rsm92

Co Ch= airs - Diana Birch Gustavo Girard Treasurer Aric Schi= chor

&= nbsp; London= Buenos Aires= = Connecticut<= span lang=3DEN-GB style=3D'font-family:Courier'>

&= nbsp; England= Argentina= &nb= sp; USA

Looki= ng forward to SAM 1997 - It is just around the corner - an earlier date than usual this year. As discussed in the last newsletter we will be holding our IRC institute. This will take pla= ce 9am to 5pm on Wednesday March 5th. See the SAM programme booklet for details of venue. At the time of going to press the format was as overleaf - but please note that= , as is usual for our International sessions, we would be delighted to include other speakers. Please FAX as soon as possible to let me know if you have something you would like to present.

We ar= e VERY fortunate this year to have secured a two way dialogue between USA based SAM members and the International members with the inclusion in the Institute programme of a welcome from Gail Slap who will be dropping in to greet memb= ers - and also our opening speaker will be Bob Blum - who is always excellent at setting the tone of the meeting - so let’s have a 100% turnout and prepare to be inspired! We also have an important contribution from PAHO an= d a truly world-wide spectrum of presentations. As they say in the British Parliament - this is a three line w= hip - (a term for an important session arising from the notice to attend being underlined three times) - it means that excuses have to be written in blood= - yours! Or there may be a short trip to the Tower of London ...<= /span>

Again= , I would also like to suggest that we all bring examples of our work in our countrie= s - leaflets or display material which could be displayed in our meeting room a= nd give members a better feel of the work we are separately involved in back in our own countries.

The o= ther events are our usual International= dinner which as usual will be in a restaurant outside the hotel - keep your eye on= the notice board at SAM for details and book with Edie at the registration desk. The dinner will be on Friday night= March 7th.

The Chapter business meeting will be= a lunch this year as opposed to a breakfast - Don’t ask me why! The lun= ch is scheduled for 12.30-2pm<= /b> on Friday 7th. = Please note that this is NOT an alternative to the evening dinner - the lunch is a business meeting over a working lunch - the evening dinner is a social occa= sion - and usually a very good one!

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The o= ther item which you will note on the timetable to have an ‘International’ flavour to it is a workshop on Teenage pregnancy whi= ch SAM have asked me to hold on Saturday = 8th March at 1.45pm. If any colleagues have material which they would like = to include please let me know - I do hope many IRC members will attend that session which should provide lively discussion.

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Society f= or Adolescent Medicine

San Francisco March 5-= 9 1997

<= /span>

‘Institute’ to be held by the International Regional Chapter (IRC)

9am to 5pm= on Wednesday March 5th 1= 997

<= /span>

‘Po= verty and Neglect - Deprived Youth in varied societies’

Description - Deprivation comes in all shape= s and sizes - Those of us working in so called ‘developed’ count= ries can sometimes be oblivious of the degree of deprivation experienced by our Youth. Class differences still exist in terms of perin= atal mortality, birth weights and growth in schoolchildren. Adolescents from differing subcultures within the same city may experience enormous variatio= ns in their socio-economic circumstances .
Pre= sentations will highlight the presence of deprivation in all aspects of youth culture - from street children to poverty in inner city Europe and north America and including the ‘poverty traps’ such as early childbearing and the ‘danger areas’ of child and youth labour and ‘survival sex’.

Objectives -   To heighten awareness of the areas of deprivation and youth poverty, to exchan= ge information on a wide experience of cross cultural issues and to discuss possible interventions available to the adolescent health practitioner.

Format - This inst= itute is suitable for all conference participants whatever their level of experience. The institute will involve didactic component - in terms of the main presentations and interactive periods of discussion where the participants = may be divided into groups addressing a subtheme and reporting back to the group as a whole..

Programme -&nbs= p; “Global trends in Adolescent Hea= lth - From where have we come - where are we going?” Robert Blum ,Minnesota.:    “A culture of poverty?” - Inner city deprivation and teen pregnancy. Diana Birch ,E= ngland.:   “PAHO - Lines of Actio= n to face the challenge of Adolescents in special circumstances” Matilda Maddaleno, Chile:   “Poverty and early childbearing - A Lisbon ghetto” Hel= ena Fonseca, Portugal<= /span>. :   “Deprivation among immigrant Youth” - Manny Chigier = Israel : “Deprivation in Latin America - how are= youth affected? ” Gustavo Girard - Argentina.: “Living on the Streets - Hea= lth aspects of life for street youth in <= span lang=3DEN-GB>Brazil” Irene Adams - Belo Horizonte, Brazil: “Nutritional issues affecting Youth” Semi Snadjerman, Israel : “Attitudes and Practi= ces of Physicians in Isra= el regarding adolescent Medicine” - Daniel Hardof= f - Haifa. :    “Marginalized Youth in British Columbia” includin= g aboriginal and street youth.= Roger Tonkin, Vancouver, Canada. =

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“Pearl of the Orient”=

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Hong Kong i= s known by most as a thriving, vibrant business centre, high rise office buildings,= a plethora of banks, shopping malls, designer clothes outlets and expensive living. The other side of this ‘Pearl of the Orient’ is overcrowded slum areas, drug abuse, crime, teenage prostitution and the general anxiety, insecurity of a culture ‘caught between’. In a few short months Hong Kong will cease to cling to the vestige of the Br= itish culture and will revert to Chinese rule. Many have left fearing communist changes, but the transition has been promised to be gentle and most now seem hopeful for the future. For the more deprived youth of Hong Kong, such political anxiety passes = over their heads.

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Withi= n this tapestry of cultures, two organisations are doing excellent work to support= and nurture young people. The Hong Kong council for social services , and the Queen Elizabeth Hospital in = Kowloon which has a flourishing adolesc= ent unit led by Dr Winnie Tse. Hopefully we will hear more of the unit in the future and we hope that Dr <= span class=3DSpellE>Tse and colleagues may be able to attend our conferen= ce in 1998. The Council for social services visited Youth Support House in 1994 a= nd I paid a return visit there and to the Hospital in September 1996. The follow= ing cases were the basis for some of our discussions - we welcome further comme= nt from readers.=

Ca= se 1

Pr= epared by Wong Yin Yu and Wu Yuk Shan (Chinese YMCA)

=

Clien= t A is a fourteen year old girl. She h= as had sex for the past year with many different boy friends. She claims that she is not a casua= l girl because she only makes love with her boy friend at the time. She only makes love with the ones = she really likes. But, she falls = in love very easily and quickly, even on the first date.

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She h= ad an abortion once. Her mother (a fortune-teller) told her that she would only have one child in her life. After being told this information,= she was even more casual with sex. She did not ask her sex partner to use a condom and changed sex partners frequently. She was also very materialistic. If a boy could provide her with more things she would stay with him longer. Otherwise, she would change partner. She is now living wi= th her boy friend and has sex regularly. She depends on her boy friend to support her.

=

As a = social worker, I have discussed with her her attitude towards sex. I have taught he= r sex education, including details concerning the prevention of pregnancy and sexually transmitted diseases. Actually, she has a good relationship with me. She agreed with my opinion, but sh= e did not practice safer sex. She n= eeds me to share her feelings, but she does not accept my advice. I do not know what I can do next w= ith this case.

Discussion -   This girl is following a pattern of serial mo= nogamy - where she sees herself as not promiscuous because she is only able to perceive the one relationship at a time. When in this relationship she is totally committed and ‘in love’ perceiving = the relationship as her solution to life’s problems and completely in den= ial that she has ever been ‘in love’ with anyone else. Just = as frequently teenage girls see each act of sex as a ‘one off’ and= do not see that they are having sex regularly or frequently - so each sexual encounter can be seen as unique and leaving a girl unable to appreciate the ‘continuum’ of her behaviour. A poorly developed sense of future time perspective plus denial of responsibility for and consequences of her behaviour conspire to maintain a potentially harmful lifestyle.<= /span>

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The d= enial is reinforced by ‘magical protection’ - inherent in the young person’s feelings of invincibility and ‘it could never happen to me’ - but also in this case specifically enhanced by the mother’= ;s fortune telling and prophecy of her daughter having only one child. Hence t= he girl does not see a need for protection either from unwanted pregnancy or f= rom sexually transmitted disease.

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By fa= lling headlong into each new relationship the girl is also demonstrating that she= has low self worth and sees her only value in a sexual relationship. by approac= hing relationships in this way she is also setting herself up to inevitably make relationships with a poor prognosis for stability, little depth and constan= cy - nevertheless she becomes dependant on her men friends and looks to them for material support - a pattern which will ensure disappointment and recurrent= let down. Work needs to be done to help her to become more self reliant and self confident, to build on her self worth and help her to see other sources of = self value rather than merely sexual attraction and sexual conquest.<= /span>

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Picture from newspaper - <= span class=3DGramE>hong k= ong
Ca= se 2

Cl= ient’s Basic Information

The c= lient was a boy of 17 who was studying form 4 at a secondary school. He was living with his father, mot= her and one younger brother who was mentally retarde= d.

Na= ture of the Problem The= client had received counselling services from the school social worker for four years because of his problem related to dating girls. Since primary 6 the client has been dating different girls. He has dated 10 girls up to now and revealed that he has had sex with one or two girlfriends. He admitted that the ‘ongoing’ dating behaviour was due to his fear of loneliness. The client actually wished to main= tain a stable relationship with one girl but he did not know how to do this. As a result, each relationship las= ted only a short time. He describ= ed his relationships with girls as only out of habit and not out of love. =

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Recen= tly, he had a ‘one night stand’ with his former girlfriend. However, he disclosed that his fee= lings were hurt after the relationship. He was further confused with love, sex and affection after this experience.

Se= rvice Rendered Through the interviews with the client,= effort was made to discuss the differences between love, sex and affection. Workers also helped the client to = share and ventilate such feelings as frustration, loneliness and guilt. The Client gradually understood mo= re about his own needs. Emphasis= was put on logical thinking about relationships with the opposite sex so that t= he client might become more rational when he encountered emotional disturbance= s.

Wo= rker’s Assessment=

The Client’s personality is rather emotional. Moreover, his emotion easily fluct= uates by the disturbances created by the unstable love affairs.=

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Howev= er, the client has lost interest in study and other hobbies. He also can not obtain warmth and affection from his family members and peers. Therefore the client had the tende= ncy to compensate for these frustrations by trying to maintain relationships with = the opposite sex.

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Discussion   This boy is unable to disting= uish friendship and warmth in a relationship - with a sexual relationship. In general he is shying away from and seems afraid of closeness and true ‘intimacy’ - which is in effect an emotional matter. He is limiting himself to physical relationships as a def= ence against emotional involvement.

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This ‘splitting’ of emotional / physical was challenged when he brie= fly went back to his first girlfriend - and this could explain his being confus= ed and uncomfortable in that situation.

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It is= likely that his difficulty with closeness and expression of emotion relates to his family of origin where possibly feelings regarding his handicapped brother = were suppressed and not shared within the family circle.

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Ca= se 3

prepared by Tsang Wai Hung

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Clien= t A was referred by his mother. As described by his mother, the client had behaved strangely in recent years.<= span style=3D'mso-spacerun:yes'> He often washed his hands for over= an hour daily. He always thought= that the things in his home were ‘dirty’ and thus he had to wear glo= ves when touching things. Recentl= y, he even used toothpaste to clean his hands rather than using soap. His mother claimed that his washing behaviour had affected his daily functioning such as late for school, and so she was extremely worried about her son’s behaviour.

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Clien= t A described that he had some sex related problem such as masturbation. He had once watched a third-class = film in his home. So, his mother w= as worried that his washing behaviour was connected with his sex related probl= em.

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Discussion - It is important to look at this boy’s problems in perspecti= ve and not to over react to what might be a normal situation. Although this co= uld be the beginning of an obsessional compulsive disorder it might not be and treating it as an ‘illness’ can compound this young man’s problems as her will then see himself as ‘not normal’ - a hint of this is seen in the fact that it is the mother who has made the referral and not the boy. Is he worried himself? How did mother know? It would seem unusual for mother and son to discuss masturbation and maybe the mother is rather overdomina= nt and ‘suffocating’ - certainly this could be explored further. Y= oung people can become anxiety and guilt ridden when experimenting with masturba= tion and it is often difficult for boys to know ‘how much is normal’. Anxiety leading to cleansing rituals and obsessive behaviour can be part of= a transient teenage condition which would be expected to resolve with attenti= on to accurate sex education information and reassurance of normality.

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Ca= se 4

Prepared by Ng Wai Ngan

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Clien= t A is growing up in a single parent family. He is now 14 years old and lives with his mother. In the past six months, he has sai= d he has had frequent masturbation. He even wanted to masturbate during lessons.&= nbsp; This disturbed his daily life. Besides, the targets of his masturbation were his mother and his aunt whom he liked. He did not thi= nk there was any problem. He sai= d he was only masturbating and he did not do any action to abuse or threaten his mother.

Qu= estions: 1. What is the reason behind his behaviour?   2. Do we nee= d to stop his behaviour? 3. If he continues, would he really sexually abuse his mother?

Discussion - It is often difficult to gauge the degree of ‘normalityR= 17; in a given situation. Is this boy going through a normal process of develop= ment part of which involves masturbation - or is he in fact obsessed with masturbatory practices which are worrying him and interfering with his ever= yday life? He reports wanting to masturbate during lessons - but is not actually putting such fantasies into practice. Looking at the situation from a posit= ive perspective - one could say that it might not be surprising that a boy rais= ed in a female household living with mother might fantasise about her sexually. Perhaps this is a relatively innocent and transient masturbatory fantasy in= a boy exploring his developing sexuality.

Howev= er this might also have a much more sinister interpretation - and this became more evident when a female worker interviewing the boy described feeling threate= ned and uncomfortable in his presence. One could be seeing a boy rebelling agai= nst the female dominated household without a positive male role figure - who is exerting his ‘maleness’ in a threatening and dominating manner = by making his mother and aunt the focus of his masturbatory fantasies. It is likely that he could enter relationships with other women also from this attitude of control and dominance and hence might well become involved in violent or sadistic sex. He is likely to be abusive to other women who would then ‘represent’ his mother - but it is unlikely he would abuse= his mother in reality.

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Adolescents’ Perception of their own Health Problems

as surveyed in 1959 and in 1994.

Inge Bo

Stavanger College= , Department of Cultural Studies= and Social Sciences, POB 2557 N-4004 Stavanger= , Norway

=

Presented 4th European Forum on Adolescent Health = Lisbon July 1996.<= /span>

<= /span>

B. Patterns of Relationships.

Staying Together-Single Partners= . The myth of the promiscuous schoolgirl mother= was exploded when it was noted that at the time of conception, over two thirds = of the couples had been together for more than six months and for over two thi= rds of the girls this was their first sexual relationship. Fifteen years later = over a third of the girls (39%) have only ever had one boyfriend. For another 12% the ‘rescuing’ boy who entered their lives at an early stage du= ring pregnancy or in the first months of the baby’s life became an ‘early replacement father’ the only other man on the scene. So = 51% of the girls only had one significant relationship.

Multiple Partners.Nearly half the sample(4= 9%)follow serial monogamy of more than two partners. Girls who ‘bounce’ f= rom one man to another without breaking down have a high level of flexibility w= hich allows them to adapt to diffe= ring domestic arrangements - but a low ability to learn from their experiences - they thus continue to ‘repeat’ their pattern. The parade of parenting partners takes a toll - both on children in terms of instability<= span style=3D'mso-spacerun:yes'> inconstant boundaries and on the m= others experiencing recurrent loss and being left ‘holding the baby’ q= uite literally over and over again. A need to fill a ‘father shaped’ gap in her life coupled with low self esteem means that she is likely to form a relationship with an inadequ= ate man or a boy with problems of his own. He is placed under enormous pressure= to cope with a needy ‘instant family’. He too does not enter the a= rena in a pristine state - nor does he leave the scene unscathed.

Asexual lives. Girls wi= thout Boyfriends. 10% of girls did not ever have a= real relationship with a boy after the birth of their first and only child. They feel let down by society and by the father of their child and do not seek sexual relationships in the future. Some never actually had a boyfriend EVER.

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The Late Relationship - the ‘Adult’ Relationship.   Many mothers who had been through painful periods in their lives made a deliberate change of lifestyle and pa= ssed through a threshold in identifying with their new ‘adult’ selve= s. They had ‘teen’ and= later their ‘adult’ lives.

C. Families

There= are many different family structures. Our society generally has moved away from the = idea of the nuclear family - mother, father and two children as being the only acceptable pattern. Single parent families are much more the ‘norm= 217; than when this study commenced in the early eighties. It has also become mo= re acceptable for couples to live together outside marriage.=

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The family of origin of the teen= age mothers.= They generally came from large = single parent families with an average of five children. Two thirds of their natur= al fathers were absent from the household&nbs= p; and the ‘father figure’ was usually a man who moved in a= nd out of the ‘family’ fathering more children and then going on h= is way. Neither fathers nor stepfathers figured significantly in most girls lives

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Just = under half the girls (45%) got on with their mothers but in half t= he of these cases -a fifth of the whole- the relationship was described as ‘over close’ and suffocating.&= nbsp; The families fell into the main groups of - good relationships with both paren= ts ; absent or weak father and dominant or poor relationship with mother; both parents absent or ineffectual. To a large extent this family pattern was recreated in the next generation.

Baby Fathers - It was noted in the early part of the study t= hat the boyfriends of schoolgirl mothers tended to be of similar background and characteristics - dropping out of school, not often in employment, having= similar family histories of school age pregnancies with regard to their mothers and sisters and had similar needs to become parents.

Despi= te all the negative connotations and difficulties a reasonably high number of the natu= ral fathers of the first born children were still in contact with their offspri= ng at the age of two years. (45%). Past this stage = a number of ‘baby-fathers’ dropped out of the children’s lives with the result that by the time the children were in their teens themselves only 20% of fathers were still in touch with their children. This figure was significantly different for the partners of young mothers who had been in c= are - they were ten times less likely to maintain contact with their children (= 2%).

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Grandmothers often have a very hard time coping with their children and grandchildren. It is also extremely difficult for a child brou= ght up by grandparents who may be too old to do some of the ‘parentalR= 17; task or have fun. Children ar= e also immensely bereaved when grandparents who have been their prime carers eventually die. Children who had been brought up by grandparents were marke= dly deprived in comparison to those brought up by their parents.

D. The Children.

Child Care-Placement of Children= . The majority of children were brought up by t= heir natural mothers and lived with them throughout the time of the survey 80% of the children were with their natural mothers at 5 years and this dropped ve= ry slightly to 78% at 10 years and 75% at 15 years. Splitting the groups into subgroups of girls who have been in care and those who had not, once more t= he care group had a worse prognosis with only 62% continuing to care for their children at 15 years as opposed to 82% of the non care group.

Children’s Views and Lifestyles = The children of school age mothe= rs are like other children of the same age. As teenagers they have similar likes a= nd dislikes and indulge in all the usual teenage activities. In the main they = came across as a confident and healthy group.

School -Forty percent of the boys reported being bull= ied at school -often this was part of a two way process of disruptive behaviour si= nce 70% had behavioural problems relating to violence in school, fighting and disregarding teachers. A quarter had been involved in something illegal.

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The r= ates for girls were lower. 20% had behavioural problems at school and were disruptive in class. 35% were bulli= ed at school 6% had been involved minor crime

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Relationships with Parents - 80% of boys and 95% of girls sai= d they get on with their parents. Ha= lf the boys and 70% of girls said they could talk to Mum about most things and 50%= of boys and two thirds of girls = said they would confide in their mothers if they had problems.

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Pregn= ant schoolgirls often lack a father figure in their lives. Their sons seem grea= tly affected by lack of a father within the household. It is the boys who appea= r to be reaching out to a paternal figure, miss their fathers and get involved in early sexual liaisons possibly in an attempt to identify with the father figure. This axis of father/teenage son has previously been ignored in the study of causes of early pregnancies. A significant factor in pregnancy prevention is the psychological and emotional status of the boy.=

Sex Education.= 50% of boys and= 75% of girls had knowledge of sex education, 10% of boys and 50% of girls learned = this from their mothers-a significant improvement on the previous generation.

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Sexual Activity. Boys were more = sexually active than the girls some started as early as 11. Most used condoms but 15% boys had unprotected sex.

Conclusions.

The i= nfluence of the care system is pernicious and young mothers who have been in care do worse than those who have not over a number of different dimensions. They h= ave more children, they have more relationships, their relationships are less stable and more of their children end up in care themselves ...But is this = an influence of the care system alone - does being a young Mum who has been in care differ from being an older Mum who happens to have been in care? If you are a family on low income, you are more likely to have a daughter who is pregnant young. If you are in an area of social deprivation you are more li= kely to have a schoolgirl who is pregnant. Schoolgirl pregnancy is very much a ‘culture of poverty’ (“School-girl Pregnancy - a Culture = of Poverty”)⁵ and traps deprived g= irls in a cycle of derivation.

̶= 0;The repercussions of teenage childbearing are long lasting: young parents acqui= re less education than&nb= sp; contemporaries ; they are more often limited to less prestigi= ous jobs and the women, to more dead end ones. ..” (Card and Wise 78)6.    “adolescent mothers consistently experienced great difficulty in realising their life plans when compared to = their classmates who did not become pregnant pre-maritally in their early teens..” (Furstenberg 76)<= sup>7. If you are in care you are more likely to get pregnant early -in our sample= 22% of the pregnant girls had been in care at a time when less than 2% of the c= hild population of the area was in care. The important message is that if famili= es are supported and the effect of social deprivation and poverty is minimised, then not only will the rate of ‘premature’ early mother-hood diminish - but those mothers who do start their families early will be able= to raise their families happily and well.

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There= is a group of girls who wish to become pregnant at an early age, are ready for i= t, are mature emotionally and physically and if it were not for the stigmatisi= ng of our society and the lack of support they would have every chance of succ= ess. Others are immature, they neither desire motherhood nor feel able to cope <= span class=3DGramE>with the= birth of their children, they may pass the child over to the care of others. Between these two extremes we have= a whole spectrum of girls who though not actively and consciously seeking pregnan= cy, nevertheless are happy to be mothe= rs and make some emotional or existential gain by virtue of their ‘mothering’ status. Most important in this context is the gain in self esteem and a sens= e of ‘purpose’ in life. Even on the other side of the Atlantic, wher= e the general view is perhaps more pessimistic than ours, there are encouraging comments - “Some adolescent parents do overcome the handicaps imposed= by adolescent childbearing; they complete their educations, get jobs, avoid welfare dependency” (Furstenberg and Craw= ford 1978)⁸

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Most = studies from the USA show that children of teenage mothers do badly in comparison to their peers. (East and Felice= 90)⁹ “The children of teenage mothers are distinctly worse off throughout = childhood than<= /span> the offspring of older childbearers.”(Furstenberg, Brooks-Gunn and Chase-Lansdale 89)¹⁰. In Britain the same factors ope= rate to an extent but are highly dependant on the social status of the young mot= hers rather than her age per se.

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Child= ren can bear a heavy burden when they are expected to fulfil the role of ‘lit= tle parent’to their child mothers. These children f= ill a need in their parents, provide love, fulfilment and self worth. Perhaps in = some ways this is a valid role? These children are valued, wanted and loved in return. What more could a child want? The male first born children seem to = fare worse. Daughters take the rol= e of sisters and at least have a mother as a role model and confidante - somethi= ng the young mothers wish they had themselves. Sons have no role model, do not know quite how to relate to their mother= s who they often end up ‘fathering’. Single mothers can lack the knowledge and resources to appreciate and provide for their developing sons needs.   These very first= born sons are more prone to early sexual acting out and their numbers swell the ranks of the less supportive and less stable teenage fathers for the next generation.

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Famil= ies certainly play an important role. Girls tend to recreate their family of origin. Those with good supportive families fare better. Those with no families do worse. There= are casualties and surprise successes in all life styles. Being a young parent = is not the end of your life and dreams -it need not be a life of toil and hard= ship -sadly for some unfortunate families it can be-but given adequate support y= oung parents can do remarkably well. Perhaps it is time to stop condemning young families and instead try= to help them. To look for the positive attributes of young parents and work on them rather than spell doom and gloom with negative statistics. Young mothe= rs have the potential to succeed in all walks of life - if we give them the ch= ance to do so.

Letter= from the Editor	2=	&= nbsp;	“= ;The Adolescent parent - a fifteen year longitudinal study of school age mothers and their children” Diana Birc= h	17 &= nbsp;
Twelft= h Forum Meeting - Self Harming Behaviour and eating disorder. &= nbsp;	3=	&= nbsp;	&= nbsp; The Ch= ild that Rocks the Cradle’	&= nbsp; 19
Intern= ational Chapter News	4=	&= nbsp;	News i= n collage	26 &= nbsp;
IRC SA= M 1997 - ‘Poverty and Neglect - deprived youth in varied societies’ &= nbsp;	5=	&= nbsp;	Youth = Support Professional Training - Seminar Programme 1997	27 &= nbsp;
Youth = Support Appeal	6= &= nbsp;	&= nbsp;	Procee= dings conference 1996	27
‘= ;Pearl of the Orient-Adolescent Care in HongKong	7=	&= nbsp;	Adoles= cent Health - conference 1998	28 &= nbsp;
Adoles= cents Perception of their own Health Problems as surveyed in 1959 and 1994 - Inge Bo	12 &= nbsp;	&= nbsp;	&= nbsp;	&= nbsp; &= nbsp;