Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.696
Filtrar
4.
Lancet Glob Health ; 9(4): e409-e417, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33662320

RESUMEN

BACKGROUND: The global health community is devoting considerable attention to adolescents and young people, but risk of death in this population is poorly measured. We aimed to reconstruct global, regional, and national mortality trends for youths aged 15-24 years between 1990 and 2019. METHODS: In this systematic analysis, we used all publicly available data on mortality in the age group 15-24 years for 195 countries, as compiled by the UN Inter-agency Group for Child Mortality Estimation. We used nationally representative vital registration data, estimated the completeness of death registration, and extracted mortality rates from surveys with sibling histories, household deaths reported in censuses, and sample registration systems. We used a Bayesian B-spline bias-reduction model to generate trends in 10q15, the probability that an adolescent aged 15 years would die before reaching age 25 years. This model treats observations of the 10q15 probability as the product of the actual risk of death and an error multiplier that varies depending on the data source. The main outcome that we assessed was the levels of and trends in youth mortality and the global and regional mortality rates from 1990 to 2019. FINDINGS: Globally, the probability of an individual dying between age 15 years and 24 years was 11·2 deaths (90% uncertainty interval [UI] 10·7-12·5) per 1000 youths aged 15 in 2019, which is about 2·5 times less than infant mortality (28·2 deaths [27·2-30·0] by age 1 year per 1000 live births) but is higher than the risk of dying from age 1 to 5 (9·7 deaths [9·1-11·1] per 1000 children aged 1 year). The probability of dying between age 15 years and 24 years declined by 1·4% per year (90% UI 1·1-1·8) between 1990 and 2019, from 17·1 deaths (16·5-18·9) per 1000 in 1990; by contrast with this total decrease of 34% (27-41), under-5 mortality declined by 59% (56-61) in this period. The annual number of deaths declined from 1·7 million (90% UI 1·7-1·9) in 1990 to 1·4 million (1·3-1·5) in 2019. In sub-Saharan Africa, the number of deaths increased by 20·8% from 1990 to 2019. Although 18·3% of the population aged 15-24 years were living in sub-Saharan Africa in 2019, the region accounted for 37·9% (90% UI 34·8-41·9) of all worldwide deaths in youth. INTERPRETATION: It is urgent to accelerate progress in reducing youth mortality. Efforts are particularly needed in sub-Saharan Africa, where the burden of mortality is increasingly concentrated. In the future, a growing number of countries will see youth mortality exceeding under-5 mortality if current trends continue. FUNDING: UN Children's Fund, Bill & Melinda Gates Foundation, United States Agency for International Development.


Asunto(s)
Salud del Adolescente/tendencias , Salud Global/tendencias , Modelos Estadísticos , Mortalidad/tendencias , Adolescente , Salud del Adolescente/estadística & datos numéricos , Teorema de Bayes , Bases de Datos Factuales/estadística & datos numéricos , Geografía , Salud Global/estadística & datos numéricos , Humanos , Organización Mundial de la Salud , Adulto Joven
6.
Value Health ; 24(3): 443-460, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33641779

RESUMEN

OBJECTIVE: This review examined the psychometric performance of 4 generic child- and adolescent-specific preference-based measures that can be used to produce utilities for child and adolescent health. METHODS: A systematic search was undertaken to identify studies reporting the psychometric performance of the Child Health Utility (CHU9D), EQ-5D-Y (3L or 5L), and Health Utilities Index Mark 2 (HUI2) or Mark 3 (HUI3) in children and/or adolescents. Data were extracted to assess known-group validity, convergent validity, responsiveness, reliability, acceptability, and feasibility. Data were extracted separately for the dimensions and utility index where this was reported. RESULTS: The review included 76 studies (CHU9D n = 12, EQ-5D-Y-3L n = 20, HUI2 n = 26,HUI3 n = 43), which varied considerably across conditions and sample size. EQ-5D-Y-3L had the largest amount of evidence of good psychometric performance in proportion to the number of studies examining performance. The majority of the evidence related to EQ-5D-Y-3L was based on dimensions. CHU9D was assessed in fewer studies, but the majority of studies found evidence of good psychometric performance. Evidence for HUI2 and HUI3 was more mixed, but the studies were more limited in sample size and statistical power, which was likely to have affected performance. CONCLUSIONS: The heterogeneity of published studies means that the evidence is based on studies across a range of countries, populations and conditions, using different study designs, different languages, different value sets and different statistical techniques. Evidence for CHU9D in particular is based on a limited number of studies. The findings raise concerns about the comparability of self-report and proxy-report responses to generate utility values for children and adolescents.


Asunto(s)
Salud del Adolescente , Salud del Niño , Prioridad del Paciente/psicología , Encuestas y Cuestionarios/normas , Adolescente , Niño , Femenino , Humanos , Masculino , Psicometría , Reproducibilidad de los Resultados , Autoinforme
8.
Nursing (Säo Paulo) ; 24(273): 5299-5310, fev.2021.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1150319

RESUMEN

Objetivo: identificar os sentimentos de pré-adolescentes e adolescentes quanto à vacinação contra o papilomavirus humano. Método: trata-se de um estudo fenomenológico, com abordagem qualitativa, realizado com 10 participantes, sendo pré- adolescentes e adolescentes, cujas quais foram vacinadas na sala de vacina de uma Unidade Básica de Saúde de um município de Minas Gerais. Os depoimentos foram gravados e transcritos na íntegra para posterior análise. O tratamento dos dados se deu por meio de Análise de Conteúdo. Resultados: a maioria das entrevistadas atribuiu à significação da vacinação relacionada ao fato de prevenir o câncer de colo uterino. O desconhecimento sobre a finalidade da vacina HPV fica em evidência em alguns depoimentos. O medo da vacina também ficou em evidência, tendo como justificativa o fato de ser injeção, da dor, da agulha e por medo da reação. Como medidas de prevenção, foram citadas o uso de preservativo e a ida periódica ao ginecologista. Seis das participantes não souberam informar nenhuma medida de prevenção contra o papilomavirus humano. Conclusão: as participantes do estudo entendem a importância da vacinação contra o papilomavirus humano, embora seis participantes, bem como suas famílias, informaram ter receio pela dor da vacinação ou possíveis eventos adversos pós-vacinais.(AU)


Objective: to identify the feelings of pre-adolescents and adolescents regarding vaccination against human papillomavirus. Method: this is a phenomenological study, with a qualitative approach, carried out with 10 participants, being pre-adolescents and adolescents, whose vaccinations were performed in the vaccination room of a Basic Health Unit in a municipality in Minas Gerais. The testimonies were recorded and transcribed in full for later analysis. The treatment of the data took place through Content Analysis. Results: most interviewees attributed the meaning of vaccination to the fact that it prevents cervical cancer. The lack of knowledge about the purpose of the HPV vaccine is evident in some statements. The fear of the vaccine was also in evidence, justified by the fact that it was an injection, pain, needle and for fear of the reaction. As preventive measures, the use of condoms and periodic visits to the gynecologist were mentioned. Six of the participants were unable to report any preventive measures against human papillomavirus. Conclusion: the participants understand the importance of vaccination against human papillomavirus, although six participants, as well as their families, reported being afraid of the pain of vaccination or possible post-vaccination adverse events.(AU)


Objetivo: identificar los sentimientos de preadolescentes y adolescentes con respecto a la vacunación contra el virus del papiloma humano. Método: se trata de un estudio fenomenológico, con abordaje cualitativo, realizado con 10 participantes, siendo preadolescentes y adolescentes, cuyas vacunaciones se realizaron en la sala de vacunación de una Unidad Básica de Salud de un municipio de Minas Gerais. Los testimonios fueron registrados y transcritos íntegramente para su posterior análisis. El tratamiento de los datos se realizó mediante Análisis de Contenido. Resultados: la mayoría de las entrevistadas atribuyó la importancia de la vacunación relacionada con el hecho de prevenir el cáncer de cuello uterino. La falta de conocimiento sobre el propósito de la vacuna contra el VPH es evidente en algunas declaraciones. El miedo a la vacuna también se evidenció, justificado por el hecho de que fue una inyección, dolor, aguja y por miedo a la reacción. Como medidas preventivas se mencionaron el uso de condones y visitas periódicas al ginecólogo. Seis de los participantes no pudieron informar ninguna medida preventiva contra el virus del papiloma humano. Conclusión: los participantes del estudio comprenden la importancia de la vacunación contra el virus del papiloma humano, aunque seis participantes, así como sus familiares, informaron tener miedo al dolor de la vacunación o posibles eventos adversos posvacunación.(AU)


Asunto(s)
Humanos , Niño , Adolescente , Papiloma/prevención & control , Papillomaviridae , Vacunación , Salud del Adolescente , Prevención de Enfermedades , Enfermería en Salud Pública , Sistema Único de Salud
9.
Behav Sci Law ; 39(1): 123-144, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33569848

RESUMEN

There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision-making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non-field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real-world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.


Asunto(s)
Salud del Adolescente , Medición de Riesgo , Adolescente , Humanos , Países Bajos , Reproducibilidad de los Resultados
10.
JAMA ; 325(7): 658-668, 2021 02 16.
Artículo en Inglés | MEDLINE | ID: mdl-33591345

RESUMEN

Importance: Pregnancy may be a key window to optimize cardiovascular health (CVH) for the mother and influence lifelong CVH for her child. Objective: To examine associations between maternal gestational CVH and offspring CVH. Design, Setting, and Participants: This cohort study used data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study (examinations: July 2000-April 2006) and HAPO Follow-Up Study (examinations: February 2013-December 2016). The analyses included 2302 mother-child dyads, comprising 48% of HAPO Follow-Up Study participants, in an ancillary CVH study. Participants were from 9 field centers across the United States, Barbados, United Kingdom, China, Thailand, and Canada. Exposures: Maternal gestational CVH at a target of 28 weeks' gestation, based on 5 metrics: body mass index, blood pressure, total cholesterol level, glucose level, and smoking. Each metric was categorized as ideal, intermediate, or poor using pregnancy guidelines. Total CVH was categorized as follows: all ideal metrics, 1 or more intermediate (but 0 poor) metrics, 1 poor metric, or 2 or more poor metrics. Main Outcomes and Measures: Offspring CVH at ages 10 to 14 years, based on 4 metrics: body mass index, blood pressure, total cholesterol level, and glucose level. Total CVH was categorized as for mothers. Results: Among 2302 dyads, the mean (SD) ages were 29.6 (2.7) years for pregnant mothers and 11.3 (1.1) years for children. During pregnancy, the mean (SD) maternal CVH score was 8.6 (1.4) out of 10. Among pregnant mothers, the prevalence of all ideal metrics was 32.8% (95% CI, 30.6%-35.1%), 31.7% (95% CI, 29.4%-34.0%) for 1 or more intermediate metrics, 29.5% (95% CI, 27.2%-31.7%) for 1 poor metric, and 6.0% (95% CI, 3.8%-8.3%) for 2 or more poor metrics. Among children of mothers with all ideal metrics, the prevalence of all ideal metrics was 42.2% (95% CI, 38.4%-46.2%), 36.7% (95% CI, 32.9%-40.7%) for 1 or more intermediate metrics, 18.4% (95% CI, 14.6%-22.4%) for 1 poor metric, and 2.6% (95% CI, 0%-6.6%) for 2 or more poor metrics. Among children of mothers with 2 or more poor metrics, the prevalence of all ideal metrics was 30.7% (95% CI, 22.0%-40.4%), 28.3% (95% CI, 19.7%-38.1%) for 1 or more intermediate metrics, 30.7% (95% CI, 22.0%-40.4%) for 1 poor metric, and 10.2% (95% CI, 1.6%-20.0%) for 2 or more poor metrics. The adjusted relative risks associated with 1 or more intermediate, 1 poor, and 2 or more poor (vs all ideal) metrics, respectively, in mothers during pregnancy were 1.17 (95% CI, 0.96-1.42), 1.66 (95% CI, 1.39-1.99), and 2.02 (95% CI, 1.55-2.64) for offspring to have 1 poor (vs all ideal) metrics, and the relative risks were 2.15 (95% CI, 1.23-3.75), 3.32 (95% CI,1.96-5.62), and 7.82 (95% CI, 4.12-14.85) for offspring to have 2 or more poor (vs all ideal) metrics. Additional adjustment for categorical birth factors (eg, preeclampsia) did not fully explain these significant associations (eg, relative risk for association between 2 or more poor metrics among mothers during pregnancy and 2 or more poor metrics among offspring after adjustment for an extended set of birth factors, 6.23 [95% CI, 3.03-12.82]). Conclusions and Relevance: In this multinational cohort, better maternal CVH at 28 weeks' gestation was significantly associated with better offspring CVH at ages 10 to 14 years.


Asunto(s)
Salud del Adolescente , Sistema Cardiovascular , Salud del Niño , Salud Materna , Embarazo , Adolescente , Adulto , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Niño , Estudios de Cohortes , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Prevalencia
11.
Am J Public Health ; 111(3): 504-513, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33476237

RESUMEN

Objectives. To investigate the long-term impacts of a family economic intervention on physical, mental, and sexual health of adolescents orphaned by AIDS in Uganda.Methods. Students in grades 5 and 6 from 48 primary schools in Uganda were randomly assigned at the school level (cluster randomization) to 1 of 3 conditions: (1) control (n = 487; 16 schools), (2) Bridges (1:1 savings match rate; n = 396; 16 schools), or (3) Bridges PLUS (2:1 savings match rate; n = 500; 16 schools).Results. At 24 months, compared with participants in the control condition, Bridges and Bridges PLUS participants reported higher physical health scores, lower depressive symptoms, and higher self-concept and self-efficacy. During the same period, Bridges participants reported lower sexual risk-taking intentions compared with the other 2 study conditions. At 48 months, Bridges and Bridges PLUS participants reported better self-rated health, higher savings, and lower food insecurity. During the same period, Bridges PLUS participants reported reduced hopelessness, and greater self-concept and self-efficacy. At 24 and 48 months, Bridges PLUS participants reported higher savings than Bridges participants.Conclusions. Economic interventions targeting families raising adolescents orphaned by AIDS can contribute to long-term positive health and overall well-being of these families.Trial Registration. ClinicalTrials.gov registration no. NCT01447615.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/economía , Salud del Adolescente/economía , Niños Huérfanos/educación , Pobreza/economía , Adolescente , Salud del Adolescente/estadística & datos numéricos , Relaciones Familiares , Femenino , Humanos , Masculino , Pobreza/prevención & control , Evaluación de Programas y Proyectos de Salud , Factores Socioeconómicos , Estudiantes/estadística & datos numéricos , Uganda
14.
Artículo en Inglés | MEDLINE | ID: mdl-33504101

RESUMEN

Mitigating the adverse physical health risks associated with COVID-19 has been a priority of public health incentives. Less attention has been placed on understanding the psychological factors related to the global pandemic, especially among vulnerable populations. This qualitative study sought to understand the experiences of children and adolescents during COVID-19. This study interviewed 48 families during the COVID-19 pandemic restrictions, and a national lockdown, to understand its impacts. The study used an Interpretative Phenomenological Analysis (IPA) methodology. Parents and children discussed the negative impact of the restrictions on young people's wellbeing. Children and adolescents experienced adverse mental health effects, including feelings of social isolation, depression, anxiety, and increases in maladaptive behaviour. Families with children with Autism Spectrum Disorders reported increased mental health difficulties during this period mostly due to changes to routine. The findings highlight the impact of severe restrictions on vulnerable populations' wellbeing and mental health outcomes, including children, adolescents, and those with Autism spectrum disorder (ASD).


Asunto(s)
/psicología , Salud Mental , Pandemias , Adolescente , Salud del Adolescente , Trastorno del Espectro Autista/psicología , Niño , Salud del Niño , Control de Enfermedades Transmisibles , Humanos , Irlanda/epidemiología , Poblaciones Vulnerables
16.
Rev Med Suisse ; 17(722): 150-154, 2021 Jan 20.
Artículo en Francés | MEDLINE | ID: mdl-33470573

RESUMEN

This article summarizes the conclusion of a two-days interprofessional online workshop held under the auspices of the Brocher Foundation. The objectives were to review the impact of COVID on adolescent health and development and to generate some key responses to the situation. The pandemic has severely affected the mental health of a large proportion of adolescents and has significantly reduced access to health care. It has as well disturbed the school education of vulnerable youngsters and decreased social contacts with adults and peers. In the future, authorities should better consider the rights of young people and request their opinion and participation in decision making. Physicians should systematically explore their young patients' opinions and queries regarding the COVID and address problematic situations such as family conflicts, misuse of internet or risky behaviour.


Asunto(s)
Médicos , Adolescente , Salud del Adolescente , Humanos , Pandemias
18.
Porto Alegre; CEVS/RS; 26 mar. 2021. 1-33 p. ilus., graf., tab., mapas.
Monografía en Portugués | Coleciona SUS, CONASS, SES-RS | ID: biblio-1151664
19.
São Paulo; s.n; 2021. 72 p.
Tesis en Portugués | Sec. Est. Saúde SP, CONASS, SESSP-ISPROD, Sec. Est. Saúde SP, SESSP-ISACERVO, SESSP-ESPECIALIZACAOSESPROD, Sec. Est. Saúde SP | ID: biblio-1151772

RESUMEN

Introdução: O Estatuto da Criança e Adolescente (ECA) assegura o acesso universal e igualitário à saúde para os (as) adolescentes por intermédio do Sistema Único de Saúde (SUS), o que inclui a saúde sexual e reprodutiva, estratégica para garantia de direitos humanos deste público, como recomenda a Organização Mundial de Saúde. Os serviços de saúde de Franco da Rocha, assim como de todos os municípios brasileiros, precisam atuar para a garantia de acesso a este direito também em diversos contextos, como ocorre hoje frente à pandemia do novo covid- 19, que, desde fevereiro de 2020, vem atingindo o Brasil, gerando impactos no setor de saúde. Objetivo: Verificar as contribuições das formações do Protocolo de Saúde Sexual e Reprodutiva de Adolescentes em Franco da Rocha e os impactos da epidemia de coronavírus na atenção em saúde sexual e reprodutiva de adolescentes. Metodologia: Trata-se de um estudo descritivo exploratório qualitativo realizado por meio de entrevistas semi-estruturadas feitas on line com profissionais de saúde da Atenção Básica de Franco da Rocha - SP e levantamento e análise de indicadores de saúde sexual e reprodutiva para a avaliação dos impactos da epidemia de coronavírus. Resultados: As formações realizadas foram bem avaliadas pelos profissionais e são apontadas como um incentivo e facilitador para a atenção do público adolescente, esclarecendo principalmente a possibilidade de atendimento deste público inclusive desacompanhado. A procura por teste ou assistência à gravidez e a contracepção são as demandas citadas como mais recorrentes entre adolescentes nos serviços de saúde, sendo a pílula oral e os injetáveis os mais procurados entre os contraceptivos, principalmente em serviços onde os profissionais incentivam e fazem busca ativa entre este público; entre as IST, a sífilis em gestantes e o HPV foram citadas como as de maior recorrência. Destaca-se a baixa participação masculina na contracepção e na busca por prevenção, bem como aos testes rápidos de IST. coronavírus foi observado o aumento de Durante a pandemia de gestações entre adolescentes,principalmente abortos, embora profissionais não terem relatado dificuldades na oferta de contraceptivos para este público. Conclusão: Adolescentes apresentam recorrente exposição de risco sexual, principalmente quanto à gravidez, por isso o esclarecimento e incentivo aos adolescentes pelos profissionais de saúde sobre os serviços, de contraceptivos e preservativos têm que ser constantes, inclusive em momentos de pandemia.


Asunto(s)
Humanos , Infecciones por Coronavirus , Salud del Adolescente , Salud Sexual y Reproductiva , Salud Pública
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...