Diagnosis and management of neurally mediated syncope and related conditions in adolescents.
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Biomedical subjects
Publications and source records attributed to K E Boehm.
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This study investigated the motivational needs of adolescent volunteers. The Volunteer Needs Profile (Francies, 1982) was administered to adolescents in a variety of volunteer settings, and data were examined using factor analysis. While there were similarities between the motivations of adolescent and older volunteers, some important differences were found. The findings are explored in the context of the adolescent developmental stage, and implications are discussed.
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Previous research found that adolescents in Toledo, Ohio, utilized a peer listening phone service predominantly for four reasons: to discuss peer relationships, family problems, and sexuality issues, as well as to have someone "just to talk to." The present study investigated whether adolescents in other areas of the United States used such services for similar reasons. Data were collected at four sites-Toledo, Los Angeles (California), Martinsville (Virginia), and Syracuse (New York)-over the course of one year. The results indicated that the callers were predominantly female and of high school age. The most frequently discussed issue was peer relationships (46% to 60%), regardless of site. Another frequent topic at all sites was family problems (10% to 20%). Other concerns varied by site.
The concerns of teenagers calling a peer listening phone service have previously been documented (Boehm & Campbell, 1995; Boehm, Chessare, Valko, & Sager, 1991; Boehm, Schondel, Marlowe, & Rose, 1995). The purpose of the present study was to determine if those calls were representative of the concerns of teenagers in the area served. Calls to Teen Line from September 1933 to May 1994 were compared with responses to selected questions from the 1994 Chemical Abuse Reduced through Education and Services (C.A.R.E.S.) student survey, which was administered to a random sample of fifth- through twelfth-grade students. The most frequent calls to Teen Line pertained to peer relationships, sexuality, family problems, the need to have someone "just to talk to," self-esteem, and drugs and alcohol. Results of the survey indicated that students' biggest concerns, and the concerns for which they would call a hotline, involved family problems, peer relationships, self-esteem, and school problems. While there were some differences, it appears that the calls to Teen Line were representative. Teenagers were more concerned about relationship and esteem issues than about high-risk behaviors.
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OBJECTIVE: To examine mutual support of inner-city parents and how it relates to the father's expected role as a parent. DESIGN: Cross-sectional study. SETTING: An urban teaching hospital in inner-city Baltimore, Md. PATIENTS OR OTHER PARTICIPANTS: Inner-city-dwelling parents whose neonates were born at an urban teaching hospital between March and May 1992. INTERVENTION: Data were collected through structured independent interviews with each parent during the neonate's hospitalization. MAIN OUTCOME MEASURES: General social support was assessed by Sarason's Social Support Questionnaire. Paternal involvement was defined as the father's expected accessibility, engagement in child-rearing tasks, and decision-making responsibility during infancy. RESULTS: Most mothers and fathers cited the other parent as a source of general support. Most believed that the other parent would help and would not hinder them in their role as parent. For mothers, the father's expected accessibility, engagement, and decision-making responsibility was positively correlated with his general support. For the fathers, expected accessibility was positively related to general support from the mother. As parents' mutual support increased, so did concordance in their expectations of the father's role. CONCLUSIONS: Many inner-city parents do rely on each other. Pediatricians can promote shared parenting by recognizing and building on this mutual support.
Calls about suicide to a teen peer listening phone service over a period of 5 1/2 years are described. The majority of those calling about suicide were females. The phone contacts were of longer duration and later in the evening than calls about other concerns. Those concerned with suicide also discussed other serious issues such as self-esteem, family problems, substance use, and abuse and were less likely to be calling "just to talk."
Having presented an overview of the available methods of contraception, the authors present one approach to prescribing contraceptives based on their experience. First, adolescent patients in our practice are discouraged from engaging in sexual intercourse. Abstinence is the only fail-safe method of contraception and provides benefits both emotionally and physically (i.e., prevention from sexually transmitted diseases and unwanted pregnancies). If the adolescent plans to be sexually active, however, she is encouraged to select some form of hormonal contraception, namely Norplant, Depo-Provera, or oral contraceptives, in conjunction with condoms. The authors have had little success recommending barrier methods alone. Condoms are used sporadically and the diaphragm is very awkward for adolescents who are still uncomfortable with their bodies and with touching themselves. Of the three hormonal methods, Depo-Provera seems to be well-accepted by our patients. It offers several advantages that we believe make it attractive. First, it does not require any forethought by the patient other than coming in for the injection every 3 months. There is an effective grace period, so the patient is afforded good contraception even if she is up to a month late for her injection. The frequent visits for injections actually can be looked upon as positive, frequent contacts with the patient and can provide opportunities for counseling. In addition, some patients become amenorrheic, which teens view as an advantage, increasing compliance. If it is not likely that a patient will be compliant with every-3-month injections, Norplant is recommended. Studies have shown good acceptance of Norplant by adolescents and that has been the experience of the authors. With appropriate counseling prior to insertion and a counseling session with patients who request removal, the number of actual Norplant removals has been limited. If Depo-Provera and Norplant are not acceptable to the patient, then oral contraceptives are recommended. Of the three methods, more opportunities for failure exist with oral contraceptives. Pills are missed for a variety of reasons, including going away for the weekend; not having a regular schedule, which can interrupt pill-taking; and even ambivalence about becoming pregnant. One recent study demonstrated certain patient characteristics that were associated with good compliance with oral contraceptives, including white race, higher education level, suburban residence, and older age of both the patient and her mate. Keeping these characteristics in mind may be helpful when prescribing oral contraceptives. Of course, it is the patient's prerogative to choose the type of contraception she feels will be best suited for her.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescents have specific concerns although these may not be readily apparent to health care providers. Described here are gender, age, and seasonal variations of concerns of adolescents calling a peer-listening phone service which has been in operation in Northwest Ohio since May 1987. The data reported are from calls received between May 1, 1987 and December 31, 1992. Demographic data as well as issues discussed are recorded for each call. There were significant gender (p < or = .001), age (p < or = .01), and seasonal (p < or = .05) variations when compared to the calls in total. Knowing which issues are important for adolescents may help us better elicit problems and give anticipatory guidance when seeing adolescents. Further studies will need to be done in order to determine how needs related to these issues can be best addressed.