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.     

Age and Gender Differences in Peer Conflict

The purpose of this study was to examine age and gender differences in peer conflict, particularly in regards to conflict issues and resolution strategies reported by children and adolescents. Students from grades 4 and 8 (60 boys, 60 girls) were asked interview questions and given 3 hypothetical scenarios to respond to. Teacher and self-reports were also gathered for each student to assess their level of adaptive ability. The results showed that adolescents tended to report higher rates of conflict and endorsed more cooperative strategies than 4th graders, who endorsed more aggressive tactics. Female students reported having more relational issues and used more conflict-mitigating strategies, while boys reported having more conflicts related to status/dominance. Finally, links were also found between effective resolution strategies and social ability. The implications and limitations of this study are discussed.M. A. Noakes received her Master's degree from the Department of Educational Psychology at the University of Alberta, Canada. Her current research interests include assessment of at-risk youth, relapse prevention programs for young offenders, and social emotional functioning of children and adolescents.C. M. Rinaldi her doctorate from the Department of Educational and Counselling Psychology at McGill University, Canada. Her current research interests include applied developmental psychology, social emotional functioning of children and adolescents, and parent-child relations.     

Epistemic Reasoning and Adolescent Egocentrism: Relations to Internalizing and Externalizing Symptoms in Problem Youth

This investigation addressed the question of how two forms of social cognitive reasoning – epistemic reasoning and adolescent egocentrism – interface with externalizing and internalizing forms of psychopathology during adolescence. Adolescents’ epistemic reasoning (i.e., types of belief entitlement, or degree of doubt, held by an individual when confronted with contradictory sides of an issue), and imaginary audience and personal fable ideation, were assessed in a sample of 29 adolescent boys with behavioral problems and 30 of their peers without behavioral problems. To assess internalizing and externalizing symptomatology, teachers completed the Child Behavior Checklist (CBCL-TRF). Results revealed that, compared to those without behavior problems, boys with behavioral problems were lower in epistemic reasoning. Further analyses revealed consistent relations between dimensions of social cognitive reasoning to specific forms of psychopathology. These findings suggest that social cognitive reasoning, particularly epistemic doubt, is important in understanding problem behaviors among typical and atypical adolescents.

Religiöse Pluralität im nationalen Verfassungsstaat

This article is intended to provide a both functionalist and institutionalist understanding of current conflicts regarding a binding cultural core, religious plurality and multiculturalism, which would allow for an explanation of the corresponding historical process. In order to attain this goal, the functional differentiation and institutional shaping of politics is systematically reconstructed with a special focus on the differentiation of religion and politics, church and state, the handling of religious plurality and the political inclusion of religious minorities. The argument unfolds in the following four steps: (1) emergence of the state’s monopoly of power and the separation of spiritual and worldly power (functionalism I); (2) nation state and popular sovereignty as historical forms of the functional differentiation of politics (functionalism II); (3) the constitution as civil religion of politics organized in state form (institutionalism I); and (4) historical forms of civil religion and the institutionalization of religious plurality (institutionalism II).     

The Cultural Politics of Curricular Reform in China: a case study of geographical education in Shanghai

This article will examine the development and implementation of the new geography curriculum in secondary schools in Shanghai. Analysis of the processes and mechanisms which underlie curricular change in China reveals how embedded bureaucratic, social and cultural norms have profoundly influenced the degree to which reforms to the geography curriculum have achieved the desired results. The analysis begins with a detailed examination of the wider institutional hierarchies which initiated and managed curricular reforms in Shanghai. Interviews with teachers and extensive classroom observations, and a review of the new curriculum and geography textbooks are utilised to evaluate the practical outcomes of curricular change in Shanghai. The findings reveal a deep dichotomy between the intended goals of curricular reform, the processes of curriculum development and implementation, and an examination system which compels teachers to cling to traditional teaching methods of lecturing and rote learning. These findings are discussed in the context of the established educational hierarchies, the cultural politics of curricular reforms in Shanghai and the nature of geography teaching in China. A more balanced approach which addresses the provision of adequate resources and professional development for teachers, and which recognises the need for a fundamental restructuring of the examination system, is suggested.     

What Do We Know and Need to Know about the Environmental Outcomes of Collaborative Management?

Many tout the benefits of collaborative environmental management as an alternative to centralized planning and command and control regulation, but the excitement over collaborative processes has not been matched by evidence that these processes actually improve the environment. The most crucial question in collaborative environmental management remains unanswered and often unasked: To what extent does collaboration lead to improved environmental outcomes? We know much about why collaboration is occurring and how collaborative processes and outputs vary. The primary goal of future research on collaborative environmental management should be to demonstrate whether collaboration improves environmental conditions more than traditional processes and newer market-based processes. Collaboration is not a panacea; it is a choice that policy makers and public managers should make based on evidence about expected outcomes.