Adolescent Health Care in Italy: A Mini-Review.

Adolescent health care in Italy: a mini-review.

Filed under: Eating Disorders

Georgian Med News. 2012 Sep; 8-12
De Sanctis V, Filati G, Fiscina B, Marsciani A, Piacentini G, Timoncini G, Reggiani L, Zucchini A

The purpose of this mini-review is to present the National Health System and services available for adolescents in Italy, and to review the most relevant data on morbidity and mortality in Italian teens. Adolescent medicine in Italy is not a separate speciality, but there are some distinct services for adolescents in paediatric departments or gynaecologic wards, mostly in large cities where university hospitals or hospital of national relevance are located. Primary health care in Italy is provided mainly by general practitioners (GPs) and pediatricians, and on-call physicians (Guardia Medica) for after-hours medical care and services. The number of centres providing care for adolescents in Italy is 4097 (50% of these are in the North of Italy, 20% in the Central regions and 20% in the South and Islands). The population of Italy on January 1st 2011 was approximately 60,477,881 and the number of adolescents, aged 10 to 19 years, was 6,214,000. The most frequent causes of death in adolescents are motor vehicle accidents – more than half of which are related to drug or alcohol use – followed by cancer and suicide. In primary care, adolescents present with a large number of issues, particularly upper respiratory infections, musculoskeletal problems, pain syndromes, obesity, eating disorders, dermatological issues, mood and somatoform disorders, school and mental health problems, and chronic fatigue, many of which require a coordinated, multidisciplinary management approach. The estimated population with a chronic illness is 8%. There are no specific protocols for the transition to adult medicine physicians for patients with chronic diseases or special health needs. In order to improve the quality and quantity of education in adolescent health for paediatricians and GPs, the Study Group of Emilia and Romagna Region for Adolescent Health Care (SGA-ER) is going to organize, beginning in 2012, a two year educational intervention course in adolescent health.
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Predicting weight outcomes in preadolescence: the role of toddlers’ self-regulation skills and the temperament dimension of pleasure.

Filed under: Eating Disorders

Int J Obes (Lond). 2012 Oct 9;
Graziano PA, Kelleher R, Calkins SD, Keane SP, Brien MO

Objectives:To investigate the role of toddlers’ self-regulation skills and temperament in predicting weight outcomes in preadolescence.Methods:Participants for this study included 195 children (114 girls) obtained from three different cohorts participating in a larger ongoing longitudinal study. At 2 years of age, participants participated in several laboratory tasks designed to assess their self-regulation abilities, including emotion regulation, sustained attention and delay of gratification, whereas parents filled out a temperament questionnaire to assess toddlers’ pleasure expression. Height and weight measures were collected when children were 4, 5, 7 and 10 years of age. Children also filled out a body image and eating questionnaire at the 10-year visit.Results:Self-regulation skills in toddlers were associated with body mass index (BMI) development and pediatric obesity as well as body image/eating concerns. The temperament dimension of pleasure was also associated with BMI development and pediatric obesity but not body image/eating concerns.Conclusions:Self-regulation difficulties across domains as well as temperament-based pleasure in toddlers represented significant individual risk factors for the development of pediatric obesity 8 years later. Early self-regulation difficulties also contributed to body image and eating concerns that typically accompanied overweight children. The mechanisms by which early self-regulation skills and temperament-based pleasure may contribute to the development of pediatric obesity and associated weight concerns are discussed.International Journal of Obesity advance online publication, 9 October 2012; doi:10.1038/ijo.2012.165.
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Increased emergency department use by adolescents and young adults with eating disorders.

Filed under: Eating Disorders

Int J Eat Disord. 2012 Oct 9;
Dooley-Hash S, Lipson SK, Walton MA, Cunningham RM

OBJECTIVE: This study describes patterns of emergency department (ED) utilization by patients who screen positive for eating disorders. METHOD: ED patients aged 14-20 years (n = 1,920) completed a computerized questionnaire. The analyses compared the rates of ED use between patients who screened positive for an eating disorder and those who did not and examined the reasons for ED use amongst patients with eating disorders. RESULTS: ED patients who screened positive for eating disorders were significantly more likely to have previously visited the ED and, on average, utilized the ED at a rate 1.6 times higher than patients who screen negative for eating disorders. The most common chief complaints among patients who screen positive for eating disorders were abdominal pain and other gastrointestinal-related problems. DISCUSSION: Patients with eating disorders utilize the ED more frequently than those without and commonly present for complaints seemingly unrelated to their eating disorder. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012).
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