Psychosocial impact and personality predictors of coherence feeling among girls with acne.

OBJECTIVE: The extent to which acne influences the emotional life of adolescents is a matter of discussion; but people with acne are prone to emotional and psychological disturbances. METHODS: 54 adolescent girls with acne were studied for their personality variables that are related to high coherence. Sense of coherence, e.g. meaningfulness of life, is crucial to cope successfully with stressors of living: it expresses the belief that a high probability exists that things will work out as well as can reasonably be expected. 58 adolescent girls without acne were in the control group. RESULTS: Neuroticism (anxiety level) was the first predictor of the sense of coherence measure for girls with acne, explaining 19% of the variance. Extraversion was the next predictor, explaining an additional 2 3% of the variance and psychoticism was the third predictor, explaining together 27% of the variance. There was a lack of difference between groups with respect to other personality variables. CONCLUSION: These predictors have to be taken into consideration while treating adolescents acne. Dermatologists, pediatricians and other physicians treating adolescents' acne should be familiar with emotional and psychosocial disturbances that accompany acne in order to effectively assist these patients.

Consumption, knowledge and attitudes of high school pupils towards alcohol and alcoholism: the Israeli experience.

Five hundred nine high school pupils from Holon (a city in the center of Israel) were surveyed about their consumption, knowledge and attitudes towards alcohol use and alcohol dependence. Two hundred fifty-nine pupils attended a vocational high school and 253 attended an academic high school. Forty percent of the pupils attending the academic school reported that they had drank beer between one to nine times during the last 2 months. In comparison with 72% of the vocational pupils, 42% of the academic pupils and 47% of the vocational pupils drank other alcoholic beverages (such as hard liquor, cognac, whisky or vodka) between one to nine times during the last 2 months. Boys drank alcohol more frequently than girls did. An earlier mean age of beer consumption was found among pupils in the vocational schools-12.8 years; as opposed to pupils in the academic school-13.4 years. Knowledge of most pupils concerning alcoholic beverages and its potential harmful effects was lacking and pupils in the academic school showed a higher level of knowledge in comparison with the vocational pupils. Pupils in the vocational school had more liberal attitudes concerning recurrent consumption of alcoholic beverages than pupils in the academic school. Among the three leading reasons for drinking in the two schools were helping foster a sense of belonging, wish to feel like an adult and desire to forget daily anxieties and conflicts. Pupils in vocational schools are a target population with a higher risk for consuming alcoholic beverages. Discussion groups should be held in school and include personal stories of recovering alcoholics.

Prevalence, attitudes and knowledge of high school pupils towards drugs and other addictions: implications for school health education in Israel.

One hundred and fifteen high school pupils from Holon (a city in the center of Israel) participated in a study about the prevalence, knowledge and attitudes of these pupils towards drugs and other addictions (cigarettes and alcohol). Their mean age was 16.13 (+/-1.59) years; 43.9% were boys and 56.1% were girls. A total of 1.6% of the pupils regularly used illicit drugs, and an additional 11.3% were offered drugs. A total of 24% of the pupils smoked regularly (at least during the past year), and 42% consumed alcoholic beverages regularly. Their knowledge concerning illicit drugs was found to be inadequate; they correctly answered only 50% of the total study questions. A more liberal attitude towards illicit drugs was found with increasing age. Pupils who consumed illicit drugs received a higher scoring for their knowledge concerning the characteristics of various illicit drugs, as well as to having a more liberal attitude. The self image of the pupils who had experience with illicit drugs was lower (in two separate tests) in comparison to their peers. As a result of our study, our recommendation is to include the subject of illicit drugs, their dangers and prevention of their use in the official school curriculum from elementary school and during all subsequent school years.

Knowledge and attitudes of high school pupils towards peers' attention deficit and learning disabilities.

The purpose of this study was to investigate pupils' knowledge and attitudes in the areas of attention deficit and hyperactivity (ADHD) and learning disabilities (LD). One hundred and four high school pupils in Holon (Israel) were interviewed and anonymously completed a questionnaire on these conditions. Pupils' knowledge on the topic of ADHD was low (62%); they showed a better knowledge about LD (75%). They showed a partially tolerant attitude (62.7%) towards pupils suffering from ADHD; on the other hand, they had a somewhat more positive and perceptive attitude (74.1%) towards peers diagnosed as learning disabled. Pupils' attitudes became more perceptive with increasing age. There was no correlation between pupils' knowledge and attitude. Pupils had learned about these two handicapped conditions from various sources; TV (66.3%), newspapers (63.5%) and school (53.8%), while physicians and nurses occupied the 5th and last place. Information about these two disabilities (ADHD and LD) should be added to the curriculum and be taught by qualified specialists, as there is an obvious statistically deficient knowledge in these areas.

Knowledge and attitudes of high school teachers towards pupils suffering from chronic diseases.

Fifty-eight high school teachers participated in a study about their knowledge and attitudes concerning chronic disease in children and adolescents. The level of knowledge of the 58 teachers was 62%. The head teachers did not have a higher score for their knowledge (63.3%) as compared with vocational teachers (60.3%). The presence of chronic diseases among children of staff teachers correlated with higher knowledge. Head teachers did not show a more tolerant attitude toward pupils with chronic diseases than the vocational teachers (14.9% vs. 13.7%). Ninety percent of teachers are ready and willing to spend extra time teaching their chronically ill pupils. The head teachers meet more frequently with chronically ill pupils, as well as with their parents, than do vocational teachers. All teachers believe and expect that they should know details about the pupil's chronic condition; more head teachers than vocational think it is important and beneficial if other pupils in class would know about the chronic condition and handicaps of the specific pupils in their class. Three quarters of the teachers consider it important and mandatory to increase awareness of chronic disease and disability in the school setting.

Attitude and knowledge of attention deficit hyperactivity disorder and learning disability among high school teachers.

The aims of the study were to investigate teachers' knowledge and attitudes towards attention deficit hyperactivity disorder (ADHD) and learning disabilities (LD). Forty-six high school teachers were interviewed in this regard. The 46 teachers were divided into two groups: 25 teachers taught at an academic school (School 1); and 21 teachers taught at special education school (School 2) and dealt with ADHD/LD cases regularly. General knowledge about ADHD (71%) and about LD (74%) was relatively low among both groups. Thirteen percent of all teachers considered LD to be the result of parental attitudes, namely 'spoiling' the children. The score for attitude and understanding of ADHD children was relatively low (72.5%) for both groups, whereas Group B teachers scored higher regarding LD cases. Almost 40% considered that ADHD children should be rebuked and/or punished in a manner similar to non-ADHD kids. Regarding long-term outcome, 45.7% of the teachers expected ADHD children to experience multiple difficulties in family life during adulthood. In relation to LD cases, the overall scoring for positive attitude was 75%. However, this score was higher for Group B teachers. Three-quarters of the teachers favored increasing peer awareness and comprehension as to the problems LD kids encounter at school. Ninety-five percent believed LD patients should enjoy a more lenient school education. There was no correlation between teachers, knowledge of ADHD and LD and their attitude. The main sources for this knowledge were: specialized textbooks, continuous education, TV shows, journals and newspapers, and medical personnel.

Knowledge and attitudes of high school pupils towards children with special health care needs: an Israeli exploration.

One hundred seventy-one pupils of a high school in Holon (Israel) were questioned regarding their attitudes towards chronically disabled individuals who have special health-care needs. The level of pupils' knowledge concerning the etiology, symptoms and complications of these chronic conditions was approximately 72%; it did not increase in four years of study. Previous personal knowledge of a child or adolescent with a chronic disease or handicap influenced the understanding of that particular ailment. The pupils' attitude towards handicapped individuals become more positive and tolerant with increasing age (and class level). A correlation was found between the level of knowledge about special medical-health needs and tolerant attitudes toward chronic patients. Most of the pupils think that the following occupational and recreational interests for the disabled will help to increase their self-image and improve their feelings of acceptance: computers, music (playing and listening), sports and domestic pets. The pupils believe the topics of chronic diseases and patients should be studied as a regular part of the school curriculum and these subjects should be taught with the participation of both physicians and teachers. The pupils stressed the role of the teacher in handling children with the chronic disease. Only half of the pupils think that their class peers should also know about the chronic disease of this individual pupil. The information sources of pupils concerning chronic disease are mainly TV, newspapers, adolescent periodicals, books, physicians and nurses, and lastly, the school. Conclusions are presented concerning health promotion activities in the school.

[Rehospitalization of children].

The aims of the study were to determine the rate of rehospitalization in 1997 a month after the end of initial hospitalization. 72 of 1174 children (6.1%) were rehospitalized. The mean age was 4.6 +/- 3.6 years (range 1 month-16 years). The average duration of the initial hospitalization of the 72 children was 8.3 +/- 6.0 (range 1-50) days, but only 3.6 days for all hospitalized children. The duration of the rehospitalization was 4.1 +/- 2.1 days (range 1-10 days), the interval between the 2 hospitalizations was 11.1 +/- 9.6 days (range 1-30 days). Among the diseases of the rehospitalized children in decreasing order were: respiratory diseases (including ORL) (40.9%), gastrointestinal diseases (27.7%), nervous system diseases, and bacteremia and septicemia (5.6%). Second hospitalizations in connection with these conditions were: gastrointestinal disease (34.7%); respiratory disease (29%); and bacteremia and septicemia (11.1%). Our recommendations are for attending physicians to follow-up regularly and periodically children who suffer from chronic diseases and are prone to develop exacerbations. This should be done in cooperation with hospital specialists so that the cooperation may reduce the rehospitalization of these children.

AIDS knowledge and attitudes of pupils attending urban high schools in Israel.

The present study compared AIDS knowledge, attitude and sources of information of 1724 students in three different high schools (academic, vocational and religious) in Holon. Forty-two percent of the students are anxious concerning the possibility of AIDS contamination; they expressed a willingness to be tested for HIV and AIDS. Pupils attending the academic school proved to have the highest knowledge concerning AIDS topics; those in the vocational school placed second; and those in the religious school came last. The knowledge increased with age (p < 0.001). Results indicated that misconceptions were still found in a second decade of that epidemic concerning the following areas: etiology, ways of exposure; symptomatology; and prognosis. Their intolerant attitudes reflect social anxiety and vulnerability to AIDS. The most liberal and comprehensive attitudes toward AIDS patients were presented by pupils attending the academic school and after that came pupils from the vocational school, while pupils in the religious school presented the most conservative and intolerant attitudes. The sources of pupils' information primarily included: the media--TV (92.3%): newspapers (87.6%); and school (66.1%) occupied the third place. It is remarkable that physicians and nurses at school and outside clinics were placed in the seventh (and last) place, as only 25.3% mentioned them at all. Only one third of the pupils agreed to participate as volunteers in medical and rehabilitation centers which help AIDS patients.

The attitude of young adults with chronic disease or handicaps towards enforced treatment and euthanasia.

One hundred fifty-nine young adults in the 17-18 year old age group suffering from chronic disease or handicap participated in this study which examined their attitudes towards enforced treatment and euthanasia in terminal patients. The comparison group included 120 healthy high school pupils of the same age group. A total of 42.6% of the chronic patients thought that enforced treatment was justified even if the patient didn't understand its importance and didn't want treatment (in comparison with 23.3% of the healthy pupils who felt the same way). Of the chronic patients, 54.4% thought that euthanasia was justified in consenting terminal patients (in comparison with 74.2% of the healthy pupils who felt the same way; P < 0.01). This may be explained by the feeling of total dependency of chronic patients upon medication and treatment. On the other hand, they may be opposed to euthanasia because of their own personal hope that a cure would be found for their severe and chronic condition. Both groups studied believed that physicians should always consider the subjective suffering of the patient and his family, as well as the short and long term prognosis when deciding about therapy.

Knowledge and attitudes of children towards cigarette smoking and its damage.

The present study reports the results of knowledge and attitudes of 280 children (mean age = 6.9 +/- 0.75 years) towards cigarettes and smoking. Subjects were divided into two groups: (I) children of parents who smoked (n = 178) and (II) children whose parents did not smoke (n = 102). The scoring for knowledge in the topics of cigarettes, smoking and the consequences was similar in the two groups (6.2 +/- 2.2 vs 6.1 +/- 2) (N.S.). The differences between the two groups were obvious and significant (p = 0.001) in their attitude towards smoking and its damage; children in group I displayed tolerant attitudes towards smoking even though they knew its consequences in comparison with the children of group II (6.1 +/- 2.4 vs 7.0 +/- 2.2). Without any exceptions among the children of the two groups, 7.4% believe that even at this young age they will begin to smoke one day. In addition, 2.1% pointed out that it is possible they will belong one day to the smokers' group. Of the population study, 90.2% believe that instruction about smoking damage should be included starting from the first grade of elementary school, and certainly, it should be at the level which will be understandable for them. As the pupils' knowledge about the consequences of smoking was lacking, we could add that the important topic of smoking and the damage it can inflict should be taught in all schools from the level of the first grade and during all subsequent years of study. Pupils should be familiar with all aspects of negative consequences caused by cigarette smoking. This knowledge may have influence upon their attitude towards smoking and smokers. More studies should be done to find what may change the positive attitudes of these pupils towards cigarettes and smoking.

Accidents among high school pupils in Israel: a recurrent disease?

Accidents are unexpected events usually producing injury. Many victims of trauma have a history of recurrent accidents. This study is a preliminary effort to verify the hypothesis that accidents may be considered as a recurrent disease in certain families; these children and families belong to a 'high risk group'. Two-hundred seventy-nine high school pupils participated in the study. Every pupil had experienced 1.7(+/- 1.7) mild to serious injuries that necessitated medical treatment during the years of elementary and high school. The geographical location of accidents was as follows: 26.4% were on the road; 23.1% occurred at school; 28.6% were associated with sport activities; and 22% occurred at home. The prevalence of injuries among boys was higher than among girls. A correlation was found between the number of accidents of the pupils and those of close family members, suggesting that these children and families are prone to accidents and form a 'high risk group'. The knowledge of accident and injury prevention did not change significantly during high school studies. The principal source of knowledge of accident and injury prevention of the pupils were the media: TV (98.8%), newspapers: (65.6%), and radio (58.1%). The contribution of physicians and nurses to this knowledge was very slight (16.5%). These families should be a target population; an educational program should be organized and transmitted by the media; family meetings with educational advisors, physicians and nurses should take place at school, especially for these target families. As a preventive measure for all, and especially to the high risk group, we would suggest that high school pupils work for 1-3 months in rehabilitation centers in which they can see the consequences of accidents and thereby gain an understanding of the effects of injury on the patient and his family.

High school students' attitudes and knowledge of food consumption and body image: implications for school based education.

One-hundred-and-forty-one high school students from Holon between the ages of 14 and 18 years participated in the study. The aims of the study were to investigate their nutritional habits, ascertain their body image, measure their knowledge concerning nutrition and finally to determine their attitudes regarding overweight, obese people and dieting. The study is a cross-sectional survey and the students involved completed a self administered questionnaire anonymously at school. The response rate was 97%. Forty-four percent of the total study population expressed a subjective feeling of being obese while, in truth, only 10% of them were actually overweight, and 48% among all participants practised weight reduction diets (girls three times more than boys). In addition to that another 53% of the pupils expressed the desire to be thinner than they were (girls four times more than boys). Nine percent of the study group experienced self-induced anorectic episodes at sometime during the past few years. It was observed that the study group's knowledge concerning food composition and nutrition remains insufficient. As far as their attitude concerning obesity, it was observed that 31% of the students regarded obesity as a handicap. Students who were athletics demonstrated more severe and stricter attitudes towards nutrition and obesity. Most of the information concerning nutrition was obtained through the media. School education about food and nutrition only amounted to 28.3% of the total. Seventy-nine percent of the students believe that nutrition should be integrated into their curriculum. Forty-four percent of the students feel themselves to be overweight, and 53.4% want to be thinner. Half of the students were on various diets. The students' knowledge of food and nutrition, the risk of obesity and the danger of excessive diets was insufficient. Most students presented negative attitudes towards obesity and overweight people. The media was the principal source of information on all these areas. Our main conclusion is that an educational nutrition program should be given to pupils in school by physicians and dietitians during all the years of public school attendance. The instructions of these programs should emphasize the importance of balanced nutritional regimes, as well as the risk and consequences of extreme dieting.

Self image, coping and familial interaction among asthmatic children and adolescents in Israel.

The study was designed to investigate self esteem, modes of coping and interfamilial relationships of asthmatic children and adolescents. Fifty-one asthmatic children (mean age: 12.26 +/- 2.56 years; 57% boys and 43% girls) were questioned about psychological factors of self image, coping with stressful situations and family interaction. The data was compared with that from 32 healthy children who had the same socio-economic parameters. The self image scoring of the asthmatic children were lower in comparison with the healthy children (P = 0.035). The scores for their mode of coping with stressful situations and their chronic disease was lower in comparison with the control group (P = 0.041). Also, the scoring of the asthmatic group for their family interaction was lower in comparison with healthy children (P = 0.036). Thus, clinicians, besides providing regular drug therapy need to invest additional effort in educational and psychological means on behalf of asthmatic children. Children should not feel guilty because of their chronic disease. Psychological support can give them a chance to improve improve their self image with this chronic disease, to improve their mode of coping with their asthma and to improve immediate familial relationships. This can be done by medical social workers, educational counsellors and psychologists in collaboration with physicians. These families can participate in support groups, which will be organized for these 'asthmatic families'.

Addiction among high school pupils in Holon (Israel) and their attitudes towards drugs: a pilot study (1993-1994).

One-hundred-and-twenty-five high school pupils aged 14-17 years had completed anonymous questionnaires dealing with smoking habits and alcohol consumption, as well as with the knowledge and attitudes towards drug addiction. Twenty-four percent of the pupils smoked regularly; the age of onset of smoking was 13.93 +/- 1.53 years. Thirty-one percent of the pupils admitted to the regular drinking of alcoholic beverages (including beer, wine, and other alcoholic beverages); the age of onset of drink was 14.65 +/- 0.79 years. The pupils' knowledge concerning drugs was relatively low (scoring of 37.78 +/- 16.87 percent). Pupils in the 16-17-year age group proved to have the highest knowledge. Pupils who used to take drugs received a higher score for their knowledge than other pupils in their classes. Most pupils presented conservative attitudes towards drugs; pupils in the 16-17-year age group received the highest (most liberal) scores; higher (liberal) scores correlated with parental familial status (cohesion) (P = 0.029) and inversely correlated with the behavior marks (r = 0.294; P = 0.03). The attitude of addicted pupils (to cigarettes, alcohol and drugs) was more liberal in comparison with their peers (P < 0.003).

Attitude, knowledge and habits of high school pupils in Israel regarding oral health.

The purpose of this project was to study the habits, knowledge and attitudes of 132 high school students in regards to their teeth and oral health. An inflated amount of consumption of snack food and sweet beverages between meals was reported. Seventy-two point seven percent claimed to brush their teeth at least twice daily. Forty-nine point three percent claimed to visit their dentist annually. The results also demonstrated a poor general knowledge and misconceptions concerning teeth, food and oral health throughout the years of high school studies. Knowledge levels correlated with with age. More than half of the pupils attributed esthetical importance to the teeth appearance. The students' knowledge concerning prevention stemmed mainly from their dentist, parents, and the media and only 2.6% learned anything from formal school teaching. In the light of the students' poor knowledge, it would appear that resources should be invested in schools at the elementary and high school level for oral hygiene and caries prevention education in the hope of improving bad habits and perpetuating improved oral health and hygiene.

Anxiety of asthmatic pupils in Israel during the Persian Gulf War: treatment and counseling implications.

The aim was to study the increase in anxiety of asthmatic pupils during a state of war in comparison with healthy pupils. Twenty-five asthmatic adolescents completed Spielberger' STAI during three periods: (1) 4 months before the war; (2) during the second week of the war; and (3) 4 months after the end of the war. The comparison group included 54 healthy pupils visiting the same school. The results showed that the level of state and trait anxiety of the asthmatic and comparison group remained constant, without any significant increase, even during the war. The anxiety was not influenced by gender nor by socioeconomic level. It is concluded that during severe stressful events, there is no need for special medication for asthmatic patients.