Gatwean GO-70% of disabled young adults are jableSS in the United States. NO study has investigat... more Gatwean GO-70% of disabled young adults are jableSS in the United States. NO study has investigated the p~eaibla pracuraors to this joblessnass. In this study, a cross seoticn of adolescants with a variety of chronic illnesses wel-e given a broad spectruw of measures to assess voiuntaer ac:ivities, paying jobs, and ettitudes abor;t Careers.
Addressing the health status and needs of incarcerated youth represents an issue at the nexus of ... more Addressing the health status and needs of incarcerated youth represents an issue at the nexus of juvenile justice reform and health care reform. Incarcerated youth face disproportionately higher morbidity and higher mortality compared to the general adolescent population. Dental health, reproductive health, and mental health needs are particularly high, likely as a result of lower access to care, engagement in high-risk behaviors, and underlying health disparities. Violence exposure and injury also contribute to the health disparities seen in this population. Further, juvenile incarceration itself is an important determinant of health. Juvenile incarceration likely correlates with worse health and social functioning across the life course. Correctional health care facilities allow time for providers to address the unmet physical and mental health needs seen in this population. Yet substantial challenges to care delivery in detention facilities exist and quality of care in detention facilities varies widely. Community-based pediatricians can serve a vital role in ensuring continuity of care in the postdetention period and linking youth to services that can potentially prevent juvenile offending. Pediatricians who succeed in understanding and addressing the underlying social contexts of their patients' lives can have tremendous impact in improving the life trajectories of these vulnerable youth. Opportunities exist in clinical care, research, medical education, policy, and advocacy for pediatricians to lead change and improve the health status of youth involved in the juvenile justice system.
Adolescents with involvement in the correctional system have significant health risks and needs. ... more Adolescents with involvement in the correctional system have significant health risks and needs. Professional guidelines and policies related to health services in correctional settings can help health care providers who work in youth detention facilities and those who see youth for follow-up care after incarceration. Several challenges exist to providing care in detention facilities, but overcoming these barriers to optimally serve youth is critical. When youth are released to their homes, community providers must understand the extent of care offered in detention facilities, the unique considerations for youth on probation, and the aspects of follow-up care that should be addressed.
In 1999 an estimated 717 036 juveniles were incarcerated in the United States [1]. Many youth rem... more In 1999 an estimated 717 036 juveniles were incarcerated in the United States [1]. Many youth remain in detention a short time while others convicted of serious crimes spend years incarcerated. The Juvenile Justice and Delinquency Prevention Act of 1974 mandated that youth not be housed with adults. Nonetheless, on June 30, 2000, an estimated 7600 youths were incarcerated in adult facilities [2]. Each state defines the limits of the juvenile age range as it applies to detention practices and the choice of being tried in juvenile rather than adult court. Health Problems of Incarcerated Youth Many health problems afflict detained youth. Communicable diseases, especially sexually transmissible infections, hepatitis, and positive tuberculosis testing are commonly encountered [3,4]. Although human immunodeficiency virus infection (HIV) remains low in this age group, delinquent youth engage in risky behaviors [5,6] and some are infected, [4] often asymptomatically but with immune suppression. Universal HIV testing for all newly admitted youth may be wise, but debate around this issue continues because of concerns regarding coercion to agree to testing and stigmatization of HIV. Approximately 10 percent of incarcerated girls are pregnant and 40 percent have been pregnant in the past [4]. This presents a dilemma for practitioners because of varying restrictive state laws regarding minors and abortion services as well as the individual practitioner's moral beliefs. Menstrual disorders, along with injuries [7], and orthopedic problems, gastrointestinal disorders, cancer, and dermatologic concerns also afflict these youth. Little recent data shed any light on health screening practices of detention facilities, but in 1974 only 64 percent of juveniles were tested for TB and 53 percent for sexually transmissible infections [8]. In 33 percent of the surveyed facilities, nonmedical personnel did the screening [8]. Facilities Correctional facilities can be divided into 2 large categories: local detention facilities and state-run institutions for longer-term incarceration. Detention facilities administered by local governments hold youth awaiting court decisions, ie, preadjudicated. These facilities are used for short-term punishment or until sentenced youth are transferred to long-term facilities. Some local governments operate camps and treatment programs such as mental health units. The states generally run long
Journal of adolescent health care : official publication of the Society for Adolescent Medicine, 1989
Just before and during the arrest procedure, juveniles may hide drugs within the body, an act cal... more Just before and during the arrest procedure, juveniles may hide drugs within the body, an act called "body stuffing." The type and quantity of drug, its container, and the hiding place modify the potential toxicity of the contraband drug. The discovery of drug contraband by medical personnel raises an ethical issue regarding confidentiality. Responsibility for prison security rests primarily with the correctional staff, not with the medical staff. The need for trust between the physician and the adolescent in the detention setting is important. Appropriate medical and psychologic intervention can only be instituted if the detainee trusts and cooperates with the physician.
Each year, increasing numbers of juveniles are incarcerated (1,2). In 1991, 823,449 youths were d... more Each year, increasing numbers of juveniles are incarcerated (1,2). In 1991, 823,449 youths were detained in long-and short-term facilities in the United States (3). As the federal and state governments move to mandate harsher penalties for delinquent youth, this population is likely to increase (4). Systems that are already taxed will find their resources diminishing relative to demand. Many youth entering detention lack comprehensive health care and have long-term neglected health needs (5,6), whereas the scope of the care offered by detention facilities varies widely. Juvenile detainees have been identified as a group that participates in high-risk behaviors including substance abuse (7-10), early sexual activity (10-13), violence (10), weapon use (10), murder (14), and gang involvement (10). This group also has a high prevalence of medical conditions including seizure disorders, respiratory disease, nutritional deficiencies, and orthopedic, skin, and dental problems (5,11,15-18). In addition, juvenile detainees often have physical or psychological disorders that contribute to behavior problems (15,19-23). For example, a high rate of depression has been reported among detained youth (10,18,24). Moreover, during detention, youth may be at risk for accidental or self-inflicted injuries (6,25) as well as stress-related symptoms (17). The time in custody presents a unique opportunity to address the basic health concerns of this population and provide health education. However, a number of factors tend to impede the provision of excellent health care to detained adolescents. Currently, under federal regulations, incarcerated populations, even detainees under 18 years of age, are ineligible for Medicaid benefits. This prohibition
Risky behavior begins early, the initiation plateauing at age 15 or 16 years. Girls and boys repo... more Risky behavior begins early, the initiation plateauing at age 15 or 16 years. Girls and boys reported comparable rates of drinking, binge drinking, and illicit drug use. North American Natives and those individuals who designated themselves as being other than any of the offered ...
Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (ST... more Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Moreover, condom use by this population is extremely low. Although interpersonal variables such as sexual communication have been found to be associated with condom use in other populations, few researchers have investigated this relationship among adolescents requiring detention in juvenile facilities. The present study investigated the relationship between communication about sexual history and incarcerated adolescents' condom use. We used multivariate logistic regression techniques to analyze interview data from a predominantly Latino sample of 2,132 sexually active adolescents detained in Los Angeles County Juvenile Hall. Despite high numbers of lifetime sexual partners, a substantial majority of respondents (67%) reported that they never used condoms during sexual intercourse. Respondents who communicated with their sex partner(s) about each others' sexual history were significantly more likely to use condoms during sexual intercourse. Adolescents who reported that they knew someone with AIDS were also more likely to use condoms. Interventions designed to increase condom use among sexually active incarcerated adolescents should include a component addressing sexual communication practices. More research is needed on the ways in which adolescents learn to communicate about sex.
... New Yorkl from.\ nrsing Homes to Home Care, edited hy Marie h. Cowart. DrPH. ... V. Montgomer... more ... New Yorkl from.\ nrsing Homes to Home Care, edited hy Marie h. Cowart. DrPH. ... V. Montgomery, PhD Tracy X. Karner. PhD Karl Kosloski, PhD PUBLIC SECTOR, STATE, AND LOCAL INITIATIVES Strengthening Senior Tax Credit Programs in Massachusetts 141 Kristin Kiesel. ...
Gatwean GO-70% of disabled young adults are jableSS in the United States. NO study has investigat... more Gatwean GO-70% of disabled young adults are jableSS in the United States. NO study has investigated the p~eaibla pracuraors to this joblessnass. In this study, a cross seoticn of adolescants with a variety of chronic illnesses wel-e given a broad spectruw of measures to assess voiuntaer ac:ivities, paying jobs, and ettitudes abor;t Careers.
Addressing the health status and needs of incarcerated youth represents an issue at the nexus of ... more Addressing the health status and needs of incarcerated youth represents an issue at the nexus of juvenile justice reform and health care reform. Incarcerated youth face disproportionately higher morbidity and higher mortality compared to the general adolescent population. Dental health, reproductive health, and mental health needs are particularly high, likely as a result of lower access to care, engagement in high-risk behaviors, and underlying health disparities. Violence exposure and injury also contribute to the health disparities seen in this population. Further, juvenile incarceration itself is an important determinant of health. Juvenile incarceration likely correlates with worse health and social functioning across the life course. Correctional health care facilities allow time for providers to address the unmet physical and mental health needs seen in this population. Yet substantial challenges to care delivery in detention facilities exist and quality of care in detention facilities varies widely. Community-based pediatricians can serve a vital role in ensuring continuity of care in the postdetention period and linking youth to services that can potentially prevent juvenile offending. Pediatricians who succeed in understanding and addressing the underlying social contexts of their patients' lives can have tremendous impact in improving the life trajectories of these vulnerable youth. Opportunities exist in clinical care, research, medical education, policy, and advocacy for pediatricians to lead change and improve the health status of youth involved in the juvenile justice system.
Adolescents with involvement in the correctional system have significant health risks and needs. ... more Adolescents with involvement in the correctional system have significant health risks and needs. Professional guidelines and policies related to health services in correctional settings can help health care providers who work in youth detention facilities and those who see youth for follow-up care after incarceration. Several challenges exist to providing care in detention facilities, but overcoming these barriers to optimally serve youth is critical. When youth are released to their homes, community providers must understand the extent of care offered in detention facilities, the unique considerations for youth on probation, and the aspects of follow-up care that should be addressed.
In 1999 an estimated 717 036 juveniles were incarcerated in the United States [1]. Many youth rem... more In 1999 an estimated 717 036 juveniles were incarcerated in the United States [1]. Many youth remain in detention a short time while others convicted of serious crimes spend years incarcerated. The Juvenile Justice and Delinquency Prevention Act of 1974 mandated that youth not be housed with adults. Nonetheless, on June 30, 2000, an estimated 7600 youths were incarcerated in adult facilities [2]. Each state defines the limits of the juvenile age range as it applies to detention practices and the choice of being tried in juvenile rather than adult court. Health Problems of Incarcerated Youth Many health problems afflict detained youth. Communicable diseases, especially sexually transmissible infections, hepatitis, and positive tuberculosis testing are commonly encountered [3,4]. Although human immunodeficiency virus infection (HIV) remains low in this age group, delinquent youth engage in risky behaviors [5,6] and some are infected, [4] often asymptomatically but with immune suppression. Universal HIV testing for all newly admitted youth may be wise, but debate around this issue continues because of concerns regarding coercion to agree to testing and stigmatization of HIV. Approximately 10 percent of incarcerated girls are pregnant and 40 percent have been pregnant in the past [4]. This presents a dilemma for practitioners because of varying restrictive state laws regarding minors and abortion services as well as the individual practitioner's moral beliefs. Menstrual disorders, along with injuries [7], and orthopedic problems, gastrointestinal disorders, cancer, and dermatologic concerns also afflict these youth. Little recent data shed any light on health screening practices of detention facilities, but in 1974 only 64 percent of juveniles were tested for TB and 53 percent for sexually transmissible infections [8]. In 33 percent of the surveyed facilities, nonmedical personnel did the screening [8]. Facilities Correctional facilities can be divided into 2 large categories: local detention facilities and state-run institutions for longer-term incarceration. Detention facilities administered by local governments hold youth awaiting court decisions, ie, preadjudicated. These facilities are used for short-term punishment or until sentenced youth are transferred to long-term facilities. Some local governments operate camps and treatment programs such as mental health units. The states generally run long
Journal of adolescent health care : official publication of the Society for Adolescent Medicine, 1989
Just before and during the arrest procedure, juveniles may hide drugs within the body, an act cal... more Just before and during the arrest procedure, juveniles may hide drugs within the body, an act called "body stuffing." The type and quantity of drug, its container, and the hiding place modify the potential toxicity of the contraband drug. The discovery of drug contraband by medical personnel raises an ethical issue regarding confidentiality. Responsibility for prison security rests primarily with the correctional staff, not with the medical staff. The need for trust between the physician and the adolescent in the detention setting is important. Appropriate medical and psychologic intervention can only be instituted if the detainee trusts and cooperates with the physician.
Each year, increasing numbers of juveniles are incarcerated (1,2). In 1991, 823,449 youths were d... more Each year, increasing numbers of juveniles are incarcerated (1,2). In 1991, 823,449 youths were detained in long-and short-term facilities in the United States (3). As the federal and state governments move to mandate harsher penalties for delinquent youth, this population is likely to increase (4). Systems that are already taxed will find their resources diminishing relative to demand. Many youth entering detention lack comprehensive health care and have long-term neglected health needs (5,6), whereas the scope of the care offered by detention facilities varies widely. Juvenile detainees have been identified as a group that participates in high-risk behaviors including substance abuse (7-10), early sexual activity (10-13), violence (10), weapon use (10), murder (14), and gang involvement (10). This group also has a high prevalence of medical conditions including seizure disorders, respiratory disease, nutritional deficiencies, and orthopedic, skin, and dental problems (5,11,15-18). In addition, juvenile detainees often have physical or psychological disorders that contribute to behavior problems (15,19-23). For example, a high rate of depression has been reported among detained youth (10,18,24). Moreover, during detention, youth may be at risk for accidental or self-inflicted injuries (6,25) as well as stress-related symptoms (17). The time in custody presents a unique opportunity to address the basic health concerns of this population and provide health education. However, a number of factors tend to impede the provision of excellent health care to detained adolescents. Currently, under federal regulations, incarcerated populations, even detainees under 18 years of age, are ineligible for Medicaid benefits. This prohibition
Risky behavior begins early, the initiation plateauing at age 15 or 16 years. Girls and boys repo... more Risky behavior begins early, the initiation plateauing at age 15 or 16 years. Girls and boys reported comparable rates of drinking, binge drinking, and illicit drug use. North American Natives and those individuals who designated themselves as being other than any of the offered ...
Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (ST... more Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Moreover, condom use by this population is extremely low. Although interpersonal variables such as sexual communication have been found to be associated with condom use in other populations, few researchers have investigated this relationship among adolescents requiring detention in juvenile facilities. The present study investigated the relationship between communication about sexual history and incarcerated adolescents' condom use. We used multivariate logistic regression techniques to analyze interview data from a predominantly Latino sample of 2,132 sexually active adolescents detained in Los Angeles County Juvenile Hall. Despite high numbers of lifetime sexual partners, a substantial majority of respondents (67%) reported that they never used condoms during sexual intercourse. Respondents who communicated with their sex partner(s) about each others' sexual history were significantly more likely to use condoms during sexual intercourse. Adolescents who reported that they knew someone with AIDS were also more likely to use condoms. Interventions designed to increase condom use among sexually active incarcerated adolescents should include a component addressing sexual communication practices. More research is needed on the ways in which adolescents learn to communicate about sex.
... New Yorkl from.\ nrsing Homes to Home Care, edited hy Marie h. Cowart. DrPH. ... V. Montgomer... more ... New Yorkl from.\ nrsing Homes to Home Care, edited hy Marie h. Cowart. DrPH. ... V. Montgomery, PhD Tracy X. Karner. PhD Karl Kosloski, PhD PUBLIC SECTOR, STATE, AND LOCAL INITIATIVES Strengthening Senior Tax Credit Programs in Massachusetts 141 Kristin Kiesel. ...
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