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Residential program characteristics for completion of treatment by adolescent drug abusers.

The relationship to treatment outcome (as measured by the National Institute of Drug Abuse Client-Oriented Data Acquisition Process [NIDA-CODAP] Reasons for Discharge classification) of specific characteristics and elements of 22 drug-free residential programs for adolescents is reported. Admission and discharge data were obtained from NIDA-CODAP on 2,532 adolescents in the 22 programs. A partial cross-validation study was conducted by analyzing separately for two annual client subsamples. The program, not the individual client, was the unit of analysis. When three differences between programs in their client populations were "partialed out" the following characteristics of programs were found to predict positively to outcome (a lower treatment failure rate) to a statistically significant degree: the number of years that the counselors had worked in the programs; the number of volunteer staff in direct service (client contact); the proportion of clients receiving bodily and mental relaxation techniques: the counselors' perceptions that their programs accept or encourage relatively more spontaneous personal expressiveness, including expression of anger by clients, in staff-client relationships, but encourage less client "autonomy" (to be self-sufficient and independent with regard to making their own decisions); the counselors report that providing practical assistance in solving clients' real-life problems is useful. There was a high degree of replication of these findings across the two annual subsamples of clients. These findings for adolescents in residential programs are compared with findings reported in a parallel study of treatment outcome for adolescents in outpatient programs.

Adolescent

Community acceptance of residential programs for developmentally disabled persons.

Deinstitutionalization and the ensuing establishment of residence programs for developmentally disabled persons has stimulated both community support and opposition. The present study considers changes in the levels of community acceptance after residence programs are established, sources of program support and opposition, and strategies used to overcome community opposition. The data are based upon responses to a survey of all community residence programs in New York (n = 459). The findings indicate marked and consistent shifts toward the acceptance of established residence programs.

Adult

FORTRAN source listing for simulating three-dimensional convergent beam patterns with absorption by the Bloch wave method.

The FORTRAN source code is given for a computer program that calculates the two-dimensional intensity distribution in convergent-beam transmission electron microdiffraction (CBED) patterns from perfect crystals. The program uses the eigenvalue or Bloch-wave method. It allows three-dimensional dynamical diffraction, and so includes all higher-order Laue zone effects without approximation. No symmetry reduction is included. The program accepts noncentrosymmetric or centrosymmetric crystal structures and allows absorption corrections to be included. It uses the "EISPACK" subroutines for the diagonalisation of a general complex matrix. Up to 100 CBED disks may be included. The code is also available via "Bitnet."

Electron Probe Microanalysis

Experiences of a health team working in a new urban settlement area in Istanbul.

A project aiming at creating a model for comprehensive maternal and child health care for urban underdeveloped areas was started in a new settlement area of migrants in the vicinity of Istanbul. The project had an impact on health care status, particularly among infants and children, but the results indicated that more effort was needed to reach the mothers. It was noted that building space and the appearance of the work place influenced the prestige of the team. Absentee problems could be partly surmounted by repeated home visits. Based on this experience, it was concluded that health services in underdeveloped areas need to be supported by non medical personnel to act as home visitors and as mediators between the community and the health team. It was also concluded that an established recording system to include both clinical data and attendance is needed to define the cases who need special care.

Adult

A program to facilitate cytotoxicity assay data reduction.

A report of a program which performs the initial computational reduction of the raw data from a cytotoxicity assay and outputs the reduced data as an image of the arrangement of the assay(s) upon the microwell plate. The program accepts the raw data either as manual or diskette file input.

Algorithms

Mortality in acute gynecology: a developing country perspective.

Over a 20-month period 109 deaths were recorded in the Acute Gynecology Ward, Kenyatta National Hospital, Nairobi; a rate of 5 deaths per month. Forty-one percent of the deaths were directly attributable to pregnancy and 46% were due to malignancy (mainly cervical carcinoma). Of the dead, 12.4% were teenagers and 63% below 35 years in age. They were generally of low parity. A tragic picture is presented of death of young women in their prime from almost entirely preventable causes. The need for improved maternal care, including family planning and cytological screening for cervical carcinoma is discussed and emphasized.

Abortion, Septic

Effects of father-daughter contact on use of pregnancy services by Mexican, Mexican-American, and Anglo adolescents.

This study describes whether frequency and quality of father-daughter contact during adolescent pregnancy differ by ethnicity, whether this contact affects health behavior, and how ethnicity conditions the relationship between contact and behavior. Health behavior is defined as timing of pregnancy test and first prenatal visit. Data were gathered from a sample of 105 Anglo, Mexican-American, and Mexican adolescents interviewed at mid-pregnancy. Almost twice as many Mexicans (64%) as Mexican-Americans never saw their fathers (p less than 0.03). Girls living with their fathers obtained pregnancy tests significantly later (p less than 0.01) than those living independently. This relationship was maintained when ethnicity was held constant (p less than 0.01). When quality of contact was included, the relationship between residency with father and timing of pregnancy test became even stronger (p less than 0.003).

Adolescent

Effects of social supports on attitudes and health behaviors of pregnant adolescents.

The influence of social support on maternal attitudes and behaviors was assessed in 57 third-trimester adolescent women attending an urban prenatal clinic. Sociodemographic characteristics, social support, self-esteem, and feelings about pregnancy were measured by questionnaire. The support and influence of the adolescent father was emphasized. Social support was measured as a multidimensional construct derived by a priori and empirical procedures. The outcomes measured were the amount of prenatal care, attendance at scheduled postpartum appointments, and pleasure with the pregnancy. Stepwise multiple-regression analyses were used to assess the contributions of the predictor to criterion variables. Pleasure with pregnancy was positively associated with the receipt of assistance from the adolescent's mother, favorable opinions of friends, and satisfaction with living arrangements. Attendance at postpartum visits was associated with high self-esteem. Notably absent as significant contributors were sociodemographic characteristics, receipt of emotional and tangible support from the adolescent father, and expectation of aid from social-assistance programs.

Adolescent

Adolescents' willingness to use a school-based clinic in view of expressed health concerns.

A health needs assessment was developed to facilitate implementation of a comprehensive school-based adolescent clinic. Students were asked about their willingness to use a school-based clinic for certain health and emotional problems. Six hundred students in grades 9 through 12 completed anonymous self-administered questionnaires. Twenty-eight percent of respondents reported recently feeling depressed; 12% reported a prior suicide attempt. Twenty-five percent of students felt they were overweight. Of 56% who had experienced intercourse at least once, only one third had ever used birth control. Twenty-one percent smoked cigarettes and 27% marijuana, 24% used other drugs, and 38% used alcohol. Students who reported depression and past suicide attempts were significantly (p less than or equal to 0.001) more willing to use the clinic for counseling needs than students not so reporting. Those with perceived weight problems reported more willingness to use a school clinic for nutrition information than those who did not feel overweight. Currently sexually active students were also more willing (p less than or equal to 0.001) than nonsexually active students to use the clinic for sexuality information and sexually transmitted disease screens. Respondents who used drugs, alcohol, or cigarettes, however, were no more willing than nonsubstance-using peers to use clinic services for relevant health information.

Adolescent

School-based clinic use and other factors affecting adolescent contraceptive behavior.

Adolescent risk taking, preventive behavior, and contraceptive use were investigated using a self-administered questionnaire in a sample of 260 inner-city high school students targeted by a school-based health clinic. Multivariate models consisting of individual and environmental variables significantly predicted sexual activity and contraceptive use. Older age at first intercourse, higher number of welfare benefits received by the household (including Medicaid, food stamps, and free or reduced price lunch), and use of the school-based clinic were significant positive predictors of more frequent contraceptive use by adolescents. Results of our study suggest that programs may be having some success in encouraging and enabling sexually active adolescents to use contraception and to use it more consistently. Rigorous program evaluations should help program planners and policy makers design and refine adolescent pregnancy-prevention efforts.

Adolescent

Incentives and their influence on appointment compliance in a teenage family-planning clinic.

The purpose of this study was to ascertain whether or not the family-planning compliance patterns of indigent adolescents could be influenced by various types of incentives. From February 1988 through January 1989, 534 postpartum inner city teenagers, aged 12-19, who delivered at a large city-county public hospital, participated. Teens were randomly assigned to two treatment groups that either offered a coupon for milk for the infant or a gift for the teenage mother if they returned for their postpartum visit 4-6 weeks after delivery. A third group, which used no incentive for appointment keeping, acted as a control. Although overall compliance was low, a significant relationship was found between type of program incentive and compliance outcome. The program using milk coupons as an incentive had the best compliance rate. This incentive appeared to be most effective with black adolescents. Such incentive programs, although not without controversy, offer a potential way to enhance postpartum contraceptive appointment-keeping compliance in a high-risk population.

Adolescent

Computerized data analysis of amino acids in physiologic fluids.

A Fortran IV computer program is described which identifies, computes, and statistically evaluates amino acid concentrations determined by an automatic amino acid analyzer in physiologic fluids. The program accepts retention time and intergrated peak areas from two calibration standards for identification and computational reference. Two internal standards are used to compensate for variations in injector performance and ninhydrin decay. Calibration standard responses are statistically treated to assist in detection of equipment malfunction. The statistical data base is automatically explanded through inclusion of data from normal patients. Amino acid concentrations are printed with appropriate mean and standard deviation values in a format acceptable as a final report.

Amino Acids

Trial of anonymous versus confidential human immunodeficiency virus testing.

Before December, 1986, all public human immunodeficiency virus (HIV) testing in Oregon was done confidentially (using names). In December, clients were offered the option of either anonymous or confidential services. As judged by questionnaire responses, the availability of anonymity increased overall demand for testing by 50%: 125% for homosexual/bisexual (gay) men, 56% for female prostitutes, 17% for intravenous drug users, and 32% for other clients. The number of gay clients who had tests increased from a mean of 42 per month during the 4 months before anonymity was available to 108 per month during the 4 months after, whereas, at public sites in Colorado or California and private sites in Oregon, the number of gay clients tested did not increase. Twice as many seropositive persons were identified during the 3 1/2 months after anonymity became available (n = 85) as in the 3 1/2 months before (n = 36). Thus, availability of anonymous HIV testing and counselling drew gay men who had not sought services under a confidential testing system.

California

Factors influencing breast-feeding among adolescents.

During a 15-month study period, 244 adolescent mothers under 18 years of age were surveyed, of whom 53% elected to breast-feed. A subset of 60 primiparous breast-feeding adolescents were studied regarding the influence of several factors on the duration of breast-feeding. An attitude questionnaire was administered in the hospital within 48 hours of delivery. Follow-up interviews were obtained by telephone or in person at approximately 2 weeks and 2 months after birth. Eighty-three percent made the decision to breast-feed before the third trimester. Thirty-five percent discontinued breast-feeding within the first postpartum month, the most common reason being "nipple confusion" in the infant; 22% nursed for more than 1 month but less than 2 months, and 43% breast-fed for 2 months or more. None of the variables examined (maternal age, ethnic group, education level, involvement of the baby's father, timing of the breast-feeding decision, intended duration of breast-feeding, age at which formula supplementation was started, or availability of maternal support) was predictive of the duration of breast-feeding. Contrary to adolescent stereotypes, 65% of mothers chose breast-feeding because it was "good for the baby," and 67% identified the "closeness" of the nursing relationship as the most enjoyable part of breast-feeding. Twenty-eight percent cited modesty issues about breast-feeding as the greatest disadvantage, and 17% returned to work or school within the first 2 postpartum months, posing additional obstacles to breast-feeding. Our data suggest that adolescents are receptive to breast-feeding, but they may require close follow-up and anticipatory guidance tailored to their individual needs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Contraceptive practice of Irish married and single first-time mothers.

This study surveys 100 married and 100 unmarried primiparous mothers, attending the National Maternity Hospital, Dublin, with regard to their contraceptive practice, their planning of their pregnancy and the timing of their first antenatal visit. Nineteen per cent of the married women, but 64% of the unmarried women, had never used any contraceptive method. The contraceptive pill was the most popular method for both groups, but while three in five of the married women had at some time used the pill, only a little more than one in five of the unmarried women had ever used it. One quarter of the women who had used contraception reported that their pregnancy was the result of a failure in their contraceptive method. Eighty-nine per cent of the single group and 20% of the married had not planned their pregnancy. None of the married women, but almost a quarter of the single, delayed their first antenatal visit until after they were 20 weeks pregnant.

Contraception Behavior