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1.
Artigo em Inglês | MEDLINE | ID: mdl-35653420

RESUMO

The aim of this study was to examine cognitive emotion regulation strategies (CERS) of help-seeking adolescents diagnosed with personality disorders. At pre-treatment, patients (N = 116) were found to use some maladaptive but also some adaptive CERS more often than adolescents from the general population. Less than 4% of these pre-treatment CERS predicted treatment outcome. In patients whose treatment outcome according to the Symptom Checklist-90 (SCL-90) showed significant improvement (N = 75), a reduction of maladaptive CERS and an increase of adaptive CERS occurred. Patients that were unchanged or deteriorated (N = 41) showed no significant changes in CERS. In conclusion, pre-treatment CERS are not predictive for treatment outcome in this sample of adolescents diagnosed with personality disorders. Even though patients who use more adaptive and less maladaptive CERS have fewer symptoms, the relationship between these CERS and symptoms in this group of severe patients remains unclear.

2.
Child Adolesc Psychiatry Ment Health ; 16(1): 40, 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35659270

RESUMO

INTRODUCTION: The bodily expression of psychological disorders is one of the leading motives for consultations in adolescent medicine. The diagnostic entity corresponding to DSM-5 "Somatic symptom and related disorders" is sparsely used in the English-language literature, especially for adolescents. Qualitative studies on this topic mostly concern the experiences of healthcare professionals. This study seeks to explore the experience of adolescents expressing psychological distress through their body. METHODS: This exploratory research took place in a Paris hospital department of adolescent medicine. Our sampling method was purposive. For inclusion, patients had to be aged 11-24 years, with a "somatic symptom disorder" meeting the DSM-5 criteria. Semi-directive interviews were proposed with visual narration inspired by photoelicitation. Thematic analysis allowed us to explore the data with an inductive approach. RESULTS: Thirty adolescents were interviewed; they were 14-22 years old and mostly had somatic symptom or functional neurological disorders. Three principal themes emerged from our analysis of the interview contents: the personal, including bodily, experience of the disorder, the experience of relationships, and the question of what is visible through the body. CONCLUSION: This research allowed us to discuss the reversal of generations, the function of the DSM-5 diagnosis, illuminated by sociology, and finally, cultural pathways. It shows the importance of recognizing the reality of the adolescents' bodily feelings, reassuring them by ruling out serious causes, and supporting their search for meaning. It is important to think about a specific framework of family therapy that can make effective use of this experience of the reversal of generations.

3.
Front Pharmacol ; 13: 787113, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35662686

RESUMO

Background: Drug use safety in children is a global public health problem. The potentially inappropriate prescription screening tools are expected to reduce adverse drug reactions and promote rational drug use. Objectives: To systematically evaluate children's potentially inappropriate prescription screening tools and validation studies on these tools. Methods: We systematically searched six databases PubMed, Embase, Cochrane Library, CNKI, VIP and Wanfang Data. Two reviewers independently selected articles by the eligible criteria and extracted data. Then we evaluated the coverage of diseases or drugs in these tools and the consistency of items between tools. Results: Five children's potentially inappropriate prescription screening tools were identified, most tools were formed by Delphi expert consensus and focused on respiratory system drugs, anti-infective drugs, and gastrointestinal drugs. The coincidence rates of items between the POPI and the POPI Int, the POPI and the POPI United Kingdom, the POPI United Kingdom and the POPI int, and the POPI United Kingdom and the PIPc were 82.0, 55.1, 51.0 and 2.2% respectively, and the KIDs List did not overlap other four tools. Only the POPI tool developed by French experts was comprehensively validated by studies and most tools have not been validated. Conclusion: The development of screening tools for potentially inappropriate prescribing in children is a neglected field and most tools lack studies to validate clinical applicability. More researchers need to form their national potentially inappropriate prescription screening tools for children based on the best available clinical evidence and the actual clinical situation in their countries.

4.
Int J Clin Health Psychol ; 22(3): 100311, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35662788

RESUMO

Background/Objective: The present study aims to explore the dynamics of social anxiety profiles in adolescents over time and the psychosocial effects these dynamics have. Method: A representative sample of Andalusian (southern Spain) adolescents in Secondary Education was drawn. The study used single-stage stratified cluster sampling. A total of 2,140 students aged 11-16 years (47% girls; Mage T1 = 13.68, SD = 1.27) were involved at two time points with a six-month interval. Results: The results provided a four-profile structure: low social anxiety, moderate cognitive disturbance, high with difficulties in new situations, and high social anxiety. The latent transition analysis showed a stability in the social anxiety profiles of between 58%-61%. Those adolescents who remained in or transitioned to profiles with higher social anxiety scored worse on peer adjustment, peer victimization and subjective well-being. Conclusions: The study may contribute the improvement of the psychological treatments in social anxiety and reduce adverse effects on peer relationships and well-being by distinguishing the profiles and their dynamics.

5.
Front Nutr ; 9: 902103, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35662953

RESUMO

Reciprocal family influences in the food domain have been little explored, particularly during the COVID-19 pandemic. To fill in this gap, this study explored actor and partner effects between parents' food modeling and parents' and their adolescent children's diet quality and satisfaction with food-related life (SWFoL); and the mediating role of diet quality between modeling and SWFoL. This study used a cross-sectional design. A sample of 430 different-sex dual-earner parents and one adolescent child were recruited in Rancagua, Chile, between March and June 2020. Parents answered the modeling dimension of the Comprehensive Feeding Practices Questionnaire. Parents and adolescents answered the Adapted Healthy Eating Index (AHEI) and the SWFoL Scale. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modeling. Results showed that one parent's modeling enhanced diet quality for themselves, their partner, and the adolescents. Parents' modeling was associated with their own SWFoL, directly and via their own diet quality. There were positive associations between mothers' modeling and adolescents' SWFoL; between mothers' diet quality and fathers' SWFoL; and between mothers' modeling and fathers' SWFoL via the fathers' diet quality. Parents' modeling can improve the three family members' diet quality, while mothers' modeling and diet quality showed to improve fathers' and adolescents' SWFoL.

6.
World J Clin Pediatr ; 11(3): 239-252, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35663001

RESUMO

There is a complex relationship between sleep disorders and childhood neurodevelopmental, emotional, behavioral and intellectual disorders (NDEBID). NDEBID include several conditions such as attention deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, epilepsy and learning (intellectual) disorders. Up to 75% of children and young people (CYP) with NDEBID are known to experience different types of insomnia, compared to 3% to 36% in normally developing population. Sleep disorders affect 15% to 19% of adolescents with no disability, in comparison with 26% to 36% among CYP with moderate learning disability (LD) and 44% among those with severe LD. Chronic sleep deprivation is associated with significant risks of behavioural problems, impaired cognitive development and learning abilities, poor memory, mood disorders and school problems. It also increases the risk of other health outcomes, such as obesity and metabolic consequences, significantly impacting on the wellbeing of other family members. This narrative review of the extant literature provides a brief overview of sleep physiology, aetiology, classification and prevalence of sleep disorders among CYP with NDEBIDs. It outlines various strategies for the management, including parenting training/psychoeducation, use of cognitive-behavioral strategies and pharmacotherapy. Practical management including assessment, investigations, care plan formulation and follow-up are outlined in a flow chart.

7.
World J Clin Cases ; 10(14): 4709-4712, 2022 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-35663083

RESUMO

Research has indicated that perfectionism is prevalent among adolescents and may be harmful in terms of its association with mental health problems. This letter aims to create a paradigm for future studies of the perfectionism. Specifically, we suggest gaps and implications that must be considered at perfectionism future research in terms of assessments, interventions, settings, potential treatments, gender, and social media.

8.
Cureus ; 14(5): e24662, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35663707

RESUMO

Background Many studies have shown the importance of patient autonomy and shared decision-making in medical treatment. However, television (TV) depiction of medicine continues to present a skewed depiction of healthcare and its effects. This has been observed in adult patients but little has been studied in the pediatric population. Methodology This study analyzed the depiction of pediatric patients (7-18 years old) autonomy and their participation in the shared decision-making process in the first season of medical TV dramas that premiered from 1994 to 2017, including ER (1994), Grey's Anatomy (2005), Red Band Society (2014), and The Good Doctor (2017). These shows were scored to record each instance of a medical decision made. Results Of the 238 medical decisions recorded, pediatric patients made a medical decision 61 times (57.5%). A total of 110 instances were omitted due to the patient's inability to give consent, usually due to altered mental status, and 22 instances were omitted due to age being less than seven years. Interestingly, there was an increasing proportion of pediatric patients involved in the decision-making process over time, moving from 17 of 39 medical decisions (43.6%) of patients in ER (1994) to 22 of 33 medical decisions (66.7%) in The Good Doctor (2017) (p = 0.050213). Conclusions The results revealed that TV medical dramas have been including children in their medical decision-making more over time. This has major implications for the way writers structure their shows and how medical providers interact with their patients.

9.
Front Psychol ; 13: 787936, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35664200

RESUMO

Persons with a disability make up a social group which is in an especially vulnerable situation. They have to face obstacles and difficulties in their participation as part of the community with equal opportunities, in which attitude of others is a determining factor. This study makes a comparative analysis of three intervention programs (1 "Simulation and Modeling," 2 "Information and Awareness Raising," and 3 "Adapted Sport") on attitudes toward persons with a disability of adolescents in secondary schools. Each program is based on a concrete technique, but they all have the common thread of the direct, structured contact technique with persons with a disability. The effectiveness of the three programs in changing attitudes is analyzed, and their impact on the different factors of the attitude construct (1 "acceptance/rejection," 2 "competence/limitation," and 3 "equality of opportunities") is also studied. The results show the effectiveness of the three programs. The students show more positive attitudes toward persons with a disability in all the groups, especially program 1. Analyzing the general influence of the three programs on the factors of the attitude construct, it can be seen that in factors 2 and 3, the attitudes have significantly improved in all three programs. Finally, the results show that each program has been more effective on a concrete attitude factor.

10.
Front Psychol ; 13: 856621, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35664205

RESUMO

Introduction: Adolescent connectedness, a key component of positive youth development, is associated with various positive health outcomes. Several measures have been developed to assess this construct. However, no study has summarized data on the existing measures of adolescent connectedness. We conducted this scoping review to fill this gap. We specifically aimed to: (i) identify the existing measures of adolescent connectedness, (ii) determine the most frequently used measures among the identified measures, and (iii) summarize the psychometric properties of these measures with a keen interest in highlighting their cross-cultural utility and validity. Methods: We searched CINAHL, Embase, PsycInfo, PubMed, and Web of Science databases for relevant articles published since database inception to 7th February 2021. Our search structure contained the key words "Adolescents", "Connectedness", and "Measures". We also searched Open Gray for potentially relevant gray literature. Results: We identified 335 measures from 960 eligible studies assessing various domains of adolescent connectedness, including school, family, community, peer, ethnic, racial, cultural, religious/spiritual, and self-connectedness. Most of the included studies (72.1%) were from North America and Europe. Most of the measures (n = 132, 39.4%) were measures of school connectedness among adolescents. Of the identified measures, 60 of them met our criteria of frequently used measures (i.e., the top five most used measures per domain of connectedness). These frequently used measures were used across 481 of the included studies with 400 of them reporting their psychometric properties. The reported reliability of these measures was adequate (Cronbach's alpha ≥ 0.70) in 89.8% of these studies. These measures also appeared to be valid in terms of their face, content, construct, criterion, convergent, discriminant, concurrent, predictive, measurement invariance, and cross-cultural validity. Conclusions: There exists a wide array of measures of adolescent connectedness. Sixty of these measures have been frequently used across studies and appear to be reliable and/or valid. However, this evidence is mostly from North America and Europe. This is a reflection of the limitation of this review where only studies published in English were considered. It might also reflect the paucity of research in other regions of the world. More research is needed for clearer insights.

11.
Front Psychiatry ; 13: 869326, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35664479

RESUMO

Introduction: Adolescents and young adults represent a vulnerable population in the context of the Coronavirus disease 2019 (COVID-19) pandemic. The present retrospective study aims to investigate the pandemic's psychological impact on adolescents and young adults by analyzing data from an outpatient mental health service dedicated to youths in Umbria, central Italy. Materials and Methods: The clinical charts of subjects aged 14-24 who first accessed the service in the timeframe between March 1st, 2019, and February 28th, 2021, were reviewed. Subjects were divided into two subgroups according to the period of time when they accessed the service (pre-COVID-19 vs. during- COVID-19 outbreak). Bivariate analyses were performed using the Chi-square test and the Welch's t-test. A secondary analysis was performed considering only subjects suffering from psychiatric disorders. Furthermore, data concerning individuals who were already followed by the service before the pandemic were analyzed by the McNemar's test and the t-paired test to assess changes in treatment features. Results: The number of new accesses during the pandemic period remained stable. After the emergency onset, youths accessing the service showed a higher prevalence of anxiety disorders (p = 0.022). During the COVID-19 period, services were more frequently delivered by using a digital mental health approach (p = 0.001). Psychopharmacological treatment was more frequently prescribed among subjects that were referred to the service after the pandemic onset (p = 0.033). As for substance use, a highly significant reduction in opioid use was observed (p = 0.003). Family therapy was delivered less frequently in the during-COVID-19 subgroup, especially in the subpopulation of subjects suffering from psychiatric disorders (p = 0.013). When considering subjects referred to the service in the pre-COVID-19 period, the number of interventions provided to this population increased after the pandemic outbreak (p = 0.038). Conclusion: In the context of the COVID-19-related public health crisis, youths represent an at-risk population for which pathways to care should be reinforced, and targeted interventions, including psychosocial treatments, should be implemented.

12.
Res Pract Thromb Haemost ; 6(4): e12727, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35664533

RESUMO

Background: Heavy menstrual bleeding (HMB) is a presenting symptom of an inherited bleeding disorder (BD) and results in hospitalizations, limitations of daily activities, and a reduction in quality of life. Adult women with BD report a sense of stigma, difficulties understanding their bleeding, and challenges with diagnostic labels. The experiences of adolescents with HMB and BD are unknown despite advances in medical management through the rapidly growing network of young women's hematology programs. Objectives: The objective of our qualitative study was to describe the experiences of adolescents with HMB with a BD and the impact on their day-to-day lives. Patients/Methods: Our qualitative study utilized semistructured interviews with adolescents with HMB after a BD diagnosis. We included adolescents with a BD within a multidisciplinary Young Women's Bleeding Disorders Clinic who had achieved menarche within the preceding 3 years and conducted interviews until theme saturation. All interviews were transcribed verbatim and analyzed using qualitative thematic descriptive analysis. Results: We identified the following themes in nine participants: anxiety and embarrassment, especially related to school; isolation and "otherness"; increased cautiousness and planning because of HMB and BD; and empowerment and identity formation because of the diagnosis of a BD. Conclusions: Our study uncovers previously unappreciated experiences of adolescents with HMB and a BD. HMB is an isolating and stressful experience in adolescents, but a BD diagnosis results in identity formation and empowerment. Psychological support and facilitating connections to others with similar life experiences soon after diagnosis represents key areas for targeted interventions.

13.
Pediatr Obes ; : e12946, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35666025

RESUMO

Increased intestinal permeability has an important role in metabolic dysregulation. In this cross-sectional study, we examined whether serum intestinal permeability marker zonulin and related pro-inflammatory molecules were associated with the oral disposition index, a predictor for the development of type 2 diabetes, in a cohort of children and adolescents with overweight and obesity. Ninety-two children and adolescents were recruited [Male: 43; 12.7 (2.35) years; BMI SDS: 2.7 (0.96)]. Anthropometric and clinical parameters, lipid profile, glucose metabolism and plasma levels of zonulin, lipopolysaccharide-binding protein and Interleukin-6 were measured. We found an association between oral disposition index and zonulin (ß = -0.243; p = 0.019) and age (ß = -0.307; p = 0.004), independent of sex and BMI SDS [R2  = 0.16; p = 0.005]. Our results show an association between serum zonulin concentration and oral disposition index supporting the hypothesis of increased intestinal permeability as a possible risk factor for glucose metabolism dysregulation in children and adolescents with obesity.

14.
Artigo em Inglês | MEDLINE | ID: mdl-35666195

RESUMO

CONTEXT: Transgender adolescents can receive GnRH analogues (GnRHa) and gender affirming hormone therapy (GAHT), but little is known about effects on growth and adult height. This is of interest since height differs between sexes and some trans girls wish to limit their growth. OBJECTIVE: Investigate effects of GnRHa and GAHT on growth, and the efficacy of growth-reductive treatment. DESIGN: Retrospective cohort study. SETTING: Specialised tertiary gender clinic. PARTICIPANTS: 161 trans girls treated with GnRHa and estradiol at a regular dose (2 mg) or high growth-reductive doses of estradiol (6 mg) or ethinylestradiol (EE, 100-200 µg). MAIN OUTCOME MEASURES: Growth, adult height and difference from predicted adult height (PAH) and target height. RESULTS: Growth velocity and bone maturation decreased during GnRHa, but increased during GAHT. Adult height after regular dose treatment was 180.8 ± 5.4 cm which was 2.2 cm below PAH at start GnRHa (95%CI 0.8 to 3.6), and close to target height (-0.2 cm, 95%CI -1.5 to 1.1). Compared to regular dose treatment, high dose estradiol and EE reduced adult height by 1.8 cm (95%CI -0.6 to 4.1) and 4.1 cm (95%CI 0.6 to 7.6), respectively. CONCLUSION: Growth decelerated during GnRHa and accelerated during GAHT. After regular dose treatment, adult height was slightly lower than predicted at start of GnRHa, likely due to systematic overestimation of PAH as described in boys from the general population, but not significantly different from target height. High dose EE resulted in greater reduction of adult height than high dose estradiol, but this needs to be weighed against possible adverse effects.

15.
J Autism Dev Disord ; 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35666330

RESUMO

This study examined the construct validity of the Autism Classification System of Functioning: Social Communication (ACSF). Participants included 145 parents of children with autism (2-19 years). The degree of convergent and discriminant validity between parent reported ACSF and subscales from Social Responsiveness Scale 2nd edition and Behavior Assessment System for Children, 3rd Edition were examined against a priori hypotheses. We examined construct validity in the entire sample as well as in specific age cohorts. Our findings suggest that ACSF can provide a valid classification system of social communication ability in children with autism 2-19 years of age, and its two subscales may be used to examine different aspects of social communication ability.

16.
Contracept Reprod Med ; 7(1): 7, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35642045

RESUMO

BACKGROUND: Adolescents and youths in Ethiopia have limited access to reproductive health services designed to address their needs. Therefore, the study aims to assess adolescents' and youth's sexual practice, contraceptive use, and behavioral patterns towards safe sexual exercise. METHODS: A quantitative cross-sectional study design was used on 374 students selected from high school and vocational colleges to assess their sexual experience and contraceptive use and related perceptions using pre-tested self-administered semi-structured questionnaires. We used descriptive analyses to report their sexual and reproductive health status and logistic regression to examine the association between contraceptive use and other variables. RESULTS: The results show that 52.7% of the respondents (students) migrated or moved from rural to urban to continue their high school and college education at urban. 41.7% of the respondents were with less than 18 years, of which 75.9% of them already initiated sexual intercourse. Of all the students who started sexual intercourse (51.1%), only 30.9% used contraceptives, but condom use accounts for 49.2%. Overall, 84.8% of those who practiced sexual intercourse were at risk of acquiring sexually transmitted diseases due to not using a condom. About 3% of the respondents reported unwanted pregnancy experiences, of which 64% of these pregnancies were reported to be aborted. CONCLUSION: Adolescents and youths attending high schools and College are at increased risk of acquiring HIV and unwanted pregnancy due to low levels of contraceptive use. Specifically, a designed youths-friendly reproductive health service is needed to avert related problems and contribute to sustainable development goals.

17.
Hand (N Y) ; : 15589447221092121, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35642736

RESUMO

Fracture-dislocation of the trapeziometacarpal (TM) joint in adolescent patients is a rare injury, with only 3 cases reported in literature to our knowledge. Its low incidence, together with the complexity of the anatomy and biomechanics of TM joint, may represent a challenge for surgeons in choosing the best treating option. Here, we report a case of a TM fracture dislocation in a 14-year-old boy treated with percutaneous Kirschner wire pinning. The results we obtained endorsed our choice in patients for whom closed reduction is achievable.

18.
JMIR Hum Factors ; 9(2): e33972, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35679113

RESUMO

BACKGROUND: There is solid evidence that lack of physical activity (PA) is a risk factor for chronic diseases. Sufficient levels of PA in childhood and adolescence are particularly important, as they can set the standards for PA levels in adulthood. The latest reports show that only a small percentage of adolescents reach the recommended levels of PA in European Union countries at the age of 15 years. In view of the scale of the problem, it is crucial to develop interventions that promote and support PA in adolescents. Considering their low implementation costs and ubiquitous presence, smartphone apps could be advantageous as a part of PA interventions. OBJECTIVE: This study aimed at investigating the attitudes and preferences of adolescents aged 16-18 years toward various PA app features and components that could (1) make the app more attractive for them and consequently (2) increase their interest and engagement with the app. METHODS: Two separate focus group discussions were conducted in 2 groups of adolescents (n=4 each) aged 16-18 years. Focus groups were carried out online via video conference. The discussions were conducted using a semistructured interview. Participants (n=8; 4 males and 4 females) had a mean age of 17.25 years (SD 0.82 years). Transcripts were analyzed following the approach by Krueger and Casey, that is, categorizing participants' answers and comments according to the questions and themes from the focus group schedule. RESULTS: Features, such as "goal setting and planning," "coaching and training programs," "activity tracking," "feedback," and "location tracking" were appraised as attractive, motivating, and interesting. An "automatic activity recognition" feature was perceived as useful only under the condition that its precision was high. The "reminders" component was also deemed as useful only if a range of conditions was fulfilled (timeliness, opportunity for customization, etc). The features "mood and sleep tracking," "sharing workout results via social networks," "digital avatar and coach," and "rewards" were generally perceived negatively and considered as useless and not motivating. In general, participants preferred features with an easy-to-navigate interface and a clear, simplistic, and straightforward layout with a modern design. Customization and personalization qualities were highly appreciated throughout an app, together with data precision. CONCLUSIONS: This study contributes to the understanding of the features and components preferred by adolescents in apps promoting PA. Such apps should provide users with precise data, and have a simplistic modern design and a straightforward easy-to-use interface. Apps should be personalized and customizable. Desired features to be included in an app are goal setting and planning, feedback, coaching and training programs, and activity tracking. The features should involve high levels of data precision and timely delivery while taking into consideration the real-life context.

19.
Pediatr Obes ; : e12948, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35686545

RESUMO

BACKGROUND: COVID-19 mitigation measures, including closures of schools and recreational facilities and alterations in eating behaviours and physical activity, may impact weight. OBJECTIVE: To examine changes in body weight and body mass index (BMI) in children and adolescents with obesity participating in an obesity treatment program before and during the COVID-19 pandemic in Ontario, Canada. METHODS: Body weight and BMI at baseline and 6 months were recorded for the 'historic' cohort (females = 34, males = 21) before the pandemic (November 1, 2018, to March 18, 2020) and for the 'pandemic' cohort (females = 30, males = 30) during the pandemic (March 19, 2020 to July 31, 2021). Analyses were adjusted for baseline weight/BMI, age, and ON-Marg score, a measure of the social determinants of health. RESULTS: In males, body weight (98.29 versus 89.28 kg, p < 0.001) and BMI (36.46 versus 34.85 kg/m2 , p = 0.027) were greater in the pandemic compared with historic cohort. In females, body weight (p = 0.769) and BMI (p = 0.548) were not different between the two cohorts. CONCLUSION: The COVID-19 pandemic may have diminished the health impacts of a weight management program, particularly in males, leading to increased body weight and BMI.

20.
JMIR Form Res ; 6(6): e32416, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35686737

RESUMO

BACKGROUND: Adolescents are disproportionately affected by sexually transmitted infections (STIs), including HIV. Many youths with asymptomatic STI or related symptoms do not seek treatment and may not be screened if accessing the health care system for other reasons. OBJECTIVE: We examined intervention completion and changes in the number of new patients, the number of STI or HIV tests, and the sexual risk profile of patients over time to determine the feasibility and acceptability of a peer-driven text messaging strategy to connect youth to STI and HIV services. METHODS: The intervention enlisted consecutive patients at an adolescent medicine clinic to send a text message to 5 peers they believed were sexually active and lived in the clinic's service area. The intervention was evaluated using an interrupted time-series design in which baseline clinic service levels were documented during a 35-week lead-in period, followed by a 20-week intervention implementation period, and a 16-week period of continued clinic observation. Clinic and patient data were obtained through chart abstraction from intake forms that occurred during the entire study period. Analyses conducted in 2015 used a generalized linear mixed model. RESULTS: Of the 153 patients approached to participate, 100 agreed to send SMS text messages. Most (n=55, 55%) reported no concerns with sending the text message. No adverse events or negative outcomes were reported. Adolescent STI testing, positive test results, and reported risk behavior increased post intervention, although this was not statistically significant, likely because of the small sample size. CONCLUSIONS: Given low youth uptake of health care services, and STI/HIV screening, in particular, new strategies are needed to address access barriers. Common approaches for reaching youth are resource-intensive and often miss those not connected to school or community programs. The peer-based text messaging strategy showed promise for both increasing the number of youths accessing health services and finding youths engaging in sexual risk behaviors and most in need of sexual health screening and services.

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