Appel à l'action : des recommandations pour améliorer la transition des jeunes ayant des besoins de santé complexes vers les soins aux adultes.

Les jeunes qui ont des besoins de santé complexes, définis comme ceux qui nécessitent des soins et services spécialisés en raison d'affections physiques, développementales ou mentales, sont souvent traités par des pédiatres et autres spécialistes en pédiatrie. Au Canada, l'âge auquel les bailleurs de fonds provinciaux et territoriaux exigent le transfert des soins pédiatriques aux soins pour adultes varie entre 16 et 19 ans. La délimitation actuelle entre les services de santé pédiatriques et aux adultes est fragmentaire, ce qui entrave la continuité des soins pendant une période déjà vulnérable du développement. Le peu d'intégration des soins entre les domaines peut nuire à l'engagement des jeunes en matière de santé et compromettre leur santé à l'âge adulte. Pour renverser ces obstacles et améliorer les résultats de la transition, les dispensateurs de soins pédiatriques et de soins aux adultes, de même que les médecins de famille et d'autres partenaires communautaires, doivent collaborer de manière satisfaisante à l'élaboration de stratégies systémiques qui rationalisent et préservent les soins aux jeunes en transition vers des soins aux adultes en milieu tertiaire, communautaire et primaire. Il est recommandé de privilégier des limites d'âge flexibles pour effectuer cette transition vers les soins aux adultes et de tenir compte de la phase de développement et de l'aptitude de chaque jeune, ainsi que des besoins et de la situation de chaque patient et de chaque famille. Une formation et un enseignement spécialisés sur les enjeux liés aux soins de transition s'imposent pour renforcer les capacités et s'assurer que les professionnels de la santé des diverses disciplines et des divers milieux soient mieux outillés pour accepter et traiter les jeunes qui ont des besoins de santé complexes.

Real and Perceived Effects of Caffeine on Sprint Cycling in Experienced Cyclists.

Anderson, DE, German, RE, Harrison, ME, Bourassa, KN, and Taylor, CE. Real and perceived effects of caffeine on sprint cycling in experienced cyclists. J Strength Cond Res 34(4): 929-933, 2020-Caffeine ingestion before an exercise bout may provide ergogenic effects on anaerobic performance, particularly in trained athletes. However, the degree of influence of caffeine may be coupled with the placebo effect. A double-blind, placebo-controlled, randomized design was used to determine the real and perceived effects of caffeine on anaerobic performance. Ten competitively trained cyclists (9 men and 1 woman) completed 3 trials of the Wingate Anaerobic Test (WAnT). Subjects were given coffee that they believed contained a high caffeine dose, a low caffeine dose, or a placebo 45 minutes before WAnT. Subjects were actually given 2 placebos (decaffeinated coffee) and one dose of caffeine (280 mg). Level of significance was p ≤ 0.05. No significant differences were found between trials for blood lactate concentration and heart rate. Seven of the subjects (70%) correctly identified the caffeine trial as the high caffeine trial. Time to peak power was significantly shorter for the trial in which subjects incorrectly guessed they had consumed caffeine when given the placebo compared with placebo trial (1.6 ± 0.1 vs. 2.3 ± 0.2 seconds). Power drop was significantly higher for the trial in which subjects incorrectly guessed they had consumed caffeine when given the placebo compared with placebo trial (524 ± 37 vs. 433 ± 35 W). There seems to be a placebo effect of caffeine on anaerobic performance. Improved performance may result from psychological advantages rather than physical advantages. Coaches may find it beneficial to use a placebo to improve anaerobic performance, especially if concerned about the side effects or cost of caffeine.

Use of cyproheptadine to stimulate appetite and body weight gain: A systematic review.

OBJECTIVE: A systematic review identifying the use of cyproheptadine (CY) as an appetite stimulant was completed. METHOD: Studies of any design exploring the efficacy of CY as an appetite stimulant in all age groups and populations were included. Primary outcomes of studies included were weight gain, appetite stimulation, and/or caloric/nutritional intake increase. The review was completed in accordance with PRISMA standards. RESULTS: A total of 46 articles across 21 different treatment populations met criteria for the review, including 32 randomized controlled trials, 4 prospective cohort studies, 4 retrospective cohort studies, 4 case reports and 2 case series. Of these, 39 demonstrated that CY resulted in significant weight gain in the sample under study. Studies exploring the use of CY in those with malignant/progressive disease states, such as HIV and cancer, showed minimal to no benefit of the medication. Transient mild to moderate sedation was the most commonly reported side effect. Studies included were heterogeneous in terms of methods as well as study patient demographics, characteristics and concurrent medical conditions. Few studies provided objective measures of appetite change. DISCUSSION: CY appears to be a safe, generally well-tolerated medication that has utility in helping facilitate weight gain in patients drawn from a variety of underweight populations. Future prospective randomized controlled studies in low weight patients that include objective measures of appetite and intake are needed to better understand the mechanism by which CY augments weight gain.

Adolescent pregnancy and eating disorders: a minireview and case report.

BACKGROUND: Despite the fact that eating disorders (EDs) during pregnancy and early child bearing can both individually increase risk to mother and child, there is a paucity of research exploring pregnancy in adolescence and concomitant EDs. CASE: We report the case of a 16-year-old female with atypical anorexia nervosa, who experiences a remission of her ED behavior during pregnancy, followed by a severe relapse in the post-partum period. CONCLUSION: In this case, pregnancy functioned as a motivator for remission in our patient with concomitant ED. Further research is needed to identify risks of EDs in adolescent pregnancy, to explore the trajectory of pre-existing EDs during pregnancy and to identify effective interventions for prolonging remission into the post-partum period.

Gastrointestinal complications associated with anorexia nervosa: A systematic review.

OBJECTIVE: A systematic review identifying gastrointestinal (GI) complications attributable to anorexia nervosa (AN) was completed. METHOD: Studies of any design exploring the pathogenesis of complications and treatment strategies were included. The review was completed in accordance with PRISMA standards. RESULTS: A total of 123 articles were retained, including one randomized control trial. The majority of included studies were case reports and case series. Controlled studies demonstrated that patients with AN were more likely to have delays in gastric motility, gastric emptying and intestinal transit than comparator groups although results were not uniform across all studies. Published reports suggest that complications can occur at any segment of the GI tract. These issues may derive as a consequence of severe malnourishment, from eating disorder related symptoms such as self-induced purging or from the refeeding process itself. Multiple studies noted that patients with AN report high rates of GI symptoms although in the few cases where medical testing was undertaken, correlations between self-reported symptoms and measurable pathology were not demonstrated. DISCUSSION: GI complications may occur throughout the entire GI tract in patients with AN. It is recommended that clinicians use careful judgment when pursuing targeted investigation or introducing symptom specific treatments in response to GI complaints. Evidence suggests that most GI complications resolve with refeeding and cessation of ED symptoms.

But We're Not Like the People on TV: A Qualitative Examination of How Media Messages are Perceived by Pregnant and Parenting Youth.

OBJECTIVES: The media has long been established as influential in the formation of youth attitudes. It remains unknown, however, whether popular media depictions of teenage pregnancy and motherhood shape the meanings pregnant and parenting youth (PPY) construct. This study explored PPY's perceptions of media messages portraying PPY. METHODS: Five focus groups were conducted at three urban centres that service pregnant youth and young parents. Convenience sample of 26 participants was recruited across sites. Focus groups were audio recorded, transcribed verbatim and analyzed thematically. RESULTS: Participants were a mean age of 18.7 years. Participants felt that the storylines in television reality programs featuring PPY were highly incongruent with their lived experiences and that these representations glamorized teenage pregnancy while failing to capture other realities, such as financial hardship. Further, it was felt that such representations informed public opinion and created a double standard for teen parents. Participants felt that healthcare providers were not immune to media messaging; some participants reported withdrawing socially and others delayed accessing health services because of what they perceived as negative media-fuelled public views. CONCLUSION: This study highlights the need for heightened awareness of the influence of popular media on the portrayal of PPY. Acknowledging and challenging stereotypes of teen pregnancy, as well as initiating dialogue with youth about the impact media has on their lives should be encouraged as a means of facilitating ongoing engagement with health care services.

Systematic review of the effects of family meal frequency on psychosocial outcomes in youth.

OBJECTIVE: To conduct a systematic review of the effects of frequent family meals on psychosocial outcomes in children and adolescents, and to examine whether there are differences in outcomes between males and females. DATA SOURCES: Studies were identified through a search of MEDLINE (1948 to fifth week of June 2011) and PsycINFO (1806 to first week of July 2011) using the Ovid interface. The MeSH terms and key words used both alone and in combination were family, meal, food intake, nutrition, diets, body weight, adolescent attitudes, eating behaviour, feeding behaviour, and eating disorders. Bibliographies of papers deemed relevant were also reviewed. STUDY SELECTION: The original search yielded 1783 articles. To be included in the analysis, studies had to meet the following criteria: have been published in a peer-reviewed journal in English; involve children or adolescents; discuss the role of family meals on the psychosocial outcomes (eg, substance use, disordered eating, depression) of children or adolescents; and have an adequate study design, including appropriate statistical methods for analyzing outcome data. Fourteen papers met inclusion criteria. Two independent reviewers studied and analyzed the papers. SYNTHESIS: Overall, results show that frequent family meals are inversely associated with disordered eating, alcohol and substance use, violent behaviour, and feelings of depression or thoughts of suicide in adolescents. There is a positive relationship between frequent family meals and increased self-esteem and school success. Studies show substantial differences in outcomes for male and female children and adolescents, with females having more positive results. CONCLUSION: This systematic review provides further support that frequent family meals should be endorsed. All health care practitioners should educate families on the benefits of having regular meals together as a family.

Exposure of breast cancer cells to a subcytotoxic dose of apigenin causes growth inhibition, oxidative stress, and hypophosphorylation of Akt.

Epidemiological studies show that fruit- and vegetable-rich diets are associated with a reduced risk of developing certain forms of cancer, including breast cancer. In this study we demonstrate that a subcytotoxic concentration of apigenin, which is a flavone found at high concentrations in parsley, onions, grapefruit, oranges, and chamomile tea, inhibited DNA synthesis in a panel of human breast cancer cell lines (MDA-MB-231, MBA-MB-468, MCF-7, SK-BR-3). Decreased proliferation of MDA-MB-468 cells in the presence of apigenin was associated with G2/M phase cell cycle arrest and the production of reactive oxygen species. Apigenin-treated MDA-MB-468 cells also showed reduced phosphorylation of Akt (protein kinase B), which is an essential effector serine/threonine kinase in the phosphatidylinositide 3-kinase pathway that promotes tumor growth and progression. However, exposure to the antioxidant reduced glutathione failed to reverse apigenin-mediated inhibition of Akt phosphorylation and cell proliferation, indicating that these effects were not due to oxidative stress. Taken together, these findings suggest that low-dose apigenin has the potential to slow or prevent breast cancer progression.

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

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

OBJECTIF: Décrire les adolescentes enceintes et les mères adolescentes vues à une clinique de santé pour adolescentes d'une communauté urbaine, dans le cadre d'un projet pilote de deux ans. MÉTHODOLOGIE: Les chercheurs ont effectué un examen rétrospectif des dossiers de toutes les adolescentes qui ont consulté aux cliniques mensuelles d'une demi-journée entre janvier 2008 et janvier 2010 (n=36). Les mesures tirées des dossiers incluaient les données démographiques, les raisons de l'orientation à la clinique, les antécédents sociaux, les antécédents de problèmes de santé mentale et les résultats cliniques de l'évaluation. RÉSULTATS: Toutes les participantes étaient de sexe féminin (âge moyen de 17 ans). Quarante-deux pour cent étaient enceintes à l'évaluation initiale, tandis que les autres avaient de un à deux enfants ou avaient récemment fait une fausse couche. Soixante et un pour cent n'avaient pas de médecin de première ligne. La raison primaire de l'orientation à la clinique était des inquiétudes en santé mentale, surtout la dépression. Près de la moitié des patientes recouraient à l'assistance sociale et près de la moitié habitaient dans un refuge. Au moment de leur première visite, 42 % des patientes ne fréquentaient pas l'école. La plupart n'avaient pas dépassé la 8e année. La majorité avait des antécédents de problèmes de santé mentale et de consommation de drogue ou d'alcool. CONCLUSIONS: Les adolescentes qui consultaient à la clinique avaient des antécédents de défavorisation sur le plan du revenu, du niveau d'instruction, des conditions de logement et de la santé mentale et avaient besoin de divers services de santé, y compris un dispensateur de soins de première ligne. Ces observations contribueront à appuyer l'élaboration de futurs programmes pour ces jeunes à risque et auront des répercussions pour les praticiens qui s'occupent de cette population.

Adolescents on an inpatient unit and their healthcare providers: what's working and what's not.

OBJECTIVES: Adolescents admitted to hospital can face unique medical and psychosocial challenges, and may be treated by healthcare providers who do not recognize or adequately address these needs. Our goal was to better understand the experiences of both patients and providers at a local level. METHODS: We designed a cross-sectional survey-based study of two participant groups: (1) adolescent patients (aged 10-19) admitted to general medical wards at a tertiary pediatric hospital and (2) pediatric healthcare providers representing multiple disciplines. RESULTS: A total of 65 individuals participated: 25 adolescents (mean age 14.6; range 11-17) and 40 multidisciplinary healthcare providers. Most adolescents reported being treated respectfully (88 %) and taken seriously (92 %) by their providers. Several identified structure and routine, a break from daily stressors, and quality time with loved ones as positive aspects to hospitalization, while the use of correct gender pronouns, privacy, and age-appropriate leisure activities were cited areas for improvement. The majority of providers reported enjoying caring for adolescents (82 %) and forging therapeutic connections with them (87 %). Several areas of discomfort were noted, including gender and sexuality, substance use, and suicidality. Identified care gaps included inadequate training/education, suboptimal ward environments, and lack of community resources. CONCLUSIONS: Hospitals should recognize adolescent patients' needs for privacy, youth-centered communication, and developmentally-appropriate spaces. Pediatric healthcare professionals generally enjoy providing care to adolescents in the in-patient setting, however, often have insufficient training in addressing adolescent-specific health and psychosocial issues.

Menstrual health inequities and "period poverty" in Canada.

Period poverty is the lack of access to menstrual products, sexual and reproductive health education, safe waste management, and adequate facilities. Despite its being a public health issue and a significant concern for numerous Canadians, there is a lack of peer-reviewed research on period poverty in Canada. Existing Canadian research has primarily been conducted by non-profit organizations/charities or industry leaders for menstrual products, resulting in incomplete data. More research is needed to explore the menstrual inequities in Canada and their impact on the well-being of Canadians. This is a critical step to ensure the menstrual needs of Canadians are appropriately addressed.

RéSUMé: La précarité menstruelle est le manque d'accès aux produits pour la menstruation, à l'éducation à la santé sexuelle et reproductive, à la gestion sûre des déchets et à des installations adéquates. Bien que ce soit un problème de santé publique et une préoccupation importante pour bon nombre de Canadiennes et de Canadiens, il n'y a pas assez de recherche évaluée par les pairs sur la précarité menstruelle au pays. La recherche canadienne existante a principalement été menée par des organismes caritatifs/à but non lucratif ou par les grandes entreprises de produits pour la menstruation, ce qui explique que les données sont incomplètes. Il faut pousser la recherche pour explorer l'iniquité menstruelle au Canada et ses effets sur le bien-être des Canadiennes et des Canadiens. C'est une étape essentielle pour pouvoir aborder convenablement les besoins menstruels de la population.

Adolescents' Cannabis Knowledge and Risk Perception: A Systematic Review.

To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO, and EMBASE using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. 133 studies from around the world (including ages 10-18 yrs) met inclusion criteria, with 70% meeting grade 2C quality. Increased knowledge and perception of risk of cannabis frequently correlated with lower levels of current use and intent to use. Studies examining correlations over time generally demonstrated increased adolescent cannabis use and decreased perception of risk. Included prevention-based interventions often enhanced knowledge and/or perception of risk in adolescents exposed to the intervention. Studies exploring outcomes relating to legislative changes for recreational marijuana use demonstrated considerable heterogeneity regarding knowledge and perception of risk whereas studies that focused on medicinal marijuana legislative changes overwhelmingly demonstrated a decrease in perception of risk post legalization. Increased knowledge and perception of risk of cannabis in adolescents often correlate with lower levels of current use and intention to use in the future. Further study and implementation of public health and clinically-oriented strategies that seek to increase knowledge among youth about the potential health harms of cannabis use should continue and be prioritized.

Sexual and Reproductive Health Outcomes Among Adolescent Females During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 (COVID-19) posed a significant threat to adolescents' sexual and reproductive health. In this study, we examined population-level pregnancy and sexual health-related care utilization among adolescent females in Ontario, Canada during the pandemic and evaluated relationships between these outcomes and key sociodemographic characteristics. METHODS: This was a population-based, repeated cross-sectional study of >630 000 female adolescents (12-19 years) during the prepandemic (January 1, 2018-February 29, 2020) and COVID-19 pandemic (March 1, 2020-December 31, 2022) periods. Primary outcome was pregnancy; secondary outcomes were contraceptive management visits, contraception prescription uptake, and sexually transmitted infection (STI) management visits. Poisson models with generalized estimating equations for clustered count data were used to model pre-COVID-19 trends and forecast expected rates during the COVID-19 period. Absolute rate differences between observed and expected outcome rates for each pandemic month were calculated overall and by urbanicity, neighborhood income, immigration status, and region. RESULTS: During the pandemic, lower-than-expected population-level rates of adolescent pregnancy (rate ratio 0.87; 95% confidence interval [CI]:0.85-0.88), and encounters for contraceptive (rate ratio 0.82; 95% CI:0.77-0.88) and STI management (rate ratio 0.52; 95% CI:0.51-0.53) were observed. Encounter rates did not return to pre-pandemic rates by study period end, despite health system reopening. Pregnancy rates among adolescent subpopulations with the highest pre-pandemic pregnancy rates changed least during the pandemic. CONCLUSIONS: Population-level rates of adolescent pregnancy and sexual health-related care utilization were lower than expected during the COVID-19 pandemic, and below-expected care utilization rates persist. Pregnancy rates among more structurally vulnerable adolescents demonstrated less decline, suggesting exacerbation of preexisting inequities.

Growth curves in short supply: a descriptive study of the availability and utility of growth curve data in adolescents with eating disorders.

BACKGROUND: Healthy body weight (HBW) determination affects multiple aspects of eating disorder (ED) treatment. For example, it can inform patients and providers as to when return of menses (ROM), an objective determinant of health, can occur. Growth curves (GCs) are sensitive indicators of health in youth and when up to date provide critical information regarding normal and expected trajectories of growth. Although not widely recommended as a first line tool for HBW calculation, a GC guides providers selecting a HBW that is individualized to each patient. The primary aim of this paper was to assess availability and feasibility of utilizing GC data for HBW prediction in adolescents referred for an ED assessment. We also sought to determine how this calculation compared to the standardized HBW calculation that uses mean body mass index (BMI) for age and how each of these numbers compared to the actual weight at ROM. METHODS: A retrospective chart review was completed on outpatients assessed for EDs between January 2004 and December 2006. A total of 102 patients met inclusion criteria. Demographic information, GC data, HBW predictions, and menstrual history were analyzed. A comparison of predicted HBWs using the aforementioned calculations and weight at ROM was performed using t-test analyses. RESULTS: Eighty-one patients (79.4%) had GC data available at assessment although HBW prediction was possible in only 24 patients (23.8%) due to poor GC completion. Of those 24 patients, 9 had ROM data available; no significant difference between our predicted HBW and the weight at ROM was found in these patients. In cases where HBW predictions could be compared using GC data and the BMI method, we found the GC calculation to be overall superior. CONCLUSIONS: We found overall rates of GC completion to be very low in our patients, which in turn limited the feasibility of relying on a GC for HBW calculation in ED patients. When complete, GCs provide accurate HBWs for most patients with EDs although it is clear that secondary methods of calculation are required given the gaps in data observed using this cohort.

Dismantling Inequities in Adolescent and Young Adult Health through a Sexual and Reproductive Health Justice Approach.

This article provides an overview of the social determinants of adolescents and young adults' (AYAs') sexual and reproductive health (SRH), from a global health perspective. The status of AYAs' SRH constitutes leading health indicators across nations and globally, and reveals the well-being of this population. Throughout the article, AYAs' SRH is approached from a health equity perspective, which includes SRH health rights and reproductive justice. Using this health equity lens, salient topics are presented: sexual abuse/assault among AYAs; immigrant and refugee populations; child, early, and forced marriage; human trafficking; and female genital mutilation. The article also discusses access to SRH services and comprehensive education. Practical implications and resources are offered for healthcare providers for their daily encounters with AYAs, as well as for community, institutional level, and advocacy action. Healthcare providers are well positioned to advance AYAs SRH through mitigating inequities and in so doing, they are assuring the health of the population and future generations.

The impact of COVID-19 on adolescents with eating disorders: a cohort study.

BACKGROUND: There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment 1 year previously; 3) to examine implications of the pandemic on the system of care. METHODS: A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame 1 year previously. Data including body measurements and results of psychological measures was extracted from patients' charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods. RESULTS: Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable (p = 0.005) and to require hospitalization (p = 0.005). Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed "urgent" were likewise associated with the pandemic period. CONCLUSIONS: During the COVID-19 pandemic, youth assessed for an ED presented with high rates of medical instability and need for hospitalization. Caring for these youth may be more challenging during the pandemic, when access to services may be limited. Further research is required to better understand the impact of the pandemic on the clinical course and outcomes of EDs in adolescents.

The objective of this study was to examine characteristics of adolescents presenting for eating disorder (ED) assessment during the COVID-19 pandemic, and also to compare them to a similar group assessed 1 year previously. A review of medical charts was completed on patients assessed at a pediatric ED program between April 1 and October 31, 2020 and on patients assessed between April 1 and October 31, 2019. Forty-eight adolescents were assessed during the pandemic-specific timeframe and 43 were assessed during the same timeframe the year previously. Forty percent of those in the 2020 cohort cited pandemic effects as a trigger for their ED; these youth had a shorter course of illness and were somewhat more likely to be medically compromised compared to those whose ED was not triggered by the pandemic. Compared to those seen in 2019, adolescents assessed for an ED in 2020 exhibited higher rates of nutritional restriction and functional impairment, were significantly more likely to be medically unstable, and required more hospitalizations or urgent consultations. Further research is required to better understand the impact of COVID-19 on the clinical course and outcomes of EDs in youth.

Sexual Health of Adolescent Patients Admitted to a Psychiatric Unit.

OBJECTIVE: To review sexual health screening practices during admission to an adolescent psychiatry unit. METHOD: Retrospective chart review of randomly selected youth admitted over a one-year period (2013). Data extracted included demographics, reasons for admission, sexual health history, as well as any comorbid behaviours noted. The main outcome measure was whether sexual health details were documented at any time during admission; if so, this information was extracted for analysis. Statistical analysis was done using univariate associations and logistic association. RESULTS: Mean age of subjects (n=99, 79 females and 20 males) was 15.24 years (SD = 1.30). Most common reasons for admission were suicidal gestures/self harm (n=57, 58%) and mood disorders (n=53, 54%). Thirty-seven patients (37%) had sexual health information documented in their charts. No demographic variables were significantly associated with being asked sexual health questions. Patients who had mood disorder diagnoses had 6 times the odds (95%CI: 1.18 to 29.96, P=0.03) of sexual health questions being documented compared to those not diagnosed with mood disorders. CONCLUSIONS: Screening for sexual health concerns is not being documented in the majority of adolescent psychiatry inpatients. Omitting sexual health screening during hospitalizations represents a missed opportunity for investigation and management of sexual health issues in this high-risk group. As many adolescents, particular those struggling with mental illness, do not attend preventative health visits, screening for pregnancy risk and other reproductive health needs is recommended at every adolescent encounter and in all settings.

OBJECTIF: Examiner les pratiques de dépistage de la santé sexuelle durant l'hospitalisation dans une unité de psychiatrie pour adolescents. MÉTHODE: Une revue rétrospective de dossiers d'adolescents choisis au hasard ayant été hospitalisés sur une période d'un an (2013). Les données extraites comprenaient des données démographiques, les raisons de l'hospitalisation, les antécédents de santé sexuelle, et tout comportement comorbide observé. La principale mesure de résultat était si les détails de la santé sexuelle étaient documentés à un moment de l'hospitalisation, si c'était le cas, cette information était extraite aux fins d'analyse. L'analyse statistique a été effectuée à l'aide d'associations univariées et d'association logistique. RÉSULTATS: L'âge moyen des sujets (n = 99, 79 filles et 20 garçons) était de 15,24 ans (ET = 1,30). Les raisons les plus communes de l'hospitalisation étaient les gestes suicidaires ou l'automutilation (n = 57, 58 %) et les troubles de l'humeur (n = 53, 54 %). Trente-sept patients (37 %) avaient de l'information sur la santé sexuelle documentée dans leur dossier. Aucune variable démographique n'était significativement associée au fait d'être interrogé sur la santé sexuelle. Les patients ayant des diagnostics de troubles de l'humeur avaient 6 fois plus de probabilités (IC à 95 % 1,18 à 29,96, P = 0,03) d'avoir des questions de santé sexuelle documentées que ceux n'ayant pas de ces diagnostics. CONCLUSIONS: Le dépistage des problèmes de santé sexuelle n'est pas documenté chez la majorité des adolescents hospitalisés en psychiatrie. L'omission du dépistage de la santé sexuelle durant les hospitalisations représente une occasion ratée d'investigation et de prise en charge des questions de santé sexuelle dans ce groupe à risque élevé. Comme bon nombre d'adolescents, en particulier ceux qui sont aux prises avec la maladie mentale ne font pas de visites de santé préventives, le dépistage du risque de grossesse et d'autres besoins de santé reproductive est recommandé pour toute rencontre avec un adolescent et dans tous les contextes.