Observa-se relativa escassez de trabalhos especializados a respeito da reconstrução histórica da institucionalização da Medicina de Adolescentes e da Atenção à Saúde Integral dos Adolescentes, no Estado de São Paulo. Esta lacuna mostra-se ainda maior quando se trata de examinar a implantação desses serviços pioneiros no âmbito das universidades e a maneira como os profissionais responsáveis por esse pioneirismo se posicionavam diante das dificuldades e embates no contexto de suas instituições de ensino, à luz daquele momento histórico: meados da década de 1970, marcado pela ditadura militar no país. O presente trabalho tem como objetivo recuperar as origens da Medicina de Adolescentes em São Paulo, entre as décadas de 1970 a 1990. Trata-se de um estudo qualitativo, orientado pela análise dos documentos históricos produzidos ao longo das mencionadas décadas acerca da institucionalização da Medicina de Adolescentes e da construção histórico-cultural do adolescente, e pela obtenção de depoimentos dos responsáveis pela implantação dos primeiros serviços de atenção à saúde dos adolescentes no Estado de São Paulo, seja no âmbito da Pediatria, Ginecologia e Obstetrícia e Psiquiatria, seja na área da Saúde Coletiva. Foram realizadas entrevistas, com roteiro semiestruturado, no período de 2009 a 2010, gerando depoimentos pessoais que visaram à recuperação de sentimentos, motivações, dificuldades enfrentadas e entraves institucionais e ideológicos que ocorreram no período da institucionalização da Medicina de Adolescentes e dos programas de saúde pública para essa faixa etária, que não poderiam ser extraídos por meio de documentação escrita. A preocupação com a saúde do adolescente se deu, sobretudo nas décadas de 1970 a 1990, em um momento em que se discutia a efetiva prática da medicina global ou integral ofertada ao indivíduo e se questionava a sua fragmentação efeito colateral da emergência das subespecialidades médicas e da medicalização do sujeito com o advento da medicina tecnológica envolvendo profissionais das áreas clínicas (pediatras, ginecologistas e psiquiatras) e da Saúde Coletiva. No tocante à saúde dos adolescentes, a discussão dos novos paradigmas de saúde fez emergir concepções divergentes entre clínicos e sanitaristas, em relação ao enfoque de atenção integral à saúde. Os sanitaristas e os idealizadores de uma política pública para a adolescência vislumbravam atingir as metas populacionais, baseados em dados epidemiológicos sobre a problemática dos adolescentes. A área clínica, ainda que considerasse as influências externas ao processo de saúde e doença, mantinha seu olhar centrado no indivíduo, nas suas peculiaridades e singularidades, aspecto esse inerente ao seu campo de atuação. Daí as dificuldades de interlocução entre essas duas áreas da saúde, e o embate acadêmico em torno da institucionalização dos programas de atenção à saúde dos adolescentes, o que foi percebido por meio da análise dos depoimentos concedidos. Essa dificuldade de diálogo entre os referidos campos, na trajetória histórica inicial da Medicina de Adolescentes e da Atenção à Saúde Integral ao Adolescente, pode ter gerado entraves e morosidade no processo de implantação de programas e estratégias de obtenção de assistência à saúde de qualidade para essa faixa etária. A reconstrução do passado é necessária para a análise do presente, donde a necessidade de compreensão de alguns aspectos da trajetória da Medicina de Adolescentes em particular, e da Atenção à Saúde dos Adolescentes, em geral, para auxiliar os profissionais de saúde na busca de soluções para as dificuldades enfrentadas no atendimento à saúde desta população. / In light of scarcity of specialized works on the historical reconstruction of the establishment of Adolescent Medicine in particular, and of Adolescents Comprehensive Health Care, in general, in the State of São Paulo, especially as regards implementing these pioneering services within the scope of the universities and also as regards the views of the professionals responsible for such pathbreaking towards the difficulties and resistances within the context of their institutions of education and further in relation to the historical moment considered herein, i.e., mid 70s (characterized by the military dictatorship in the country), the purpose thereof was to recover the origins of Adolescent Medicine in the State of São Paulo between the 70s and the 90s. It regards a qualitative study, oriented by the analysis of the historical documents produced throughout the decades referred to above as regards the establishment of Adolescent Medicine and as regards the historical and cultural development of adolescents, and by gathering testimonies from those responsible for implementing the pioneering services related to adolescents health care in the State of São Paulo, either within the scope of Pediatrics, Gynecology and Obstetrics and Psychiatry, or within the Public Health area. Interviews, with a semi-structured plan, were conducted between 2009 and 2010, generating personal testimonies with the purpose of recovering feelings, motivations, difficulties experienced and institutional and ideological obstacles encountered during the period of establishment of Adolescent Medicine and public health programs for adolescents, which could not be extracted by means of written documentation. Concern for adolescents health was expressed, especially from 1970 to 1990, on an occasion on which discussions were being conducted as regards the actual practice of global or full medicine offered to individuals and questions were being raised as regards fragmenting the individuals side effect of the emergency for medical sub-specialties and for medicalization of the individuals upon arrival of the technological medicine involving professionals from the clinical areas (pediatricians, gynecologists and psychiatrists), and from Public Health. As regards adolescents health, discussions on the new health paradigms gave rise to diverging conceptions among doctors and sanitarians in relation to the full health care focus. The purpose of the sanitarians and the creators of a public policy for adolescence was to achieve the population goals, based upon epidemiological data on the adolescents problems. The clinical area, even considering the external influences on the health and disease process, focused on the individuals, on their individuality and peculiarity, aspect inherent to their field of operations, thus giving rise to difficulties of communication between those two health areas and academic resistance to the establishment of the adolescents health care programs, which have been noticed by analyzing the given testimonies. Such difficulty to establish communication between the said fields, on the initial historical path of Adolescent Medicine and of Adolescents Comprehensive Health Care, may have given rise to obstacles and slowness in the process of implementing programs and strategies to obtain quality health care for this age group. It is necessary to reconstruct the past to analyze the present, thus the need to understand a few aspects of Adolescent Medicine path in particular, and of Adolescents Health Care, in general, to assist health professionals in search of solutions for the difficulties encountered at providing health to this population.

INTRODUÇÃO: Evidências sobre a disponibilidade de alimentos no Brasil indicam que a transição alimentar tem sido, em geral, desfavorável em relação à prevenção e controle da obesidade e das demais doenças crônicas não transmissíveis, como comprovado pelos dados antropométricos nacionais ao longo dos anos. Mudanças dietéticas adversas incluem maior ingestão de refrigerantes, biscoitos e alimentos ricos em gordura saturada, e queda no consumo de frutas e verduras, fontes de carboidratos complexos e fibras alimentares, especialmente entre adolescentes. OBJETIVOS: Verificar a relação entre a frequência de consumo de alimentos e grupos de alimentos com variáveis demográficas, socioeconômicas e comportamentais de escolares adolescentes no município de Curitiba. MÉTODOS: Trata-se de um estudo transversal. A amostra foi de adolescentes de duas escolas municipais (EM), sendo uma de área central e uma de área periférica. O consumo de alimentos foi avaliado por um questionário baseado nos Dez passos para uma alimentação saudável do Ministério da Saúde. As informações socioeconômicas foram obtidas de um questionário respondido pelos pais ou responsáveis pelos escolares. Para caracterização da população foram utilizadas frequências, médias, medianas e desvios padrão. A resposta para cada grupo de alimentos foi dicotômica, ou seja, frequência adequada e frequência não adequada. A análise da relação entre as variáveis frequência de consumo e número de refeições/dia (variáveis dependentes) e as variáveis demográficas, socioeconômicas e comportamentais (variáveis independentes) foi feita para cada uma das questões sobre consumo de alimentos ou grupos de alimentos (8 questões) e para a questão sobre número de refeições. Utilizou-se regressão logística múltipla, com a técnica stepwise, sendo obtidos Odds Ratio de consumo adequado entre as categorias das variáveis independentes. A análise dos dados foi realizada utilizandose o pacote estatístico R. RESULTADOS: Houve maior participação no estudo de adolescentes do sexo feminino, nas duas escolas, e a média de idade foi de 13 anos. A maioria dos pais e mães dos alunos da EM central (EM1), completou o 2° grau, e na EM periférica (EM2), a maioria estudou até a 8º série. Renda familiar de até dois salários mínimos (SM), foi mais comum na regional periférica, e rendas superiores a 3 SM foram mais presentes nas famílias da EM 1. Os adolescentes das duas escolas consomem, em média, 2 porções de frutas/suco natural de frutas, verduras, carnes e leite/derivados (cada). Arroz e feijão são consumidos 6 e 7 vezes na semana, salgados e frituras, 2 e 3 vezes, por adolescentes da EM1 e EM2, respectivamente. A maioria dos adolescentes das duas escolas consome doces e refrigerantes/sucos industrializados diariamente, realizam em média 4 refeições/dia, assistem à televisão por 3 horas (EM1) ou 4 horas (EM2), e jogam videogame por 1 hora, e utilizam o computador por 2 horas, nas duas escolas. Pelo ajuste do modelo logístico pode-se inferir que: o fato do pai não trabalhar fora, associou-se positivamente ao consumo adequado de frutas pelo adolescente; o aumento do tempo utilizando o vídeo game, associou-se ao consumo adequado de carnes; o aumento do tempo de uso do computador associou-se ao consumo inadequado de carne, consumo inadequado de doces e refrigerantes, e número de refeições inadequado; o aumento do tempo de uso da TV associou-se ao consumo inadequado de doces; o aumento da idade associou-se ao consumo inadequado de salgados, e adequado de refrigerante; o sexo masculino relacionou-se a um número de refeições adequado; não se tem evidências significativas, para dizer que algumas das covariáveis consideradas influenciam o consumo de leite/derivados, verduras e arroz/feijão. CONCLUSÃO: A frequência de consumo de frutas/suco natural de frutas, verduras e leite/derivados está inferior ao recomendado pelo MS nos 10 passos para uma alimentação saudável, para a maioria dos adolescentes. O consumo de carnes, arroz/feijão e o numero de refeições ao dia está dentro do recomendado, para a maior proporção dos escolares. As frequências do consumo de frutas, carnes, doces, salgados, refrigerante e numero de refeições foram as que se associaram às variáveis demográficas, socioeconômicas e uso do tempo de lazer / BACKGROUND: Evidence on food availability in Brazil indicates that the food transition has been, generally unfavorable to prevent and control obesity and other chronic noncommunicable diseases, as evidenced by the national demographics over the years. Adverse dietary changes include increased intake of soft drinks, snacks and foods high in saturated fat, and decrease in consumption of fruits and vegetables, sources of complex carbohydrates and fiber, especially among adolescents. OBJECTIVES: To investigate the relationship between the frequency of consumption of foods and food groups with demographic, socioeconomic and behavioral characteristics of schoolchildren in the city of Curitiba. METHODS: This is a cross-sectional study. The sample of adolescents was from two public schools (PS), one of the central area and a peripheral area. The dietary intake was assessed by a questionnaire based on the \"Ten steps to a healthy diet, of Ministry of Health. The socioeconomic information were obtained from a questionnaire answered by parents or guardians by the school. To characterize the population were used frequencies, means, medians and standard deviations. The answer to each food group was dichotomous, ie, at often appropriate and often not adequate. The analysis of the relationship between the variables frequency of consumption and number of meals per day (dependent variables) and demographic, socioeconomic and behavioral variables (independent variables) was performed for each of the questions about consumption of foods or food groups food (8 questions) and to the question about number of meals. We used multiple logistic regression with the stepwise technique, and obtained an odds ratio of consumption between the appropriate categories of independent variables. Data analysis was performed using the statistical package R. RESULTS: There was greater participation in the study of female adolescents in two schools, and the average age was 13 years. Most parents of students in central PS (PS1), completed the 2nd degree, and in peripheral PS (PS2), most studied up to 8th degree. Family income of up to two minimum wages (MW), was more common in peripheral regional, and incomes over 3 MW were more common in families of central PS. The adolescents from two schools consume an average of 2 servings of fruit/ natural juice of fruits, vegetables, meat and milk/dairy products (each). Rice and beans is consumption 6 and 7 times a week, snacks and fried foods, 2 and 3 times for adolescents in PS1 and PS2, respectively. Most adolescents from two schools consume sweets and soft drinks/juices industrialized daily, realize an average of 4 meals a day, watch television for 3 hours (PS 1) or 4 hours (PS 2), and play video games for 1 hour, and use the computer for 2 hours, the two schools. By adjusting the logistic model can be inferred that: the fact that the father did not work out, was positively associated with the adequate intake of fruit by the adolescent; the increase in time using the video game, was associated with adequate intake of meat; the increased in time using the computer was associated with inadequate intake of meat, inadequate intake of sweets and soft drinks, and inadequate number of meals; the time increased use of TV was associated with inadequate intake of sweets; increasing age was associated with inadequate intake of salt, and appropriate refrigerant; the male was related to an appropriate number of meals; not have significant evidence to say that some of the covariates considered influencing the consumption of milk / milk products, vegetables and rice / beans. CONCLUSION: The frequency of fruit/ natural juice of fruits, vegetables and milk/ dairy products is lower than that recommended by Ministry of Health in the \"10 steps to a healthy diet,\" for most teenagers. The consumption of meat, rice/beans and the number of meals a day is within the recommended for the largest proportion of students. The frequency of consumption of fruits, meats, sweets, snacks, soft drinks and number of meals were those associated with demographic, socioeconomic and use of leisure time

Introdução: O consumo alimentar de adolescentes pode ser influenciado por diversos fatores, como por exemplo, o ambiente familiar, o acesso e a disponibilidade dos alimentos. Objetivos: Verificar as associações entre fatores com o consumo alimentar dos oito grupos da pirâmide dos alimentos. Materiais e métodos: A amostra foi constituída por adolescentes de 14 escolas técnicas da cidade de São Paulo, que responderam questões sobre percepção de alimentos e de alimentação saudável, acesso e disponibilidade, refeições em família, frequencia das refeições, influência dos pais, da mídia, da escola e dos amigos. Avaliou-se associação destas variáveis com o consumo alimentar dos oito grupos da pirâmide dos alimentos por meio dos testes Qui-Quadrado e t-Student, com nível de significância de 5 por cento . Foi realizada análise de regressão logística para identificar os fatores que influenciaram o consumo alimentar dos grupos de alimentos. Resultados: Participaram do estudo 1167 adolescentes, 51,1 por cento do sexo masculino. Foram observadas as associações: percepção de alimentação saudável com os grupos dos açúcares, das carnes, dos feijões, das frutas e do arroz; acesso e disponibilidade com os açúcares, óleos, leite, carnes, feijões, frutas e arroz; estado nutricional com os açúcares e feijões; frequencia das refeições com os óleos, leite, carnes e feijões; lazer sedentário com os óleos; sexo com leite, carne, feijões e arroz; refeição em família e influência dos amigos com as carnes; e, idade com os feijões. O risco de consumir acima recomendado foi observado no grupo dos açúcares, dos óleos e das carnes. Os grupos do leite, dos feijões, das frutas e do arroz tiveram maior risco de consumir abaixo da recomendação. Conclusões: O presente estudo confirma a importância de conhecer essas associações a fim de contribuir para o planejamento de estratégias de intervenção com ações educativas e de prevenção mais abrangentes e efetivas para os adolescentes. / Introduction: Food intake of adolescents can be influenced by several factors, such as, family environment, food access and availability. Purpose: To identify the associations between factors and food intake of the food pyramid groups. Methods: The sample consisted of adolescents from 14 technical schools in the city of São Paulo, who answered questions about food perception and eating health perception, access and availability, family meals, meals, parental, media, school and friends influences. We evaluated the associations between variables with food intake of food pyramid groups using Chi-Square and t-student tests with significance level 5 per cent . Logistic regression was performed to identify the factors influencing food intake of the pyramid food groups. Results: The study include 1167 adolescents, 51,1 per cent male. Observed associations: eating health perception with sugar, meat, beans, fruits and rice; access and availability with sugars, oils, milk, meat, beans, fruits and rice; nutritional status with sugar and beans, meals patterns with oils, milk, meat and beans; sedentary leisure with oils; sex with milk, meat, beans and rice; family meals and friends influence with meats; and age with beans. The risk of dietary intake excess was observed in the sugars, oils and meat. The milk, beans, fruits and rice groups had higher risk of dietary intake below of recommendation. Conclusion: Were found associations between several factors with food groups. This study confirms the importance of knowing the associations to contribute in the planning intervention strategies with educational and preventive action for adolescents

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-01-13T12:18:51Z No. of bitstreams: 1 camiladasilvamarquesbadaro.pdf: 4578785 bytes, checksum: fc34a047bf740989623b1ed177d628f9 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-02-02T12:04:30Z (GMT) No. of bitstreams: 1 camiladasilvamarquesbadaro.pdf: 4578785 bytes, checksum: fc34a047bf740989623b1ed177d628f9 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-02-02T12:04:40Z (GMT) No. of bitstreams: 1 camiladasilvamarquesbadaro.pdf: 4578785 bytes, checksum: fc34a047bf740989623b1ed177d628f9 (MD5) / Made available in DSpace on 2017-02-02T12:04:40Z (GMT). No. of bitstreams: 1 camiladasilvamarquesbadaro.pdf: 4578785 bytes, checksum: fc34a047bf740989623b1ed177d628f9 (MD5) Previous issue date: 2016-09-30 / Objetivou-se desvelar o vivido do cotidiano de adolescentes soropositivos em tratamento com antirretroviral. Trata-se de uma pesquisa de natureza qualitativa de abordagem fenomenológica, fundamentada no referencial teórico-filosóficometodológico de Martin Heidegger. O cenário constituiu-se de um Serviço de Assistência Especializada da Zona da Mata Mineira e os participantes foram dez adolescentes soropositivos com idade entre 12 a 18 anos em tratamento ambulatorial. Para a obtenção das informações utilizou-se a entrevista fenomenológica, por meio da técnica da entrevista aberta e um questionário. Buscou-se nos depoimentos as estruturas essenciais que originaram seis Unidades de Significados: Para os adolescentes é difícil aceitar a doença; Os adolescentes possuem conhecimento sobre sua própria doença, suas formas de transmissão e de prevenção; Cotidiano terapêutico: dificuldades encontradas e as formas de manter a adesão ao tratamento; Para não serem discriminados optam por manter em segredo a ingestão dos Antirretroviral. Este segredo só é compartilhado com a família e pessoas próximas; Os adolescentes conhecem os efeitos que a não adesão causa ao organismo; e A importância do tratamento prestado pelo Serviço de Assistência Especializado é reconhecida pelos adolescentes. A compreensão vaga e mediana permitiu alcançar o fio condutor, que por sua vez, originou o conceito de ser em direção à análise interpretativa. A hermenêutica desvelou que o ser-adolescente portador de HIV leva uma vida normal como qualquer outra; têm bom relacionamento com os colegas, porém sua condição de saúde é mantida em segredo com a família ou poucos amigos; sente raiva, nega, tem dificuldade de aceitar a doença. Os adolescentes conhecem algumas formas de transmissão e prevenção do HIV, mas não possuem compreensão aprofundada, buscam maneiras de superar as dificuldades da terapia medicamentosa mantendo-se aderentes ao tratamento e saudáveis e reconhecem a importância de serem acompanhados por um serviço especializado. Esta pesquisa apontou a in-visibilidade dos profissionais de enfermagem junto aos adolescentes e que faz-se necessário um cuidado integral e humanizado para se alcançar uma melhor adesão a terapia antirretroviral, tendo em vista melhorar a qualidade de vida e saúde dos adolescentes soropositivos e permitir que os mesmos vivenciem novas possibilidades. / This study aimed to reveal the living of everyday life for HIV-positive adolescents in treatment with antiretroviral. This is a qualitative research phenomenological approach, based on the theoretical-philosophical and methodological framework of Martin Heidegger. The scenario consisted of a Specialized Service at Zona da Mata Mineira and participants were seropositive ten adolescents aged 12 to 18 in outpatient treatment. To obtain the information used to phenomenological interview, through the open technical interview and a questionnaire. He sought in the statements the essential structures that originated six meanings of Units: For adolescents is difficult to accept the disease; Teenagers have knowledge about their own disease, its transmission and prevention; therapeutic daily: difficulties encountered and ways to maintain adherence to treatment; Not to be discriminated choose to keep secret the intake of antiretroviral. This secret is shared only with family and close people; Teenagers know the effects that non-adherence causes the body; and the importance of treatment provided by Specialized Service Centre is recognized by adolescents. The vague understanding and median allowed to achieve the thread, which in turn, originated the concept of being toward the interpretative analysis. The hermeneutics unveiled that the teen be HIV carrier leads a normal life like any other; They have good relationships with colleagues, but his condition is kept secret with family or few friends; feel angry, denies, has difficulty in accepting the disease. Teenagers know some forms of transmission and prevention of HIV, but do not have in-depth understanding, seek ways to overcome the difficulties of drug therapy while remaining compliant with the treatment and healthy and recognize the importance of being accompanied by a specialized service. This research pointed to in-visibility of nursing professionals with adolescents and that it is necessary an integral and humanized care to achieve better adherence to antiretroviral therapy, to improve the quality of life and health of HIV-positive adolescents and allow that these new possibilities to experience.

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No. of bitstreams: 1 jordanaaparecidadepaula.pdf: 4755830 bytes, checksum: b44691db141d1deda27ca2346260e31a (MD5) Previous issue date: 2017-08-22 / Pesquisa de natureza qualitativa na abordagem fenomenológica fundada no pensamento teórico e metodológico de Martin Heidegger, com o objetivo de desvelar o sentido de cuidar de si para o adolescente no contexto da promoção da saúde. Foram entrevistados dezessete adolescentes matriculados no ensino médio, do Instituto Estadual de Educação, com idade entre 14 e 18 anos, independente de raça/etnia, cor, sexo, gênero e religião. A opção por realizar o estudo e dar voz ao adolescente partiu da necessidade de direcionar o olhar à ele nesta época de sua vida, em que pode ser propenso a comportamentos prejudiciais à sua saúde. Para as entrevistas foram previamente elaboradas indagações sobre sua caracterização e questões amplas que favoreceram a conversa sobre o objeto da pesquisa. As falas foram acessadas para a imersão na leitura e apreensão dos significados expressos pelos participantes e em seguida, organizadas em unidades de significação para a compreensão vaga e mediana, primeiro momento metódico. Com a elaboração do fio condutor de análise, movimentei-me para o segundo momento metódico, a análise interpretativa ou hermenêutica, buscando o desvelamento do fenômeno estudado, fundada no pensamento de Martin Heidegger, expresso no livro Ser e Tempo. Interpretar e dar sentido ao cuidar-de-si-para-o-adolescente-no-contexto-da-promoção-dasaúde é compreender as relações que o ser-adolescente estabelece com as coisas, consigo mesmo e com os outros. E, enquanto ser-no-mundo, encontra-se fragmentado em como se relaciona, apreende, comporta, cuida, comunica e compreende. O ser-adolescente é presença no mundo circundante e através da linguagem, se desvela na medida em que os significados são revelados pelo mundo. Refere o que faz, ou não faz, para cuidar da sua saúde com as coisas que estão presentes no seu cotidiano, para ter uma alimentação adequada, realizar atividade física, não consumir bebida alcoólica, tabaco e drogas. O fenômeno do falatório é observado em sua fala quando repete o que já foi dito e segue passando à frente o que ouviu. A curiosidade, modo próprio do cotidiano do adolescente, emerge quando ele se depara com a novidade e será o outro a fazer com que desperte para a busca pelo diferente, pelo que é novo e o atrai sem qualquer pretensão de buscar compreender aquilo que vê ou ouviu sobre. O ser-adolescente demonstra ser ambíguo ao relatar seus hábitos de saúde inadequados, contradizendo o conhecimento e compreensão que previamente, regido pelo falatório, expressou ter. Ser-com é a possibilidade do ser-aí se relacionar, estar, ver e se identificar com o outro. O ser-adolescente senti pavor ao reconhecer as possibilidades de adquirir algum problema de saúde no futuro ou mesmo na vida adulta. A realização deste estudo oportunizou suscitar a reflexão dos participantes sobre a temática, contribuindo para a construção e aprofundamento do conhecimento na área da saúde e da enfermagem, que pode subsidiar a qualidade assistencial, no desenvolvimento de ações de promoção da saúde para o adolescente que também devem envolver a família, unidade de saúde e comunidade. / Research of a qualitative nature in the phenomenological approach based on the theoretical and methodological thinking of Martin Heidegger, with the objective of revealing the sense of caring for the adolescent in the context of health promotion. Seventeen adolescents enrolled in high school, from the State Institute of Education, between 14 and 18 years of age, regardless of race / ethnicity, color, sex, gender and religion were interviewed. The choice to perform the study and give voice to the teenager started from the need to direct the look to him at this time of his life, in which he can be prone to behaviors that are harmful to his health. For the interviews, they were previously elaborated inquiries about their characterization and broad questions that favored the conversation about the object of the research. The speeches were accessed for the immersion in the reading and apprehension of the meanings expressed by the participants and then, organized in units of signification for the vague and medium understanding, first methodical moment. With the elaboration of the thread of analysis, I moved to the second methodical moment, the interpretive or hermeneutical analysis, seeking the unveiling of the phenomenon studied, founded on the thought of Martin Heidegger, expressed in the book Being and Time. To interpret and give meaning to the self-care-of-the-teen-incontext-of-health-promotion is to understand the relationships that the adolescent being establishes with things, with oneself and with others. And, as a being-in-the-world, it is fragmented in how it relates, apprehends, behaves, cares, communicates and understands. The being-teenager is presence in the surrounding world and through language, reveals itself to the extent that meanings are revealed by the world. It refers to what it does or does not do to take care of its health with the things that are present in its daily life, to have adequate food, to carry out physical activity, not to consume alcohol, tobacco and drugs. The phenomenon of speaking is observed in his speech when he repeats what has already been said and goes on passing what he has heard. Curiosity, a characteristic of the adolescent's daily life, emerges when he comes face to face with the novelty and will be the other to make him wake up to the search for the different, for what is new and attracts him without any pretension to seek to understand what he sees or heard about. The adolescent being proves to be ambiguous in reporting his inadequate health habits, contradicting the knowledge and understanding that previously, ruled by the phallus, expressed ter. Being-with is the possibility of being-there relating, being, seeing and identifying with the other. The being-teenager felt dread to recognize the possibilities of acquiring some health problem in the future or even in adult life. The realization of this study gave participants the opportunity to reflect on the theme, contributing to the construction and deepening of knowledge in the area of health and nursing, which can subsidize the quality of care, in the development of health promotion actions for the adolescent, should involve the family, health unit and community.

Some early puberty girls engage in high-risk externalizing behaviors such as early sexual activity, delinquent behavior, and disruptive behaviors. Harsh parenting experienced by girls who develop early has been associated with delinquent and disruptive behaviors. The purpose of this quantitative correlational study was to examine predictive relationships between the style of parental discipline by mothers of early puberty girls and the likelihood and frequency of the girls' engagement in high-risk behaviors. Parenting style theory, including the authoritarian, authoritative, and permissive style of parenting, served as the theoretical foundation for the study. Survey data were collected from 28 mothers who identified as having a daughter who experienced early puberty. The Parenting Scale subscales were used to measure the dysfunctional parenting behaviors of laxness, overreactivity, and verbosity. Logistic regression analysis revealed no statistically significant relationships between the early puberty girl's involvement in risky behaviors and dysfunctional parenting. Results may be used by human service and public health officials to increase awareness of early puberty and to promote public health policies to address the individual, social, and economic implications of early puberty in girls.

Background Youth and young adults represent a critical time for early detection and intervention of serious mental health conditions (SMHCs); however, of all age groups, health care use is lowest in young adults. Continued access to health services such as outpatient primary care and specialized mental health care, especially during the transition from pediatric to adult care, is important to improving outcomes in those with serious mental health conditions. Methods Stakeholder engagement and a mixed-method design were used. Quantitative Aims 1 and 2 used the IBM MarketScanCommercial Database. Qualitative Aim 3 used semi-structured interviews with a purposive sample of pediatricians and child/adolescent psychiatrists. Stakeholders were engaged throughout all Aims to ensure relevance of goals, real-world interpretation of results, and dissemination of key findings. Aim 1 described patterns of outpatient (e.g., primary, reproductive, mental health care) and acute (e.g., emergency room use, inpatient hospitalization) health care use by age, and serious mental health condition for youth and young adults. Aim 2 used logistic models with generalized estimating equations to identify factors associated with mental health follow-up after hospitalization and emergency room use for a serious mental health condition. Aim 3 explored pediatrician and child/adolescent psychiatrist perspectives on coordinated care for youth and young adults with serious mental health conditions, particularly as they transition to adult care. Main Results The prevalence of outpatient mental health care and primary care decreased with age, with a larger drop in primary care utilization. While 74.0-78.4% of those aged 12-17 years used both outpatient mental health care and primary care, 53.1-59.7% of those aged 18-27 years did. Differences were observed by mental health condition; those with schizophrenia and other psychotic disorders had the lowest rates of outpatient primary care use and the highest rates of acute care use. Of those hospitalized, 42.7% received follow-up within 7 days and 64.7% within 30 days. Of those with emergency room use not resulting in a hospitalization, 28.6% received follow-up within 7 days and 46.4% within 30 days. Having established mental health care strongly predicted follow-up, and more so than having established primary care. Providers described poor communication systems, no organized process for the transition from pediatric to adult care, a lack of time and reimbursement, and inadequate connection to community supports as key barriers to continuous, coordinated care for youth with serious mental health conditions. Conclusion Findings provide foundational knowledge to inform efforts to provide a comprehensive continuum of care for people with serious mental health conditions, potentially through increased access to primary care and specialized mental health care via enhanced care coordination of providers.

Many U.S. adolescents suffer from sleep disorders. Although poor sleep habits may contribute to health issues, less is known about how parental perspectives influence sleep health in adolescents. The purpose of this descriptive phenomenological study was to address a knowledge gap in understanding parental views to promote better sleep habits in adolescents. The blended theoretical framework included the theories of caring science, social learning, advocacy paradigm, and repair and restoration of sleep. Twenty parents in the Southeastern United States participated in open-ended interviews. Research questions were designed to elicit parental perspectives about recognizing unhealthy sleep habits, improving daily sleep health routines, and identifying conditions that led to consultation with health professionals. Colaizzi's data analysis strategy demonstrated thematic parental reports of declines in attitudes, behaviors, and performances as factors for recognizing unhealthy sleep habits; consistent and routine schedules as options for promoting improved sleep habits; and irregular sleep or health problems as reasons for consultation with health professionals. Recommendations for future research include exploring other geographical locations and investigating school bus schedules interfering with early morning sleep loss. To affect positive social change, dissemination of this study's findings to health practitioners may influence enhanced provider-patient communications and ultimately contribute to improved sleep habits among adolescents. Additionally, this study's findings may inform health care administrators with strategies to develop effective parent and provider education programs while reducing unnecessary health services' utilization and resulting costs for adolescent health.

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