Abstract available in the Journal of Investigative Medicine.

No description available.

Background. The continuation of eating disorders from adolescence into adulthood often requires youth to undergo a healthcare transition from pediatric to adult eating disorder services. This transition is difficult, uncoordinated, and puts affected adolescents at an increased risk of relapse. Although transition barriers and recommendations have been identified, no known interventions exist to support youth and families transitioning to adult eating disorder services. Methods. Over a three-month period, ten 17-year-old adolescents and their parents (n=9) completed up to five intervention components designed to prepare them for the transition out of pediatric eating disorder treatment in Hamilton, Ontario. A convergent parallel mixed methods design was used to assess intervention feasibility, the nature of transition, and other outcomes, with equal emphasis on the quantitative data, where measures were collected using a single arm pre-post design, and qualitative data, which comprised of written reflection entries and interview data, was informed by Qualitative Description, and analyzed using qualitative content analysis. Results. Quantitative data pertaining to chosen feasibility indicators showed that adolescents and parents completed an average of 73% and 78% of expected components respectively, all within the three-month intervention period. Findings generated from the qualitative data indicated that participants found the intervention helpful, convenient, and easy to navigate. Of the seven adolescents interviewed, most were planning to transition to their family doctor, a private therapist, or both, while awaiting entry to specialized adult mental health care. Conclusions. This intervention is acceptable, feasible, and highlights likely care pathways among transition-age youth with eating disorders. These findings support the continuation of this research using more rigorous study designs to examine the effectiveness of this intervention in larger and more diverse samples. / Thesis / Master of Science (MSc) / Most programs that specialize in treating children with eating disorders discharge patients when they turn 18. This sudden change often leaves youth without a solid plan to continue this care as an adult. Currently, no known interventions exist to help with this problem. In our study, ten adolescents and their parents completed five activities designed to improve their transition into adult mental health care. Interviews, reflections, and questionnaires were used to explore multiple outcomes, such as how many or the duration to complete these activities and where they plan to go for adult mental health treatment. Adolescents and parents completed most of the supports, described them as easy and helpful, and set up a plan for their future care. The activities in this study have the potential to improve this difficult transition for youth and families affected by eating disorders and should be further studied.

Several studies have documented a deficiency in the delivery of preventive services to adolescents during physician visits in the United States. In many instances, a correlation has been noted between insufficient training and provision of adolescent medicine services in the practicing physician population. The American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetrics and Gynecology and Society for Adolescent Medicine recommend adolescent providers deliver comprehensive health services to teenagers. This study sought to assess and compare Pediatric, Family Medicine and Obstetric-Gynecology resident perceptions of their responsibility, training, experience and comfort with providing comprehensive health care services adolescents. We asked residents to identify the following: (1) adolescent health services they considered part of their scope of practice in their respective field; (2) the level of training they had received with regard to select adolescent health services; (3) the experience they had performing select clinical activities with adolescents; and (4) their comfort with aspects of adolescent care. We further asked two questions to test resident knowledge of an adolescents right to consent to contraception or an abortion without parental notification in the state of their residency. A total of 87 residents (31 Obstetric-Gynecology, 29 Family Medicine and 27 Pediatric) were surveyed. Most residents from all three fields felt the full range of adolescent preventive and clinical services represented in the survey fell under the scope of their practice. Most residents also reported high levels of comfort with examined aspects of adolescent care. In regard to some activities, the positive scope and comfort responses were matched by high reported levels of training and experience, including defining confidentiality; counseling about eating, exercise and obesity; counseling about substance abuse; and discussing STDs, sexual partners and contraception. However, for multiple key adolescent services, considerable discrepancies existed between reported levels of training and experience and the positive responses concerning scope and comfort. In particular the results of study suggested all residents need considerably more training and experience with mental health issues, referring teenagers for substance abuse treatment, and addressing physical and sexual abuse. Overall, there were also significant differences between fields. Family Medicine residents reported the greatest potential for providing comprehensive health care. However, they suffered from the overall deficiencies in training and experience noted above. Obstetric-Gynecology residents reported deficiencies in the provision of several preventive counseling and general health services. Pediatric residents reported multiple deficiencies in the provision of sexual health services. Our results indicate, at this time and in the near future, it is unlikely that adolescents will be able to obtain the full range of recommended preventive and clinical services in a single physician visit unless residencies programs actively incorporate increased training in the full range of adolescent preventive and clinical health services.

Thesis (MPsy(Clinical))--University of South Australia, 2002.

Thesis (MPsy(Clinical))--University of South Australia, 2002.

Made available in DSpace on 2014-06-11T19:29:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-03-12Bitstream added on 2014-06-13T19:37:52Z : No. of bitstreams: 1 buchianeri_lgc_me_assis.pdf: 866093 bytes, checksum: 2af8124b1024afb7541af0bc5b3b4586 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A valorização da adolescência a partir do século XX repercutiu também na medicina impondo a ela a necessidade de criar uma especialidade para o tratamento dos problemas que passaram a ser visualizados especificamente nessa fase do desenvolvimento. Surge então a Hebiatria ou a Medicina do Adolescente como uma área de atuação, segundo a resolução do Conselho Federal de Medicina ou como uma especialidade propriamente dita na visão do profissionais que passaram a se ocupar da adolescência. Como uma nova especialidade ou área de atuação constitui-se como um campo privilegiado para a compreensão das injunções que cercam o aparecimento de um novo campo de saber e prática profissional portando as marcas do seu tempo. Nesse sentido, o objetivo dessa dissertação foi procurar mapear o trajeto da constituição da Medicina do Adolescente, seu corpo teórico e seus atravessamentos pelos paradigmas atuais da ciência dentro desse momento de transição ou de surgimento de novos modos de concepção da ciências e de metodologia que tem alterado profundamente os fundamentos da ciência moderna. Para tanto, foi feita uma revisão da literatura sobre a Medicina do Adolescente e sobre as transformações paradigmáticas da ciência na atualidade e coletadas informações junto a profissionais que participaram no nascimento da Medicina do Adolescente no país e que ainda são referências nesse campo. Como principal conclusão, foi possível constatar que essa especialidade não teria surgido na medicina sem que houvesse a centralização... / The valorization of adolescence from XX century until now has also rebounded inside Medicine imposing to it the necessity of creating a specialty to treat the problems which began to be seen especially in this phase of development. Then Hebiatrics or Adolescent Medicine appeared as an area of acting, according to the resolution of Federal Medicine Council or as a specialty in the view of the professionals who started working with adolescents. As a new specialty or area of acting constituted itself as a privileged field to understand the ideas which surround the emergence of a new field of professional knowledge and practice carrying the mark of its time. In this direction, the aim of this dissertation was to map the way of Adolescent Medicine was constituted, its theoretic body and its crosses through the new science paradigms inside this moment of change or from the emergence of new ways of science conception and methodology which has deeply changed the bases of modern science. For so, it was done a review of the literature about Adolescent Medicine and about the paradigmatic changes of science nowadays and it was collected information with professionals who participated of Adolescent Medicine born in our country and who are still references in this field. As main conclusion, it was possible to note that this specialty wouldn't have appeared in medicine if there hadn't been the centralization of adolescence in contemporaneous culture outlined especially ...(Complete abstract, click electronic access below)

Orientador: José Sterza Justo / Banca: Tamara Beres Lederer Goldberg / Banca: Francisco de Agostinho Junior / Resumo: A valorização da adolescência a partir do século XX repercutiu também na medicina impondo a ela a necessidade de criar uma especialidade para o tratamento dos problemas que passaram a ser visualizados especificamente nessa fase do desenvolvimento. Surge então a Hebiatria ou a Medicina do Adolescente como uma área de atuação, segundo a resolução do Conselho Federal de Medicina ou como uma especialidade propriamente dita na visão do profissionais que passaram a se ocupar da adolescência. Como uma nova especialidade ou área de atuação constitui-se como um campo privilegiado para a compreensão das injunções que cercam o aparecimento de um novo campo de saber e prática profissional portando as marcas do seu tempo. Nesse sentido, o objetivo dessa dissertação foi procurar mapear o trajeto da constituição da Medicina do Adolescente, seu corpo teórico e seus atravessamentos pelos paradigmas atuais da ciência dentro desse momento de transição ou de surgimento de novos modos de concepção da ciências e de metodologia que tem alterado profundamente os fundamentos da ciência moderna. Para tanto, foi feita uma revisão da literatura sobre a Medicina do Adolescente e sobre as transformações paradigmáticas da ciência na atualidade e coletadas informações junto a profissionais que participaram no nascimento da Medicina do Adolescente no país e que ainda são referências nesse campo. Como principal conclusão, foi possível constatar que essa especialidade não teria surgido na medicina sem que houvesse a centralização ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The valorization of adolescence from XX century until now has also rebounded inside Medicine imposing to it the necessity of creating a specialty to treat the problems which began to be seen especially in this phase of development. Then Hebiatrics or Adolescent Medicine appeared as an area of acting, according to the resolution of Federal Medicine Council or as a specialty in the view of the professionals who started working with adolescents. As a new specialty or area of acting constituted itself as a privileged field to understand the ideas which surround the emergence of a new field of professional knowledge and practice carrying the mark of its time. In this direction, the aim of this dissertation was to map the way of Adolescent Medicine was constituted, its theoretic body and its crosses through the new science paradigms inside this moment of change or from the emergence of new ways of science conception and methodology which has deeply changed the bases of modern science. For so, it was done a review of the literature about Adolescent Medicine and about the paradigmatic changes of science nowadays and it was collected information with professionals who participated of Adolescent Medicine born in our country and who are still references in this field. As main conclusion, it was possible to note that this specialty wouldn't have appeared in medicine if there hadn't been the centralization of adolescence in contemporaneous culture outlined especially ...(Complete abstract, click electronic access below) / Mestre

Despite older adolescence being a risk period for the development of mental health concerns, mental health service engagement is low amongst 16-18 year olds. As therapeutic attendance is linked to clinical outcome, it is important to understand engagement in this population. There is a paucity of research looking specifically at the older adolescent engagement phenomenon. Previous qualitative research into adolescent experiences has provided rich and detailed results. Ten 16-18 years olds, engaged in Child and Adolescent Mental Health Services, were recruited from two London-based services. Each young person was interviewed in order to understand their personal experience of engaging in mental health services. Interviews were transcribed and underwent Interpretative Phenomenological Analysis. Analysis produced twelve subthemes subsumed within five superordinate themes: engagement begins at help seeking, strength of inner resolve, evolution of the self, in the clinic room, and, existing within service walls: physical and policy-based boundaries. Themes are discussed in detail. Conclusions are drawn in relation to previous theory and research. When considering 16-18 year understandings of the engagement phenomena, key elements include: clinician and service developmental appropriateness, negotiation of developmental tasks in relation to engagement, experience of the physical building environment, and awareness of service policy limitations. Suggestions for clinical practice in relation to engagement facilitators and threat are made, and recommendations for future research proposed.

Positive health-related behaviour is particularly important for liver transplant recipients’ (LTRs) recovery. However, non-adherence in adolescents post-transplant is thought to be greater than, or equal to, 50%. Literature searches have found limited research into the area of young adults’ experiences of having a donated liver. Knowing more of their experience seems important to help inform practice to improve adherence and ultimately save lives. The present study aimed to construct a grounded theory of young adults’ experiences of having a liver transplant, in order to better understand how young adults may adjust following such experiences. Semi-structured interviews were conducted with twelve liver transplant recipients (LTRs; five female, seven male). Data were analysed using constructivist grounded theory. A model was constructed to capture the dynamic interactions between thirteen categories, resulting in four main themes: Finding Identity Post-Transplant, Carrying Responsibility, Unseen, Unspoken or Misunderstood Challenges and Adjusting to Life After Transplant. The study highlights the importance of the themes in psychological adjustment post-transplant. Understanding this process is imperative in order to improve health-related behaviours in a cohort with traditionally poor adherence. Implications for further research and clinical practice are discussed, including educating LTRs to raise their levels of self-efficacy, which have a positive impact on adherence.