B.1 What Transition Skills Should be Targeted in Epilepsy Transition Clinics?

Background: Transition from pediatric to adult care can be a difficult time for adolescents with epilepsy. This period is often a period of extreme vulnerability and stress. As a result, research has recommended transition clinics to help these adolescents develop needed transition skills. However, the skills that need to be focused on remain unclear. Methods: Baseline transition skills in 113 adolescents with epilepsy, aged 14 to 18 (M= 16.46, male= 56) were analyzed. Results: Analyses showed that older adolescents showed significantly more transition skills than younger adolescents (F(4,108)=5.522, p=000). Although positive, older adolescents only scored, on average, 16.3/28 on the transition questionnaire; suggesting that many skills are still lacking, even at the time of transition. Specifically, although the majority of these older adolescents demonstrated being able to manage their condition independently (e.g., summarizing medical history, taking/knowing medications), these adolescents were less likely to demonstrate skills needed to be advocates for themselves and their health (e.g., asking questions, discussing concerns, speaking to the doctor instead of letting their parents). Conclusions: Results suggest it may be beneficial to restructure adolescent clinic visits; encouraging these patients to attend the initial portion of visits independently to help them feel more comfortable and confident championing for themselves.

Knowledge and attitudes towards contraceptives among adolescents and young adults

Background Despite endorsements supporting the use of intrauterine devices (IUDs) for adolescents and young adult women (AYA), they have limited knowledge about them Male partners can influence contraceptive decisions, however their perceived knowledge about IUDs is lower than their objective knowledge. We aim to establish current AYA baseline contraceptive knowledge and attitudes so providers can better target their sexual health educational interventions. Methods Females and males, aged 13 to 23 years old, from our suburban adolescent clinic, completed an anonymous survey that assessed their knowledge and attitudes towards methods of contraception, with an emphasis on the IUD. Results Completed surveys totaled 130 (99 females/31 males). Demographic results revealed 31.3% Black/African-American, 30.5% Latino/Hispanic, 17.6% White, 3.0% Asian, and 14.5% Other. The majority of participants (80%) were sexually active. The majority (69.5%) stated they/their partner were currently using a contraceptive method; only 2.6% used IUDs. Half of females (56.6%) and 10.1% of males had heard of IUDs. Despite this, male and female participants lacked knowledge regarding specific IUD facts. Of the participants who had used emergency contraception (EC), only 6.4% knew the copper IUD could be used for EC. Conclusion Contraceptive knowledge deficits, especially regarding the IUD, continue to exist for AYA patients. Many participants stated they required EC despite “satisfaction” with their birth control method(s) and most were unaware that the copper IUD could be used as EC. These discrepancies highlight the importance of comprehensive contraceptive education for AYA patients. Enhanced and consistent contraceptive options counseling can help providers ensure that their AYA patients make well-informed decisions about family planning, thus improving their quality of life.

EFFECT OF POLY-CYSTIC OVARIAN SYNDROME ON SELF-ESTEEM AND BODYIMAGE AMONG ADOLESCENT GIRLS ATTENDING ADOLESCENT CLINIC IN A TERTIARY CARE CENTRE

Background: Polycystic ovary syndrome (PCOS) have serious health issues, affecting female health, causing body disfigurement, lowers self- esteem decreases the quality of life and, lifelong health consequences related to metabolic disorders. Objective: The objective of the study was to evaluate, 'the impact of various clinical features of PCOS namely obesity, hirsutism, acne, menstrual irregularities on psychological well-being in adolescent girls'. Material and methods: A cross-sectional study conducted in the adolescent clinic, BHU. Tools used for data collection were a self-structured questionnaire which includes socio-demographic status, menstrual history, and anthropometric assessment. Hirsutism was assessed by the Ferriman-Gallwey scoring system, acne by the Global acne grading system, self-esteem by Rosenberg self-esteem scale, and body image by Body Image Concern Inventory scale. Statistical analysis was done by SPSS version '22'. Results: Findings of multiple regression analysis suggests that adolescent girls with hirsutism experienced poorer self-esteem (β= -2.621, p=0.01) and greater body dissatisfaction (β= 0.258, p= 0.02) than adolescents girls without hirsutism. Furthermore, obese adolescents had a lower level of self-esteem (β= -0.056, p=0.01) and negative body image (β= 0.748, p=0.01) compared with non- obese PCOS adolescents. Adolescent girls with menstrual irregularities had higher body dissatisfaction (β=0.143, p=0.05) than patients with a regular cycle. Conclusion: PCOS in adolescents having obesity, menstrual irregularities, and features of hyper-androgenism have a profound effect on psychological well being. So, the recognition of the early signs of PCOS during adolescence and early treatment can improve the quality of life.

Knowledge and Attitudes Towards Contraceptives Among Adolescents and Young Adults

Background: Despite endorsements supporting the use of intrauterine devices (IUDs) for adolescents and young adult women (AYA), they have limited knowledge about them Male partners can influence contraceptive decisions, however their perceived knowledge about IUDs is lower than their objective knowledge. We aim to establish current AYA baseline contraceptive knowledge and attitudes so providers can better target their sexual health educational interventions.Methods: Females and males, aged 13 to 23 years old, from our suburban adolescent clinic, completed an anonymous survey that assessed their knowledge and attitudes towards methods of contraception, with an emphasis on the IUD.Results: Completed surveys totaled 130 (99 females/31 males). Demographic results revealed 31.3% Black/African-American, 30.5% Latino/Hispanic, 17.6% White, 3.0% Asian, and 14.5% Other. The majority of participants (80%) were sexually active. The majority (69.5%) stated they/their partner were currently using a contraceptive method; only 2.6% used IUDs. Half of females (56.6%) and 10.1% of males had heard of IUDs. Despite this, male and female participants lacked knowledge regarding specific IUD facts. Of the participants who had used emergency contraception (EC), only 6.4% knew the copper IUD could be used for EC.Conclusion: Contraceptive knowledge deficits, especially regarding the IUD, continue to exist for AYA patients. Many participants stated they required EC despite “satisfaction” with their birth control method(s) and most were unaware that the copper IUD could be used as EC. These discrepancies highlight the importance of comprehensive contraceptive education for AYA patients. Enhanced and consistent contraceptive options counseling can help providers ensure that their AYA patients make well-informed decisions about family planning, thus improving their quality of life.

The Use of Collaborative/Therapeutic Assessment With Oppositional Defiant Disorder

The aim of the present single case study was to demonstrate the effectiveness of a therapeutic evaluation model (CTA) used for 4 years with a teenage girl (13–17 years of age) with oppositional defiant disorder (ODD). Clinical evaluations using autobiography as well as the Millon Adolescent Clinic Inventory, House–Tree–Person Drawing, and Rorschach test (Comprehensive System) were conducted at each of four time points: 13, 14, 15, and 17 years of age. An average of four evaluation sessions were carried out at each time point following feedback of the results to the client, reflections about her experience with the evaluation process and with results obtained were requested in writing. Progressive findings reveal a gradual decrease in ODD markers and increasing sophistication, organization, and realism in the configuration of the drawings. The Rorschach test gradually indicated a decrease in aggression content and improvement in the quality of responses. In conclusion, the longitudinal design used in the case shows a strengthening of the self, a notable decrease in oppositional defiant behavior, and an adaptation and adjustment to reality as expected for a young woman of the client’s age.

Barriers and facilitators for transitioning of young people from adolescent clinics to adult ART clinics in Uganda: Unintended consequences of successful adolescent ART clinics

BackgroundThere is a growing number of adolescents and young adults with HIV who require transfer of care from pediatric/ adolescent clinics to adult ART clinic. Currently, adolescents are largely in the care of pediatricians; but as they grow, they transition to adult HIV clinics. The purpose of this study was to explore the facilitators and barriers of transitioning among adolescents from adolescent clinics to adult ART clinics.MethodAn explorative qualitative approach was utilised for this study. Eighteen focus group discussions were held in nine health facility with (191) adolescents and young people in order to capture their experiences, barriers and facilitators regarding transitioning to adult clinics. The focus group discussions were audio recorded and transcribed. The Silences Framework using thematic approach guided the analysis.Results The key emerging issues were: Care provided in the adolescent clinics, Unfriendly adults, stigma and discrimination, Congestion and long waiting time, health providers in adult clinics were barriers to transitioning. Moving as a cohort, Transition preparation, care in clinics, positive living, support from the guardian and Young adolescent program Support (YAPS) could facilitate readiness and transitioning.ConclusionAdolescents and young people expressed fear to transition to adult clinics mainly because of the perceived better care provided in adolescent clinic, thus constituting a barrier to smooth transition A range of individual, social and health system and services-related factors hindered transitioning. Expectation of transitioning as a group, assurance of similar care as in the adolescent clinic, and guarantees of confidentiality, privacy and autonomy in decision-making for care were perceived as facilitators. There is need to strengthen implementation of age-appropriate care and individualized case management during care transition at all health facilities. Furthermore, the findings suggest the need to create supportive family, peer, and healthcare environments for adolescent transition.

Knowledge and Attitudes Towards Contraceptives Among Adolescents and Young Adults

Background : Despite endorsements supporting the use of intrauterine devices (IUDs) for adolescents and young adult women (AYA), they have limited knowledge about them Male partners can influence contraceptive decisions, however their perceived knowledge about IUDs is lower than their objective knowledge. We aim to establish current AYA baseline contraceptive knowledge and attitudes so providers can better target their sexual health educational interventions.Methods Females and males, aged 13- 23, from our suburban adolescent clinic, completed an anonymous survey that assessed their knowledge and attitudes towards methods of contraception, with an emphasis on the IUD.Results Completed surveys totaled 130 (99 females/31 males). Demographics: Black/African-American (31.3%), Latino/Hispanic (30.5%), White (17.6%), Asian (3%), and Other (14.5%). 80% of participants were sexually active. 69.5% stated they/their partner were currently using a contraceptive method; only 2.6% used IUDs. 56.6% of females and 10.1% of males had heard of IUDs. Despite this, male and female participants lacked knowledge regarding specific IUD facts. 6.4% who had used EC knew the copper IUD could be used for EC.Conclusion: Contraceptive knowledge deficits, especially regarding the IUD, continue to exist for AYA patients. Many participants stated they required EC despite “satisfaction” with their birth control method and most were unaware that the copper IUD could be used as EC. These discrepancies highlight the importance of comprehensive contraceptive education for AYA patients. Enhanced and consistent contraceptive options counseling can help providers ensure that their AYA patients make well-informed decisions about family planning, thus improving their quality of life.

The psycho phenotypic profile of an Egyptian sample of patients with ADHD

Objectives The current study aimed to investigate the psycho-phenotypic profile of an Egyptian sample with ADHD cases. Subjects & Methods Eighty cases diagnosed as ADHD (according to the DSMV) were enrolled in the current study. They were selected sequentially from those following up in the child and adolescent clinic, children hospital, Ain shams University. Results The ages of the enrolled sample ranged between 4&12 years. Males were (86%) and Female (14%) with ratio 7:1. Consanguinity rate was (25%) while positive family history was (12%). Perinatal insult was detected in (22%). Inattentive ADHD was seen in 90% of cases while combined type in 10%. According to Conner’s parents’ scale (5%) had mild, (25%) moderate and (70%) severe ADHD symptoms. Comorbid conditions were seen as follows; Delayed language development (30%), stuttering (9%), delayed bladder control (15%), pica (2%), polyphagia (2%), sleep disorders [nightmares (4%), insomnia (9%), somnambulism (3%)], poor academic performance (95%), dyslexia (15%), dysgraphia (18%), conduct disorder (5%) and aggression (12%). Conclusion The current study delineated that there are so many phenotypic variation in Egyptian ADHD cases. This high-lightened the importance of individual assessment of such cases in order to configure the subtype, severity and identification of possible comorbidity. This enable the clinicians to individualize a treatment plan for each patient aiming at better outcome.

Knowledge and Attitudes Towards Contraceptives Among Adolescents and Young Adults

Background: Despite endorsements supporting the use of intrauterine devices (IUDs) for adolescents and young adult women (AYA), they have limited knowledge about them Male partners can influence contraceptive decisions, however their perceived knowledge about IUDs is lower than their objective knowledge. We aim to establish current AYA baseline contraceptive knowledge and attitudes so providers can better target their sexual health educational interventions.Methods: Females and males, aged 13- 23, from our suburban adolescent clinic, completed an anonymous survey that assessed their knowledge and attitudes towards methods of contraception, with an emphasis on the IUD.Results: Completed surveys totaled 130 (99 females/31 males). Demographics: Black/African-American (31.3%), Latino/Hispanic (30.5%), White (17.6%), Asian (3%), and Other (14.5%). 80% of participants were sexually active. 69.5% stated they/their partner were currently using a contraceptive method; only 2.6% used IUDs. 56.6% of females and 10.1% of males had heard of IUDs. Despite this, male and female participants lacked knowledge regarding specific IUD facts. 6.4% who had used EC knew the copper IUD could be used for EC.Conclusion: Contraceptive knowledge deficits, especially regarding the IUD, continue to exist for AYA patients. Many participants stated they required EC despite “satisfaction” with their birth control method and most were unaware that the copper IUD could be used as EC. These discrepancies highlight the importance of comprehensive contraceptive education for AYA patients. Enhanced and consistent contraceptive options counseling can help providers ensure that their AYA patients make well-informed decisions about family planning, thus improving their quality of life.