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Biomedical subjects

E S Rome

Publications and source records attributed to E S Rome.

At least 19 recordsLinked to original sources
PubMed2001

Condom use by adolescents.

The use of condoms as part of the prevention of unintended pregnancies and sexually transmitted diseases (STDs) in adolescents is evaluated in this policy statement. Sexual activity and pregnancies decreased slightly among adolescents in the 1990s, reversing trends that were present in the 1970s and 1980s, while condom use among adolescents increased significantly. These trends likely reflect initial success of primary and secondary prevention messages aimed at adolescents. Rates of acquisition of STDs and human immunodeficiency virus (HIV) among adolescents remain unacceptably high, highlighting the need for continued prevention efforts and reflecting the fact that improved condom use can decrease, but never eliminate, the risk of acquisition of STDs and HIV as well as unintended pregnancies. While many condom education and availability programs have been shown to have modest effects on condom use, there is no evidence that these programs contribute to increased sexual activity among adolescents. These trends highlight the progress that has been made and the large amount that still needs to be accomplished.

Adolescent↗
PubMed2001

Care of the adolescent sexual assault victim.

Sexual assault is a broad-based term that encompasses a wide range of sexual victimizations, including rape. Since the American Academy of Pediatrics published its last policy statement on this topic in 1994, additional information and data have emerged about sexual assault and rape in adolescents, the adolescent's perception of sexual assault, and the treatment and management of the adolescent who has been a victim of sexual assault. This new information mandates an updated knowledge base for pediatricians who care for adolescent patients. This statement provides that update, focusing on sexual assault and rape in the adolescent population.

Adolescent↗
PubMed2001

It's a rave new world: rave culture and illicit drug use in the young.

Illicit drug use by young people has changed in the last decade, with the increasing use of "designer" or "club" drugs such as ecstasy. Keeping abreast of current trends in illicit drug use prepares the primary care clinician to recognize the clinical effects of drug use, to manage drug emergencies, and to detect addictive behavior. Today's widely used drugs, their street names, their effects, and how to manage overdoses are reviewed.

3,4-Methylenedioxyamphetamine↗
PubMed1999

Adolescent pregnancy--current trends and issues: 1998 American Academy of Pediatrics Committee on Adolescence, 1998-1999.

Although the prevention of unintended adolescent pregnancy is a primary goal of the American Academy of Pediatrics and society, many adolescents continue to become pregnant. Since the last statement on adolescent pregnancy was issued by the Academy in 1989, new observations have been recorded in the literature. The purpose of this new statement is to review current trends and issues on adolescent pregnancy to update practitioners on this topic.

Adolescent↗
PubMed1999

Sexually transmitted diseases: testing and treating.

Adolescents remain a group at particular risk for STD acquisition due to a combination of biological and psychosocial factors. Access to care can be an obstacle to seeking appropriate screening and treatment for many adolescents; undetected infection may lead to unwanted sequelae, including pelvic inflammatory disease, chronic abdominal pain, tubal scarring, and increased risk of ectopic pregnancy. With respect to gonorrhea, chlamydia, syphilis, and chancroid, the hope is that improved detection will decrease sequelae by prompting earlier recognition and treatment. In all cases of suspected sexual abuse cultures remain of utmost importance because of the negative consequences associated with a possible false-positive test result. Urine screening in certain settings, such as school-based health centers and juvenile detention centers, remains positive; however, adolescents with a positive test may still require further evaluation to identify HPV and abnormal Pap smear findings, syphilis, and other STDs currently not recognizable with a simple urine screen.

Adolescent↗
PubMed1999

American Academy of Pediatrics. Committee on Adolescence. Contraception in adolescents.

The risks and negative consequences of adolescent sexual intercourse are of national concern, and promoting sexual abstinence is an important goal of the American Academy of Pediatrics. In previous publications, the American Academy of Pediatrics has addressed important issues of adolescent sexuality, pregnancy, sexually transmitted diseases, and contraception. The development of new contraceptive technologies mandates a revision of this policy statement, which provides the pediatrician with an updated review of adolescent sexuality and use of contraception by adolescents and presents current guidelines for counseling adolescents on sexual activity and contraceptive methods.

Adolescent↗
PubMed1998

Pregnancy and other risk behaviors among adolescent girls in Ohio.

PURPOSE: The purpose of this study was to determine whether teenage girls who had been pregnant were more likely to engage in other risk or problem behaviors than girls who had had sexual intercourse without becoming pregnant. METHODS: The 1993 Ohio Youth Risk Behavior Survey was administered to a random sample of 2461 high school students. A subset of 592 girls (mean age 16.1 +/- 1.1 years, 69.2% Caucasian, 24.1% African-American, 2.4% Hispanic, 4.3% other) reported sexual activity (SA) on the anonymous survey. Demographic factors plus risk and problem behaviors were compared between 98 girls who had been pregnant and 494 girls who had never been pregnant using Chi-square analysis. Risk and problem behaviors were classified into four distinct groups: recent risk behaviors, age of onset of behavior, lifetime behavior, and general behavior. Variables which were univariately significant at p < 0.15 were considered in one of four stepwise multiple logistic regression models based on behavior type, with demographic factors considered in all four models. The final logistic regression model was developed using variables which were significant at p < 0.01. Variables which were significantly associated with pregnancy were summarized as odds ratios (OR) and 99% confidence intervals (CI); these ORs were adjusted for the effects of the other variables in the model. RESULTS: Pregnancy was more common in girls of color than in Caucasian girls (OR 99% and CI, 2.09, 1.06-4.11) and in older girls than in younger girls (1.52, 1.12-2.08). Among SA girls, weapon carrying in the past 30 days (4.06, 1.75-9.42) was significantly associated with pregnancy, whereas alcohol use in the past 30 days (0.37, 0.18-0.76) was less likely to be associated with pregnancy. The risk of pregnancy increased 1.75 times (1.26-2.43) for each additional sexual partner. Girls who had tried cocaine were 4.88 times (1.40-16.95) more likely to have been pregnant, and the risk of having been pregnant increased 1.43 times (1.14-1.80) for each additional year of SA. Past history of sexually transmitted disease (3.50, 1.28-9.55) was associated with increased pregnancy risk. CONCLUSIONS: Girls who had been pregnant also had engaged in other risk behaviors, including recent weapon carrying and cocaine use. A history of previous sexually transmitted diseases plus increasing numbers of partners add to the risk of pregnancy. Counseling and educational efforts should continue to identify teens at risk both to prevent pregnancy and to decrease associated risks.

Adolescent↗
PubMed1997

Violence and weapon carrying in music videos. A content analysis.

BACKGROUND: The positive portrayal of violence and weapon carrying in televised music videos is thought to have a considerable influence on the normative expectations of adolescents about these behaviors. OBJECTIVES: To perform a content analysis of the depictions of violence and weapon carrying in music videos, including 5 genres of music (rock, rap, adult contemporary, rhythm and blues, and country), from 4 television networks and to analyze the degree of sexuality or eroticism portrayed in each video and its association with violence and weapon carrying, as an indicator of the desirability of violent behaviors. METHODS: Five hundred eighteen videos were recorded during randomly selected days and times of the day from the Music Television, Video Hits One, Black Entertainment Television, and Country Music Television networks. Four female and 4 male observers aged 17 to 24 years were trained to use a standardized content analysis instrument. Interobserver reliability testing resulted in a mean (+/- SD) percentage agreement of 89.25% +/- 7.10% and a mean (+/- SD) kappa of 0.73 +/- 0.20. All videos were observed by rotating 2-person, male-female teams that were required to reach agreement on each behavior that was scored. Music genre and network differences in behaviors were analyzed with chi 2 tests. RESULTS: A higher percentage (22.4%) of Music Television videos portrayed overt violence than Video Hits One (11.8%), Country Music Television (11.8%), and Black Entertainment Television (11.5%) videos (P = .02). Rap (20.4%) had the highest portrayal of violence, followed by rock (19.8%), country (10.8%), adult contemporary (9.7%), and rhythm and blues (5.9%) (P = .006). Weapon carrying was higher on Music Television (25.0%) than on Black Entertainment Television (11.5%), Video Hits One (8.4%), and Country Music Television (6.9%) (P < .001). Weapon carrying was also higher in rock (19.8%) and rap (19.5%) videos than in adult contemporary (16.1%), rhythm and blues (6.9%), and country (6.3%) videos (P = .002). The videos with the highest level of sexuality or eroticism were found to be less likely to contain violence (P < or = .04). CONCLUSION: Because most music videos are between 3 and 4 minutes long, these data indicate that even modest levels of viewing may result in substantial exposure to violence and weapon carrying, which is glamorized by music artists, actors, and actresses.

Adolescent↗
PubMed1997

Eating disorders.

Explore the source record for details and available documents.

Adolescent↗
PubMed1997

Tobacco and alcohol use behaviors portrayed in music videos: a content analysis.

OBJECTIVES: Music videos from five genres of music were analyzed for portrayals of tobacco and alcohol use and for portrayals of such behaviors in conjunction with sexuality. METHODS: Music videos (n = 518) were recorded during randomly selected days and times from four television networks. Four female and four male observers aged 17 to 24 years were trained to use a standardized content analysis instrument. All videos were observed by rotating two-person, male-female teams who were required to reach agreement on each behavior that was scored. Music genre and network differences in behaviors were analyzed with chi-squared tests. RESULTS: A higher percentage (25.7%) of MTV videos than other network videos portrayed tobacco use. The percentage of videos showing alcohol use was similar on all four networks. In videos that portrayed tobacco and alcohol use, the lead performer was most often the one smoking or drinking and the use of alcohol was associated with a high degree of sexuality on all the videos. CONCLUSIONS: These data indicate that even modest levels of viewing may result in substantial exposure to glamorized depictions of alcohol and tobacco use and alcohol use coupled with sexuality.

Adolescent↗
PubMed1996

Prevalence of abnormal eating attitudes and behaviors in hospital-based primary and tertiary care clinics: a window of opportunity?

OBJECTIVE: The "athletic triad" of amenorrhea, osteopenia, and eating disorders (EDs) has received increasing attention in the past decade. Adolescents may seek care for amenorrhea or other menstrual irregularity before disclosure of an eating disorder to a primary care clinician. The purpose of this study was to determine the prevalence of abnormal eating attitudes and behaviors in adolescent girls going to a clinic for reproductive endocrinology (RE) visits versus the prevalence in girls going for health maintenance (HM) visits. DESIGN: All patients aged 8-22 years going to RE or HM clinics were given a 26-item modified eating attitudes test (EAT) and two pages of questions on other eating issues and demographics. Informed consent was obtained from all participants, and also from the parents of those less than 18 years of age. SETTING: All subjects were seen at a hospital-based ambulatory (HM) or subspecialty (RE) clinic, with both clinics located on the same floor. PARTICIPANTS: The study included 53 girls from the RE clinic and 108 girls from the HM clinic. All demographics were similar except that the RE patients were slightly older and had significantly more parents with masters or doctorate degrees. MAIN OUTCOME MEASURES: Study variables were compared between RE and HM groups using either the Student's t test or the Chi-square test, with statistical significance defined as p < 0.05. A score of 20 or higher on the modified EAT was correlated with a high risk of EDs and was used as a measure of prevalence of abnormal eating attitudes and behaviors. RESULTS: Modified EAT scores were 11.8 +/- 8.9 in RE patients vs 7.0 +/- 7.2 in HM patients (p < 0.001), with 10 (18.9%) RE patients and 7 (6.5%) HM patients having scores of at least 20 (p = 0.016). No differences in daily exercise, dairy consumption, or use of vomiting or laxatives to control weight were found. As expected, RE patients were significantly more likely to experience menstrual irregularities than the HM patients (p < 0.001). CONCLUSIONS: Adolescents attending a reproductive endocrinology clinic showed a higher prevalence of abnormal eating attitudes and behaviors than did those going to a clinic for HM visits. Early detection of eating disorders may occur both within and outside of the primary care setting through use of a modified EAT.

Adolescent↗
PubMed1994

Pelvic inflammatory disease in the adolescent.

This article reviews new developments in the detection and treatment of pelvic inflammatory disease, including known risk factors, microbial etiologies, treatment standards, and associated morbidity. The use of transvaginal ultrasound and the role of the male partner in infection control is also discussed.

Adolescent↗
PubMed1984

Limitations of transcutaneous PO2 and PCO2 monitoring in infants with bronchopulmonary dysplasia.

Despite the well-documented correlation between transcutaneous and arterial PO2 and PCO2 in sick neonates, the effect of maturation on this relationship has not been well characterized. Eight premature infants with bronchopulmonary dysplasia (BPD) and indwelling arterial lines beyond the immediate neonatal period were studied. Transcutaneous PO2 always underestimated PaO2 beyond 10 weeks of postnatal life, such that transcutaneous PO2 - PaO2 was -16 +/- 5 torr (P less than .001). Corrected transcutaneous PCO2 simultaneously overestimated PaCO2 by 9 +/- 3 torr (P less than .001), although this occurred over a wider range of postnatal ages. Transcutaneous PO2 monitoring may be a useful tool for estimating PaO2 in this population, provided an appropriate correction is made beyond 10 weeks of age. It is suggested that caution be exercised when using transcutaneous PCO2 measurements to estimate absolute arterial values in older infants with bronchopulmonary dysplasia.

Age Factors↗
PubMedDate not supplied

Effect of sleep state on chest wall movements and gas exchange in infants with resolving bronchopulmonary dysplasia.

During active sleep, neonates exhibit asynchronous chest wall movements, which have been associated with a small but significant decrease in oxygenation. To determine the effects of maturation and residual chronic lung disease on both these phenomena, we studied 11 preterm infants with resolving bronchopulmonary dysplasia (BPD) and compared these infants to ten healthy preterm infants all at time of discharge. Synchrony of chest wall (upper rib cage and abdominal) movements, sleep state, O2 saturation, and transcutaneous CO2 (TcPCO2) were recorded during both active (AS) and quiet sleep (QS). Sleep state was determined by electroencephalographic and behavioral criteria. Normal preterm infants displayed asynchronous chest wall movements only in AS, whereas, in infants with BPD, asynchrony predominated in both sleep states, although O2 saturation and TcPCO2 did not differ between sleep states in either group. The O2 saturation during AS was lower in the BPD group than in the group of normal infants (92% vs 96%; P less than 0.02), whereas TcPCO2 was higher in the BPD group unrelated to sleep state. We conclude that infants with resolving BPD exhibit asynchronous chest wall movements in both AS and QS, and that change in sleep state from QS to AS is not associated with a detrimental fall in oxygenation in these infants.

Bronchopulmonary Dysplasia↗