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Biomedical subjects

L V Klerman

Publications and source records attributed to L V Klerman.

At least 37 records · Page 2Linked to original sources
PubMed1993

Adolescent pregnancy and parenting: controversies of the past and lessons for the future.

Recent research findings suggest that old ways of looking at adolescent sexuality, pregnancy, and parenting should be revised and that new approaches to service programs should be developed. This paper presents some new facts by examining the validity of nine beliefs about adolescent pregnancy: that nothing can reduce the rate of adolescent pregnancy; that pregnant adolescents experience poor pregnancy outcomes; that adolescent mothers do not complete their high school education; that pregnant adolescents have large families; that adolescent mothers remain on welfare for long periods; that pregnancy in adolescence is a mistake and, given a chance to overcome the immediate problems associated with it, young mothers can go on to lead normal lives; that welfare causes adolescent pregnancy and parenting; that adolescent mothers are poor parents; and that service programs can have a significant impact on adolescent pregnancy and parenting. Although programs aimed at the prevention and amelioration of the problems experienced by pregnant adolescents, young mothers, and their children and families have shown some success, relatively few are sufficiently powerful to bring about major changes--and even these are infrequently replicated because of high costs. Further progress in this area depends not only on new and expanded programs, but also on attacking the problem of poverty, which is an underlying cause of early sexual activity and childbearing.

Adolescent↗
PubMed1991

The effect of source of prenatal care on care-seeking behavior and pregnancy outcomes among adolescents.

This study measured the extent to which pregnancy outcomes of adolescents are related to the environment of the prenatal clinic where they receive care. The study sample consisted of women aged 18 years and under living in a medium-sized urban city in the Northeast, and who delivered their babies during 1984 or 1985 (N = 466). Hypotheses were tested using multiple regression analysis. Findings support the study's hypotheses: adolescents are likely to obtain more adequate care if the prenatal site is attractive and inviting, and if special efforts are made to register and retain them in care, and adequate care results in better outcomes.

Adolescent↗
PubMed1991

School-age mothers: predictors of long-term educational and economic outcomes.

The long-term effects of school-age pregnancy were investigated in a 20-year follow-up of a cohort of women who were pregnant adolescents in the late 1960s. Of the 149 living young black primiparas in the original cohort, 121 (81%) were located and interviewed. At follow-up the study population ranged in age from 32 to 38 years, 68% were unmarried, 71% had finished high school, 82% were completely self-supporting, and 27% reported living in public housing. Long-term success, defined as currently employed or supported by a spouse and a high school education (62%) or its equivalent, was associated with six features: having completed more school prior to becoming pregnant (odds ratio [OR] = 18; 95% confidence interval [CI] 2.3, 139.5); participating more actively in a program intervention offered to these pregnant teenagers 20 years ago (OR = 11.11; 95% CI 1.54, 79.87); being in school with no subsequent pregnancy at 26 months postpartum (OR = 10.1; 95% CI 1.64, 62.07); feeling in control of one's life (OR = 5.4; 95% CI 1.36, 21.54) and little social isolation (OR = 8.24; 95% CI 1.56, 43.50) at 26 months postpartum; and lifetime fertility control defined as one or two children after the index child (OR = 14.19; 95% CI 3.28, 61.29). It is concluded that most former teenage mothers complete a reasonable amount of education and are economically self-sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

School absence--a health perspective.

Excessive school absence may result in difficulty in completing academic work, being retained in grade, or dropping out of school prior to high school graduation. Frequent or prolonged absence may be an indication that a student has a serious physical or emotional health problem, that he or she is engaged in problem behaviors with potentially serious health and social consequences, that other family members have physical or psychological problems, or that the student is reacting to an unfavorable school environment.

Absenteeism↗
PubMed1988

School-based clinics: their role in helping students meet the 1990 objectives.

Service statistics and observations from site visits across the country indicate that school-based clinics (SBCs) may be having an impact on several of the problems targeted in the 1990 health objectives, including unplanned pregnancy and substance abuse. At least 120 junior and senior high schools in 61 communities are currently operating or developing clinics. Growth is attributed to increasing concern about high-risk youth, especially among educators in their roles of "surrogate parents"; to disillusion with categorical interventions and a movement toward more comprehensive services; and to student, parent, school, and community approval of the new programs. This article describes the comprehensive school-based clinic model, including its history, organizational strategies, school/community partnerships, and services.

Adolescent↗
PubMed1987

Why adolescents do not attend school. The views of students and parents.

Despite the magnitude and importance of the problem, little is known about why many students are absent from school. This study assessed what a sample of excessively absent students and their parents believed were the reasons for the students' absences. In response to an open-ended question about their main reason for absence, almost half of the students reported a health-related reason. When asked whether any of 15 potential problems contributed to their absence, many reported common and acute physical illnesses, headaches or stomachaches, and other aches or pains. Half mentioned factors relating to low motivation or a concern about the school environment. The parents' responses were remarkably similar except they were more likely to cite emotional problems of the student, school violence, and racial problems. When individual student's responses were compared with those of his or her parents, agreement on individual items were little better than would be expected by chance.

Absenteeism↗
PubMed1986

Parental consent for abortion: impact of the Massachusetts law.

This study assessed the impact of Massachusetts' parental consent law, which requires unmarried women under age 18 to obtain parental or judicial consent before having an abortion. Data were analyzed on monthly totals of abortions and births to Massachusetts minors prior to and following the April 1981 implementation of the law. Findings indicate that half as many minors obtained abortions in the state during the 20 months after the law went into effect as had done so previously. More than 1,800 minors residing in Massachusetts traveled to five surrounding states during these 20 months to avoid the statute's mandates. This group accounts for the reduction in in-state abortions. A small number of minors (50 to 100) bore children rather than aborting during 1982, perhaps because of the law. Findings suggest that this state's parental consent law had little effect on adolescent's pregnancy-resolution behavior.

Abortion, Legal↗
PubMed1986

High-risk youth and health: the case of excessive school absence.

Excessive school absence is a major educational and social problem in the United States, yet very little is known about its etiology or how to prevent or ameliorate it. This paper reports results from a series of related studies conducted in seven Boston middle schools (grades 6, 7, and 8) to test the hypotheses that health problems and unmet health needs are major characteristics distinguishing excessively absent students from regular attenders and that a health-oriented approach using medically mediated interventions is effective in reducing absences among excessively absent students. There were no significant differences between regular attenders and excessively absent students on multiple measures of student and family health status, health habits, and health service utilization patterns in a case-control study. The intervention program was not associated with a significant decrease in absence school-wide or for participating students. We conclude that demographic and educational characteristics of students exert a greater effect on their behavior in regard to absence from school than do health status or receipt of health services and that a health-oriented approach, such as the one used here, will not have a major impact on what remains one of the most profound educational and social problems involving children in the United States today.

Absenteeism↗
PubMed1986

Factors associated with excessive school absence.

Excessive school absence is a major educational and social problem in the United States which is most pronounced in urban school systems. A case control study of excessively absent inner-city middle-school students and regular attenders failed to demonstrate any differences between groups in terms of health status, health-related behaviors, or utilization of health services. These results contrast dramatically with the findings of a previous study which identified a number of educational and demographic characteristics which clearly distinguish excessively absent students from regular attenders. It is concluded that educational and demographic factors are far more important in influencing excessive absence behavior than are health-related factors. The implications of these findings for the pediatrician are discussed.

Absenteeism↗
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↗
PubMed1980

Changes in life style following mental hospitalization.

The life situations of discharged mental hospital patients were examined by comparing living arrangements, employment, financial support, and role functioning before and after hospitalization for a sample of patients released from three state mental hospitals. Results indicate significant negative change for both males and females. These negative consequences seemed to be most often due to loss of employment and the accompanying decrease in financial support. Three possible explanations for the findings are discussed:a)effects of the hospitalization;b)effects of the psychiatric illness; or c) prior role socialization and competence.

Adolescent↗
PubMed1979

Evaluating service programs for school-age parents: design problems.

In response to increasing societal concern about school-age pregnancy, many communities have developed special medical, educational, and counseling service programs for pregnant girls and young parents. A small number of these programs have attempted to evaluate their accomplishments. Unfortunately, most of the reports suffer from methodological weaknesses. Such studies could be improved by use of properly selected control groups, improved analytic procedures, and specification of realistic program goals. To date, the range of evaluative methods has been narrow and most studies have been of largely minority populations. The reports indicate some success in the medical and short-range educational areas; but limited accomplishments in terms of long-term continuation of education, avoidance or delay of subsequent pregnancies, and achievement of economic independence. Suggestions are provided for improving both study design and program effectiveness.

Adolescent↗