Careers in paediatrics: Community paediatrics revisited.

The concept of 'community paediatrics', as enunciated by Robert Haggerty in 1968, has informed and shaped many paediatric careers. The principle tenets of inclusiveness: attention to unmet needs; addressing common health problems of children and youth; using and applying preventive and harm-reduction strategies; and securing community input and control, were part of the Haggerty model. The present article revisits Haggerty's model and describes how the concepts have shaped contemporary paediatrics in North America.

Surveying adolescents: Focusing on positive development.

Although risk behaviours can threaten healthy youth development, reducing risks alone is not sufficient to help youth successfully negotiate adolescence. Promoting protective factors that buffer risk, such as family and school connectedness, community engagement and positive peer support, are also important for helping youth to thrive. Since 1992, the Adolescent Health Surveys conducted by McCreary Centre Society (Vancouver, British Columbia) have monitored both risk behaviours and protective factors among high school students across British Columbia. They have shown that, contrary to media images and community perceptions, the majority of young people are not exposed to risk factors such as violence and abuse; most do not have unprotected sex, drink and drive, use illegal drugs or consider suicide. They have also documented key protective factors that are linked to lower rates of risk behaviours and more positive outcomes, even for youth who face unsafe environments, family problems and other stressors. The shift toward assessing and promoting protective factors is a major paradigm change in adolescent health care, and clinicians can be an important partner with families and schools to foster healthy youth development.

International developments in adolescent health care: a story of advocacy and achievement.

The contemporary health problems of young people occur within the context of the physical, social, cultural, economic, and political realities within which they live. There are commonalities and differences in this context among developed and developing countries, thus differing effects on the individual's personal as well as national development. Internationally, the origins and evolution of health care for adolescents can be viewed as an unfolding saga taking place particularly over the past 30 years. It is a story of advocacy and subsequent achievement in all corners of the world. This paper reviews the important developments in the international arena, recognizes major pioneers and milestones, and explores some of the current and future issues facing the field. The authors draw heavily on their experiences with the major nongovernmental adolescent health organizations. The special roles of the World Health Organization, Pan American Health Organization, and United Nations Children's Fund (UNICEF) are highlighted, and special consideration is given to the challenge of inclusion through youth participation.

Youth health in Canada.

Youth Health in Canada is at a favorable level and adolescents have access to a reasonable standard of health care services. The framework is evolving in response to changing concepts and to the participation of youth themselves. The role of the academic and research leadership in Canada is described. The youth population is healthy and contributes in a positive way to the national fabric and the needs of the majority are adequately met. However, there are sub-populations of youth, who continue to warrant a special focus and are deserving of the attention of youth health professionals. Youth health in Canada is emerging as an adaptation of the American Adolescent Medicine model of the early 1960s. It is a challenging multidisciplinary field in which should play a significant role in shaping its future. Its mandate will be to exercise leadership in addressing the changing needs of the general adolescent population and bringing renewed focus to the special needs of identifiable sub-populations.

Marijuana use in adolescence.

The prevalence of marijuana use by adolescents has fluctuated in recent decades, but, overall, has increased significantly. In a study of adolescent health status and risk behaviours among students in grades 7 to 12 in British Columbia, it was found that the patterns of marijuana use had changed, especially among early adolescents. An earlier age of onset of use and an increased frequency of use were noted. The present paper examines the clinical and psychosocial implications of early age of onset of marijuana use, and reports important differences in risky behaviours between users and nonusers. The prevailing attitude that marijuana is a 'safe, recreational' drug is challenged.

Reunión Latinoamericana sobre Salud Integral del Adolescente. Jóvenes de hoy, padres del mañana. Memorias / Latinamerican Meeting on Integral Health of the Adolescent. Young people of today, parents of tomorow. Memories

Recopilación de los discursos pronunciados durante la Reunión Latinoamericana sobre la Salud Integral del Adolescente en su calidad de futuros padres de familia, marcándoles el compromiso con el que cuentan a partir de ahora en cuestiones de salud y planificación familiar, entre otros temas. El documento contiene los siguientes capítulos: 1. Adolescencia, equivocaciones y esperanzas 2. La educación y los valores 3. Perfil de la salud en los adolescentes latinoamericanos 4. Salud reproductiva de los adolescentes latinoamericanos 5. Estilos de vida sana y factores de riesgo 6. Tendencias de salud del adolescente 7. El comportamiento sexual y reproductivo de los adolescentes 8. Redes de salud para los adolescentes