Adolescent parenting is assoc w:
Lower lifetime educational achievement
Lower income
Increased reliance on social support programs
Experiencing social and family difficulties
Whose mothers were adolescent mothers
Undergoing early puberty
Who have been sexually abused
With frequent school absenteeism or lacking vocational goals
With siblings who were pregnant during adolescence
Who use tobacco, alcohol and other substances
Who live in group homes, detention centers or are street-involve
First line contraception and failure rate?
LARCs
<1%
Biggest barrier to contraception use
Cost
How to improve adherence to contraception?
Provide a year supply
What dose of Estradiol in COC should you use?
30-35 mcg of ethinyl estradiol (EE)
EE doses below 30 mcg may be associated with poorer bone mineralization in youth
Smoking initiation associated with:
- Older age at time of parental smoking cessation (if parents are ex-smokers)
- Low socio-economic status
- Peer and family influence, including lack of parental support
- Misinformation about the health consequences of smoking
- Easy access to tobacco products
- Influence of marketing, exposure to tobacco promotions
- Previous experimentation
- Depression and mental health conditions
- Poor school performance
- Adverse experiences such as:
- emotional, and physical or sexual abuse,
- parental separation or divorce,
- a household member who is substance abusing, mentally ill or incarcerated
Motivational interviewing
Open ended Qs Reflective listening Affirmation Summary statements Eliciting change talk
Who is at risk for unprotected intercourse:
–Social and family difficulties –Child of a teen mom –History of sexual abuse –Early puberty –Frequent school absences –Siblings with teen pregnancies –Use of tobacco, alcohol, other substances –Living in group homes, detention centers, street-youth
Estimated number of street involved youth in Canada in 2007
150,000
Causes of street involved youth?
poverty dysfunctional family life violence abuse mental illness parental drug use
Street involved youth - higher risk of?
- TB, asthma, dental caries, skin infections, lice, scabies, malnutrition, injuries
- Hep B and HPV
- STI
- Mental health issues (those with mental illness also at higher risk of running away)
substance abuse
Comorbid conditions for gambling
personality disorders substance abuse ADHD anxiety depression
What is best treatment for Anorexia Nervosa?
Family based treatment
Parents are given responsibility to return their child to physical health and ensure full wt restoration
What are developmental concerns of a adolescent w chronic medical condition?
- independence and assertiveness
- physical appearance
- sexuality
- peer relationships
- school and work
- death and dying
Chance of repeat pregnancy within 24 months after birth in adolescents?
23%
Factors making smoking cessation more likely?
- Older teenager
- Male sex
- Teen pregnancy and parenthood
- Scholastic success
- Team sport participation
- Peer and family support for cessation
- CYP2A6 slow nicotine metabolizer
Factors making smoking cessation less likely?
- Nicotine Addiction
- Mental health conditions, including ADHD
- Drug and/or alcohol use
- Chronic illness
- Family stress
- Peer and family tobacco use
- Overweight or weight preoccupation
- Developmental drive to experiment
- Fear of peer rejection
- Perceived lack of privacy and autonomy
5 A’s of smoking cessation
Ask Advice Assess Assist Arrange
Best smoking cessation intervention?
Individual counselling
Motivational enhancement
CBT
How should firearms be stored?
unloaded, locked and separate from its ammunition.
Physical consequences of disordered eating
- Nutritional deficiencies - iron and calcium
- Growth deceleration (even small reduction of energy intake)
- Menstrual irregularity (incl secondary amenorrhea
- Long-term risk of osteopenia and osteoporosis
RF for dieting/unhealthy weight behaviours
Female Overweight and obesity Body image dissatisfaction and distortion Low self-esteem Low sense of control over life Psychiatric symptoms: depression and anxiety Vegetarianism Early puberty
Low family connectedness Absence of positive adult role models Parental dieting Parental endorsement or encouragement to diet Parental criticism of child’s weight
Weight-related teasing
Poor involvement in school
Peer group endorsement of dieting
Involvement in weight-related sports
Certain chronic illnesses, especially diabetes
Presence of other risk behaviors: smoking, substance use, unprotected sex
Cannabis use disorder
problematic pattern of cannabis use leading to clinically significant impairment in areas of function or distress within a 12-month period
leads to: reduced academic performance, truancy, reduced participation and interest in extracurricular activities, withdrawal from their usual peer groups and conflict with family.
Cannabis withdrawal syndrome
2/5 psychological symptoms—irritability, anxiety, depressed mood, sleep disturbance, appetite changes
1/6 physical symptoms—abdominal pain, shaking, fever, chills, headache, diaphoresis
after cessation of heavy cannabis use
Withdrawal symptoms commonly occur 24 h to 72 h after last use and persist for 1 to 2 weeks. Sleep disturbance is often reported for up to 1 month
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ID135
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Adolescent25
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ENT + Ophthalmo4
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Maltreatment8
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Allergy9
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Community + Thoracic+Digital57
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Acute Care39
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Drug and Hazards7
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GI Nutrition29
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Newborn67
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First Nations12
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Global Health15
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Healthy Active Living16
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Hospital Medicine6
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Mental Health + Development25
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Injury Prevention23
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ASD Guidelines Taskforce7
