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Sources of prescription contraceptives and subsequent pregnancy among young women.

For more than four in 10 teenage women who first obtained a prescription contraceptive from a private doctor or family planning clinic prior to pregnancy, marriage or interview in 1979, that method was the first they had ever used. Whites were over two times more likely to have previously used a nonprescription method than were blacks. Blacks, on the other hand, were two times more likely than whites to have been virgins before first using a prescription method. Slightly more than half of all young women who used a prescription method first obtained it from a family planning clinic, and the remainder got it from a private physician. Blacks were much more likely to have gone to a clinic than were whites. Nine in 10 of those who obtained a prescription method chose the pill. Among blacks, there was no appreciable difference between those who got the method from a clinic and those whose source was a private doctor. Whites who obtained their method from a private doctor, however, were somewhat more likely to choose the pill than were those who got it from a clinic. Of all who had been sexually active before ever using a prescription method, about eight out of 10 whites, but only about five in 10 blacks, had previously used a nonprescription method. Overall, there was an interval of about one year between first intercourse and the time the young women first got a prescription method. Among whites, there was no difference in parental education or family stability between clinic and private physician patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Factors influencing duration of breast feeding among low-income women.

Forty low-income breast feeding primiparous women were interviewed to determine whether family member and peer attitudes toward breast feeding and available postpartum support were associated with continued or early termination of breast feeding. Mean breast feeding duration equalled 20.5 weeks (range, 1 to 52 weeks). When an outside source of assistance (a doula) was available during the first 2 weeks postpartum, mean duration was 23.4 weeks compared with 12.3 weeks when a doula was unavailable (p less than .05). Breast feeding duration was independent of the doula's attitude regarding breast feeding. Duration of breast feeding was significantly longer for breast feeding women who participated in the USDA Special Supplemental Program for Women, Infants, and Children (WIC) than for those who did not participate. All of the women claimed to like breast feeding; 93% of the husbands or boyfriends, 83% of the women's mothers, and 81% of the women's best friends had positive attitudes toward breast feeding. The more breast feeding friends the woman had, the longer she breast fed (r = .32, p less than .05). Termination of breast feeding was not due to perceived negative attitudes of family members and peers regarding breast feeding.

Adolescent↗

Preferred sources of AIDS information, risk perceptions, and risk behaviors among inner-city community college students.

To understand preferred sources of acquired immunodeficiency syndrome (AIDS) information and level of worry about human immunodeficiency virus (HIV) among community college students, a survey of 102 students in an inner-city community college was conducted. The survey requested information on preferred sources of information about AIDS, risk behaviors, and level of worry about HIV infection compared with other life risks. Forty-six per cent of respondents had engaged in risk behaviors for AIDS. Of those who were sexually active, 81% acknowledged not always using a condom. Students noted that they were more likely to believe AIDS information from a health professional than from a friend, relative, teacher, clergy, or celebrity. Overall, getting AIDS ranked third on a list of life worries, ranking only behind getting bad grades and the death of a family member. For students who identified themselves as black or Latino, however, getting AIDS ranked first on a list of life risks. For those students who reported highrisk behavior for getting HIV, getting AIDS also ranked first on a list of life worries. We conclude that those students at whom messages about risk status have been targeted are most likely to report being more worried about getting AIDS than about other adverse life events. It remains unclear, however, whether heightened levels of worry about HIV actually translate into changes in risk behavior.

Acquired Immunodeficiency Syndrome↗

Absence of effect of depression on cognitive performance in early-stage Alzheimer disease.

BACKGROUND: Depression can interfere with the normal expression of cognitive abilities in adults of all ages, but it is unclear if depression in demented people, which is common, is associated with reduced cognitive performance beyond the effect of the dementia itself. OBJECTIVE: To determine if depression adds to the cognitive deficit in dementia. DESIGN: Performance on psychometric tests of memory and other cognitive function was correlated with the number of depressive features reported by the individual and by a knowledgeable collateral source, as well as the judgment of a research clinician as to whether the person was depressed. SETTING: An Alzheimer disease research center. PARTICIPANTS: The convenience sample included individuals with very mild (Clinical Dementia Rating, 0.5; n = 167 [mean age, 76.03 years]) or mild (Clinical Dementia Rating, 1; n = 155 [mean age, 78.41 years]) Alzheimer disease who were enrolled in ongoing longitudinal studies at the center. MAIN OUTCOME MEASURES: Psychometric measures of memory and cognition. RESULTS: Depression was present in 15% of the very mild and 24% of the mild dementia groups. There was no relation between the clinicians' diagnoses of depression and psychometric scores. Little relation was found between performance on the cognitive tests and the number of depressive features (maximum, 9) reported by the individual or collateral source. The few statistically significant (P<.05) correlations were modest (< or =0.21). CONCLUSION: Depression does not worsen cognitive test performance beyond the effect of dementia.

Aged↗

Some characteristics of tribal peoples.

The study of health and disease in distinctive human groups is an important source of knowledge, and ultimately of understanding. Tribal societies are at the polar extreme from modernized communities. However, with the breakdown of isolation this distinctiveness is being eroded, slowly for genes, more rapidly for ideas and behaviour, and fastest for infective agents of disease. Though comtemporary tribal men cannot be equated with prehistoric men, they resemble them more than do modernized men. Therefore the study of tribal peoples not only widens the range of circumstances in which human adaptability is observed, it throws some light on the evolution of human diseases. This is particularly the case with regard to the study of 'diseases of modern life'. Tribal life is characterized by comparative physical and cultural isolation, simplicity, small group size, low population density and closeness to nature, both physically and conceptually. In spite of rapid change, which itself needs study, there are still situations where what is studied has shown little recent change. In a world where dissatisfaction with life and medicine grows in spite of unparalleled technical success, we should look again at tribal men. There is much to learn from each other's successes and failures.

Animals↗

Addressing human variability in risk assessment--the robustness of the intraspecies uncertainty factor.

Addressing human variability and sensitive subpopulations is one of the challenges of risk assessment and is an important aspect of the Food Quality Protection Act, the law passed in 1996 that regulates food use pesticides in the United States. The intraspecies uncertainty factor is intended to address differences in susceptibility within the human population. This paper examines the history and scientific basis for the intraspecies uncertainty factor. Our best source of knowledge about human variability in the response to chemicals comes from clinical trials of pharmaceuticals. This large body of data allows both qualitative and quantitative characterization of variability in pharmacokinetic and pharmacodynamic parameters in the general population and in subgroups such as children. The preponderance of evidence in the areas of pharmacodynamics and pharmacokinetics supports the routine use of an intraspecies uncertainty factor in the range of 1-10 as being protective of greater than 99% of the human population. The intraspecies uncertainty factor is highly protective of various subpopulations, including infants and children.

Animals↗

Social and behavioral factors associated with high-risk sexual behavior among adolescents.

Relationships among risky sexual behaviors, other problem behaviors, and the family and peer context were examined for two samples of adolescents. Many adolescents reported behaviors (e.g., promiscuity or nonuse of condoms) which risked HIV or other sexually transmitted disease infection. Such risky behaviors were significantly intercorrelated. Consistent condom use was rare among those whose behavior otherwise entailed the greatest risk of infection. In both samples, an index of high-risk sexual behavior was significantly related to antisocial behavior, cigarette smoking, and illicit drug or alcohol use. Social context variables, including family structure, parenting practices, and friends' engagement in problem behaviors, were associated with high-risk sexual behavior. Finally, for sexually active adolescents, problem behaviors and social context variables were predictive of nonuse of condoms. Results were consistent across the two studies and regression weights held up well under cross-validation.

Adolescent↗

Adolescent pregnancy: networking and the interdisciplinary approach.

The networking approach to providing needed services to pregnant and parenting teenagers has numerous merits. An historical overview of the formation of the Brooklyn Teen Pregnancy Network highlights service agency need for information and resource sharing, and improved client referral systems as key factors in the genesis of the Network. The borough-wide approach and its spread as an agency model throughout New York City's other boroughs and several other northeastern cities is also attributed to its positive client impact, including: improved family communication and cooperation; early prenatal care with its concomitant improved pregnancy outcomes; financial support for teens; continued teen education; and parenting skills development. Resource information is provided regarding networks operating in the Greater New York metropolitan area. A planned Eastern Regional network initiative is under development.

Adolescent↗

Some myths in the demography of aboriginal Australians.

The author discusses the proliferation of stereotypes and myths concerning the demography of aboriginal Australians. "In this paper, four of these myths will be discussed, in the hope that a basis for constructive analysis of recent and historical demographic change can be laid." The myths considered pertain to the validity of studying aboriginal societies that have been in contact with non-aboriginal societies, disorder in the aboriginal family, the study of aborigines as a third world population, and the relationship between high fertility and aboriginal poverty.

Australia↗