Search PubMed⌕ Search

Biomedical subjects

M E Felice

Publications and source records attributed to M E Felice.

34 records · Page 2Linked to original sources

Psychosocial aspects of Mexican-American, white, and black teenage pregnancy.

This study assesses whether pregnant Mexican-American adolescents have psychosocial characteristics different from their pregnant white or black peers. The study population consisted of 199 consecutive Mexican-American, white, and black pregnant adolescents, ages 11-19 years, followed prospectively at the University of California San Diego Medical Center Teen Obstetric Clinic from 1978 to 1981 (79 whites, 76 Mexican-Americans, and 44 blacks). Although all three groups had the same chronologic age (X = 16.4 +/- 1.4 years), and the same number of years of schooling, pregnant black adolescents were more likely to be in school at the time of registration for prenatal care (p less than 0.01). Mexican-American teens were more likely to be married at conception and/or delivery (p less than 0.001), and to breastfeed their infants (p less than 0.05). The fathers of the Mexican-American babies were more likely than other fathers to be full-time students or employed (p less than 0.001). Although pregnant Mexican-American teens came from the largest families (p less than 0.001), black teenagers most frequently reported a good mother-daughter relationship (p less than 0.05). White pregnant teens most frequently reported a family history of psychiatric illness (p less than 0.01), parental death (p less than 0.05), or runaway behavior (p less than 0.01). These data suggest that pregnant teenagers from these three racial/ethnic backgrounds have different psychosocial profiles and hence different psychosocial problems and needs.

Adolescent↗

Physical growth and development: current concepts.

The process we call puberty is complex and still poorly understood. Some of the hormonal effects have been discussed, but much work remains before the specific mechanisms are defined. Genetic and nutritional influences affect puberty and further complicate the study of this population. Knowledge of the developmental sequence and SMR scale is useful in clinical practice. Understanding the changes that an adolescent is experiencing will help in the early diagnosis of abnormalities in growth and development. This knowledge will also serve as a guide in providing useful anticipatory guidance.

Adolescent↗

Health care needs of Indochinese refugee teenagers.

Although 50% of Indochinese refugees are under 18 years of age, previous studies have emphasized the prevalence of parasites, anemia, tuberculosis, and hepatitis, with few addressing age-related health care needs. In this study the specific health care needs of 80 Indochinese refugee teenagers, evaluated during a 4-year period, were determined. The Centers for Disease Control's suggested screening measures were used, and it was found that 52% had positive purified protein derivative skin tests, 38% lacked immunizations, 35% had stool specimens positive for parasites (prevalence and number of parasites greatest among Cambodians), 14% had blood tests positive for hepatitis B surface antigen, and 10% were anemic. Additional evaluations showed that 19% had hemoglobinopathies, 14% were in or below the fifth percentile for height and weight, 12% had goiters, 12% had skin disorders, 8% had positive hepatitis B surface antigen, 5% had visual defects, 5% had hearing loss, 5% had psychosomatic illness, and 4% had idiopathic scoliosis. Although suggested Centers for Disease Control screening measures may be adequate for younger Indochinese children, these data suggest that additional studies are necessary for teenagers. For the sexually active adolescent, identification of and counseling for hepatitis antigenemia and hemoglobinopathies are crucial. In addition, early identification of emotional and physical problems during screening may enhance assimilation into a new society and facilitate completion of the psychosocial tasks of adolescence.

Adolescent↗

Clinical observations of Mexican-American, Caucasian, and black pregnant teenagers.

Few data are available on the prenatal health problems and postnatal outcomes of Mexican-American pregnant teenagers. Our study population consisted of 199 consecutive Caucasian, Mexican-American, or Black pregnant adolescents, ages 11-19 years, followed prospectively at the University of California San Diego Medical Center Teen Obstetric Clinic from 1978 to 1981. The patients included 79 Caucasians, 76 Mexican-Americans, and 44 Blacks. Mexican-American adolescents were shorter, less likely to be cigarette smokers, and delivered heavier babies than their non-Hispanic peers. More than 50% of the teenagers in all three groups gained more than the recommended upper limit of 12 kg during the pregnancy, but excessive gain was most pronounced in the Mexican-American group. Black pregnant adolescents were more likely to be anemic and had a higher frequency of goiter. It is recommended that data concerning Hispanic mothers and infants be analyzed separately from data of Caucasian and Black adolescents to more accurately define their pregnancy problems.

Adolescent↗

Goiter in pregnant teenagers.

Enlargement of the thyroid gland is common in adolescent girls, but there have been no previous reports of the frequency of goiter in pregnant teenagers. This study was undertaken to determine the prevalence of goiter in 309 consecutive pregnant adolescent patients, ages 11 to 19 years, who presented for prenatal care at the University of California (San Diego) Medical Center Teen OB Clinic. Eighteen patients (6%) were found to have a goiter. Subsequent diagnostic tests revealed that 28% of the patients had autoimmune thyroid disorders (chronic thyroiditis or Graves' disease), and the remainder had nontoxic goiters or subacute thyroiditis. Black patients had significantly more thyroid disease than Mexican-American (p less than 0.01) or white patients (p less than 0.005). The incidence of thyroid problems during pregnancy did not differ significantly from that of 600 nonpregnant teenagers who came to the general Adolescent Medicine Clinic for other health problems. Because abnormalities in thyroid function may have potentially adverse implications for mothers and their infants, we recommend careful evaluation of all pregnant teenagers with goiter to assess maternal thyroid function and to provide treatment if necessary.

Adolescent↗

Rubella seronegativity in a low socioeconomic adolescent female population.

Ninety low socioeconomic adolescent females (aged 16-22 years, means 18.6 years) were screened for rubella immunity using a rubella IgG enzyme immunoassay. Data concerning past immunizations (with documentation, if possible), prior rubella disease, and previous pregnancies were gathered through direct interviews. Results revealed 20 percent (18/90 girls) were seronegative. Fifty-eight percent (42/72) of the seropositive girls and 50 percent (9/18) of the seronegative girls gave verbal reports of previous rubella immunization, but only 11 subjects (12.2%) could provide documentation of previous vaccination, including one seronegative subject. Thirty-one percent (28/90) of the study population had a history of one or more previous pregnancies (22 therapeutic abortions, 10 live births, and 8 spontaneous abortions). A comparison of the seronegativity rate between the 28 girls who were pregnant previously and the 62 girls who were never pregnant demonstrated a significantly higher seronegativity rate among those who had been pregnant (29% vs. 16%; chi 2 = 5.51; p less than 0.05). The results of this study suggest that the seronegativity rate in this age group is consistent with previous reports of rubella immunity, few adolescents can provide documentation of rubella vaccination, and presentation for abortion is an optimal time to vaccinate rubella susceptible females.

Adolescent↗

Subcultural differences in alcohol use among youth.

A specifically designed anonymous questionnaire concerning the use of alcoholic beverages was given to all young people in residence at the San Diego Job Corps Center. Corpsmembers (n = 335), age 16-22 years (mean 18.7 years) completed the questionnaire. There were 67 Caucasians, 65 Blacks, 111 Hispanics, 69 Indochinese, and 23 others. Eighty-five percent of the corpsmembers reported drinking alcohol 1-5 times weekly during the previous six months, and 14% reported average weekend binges of more than 20 drinks. Sixty percent of the adolescent drinkers reported medical, legal, or vocational problems as a result of their drinking. Some striking differences were noted in the drinking habits of the four major subcultural groups represented: 1) Caucasian males began serious drinking at an earlier age than Black, Hispanic or Indochinese youth; 2) more Hispanic youth than others used multiple drugs in addition to marijuana, which was commonly used by all adolescent drinkers; and 3) recently immigrated Indochinese youth indicated that they had turned to alcohol as a means of forgetting past experiences.

Adolescent↗

Evaluation of a residency training program in behavioral pediatrics.

The impact of behavioral training upon first-year residents was evaluated by assessing attitudes with regard to 15 clinical "entities," including behavioral disorders, physical disorders, and "mixed" disorders. Each entity was rated at four times: beginning of the year, start of the behavioral rotation, end of the rotation, and end of the year. Multiple-choice questions were also included to assess knowledge regarding behavioral pediatrics. Data were collected from 37 residents, from 1977 to 1980. For behavioral disorders and mixed disorders, residents' self-reported competence increased with regard to diagnosis, management, advising parents, and knowledge of resources. Further, the greatest change occurred during the 2-month rotation. In contrast, change in perceived competence for physical disorders was not specific to the rotation but, rather, increased evenly over the year. Ratings of faculty and housestaff interest remained constant across testing points, and residents' "desire to learn more" and prediction of "future relevance" showed a slight decrease over time, for all disorders. Knowledge regarding behavioral pediatrics increased significantly from the beginning of the year to the start of the rotation, and also during the rotation. These data demonstrate that changes in residents' perceived competence are directly related to their rotation experience, and suggest that behavioral issues can be introduced successfully during the first year of residency training.

Attitude of Health Personnel↗

Teaching behavioral pediatrics and to pediatric residents: the state o the art and description of a program.

In 1978, the Task Force on Pediatric Education strongly recommended that all pediatric residency programs include at least one full-time rotation and biosocial pediatric, preferably in the 1st or 2nd year. Since 1977, the University of Maryland has had a structured, integrated, required program in Behavioral Pediatrics, including 2 months in both the PL-1 and PL-2 years for a total of 4 months addition of elective experience is available in the PL-3 year. The development and description of this program is presented as well as a review to the relevant literature.

Behavioral Medicine↗

The young pregnant teenager. Impact of comprehensive prenatal care.

Pregnant teenagers under the age of 15 years are known to be at highest risk for delivering low-birth-weight infants, particularly poor black girls. Sixty-seven inner-city pregnant adolescent girls 15 years or less at the time of delivery were followed in a special Teen Obstetric Clinic staffed by an interdisciplinary team trained in adolescent and prenatal health care. Ninety-three percent of the clinic population was black. The fetal outcomes of these girls were compared with the fetal outcomes of 67 girls who attended the regular obstetric clinic. Girls were matched for age at delivery, race, socioeconomic status, and parity. Only 9.0% of the infants of the teenagers in the Teen Obstetric Clinic group weighed less than 2500 g, compared with 20.9% of the infants of the girls in the regular Obstetric Clinic group. This finding has implications for the type of prenatal care provided to young adolescents.

Adolescent↗

Observations related to chronologic and gynecologic age in pregnant adolescents.

A low chronologic age (less than or equal to 15 years) and low gynecologic age (less than or equal to 2 years) have been considered factors that increase medical complications among adolescent pregnant women. Gynecologic age (GA) is defined in this study as age in years at conception minus age at menarche. Two hundred twelve consecutive pregnant teenagers were followed prospectively in the Teen OB Clinic at the University of California, San Diego Medical Center, between August 1978 and July 1981. The clinic population consisted of 37.3 percent Whites, 35.8 percent Hispanics, 20.8 percent Blacks, and 6.1 percent other (mostly Indochinese). Sixty-eight percent of the patients were funded by MediCal. The patient population was divided by chronological age (CA) at conception into those 15 years or less or 16 years or older. A low chronological age was found to be a significant risk factor for premature rupture of membranes. Teenagers with a low gynecologic age (less than or equal to 2) had a lower mean pre-pregnancy weight and body mass index (Kg/M2) than teenagers with a higher gynecologic age. In this study, we did not find that a low CA or GA was correlated with a higher frequency of pregnancy-induced hypertension, prenatal medical problems, obstetrical problems at labor or delivery, or an excessive number of low-birthweight infants.

Adolescent↗

When children have children: the teen pregnancy predicament.

Despite developments in contraceptive technology and changes in societal norms, adolescent pregnancy remains a key issue for politicians, social scientists, health care providers, and educators. The adolescent's access to contraception and abortion services continues to spark legal debate. The implications of research call for the development of innovative programs to address larger issues, such as poverty and limited access to health care, in the management and prevention of adolescent pregnancies. Clinical interventions, such as school-linked clinics to provide contraception and prenatal care programs to reduce perinatal morbidity, have varied in their approaches and their subsequent success.

Abortion, Induced↗