Narrative Review of the Educational, Vocational, and Financial Needs of Adolescents and Young Adults with Cancer: Recommendations for Support and Research.

Adolescents and young adults (AYAs) with cancer have unique needs around education and vocation during and after treatment. This narrative review series aims at documenting the unique needs of AYAs from the current literature and at providing recommendations to inform an update of the Australian National Service Delivery Framework for AYAs with Cancer. AYAs with cancer may experience impairments to cognitive, physical, and psychological functioning and health, which can adversely affect their academic grades, peer relationships, and likelihood of entering the workforce. Treatment expenses and time off work can stifle AYAs' financial independence from their parents. The combined effect of disrupted education, vocation, and financial dependence can reduce AYAs' sense of identity. Although support is available in some countries, support efficacy is yet to be clearly established. Continued research is required to deliver successful education and work reintegration programs that build the confidence of AYAs with cancer to achieve their best. Educational and vocational support, as well as financial advice, may improve AYAs' financial security and quality of life during survivorship.

The cost of comprehensive preventive medical services for adolescents.

OBJECTIVES: To address the need for clinical preventive services for 11- to 21-year-old males and females and provide cost estimates for those services under a fee-for-service system. Preventive services include screening, health promotion, and immunizations. DESIGN: The prevalence of adolescent morbidities was derived from national surveys. Estimated costs of these morbidities were obtained from published data and adjusted for 1992 dollars using the Consumer Price Index. The estimated costs of preventive services for adolescents under a fee-for-service system were derived from a 1993 survey of nine Blue Cross and Blue Shield plans and four insurance companies. MAIN OUTCOME MEASURES: The cost of adolescent morbidities includes only direct medical costs for a single year and excludes long-term and indirect costs. The cost of clinical preventive services is calculated at 100% participation levels. RESULTS: Each year, an estimated $33.5 billion is spent on medical treatment for select adolescent morbidities, approximately $859 per adolescent per year; this is a conservative estimate. The average cost of clinical preventive services per adolescent per year would be approximately $130 in a fee-for-service system, although these are not entirely "new" costs because payers already incur screening costs for some conditions. CONCLUSION: The cost-effectiveness of clinical interventions for various health risk behaviors among adolescents is unknown. It appears that preventive interventions would have to eliminate 15% of adolescent morbidities overall to break even in economic terms.

Administración de proyectos y programas de salud integral del adolescente

El horizonte previsible de los cambios sociales actuales , cambios sociales esperables en la próxima decada, consideraciones prospectivas para sud América y Argentina. El marco conceptual de la salud integral del adolescente y de su cuidado. Distribución de la riqueza en la Argentina, visión prospectiva del impacto de las variables económicas en la vida social. Estrategias de supervivencia en época de crisis. Centros de acción comunitaria. De la epidemiología a la endoepidemiología. Planificación estratégica en salud. Evaluación de programas y proyectos de salud integral, Desafios en salud para el próximo decenio

Administración de proyectos y programas de salud integral del adolescente

El horizonte previsible de los cambios sociales actuales , cambios sociales esperables en la próxima decada, consideraciones prospectivas para sud América y Argentina. El marco conceptual de la salud integral del adolescente y de su cuidado. Distribución de la riqueza en la Argentina, visión prospectiva del impacto de las variables económicas en la vida social. Estrategias de supervivencia en época de crisis. Centros de acción comunitaria. De la epidemiología a la endoepidemiología. Planificación estratégica en salud. Evaluación de programas y proyectos de salud integral, Desafios en salud para el próximo decenio

The practice of adolescent medicine in staff model HMOs.

Adolescent medicine is a medical specialty that may be represented in a prepaid group practice, but has generally not been perceived as necessary. A survey of The HMO Group shows considerable variation in staffing and the centralization of adolescent health care. An adolescent medicine practice may be rapidly created and promoted through notification of patients and professionals. Adolescent medicine providers can attend to age-appropriate educational and office setting needs of their patients, and study quality assurance of adolescent care by others. The HMO may benefit from improved age-specific care and increased physician and patient satisfaction. Problems with coverage and staffing may occur. HMOs should consider using one adolescent medicine specialist for each five to six pediatricians.