Adolescent Health Medicine and Therapeutics最新文献

{"title":"An economic examination of private insurance claims among adolescents and young adults who were enrolled in hospice during the last year of life.","authors":"Jessica Keim-Malpass,&nbsp;Austin C Cohrs,&nbsp;Lisa C Lindley,&nbsp;Douglas L Leslie","doi":"10.2147/AHMT.S168501","DOIUrl":"https://doi.org/10.2147/AHMT.S168501","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to generate baseline data on the health characteristics, health care utilization, and health care spending among privately insured adolescents and young adults (AYA), who were enrolled in hospice care during their last year of life.</p><p><strong>Methods: </strong>A retrospective, nonexperimental design was used to collect and analyze longitudinal claims data from the Truven Health MarketScan™ database. The sample included AYA (aged 15-24 years) who utilized hospice during their last year of life.</p><p><strong>Results: </strong>Totally, 17,408 AYA were included in this analysis. Mean hospice length of stay (LOS) was low overall, but there was a statistically significant difference in hospice LOS in ages 15-19 years (mean 3.56, SD 15.17 days) compared with those aged 20-24 years (mean 2.26, SD 8.24; <i>P</i><0.001 days). More than a third (37%) of the AYAs used the emergency department during the last year of life and 83% sought care from a primary care visit. However, only 6% of the sample who were hospice enrollees used frequent inpatient hospital services.</p><p><strong>Conclusions: </strong>This study provides preliminary data for private insurance expenditures and clinical utilization for AYA who were enrolled in hospice. This analysis also provides initial evidence to suggest extremely short hospice LOS for AYAs prior to the end of life and represents an area of future research need.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S168501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36488358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eating disorders in adolescent and young adult males: prevalence, diagnosis, and treatment strategies.","authors":"Christine A Limbers,&nbsp;L Adelyn Cohen,&nbsp;Bethany A Gray","doi":"10.2147/AHMT.S147480","DOIUrl":"https://doi.org/10.2147/AHMT.S147480","url":null,"abstract":"<p><p>Males have largely been underrepresented in the eating disorder (ED) peer-reviewed literature. The current review paper examines prevalence rates, ED symptom presentation, and assessment and treatment strategies relevant to adolescent and young adult males. Adolescent and young adult males often report a greater desire to be bigger and more muscular compared to their female counterparts. Due to concerns that contemporary ED assessment tools are over reliant on items that evaluate stereotypically feminine indicators of ED pathology, male-specific ED measures, such as the Eating Disorder Assessment for Men, have been developed. Further validation work is necessary to establish the psychometric properties of these male-specific measures, particularly in adolescent male populations. Attention to a heightened prevalence of comorbid substance abuse disorders and the role that competitive sports play in perpetuating ED pathology are two factors that have been identified as important in the treatment of adolescent and young adult males with EDs.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S147480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36414171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of ledipasvir/sofosbuvir in the treatment of adolescents and children with hepatitis C.","authors":"Christine Hong Ting Yang,&nbsp;Aparna Goel,&nbsp;Aijaz Ahmed","doi":"10.2147/AHMT.S147896","DOIUrl":"https://doi.org/10.2147/AHMT.S147896","url":null,"abstract":"<p><p>Chronic infection with hepatitis C virus (HCV) affects an estimated 0.1%-2% of the pediatric population in the United States. While the clinical course in young children is indolent, adolescents who contract HCV have a disease course similar to adults, with a 26-fold increased risk of chronic liver disease-associated mortality, hepatocellular carcinoma, and need for curative liver transplantation. Furthermore, adolescent patients are entering childbearing age and carry a risk of passing HCV to their offspring via vertical transmission. Pegylated-interferon (PEG-IFN) with ribavirin was previously the only treatment option for pediatric patients with chronic hepatitis C (CHC), but the high likelihood of adverse reactions and subcutaneous route of administration limited its use and efficacy. Recently, the direct-acting antivirals (DAAs) ledipasvir (LDV) and sofosbuvir (SOF) were approved for adolescents with CHC. This review discusses the natural history of CHC in pediatric patients, data supporting LDV/SOF in adolescents, and ongoing studies evaluating DAAs in pediatric patients.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S147896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36392873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of an educational program on adolescent premenstrual syndrome: lessons from the Great East Japan Earthquake.","authors":"Takashi Takeda,&nbsp;Masami Shiina","doi":"10.2147/AHMT.S169944","DOIUrl":"https://doi.org/10.2147/AHMT.S169944","url":null,"abstract":"<p><strong>Background: </strong>Catastrophic disasters such as great earthquakes cause tremendous physical and mental damage. We previously reported that the Great East Japan Earthquake worsened premenstrual symptoms among adolescent girls in the disaster-stricken area.</p><p><strong>Objectives: </strong>We reanalyzed these data to determine the positive effects of education on premenstrual symptoms.</p><p><strong>Materials and methods: </strong>Annual school-based surveys about premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) have been conducted in Sendai since 2009. The Great East Japan Earthquake occurred on March 11, 2011. First-year students in one school had received education on PMS/PMDD before the earthquake, whereas those in another school had not. We reanalyzed data for 1431 girls (November 2010) and 1489 girls (December 2011) aged 15-18 years.</p><p><strong>Results: </strong>The severity of PMS/PMDD in students who had received the education program showed no changes between before and after the earthquake. However, students who had not received education showed worsening of the severity of PMS/PMDD.</p><p><strong>Conclusion: </strong>This study showed education had a possible beneficial effect for the prevention of stress-induced PMS/PMDD.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S169944","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36296611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and attitudes toward clinical trials in adolescent and young adults with cancer: a systematic review.","authors":"Victoria Forcina,&nbsp;Branavan Vakeesan,&nbsp;Chelsea Paulo,&nbsp;Laura Mitchell,&nbsp;Jennifer Ah Bell,&nbsp;Seline Tam,&nbsp;Kate Wang,&nbsp;Abha A Gupta,&nbsp;Jeremy Lewin","doi":"10.2147/AHMT.S163121","DOIUrl":"https://doi.org/10.2147/AHMT.S163121","url":null,"abstract":"<p><strong>Purpose: </strong>Although cancer clinical trials (CT) offer opportunities for novel treatments that may lead to improved outcomes, adolescents and young adults (AYA) are less likely to participate in these trials as compared to younger children and older adults. We aimed to identify the perceptions and attitudes toward CT in AYA that influence trial participation.</p><p><strong>Materials and methods: </strong>A systematic review of cancer literature was conducted that assessed perceptions and attitudes toward CT enrollment limited to AYA patients (defined as age 15-39). We estimated the frequency of identified themes by pooling identified studies.</p><p><strong>Results: </strong>In total, six original research articles were identified that specifically addressed perceptions or attitudes that influenced CT participation in AYA patients. Three studies were conducted at pediatric centers - one at an AYA unit, one at an adult cancer hospital, and one was registry based. Major themes identified for CT acceptability included: hope for positive clinical affect, altruism, and having autonomy. Potential deterrents included: prolonged hospitalization, worry of side effects, and discomfort with experimentation.</p><p><strong>Conclusion: </strong>Limited information is available with regard to the perceptions and attitudes toward CT acceptability among AYA patients, especially those treated at adult cancer centers, which prevents generalization of data and themes. Future research assessing strategies for understanding and supporting CT decision-making processes among AYA represents a key focus for future funding to improve CT enrollment.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S163121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36256911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents and young adults with cancer: aspects of adherence - a questionnaire study.","authors":"Anne Marie Kleinke,&nbsp;Carl Friedrich Classen","doi":"10.2147/AHMT.S159623","DOIUrl":"https://doi.org/10.2147/AHMT.S159623","url":null,"abstract":"<p><strong>Purpose: </strong>For adolescents and young adults (AYAs), a cancer diagnosis represents an extraordinary strike in a vulnerable phase of life. They have special needs that the medical system has to take into consideration, and they exhibit a lower degree of therapy adherence than both older and younger patients. The purpose of this study was first to analyze the adherence of AYAs with cancer compared to a group of older patients and, second, to determine correlated parameters, with focus on the psychosocial interaction between physicians and patients.</p><p><strong>Patients and methods: </strong>In 2012, a complete 1 year cohort of patients reported, by use of a questionnaire, to the Rostock clinical cancer registry, and a group of older patients were invited to answer a multi-item set of questionnaires on a volunteer basis, leading to a population-based cross-sectional analysis. This included a bias due to non-answering which is unavoidable in such a setting. The questionnaire consisted of well-established standard questionnaires, a questionnaire on adherence that has just recently been published, and a self-written questionnaire focusing on patient-physician relationship. The responses were analyzed for our current study.</p><p><strong>Results: </strong>Gender, religion, education, age, anxiety, family atmosphere, or physician-patient relationship were not significantly correlated to adherence in AYAs. However, markedly more AYAs, as compared to the older patients group, considered breaking off therapy and reported suboptimal communication with the physicians. Only the perceived physical illness could be identified as a factor related to adherence among the AYA group.</p><p><strong>Conclusion: </strong>Our findings confirm the need for more focused approaches to serve the special needs of AYAs, with particular attention on specific items that showed up discriminating AYAs from older patients, that is, Internet use and communication with physicians. Here, further research is needed to examine adherence to specific treatment protocols.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S159623","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36089167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What does it mean to be youth-friendly? Results from qualitative interviews with health care providers and clinic staff serving youth and young adults living with HIV.","authors":"Parya Saberi,&nbsp;Kristin Ming,&nbsp;Carol Dawson-Rose","doi":"10.2147/AHMT.S158759","DOIUrl":"https://doi.org/10.2147/AHMT.S158759","url":null,"abstract":"<p><strong>Purpose: </strong>Given the consistent associations between younger age and numerous suboptimal clinical outcomes, there is a critical need for more research in youth living with human immunodeficiency virus (YLWH) and tailoring of health care delivery to the unique and complex needs of this population. The objective of this study was to examine the facilitators of and barriers to engagement in care among YLHW at the system and provider/staff level, as well as the barriers to using technology-based forms of communication with YLWH to improve retention and engagement in care.</p><p><strong>Patients and methods: </strong>We conducted in-depth qualitative interviews with health care providers and staff members at the clinics and organizations serving YLWH in the San Francisco Bay Area.</p><p><strong>Results: </strong>We interviewed 17 health care providers and staff members with a mean of 8 years of experience in providing clinical care to YLWH. Interviewees noted various facilitators of and barriers to engagement in care among YLWH, including the environment of the clinic (e.g., clinic location and service setting), provision of youth-friendly services (e.g., flexible hours and use of technology), and youth-friendly providers/staff (e.g., nonjudgmental approach). With regard to barriers to using technology in organizations and clinics, interviewees discussed the challenges at the system level (e.g., availability of technology, clinic capacity, and Health Insurance Portability and Accountability Act compliance), provider/staff level (e.g., time constraints and familiarity with technology), and youth level (e.g., changing of cellular telephones and relationship with provider/staff).</p><p><strong>Conclusion: </strong>Given the need for improved clinical outcomes among YLWH, our results can provide guidance for clinics and institutions providing care for this population to enhance the youth-friendliness of their services and examine their guidelines around the use of technology.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S158759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36074741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duchenne and Becker muscular dystrophy in adolescents: current perspectives.","authors":"Jennifer G Andrews,&nbsp;Richard A Wahl","doi":"10.2147/AHMT.S125739","DOIUrl":"https://doi.org/10.2147/AHMT.S125739","url":null,"abstract":"<p><p>Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are life-limiting and progressive neuromuscular conditions with significant comorbidities, many of which manifest during adolescence. BMD is a milder presentation of the condition and much less prevalent than DMD, making it less represented in the literature, or more severely affected individuals with BMD may be subsumed into the DMD population using clinical cutoffs. Numerous consensus documents have been published on the clinical management of DMD, the most recent of which was released in 2010. The advent of these clinical management consensus papers, particularly respiratory care, has significantly increased the life span for these individuals, and the adolescent years are now a point of transition into adult lives, rather than a period of end of life. This review outlines the literature on DMD and BMD during adolescence, focusing on clinical presentation during adolescence, impact of living with a chronic illness on adolescents, and the effect that adolescents have on their chronic illness. In addition, we describe the role that palliative-care specialists could have in improving outcomes for these individuals. The increasing proportion of individuals with DMD and BMD living into adulthood underscores the need for more research into interventions and intracacies of adolescence that can improve the social aspects of their lives.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S125739","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35956432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender dysphoria in adolescence: current perspectives.","authors":"Riittakerttu Kaltiala-Heino, Hannah Bergman, Marja Työläjärvi, Louise Frisén","doi":"10.2147/AHMT.S135432","DOIUrl":"10.2147/AHMT.S135432","url":null,"abstract":"<p><p>Increasing numbers of adolescents are seeking treatment at gender identity services in Western countries. An increasingly accepted treatment model that includes puberty suppression with gonadotropin-releasing hormone analogs starting during the early stages of puberty, cross-sex hormonal treatment starting at ~16 years of age and possibly surgical treatments in legal adulthood, is often indicated for adolescents with childhood gender dysphoria (GD) that intensifies during puberty. However, virtually nothing is known regarding adolescent-onset GD, its progression and factors that influence the completion of the developmental tasks of adolescence among young people with GD and/or transgender identity. Consolidation of identity development is a central developmental goal of adolescence, but we still do not know enough about how gender identity and gender variance actually evolve. Treatment-seeking adolescents with GD present with considerable psychiatric comorbidity. There is little research on how GD and/or transgender identity are associated with completion of developmental tasks of adolescence.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2018-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/c1/ahmt-9-031.PMC5841333.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35909716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gambling disorder in adolescents: prevalence, new developments, and treatment challenges.","authors":"Georgios D Floros","doi":"10.2147/AHMT.S135423","DOIUrl":"https://doi.org/10.2147/AHMT.S135423","url":null,"abstract":"<p><p>Research on adolescence gambling over the past twenty years has revealed significant incidence and prevalence rates and highlighted the possible negative effects on an adolescent's well-being. Several risk and protective factors have also been identified. Over the course of the past few years, technological advances have heralded the advent of new avenues for gambling as well as new opportunities to gamble without any direct monetary exchange. This review article examines those established trends as well as the new issues that we are faced with, in order to accurately portray the current challenges in research, prevention, and treatment.</p>","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2018-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S135423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35909717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}