubic hair (time ratio = 0.988, 95% CI 0.980, 0.996), but not breast or genitalia, development. Firstborns had greater BMI (0.07 z-score, 95% CI 0.002, 0.15), but not height (0.05 z-score, 95% CI -0.01, 0.11), at 13 years, but similar blood pressure. Conclusions Differences by birth order continue into early adolescence with firstborns being heavier with earlier pubic hair development, which could indicate long-term cardiovascular risk. PMID:27088360

  9. Spinal pain in adolescents: prevalence, incidence, and course: a school-based two-year prospective cohort study in 1,300 Danes aged 11–13

    PubMed Central

    2014-01-01

    Background The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain). Methods This study was a school-based prospective cohort study. All 5th and 6th grade students (11–13 years) at 14 schools in the Region of Southern Denmark were invited to participate (N = 1,348). Data were collected in 2010 and again two years later, using an e-survey completed during school time. Results The lifetime prevalence of spinal pain was 86% and 89% at baseline and follow-up, respectively. A group of 13.6% (95% CI: 11.8, 15.6) at baseline and 19.5% (95% CI: 17.1, 22.0) at follow-up reported that they had pain frequently. The frequency of pain was strongly associated with the intensity of pain, i.e., the majority of the participants reported their pain as relatively infrequent and of low intensity, whereas the participants with frequent pain also experienced pain of higher intensity. The two-year incidence of spinal pain varied between 40% and 60% across the physical locations. Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period. Conclusions Spinal pain is common at the age of 11–15 years, but some have more pain than others. The pain is likely to progress, i.e., to more locations, higher frequency, and higher pain intensity over a two-year period. PMID:24885549

  10. Change of School in Early Adolescence and Adverse Obesity-Related Dietary Behavior: A Longitudinal Cohort Study, Victoria, Australia, 2013–2014

    PubMed Central

    Barnett, Lisa M.; Allender, Steven

    2015-01-01

    Introduction Environments that facilitate energy-dense, nutrient-poor diets are associated with childhood obesity. We examined the effect of a change of school environment on the prevalence of obesity and related dietary behavior in early adolescence. Methods Fifteen schools in Victoria, Australia, were recruited at random from the bottom 2 strata of a 5-level socioeconomic scale. In 9 schools, students in grade 6 primary school transitioned to different schools for grade 7 secondary school, whereas in 6 schools, students remained in the same school from grade 6 to grade 7. Time 1 measures were collected from students (N = 245) in grade 6 (aged 11–13 y). Time 2 data were collected from 243 (99%) of the original cohort in grade 7. Data collected were dietary recall self-reported by students via questionnaire, measured height and weight of students, and aspects of the school food environment via school staff survey. Comparative and mixed model regression analyses were conducted. Results Of 243 students, 63% (n= 152) changed schools from time 1 to time 2, with no significant difference in weight status. Students who changed schools reported an increase in purchases of after-school snack food, greater sweetened beverage intake, fewer fruit-and-vegetable classroom breaks, and less encouragement for healthy eating compared with students who remained in the same school. School staff surveys showed that more primary than secondary schools had written healthy canteen policies and fewer days of canteen or food services operation. Conclusion A change of school environment has negative effects on children’s obesity-related dietary behavior. Consistent policy is needed across school types to support healthy eating in school environments. PMID:26355826

  11. Adverse Obstetric and Perinatal Outcomes following Treatment of Adolescent and Young Adult Cancer: A Population-Based Cohort Study

    PubMed Central

    Haggar, Fatima A.; Pereira, Gavin; Preen, David; Holman, C. D'Arcy; Einarsdottir, Kristjana

    2014-01-01

    Objective To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. Methods Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982–2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery. Results Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51–2.74), gestational diabetes (2.65, 2.08–3.57), pre-eclampsia (1.32, 1.04–1.87), post-partum hemorrhage (2.83, 1.92–4.67), cesarean delivery (2.62, 2.22–3.04), and maternal postpartum hospitalization>5 days (3.01, 1.72–5.58), but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21–2.08), low birth weight (<2500 g: 1.51, 1.23–2.12), fetal growth restriction (3.27, 2.45–4.56), and neonatal distress indicated by low Apgar score (<7) at 1 minute (2.83, 2.28–3.56), need for resuscitation (1.66, 1.27–2.19) or special care nursery admission (1.44, 1.13–1.78). Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth) were not increased among offspring of survivors. Conclusion Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention. PMID:25485774

  12. Multiple components of fitness improved among overweight and obese adolescents following a community-based lifestyle intervention.

    PubMed

    Howie, Erin K; McVeigh, Joanne A; Abbott, Rebecca A; Olds, Tim S; Straker, Leon M

    2016-08-01

    Fitness is an important component of health, and obese adolescents regularly have poor fitness. Unfortunately, few have assessed the impact of community-based lifestyle interventions on multiple components of fitness. The purpose of this study was to assess the impact of participation in a community-based intervention involving adolescents and parents on multiple components of fitness of obese adolescents. In a within-subject, waitlist controlled clinical trial with 12 months follow-up in Western Australia, participants (n = 56) completed multiple fitness measures at baseline, immediately prior to beginning an 8-week intervention and at 3, 6 and 12 months during a maintenance period. Performance on the shuttle walk was improved immediately post-intervention (increase of 42.8 m, 95% CI: 7.5, 78.2) and at 12 months post-intervention (increase of 44.6 m, 95% CI: 1.3, 87.8) compared with pre-intervention. Muscle performance of quadriceps and deltoids were improved post-intervention (increase of 1.1 (95% CI: 0.1, 2.1) kg · F and 1.0 (0.02, 2.1) kg · F, respectively) and all muscle performance measures were improved at 12 months following the intervention. There were no changes in waist circumference. A community-based lifestyle programme such as Curtin University's Activity, Food and Attitudes Program (CAFAP) may be a viable strategy for improving fitness in overweight adolescents.

  13. A Qualitative Analysis Exploring Explanatory Models of Aggression and Violence in a Small Cohort of Rural Psychiatrically Hospitalized Adolescents, Their Parents, and Selected Hospital Staff

    ERIC Educational Resources Information Center

    Johnson, Daniel C.

    2010-01-01

    The purpose of this study was to examine the etiology and cultural underpinnings of adolescent violence as collective case study analysis of three inter-related groups: psychiatrically hospitalized rural adolescents, their parent/guardian, and various hospital staff. Violence among adolescents is a serious societal issue that has had varying…

  14. Expectations of barriers to psychosocial care: views of parents and adolescents in the community.

    PubMed

    Nanninga, Marieke; Reijneveld, Sijmen A; Knorth, Erik J; Jansen, Danielle E M C

    2016-01-01

    Parents with a child suffering from psychosocial problems frequently experience barriers to psychosocial care, which may hinder access. Expectations of barriers may have the same effect, but evidence is lacking. The aim of this study is to examine parents' and adolescents' expectations of barriers regarding psychosocial care for the child, along with associated child and family characteristics. We obtained data on an age-stratified random sample of school children/pupils aged 4-18 via questionnaires (N = 666; response rate 70.3 %). Expectations of barriers to psychosocial care were measured with the "Barriers to Treatment Participation Scale-Expectancies" questionnaire (BTPS-exp). Results showed that 64 % of the parents of children below age 12, 59 % of the parents of adolescents (age 12-18), and 84 % of the adolescents expected one or more barriers. Parents and adolescents expected barriers most frequently with respect to irrelevance of treatment. Mainly parents with low educational level and their adolescents expected barriers regarding treatment, and quite a few characteristics of parents of adolescents were associated with expecting multiple barriers regarding treatment demands and issues, for example, single parents, parents of lower educational level and of adolescent boys, and parents of adolescents with psychosocial problems. We conclude that adolescents especially, but also their parents and parents of younger children, expect major barriers to psychosocial care, which may greatly hinder appropriate care seeking. This evidence may support professionals and policymakers in their attempts to improve access to psychosocial care. PMID:25969373

  15. Expectations of barriers to psychosocial care: views of parents and adolescents in the community.

    PubMed

    Nanninga, Marieke; Reijneveld, Sijmen A; Knorth, Erik J; Jansen, Danielle E M C

    2016-01-01

    Parents with a child suffering from psychosocial problems frequently experience barriers to psychosocial care, which may hinder access. Expectations of barriers may have the same effect, but evidence is lacking. The aim of this study is to examine parents' and adolescents' expectations of barriers regarding psychosocial care for the child, along with associated child and family characteristics. We obtained data on an age-stratified random sample of school children/pupils aged 4-18 via questionnaires (N = 666; response rate 70.3 %). Expectations of barriers to psychosocial care were measured with the "Barriers to Treatment Participation Scale-Expectancies" questionnaire (BTPS-exp). Results showed that 64 % of the parents of children below age 12, 59 % of the parents of adolescents (age 12-18), and 84 % of the adolescents expected one or more barriers. Parents and adolescents expected barriers most frequently with respect to irrelevance of treatment. Mainly parents with low educational level and their adolescents expected barriers regarding treatment, and quite a few characteristics of parents of adolescents were associated with expecting multiple barriers regarding treatment demands and issues, for example, single parents, parents of lower educational level and of adolescent boys, and parents of adolescents with psychosocial problems. We conclude that adolescents especially, but also their parents and parents of younger children, expect major barriers to psychosocial care, which may greatly hinder appropriate care seeking. This evidence may support professionals and policymakers in their attempts to improve access to psychosocial care.

  16. Examining the Moderating Role of Family Cohesion on the Relationship between Witnessed Community Violence and Delinquency in a National Sample of Adolescents

    ERIC Educational Resources Information Center

    Barr, Simone C.; Hanson, Rochelle; Begle, Angela M.; Kilpatrick, Dean G.; Saunders, Benjamin; Resnick, Heidi; Amstadter, Ananda

    2012-01-01

    Witnessed community violence has been linked to a number of internalizing and externalizing problems in adolescents. Guided by Cicchetti and Lynch's (1993) ecological-transactional model, this study aimed to examine the impact that family-level factors had on negative outcomes associated with witnessed community violence. Using a nationally…

  17. The psychometric development and initial validation of the DCI-A short form for adolescent therapeutic community treatment process.

    PubMed

    Stucky, Brian D; Edelen, Maria Orlando; Vaughan, Christine A; Tucker, Joan S; Butler, Jennifer

    2014-04-01

    The 5-factor client-report Dimensions of Change in Therapeutic Communities Treatment Instrument-Adolescent (DCI-A) was developed to assess adolescent substance abuse treatment process in the therapeutic community (TC). The goal of this study was to use bifactor modeling to derive a unidimensional DCI-A short-form (DCI-A-SF) that would represent content from the original DCI-A factors. Data are from 442 adolescents receiving treatment at one of seven residential TC programs. Bifactor analyses suggested selection of seven DCI-A items to comprise the short form. Three items are from the treatment motivation factor, and one item was selected from each of the remaining four factors. Confirmatory factor analysis suggested that the 7-item DCI-A-SF is strongly unidimensional, and unidimensional IRT analysis of the items indicated good internal consistency. A structural equation model that demonstrates the mediating relationship of DCI-A-SF with other measures, including demographic and pre-treatment characteristics, and subsequent treatment completion, provides preliminary evidence of internal validity.

  18. The Psychometric Development and Initial Validation of the DCI-A Short Form for Adolescent Therapeutic Community Treatment Process

    PubMed Central

    Stucky, Brian D.; Edelen, Maria Orlando; Vaughan, Christine A.; Tucker, Joan S.; Butler, Jennifer

    2014-01-01

    The 5-factor client-report Dimensions of Change in Therapeutic Communities Treatment Instrument-Adolescent (DCI-A) was developed to assess adolescent substance abuse treatment process in the therapeutic community (TC). The goal of this study was to use bifactor modeling to derive a unidimensional DCI-A short-form (DCI-A-SF) that would represent content from the original DCI-A factors. Data are from 442 adolescents receiving treatment at one of seven residential TC programs. Bifactor analyses suggested selection of seven DCI-A items to comprise the short form. Three items are from the Treatment Motivation factor, and one item was selected from each of the remaining four factors. Confirmatory factor analysis suggested that the 7-item DCI-A-SF is strongly unidimensional, and unidimensional IRT analysis of the items indicated good internal consistency. A structural equation model that demonstrates the mediating relationship of DCI-A-SF with other measures, including demographic and pre-treatment characteristics, and subsequent treatment completion, provides preliminary evidence of internal validity. PMID:24462245

  19. Adolescents and parents’ perceptions of best time for sex and sexual communications from two communities in the Eastern and Volta Regions of Ghana: implications for HIV and AIDS education

    PubMed Central

    2013-01-01

    Background Adolescents and parents’ differ in their perceptions regarding engaging in sexual activity and protecting themselves from pregnancy and sexually transmitted infections (STIs). The views of adolescents and parents from two south-eastern communities in Ghana regarding best time for sex and sexual communications were examined. Methods Focus Group interviews were conducted with parents and adolescents (both In-school and Out-of school) from two communities (Somanya and Adidome) in the Eastern and Volta regions of Ghana with epidemiological differentials in HIV infection. Results Findings showed parents and adolescents agree that the best timing for sexual activity amongst adolescents is determined by socioeconomic viability. In practice however, there were tensions between adolescents and parents crystallized by spoilt generation and physiological drive ideologies. Whilst one community relied on a more communal approach in controlling their children; the other relied on a confrontational approach. Sex-talk is examined as a measure to reduce these tensions, and children in both communities were ambivalent over sexual communication between their parents and themselves. Parents from the two communities however differed in their perceptions. Whilst parents in one community attributed reduced teenage pregnancies to sex education, those in the other community indicated a generalized adolescents’ sexual activeness manifested in the perceived widespread delinquency in the community. Conclusion Parents in both communities reported significant barriers to parents-adolescents sexual communication. Parents in both communities should be educated to discuss the broader issues on sexuality that affects adolescents and their reproductive health needs. PMID:24070548

  20. Project Northland in Croatia: A Community-Based Adolescent Alcohol Prevention Intervention

    ERIC Educational Resources Information Center

    Abatemarco, Diane J.; West, Bernadette; Zec, Vesna; Russo, Andrea; Sosiak, Persis; Mardesic, Vedran

    2004-01-01

    War and social transition in Croatia have increased unemployment and rates of substance abuse. A decrease in prevention programs places adolescents at an increased risk. Data collected from the 2002 Split Youth Behavior Risk Survey (YRBS) showed that adolescents are at risk for alcohol use and related problems. Thus, there is a need to strengthen…

  1. Training Health Care Professionals to Manage Overweight Adolescents: Experience in Rural Georgia Communities

    ERIC Educational Resources Information Center

    Dennison, David A.; Yin, Zenong; Kibbe, Debra; Burns, Susan; Trowbridge, Frederick

    2008-01-01

    Context: The obesity epidemic threatens the present and future health of adolescents in the United States. Yet, health care providers lack specific training for pediatric obesity assessment and management. Purpose: This study examined the adherence of rural Georgia primary care practitioners to an overweight adolescent management protocol. The…

  2. Academic Success Strategy Use among Community-Active Urban Hispanic Adolescents

    ERIC Educational Resources Information Center

    Vick, Rebecca M.; Packard, Becky Wai-Ling

    2008-01-01

    Although much has been written about the "risky" behaviors in which some Hispanic adolescents participate, the predictors of academic success are less understood. Toward this end, predictors of academic self-regulation were investigated in Hispanic adolescents. Specifically, a predictive model incorporating self-efficacy, instrumentality, salience…

  3. Parenting, Community, and Religious Predictors of Positive and Negative Developmental Outcomes among Muslim Adolescents

    ERIC Educational Resources Information Center

    Krauss, Steven Eric; Hamzah, Azimi; Ismail, Ismi Arif; Suandi, Turiman; Hamzah, Siti Raba'ah; Dahalan, Dzuhailmi; Idris, Fazilah

    2014-01-01

    Despite existing research on the contribution of social context and religiosity to adolescent behavioral outcomes, few studies have attempted to explore this topic among Muslim adolescents in non-Western settings, looking at both positive and negative outcomes. In response to this gap, the current study explored the effects of three dimensions of…

  4. Brief Report: Adolescent Adjustment in Affluent Communities: The Role of Motivational Climate and Goal Orientation

    ERIC Educational Resources Information Center

    Travers, Lea V.; Bohnert, Amy M.; Randall, Edin T.

    2013-01-01

    Researchers now recognize that affluent youth experience tremendous achievement pressures, yet contributing factors or outcomes are rarely explored. Using a sample of affluent adolescents, the present study investigates the mediating role of goal orientation (GO) on relations between school motivational climate (MC) and adolescent adjustment.…

  5. 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…

  6. One-Year Incidence of Psychiatric Disorders and Associated Risk Factors among Adolescents in the Community

    ERIC Educational Resources Information Center

    Roberts, Robert E.; Roberts, Catherine R.; Chan, Wenyaw

    2009-01-01

    Background: We have few data on incidence of psychiatric disorders among adolescents. This study examined first incidence of disorders among adolescents and baseline factors which increased or decreased risk of new onset cases a year later. Methods: Data were analyzed from Teen Health 2000 (TH2K), a probability sample of 4,175 youths 11-17 and…

  7. Rural Adolescent Health: The Importance of Prevention Services in the Rural Community

    ERIC Educational Resources Information Center

    Curtis, Alexa C.; Waters, Catherine M.; Brindis, Claire

    2011-01-01

    Context: Adolescence is a pivotal developmental period for the establishment of positive health and health practices. However, developmentally propelled risk behaviors coinciding with barriers to health services may increase the propensity for untoward health outcomes in adolescence. In addition, the sociocultural context of the rural environment…

  8. Transition into First Sex among Adolescents in Slum and Non-Slum Communities in Nairobi, Kenya

    ERIC Educational Resources Information Center

    Kabiru, Caroline W.; Beguy, Donatien; Undie, Chi-Chi; Zulu, Eliya Msiyaphazi; Ezeh, Alex C.

    2010-01-01

    While early sexual experiences are a key marker of the transition from childhood to adulthood, it is widely acknowledged that precocious initiation of sexual activity predisposes adolescents to negative health and psychological outcomes. Extant studies investigating adolescent sexuality in sub-Saharan Africa often rely on cross-sectional data…

  9. Violent and Prosocial Behavior by Adolescents toward Parents and Teachers in a Community Sample

    ERIC Educational Resources Information Center

    Jaureguizar, Joana; Ibabe, Izaskun; Straus, Murray A.

    2013-01-01

    This study focused on violent and prosocial behaviors by adolescents toward parents and teachers, and the relation between such behaviors and adolescents' perceptions about the family and school environment. Gender differences in child-to-parent violence and student-to-teacher violence were also studied. The sample comprised 687 adolescents…

  10. Rural Adolescents and Mental Health: Growing Up in the Rural Community.

    ERIC Educational Resources Information Center

    Hagen, Beverly Hartung

    1987-01-01

    Reviews relevant literature on the subject of rural adolescent mental health. Discusses demographics, unique situations, and problems of rural youth. Presents impact of the rural economic crisis. Suggests treatment strategies to deal with mental health problems of rural adolescents: individual therapy, family therapy, and peer group programs. (NEC)

  11. Gender Differences in Two Decision-Making Tasks in a Community Sample of Adolescents

    ERIC Educational Resources Information Center

    d'Acremont, Mathieu; Van der Linden, Martial

    2006-01-01

    In adolescence, externalized problems such as risk taking and antisocial behavior are more frequent in boys. This suggests that there are differences in the way boys and girls evaluate risk and make decisions during this period. To explore decision making and highlight possible gender differences, 124 adolescents at a junior secondary school…

  12. Reactive and Proactive Control in Incarcerated and Community Adolescents and Young Adults

    ERIC Educational Resources Information Center

    Iselin, Anne-Marie R.; DeCoster, Jamie

    2009-01-01

    This study compared the cognitive control skills of male incarcerated adolescents (n = 44), male control adolescents (n = 33), male incarcerated young adults (n = 41), and male control young adults (n = 35) using the AX-continuous performance test (AX-CPT). This test measures proactive control (the ability to maintain a mental representation of…

  13. Video game genre preference, physical activity and screen-time in adolescent boys from low-income communities.

    PubMed

    Thorne, Hayden T; Smith, Jordan J; Morgan, Philip J; Babic, Mark J; Lubans, David R

    2014-12-01

    The primary aim of this study was to examine the association between the types of video games played by adolescent boys and their participation in physical activity and recreational screen-time. Participants were 320 boys (mean age = 12.7, ±0.5 years) from 14 secondary schools located in low-income areas of New South Wales, Australia. Outcomes included height, weight, physical activity (accelerometers), total screen-time, and video game genre preference. Significant differences in both weekday and weekend screen-time were found between video game genre groups. In addition, significant differences in overall activity and moderate-to-vigorous physical activity were found between genre groups on weekdays. Between-group differences in physical activity on weekends were not statistically significant. This cross-sectional study has demonstrated that video game genre preference is associated with physical activity and screen-time in adolescent boys from low-income communities.

  14. Perceptions of adolescents, parents, and school personnel from a predominantly Cuban American community regarding dating and teen dating violence prevention.

    PubMed

    Gonzalez-Guarda, Rosa M; Cummings, Amanda M; Pino, Karen; Malhotra, Krithika; Becerra, Maria M; Lopez, Jessica E

    2014-04-01

    The purpose of this study was to explore perceptions of dating relationships and teen dating violence prevention within a predominantly Cuban American community in Miami-Dade County. Eight focus groups (n = 74 participants) with adolescents of Hispanic origin (n = 29), their parents (n = 29), and school personnel (n = 16) were conducted and analyzed using content analysis. Four themes characterized the nature and context of dating relationships among adolescents of Hispanic origin: YOLO -You Only Live Once, cultural unity but social division, dating is not going out, and the social environment challenges healthy relationships. The information generated from this study can be used to develop culturally tailored teen dating violence prevention programs targeting youth of Hispanic origin. PMID:24481848

  15. A clustered randomised trial examining the effect of social marketing and community mobilisation on the age of uptake and levels of alcohol consumption by Australian adolescents

    PubMed Central

    Rowland, Bosco; Toumbourou, John Winston; Osborn, Amber; Smith, Rachel; Hall, Jessica Kate; Kremer, Peter; Kelly, Adrian B; Williams, Joanne; Leslie, Eva

    2013-01-01

    Introduction Throughout the world, alcohol consumption is common among adolescents. Adolescent alcohol use and misuse have prognostic significance for several adverse long-term outcomes, including alcohol problems, alcohol dependence, school disengagement and illicit drug use. The aim of this study was to evaluate whether randomisation to a community mobilisation and social marketing intervention reduces the proportion of adolescents who initiate alcohol use before the Australian legal age of 18, and the frequency and amount of underage adolescent alcohol consumption. Method and analysis The study comprises 14 communities matched with 14 non-contiguous communities on socioeconomic status (SES), location and size. One of each pair was randomly allocated to the intervention. Baseline levels of adolescent alcohol use were estimated through school surveys initiated in 2006 (N=8500). Community mobilisation and social marketing interventions were initiated in 2011 to reduce underage alcohol supply and demand. The setting is communities in three Australian states (Victoria, Queensland and Western Australia). Students (N=2576) will complete school surveys in year 8 in 2013 (average age 12). Primary outcomes: (1) lifetime initiation and (2) monthly frequency of alcohol use. Reports of social marketing and family and community alcohol supply sources will also be assessed. Point estimates with 95% CIs will be compared for student alcohol use in intervention and control communities. Changes from 2006 to 2013 will be examined; multilevel modelling will assess whether random assignment of communities to the intervention reduced 2013 alcohol use, after accounting for community level differences. Analyses will also assess whether exposure to social marketing activities increased the intervention target of reducing alcohol supply by parents and community members. Trial registration ACTRN12612000384853. PMID:23355674

  16. Interactive Effect of Child Maltreatment and Substance Use on Depressed Mood Among Adolescents Presenting to Community-Based Substance Use Treatment.

    PubMed

    Gomez, Judelysse; Becker, Sara; O'Brien, Kimberly; Spirito, Anthony

    2015-10-01

    Adolescents referred to community behavioral health centers (CBHC) for substance use (SU) problems report high rates of child maltreatment. Although SU and maltreatment are independent risk factors for adolescent depression, few studies have examined their interactive effects. This study examined the interactive effects of SU (alcohol and marijuana) and exposure to different types of trauma on depressed mood among 74 adolescents referred to a CBHC for SU. Hierarchical regressions controlling for sex and common adolescent comorbidities showed that sexual abuse had a stronger relationship with depressed mood than other types of maltreatment. Although SU was not independently related to depressed mood, consistent with the self-medication hypothesis, increased SU was associated with lower levels of depressed mood among adolescents with greater exposure to sexual abuse. Results suggest that teens presenting to CBHCs for SU should be assessed for multiple forms of maltreatment and for depressed mood. PMID:26017474

  17. Specificity in the Association of Anxiety, Depression, and Atopic Disorders in a Community Sample of Adolescents

    PubMed Central

    Slattery, Marcia J.; Essex, Marilyn J.

    2010-01-01

    The specificity of relationships between anxiety and depressive symptoms, with each of the major atopic disorders of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) was systematically investigated within a single study sample. Participants included 367 adolescents who participated in a community, longitudinal study investigating risk factors for the development of psychiatric and physical health problems. Mental health symptoms were assessed at 7, 9, 11, and 13 years of age. Lifetime history of atopic disorders was assessed by parent report at age 13. Analysis of variance was used to investigate the specificity of the associations between anxiety and depression, and each of the atopic disorders. Results indicated that anxiety was associated with a lifetime history of atopic disorders as a group. The association was significantly strengthened when controlling for depression and externalizing psychiatric symptoms. Among atopic disorders, “pure” anxiety was associated with asthma and AR, and having both asthma and AR strengthened the association compared to having either disorder alone. The association of “pure” anxiety with asthma and AR is consistent with existing data suggesting a relationship between anxiety and respiratory disorders. Having both asthma and AR appeared to confer an additive “dose effect” on the strength of the association. The lack of an association with depression suggests that other factors may contribute to the differential expression of anxiety and depression with atopic disorders. Findings demonstrate the importance of assessing the impact of co-morbid psychiatric symptoms and atopic disorders within individual studies to determine the specificity of underlying relationships between these conditions. PMID:21111430

  18. Nested Cohort

    Cancer.gov

    NestedCohort is an R software package for fitting Kaplan-Meier and Cox Models to estimate standardized survival and attributable risks for studies where covariates of interest are observed on only a sample of the cohort.

  19. Cultural practices and sexual risk behaviour among adolescent orphans and non-orphans: a qualitative study on perceptions from a community in western Kenya

    PubMed Central

    2014-01-01

    Background This study explored community perceptions of cultural beliefs and practices that may increase sexual risk behaviour of adolescents, to understand more about meaning they hold within the culture and how they expose adolescent orphans and non-orphans to higher risks in a high HIV and teenage pregnancy prevalence context. Methods Using a qualitative descriptive cross-sectional design 14 focus group discussions were conducted with 78 adolescents and 68 parents/guardians purposively selected to represent their communities. Thirteen key informant interviews were also conducted with community leaders, health care and child welfare workers, and adolescents who were also selected purposively. The two methods were used to explore how cultural beliefs and practices predispose adolescent orphans and non- orphans to risky sexual behaviours. Data were analysed through line-by-line coding, grouped into families and retrieved as themes and sub-themes. Results Identified cultural practices that predisposed adolescents orphans and non-orphans to risky sexual behaviours included: adolescent sleeping arrangements, funeral ceremonies, replacing a deceased married daughter with her younger sister in marriage, widow inheritance among boys, early marriage among girls, and preference for boys/sons. Cultural risks perceived to equally affect both orphans and non-orphans were sleeping arrangements, funeral ceremonies, and sister replacement. Factors associated more with orphans than non-orphans were widow inheritance among boys and a preference for boy over girl children. Conclusions Adolescent sexual risk reduction programs should be developed considering the specific cultural context, using strategies that empower communities to challenge the widely accepted cultural norms that may predispose young people in general to sexual risks while targeting those that unequally influence orphans. PMID:24467940

  20. Long-Term Outcomes Associated with Traumatic Brain Injury in Childhood and Adolescence: A Nationwide Swedish Cohort Study of a Wide Range of Medical and Social Outcomes

    PubMed Central

    Sariaslan, Amir; Sharp, David J.; D’Onofrio, Brian M.; Larsson, Henrik; Fazel, Seena

    2016-01-01

    Background Traumatic brain injury (TBI) is the leading cause of disability and mortality in children and young adults worldwide. It remains unclear, however, how TBI in childhood and adolescence is associated with adult mortality, psychiatric morbidity, and social outcomes. Methods and Findings In a Swedish birth cohort between 1973 and 1985 of 1,143,470 individuals, we identified all those who had sustained at least one TBI (n = 104,290 or 9.1%) up to age 25 y and their unaffected siblings (n = 68,268) using patient registers. We subsequently assessed these individuals for the following outcomes using multiple national registries: disability pension, specialist diagnoses of psychiatric disorders and psychiatric inpatient hospitalisation, premature mortality (before age 41 y), low educational attainment (not having achieved secondary school qualifications), and receiving means-tested welfare benefits. We used logistic and Cox regression models to quantify the association between TBI and specified adverse outcomes on the individual level. We further estimated population attributable fractions (PAF) for each outcome measure. We also compared differentially exposed siblings to account for unobserved genetic and environmental confounding. In addition to relative risk estimates, we examined absolute risks by calculating prevalence and Kaplan-Meier estimates. In complementary analyses, we tested whether the findings were moderated by injury severity, recurrence, and age at first injury (ages 0–4, 5–9, 6–10, 15–19, and 20–24 y). TBI exposure was associated with elevated risks of impaired adult functioning across all outcome measures. After a median follow-up period of 8 y from age 26 y, we found that TBI contributed to absolute risks of over 10% for specialist diagnoses of psychiatric disorders and low educational attainment, approximately 5% for disability pension, and 2% for premature mortality. The highest relative risks, adjusted for sex, birth year, and

  1. Pre-Operative Autologous Blood Donation Does Not Affect Pre-Incision Hematocrit in Adolescent Idiopathic Scoliosis Patients. A Retrospective Cohort of a Prospective Randomized Trial

    PubMed Central

    Verma, Kushagra; Peters, Austin; Lonner, Baron S.; Errico, Thomas

    2016-01-01

    Background Pre-donation of autologous blood prior to spine fusion for adolescent idiopathic scoliosis (AIS) has been used in deformity surgery. The effect of pre-donation on pre-operative hematocrit (Hct) remains debated. Multiple factors may influence pre-operative Hct including intravascular volume status, patient factors, and timing of pre-operative blood donation. The purpose of this study was to determine if pre-donation significantly lowers pre-incision Hct in AIS patients. Methods A retrospective cohort study of a Level-1 prospective randomized trial was conducted. 125 patients from the homogeneous population were included. AIS patients undergoing a posterior only spinal fusion for AIS were separated into two groups based on their pre-operative blood donation history. Demographic variables, pre-incision Hct, and transfusion rates were compared between the two groups using the Student's T-test. Results Pre-donation and non pre-donation groups had 28 and 97 patients, respectively. Pre-donation group was 75% female (21F, 7M) and non pre-donation group was 78% female (76F, 21M). There was no difference between pre-donation and non pre-donation groups in mean age (15.6 ± 2.2 vs 14.8 ± 2.2, p = 0.081), BMI (23.1 ± 4.2 vs 21.7 ± 5.3, p = 0.219), and pre-incision Hct (32.8 ± 3.4 vs 33.8 ± 3.1, p = 0.628). The overall transfusion rates were equivalent (32.1± 48.0% vs 25.8 ± 44.0%, p = 0.509), however, the rate of allogenic transfusion for the pre-donation group was significantly lower (3.6 ± 18.9% vs 25.8 ± 44.0%, p = 0.011). Conclusions This study supports the use of pre-donation for AIS, without a significant drop in pre-incision Hct. Patients that donate are also much less likely to be exposed to allogenic blood. There may be a surgeon bias to recommend pre-donation in patients with a larger BMI and older age. Future studies are needed from a larger population of patients including those with non-AIS pathology. Level of evidence: Level III. PMID:27652198

  2. Pre-Operative Autologous Blood Donation Does Not Affect Pre-Incision Hematocrit in Adolescent Idiopathic Scoliosis Patients. A Retrospective Cohort of a Prospective Randomized Trial

    PubMed Central

    Verma, Kushagra; Peters, Austin; Lonner, Baron S.; Errico, Thomas

    2016-01-01

    Background Pre-donation of autologous blood prior to spine fusion for adolescent idiopathic scoliosis (AIS) has been used in deformity surgery. The effect of pre-donation on pre-operative hematocrit (Hct) remains debated. Multiple factors may influence pre-operative Hct including intravascular volume status, patient factors, and timing of pre-operative blood donation. The purpose of this study was to determine if pre-donation significantly lowers pre-incision Hct in AIS patients. Methods A retrospective cohort study of a Level-1 prospective randomized trial was conducted. 125 patients from the homogeneous population were included. AIS patients undergoing a posterior only spinal fusion for AIS were separated into two groups based on their pre-operative blood donation history. Demographic variables, pre-incision Hct, and transfusion rates were compared between the two groups using the Student's T-test. Results Pre-donation and non pre-donation groups had 28 and 97 patients, respectively. Pre-donation group was 75% female (21F, 7M) and non pre-donation group was 78% female (76F, 21M). There was no difference between pre-donation and non pre-donation groups in mean age (15.6 ± 2.2 vs 14.8 ± 2.2, p = 0.081), BMI (23.1 ± 4.2 vs 21.7 ± 5.3, p = 0.219), and pre-incision Hct (32.8 ± 3.4 vs 33.8 ± 3.1, p = 0.628). The overall transfusion rates were equivalent (32.1± 48.0% vs 25.8 ± 44.0%, p = 0.509), however, the rate of allogenic transfusion for the pre-donation group was significantly lower (3.6 ± 18.9% vs 25.8 ± 44.0%, p = 0.011). Conclusions This study supports the use of pre-donation for AIS, without a significant drop in pre-incision Hct. Patients that donate are also much less likely to be exposed to allogenic blood. There may be a surgeon bias to recommend pre-donation in patients with a larger BMI and older age. Future studies are needed from a larger population of patients including those with non-AIS pathology. Level of evidence: Level III.

  3. Asthma and Rhinitis Are Associated with Less Objectively-Measured Moderate and Vigorous Physical Activity, but Similar Sport Participation, in Adolescent German Boys: GINIplus and LISAplus Cohorts

    PubMed Central

    Berdel, Dietrich; Bauer, Carl-Peter; Koletzko, Sibylle; Nowak, Dennis; Heinrich, Joachim; Schulz, Holger

    2016-01-01

    Introduction Physical activity (PA) protects against most noncommunicable diseases and has been associated with decreased risk of allergic phenotype, which is increasing worldwide. However, the association is not always present; furthermore it is not clear whether it is strongest for asthma, rhinitis, symptoms of these, or atopic sensitization; which sex is most affected; or whether it can be explained by either avoidance of sport or exacerbation of symptoms by exercise. Interventions are thus difficult to target. Methods PA was measured by one-week accelerometry in 1137 Germans (mean age 15.6 years, 47% boys) from the GINIplus and LISAplus birth cohorts, and modeled as a correlate of allergic symptoms, sensitization, or reported doctor-diagnosed asthma or rhinitis. Results 8.3% of children had asthma, of the remainder 7.9% had rhinitis, and of the remainder 32% were sensitized to aero-allergens (atopic). 52% were lung-healthy controls. Lung-healthy boys and girls averaged 46.4 min and 37.8 min moderate-to-vigorous PA per day, of which 14.6 and 11.4 min was vigorous. PA in allergic girls was not altered, but boys with asthma got 13% less moderate and 29% less vigorous PA, and those with rhinitis with 13% less moderate PA, than lung-healthy boys. Both sexes participated comparably in sport (70 to 84%). Adolescents with wheezing (up to 68%, in asthma) and/or nose/eye symptoms (up to 88%, in rhinitis) were no less active. Conclusions We found that asthma and rhinitis, but not atopy, were independently associated with low PA in boys, but not in girls. These results indicate that allergic boys remain a high-risk group for physical inactivity even if they participate comparably in sport. Research into the link between PA and allergy should consider population-specific and sex-specific effects, and clinicians, parents, and designers of PA interventions should specifically address PA in allergic boys to ensure full participation. PMID:27560942

  4. The Association of a Mediterranean-Style Diet Pattern with Polycystic Ovary Syndrome Status in a Community Cohort Study.

    PubMed

    Moran, Lisa J; Grieger, Jessica A; Mishra, Gita D; Teede, Helena J

    2015-10-01

    Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. While lifestyle management is first-line treatment in PCOS, the dietary intake of women with PCOS is unclear and there is no research assessing dietary patterns of women with and without PCOS. The aim of this study was to examine dietary patterns in a large cohort of women with and without PCOS. Data were from 7569 participants in the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health population assessed at 2009 (Survey 5) (n = 414 PCOS, n = 7155 non-PCOS). Dietary patterns were evaluated using factor analysis and multiple logistic regressions assessed their associations with PCOS status. Three dietary patterns were identified that explained 27% of the variance in food intake between women with and without PCOS: Non-core foods; Meats and take-away and Mediterranean-style. The Mediterranean-style dietary pattern was independently associated with PCOS status. On adjusted analysis for each 1 SD increase in the Mediterranean-style dietary pattern, there was a 26% greater likelihood that women had PCOS. This may indicate an improvement in the quality of dietary intake following a diagnosis of PCOS. Future research should examine the contribution of dietary patterns to the incidence and severity of PCOS and the potential for modification of dietary patterns in the lifestyle management of PCOS. PMID:26501318

  5. The Association of a Mediterranean-Style Diet Pattern with Polycystic Ovary Syndrome Status in a Community Cohort Study

    PubMed Central

    Moran, Lisa J.; Grieger, Jessica A.; Mishra, Gita D.; Teede, Helena J.

    2015-01-01

    Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. While lifestyle management is first-line treatment in PCOS, the dietary intake of women with PCOS is unclear and there is no research assessing dietary patterns of women with and without PCOS. The aim of this study was to examine dietary patterns in a large cohort of women with and without PCOS. Data were from 7569 participants in the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health population assessed at 2009 (Survey 5) (n = 414 PCOS, n = 7155 non-PCOS). Dietary patterns were evaluated using factor analysis and multiple logistic regressions assessed their associations with PCOS status. Three dietary patterns were identified that explained 27% of the variance in food intake between women with and without PCOS: Non-core foods; Meats and take-away and Mediterranean-style. The Mediterranean-style dietary pattern was independently associated with PCOS status. On adjusted analysis for each 1 SD increase in the Mediterranean-style dietary pattern, there was a 26% greater likelihood that women had PCOS. This may indicate an improvement in the quality of dietary intake following a diagnosis of PCOS. Future research should examine the contribution of dietary patterns to the incidence and severity of PCOS and the potential for modification of dietary patterns in the lifestyle management of PCOS. PMID:26501318

  6. Partnership Selection and Formation: A Case Study of Developing Adolescent Health Community-Researcher Partnerships in 15 U.S. Communities

    PubMed Central

    Straub, Diane M.; Deeds, Bethany Griffin; Willard, Nancy; Castor, Judith; Peralta, Ligia; Francisco, Vincent T; Ellen, Jonathan

    2007-01-01

    Purpose This study describes the partner selection process in 15 U.S. communities developing community-researcher partnerships for the Connect to Protect® (C2P): Partnerships for Youth Prevention Interventions, an initiative of the Adolescent Trials Network for HIV/AIDS Interventions. Methods Each site generated an epidemiological profile of urban youth in their community, selected a focus population and geographic area of youth at risk for HIV, conducted a series of successive structured interviews, and engaged in a process of relationship-building efforts culminating in a collaborative network of community agencies. Results Sites chose as their primary target population young women who have sex with men (n=8 sites), young men who have sex with men (n=6), and intravenous drug users (n=1). Of 1,162 agencies initially interviewed, 281 of 335 approached (84%) agreed to join the partnership (average 19/site). A diverse array of community agencies were represented in the final collaborative network; specific characteristics included: 93% served the sites' target population, 54% were predominantly youth-oriented, 59% were located in the geographical area of focus, and 39% reported provision of HIV/STI prevention services. Relationship-building activities, development of collaborative relationships, and lessons learned, including barriers and facilitators to partnership, are also described. Conclusions Study findings address a major gap in the community partner research literature. Health researchers and policy makers need an effective partner selection framework whereby community-researcher partnerships can develop a solid foundation to address public health concerns. PMID:17531754

  7. Etiological Role and Repeated Infections of Sapovirus among Children Aged Less than 2 Years in a Cohort Study in a Peri-urban Community of Peru.

    PubMed

    Liu, Xiaofang; Jahuira, Helena; Gilman, Robert H; Alva, Alicia; Cabrera, Lilia; Okamoto, Michiko; Xu, Hang; Windle, Henry J; Kelleher, Dermot; Varela, Marco; Verastegui, Manuela; Calderon, Maritza; Sanchez, Gerardo; Sarabia, Vanessa; Ballard, Sarah B; Bern, Caryn; Mayta, Holger; Crabtree, Jean E; Cama, Vitaliano; Saito, Mayuko; Oshitani, Hitoshi

    2016-06-01

    Human sapovirus has been shown to be one of the most important etiologies in pediatric patients with acute diarrhea. However, very limited data are available about the causative roles and epidemiology of sapovirus in community settings. A nested matched case-control study within a birth cohort study of acute diarrhea in a peri-urban community in Peru from 2007 to 2010 was conducted to investigate the attributable fraction (AF) and genetic diversity of sapovirus. By quantitative reverse transcription-real-time PCR (qPCR) sapovirus was detected in 12.4% (37/299) of diarrheal and 5.7% (17/300) of nondiarrheal stools (P = 0.004). The sapovirus AF (7.1%) was higher in the second year (13.2%) than in the first year (1.4%) of life of children. Ten known genotypes and one novel cluster (n = 5) within four genogroups (GI, GII, GIV, and GV) were identified by phylogenetic analysis of a partial VP1 gene. Further sequence analysis of the full VP1 gene revealed a possible novel genotype, tentatively named GII.8. Notably, symptomatic reinfections with different genotypes within the same (n = 3) or different (n = 5) genogroups were observed in eight children. Sapovirus exhibited a high attributable burden for acute gastroenteritis, especially in the second year of life, of children in a Peruvian community. Further large-scale studies are needed to understand better the global burden, genetic diversity, and repeated infections of sapovirus.

  8. Etiological Role and Repeated Infections of Sapovirus among Children Aged Less than 2 Years in a Cohort Study in a Peri-urban Community of Peru.

    PubMed

    Liu, Xiaofang; Jahuira, Helena; Gilman, Robert H; Alva, Alicia; Cabrera, Lilia; Okamoto, Michiko; Xu, Hang; Windle, Henry J; Kelleher, Dermot; Varela, Marco; Verastegui, Manuela; Calderon, Maritza; Sanchez, Gerardo; Sarabia, Vanessa; Ballard, Sarah B; Bern, Caryn; Mayta, Holger; Crabtree, Jean E; Cama, Vitaliano; Saito, Mayuko; Oshitani, Hitoshi

    2016-06-01

    Human sapovirus has been shown to be one of the most important etiologies in pediatric patients with acute diarrhea. However, very limited data are available about the causative roles and epidemiology of sapovirus in community settings. A nested matched case-control study within a birth cohort study of acute diarrhea in a peri-urban community in Peru from 2007 to 2010 was conducted to investigate the attributable fraction (AF) and genetic diversity of sapovirus. By quantitative reverse transcription-real-time PCR (qPCR) sapovirus was detected in 12.4% (37/299) of diarrheal and 5.7% (17/300) of nondiarrheal stools (P = 0.004). The sapovirus AF (7.1%) was higher in the second year (13.2%) than in the first year (1.4%) of life of children. Ten known genotypes and one novel cluster (n = 5) within four genogroups (GI, GII, GIV, and GV) were identified by phylogenetic analysis of a partial VP1 gene. Further sequence analysis of the full VP1 gene revealed a possible novel genotype, tentatively named GII.8. Notably, symptomatic reinfections with different genotypes within the same (n = 3) or different (n = 5) genogroups were observed in eight children. Sapovirus exhibited a high attributable burden for acute gastroenteritis, especially in the second year of life, of children in a Peruvian community. Further large-scale studies are needed to understand better the global burden, genetic diversity, and repeated infections of sapovirus. PMID:27076657

  9. Decrease in self-esteem mediates the association between symptoms of social phobia and depression in middle adolescence in a sex-specific manner: a 2-year follow-up of a prospective population cohort study

    PubMed Central

    2014-01-01

    Background Social phobia and depression are common, highly comorbid disorders in middle adolescence. The mechanism underlying this comorbidity, however, is unclear. Decrease in self-esteem caused by the initial disorder might play a decisive role in the development of the subsequent disorder. The present study aimed to determine whether the association between symptoms of social phobia and depression is mediated by decrease in self-esteem in mid-adolescent girls and boys. Methods As a part of the prospective Adolescent Mental Health Cohort (AMCH), subjects of this study were 9th grade pupils (mean age, 15.5) responding to a survey conducted in 2002–2003 (T1) and to a 2-year follow-up survey in 2004–2005 (T2) (N = 2070, mean age 17.6 years, 54.5% girls). Results Symptoms of social phobia without symptoms of depression at age 15 and symptoms of depression at age 17 were associated only among boys, and this association was mediated by decrease in self-esteem. Symptoms of depression without symptoms of social phobia at age 15 and symptoms of social phobia at age 17 were associated only among girls, and this association was partially mediated by decrease in self-esteem. Conclusions Decrease in self-esteem plays a decisive role in the association between social phobia and depression. Self-esteem should be a key focus in interventions for adolescents suffering from social phobia or depression. Efficient intervention for the first disorder might help to prevent the decline in self-esteem and thus the incidence of the subsequent disorder. These findings are based on a sample of Finnish adolescents and should be confirmed in other jurisdictions or in more ethnically diverse samples. PMID:24641987

  10. Co-Occurring Trajectories of Symptoms of Anxiety, Depression, and Oppositional Defiance from Adolescence to Young Adulthood

    ERIC Educational Resources Information Center

    Leadbeater, Bonnie; Thompson, Kara; Gruppuso, Vincenza

    2012-01-01

    This study uses a cohort-sequential longitudinal design to examine the patterns of change and codevelopment of anxiety, depression, and oppositional defiant symptoms (ODS) from late adolescence to young adulthood. Four waves of data were collected biennially by individual interview with a random, community-based sample of 662 youth ages 12 to 18…

  11. Psychotic experiences are linked to cannabis use in adolescents in the community because of common underlying environmental risk factors.

    PubMed

    Shakoor, Sania; Zavos, Helena M S; McGuire, Philip; Cardno, Alastair G; Freeman, Daniel; Ronald, Angelica

    2015-06-30

    Cannabis users are more likely to have psychotic experiences (PEs). The degree to which these associations are driven by genetic or environmental influences in adolescence is unknown. This study estimated the genetic and environmental contributions to the relationship between cannabis use and PEs. Specific PEs were measured in a community-based twin sample (4830 16-year-old pairs) using self-reports and parent-reports. Adolescents reported on ever using cannabis. Multivariate liability threshold structural equation model-fitting was conducted. Cannabis use was significantly correlated with PEs. Modest heritability (37%), common environmental influences (55%) and unique environment (8%) were found for cannabis use. For PEs, modest heritability (27-54%), unique environmental influences (E=12-50%) and little common environmental influences (11-20%), with the exception of parent-rated Negative Symptoms (42%), were reported. Environmental influences explained all of the covariation between cannabis use and paranoia, cognitive disorganization and parent-rated negative symptoms (bivariate common environment=69-100%, bivariate unique environment=28-31%), whilst the relationship between cannabis use and hallucinations indicated familial influences. Cannabis use explains 2-5% of variance in positive, cognitive, and negative PEs. Cannabis use and psychotic experience co-occur due to environmental factors. Focus on specific environments may reveal why adolescent cannabis use and psychotic experiences tend to 'travel together'.

  12. Functions of nonsuicidal self-injury: exploratory and confirmatory factor analyses in a large community sample of adolescents.

    PubMed

    Dahlström, Örjan; Zetterqvist, Maria; Lundh, Lars-Gunnar; Svedin, Carl Göran

    2015-03-01

    Given that nonsuicidal self-injury (NSSI) is prevalent in adolescents, structured assessment is an essential tool to guide treatment interventions. The Functional Assessment of Self-Mutilation (FASM) is a self-report scale that assesses frequency, methods, and functions of NSSI. FASM was administered to 3,097 Swedish adolescents in a community sample. With the aim of examining the underlying factor structure of the functions of FASM in this sample, the adolescents with NSSI who completed all function items (n = 836) were randomly divided into 2 subsamples for cross-validation purposes. An exploratory factor analysis (EFA) was followed by a confirmatory factor analysis (CFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator in the Mplus statistical modeling program. The results of the EFA suggested a 3-factor model (social influence, automatic functions, and nonconformist peer identification), which was supported by a good fit in the CFA. Factors differentiated between social/interpersonal and automatic/intrapersonal functions. Based on learning theory and the specific concepts of negative and positive reinforcement, the nonconformist peer identification factor was then split into 2 factors (peer identification and avoiding demands). The resulting 4-factor model showed an excellent fit. Dividing social functions into separate factors (social influence, peer identification, and avoiding demands) can be helpful in clinical practice, where the assessment of NSSI functions is an important tool with direct implications for treatment.

  13. Functions of nonsuicidal self-injury: exploratory and confirmatory factor analyses in a large community sample of adolescents.

    PubMed

    Dahlström, Örjan; Zetterqvist, Maria; Lundh, Lars-Gunnar; Svedin, Carl Göran

    2015-03-01

    Given that nonsuicidal self-injury (NSSI) is prevalent in adolescents, structured assessment is an essential tool to guide treatment interventions. The Functional Assessment of Self-Mutilation (FASM) is a self-report scale that assesses frequency, methods, and functions of NSSI. FASM was administered to 3,097 Swedish adolescents in a community sample. With the aim of examining the underlying factor structure of the functions of FASM in this sample, the adolescents with NSSI who completed all function items (n = 836) were randomly divided into 2 subsamples for cross-validation purposes. An exploratory factor analysis (EFA) was followed by a confirmatory factor analysis (CFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator in the Mplus statistical modeling program. The results of the EFA suggested a 3-factor model (social influence, automatic functions, and nonconformist peer identification), which was supported by a good fit in the CFA. Factors differentiated between social/interpersonal and automatic/intrapersonal functions. Based on learning theory and the specific concepts of negative and positive reinforcement, the nonconformist peer identification factor was then split into 2 factors (peer identification and avoiding demands). The resulting 4-factor model showed an excellent fit. Dividing social functions into separate factors (social influence, peer identification, and avoiding demands) can be helpful in clinical practice, where the assessment of NSSI functions is an important tool with direct implications for treatment. PMID:25558962

  14. Cohort Study of Airway Mycobiome in Adult Cystic Fibrosis Patients: Differences in Community Structure between Fungi and Bacteria Reveal Predominance of Transient Fungal Elements.

    PubMed

    Kramer, Rolf; Sauer-Heilborn, Annette; Welte, Tobias; Guzman, Carlos A; Abraham, Wolf-Rainer; Höfle, Manfred G

    2015-09-01

    The respiratory mycobiome is an important but understudied component of the human microbiota. Like bacteria, fungi can cause severe lung diseases, but their infection rates are much lower. This study compared the bacterial and fungal communities of sputum samples from a large cohort of 56 adult patients with cystic fibrosis (CF) during nonexacerbation periods and under continuous antibiotic treatment. Molecular fingerprinting based on single-strand conformation polymorphism (SSCP) analysis revealed fundamental differences between bacterial and fungal communities. Both groups of microorganisms were taxonomically classified by identification of gene sequences (16S rRNA and internal transcript spacer), and prevalences of single taxa were determined for the entire cohort. Major bacterial pathogens were frequently observed, whereas fungi of known pathogenicity in CF were detected only in low numbers. Fungal species richness increased without reaching a constant level (saturation), whereas bacterial richness showed saturation after 50 patients were analyzed. In contrast to bacteria, a large number of fungal species were observed together with high fluctuations over time and among patients. These findings demonstrated that the mycobiome was dominated by transient species, which strongly suggested that the main driving force was their presence in inhaled air rather than colonization. Considering the high exposure of human airways to fungal spores, we concluded that fungi have low colonization abilities in CF, and colonization by pathogenic fungal species may be considered a rare event. A comprehensive understanding of the conditions promoting fungal colonization may offer the opportunity to prevent colonization and substantially reduce or even eliminate fungus-related disease progression in CF.

  15. The Burden of Non-Communicable Disease in Transition Communities in an Asian Megacity: Baseline Findings from a Cohort Study in Karachi, Pakistan

    PubMed Central

    Khan, Faisal S.; Lotia-Farrukh, Ismat; Khan, Aamir J.; Siddiqui, Saad Tariq; Sajun, Sana Zehra; Malik, Amyn Abdul; Burfat, Aziza; Arshad, Mohammad Hussham; Codlin, Andrew J.; Reininger, Belinda M.; McCormick, Joseph B.; Afridi, Nadeem; Fisher-Hoch, Susan P.

    2013-01-01

    Background The demographic transition in South Asia coupled with unplanned urbanization and lifestyle changes are increasing the burden of non-communicable disease (NCD) where infectious diseases are still highly prevalent. The true magnitude and impact of this double burden of disease, although predicted to be immense, is largely unknown due to the absence of recent, population-based longitudinal data. The present study was designed as a unique ‘Framingham-like’ Pakistan cohort with the objective of measuring the prevalence and risk factors for hypertension, obesity, diabetes, coronary artery disease and hepatitis B and C infection in a multi-ethnic, middle to low income population of Karachi, Pakistan. Methods We selected two administrative areas from a private charitable hospital’s catchment population for enrolment of a random selection of cohort households in Karachi, Pakistan. A baseline survey measured the prevalence and risk factors for hypertension, obesity, diabetes, coronary artery disease and hepatitis B and C infection. Results Six hundred and sixty-seven households were enrolled between March 2010 and August 2011. A majority of households lived in permanent structures (85%) with access to basic utilities (77%) and sanitation facilities (98%) but limited access to clean drinking water (68%). Households had high ownership of communication technologies in the form of cable television (69%) and mobile phones (83%). Risk factors for NCD, such as tobacco use (45%), overweight (20%), abdominal obesity (53%), hypertension (18%), diabetes (8%) and pre-diabetes (40%) were high. At the same time, infectious diseases such as hepatitis B (24%) and hepatitis C (8%) were prevalent in this population. Conclusion Our findings highlight the need to monitor risk factors and disease trends through longitudinal research in high-burden transition communities in the context of rapid urbanization and changing lifestyles. They also demonstrate the urgency of public

  16. Effectiveness and Feasibility of Weekly Iron and Folic Acid Supplementation to Adolescent Girls and Boys through Peer Educators at Community Level in the Tribal Area of Gujarat

    PubMed Central

    Shah, Shobha P; Shah, Pankaj; Desai, Shrey; Modi, Dhiren; Desai, Gaytri; Arora, Honey

    2016-01-01

    Background: Anemia during adolescence affects growth and development of girls and boys increasing their vulnerability to dropping out-of-school. Hence investing in preventing anemia during adolescence is critical for their survival, growth and development. Objective: To find out the burden of anemia on adolescent age group in the tribal area of Jhagadia block and to assess the change in the hemoglobin level through the weekly Iron and Folic Acid IFA (DOTS) directly observed treatment supplementation under Supervision by Peer Educators at Community level among adolescents. Methods: Community based intervention study conducted with adolescents (117 girls and 127 boys) aged 10-19 years, through supplementation of IFA (DOTS) by trained Peer Educators for 52 weeks in 5 tribal villages of Jhagadia. Hemoglobin level was determined by HemoCue method before and after intervention and sickle cell anemia by Electrophoresis method. Primary data on hemoglobin and number of tablets consumed was collected and statistically analyzed in SPSS 16.0 software by applying paired t-test. Results: The overall findings suggest that the prevalence of anemia reduced from 79.5% to 58% among adolescent girls and from 64% to 39% among boys. Mean rise of hemoglobin seen was 1.5 g/dl among adolescent boys and 1.3 g/dl among girls. A significant association was found in change in hemoglobin before and after intervention (P = 0.000) Conclusion: Prevalence of anemia among girls and boys can be reduced in their adolescent phase of life, through weekly supplementation of iron folic acid tablets under direct supervision and Nutrition Education by Peer Educator at community level. PMID:27051093

  17. Variation in the Sustained Effects of the Communities That Care Prevention System on Adolescent Smoking, Delinquency, and Violence

    PubMed Central

    Hawkins, J. David; Fagan, Abigail A.; Abbott, Robert D.; Catalano, Richard F.

    2013-01-01

    Communities That Care (CTC) is a universal, science-based community prevention system designed to reduce risk, enhance protection, and prevent adolescent health and behavior problems community wide. CTC has been found to have sustained effects on cigarette use and delinquent and violent behaviors in grade 10 in a panel of 4,407 students followed from fifth grade in a community randomized trial. It is important to test variation in the effects of this prevention system designed to be universal to understand for whom it is most effective and whether it fails to produce change or leads to iatrogenic effects for certain categories of individuals. The present study examined variation in the sustained effects of CTC on tenth-grade cigarette use and delinquent and violent behaviors. Interaction analyses suggest that the effect of CTC did not differ between those who had high levels of community-targeted risk factors at baseline or had already engaged in substance use, delinquency, or violence at baseline versus those who had not. Although CTC reduced the prevalence of both girls’ and boys’ problem behaviors, the effect on delinquency was marginally (p=0.08) larger for boys than for girls. PMID:23412948

  18. Variation in the sustained effects of the communities that care prevention system on adolescent smoking, delinquency, and violence.

    PubMed

    Oesterle, Sabrina; Hawkins, J David; Fagan, Abigail A; Abbott, Robert D; Catalano, Richard F

    2014-04-01

    Communities That Care (CTC) is a universal, science-based community prevention system designed to reduce risk, enhance protection, and prevent adolescent health and behavior problems community wide. CTC has been found to have sustained effects on cigarette use and delinquent and violent behaviors in grade 10 in a panel of 4,407 students followed from fifth grade in a community randomized trial. It is important to test variation in the effects of this prevention system designed to be universal to understand for whom it is most effective and whether it fails to produce change or leads to iatrogenic effects for certain categories of individuals. The present study examined variation in the sustained effects of CTC on tenth-grade cigarette use and delinquent and violent behaviors. Interaction analyses suggest that the effect of CTC did not differ between those who had high levels of community-targeted risk factors at baseline or had already engaged in substance use, delinquency, or violence at baseline versus those who had not. Although CTC reduced the prevalence of both girls' and boys' problem behaviors, the effect on delinquency was marginally (p = 0.08) larger for boys than for girls.

  19. Parenting and Trajectories of Children's Maladaptive Behaviors: A 12-Year Prospective Community Study

    ERIC Educational Resources Information Center

    Luyckx, Koen; Tildesley, Elizabeth A.; Soenens, Bart; Andrews, Judy A.; Hampson, Sarah E.; Peterson, Missy; Duriez, Bart

    2011-01-01

    This study investigated how parenting accounted for interindividual differences in developmental trajectories of different child behaviors across childhood and adolescence. In a cohort sequential community sample of 1,049 children, latent class growth analysis was applied to three parent-reported dimensions (monitoring, positive parenting,…

  20. The process evaluation of It's Your Move!, an Australian adolescent community-based obesity prevention project

    PubMed Central

    2010-01-01

    Background Evidence on interventions for preventing unhealthy weight gain in adolescents is urgently needed. The aim of this paper is to describe the process evaluation for a three-year (2005-2008) project conducted in five secondary schools in the East Geelong/Bellarine region of Victoria, Australia. The project, 'It's Your Move!' aimed to reduce unhealthy weight gain by promoting healthy eating patterns, regular physical activity, healthy body weight, and body size perception amongst youth; and improve the capacity of families, schools, and community organisations to sustain the promotion of healthy eating and physical activity in the region. Methods The project was supported by Deakin University (training and evaluation), a Reference Committee (strategic direction, budgetary approval and monitoring) and a Project Management Committee (project delivery). A workshop of students, teachers and other stakeholders formulated a 10-point action plan, which was then translated into strategies and initiatives specific to each school by the School Project Officers (staff members released from teaching duties one day per week) and trained Student Ambassadors. Baseline surveys informed intervention development. Process data were collected on all intervention activities and these were collated and enumerated, where possible, into a set of mutually exclusive tables to demonstrate the types of strategies and the dose, frequency and reach of intervention activities. Results The action plan included three guiding objectives, four on nutrition, two on physical activity and one on body image. The process evaluation data showed that a mix of intervention strategies were implemented, including social marketing, one-off events, lunch time and curriculum programs, improvements in infrastructure, and healthy school food policies. The majority of the interventions were implemented in schools and focused on capacity building and healthy eating strategies as physical activity practices

  1. Factors influencing abstinence, anticipation, and delay of sex among adolescent boys in high-STI prevalence communities

    PubMed Central

    Cummings, Teresa; Auerswald, Colette L.; Ott, Mary A.

    2013-01-01

    Purpose Abstinence is a core pregnancy and STI prevention strategy. We explore the attitudinal, behavioral, and family contexts relating to abstinence and the decision to delay sex among adolescent boys. Methods Adolescent boys ages 14–17 were recruited from community sites using a venue-based sampling method. All eligible boys at venues were invited to participate in an electronic survey. Question items included sexual behaviors, attitudes related to sex, relationships, masculine values, and family contextual items. Results We enrolled 667 participants, age 15.7 years, of diverse ethnicity. 252 (38%) were abstinent. Abstinent participants were younger, less likely to report non-coital behaviors, and reported lower conventional masculine values. Among abstinent participants, 62% planned to delay sex, while 38% anticipated sex in the next year. Participants with lower conventional masculine values, and more religious or moral motivations for abstinence were more likely to plan to delay sex. Discussion Abstinence among boys is common, even in high STI risk communities. For these boys, abstinence appears to be a complex behavioral decision, influenced by demographic, behavioral, attitudinal and contextual factors such as age, race, non-coital sexual behaviors and masculine values. Understanding the attitudes and contexts of abstinence, including plans to delay sex, can inform the development of public health programs for early fatherhood and STI prevention. PMID:24355627

  2. The effects of a comprehensive community trial on cardiometabolic risk factors in adolescents: Isfahan Healthy Heart Program

    PubMed Central

    Kelishadi, Roya; Mohammadifard, Noushin; Sarrazadegan, Nizal; Nouri, Fatemeh; Pashmi, Rezvan; Bahonar, Ahmad; Heidari, Hossein; Asgary, Sedigheh; Boshtam, Maryam; Mardani, Alireza

    2012-01-01

    BACKGROUND: This study aimed to assess the effects of a 6-year-long community-participatory program including school-based interventions on mean values and prevalence of cardiometabolic risk factors among adolescents. METHODS: The interventions of this community trial, conducted from 2000 to 2007 in Iran, targeted the whole population (of nearly two millions) living in two cities considered as the intervention area (IA) in comparison with a reference area (RA). Data from surveys conducted before and after interventions was used to compare the differences between the secondary school students of the IA and RA. RESULTS: The prevalence of hypercholesterolemia and hypertriglyceridemia declined significantly in girls and boys in the IA (P < 0.01). The prevalence of high LDL-C decreased significantly in the girls in the RA (P = 0.002). Among both sexes in the IA, the prevalence of low HDL-C increased significantly (P < 0.001), whereas it decreased in the girls and boys in the RA (P = 0.04). Although in the IA, the prevalence of overweight and obesity decreased significantly in girls (P = 0.001), it increased in boys (P = 0.001) as well as in the girls of the RA (P = 0.01). CONCLUSION: By performing school-based interventions, our study was successful, at least in part, in controlling some cardiometabolic risk factors in adolescents. Such modifications may have long-term impacts on non-communicable diseases prevention in adulthood. PMID:23205053

  3. 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

  4. 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.

  5. Adolescents' Sense of Community on MySpace and Facebook: A Mixed-Methods Approach

    ERIC Educational Resources Information Center

    Reich, Stephanie M.

    2010-01-01

    Communities are foundational to the field of Community Psychology yet they are difficult to define and measure. Once viewed as social groups with ties to geographical locations, online communities interact free of physical or face-to-face contact. This cyberexistence makes the study of communities more challenging. Social networking sites (SNS),…

  6. A Cross-Sectional Cohort Study of a Large, Statewide Medicaid Home and Community-Based Services Autism Waiver Program

    ERIC Educational Resources Information Center

    Eskow, Karen Goldrich; Chasson, Gregory S.; Summers, Jean Ann

    2015-01-01

    State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families…

  7. Community College Low-Income and Minority Student Completion Study: Descriptive Statistics from the 1992 High School Cohort

    ERIC Educational Resources Information Center

    Bailey, Thomas; Jenkins, Davis; Leinbach, Timothy

    2005-01-01

    This report summarizes statistics on access and attainment in higher education, focusing particularly on community college students, using data from the National Education Longitudinal Study of 1988 (NELS:88), which follows a nationally representative sample of individuals who were eighth graders in the spring of 1988. A sample of these…

  8. "Going beyond the call of doula": a grounded theory analysis of the diverse roles community-based doulas play in the lives of pregnant and parenting adolescent mothers.

    PubMed

    Gentry, Quinn M; Nolte, Kim M; Gonzalez, Ainka; Pearson, Magan; Ivey, Symeon

    2010-01-01

    This article presents some of the most salient qualitative results from a larger program evaluation of pregnant and parenting adolescents who participated in a community-based doula program. Using grounded theory analysis, seven problem-solving strategies emerged that doulas apply in helping pregnant and parenting adolescents navigate multiple social and health settings that often serve as barriers to positive maternal- and child-health outcomes. The ethnographic findings of this study suggest that the doulas provide valuable assistance to pregnant and parenting adolescents by addressing social-psychological issues and socio-economic disparities. "Diverse role-taking" results in doulas helping pregnant adolescents navigate more successfully through fragmented social and health service systems that are less supportive of low-income adolescents, who are often perceived to be draining scarce resources. The findings have implications for the roles of community-based doulas assigned to low-income adolescents of color seeking to overcome obstacles and attain better educational and economic opportunities.

  9. Exit Interviews from Adolescent Girls who Participated in a Sexual Risk-Reduction Intervention: Implications for Community-Based, Health Education Promotion for Adolescents

    PubMed Central

    Morrison-Beedy, Dianne; Passmore, Denise; Carey, Michael P.

    2013-01-01

    Introduction The purpose of this study was to invite girls who participated in a gender-specific, sexual risk-reduction intervention to describe their experiences and identify program characteristics most or least beneficial to their involvement. Method Semi-structured interviews were completed with 26 African American, low income girls ages 15–19 who had participated in a sexual risk reduction intervention as part of a randomized controlled trial. The girls were interviewed after completing a 12-month post-intervention survey. Interviews were recorded, transcribed and analyzed for categories. Results Analyses of the interview data identified six categories: 1) reasons for participating, 2) strategies for maintaining behavior changes, 3) interacting with others, 4) communicating with mothers, 5) disseminating information to friends and family, and 6) disseminating information to the males in the community. Implications and Conclusions Many of the girls participating in the theory-based behavior change intervention reported selecting from a “menu” of strategies learned through the intervention to reduce their sexual risk. Having the opportunity to discuss sexual health with peers and trained facilitators, particularly in an all-female environment, was cited as a positive benefit. Community health organizations and clinicians who care for adolescent girls can adapt many aspects of this intervention to help reduce their sexual risk. PMID:23758719

  10. Factors Associated With American Indian and White Adolescent Drug Selling in Rural Communities

    PubMed Central

    Eitle, David; Eitle, Tamela McNulty

    2014-01-01

    Relatively few studies have examined the correlates of adolescent drug selling in America, with most of these studies focusing on urban settings. The present study examines the risk and protective factors associated with drug selling among American Indian and white adolescents residing in a rural Northwestern state in the United States. Using survey data collected in 2010-2012, we conduct logistic regression analyses exploring the correlates of drug selling (n=568). Generally, we found support for prior explanations of drug selling, but identified some important race-specific differences. Specifically, we found that stress exposure was a risk factor for American Indians, but not whites. Conversely, academic achievement served as a protective factor for white adolescents but not American Indians. Our findings suggest that the race gap in rural drug selling can be explained by considering differences in social bonds, stress exposure, and exposure to substance using family and friends. PMID:26120365

  11. Increasing healthy behaviors in adolescents of Mexican heritage in rural emerging Latino communities: results from a school-based health intervention pilot study.

    PubMed

    Villalba, José A; Amirehsani, Karen; Lewis, Todd F

    2011-06-01

    The rapid Latino population growth in emerging Latino communities (EmLCs) presents a challenge to health care providers as most current health interventions and health promotion programs intended for Latinas/os are based on characteristics of established Latino communities (EsLCs). This study addresses the gap in the literature by modifying and testing the beginning efficacy of a school-based health intervention for adolescents of Mexican heritage in a rural EmLC. Seventy adolescents of Mexican heritage attending a rural middle school participated in the intervention. Paired samples t-tests were performed to determine differences between healthy behaviors at post-intervention compared to pre-intervention. Significant improvements in participants' physical activity and healthy eating were observed between pre-intervention and post-intervention. A school-based health intervention designed to increase healthy behaviors of adolescents of Mexican heritage in a rural EmLC was successful. PMID:20803071

  12. Total white blood cell count or neutrophil count predict ischemic stroke events among adult Taiwanese: report from a community-based cohort study

    PubMed Central

    2013-01-01

    Background Evidence about whether white blood cell (WBC) or its subtypes can act as a biomarker to predict the ischemic stroke events in the general population is scanty, particularly in Asian populations. The aim of this study is to establish the predictive ability of total WBC count or subtypes for long-term ischemic stroke events in the cohort population in Taiwan. Methods The Chin-Shan Community Cohort Study began from 1990 to 2007 by recruiting 1782 men and 1814 women of Chinese ethnicity. Following a total of 3416 participants free from ischemic stroke events at baseline for a median of 15.9 years; we documented 187 new incident cases. Results The multivariate relative risk for the comparison of the participants in the fifth and first WBC count quintiles was 1.67 (95% confidence interval [CI], 1.02–2.73; P for trend=0.03), and the corresponding relative risk for neutrophil count was 1.93 (95% CI, 1.13–3.29; P for trend=0.02). The discriminative ability by WBC and neutrophil counts were similar (area under the receiver operating characteristic curve, 0.600 for adding WBC, 0.610 for adding neutrophils, 0.595 for traditional risk factor model). In addition, the net reclassification improvement (NRI) values between the neutrophil and white blood cell count models were not significant (NRI, =-2.60%, P=0.35), indicating the similar discrimination performance for both WBC and neutrophil counts. Conclusions WBC and neutrophil count had a similar ability to predict the long-term ischemic stroke events among Taiwanese. PMID:23317415

  13. Long-term mortality after community-acquired pneumonia—impacts of diabetes and newly discovered hyperglycaemia: a prospective, observational cohort study

    PubMed Central

    Koskela, Heikki O; Salonen, Päivi H; Romppanen, Jarkko; Niskanen, Leo

    2014-01-01

    Objectives Community-acquired pneumonia is associated with a significant long-term mortality after initial recovery. It has been acknowledged that additional research is urgently needed to examine the contributors to this long-term mortality. The objective of the present study was to assess whether diabetes or newly discovered hyperglycaemia during pneumonia affects long-term mortality. Design A prospective, observational cohort study. Setting A single secondary centre in eastern Finland. Participants 153 consecutive hospitalised patients who survived at least 30 days after mild-to-moderate community-acquired pneumonia. Interventions Plasma glucose levels were recorded seven times during the first day on the ward. Several possible confounders were also recorded. The surveillance status and causes of death were recorded after median of 5 years and 11 months. Results In multivariate Cox regression analysis, a previous diagnosis of diabetes among the whole population (adjusted HR 2.84 (1.35–5.99)) and new postprandial hyperglycaemia among the non-diabetic population (adjusted HR 2.56 (1.04–6.32)) showed independent associations with late mortality. New fasting hyperglycaemia was not an independent predictor. The mortality rates at the end of follow-up were 54%, 37% and 10% among patients with diabetes, patients without diabetes with new postprandial hyperglycaemia and patients without diabetes without postprandial hyperglycaemia, respectively (p<0.001). The underlying causes of death roughly mirrored those in the Finnish general population with a slight excess in mortality due to chronic respiratory diseases. Pneumonia was the immediate cause of death in just 8% of all late deaths. Conclusions A previous diagnosis of diabetes and newly discovered postprandial hyperglycaemia increase the risk of death for several years after community-acquired pneumonia. As the knowledge about patient subgroups with an increased late mortality risk is gradually gathering

  14. Impact of physical function impairment and multimorbidity on mortality among community-living older persons with sarcopaenia: results from the ilSIRENTE prospective cohort study

    PubMed Central

    Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna Maria; Bernabei, Roberto; Onder, Graziano; Marzetti, Emanuele

    2016-01-01

    Objective Sarcopaenia and physical function impairment may have a greater effect on survival than other clinical characteristics, including multimorbidity. In this study, we evaluated the impact of sarcopaenia on all-cause mortality and the interaction among muscle loss, physical function impairment and multimorbidity on mortality risk over 10 years in older community-dwellers. Design Prospective cohort study. Setting Population-based study. Participants All persons aged 80+ years living in the community in the Sirente geographic area (L'Aquila, Italy) (n=364). Participants were categorised in the sarcopaenic or non-sarcopaenic group based on the European Working Group on Sarcopenia in Older People criteria. Primary and secondary outcome measures (1) All-cause mortality over 10 years according to the presence of sarcopaenia and (2) impact of physical function impairment, assessed using the Short Physical Performance Battery (SPPB), and multimorbidity on 10-year mortality risk in persons with sarcopaenia. Results Sarcopaenia was identified in 103 participants (29.1%). A total of 253 deaths were recorded over 10 years: 90 among sarcopaenic participants (87.4%) and 162 among non-sarcopaenic persons (65.1%; p<0.001). Participants with sarcopaenia had a higher risk of death than those without sarcopaenia (HR=2.15; 95% CI 1.02 to 4.54). When examining the effect of sarcopaenia and physical function impairment on mortality, participants with low physical performance levels showed greater mortality. Conversely, the mortality risk was unaffected by multimorbidity. Conclusions Our findings show that physical function impairment, but not multimorbidity, is predictive of mortality in older community-dwellers with sarcopaenia. Hence, in sarcopaenic older persons, interventions against functional decline may be more effective at preventing or postponing negative health outcomes than those targeting multimorbidity. PMID:27456324

  15. Adolescents and Teachers as Partners in a School-Based Research Project to Increase Physical Activity Opportunities in a Rural Community

    ERIC Educational Resources Information Center

    Rye, James; Tompkins, Nancy O'Hara; McClure, Darlene; Aleshire, Jacqueline

    2008-01-01

    Schools are an important resource in combating the physical inactivity and obesity epidemics in rural economically depressed areas. Through a University-community partnership, teachers and adolescents in a rural West Virginia county with one of the highest obesity rates in the state developed a school-based research intervention to increase…

  16. Sexual Intercourse and Pregnancy among African-American Adolescent Girls in High-Poverty Neighborhoods: The Role of Family and Perceived Community Environment. JCPR Working Paper.

    ERIC Educational Resources Information Center

    Moore, Mignon R.; Chase-Lansdale, P. Lindsay

    This study used data from a random sample of African American families living in poor urban communities to examine: how well socialization, supervision, and marital transition hypotheses explained the relationship between family structure and the probability of sexual debut and pregnancy for African American adolescents in disadvantaged…

  17. Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders. Second Edition. In Brief

    ERIC Educational Resources Information Center

    Robertson, Elizabeth B.; David, Susan L.; Rao, Suman A.

    2003-01-01

    This "In Brief" edition provides highlights from the "Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders, Second Edition." It presents the updated prevention principles, an overview of program planning, and critical first steps for those learning about prevention. Thus, this…

  18. Nonsuicidal Self-Injury as a Time-Invariant Predictor of Adolescent Suicide Ideation and Attempts in a Diverse Community Sample

    ERIC Educational Resources Information Center

    Guan, Karen; Fox, Kathryn R.; Prinstein, Mitchell J.

    2012-01-01

    Objective: Longitudinal data on adolescent self-injury are rare. Little is known regarding the associations between various forms of self-injurious thoughts and behaviors over time, particularly within community samples that are most relevant for prevention efforts. This study examined nonsuicidal self-injury (NSSI) as a time-invariant,…

  19. Current Fear of Crime, Sense of Community, and Loneliness in Italian Adolescents: The Role of Autonomous Mobility and Play during Childhood

    ERIC Educational Resources Information Center

    Prezza, Miretta; Pacilli, Maria Giuseppina

    2007-01-01

    A structural equation model was used to examine the role of autonomous mobility and play in public and semipublic places in childhood to predict adolescents' sense of community, fear of crime, and, through the mediation of these two last psychosocial factors, feelings of loneliness. Participants included 789 Italian students (469 females and 320…

  20. Becoming Job-Ready: Collaborative Future Plans of Latina Adolescent Girls and Their Mothers in a Low-Income Urban Community

    ERIC Educational Resources Information Center

    Packard, Becky Wai-Ling; Babineau, Maureen E.; Machado, Haidee

    2012-01-01

    This article examined the future plans constructed by Latina adolescent girls and their mothers within a lower income urban community. Seventeen high school juniors and their mothers were interviewed about the girls' pursuit of a trade during high school and anticipated postsecondary pathways in the nursing field. Thematic content analyses…

  1. Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community

    PubMed Central

    Ward, Alison; Tompson, Alice; Fitzmaurice, David; Sutton, Stephen; Perera, Rafael; Heneghan, Carl

    2015-01-01

    Background Trials show that oral anticoagulation therapy (OAT) substantially reduces thromboembolic events without an increase in major haemorrhagic events, but it is not known whether these results translate into routine practice. Aim To estimate the current levels of control and adverse events in patients self-monitoring OAT, explore the factors that predict success, and determine whether the level of side effects reported from randomised controlled trials are translated to a non-selected population. Design and setting Prospective cohort study in the UK. Method Participants were aged ≥18 years and registered with a GP. Main outcomes were the proportion of participants, over 12 months, who were still self-monitoring, had not experienced adverse events, and had achieved >80% of time in therapeutic range (TTR). Results In total, 296 participants were recruited; their median age was 61 years and 55.1% were male. Participants were predominately professional or held a university qualification (82.7%). At 12 months, 267 (90.2%) were still self-monitoring. Mean TTR was 75.3% (standard deviation 16.9).Six serious and two minor adverse events were reported by GPs. Only 45.9% of participants received any in-person training at the outset. Increased age (P = 0.027), general wellbeing (EQ-5D visual score, P = 0.020), and lower target international normalised range (INR, P = 0.032) were all associated with high (>80% TTR) levels of control. Conclusion The findings show that, even with little training, people on OAT can successfully self-monitor, and even self-manage, their INR. TTR was shown to improve with age. However, widespread use of self-monitoring of INR may be limited by the initial costs, as well as a lack of training and support at the outset. PMID:26077267

  2. Sustained Reduction in Adolescent Pregnancy Rates through School and Community-Based Education, 1982-2000

    ERIC Educational Resources Information Center

    Vincent, Murray; Drane, J. Wanzer; Joshi, Praphul; Shankarnarayan, Saikiran; Nimmons, Michelle

    2004-01-01

    The resident population of Bamberg County, SC, has been exposed to multiples of public health information and education interventions since October 1982 with the intent to reduce the occurrence of unintended pregnancies among unmarried adolescents. Data analyses were conducted to compare 20 years of pregnancy rates among girls aged 14-17 years for…

  3. Family, Community, and School Influences on Resilience among American Indian Adolescents in the Upper Midwest

    ERIC Educational Resources Information Center

    LaFromboise, Teresa D.; Hoyt, Dan R.; Oliver, Lisa; Whitbeck, Les B.

    2006-01-01

    This study examines resilience among a sample of American Indian adolescents living on or near reservations in the upper Midwest. Data are from a baseline survey of 212 youth (115 boys and 97 girls) who were enrolled in the fifth through eighth grades. Based upon the definition of resilience, latent class analyses were conducted to identify youth…

  4. Building Emergency Contraception Awareness among Adolescents. A Toolkit for Schools and Community-Based Organizations.

    ERIC Educational Resources Information Center

    Simkin, Linda; Radosh, Alice; Nelsesteun, Kari; Silverstein, Stacy

    This toolkit presents emergency contraception (EC) as a method to help adolescent women avoid pregnancy and abortion after unprotected sexual intercourse. The sections of this toolkit are designed to help increase your knowledge of EC and stay up to date. They provide suggestions for increasing EC awareness in the workplace, whether it is a school…

  5. A Study of the Frequency of Self-Mutilation in a Community Sample of Adolescents.

    ERIC Educational Resources Information Center

    Ross, Shana; Heath, Nancy

    2002-01-01

    Studied the frequency of self-mutilation among adolescents through a literature review, epidemiological data, and screening measure results for 440 students from an urban and a suburban high school. Interviews suggest that 13.9% of students had hurt themselves on purpose at some time, with girls more likely to hurt themselves and cutting the most…

  6. 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…

  7. Adolescents Who Witness Community Violence: Can Parent Support and Prosocial Cognitions Protect Them from Committing Violence?

    ERIC Educational Resources Information Center

    Brookmeyer, Kathryn A.; Henrich, Christopher C.; Schwab-Stone, Mary

    2005-01-01

    This longitudinal study investigated the effects of witnessing violence on committing violence among diverse urban middle school students (11-15 years old) over a 1-year period (N=1,599). It examined parent support and prosocial cognitions as moderators that might interact with one another in buffering adolescents from the effects of witnessing…

  8. Subjective Well-Being in Urban Adolescents: Interpersonal, Individual, and Community Influences

    ERIC Educational Resources Information Center

    Morgan, Melissa L.; Vera, Elizabeth M.; Gonzales, Rufus R.; Conner, Wendy; Vacek, Kim Bena; Coyle, Laura Dick

    2011-01-01

    This study examined the relationship between subjective well-being criteria (negative affect, positive affect, and subjective well-being) and individual, family, friend, school, and neighborhood predictor variables in 159 ethnically diverse, urban adolescents. Results indicated that negative affect was significantly predicted by family variables,…

  9. Prevalence of Child and Adolescent Mental Disorders in Chile: A Community Epidemiological Study

    ERIC Educational Resources Information Center

    Vicente, Benjamin; Saldivia, Sandra; de la Barra, Flora; Kohn, Robert; Pihan, Ronaldo; Valdivia, Mario; Rioseco, Pedro; Melipillan, Roberto

    2012-01-01

    Background: In Latin America, there is limited research on the prevalence of mental disorders in children and adolescents. This Chilean survey is the first national representative survey in the Latin American region to examine the prevalence of Diagnostic and Statistical Manual-IV (DSM-IV) psychiatric disorders in the region in children and…

  10. Striving for Effectiveness in the Treatment of Adolescent Depression: Cognitive Behavior Therapy for Multisite Community Intervention

    ERIC Educational Resources Information Center

    Curry, John F.; Wells, Karen C.

    2005-01-01

    The Treatment for Adolescents With Depression Study (TADS) was designed to compare the relative and combined effectiveness of cognitive behavior therapy (CBT) and fluoxetine, each of which had demonstrated efficacy in carefully controlled single-site studies. Models of CBT from these efficacy studies served as the foundation for the TADS…

  11. Parental Coping with Developmental Disorders in Adolescents within the Ultraorthodox Jewish Community in Israel

    ERIC Educational Resources Information Center

    Manor-Binyamini, Iris

    2012-01-01

    This preliminary study compares the coping strategies used by 100 ultraorthodox Jewish parents and 100 secular Jewish parents for dealing with adolescent children with developmental disorders. The parents completed two questionnaires on the sense of stress-related personal growth and the sense of coherence. The ultraorthodox parents reported a…

  12. A longitudinal investigation of childhood communication ability and adolescent psychotic experiences in a community sample

    PubMed Central

    Sullivan, Sarah A.; Hollen, Linda; Wren, Yvonne; Thompson, Andrew D.; Lewis, Glyn; Zammit, Stan

    2016-01-01

    Background Some childhood speech and language impairments precede psychosis but it is not clear whether they also precede adolescent psychotic experiences and whether this association is specific to psychotic experiences. Methods Pragmatic language and expressive speech and language (parent-assessed using the Children's Communication Checklist) at age 9 and psychotic experiences and depression at ages 12 and 18 were investigated in 7659 participants from the Avon Longitudinal Study of Parents and Children. Associations were investigated using multivariate modelling. Results Poorer pragmatic language at 9 years was associated with psychotic experiences at both ages (12 years OR 1.22, 95% CI 1.11, 1.34; 18 years OR 1.25, 95% CI 1.10, 1.41) but only with depression at 18 years (OR 1.10, 95% CI 1.00, 1.22). Poorer expressive speech and language ability was not associated with psychotic experiences or depression at either age. There was evidence that pragmatic language was specifically associated with psychotic experiences at age 12 but no evidence that the strength of any of the associations changed over time. Conclusions Deficits in pragmatic language precede early and late adolescent psychotic experiences and early adolescent depression. Interventions aimed at helping children improve pragmatic language skills may reduce the incidence of adolescent psychopathology and associated psychological disorder and dysfunction later in life. PMID:26972475

  13. Literacy and Advocacy in Adolescent Family, Gang, School, and Juvenile Court Communities: "Crip 4 Life"

    ERIC Educational Resources Information Center

    Smith, Debra; Whitmore, Kathryn F.

    2006-01-01

    The goal of this book is to encourage educators and researchers to understand the complexities of adolescent gang members' lives in order to rethink their assumptions about these students in school. The particular objective is to situate four gang members as literate, caring students from loving families whose identities and literacy keep them on…

  14. Ethnic label use in adolescents from traditional and non-traditional immigrant communities.

    PubMed

    Kiang, Lisa; Perreira, Krista M; Fuligni, Andrew J

    2011-06-01

    Understanding adolescents' use of ethnic labels is a key developmental issue, particularly given the practical significance of identity and self-definition in adolescents' lives. Ethnic labeling was examined among adolescents in the traditional immigrant receiving area of Los Angeles (Asian n = 258, Latino n = 279) and the non-traditional immigrant receiving area of North Carolina (Asian n = 165, Latino n = 239). Logistic regressions showed that adolescents from different geographic settings use different ethnic labels, with youth from NC preferring heritage and panethnic labels and youth from LA preferring hyphenated American labels. Second generation youth were more likely than first generation youth to use hyphenated American labels, and less likely to use heritage or panethnic labels. Greater ethnic centrality increased the odds of heritage label use, and greater English proficiency increased the odds of heritage-American label use. These associations significantly mediated the initial effects of setting. Further results examine ethnic differences as well as links between labels and self-esteem. The discussion highlights implications of ethnic labeling and context.

  15. School and Community Violence and Victimization as Predictors of Adolescent Suicidal Behavior

    ERIC Educational Resources Information Center

    Nickerson, Amanda B.; Slater, Evan D.

    2009-01-01

    This study examined the extent to which violent behavior and peer victimization were associated with suicidal ideation, plans, and attempts in a nationally representative sample of 11,113 adolescents who completed the 2005 Youth Risk Behavior Survey. Boys were more likely to be involved in physical fighting and weapon carrying, whereas girls were…

  16. A COMMUNITY WIDE PROGRAM OF FAMILY LIFE EDUCATION FOR PARENTS OF ADOLESCENTS.

    ERIC Educational Resources Information Center

    GAMBLE, BETTY ROBERTS

    A STUDY WAS MADE IN THE KINGS MOUNTAIN AREA OF NORTH CAROLINA TO DETERMINE THE NEEDS FOR FAMILY LIFE EDUCATION FOR PARENTS OF ADOLESCENTS, TO PROMOTE A SUITABLE PROGRAM, TO EVALUATE POSSIBLE OUTCOMES, AND TO DEVELOP IMPLICATIONS FOR FURTHER FAMILY LIFE EDUCATION. ENROLLED IN THE FOUR WEEK PROGRAM, WHICH MET ONCE A WEEK IN THE LOCAL HIGH SCHOOL,…

  17. Adolescent pregnancy prevention for Hispanic youth: the role of schools, families, and communities.

    PubMed

    Brindis, C

    1992-09-01

    A sociodemographic profile of Hispanic youth is presented as well as a description of the incidence of adolescent pregnancy and parenting in this population. Strategies and recommendations that should be implemented to provide Hispanic youth with viable options and assistance in delaying early childbearing also are offered.

  18. The effect of social relationships on survival in elderly residents of a Southern European community: a cohort study

    PubMed Central

    Rodriguez-Laso, Angel; Zunzunegui, Maria Victoria; Otero, Angel

    2007-01-01

    Background Comparative evidence regarding the effects of social relationships on mortality in Mediterranean communities will increase our knowledge of their strengths and the ways in which they influence longevity across cultures. Men and women may benefit differently from social relationships because of cultural differences in gender roles. Psychosocial mechanisms such as social support, which may explain the effects of social networks, may also vary by culture. Methods Detailed information on the social relationships of a representative sample of 1,174 community-dwelling older adults was collected in Leganés, a city in central Spain. Mortality over a 6-year follow-up period was ascertained. Information on socio-demographic, health and disability variables was also collected. Cox proportional hazards models were fitted separately for men and women and for the combined sample. Results Having a confidant was associated with a 25% (95% CI 5–40%) reduction in the mortality risk. The hazard ratio for lack of social participation was 1.5 (95% CI 1.3–1.7). Being engaged in meaningful roles protected against mortality, while receipt of emotional support did not affect survival. These results were comparable for men and women. Having contact with all family ties was associated with reduced mortality only in men. Structural aspects of social networks make a unique contribution to survival, independently of emotional support and the role played in the lives of significant others. Conclusion In this elderly Southern European population, the beneficial effects of social networks, social participation, engagement in the life of significant others and having a confidant call for public policies that foster intergenerational and community exchanges. PMID:17678536

  19. Does It Take a Village? Community Effects on Children, Adolescents, and Families.

    ERIC Educational Resources Information Center

    Booth, Alan, Ed.; Crouter, Ann C., Ed.

    Although our society has made substantial investments in research and programs based on the idea that communities affect families and children, significant questions have emerged about the validity of the link between communities, children, and families. This book, presented in four sections, focuses on how communities undergird or undermine human…

  20. Defining Early Adolescent Childbearing.

    ERIC Educational Resources Information Center

    Phipps, Maureen G.; Sowers, MaryFran

    2002-01-01

    Determined the age group for defining early adolescent childbearing based on rates of adverse clinical outcomes. Data on infant mortality, very low birth weight, and very pre-term delivery per 1,000 live births for women age 12-23 years in the 1995 U.S. birth cohort indicate that early adolescent childbearing is best defined as giving birth at age…

  1. Habitual Sleep Duration and Insomnia and the Risk of Cardiovascular Events and All-cause Death: Report from a Community-Based Cohort

    PubMed Central

    Chien, Kuo-Liong; Chen, Pei-Chung; Hsu, Hsiu-Ching; Su, Ta-Chen; Sung, Fung-Chang; Chen, Ming-Fong; Lee, Yuan-Teh

    2010-01-01

    Study Objectives: To investigate the relationship between sleep duration and insomnia severity and the risk of all-cause death and cardiovascular disease (CVD) events Design: Prospective cohort study Setting: Community-based Participants: A total of 3,430 adults aged 35 years or older Intervention: None Measurements and Results: During a median 15.9 year (interquartile range, 13.1 to 16.9) follow-up period, 420 cases developed cardiovascular disease and 901 cases died. A U-shape association between sleep duration and all-cause death was found: the age and gender-adjusted relative risks (95% confidence interval [CI]) of all-cause death (with 7 h of daily sleep being considered for the reference group) for individuals reporting ≤ 5 h, 6 h, 8 h, and ≥ 9 h were 1.15 (0.91–1.45), 1.02 (0.85–1.25), 1.05 (0.88–1.27), and 1.43 (1.16–1.75); P for trend, 0.019. However, the relationship between sleep duration and risk of CVD were linear. The multivariate-adjusted relative risk (95% CI) for all-cause death (using individuals without insomnia) were 1.02 (0.86–1.20) for occasional insomnia, 1.15 (0.92–1.42) for frequent insomnia, and 1.70 (1.16–2.49) for nearly everyday insomnia (P for trend, 0.028). The multivariate adjusted relative risk (95% CI) was 2.53 (1.71–3.76) for all-cause death and 2.07 (1.11–3.85) for CVD rate in participants sleeping ≥9 h and for those with frequent insomnia. Conclusions: Sleep duration and insomnia severity were associated with all-cause death and CVD events among ethnic Chinese in Taiwan. Our data indicate that an optimal sleep duration (7–8 h) predicted fewer deaths. Citation: Chien K; Chen P; Hsu H; Su T; Sung F; Chen M; Lee Y. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. SLEEP 2010;33(2):177–184. PMID:20175401

  2. “There are bugs in condoms”: Tanzanian close-to-community providers' ability to offer effective adolescent reproductive health services

    PubMed Central

    Dusabe, John; Mchome, Zaina; Nnko, Soori; Changalucha, John; Obasi, Angela

    2015-01-01

    Objectives Young people in Tanzania are known to access reproductive health services from a range of close-to-community providers outside formal health settings such as drug stores, village AIDS committees, traditional healers and traditional birth attendants (TBAs). However, questions remain about the quality of services such agents provide. This study investigated their capacity to provide adolescent reproductive health (ARH) services and explored their readiness and ability to integrate with the mainstream health sector through community referral interventions. Methods Thirty-five focus group discussions exploring close-to-community provider experiences and attitudes to ARH service provision were carried out in two districts in Northern Tanzania. Discussions were conducted in Kiswahili, digitally recorded, verbatim-transcribed, translated and back-translated from Swahili to English. A thematic analysis was conducted using NVivo 9. Results The major close-to-community cadres providing reproductive health services were drug stores, traditional healers, TBAs and village health workers. They reported being the first port of call for adolescents seeking reproductive health services, but their knowledge of ARH needs was poor. They had negative attitudes to, and lacked the necessary resources for, the provision of such services for adolescents. Some were particularly unwilling to provide condom services and were prejudiced against adolescents using them. There was poor integration between the close-to-community providers and the formal health sector, further limiting their ability to provide adequate services. Conclusions Although close-to-community providers are considered a key resource in the community, most have limited capacity to provide ARH services. Without capacity-building investments such as training and cooperation with the mainstream health sector, their contribution to positive reproductive health outcomes is limited, or could indeed lead to adverse

  3. Diversifying a Famous Science Community One Cohort at a Time: The Woods Hole Partnership Education Program (PEP)

    NASA Astrophysics Data System (ADS)

    Scott, O.; Jearld, A.

    2012-12-01

    In March 2009, the Woods Hole Diversity Initiative launched the Partnership Education Program (PEP), a multi-institutional effort to increase diversity in the student population (and ultimately the work force) in the Woods Hole science community. PEP, a summer research internship program, is open to students of all backgrounds but is designed especially to provide opportunities for individuals from populations under-represented in science, technology, engineering, and mathematics (STEM) and who otherwise would not have had the opportunity to come to Woods Hole to study or do research. To date, 60 students from 39 colleges and universities have participated and there is evidence that PEP students are being retained and continuing on the path towards completing STEM degrees and pursuing careers in marine and environmental science. PEP alumni are enrolled in graduate programs and employed in STEM-related jobs. They have availed themselves to other experiential learning and career development opportunities in the Woods Hole community and beyond. They have published papers with their PEP research mentors, and have won awards from presentations at professional conferences. During the PEP summer program, students gain a range of skills and knowledge as well as acquire the dispositions, attitudes and behaviors that are essential to their educational and career success. These run the gamut and include areas such as content and technical research knowledge related to the marine and environmental sciences, next step education and career transitions, and key competencies related to educational and career progression in STEM fields. As an evidence-based, promising practice for retaining students in STEM, the PEP model is emerging as an effective and sustainable approach. Beyond Woods Hole, PEP is gaining national recognition as information about PEP is disseminated via multiple channels, both electronic and non electronic. PEP's applicant pool has increased from 24 in Year 1 to

  4. Exploring psychosocial support online: a content analysis of messages in an adolescent and young adult cancer community.

    PubMed

    Love, Brad; Crook, Brittani; Thompson, Charee M; Zaitchik, Sarah; Knapp, Jessica; Lefebvre, Leah; Jones, Barbara; Donovan-Kicken, Erin; Eargle, Emily; Rechis, Ruth

    2012-10-01

    The increased usage of online cancer support groups as a resource for health-related information and social support has sparked numerous discussions about the role of online support in healthcare. However, little is known about the role of social-networking groups focused on supporting adolescents and young adults (AYAs) dealing with cancer. The current investigation report findings from a content analysis designed to explore how AYAs use an online support group to meet their psychosocial needs. Overall, members of the community focused on exchanging emotional and informational support, coping with difficult emotions through expression, describing experiences of being an AYA dealing with cancer through language (metaphors), enacting identity through evaluations of the new normal (life with and after cancer), and communicating membership as an AYA with cancer. This study highlights the unique needs of the AYA cancer community and offers a preliminary roadmap for practitioners, and network members, such as family and friends, to attempt to meet the needs of this unique community. PMID:22970826

  5. Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up.

    PubMed

    Rojo-Moreno, Luis; Arribas, Pilar; Plumed, Javier; Gimeno, Natalia; García-Blanco, Ana; Vaz-Leal, Francisco; Luisa Vila, María; Livianos, Lorenzo

    2015-05-30

    The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis.

  6. Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up.

    PubMed

    Rojo-Moreno, Luis; Arribas, Pilar; Plumed, Javier; Gimeno, Natalia; García-Blanco, Ana; Vaz-Leal, Francisco; Luisa Vila, María; Livianos, Lorenzo

    2015-05-30

    The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis. PMID:25771751

  7. Community Violence Exposure and Adolescent Substance Use: Does Monitoring and Positive Parenting Moderate Risk in Urban Communities?

    ERIC Educational Resources Information Center

    Lee, Rosalyn

    2012-01-01

    This study investigates whether monitoring and positive parenting moderate the relationship between community violence exposure (CVE) and youth substance use. Analyses utilized a subsample (N = 2197) of a cross-sectional, ethnically diverse, urban school district sample. Dependent variables were any past year alcohol or drug use (AOD) and binge…

  8. Epigenetic Analysis of Neurocognitive Development at 1 year of Age in a Community-Based Pregnancy Cohort

    PubMed Central

    Murphy, Laura E.; Palmer, Frederick B.; Graff, J. Carolyn; Sutter, Thomas R.; Mozhui, Khyobeni; Hovinga, Collin A.; Thomas, Fridtjof; Park, Vicki; Tylavsky, Frances A.; Adkins, Ronald M.

    2014-01-01

    Multiple studies show that molecular genetic changes and epigenetic modifications affect the risk of cognitive disability or impairment. However, the role of epigenetic variation in cognitive development of neurotypical young children remains largely unknown. Using data from a prospective, community-based study of mother-infant pairs, we investigated the association of DNA methylation patterns in neonatal umbilical cord blood with cognitive and language development at 1 year of age. No CpG loci achieved genome-wide significance, although a small number of weakly suggestive associations with Bayley-III Receptive Communication scales were noted. While umbilical cord blood is a convenient resource for genetic analyses of birth outcomes, our results do not provide conclusive evidence that its use for DNA methylation profiling yields epigenetic markers that are directly related to postnatal neurocognitive outcomes at 1 year of age. PMID:24452678

  9. Psychosocial Factors Associated with Resilience in a National Community-Based Cohort of Australian Gay Men Living with HIV.

    PubMed

    Lyons, Anthony; Heywood, Wendy; Rozbroj, Tomas

    2016-08-01

    HIV-positive gay men may experience multiple sources of adversity and stress, related both to their HIV diagnosis and sexual identity. Most of these men, however, do not experience mental health problems. Little is known about factors that help them achieve resilience in the face of life challenges. This study examined psychosocial factors associated with resilience in a national community-based sample of 357 Australian HIV-positive gay men. Resilience was measured using the Connor-Davidson Resilience Scale. Higher levels of resilience were linked with experiencing low or no internalized HIV-related stigma, having no previous history of mental health problems, and a number of socioeconomic indicators. In addition to providing a more complete picture of the mental health of HIV-positive gay men, findings from this study can be used to inform strength-based approaches to mental health prevention and support.

  10. Reciprocal prospective associations between disordered eating and other psychological problems in a community sample of Swedish adolescent girls.

    PubMed

    Viborg, Njördur; Wångby-Lundh, Margit; Lundh, Lars-Gunnar

    2014-01-01

    Disordered eating and its associations with psychological difficulties and body satisfaction were prospectively studied in a community sample of 13-15 year old adolescent girls (N=428). General psychological difficulties (including hyperactivity-inattention) and lower levels of body satisfaction at T1 were found to predict disordered eating at follow-up one year later (T2). Furthermore, reciprocal associations were found between disordered eating and psychological difficulties (but not body dissatisfaction) so that disordered eating at T1 predicted general psychological difficulties (including hyperactivity-inattention) at T2. The results support the notion of a vicious interplay between disordered eating and other subclinical psychological problems, which may represent a potential mechanism for the development of clinically significant eating disorders. It is suggested that it could be important to identify these kinds of bidirectional processes at an early stage, in order to prevent further developments of clinical forms of psychopathology. PMID:24411769

  11. Reward-Related Neural Activity and Adolescent Antisocial Behavior in a Community Sample.

    PubMed

    Sheffield, James G; Crowley, Michael J; Bel-Bahar, Tarik; Desatnik, Alexander; Nolte, Tobias; Fonagy, Peter; Fearon, R M Pasco

    2015-01-01

    Behavioral research has found evidence supporting reward dominance in adolescence with externalizing disorders, but findings from neuroimaging studies have been largely heterogeneous. We examined the Feedback-Related Negativity (FRN) and P3b in relation to self-reported externalizing behavior among 78 adolescents (11-18 yrs) during a monetary gambling task with concurrent high-density electroencephalogram. As expected, the P3b and the FRN demonstrated greater evoked activity to reward and punishment, respectively. Further, high externalizing behavior was associated with greater P3b difference and reduced FRN difference in response to reward and punishment, suggesting that externalizing behaviors may be associated with both reward dominance and reduced feedback-monitoring. PMID:26491989

  12. Reasons for Fighting among Violent Female Adolescents: A Qualitative Investigation from an Urban, Midwestern Community.

    PubMed

    Resko, Stella M; Reddock, Ebony C; Ranney, Megan L; Epstein-Ngo, Quyen; Mountain, Sarah Kruman; Zimmerman, Marc A; Cunningham, Rebecca M; Walton, Maureen A

    2016-01-01

    This qualitative study examines the self-reported reasons for fighting among female adolescents (N = 72). Data are drawn from brief intervention sessions addressing violent behavior and alcohol use. Young women age 14 to 18 (Mean = 16) were recruited in an urban emergency department (58.3% African American/Black, 31.9% White, and 9.7% other races/ethnicities). Participants identified multiple reasons that they engage in fights including self-protection/self-defense, enhancing social status and respect, safety (e.g., preventing future fights or sexual assaults), revenge/retaliation, social motivations (e.g., defending family or friends, fighting over romantic interests), coping, and enjoyment. Results provide insight into opportunities and challenges in developing interventions addressing aggression among female adolescents. PMID:27018828

  13. Individual and community-level socioeconomic position and its association with adolescents experience of childhood sexual abuse: a multilevel analysis of six countries in Sub-Saharan Africa

    PubMed Central

    Yahaya, Ismail; Ponce de Leon, Antonio; Uthman, Olalekan A.; Soares, Joaquim; Macassa, Gloria

    2014-01-01

    Abstract: Background: Childhood sexual abuse (CSA) is a substantial global health and human rights problem and consequently a growing concern in sub-Saharan Africa. We examined the association between individual and community-level socioeconomic status (SES) and the likelihood of reporting CSA. Methods: We applied multiple multilevel logistic regression analysis on Demographic and Health Survey data for 6,351 female adolescents between the ages of 15 and 18 years from six countries in sub-Saharan Africa, between 2006 and 2008. Results: About 70% of the reported cases of CSA were between 14 and 17 years. Zambia had the highest proportion of reported cases of CSA (5.8%). At the individual and community level, we found that there was no association between CSA and socioeconomic position. This study provides evidence that the likelihood of reporting CSA cut across all individual SES as well as all community socioeconomic strata. Conclusions: We found no evidence of socioeconomic differentials in adolescents’ experience of CSA, suggesting that adolescents from the six countries studied experienced CSA regardless of their individual and community-level socioeconomic position. However, we found some evidence of geographical clustering, adolescents in the same community are subject to common contextual influences. Further studies are needed to explore possible effects of countries’ political, social, economic, legal, and cultural impact on childhood sexual abuse. PMID:23797565

  14. Community epidemiology of risk and adolescent substance use: practical questions for enhancing prevention.

    PubMed

    Feinberg, Mark E

    2012-03-01

    To promote an effective approach to prevention, the community diagnosis model helps communities systematically assess and prioritize risk factors to guide the selection of preventive interventions. This increasingly widely used model relies primarily on individual-level research that links risk and protective factors to substance use outcomes. I discuss common assumptions in the translation of such research concerning the definition of risk factor elevation; the equivalence, independence, and stability of relations between risk factors and problem behaviors; and community differences in risk factors and risk factor-problem behavior relations. Exploring these assumptions could improve understanding of the relations of risk factors and substance use within and across communities and enhance the efficacy of the community diagnosis model. This approach can also be applied to other areas of public health where individual and community levels of risk and outcomes intersect.

  15. Gender hierarchy and adolescent sexuality: the control of female reproduction in an Australian aboriginal community.

    PubMed

    Burbank, V K

    1995-03-01

    Women can bear children; men cannot. The author explores why women fail to realize more power from their ability to procreate. An instance is considered in which the practice and resistance of female Australian Aboriginal adolescents created circumstances in which their sexuality and reproduction were largely uncontrolled. The products of women's reproductive ability, children, are socially appropriated, but not women's reproductive abilities. The author views gender as a system of power relations both generated and changed in the quotidian interactions between human males and females. Adolescent sexuality and reproduction in Mangrove, and culture, power, and reproduction are discussed. The author finds women's sexual and reproductive freedom, as it is currently experienced by adolescent girls in Mangrove, to be supported by the confluence of the following factors: the diminished force of ideologies which may circumscribe women's behavior, the control of male violence, and the appreciation of motherhood and of any child simply by virtue of its being a child. It is unclear how long this arrangement will persist. Changes which may presage diminished freedom for women can already be discerned. Women's sexual and reproductive freedom are clearly human possibilities, but they are possibilities which can easily be denied.

  16. Associations between television viewing and physical activity and low back pain in community-based adults: A cohort study.

    PubMed

    Hussain, Sultana Monira; Urquhart, Donna M; Wang, Yuanyuan; Dunstan, David; Shaw, Jonathan E; Magliano, Dianna J; Wluka, Anita E; Cicuttini, Flavia M

    2016-06-01

    Two systematic reviews concluded that there was limited evidence to support an association between physical activity and sedentary behavior and developing low back pain (LBP). The aim of this study was to examine the associations of physical activity and television viewing time with LBP intensity and disability in community-based adults.Five thousand fifty-eight participants (44% men) of the Australian Diabetes, Obesity and Lifestyle Study had physical activity and television viewing time measured in 1999 to 2000, 2004 to 2005, and 2011 to 2012, and LBP intensity and disability assessed in 2013 to 2014 using the Chronic Pain Grade Questionnaire. Multinomial logistic regressions were used to estimate the odds ratio for LBP intensity and disability associated with physical activity and television viewing time. Analyses were adjusted for age, education, smoking, dietary guideline index score, body mass index, and mental component summary score. To test whether associations of physical activity or television viewing time with LBP intensity and disability were modified by sex, obesity, or age, interactions were tested using the likelihood ratio test.As gender modified the associations between physical activity and television viewing time and LBP disability (P = 0.05), men and women were examined separately. A total of 81.7% men and 82.1% women had LBP. Most men (63.6%) and women (60.2%) had low intensity LBP with fewer having high intensity LBP (18.1% men, 21.5% women). Most participants had no LBP disability (74.5% men, 71.8% women) with the remainder reporting low (15.8% men, 15.3% women) or high (9.7% men, 12.9% women) LBP disability. Insufficient physical activity (<2.5 hours/week) was not associated with LBP intensity or disability. High television viewing time (≥2 hours/day) was associated with greater prevalence of LBP disability in women (low disability OR 1.35, 95% CI 1.04-1.73; high disability OR 1.29, 95% CI 1.01-1.72).Although it needs to be confirmed

  17. Healthcare-associated, community-acquired and hospital-acquired bacteraemic urinary tract infections in hospitalized patients: a prospective multicentre cohort study in the era of antimicrobial resistance.

    PubMed

    Horcajada, J P; Shaw, E; Padilla, B; Pintado, V; Calbo, E; Benito, N; Gamallo, R; Gozalo, M; Rodríguez-Baño, J

    2013-10-01

    The clinical and microbiological characteristics of community-onset healthcare-associated (HCA) bacteraemia of urinary source are not well defined. We conducted a prospective cohort study at eight tertiary-care hospitals in Spain, from October 2010 to June 2011. All consecutive adult patients hospitalized with bacteraemic urinary tract infection (BUTI) were included. HCA-BUTI episodes were compared with community-acquired (CA) and hospital-acquired (HA) BUTI. A logistic regression analysis was performed to identify 30-day mortality risk factors. We included 667 episodes of BUTI (246 HCA, 279 CA and 142 HA). Differences between HCA-BUTI and CA-BUTI were female gender (40% vs 69%, p <0.001), McCabe score II-III (48% vs 14%, p <0.001), Pitt score ≥2 (40% vs 31%, p 0.03), isolation of extended spectrum β-lactamase-producing Enterobacteriaciae (13% vs 5%, p <0.001), median hospital stay (9 vs 7 days, p 0.03), inappropriate empirical antimicrobial therapy (21% vs 13%, p 0.02) and mortality (11.4% vs 3.9%, p 0.001). Pseudomonas aeruginosa was more frequently isolated in HA-BUTI (16%) than in HCA-BUTI (4%, p <0.001). Independent factors for mortality were age (OR 1.04; 95% CI 1.01-1.07), McCabe score II-III (OR 3.2; 95% CI 1.8-5.5), Pitt score ≥2 (OR 3.2 (1.8-5.5) and HA-BUTI OR 3.4 (1.2-9.0)). Patients with HCA-BUTI are a specific group with significant clinical and microbiological differences from patients with CA-BUTI, and some similarities with patients with HA-BUTI. Mortality was associated with patient condition, the severity of infection and hospital acquisition.

  18. Epidemiological characteristics of the carriers with coexistence of HBsAg and anti-HBs based on a community cohort study.

    PubMed

    Pu, Z; Li, D; Wang, A; Su, H; Shao, Z; Zhang, J; Ji, Z; Gao, J; Choi, B C K; Yan, Y

    2016-04-01

    The coexistence of HBsAg and anti-HBs is an atypical serological pattern in HBV infection. There is no epidemiological characteristics of this serological pattern in the community and there is controversy over the molecular mechanisms underlying this pattern. We investigated the epidemiological characteristics of the carriers with HBsAg and anti-HBs in a longitudinal community cohort study. The prevalence of this atypical serological pattern was 2.93% (122/4169) in HBsAg-positive populations. The prevalence progressively increased with age from 40 to 70 years old. The rate of HBeAg positive and detectable HBV DNA were both significantly higher in carriers with this pattern than in carriers who were HBsAg positive but anti-HBs negative (26/122 verse 598/4047, P = 0.046; 86/122 verse 275/529,P < 0.001). After 1 year of follow-up, 85.19% of the carriers still had coexistence HBsAg and anti-HBs, 14.81% of the carriers lost their anti-HBs. Viral sequencing showed that carriers with coexistence of HBsAg and anti-HBs had higher numbers of residue changes within the S gene than carriers who were HBsAg positive but anti-HBs negative (2.42 verse 1.33 changes per 100 residues, P < 0.05). Hence, the coexistence of HBsAg and anti-HBs is a unique serological pattern which may be associated with an increased risk of adverse clinical outcome and may be related to HBsAg immune variants which have genotypic heterogeneity.

  19. The experience of labor, maternal perception of the infant, and the mother's postpartum mood in a low-risk community cohort.

    PubMed

    Weisman, Omri; Granat, Adi; Gilboa-Schechtman, Eva; Singer, Magi; Gordon, Ilanit; Azulay, Hila; Kuint, Jacob; Feldman, Ruth

    2010-12-01

    Postpartum negative mood interferes with maternal-infant bonding and carries long-term negative consequences for infant growth. We examined the effects of birth-related risks on mother's postpartum anxiety and depression. A community cohort of 1,844 low-risk women who delivered a singleton term baby completed measures assessing delivery, emotions during labor, attitudes toward pregnancy and infant, mood regulation, and postpartum anxiety and depression. Under conditions of low risk, 20.5% of parturient women reported high levels of depressive symptoms. Following Cesarean Section Delivery (CSD), 23% reported high depressive symptoms, compared to 19% following Vaginal Delivery (VGD), and 21% after Assisted Vaginal Delivery (AVGD). State anxiety was highest in CSD and lowest in VGD. Mothers undergoing CSD experienced labor as most negative, reported highest somatic symptoms during the last trimester, and were least efficient in regulating negative mood. Postpartum depression was independently associated with higher maternal age, CSD, labor pain, lower negative and higher positive emotions during labor, inefficient mood regulation, somatic symptoms, and more negative and less positive perception of fetus during last trimester. Results demonstrate that elevated depressive symptoms are prevalent in the postpartum even under optimal socioeconomic and health conditions and increase following CSD. Interventions to increase positive infant-related perceptions and emotions may be especially important for promoting bond formation following CSD.

  20. Towards large-cohort comparative studies to define the factors influencing the gut microbial community structure of ASD patients

    PubMed Central

    McDonald, Daniel; Hornig, Mady; Lozupone, Catherine; Debelius, Justine; Gilbert, Jack A.; Knight, Rob

    2015-01-01

    Differences in the gut microbiota have been reported between individuals with autism spectrum disorders (ASD) and neurotypical controls, although direct evidence that changes in the microbiome contribute to causing ASD has been scarce to date. Here we summarize some considerations of experimental design that can help untangle causality in this complex system. In particular, large cross-sectional studies that can factor out important variables such as diet, prospective longitudinal studies that remove some of the influence of interpersonal variation in the microbiome (which is generally high, especially in children), and studies transferring microbial communities into germ-free mice may be especially useful. Controlling for the effects of technical variables, which have complicated efforts to combine existing studies, is critical when biological effect sizes are small. Large citizen-science studies with thousands of participants such as the American Gut Project have been effective at uncovering subtle microbiome effects in self-collected samples and with self-reported diet and behavior data, and may provide a useful complement to other types of traditionally funded and conducted studies in the case of ASD, especially in the hypothesis generation phase. PMID:25758371