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1.
Eur J Obstet Gynecol Reprod Biol ; 235: 116-120, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30826159

RESUMO

Paediatric and Adolescent Gynaecology (PAG) is a multidisciplinary field combining aspects of gynaecology but also includes paediatrics, endocrinology, genetics, radiology, psychology and urology. Specialist knowledge is warranted for the care of these youngsters, and it is important that doctors attending to the gynaecological needs of children must understand that they are not just "little women". Their needs and accompanying clinical approaches required are very different from those of adults in this sensitive area, as is the spectrum of diseases and problems. A multidisciplinary collaboration is as important as the establishment and adoption of standards in education, training and management. The situation in Europe in PAG is varied, reflecting the relative youth of this area of special interest and thereby allowing for earlier consolidation of standards and services across Europe. This article summarises the background to PAG in Europe, inequitable current provision of care and issues relating to education and training all of which are relevant in providing a common approach to PAG problems and endeavouring to obtain the best outcomes. There remains huge diversity how the services for "young women" are currently delivered across different countries within Europe. A concerted European approach is urgently required to streamline standards of training and clinical care, to ensure high quality care by using agreed national and European pathways.


Assuntos
Serviços de Saúde do Adolescente , Medicina do Adolescente/métodos , Serviços de Saúde da Criança , Ginecologia/métodos , Pediatria/métodos , Adolescente , Criança , Assistência à Saúde , Europa (Continente) , Feminino , Ginecologia/organização & administração , Humanos , Obstetrícia/métodos , Obstetrícia/organização & administração , Equipe de Assistência ao Paciente , Gravidez , Sociedades Médicas , Conselhos de Especialidade Profissional
2.
Eur J Obstet Gynecol Reprod Biol ; 235: 30-35, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30780074

RESUMO

BACKGROUND: The British Society of Paediatric and Adolescent Gynaecology (BritSPAG) was created in 2000 with specific aims to include raising the profile of paediatric and adolescent gynaecology (PAG) within the United Kingdom (UK). The Society has since developed a set of clinical standards for all acute hospitals providing gynaecological services to enable successful provision of paediatric and adolescent gynaecology care. AIMS: To determine the depth of knowledge that obstetric and gynaecology trainees have with regards to the PAG services provided at their Hospital, reflecting how widely PAG services have had an impact on trainees. METHOD: The national survey was distributed to all deaneries in the UK for circulation to all their trainees via e mail during Nov 2017-March 2018. RESULTS: 28% of the trainees said there was a PAG clinic at their hospital, 46.9% did not have a clinic and 24.7% were unsure. 41.6% of the respondents were aware of BritSPAG, however only 10.4% were aware of the BritSPAG clinical standards for service planning with regards to PAG clinics. Nearly half were aware of the PAG specialist centre for their region but only 6.5% were aware of the BritSPAG UK map of services. A large majority (93.24%) didn't believe that trainees in O&G received adequate exposure to PAG in their training. CONCLUSION: This study represents the largest and first national survey to seek obstetric and gynaecology trainees' thoughts on the provision of PAG training in the UK today. Given that only 28% of trainees answering said that they were aware of a PAG clinic at their hospital, this indicates not only that many hospitals did not have a dedicated PAG clinic but more worryingly five of the trainees were not aware of the existence of a confirmed PAG clinic at their hospital, and therefore are potentially losing out on training opportunities. Disappointingly the results of our survey reveal that trainees in Obstetrics and Gynaecology still have very little experience or exposure to PAG during their training despite there being opportunities to do so.


Assuntos
Ginecologia/educação , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde Materna , Obstetrícia/educação , Estudantes de Medicina/psicologia , Adolescente , Medicina do Adolescente/métodos , Adulto , Criança , Feminino , Ginecologia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Obstetrícia/métodos , Pediatria/métodos , Gravidez , Pesquisa Qualitativa , Inquéritos e Questionários , Reino Unido
3.
Recurso educacional aberto em Português | CVSP - Brasil | ID: cfc-346695

RESUMO

Entrevista com a pediatra Helena Fonseca, coordenadora da consulta de adolescentes do Hospital de Santa Maria e autora de livros e artigos sobre esta problemática. Referência Videográfica: Universidade Aberta - Entre Nós [Em linha]: entrevista a Helena Fonseca. Realização de Elisa Antunes; Tecnóloga Teresa Ribeiro. Lisboa: Universidade Aberta, [2005]. 1 prog. vídeo (25 min., 56 seg.) Link do vídeo: https://vimeo.com/user34119652/review/150908034/2dae3bcfab


Assuntos
Comportamento Alimentar , Alimentação , Medicina do Adolescente , Relações Pais-Filho , Pediatria
4.
Einstein (Sao Paulo) ; 16(2): eAO4225, 2018 Jun 28.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29972440

RESUMO

OBJECTIVE: To characterize the care flow and the primary diagnoses of an Adolescent Medicine Clinic. METHODS: A retrospective descriptive study, with analysis of clinical processes of adolescents (10-18 years) seen at the Adolescent Medicine Clinic, from January 2006 to December 2013. The following variables were analyzed: sex, age, number of visits, referring service and primary diagnoses according to the International Statistical Classification of Diseases and Related Health Problems. As to the variable age, the adolescents were divided into two groups: Group I comprised those aged 10-14 years, and Group II, 15-18 years. RESULTS: A total of 7,692 visits were carried out, in that, 1,659 first visits (22%), with an annual growth rate of 6%. The mean age was 14.2 years, and 55% of patients were female. The group of endocrine, nutritional and metabolic diseases was the most representative in our sample (34%), with obesity being the most frequent diagnosis in both sexes and age groups (23%), with a higher prevalence in males (13% male versus 10% female, p<0.001) and younger adolescents (18% in Group I versus 5% in Group II p<0.001). The group of mental and behavioral disorders was the second most prevalent (32%), affecting mainly females (39% female versus 22% male, p<0.001) and the older age group (39% Group II versus 27% Group I, p<0.001). Social problems were the primary diagnosis in 8% of visits. CONCLUSION: Most diseases diagnosed have a strong behavioral and social component, particularly mental disorders and obesity. This specific type of diagnoses reinforces the need for a global approach for adolescents and specialized adolescent medicine units/clinics.


Assuntos
Medicina do Adolescente/estatística & dados numéricos , Instituições de Assistência Ambulatorial , Grupos Diagnósticos Relacionados/estatística & dados numéricos , Adolescente , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Estudos Retrospectivos
5.
Sci. med. (Porto Alegre, Online) ; 28(3): ID29642, jul-set 2018.
Artigo em Português | LILACS | ID: biblio-909969

RESUMO

OBJETIVOS: Caraterizar como os especialistas e residentes de Pediatria e de Medicina Geral e Familiar consideram que abordam os adolescentes, identificar as suas habilitações em Medicina do Adolescente, averiguar que tópicos dessa área os médicos gostariam de ver abordados em futuros treinamentos e comparar as percepções dos médicos das duas especialidades em relação à sua experiência na prática em saúde do adolescente. MÉTODOS: Estudo transversal com base em inquérito enviado via correio eletrônico a 241 médicos da área de influência de um hospital de nível II, tendo-se incluído especialistas e residentes de Pediatria e de Medicina Geral e Familiar de centros de saúde do concelho de Viseu, Portugal. Utilizaram-se os testes Qui-quadrado ou teste Exacto de Fisher para testar associações entre variáveis, assumindo-se significado estatístico quando p<0,05. RESULTADOS: Um total de 113 médicos completou o inquérito, sendo 74% do gênero feminino, com uma mediana de anos de prática de 12 anos (intervalo interquartil 5-30, mínimo 2 anos, máximo 38 anos). O grupo de Pediatria tinha mais formação em Medicina do Adolescente (57%) do que o grupo de Medicina Geral e Familiar (25%) (p=0,007). Mais médicos com formação específica em Medicina do Adolescente consideravam-se preparados para a entrevista ao adolescente (51%, vs. 28% dos que não tinham formação específica, p=0,03). Os médicos Gerais e de Família orientavam mais os adolescentes sobre consumo de substâncias, contracepção e doenças sexualmente transmissíveis, enquanto os médicos de Pediatria identificavam mais adolescentes com depressão. A maioria dos médicos avaliou-se como tendo conhecimentos insuficientes em Medicina do Adolescente, sendo o treino insuficiente a barreira mais frequentemente referida. Cinquenta e sete por cento dos médicos de Pediatria, 78% dos médicos Gerais e de Família e 84% dos que não tinham formação específica em Medicina do Adolescente, considerando as duas especialidades, gostariam de aprofundar os seus conhecimentos nessa área. CONCLUSÕES: Este estudo permitiu identificar que áreas de conhecimento sobre Medicina do Adolescente estão deficitárias na formação dos pediatras e dos médicos gerais e de família. A maioria dos médicos, principalmente os que não tiveram formação em Medicina do Adolescente, mostraram-se interessados em preencher essa lacuna.


AIMS: To characterize the way in which General and Family physicians and Pediatricians consider approaching adolescents, identify their qualifications in Adolescent Medicine, ascertain which topics of this specialty these physicians would like to see addressed in future training, and to compare the perceptions of physicians of both specialties with respect to their experience in adolescent health practice. METHODS: Cross-sectional study based on a survey sent by e-mail to 241 physicians in the area of influence of a level II hospital, including specific training interns or experts in Pediatrics and General and Family Medicine from health centers of the municipality of Viseu, Portugal. Chi-square tests or Fisher's exact test were used to test associations between variables, assuming statistical significance when p<0.05. RESULTS: A total of 113 physicians completed the survey, of them 74% female, with a median of 12 years of practice (interquartile range 5-30, minimum 2 years, maximum 38 years). The Pediatrics group had more training in Adolescent Medicine (57%) than the General and Family Medicine group (25%) (p=0.007). More physicians with specific training in Adolescent Medicine considered themselves prepared for the adolescent interview (51%, vs. 28% of those who did not have specific training, p=0.03). Family and General practitioners guided adolescents more about substance use, contraception, and sexually transmitted diseases, while Pediatrics doctors identified more adolescents with depression. Most physicians rated themselves as having insufficient knowledge in Adolescent Medicine, with insufficient training being the most frequently referred barrier. Fifty-seven percent of Pediatrics doctors, 78% of General practitioners and 84% of those with no specific training in Adolescent Medicine, considering the two specialties, would like to deepen their knowledge in this area. CONCLUSIONS: This study allowed identifying which areas of knowledge on Adolescent Medicine are deficient in the training of Pediatricians and General practitioners. Most physicians, especially those with no training in Adolescent Medicine, showed interest in filling this gap.


Assuntos
Saúde do Adolescente , Medicina do Adolescente , Educação Médica
6.
J Pediatr Adolesc Gynecol ; 31(2): 71-76, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29566846

RESUMO

The degree of exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology and pediatrics. Nevertheless, these programs are responsible for training residents and providing opportunities within their programs to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG resident education by creating and systematically updating the Short Curriculum. This curriculum outlines specific learning objectives that are central to PAG education and lists essential resources for learners' reference. This updated curriculum replaces the previous 2014 publication with added content, resources, and updated references. Additionally, attention to the needs of learners in pediatrics and adolescent medicine is given greater emphasis in this revised North American Society for Pediatric and Adolescent Gynecology Short Curriculum 2.0.


Assuntos
Medicina do Adolescente/educação , Currículo , Ginecologia/educação , Internato e Residência/métodos , Pediatria/educação , Adolescente , Criança , Feminino , Humanos , Médicos , Gravidez
7.
J Pediatr Adolesc Gynecol ; 31(4): 346-349, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29524594

RESUMO

STUDY OBJECTIVE: The American Academy of Pediatrics and American College of Obstetricians and Gynecologists have identified the menstrual cycle as essential in assessing overall health of adolescent girls. Menses should be considered a "vital sign" and documentation of last menstrual period (LMP) is recommended at every patient encounter. The aim of this study was to estimate and compare LMP documentation among adolescent and pediatric health care providers. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study identified a random sample of 50 female patients seen in the general pediatrics (PEDS), adolescent medicine (AM), and pediatric and adolescent gynecology (PAG) ambulatory clinics at Phoenix Children's Hospital between January 1, 2016 and March 31, 2016. INTERVENTIONS AND MAIN OUTCOME MEASURES: Rates of LMP documentation were compared between clinics using the Pearson χ2 test. Multivariable logistic regression analyses quantified the association of clinic and LMP documentation, with adjustments for visit reason, provider gender, and age at presentation. RESULTS: Rates of LMP documentation were 100% for adolescent gynecologists, but significantly lower for general pediatricians (14%) and AM (60%) providers (P < .0001). These findings were confirmed in multivariable analyses (PAG vs PEDS: odds ratio [OR], 280; 95% confidence interval [CI], 32-2331; PAG vs AM: OR, 34; 95% CI, 4.4-270; AM vs PEDS: OR, 3.8; 95% CI, 1.3-11.0). CONCLUSION: Adolescent gynecologists document LMP routinely. In contrast, LMP documentation rates in AM, and especially in PEDS, were significantly lower. Quality improvement methods such as incorporation of an LMP section into the vitals portion of an electronic medical record could help improve rates of compliance.


Assuntos
Documentação/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Ciclo Menstrual , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Medicina do Adolescente , Instituições de Assistência Ambulatorial , Criança , Estudos de Coortes , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Ginecologia , Hospitais Pediátricos , Humanos , Masculino , Pediatria , Estudos Retrospectivos
8.
J Pediatr Adolesc Gynecol ; 31(4): 367-371, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29408736

RESUMO

STUDY OBJECTIVE: A polycystic ovary syndrome (PCOS) diagnosis in adolescence can have significant long-term health implications. The criteria for its diagnosis in adolescents have been subject to much debate. In this study we aimed to characterize the variability in diagnosis and management among different pediatric specialties. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: This was a retrospective review of electronic medical records of female patients (11-21 years old) who presented to 3 specialties (adolescent medicine [ADO], pediatric endocrinology [ENDO], and gynecology [GYN]), with a postvisit diagnosis of PCOS, menstrual disorders, or hirsutism, at a large tertiary care center, from November 1, 2011 to October 31, 2012. Demographic, clinical, laboratory, and treatment data were abstracted. MAIN OUTCOME MEASURES: Testing for diagnosis of PCOS and its comorbidities, and treatment strategies in the 3 pediatric specialties. RESULTS: One hundred forty-one patients (50 ADO, 48 ENDO, and 43 GYN) were eligible. Testing for hyperandrogenemia (17-hydroxy-progesterone, dehydroepiandrosterone, estradiol), thyroxine, and use of pelvic ultrasound differed among specialties. Providers failed to document weight concerns in 28.3% (29 of 101) of overweight or obese patients. Patients seen by ENDO were most likely, and GYN least likely, to be identified as having elevated weight, and to be tested for glucose abnormalities, dyslipidemia, and liver disease. ENDO providers prescribed metformin more often and hormonal therapy less often than ADO and GYN. CONCLUSION: There is considerable variability across pediatric specialties in the evaluation of PCOS, with significant underassessment of comorbidities. Use of unified guidelines, including for the evaluation of comorbidities, would improve evidence-based management of adolescent PCOS.


Assuntos
Programas de Rastreamento/métodos , Síndrome do Ovário Policístico/diagnóstico , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Medicina do Adolescente/estatística & dados numéricos , Antagonistas de Androgênios/uso terapêutico , Criança , Comorbidade , Anticoncepcionais Orais Hormonais/uso terapêutico , Endocrinologia/estatística & dados numéricos , Feminino , Ginecologia/estatística & dados numéricos , Humanos , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Síndrome do Ovário Policístico/tratamento farmacológico , Estudos Retrospectivos , Adulto Jovem
9.
Psicol. educ. (Madr.) ; 24(1): 1-6, ene. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-180270

RESUMO

The study evaluated, in a sample of 230 adolescents (147 males and 83 females, mean age = 16.67) and a sample of 181 young people (21 males and 160 females, mean age = 22.57), the relationships between time perspective and the following personal skills: coping styles, perceived efficacy on affect regulation, and creative divergent problem solving. Results highlight that future time perspective increases in value from adolescence to youth, while present time perspective decreases. Future time perspective is correlated with creative problem solving and problem solving coping style in both age groups, while present time perspective is positively correlated with expression of positive emotions in both age groups. Results are discussed also for their relevance for school educational and training programs


El estudio evalúa en un grupo de 230 adolescentes (147 varones y 83 mujeres, media de edad = 16.67) y un grupo de 181 jovenes (21 varones y 160 mujeres, media de edad = 22.57) las relaciones entre las siguientes habilidades personales: estilos de afrontamiento, eficacia percibida en la regulación de las emociones y resolución creativa de problemas en la adolescencia y la juventud. Los resultados maestran que la perspectiva temporal futura aumenta de la adolescencia a la juventud, mientras la perspectiva presente disminuye. La perspectiva temporal futura está relacionada con la resolución creativa de problemas y con el estilo de afrontamiento de la resolución de problemas en ambos grupos de edad. La perspectiva temporal presente está positivamente relacionada con la expresión de las emociones positivas en ambos grupos de edad. Se discuten los resultados en cuanto a su relevancia para los programas de educación y formación escolar


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adaptação Psicológica , Percepção do Tempo , Comportamento do Adolescente/psicologia , Medicina do Adolescente/educação , Depressão/psicologia , Relações Interpessoais , Psicologia Educacional/métodos
10.
J Pediatr Adolesc Gynecol ; 31(2): 102-106, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29175430

RESUMO

STUDY OBJECTIVE: To develop and evaluate an educational activity designed to teach the adolescent Home, Education and employment, Eating, Activities, Drugs, Sexuality, Suicide/depression, and Safety (HEADS) examination. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Participants were third-year medical students in their pediatric clerkships. Students received an article on the HEADS interview and attended an adolescent medicine educational session. The session included individualized goal-setting and coached role play. Students' skills in doing a HEADS interview were evaluated through a standardized patient encounter (SPE) with a checklist and a retrospective pre- and post-test survey. The SPE checklist was used to assess whether the students included questions in 6 key areas of a HEADS interview. RESULTS: One hundred fifty-two students participated. During the SPE, 90% of students queried the adolescent's home life, 91% education, 82% activities, 84% drug/substance abuse, 95% sexual history, and 61% symptoms of depression. Pre- and postintervention data were compared using the Kruskal-Wallis Test and showed a statistically significant difference in the students' ability to list key topic areas of the HEADS exam (P < .001) and to use the skills needed for an adolescent interview using the HEADS exam (P < .001). CONCLUSION: After an introduction to the HEADS examination, most students covered almost all of the topic areas of this screening interview during a SPE. Only three-fifths of the students, however, included questions about symptoms of depression. Coached role play with goal-setting facilitated effective learning of this approach to adolescent interviewing.


Assuntos
Medicina do Adolescente/educação , Educação Médica/métodos , Desempenho de Papéis , Adolescente , Competência Clínica , Feminino , Humanos , Masculino , Estudos Retrospectivos , Estudantes de Medicina
11.
Eur J Pediatr ; 177(4): 479-487, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29270826

RESUMO

In many European countries, paediatric junior staff has no formal training in adolescent medicine and is ill-equipped to deal with issues and health problems such as substance use, unprotected sex, eating disorders and transition to adult care. This position paper of the European Academy of Paediatrics proposes a set of competency-based training goals and objectives as well as pedagogic approaches that are expected to improve the capacity of paediatricians to meet the needs of this important segment of the paediatric population. The content has been developed from available publications and training programmes and mostly covers the generic aspects of adolescent healthcare, such as how to communicate effectively, how to review and address lifestyles, how to perform a respectful and relevant physical examination, how to address common problems of adolescents and how to support adolescents in coping with a chronic condition. CONCLUSION: The European Academy of Paediatrics urges national bodies, paediatric associations and paediatric teaching departments to adopt these training objectives and put them into practice, so that paediatricians will be better prepared in the future to meet the challenge of delivering appropriate and effective healthcare to adolescents.


Assuntos
Medicina do Adolescente/métodos , Competência Clínica/normas , Internato e Residência/métodos , Pediatria/métodos , Academias e Institutos , Adolescente , Serviços de Saúde do Adolescente/normas , Medicina do Adolescente/normas , Europa (Continente) , Departamentos Hospitalares , Humanos , Internato e Residência/normas , Pediatria/normas
12.
J Contemp Dent Pract ; 18(12): 1097-1098, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29208781

RESUMO

Adolescence is an age group defined from the onset of puberty to establishment of social independence. Chronologically it is defined as the age of 10 to 18 years but social and behavioral situations may dictate vari-ability.1 Ephebodontics is the term coined for adolescent dentistry in the April 1969 issue of Dental Clinics of North America. The dental needs of adolescents differ largely from other established age groups. There are anomalous physical, emotional, and psychological changes in adolescents that need specific health care protocol.2.


Assuntos
Medicina do Adolescente , Assistência Odontológica , Saúde Bucal , Especialidades Odontológicas , Adolescente , Humanos
14.
Recurso educacional aberto em Português | CVSP - Brasil | ID: cfc-324200

RESUMO

Vídeoaula sobre a Saúde dos adolescentes, exibido em 10/08/2015 no programa Ligado em Saúde. A adolescência é um período intenso. É o corpo que muda, o humor, novas vontades e desejos aparecem e o adolescente quer viver todas as experiências como se não houvesse amanhã. E a saúde nessa história, como fica? Tanto os pais como os próprios adolescentes ficam confusos. Não é mais criança mais ainda não é adulto. O cuidado com a saúde é responsabilidade de quem? Hoje no ligado em saúde vamos conversar sobre essa fase tão cheia de mudanças e descobertas. Você sabia que existe uma especialidade médica só para os adolescentes? Participações de Mariana Caroni, mestre em saúde da criança e adolescente do Núcleo de Estudos da Saúde do Adolescente da Universidade do Estado do Rio de Janeiro (NESA/UERJ) e José Augusto Messias, professor titular do NESA/UERJ.


Assuntos
Medicina do Adolescente , Comportamento do Adolescente , Defesa da Criança e do Adolescente , Assistência Integral à Saúde
16.
Curr Sports Med Rep ; 16(3): 202-210, 2017 May/Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28498229

RESUMO

In August 2016, a group including sport medicine clinicians, researchers, and a bioethicist met in Vail, Colorado to discuss regenerative medicine and its potential role in youth sports injuries. There was consensus that a call to action is urgently needed to understand the current evidence base, the risks and rewards, and future directions of research and clinical practice for regenerative medicine therapies in youth sports. We present here a summary of our meeting, which was supported by the National Youth Sports Health and Safety Institute (NYSHSI), a partnership between the American College of Sports Medicine (ACSM) and Sanford Health. The group's goal is to educate practitioners and the public, and to pioneer a means of accumulating meaningful clinical data on regenerative medicine therapies in pediatric and adolescent athletes.


Assuntos
Medicina do Adolescente/tendências , Traumatismos em Atletas/terapia , Pesquisa Biomédica/tendências , Previsões , Pediatria/tendências , Medicina Regenerativa/tendências , Medicina Esportiva/tendências , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estados Unidos , Adulto Jovem
17.
Pediatr Clin North Am ; 64(2): 331-342, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28292449

RESUMO

Menstrual disorders and abnormal uterine bleeding are common concerns of young women. Complaints include menses that are: too painful (dysmenorrhea), absent or occur irregularly (amenorrhea or oligoamenorrhea), or prolonged and heavy (menorrhagia, or excessive uterine bleeding). In providing optimal reproductive care, the medical provider must be able to distinguish between normal developmental patterns or symptoms requiring education and reassurance from pathologic conditions requiring prompt assessment and treatment. This article discusses the normal menstrual patterns seen in adolescent females and provides an evaluation and management approach to primary and secondary dysmenorrhea.


Assuntos
Medicina do Adolescente/métodos , Dismenorreia/diagnóstico , Dismenorreia/tratamento farmacológico , Adolescente , Amenorreia/diagnóstico , Amenorreia/tratamento farmacológico , Anticoncepcionais Orais/uso terapêutico , Feminino , Humanos , Anamnese , Ciclo Menstrual/fisiologia , Saúde Reprodutiva
18.
Chronobiol Int ; 34(2): 225-234, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28055288

RESUMO

Circadian preference toward eveningness has been associated with increased risk for mental health problems both in early adolescence and in adulthood. However, in late adolescence, when circadian rhythm naturally shifts to later, its significance for mental health is not clear. Accordingly, we studied how circadian rhythm estimated both by self-reported chronotype and by actigraph-defined midpoint of sleep was associated with self-reported psychiatric problems based on Youth Self Report (YSR). The study builds on a community cohort born in 1998, Helsinki, Finland. At age 17 years (mean age = 16.9, SD = 0.1 years), 183 adolescents (65.6% of the invited) participated in the study. We used the shortened version of the Horne-Östberg morningness-eveningness Questionnaire to define the chronotype, and actigraphs to define the naturally occur circadian rhythm over a 4 to 17 days' period (mean nights N = 8.3, SD = 1.8). The Achenbach software was used to obtain T-score values for YSR psychiatric problem scales. The analyses were adjusted for important covariates including gender, socioeconomic status, body mass index, pubertal maturation, mother's licorice consumption during pregnancy, and actigraph-defined sleep duration and quality. Eveningness was associated with higher scores in rule-breaking behavior and conduct problems (as assessed either by midpoint of sleep or by self-reported chronotype, p-values <0.05), attention deficit/hyperactivity problems (by self-reported chronotype, p-values <0.05), with affective problems (by midpoint of sleep and by self-reported chronotype, p-values <0.05) and somatic complaints (by self-reported chronotype, p-values <0.05), as compared to circadian tendency toward morningness. Our results suggest that the association between eveningness and externalizing problem behavior, present in children and younger adolescents, is also present in late adolescence when circadian rhythms shift toward evening.


Assuntos
Ritmo Circadiano , Transtornos Mentais/epidemiologia , Comportamento Problema/psicologia , Autorrelato , Sono , Actigrafia , Adolescente , Medicina do Adolescente , Peso ao Nascer , Índice de Massa Corporal , Estudos de Coortes , Feminino , Finlândia , Humanos , Masculino , Transtornos Mentais/diagnóstico , Fatores de Risco , Software , Inquéritos e Questionários
19.
Clin Teach ; 14(6): 401-406, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28078778

RESUMO

PURPOSE: Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question-and-answer (Q&A) texting format; and (2) pre-/post-paediatric in-training exam (ITE) performance. METHODS: A prospective study with paediatrics and internal medicine-paediatrics residents. Residents were divided into subgroups: adolescent medicine (AM) and developmental medicine (DM). Messages were derived from ITE questions and sent Monday-Friday with a 20 per cent variance in messages specific to the sub-group. Residents completed surveys gauging perceptions of the programme, and pre- and post-programme ITE scores were analysed. RESULTS: Forty-one residents enrolled and 32 (78%) completed a post-programme survey. Of those, 21 (66%) preferred a Q&A format with an immediate text response versus information-only texts. The percentage change in ITE scores between 2013 and 2014 was significant. Comparing subgroups, there was no significant difference between the percentage change in ITE scores. Neither group performed significantly better on either the adolescent or developmental sections of the ITE. Text messaging… remains an underused educational tool CONCLUSIONS: Overall, participants improved their ITE scores, but no improvement was seen in the targeted subgroups on the exam. Although Q&A texts are preferred by residents, further assessment is required to assess the effect on educational outcomes.


Assuntos
Internato e Residência , Pediatria/educação , Mensagem de Texto , Medicina do Adolescente/educação , Adulto , Avaliação Educacional , Feminino , Humanos , Internato e Residência/métodos , Masculino , Estudos Prospectivos , Mensagem de Texto/estatística & dados numéricos
20.
Clin Teach ; 14(1): 20-26, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26840988

RESUMO

BACKGROUND: Motivational interviewing (MI) is a collaborative, evidence-based, person-centred counselling style for addressing ambivalence about behaviour change. Despite its proven effectiveness, there is little formal instruction of MI in paediatric training programmes. METHODS: Second-year paediatric residents participated in a 4-hour MI workshop, followed by a 1-hour small group review course and hands-on supervision during their Adolescent Medicine rotation. After the MI workshop, and again after their refresher course, we assessed residents' attitudes and skill with written and online surveys, as well as with a modified Helpful Responses Questionnaire (HRQ). RESULTS: Results revealed a statistically significant improvement in residents' confidence in eliciting health behaviour change [t-score(59) = 3.76, p = 0.008]. HRQ scores for all three clinical scenarios improved significantly following the workshop (p < 0.000). Residents most valued the interactive components of the workshop and review course, particularly the practice exercises, videos/video vignettes, feedback and coaching. DISCUSSION: A standardised MI curriculum for paediatric residency training improved residents' confidence in eliciting health behaviour change and use of empathic, reflective language. The curriculum is both feasible and widely accepted by residents, with opportunities for residents to practise MI under supervision during resident training. In conclusion, providing a 4-hour MI workshop for paediatric residents, with reinforcement through a review course and clinical opportunities to practise MI under supervision, improved confidence in eliciting health behaviour change and the use of MI-consistent language. This innovative and time-sensitive effort could serve as a future model for MI training for paediatric residents. There is little formal instruction of MI in paediatric training programmes.


Assuntos
Medicina do Adolescente/educação , Internato e Residência/métodos , Entrevista Motivacional , Pediatria/educação , Atitude do Pessoal de Saúde , Competência Clínica , Currículo , Humanos , Inquéritos e Questionários
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