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Biomedical subjects

A Joffe

Publications and source records attributed to A Joffe.

At least 55 records · Page 3Linked to original sources

Cigarette, alcohol, and other drug use by school-age pregnant adolescents: prevalence, detection, and associated risk factors.

Use of cigarettes, alcohol, and other drugs among pregnant adolescents is just beginning to be documented. This study sought to determine the prevalence and associated risk factors of cigarette, alcohol, and other drug use among school-age adolescents attending a comprehensive teenage pregnancy program. All enrollees completed a self-administered questionnaire and provided a breath sample for carbon monoxide analysis. Urine was obtained for quantitative determination of drug metabolites at the initial and one third-trimester visit. A chart review determined medical provider recognition of cigarette, alcohol, and other drug use. Results were analyzed for 93% of 229 eligible patients. Seventeen percent were positive for alcohol or other drug use by questionnaire self-report, provider report, or initial urine screen. Eleven percent were positive by urine screen alone at either the initial or third-trimester visit. Medical providers were successful in identifying nearly all of the cigarette smokers, but fewer than half of the alcohol drinkers and few of the other drug users. Forward stepwise multiple regression determined the most efficient model for predicting alcohol and other drug use. A report of having been high at school and personal or friends' use of cigarettes were the most significant risk factors. Results indicate a high prevalence of alcohol and other drug use and suggest a need for changes in current practice related to the detection and management of such drug use in pregnant adolescents.

Adolescent↗

Hepatic vein thrombosis in a teenager: a case report.

Hepatic vein thrombosis or the Budd-Chiari syndrome is an uncommon condition which rarely occurs in teenagers. The condition involves obstruction of blood flow from the liver with progressive congestion and hepatic failure. The etiology is often idiopathic but may involve conditions that increase thrombogenic tendencies. Oral contraceptives are known to increase the risk of a number of thrombotic conditions and have been associated with the Budd-Chiari syndrome. Although millions of teenagers have used oral contraceptives without incident, occasionally we are reminded of their potential serious complications. The case of a 19-year-old who developed hepatic vein thrombosis while using oral contraceptives is presented.

Adult↗

Barrier versus oral contraceptive use: a study of female college students.

Although they provide birth control and are easier to use, oral contraceptives (OCPs) are not the preferred approach to preventing sexually transmitted disease (STD). Do the knowledge, attitudes, and experiences of oral contraceptive users place them at greater risk for STDs than those who employ barrier methods? This study examined differences between sexually active female college students (ie, those who reported ever having had vaginal intercourse) who used OCPs and those who employed barrier methods of contraception at the time of their most recent intercourse. The authors analyzed HIV- and other STD-related knowledge, attitudes, and behaviors from three consecutive annual health surveys of young women about to begin their first year of college. Findings showed barrier and OCP users to be comparable in knowledge about the effectiveness of various contraceptive methods in protecting them against STDs, perceived personal susceptibility to HIV, and experiences with alcohol before sexual intercourse. Oral contraceptive users, compared with those in the group who used barrier methods, reported a greater number of recent partners (p less than .03) and greater perceived vulnerability to STDs (p less than .03). Student healthcare providers must develop creative educational strategies to encourage simultaneous use of both oral contraceptives and barrier methods to protect students against STDs and pregnancy.

Adolescent↗

Measuring depressive mood in elderly Israeli: reliability and validity of the Depression Adjective Check Lists.

To establish the psychometric properties of the state form of the Depression Adjective Check List (DACL) with elderly Israeli, a 1981 Hebrew version of the DACL by Lomranz, Lubin, Eyal, and Medini, along with the Zung Self-rating Depression Scale and Cantril's Self-anchoring Striving Scale, were administered to 86 independently functioning elderly persons (35 men and 51 women) living in a home for the aged. Reliability estimates (alphas and test-retest) were moderate to high; validity estimates (concurrent and construct) were again moderate to high. It was concluded that the state form of the Depression Adjective Check List is suitable for use with elderly Israeli.

Aged↗

Health counseling of adolescents.

Health counseling is a fundamental aspect of health care for adolescents and is a natural extension of the concept of anticipatory guidance. It is a dynamic process involving active participation by adolescents. Pediatricians are a valued source of health-relevant information, but must also recognize how their attitudes and beliefs can affect the counseling process. Knowledge of the multitude of changes occurring during adolescence and an understanding of the role of health-risking behaviors in meeting various developmental needs are critical to successful counseling. Particular attention must be focused on ways to help adolescents develop the skills necessary to maintain health-promoting lifestyles and to resist peer pressure to engage in health-risking behaviors.

Adolescent↗

Rehospitalization of infants born to adolescent mothers.

This study defines the variables that predict rehospitalization of infants born to teen mothers. Rehospitalization was defined as hospital admission during the first year of life subsequent to hospitalization at birth. Normal birth weight (NBW), but not low birth weight (LBW), infants of adolescent mothers had higher rehospitalization rates than infants of older mothers. NBW infants of young vs. older mothers had significantly higher rehospitalization rates for gastroenteritis. Among infants of adolescent mothers, the variables associated with increased risk of rehospitalization were unemployed household head, presence of a congenital anomaly or developmental delay, and an unusually high or low number of well child care visits. Although individual variables were significant at the bivariate level, in combination, these variables were poor predictors of which infants would be rehospitalized. Our study suggests that all teen mothers of NBW infants may require additional education to prevent excess rehospitalization of their infants.

Adolescent↗

Understanding adolescent mothers' feelings about breast-feeding. A study of perceived benefits and barriers.

This study was designed to assess the benefits and barriers accruing to breast-feeding as perceived by pregnant adolescents, and to establish whether these perceptions distinguished between adolescent mothers who chose to breast versus bottle feed. Surveys were completed by 254 young women attending prenatal clinics. Overall, 19.3% indicated their intent to breast-feed. When categorized by intended method of infant feeding (breast versus bottle), breast-feeding mothers cited more benefits and fewer barriers associated with that method of infant feeding. Overall, perceived benefits were more successful than perceived barriers in distinguishing between the groups of respondents. For those interested in promoting breast-feeding among adolescent mothers, our data support an emphasis on the diverse benefits of this method of infant feeding. Our results also suggest the usefulness of peer role models in correcting misinformation and encouraging breast-feeding among adolescent mothers.

Adolescent↗

Health counseling for adolescents: what they want, what they get, and who gives it.

To determine the extent of health counseling received by college freshmen from their primary health care providers, 362 students answered questions regarding 15 health topics. Internists provided more counseling than pediatricians and family/general practitioners about smoking and alcohol use, more than pediatricians about drug use and heart disease prevention, and more than family/general practitioners about weight control and nutrition. Pediatricians exceeded family/general practitioners in counseling about weight control and nutrition but did not exceed internists in any areas. For 11 of 15 topics, more than 75% of students reported receiving no counseling. Women were counseled for stress and contraception more frequently than men. Overall, topics most often discussed by physicians were exercise, nutrition, and breast self-examination. The topics most frequently requested by students were exercise, stress (women), depression, weight control (women) and sexually transmitted diseases (men). These data suggest that adolescents receive little health counseling from personal physicians, especially regarding topics leading to great morbidity and mortality for this age group. Pediatricians, especially, must increase the extent of counseling if they are to meet the American Academy of Pediatrics' goal of providing care to adolescents and young adults.

Adolescent↗

Hematologic changes during sexual maturation. Why do black adolescents have low hemoglobin concentrations?

A group of black adolescents stratified by age and sexual maturity (Tanner stage) had electronic blood counts determined. Hemoglobin, hematocrit, and red cell count were lower than the means reported for white or Hispanic children of the same age. The difference could not be explained by iron deficiency, but the data were insufficient to exclude alpha thalassemia as a cause.

Adolescent↗

Breast versus bottle: correlates of adolescent mothers' infant-feeding practices.

Since the 1970s, breast-feeding as the preferred method of infant feeding has increased in overall popularity. However, certain populations, particularly poor, young, black, and less-educated women, have been slow to adopt this method. This prospective study was undertaken to identify factors relating to the choice of infant-feeding method among inner-city adolescents. Two hundred fifty-four pregnant adolescents completed a questionnaire supplying information regarding attitudes toward and knowledge about breast-feeding, social support, personal experience, and other variables hypothesized to correlate with their choice of infant-feeding method. Of the total sample, 17% said they were "probably" or "definitely" going to breast-feed their babies. Analyses revealed adolescents most likely to intend to breast-feed were those who perceived more benefits to breast-feeding, who desired more knowledge about it, who were themselves breast-fed, who reported supportive social environments, and who perceived relatively fewer barriers to breast-feeding their infants. Specific interventions based upon these findings are proposed. We conclude that adolescent mothers are interested in breast-feeding their babies and that interventions are feasible to increase breast-feeding within this population.

Adolescent↗

The kin number problem in a multitype Galton-Watson population.

"The kin number problem in its simplest form is that of the relationship between sibship sizes and offspring numbers.... Further studies have been made, concerning relatives of other degrees of affinity than siblings, but these did not usually yield joint distributions. Recently this aspect of the problem has been studied in the framework of a Galton-Watson process.... In these studies the population is treated as monotype. Applications such as pedigree studies of diseases require a multitype approach (in the example, two types: victims and others). In this paper such a study is undertaken." Problems and questions involved in this type of approach are discussed, and joint distributions are obtained under a number of sampling schemes.

Demography↗