O adolescente, ao se deparar com o adoecimento pelo câncer, se vê diante de um grande desafio que desencadeia grandes transformações em sua vida. As limitações impostas pela doença alteram a rotina dos adolescentes que se veem forçados a se submeter a um tratamento agressivo e doloroso e a se adaptar às restrições tanto de atividades quanto de relacionamentos. O objetivo da presente investigação é compreender como se configura o cuidado do adolescente com câncer, articulando as perspectivas dos adolescentes, familiares e da equipe de saúde, no contexto de um hospital de nível terciário de atenção, e apontar elementos que se aproximam e se distanciam de um cuidado que considere a complexidade humana. Foi utilizada a abordagem metodológica qualitativa, com fundamentação nas ideias acerca do pensamento complexo, tratado por Edgar Morin, pensador francês, que defende a necessidade de um modo de pensar multidimensional, em consonância com a complexidade da realidade. Participaram do estudo 12 adolescentes (com idade entre 12 e 18 anos), 14 familiares (dois pais, nove mães e três irmãos) além de 37 profissionais (15 médicos, quatro alunos do sexto ano de medicina, seis enfermeiras, cinco auxiliares de enfermagem, uma técnica de enfermagem, duas assistentes sociais, dois psicólogos, uma terapeuta ocupacional e duas nutricionistas). A entrevista e a observação foram utilizadas para a coleta de dados. A análise compreensiva dos dados foi desenvolvida buscando preservar a sua característica multidimensional, mediante a articulação dos diferentes sujeitos, considerando as distintas perspectivas, envolvidas no contexto do estudo, bem como o conjunto e suas relações, reconhecendo a complexidade do todo. Foram construídas três temáticas, inter-relacionando os dados empíricos com o referencial teórico proposto: a dialógica racionalidade-afetividade, a dialógica vida-morte e a dialógica indivíduoequipe- instituição no cuidado do adolescente com câncer. Considerando a questão do cuidado do adolescente com câncer como um fenômeno complexo que envolve múltiplas dimensões (indivíduos em um momento peculiar de seu desenvolvimento, com demandas específicas, inseridos em uma unidade familiar e social, vivenciando uma doença grave que os aproxima cotidianamente de uma equipe de profissionais com diferentes formações e diversos enfoques no cuidado), cabe construir práticas de cuidar condizentes com a complexidade da condição humana. Deste modo, cabe integrar a racionalidade técnica com a realidade vivida que comporta também a afetividade, a religiosidade, a angústia existencial e a possibilidade da criação, algumas das condições próprias do sujeito humano. / When faced with cancer, adolescents are confronted with a big challenge that leads to great transformations in their lives. The limitations the disease imposes alter the adolescents\' routine, who are forced to submit to an aggressive and painful treatment and to adapt to restrictions in their activities and relationships. This research aims to understand care delivery to adolescents with cancer, articulating the perspectives of adolescents, relatives and the health team in the context of a tertiary care hospital, as well as to appoint elements that approach and get away from care that takes into account human complexity. A qualitative methodological approach was used, based on the ideas of complex thinking according to the French thinker Edgar Morin, who defends the need for a multidimensional way of thinking, in line with the complexity of reality. Study participants were 12 adolescents (between 12 and 18 years old), 14 relatives (two fathers, nine mothers and three siblings), besides 37 professionals (15 physicians, four sixth-year medical school students, six nurses, five nursing auxiliaries, one nursing technician, two social workers, two psychologists, one occupational therapist and two nutritionists). Interview and observation were used for data collection. Comprehensive data analysis was developed in the attempt to preserve its multidimensional nature, through the articulation among different subjects, considering the distinct perspectives involved in the study context, as well as the collective picture and its relations, acknowledging the complexity of the whole. Three themes were constructed, interrelating empirical data with the proposed theoretical framework: the rationality-affectivity dialogue, the life-death dialogue and the individual-team-institution dialogue in care for adolescents with cancer. Considering care delivery to adolescents with cancer as a complex phenomenon, involving multiple dimensions (individuals at a peculiar moment in their development, with specific demands, inserted in a family and social unit, experiencing a severe disease, which every data approximates them to a professional theme with different backgrounds and various care foci), care practices should be constructed that are in line with the complexity of the human condition. Thus, technical rationality should be integrated with the experience reality, which also includes affectivity, religiosity, existential anguish and the possibility of creation, which are some of the conditions characteristic of human beings.

Man-Chi Leung. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1989. / Bibliography: leaves 34-39.

Acute and chronic methylphenidate (MPD) administration was recorded simultaneously in freely moving adolescent rats previously implanted with permanent semi-microelectrodes using telemetric wireless technology for the rat's locomotor activity and for the locus coeruleus (LC) neuronal activity. The evaluation of neuronal events was separated based on the rat's behavioral response to chronic MPD exposure, with rats eliciting behavioral sensitization or behavioral tolerance. On experimental day (ED) 1, the locomotor and neuronal activity was recorded after saline (baseline) and MPD (0.6, 2.5, or 10.0 mg/kg) injection (i.p.). The rats were administered daily with a single dose of MPD for five consecutive days (ED2-ED6) to elicit behavioral sensitization or behavioral tolerance. Following three washout days with no drugs, the locomotor and neuronal activity recordings resumed on ED10 post saline and rechallenge MPD administration. The main findings were as follows. The same dose of chronic MPD administration elicited behavioral sensitization in some rats and behavioral tolerance in other rats. A total of 51.5%, 56.6%, and 86.3% of LC units responded significantly to acute 0.6, 2.5, and 10.0 mg/kg MPD respectively. A total of 51.5%, 72.4%, and 82.3% of LC units responded significantly by changing their baseline activity on ED10 compared to that on ED1 in 0.6, 2.5, and 10.0 mg/kg MPD dose groups respectively. A total of 53%, 67.1%, and 90.2% of LC units responded significantly to chronic 0.6, 2.5, and 10.0 mg/kg MPD respectively. The LC neuronal population recording following acute MPD on ED1 and rechallenge MPD on ED10 from the rats eliciting behavioral sensitization was significantly different from the neuronal population recorded from the rats eliciting behavioral tolerance. Overall, these findings show that the same dose of chronic MPD can elicit behavioral sensitization or behavioral tolerance. We were able to verify our hypothesis that the LC units recorded from the rats eliciting behavioral sensitization responded significantly different to MPD from the rats eliciting behavioral tolerance. This correlation suggests that LC neuronal activity plays an important role in the expression of behavioral sensitization and behavioral tolerance by chronic MPD exposure.

Study One: Study One aims to better understand the roles that adolescents take during cyberbullying situations exploring the influence of attitudes towards cyberbullying, social grouping (being alone or with others), age and gender. Methods: Focus groups were used to adapt the Participant Role Scales (Salmivalli, 1998) and the Pro Victim Scale (Rigby & Slee, 1991) to explore cyberbullying. These adapted measures were completed by 261 participants across four year groups (year 7 to 10) via self report questionnaires. Results: Across social groupings an average of 73% of adolescents took participant roles in cyberbullying situations. There were significant differences between assistant, defender, outsider and victim behaviour when alone or when physically with others. In addition attitude towards cyberbullying significantly influenced the role taken and females were more likely to be defenders than males. Age significantly influenced outsider behaviour when participants were alone and defender behaviour when participants were physically with others. Study Two: Study Two aims to better understand what promotes or inhibits bystander involvement in cyberbullying situations. Methods: The study adopted an explorative approach to understand the experiences of 28 adolescents in a South West Local Authority in England. Data was collected via a semi-structured interview schedule administered in focus groups. Findings were analysed using latent thematic analysis (Braun & Clarke, 2006). Results: The decision for adolescent bystanders to actively join a cyberbullying situation was found to be complex. CMC, social influence (prior relationship, being alone or with others) and popularity and status of those participating in cyberbullying contribute to bystanders’ assessment of the risk and reward of participation. If reward outweighs risk an active role is taken (assistant, reinforcer, defender). However if risks are perceived to be higher than rewards then an outsider role is adopted.

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Estudos de acurÃcia diagnÃstica tÃm como finalidade apresentar indicadores clÃnicos que possam predizer as respostas humanas, gerando conhecimentos para melhorar o processo de inferÃncia diagnÃstica. Dessa forma, este estudo teve como objetivo analisar a acurÃcia dos indicadores clÃnicos do diagnÃstico de enfermagem Enfrentamento familiar comprometido no contexto de cÃncer na adolescÃncia. Trata-se de um estudo de acurÃcia diagnÃstica, com corte transversal. Participaram do estudo 236 cuidadores e adolescentes entre 10 e 19 anos completos, com diagnÃstico de cÃncer, internados ou em consulta ambulatorial ou no hospital dia de uma instituiÃÃo terciÃria de referÃncia em oncologia infatojuvenil, nos meses de marÃo a maio de 2015. A estratÃgia de amostragem foi nÃo probabilÃstica por conveniÃncia. O instrumento de coleta dados foi composto com base nos indicadores clÃnicos do diagnÃstico em estudo e foi aplicado por entrevista realizada com o adolescente e seu cuidador. Os dados foram reunidos no software Excel (2007), analisados com o apoio do pacote estatÃstico SPSS versÃo 19.0 for Windows e do software R versÃo 2.12.1 e sintetizados em 10 tabelas. A anÃlise descritiva dos dados incluiu o cÃlculo de frequÃncias absolutas, percentuais, medidas de tendÃncia central e de dispersÃo. Para as proporÃÃes de variÃveis categÃricas, foram calculados intervalos de confianÃa de 95%. Aplicaram-se os testes de Lilliefors, Qui-quadrado e Mann-Whitney. Para verificar a sensibilidade e especificidade de cada indicador clÃnico, foi utilizado o mÃtodo de anÃlise de Classes Latentes. Os resultados mostram que a maior parte dos adolescentes avaliados eram do sexo masculino, acompanhados em hospital dia. Metade dos adolescentes possuÃa idade de atà 14 anos, renda de R$ 780,00 reais e mais que cinco membros na famÃlia. Os tumores hematolÃgicos foram os mais frequentes. Os adolescentes consideraram a famÃlia como um todo importante na sua vida, mas quem mais ajuda no tratamento e mais o acompanha à a figura materna. Os indicadores clÃnicos de maior prevalÃncia foram: Pessoa significante relata entendimento inadequado, que interfere na eficÃcia dos comportamentos de apoio e Pessoa significante relata preocupaÃÃo com a reaÃÃo pessoal (p.ex. medo, pesar, culpa, ansiedade) à necessidade do cliente. O diagnÃstico Enfrentamento familiar comprometido apresentou baixa prevalÃncia tanto na populaÃÃo geral, quanto nos subgrupos amostrais de sexo, idade e tempo de diagnÃstico. Para adolescente com tempo de diagnÃstico igual ou inferior a 24 meses, foram encontradas: trÃs indicadores sensÃveis e um especÃfico. Para o sexo masculino, dois indicadores foram sensÃveis e dois especÃficos. Para o sexo feminino, foram encontrados quatro indicadores sensÃveis. Dentre estes, dois indicadores tambÃm se mostraram especÃficos. Para indivÃduos com idade menor que 14, dois indicadores revelaram-se sensÃveis e um mostrou-se especÃfico. Para indivÃduos com idade superior ou igual a 14 anos, trÃs indicadores clÃnicos obtiveram valores vÃlidos e elevados de sensibilidade e especificidade. A identificaÃÃo de indicadores clÃnicos preditores de um diagnÃstico de enfermagem à importante para a conclusÃo diagnÃstica. E este estudo contribuirà para a inferÃncia diagnÃstica de Enfrentamento familiar comprometido no contexto de cuidado de adolescentes com cÃncer. / Studies of accuracy diagnostic in family are intended to provide clinical indicators that can predict human responses, generating knowledge to improve the diagnostic inference process. Thus, this study aimed to analyze the accuracy of clinical indicators of nursing diagnosis of Compromited family coping in the context of cancer in adolescence. It is a study of diagnostic accuracy, cross-sectional. Study participants were 236 caregivers and adolescents between 10 and 19 full years, diagnosed with cancer, hospitalized or outpatient visit or hospital day of a tertiary institution of reference in infatojuvenil oncology, in the months from March to May 2015. The strategy sample was not probabilistic for convenience and the collection held by the author and academic nursing. The data collection instrument was made based on clinical indicators of diagnosis under study and was administered by interview with the teen and his caregiver. Data were gathered on Excel software (2007), analyzed with the support of statistical package SPSS version 19.0 for Windows and the R version 2.12.1 software and synthesized in 10 tables. The descriptive analysis included the calculation of absolute frequencies, percentages, measures of central tendency and dispersion. For categorical variables the proportions of 95% confidence intervals were calculated. They applied to the Lilliefors tests, chi-square and Mann-Whitney. To check the sensitivity and specificity of each clinical indicator, we used the method of analysis of Latent Classes. Most of the adolescents evaluated were male, accompanied on hospital day. Sample teen half had aged under 14 years, real income of R$ 780.00 and more than 5 members in the family. Hematological tumors were the most frequent. Teenagers consider the family as a whole important in your life, but who else helps to treat and more accompanies is the mother figure. Clinical indicators of higher prevalence were: significant person reports inadequate understanding, which interferes with the effectiveness of behavior support and significant person reports preoccupation with personal reaction (eg fear, grief, guilt, anxiety) to customer needs. Compromited family coping diagnosis showed low prevalence both in the general population, as the sample subgroups of gender, age and time of diagnosis. For teen with diagnostic time equal to or less than 24 months were found: three sensitive and specific indicators. For males, two indicators were sensitive and two specific. For females, were found four sensitive indicators. Among these, also shown two indicators are specific. For individuals younger than 14, two indicators were receptive and proved to be specific. For individuals older than or equal to 14 years, three clinical indicators obtained valid and high levels of sensitivity and specificity. Identifying predictors of clinical indicators of a nursing diagnosis is important. And this study contributed to the diagnostic inference compromised family coping in the context of adolescent care with cancer.

O adolescente, ao se deparar com o adoecimento pelo câncer, se vê diante de um grande desafio que desencadeia grandes transformações em sua vida. As limitações impostas pela doença alteram a rotina dos adolescentes que se veem forçados a se submeter a um tratamento agressivo e doloroso e a se adaptar às restrições tanto de atividades quanto de relacionamentos. O objetivo da presente investigação é compreender como se configura o cuidado do adolescente com câncer, articulando as perspectivas dos adolescentes, familiares e da equipe de saúde, no contexto de um hospital de nível terciário de atenção, e apontar elementos que se aproximam e se distanciam de um cuidado que considere a complexidade humana. Foi utilizada a abordagem metodológica qualitativa, com fundamentação nas ideias acerca do pensamento complexo, tratado por Edgar Morin, pensador francês, que defende a necessidade de um modo de pensar multidimensional, em consonância com a complexidade da realidade. Participaram do estudo 12 adolescentes (com idade entre 12 e 18 anos), 14 familiares (dois pais, nove mães e três irmãos) além de 37 profissionais (15 médicos, quatro alunos do sexto ano de medicina, seis enfermeiras, cinco auxiliares de enfermagem, uma técnica de enfermagem, duas assistentes sociais, dois psicólogos, uma terapeuta ocupacional e duas nutricionistas). A entrevista e a observação foram utilizadas para a coleta de dados. A análise compreensiva dos dados foi desenvolvida buscando preservar a sua característica multidimensional, mediante a articulação dos diferentes sujeitos, considerando as distintas perspectivas, envolvidas no contexto do estudo, bem como o conjunto e suas relações, reconhecendo a complexidade do todo. Foram construídas três temáticas, inter-relacionando os dados empíricos com o referencial teórico proposto: a dialógica racionalidade-afetividade, a dialógica vida-morte e a dialógica indivíduoequipe- instituição no cuidado do adolescente com câncer. Considerando a questão do cuidado do adolescente com câncer como um fenômeno complexo que envolve múltiplas dimensões (indivíduos em um momento peculiar de seu desenvolvimento, com demandas específicas, inseridos em uma unidade familiar e social, vivenciando uma doença grave que os aproxima cotidianamente de uma equipe de profissionais com diferentes formações e diversos enfoques no cuidado), cabe construir práticas de cuidar condizentes com a complexidade da condição humana. Deste modo, cabe integrar a racionalidade técnica com a realidade vivida que comporta também a afetividade, a religiosidade, a angústia existencial e a possibilidade da criação, algumas das condições próprias do sujeito humano. / When faced with cancer, adolescents are confronted with a big challenge that leads to great transformations in their lives. The limitations the disease imposes alter the adolescents\' routine, who are forced to submit to an aggressive and painful treatment and to adapt to restrictions in their activities and relationships. This research aims to understand care delivery to adolescents with cancer, articulating the perspectives of adolescents, relatives and the health team in the context of a tertiary care hospital, as well as to appoint elements that approach and get away from care that takes into account human complexity. A qualitative methodological approach was used, based on the ideas of complex thinking according to the French thinker Edgar Morin, who defends the need for a multidimensional way of thinking, in line with the complexity of reality. Study participants were 12 adolescents (between 12 and 18 years old), 14 relatives (two fathers, nine mothers and three siblings), besides 37 professionals (15 physicians, four sixth-year medical school students, six nurses, five nursing auxiliaries, one nursing technician, two social workers, two psychologists, one occupational therapist and two nutritionists). Interview and observation were used for data collection. Comprehensive data analysis was developed in the attempt to preserve its multidimensional nature, through the articulation among different subjects, considering the distinct perspectives involved in the study context, as well as the collective picture and its relations, acknowledging the complexity of the whole. Three themes were constructed, interrelating empirical data with the proposed theoretical framework: the rationality-affectivity dialogue, the life-death dialogue and the individual-team-institution dialogue in care for adolescents with cancer. Considering care delivery to adolescents with cancer as a complex phenomenon, involving multiple dimensions (individuals at a peculiar moment in their development, with specific demands, inserted in a family and social unit, experiencing a severe disease, which every data approximates them to a professional theme with different backgrounds and various care foci), care practices should be constructed that are in line with the complexity of the human condition. Thus, technical rationality should be integrated with the experience reality, which also includes affectivity, religiosity, existential anguish and the possibility of creation, which are some of the conditions characteristic of human beings.

Learning Objectives: (1) Identify three primary care friendly screening tools useful for identifying behavioral health concerns in adolescents. (2) Describe how a "champion" (quality improvement) team can help facilitate implementation of a screener in a primary care.

Increasingly, health providers are recognizing the importance of providing behavioral and mental health services to children and adolescents. As a result, school districts are adopting the School-Based Mental Health Program approach to provide mental health services to their students. The purpose of this study is to test if there is a disparity between children being referred due to externalizing behavior versus internalizing behaviors. The data was collected from archival sources, and it was analyzed utilizing the SPSS software for a quantitative and descriptive study. The findings indicated that students experiencing Internalizing and/or Externalizing behaviors are almost equally receiving services. This study found that most of the referrals were made by school counselors, only a few by parents and even less by students themselves. For this reason, the study’s recommendation is for social workers to engage in providing training for parents and students in identifying mental health issues before they become a significant problem.

The purpose of this study was to investigate factors which might influence the identity formation process in adopted adolescents. Specifically, this research looked at agency versus independent adoption placement as a choice reflecting the adoptive parents' preference for involvement with or distance from a possible adoptive family support network before and after placement. Subjects were also divided according to those whose family had belonged to an adoptive family support group and those who had not. The study involves a combination of descriptive and correlational research methods.

As I have worked with teenagers in regular and alternative schools, I have often wondered why some children seem to be more prone to displaying behavioral problems. One popular explanation points to the home environment as the place where appropriate behaviors are learned, and strength, discipline and positive self-image are developed to resist negative pressures of the child's peer culture. Bronfenbrenner (1986) very eloquently describes the importance of an enriched home life for the development of a well-adjusted child. Likewise, the Rochester Schools Project (Connell, Deci, Ryan, and Grolnick, 1989) speaks to the need for teachers and staff to "connect" with students, and thus through their interactions help them work through difficult times and make decisions regarding their choices of actions.