Ricardo Becker Feijó

Risk behavior in adolescence

OBJECTIVE: The present article reviews the methods and criteria used to assess risk behavior in adolescents. METHODS: Non-systematic review of scientific literature, as well as the assessment of the clinical and research experience accumulated by the Adolescent Outpatient Clinic of the Hospital de Clínicas de Porto Alegre. RESULTS: Physicians can apply a comprehensive healthcare model by using a psychosocial approach, trying to understand the influence the media exerts on adolescents, and trying to establish a confidentiality relationship with them. The major factors that should be evaluated regarding risk behavior among adolescents include clinical and nutritional aspects, as well as sexuality, violence, mental health and alcohol and drug use issues. CONCLUSIONS: Health care providers should use their sensitivity and expertise, in addition to establishing ethically clear approaches to evaluate risk factors. The authors suggest a route of investigation of risk behavior that should be used in routine consultation.

Mental health screening by self-report questionnaire among community adolescents in Southern Brazil

PURPOSE To evaluate the frequency of symptoms of depression, suicidal ideation, suicide behavior, and hopelessness among adolescents in southern Brazil. METHODS The Self-Report Questionnaire (SRQ) was administered to a random sample of 126 community youngsters to screen for mental problems, the Montgomery-Asberg Depression Rating scale for signs and symptoms of depression, an adapted version of DIS (Diagnostic Interview Schedule) for suicidal ideation and behavior, and the Backs Hopelessness scale (adapted version). Social class, cognitive performance, age, and sex were also analyzed. RESULTS Levels of symptoms of depression, suicidal ideation and behavior, and hopelessness were higher among those who were SRQ positive (8%). Female youngsters presented higher SRQ scores and on the Montgomery-Asberg scale. Cognitive performance was similar among all groups. Differences were not found according to social classes. The 15-17 year-old individuals (middle stage) presented higher hopelessness than the other stages of adolescence. CONCLUSIONS The present findings suggest that screening for mental health conditions by self-report questionnaires may be of value of identify groups at major risk for violent, self-destructive behavior among community adolescents.

Vaccination schedule for childhood and adolescence: comparing recommendations

OBJECTIVES To present the criteria used to define a vaccination schedule for childhood and adolescence, comparing the recommendations of national and international excellence institutions. SOURCES OF DATA Review of publications by the Brazilian Society of Pediatrics, the Brazilian Ministry of Health, the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) covering the period from 2000 to 2005. SUMMARY OF THE FINDINGS Local epidemiological and socioeconomic factors and the available infrastructure often define the priorities of immunobiological recommendations. The publications reviewed, both national and international, differ in terms of the vaccination schedule for tuberculosis, poliomyelitis, rotavirus, pertussis, pneumococcus, meningococcus, varicella and hepatitis A. In Brazil, there are Special Immunobiology Referral Centers (CRIE--Centros de Referência de Imunobiológicos Especiais), which, according to specific criteria, offer the population immunobiologicals that are unavailable on the public health network. CONCLUSIONS While the use of a universal schedule is impossible due to epidemiological and operational differences, there are similarities that can be incorporated with different populations, as long as technical and scientific criteria are respected.

Calendário vacinal na infância e adolescência : avaliando diferentes propostas

OBJETIVOS: Apresentar os criterios utilizados para elaboracao de um calendario de vacinacao na infância e adolescencia, comparando recomendacoes de instituicoes de referencia em nivel nacional e internacional FONTES DOS DADOS: Revisao da literatura cientifica a partir de publicacoes da Sociedade Brasileira de Pediatria (SBP), Ministerio da Saude, Advisory Committee on Immunization Practices (ACIP), American Academy of Pediatrics (AAP) e Centers for Disease Control and Prevention (CDC) no periodo de 2000 a 2005. SINTESE DOS DADOS: Aspectos epidemiologicos locais, socioeconomicos e infra-estrutura disponivel podem definir prioridades nas recomendacoes de imunobiologicos. As referencias consultadas, tanto nacionais como internacionais, apresentam calendarios vacinais para infância e adolescencia com diferencas nas vacinas contra tuberculose, poliomielite, rotavirus, pertussis, pneumococo, meningococo, varicela e hepatite A, havendo grande semelhanca em relacao as demais. No Brasil, existem a disposicao da populacao, conforme criterios especificos, os Centros de Referencia de Imunobiologicos Especiais (CRIE), os quais oferecem imunobiologicos nao disponiveis na rede publica. CONCLUSOES:Embora a utilizacao de um calendario universal nao seja possivel em funcao de diferencas epidemiologicas e operacionais, existem semelhancas que podem ser incorporadas as diferentes populacoes, desde que sejam contemplados criterios tecnicos e cientificos.

Immunizations: three centuries of success and ongoing challenges

Nas últimas décadas, entre os maiores avanços observados na área da saúde, a imunização vem ocupando um espaço progressivamente maior em todo o mundo. O desenvolvimento da ciência, microbiologia, farmacologia e da imunologia tem se somado aos estudos de epidemiologia e sociologia, os quais evidenciam o grande impacto que as vacinas têm representado para a sociedade atual, significando um dos principais fatores de promoção de saúde e prevenção de doenças.

[Teaching and healthcare in adolescence: reality and perspectives]

Diante da realidade mundial apresentada na Conferência Internacional de População e Desenvolvimento de 1994, nos últimos 5 anos, as Nações Unidas vêm desempenhando esforços de avaliar as perspectivas dos programas quanto ao bem-estar e à qualidade de vida, principalmente no que diz respeito à adolescência e à juventude, que, no Brasil, representam aproximadamente 49 milhões de pessoas entre 10 e 24 anos.