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Biomedical subjects

J J Alpert

Publications and source records attributed to J J Alpert.

At least 55 records · Page 3Linked to original sources
PubMed1982

School absence: a problem for the pediatrician.

Children who are frequently or persistently absent from school tend to perform poorly in school and are likely to drop out before graduation from high school. Excessive school absence was significant implications in terms of maladaptive behavior, wasted opportunities, and future unemployment and welfare costs. Epidemiologic information about this problem suggests that physical and mental health problems of students or their families are the sole or contributing cause of this behavior in more than 50% of cases. Excessive school absence may signal such health problems as poor coping with or management of chronic illness, masked depression, teenage pregnancy, substance abuse, inappropriate responses to minor illnesses, or severe family dysfunction. School absence patterns appear to be a readily available, easy-to-use marker of childhood dysfunction which lends itself to screening large numbers of children for unmet health needs. Attention to this area of child behavior as part of routine health care will frequently uncover previously unrecognized health problems in children and their families.

Absenteeism↗
PubMed1981

Residency training in community pediatrics.

A required PL-3 rotation in community pediatrics, including assignments to preschool and school settings, private pediatric offices, and in-hospital responsibilities, is described. A university-affiliated community hospital provides the organizational base for the program. After 14 PL-3 rotations, analysis of program content, as well as resident and community response, shows the experience to be a practical and workable model for incorporating community pediatrics into residency training.

Boston↗
PubMed1981

Maternal alcohol consumption and newborn assessment: methodology of the Boston City Hospital prospective study.

This paper describes the methods of the Maternal Health and Child Development of Project at the Boston City Hospital which explored the impact of maternal drinking prior to and during pregnancy on fetal development. Between February 1977 and October 1979, of 3222 women who delivered single infants, 1690 were interviewed in hospital after delivery and their babies examined by a pediatrician who was unaware of the interview results. The 1690 mother-infant pairs of whom both interview and exam are available did not systematically differ from the 272 for whom the interview only or 824 for whom the exam only was conducted. Interviews were also collected prenatally in the Boston City Hospital's Women's Clinic, from 470 women whose infants were examined. Maternal and infant characteristics are described. Heavy drinkers were much more likely to smoke cigarettes and to have used psychoactive drugs than lighter drinkers. Heavy drinkers also differed from non-heavy drinkers on several other factors which may influence fetal development.

Adolescent↗
PubMed1980

Care-seeking patterns of families using a municipal hospital emergency room.

Families bringing children to the pediatric walk-in clinic at Boston City Hospital were interviewed randomly over a 15-week period. Families were classified as having a stable or unstable relationship with either a hospital or a neighborhood health center (NHC) from their answers to a structured questionnaire. Little change was found in the proportion of unstable users of health facilities from a similar study conducted in 1964, suggesting that the introduction of the NHCs and Medicaid, which increased the availability and accessibility of health services for the urban poor, has no effect on patterns of multiple utilization of health providers. The major variables affecting a family's utilization pattern are hypothesized to be the level of satisfaction toward the primary care facility, as expressed by the family, and the perceived ability of different health care facilities to deal with a particular health situation.

Attitude to Health↗
PubMed1979

A study of attitudes and support systems of inner city adolescent mothers.

Because the simultaneous demands of adolescence and motherhood could result in special infant rearing attitudes and concerns, a prospective pilot study of inner city adolescent mothers was undertaken. A sample of primiparous adolescent mothers was compared with primiparous and multiparous nonadolescent mothers. Data were collected by home interviews at two weeks and three months postpartum. The major hypothesis, that the simultaneous occurrence of adolescence and motherhood would result in special infant rearing attitudes, concerns, and support systems which interfered with mothering, was not fully supported by our findings. Few of the adolescent mothers were married (8%) but of those not married, most (95%) lived in an extended family. Adolescent mothers, when compared with older mothers, were more likely to seek medical advice from their mothers as opposed to health professionals and were more insecure in their maternal self-image if caretaking was shared. Attitudinal differences around feeding were seen, but attitudes about spoiling, perception of the baby's behavior, discipline, caretaking, and enjoyment were the same among groups. Adolescent mothers and their infants provide physicians and other child health professional with a special pediatric family. The differences in available support systems and maternal self-image suggest areas for further investigation.

Adaptation, Psychological↗
PubMed1979

The effect of a course in family medicine on future career choice: a long-range follow-up of a controlled experiment in medical education.

The career choices and professional behavior of three cohorts of students who participated in a family medicine program were studied by mail questionnaire. Cohort I (1957--1960), as part of an educational experiment, had been randomly assigned to the course; unselected classmates were used as controls. Cohort II (1961--1965) and Cohort III (1966--1970) were volunteers; alphabetically adjacent classmates were used as a comparison group. The results suggest that the impact of a given medical school course on future behavior must be evaluated in the context of general medical school orientation and societal trends extraneous to the school itself.

Boston↗
PubMed1976

Delivery of health care for children: report of an experiment.

This paper summarizes an experiment evaluating the effectiveness of primary pediatric care delivered to a sample of low-income inner-city families. Primary pediatric care in this study was similar to pediatric group practice. The study findings indicated that the effects of primary care compared with the episodic care received by the control families were appreciable. This included the decreasing of hospitalizations, operations, illness visits, and appointment breaking; increasing of health supervision visits, preventive services, and patient satisfactions; and accomplishing these changes at a lower cost. Patient morbidity was not altered. Medicaid made no difference in the care patterns of the experimental families and apparently benefited only those control families who were white. The controlled clinical trial offers the best opportunity to compare different models of priervices for children.

Attitude to Health↗