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Sample records for adolescent community cohort

  1. Multilevel Predictors of Smoking Initiation among Adolescents: Findings from the Minnesota Adolescent Community Cohort (MACC) Study

    PubMed Central

    Choi, Kelvin; Bernat, Debra H.; Klein, Elizabeth G.; Okuyemi, Kolawole S.; Forster, Jean

    2012-01-01

    Objective To understand how factors at multiple levels of influence impact adolescent smoking initiation. Method Data from the Minnesota Adolescent Community Cohort, a population-based cohort, were analyzed. Adolescents were recruited from randomly selected geopolitical units (GPUs) in Minnesota at ages 12 to 13 (n=1,953), and were surveyed every six months (2000–2006) until 18. The association between baseline social factors and smoking initiation was analyzed using logistic regression. Linear regression was used to analyze predictors and age of initiation among smokers (n=603). Results Higher proportion of 15–16 year-olds who smoke at the area-level (GPU) was associated with younger initiation (15.47 vs 15.87, p<.05). Higher proportion of the population employed and higher median household income were associated with older initiation (15.90 vs. 15.56 p<.05). Parent education, living with parents or siblings who smoke, living in homes that allow smoking, and having friends who smoke at baseline were associated with smoking initiation or younger initiation (p<.05). Participants whose parents had less than a high school education were 1.6 times more likely than those with college educated parents to have smoked more than a whole cigarette (CI=1.06, 2.26). Conclusion Factors at multiple levels of influence affect adolescent smoking initiation. Smoking by older age peers and lower SES predicts earlier smoking. PMID:22245269

  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. Walkable Communities and Adolescent Weight

    PubMed Central

    Slater, Sandy J.; Nicholson, Lisa; Chriqui, Jamie; Barker, Dianne; Chaloupka, Frank J.; Johnston, Lloyd D.

    2012-01-01

    Background Neighborhood design features have been associated with health outcomes, including the prevalence of obesity. Purpose This study examined the association between walkability and adolescent weight in a national sample of public secondary school students and the communities in which they live. Methods Data were collected through student surveys and community observations between February and August 2010, and analyses were conducted in Spring 2012. The sample size was 154 communities and 11,041 students. A community walkability index and measures of the prevalence of adolescent overweight and obesity were constructed. Multivariable analyses from a cross-sectional survey of a nationally representative sample of 8th-, 10th- and 12th-grade public school students in the U.S. were run. Results The odds of students being overweight (OR 0.975; 95% CI=0.94, 0.99) or obese (OR 0.971; 95% CI=0.94, 0.99) decreased if they lived in communities with higher walkability index scores. Conclusions Results suggest that living in more-walkable communities is associated with reduced prevalence of adolescent overweight and obesity. PMID:23332334

  5. Adolescents in Therapeutic Communities.

    ERIC Educational Resources Information Center

    Mann-Feder, Varda R.

    1996-01-01

    Compares the course of change of two groups of conduct-disoriented adolescents in two theoretically distinct residential treatment programs. Despite an overall trend toward improvement in both groups, there was little significant difference between the rates of progress over time. Supports the need for qualitative research focusing on the…

  6. 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…

  7. Design and analysis of the Community Youth Development Study longitudinal cohort sample.

    PubMed

    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

    2009-08-01

    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 communities across the United States. This article describes the rationale, multilevel analyses, and baseline comparability for the study's longitudinal cohort design. The cohort sample consists of 4,407 fifth- and sixth-grade students recruited in 2004 and 2005 and surveyed annually through ninth grade. Results of mixed-model ANOVAs indicated that students in CTC and control communities exhibited no significant differences (ps > .05) in baseline levels of student outcomes. PMID:19509119

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

    PubMed Central

    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 communities across the United States. This paper describes the rationale, multilevel analyses, and baseline comparability for the study’s longitudinal cohort design. The cohort sample consists of 4,407 fifth- and sixth-grade students recruited in 2004 and 2005, and surveyed annually through ninth grade. Results of mixed-model ANOVAs indicated that students in CTC and control communities exhibited no significant differences (ps > .05) in baseline levels of student outcomes. PMID:19509119

  9. 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

  10. 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

  11. The Southern Community Cohort Study: Investigating Health Disparities

    PubMed Central

    Signorello, Lisa B.; Hargreaves, Margaret K.; Blot, William J.

    2010-01-01

    Summary Over 73,700 adults age 40–79, nearly 70% African American, were recruited at community health centers across 12 southeastern states; individual characteristics were recorded and biologic specimens collected at baseline for later follow-up. The Southern Community Cohort Study is a unique national resource for assessing determinants of racial/ethnic differentials in diseases. PMID:20173283

  12. Adolescent Borderline Symptoms in the Community: Prognosis for Functioning over 20 Years

    ERIC Educational Resources Information Center

    Winograd, Greta; Cohen, Patricia; Chen, Henian

    2008-01-01

    Background: The long-term prognosis associated with adolescent symptoms of borderline personality disorder (BPD) in the general population is virtually unknown. In this study, the relationship of early borderline symptoms to subsequent psychosocial functioning and attainment was investigated based on data from the Children in the Community cohort.…

  13. 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

  14. 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…

  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. Southern community cohort study: establishing a cohort to investigate health disparities.

    PubMed Central

    Signorello, Lisa B.; Hargreaves, Margaret K.; Steinwandel, Mark D.; Zheng, Wei; Cai, Qiuyin; Schlundt, David G.; Buchowski, Maciej S.; Arnold, Carolyne W.; McLaughlin, Joseph K.; Blot, William J.

    2005-01-01

    OBJECTIVES: To demonstrate the methods of recruitment of a low-income, predominantly African-American study population for the Southern Community Cohort Study (SCCS), a prospective epidemiologic investigation of racial disparities in cancer risk. METHODS: Partnerships with community health centers (CHCs) were formed to reach underserved populations throughout the south. Recruitment of participants (aged 40-79) in CHCs began in March 2002. Participants complete a comprehensive baseline interview and provide a blood or buccal cell sample. Recruitment will expand to the general population of the south to achieve a broad cross-section of socioeconomic status, The final cohort size is expected to be approximately 100,000. RESULTS: A high level of cooperation and recruitment was achieved in the CHCs. From March 2002 to October 2004, 32,632 participants (80% black, 41% male, 62% with total household income < $15,000, 34% with < 12 years schooling) enrolled. Participants reported a high prevalence of medical conditions (21% diabetic, 44% obese) and adverse health behaviors (45% current smokers). CONCLUSIONS: Working in CHCs is successful for recruiting a population that has been difficult to reach in previous studies. The SCCS is a unique cohort that will provide a rich resource for evaluating disparities in cancer and other chronic disease risk as it is followed over time. PMID:16080667

  18. 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

  19. A prospective cohort study of the changing mental health needs of adolescents in custody

    PubMed Central

    Lennox, Charlotte; Bell, Vicky; O'Malley, Kate; Shaw, Jenny; Dolan, Mairead

    2013-01-01

    Objective To investigate changes in mental health and other needs, as well as clinical and diagnostic ‘caseness’, in a sample of adolescents over a 6-month period following entry into a Young Offenders Institution in the UK. Design Prospective cohort study. Setting One Young Offenders Institution between November 2006 and August 2009. Participants 219 male adolescents aged 15–18 years (M=16.56; SD=0.6) were assessed at baseline (median=4; range 0–26 days following reception into custody) on the Salford Needs Assessment Schedule for Adolescents (SNASA) and Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Participants were then reassessed at 3-month and 6-month postbaseline to document any change in mental health. Results Of the initial baseline sample, 132 were still in the study at 3-month postbaseline and 63 were still available for assessment at 6 months. There were no differences between those who were not available for assessment at the three key stages in terms of demographic and criminological data. Over time there was a general improvement in mental health. While the proportion of participants with a mental health need (SNASA) did not change over time, symptom severity as measured by the SNASA did reduce significantly. When we assessed diagnostic ‘caseness’ using the K-SADS, three young people showed significant mental health deterioration. Conclusions In line with previous studies, we found that symptoms in prison generally improved over time. Prison may provide an opportunity for young people previously leading chaotic lifestyles to settle into a stable routine and engage with services; however, it is unclear if these would be maintained either within the prison or on release into the community. PMID:23474795

  20. The Community Context of Family Structure and Adolescent Drug Use.

    ERIC Educational Resources Information Center

    Hoffmann, John P.

    2002-01-01

    Investigates hypothesis used to explain the relationship between family structure and adolescent drug use, using data from the National Education Longitudinal Study (NELS). Reports that adolescents who resided in single-parent or stepparent families had heightened drug use. Higher adolescent drug use was found in communities with a large…

  1. The Role of Stressful Life Events in the Development of Depressive Symptoms in Adolescence--A Longitudinal Community Study

    ERIC Educational Resources Information Center

    Waaktaar, Trine; Borge, Anne Inger Helmen; Fundingsrud, Hans Petter; Christie, Helen Johnsen; Torgersen, Svenn

    2004-01-01

    Depressive symptoms were measured in a cohort of community-based adolescents (n=163) at two time-points, with 1 year intervening. At Time 2, participants also answered a scale about past-year stressful life events. Depressive symptoms increased from Time 1 to Time 2, the effect being stronger for girls than for boys. Depressive symptoms were…

  2. 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…

  3. Learning Communities or Support Groups: The Use of Student Cohorts in Doctoral Educational Leadership Programs

    ERIC Educational Resources Information Center

    Brown, Christy J.

    2011-01-01

    This mixed-method study explored how students in a doctoral educational leadership cohort at one university used the cohort structure as a learning community or as a method of social support. Survey data were collected from 45 past and present cohort students and qualitative data were collected from three focus groups of 15 participants total. The…

  4. Machos and sluts: gender, sexuality, and violence among a cohort of Puerto Rican adolescents.

    PubMed

    Asencio, M W

    1999-03-01

    During the past decade, interpersonal violence increasingly has become a public health concern. As a result, prevention programs now aim to decrease violence among diverse populations. This article describes the beliefs and rationale for gender-based violence among a cohort of low-income, predominantly second-generation, mainland Puerto Rican adolescents. Based on a three-year (1989-91) ethnographic study, the findings describe how these young people, through the use of gender-based social constructs such as "machos" and "sluts," justify violence by linking it to beliefs about gender roles, sexuality, and biology, and thus perpetuate gender-role conformity, particularly heterosexual male dominance. The findings suggest that if the public health community is going to reduce gender-based violence among Puerto Rican youth, it needs to acknowledge that gender and sexuality are important ingredients that support violence and avoid a simplified and stereotypical model of culture that ignores other social factors and changes in traditional Latino gender roles. PMID:10322604

  5. 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

  6. 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

  7. The Link between Mother and Adolescent Substance Use: Intergenerational Findings from the British Cohort Study.

    PubMed

    Patrick, Megan E; Maggs, Jennifer L; Greene, Kaylin M; Morgan, Nicole R; Schulenberg, John E

    2014-01-01

    The objective of this study was to identify mother, family, and individual factors associated with adolescent alcohol, tobacco, and marijuana use using mother and child self-reports. Adolescents aged 12-15 (N=276) and their mothers who were participants in the British Cohort Study (BCS; born 1970) were both surveyed when mothers were 34 years old. Predictors included mother's substance use as well as characteristics of the child (gender, age, conduct problems) and family (social class, two-parent family, parent-adolescent conflict). Outcome variables were adolescent alcohol, cigarette, and marijuana use. Child characteristics were predictive, with older children more likely to engage in all behaviors. After controlling for other predictors, mothers' current drinking frequency and problems (i.e., CAGE 1+) predicted adolescent ever and sometimes/regular drinking; mothers' marijuana use was a marginally significant predictor of adolescent marijuana use. Results suggest that mothers' substance use is an important component of adolescent use, even after accounting for characteristics of the child and the intergenerational family context. PMID:24489608

  8. Assessing Community Effects on Adolescent Substance Use and Delinquency

    ERIC Educational Resources Information Center

    Van Horn, M. Lee; Hawkins, J. David; Arthur, Michael W.; Catalano, Richard F.

    2007-01-01

    This study investigates community-level prediction of adolescent substance use and problem behaviors using ratings by community leaders to assess the effects of four risk factors on levels of drug use and problem behaviors. Three questions are examined: (a) Can psychometrically sound measures of community leader perceptions of risk factors in…

  9. 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…

  10. A community-based comprehensive approach to serving adolescent parents.

    PubMed

    Palmer, E

    1981-03-01

    A community-based social service center, working together with existing educational, medical, and social institutions, can offer a continuity of service to adolescent parents who cannot yet function independently and were not previously reached. PMID:16295132

  11. Depression and blood pressure in high-risk children and adolescents: an investigation using two longitudinal cohorts

    PubMed Central

    Hammerton, Gemma; Harold, Gordon; Thapar, Anita; Thapar, Ajay

    2013-01-01

    Objective To examine the relationship between blood pressure and depressive disorder in children and adolescents at high risk for depression. Design Multisample longitudinal design including a prospective longitudinal three-wave high-risk study of offspring of parents with recurrent depression and an on-going birth cohort for replication. Setting Community-based studies. Participants High-risk sample includes 281 families where children were aged 9–17 years at baseline and 10–19 years at the final data point. Replication cohort includes 4830 families where children were aged 11–14 years at baseline and 14–17 years at follow-up and a high-risk subsample of 612 offspring with mothers that had reported recurrent depression. Main outcome measures The new-onset of Diagnostic and Statistical Manual of Mental Disorder, fourth edition defined depressive disorder in the offspring using established research diagnostic assessments—the Child and Adolescent Psychiatric Assessment in the high-risk sample and the Development and Wellbeing Assessment in the replication sample. Results Blood pressure was standardised for age and gender to create SD scores and child's weight was statistically controlled in all analyses. In the high-risk sample, lower systolic blood pressure at wave 1 significantly predicted new-onset depressive disorder in children (OR=0.65, 95% CI 0.44 to 0.96; p=0.029) but diastolic blood pressure did not. Depressive disorder at wave 1 did not predict systolic blood pressure at wave 3. A significant association between lower systolic blood pressure and future depression was also found in the replication cohort in the second subset of high-risk children whose mothers had experienced recurrent depression in the past. Conclusions Lower systolic blood pressure predicts new-onset depressive disorder in the offspring of parents with depression. Further studies are needed to investigate how this association arises. PMID:24071459

  12. 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

  13. Adverse childhood experiences: Prevalence and related factors in adolescents of a Brazilian birth cohort.

    PubMed

    Soares, Ana Luiza Gonçalves; Howe, Laura D; Matijasevich, Alicia; Wehrmeister, Fernando C; Menezes, Ana M B; Gonçalves, Helen

    2016-01-01

    Adverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities. PMID:26707919

  14. Factors underlying variable DNA methylation in a human community cohort

    PubMed Central

    Lam, Lucia L.; Emberly, Eldon; Fraser, Hunter B.; Neumann, Sarah M.; Chen, Edith; Miller, Gregory E.; Kobor, Michael S.

    2012-01-01

    Epigenetics is emerging as an attractive mechanism to explain the persistent genomic embedding of early-life experiences. Tightly linked to chromatin, which packages DNA into chromosomes, epigenetic marks primarily serve to regulate the activity of genes. DNA methylation is the most accessible and characterized component of the many chromatin marks that constitute the epigenome, making it an ideal target for epigenetic studies in human populations. Here, using peripheral blood mononuclear cells collected from a community-based cohort stratified for early-life socioeconomic status, we measured DNA methylation in the promoter regions of more than 14,000 human genes. Using this approach, we broadly assessed and characterized epigenetic variation, identified some of the factors that sculpt the epigenome, and determined its functional relation to gene expression. We found that the leukocyte composition of peripheral blood covaried with patterns of DNA methylation at many sites, as did demographic factors, such as sex, age, and ethnicity. Furthermore, psychosocial factors, such as perceived stress, and cortisol output were associated with DNA methylation, as was early-life socioeconomic status. Interestingly, we determined that DNA methylation was strongly correlated to the ex vivo inflammatory response of peripheral blood mononuclear cells to stimulation with microbial products that engage Toll-like receptors. In contrast, our work found limited effects of DNA methylation marks on the expression of associated genes across individuals, suggesting a more complex relationship than anticipated. PMID:23045638

  15. 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

  16. 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

  17. 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…

  18. Effects of the Communities That Care Model in Pennsylvania on Change in Adolescent Risk and Problem Behaviors

    PubMed Central

    Jones, Damon; Greenberg, Mark T.; Osgood, D. Wayne; Bontempo, Daniel

    2015-01-01

    Despite the public health burden of adolescent substance use, delinquency, and other problem behavior, few comprehensive models of disseminating evidence-based prevention programs to communities have demonstrated positive youth outcomes at a population level, capacity to maintain program fidelity, and sustainability. We examined whether the Communities That Care (CTC; Hawkins and Catalano 1992) model had a positive impact on risk/protective factors and academic and behavioral outcomes among adolescents in a quasi-experimental effectiveness study. We conducted a longitudinal study of CTC in Pennsylvania utilizing biannual surveillance data collected through anonymous in-school student surveys. We utilized multilevel models to examine CTC impact on change in risk/protective factors, grades, delinquency, and substance use over time. Youth in CTC communities demonstrated less growth in delinquency, but not substance use, than youth in non-CTC communities. Levels of risk factors increased more slowly, and protective factors and academic performance decreased more slowly, among CTC community grade-cohorts that were exposed to evidence-based, universal prevention programs than comparison grade cohorts. Community coalitions can affect adolescent risk and protective behaviors at a population level when evidence-based programs are utilized. CTC represents an effective model for disseminating such programs. PMID:20020209

  19. Racial Differences in Adolescent Distress: Differential Effects of the Family and Community for Blacks and Whites

    ERIC Educational Resources Information Center

    Wickrama, K. A. S.; Noh, Samuel; Bryant, Chalandra M.

    2005-01-01

    Using a sample of 15,885 adolescents derived from the National Longitudinal Study of Adolescent Health, this study examined (1) unique additive influences of race, family, and community and (2) various multiplicative influences among race, family, and community factors on adolescent distress. Community characteristics such as community poverty and…

  20. 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…

  1. 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…

  2. 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…

  3. Rash in Psychiatric and Nonpsychiatric Adolescent Patients Receiving Lamotrigine in Korea: A Retrospective Cohort Study

    PubMed Central

    Tak, Hee-Jong; Ahn, Joon-Ho; Kim, Kun-Woo; Kim, Yeni; Choi, Sam-Wook; Lee, Kyung-Yeon; Park, Eun Jin

    2012-01-01

    Objective Lamotrigine is a widely used medication for psychiatric disorders and epilepsy, but the adverse effects of this drug in adolescent Korean patients have not yet been investigated. In the present study, we sought to compare the incidence and impact of lamotrigine-induced skin rashes and different pattern of adverse events in psychiatric and nonpsychiatric adolescent patients. Methods Using a retrospective cohort design, all of the charts were reviewed for adolescents (13 to 20 years old), treated with lamotrigine during the previous 2 years in the Child and Adolescent Psychiatric Clinic and Pediatric Neurologic Clinic of the Ulsan University Hospital in South Korea. Results Of the 102 subjects, 23 patients developed a skin rash. All of these rashes were observed within 7 weeks of the initiation of the lamotrigine therapy. Only one subject developed a serious rash, which was diagnosed as Stevens-Johnson syndrome. Although the psychiatric subjects were administered statistically lower doses of lamotrigine during weeks 1 through 5 and at week 12, the likelihood of developing a rash was not significantly different between the psychiatric and nonpsychiatric patients. Conclusion Careful dose escalation and close observation of side effects for the first 7 weeks of treatment is important. The present study reveals the tolerability of lamotrigine in an adolescent population, although a double-blind, controlled trial is needed to confirm these findings. PMID:22707969

  4. Average Heart Rates of Hispanic and Caucasian Adolescents during Sleep: Longitudinal Analysis from the TuCASA Cohort

    PubMed Central

    Hedger-Archbold, Kristen; Sorensen, Seth T.; Goodwin, James L.; Quan, Stuart F.

    2014-01-01

    Objective: The current study describes sleeping heart rate patterns in an adolescent cohort of Hispanic and Caucasian children over approximately a 5-year period to determine how sex, ethnicity, and body mass index (BMI) contribute to sleeping heart rate patterns over time. Methods: Participants were recruited from a large urban school district in the southwest United States as part of the Tucson Children's Assessment of Sleep Apnea Study (TuCASA). Heart rate data was obtained through electrocardiogram (ECG) recordings during in-home polysomnography, approximately 5 years apart. Second-wave cohort data were analyzed to determine how age, sex, ethnicity, physical activity, and BMI contribute to average sleeping heart rates. The same variables were used to investigate how sleeping heart rate patterns change longitudinally from school-age (6–11 years) to adolescence (10–17 years) during sleep. Results: Female adolescents had significantly faster average heart rates during sleep. Sleeping heart rate decreased significantly with increasing age in the adolescent cohort. Although the Hispanic group had a statistically significant higher body mass index than Caucasians, there were no significant differences in heart rate observed between ethnicities or in those who were classified as obese (BMI ≥ 95th percentile for age). Longitudinal analysis between the school-aged and adolescent cohort revealed a significant overall decrease in heart rate across a 5-year period. Conclusions: Hispanic and Caucasian adolescents experience a similar decrease in sleeping heart rate with age. Female adolescents had significantly faster heart rates than males, and no significant differences were observed between Caucasians and Hispanics, or obese vs. nonobese adolescents. Citation: Hedger-Archbold K, Sorensen ST, Goodwin JL, Quan SF. Average heart rates of Hispanic and Caucasian adolescents during sleep: longitudinal analysis from the TuCASA cohort. J Clin Sleep Med 2014

  5. Age and Cohort Patterns of Medical and Nonmedical Use of Controlled Medication Among Adolescents

    PubMed Central

    Austic, Elizabeth; McCabe, Sean Esteban; Stoddard, Sarah; Ngo, Quyen Epstein; Boyd, Carol

    2015-01-01

    Objectives We identified peak annual incidence rates for medical and nonmedical use of prescription opioid analgesics, stimulants, sedatives and anxiolytics (controlled medication), and explored cohort effects on age of initiation. Methods Data were gathered retrospectively between 2009–2012 from Detroit area students (n=5185). Modal age at last assessment was 17 years. A meta-analytic approach produced age-, year-, and cohort-specific risk estimates of first-time use of controlled medication. Cox regression models examined cohort patterns in age of initiation for medical and nonmedical use with any of four classes of controlled medication (opioid analgesics, stimulants, sedatives or anxiolytics). Results Peak annual incidence rates were observed at age 16, when 11.3% started medical use, and 3.4% started using another person’s prescription for a controlled medication (i.e., engaged in nonmedical use). In the more recent birth cohort group (1996–2000), 82% of medical users and 76% of nonmedical users reported initiating such use by age 12. In contrast, in the less recent birth cohort group (1991–1995), 42% of medical users and 35% of nonmedical users initiated such use by age 12. Time to initiation was 2.6 times less in the more recent birth cohort group (medical use: adjusted hazard ratio [aHR]=2.57 [95% confidence interval (CI)= 2.32, 2.85]; nonmedical use: aHR=2.57 [95% CI=2.17, 3.03]). Conclusions Peak annual incidence rates were observed at age 16 for medical and nonmedical use. More recent cohorts reported initiating both types of use at younger ages. Earlier interventions may be needed to prevent adolescent nonmedical use of controlled medication. PMID:26291544

  6. Growth changes in infants born of adolescent mothers: Results of a national cohort study in Taiwan

    PubMed Central

    Chen, Yu-Ju; Li, Chi-Rong; Lee, Shu-Hsin; Hsu, Bu-Qing; Wu, Wei-Ya; Kuo, Ching-Pyng; Hwang, Shiow-Li; Lee, Ming-Chih

    2014-01-01

    Background: Adolescent pregnancy and childbirth are associated with increased risk and challenges for both mothers and birth outcomes. Objective: To investigate the associations of growth change over time with parenting factors and to compare the differences between children born to adolescent and adult mothers in Taiwan. Materials and Methods: The dataset retrieved from Taiwan birth cohort study (TBCS) was collected by interviews using structured questionnaires, birth certificate and Passport of Well-baby Care of each child. Changes in body weight, body height and head circumference from birth to 18 months, as well as other variables were assessed by statistical analysis. Results: There were 4.13% births born to adolescent mothers in 2005. Higher ratios of breastfeeding and working were found among adult mothers (p<0.001). Significantly higher percentage of adolescent mothers caregave their infants up to 18 months (p<0.001). Children born to adolescent mothers were associated with statistically significant lower body weight (p<0.001), body height (p<0.001) and head circumference (p<0.001) in spite of velocity and slop of growth patterns were similar over time. Breastfeeding did not significantly affected growth rate during the first 6 months. Generalized estimated equation models showed that gender and preterm birth were predictive factors for birth outcomes (both p<0.001) and correlated to changes over time. Conclusion: Adolescent childbearing was associated with preterm birth and lower body weight, body height and head circumference from birth to 18 months. The changes in growth and development among children born to adolescent mothers remain to be followed and evaluated with the TBCS. PMID:25709629

  7. Assessing Sense of Community on Adolescents: Validating the Brief Scale of Sense of Community in Adolescents (SOC-A)

    ERIC Educational Resources Information Center

    Chiessi, Monica; Cicognani, Elvira; Sonn, Christopher

    2010-01-01

    Sense of Community (SoC) is a key theoretical construct in community psychology. This study validated a SoC scale for adolescents (SoC-A) in Italy. The scale comprises 20 items and five components: satisfaction of needs and opportunities for involvement; support and emotional connection with peers; support and emotional connection in the…

  8. Psychiatric disorders in a community sample of adolescents.

    PubMed

    Kashani, J H; Beck, N C; Hoeper, E W; Fallahi, C; Corcoran, C M; McAllister, J A; Rosenberg, T K; Reid, J C

    1987-05-01

    The prevalence of psychiatric disorders diagnosed according to DSM-III in adolescents in the general population is not known. The authors address this issue in a community sample of 150 adolescents 14-16 years of age. Structured interviews as well as other instruments were used to collect data. Twenty-eight (18.7%) of the 150 adolescents were identified as having a psychiatric disorder. These 28 adolescents viewed their parents as less caring, had lower self-esteem, and resolved their conflicts through verbal aggression and physical violence more often than did the adolescents who did not have a psychiatric disorder. The authors make recommendations regarding the use of structured interviews in future research. PMID:3495187

  9. Early age at menarche and wheezing in adolescence. The 1993 Pelotas (Brazil) birth cohort study

    PubMed Central

    Joseph, Gary; Baptista Menezes, Ana Maria; Wehrmeister, Fernando C.

    2015-01-01

    Objective To evaluate the effect of menarche before 11 years of age on the incidence of wheezing/asthma in girls 11 to 18 years of age. Methods The study sample comprised 1,350 girls from a birth cohort that started in 1993 in the urban area of the city of Pelotas, southern Brazil; this cohort was followed until 18 years of age. We assessed wheezing by the question, “Have you ever had wheezing in the chest at any time in the past?,” from the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Early menarche was defined as occurring before 11 years of age. We estimated the cumulative incidence of wheezing excluding from the analysis all those participants who reported wheezing before age of 11 years. We performed the chi-square test to assess the association between ever wheezing and independent variables. Poisson regression models with robust variance were used to estimate cumulative incidence ratios. Results The average age at menarche in the cohort girls was 12 years (95% CI: 11.1–12.1). The prevalence of early menarche before 11 years of age was 11% (95% CI: 9.7–12.3). The cumulative incidence of wheezing from 11 to 18 years of age was 33.5% (95% CI: 30.9– 36.0). The crude association between ever wheezing in adolescence and early menarche before age 11 was 1.19 (95% CI: 0.96–1.48). After adjusting for early childhood and contemporaneous variables, no significant association for early menarche before 11 years of age and wheezing during adolescence was found (CIR: 1.18; CI95%: 0.93-1.49). Conclusion Early menarche before 11 years of age is not associated with an increased risk of wheezing during adolescence. PMID:26870751

  10. 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. PMID:24331300

  11. 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

  12. Pubertal maturation and affective symptoms in adolescence and adulthood: Evidence from a prospective birth cohort.

    PubMed

    Gaysina, Darya; Richards, Marcus; Kuh, Diana; Hardy, Rebecca

    2015-11-01

    The higher prevalence of affective symptoms among women compared to men emerges in adolescence, and it has been associated with pubertal maturation. However, it remains unclear whether pubertal timing has long-term influences on affective symptoms. Using data from the British 1946 birth cohort, we investigated whether pubertal timing was associated with affective symptoms over the life course, distinguishing those with symptoms in adolescence only, symptoms in adulthood only, and symptoms in both adolescence and adulthood. In females, there was no evidence that early pubertal maturation was a risk factor for affective symptoms. However, those with particularly late menarche (≥15 years) showed a lower risk of adult-onset affective symptoms (odds ratio = 0.54, 95% confidence interval = 0.31, 0.95). This effect of late pubertal timing was not explained by a range of sociobehavioral factors. In contrast, in males, late pubertal timing was associated with increased risk of adolescent-onset affective symptoms that tracked into adulthood (odds ratio = 2.10, 95% confidence interval = 1.44, 3.06). This effect was partly explained by low prepubertal body mass index. Sex-specific effects of pubertal timing on the long-term risk of affective symptoms might be due to different effects of gonadal hormonal on the central nervous system, as well as different social experiences during puberty. PMID:26439078

  13. 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

  14. Is fetal macrosomia related to blood pressure among adolescents? A birth cohort study in China.

    PubMed

    Li, Y; Wu, J; Yu, J; Gao, E; Meads, C; Afnan, M; Ren, J; Rong, F

    2013-11-01

    Birth weight (BW) has effects on blood pressure (BP). In order to explore the effects of macrosomia on BP in childhood and in adolescence, a longitudinal cohort study was conducted in Wuxi, China. Subjects with BW ≥4000 g, born in 1993-1995, were the exposed group; the unexposed comparisons were matched by year of birth and sex of infant, with BW of 2500-4000 g. Follow-ups in 2005-6 and 2011-12 were conducted, and height, weight and BP were measured by trained doctors. Multi-mixed models in SAS were used to control for repeated measures to explore the effects of fetal macrosomia on BP. At the inception of the cohort, 1595 pairs of participants were recruited. At the end, 1112 in the exposed group and 1126 in the unexposed group finished both follow-ups. Among adolescents, mean (s.d.) of systolic BP (SBP) was 110.83 (9.43)  mm  Hg, which was statistically significantly higher than that in the unexposed group (mean ± s.d.: 109.33 ± 9.26)  mm  Hg (P=0.0002). After adjusting the repeated measures and birth year, sex, mother's occupation and delivery age, adding weight during pregnancy, hypertension during delivery, gestational age and parity, being a picky eater in childhood, the macrosomia group had higher SBP than the normal BW group; the parameter estimate value was 1.03 (s.e.=0.30). When BMI in childhood and BMI in adolescence were added in the multi-model, the estimated β was 0.71 (s.e.=0.29). No statistically significant effect of macrosomia was found on diastolic BP among adolescents in the multianalysis. PMID:23595162

  15. Estimation of Newborn Risk for Child or Adolescent Obesity: Lessons from Longitudinal Birth Cohorts

    PubMed Central

    Morandi, Anita; Meyre, David; Lobbens, Stéphane; Kleinman, Ken; Kaakinen, Marika; Rifas-Shiman, Sheryl L.; Vatin, Vincent; Gaget, Stefan; Pouta, Anneli; Hartikainen, Anna-Liisa; Laitinen, Jaana; Ruokonen, Aimo; Das, Shikta; Khan, Anokhi Ali; Elliott, Paul; Maffeis, Claudio; Gillman, Matthew W.

    2012-01-01

    Objectives Prevention of obesity should start as early as possible after birth. We aimed to build clinically useful equations estimating the risk of later obesity in newborns, as a first step towards focused early prevention against the global obesity epidemic. Methods We analyzed the lifetime Northern Finland Birth Cohort 1986 (NFBC1986) (N = 4,032) to draw predictive equations for childhood and adolescent obesity from traditional risk factors (parental BMI, birth weight, maternal gestational weight gain, behaviour and social indicators), and a genetic score built from 39 BMI/obesity-associated polymorphisms. We performed validation analyses in a retrospective cohort of 1,503 Italian children and in a prospective cohort of 1,032 U.S. children. Results In the NFBC1986, the cumulative accuracy of traditional risk factors predicting childhood obesity, adolescent obesity, and childhood obesity persistent into adolescence was good: AUROC = 0·78[0·74–0.82], 0·75[0·71–0·79] and 0·85[0·80–0·90] respectively (all p<0·001). Adding the genetic score produced discrimination improvements ≤1%. The NFBC1986 equation for childhood obesity remained acceptably accurate when applied to the Italian and the U.S. cohort (AUROC = 0·70[0·63–0·77] and 0·73[0·67–0·80] respectively) and the two additional equations for childhood obesity newly drawn from the Italian and the U.S. datasets showed good accuracy in respective cohorts (AUROC = 0·74[0·69–0·79] and 0·79[0·73–0·84]) (all p<0·001). The three equations for childhood obesity were converted into simple Excel risk calculators for potential clinical use. Conclusion This study provides the first example of handy tools for predicting childhood obesity in newborns by means of easily recorded information, while it shows that currently known genetic variants have very little usefulness for such prediction. PMID:23209618

  16. Student Cohorts in Teacher Education: Support Groups or Intellectual Communities?

    ERIC Educational Resources Information Center

    Seifert, Kelvin; Mandzuk, David

    2006-01-01

    Recent initiatives in preservice teacher education have experimented with cohorts as a way to create supportive ties among peers, mutual intellectual support, and a sense of professionalism. The initiatives reflect a belief in collaboration, one expressed in educational literature supporting related forms of collaboration in education, such as…

  17. 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…

  18. 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

  19. Self-Medication Among Adolescents Aged 18 Years: The 1993 Pelotas (Brazil) Birth Cohort Study

    PubMed Central

    Bertoldi, Andréa Dâmaso; Camargo, Aline Lins; Silveira, Marysabel Pinto Telis; Menezes, Ana M.B.; Assunção, Maria Cecília Formoso; Gonçalves, Helen; Hallal, Pedro Curi

    2014-01-01

    Purpose To estimate the point prevalence of self-medication among adolescents aged 18 years and to evaluate the type of drugs used (either over-the-counter or prescription drugs) and socioeconomic, health-related, and behavioral correlates of self-medication. Methods This cross-sectional study used data from the 1993 Pelotas (Brazil) Birth Cohort Study. Data were obtained through the administration of a questionnaire to adolescents aged 18 years. The outcome variables were point prevalence of medicine use and self-medication collected by self-report. The independent variables studied were gender, continuous medicine use, socioeconomic status, schooling, self-rated health, body mass index, and physical activity levels. Medicines were classified into therapeutic groups according to the Anatomical Therapeutic Chemical classification system. Results A total of 4,106 adolescents were interviewed. The point prevalence of medicine use was 41.1% (95% confidence interval [CI] 39.6–42.6), and the proportion of self-medication among medicine users was 65.1% (95% CI 62.8–67.4). The point prevalence of self-medication was 26.7% (95% CI 25.4–28.1), and it was higher among female adolescents, those more educated, and those who rated their health as poor. Out of the drugs used for self-medication (58% of all drugs used), 1,003 (78.7%) were nonprescription drugs and 271 (21.3%) were prescription drugs. The most frequently used drugs for self-medication were analgesics (56.1%), systemic antihistamines (7.4%), and anti-inflammatory and antirheumatic products (7.1%). Conclusions A high point prevalence of self-medication was found among adolescents, which is particularly concerning due to high use of prescription drugs for self-medication. Interventions are needed to promote rational use of medicines in this population. PMID:24713443

  20. 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

  1. 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

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

    PubMed Central

    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 equation modeling revealed that a six-factor correlated model best fit the data, indicating that the six subscales of the threat appraisal measure represent distinct but related constructs. The factor structure was invariant across age and gender. Exposure to violence was associated prospectively with caregiver- and adolescent-rated adjustment problems. Each of the six threat appraisals mediated links between exposure to violence at Wave 1 and adolescent-rated internalizing adjustment problems 1 year later. PMID:18991135

  3. Family Structure, Community Context, and Adolescent Problem Behaviors

    ERIC Educational Resources Information Center

    Hoffman, John P.

    2006-01-01

    A number of models have been proposed to explain the relationship between family structure and adolescent problem behaviors, including several that consider parent-child relations, family income, stress, and residential mobility. However, studies have not explored whether the different types of communities within which families reside affect the…

  4. 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…

  5. 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…

  6. Estimation of genetic effects on BMI during adolescence in an ethnically diverse cohort: The National Longitudinal Study of Adolescent Health

    PubMed Central

    Graff, M; North, K E; Mohlke, K L; Lange, L A; Luo, J; Harris, K M; Young, K L; Richardson, A S; Lange, E M; Gordon-Larsen, P

    2012-01-01

    Objective: The contribution of genetic variants to body mass index (BMI) during adolescence across multiethnic samples is largely unknown. We selected genetic loci associated with BMI or obesity in European-descent samples and examined them in a multiethnic adolescent sample. Design and Sample: In 5103 European American (EA), 1748 African American (AfA), 1304 Hispanic American (HA) and 439 Asian American (AsA) participants of the National Longitudinal Study of Adolescent Health (Add Health; ages 12–21 years, 47.5% male), we assessed the association between 41 established obesity-related single-nucleotide polymorphisms (SNPs) with BMI using additive genetic models, stratified by race/ethnicity, and in a pooled meta-analysis sample. We also compared the magnitude of effect for BMI–SNP associations in EA and AfA adolescents to comparable effect estimates from 11 861 EA and AfA adults in the Atherosclerosis Risk in Communities study (ages 45–64 years, 43.2% male). Results: Thirty-five of 41 BMI–SNP associations were directionally consistent with published studies in European populations, 18 achieved nominal significance (P<0.05; effect sizes from 0.19 to 0.71 kg m−2 increase in BMI per effect allele), while 4 (FTO, TMEM18, TFAP2B, MC4R) remained significant after Bonferroni correction (P<0.0015). Of 41 BMI–SNP associations in AfA, HA and AsA adolescents, nine, three and five, respectively, were directionally consistent and nominally significant. In the pooled meta-analysis, 36 of 41 effect estimates were directionally consistent and 21 of 36 were nominally significant. In EA adolescents, BMI effect estimates were larger (P<0.05) for variants near TMEM18, PTER and MC4R and smaller for variants near MTIF3 and NRXN3 compared with EA adults. Conclusion: Our findings suggest that obesity susceptibility loci may have a comparatively stronger role during adolescence than during adulthood, with variation across race/ethnic subpopulation. PMID:23168566

  7. Adolescent Health-Risk Behavior and Community Disorder

    PubMed Central

    Wiehe, Sarah E.; Kwan, Mei-Po; Wilson, Jeff; Fortenberry, J. Dennis

    2013-01-01

    Background Various forms of community disorder are associated with health outcomes but little is known about how dynamic context where an adolescent spends time relates to her health-related behaviors. Objective Assess whether exposure to contexts associated with crime (as a marker of community disorder) correlates with self-reported health-related behaviors among adolescent girls. Methods Girls (N = 52), aged 14–17, were recruited from a single geographic urban area and monitored for 1 week using a GPS-enabled cell phone. Adolescents completed an audio computer-assisted self-administered interview survey on substance use (cigarette, alcohol, or marijuana use) and sexual intercourse in the last 30 days. In addition to recorded home and school address, phones transmitted location data every 5 minutes (path points). Using ArcGIS, we defined community disorder as aggregated point-level Unified Crime Report data within a 200-meter Euclidian buffer from home, school and each path point. Using Stata, we analyzed how exposures to areas of higher crime prevalence differed among girls who reported each behavior or not. Results Participants lived and spent time in areas with variable crime prevalence within 200 meters of their home, school and path points. Significant differences in exposure occurred based on home location among girls who reported any substance use or not (p 0.04) and sexual intercourse or not (p 0.01). Differences in exposure by school and path points were only significant among girls reporting any substance use or not (p 0.03 and 0.02, respectively). Exposure also varied by school/non-school day as well as time of day. Conclusions Adolescent travel patterns are not random. Furthermore, the crime context where an adolescent spends time relates to her health-related behavior. These data may guide policy relating to crime control and inform time- and space-specific interventions to improve adolescent health. PMID:24278107

  8. South African-ness among Adolescents: The Emergence of a Collective Identity within the Birth to Twenty Cohort Study

    ERIC Educational Resources Information Center

    Norris, Shane A.; Roeser, Robert W.; Richter, Linda M.; Lewin, Nina; Ginsburg, Carren; Fleetwood, Stella A.; Taole, Elizabeth; van der Wolf, Kees

    2008-01-01

    The authors assessed the emergence of a South African identity among Black, Colored (mixed ancestral origin), White (predominantly English speaking), and Indian adolescents participating in a birth cohort study called "Birth to Twenty" in Johannesburg, South Africa. They examined young people's certainty of their self-categorization as South…

  9. Antidepressant Use and Body Mass Index Change in Overweight Adolescents: A Historical Cohort Study

    PubMed Central

    Biggs, Bridget K.; Oesterle, Tyler S.; Croarkin, Paul E.

    2014-01-01

    Objective: Given the limited empirical data on antidepressant use and weight change in children, we performed a historical cohort study to assess change in age- and sex-standardized body mass index associated with antidepressant use among overweight adolescents diagnosed with a depressive disorder. Methods: We systematically reviewed electronic medical records from a tertiary academic medical center and identified adolescents (age 13–18 years) who were overweight (body mass index >85th percentile) and had a depression diagnosis. Patients were seen from January 1, 2000, through January 1, 2010. Age- and sex-standardized body mass index scores were calculated at initiation of antidepressant medication and at the end of treatment. Unmedicated patients had baseline and final age- and sex-standardized body mass index calculated using the first and last recorded measurements in the study period (maximum time between measures was 5 years). Results: In total, 435 patients (301 female) met our inclusion criteria; of these, 255 were prescribed an antidepressant (selective serotonin reuptake inhibitor, serotonin norepinephrine reuptake inhibitor, tricyclic antidepressant, or dopamine-norepinephrine reuptake inhibitor). Age- and sex-standardized body mass index significantly increased (F1,193=14.34; P<0.001) only for adolescents treated with selective serotonin reuptake inhibitors. For patients receiving other medications or no medication, age- and sex-standardized body mass index did not change significantly. Conclusion: This study provides initial empiric evidence for a link between selective serotonin reuptake inhibitor use and weight gain in already overweight adolescents. Further study of antidepressant use and weight gain in other pediatric populations and in prospective studies is warranted. PMID:25621183

  10. 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

  11. 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…

  12. 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…

  13. 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

  14. 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…

  15. 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 =…

  16. 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…

  17. Intrauterine exposure to smoking and wheezing in adolescence: the 1993 Pelotas Birth Cohort.

    PubMed

    Werhmeister, F C; Nunes, B P; Loret de Mola, C; Gómez-Cofré, N; de Oliveira, P D; Marco, P L; Assunção, M C F; Gonçalves, H; Horta, B L; Menezes, A M B

    2015-06-01

    Previous studies have suggested an association between maternal smoking during pregnancy and asthma symptoms such as wheezing during childhood. However, few have evaluated this association in adolescence, especially in populations with high prevalence of wheezing as in Brazil. Using the 1993 Pelotas birth cohort, a longitudinal study set in southern Brazil of 5249 urban live births, we aimed to evaluate the association between maternal and the partner's smoking during pregnancy and wheezing at 11 and 15 years of age. We evaluated smoking during pregnancy using number of cigarettes/day, and our main outcomes were as follows: wheezing in the last year and number of wheezing crises, at both 11 and 15 years of age, as well as persistent wheezing (having crises at 11 and 15 years of age) and medical asthma diagnosis at age 15. In addition, other socio-demographic variables were included as possible confounders and mediators of this association. We used Poisson regression models to evaluate crude and adjusted associations. Of the 5249 live births in 1993, 87.5% and 85.7% were followed-up to 11 and 15 years of age, respectively. Maternal smoking during pregnancy showed a dose-response association with number of wheezing crises at age 15 (P = 0.023), presence of persistent wheezing (P = 0.034) and asthma diagnosis (P = 0.023). Partner's smoking was not associated with any wheezing variables. Maternal smoking during pregnancy appears to exert an effect on respiratory morbidity of adolescents, evaluated by wheezing symptoms. PMID:25404101

  18. Possible involvement of the circadian pathway in alcohol use disorder in a South African adolescent cohort.

    PubMed

    Dalvie, Shareefa; King, Anthony; Fein, George; Ramesar, Raj; Stein, Dan J

    2016-02-01

    Alcoholism has an estimated heritability of between 40 and 60% and it is thought that several genes of small effect may contribute to the risk of developing this disorder. Studies of the genetics of alcohol use disorder (AUD) may, however, be confounded by issues of comorbidity. The aim of this investigation was to assess associations between variants in a range of candidate genes and AUD in a unique sample of adolescents without comorbidity. Our cohort consisted of 80 adolescents with an AUD diagnosis and 80 matched controls of mixed ancestry ethnicity. An Illumina Infinium iSelect custom 6000 bead chip was used to genotype 5348 SNPs in 378 candidate genes. Association analysis, gene-based analysis and polygenic scoring were performed. There was no statistical association between any of the investigated SNPs and AUD after correction for multiple testing. However, from the gene-based analysis it was found that the circadian rhythm genes NR1D1 and BHLHE41 are associated with AUD. While preliminary, these data provide some evidence that the circadian pathway may be relevant to the pathophysiology of AUD. Study of early onset non-comorbid populations with AUD may be useful in identifying target genes for study in larger more representative samples. PMID:26446021

  19. Child maltreatment and adolescent mental health problems in a large birth cohort

    PubMed Central

    Scott, James; Alati, Rosa; O'Callaghan, Michael; Najman, Jake; 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 7223 mother and child pairs enrolled in a population-based birth cohort study in Brisbane, Australia. Exposure to suspected child maltreatment was measured by linkage with state child protection agency data. The primary outcomes were the internalizing and externalizing scales of the Youth Self Report (YSR) at approximately 14 years of age. Results The YSR was completed by 5172 subjects (71.6%), with increased attrition of cases of notified maltreatment. After adjustment for potential confounders, notified maltreatment was significantly associated with both internalizing behavior and externalizing behavior at 14. When evaluated as non-exclusive categories of maltreatment, physical abuse, neglect, and emotional abuse were each significantly associated with both internalizing and externalizing behavior after adjustment. When evaluated using an expanded hierarchical scheme that included combinations of multi-type maltreatment, the following groups had significantly higher internalizing behavior after adjustment: emotional abuse (with or without neglect), and multi-type maltreatment including physical (but not sexual) abuse with neglect and/or emotional abuse. The following groups were associated with externalizing behavior after adjustment: emotional abuse (with or without neglect), and multi-type maltreatment including physical abuse (with neglect and/or emotional abuse), or sexual abuse (with neglect and/or emotional abuse, and/or physical abuse). Conclusions This study suggests that child neglect and emotional abuse have serious adverse effects on adolescent mental health and warrant the attention given to other forms of child maltreatment. Additionally, it confirms that young people who are notified for more than

  20. Developmental Trajectories of Adolescent Anxiety Disorder Symptoms: A 5-Year Prospective Community Study

    ERIC Educational Resources Information Center

    Hale, William W., III; Raaijmakers, Quinten; Muris, Peter; Van Hoof, Anne; Meeus, Wim

    2008-01-01

    A study to examine the adolescent developmental trajectories of anxiety disorder symptoms from the general population is conducted. Results using individually focused trajectory-based analyses show that the symptoms differed from one another for various adolescent age and sex cohorts.

  1. 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…

  2. 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

  3. 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

  4. Community violence exposure of Southeast Asian American adolescents.

    PubMed

    Ho, Joyce

    2008-01-01

    Southeast Asian adolescents in the United States face the daily challenge of adjusting to the American culture and their culture of origin. However, little is known about how the patterns of their bicultural adjustment influence psychological symptoms, especially when faced with other challenges such as community violence and negative life events. Additionally, the overrepresentation of Southeast Asian youth in the mental health and juvenile justice systems also necessitates a deeper understanding of the adjustment of this group of adolescents. Data from a sample of 80 Vietnamese and Cambodian adolescents who were between 13 and 18 years old revealed high rates of community violence witnessing and victimization, and a moderate level of negative life events. All of these stressors were related to higher externalizing and trauma-related symptoms, but only violence victimization and negative life events were related to higher internalizing symptoms. There was an additive effect of higher bicultural orientation related to lower externalizing and traumatic-stress symptoms in the face of stress and violence exposure, but no moderation effects were found. PMID:18087036

  5. Perspectives of Adolescents with Disabilities on Summer Employment and Community Experiences

    ERIC Educational Resources Information Center

    Trainor, Audrey A.; Carter, Erik W.; Swedeen, Beth; Owens, Laura; Cole, Odessa; Smith, Shane

    2011-01-01

    Although summer represents an opportune time for adolescents to garner employment and community experiences that may further long-term transition goals, little is known about the expectations and needs of adolescents with disabilities during this break in the academic school year. In this article, the authors explore adolescents' perceptions about…

  6. 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…

  7. Multiple risk behaviour in adolescence and socio-economic status: findings from a UK birth cohort

    PubMed Central

    Kipping, Ruth R; Smith, Michèle; Hickman, Matthew; Campbell, Rona

    2015-01-01

    Background. Patterns of risk behaviour during teenage years may vary by socio-economic status (SES). We aimed to examine possible associations between individual and multiple risk behaviours and three measures of SES in mid-adolescence. Methods. The sample (n = 6406) comprised participants from the Avon Longitudinal Study of Parents and Children, a UK birth cohort. Thirteen risk behaviours spanning sexual health, substance use, self-harm, vehicle-related injury, criminality and physical inactivity were assessed in mid-adolescence (age 15–16 years). Associations between three measures of SES (maternal education, household income and parental social class) and (i) individual risk behaviours and (ii) the total number of risk behaviours were examined. Results. For a one-category reduction in social class, maternal education or income, the odds of having a greater number of multiple risk behaviours increased by 22, 15 and 12%, respectively. At the individual level, there was evidence of a strong relationship with decreasing SES across all three measures of SES and criminality, car passenger risk, TV viewing, scooter risk, early sexual behaviour and weekly tobacco use but insufficient evidence of a relationship for physical inactivity, cycling without a helmet and illicit substance use. There was weak evidence of association between SES and hazardous drinking, self-harm, cannabis use and unprotected sex, but this was not consistent across the SES measures. Conclusion. The association between multiple risk behaviours and SES suggests that prevention strategies should apply the principal of proportionate universalism with a focus on more deprived populations, within a population-wide strategy, to prevent widening of social inequalities. PMID:24963150

  8. Active Commuting Throughout Adolescence and Central Fatness before Adulthood: Prospective Birth Cohort Study

    PubMed Central

    Martinez-Gomez, David; Mielke, Gregore I.; Menezes, Ana M.; Gonçalves, Helen; Barros, Fernando C.; Hallal, Pedro C.

    2014-01-01

    Background Active commuting is a good opportunity to accumulate physical activity (PA) across the lifespan that potentially might influence central body fat. We aimed to examine the prospective associations of active commuting at 11, 15 and 18 years of age with central body fat at 18 years. Methods Participants were part of a large birth cohort study in Pelotas, Brazil (n = 3,649 participants). Active commuting, leisure-time PA and income were self-reported at 11, 15 and 18 years. Waist circumference and trunk fat mass were collected at 18 years with the use of a 3-dimensional photonic scanner and dual-energy X-ray absorptiometry, respectively. Results Active commuting at 11 years was not prospectively associated with central body fat. However, we found that active commuting at 15 and 18 years were prospectively and cross-sectionally associated with central body fat variables, respectively, in boys but not in girls. Also, boys in the highest tertile of accumulated active commuting (i.e., average of active commuting at 11, 13 and 18 years) were associated with −2.09 cm (95%CI: −3.24; −0.94) of waist circumference and −1.11 kg (95%CI: −1.74; −0.48) of trunk fat mass compared to boys in the lowest tertile. Analyses on changes in tertiles of active commuting from 11 and 15 years to 18 years with central body fat variables at 18 years showed that boys who remained consistently in the highest tertile or moved to a higher tertile had lower levels of central body fat compared to those consistently in the lowest tertile. Conclusions Active commuting throughout adolescence in boys, especially during middle and late adolescence, is associated with lower levels in central fatness before adulthood. PMID:24791780

  9. 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…

  10. 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…

  11. Influenza Vaccine Effectiveness in a Low-Income, Urban Community Cohort.

    PubMed

    Smithgall, Marie; Vargas, Celibell Y; Reed, Carrie; Finelli, Lyn; LaRussa, Philip; Larson, Elaine L; Saiman, Lisa; Stockwell, Melissa S

    2016-02-01

    In this community-based cohort study of 275 primarily low-income, urban households in New York City, overall 2013-2014 influenza vaccine effectiveness (VE) was 62.5% (95% confidence interval, 21.7%-82.0%). VE point estimates were highest against 2009 H1N1 and for those who were vaccinated in 2013-2014 but not in 2012-2013. PMID:26420801

  12. Residents' awareness and attitudes about an ongoing community-based genome cohort study in Nagahama, Japan.

    PubMed

    Miyamoto, Keiko; Iwakuma, Miho; Nakayama, Takeo

    2015-11-01

    This study's objective was to examine residents' attitudes toward and factors associated with an ongoing, real genome cohort study based on a community in Japan. After the genome cohort study's launch in 2007, in November and December 2009, a self-administered questionnaire survey was conducted with 2500 randomly sampled residents aged 30-74 years, living in Nagahama, Japan. Responses were received from 1363 people (response rate = 54.5%), of whom 187 respondents had already participated in the study. Although the local government and researchers disseminated information through leaflets and citizen-information papers to every household, sent notices by personalized letter, and held symposia and other meetings, 65.7% of males and 47.2% of females first became aware of the study when they received our questionnaire. Among all respondents, 81.2% of those who knew that the genome cohort study had begun and 68.6% of those who did not know had a positive attitude toward the study. Their attitudes were significantly associated with high health consciousness and the desire for an extensive health check-up. Although for males there were no particular negative aspects of the genome study, for females, positive aspects were associated with participating in community activities and desiring an extensive health check-up. Although promoting a community-based genome cohort study requires huge effort, it is essential to popularize it. Actions are vital both for monitoring public awareness and attitudes at a community level and for keeping communication channels open. PMID:25767212

  13. 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

  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. Nutritional status of adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

    PubMed Central

    Araújo, Cora Luiza; Dumith, Samuel C.; Menezes, Ana M. B.; Hallal, Pedro C.; Vieira, Maria de Fátima A.; Madruga, Samanta W.; Victora, Cesar G.

    2013-01-01

    We evaluate the influence of demographic, socioeconomic, and maternal variables on the nutritional status of adolescents aged 11 years. We conducted a prospective cohort study including 4,452 adolescents born in Pelotas, Southern Brazil, in 1993, accounting for 87.5% of the original cohort. Nutritional status was evaluated based on World Health Organization criteria. Subjects were classified according to nutritional status into thin, normal, overweight and obese. Independent variables analyzed included skin color, socioeconomic status, maternal schooling, and maternal body mass index (BMI). Analyses were stratified by sex, and multivariable regression was performed using the multinomial logistic approach. Overall, 7% of adolescents were classified as thin, 11.6% as overweight, and 11.6% as obese. Among boys, thinness was inversely associated with maternal schooling and maternal BMI. Among girls, thinness was directly associated with maternal BMI. Overweight and obesity were directly associated with socioeconomic status and maternal BMI, the former showing the strongest association with nutritional status among adolescents. PMID:20963286

  16. Peer victimisation during adolescence and its impact on depression in early adulthood: prospective cohort study in the United Kingdom

    PubMed Central

    Joinson, Carol; Wolke, Dieter; Lewis, Glyn

    2015-01-01

    Objective To investigate the strength of the association between victimisation by peers at age 13 years and depression at 18 years. Design Longitudinal observational study. Setting Avon Longitudinal Study of Parents and Children, a UK community based birth cohort. Participants 6719 participants who reported on peer victimisation at age 13 years. Main outcome measures Depression defined according to international classification of diseases, 10th revision (ICD-10) criteria, assessed using the clinical interview schedule-revised during clinic assessments with participants when they were aged 18 years. 3898 participants had data on both victimisation by peers at age 13 years and depression at age 18 years. Results Of the 683 participants who reported frequent victimisation at age 13 years, 101 (14.8%) were depressed according to ICD-10 criteria at 18 years; of the 1446 participants reporting some victimisation at age 13 years, 103 (7.1%) were depressed at age 18 years; and of the 1769 participants reporting no victimisation at age 13 years, 98 (5.5%) were depressed at age 18 years. Compared with children who were not victimised those who were frequently victimised by peers had over a twofold increase in odds of depression (odds ratio 2.96, 95% confidence interval 2.21 to 3.97, P<0.001). This association was slightly reduced when adjusting for confounders (2.32, 1.49 to 3.63, P<0.001). The population attributable fraction suggested that 29.2% (95% confidence interval 10.9% to 43.7%) of depression at age 18 years could be explained by peer victimisation if this were a causal relation. Conclusion When using observational data it is impossible to be certain that associations are causal. However, our results are consistent with the hypothesis that victimisation by peers in adolescence is associated with an increase in the risk of developing depression as an adult. PMID:26037951

  17. Early anthropometric indices predict short stature and overweight status in a cohort of Peruvians in early adolescence

    PubMed Central

    Sterling, Robie; Miranda, J Jaime; Gilman, Robert H; Cabrera, Lilia; Sterling, Charles R; Bern, Caryn; Checkley, William

    2014-01-01

    While childhood malnutrition is associated with increased morbidity and mortality, less well understood is how early childhood growth influences height and body composition later in life. We revisited 152 Peruvian children who participated in a birth cohort study between 1995 and 1998, and obtained anthropometric and bioimpedance measurements 11 to 14 years later. We used multivariable regression models to study the effects of childhood anthropometric indices on height and body composition in early adolescence. Each standard deviation decrease in length-for-age at birth was associated with a decrease in adolescent height-for-age of 0.7 SD in both boys and girls (all p<0.001) and 9.7 greater odds of stunting (95% CI 3.3 to 28.6). Each SD decrease in length-for-age in the first 30 months of life was associated with a decrease in adolescent height-for-age of 0.4 in boys and 0.6 standard deviation in girls (all p<0.001) and with 5.8 greater odds of stunting (95% CI 2.6 to 13.5). The effect of weight gain during early childhood on weight in early adolescence was more complex to understand. Weight-for-length at birth and rate of change in weight-for-length in early childhood were positively associated with age- and sex-adjusted body mass index and a greater risk of being overweight in early adolescence. Linear growth retardation in early childhood is a strong determinant of adolescent stature, indicating that, in developing countries, growth failure in height during early childhood persists through early adolescence. Interventions addressing linear growth retardation in childhood are likely to improve adolescent stature and related-health outcomes in adulthood. PMID:22552904

  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. Bidirectional association between autism spectrum disorder and epilepsy in child and adolescent patients: a population-based cohort study.

    PubMed

    Su, Chien-Chou; Chi, Mei Hung; Lin, Shin-Hsien; Yang, Yen Kuang

    2016-09-01

    This study aimed to assess whether there is a bidirectional association between autism spectrum disorder (ASD) and epilepsy in child and adolescent patients. The National Health Insurance Research Database of Taiwan was used to conduct two cohort studies of patients who were under 18 years of age during the period 1997-2008. Cohort 1 comprised patients with newly diagnosed ASD but excluded those diagnosed with epilepsy prior to ASD. A non-ASD comparison group was matched to each case in terms of age and sex. Cohort 2 comprised patients with newly diagnosed epilepsy but excluded those diagnosed with ASD prior to epilepsy. A non-epilepsy comparison group was matched to each case in terms of age and sex. We calculated the incidence of epilepsy in patients with ASD and hazard ratio (HR) to estimate the risk of epilepsy in association with ASD in cohort 1, and the reverse in cohort 2. In cohort 1, the incidence of epilepsy was 13.7 in the ASD group and 1.3 in the non-ASD group (per 1000 person-years). The adjusted HR for epilepsy was 8.4 (95 % CI 5.5-12.7) in the ASD group when compared with the non-ASD group. In cohort 2, the incidence of ASD was 3.4 in the epilepsy group and 0.3 in the non-epilepsy group (per 1000 person-years). The adjusted HR for ASD was 8.4 (95 % CI 6.2-11.4) in the epilepsy group when compared with the non-epilepsy group. A bidirectional association was, therefore, found to exist between ASD and epilepsy. These findings implicate that ASD and epilepsy probably share common risk factors. However, further studies are required to reveal more detail on the mechanism of this bidirectional association. PMID:26791195

  3. Effect of self-reported home smoking restriction on smoking initiation among adolescents in Taiwan: a prospective cohort study

    PubMed Central

    Luh, Dih-Ling; Chen, Hsiu-Hsi; Yen, Amy Ming-Fang; Wang, Ting-Ting; Chiu, Sherry Yueh-Hsia; Fann, Ching-Yuan; Chen, Sam Li-Sheng

    2015-01-01

    Objective The aims of this study were to investigate the influence of home smoking restriction (HSR) and the modified effect of parental smoking on smoking initiation among adolescents. Design Prospective Cohort Study. Setting Junior high school in Keelung City, Taiwan. Participants This study collected and evaluated primary data from the Adolescent Smoking and Other Health-Related Behaviour Survey conducted in Keelung City, which aimed to investigate smoking and health-related behaviours in junior high school students (2008–2009). Data on students free of smoking in 2008 and following them until 2009 (n=901) to ascertain whether they had started smoking were analysed with logistic regression mode to examine the proposed postulates. Main outcome measure The outcome variable was smoking initiation, which was defined as smoking status (yes/no) in the 2009 follow-up questionnaire. The main independent variable was HSR obtained from an adolescent self-reported questionnaire. Information on parental smoking was measured by adolescents self-reporting the smoking behaviour of their father and mother. Results The rate of HSR was 29.79% among 7th grade adolescents. The effect of HSR on smoking initiation in adolescents was statistically significantly modified by paternal smoking (p=0.04) but not by maternal smoking (p=0.54). The effect of HSR on smoking initiation was small for fathers with the habit of smoking (OR=0.89, 95% CI (0.42 to 1.88)), but the corresponding effect size was 3.2-fold (OR=2.84, 95% CI 1.19 to 6.81) for fathers without the habit of smoking. Conclusions Paternal smoking behaviour may play an interactive role with HSR in preventing smoking initiation among Taiwanese adolescents. PMID:26116613

  4. 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

  5. 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

  6. 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

  7. 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

  8. Retention of female volunteer community health workers in Dhaka urban slums: a prospective cohort study

    PubMed Central

    2014-01-01

    Background Volunteer community health workers (CHWs) are a key approach to improving community-based maternal and child health services in developing countries. BRAC, a large Bangladeshi non-governmental organization (NGO), has employed female volunteer CHWs in its community-based health programs since 1977, recently including its Manoshi project, a community-based maternal and child health intervention in the urban slums of Bangladesh. A case–control study conducted in response to high dropout rates in the first year of the project showed that financial incentives, social prestige, community approval and household responsibilities were related to early retention in the project. In our present prospective cohort study, we aimed to better understand the factors associated with retention of volunteer CHWs once the project was more mature. Methods We used a prospective cohort study design to examine the factors affecting retention of volunteer CHWs who remained in the project after the initial start-up period. We surveyed a random sample of 542 CHWs who were working for BRAC Manoshi in December 2008. In December 2009, we revisited this cohort of CHWs and interviewed those who had dropped out about the main reasons for their dropping out. We used a multivariable generalized linear model regression analysis with a log link to estimate the relative risk (RR) of independent factors on retention. Results Of the 542 CHWs originally enrolled, 120 had dropped out by the end of one year, mainly because they left the slums. CHWs who received positive community appraisal (adjusted RR = 1.45, 95% confidence interval (CI) = 1.10 to 1.91) or were associated with other NGOs (adjusted RR = 1.13, 95% CI = 1.04 to 1.23) were more likely to have been retained in the project. Although refresher training was also associated with increased retention (adjusted RR = 2.25, 95% CI = 1.08 to 4.71) in this study, too few CHWs had not attended refresher training

  9. 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…

  10. 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

  11. Associations between Community Attachments and Adolescent Substance Use in Nationally Representative Samples

    PubMed Central

    Wray-Lake, Laura; Maggs, Jennifer L.; Johnston, Lloyd D.; Bachman, Jerald G.; O’Malley, Patrick M.; Schulenberg, John E.

    2012-01-01

    Purpose Social capital and social attachment theories of substance use argue that positive bonds to society and the conventional values they promote deter adolescents from substance use. Using nationally representative samples of U.S. high school seniors, we hypothesized that adolescents’ community attachments, measured by social trust, social responsibility, and religiosity, would be negatively associated with lifetime and 30-day substance use. Method We used repeated cross-sectional nationally representative high school senior data from 1976–2008 Monitoring the Future Study cohorts (weighted N = 64,246; 51.6% female). Participation rate ranged from 77% to 86% across years. A series of multiple linear and logistic regressions examined unique associations of adolescents’ social trust, social responsibility, and religiosity with lifetime and 30-day use of cigarettes, alcohol, marijuana, hallucinogens, cocaine, amphetamines, barbiturates, tranquilizers, and narcotics. Models controlled for gender, race, college aspirations, high school grades, parents’ education, and survey year. Results Social trust, social responsibility, and religiosity showed independent negative associations with use of cigarettes, alcohol, marijuana, and six other types of drugs. After accounting for controls, community attachments related to lower lifetime and past 30-day use. Associations were consistent across measures, except social responsibility was not associated with binge drinking or lifetime illicit drugs besides marijuana. Conclusions Study strengths included the nationally representative sample, diverse substance use measures, and inclusion of controls. We extend theory by suggesting that distinct aspects of adolescents’ community attachments uniquely relate to lower substance use. Results suggest potential public health benefits of integrating promotion of community attachments with substance use prevention. PMID:22999832

  12. 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

  13. Cohort comparisons: emotional well-being among adolescents and older adults

    PubMed Central

    Momtaz, Yadollah Abolfathi; Hamid, Tengku Aizan; Ibrahim, Rahimah

    2014-01-01

    Background There are several negative stereotypes about older adults that have negatively influenced people’s attitude about aging. The present study compared emotional well-being between older adults and adolescents. Methods Data for this study came from 1,403 community-dwelling elderly persons and 1,190 secondary school students and were obtained from two national cross-sectional surveys. Emotional well-being was measured using the World Health Organization-Five Well-Being Index. Data analysis was conducted using a multivariate analysis of covariance with SPSS software version 20 (IBM Corporation, Armonk, NY, USA). Results Elderly people significantly scored higher levels of emotional well-being (mean, 62.3; standard deviation, 22.55) than younger people (mean, 57.9; standard deviation, 18.46; t, 5.32; P≤0.001). The findings from the multivariate analysis of covariance revealed a significant difference between older adults and younger people in emotional well-being [F(3, 2587)=120.21; P≤0.001; η2=0.122] after controlling for sex. Conclusion Contrary to negative stereotypes about aging, our findings show a higher level of emotional well-being among older adults compared with younger people. PMID:24872683

  14. Community social capital and tooth loss in Japanese older people: a longitudinal cohort study

    PubMed Central

    Koyama, Shihoko; Aida, Jun; Saito, Masashige; Kondo, Naoki; Sato, Yukihiro; Matsuyama, Yusuke; Tani, Yukako; Sasaki, Yuri; Kondo, Katsunori; Ojima, Toshiyuki; Yamamoto, Tatsuo; Tsuboya, Toru; Osaka, Ken

    2016-01-01

    Objective To date, no study has prospectively examined the association between social capital (SC) in the community and oral health. The aim of this longitudinal cohort study was to examine the association between both community-level and individual-level SC and tooth loss in older Japanese people. Design Prospective cohort study Setting We utilised data from the Japan Gerontological Evaluation Study (JAGES) performed in 2010 and 2013 and conducted in 525 districts. Participants The target population was restricted to non-institutionalised people aged 65 years or older. Participants included 51 280 people who responded to two surveys and who had teeth at baseline. Primary outcome measure The primary outcome measure was loss of remaining teeth, measured by the downward change of any category of remaining teeth, between baseline and follow-up. Results The mean age of the participants was 72.5 years (SD=5.4). During the study period, 8.2% (n=4180) lost one or more of their remaining teeth. Among three community-level SC variables obtained from factor analysis, an indicator of civic participation significantly reduced the risk of tooth loss (OR 0.93; 95% CI 0.88 to 0.99). The individual-level SC variables ‘hobby activity participation’ and ‘sports group participation’ were also associated with a reduced risk of tooth loss (OR 0.88; 95% CI 0.81 to 0.95 and OR 0.90; 95% CI 0.82 to 0.99, respectively). Conclusions Living in a community with rich SC and individuals with good SC is associated with lower incidence of tooth loss among older Japanese people. PMID:27048636

  15. [The experience of paternity during adolescence in a low-income Brazilian community].

    PubMed

    Hoga, Luiza Akiko Komura; Reberte, Luciana Magnoni

    2009-03-01

    There are gaps in the knowledge related to paternity during adolescence. This investigation had the purpose to explore the experiences of paternity during adolescence. The investigation method was the thematic oral history, with 19 members of a low-income Brazilian community being interviewed. The categories describing the experience were: a) Gaps in sexual education, lack of attention to contraceptive methods and the desire for fatherhood contributed for the occurrence of paternity during adolescence; b) The adolescents were surprised by pregnancy and assumed the paternal responsibilities as best as they could; c) Paternity during adolescence meant a faster process of maturation and having their lives transformed; d) Regret or happiness: distinct results of paternity in adolescence. Interventions focused on adolescents must be performed in safe, ethical and contextualized ways. PMID:19437861

  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. Beyond the "Village" Rhetoric: Creating Healthy Communities for Children and Adolescents

    ERIC Educational Resources Information Center

    Benson, Peter L.; Leffert, Nancy; Scales, Peter C.; Blyth, Dale A.

    2012-01-01

    The role of community in child and adolescent development is emerging as a significant area of theoretical inquiry, research, and application. This article describes the development and utilization of a comprehensive community change effort designed to increase the attention of all community members toward strengthening core developmental…

  20. Urban, Suburban, and Rural: Adolescents' Use and Preferences for Fitness Promotion Technologies across Communities

    PubMed Central

    Mikulec, Erika; Goniu, Natalie; Moreno, Megan

    2013-01-01

    Introduction. An understanding of adolescents' use of technology across ages and communities could allow for future targeted obesity intervention strategies. Methods. Focus groups of adolescents from rural, suburban, and urban cities in three states were conducted. Focus groups were led by a trained facilitator to explore how participants used technologies and whether they applied them for fitness purposes. All focus groups were audio recorded and manually transcribed. Analysis was conducted by three investigators using an iterative process. Results. Five focus groups included adolescents between the ages of 12 and 18 years (20 females and 8 males.) Three themes were derived from our data. First, we found age differences regarding technology applied to fitness. Younger participants described technology as a complement to fitness; older participants viewed technology as a motivator for fitness. Second, differences in fitness approaches existed between rural and urban adolescents. Adolescents in rural communities reported focusing on the outdoors for fitness, while urban adolescents relied on fitness-oriented video games. Both rural and urban teens related having a lack of fitness-focused resources in their communities. Conclusions. Our findings indicate differences in adolescents' application of technology for fitness. Despite adolescents' differing uses of technology across communities, a common need exists to expand their resources. PMID:24533221

  1. 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…

  2. 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…

  3. 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…

  4. 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.…

  5. Understanding the Educational Aspirations of African American Adolescents: Child, Family, and Community Factors

    ERIC Educational Resources Information Center

    Nichols, Tanya M.; Kotchick, Beth A.; Barry, Carolyn McNamara; Haskins, Deborah G.

    2010-01-01

    The current study examined the association between multiple systems of influence (adolescent, family, and community) and the educational aspirations of African American adolescents. Guided by ecological and integrative models of child development, in the current study the authors examined the association between the educational aspirations of 130…

  6. 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…

  7. Implementing Dialectical Behavior Therapy with Adolescents and Their Families in a Community Outpatient Clinic

    ERIC Educational Resources Information Center

    Woodberry, Kristen A.; Popenoe, Ellen J.

    2008-01-01

    Dialectical behavior therapy (DBT), an empirically supported treatment for adult women diagnosed with borderline personality disorder (BPD), has been increasingly adapted for use with adolescents across a variety of settings. This article describes a community-based application of DBT principles and strategies for adolescents and their families.…

  8. School-Based Required Community Service and Civic Development in Adolescents

    ERIC Educational Resources Information Center

    Reinders, Heinz; Youniss, James

    2006-01-01

    This study focused on the role of school-based required community service in promoting adolescents' prosocial behavior and intended future civic involvement when service is differentiated by types and by adolescents' perceived experience. A longitudinal data set of high school students (N = 603) was analyzed to investigate the developmental steps…

  9. Gendered Academic Adjustment among Asian American Adolescents in an Emerging Immigrant Community

    ERIC Educational Resources Information Center

    Kiang, Lisa; Supple, Andrew J.; Stein, Gabriela L.; Gonzalez, Laura M.

    2012-01-01

    Research on the academic adjustment of immigrant adolescents has been predominately conducted in large cities among established migration areas. To broaden the field's restricted focus, data from 172 (58% female) Asian American adolescents who reside within a non-traditional or emerging immigrant community in the Southeastern US were used to…

  10. 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,…

  11. Suppressor Effects in Coping Research with African American Adolescents from Low-Income Communities

    ERIC Educational Resources Information Center

    Gaylord-Harden, Noni K.; Cunningham, Jamila A.; Holmbeck, Grayson N.; Grant, Kathryn E.

    2010-01-01

    Objective: The purpose of the current study was to demonstrate the replicable nature of statistical suppressor effects in coping research through 2 examples with African American adolescents from low-income communities. Method: Participants in the 1st example included 497 African American adolescents (mean age = 12.61 years, SD = 0.99; 57% female)…

  12. 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…

  13. 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. PMID:26074279

  14. 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.

  15. Trends in Adolescent Emotional Problems in England: A Comparison of Two National Cohorts Twenty Years Apart

    ERIC Educational Resources Information Center

    Collishaw, Stephan; Maughan, Barbara; Natarajan, Lucy; Pickles, Andrew

    2010-01-01

    Background: Evidence about trends in adolescent emotional problems (depression and anxiety) is inconclusive, because few studies have used comparable measures and samples at different points in time. We compared rates of adolescent emotional problems in two nationally representative English samples of youth 20 years apart using identical symptom…

  16. 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…

  17. Socioeconomic patterns of overweight, obesity but not thinness persist from childhood to adolescence in a 6 -year longitudinal cohort of Australian schoolchildren from 2007 to 2012

    PubMed Central

    2014-01-01

    Background The prevalence of childhood overweight and obesity increased during the 1980s to the late 1990s. The prevalence of obesity is higher in socially and economically disadvantaged communities in most Westernised countries. The purpose of this study was to examine how the socioeconomic gradient in weight status, namely thinness, overweight and obesity, changes over time in a longitudinal cohort of Australian schoolchildren, from 2007–2012. Methods 939 Australian children in school grades 2–6 from 10 primary schools initially participated in the study in 2007. Height and weight were directly measured by research assistants each year. Obesity/overweight and thinness were defined by using the International Obesity Task Force BMI cut-offs. Chi-square analyses were used to test associations between categorical variables and linear mixed models were used to estimate whether the differences in SES groups were statistically significant over time. Results Results found both males and females in the low SES group were more likely to be obese (6-7%) than middle (4-5%) and high (2-3%) SES groups and this pattern tended to be similar over the 6 year study period. There appeared to be no particular SES pattern for thinness with all SES groups having 4-5% of participants who were thin. The gender and SES patterns were also similar over 6 years for BMI with low and middle SES participants having significantly greater BMI than their high SES peers. Conclusions Patterns of obesity and overweight in children from socially and economically disadvantaged communities in regional NSW are identifiable from a young age and the socioeconomic pattern persists into adolescence. Obesity prevention and intervention programs should be designed, implemented and evaluated with the social determinants of health in mind and in collaboration with community members. Community programs should continue to be based on positive rather than negative messages in order to avoid unintended stigma

  18. 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. PMID:17919796

  19. 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

  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. [Physical activity, screen time, and use of medicines among adolescents: the 1993 Pelotas (Brazil) birth cohort study].

    PubMed

    Bergmann, Gabriel Gustavo; Bertoldi, Andréa Dâmaso; Mielke, Grégore Iven; Camargo, Aline Lins; Matijasevich, Alicia; Hallal, Pedro Curi

    2016-01-01

    This study aimed to evaluate cross-sectional and longitudinal associations between physical activity, screen time, and use of medicines among adolescents from the 1993 Pelotas (Brazil) birth cohort study, followed at 11 (N = 4,452), 15 (N = 4,325), and 18 years of age (N = 4,106). The study recorded the use of medicines in the previous 15 days, continuous use of some medication, level of physical activity (by questionnaire and accelerometry), and screen time (TV, computer, and videogame). One-third of adolescents had used at least one medicine in the previous 15 days and approximately 10% were on some continuous medication. In the adjusted analysis, the results showed that higher levels of physical activity at 18 years and less screen time at 15 years in boys were associated with lower overall use of medicines (p < 0.05). For boys, physical activity at 11 and 18 years were inversely related to continuous medication (p < 0.05). More physically active boys and those with less screen time in adolescence showed lower use of medicines at 18 years of age. PMID:27167041

  2. 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

  3. 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

  4. 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

  5. Circulating Adipokines and Vascular Function: Cross-Sectional Associations in a Community-Based Cohort.

    PubMed

    Zachariah, Justin P; Hwang, Susan; Hamburg, Naomi M; Benjamin, Emelia J; Larson, Martin G; Levy, Daniel; Vita, Joseph A; Sullivan, Lisa M; Mitchell, Gary F; Vasan, Ramachandran S

    2016-02-01

    Adipokines may be potential mediators of the association between excess adiposity and vascular dysfunction. We assessed the cross-sectional associations of circulating adipokines with vascular stiffness in a community-based cohort of younger adults. We related circulating concentrations of leptin and leptin receptor, adiponectin, retinol-binding protein 4, and fatty acid-binding protein 4 to vascular stiffness measured by arterial tonometry in 3505 Framingham Third Generation cohort participants free of cardiovascular disease (mean age 40 years, 53% women). Separate regression models estimated the relations of each adipokine to mean arterial pressure and aortic stiffness, as carotid femoral pulse wave velocity, adjusting for age, sex, smoking, heart rate, height, antihypertensive treatment, total and high-density lipoprotein cholesterol, diabetes mellitus, alcohol consumption, estimated glomerular filtration rate, glucose, and C-reactive protein. Models evaluating aortic stiffness also were adjusted for mean arterial pressure. Mean arterial pressure was positively associated with blood retinol-binding protein 4, fatty acid-binding protein 4, and leptin concentrations (all P<0.001) and inversely with adiponectin (P=0.002). In fully adjusted models, mean arterial pressure was positively associated with retinol-binding protein 4 and leptin receptor levels (P<0.002 both). In fully adjusted models, aortic stiffness was positively associated with fatty acid-binding protein 4 concentrations (P=0.02), but inversely with leptin and leptin receptor levels (P≤0.03 both). In our large community-based sample, circulating concentrations of select adipokines were associated with vascular stiffness measures, consistent with the hypothesis that adipokines may influence vascular function and may contribute to the relation between obesity and hypertension. PMID:26628673

  6. 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

  7. 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…

  8. Modeled PFOA Exposure and Coronary Artery Disease, Hypertension, and High Cholesterol in Community and Worker Cohorts

    PubMed Central

    Steenland, Kyle

    2014-01-01

    Background: Several previous studies, mostly cross-sectional, have found associations between perfluorooctanoic acid (PFOA) and high cholesterol levels, but studies of hypertension and heart disease have had inconsistent findings. Objectives: In this study we examined the association between modeled PFOA exposure and incident hypertension, hypercholesterolemia, and coronary artery disease among workers at a Mid-Ohio Valley chemical plant that used PFOA, and residents of the surrounding community. Methods: Community- and worker-cohort participants completed surveys during 2008–2011 covering demographics, health-related behaviors, and medical history. Cox proportional hazard models, stratified by birth year, modeled the hazard of each outcome (starting at 20 years of age) as a function of retrospective serum PFOA concentration estimates (generated through fate, transport and exposure modeling), controlling for sex, race, education, smoking, alcohol use, body mass index, and diabetes. Results: Among 32,254 participants (28,541 community; 3,713 worker), 12,325 reported hypertension with medication, 9,909 reported hypercholesterolemia with medication, and 3,147 reported coronary artery disease (2,550 validated). Hypercholesterolemia incidence increased with increasing cumulative PFOA exposure (sum of yearly serum concentration estimates), most notably among males 40–60 years of age. Compared with the lowest exposure quintile (< 142 ng/mL-years), hazard ratios for subsequent quintiles (ng/mL-years: 142 to < 234; 234 to < 630; 630 to < 3,579; ≥ 3,579) were 1.24, 1.17, 1.19, and 1.19 overall and 1.38, 1.32, 1.31, and 1.44 among men 40–60 years of age. There was no apparent association between PFOA exposure and hypertension or coronary artery disease incidence. Conclusions: Higher PFOA exposure was associated with incident hypercholesterolemia with medication, but not with hypertension or coronary artery disease. Citation: Winquist A, Steenland K. 2014. Modeled PFOA

  9. Metabolic, Digestive, and Reproductive Adverse Events Associated With Antimanic Treatment in Children and Adolescents: A Retrospective Cohort Study

    PubMed Central

    McIntyre, Roger S.

    2010-01-01

    Objective: To identify factors associated with incident metabolic and reproductive adverse events in children and adolescents. Method: A retrospective cohort design evaluating Medicaid medical and pharmacy claims made in South Carolina between January 1996 and December 2005 was employed for 3,657 children and adolescents (aged 17 years old and younger) prescribed 1 of 3 antimanic medications (ie, lithium, carbamazepine, or valproic acid derivatives) and a random sample of 4,500 children and adolescents not treated with psychotropic medications. Results: Compared to the control sample, the treated cohort was more likely to be diagnosed with obesity/weight gain (odds ratio [OR] = 1.89), type 2 diabetes mellitus (OR = 2.50), dyslipidemia (OR = 1.89), nausea (OR = 1.61), anorexia (OR = 3.85), and sexual/reproductive adverse events (OR = 2.04). Within the treated cohort, incident dyslipidemia was more likely for those prescribed carbamazepine (OR = 1.52) compared to valproate and coprescribed antipsychotics (OR = 1.47) or selective serotonin reuptake inhibitors (SSRIs) (OR = 1.49) compared to those not taking antipsychotics or taking serotonin-norepinephrine reuptake inhibitor/heterocyclic (SNRI/other) antidepressants. The odds of developing nausea/vomiting were higher for those prescribed carbamazepine (OR = 1.70) or lithium (OR = 1.49) compared to valproate, and those coprescribed psychostimulants (OR = 1.25) compared to those not taking psychostimulants. The odds of developing obesity/weight gain and type 2 diabetes mellitus were higher for those coprescribed SSRIs (ORs = 1.72, 2.58) or antipsychotics (ORs = 1.69, 1.77) compared to those taking SNRI/other antidepressants or not taking antipsychotics. Incident sexual/reproductive adverse events were more likely for those coprescribed SSRIs (OR = 2.02) compared to those taking SNRI/other antidepressants. Conclusion: Commonly employed psychotropic agents are associated with clinically significant metabolic, digestive

  10. Adolescent mental health and subsequent parenting: a longitudinal birth cohort study

    PubMed Central

    Byford, M; Abbott, R A; Maughan, B; Richards, M; Kuh, D

    2014-01-01

    Background Adolescent mental health problems are associated with a range of adverse outcomes in adulthood but little is known about the effects on adult parenting practices. This study aimed to examine prospective associations between adolescent conduct and emotional problems and subsequent parenting behaviours in adulthood. Methods The study sample comprised 1110 members from the MRC National Survey of Health and Development. Prospective data were collected from teacher reports of conduct and emotional problems at age 13 and 15 years and adult outcome measures of parenting included intellectual environment, cognitive stimulation, coercive discipline, parental interest and parental aspiration. Results In regression models adjusted for the confounding effects of social background, cognition and education, adolescent conduct problems predicted coercive parenting behaviours in adulthood. The effects of adolescent emotional problems on the development of coercive discipline practices were explained by covariates. Likewise, the inability of parents who displayed conduct problems in adolescence to provide an intellectually stimulating home environment was fully explained by the adjustment for education. Conclusions Adolescents who exhibit conduct problems are more likely to develop coercive styles of parenting. PMID:24357583

  11. 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

  12. Impact of physical frailty on disability in community-dwelling older adults: a prospective cohort study

    PubMed Central

    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutsumimoto, Kota; Suzuki, Takao

    2015-01-01

    Objective To examine the relationship between physical frailty and risk of disability, and to identify the component(s) of frailty with the most impact on disability in community-dwelling older adults. Design Prospective cohort study. Setting A Japanese community. Participants 4341 older adults aged ≥65 living in the community participated in a baseline assessment from 2011 to 2012 and were followed for 2 years. Main outcome measures Care-needs certification in the national long-term care insurance (LTCI) system of Japan, type of physical frailty (robust, prefrail, frail) and subitems (slowness, weakness, exhaustion, low activity, weight loss), adjusted for several potential confounders such as demographic characteristics, analysed with Kaplan-Meier survival curves for incidence of disability by frailty phenotype. Results During the 2-year follow-up period, 168 participants (3.9%) began using the LTCI system for incidence of disability. Participants classified as frail (HR 4.65, 95% CI 2.63 to 8.22) or prefrail (2.52, 1.56 to 4.07) at the baseline assessment had an increased risk of disability incidence compared with robust participants. Analyses for subitems of frailty showed that slowness (2.32, 1.62 to 3.33), weakness (1.90, 1.35 to 2.68) and weight loss (1.61, 1.13 to 2.31) were related to increased risk of disability incidence. In stratified analyses, participants who were classified as frail and who had lower cognitive function had the highest percentage (30.3%) of disability incidence during the 2 years after baseline assessment. Conclusions Physical frailty, even being prefrail, had a strong impact on the risk of future disability. Some components of frailty, such as slowness, weakness and weight loss, are strongly associated with incident disability in community-dwelling older adults. PMID:26338685

  13. Caries incidence and lesion progression from adolescence to young adulthood: a prospective 15-year cohort study in Sweden.

    PubMed

    Mejàre, I; Stenlund, H; Zelezny-Holmlund, C

    2004-01-01

    The objectives were (1) to assess caries development, including the incidence and rate of lesion progression, in a Swedish cohort from adolescence to young adulthood and (2) to compare the caries incidence rates in adolescents with those of young adults. The original material consisted of 536 children aged 11-13 years at baseline. This cohort had been followed through annual bitewing radiographs to 21-22 years of age. In 1998-1999, 250 of these individuals were re-examined at the age of 26-27, and the new caries data were added to the original data. The results showed that fewer new enamel lesions developed on approximal surfaces during young adulthood than during adolescence; the caries incidence rates for enamel lesions decreased from 4.3 in the age group 12-15 years to 2.7 new caries lesions/100 surface-years in the age group 20-27 years. The same applied to the rate of lesion progression, where the corresponding values from the enamel-dentin border to the outer dentin were 32.5 for the youngest and 10.9 new lesions/100 surface-years for the oldest age group. The caries incidence of outer dentin lesions on approximal surfaces was low but increased from 0.2 in the age group 12-15 years to 0.9 new outer dentin lesions/100 surface-years in the age group 20-27 years. The incidence rates varied considerably between different tooth surfaces. Also for occlusal surfaces, fewer new dentin lesions developed during young adulthood than during adolescence; the incidence was 2.0 new dentin lesions/100 surface-years in the youngest age group and 0.7 during young adulthood. At the age of 13, the proportion of DFS of occlusal surfaces predominated over DFS of approximal surfaces but at the age of 26-27 the proportions of occlusal and approximal DFS were almost equal. PMID:14767170

  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. South African-ness Among Adolescents: The Emergence of a Collective Identity within the Birth to Twenty Cohort Study

    PubMed Central

    Norris, Shane A; Roeser, Robert W.; Richter, Linda M; Lewin, Nina; Ginsburg, Carren; Fleetwood, Stella A; Taole, Elizabeth; van der Wolf, Kees

    2009-01-01

    We assessed the emergence of a South African identity among Black, Colored (mixed ancestral origin), White (predominantly English speaking), and Indian adolescents participating in a birth cohort study called “Birth to Twenty” in Johannesburg, South Africa. We examined young people's certainty of their self-categorization as South African, the centrality of their personal, racial and linguistic, and South African identities in their self-definition, and their perceptions of South African life and society today. These results reflect a historical opportunity for full citizenship and national enfranchisement that the end of Apartheid heralded for Black and Colored individuals. Black and Colored youth tend to be more certain about their South African-ness, have a more collective identity, and have a more positive perception around South Africa. In contrast, White and Indian youth are less certain about their South African-ness, have a more individualistic identity, and have a less positive perception about South Africa today. PMID:19461896

  16. 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…

  17. 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…

  18. 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…

  19. 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,…

  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. 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

  2. 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

  3. Pace: A Residential Community Oriented Behavior Modification Program for Adolescents

    ERIC Educational Resources Information Center

    Wagner, Bernard R.; Breitmeyer, Rudolf G.

    1975-01-01

    After briefly citing the wide scope and diversity of token programs, and reviewing some of these programs for adolescents in greater detail, the authors describe the structure and operation of a residential behavior modification program for emotionally disturbed, pre-delinquent, and mentally retarded adolescents. (Author)

  4. Adolescent Health and High School Dropout: A Prospective Cohort Study of 9000 Norwegian Adolescents (The Young-HUNT)

    PubMed Central

    De Ridder, Karin A. A.; Pape, Kristine; Johnsen, Roar; Holmen, Turid Lingaas; Westin, Steinar; Bjørngaard, Johan Håkon

    2013-01-01

    Background High school dropout is of major concern in the western world. Our aims were to estimate the risk of school dropout in adolescents following chronic somatic disease, somatic symptoms, psychological distress, concentration difficulties, insomnia or overweight and to assess to which extent the family contributes to the association between health and school dropout. Methods A population of 8950 school-attending adolescents (13–21 years) rated their health in the Young-HUNT 1 Study (90% response rate) in 1995–1997. High school dropout or completion, was defined with the Norwegian National Education Database in the calendar year the participant turned 24 years old. Parental socioeconomic status was defined by using linkages to the National Education Database, the National Insurance Administration and the HUNT2 Survey. We used logistic regression to estimate odds ratios and risk differences of high school dropout, both in the whole population and among siblings within families differentially exposed to health problems. Results All explored health dimensions were strongly associated with high school dropout. In models adjusted for parental socioeconomic status, the risk differences of school dropout according to health exposures varied between 3.6% (95% CI 1.7 to 5.5) for having ≥1 somatic disease versus none and 11.7% (6.3 to 17.0) for being obese versus normal weight. The results from the analyses comparing differentially exposed siblings, confirmed these results with the exception of weaker associations for somatic diseases and psychological distress. School dropout was strongly clustered within families (family level conditional intraclass correlation 0.42). Conclusions Adolescent health problems are markers for high school dropout, independent of parental socioeconomic status. Although school dropout it strongly related to family-level factors, also siblings with poor health have reduced opportunity to complete high school compared to healthy siblings

  5. A genome-wide screen for copy number alterations in an adolescent pilot cohort with Müllerian anomalies

    PubMed Central

    Murry, Jaclyn B.; Santos, Xiomara; Wang, Xiaoling; Wan, Ying-Wooi; Van den Veyver, Ignatia B.; Dietrich, Jennifer E.

    2015-01-01

    Objective To examine whether pathogenic CNCs can be identified in DNA from females with different classes of Müllerian anomalies. Design We conducted array-based CNV analysis using an oligonucleotide array from DNA in 12 adolescent females with different types of Müllerian anomalies. Setting University-affiliated tertiary care institution Patients 20 adolescent females with clinically confirmed Müllerian anomalies Interventions array-based CNV analysis Main Outcome Measure(s) Copy number changes and/or regions with absence of heterozygosity Results 192 copy-number variants that we identified in these samples were previously annotated as polymorphic. Three copy number changes that were identified in regions with minimal to no overlap with annotated polymorphisms failed significance criteria with detailed inspection. One subject harbored a 5.1 Mb region of absence of heterozygosity at Xq23 that is of unknown significance. Conclusions In conclusion, we did not identify pathogenic CNCs in this small pilot cohort of patients with various Müllerian anomalies, but larger studies will be needed to further investigate more comprehensively whether CNCs are associated with all classes of Müllerian anomalies. PMID:25492685

  6. Profiling the preterm or VLBW born adolescent; implications of the Dutch POPS cohort follow-up studies.

    PubMed

    van der Pal-de Bruin, K M; van der Pal, S M; Verloove-Vanhorick, S P; Walther, F J

    2015-02-01

    In 1983, data of a unique nationwide cohort of 1338 very preterm (<32 weeks of gestation) or VLBW (birth weight<1500g) infants in the Netherlands was collected and followed at several ages until they reached the age of 19 years. At 19 years of age a more extensive follow-up study was done, including questionnaires, tests on a computer and a full physical exam. These studies provide insight into how Dutch adolescents at 19 years of age, who were born very preterm or with a very low birth weight (VLBW), reach adulthood. At 19 years, 705 POPS participants participated (74% of 959 still alive). Outcome measures at 19 years included: physical outcomes (e.g. blood pressure), cognition, behavior, quality of life, and impact of handicaps. The POPS participants showed more impairments on most outcome measures at various ages, compared to norm data. Major handicaps remained stable as the children grew older, but minor handicaps and disabilities increased. At 19 years of age, only half (47.1%) of the survivors had no disabilities and no minor or major handicaps. Especially those born small for gestational age (SGA) seem most vulnerable. These long-term results help to support preterm and SGA born children and adolescents in reaching independent adulthood, and stress the need for long term follow-up studies and to promote prevention of disabilities and of preterm birth itself. PMID:25590235

  7. 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

    2016-01-01

    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 results

  8. 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

  9. Testing the temporal relationship between maternal and adolescent depressive and anxiety symptoms in a community sample.

    PubMed

    Brown, Ruth C; Clark, Shaunna L; Dahne, Jennifer; Stratton, Kelcey J; MacPherson, Laura; Lejuez, C W; Amstadter, Ananda B

    2015-01-01

    Transactional models have been used to explain the relationship between maternal depression and child behavioral problems; however, few studies have examined transactional models for maternal depression and adolescent depression and anxiety. Using an autoregressive cross-lagged analysis, we examined the longitudinal association between maternal and adolescent depression to determine the extent to which maternal depression influences adolescent depression and anxiety, and vice versa, over the course of a 4-year period. Participants were a community sample of 277 mother-adolescent dyads with offspring 10 to 14 years of age at the 1st year used in the analyses (43.7% female; 35% African American, 2.9% Hispanic/Latino). Depressive symptoms were assessed using maternal self-report (Center for Epidemiological Studies-Depression Scale; Radloff, 1977), and adolescent depression and anxiety were assessed by self-report (Revised Child Anxiety and Depression Scale; Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000). The final model, χ(2)(14) = 23.74, p = .05 (TLI = .97, CFI = .98, RMSEA = .05), indicated that maternal depression was significantly associated with adolescent depression 2 years later. Of interest, adolescent depression did not significantly predict maternal depression, and the association between maternal and adolescent depression was not moderated by gender, age, or ethnicity. The association between maternal depression and adolescent anxiety was weaker than that observed for adolescent depression. Results suggest that the transaction model of maternal depression may not extend to adolescent depression and anxiety. Furthermore, maternal depression can have an enduring effect on adolescent depression, and continued research and clinical monitoring over extended periods is warranted. PMID:24702257

  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. 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"…

  12. Predictors of Violent Behavior in an Early Adolescent Cohort: Similarities and Differences across Genders

    ERIC Educational Resources Information Center

    Blitstein, Jonathan L.; Murray, David M.; Lytle, Leslie A.; Birnbaum, Amanda S.; Perry, Cheryl L.

    2005-01-01

    The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the…

  13. Adolescents' perceptions of health from disadvantaged urban communities: findings from the WAVE study.

    PubMed

    Mmari, Kristin; Blum, Robert; Sonenstein, Freya; Marshall, Beth; Brahmbhatt, Heena; Venables, Emily; Delany-Moretlwe, Sinead; Lou, Chaohua; Gao, Ershang; Acharya, Rajib; Jejeebhoy, Shireen; Sangowawa, Adesola

    2014-03-01

    The Well-being of Adolescents in Vulnerable Environments (WAVE) is a global study of young people living in disadvantaged urban communities from Baltimore, MD, Johannesburg, South Africa, Shanghai, China, New Delhi, India and Ibadan, Nigeria. WAVE was launched in the summer of 2011 to: 1) explore adolescents' perceived health and their top health challenges; and 2) describe the factors that adolescents perceive to be related to their health and health care utilization. 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. Findings from the study showed that gender played a large role with regards to what adolescents considered as their top health challenges. Among females, sexual and reproductive health problems were primary health challenges, whereas among males, tobacco, drug, and alcohol consumption was of highest concern, which often resulted into acts of violence. Personal safety was also a top concern among males and females from Baltimore and Johannesburg, and among females in New Delhi and Ibadan. Factors perceived to influence health the most were the physical environment, which was characterized by inadequate sanitation and over-crowded buildings, and the social environment, which varied in influence by gender and site. Regardless of the study site, adolescents did not consider physical health as a top priority and very few felt the need to seek health care services. This study highlights the need to focus on underlying structural and social factors for promoting health and well-being among adolescents in disadvantaged urban environments. PMID:24581070

  14. Prenatal Alcohol Exposure Is Associated with Conduct Disorder in Adolescence: Findings from a Birth Cohort

    ERIC Educational Resources Information Center

    Larkby, Cynthia A.; Goldschmidt, Lidush; Hanusa, Barbara H.; Day, Nancy L.

    2011-01-01

    Objective: To evaluate the association between prenatal alcohol exposure and the rate of conduct disorder in exposed compared with unexposed adolescents. Method: Data for these analyses are from a longitudinal study of prenatal substance exposures. Women were interviewed at their fourth and seventh prenatal months, and with their children, at…

  15. Correlates of Identity Configurations: Three Studies with Adolescent and Emerging Adult Cohorts

    ERIC Educational Resources Information Center

    Crocetti, Elisabetta; Scrignaro, Marta; Sica, Luigia Simona; Magrin, Maria Elena

    2012-01-01

    Adolescence and emerging adulthood are two core developmental periods in which individuals can develop a meaningful identity across domains. However, there is a lack of studies exploring correlates of different identity configurations. The purpose of this article was to fill this gap in examining correlates of configurations characterized by…

  16. Etiology of community acquired pneumonia among children in India: prospective, cohort study

    PubMed Central

    Mathew, Joseph L.; Singhi, Sunit; Ray, Pallab; Hagel, Eva; Saghafian–Hedengren, Shanie; Bansal, Arun; Ygberg, Sofia; Sodhi, Kushaljit Singh; Kumar, B V Ravi; Nilsson, Anna

    2015-01-01

    Background Childhood community acquired pneumonia (CAP) is a significant problem in developing countries, and confirmation of microbial etiology is important for individual, as well as public health. However, there is paucity of data from a large cohort, examining multiple biological specimens for diverse pathogens (bacteria and viruses). The Community Acquired Pneumonia Etiology Study (CAPES) was designed to address this knowledge gap. Methods We enrolled children with CAP (based on WHO IMCI criteria of tachypnea with cough or breathing difficulty) over 24 consecutive months, and recorded presenting symptoms, risk factors, clinical signs, and chest radiography. We performed blood and nasopharyngeal aspirate (NPA) bacterial cultures, and serology (Mycoplasma pneumoniae, Chlamydophila pneumoniae). We also performed multiplex PCR for 25 bacterial/viral species in a subgroup representing 20% of the cohort. Children requiring endotracheal intubation underwent culture and PCR of bronchoalveolar lavage (BAL) specimens. Findings We enrolled 2345 children. NPA and blood cultures yielded bacteria in only 322 (13.7%) and 49 (2.1%) children respectively. In NPA, Streptococcus pneumoniae (79.1%) predominated, followed by Haemophilus influenzae (9.6%) and Staphylococcus aureus (6.8%). In blood, S. aureus (30.6%) dominated, followed by S. pneumoniae (20.4%) and Klebsiella pneumoniae (12.2%). M. pneumoniae and C. pneumoniae serology were positive in 4.3% and 1.1% respectively. Multiplex PCR in 428 NPA specimens identified organisms in 422 (98.6%); of these 352 (82.2%) had multiple organisms and only 70 (16.4%) had a single organism viz. S. pneumoniae: 35 (50%), Cytomegalovirus (CMV): 13 (18.6%), Respiratory Syncytial Virus (RSV): 9 (12.9%), other viruses: 6 (8.7%), S. aureus: 5 (7.1%), and H. influenzae: 2 (2.9%). BAL PCR (n = 30) identified single pathogens in 10 (S. pneumoniae–3, CMV–3, S. aureus–2, H. influenzae–2) and multiple pathogens in 18 children. There were

  17. Impact of body size and physical activity during adolescence and adult life on overall and cause-specific mortality in a large cohort study from Iran.

    PubMed

    Etemadi, Arash; Abnet, Christian C; Kamangar, Farin; Islami, Farhad; Khademi, Hooman; Pourshams, Akram; Poustchi, Hossein; Bagheri, Mohammad; Sohrabpour, Amir Ali; Aliasgar, Ali; Khoshnia, Masoud; Wacholder, Sholom; Matthews, Charles C; Pharoah, Paul D; Brennan, Paul; Boffetta, Paolo; Malekzadeh, Reza; Dawsey, Sanford M

    2014-02-01

    We conducted this study to examine life-course body size and physical activity in relation to total and cause-specific mortality, which has not previously been studied in the low and middle-income countries in Asia. The Golestan Cohort Study is a population-based cohort in northeastern Iran in which 50,045 people above the age of 40 have been followed since 2004. Participants were shown a validated pictogram to assess body size at ages 15, 30, and the time of recruitment. Information on occupational physical activity at these ages was also collected. Subjects were followed up annually, and cause of death was determined. Cox regression models were adjusted for age at cohort start, smoking, socioeconomic status, ethnicity, place of residence, education, and opium use. Models for body size were also adjusted for physical activity at the same age, and vice versa. During a total of 252,740 person-years of follow-up (mean follow-up duration 5.1 ± 1.3 years) through December 2011, 2,529 of the cohort participants died. Larger body sizes at ages 15 or 30 in both sexes were associated with increased overall mortality. Cancer mortality was more strongly associated with adolescent obesity, and cardiovascular mortality with early adulthood body size. Weight gain between these ages was associated with cardiovascular mortality. Obese adolescents who lost weight still had increased mortality from all medical causes in both sexes. Physical activity during adolescence and early adulthood had no association with mortality, but at cohort baseline higher levels of activity were associated with reduced mortality. Mortality in this Middle-Eastern population was associated with obesity both during adolescence and early adult life. PMID:24557643

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. Osteoporotic Fracture Risk Assessment Using Bone Mineral Density in Korean: A Community-based Cohort Study

    PubMed Central

    Jang, Eun Jin; Lee, Young-Kyun; Choi, Hyung Jin

    2016-01-01

    Background Fracture-risk assessment tool (FRAX) using just clinical risk factors of osteoporosis has been developed to estimate individual risk of osteoporotic fractures. We developed prediction model of fracture risk using bone mineral density (BMD) as well as clinical risk factors in Korean, and assessed the validity of the final model. Methods To develop and validate an osteoporotic FRAX, a total of 768 Korean men and women aged 50 to 90 years were followed for 7 years in a community-based cohort study. BMD as well as clinical risk factors for osteoporotic fracture including age, sex, body mass index, history of fragility fracture, family history of fracture, smoking status, alcohol intake, use of oral glucocorticoid, rheumatoid arthritis, and other causes of secondary osteoporosis were assessed biannually. Results During the follow-up period, 86 osteoporotic fractures identified (36 in men and 50 in women). The developed prediction models showed high discriminatory power and had goodness of fit. Conclusions The developed a Korean specific prediction model for osteoporotic fractures can be easily used as a screening tool to identify individual with high risk of osteoporotic fracture. Further studies for validation are required to confirm the clinical feasibility in general Korean population. PMID:26981519

  5. 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

  6. 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

  7. 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…

  8. Predictors of suicidal ideation in late childhood and adolescence: a 5-year follow-up of two nationally representative cohorts in the Republic of Korea.

    PubMed

    Park, Sunhee

    2013-02-01

    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 occurrence of suicidal ideation in adolescence, a higher prevalence of suicidal ideation among females than among males, and differences in predictors of suicide ideation by developmental stages and gender. The results suggest that multifaceted factors specific to developmental stages and gender should be simultaneously considered to diminish the occurrences of suicidal ideation. PMID:23356784

  9. 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’,

  10. 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…

  11. 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…

  12. 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

  13. Adolescent growth events in eight decades of Japanese cohort data: sex differences.

    PubMed

    Ali, M A; Lestrel, P E; Ohtsuki, F

    2001-01-01

    The presence of secular trends in sex differences for the onset or takeoff of the adolescent growth spurt and subsequent (adolescent) growth of Japanese boys and girls were investigated using data published in "The Statistical Report of the School Health Survey" of the Ministry of Education, Science, Sports and Culture, Japan. An optimum kernel regression method was used to derive the biological parameters of the adolescent growth curve. The six parameters derived from the regression analysis were age at takeoff (ATO), height at takeoff (HTO), velocity at takeoff (VTO), peak height velocity (PHV), age at PHV (APHV), and height at PHV (HPHV). The sex difference in age at PHV is about 2.1 years. The sex difference in age at takeoff was about 2.1 years starting with the birth year of 1943, but has become almost insignificant with the birth year of 1980. After 1960, the sex difference in mean HPHV varied within 12-13 cm, but the difference in HTO showed a decreasing trend. After the birth year of 1911, the rate of growth at HTO for girls has become markedly greater than for boys. In contrast, the rate of growth at HPHV for girls has become significantly smaller than for boys (P < 0.05). Sex differences in ATO, HTO and VTO were significantly and negatively correlated with differences in APHV and HPHV, but positively correlated with the difference in PHV. The sex difference in PHV had no relationship with the differences in APHV and HPHV. PMID:11460905

  14. Correlates of identity configurations: three studies with adolescent and emerging adult cohorts.

    PubMed

    Crocetti, Elisabetta; Scrignaro, Marta; Sica, Luigia Simona; Magrin, Maria Elena

    2012-06-01

    Adolescence and emerging adulthood are two core developmental periods in which individuals can develop a meaningful identity across domains. However, there is a lack of studies exploring correlates of different identity configurations. The purpose of this article was to fill this gap in examining correlates of configurations characterized by identity stability or instability in both ideological and relational domains or identity stability in one domain and instability in the other domain. Three studies were presented. In the first study, we investigated links between identity configurations and internalizing problem behaviors in early and middle adolescents (N=1,891; M (age) =14; 55% female); in the second study, we focused on associations between identity configurations and identity functions in late adolescents and early emerging adults (N=1,085; M (age) =19; 63% female); in the third study, we investigated relationships between identity configurations, sense of coherence, and basic psychological need satisfaction in emerging adults (N=489; M (age) =21; 71% female). Overall, findings highlighted that participants experiencing a condition of identity stability in both domains reported a better profile than their peers displaying a condition of instability in both realms. Further, individuals with identity stability only in one domain reported intermediate scores and the effect provided by each domain varied according to the correlate examined and the age group taken into account. Implications of these findings are discussed. PMID:21809219

  15. 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.

  16. Aetiology of community-acquired, acute gastroenteritis in hospitalised adults: a prospective cohort study

    PubMed Central

    Jansen, Andreas; Stark, Klaus; Kunkel, Jan; Schreier, Eckart; Ignatius, Ralf; Liesenfeld, Oliver; Werber, Dirk; Göbel, Ulf B; Zeitz, Martin; Schneider, Thomas

    2008-01-01

    Background The aetiology of severe gastroenteritis leading to hospitalisation in adults frequently remains unclear. Our objective was to study the causes and characteristics of community-acquired, acute gastroenteritis in adult hospitalized patients to support the clinical management of these patients. Methods From August 2005 to August 2007, we conducted a prospective cohort study among patients ≥18 y hospitalized with community-acquired gastroenteritis in a university hospital in Berlin, Germany. Stool specimens were examined for 26 gastrointestinal pathogens, supplemented by serologic tests for antibodies to Campylobacter spp., Yersinia spp., and Entamoeba histolytica. Patient data on demographics and clinical presentation were recorded and analyzed. Coexisting medical conditions were assessed using the Charlson Comorbidity Index score. Results Of 132 patients presenting with acute community-acquired gastroenteritis, 104 were included in the study. A non-infectious aetiology was diagnosed in 8 patients (8%). In 79 (82%) of the remaining 96 patients at least one microorganism was identified. Campylobacter spp. (35%) was detected most frequently, followed by norovirus (23%), Salmonella spp. (20%), and rotavirus (15%). In 46% of the patients with Campylobacter spp. infection, the diagnosis was made solely by serology. More than one pathogen was found in seventeen (22%) patients. Simultaneous infection was significantly more likely in patients with rotavirus and salmonella infections (RR 3.6; 95% CI: 1.8–7.4; RR 2.5; 95%CI: 1.2–5.5). Length of hospital stay (median: 5.5 days) was independent of the pathogen, but was associated with coexisting medical conditions (OR 4,8; 95%CI:2,0–11,6). Conclusion Known enteric pathogens were detected in 82% of adult patients who were hospitalized with acute gastroenteritis. We found that currently used culture-based methods may miss a substantial proportion of Campylobacter infections, and additional serological testing for

  17. 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. PMID:24846701

  18. Adolescent sexual assault victims and the legal system: building community relationships to improve prosecution rates.

    PubMed

    Campbell, Rebecca; Greeson, Megan R; Bybee, Deborah; Fehler-Cabral, Giannina

    2012-09-01

    Adolescents are at high risk for sexual assault, but few of these crimes are reported to the police and prosecuted by the criminal justice system. To address this problem, communities throughout the United States have implemented multidisciplinary interventions to improve post-assault care for victims and increase prosecution rates. The two most commonly implemented interventions are Sexual Assault Nurse Examiner (SANE) Programs and Sexual Assault Response Teams (SARTs). The purpose of this study was to determine whether community-level context (i.e., stakeholder engagement and collaboration) was predictive of adolescent legal case outcomes, after accounting for "standard" factors that affect prosecution success (i.e., victim, assault, and evidence characteristics). Overall, 40% of the adolescent cases from these two SANE-SART programs (over a 10-year period) were successfully prosecuted. Cases were more likely to be prosecuted for younger victims, those with disabilities, those who knew their offenders, and instances in which the rape evidence collection kit was submitted by police for analysis. After accounting for these influences, multi-level modeling results revealed that in one site decreased allocation of community resources to adolescent sexual assault cases had a significant negative effect on prosecution case outcomes. Results are explained in terms of Wolff's (Am J Community Psychol 29:173-191, 2001) concept of "over-coalitioned" communities and Kelly's (1968) ecological principles. PMID:22124620

  19. 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

  20. NIMH Project Accept (HPTN 043): Results from In-Depth Interviews with a Longitudinal Cohort of Community Members

    PubMed Central

    Maman, Suzanne; van Rooyen, Heidi; Stankard, Petra; Chingono, Alfred; Muravha, Tshifhiwa; Ntogwisangu, Jacob; Phakathi, Zipho; Srirak, Namtip; F.Morin, Stephen

    2014-01-01

    Introduction NIMH Project Accept (HPTN 043) is a community- randomized trial to test the safety and efficacy of a community-level intervention designed to increase testing and lower HIV incidence in Tanzania, Zimbabwe, South Africa and Thailand. The evaluation design included a longitudinal study with community members to assess attitudinal and behavioral changes in study outcomes including HIV testing norms, HIV-related discussions, and HIV-related stigma. Methods A cohort of 657 individuals across all sites was selected to participate in a qualitative study that involved 4 interviews during the study period. Baseline and 30-month data were summarized according to each outcome, and a qualitative assessment of changes was made at the community level over time. Results Members from intervention communities described fewer barriers and greater motivation for testing than those from comparison communities. HIV-related discussions in intervention communities were more grounded in personal testing experiences. A change in HIV-related stigma over time was most pronounced in Tanzania and Zimbabwe. Participants in the intervention communities from these two sites attributed community-level changes in attitudes to project specific activities. Discussion The Project Accept intervention was associated with more favorable social norms regarding HIV testing, more personal content in HIV discussions in all study sites, and qualitative changes in HIV-related stigma in two of five sites. PMID:24489841

  1. 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

  2. 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. PMID:26872341

  3. 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,…

  4. 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…

  5. 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

  6. 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

  7. Changing interpretation of chromosomal microarray over time in a community cohort with intellectual disability.

    PubMed

    Palmer, Emma; Speirs, Helen; Taylor, Peter J; Mullan, Glenda; Turner, Gill; Einfeld, Stewart; Tonge, Bruce; Mowat, David

    2014-02-01

    Chromosomal microarray (CMA) is the first-line diagnostic test for individuals with intellectual disability, autism, or multiple congenital anomalies, with a 10-20% diagnostic yield. An ongoing challenge for the clinician and laboratory scientist is the interpretation of variants of uncertain significance (VOUS)-usually rare, unreported genetic variants. Laboratories differ in their threshold for reporting VOUS, and clinical practice varies in how this information is conveyed to the family and what follow-up is arranged. Workflows, websites, and databases are constantly being updated to aid the interpretation of VOUS. There is a growing literature reporting new microdeletion and duplication syndromes, susceptibility, and modifier copy number variants (CNVs). Diagnostic methods are also evolving with new array platforms and genome builds. In 2010, high-resolution arrays (Affymetrix 2.7 M Oligo and SNP, 50 kB resolution) were performed on a community cohort of 67 individuals with intellectual disability of unknown aetiology. Three hundred and one CNVs were detected and analyzed using contemporary resources and a simple scoring system. Thirteen (19%) of the arrays were assessed as potentially pathogenic, 4 (6%) as benign and 50 (75%) of uncertain clinical significance. The CNV data were re-analyzed in 2012 using the contemporary interpretative resources. There was a statistically significant difference in the assessment of individual CNVs (P < 0.0001). An additional eight patients were reassessed as having a potentially pathogenic array (n = 21, 31%) and several additional susceptibility or modifier CNVs were identified. This study highlights the complexity involved in the interpretation of CMA and uniquely demonstrates how, even on the same array platform, it can be subject to change over time. PMID:24311194

  8. 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

  9. Characteristics of Adolescents and Youth with Recent-Onset Type 2 Diabetes: The TODAY Cohort at Baseline

    PubMed Central

    Copeland, Kenneth C.; Zeitler, Philip; Geffner, Mitchell; Guandalini, Cindy; Higgins, Janine; Hirst, Kathryn; Kaufman, Francine R.; Linder, Barbara; Marcovina, Santica; McGuigan, Paul; Pyle, Laura; Tamborlane, William; Willi, Steven

    2011-01-01

    Context: The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) cohort represents the largest and best-characterized national sample of American youth with recent-onset type 2 diabetes. Objective: The objective of the study was to describe the baseline characteristics of participants in the TODAY randomized clinical trial. Design: Participants were recruited over 4 yr at 15 clinical centers in the United States (n = 704) and enrolled, randomized, treated, and followed up 2–6 yr. Setting: The study was conducted at pediatric diabetes care clinics and practices. Participants: Eligible participants were aged 10–17 yr inclusive, diagnosed with type 2 diabetes for less than 2 yr and had a body mass index at the 85th percentile or greater. Interventions: After baseline data collection, participants were randomized to one of the folllowing groups: 1) metformin alone, 2) metformin plus rosiglitazone, or 3) metformin plus a lifestyle program of weight management. Main Outcome Measures: Baseline data presented include demographics, clinical/medical history, biochemical measurements, and clinical and biochemical abnormalities. Results: At baseline the cohort included the following: 64.9% were female; mean age was 14.0 yr; mean diabetes duration was 7.8 months; mean body mass index Z-score was 2.15; 89.4% had a family history of diabetes; 41.1% were Hispanic, 31.5% were non-Hispanic black; 38.8% were living with both biological parents; 41.5% had a household annual income of less than $25,000; 26.3% had a highest education level of parent/guardian less than a high school degree; 26.3% had a blood pressure at the 90th percentile or greater; 13.6% had a blood pressure at the 95th percentile or greater; 13.0% had microalbuminuria; 79.8% had a low high-density lipoprotein level; and 10.2% had high triglycerides. Conclusions: The TODAY cohort is predominantly from racial/ethnic minority groups, with low socioeconomic status and a family history of diabetes

  10. Effects of an Adolescent Sexual and Reproductive Health Intervention on Health Service Usage by Young People in Northern Ghana: A Community-Randomised Trial

    PubMed Central

    Aninanya, Gifty Apiung; Debpuur, Cornelius Y.; Awine, Timothy; Williams, John E.; Hodgson, Abraham; Howard, Natasha

    2015-01-01

    Background While many Ghanaian adolescents encounter sexual and reproductive health problems, their usage of services remains low. A social learning intervention, incorporating environment, motivation, education, and self-efficacy to change behaviour, was implemented in a low-income district of northern Ghana to increase adolescent services usage. This study aimed to assess the impact of this intervention on usage of sexual and reproductive health services by young people. Methods Twenty-six communities were randomly allocated to (i) an intervention consisting of school-based curriculum, out-of-school outreach, community mobilisation, and health-worker training in youth-friendly health services, or (ii) comparison consisting of community mobilisation and youth-friendly health services training only. Outcome measures were usage of sexually-transmitted infections (STIs) management, HIV counselling and testing, antenatal care or perinatal services in the past year and reported service satisfaction. Data was collected, at baseline and three years after, from a cohort of 2,664 adolescents aged 15–17 at baseline. Results Exposure was associated with over twice the odds of using STI services (AOR 2.47; 95%CI 1.78–3.42), 89% greater odds of using perinatal services (AOR 1.89; 95%CI 1.37–2.60) and 56% greater odds of using antenatal services (AOR 1.56; 95%CI 1.10–2.20) among participants in intervention versus comparison communities, after adjustment for baseline differences. Conclusions The addition of targeted school-based and outreach activities increased service usage by young people more than community mobilisation and training providers in youth-friendly services provision alone. PMID:25928562

  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. 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…

  13. 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…

  14. 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…

  15. Stages of Change for Physical Activity in a Community Sample of Adolescents

    ERIC Educational Resources Information Center

    De Bourdeaudhuij, Ilse; Philippaerts, Renaat; Crombez, Geert; Matton, Lynn; Wijndaele, Katrien; Balduck, Anne-Line; Lefevre, Johan

    2005-01-01

    The aims of the present study were to investigate (1) the proportion of adolescents in each of the stages of change, (2) the differences in psychosocial factors and in physical activity between the stages, and (3) the classification accuracy using several reference criteria. A random sample of 38 schools from the Flemish community in Belgium…

  16. 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…

  17. Community Opportunity, Perceptions of Opportunity, and the Odds of an Adolescent Birth

    ERIC Educational Resources Information Center

    Driscoll, Anne; Sugland, Barbara; Manlove, Jennifer; Papillo, Angela

    2005-01-01

    The ability of the opportunity cost framework to predict the risk of a teen birth is tested by analyzing the relationship between adolescents perceptions of opportunity and the odds of a teen birth across levels of community opportunity. Patterns of this relationship are compared across African American, Latina, and White teens and across…

  18. Development of Community-Based Health Services for Adolescents at Risk for Sociomedical Problems.

    ERIC Educational Resources Information Center

    Lear, Julia Graham; And Others

    1985-01-01

    In 1981 the Robert Wood Johnson Foundation provided funds to 20 teaching hospitals to support health services to high-risk adolescents (young people living in communities with high rates of pregnancy, drug abuse, alcohol abuse, accidents, homicide, suicide, and depression). The experiences of these institutions are described. (Author/MLW)

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. 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,…

  5. Caring and Fun: Fostering an Adolescent-Centered Community within an Interdisciplinary Team

    ERIC Educational Resources Information Center

    Kiefer, Sarah M.; Ellerbrock, Cheryl R.

    2012-01-01

    This qualitative case study analyzed how one interdisciplinary team within a large middle school fostered a responsive adolescent-centered community for eighth-grade team students. Data were collected during the spring semester of the 2009 school year via observations, individual interviews, and focus group interviews with nine participants,…

  6. Effects of a replication of a multicomponent model for preventing adolescent pregnancy in three Kansas communities.

    PubMed

    Paine-Andrews, A; Harris, K J; Fisher, J L; Lewis, R K; Williams, E L; Fawcett, S B; Vincent, M L

    1999-01-01

    This paper evaluates a multi-component program for reducing pregnancy among adolescents in the US. The study employed a pretest-posttest comparison group design to analyze the effects of a comprehensive multi-component school and community intervention on estimated pregnancy rates and birthrates among young people in three Kansas communities: Geary County, Franklin County and selected neighborhoods of Wichita. Results revealed high levels of program activity in all three communities during the intervention period, including teacher training and sexuality education for students. From 1994-97, the proportion of adolescents who reported that they had experienced sex decreased significantly among all 9th and 10th graders in Geary County. Condom use among males in grades 11 and 12 in Franklin County increased from 39% in 1994 to 55% in 1996. In Franklin County and its comparison areas, the estimated pregnancy rates decreased among adolescents aged 14-17 years. The birthrate declined both in one target area of Wichita and in its comparison area from 1991-93 and 1994-96. In general, this research contributed to an understanding on the impact of multi-component school- and community-based interventions on adolescent pregnancy rates. PMID:10435217

  7. 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…

  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. Callous-Unemotional Traits in a Community Sample of Adolescents

    ERIC Educational Resources Information Center

    Essau, Cecilia A.; Sasagawa, Satoko; Frick, Paul J.

    2006-01-01

    This study examined the structure, distribution, and correlates of a new measure of self-reported callous-unemotional (CU) traits in 1,443 adolescents (774 boys, 669 girls) between the ages of 13 to 18 years. The Inventory of Callous-Unemotional Traits was subjected to exploratory factor analysis and confirmatory factor analysis. Exploratory…

  10. 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…

  11. 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

  12. 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

  13. 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. PMID:20078824

  14. High Individuality of Respiratory Bacterial Communities in a Large Cohort of Adult Cystic Fibrosis Patients under Continuous Antibiotic Treatment

    PubMed Central

    Kramer, Rolf; Sauer-Heilborn, Annette; Welte, Tobias; Jauregui, Ruy; Brettar, Ingrid; Guzman, Carlos A.; Höfle, Manfred G.

    2015-01-01

    Background Routine clinical diagnostics of CF patients focus only on a restricted set of well-known pathogenic species. Recent molecular studies suggest that infections could be polymicrobial with many bacteria not detected by culture-based diagnostics. Methodology and Principal Findings A large cohort of 56 adults with continuous antibiotic treatment was studied and different microbial diagnostic methods were compared, including culture-independent and culture-based bacterial diagnostics. A total of 72 sputum samples including longitudinal observations was analysed by 16S rRNA gene sequence comparison. Prevalence of known pathogens was highly similar among all methods but the vast spectrum of bacteria associated with CF was only revealed by culture-independent techniques. The sequence comparison enabled confident determination of the bacterial community composition and revealed a high diversity and individuality in the communities across the cohort. Results of microbiological analyses were further compared with individual host factors, such as age, lung function and CFTR genotype. No statistical relationship between these factors and the diversity of the entire community or single bacterial species could be identified. However, patients with non-ΔF508 mutations in the CFTR gene often had low abundances of Pseudomonas aeruginosa. Persistence of specific bacteria in some communities was demonstrated by longitudinal analyses of 13 patients indicating a potential clinical relevance of anaerobic bacteria, such as Fusobacterium nucleatum and Streptococcus millerii. Conclusions The high individuality in community composition and the lack of correlation to clinical host factors might be due to the continuous treatment with antibiotics. Since this is current practice for adult CF patients, the life-long history of the patient and the varying selection pressure on the related microbial communities should be a focus of future studies and its relation to disease progression

  15. 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

  16. Community-Based Participatory Clinical Research in Obesity by Adolescents: Pipeline for Researchers of the Future

    PubMed Central

    Branch, Robert; Chester, Ann

    2015-01-01

    We propose a novel, untapped opportunity, challenging cultural and man-power barriers to transferring advances in biomedical science knowledge that will improve community health care (Type II Clinical Translational Research) in a medically underserved community. We describe a pilot model in which adolescents apply principles of Community-Based Participatory Research (CBPR) at the epicenter of the obesity diabetes epidemic in rural Appalachia in West Virginia. The model invites minority, financially disadvantaged, and educationally disadvantaged adolescents to become educated on ethics, then provides infrastructure to support study design and conduct of CBPR. This experience demonstrates that these adolescents can efficiently, with quality and integrity, reach into the most vulnerable of communities and their own families to show that the prevalence of obesity is at 50% and diabetes 10.4% (n = 989). Our experience illustrates the infrastructure requirements for this strategy to be successful and emphasizes the substantial benefit that could accrue if the model is successfully sustained. The benefit includes not only the translation of knowledge to influence community lifestyle behavior but also the creation of a pipeline of new biomedical scientists for the future. PMID:20443918

  17. 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

  18. Children of low birthweight in the 1946 national cohort. Behaviour and educational achievement in adolescence.

    PubMed Central

    Douglas, J W; Gear, R

    1976-01-01

    Among 12 468 legitimate single births in the first week of March 1946, 163 weighed 200 g or less (LBW group) and of these 80 survived to 18 years. 6 of the LBW survivors emigrated with their families and 5 have not been traced since birth. The remaining 69 were followed up to the age of 15 at which time two early school leavers were lost to the study. There is evidence that none of the survivors who emigrated or left the sample and serious physical or mental impairment. Compared with individually matched controls, the LBW children showed similar proportions with severe physical, mental, or behavioural handicaps. There are small and statistically nonsignificant differences in favour of the controls in ability and attainment scores at 15 years and in the level of academic qualifications gained by the age of 18. If the mean ability and attainment scores are expressed as an "intelligence quotient" with a mean of 100 and a standard deviation of 15, the LBW group has an average IQ of 93 and the controls of 97. Hospital stay after childbirth was much longer in 1946 than today and many LBW children spent more than 3 weeks in hospital. There is no evidence that long hospital stay was associated with problems of behaviour or learning in adolescence. PMID:137695

  19. [Quality of the diet of 18-year-old adolescents belonging to the birth cohort of 1993 in Pelotas in the State of Rio Grande do Sul, Brazil].

    PubMed

    Castilhos, Cristina Bossle de; Schneider, Bruna Celestino; Muniz, Ludmila Correa; Assunção, Maria Cecília Formoso

    2015-11-01

    The scope of this article is to describe the quality of the diet of adolescents according to sociodemographic and behavioral factors. It involved a cross-sectional study with 3,959 eighteen-year-old adolescents belonging to the birth cohort of 1993 in Pelotas in the State of Rio Grande do Sul, Brazil. Dietary intake was assessed using a semi quantitative Food Frequency Questionnaire with a recall period of 12 months. The diet quality was assessed using the Diet Quality Index Revised (DQI-R). This index ranges from 0 to 100 points and the higher the score, the better the diet quality. The overall DQI-R mean score was 62.4 points (DP). The lowest rates were observed for dark green and orange vegetables (3.0), total vegetables (3.4) and dairy products (3.6). Non-Caucasian adolescents (63.1), from families in which the heads of the household had less schooling (63.6) and belonging to the lowest quintile of the asset index (64.7) had higher average scores in the DQI-R. Lower averages were found among adolescents who smoked (58.5) and who consumed alcoholic beverages (56.0). This study showed that diet quality of the adolescents assessed deserve attention, especially with regard to the intake of vegetables, milk and dairy products. PMID:26602709

  20. The behavioral medicine unit: a community hospital model for inpatient treatment of adolescent depression.

    PubMed

    Greydanus, D E; Porter, J; Rypma, C B; Heuer, T; Granberg, A; Ruch, R

    1986-12-01

    This article describes one community hospital's response to the overwhelming needs of adolescents in central Iowa. It is based on the premise that many youths who have severe depression do not effectively respond to various outpatient counseling measures, and are in need of some type of inpatient treatment. Most such programs are locked psychiatric units run by child or adolescent psychiatrists. In our case, those wards already in existence are filled to capacity and cannot respond to outside needs. Placing these youth on traditional medical adolescent wards does not work, since medical staff are usually not geared to deal with the many, ever-changing mental health needs of these patients. Thus, we developed an unlocked adolescent inpatient unit with a pediatrician experienced in adolescent medicine as medical director; moreover, the program extensively utilizes psychologists, nurse-counselors, social worker-family therapists, recreation therapists, and other specialists. This program is a way for physicians trained in adolescent medicine and other appropriate persons to contribute to the complex health needs of youth; it is preferable to do this rather than send all depressed teenagers away by referrals, as seems to happen in some cases. It is also an important way for physicians and other specialists to demonstrate their expertise--both the Society for Adolescent Medicine and American Academy of Pediatrics have advocated such a demonstration--and to give physicians important training in the medical and mental health care needs of youth. Finally, the Spectrum Unit program provides a meaningful way for the primary care physician to be involved in the inpatient treatment of depressed adolescent patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3602650

  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. Community Risk and Protective Factors and Adolescent Substance Use.

    ERIC Educational Resources Information Center

    Hays, Scott P.; Hays, Carol E.; Mulhall, Peter F.

    2003-01-01

    Study researched the impact of the contextual characteristics of the community on self-reported 8th grade alcohol, tobacco, and other drug use. Results indicate that community disorganization is an important risk factor for ATOD use while family supports is an important protective factor. Greater economic constraints decreases, rather than…

  3. 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…

  4. 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

  5. Metabolic syndrome burden in apparently healthy adolescents are adversely associated with cardiac autonomic modulation- Penn State Children Cohort

    PubMed Central

    Rodríguez-Colón, Sol M.; He, Fan; Bixler, Edward O.; Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Calhoun, Susan; Zheng, Zhi-Jie; Liao, Duanping

    2015-01-01

    Background Reduced cardiac autonomic modulation (CAM) has been associated with metabolic syndrome (MetS) in adults. However, the association between MetS component cluster and CAM has not been examined in adolescents. Methods We conducted a cross-sectional analysis using data from the Penn State Child Cohort follow-up examination. CAM was assessed by heart rate variability (HRV) analysis of 39-hour RR intervals, including frequency (high frequency, HF; low frequency, LF; and LF/HF ratio) and time (SDNN, standard deviation of all RR intervals; RMSSD, square root of the mean of the sum of the squares of differences between adjacent RR intervals; and HR, heart rate) domain variables. To assess the MetS burden, we used continuous MetS score (cMetS)–sum of the age and sex-adjusted standardized residual (Z-score) of five established MetS components. Linear mixed-effect models were used to analyze the association between cMetS and CAM in the entire population and stratified by gender. Results After adjusting for age, sex, and race, cMetS was significantly associated with reduced HRV and higher HR. With 1 standard deviation increase in cMetS, there was a significant decrease in HF(−0.10(SE=0.02)), LF(−0.07(SE=0.01)), SDNN(−1.97(SE=0.50)), and RMSSD(−1.70(SE=0.72)), and increase in LF/HF(0.08(SE=0.02)) and HR(1.40(SE=0.26)). All cMetS components, with the exception of high-density lipoprotein (HDL), were associated with significantly decreased HRV and increased HR. High blood pressure (MAP) and triglyceride (TG) levels were also associated with an increase in LF/HF and decrease in RMSSD. An increase in high-density lipoprotein was only associated with higher LF and SDNN. Moreover, cMetS and HRV associations were more pronounced in males than in females. The associations between HRV and. MAP, TG, and HDL were more pronounced in females. Conclusions cMetS score is associated with lower HRV, suggesting an adverse impact on CAM, even in apparently healthy adolescents

  6. 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

  7. Maternal Depression and Adolescent Behavior Problems: An Examination of Mediation among Immigrant Latino Mothers and Their Adolescent Children Exposed to Community Violence

    ERIC Educational Resources Information Center

    Aisenberg, Eugene; Trickett, Penelope K.; Mennen, Ferol E.; Saltzman, William; Zayas, Luis H.

    2007-01-01

    This study examines the psychological and behavioral effects of exposure to community violence of 47 Latino mothers and their young adolescent children. Using data gathered from multiple sources, this study tests the associations between lifetime exposure to community violence, maternal depression, and child behavior problems. More than 80% of the…

  8. 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…

  9. A Pilot Study of Coping Processes Utilized by African-American Male Adolescents Living in Violent Communities.

    ERIC Educational Resources Information Center

    Sparks, Elizabeth

    This paper is a preliminary report on a study that explored the ways in which African American male adolescents cope with the interpersonal assaultive violence that takes place in their urban communities. Participants were 27 African American male adolescents, aged 13-19, who live in and/or spend the majority of their non-school hours interacting…

  10. 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…

  11. 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…

  12. 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…

  13. Multilevel Modeling of Direct Effects and Interactions of Peers, Parents, School, and Community Influences on Adolescent Substance Use

    ERIC Educational Resources Information Center

    Mayberry, Megan L.; Espelage, Dorothy L.; Koenig, Brian

    2009-01-01

    This study tested a social-ecological model of adolescent substance use. Multilevel modeling was used to investigate how systems, such as parents, peers, schools, and communities, directly influence and interact together to influence adolescent substance use. Participants included 14,548 (50.3% female) middle school students who were 78.6% White,…

  14. Fatherhood in adolescence: prevalence and associated factors in a community sample of youngsters.

    PubMed

    Oliveira, Milene Maria Saalfeld de; Branco, Jerônimo Costa; Souza, Luciano Dias de Mattos; Silva, Ricardo Azevedo da; Lara, Diogo Rizzato; Mota, Denise Marques; Jansen, Karen

    2015-11-01

    This article aims to assess the prevalence of fatherhood in adolescence (FA) and associated factors in a community sample of 14 to 35 year-old men. Cross-sectional population-based study realized in the urban area of the city of Pelotas-RS, Brazil. The sample was selected by clusters, according to the city census. This sub-study only comprised sexually active men. Data were collected using a self-administered questionnaire in the participants' homes. The sample was composed for 934 men. The prevalence of fatherhood in adolescence was 8% (n = 75). We verified higher prevalence of FA among those that reported paternal absence (p < 0.001), those that had lived with stepfather (p = 0.044), and among those that had sexual debut before the age of 14 (p = 0.011). Paternal absence, have lived with a stepfather, and early sexual experience are associated factors to fatherhood in adolescence. PMID:26602726

  15. 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

  16. Risk factors for suicidal thoughts in adolescence-a prospective cohort study: the Young-HUNT study

    PubMed Central

    Strandheim, Arve; Bjerkeset, Ottar; Gunnell, David; Bjørnelv, Sigrid; Holmen, Turid Lingaas; Bentzen, Niels

    2014-01-01

    Objectives Examining the associations between health and lifestyle factors recorded in the participants’ early teens and development of suicidal thoughts recorded 4 years later. Design Population-based prospective cohort study. Settings All students in the two relevant year classes in Nord-Trøndelag County were invited, 80% attended both waves of data collection. Participants 2399 secondary school students who participated in the Young-HUNT1 study in 1995–1997 (13–15 years old) were included in a follow-up study 4 years later (17–19 years old). Primary outcome measure Suicidal thoughts reported at age 17–19 years. Results 408 (17%, 95% CI 15.5% to 18.5%) of the adolescents reported suicidal thoughts at follow-up, 158 (14.2%, CI 13.6% to 16.4%) boys and 250 (19.5%, CI 18.8% to 22.0%) girls. Baseline anxiety and depressive symptoms (adjusted OR (aOR) 1.9, CI 1.4 to 2.6), conduct problems (aOR 1.8, CI 1.3 to 2.6), overweight (aOR 1.9 CI 1.4 to 2.4), and muscular pain and tension (aOR 1.8, CI 1.4 to 2.4), were all associated with reporting suicidal thoughts at follow-up. Conclusions One in six young adults experienced suicidal thoughts, girls predominating. Suicidal thoughts were most strongly associated with symptoms of anxiety/depression, conduct problems, pain/tension and overweight reported when participants were 13–15 years old. Specific preventive efforts in these groups might be indicated. Future research should investigate whether similar associations are seen with suicide/suicidal attempts as endpoints. PMID:25142264

  17. 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

  18. Parents and peer group as mediators of the effect of community structure on adolescent problem behavior.

    PubMed

    Simons, R L; Johnson, C; Beaman, J; Conger, R D; Whitbeck, L B

    1996-02-01

    Used a sample of 207 single-parent families residing in 104 small, Midwestern communities to test hypotheses regarding the link between community context and adolescent conduct problems and psychological distress. For boys, community disadvantage had a direct affect on psychological distress, while it indirectly boosted the probability of conduct problems by disrupting parenting and increasing affiliation with deviant peers. Community disadvantage was unrelated to the deviant behavior or emotional well-being of girls. Proportion of single-parent households in the community had a direct effect on girls' conduct problems. It also contributed indirectly to girls' conduct problems by increasing the probability of involvement with deviant peers. Possible explanations for these gender differences are provided. PMID:8712184

  19. 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

  20. 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

  1. Alteration in unhealthy nutrition behaviors in adolescents through community intervention: Isfahan Healthy Heart Program

    PubMed Central

    Mohammadifard, Noushin; Sarrafzadegan, Nizal; Ghassemi, Gholam Reza; Nouri, Fatemeh; Pashmi, Rezvan

    2013-01-01

    BACKGROUND Primary prevention of chronic diseases has been suggested to initiate health promotion activities from childhoods. The impact of Isfahan Healthy Heart Program (IHHP), a comprehensive community trial, on unhealthy snacks and fast food intake changes was evaluated in Iranian adolescents between 2001 and 2007. METHODS Healthy Heart Promotion from Childhood (HHPC) as one of the IHHP interventional projects was conducted in adolescents aged 11-18 years, selected randomly by multistage random sampling. Isfahan and Najafabad districts were intervention areas (IA) and Arak district was reference area (RA). The baseline and post-intervention surveys were conducted on 1941 and 1997 adolescents, respectively. Healthy lifestyle interventions were performed during the 2nd phase of the study targeting about 410000 students in urban and rural areas of the IA via education, environmental and legislation activities. Dietary intake was assessed annually using a fifty-item food frequency questionnaire in both communities. RESULTS The interaction of year×area demonstrated that the consumption of unhealthy snacks decreased significantly in middle school boys of RA compared to IA (P for interaction=0.01). However, middle school girls (P for interaction = 0.002) and both sexes of high school students in IA showed a significant reduction in fast food consumption against RA (P for interaction < 0.001). CONCLUSION The HHPC interventions made some improvement in fast food consumption. It did not show significant decrease regarding unhealthy snacks in adolescents. Proper and higher dose of interventions may be effective in achieving this goal. PMID:23696765

  2. Geospatial Ecology of Adolescent Problem Behavior: Contributions of Community Factors and Parental Monitoring

    PubMed Central

    Gartstein, Maria; Seamon, Erich; Dishion, Thomas J.

    2015-01-01

    Addressed the ecology of deviant peer involvement, antisocial behavior and alcohol use, utilizing publically available information for indices of community risk/protective factors. A geospatial model was developed, combining geographic data (census, crime proximity, race/ethnicity, transportation accessibility) with information gathered for individual adolescents/household, geo-coded by home address. Adolescent-report of delinquency, association with deviant peers, substance use, and parental monitoring was obtained, along with parent-report of demographic characteristics. Deviant peer involvement was predicted by the Crime Proximity Index, with closeness of crime being associated with more deviant peer affiliation, as well as the Transportation Index, with greater accessibility leading to more involvement with troubled peers. Antisocial behaviors also increased with greater access to transportation. Adolescent alcohol use was lower in communities with a higher proportion of a non-Caucasian population, and increased with greater transportation access. Adolescent outcomes were associated with different prediction models, yet parental monitoring emerged as a consistent contributing factor. PMID:25825548

  3. Dimensional psychotic experiences in adolescence: Evidence from a taxometric study of a community-based sample.

    PubMed

    Taylor, Mark J; Freeman, Daniel; Ronald, Angelica

    2016-07-30

    Psychotic experiences of varying severity levels are common in adolescence. It is not known whether beyond a certain severity in the general population, psychotic experiences represent a categorically distinct phenomena to milder psychotic experiences. We employed taxometric analytic procedures to determine whether psychotic experiences in adolescence are taxonic (i.e. categorical) or dimensional. Six different psychotic experiences were assessed in a community sample of approximately 5000 adolescents. Three taxometric procedures were conducted. Across all procedures, there was no evidence of a taxon (i.e. a separate latent population) underlying psychotic experiences in adolescence. Rather, a dimensional structure was supported. The results support the notion that psychotic experiences are continuously distributed throughout the general population, and there is no clear discontinuity between milder and more severe psychotic experiences. Thus, these findings support the use of dimensional approaches to understanding psychotic experiences in etiological studies. In clinical practice, categorical cut-offs are needed: the present findings show that a 'natural' break point is not present for identifying severe psychotic experiences, and it is likely therefore that other criteria (such as general functioning) might better aid decision-making with regards to identifying individuals with severe psychotic experiences in need of care during adolescence. PMID:27155285

  4. [The role of community-based public health services in child and adolescent health in Germany].

    PubMed

    Wegner, R E

    2005-10-01

    Children and adolescents increasingly show health-related problems which may not be considered as diseases to be treated but nevertheless severely affect academic performance and social behaviour. Regarding the consequences, e.g. from the PISA study, the significance of health problems and their negative impact on academic success are still not sufficiently taken into account. The tasks of paediatric public health services include: (1) health promotion in schools and kindergartens, (2) preventive and other medical checkups in kindergartens and schools to detect the individual needs of children and adolescents for support, (3) reducing the risk of long-term damage in handicapped or retarded children and adolescents by seeking out these children where necessary, and (4) advising the political decision makers by reporting on the population's health and social situation. The main aim is to provide children with special needs with what they need in order to prevent them, especially those whose parents cannot ensure this support themselves, developing a deeper disturbance, or to make sure that these young people are able to participate in social life and to integrate into society in spite of health problems or handicaps. To achieve these goals and to improve the health of children and adolescents, a community-based paediatric public health service has to cooperate with other institutions such as youth authorities, social welfare, education authorities, schools and other local institutions with an input into the health of children and adolescents. PMID:16179986

  5. Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

    PubMed Central

    Fazeli Farsani, Soulmaz; Souverein, Patrick C.; van der Vorst, Marja M. J.; Knibbe, Catherijne A. J.; de Boer, Anthonius

    2014-01-01

    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. PMID:24890584

  6. Community-based adolescent health services in Israel: from theory to practice.

    PubMed

    Wilf-Miron, Rachel; Sikron, Fabienne; Glasser, Saralee; Barell, Vita

    2002-01-01

    Despite their engagement in health-risk behaviors and their health-related concerns, adolescents have the lowest rate of health service utilization of any age group. Time constraints during routine medical encounters generally leave little opportunity for professional screening for health-risk behaviors or for discussing psychosocial problems. In addition, providers express low levels of perceived competency in areas such as sexuality, eating disorders or drug abuse. To address these needs, a walk-in Adolescent Health Service was established by the Sheba Medical Center to provide diagnosis and short-term treatment for individual adolescents, as well as counseling and support for local care providers. A three-way model of cooperation and partnership was developed and implemented. A professional and financial partnership with local authorities were established to help define the particular needs of the community's youth and to improve the ability to reach youth with special health needs. The partnership along with the main medical provider (Kupat Holim Clalit) helped define local health needs, served as a referral source of patients with unmet health needs, and improved the continuity of care. The regional medical center (Sheba Medical Center) provided supervision and consultation for the medical staff of the service, as well as a referral center for patients. It was emphasized that the service staff was intended as a professional source for the primary physician and should not be considered a rival. The core staff included a specialist in adolescent medicine, gynecologist, mental health specialist and social worker. A structured intake procedure was developed for assessing health concerns and problems of adolescents in the context of a community clinic. Findings from the first years of services showed that the first 547 female adolescents demonstrated that a majority of adolescents presented with primary complaints of a somatic nature, while one third were diagnosed

  7. 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

  8. High rate of lymphoma among a UK cohort of adolescents with vertically acquired HIV-1 infection transitioning to adult care in the era of antiretroviral therapy.

    PubMed

    Eades, Chris P; Herbert, Sophie A; Edwards, Simon G; Waters, Laura J; Peake, Tabitha; Miller, Robert F; Jungmann, Eva

    2016-01-01

    Among an inner London UK cohort of 147 adolescents transitioning from paediatric into adult care between 2007 and 2015, a new diagnosis of lymphoma was made in five patients; incidence rate = 0.425/100 person-years (95% confidence interval = 0.424-0.426). Previously described risk factors, including low nadir CD4 cell count and ongoing HIV-1 viraemia, appeared to be important. These data suggest that careful surveillance and a low threshold for investigating relevant symptoms continue to be essential for such patients. PMID:26558727

  9. 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

  10. Concurrent determinants of blood pressure among adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

    PubMed Central

    Menezes, Ana M. B.; Hallal, Pedro C.; Araújo, Cora Luiza; Barros, Fernando C.; Victora, Cesar G.

    2013-01-01

    The aim of this study was to evaluate concurrent risk factors for high blood pressure in adolescents. This is a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Blood pressure was measured before and after the interview, and the mean value was used in the analyses. Mean systolic blood pressure was 101.9mmHg (SD = 12.3) and mean diastolic pressure was 63.4mmHg (SD = 9.9). Adolescents with black skin had higher blood pressure than those with white skin. Mean systolic pressure among subjects in the top quartile of body mass index (BMI) was 11.6mmHg higher than among those in the lowest quartile. Mean systolic pressure among postmenarcheal girls was 5.4mmHg higher than among premenarcheal girls. Similar trends were found for diastolic arterial pressure. Our findings suggest that blood pressure control must begin already in childhood and adolescence. PMID:20963295

  11. 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

  12. 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…

  13. 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

  14. Increasing Community Independence for Adolescents with Spina Bifida.

    ERIC Educational Resources Information Center

    Sherman, Roberta G.; And Others

    1985-01-01

    Examined whether a community-based habilitation program focusing on normalization and individual goal setting was effective in enhancing levels of independence in teenagers with spina bifida. Subjects (N=14) participated in an eight-week summer program. Results suggested the program was effective with the greatest strength being support and…

  15. 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…

  16. 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. PMID:23159996

  17. Project Northland high school interventions: community action to reduce adolescent alcohol use.

    PubMed

    Perry, C L; Williams, C L; Komro, K A; Veblen-Mortenson, S; Forster, J L; Bernstein-Lachter, R; Pratt, L K; Dudovitz, B; Munson, K A; Farbakhsh, K; Finnegan, J; McGovern, P

    2000-02-01

    Project Northland is a randomized community trial initially implemented in 24 school districts and communities in northeastern Minnesota, with goals of delaying onset and reducing adolescent alcohol use using community-wide, multiyear, multiple interventions. The study targets the Class of 1998 from the 6th to 12th grades (1991-1998). The early adolescent phase of Project Northland has been completed, and reductions in the prevalence of alcohol use at the end of 8th grade were achieved. Phase II of Project Northland, targeting 11th- and 12th-grade students, uses five major strategies: (1) direct action community organizing methods to encourage citizens to reduce underage access to alcohol, (2) youth development involving high school students in youth action teams, (3) print media to support community organizing and youth action initiatives and communicate healthy norms about underage drinking (e.g., providing alcohol to minors is unacceptable), (4) parent education and involvement, and (5) a classroom-based curriculum for 11th-grade students. This article describes the background, design, implementation, and process measures of the intervention strategies for Phase II of Project Northland. PMID:10709791

  18. 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

  19. Maternal depression and adolescent behavior problems: an examination of mediation among immigrant Latino mothers and their adolescent children exposed to community violence.

    PubMed

    Aisenberg, Eugene; Trickett, Penelope K; Mennen, Ferol E; Saltzman, William; Zayas, Luis H

    2007-10-01

    This study examines the psychological and behavioral effects of exposure to community violence of 47 Latino mothers and their young adolescent children. Using data gathered from multiple sources, this study tests the associations between lifetime exposure to community violence, maternal depression, and child behavior problems. More than 80% of the youngsters ranging from age 11 to 14 years and 68% of the mothers reported being exposed to at least one act of community violence either as a victim or as a witness. Analyses reveal that maternal depression is a mediator of child behavior problems, reducing the direct effect of community violence exposure by more than 50%. Findings suggest that maternal depression is a factor more important than child's community violence exposure in contributing to young adolescents' behavioral problems. PMID:17766724

  20. 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. PMID:23011517

  1. 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

  2. Lifetime Prevalence and Characteristics of Child Sexual Victimization in a Community Sample of Spanish Adolescents.

    PubMed

    Pereda, Noemí; Abad, Judit; Guilera, Georgina

    2016-01-01

    The purpose of this study was to investigate the lifetime prevalence and characteristics of self-reported child sexual victimization and associations between sexual victimization and sociodemographic characteristics and victimological profiles in community adolescents in Spain. The Juvenile Victimization Questionnaire (Finkelhor, Hamby, Ormrod, & Turner, 2005) was applied to a sample of 1,105 community adolescents (M = 14.52 years, SD = 1.76). Experience of sexual victimization (with or without physical contact) was reported by 8.8% of the sample, at a mean age of 13 years old. Sexual victimization was more prevalent in girls (14.2%) and in older adolescents (10.6%). Offenders were mainly male (87.6%) and were mostly friends, neighbors, or schoolmates (52.6%). No injuries resulted from victimization (4.3%), although the percentage of penetration or attempted penetration was very high (30.6%). Only 9.3% of victims reported the incident to the police or the justice system. In regard to victimological profiles, sexual victims also experienced other forms of victimization (M = 7.16; SD = 3.39): boys reported more conventional crimes, peer and sibling victimization, and witnessing community violence than other victims, whereas sexually victimized girls reported more caregiver victimization and property crimes. Sexually victimized youth present a distinctive sociodemographic and victimological profile. Professionals need to be aware of these characteristics in order to conduct adequate prevention programs. We also need to assess a wide range of victimization experiences when treating sexual abuse victims in order to make adolescents less vulnerable to violence. PMID:26849005

  3. A Longitudinal Assessment of an Initial Cohort in a Psychology Learning Community

    ERIC Educational Resources Information Center

    Buch, Kim; Spaulding, Sue

    2008-01-01

    Discipline-based learning communities have become a popular strategy for improving student performance and satisfaction. This article describes the goals and features of a university-based, first-year psychology learning community (PLC) implemented in Fall 2003. We also report the results of a longitudinal assessment of the impact of the PLC on…

  4. Evolution of blood pressure from adolescents to youth in salt sensitivies: a 18-year follow-up study in Hanzhong children cohort

    PubMed Central

    2012-01-01

    Background Essential hypertension mostly originates from children. Salt Sensitivity (SS) is regarded as the intermediate phenotype of essential hypertension. The present study investigated the effects of salt-sensitivity on evolution of blood pressure (BP) and development to hypertension from adolescents to youth. Methods A baseline survey was carried out in 4,623 adolescents aged 6-15 years old in Hanzhong rural areas in 1987, 310 of whom(mean 9.2 years) were randomly recruited for determination of salt sensitivity using the tests of oral saline load and furosemide sodium-volume depletion. SS was diagnosed in 101 subjects while 209 were determined as non-salt-sensitive (NSS). We made a 18-year followed-up of the cohort in 2005. Results The response rate for surviving baseline adolescents was 71.9%. At follow up, BP in youth with baseline SS was higher than that in NSS (SBP:122.9 ± 13.1 VS 117.3 ± 12.4, P < 0.01; DBP: 78.2 ± 10.4 VS 74.7 ± 10.8, P < 0.05). Longitudinal analysis of 18-year BP evolution, subjects in SS had greater Systolic BP change than subjects in NSS(19.6 ± 12.714.7 ± 12.2, P < 0.01). The incidence of hypertension in salt sensitive group was higher than that in NSS group (15.5% VS 6.3%, RR = 2.34, P < 0.05). Conclusion Our findings indicate that adolescents with higher BP salt-sensitivity have a higher rate of incident hypertension in youth. Salt sensitivity could be at high risk predisposing to development of hypertension from adolescents to youth. PMID:22978814

  5. 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

  6. 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. PMID:26872478

  7. 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

  8. 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…

  9. 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.…

  10. 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…

  11. Witnessed Community and Parental Violence in Relation to Substance Use and Delinquency in a National Sample of Adolescents

    PubMed Central

    Zinzow, Heidi M.; Ruggiero, Kenneth J.; Hanson, Rochelle F.; Smith, Daniel W.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2009-01-01

    This study examined whether witnessed community and parental violence represented risk factors for substance use and delinquency among adolescents, beyond the contribution of direct violence and other risk factors. We also examined the role of violence characteristics. Participants were a national sample of 3,614 adolescents. Structured telephone interviews assessed demographics, trauma history, witnessed violence, delinquency, and substance use. While accounting for trauma history and other risk factors, witnessed community and parental violence were associated with delinquency. Community violence was associated with substance use. Chronic violence, knowing the perpetrator, and violence outside of school were correlated with substance use and delinquency among adolescents who witnessed community violence. These findings highlight the importance of targeting witnessed violence in prevention and intervention efforts. PMID:19885872

  12. Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV.

    PubMed

    Burke-Miller, Jane K; Weber, Kathleen; Cohn, Susan E; Hershow, Ronald C; Sha, Beverly E; French, Audrey L; Cohen, Mardge H

    2016-10-01

    Recent studies have found geographic variations in immune and viral human immunodeficiency virus (HIV) disease outcomes associated with census measures of neighborhood poverty and segregation. Although readily available, such aggregate census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multi-dimensional survey measures were related to each other and to census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women's CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression, and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor-quality built environment) and one census measure (racial segregation) were significantly associated with greater likelihood of CD4 < 500 (p < .05). PMID:27098593

  13. 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

  14. Social Impairment in the "Care in the Community" Cohort: The Effect of Deinstitutionalization and Changes over Time in the Community.

    ERIC Educational Resources Information Center

    Beadle-Brown, Julie; Forrester-Jones, Rachel

    2003-01-01

    A longitudinal study involving 250 adults who had been institutionalized found that once they moved into the community, social impairment did not change over time, although there was a significant decrease in conversation and social mixing, non-verbal communication, and initiation of conversation and social interaction. (Contains references.) (CR)

  15. 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…

  16. Factors Associated with Insulin Resistance among Children and Adolescents Perinatally Infected with HIV-1 in the Pediatric HIV/AIDS Cohort Study

    PubMed Central

    Geffner, Mitchell E.; Patel, Kunjal; Miller, Tracie L.; Hazra, Rohan; Silio, Margarita; Van Dyke, Russell B.; Borkowsky, William; Worrell, Carol; DiMeglio, Linda A.; Jacobson, Denise L.

    2011-01-01

    Background/Aims: Because of prior inconsistent findings, we studied a large cohort of HIV-infected children to determine: (1) prevalence of insulin resistance (IR); (2) anthropometric and clinical correlates of IR, and (3) concomitant abnormalities of glucose tolerance. Methods The study population consisted of 451 children from the Pediatric HIV/AIDS Cohort Study. The outcome of interest was HOMA-IR. Covariates included demographic, metabolic, growth, body composition, HIV laboratory tests, and treatment characteristics. Children meeting triggers for IR underwent oral glucose tolerance tests and hemoglobin A1c (HbA1c) measurements. Results Among 402 children with glucose and insulin measurements, 15.2% had IR of whom 79% were pubertal. IR was associated with higher alanine aminotransferase, body mass index, and nadir CD4%, Tanner stage 5, and ever having received amprenavir. Of those with IR, three had impaired fasting glucose (IFG), three impaired glucose tolerance (IGT), one IFG and IGT, none diabetic glucose tolerance, and three HbA1c between 6.1 and 6.5%. Conclusion In our cohort of HIV-infected adolescents, we observed a 15.2% prevalence of IR more closely linked to obesity than any other variable. This finding mirrors the high prevalence of obesity-mediated IR in American youth. However, associations with CD4 count and use of protease inhibitors may indicate some effect of HIV and/or its treatment. PMID:22042056

  17. Parental coping with developmental disorders in adolescents within the ultraorthodox Jewish community in Israel.

    PubMed

    Manor-Binyamini, Iris

    2012-05-01

    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 higher sense of growth and a higher sense of coherence than the secular parents. In addition, there were associations found between demographic characteristics. Gender differences between mothers and fathers in the sense of growth and community differences between ultraorthodox fathers and secular fathers in the sense of coherence are discussed. The study highlights the uniqueness of the religious point of view in dealing with adolescent children with developmental disorders. PMID:21695559

  18. 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

  19. Utilization of mental health services among adolescents in community-based substance abuse outpatient clinics.

    PubMed

    Chan, Ya-Fen; Godley, Mark D; Godley, Susan H; Dennis, Michael L

    2009-01-01

    This study examined the rates and correlates of self-reported receipt for mental health services among 1,190 adolescents, aged 12-19, who were admitted to community-based substance abuse outpatient clinics and had a co-occurring mental health problem. Utilization of mental health service was ascertained 3 months post-intake. About one third (35%) of adolescents with a co-occurring mental health problem identified at intake received mental health service in the 3 months after treatment entry. After holding other correlates constant, history of mental health treatment, suicidal behavior, family history of mental disorder and insurance coverage at intake were associated with mental health service utilization at the 3-month follow up. Predictors of service utilization varied by gender and racial/ethnic status. Implications for integrated substance use and mental health services are discussed. PMID:18157641

  20. Social Patterning in Adiposity in Adolescence: Prospective Observations from the Chinese Birth Cohort ‘‘Children of 1997’’

    PubMed Central

    Hui, L. L.; Leung, Gabriel M.; Schooling, C. Mary

    2016-01-01

    Introduction Low early life socio-economic position is more strongly associated with adiposity among women than men. We examined whether the sex difference of social patterning in general and central adiposity exists before adulthood. Methods In Hong Kong’s “Children of 1997” birth cohort, we used multivariable regression to examine the association of parental education, a marker of early life socio-economic position, with body mass index (BMI) (n = 7252, 88% follow-up) and waist-height ratio (n = 5636, 68% follow-up), at 14 years. Results Parental education of Grade 9 or below, compared to Grade 12 or above, was associated with higher waist-height ratio z-score particularly in girls (0.30, 95% confidence interval (CI) 0.19, 0.41) compared to boys (0.12, 95% CI 0.02, 0.22) (p for sex interaction = 0.02). Lower parental education was associated with greater BMI z-score in adolescents of locally born mothers, but not adolescents of migrant mothers, with no difference by sex. Conclusions Different social patterning in different markers of adiposity may imply different sociological and biological mediating pathways. A stronger association between low early life socio-economic position and waist-height ratio in adolescent girls may indicate sex-specific influences of SEP related early life exposures on central adiposity. PMID:26735134

  1. The Relationship Between Developmental Assets and Food Security In Adolescents From A Low-Income Community

    PubMed Central

    Shtasel-Gottlieb, Zoë; Palakshappa, Deepak; Yang, Fanyu; Goodman, Elizabeth

    2014-01-01

    Purpose To explore the association between developmental assets (characteristics, experiences, and relationships that shape healthy development) and food insecurity among adolescents from a low-income, urban community. Methods This mixed methods study occurred in two phases. In Phase 1, using a census approach, 2350 6-12th graders from the public school district completed an anonymous survey that included the Development Assets Profile (DAP), youth self-report form of the Core Food Security Module, and demographic questions. Logistic and multinomial regression analyses determined independent associations between developmental assets and food security adjusting for demographics. In Phase 2, 20 adult key informant interviews and four semi-structured student focus groups were performed to explain findings from Phase 1. Results On average, DAP scores were consistent with national norms. Food insecurity was prevalent; 14.9% reported low food security and 8.6% very low food security (VLFS). Logistic regression revealed that higher DAP was associated with lower odds of food insecurity (OR=.96, 95% CI=.95-.97); family assets drove this association(OR=.93, 95% CI=.91-.95). In multinomial regression modeling, these associations persisted and, paradoxically, higher community assets were also associated with VLFS (ORVLFS=1.08, 95% CI=1.04-1.13). Qualitative analyses suggested that greater need among VLFS youth led to increased connections to community resources despite barriers to access such as stigma, home instability, and cultural differences. Conclusion Food insecurity is a pervasive problem among adolescents from low-income communities and is associated with lower developmental assets, particularly family assets. That community assets were higher among VLFS youth underscores the importance of community-level resources in struggling areas. PMID:25620305

  2. Social change in adolescent sexual behavior, mate selection, and premarital pregnancy rates in a Kikuyu community.

    PubMed

    Worthman, C M; Whiting, J W

    1987-06-01

    This report documents an example of interactions of cultural change with adolescent fertility and marriage patterns in an East African community. Between 1950 and 1980 the rate of unwed motherhood in Ngeca, Kenya, showed a marked increase from 0% in the 1940s to 11.4% in the 1960s. The authors present evidence of recent changes in Kikuyu culture that may account for this change. Traditional Kikuyu culture structured adolescence through status and role changes bounded and reinforced by ritual and instruction. Abandonment of traditional initiation rites and attenuation of the age-set system have most markedly altered the structure of adolescent experience by shifting the content and context of socialization. Major agents for change in this process have been the school, church, and modern economy. Responsibility for mate selection has remained with young people, but the determinants of partner desirability and gender ratios in partner availability have shifted considerably. Traditional criteria of male desirability included ability to pay bridewealth and to provide the wife with land; diligence and demeanor measured female attractiveness. At present, education and wage earning capacity affect partner attractiveness of each sex. The decline of polygyny has both shifted the balance of competition for spouses toward females, and has had significant repercussions in the marital and reproductive histories of males. Decreases in brideprice and reversals in direction of transfers of wealth at marriage are tangible signs of change in the marriage market. Deritualization of genital operations and attendant weakening of the age-set system have interrupted the flow of information on sex behavior and reproduction, controlled physical intimacy, and partner selection reinforced by peer pressure. Denial of contraception, the continued importance of marriage and fertility, and ambivalence toward sexual activity in adolescence all support adolescent sexual experimentation and

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. Effectiveness of very low-cost contingency management in a community adolescent treatment program.

    PubMed

    Lott, David C; Jencius, Simon

    2009-06-01

    Controlled studies have shown that motivational incentives reduce drug use, but community implementation has been limited. This observational study examines the effect of a contingency management (CM) program on urine, attendance, and cost measures in a community substance abuse treatment program for adolescents. Treatment included elements of 12-step facilitation, cognitive behavioral therapy, and motivational enhancement. All urine tests included cannabinoids, opioids, benzodiazepines, cocaine, and amphetamines. Patients with negative urines or perfect attendance earned chances to draw weekly from a bag for prizes of varying value, and the number of draws increased with each consecutive negative urine test. Data were collected for those patients (age 12-18) treated immediately before (n=83) and after (n=264) the CM program was introduced to the treatment center, and positive urine rates were compared using chi-square tests. Patients treated with the CM program had lower rates of urines positive for opioids (p<0.005) and cocaine (p<0.05), and non-significantly but consistently lower rates of urines positive for all other drug classes. Altogether, the proportion of urines positive for any drug decreased from 33.3% to 23.4% (p<0.01). Pre- and post-CM comparisons of attendance reveal lower daily attendance rates but longer retention in treatment. Expenses were minimal at $0.39 per patient per day. These data yield additional evidence for the feasibility and effectiveness of CM methods in community adolescent treatment programs. PMID:19250774

  9. 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. PMID:27152056

  10. 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

  11. Behavioral and Community Correlates of Adolescent Pregnancy and Chlamydia Rates in Rural Counties in Minnesota1

    PubMed Central

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

    2014-01-01

    Purpose 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. Methods 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. Findings 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. Conclusions 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

  12. 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

  13. 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. PMID:25465319

  14. Perceptions of parents on how religion influences adolescents' sexual behaviours in two Ghanaian communities: implications for HIV and AIDS prevention.

    PubMed

    Osafo, Joseph; Asampong, Emmanuel; Langmagne, Sussan; Ahiedeke, Clement

    2014-08-01

    To understand the role of religion in the sexual behaviours of adolescents, the views of parents who are key agents of socialization were examined from two south-eastern communities in Ghana. Focus Group interviews were conducted with mothers (and female caregivers) of adolescents and one with fathers (and male caregivers) of adolescents. Thematic analysis was used to analyse the data. Findings indicated that parents from one community perceived religion as playing a double-edged role in adolescents' sexual behaviours as on one hand it played a protective role by restraining adolescents from risky sexual behaviours; on the other hand it disparaged the existing traditional measures that regulated adolescents' sexual behaviour. However, parents from the other community found a collaborative interface between the existing social control measures-communal socialization and proscriptive morality with religious ethics. Religious socialization, social capital theory and the concept of social suffering are used to explain some of the findings of this study. Implications for HIV and AIDS education and prevention are also discussed. PMID:23440475

  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 Central

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

    2016-01-01

    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. PMID:26890854

  17. 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

    2016-02-01

    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. PMID:26890854

  18. A Student Outcomes Typology for Community Colleges: Identifying Achievers with Longitudinal Cohort Analysis.

    ERIC Educational Resources Information Center

    Boughan, Karl; Clagett, Craig A.

    A study was conducted by Prince George's Community College, in Maryland, to determine outcomes after 4 years for the 2,643 first-time students who entered the college in fall 1990. The analysis was based on an outcomes typology developed at the college which defines outcomes as award and transfer; transfer without an award; award without transfer;…

  19. 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

  20. Help-Seeking and Internal Obstacles to Receiving Support in the Wake of Community Violence Exposure: The Case of Arab and Jewish Adolescents in Israel

    ERIC Educational Resources Information Center

    Guterman, Neil B.; Haj-Yahia, Muhammad M.; Vorhies, Vanessa; Ismayilova, Leyla; Leshem, Becky

    2010-01-01

    We examined help-seeking and internal obstacles to receiving psychosocial support in the wake of community violence exposure in a sample of 1,835 Arab and Jewish adolescents living in Israel. Paper and pencil surveys conducted in schools examined adolescents' personal victimization and witnessing of community violence in the past year, and then…

  1. Associations between mothers' and children's secure base scripts in ADHD and community cohorts.

    PubMed

    Guttmann-Steinmetz, Sarit; Crowell, Judy; Doron, Guy; Mikulincer, Mario

    2011-11-01

    This study explored the relation between mothers' and their children's secure base scripts in two samples of school-aged children: a community sample (N = 29; mean age 8.9) and a sample of children diagnosed with ADHD (N = 50; mean age 8.9). Using the Attachment Script Representation Task, mothers and children were asked to construct narratives using word prompt outlines. In addition, mothers and children completed questionnaires focusing on symptoms. The results revealed that while the link between mothers' and children's scriptedness was significant in the community, no significant association was found in the ADHD sample. In the ADHD group, maternal reports of children's symptoms were negatively linked to children's secure-base scriptedness. Implications of these findings for theory and intervention are discussed. PMID:22011102

  2. 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

  3. The Association between Participation of Adolescents in Community Groups and Dental Caries in a Deprived Area in Brazil.

    PubMed

    de Araújo Teixeira Silva, Catarina; Rebelo Vieira, Janete Maria; Rebelo, Maria Augusta Bessa; Vettore, Mario Vianna

    2015-01-01

    There is limited evidence concerning the role of social networks on the oral health of adolescents. This study assessed the association between the participation of adolescents in community groups and dental caries. A cross-sectional household-based study was carried out involving 200 subjects aged 15-19 years living in a deprived area in the state of Amazon, Brazil. Dental caries was assessed through dental examinations using the DMFT index conducted by a single examiner who was previously calibrated. Four dental caries outcomes were investigated, including caries experience (DMFT score), current caries (number of current decayed teeth), missing teeth due to caries, and the care index (ratio between number of filled teeth and DMFT score). Details of participation of adolescents in community groups, demographic and socioeconomic data and information on dental visiting were obtained through individual interviews. All caries measures were significantly higher in adolescents who did not participate in community groups compared to their counterparts. Multivariate Poisson regression showed that participation of adolescents in community groups was independently associated with all dental caries outcomes. After adjusting for confounders, participation in community groups was statistically associated with lower DMFT score (ratio of mean, RM: 0.33, 95% CI: 0.24-0.46), fewer decayed teeth (RM: 0.23, 95% CI: 0.11-0.47), fewer missing teeth (RM: 0.28, 95% CI: 0.17-0.47), and higher care index (RM: 1.69, 95% CI: 1.24-2.29) than those who did not participate. Participation of adolescents in community activities was related to lower levels of dental caries. PMID:26346951

  4. The effect of dietary antioxidant on the COPD risk: the community-based KoGES (Ansan–Anseong) cohort

    PubMed Central

    Joshi, Pankaj; Kim, Woo Jin; Lee, Sang-Ah

    2015-01-01

    Background Dietary antioxidants have been suggested to have protective role against chronic obstructive pulmonary disease (COPD), but few prospective studies examined this relationship. The prospective study was conducted to evaluate the effect of dietary antioxidants on COPD risk and lung function in the Korean population. Methods The data were collected from the community-based Korean Genome Epidemiology Study (KoGES) cohort. To diagnose COPD, forced expiratory volume (FEV1) and forced vital capacity (FVC) were measured by spirometry. The dietary intake of antioxidant vitamins was estimated from validated Food-Frequency Questionnaire. For the analysis, 325 COPD patients and 6,781 at risk subjects were selected from the cohort of 10,038 subjects. Multiple logistic regression models were used to examine the odds ratio (OR) after adjusting for age, sex, marital status, income, history of asthma, history of tuberculosis, and smoking. Results The risk of COPD was positively associated with aging, low education, low household income, lower body mass index, and cigarette smoking. The risk of COPD decreased with increase in the dietary vitamin C (ORQ1 vs Q5=0.66, Ptrend=0.03) and vitamin E (ORQ1 vs Q5=0.56, Ptrend=0.05) intake, predominantly, in men (Ptrend=0.01 and 0.05 for vitamins C and E, respectively). In addition, the lung function was significantly improved with increase in vitamins C (FEV1, P=0.04; FVC, P=0.03) and E (FEV1, P=0.03; FVC, P=0.04) intake. No statistically significant interactions were observed between smoking and vitamin C or E intake in relation to COPD risk among men. Conclusion Our results suggest the independent beneficial effect of antioxidants, particularly vitamins C and E, on COPD risk and lung function in men. PMID:26504380

  5. Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample

    PubMed Central

    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 ages 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 ADHD criteria were matched with demographically similar low risk peers (n=163). Outcomes domains included symptoms; functional impairment; quality of life; substance use; educational outcomes; and juvenile justice involvement. Results 44% of youths with childhood ADHD had not experienced remission. Compared to unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (OR=12.9; 95% CI 5.6-30.0), anxiety/depression (OR=10.3; 95% CI 2.7-39.3), significant functional impairment (OR=3.4; 95% CI 1.7-6.9), reduced quality of life (OR=2.5, 95% CI 1.3-4.7), and to have been involved with juvenile justice (OR=3.1; 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty. Conclusions ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions, yet increase the risk for adverse educational outcomes. Findings stress the importance of early ADHD recognition, especially its comorbid presentation with ODD, for prevention and intervention strategies. PMID:20494269

  6. 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

  7. 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

  8. Menopause Effects on Verbal Memory: Findings From a Longitudinal Community Cohort

    PubMed Central

    Sammel, Mary D.; Freeman, Ellen W.

    2013-01-01

    Context: Although cognitive complaints are common among menopausal women, it is debatable whether there is an objective decline in cognition with menopause that exceeds what is expected with normal aging. Objective: The objective of the study was to determine whether reproductive senescence is associated with an age-independent decline in verbal memory. Design and Setting: The study was a 14-year, longitudinal, population-based cohort study of women who underwent yearly endocrine, behavioral, and cognitive assessments from pre- to postmenopause. Participants: Caucasian and African American premenopausal women (n = 403), who were enrolled in the Penn Ovarian Aging Study, participated in the study. Main Outcome Measures: Buschke Selective Reminding Test (immediate and delayed verbal recall), the digit symbol substitution task, and the symbol copy task were used to measure outcomes. Results: A total of 3958 assessments were conducted in this sample of 403 women. In models that were adjusted for age and important cofactors, immediate (P = .03) and delayed (P = .03) recall on the Buschke Selective Reminding Test declined from the pre- to postmenopausal stages. Further evaluation identified a significant decline (P < .002) in delayed recall early in the transition and immediate recall (P = .04) late in the transition. Race was a significant factor in performance on all tasks (all P < .0001) except the delayed verbal recall task (P = .06) in adjusted models. Endocrine measures were significantly associated with cognitive performance in unadjusted models. Conclusions: Certain cognitive domains are sensitive to the physiological changes of reproductive senescence independent of age. The differences in cognitive performance between African American and Caucasian women were not explained by factors examined in this study but are of important public health concern that warrants further investigation. PMID:23836935

  9. 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. PMID:17659936

  10. Childhood and adolescent predictors of leisure time physical activity during the transition from adolescence to adulthood: a population based cohort study

    PubMed Central

    2011-01-01

    Background Few studies have investigated factors that influence physical activity behavior during the transition from adolescence to adulthood. This study explores the associations of sociodemographic, behavioral, sociocultural, attitudinal and physical factors measured in childhood and adolescence with physical activity behavior during the transition from adolescence to adulthood. Methods Childhood and adolescent data (at ages 7-15 years) were collected as part of the 1985 Australian Health and Fitness Survey and subdivided into sociodemographics (socioeconomic status, parental education), behavioral (smoking, alcohol, sports diversity, outside school sports), sociocultural (active father, active mother, any older siblings, any younger siblings, language spoken at home), attitudinal (sports/recreational competency, self-rated health, enjoyment physical education/physical activity, not enjoying school sports) and physical (BMI, time taken to run 1.6 km, long jump) factors. Physical activity between the ages 15 and 29 years was reported retrospectively using the Historical Leisure Activity Questionnaire at follow-up in 2004-2006 by 2,048 participants in the Childhood Determinants of Adult Health Study (CDAH). Australia's physical activity recommendations for children and adults were used to categorize participants as persistently active, variably active or persistently inactive during the transition from adolescence to adulthood. Results For females, perceived sports competency in childhood and adolescence was significantly associated with being persistently active (RR = 1.88, 95% CI = 1.39, 2.55). Smoking (RR = 0.31 CI = 0.12, 0.82) and having younger siblings (RR = 0.69 CI = 0.52, 0.93) were inversely associated with being persistently active after taking physical and attitudinal factors into account. For males, playing sport outside school (RR = 1.47 CI = 1.05, 2.08), having active fathers (RR = 1.25 CI = 1.01, 1.54) and not enjoying school sport (RR = 4.07 CI

  11. 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

  12. State of personal hygiene among primary school children: A community based cohort study

    PubMed Central

    Ahmadu, Baba Usman; Rimamchika, Musa; Ibrahim, Ahmad; Nnanubumom, Andy Angela; Godiya, Andrew; Emmanuel, Pembi

    2013-01-01

    Good personal hygiene in primary school children could be effective towards preventing infectious diseases. This work examined personal cleanliness of primary school children in Banki based on the following variables: bathing, state of uniforms, hair, nails and oral hygiene. One hundred and fifty primary school children in Banki community were selected using the cluster random sampling method. Analysis of variance was used to compare means and to test for significance of data, and coefficient of correlation to investigate the relationship between cleanliness and age of subjects. There were 87 (58 %) boys and 63 (42 %) girls in a ratio of 1.4:1. Ninety six (64 %) pupils belong to low socioeconomic class. Whereas, 53 (35.3 %) were found within 11–13 years age group, the overall mean age was 9 years (Standard deviation [SD] was 2.2), 95 CI (7.0 – 11.0) years. Comparing means for the different categories of personal hygiene, there was significant difference (F= 61.47, p < 0.0001). General personal cleanliness in our participants improved with age, and a positive significant correlation was observed between age and personal cleanliness in (r = 0.971, p = 0.026). In conclusion, significant number of primary school pupils in Banki community had good personal hygiene, which was observed to be directly proportional with age. Therefore, all efforts towards quality health education on personal hygiene as a means of primary prevention of illnesses in primary school pupils should be sustained. PMID:27493356

  13. 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

  14. Direct and Indirect Effects of Caregiver Social Support on Adolescent Psychological Outcomes in Two South African AIDS-Affected Communities.

    PubMed

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

    2015-06-01

    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 2,477 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

  15. 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

  16. 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

  17. 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

  18. Identifying community risk factors for HIV among South African adolescents with mental health problems: a qualitative study of parental perceptions.

    PubMed

    Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky

    2014-01-01

    High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services. PMID:25533404

  19. Evaluation of e-mail contact to conduct follow-up among adolescent women participating in a longitudinal cohort study of contraceptive use☆

    PubMed Central

    Haider, Sadia; Dodge, Laura E.; Brown, Beth A.; Hacker, Michele R.; Raine, Tina R.

    2013-01-01

    Background The purpose of this study was to determine whether e-mail contact is a viable method for gathering information from adolescent women about contraceptive use. Study design Adolescent women initiating contraception followed in a prospective longitudinal cohort study and who had access to the Internet were randomized to the control or intervention arm and were contacted at 3, 6 and 12 months after enrollment. The control arm completed follow-up surveys in-person or by telephone. The intervention arm received Web-based surveys via e-mail. Results There were 46 women in each group. Women in both groups were approximately 20 years old, were sexually active minority women, and were in school or employed. While participants in the intervention group initially had lower response rates than those in the control group (59% vs. 91%, respectively), with the addition of traditional follow-up methods, the overall response rates were comparable (94% vs. 91%, respectively). Conclusions E-mail follow-up with Web-based surveys was effective amongst adolescent women at risk for unintended pregnancy. This indicates that e-mail contact could be used as a preliminary follow-up strategy to capture a substantial proportion of participants and that standard follow-up can be used as a second-line approach. A two-pronged approach with initial e-mail contact and traditional follow-up for participants who do not respond may be a viable method when evaluating sensitive areas such as contraceptive use. PMID:23290427

  20. 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

  1. 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…

  2. Evaluation of Community-Level Effects of Communities That Care on Adolescent Drug Use and Delinquency Using a Repeated Cross-Sectional Design.

    PubMed

    Rhew, Isaac C; Hawkins, J David; Murray, David M; Fagan, Abigail A; Oesterle, Sabrina; Abbott, Robert D; Catalano, Richard F

    2016-02-01

    The Communities That Care (CTC) prevention system has shown effects on reducing incidence and prevalence of problem behaviors among a panel of youth followed from 5th through 12th grade. The present report examines whether similar intervention effects could be observed using a repeated cross-sectional design in the same study. Data were from a community-randomized trial of 24 US towns. Cross-sectional samples of sixth, eighth, and tenth graders were surveyed at four waves. Two-stage ANCOVA analyses estimated differences between CTC and control communities in community-level prevalence of problem behaviors for each grade, adjusting for baseline prevalence. No statistically significant reductions in prevalence of problem behaviors were observed at any grade in CTC compared to control communities. Secondary analyses examined intervention effects within a “pseudo cohort” where cross-sectional data were used from sixth graders at baseline and tenth graders 4 years later. When examining effects within the pseudo cohort, CTC compared to control communities showed a significantly slower increase from sixth to tenth grade in lifetime smokeless tobacco use but not for other outcomes. Exploratory analyses showed significantly slower increases in lifetime problem behaviors within the pseudo cohort for CTC communities with high, but not low, prevention program saturation compared to control communities. Although CTC demonstrated effects in a longitudinal panel from the same community-randomized trial, we did not find similar effects on problem behaviors using a repeated cross-sectional design. These differences may be due to a reduced ability to detect effects because of potential cohort effects, accretion of those who were not exposed, and attrition of those who were exposed to CTC programming in the repeated cross-sectional sample. PMID:26462492

  3. 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…

  4. Long-term effectiveness of the community-based Complete Health Improvement Program (CHIP) lifestyle intervention: a cohort study

    PubMed Central

    Kent, Lillian; Morton, Darren; Hurlow, Trevor; Rankin, Paul; Hanna, Althea; Diehl, Hans

    2013-01-01

    Objective To examine the long-term (three or more years) effectiveness of the volunteer-delivered Complete Health Improvement Program (CHIP) intervention. Design Cohort study. Setting Hawera, New Zealand. Participants Of the total cohort of 284 individuals who self-selected to complete the CHIP lifestyle intervention between 2007 and 2009, 106 (37% of the original cohort, mean age=64.9±7.4 years, range 42–87 years; 35% males, 65% female) returned in 2012 for a complimentary follow-up health assessment (mean follow-up duration=49.2+10.4 months). Intervention 30-day lifestyle modification programme (diet, physical activity, substance use and stress management) delivered by volunteers in a community setting. Main outcome measures Changes in body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG). Results After approximately 4 years, participants with elevated biometrics at programme entry maintained significantly lowered BMI (−3.2%; 34.8±5.4 vs 33.7±5.3 kg/m2, p=0.02), DBP (−9.4%; 89.1±4.1 vs 80.8±12.6 mm Hg, p=0.005), TC (−5.5%; 6.1±0.7 vs 5.8±1.0 mmol/L, p=0.04) and TG (−27.5%; 2.4±0.8 vs 1.7±0.7 mmol/L, p=0.002). SBP, HDL, LDL and FPG were not significantly different from baseline. Participants with elevated baseline biometrics who reported being compliant to the lifestyle principles promoted in the intervention (N=71, 67% of follow-up participants) recorded further reductions in BMI (−4.2%; 34.8±4.5 vs 33.4±4.8 kg/m2, p=0.02), DBP (−13.3%; 88.3±3.2 vs 77.1±12.1 mm Hg, p=0.005) and FPG (−10.4%; 7.0±1.5 vs 6.3±1.3 mmol/L, p=0.02). Conclusions Individuals who returned for follow-up assessment and entered the CHIP lifestyle intervention with elevated risk factors were able to maintain improvements in most biometrics for more than 3

  5. 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…

  6. Poor Outcomes in a Cohort of HIV-Infected Adolescents Undergoing Treatment for Multidrug-Resistant Tuberculosis in Mumbai, India

    PubMed Central

    Isaakidis, Petros; Paryani, Roma; Khan, Samsuddin; Mansoor, Homa; Manglani, Mamta; Valiyakath, Asmaa; Saranchuk, Peter; Furin, Jennifer

    2013-01-01

    Background Little is known about the treatment of multidrug-resistant tuberculosis (MDR-TB) in HIV-co-infected adolescents. This study aimed to present the intermediate outcomes of HIV-infected adolescents aged 10–19 years receiving second-line anti-TB treatment in a Médecins Sans Frontières (MSF) project in Mumbai, India. Methods A retrospective review of medical records of 11 adolescents enrolled between July 2007 and January 2013 was undertaken. Patients were initiated on either empirical or individualized second-line ambulatory anti-TB treatment under direct observation. Results The median age was 16 (IQR 14–18) years and 54% were female. Five (46%) adolescents had pulmonary TB (PTB), two (18%) extrapulmonary disease (EPTB) and four (36%) had both. Median CD4 count at the time of MDR-TB diagnosis was 162.7 cells/µl (IQR: 84.8–250.5). By January 2013, eight patients had final and 3 had interim outcomes. Favourable results were seen in four (36.5%) patients: one was cured and three were still on treatment with negative culture results. Seven patients (64%) had poor outcomes: four (36.5%) died and three (27%) defaulted. Three of the patients who died never started on antiretroviral and/or TB treatment and one died 16 days after treatment initiation. Two of the defaulted died soon after default. All patients (100%) on-treatment experienced adverse events (AEs): two required permanent discontinuation of the culprit drug and two were hospitalized due to AEs. No patient required permanent discontinuation of the entire second-line TB or antiretroviral regimens. Conclusions Early mortality and mortality after default were the most common reasons for poor outcomes in this study. Early mortality suggests the need for rapid diagnosis and prompt treatment initiation, and adolescents might benefit from active contact-tracing and immediate referral. Default occurred at different times, suggesting the need for continuous, intensified and individualized psychosocial

  7. The spatial association between community air pollution and mortality: a new method of analyzing correlated geographic cohort data.

    PubMed Central

    Burnett, R; Ma, R; Jerrett, M; Goldberg, M S; Cakmak, S; Pope, C A; Krewski, D

    2001-01-01

    We present a new statistical model for linking spatial variation in ambient air pollution to mortality. The model incorporates risk factors measured at the individual level, such as smoking, and at the spatial level, such as air pollution. We demonstrate that the spatial autocorrelation in community mortality rates, an indication of not fully characterizing potentially confounding risk factors to the air pollution-mortality association, can be accounted for through the inclusion of location in the model assessing the effects of air pollution on mortality. Our methods are illustrated with an analysis of the American Cancer Society cohort to determine whether all cause mortality is associated with concentrations of sulfate particles. The relative risk associated with a 4.2 microg/m(3) interquartile range of sulfate distribution for all causes of death was 1.051 (95% confidence interval 1.036-1.066) based on the Cox proportional hazards survival model, assuming subjects were statistically independent. Inclusion of community-based random effects yielded a relative risk of 1.055 (1.033, 1.077), which represented a doubling in the residual variance compared to that estimated by the Cox model. Residuals from the random-effects model displayed strong evidence of spatial autocorrelation (p = 0.0052). Further inclusion of a location surface reduced the sulfate relative risk and the evidence for autocorrelation as the complexity of the location surface increased, with a range in relative risks of 1.055-1.035. We conclude that these data display both extravariation and spatial autocorrelation, characteristics not captured by the Cox survival model. Failure to account for extravariation and spatial autocorrelation can lead to an understatement of the uncertainty of the air pollution association with mortality. PMID:11427386

  8. 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

  9. 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

  10. 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…

  11. Patterns and predictors of health service utilization in adolescents with pain: comparison between a community and a clinical pain sample

    PubMed Central

    Toliver-Sokol, Marisol; Murray, Caitlin B.; Wilson, Anna C.; Lewandowski, Amy; Palermo, Tonya M.

    2011-01-01

    There is limited research describing the patterns of healthcare utilization in adolescents with chronic pain. This study describes healthcare utilization in a clinical chronic pain sample, and compares the patterns of service use of this group to a community sample with intermittent pain complaints. We also investigated demographic and clinical factors that predicted healthcare visits and medication use in the clinical sample. Data on 117 adolescents (aged 12-18; n=59 clinical pain sample, n=58 community) were collected. Caregivers and adolescents reported on sociodemographics, medical visits, current medications, pain, activity limitations, and depression. As hypothesized, the clinical pain sample had higher rates of healthcare consultation on all types of medical visits (general, specialty care, complementary medicine, mental health, OT/PT), and higher medication use compared to the community sample. Regression analyses revealed that higher annual income, greater pain frequency, and higher levels of caregiver reported activity limitations were associated with a greater number of healthcare visits for the total sample. Within the clinical pain sample, higher pain frequency and greater activity limitations (caregiver-report) predicted more specialty care visits. Additionally, higher income and greater levels of depressive symptoms predicted a higher number of prescribed medications. Perspective This study contributes to the limited available data on health service and medication use in a clinical chronic pain sample versus a community sample of adolescents. We also identify clinical factors (pain frequency, parent-reported activity limitations, depressive symptoms) and demographic factors (gender, income) associated with healthcare utilization. PMID:21481647

  12. 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…

  13. Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders. Second Edition

    ERIC Educational Resources Information Center

    Robertson, Elizabeth B.; David, Susan L.; Rao, Suman A.

    2003-01-01

    In 1997, the National Institute on Drug Abuse (NIDA) published the first edition of "Preventing Drug Use among Children and Adolescents: A Research-Based Guide" to share the latest NIDA-funded prevention research findings with parents, educators, and community leaders. The guide introduced the concept of "research-based prevention" with questions…

  14. 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…

  15. 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…

  16. The Impact of a Community Based Exercise Program in Children and Adolescents with Disabilities: A Pilot Study

    ERIC Educational Resources Information Center

    Oriel, Kathryn N.; George, Cheryl L.; Blatt, Philip J.

    2008-01-01

    This pilot study sought to determine if participation in an after school community-based exercise program would result in improved fitness, self-concept, and social skills in a heterogeneous sample of children and adolescents with disabilities. Eighteen participants with physical and/or cognitive disabilities were recruited for an 8-week exercise…

  17. Prevalence of Sexually Abusive Experiences in Childhood and Adolescence among a Community Sample of Latinas: A Descriptive Study

    ERIC Educational Resources Information Center

    Ulibarri, Monica D.; Ulloa, Emilio C.; Camacho, Lizeth

    2009-01-01

    This study examined the prevalence, severity, and circumstances of self-reported sexually coercive and abusive experiences in childhood and adolescence in a community sample of Latina women (N = 204) ages 18 to 34 years. Results from structured phone interviews indicated that 35% of the women reported experiencing some form of sexual abuse, 31% of…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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. PMID:20471097

  4. 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

  5. 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

  6. School Mental Health Services: Signpost for Out-of-School Service Utilization in Adolescents with Mental Disorders? A Nationally Representative United States Cohort

    PubMed Central

    Tegethoff, Marion; Stalujanis, Esther; Belardi, Angelo; Meinlschmidt, Gunther

    2014-01-01

    Background School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors. Methods Analyses are based on weighted data (N = 6483) from the United States National Comorbidity Survey Replication Adolescent Supplement (participants' age: 13–18 years). Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents. Results School mental health service use predicted subsequent out-of-school service utilization for mental disorders i) in the medical specialty sector, in adolescents with affective (hazard ratio (HR) = 3.01, confidence interval (CI) = 1.77–5.12), anxiety (HR = 3.87, CI = 1.97–7.64), behavior (HR = 2.49, CI = 1.62–3.82), substance use (HR = 4.12, CI = 1.87–9.04), and eating (HR = 10.72, CI = 2.31–49.70) disorders, and any mental disorder (HR = 2.97, CI = 1.94–4.54), and ii) in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17–4.56), behavior (HR = 1.99, CI = 1.29–3.06), and substance use (HR = 2.48, CI = 1.57–3.94) disorders, and any mental disorder (HR = 2.33, CI = 1.54–3.53), but iii) not in the mental health specialty sector. Conclusions Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders

  7. Process evaluation of a community-based adolescent obesity prevention project in Tonga

    PubMed Central

    2011-01-01

    Background The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. Methods MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. Results While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. Conclusions The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider than the target group), but

  8. 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. PMID:26283972

  9. 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

  10. Incidence, Outcomes, and Risk Factors of Community-Acquired and Hospital-Acquired Acute Kidney Injury: A Retrospective Cohort Study.

    PubMed

    Hsu, Chien-Ning; Lee, Chien-Te; Su, Chien-Hao; Wang, Yu-Ching Lily; Chen, Hsiao-Ling; Chuang, Jiin-Haur; Tain, You-Lin

    2016-05-01

    The disease burden and outcomes of community-acquired (CA-) and hospital-acquired acute kidney injury (HA-AKI) are not well understood. The aim of the study was to investigate the incidence, outcomes, and risk factors of AKI in a large Taiwanese adult cohort.This retrospective cohort study examined 734,340 hospital admissions from a group of hospitals within an organization in Taiwan between January 1, 2010 and December 31, 2014. Patients with AKI at discharge were classified as either CA- or HA-AKI based on the RIFLE (risk, injury, failure, loss of function, end stage of kidney disease) classification criteria. Outcomes were in-hospital mortality, dialysis, recovery of renal function, and length of stay. Risks of developing AKI were determined using multivariate logistic regression based on demographic and baseline clinical characteristics and nephrotoxin use before admission.AKI occurred in 1.68% to 2% hospital discharges among adults without and with preexisting chronic kidney disease (CKD), respectively. The incidence of CA-AKI was 17.25 and HA-AKI was 8.14 per 1000 admissions. The annual rate of CA-AKI increased from 12.43 to 19.96 per 1000 people, but the change in HA-AKI was insignificant. Comparing to CA-AKI, those with HA-AKI had higher levels of in-hospital mortality (26.07% vs 51.58%), mean length of stay (21.25 ± 22.35 vs 35.84 ± 34.62 days), and dialysis during hospitalization (1.45% vs 2.06%). Preexisting systemic diseases, including CKD were associated with increased risks of CA-AKI, and nephrotoxic polypharmacy increased risk of both CA- and HA-AKI.Patients with HA-AKI had more severe outcomes than patients with CA-AKI, and demonstrated different spectrum of risk factors. Although patients with CA-AKI with better outcomes, the incidence increased over time. It is also clear that optimal preventive and management strategies of HA- and CA-AKI are urgently needed to limit the risks in susceptible individuals. PMID:27175701

  11. Effects of the Communities That Care System on Cross-Sectional Profiles of Adolescent Substance Use and Delinquency

    PubMed Central

    Van Horn, M. Lee; Fagan, Abigail A.; Hawkins, J. David; Oesterle, Sabrina

    2014-01-01

    Introduction Adolescent substance use and delinquency are major public health problems. Although community–based prevention strategies have been recommended to produce population-level reductions in rates of substance use and delinquency, few models show evidence of effectiveness. Purpose To test the efficacy of a community–based prevention system, Communities That Care (CTC), in reducing community rates of problem behaviors, particularly effects on specific profiles of adolescent substance use and delinquency in eighth and tenth graders. Methods Twenty-four communities were randomized to CTC intervention or control groups. Data were collected from 14,099 eighth and tenth grade students in these communities using anonymous cross-sectional surveys in 2004 and 2010 and analyzed in 2012. Outcomes were four different profiles of self–reported substance use and delinquency in eighth grade and five profiles in tenth grade. Results In the cross-sectional 2010 data, there was no intervention effect on the probability of experimenting with substances or of substance use coupled with delinquent activities for either grade. However, tenth graders in intervention communities were significantly less likely to be alcohol users than those in control communities (OR=0.69, CI=0.48, 1.00). Conclusions Cross–sectional population surveys showed evidence of CTC effects in reducing tenth grade alcohol users but not experimenters. A community-wide reduction in adolescent alcohol use is important because alcohol is the most commonly used illicit substance during adolescence, and early initiation of alcohol use has been associated with alcohol-related disorders in adulthood. Failure to find hypothesized effects on experimenters qualifies these results. PMID:24986217

  12. 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…

  13. Neighborhood disadvantage and obesity across childhood and adolescence: Evidence from the NLSY children and young adults cohort (1986-2010).

    PubMed

    Alvarado, Steven Elías

    2016-05-01

    Previous research suggests that youth who grow up in socioeconomically disadvantaged neighborhoods face higher odds of becoming obese. Neighborhood effects scholars, meanwhile, have suggested that contextual influences may increase in strength as children age. This is the first study to examine whether developmental epochs moderate the effect of neighborhood disadvantage on obesity over time. I use thirteen waves of new restricted and geo-coded data on children ages 2-18 from the National Longitudinal Survey of Youth, Children and Young Adults. Bivariate and pooled logistic regression results suggest that neighborhood disadvantage has a stronger impact on adolescents' likelihood of becoming obese. Fixed effects models reveal that after adjusting for observed and unobserved confounders, adolescents continue to face higher odds of becoming obese due to the conditions associated with living in disadvantaged neighborhoods. Moreover, as research on adults suggests, girls experience larger impacts of neighborhood disadvantage than boys. PMID:26973033

  14. Can negative life events and coping style help explain socioeconomic differences in perceived stress among adolescents? A cross-sectional study based on the West Jutland cohort study

    PubMed Central

    2013-01-01

    Background Previous research suggests that perceived stress in adolescence is socially patterned, but that this relationship may depend on the measure of socioeconomic status (SES) used. This study examines if social gradients in perceived stress, negative life events, and coping exist amongst Danish adolescents, and, if life events and coping strategies can partly account for an association between SES and perceived stress. These relationships are studied separately for two different measures of SES. Methods Questionnaire data were collected from 3054 14–15 year old youths (83% response rate) during baseline measurement in the West Jutland birth cohort study. Parents were identified via the Central Office of Civil Registration in which the respondents are linked to their parents or guardians via their CPR-number, a personal identification number given to everyone in Denmark. The study employs data from two independent sources, adolescent self-report data (stress, life events and coping) and national registers (parental educational level, household income and confounder variables). Ordinary Least Squares regression estimated the effects of parental SES, negative life events and coping on perceived stress. Analyses were stratified by gender. Results Girls reported more perceived stress than boys. SES accounted for a small but significant amount of the variance in perceived stress. Lower parental education and lower household income were associated with higher stress levels irrespective of gender, but the social gradient was strongest amongst girls when parents’ education was used to measure SES, and strongest for boys when income was used. Life events and coping were also found to be associated with SES and both mediated part of the SES-perceived stress relationship. In general, the social gradient in perceived stress was accounted for by the study variables to a higher degree among girls than among boys. Conclusions Lower parental education and household

  15. 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…

  16. Early childhood precursors for eating problems in adolescence: a 15-year longitudinal community study

    PubMed Central

    2013-01-01

    Background This longitudinal community study investigated the role of individual risk factors in early childhood (before age five) for the development of eating problems in adolescence. Nine hundred twenty-one mothers completed the first questionnaire when their child was 1.5 years old, and again when their child was 2.5 (n = 784) and 4.5 (n = 737) years old. Three hundred seventy-three of these children completed the Eating Attitudes Test (EAT) when they were 16 years old. Results Mother-rated early childhood sleep problems (assessed before the age of five) predicted self-rated eating problems in adolescents, with gender, birth weight, and a number of early childhood internal and environmental factors controlled. Unexpectedly, early childhood eating problems were not associated with later eating problems. Conclusions The possible role of sleep in the development of eating problems needs further investigation. In particular, mediating mechanisms should be studied more closely. PMID:24999414

  17. An Independent Replication of the Adolescent-Community Reinforcement Approach With Justice-Involved Youth

    PubMed Central

    Henderson, Craig E.; Wevodau, Amy L.; Henderson, Susan E.; Colbourn, Scholar L.; Gharagozloo, Laadan; North, Lindsey W.; Lotts, Vivian A.

    2016-01-01

    Background and Objectives Substance use disorders among youth remain a serious public health problem. Although research has overwhelmingly supported the use of evidenced-based interventions, one of the primary limitations of the current evidence base is that for the vast majority of treatments, the developers of the treatments are also the ones conducting research on them, raising the possibility of allegiance bias. Methods The present study was an independently conducted randomized controlled trial (n =126) comparing an evidenced-based treatment for adolescent substance use, Adolescent-Community Reinforcement Approach (A-CRA), and assertive continuing care (ACC), to services as usual (SAU) provided by a juvenile probation department. Latent growth curve modeling was used to compare the treatments on change in substance use assessed by the Global Appraisal of Individual Needs (GAIN) at baseline and 3, 6, and 12 months following treatment entry. Results All youth evidenced a substantial reduction in substance use frequency and substance-related problems following treatment; however, youth treated with A-CRA/ACC evidenced a substantially greater decrease in substance-related problems. Conclusions and Scientific Significance Results are consistent with studies conducted by A-CRA/ACC model developers supporting the effectiveness of the clinical approach and, because the outcomes resulted from an independent replication, are encouraging for the transportation potential of A-CRA/ACC. PMID:26992083

  18. [Exposure to violence among adolescents in a low-income community in the northeast of Brazil].

    PubMed

    Moreira, Deborah Pedrosa; Vieira, Luiza Jane Eyre de Souza; Pordeus, Augediva Maria Jucá; Lira, Samira Valentim Gama; Luna, Geisy Lanne Muniz; e Silva, Juliana Guimarães; Machado, Maria de Fátima Antero Sousa

    2013-05-01

    This a cross-sectional study made in Fortaleza, Ceará, 2009, which included 458 teenagers and analyzed their exposure to violence, describing their access to weapons, alcohol abuse, illegal drug use and their self-esteem by investigating their socio-economic, school and family characteristics and exposure to the phenomenon. A questionnaire and/or structured interviews were used for data collection, and analysis involved Pearson's chi-square test, with 95% reliability. Of the 458 participants, 17.7% were considered to be exposed to criminal violence. Significant variables for exposure to violence included: place of birth (p = 0.020), years of schooling (p = 0,009), school absenteeism (p < 0.001), the father as the head of the family (p = 0.026), alcohol-addicted parents (p < 0.001), good/very good family relationships (p = 0.009), and parents' dissatisfaction with their children's friends (p < 0.001). Thus, it is necessary that public policies focus on a support network for care of adolescents and that urban centers organize themselves socially and politically in the quest for understanding the effects of exposure to violence among adolescents in low-income communities. PMID:23670455

  19. The relationship of moderate-to-vigorous physical activity to cognitive processing in adolescents: findings from the ALSPAC birth cohort.

    PubMed

    Pindus, Dominika M; Davis, Robert D Moore; Hillman, Charles H; Bandelow, Stephan; Hogervorst, Eef; Biddle, Stuart J H; Sherar, Lauren B

    2015-09-01

    The aim of this study was to assess the relations of daily moderate-to-vigorous physical activity (MVPA) to cognitive functions in 15-year-old adolescents from the Avon Longitudinal Study of Parents and Children while controlling for aerobic fitness. A sub-sample of 667 adolescents (M(age) = 15.4 ± 0.16 years; 55% females) who provided valid data on variables of interest, were used in the analyses. MVPA was objectively assessed using an Actigraph GT1M accelerometer and aerobic fitness was expressed as physical work capacity at the heart rate of 170 beats per minute from a cycle ergometer test. A computerized stop-signal task was used to measure mean reaction time (RT) and standard deviation of RT, as indicators of cognitive processing speed and variability during an attention and inhibitory control task. MVPA was not significantly related to cognitive processing speed or variability of cognitive performance in hierarchical linear regression models. In simple regression models, aerobic fitness was negatively related to mean RT on the simple go condition. Our results suggest that aerobic fitness, but not MVPA, was associated with cognitive processing speed under less cognitively demanding task conditions. The results thus indicate a potential global effect of aerobic fitness on cognitive functions in adolescents but this may differ depending on the specific task characteristics. PMID:25351943

  20. 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. PMID:25716137

  1. 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

  2. Rumination, anxiety, depressive symptoms and subsequent depression in adolescents at risk for psychopathology: a longitudinal cohort study

    PubMed Central

    2013-01-01

    Background A ruminative style of responding to low mood is associated with subsequent high depressive symptoms and depressive disorder in children, adolescents and adults. Scores on self-report rumination scales correlate strongly with scores on anxiety and depression symptom scales. This may confound any associations between rumination and subsequent depression. Methods Our sample comprised 658 healthy adolescents at elevated risk for psychopathology. This study applied ordinal item (non-linear) factor analysis to pooled items from three self-report questionnaires to explore whether there were separate, but correlated, constructs of rumination, depression and anxiety. It then tested whether rumination independently predicted depressive disorder and depressive symptoms over the subsequent 12 months, after adjusting for confounding variables. Results We identified a single rumination factor, which was correlated with factors representing cognitive symptoms of depression, somatic symptoms of depression and anxiety symptoms; and one factor representing adaptive responses to low mood. Elevated rumination scores predicted onset of depressive disorders over the subsequent year (p = 0.035), and levels of depressive symptoms 12 months later (p < 0.0005), after adjustment for prior levels of depressive and anxiety symptoms. Conclusion High rumination predicts onset of depressive disorder in healthy adolescents. Therapy that reduces rumination and increases distraction/problem-solving may reduce onset and relapse rates of depression. PMID:24103296

  3. 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

  4. 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

  5. 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. PMID:25460909

  6. Community-Level Successes and Challenges to Implementing Adolescent Sex Education Programs

    PubMed Central

    Rouse, Maura; Resseguie, Jamie; Smith, Hannah; Woodcox, Stephanie

    2010-01-01

    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. PMID:20180004

  7. A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa

    PubMed Central

    2013-01-01

    Background The health of adolescents is increasingly seen as an important international priority because the world’s one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence (such as smoking, obesity, and physical inactivity). In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services. Methods We reviewed the literature on CHWs using Medline (PubMed), EBSCO Global Health, and Global Health Archive. Search terms (n = 19) were sourced from various review articles and combined with subject heading ‘sub-Saharan Africa’ to identify English language abstracts of original research articles on generalist and specialist CHWs. Results A total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services. Conclusions This review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in

  8. Variants of callous-unemotional conduct problems in a community sample of adolescents.

    PubMed

    Fanti, Kostas A; Demetriou, Chara A; Kimonis, Eva R

    2013-07-01

    Callous-unemotional traits are believed to be a childhood precursor to psychopathy, and among youth with conduct problems they designate those showing a particularly severe, stable, and aggressive pattern of antisocial behavior. Youth with callous-unemotional traits are a heterogeneous population and, analogous to adults with psychopathy, research suggests that lower anxious primary and high-anxious secondary variants exist. Using a community sample of 2,306 Greek-Cypriot adolescents (M age = 16 years; 49.7 % female), the first aim of the study was to examine whether variants of callous-unemotional traits could be identified using latent profile analysis of scores on measures of callous-unemotional traits, conduct problems, and anxiety. Additional aims of the study were to compare the identified clusters on external measures theorized to distinguish them (i.e., self-esteem, narcissism, impulsivity, sensation seeking and proactive/reactive aggression) and social factors relevant to adolescent development. Results indicated that, in addition to low risk (i.e., low scores on callous-unemotional traits, conduct problems, and anxiety) and anxious (i.e., high scores on anxiety, low scores on callous-unemotional traits and conduct problems) subgroups, two groups of youth scoring high on callous-unemotional traits and conduct problems were identified. High-anxious secondary callous-unemotional variants were distinguished by lower self-esteem in combination with greater narcissism, aggression, and markedly higher conduct problems, whereas lower anxious primary variants showed higher self-esteem. Secondary callous-unemotional variants also reported greater susceptibility to peer pressure and popularity striving than primary variants. Both variants exhibited poorer outcomes relative to low risk and anxious youth, although anxious youth reported lower self-esteem and higher impulsivity and reactive aggression scores in comparison with low risk youth. Findings integrate two

  9. 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

  10. Carotid atherosclerosis, cytomegalovirus infection, and cognitive decline in the very old: a community-based prospective cohort study.

    PubMed

    Kawasaki, Midori; Arai, Yasumichi; Takayama, Michiyo; Hirata, Takumi; Takayama, Midori; Abe, Yukiko; Niimura, Hidehito; Mimura, Masaru; Takebayashi, Toru; Hirose, Nobuyoshi

    2016-04-01

    To investigate various risk factors of cognitive decline in the very old, we studied 494 subjects over 85 years old without diagnosis of dementia at baseline from the Tokyo Oldest Old Survey on Total Health, an ongoing, community-based cohort in Japan. Cognitive function was assessed at baseline and at 3-year follow-up using Mini-Mental State Examination (MMSE). Plasma samples were assayed for levels of cytomegalovirus (CMV) immunoglobulin G (IgG) antibodies, tumor necrosis factor-alpha, interleukin-6, and blood chemistry. Carotid artery plaques were measured using an ultrasonography. In the cross-sectional analyses using Tobit regression, individuals with high carotid artery plaque score (≥5.0) had MMSE scores that were 1.08 points lower compared to those with no plaque (95 % confidence interval (CI) -1.95 to -0.20; p = 0.016), adjusted for age, sex, and education. Individuals with CMV IgG titers in the highest quartile had MMSE scores that were 1.47 points lower compared to individuals in the lowest quartile (95 % CI -2.44 to -0.50; p = 0.003). CMV and carotid atherosclerosis showed evidence of an interaction, where the association between CMV and MMSE was present only in subjects with carotid artery plaque. In the longitudinal analyses using linear regression, carotid atherosclerosis, smoking, low grip strength, and poor activities of daily living (ADL) status were associated with faster cognitive decline, adjusted for age, sex, education, and baseline cognitive function. Our findings suggest that carotid atherosclerosis is consistently associated with low cognitive function in the very old and modifies the association between latent CMV infection and cognition. PMID:26886582

  11. 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

  12. Harm avoidance is associated with progression of parkinsonism in community-dwelling older adults: a prospective cohort study

    PubMed Central

    2014-01-01

    Background We tested the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the rate of change in parkinsonism in older adults. Methods At baseline harm avoidance was assessed with a standard self-report instrument in 969 older people without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Parkinsonism was assessed annually with a modified version of the motor section of the Unified Parkinson’s Disease Rating Scale (mUPDRS). Results Average follow-up was 5 years. A linear mixed-effects model controlling for age, sex and education showed that for an average participant (female, 80 years old at baseline, with 14 years of education and a harm avoidance score of 10), the overall severity of parkinsonism increased by about 0.05 unit/ year (Estimate, 0.054, S.E., 0.007, p <0.001) and that the level of harm avoidance was associated with the progression of parkinsonism (Estimate, 0.004, S.E., 0.001, p <0.001). Thus, for an average participant, every 6 point (~1 SD) increase in harm avoidance score at baseline, the rate of progression of parkinsonism increased about 50% compared to an individual with an average harm avoidance score. This amount of change in parkinsonism over the course of the study was associated with about a 5% increased risk of death. The association between harm avoidance and progression of parkinsonism persisted when controlling for cognitive function, depressive symptoms, loneliness, neuroticism, late-life cognitive, social and physical activities and chronic health conditions. Conclusion A higher level of the harm avoidance trait is associated with a more rapid progression of parkinsonism in older adults. PMID:24754876

  13. Associations between serum potassium and sodium levels and risk of hypertension: a community-based cohort study

    PubMed Central

    Xi, Lu; Hao, Yong-Chen; Liu, Jing; Wang, Wei; Wang, Miao; Li, Guo-Qi; Qi, Yue; Zhao, Fan; Xie, Wu-Xiang; Li, Yan; Sun, Jia-Yi; Liu, Jun; Qin, Lan-Ping; Zhao, Dong

    2015-01-01

    Objective Several studies have examined the relationships between dietary potassium and sodium and hypertension, but few have evaluated the association between serum potassium or sodium and risk of incident hypertension. We therefore investigated the associations between serum potassium and sodium and risk of incident hypertension in a Chinese community-based population. Methods A total of 839 normotensive individuals without cardiovascular disease from the Chinese Multi-Provincial Cohort Study who took part in the baseline examination in 2007–2008 and the follow-up survey in 2012–2013 were included in this study. Odds ratios (OR) and 95% confidence intervals (95%CI) for baseline serum potassium and sodium in relation to the risk of new-onset hypertension were evaluated using multivariate logistic regression models. Results During five years of follow-up, 218 (26.0%) individuals progressed to hypertension. Logistic regression adjusting for multiple confounders showed that every 1 mEq/L increment in baseline serum potassium level was associated with a 75% increased risk of hypertension (OR: 1.75; 95%CI: 1.01–3.04; P = 0.04). Compared with adults with serum potassium level of 4.20–4.79 mEq/L, adults with level ≥ 4.80 mEq/L had an 84% increased risk of hypertension (OR: 1.84; 95%CI: 1.14–2.96; P = 0.01). There was no significant association between serum sodium and risk of hypertension (OR: 0.96; 95%CI: 0.89–1.04; P = 0.33). Conclusions Baseline serum potassium level, but not baseline serum sodium level, was positively related to the risk of incident hypertension in the Chinese population. PMID:25870614

  14. The association between glomerular filtration rate and left ventricular function in two independent community-based cohorts of elderly

    PubMed Central

    Nerpin, Elisabet; Ingelsson, Erik; Risérus, Ulf; Sundström, Johan; Andren, Bertil; Jobs, Elisabeth; Larsson, Anders; Lars, Lind; Ärnlöv, Johan

    2014-01-01

    Background The cardiorenal syndrome, the detrimental bi-directional interplay between symptomatic heart failure and chronic kidney disease, is a major clinical challenge. Nonetheless, it is unknown if this interplay begins already at an asymptomatic stage. Therefore we investigated whether the glomerular filtration rate (GFR) is associated with left ventricular function in participants free from clinical heart failure and with a left ventricular ejection fraction (LVEF) >40% and with pre-specified sub-group analyses in individuals with a GFR >60 mL/min/m2. Methods Two independent community-based cohorts were used; the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; n = 911; 50% women; mean age: 70 years) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n = 538; mean age: 71 years). We investigated cross-sectional association between cystatin C-based GFR (estimated glomerular function [eGFR]) and systolic (LVEF), diastolic- (isovolumic relaxation time [IVRT]) and global left ventricular function (myocardial performance index [MPI]) determined by echocardiography. Results In both PIVUS and ULSAM, higher eGFR was significantly associated with higher LVEF (P = 0.004 [PIVUS] and P = 0.005 [ULSAM]). In PIVUS, higher eGFR was significantly associated with lower IVRT (P = 0.001) and MPI (P = 0.006), in age- and sex-adjusted models. After further adjustment for cardiovascular risk factors, the association between higher eGFR and higher LVEF was still statistically significant (P = 0.008 [PIVUS] and P = 0.02 [ULSAM]). In PIVUS, the age- and sex-adjusted association between eGFR and left ventricular function was similar in participants with eGFR >60 mL/min/m2. Conclusions Our data suggest that the interplay between kidney and heart function begins prior to the development of symptomatic heart failure and kidney disease. PMID:24916339

  15. Effectiveness of community-based support for pregnant women living with HIV: a cohort study in South Africa.

    PubMed

    Fatti, Geoffrey; Shaikh, Najma; Eley, Brian; Grimwood, Ashraf

    2016-03-01

    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 ZDV with shorter

  16. 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

  17. Race-Ethnic Differences in Subclinical Left Ventricular Systolic Dysfunction by Global Longitudinal Strain: a Community-based Cohort Study

    PubMed Central

    Russo, Cesare; Jin, Zhezhen; Homma, Shunichi; Rundek, Tatjana; Elkind, Mitchell S.V.; Sacco, Ralph L.; Di Tullio, Marco R.

    2015-01-01

    Background Race-ethnic differences exist in the epidemiology of heart failure, with blacks experiencing higher incidence and worse prognosis. Left ventricular (LV) systolic dysfunction (LVSD) detected by speckle-tracking global longitudinal strain (GLS) is a predictor of cardiovascular events including heart failure. It is not known whether race-ethnic differences in GLS-LVSD exist in subjects without overt LV dysfunction. Methods Participants from a tri-ethnic community-based study underwent two-dimensional echocardiography with assessment of LV ejection fraction (LVEF) and GLS by speckle-tracking. Participants with LVEF<50% were excluded. GLS-LVSD was defined as GLS > 95% percentile in a healthy sample (−14.7%). Results Of the 678 study participants (mean age 71±9 years, 61% women), 114 were blacks, 464 Hispanics, and 100 whites. GLS was significantly lower in blacks (−16.5±3.5%) than in whites (−17.5±3.0%) and Hispanics (−17.3±2.9%) in both univariate (p=0.015) and multivariate analysis (p=0.011), whereas LVEF was not significantly different between the 3 groups (64.3±4.6%, 63.4±4.9%, 64.7±4.9% respectively, univariate p=0.064, multivariate p=0.291). GLS-LVSD was more frequent in blacks (27.2%) than in whites (19.0%) and Hispanics (14.9%, p=0.008). In multivariate analysis adjusted for confounders and cardiovascular risk factors, blacks were significantly more likely to have GLS-LVSD (adjusted odds ratio=2.6, 95% confidence intervals=1.4–4.7, p=0.002) compared to the other groups. Conclusions Among participants from a tri-ethnic community cohort, black race was associated with greater degree of subclinical LVSD by GLS than other race-ethnic groups. This difference was independent of confounders and cardiovascular risk factors. PMID:25965720

  18. Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study

    PubMed Central

    2012-01-01

    Background Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL). The odds ratio and 95% Confidence Interval (CI) were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results In 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6) and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6). At baseline, 718 (82.5%) participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65). Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total daily physical activity

  19. 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

  20. 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

  1. Hepatitis B immune status in adolescents vaccinated during infancy: A retrospective cohort study from a pediatric practice in Germany.

    PubMed

    Anderson, Carrie L; Remschmidt, Cornelius; Drobnitzky, Frank-Peter; Falkenhorst, Gerhard; Zimmermann, Ruth; Wichmann, Ole; Harder, Thomas

    2016-03-01

    In Germany, vaccination of infants against hepatitis B is recommended since 1995. However, data on long-term immunity is sparse and the necessity of a booster dose remains uncertain. Aims of this study were to assess the long-term persistence of antibodies to the hepatitis B surface antigen (anti-HBs) after immunization during infancy and the effect of a subsequent hepatitis B booster vaccination during adolescence on anti-HBs levels. Patients from a private pediatric practice who had received a full vaccination course of hepatitis B as infants and who were quantitatively tested for anti-HBs during adolescence (pre-booster levels) were included. In those participants who received a hepatitis B booster, post-booster anti-HBs levels were measured. Univariate analyses were conducted to determine factors associated with pre- and post-booster anti-HBs levels, respectively. 106 participants (53% male) were included in the study. At an average of 13.7 y after primary vaccination, 14% of participants had an anti-HBs level of ≥100 IU/l, while 46% were at 10-99 IU/l and 40% had anti-HBs levels of <10 IU/l. In total, 34 received a booster vaccination. Of those, 97% (33/34) had post-booster anti-HBs levels ≥ 100 IU/l, which were independent from pre-booster levels. No other patient characteristics were associated with pre-booster or post-booster anti-HBs≥ 100 IU/l. Although almost half of study participants showed low anti-HBs levels at follow-up, robust responses to booster vaccination suggest that adolescents who received the full vaccination course during infancy are still protected against hepatitis B infection. PMID:26633195

  2. 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

  3. 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

  4. 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…

  5. 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

  6. Brief report: The impact of attention deficit hyperactivity disorder (ADHD) symptoms on academic performance in an adolescent community sample.

    PubMed

    Birchwood, James; Daley, Dave

    2012-02-01

    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 participants, aged 15 and 16, in their final year of compulsory education, completed measures of ADHD, anxiety, depression, and motivation, and a test of general cognitive ability. Participants were also asked for permission for their academic grades to be viewed on a later occasion (approximately 6 months later). In regression analyses, ADHD symptoms were the most significant independent psychopathological predictor of academic performance, and were almost as significant as motivation and cognitive ability. The results suggest that adolescents with more ADHD symptoms are likely to encounter greater academic difficulties. PMID:20880572

  7. 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. PMID:22287568

  8. Meal frequencies modify the effect of common genetic variants on body mass index in adolescents of the northern Finland birth cohort 1986.

    PubMed

    Jääskeläinen, Anne; Schwab, Ursula; Kolehmainen, Marjukka; Kaakinen, Marika; Savolainen, Markku J; Froguel, Philippe; Cauchi, Stéphane; Järvelin, Marjo-Riitta; Laitinen, Jaana

    2013-01-01

    Recent studies suggest that meal frequencies influence the risk of obesity in children and adolescents. It has also been shown that multiple genetic loci predispose to obesity already in youth. However, it is unknown whether meal frequencies could modulate the association between single nucleotide polymorphisms (SNPs) and the risk of obesity. We examined the effect of two meal patterns on weekdays -5 meals including breakfast (regular) and ≤ 4 meals with or without breakfast (meal skipping) - on the genetic susceptibility to increased body mass index (BMI) in Finnish adolescents. Eight variants representing 8 early-life obesity-susceptibility loci, including FTO and MC4R, were genotyped in 2215 boys and 2449 girls aged 16 years from the population-based Northern Finland Birth Cohort 1986. A genetic risk score (GRS) was calculated for each individual by summing the number of BMI-increasing alleles across the 8 loci. Weight and height were measured and dietary data were collected using self-administered questionnaires. Among meal skippers, the difference in BMI between high-GRS and low-GRS (<8 and ≥ 8 BMI-increasing alleles) groups was 0.90 (95% CI 0.63,1.17) kg/m(2), whereas in regular eaters, this difference was 0.32 (95% CI 0.06,0.57) kg/m(2) (p interaction = 0.003). The effect of each MC4R rs17782313 risk allele on BMI in meal skippers (0.47 [95% CI 0.22,0.73] kg/m(2)) was nearly three-fold compared with regular eaters (0.18 [95% CI -0.06,0.41] kg/m(2)) (p interaction = 0.016). Further, the per-allele effect of the FTO rs1421085 was 0.24 (95% CI 0.05,0.42) kg/m(2) in regular eaters and 0.46 (95% CI 0.27,0.66) kg/m(2) in meal skippers but the interaction between FTO genotype and meal frequencies on BMI was significant only in boys (p interaction = 0.015). In summary, the regular five-meal pattern attenuated the increasing effect of common SNPs on BMI in adolescents. Considering the epidemic of obesity in youth, the promotion of regular eating may have

  9. Effects of economic status and education level on the height and weight of community adolescents in Nepal.

    PubMed

    Joshi, Nira; Rikimaru, Toru; Pandey, Sharada

    2005-08-01

    There is scarce information on the relative importance of socio-economic factors in determining the adolescent anthropometric measurements. The objective of this study was to examine the effects of economic status, education level, and food consumption on the height and weight of community adolescents in Nepal. The study was done in the communities of the Kathmandu Valley area in Nepal. All together 426 unmarried adolescent girls aged 14-19 y were selected. The adolescents were interviewed regarding socioeconomic background (education, occupation and property possessions) and frequency of foods consumption. Height and weight were determined and BMI was calculated. Z-scores of height-for-age and weight-for-age were calculated based on the WHO/NCHS standard to avoid bias by age. The adolescents participating in the survey were categorized into three groups using the various indicators of economic status: Low Economic Status (LES) group, Middle Economic Status (MES) group and High Economic Status (HES) group. The Z-scores of height and weight were significantly lower in the LES group than in the MES and HES groups (p<0.05). The Z-score of height was significantly increased with education level even under the condition of controlling economic level (p<0.05). Since the frequency of milk consumption was significantly related not only with height (p<0.05), but also with economic (chi2=31.6, df=4, p<0.001) and education levels (chi2=22.4, df=6, p<0.01), the increased height in the groups of the better economic status or the better education level was interpreted to be due to the outcome of the higher frequency of milk consumption. This study indicated that education was a more important factor affecting the height of the adolescents via improved food habits even under adverse economic conditions. PMID:16261994

  10. 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

  11. 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

  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. 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…

  14. 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

  15. 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

  16. 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

  17. 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. PMID:26611829

  18. 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

  19. 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…

  20. 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

  1. Depressive Symptoms and Deliberate Self-Harm in a Community Sample of Adolescents: A Prospective Study

    PubMed Central

    Lundh, Lars-Gunnar; Wångby-Lundh, Margit; Paaske, My; Ingesson, Stina; Bjärehed, Jonas

    2011-01-01

    The associations between depressive symptoms and deliberate self-harm were studied by means of a 2-wave longitudinal design in a community sample of 1052 young adolescents, with longitudinal data for 83.6% of the sample. Evidence was found for a bidirectional relationship in girls, with depressive symptoms being a risk factor for increased self-harm one year later and self-harm a risk factor for increased depressive symptoms. Cluster analysis of profiles of depressive symptoms led to the identification of two clusters with clear depressive profiles (one severe, the other mild/moderate) which were both characterized by an overrepresentation of girls and elevated levels of self-harm. Clusters with more circumscribed problems were also identified; of these, significantly increased levels of self-harm were found in a cluster characterized by negative self-image and in a cluster characterized by dysphoric relations to parents. It is suggested that self-harm serves more to regulate negative self-related feelings than sadness. PMID:21234107

  2. Bacterial Communities of the Coronal Sulcus and Distal Urethra of Adolescent Males

    PubMed Central

    Nelson, David E.; Toh, Evelyn; Fan, Baochang; Katz, Barry P.; Mi, Deming; Rong, Ruichen; Weinstock, George M.; Sodergren, Erica; Fortenberry, J. Dennis

    2012-01-01

    Lactobacillus-dominated vaginal microbiotas are associated with reproductive health and STI resistance in women, whereas altered microbiotas are associated with bacterial vaginosis (BV), STI risk and poor reproductive outcomes. Putative vaginal taxa have been observed in male first-catch urine, urethral swab and coronal sulcus (CS) specimens but the significance of these observations is unclear. We used 16 S rRNA sequencing to characterize the microbiota of the CS and urine collected from 18 adolescent men over three consecutive months. CS microbiotas of most participants were more stable than their urine microbiotas and the composition of CS microbiotas were strongly influenced by circumcision. BV-associated taxa, including Atopobium, Megasphaera, Mobiluncus, Prevotella and Gemella, were detected in CS specimens from sexually experienced and inexperienced participants. In contrast, urine primarily contained taxa that were not abundant in CS specimens. Lactobacilllus and Streptococcus were major urine taxa but their abundance was inversely correlated. In contrast, Sneathia, Mycoplasma and Ureaplasma were only found in urine from sexually active participants. Thus, the CS and urine support stable and distinct bacterial communities. Finally, our results suggest that the penis and the urethra can be colonized by a variety of BV-associated taxa and that some of these colonizations result from partnered sexual activity. PMID:22606251

  3. 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

  4. 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

  5. Bacterial communities of the coronal sulcus and distal urethra of adolescent males.

    PubMed

    Nelson, David E; Dong, Qunfeng; Van der Pol, Barbara; Toh, Evelyn; Fan, Baochang; Katz, Barry P; Mi, Deming; Rong, Ruichen; Weinstock, George M; Sodergren, Erica; Fortenberry, J Dennis

    2012-01-01

    Lactobacillus-dominated vaginal microbiotas are associated with reproductive health and STI resistance in women, whereas altered microbiotas are associated with bacterial vaginosis (BV), STI risk and poor reproductive outcomes. Putative vaginal taxa have been observed in male first-catch urine, urethral swab and coronal sulcus (CS) specimens but the significance of these observations is unclear. We used 16 S rRNA sequencing to characterize the microbiota of the CS and urine collected from 18 adolescent men over three consecutive months. CS microbiotas of most participants were more stable than their urine microbiotas and the composition of CS microbiotas were strongly influenced by circumcision. BV-associated taxa, including Atopobium, Megasphaera, Mobiluncus, Prevotella and Gemella, were detected in CS specimens from sexually experienced and inexperienced participants. In contrast, urine primarily contained taxa that were not abundant in CS specimens. Lactobacilllus and Streptococcus were major urine taxa but their abundance was inversely correlated. In contrast, Sneathia, Mycoplasma and Ureaplasma were only found in urine from sexually active participants. Thus, the CS and urine support stable and distinct bacterial communities. Finally, our results suggest that the penis and the urethra can be colonized by a variety of BV-associated taxa and that some of these colonizations result from partnered sexual activity. PMID:22606251

  6. Associations of deliberate self-harm with loneliness, self-rated health and life satisfaction in adolescence: Northern Finland Birth Cohort 1986 Study

    PubMed Central

    Rönkä, Anna Reetta; Taanila, Anja; Koiranen, Markku; Sunnari, Vappu; Rautio, Arja

    2013-01-01

    Background Deliberate self-harm (DSH) is an act with a non-fatal outcome in which an individual initiates a behavior, such as self-cutting or burning, with the intention of inflicting harm on his or her self. Interpersonal difficulties have been shown to be a risk factor for DSH, but the association between subjective experience of loneliness and DSH have rarely been examined. Objective To examine the frequency of DSH or its ideation and loneliness among 16-year-olds to determine if associations exist between DSH and loneliness, loneliness-related factors, self-rated health and satisfaction with life. Design The study population (n=7,014) was taken from Northern Finland Birth Cohort 1986 (N=9,432). Cross-tabulations were used to describe the frequency of DSH by factors selected by gender. Logistic regression analysis was used to describe the association between DSH and loneliness and other selected factors. Results Nearly 8.7% (n=608) of adolescents reported DSH often/sometimes during the preceding 6 months, with girls (n=488, 13.4%) reporting DSH almost 4 times than that of boys (n=120, 3.6%). Nearly 3.2% of the adolescents (girls: n=149, 4.1%; boys: n=72, 2.2%) expressed that the statement I feel lonely was very/often true, and 26.4% (girls: n=1,265, 34.8%; boys: n=585, 17.4%) expressed that the statement was somewhat/sometimes true. Logistic regression showed that those who reported to be very/often lonely (girls: odds ratio (OR) 4.1; boys: OR 3.2), somewhat/sometimes lonely (girls: OR 2.4; boys: OR 2.4) were dissatisfied with life (girls: OR 3.3; boys: OR 3.3), felt unliked (girls: OR 2.2; boys: OR 6.0) and had moderate self-rated health (girls: OR 2.0; boys: OR 1.7), were more likely to report DSH than those without these feelings. Conclusion The results show that loneliness is associated with DSH, and that loneliness should be considered as a risk for individual health and well-being. PMID:23984286

  7. 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

  8. 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. PMID:26654751

  9. Assessing the triarchic model of psychopathy in adolescence: Reliability and validity of the Triarchic Psychopathy Measure (TriPM) in three samples of Italian community-dwelling adolescents.

    PubMed

    Somma, Antonella; Borroni, Serena; Drislane, Laura E; Fossati, Andrea

    2016-04-01

    To assess the psychometric properties and construct validity of the Italian translation of the Triarchic Psychopathy Measure (TriPM) in adolescents, we administered the inventory to 3 independent samples of Italian high school students (Ns = 609, 618, and 1,142). Cronbach's alpha values greater than .80 were observed for the TriPM scale scores in all samples. In Sample 1, overall scores on the Youth Psychopathic Traits Inventory correlated substantially with TriPM total scores, r = .77, p < .001. Data from Study 1 also demonstrated adequate 3-month test-retest reliabilities for the 3 TriPM subscales. In Study 2, TriPM scores significantly predicted scores on a self-report measure of delinquent behaviors, Radjusted2 = .25, p < .001. In Study 3, five-factor domain scores showed significant relations with TriPM scale scores consistent with results reported for adults. Consistent with a hypothesized role of fearlessness in psychopathy, adolescents at high psychopathy risk (i.e., >97th percentile on the TriPM) reported lower fear in response to emotion-eliciting movie clips than low-psychopathy participants. In addition, scores on a measure of hedonistic moral tendencies discriminated between adolescents at high as opposed to low psychopathy. Similarly, scores on the Reflective Function Questionnaire for Youths were negatively correlated with TriPM scores. As a whole, our findings provide further support for the reliability and validity of the TriPM and its cross-cultural utility, and provide initial evidence of its effectiveness with community-dwelling adolescents. (PsycINFO Database Record PMID:26237210

  10. 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. PMID:25655669

  11. 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

  12. Long-term secondary prophylaxis in children, adolescents and young adults with von Willebrand disease. Results of a cohort study.

    PubMed

    Halimeh, Susan; Krümpel, Anne; Rott, Hannelore; Bogdanova, Nadja; Budde, Ulrich; Manner, Daniela; Faeser, Britta; Mesters, Rolf; Nowak-Göttl, Ulrike

    2011-04-01

    In patients with von Willebrand disease (VWD) replacement therapy with factor VIII/von Willebrand (VWF) concentrates is increasingly applied as prophylactic regimen. Since 2000, 82 consecutively enrolled patients with clinically relevant bleeding episodes (spontaneous, peri- or postoperative) were diagnosed with VWD [type 1: 42/82; type 2: 24/82; type 3: 13/82; acquired: 3/82]. In all patients, decision for initiating prophylaxis was based on a bleeding score > 2 prior to diagnosis, concomitant with recurrent bleeds associated with anaemia in patients with on-demand VWD therapy. We report results on secondary prophylactic VWF replacement therapy applied in 32 patients [children n=13; adolescents n=7; adults n=12] with VWD [type 1: 4; type 2: 15; type 3: 13], 15 of which were females, and nine of these at the reproductive period. Eight patients were treated with Humate P® or Wilate® (n=24). Median [min-max] dose [vWF:RCo] was 40 [20-47] IU/kg, 23 patients were given substitution therapy twice weekly, seven patients three times a week, and two children four times per week. Within a 12-month-period haemoglobin concentrations returned to normal values. Median duration of prophylaxis was three years. Recurrent bleeding episodes stopped in 31 of 32 patients, whereas inhibitors developed in one. Following a 12-month observation period the monthly bleeding frequency and the bleeding score was significantly reduced [3 vs. 0.07; 3 vs. 0: p< 0.001], compared to the pre-prophylaxis/pre-diagnostic values. The use of secondary prophylactic VWF replacement therapy is an effective tolerated treatment modality, highly beneficial for patients with VWD, who present with recurrent bleeding events during on-demand therapy. PMID:21301780

  13. 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...

  14. 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

  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. PMID:25969373

  16. Self-reported school experience as a predictor of self-harm during adolescence: A prospective cohort study in the South West of England (ALSPAC)

    PubMed Central

    Kidger, Judi; Heron, Jon; Leon, David A; Tilling, Kate; Lewis, Glyn; Gunnell, David

    2015-01-01

    Background Several aspects of school life are thought to be associated with increased risk of self-harm in adolescence, but these have rarely been investigated in prospective studies. Methods Members of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort completed postal surveys of school experiences aged 14, and self-harm behaviour aged 16 (n=3939). Associations between school experiences (feeling connected to school, enjoyment of school and perception of teachers as fair) and subsequent self-harm were examined using multivariable logistic regression models. Results Self-harm aged 16 was associated with earlier perceptions of school, specifically not getting on well with or feeling accepted by others (OR=2.43 [1.76, 3.35] and OR=2.69 [2.16, 3.35] respectively), not liking school or the work done in class (OR=1.40 [1.17, 1.69] and OR=1.36 [1.10, 1.67]), and feeling that teachers are not clear about behaviour or fail to address misbehaviour consistently (OR=1.59 [1.20, 2.12] OR=1.89 [1.51, 2.37]). These associations were partially attenuated in models controlling for mental health concurrent with the outcome. Poor school experiences were related to both suicidal and non-suicidal self-harm, with slightly stronger associations visible for the former. Limitations (i) There was some loss to follow up, (ii) experience of bullying was not measured, and (iii) exposure and outcome measures were self-report. Conclusions Students who feel unconnected to school, unhappy at school, or feel that teachers are unfair are more likely to self-harm in the future. Assessing students׳ perceptions of school may serve to identify those at risk of self-harm who would benefit from preventative interventions. PMID:25462412

  17. 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

  18. 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

  19. Informal Child Care and Adolescent Psychological Well-Being: Hong Kong’s “Children of 1997” Birth Cohort

    PubMed Central

    Leung, Cherry Y.; Leung, Gabriel M.; Schooling, C. Mary

    2015-01-01

    Background Informal child care (child care by untrained family members, relatives or employees in the home) in Western populations is often associated with poorer psychological well-being, which may be confounded by socioeconomic position. We examined the association of informal child care, common in non-Western settings, with adolescent psychological well-being, using Hong Kong’s Chinese “Children of 1997” birth cohort. Methods Multivariable linear regression was used to examine the adjusted associations of informal child care (at 0.5, 3, 5 and 11 years) with parent-reported Rutter score for child behavior at 11 years, self-reported Culture-Free Self-Esteem Inventories score at 11 years and self-reported Patient Health Questionnaire-9 depressive symptom score at 13 years. Model comparisons were used to identify the best representation of child care, in terms of a critical period of exposure to informal child care (independent variable) at a specific age, combination of exposures to informal child care at several ages or an accumulation of exposures to informal child care. Results Child care was not associated with behavioral problems. A model considering child care at 3 years best represented the association of child care with self-esteem while a model considering child care at 5 years best represented the association of child care with depressive symptoms. Informal child care at 3 years was associated with lower self-esteem (-0.70, 95% confidence interval (CI) -1.26 to -0.14). Informal child care at 5 years was associated with more depressive symptoms (0.45, 95% CI 0.17 to 0.73). Conclusion In a developed non-Western setting, informal child care was associated with lower self-esteem and more depressive symptoms. PMID:25781484

  20. 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

  1. 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…

  2. 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…

  3. 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

  4. 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

  5. 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. PMID:25448829

  6. 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…

  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. 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…

  10. 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…

  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. 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…

  13. 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…

  14. 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…

  15. 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…

  16. Ethnic Peer Preferences among Asian American Adolescents in Emerging Immigrant Communities

    ERIC Educational Resources Information Center

    Kiang, Lisa; Peterson, Jamie Lee; Thompson, Taylor L.

    2011-01-01

    Growing diversity and evidence that diverse friendships enhance psychosocial success highlight the importance of understanding adolescents' ethnic peer preferences. Using social identity and social contact frameworks, the ethnic preferences of 169 Asian American adolescents (60% female) were examined in relation to ethnic identity, perceived…

  17. 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…

  18. 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

  19. 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

  20. 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

  1. Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents

    PubMed Central

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

    2015-01-01

    Objectives This paper aimed to systematically evaluate the mental health and well-being outcomes observed in previous community-based obesity prevention interventions in adolescent populations. Setting Systematic review of literature from database inception to October 2014. Articles were sourced from CINAHL, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsycARTICLES and PsycINFO, all of which were accessed through EBSCOhost. The Cochrane Database was also searched to identify all eligible articles. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. Participants Intervention studies were eligible for inclusion if they were: focused on overweight or obesity prevention, community-based, targeted adolescents (aged 10–19 years), reported a mental health or well-being measure, and included a comparison or control group. Studies that focused on specific adolescent groups or were treatment interventions were excluded from review. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Primary and secondary outcome measures Primary outcomes were measures of mental health and well-being, including diagnostic and symptomatic measures. Secondary outcomes included adiposity or weight-related measures. Results Seven studies met the inclusion criteria; one reported anxiety/depressive outcomes, two reported on self-perception well-being measures such as self-esteem and self-efficacy, and four studies reported outcomes of quality of life. Positive mental health outcomes demonstrated that following obesity prevention, interventions included a decrease in anxiety and improved health-related quality of life. Quality of evidence was graded as very low. Conclusions Although positive outcomes for mental health and well-being do exist, controlled evaluations of community-based obesity prevention interventions have

  2. A prospective study of childhood and adolescent antecedents of homelessness among a community population of African Americans.

    PubMed

    Fothergill, Kate E; Doherty, Elaine E; Robertson, Judith A; Ensminger, Margaret E

    2012-06-01

    Much is known about contemporaneous correlates of homelessness from studies of homeless individuals. However, few studies have prospectively examined early antecedents and prevalence of homelessness in community populations. We use data from a 35-year study of a community population of African Americans to examine relationships between homelessness and prior structural, family, school, and behavioral influences. Nearly 22% of males and 16% of females reported homelessness between ages 15 and 42, providing a rare estimate within an African American urban community population. In bivariate analyses, lower school bonds, depressed mood, violent behavior, and running away in adolescence are predictive for both males and females. Teen parenting and angry mood are unique influences for females, while for males, poor first grade classroom conduct and adolescent substance use are unique risks. In multivariate analyses, poor classroom conduct and weaker school bonds predict homelessness among males, while teen parenting does so for females. Running away before age 15 is strongly predictive of later homelessness for both males and females. These results reveal the relative influence of multiple, interrelated early risks on homelessness and confirm our hypothesis that factors linked to other poor outcomes also relate to homelessness, underscoring another benefit to early prevention efforts. PMID:22234393

  3. Effects of parental monitoring and exposure to community violence on antisocial behavior and anxiety/depression among adolescents.

    PubMed

    Bacchini, Dario; Concetta Miranda, Maria; 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 16 to 19 (mean age = 17.53, standard deviation = 1.24). All were in the 3rd (11th grade) or 5th year (13th grade) of high school. Self-reported measures were used to assess antisocial behavior, symptoms of anxiety/depression, parental monitoring and exposure to community violence as a victim or as a witness. First of all we tested, through a hierarchical multiple regression, the independent contribution of gender, exposure to community violence and parental monitoring upon antisocial behavior and symptoms of anxiety/depression; then we tested the moderating role of gender and parental monitoring on the negative effects of exposure to violence. The results show that male gender, high level of exposure to community violence (both as a victim and a witness), and low level of parental monitoring predict a higher involvement in antisocial behavior. Female gender, being a victim and low level of parental monitoring predict symptoms of anxiety/depression. Furthermore, parental monitoring and gender play a moderating role, minimizing or amplifying the negative effects of exposure to community violence. The results of the research suggest that a similar pattern of risk and protective factors can give rise to multiple paths of adaptive or maladaptive development. PMID:20234055

  4. 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

  5. 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.

  6. Applying qualitative data derived from a Rapid Assessment and Response (RAR) approach to develop a community-based HIV prevention program for adolescents in Thailand.

    PubMed

    Watthayu, Nantiya; Wenzel, Jennifer; Panchareounworakul, Kobkul

    2015-01-01

    HIV education programs are needed to address risk-taking behavior for adolescents. The purpose of our study was to use the World Health Organization's Rapid Assessment and Response (RAR) method to design a community-based, cultural- and age-appropriate HIV prevention program for adolescents in Bangkok, Thailand. Adolescent single-gender-specific focus groups (n = 3; 28 participants) were used to gather reactions/ideas about program topics/approaches. An adult, mixed-gender group was held to review information identified by adolescents. Sessions were audiotaped and transcribed verbatim. Themes regarding HIV content and the process of implementation emerged from a qualitative content analysis of the data. Community representatives recommended incorporation of HIV information and risk-prevention skills. Information delivery suggestions included small group discussions, interactive games/role-playing, program materials/terminology, and HIV-infected program facilitators. Community members provided critical input toward an HIV prevention program tailored to meet adolescents' unique needs/interests. The RAR model provides opportunities to engage communities in developing health-related interventions. PMID:26279387

  7. 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

  8. 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…

  9. 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

  10. Can We Predict Oral Antibiotic Treatment Failure in Children with Fast-Breathing Pneumonia Managed at the Community Level? A Prospective Cohort Study in Malawi

    PubMed Central

    King, Carina; McCollum, Eric D.; Mankhambo, Limangeni; Colbourn, Tim; Beard, James; Hay Burgess, Debbie C.; Costello, Anthony; Izadnegahdar, Raza; Lufesi, Norman; Masache, Gibson; Mwansambo, Charles; Nambiar, Bejoy; Johnson, Eric; Platt, Robert; Mukanga, David

    2015-01-01

    Background Pneumonia is the leading cause of infectious death amongst children globally, with the highest burden in Africa. Early identification of children at risk of treatment failure in the community and prompt referral could lower mortality. A number of clinical markers have been independently associated with oral antibiotic failure in childhood pneumonia. This study aimed to develop a prognostic model for fast-breathing pneumonia treatment failure in sub-Saharan Africa. Method We prospectively followed a cohort of children (2–59 months), diagnosed by community health workers with fast-breathing pneumonia using World Health Organisation (WHO) integrated community case management guidelines. Cases were followed at days 5 and 14 by study data collectors, who assessed a range of pre-determined clinical features for treatment outcome. We built the prognostic model using eight pre-defined parameters, using multivariable logistic regression, validated through bootstrapping. Results We assessed 1,542 cases of which 769 were included (32% ineligible; 19% defaulted). The treatment failure rate was 15% at day 5 and relapse was 4% at day 14. Concurrent malaria diagnosis (OR: 1.62; 95% CI: 1.06, 2.47) and moderate malnutrition (OR: 1.88; 95% CI: 1.09, 3.26) were associated with treatment failure. The model demonstrated poor calibration and discrimination (c-statistic: 0.56). Conclusion This study suggests that it may be difficult to create a pragmatic community-level prognostic child pneumonia tool based solely on clinical markers and pulse oximetry in an HIV and malaria endemic setting. Further work is needed to identify more accurate and reliable referral algorithms that remain feasible for use by community health workers. PMID:26313752

  11. 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

  12. 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

  13. 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

  14. Feasibility of Adolescents to Conduct Community-Based Participatory Research on Obesity and Diabetes in Rural Appalachia

    PubMed Central

    Bardwell, Genevieve; Morton, Cathy; Chester, Ann; Pancoska, Petr; Buch, Shama; Cecchetti, Alfred; Vecchio, Marcella; Paulsen, Stephanie; Groark, Stephen; Branch, Robert A.

    2015-01-01

    Community-Based Participatory Research (CBPR) has been advocated to translate advances in health care sciences to the community. We describe a novel approach applied to obesity management and diabetes prevention. This takes advantage of a network of science clubs organized by the Health Sciences and Technology Academy (HSTA) for extracurricular activity of disadvantaged high school students in rural Appalachia. Physician scientists and educators provided an intensive summer course on CBPR, ethics, and study design on obesity management and diabetes prevention. Ethical certification for CBPR investigation was obtained for 210 students and 18 mentors for a study on the prevalence of obesity and Type II diabetes within their community. Over a 6-month period, 989 had a collection of complete analyzable data, of which 103 had diabetes. The proportion with obesity (BMI ≥ 30) was over 50%. The frequency of diabetes was related to increasing BMI. When BMI ≥ 40, the frequency approached 50%, and exhibited a clear familial distribution. We conclude that trained adolescents can effectively conduct CBPR, and obesity and diabetes are more prevalent than previously reported in this community. This experience provides encouragement to conduct future studies to influence weight management from high-risk populations in this medically disadvantaged community. PMID:20443917

  15. 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. PMID:23412948

  16. 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

  17. 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

  18. 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

  19. [Malocclusions in children and adolescents from villages and native communities in the Ucayali Amazon region in Peru].

    PubMed

    Aliaga-Del Castillo, Arón; Mattos-Vela, Manuel Antonio; Aliaga-Del Castillo, Rosalinda; Del Castillo-Mendoza, Claudia

    2011-03-01

    We conducted a cross-sectional descriptive study to assess the prevalence of malocclusions in children and adolescents aged 2 to 18 years of villages and native communities of the Ucayali jungle of Peru. We assessed the presence of malocclusions using Angle's classification and orthodontic changes. We evaluated 201 individuals, 106 (52.7%) were women, most of them (54.7%) had between 6 and 12 years. The prevalence of malocclusions was 85.6%, the most prevalent according to Angle's classification was class I (59.6%). Orthodontic alterations were present in 67.2% of cases. The most frequent were dental crowding (28.4%), anterior crossbite (17.4%), exaggerated overjet (8.5%), excessive overbite (5.0%) and anterior open bite (5.0%). We found a high prevalence of malocclusion and orthodontic changes in the evaluated native communities, highlighting the need to implement preventive programs to improve the oral health of these neglected populations. PMID:21537775

  20. 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,…

  1. Rationale and Design of a Multicenter Echocardiographic Study to Assess the Relationship between Cardiac Structure and Function and Heart Failure Risk in a Biracial Cohort of Community Dwelling Elderly Persons: The Atherosclerosis Risk in Communities (ARIC) Study

    PubMed Central

    Shah, Amil M.; Cheng, Susan; Skali, Hicham; Wu, Justina; Mangion, Judy R.; Kitzman, Dalane; Matsushita, Kunihiro; Konety, Suma; Butler, Kenneth R.; Fox, Ervin R.; Cook, Nakela; Ni, Hanyu; Coresh, Joseph; Mosley, Thomas H.; Heiss, Gerardo; Folsom, Aaron R.; Solomon, Scott D.

    2014-01-01

    Background Heart failure (HF) is an important public health concern particularly among persons over 65 years of age. Women and African Americans are critically understudied populations that carry a sizeable portion of the HF burden. Limited normative and prognostic data exist regarding measures of cardiac structure, diastolic function, and novel measures of systolic deformation in older adults living in the community. Methods and Results The Atherosclerosis Risk in Communities (ARIC) study is a large, predominantly biracial NHLBI-sponsored epidemiologic cohort study. Between 2011 and 2013, approximately 6,000 surviving participants, now in their seventh to ninth decade of life, are expected to return for a 5th study visit during which comprehensive 2D, Doppler, tissue Doppler, and speckle-tracking echocardiography will be performed uniformly in all cohort clinic visit participants. The following objectives will be addressed: (1) to characterize cardiac structural and functional abnormalities among the elderly and determine how these differ by gender and race/ethnicity, (2) determine the relationship between ventricular and vascular abnormalities, and (3) prospectively examine the extent to which these non-invasive measures associate with incident HF. Conclusions We describe the design, imaging acquisition and analysis methods, and quality assurance metrics for echocardiography in Visit 5 of the ARIC cohort. A better understanding of the differences in cardiac structure and function through the spectrum of HF stages in the elderly generally, and between genders and racial/ethnic groups specifically, will deepen our understanding of the pathophysiology driving HF progression in these at-risk populations and may inform novel prevention or therapeutic strategies. PMID:24214885

  2. Factors associated with uptake of services to prevent mother-to-child transmission of HIV in a community cohort in rural Tanzania

    PubMed Central

    Gourlay, Annabelle; Wringe, Alison; Todd, Jim; Cawley, Caoimhe; Michael, Denna; Machemba, Richard; Reniers, Georges; Urassa, Mark; Zaba, Basia

    2015-01-01

    Objectives This study aimed to identify factors associated with access to HIV care and antiretroviral (ARV) drugs for prevention of mother-to-child transmission (PMTCT) of HIV among HIV-positive pregnant women in a community cohort in rural Tanzania (Kisesa). Methods Kisesa-resident women who tested HIV-positive during HIV serosurveillance and were pregnant (while HIV-positive) between 2005 and 2012 were eligible. Community cohort records were linked to PMTCT and HIV clinic data from four facilities (PMTCT programme implemented in 2009; referrals to city-based hospitals since 2005) to ascertain service use. Factors associated with access to HIV care and ARVs during pregnancy were analysed using logistic regression. Results Overall, 24% of women accessed HIV care and 12% accessed ARVs during pregnancy (n=756 pregnancies to 420 women); these proportions increased over time. In multivariate analyses for 2005–2012, being married, prior voluntary counselling and testing, increasing age, increasing year of pregnancy and increasing duration of infection were independently associated with access to care and ARVs. Residence in roadside areas was an independent predictor of access to care but not ARVs. There was no evidence of an interaction with time period. Conclusions Access to PMTCT services was low in this rural setting but improved markedly over time. There were fairly few sociodemographic differentials although support for young women and those without partners may be needed. Further decentralisation of HIV services to more remote areas, promotion of voluntary counselling and testing and implementation of Option B+ are likely to improve uptake and may bring women into care and treatment sooner after infection. PMID:26045467

  3. 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. PMID:26135861

  4. 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 Central

    Sauer-Heilborn, Annette; Welte, Tobias; Guzman, Carlos A.; Abraham, Wolf-Rainer; Höfle, Manfred G.

    2015-01-01

    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. PMID:26135861

  5. Results of sustained long-term use of interferon beta-1a in a community-based cohort of patients with relapsing multiple sclerosis

    PubMed Central

    Cohan, Stanley; Chen, Chiayi; Baraban, Elizabeth; Stuchiner, Tamela; Grote, Lois; Rodriguez, Monica

    2015-01-01

    Background Few studies have evaluated long-term efficacy of interferon beta-1a in large community-based cohorts. Objective Evaluate time to relapse, relapse rate, and disability progression in patients treated with intramuscular interferon beta-1a. Methods A retrospective review of medical records from 2000–2010 was performed. Adult patients with relapsing-remitting MS or clinically isolated syndrome treated with interferon beta-1a were included. Primary outcomes were time to relapse, annualized relapse rate, and changes in Expanded Disability Status Scale score. Other outcomes included factors associated with time to first relapse, risk of having a relapse while receiving interferon beta-1a, and discontinuation of therapy. Results In total, 364 of 696 patients screened were enrolled, with a mean age of 51 ± 12.1 years, disease duration of 9.39 ± 7.02 years, and duration of therapy of 4.03 ± 2.56 years. Mean time to first on-therapy relapse was 5.58 ± 0.26 years, annualized relapse rate was 0.30 ± 0.55 years, and mean increase in sustained Expanded Disability Status Scale score was 0.018. Relapse risk was associated with higher baseline Expanded Disability Status Scale score, age at disease onset, and number of relapses in the 12 months prior to therapy initiation. Conclusions This study demonstrates favorable clinical outcomes observed in a large community-based cohort, and serves to emphasize the continued therapeutic importance of interferon beta-1a, despite the development of newer agents with greater convenience of use, but also more potential risk of serious morbidity.

  6. 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

  7. A cohort study comparing cardiovascular risk factors in rural Māori, urban Māori and non-Māori communities in New Zealand

    PubMed Central

    Faatoese, Allamanda F; Gillies, Matea W; Robertson, Paul J; Huria, Tania M; Doughty, Rob N; Whalley, Gillian A; Richards, Mark A; Troughton, Richard W; Tikao-Mason, Karen N; Wells, Elisabeth J; Sheerin, Ian G; Pitama, Suzanne G

    2012-01-01

    Objectives To understand health disparities in cardiovascular disease (CVD) in the indigenous Māori of New Zealand, diagnosed and undiagnosed CVD risk factors were compared in rural Māori in an area remote from health services with urban Māori and non-Māori in a city well served with health services. Design Prospective cohort study. Setting Hauora Manawa is a cohort study of diagnosed and previously undiagnosed CVD, diabetes and risk factors, based on random selection from electoral rolls of the rural Wairoa District and Christchurch City, New Zealand. Participants Screening clinics were attended by 252 rural Māori, 243 urban Māori and 256 urban non-Māori, aged 20–64 years. Main outcome measures The study documented personal and family medical history, blood pressure, anthropometrics, fasting lipids, insulin, glucose, HbA1c and urate to identify risk factors in common and those that differ among the three communities. Results Mean age (SD) was 45.7 (11.5) versus 42.6 (11.2) versus 43.6 (11.5) years in rural Māori, urban Māori and non-Māori, respectively. Age-adjusted rates of diagnosed cardiac disease were not significantly different across the cohorts (7.5% vs 5.8% vs 2.8%, p=0.073). However, rural Māori had significantly higher levels of type-2 diabetes (10.7% vs 3.7% vs 2.4%, p<0.001), diagnosed hypertension (25.0% vs 14.9% vs 10.7%, p<0.001), treated dyslipidaemia (15.7% vs 7.1% vs 2.8%, p<0.001), current smoking (42.8% vs 30.5% vs 15.2%, p<0.001) and age-adjusted body mass index (30.7 (7.3) vs 29.1 (6.4) vs 26.1 (4.5) kg/m2, p<0.001). Similarly high rates of previously undocumented elevated blood pressure (22.2% vs 23.5% vs 17.6%, p=0.235) and high cholesterol (42.1% vs 54.3% vs 42.2%, p=0.008) were observed across all cohorts. Conclusions Supporting integrated rural healthcare to provide screening and management of CVD risk factors would reduce health disparities in this indigenous population. PMID:22685219

  8. A Comparison between a 1986 and 1989 Cohort of Inner-City Adolescent Females on Knowledge, Beliefs, and Risk Factors for AIDS.

    ERIC Educational Resources Information Center

    Weinman, Maxine L.; And Others

    1992-01-01

    Compared responses of inner-city adolescent girls to measures of knowledge, beliefs and risk factors for Acquired Immune Deficiency Syndrome (AIDS) obtained in 1986 (n=205) and in 1989 (n=510). Between 1986 and 1989, number of sexual partners increased whereas concern about AIDS decreased. Those adolescents with most sexual partners also had most…

  9. 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),…

  10. Change in attitudes and knowledge of problem drug use and harm reduction among a community cohort in Kabul, Afghanistan.

    PubMed

    Todd, C S; Stanekzai, M R; Nasir, A; Fiekert, K; Orr, M G; Strathdee, S A; Vlahov, D

    2016-03-01

    This pre-post evaluation aimed to measure changes in knowledge and attitudes towards drug users among community representatives in Kabul, Afghanistan, over a period of expansion of harm reduction and drug dependence programming. A convenience sample of 160 professionals aged 18+ years completed interview questionnaires in 2007 and 2009. Views endorsing programme quality and the provision of condoms, infection counselling/testing and needle/syringe distribution increased significantly over the 2-year period. In 13 of 38 statements, there was a substantial (> 10%) change in agreement level, most commonly among men and medical professionals. Attitudes concerning support of drug users remained largely positive, with substantial attitude changes in some subgroups of the population. Further community education through the media and a more cohesive government drug policy may be needed to strengthen community support for harm reduction/drug treatment in Afghanistan. PMID:27334075

  11. Incremental health care costs for chronic pain in Ontario, Canada: a population-based matched cohort study of adolescents and adults using administrative data.

    PubMed

    Hogan, Mary-Ellen; Taddio, Anna; Katz, Joel; Shah, Vibhuti; Krahn, Murray

    2016-08-01

    Little is known about the economic burden of chronic pain and how chronic pain affects health care utilization. We aimed to estimate the annual per-person incremental medical cost and health care utilization for chronic pain in the Ontario population from the perspective of the public payer. We performed a retrospective cohort study using Ontario health care databases and the electronically linked Canadian Community Health Survey (CCHS) from 2000 to 2011. We identified subjects aged ≥12 years from the CCHS with chronic pain and closely matched them to individuals without pain using propensity score matching methods. We used linked data to determine mean 1-year per-person health care costs and utilization for each group and mean incremental cost for chronic pain. All costs are reported in 2014 Canadian dollars. After matching, we had 19,138 pairs of CCHS respondents with and without chronic pain. The average age was 55 years (SD = 18) and 61% were female. The incremental cost to manage chronic pain was $1742 per person (95% confidence interval [CI], $1488-$2020), 51% more than the control group. The largest contributor to the incremental cost was hospitalization ($514; 95% CI, $364-$683). Incremental costs were the highest in those with severe pain ($3960; 95% CI, $3186-$4680) and in those with most activity limitation ($4365; 95% CI, $3631-$5147). The per-person cost to manage chronic pain is substantial and more than 50% higher than a comparable patient without chronic pain. Costs are higher in people with more severe pain and activity limitations. PMID:26989805

  12. 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…

  13. 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

  14. Working memory performance is related to intrinsic resting state functional connectivity changes in community-dwelling elderly cohort.

    PubMed

    Charroud, Céline; Le Bars, Emmanuelle; Deverdun, Jérémy; Steffener, Jason; Molino, François; Abdennour, Meriem; Portet, Florence; Bonafe, Alain; Stern, Yaakov; Ritchie, Karen; Akbaraly, Tasnime N; Menjot de Champfleur, Nicolas

    2016-07-01

    Characterization of normal age-related changes in resting state brain networks associated with working memory performance is a major prerequisite for studying neurodegenerative diseases. The aim of this study was to investigate the relationship between performing a working memory task (under MRI) and resting-state brain networks in a large cohort of healthy elderly subjects (n=337). Functional connectivity and interactions between networks were assessed within the default mode (DMN), salience (SN), and right and left central executive (CEN) networks in two groups of subjects classed by their performance (low and high). The low performance group showed lower functional connectivity in both the DMN and SN, and higher functional connectivity in the right and left CEN compared to the high performance group. Overall the functional connectivity within the DMN and the CEN were correlated. The lower functional connectivity within the DMN and SN in the low performance group is suggestive of altered attentional and memory processes and/or altered motivation. The higher functional connectivity within the CEN could be related to compensatory mechanisms, without which the subjects would have even lower performances. The correlation between the DMN and CEN suggests a modulation between the lower functional connectivity within the DMN and the higher functional connectivity within the CEN when performance is reduced. Finally, this study suggests that performance modifications in healthy elderly subjects are associated with reorganization of functional connectivity within the DMN, SN, and CEN. PMID:27234057

  15. 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…

  16. 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,…

  17. Urban Adolescent Mothers Exposed to Community, Family, and Partner Violence: Is Cumulative Violence Exposure a Barrier to School Performance and Participation?

    ERIC Educational Resources Information Center

    Kennedy, Angie C.; Bennett, Larry

    2006-01-01

    Using a risk and resilience perspective, the authors assessed urban adolescent mothers' exposure to community, family, and partner violence and analyzed the relationships between cumulative violence exposure and multiple school outcomes, within the context of welfare reforms. Positive attitude toward school and social support were examined as…

  18. 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…

  19. 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…

  20. 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…