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The Objective of the Research

S ocial Services Actions for Prevention Of Digestive Disorders Among Adolescents Medea Chikava M.D., Ph.D THE UNIVERSITY Of GEORGIA.

marshall-garrett
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The Objective of the Research

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  1. Social Services Actions for Prevention Of Digestive Disorders Among AdolescentsMedea ChikavaM.D., Ph.DTHE UNIVERSITY Of GEORGIA

  2. Among the greatest advances in elucidating the determinants of disease over therecent period has been the identification of social conditions that seem to influence morbidity. While planning social services it is important to determine the impact level of each social risk factor on disease development in order to form prevention measures ranked list and outline the priority problems. Despite all the achievements of the contemporary Medicine, improvement of prevention of Digestive Disorders (DD) still remain a priority objective, since there is a trend of uncontrolled growth of these disorders in the World.

  3. Adolescence is one of the most critical periods of the human postnatal ontogenesis and one of the most difficult periods of psychological development. That is why so important is timely development of the effective, scientifically sound model of prevention of these disorders among adolescents,based on the evaluation of social risks that have impact on them. This is the first study in Georgia that using the two step model epidemiological research definespathogenic strength and prognosed values ofsocial and otherrisk factors.

  4. The Objective of the Research _ to study the role of micro-social environment in formation of DD among adolescents of Georgia aged 14-21; _ to establish which factors have more negative influence on the development and progression of DD in adolescents; _ what measures will be more effective to be conducted during the delivery of social services.

  5. Materials and Methods

  6. One stage epidemiological research was conducted among 1. the medium (14-16 years old) 2. late (17-21 years old) period adolescents population of Georgia. We developed: 1. primary questionnaire for DD morbid forms screening 2. specialized map-questionnaire of epidemiological research of DD

  7. Statistical study of DD was conducted not as complete study of “general entity” but with “partial” method. To receive statistically reliable values, the value of “selection entity” was defined by the method, accepted on the tenth report of the WHO Experts’ Committee, the following formula [143]: n = t2 * P * (100 – P ) / ∆ 2 where: n – is needed number of observations; P = 13,25% – distribution of disease, expressed in % (prevalence index of DD, received as a result of epidemiological research, conducted in 2003in adolescents aged 15-18); t = 1,96 – reliability coefficient (95% accuracy); ∆ = 3,25 – limiting error of index. n = 1,962 * 13,25 * 86,75 / 3,252 = 418

  8. Theepidemiological research _ 430 adolescents I step _ the screening questionnaires

  9. II step _ the map-questionnaires Each map contained questions to study psychosocial, alimentary and other risk factors. Data, received as a result of research, was statistically processed by the SPSS program application, Excel, using contemporary biostatistics techniques. The risk factors significances were studied by the Case-Control Study method.

  10. For each risk factor 1. pathogenic strength _ Relative Risk (RR) 2. prognosed values – Relative Intensity coefficient (K) RR evaluates level of impact of the risk factors on DD development. K evaluates level of impact of the risk factors on DD progression.

  11. In order to define sequence of the preventive measures which are recommended to be conducted during the delivery of social services in the groups ranking of the risk factors was held according to decrease of RR, K values: 1.forthe conditionally healthy adolescents(II group) – according to RR was defined ranked list of DD predictors; 2.for the adolescents with DD(I group) – according to K was defined rank of risk factors that help the progress of these disorders in case of already developed disease

  12. Results and Discussion

  13. The prevalence of DD in adolescents population was stated – 19,5% (95%CI: 17,6-21,4); from which10,5% were girls and 9,0% were boys (diagram 1). Among 84 adolescents with DD 45 were girls and 39 were boys, 53,6% (95%CI: 48,1- 59,1) and 46,4% (95%CI: 40,9-51,9), respectively (diagram 2).

  14. DDiagram 1The prevalence of Digestive Disordersin Adolescents According to Intensive Indices

  15. Diagram 2The prevalence of Digestive Disordersin Adolescents According to Extensive Indices

  16. Diagram 3The structureof Digestive Disordersin Adolescents 1. Esophageal disorders 2. Stomach and duodenal disorders 3. Hepatobiliar and pancreatic system disorders 4. Intestinal disorders

  17. Diagram 4 Theprevalence of Digestive Disordersin Adolescents According to Age and Sex

  18. Table 1The social Risk Factors Impact On AdolescentsDigestive Disorders Development

  19. Table 2 The impact chronic overload On AdolescentsDigestive Disorders Development

  20. In contrast to chronic psychological overloads, a healthy lifestyle has positive impact on DD development among adolescents.

  21. Diagram 5 Irregular Consumption ofFood Products among Adolescents Population(%) 1. plural vegetables (except potatoes); 5. macaroni, plural grouts; 2. fish; 6. butter; 3. milk and dairy products; 7. meat; 4. fruit and berry; 8. egg.

  22. Unhealthy diet is risk factor for DD development: 1. overweight eating of carbohydratic food (bread and bread products, potatoes and sweets) – RR=2,98 (95%CI: 2,29-3,88); 2. irregular consumption of milk and dairy products – RR=1,82 (95%CI: 1,38-2,49), 3. insufficient use of fruit and berry RR=1,41 (95%CI: 1,06-1,85).

  23. Diagram 5The frequencies of active and passive lifestyleamong adolescents population (RR=1,46)

  24. Table 2The social Risk Factors Impact On AdolescentsDigestive Disorders Development

  25. The unhealthy habits_ RR=3,42 1. smoking_ RR=2,27 2. excessive consumption of alcohol _ RR=1,87

  26. Diagram 6The frequencies of bad habits _ RR = 3,42(smoking _RR- 2,27, alcohol consumption RR- 1,87)among adolescents population

  27. The fact, that the majority of familiars smoke (RR=2,14), is one of the less significant risk factors. The correlation coefficient between this factor and adolescents’ bad habits is 0,4 (r=0,4). This average correlation indicates that unhealthy microsocial environment imfluences on the adolescents in this way that they early begin to smoke. Passive smoking more than 2 years time (RR=1,62) also has impact on DD development, but to less considerable degree.

  28. The unsatisfactory living conditions (RR=2,72) have very important negative influence on children’s and adolescents’ development and these occupy the third place among the social risk factors after the bad habits.

  29. Excessive Use of New Information Technologies _ RR=2,26 1. Excessive use of computer _ RR=2,14 2. Excessive use of TV _ RR=1,67

  30. The parents separation has low average correlation with presence of DD among adolescents (r=0,39). So it also influences on DD development among them (RR= 1,89).

  31. The use of computer has different impacts on the I and II groups adolescents. On the question ’’what do you feel after using computer?’’, adolescents of I and II groups, respectively, answered: ’’weakness’’ – 6,8% and 2,3%; ’’exhaustion’’ – 13,8% and 3,4%, ’’has worst influence’’ – 3,4% and 2,3%. Overall, the computer negatively influences on 24,0% of adolescent with DD and 8,0% of others (p<0,05). 25% of the whole population feels tired after using the new information technologies and it has the positive impact on 18,4% of conditionally healthy adolescents, but nobody feels the same in the I group.

  32. Just because adolescenthas one or more risk factors doesn’t mean he will definitely develop poor digestive health. Knowing one’s risk factors to his digestive health can guide him into making the best choices for himself – whether it’s making lifestyle changes or other changes.

  33. Conclusions Thus, according to the obtained results from the epidemiological research the prevalence of digestive disorders in adolescents population is more high among girls, than _among boys and it has tendency of growth by age. Accordingly, the influence of micro-social environment is more negatively represented on the pubertative age girls health, than on the boys of the same age.

  34. The results obtained indicates that while planning social services for preventing development of DD in adolescents first of all the following actions are recommended to be implemented: 1. the reduction of chronic overload (RR=11,6), especiallystudy overload (RR=5,85) 2. and conflict situations in family (RR=3,75); 3. explanation of bad habits negative role to the adolescents (RR=3,42); 4. improvement of living conditions (RR=2,72); 5. moderately use of computer, TV (RR=2,26).

  35. For right prevention of adolescents DD it’s important to providerational using of nutritional resources by adolescents, especially by girls: 1. milk and dairy products (RR=1,82), 2. fruit and berry (RR=1,41). It’s essential to limite the consumption of bread and bread products, potatoes and sweets (RR=2,98).

  36. The results of our research show the risk factors the modification of which is the most important during delivery of social services. Based on the results of our research it is possible to develop scientifically approved model of prevention DD among adolescents. This shall be much cheaper than treatment expenses.

  37. ThANK YOU FOR ATTENTION

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