Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health
Cross-Sectional Studies; Female; Humans; Male; Pregnancy; Longitudinal Studies; Mental Health; Multivariate Analysis; Adolescent Behavior; Regression Analysis; Health Behavior; adolescent; Adolescent Transitions; Risk-Taking; Health Surveys; Pregnancy in Adolescence; Sexuality; Substance-Related Disorders/epidemiology; United States/epidemiology; Violence/statistics & numerical data
CONTEXT: The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. OBJECTIVE: To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. DESIGN: Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. PARTICIPANTS: A total of 12118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90118 adolescents from 80 high schools plus their feeder middle schools. SETTING: The interview was completed in the subject's home. MAIN OUTCOME MEASURES: Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. RESULTS: Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12: P
1997
Resnick MD; Bearman PS; Blum RW; Bauman KE; Harris KM; Jones J; Tabor J; Beuhring T; Sieving RE; Shew M; Ireland M; Bearinger LH; Udry JR
Jama
1997
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1001/jama.1997.03550100049038" target="_blank" rel="noreferrer">10.1001/jama.1997.03550100049038</a>
PS-228 The Babies Who Unexpectedly Survive Long-term After Withdrawal Of Neonatal Intensive Care
Background and aim Not all babies from whom neonatal intensive care (IC) is withdrawn die swiftly. We reviewed cases, characteristics, and outcomes of babies who unexpectedly survived for ≥1 week following IC withdrawal. Methods Retrospective review of the medical notes of infants cared for in our NICUs in the period 1/7/06 to 31/12/13 who had IC withdrawn but who unexpectedly survived for ≥1 week. Babies with trisomies were excluded. Our study had prior research ethics approval. Results We identified 9 long-term survivors (6 term, 3 preterm). 8 had a main diagnosis of grade 3 hypoxic ischaemic encephalopathy; 1 preterm infant had a diagnosis of myelomeningocele and hydrocephalus. All had abnormal neuroimaging prior to planned IC withdrawal. IC was withdrawn with parental agreement at median 5 days postnatal age (range: 1–9 days). The possibility of long-term survival had been broached by clinicians prior to IC withdrawal in only 2 of the 9 cases. Median age at discharge/transfer from NICU was 10 days (range: 1–31 days) and destination was home (n = 3) or hospice (n = 6). 4 infants died at ages ranging between 19–66 days. Yet remarkably, 5 infants remain alive to date with current ages ranging between 10 months and 5.3 years, but all have cerebral palsy. Conclusion Unexpected long-term survival after neonatal IC withdrawal is neither predictable nor uncommon. Significant disability in survivors is invariable. Even if protracted survival is considered very unlikely, the possibility should always be specifically mentioned during the sensitive discussions with parents that precede IC withdrawal.
2014-10
Jones J; Job S; Pal S; Maynard L; Curley A; Clarke P
Archives Of Disease In Childhood
2014
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1136/archdischild-2014-307384.527" target="_blank" rel="noreferrer">10.1136/archdischild-2014-307384.527</a>
Emotional Wellbeing in Adolescents Living With Chronic Conditions: A Metasynthesis of the Qualitative Literature
Adolescents; Anxiety; Depression; Mental health; Pediatrics; Positive health assets; Psychological wellbeing; Subjective wellbeing; Suicide; Teen
Adolescents living with chronic conditions (ALWCCs) are at a higher risk of suicide (odds ratio: 4.3) than their peers. No consensus exists in the scientific community on a definition or conceptual elements of emotional well-being in this vulnerable population, hindering informed interventional research. This study investigated the meaning of emotional well-being in ALWCCs. A systematic metasynthesis of the qualitative literature was performed and structured using ENTREQ guidelines for reporting qualitative metasynthesis. A final sample of 11 primary qualitative studies met inclusion criteria and was critically analyzed using a team-based thematic synthesis and reciprocal translation approach. The meaning of emotional well-being in ALWCCs is having positive relationships that ease loss, foster hope and resilience, and promote self-efficacy and self-actualization. The role of healthcare providers as a safe, stable nurturing relationship which promotes hope and positive body image emerges an area for future research. Spirituality as it relates to emotional well-being in this population is scarce in the qualitative literature and should be further explored.
Courtwright SE; Le Pard A; Jones J
Journal of Adolescent Health
2022
<a href="http://doi.org/10.1016/j.jadohealth.2021.12.020" target="_blank" rel="noreferrer noopener">10.1016/j.jadohealth.2021.12.020</a>