Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.     

Reconfiguring Chinese Propaganda and Control Modalities: A case study of Shanghai's television system

China's television industry has experienced a number of internal changes that have shaped this system's structure into the new millennium. The Chinese Government has reconfigured the propaganda and control modalities of this industry to allow television to become the prime mover for economic reform. A case study of Shanghai's dynamic television system from 1995 to 1999 is used to understand the changes that have taken place. This analysis provides an understanding of how the Chinese Government policy changes impact on the interrelatedness of the system's components. The consequences of these changes have had dramatic and lasting effects on the way the television industry operates in China. These effects have serious implications for foreign organisations, that are attempting to find a foothold in this booming industry, and for the Chinese television viewer.     

Fission and Federalism: The Disaggregation of Canadian Party Activists

This article focuses on the Progressive Conservative (PC) partyof Canada and contrasts the orientations of four different setsof PC party workers: those who are active in the provincialarena in Nova Scotia and in Alberta, as well as those who areactive in the national arena from the same two provinces. Thedata reveal that federalism has had a disaggregative effecton Canadian political party ideology. Not only is the cleavagebetween activists in different orders of government consistentlylarge; it also generally exceeds that which exists between activistsin different provinces.     

POLITICS, POLICY MAKING AND PRESSURE GROUPS: SOME SUGGESTIONS FOR REFORM OF THE AUSTRALIAN POLITICAL SYSTEM

Abstract: In Australia, current policy making is characterized by immobilism, drift and "pluralistic stagnation". The problem is not lack of technical expertise, but the mobilization of political consent in a polity in which pressure groups have proliferated. In the post-war period, the welfare state/managed economy has transformed the role of government and the potential power of pressure groups. New networks of interdependency have developed. Some of the principal groups are beneficiaries of redistributive programs, producer groups, state and local government agencies and professionals in government. Their potential power has been made actual by a new participative ethic. The post-materialist values of which this is part also result in the growth of groups focusing on quality of life and moral issues. In this context the political parties are losing their central place in the polity and the centralized organs of executive government appear over-secretive and aloof. Reforms are needed to realign institutions with the new cultural and structural realities. Broader interest group involvement is needed. Parliament, through a committee system, could play a major role and its historical function as custodian of the public interest should be revived. Departments must find new ways to involve more groups in policy formulation and implementation. Information must be shared more widely and policy analysts and advisors should work more closely with groups in defining issues, negotiating alternatives and encouraging the development of supportive coalitions. New "intelligence" and "outreach" functions within the public service are required, and the existing approaches of policy units and research bureaux should be remodelled.     

Adolescent self-poisoning: a cohort study of subsequent suicide and premature deaths

Previous self-harm has been identified as a risk factor for subsequent suicide by adolescents. The objective of the study was to identify further risk factors for subsequent premature death and suicide in a population of adolescents presenting with self-poisoning. A longitudinal cohort design using data-linkage of consecutive adolescent patients presenting to the Hunter Area Toxicology Service, a regional toxicology service for Newcastle, Australia, with the National Death Index of the Australian Institute of Health and Welfare was used. A total of 441 adolescents aged 10 to 19 years presented with self-poisoning over 5 years from January 1991 to December 1995, with follow-up to March 2001. There were 14 deaths total, eight of which were likely suicides. There was a 22-fold increase in suicide rate for males and a 14-fold increase for females compared with age-normalized population rates. Adjusted hazard ratios (95% CI) forpremature death were male gender 3.77 (1.11-12.78), nonaffective psychotic disorders 16.3 (3.83-69.34) and the mental illnesses of childhood 6.12 (1.68-22.23). There was a similar pattern for suicide: Male gender, nonaffective psychotic disorders, and the mental illnesses of childhood confer greater risk for subsequent suicide or premature death in this population.