Major depressive disorder is a common adolescent psychiatric disorder. Pediatricians must be equipped with appropriate interpersonal and diagnostic skills to detect this and other psychiatric disorders. Standardized patients represent one useful way to teach and assess these skills. This study suggests that residents' interpersonal and diagnostic skills can improve with practice. Although resident scores improved, post-encounter checklists showed that residents were still not asking all the necessary questions for a DSM-IV diagnosis, concluding prematurely that the standardized patients had major depressive disorder before satisfying all diagnostic criteria. The majority did not consider other depressive conditions or comorbid disorders.
Objectives After completing this article, readers should be able to: 1. Describe the values held by the different generations in today's workplace. 2. Discuss how respecting values is the first step to resolving generational conflicts. 3. Review practical solutions to improve the work environment for all generations.
AbstractCurrently, four generations are actively working in today's health-care environment. Differences between these generations are creating conflicts and negatively affecting communication, productivity, and the satisfaction of all ages. Each of the generations has different values. Being aware and respecting these values is the first step in improving the academic and work environment. Practical solutions that address the generational preferences then can be developed.
This paper reviews a study that evaluated the health and services available to adolescents within Oregon's adult correctional system. Information was obtained by reviewing the adolescents' institutional records, surveying correctional staff, and completing a history and physical. All 15 youth who were eligible consented to the study; 80% were white, 13% black, and 7% Hispanic. Upon enrollment, the youth had served an average of 230 days, of which approximately 47% were spent in a segregated unit with limited access to educational, recreational, and religious services. Seventy-seven percent reported chronic health conditions, 87% mental health disorders, 77% alcohol and substance abuse, and 33% prior suicide attempts. The youth reported responsibility for 13 pregnancies and six children. While these youth are at high risk for STDs, no specific policies or procedures for screening for common infections were in place. In addition, immunization practices were not consistent with national standards. The results of this study showed that adolescents assigned to an adult prison facility have significant health and educational needs that require developmentally appropriate services.
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