Adolescents' decision-making and attitudes towards abortion in north-east Brazil

Three groups of adolescents are compared with regard to their own considerations of abortion and when they believe abortion is justified. One group of adolescents terminated their pregnancies (n=95), a second became pregnant and carried their pregnancies to term but considered abortion (n=68), and the third also carried their pregnancies to term but did not consider abortion (n=204). The study was carried out between 1995 and 1998 in Fortaleza, Brazil. Adolescents were interviewed at the time of their hospitalization or their first prenatal visit and again at 6 weeks and 1 year post-abortion or postpartum. Friends and family recommended abortion to at least half of the teenagers in each group. Teenagers who aborted were more accepting of abortion than those who did not abort, while those who considered abortion found the practice more justified than those who did not consider abortion. Teenagers who aborted became less accepting a year later, while those who did not consider abortion became more accepting. A better understanding of adolescent attitudes towards abortion and their decision-making process should help adults and professionals meet the needs of adolescents for support in the process and in the reduction of the number of unintended pregnancies in the future.     

美容整形受术者心理评估与术后满意度的相关性研究

目的:探讨女性美容整形受术者的心理状态及与术后满意度的相关性,为临床工作提供科学的理论依据,以减少不必要的医疗纠纷.方法:采用临床90项症状问卷(SCL-90),艾森克人格问卷(EPQ)和美容整形术后满意度问卷(CSPPOSR)对145例受术者进行调查分析.被调查者分为满意组和不满意组,比较两组中各指标的差异性及对术后满意度的相关性.结果:满意组和不满意组在躯体化、偏执及精神质等方面存在统计学差异(p＜0.05).躯体化、偏执两因子的标准得分与满意度总分之间呈负相关(r=-0.527～-0.207).精神质因子得分与满意度总分之间呈负相关(r=-0.352).结论:不满意组具有躯体化、偏执及精神质的心理状态和人格特征.并且情绪不稳定、身体不适、有强迫思维及行为、易猜疑的受术者术后易出现不满意结果.     

Reconstructive surgery with a dermal regeneration template: clinical and histologic study.

Integra artificial skin was introduced in 1981 and its use in acute surgical management of burns is well established, but Integra has also been used in patients undergoing reconstructive surgery. Over a period of 25 months, the authors used Integra to cover 30 anatomic sites in 20 consecutive patients requiring reconstructive surgery and then analyzed the clinical and histologic outcomes. The most common reason for surgery was release of contracture followed by resurfacing of tight or painful scars. The authors assessed patients' satisfaction using a visual analog scale and scar appearance using a modified Vancouver Burn Index Scale. They evaluated the progress of wound healing by examining weekly punch-biopsy specimens with standard and immunohistochemical stains. Patients reported a 72 percent increase in range of movement, a 62 percent improvement in softness, and a 59 percent improvement in appearance compared with their preoperative states. Pruritus and dryness were the main complaints, and neither was improved much. Four distinct phases of dermal regeneration could be demonstrated histologically: imbibition, fibroblast migration, neovascularization, and remodeling and maturation. Full vascularization of the neodermis occurred at 4 weeks. The color of the wound reflected the state of neodermal vascularization. No adnexa, nerve endings, or elastic fibers were seen in any of the specimens. The new collagen was histologically indistinguishable from normal dermal collagen. The authors conclude that Integra is a useful tool in reconstructive surgery. The additional cost of its use can be justified by its distinct benefits compared with current methodology.     

Perceived functional impact of abnormal facial appearance

Functional facial deformities are usually described as those that impair respiration, eating, hearing, or speech. Yet facial scars and cutaneous deformities have a significant negative effect on social functionality that has been poorly documented in the scientific literature. Insurance companies are declining payments for reconstructive surgical procedures for facial deformities caused by congenital disabilities and after cancer or trauma operations that do not affect mechanical facial activity. The purpose of this study was to establish a large, sample-based evaluation of the perceived social functioning, interpersonal characteristics, and employability indices for a range of facial appearances (normal and abnormal). Adult volunteer evaluators (n = 210) provided their subjective perceptions based on facial physical appearance, and an analysis of the consequences of facial deformity on parameters of preferential treatment was performed. A two-group comparative research design rated the differences among 10 examples of digitally altered facial photographs of actual patients among various age and ethnic groups with "normal" and "abnormal" congenital deformities or posttrauma scars. Photographs of adult patients with observable congenital and posttraumatic deformities (abnormal) were digitally retouched to eliminate the stigmatic defects (normal). The normal and abnormal photographs of identical patients were evaluated by the large sample study group on nine parameters of social functioning, such as honesty, employability, attractiveness, and effectiveness, using a visual analogue rating scale. Patients with abnormal facial characteristics were rated as significantly less honest (p = 0.007), less employable (p = 0.001), less trustworthy (p = 0.01), less optimistic (p = 0.001), less effective (p = 0.02), less capable (p = 0.002), less intelligent (p = 0.03), less popular (p = 0.001), and less attractive (p = 0.001) than were the same patients with normal facial appearances. Facial deformity caused by trauma, congenital disabilities, and postsurgical sequelae present with significant adverse functional consequences. Facial deformities have a significant negative effect on perceptions of social functionality, including employability, honesty, and trustworthiness. Adverse perceptions of patients with facial deformities occur regardless of sex, educational level, and age of evaluator.     

A prospective analysis of patients undergoing silicone breast implant explantation

Despite the lack of a scientifically proven link between silicone implants and disease, many women have chosen to have their implants removed out of concern for their health. Unfortunately, there are few studies in the literature that have investigated the outcome of explanations, and there are no prospective analyses of the effect explantation has on a patient's general health. The goal of this study was to use a prospective database to determine whether there were any preoperative parameters that could be used to predict which patients would be improved following removal of silicone breast implants and to provide a quantifiable measure of that improvement. A total of 38 patients with silicone breast implants underwent operative removal of their breast implants by faculty at the University of Texas Southwestern Medical Center. They were given questionnaires regarding several personal and medical parameters to be completed preoperatively, at 6 weeks postoperatively, and at 6 months postoperatively. In addition, their physicians completed preoperative and postoperative evaluations of the patient's general health status. A control group of 38 patients was established; they were matched with the experimental group with regard to age and other initial parameters. Their responses to questionnaires were then grouped according to standard subscales to evaluate physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role, mental health, appearance evaluation, appearance orientation, illness orientation, and body area satisfaction. When compared with the control group, we found that patients who had undergone explantation showed a temporary decrease in musculoskeletal symptoms and bodily pain, as well as an increase in vitality, mental health, and body area satisfaction. Of the experimental group, those who initially indicated a higher number of musculoskeletal symptoms and a higher appearance evaluation were more likely to indicate a significant improvement in general health since explantation.     

TRAM flap versus nonautologous breast reconstruction: what do patients really think?

Although there have been many reports of aesthetic outcomes after breast reconstruction, there have been comparatively few studies examining patient satisfaction and related subjective issues. The variables affecting satisfaction are only beginning to be understood, and patient satisfaction issues were explored in a more homogeneous patient population. A questionnaire surveying overall and aesthetic satisfaction, postoperative recuperation time, and symptoms was used to elicit candid patient responses. Fifty-seven patients replied (86 percent response rate), of whom 38 had undergone transverse rectus abdominis musculocutaneous (TRAM) flap (pedicled, n = 29; free, n = 9) reconstruction and 19 had undergone nonautologous reconstruction. Although the median patient satisfaction score was higher for the TRAM flap group, this was not statistically significant (p = 0.92). Recuperation was significantly longer for the TRAM flap group, with only 47 percent of patients being able to resume full activities within 2 months after the surgical procedure, compared with 95 percent of the implant group (p = 0.002). Of the TRAM flap-treated patients, 50 percent described some postoperative abdominal weakness, but only 5 percent of all TRAM flap-treated patients said that abdominal weakness was actually a functional problem. Our results suggest that patients may derive equal satisfaction with the two methods of reconstruction. The postoperative recuperation time after TRAM flap reconstruction is significantly longer than that after nonautologous procedures, although the postoperative abdominal weakness after TRAM flap reconstruction is not as significant a clinical problem as previously thought. The patient-derived information on satisfaction should assist both surgeons and patients in matching reconstructive options with patients' expectations and lifestyle.     

Surgical correction of facial asymmetry]

It is not possible to group the facial asymmetries in one single nosological entity. However, whatever the origin of these malformations, their surgical treatment is governed by the same principles. In this article, the author attempts to define certain aetiologies:genetic, congenital and developmental, of the minor assymmetries of the face. He then reviews the different techniques in current use, in plastic and reconstructive surgery:autogenic or homogenic tissue grafts (bone, cartilage, derm, fascia, etc.), implants of plastic material, osteotomies. He stresses the use of simple techniques which cause little mutilation, as well as the simultaneous correction of the profile which greatly enhances the aesthetic appearance and the psychological well-being of these patients.     

Effects of Voluntary Alcohol Intake on Risk Preference and Behavioral Flexibility during Rat Adolescence

Alcohol use is common in adolescence, with a large portion of intake occurring during episodes of binging. This pattern of alcohol consumption coincides with a critical period for neurocognitive development and may impact decision-making and reward processing. Prior studies have demonstrated alterations in adult decision-making following adolescent usage, but it remains to be seen if these alterations exist in adolescence, or are latent until adulthood. Here, using a translational model of voluntary binge alcohol consumption in adolescents, we assess the impact of alcohol intake on risk preference and behavioral flexibility during adolescence. During adolescence (postnatal day 30–50), rats were given 1-hour access to either a 10% alcohol gelatin mixture (EtOH) or a calorie equivalent gelatin (Control) at the onset of the dark cycle. EtOH consuming rats were classified as either High or Low consumers based on intake levels. Adolescent rats underwent behavioral testing once a day, with one group performing a risk preference task, and a second group performing a reversal-learning task during the 20-day period of gelatin access. EtOH-High rats showed increases in risk preference compared to Control rats, but not EtOH-Low animals. However, adolescent rats did a poor job of matching their behavior to optimize outcomes, suggesting that adolescents may adopt a response bias. In addition, adolescent ethanol exposure did not affect the animals'' ability to flexibly adapt behavior to changing reward contingencies during reversal learning. These data support the view that adolescent alcohol consumption can have short-term detrimental effects on risk-taking when examined during adolescence, which does not seem to be attributable to an inability to flexibly encode reward contingencies on behavioral responses.     

Female college students and cosmetic surgery: an investigation of experiences, attitudes, and body image

This large, multisite study investigated female college students' experiences with and attitudes about cosmetic surgery. The study also assessed the relationship between several aspects of body image, including appearance satisfaction and investment and symptoms of body dysmorphic disorder, and interest in cosmetic surgery. Thirty (5 percent) of the 559 women surveyed reported that they had undergone cosmetic surgery. Two thirds of respondents reported knowing someone who had received cosmetic surgery, and approximately one third indicated that a family member had undergone surgery. Overall, participants held relatively favorable attitudes about surgery. Regression analysis suggested that a greater psychological investment in physical appearance and greater internalization of mass media images of beauty predicted more favorable attitudes toward cosmetic surgery. Fourteen women (2.5 percent) screened positive for body dysmorphic disorder based on the nature and severity of their self-reported body-image concerns. Results of this study provide new information on young women's experiences and attitudes about cosmetic surgery and how these attitudes relate to body image.     

Safety and efficacy of office-based surgery with monitored anesthesia care/sedation in 4778 consecutive plastic surgery procedures

Office-based surgery has several potential benefits over hospital-based surgery, including cost containment, ease of scheduling, and convenience to both patients and surgeons. Scrutiny of office-based surgery by regulators and state-licensing agencies has increased and must be addressed by improved documentation of safety and efficacy. To evaluate the safety and efficacy of the authors' office-based plastic surgery, a review was undertaken of 3615 consecutive patients undergoing 4778 outpatient plastic surgery procedures under monitored anesthesia care/sedation in a single office. The charts of 3615 consecutive patients who had undergone office-based surgery with monitored anesthesia care/sedation between May of 1995 and May of 2000 were reviewed. In all cases, the anesthesia protocol used included sedation with midazolam, propofol, and a narcotic administered by a board-certified registered nurse anesthetist with local anesthesia provided by the surgeon. Charts were reviewed for patient profile, types of procedures, multiple procedures, duration of anesthesia, American Society of Anesthesiologists class, and complications related to anesthesia. Outcomes measured included death, airway compromise, dyspnea, hypotension, venous thrombosis, pulmonary emboli, protracted nausea and vomiting lasting more than 24 hours, and unplanned hospital admissions. Statistical analyses were performed using the Microsoft Excel program and the SAS package. Results were as follows: 92.3 percent of the patients were female and 7.7 percent were male, with a mean age of 42.7 years (range, 3 to 83 years). Patients underwent aesthetic (95.6 percent) and reconstructive (4.4 percent) plastic surgery procedures. Same-session multiple procedures occurred in 24.8 percent of patients. The vast majority of patients were healthy: 84.3 percent of patients were American Society of Anesthesiologists class I, 15.6 percent were class II, and 0.1 percent were class III. The operations required a mean of 111 minutes. There were no deaths, ventilator requirements, deep venous thromboses, or pulmonary emboli. Complications were as follows: 0.05 percent (n = 2) of patients had dyspnea that resolved, 0.2 percent (n = 6) of patients had protracted nausea and vomiting, and 0.05 percent (n = 2) of patients had unplanned hospital admissions (<24 hours). One patient had an emergent intubation. No prolonged adverse effects were noted. There was a 30-day follow-up minimum. Outpatient surgery is an important aspect of plastic surgery. It was shown that office-based surgery with intravenous sedation, performed by board-certified plastic surgeons and nurse anesthetists, is safe. Appropriate accreditation, safe anesthesia protocols, and proper patient selection constitute the basis for safe and efficacious office-based outpatient plastic surgery.     

Right ventricular collagen and fibronectin levels in patients with pulmonary atresia and ventricular septal defect

Pulmonary atresia (PA) with ventricular septal defect (VSD) is an extreme form of tetralogy of Fallot with characteristic right ventricular hypertrophy. To reduce the right ventricular overload, these children have to undergo staged corrective surgery to restore physiological pulmonary perfusion. We studied the degree of fibrosis by analysing the myocardial expression pattern (at mRNA and protein level) of the extracellular matrix proteins, collagen and fibronectin in biopsies taken at corrective surgery from 14 patients affected by PA,VSD. Expression analysis by RT-PCR showed significantly higher levels for collagen III (p = 0.03), whereas collagen I (p = 0.31) and fibronectin (p = 0.47) mRNA levels remained unaltered in PA, VSD patients as compared to age matched controls. Video image analysis of immunohistochemical staining showed unchanged interstitial levels for total collagen (p = 0.17) as well as for fibronectin (p = 0.13) in the patients with PA, VSD. However, peri-vascular staining for collagen (p < 0.01) and fibronectin (p = 0.02) represented as the peri-vascular stained area corrected for the vessel lumen area showed significantly decreased levels in the PA,VSD group as compared to controls. Our results indicate that the patients with PA, VSD have inadequate extracellular matrix support for their coronary blood vessels and perhaps due to an altered biosynthesis of collagen and fibronectin network.     

The economics of plastic surgery practices: trends in income, procedure mix, and volume

Anecdotally, plastic surgeons have complained of working harder for the same or less income in recent years. They also complain of falling fees for reconstructive surgery and increasing competition for cosmetic surgery. This study examined these notions using the best available data. To gain a better understanding of the current plastic surgery market, plastic surgeon incomes, fees, volume, and relative mix of cosmetic and reconstructive surgery were analyzed between the years 1992 and 2002. To gain a broader perspective, plastic surgeon income trends were then compared with those of other medical specialties and of nonmedical professions. The data show that in real dollars, plastic surgeon incomes have remained essentially steady in recent years, despite plastic surgeons increasing their surgery load by an average of 41 percent over the past 10 years. The overall income trend is similar to that of members of other medical specialties and other nonmedical professionals. The average practice percentage of cosmetic surgery was calculated and found to have increased from 27 percent in 1992 to 58 percent in 2002. This most likely can be explained by the findings that real dollar fees collected for cosmetic surgery have decreased very slightly, whereas those for reconstructive procedures have experienced sharp declines. This study demonstrates that plastic surgeons have adjusted their practice profiles in recent years. They have increased their case loads and shifted their practices toward cosmetic surgery, most likely with the goal of maintaining their incomes. The strategy appears to have been successful in the short term. However, with increasing competition and falling prices for cosmetic surgery, it may represent a temporary bulwark for plastic surgeon incomes unless other steps are taken.     

Reduced atrial connexin43 expression after pediatric heart surgery

Myocardial dysfunction and arrhythmias may be induced by congenital heart defects, but also be the result of heart surgery with cardiopulmonary bypass (CPB), potentially caused by differential expression of connexin40 (Cx40) and connexin43 (Cx43). In 16 pediatric patients undergoing corrective heart surgery, connexin mRNA expression was studied in volume overloaded (VO group, n=8) and not overloaded (NO group, n=8) right atrial myocardium, excised before and after CPB. Additionally, in eight of these patients ventricular specimens were investigated. The atrial Cx43 expression decreased during CPB, which was restricted to the VO group (p=0.008). In contrast, atrial Cx40 mRNA did not change during CPB. In ventricular myocardium compared to atrial mRNA levels, Cx40 was lower (p=0.006) and Cx43 higher (p=0.017) expressed, without significant change during CPB. This study revealed a significant influence of CPB and the underlying heart defect on Cx43 expression.     

Short-term psychological outcomes in severely obese adolescents after bariatric surgery

Bariatric surgery is suggested as a treatment option for severely obese adolescents. Because adolescence is characterized by intense psychosocial adjustment and development, it is important to study the effect of this procedure on adolescents' psychological health. This study examined baseline status and short-term changes in anxiety, depression, anger, disruptive behavior, and self-concept in 37 adolescents (mean age 16.6 ± 1.3). Participants completed the Beck Youth Inventories (BYI) at inclusion and (on average) 4 months after undergoing Roux-en-Y gastric bypass (RYGB). Internalizing (anxiety and depression) and externalizing (anger and disruptive behavior) symptoms were higher at baseline than gender-specific norms. One fifth had a very low self-concept. Four months after surgery, the adolescents showed significantly fewer symptoms of anxiety and depression and significantly improved self-concept from baseline. Anger and disruptive behavior showed no significant changes. An analysis of clinically meaningful changes was conducted, and besides the overall positive outcome, 16% (n = 6) of the adolescents had deteriorated on two or more inventories in BYI shortly after surgery. This impaired group did not show any specific features at inclusion. The results indicate the importance of psychological monitoring immediately after bariatric surgery and the need for additional psychosocial support to be available for vulnerable sub-groups of adolescents. Further studies with larger samples are necessary to identify characteristics predictive of short-term adverse psychological outcomes in adolescents after bariatric surgery.     

Computer-designed prostheses for orbitocranial reconstruction

Three-dimensional imaging is an adjunct to preoperative evaluation and surgical management in some patients with complex anatomic defects of various etiologies. Deformities defined by conventional computerized tomography can be viewed as accurate three-dimensional images calculated from the original scan. The images are viewed on a high-resolution video monitor and can be photographed for a permanent record. A computer-controlled milling device can use these data to fabricate prostheses. The prostheses aid reconstructive surgery through use as an alloplastic implant, as a template to fashion autogenous bone grafts, or as a model for tissue removal. We have utilized three-dimensional imaging in combination with computer-assisted prosthesis manufacture in six patients with complex orbitocranial deformities. Four patients have undergone reconstructive surgery with satisfactory results and no complications thus far. The use of computer-designed prostheses adds a new aspect to orbitocranial reconstructive surgery that facilitates increased accuracy in the correction of anatomic defects.     

The psychological contribution of nipple addition in breast reconstruction

Two groups of consecutive patients from two different plastic surgical practice populations were evaluated to determine psychosocial differences between those who underwent nipple-areola reconstruction in addition to breast reconstruction (N = 33) versus those who did not undergo nipple-areola reconstruction in addition to breast reconstruction (N = 26). Psychological assessment consisted of a standardized symptom inventory (Brief Symptom Inventory) and a specially designed self-report questionnaire investigating reactions unique to surgeries for breast cancer and breast reconstruction. Both groups were equivalent sociodemographically, with the exception of age, where the nipple-added group was significantly younger (P = 0.035) than the nipple-not-added group. The nipple-added group reported significantly greater satisfaction with breast reconstruction with regard to overall satisfaction (P = 0.004), satisfaction with size (P = 0.02), satisfaction with softness (P = 0.0004), sexual sensitivity (P = 0.006), and satisfaction with nude appearance (P = 0.02). Of the nine scales of clinical symptomatology on the Brief Symptom Inventory, the nipple-added group showed more increased symptoms on seven of the nine. The nipple-added group was significantly higher on two of these scales, namely, paranoid ideation (P = 0.009) and anxiety (P = 0.03).     

Long-term outcome of cleft lip nasal reconstruction in childhood

This study documents the pattern of unilateral cleft lip nasal reconstruction in the practice of one surgeon at a tertiary cleft center, evaluating the long-term appearance outcome of single-operation unilateral cleft lip nasal reconstruction in childhood. A retrospective medical record review was performed for all patients with a diagnosis of unilateral cleft lip and age greater than 15 years. Operative notes were reviewed, recording 15 variables identifying specific rhinoplastic maneuvers. Nasal appearance outcome analysis was performed for all patients who underwent only one nasal surgery before 12 years of age (n = 19). Standard frontal whole face photographic images were presented as opposing pairs in a looseleaf binder to two panels, 1 of 10 lay persons and 1 of 10 plastic surgeons. Each pair consisted of photographs of the same patient at different ages in one of three combinations: preoperative-perioperative, perioperative-longest postoperative, or preoperative-longest postoperative. Participants were asked to compare the appearance of the noses in the two photographs and assign a rating based on a 5-point Likert scale. Statistical analyses were performed on the data collected in the aesthetic analysis. The effect of surgery upon nasal appearance was assessed by comparing the preoperative and perioperative photographs. The effect of growth was assessed by comparing the perioperative and long-term postoperative photographs. The combined effect of surgery and growth was assessed by comparing the preoperative and long-term postoperative photographs. The data were assessed by lay and professional evaluators, together and separately, to determine whether differences existed. The majority of patients did not undergo revisional nasal surgery, whereas those who did usually had one nasal operation. Most revisional nasal surgery was performed in conjunction with other cleft-related secondary surgery. A majority of lay and professional evaluators perceived revisional nasal surgery as improving nasal appearance in the short-term and to a lesser degree in the long-term, as compared with the preoperative state. Evaluations of revisional nasal surgery are generally constant between the short-term and long-term postoperative images. Lay evaluations may be contaminated by a general decline in attractiveness with aging. Patient preference should be a major factor in the decision for nasal revision surgery. Multiple means of assessing nasal appearance outcome need to be used to validate results. Nasal appearance outcomes need to be correlated with outcomes with respect to nasal morphology and function as well as patient and parent satisfaction.     

Hypoglossia-hypodactyly syndrome: report of 2 patients

Hypoglossia-hypodactyly syndrome: report of 2 patients: Two newborns with severe limb deformities and hypoglossia, with micro- and retrognathia are reported. The first patient had a transverse agenesia just below the knee of both legs and below the elbow of both arms. A Krukenberg phalangisation was performed and rehabilitation of march with prosthetics at an early age. The second child had less severe deformities and needed no corrective surgery till now.     

Psychosocial correlates of immediate versus delayed reconstruction of the breast

Two groups of consecutive patients from two different plastic surgical practice populations were evaluated to determine psychosocial differences between those who underwent immediate (n = 25) versus delayed (n = 38) breast reconstruction. Psychological assessment consisted of a standardized symptom inventory (BSI) and a specially designed self-report questionnaire investigating reactions unique to mastectomy and reconstruction. Both groups were extremely equivalent with regard to sociodemographic data, with the typical subject being a well-educated and employed Caucasian wife. Verbal reports of physical complaints revealed no significant differences between the two groups except for difficulty with arm movement, which was statistically higher for the immediate group (p = 0.006.). This difference most likely was due to the axillary dissection being performed simultaneously at the time of reconstruction. The relationship between timing of reconstruction and self-reported distress over the mastectomy experience revealed that only 25 percent of the women who underwent immediate repair reported "high distress" in recalling their mastectomy surgery compared with 60 percent of the delayed reconstruction group (p = 0.02). In reference to the two scales measuring psychological symptoms, a general trend was present, with the delayed group scoring higher (although not statistically significantly) on 9 of our 12 scales. Ninety-six percent of the immediate group and 89 percent of the delayed group reported satisfaction with results.(ABSTRACT TRUNCATED AT 250 WORDS)     

A cross-cultural study of adolescents--BMI, body image and psychological well-being

Physical, psychological and social changes that occur during adolescence can markedly affect dietary habits and nutritional health. Physical changes including rapid growth place extra nutritional requirements on adolescents, while culture and society require adjustments in all of the aspects of daily living, including psychosocial well-being. Adolescents become focused on the physical appearance and any deviation from the ideal figure can result in negative dieting behavior, social withdrawal, poor self-esteem and increased health vulnerability. The paper presents some of the results of an international comparative study on risk and protective factors of adolescent health and well being, related to BMI, dieting behavior and body image and their relationship to psychosocial well-being (somatic stress, anxiety, depression, life satisfaction and self-esteem). Within an ecological cultural framework, it looks at group-specific differences of Albanian and Bosnian adolescents within different socio-cultural contexts across six European countries: two EU members (Italy and Austria) and four communities in the state of socioeconomic and political transition (Croatia, Bosnia and Herzegovina, Albania and Kosovo). The survey collected data from 2000 adolescents between 15 and 18 years of age. The study demonstrated a strong relationship between BMI and body dissatisfaction, between body image and dietary habits, and strong effects of body image on all indicators of psychosocial health. In addition to expected marked gender differences in all countries, the obtained results indicate significant intracultural variations related to socioeconomic status as well as considerable intercultural variations due to variable influence specific social and cultural contexts.