PubMed Health⌕ Search

Biomedical subjects

L H Flick

Publications and source records attributed to L H Flick.

7 recordsLinked to original sources
PubMed1997

Genetic and environmental contributions to healthcare need and utilization: a twin analysis.

OBJECTIVE: An exploratory study to examine the genetic and environmental influences on healthcare-seeking behavior for four health conditions (high blood pressure, mental health problems, joint disorders, and hearing problems). DATA SOURCES: Data collected from 3,602 male-male twin pair members of the Vietnam Era Twin (VET) Registry. STUDY DESIGN: Varying models for the relationship between genetic and environmental influences on health condition liability and on treatment use were tested in an attempt to explain the relative contributions of additive genetic, common, and unique environmental effects to health condition and treatment use. DATA COLLECTION: A mail and telephone survey of general health status was administered in 1987 to VET Registry twins. PRINCIPAL FINDINGS: Variance component estimates under the best-fitting model for the genetic component ranged from 24 percent to 52 percent for the condition status and from 42 percent to 56 percent for treatment-seeking behavior. CONCLUSIONS: Utilization models that consider only environmental parameters will leave a large percentage of variability unexplained. Familial patterns have an impact not only on disease susceptibility but also on healthcare utilization, thereby having lifelong implications for social and fiscal constraints placed on the healthcare system. Thus, explanatory models for healthcare utilization behavior should consider the contribution of genetic factors in the decision to seek and use health services.

Adult↗
PubMed1996

Aggregate/community-centered undergraduate community health nursing clinical experience.

Debate continues about the appropriateness of clinical experiences targeting aggregates in undergraduate community health nursing education. This paper describes a practical model to teach, through experience, the concepts of aggregate/community-centered practice at the baccalaureate level. As a voluntary alternative to the usual community assessment paper, groups of students worked in partnership with community groups to define health needs and to address one need. Sequential student groups focused the assessment and implemented a plan. The required time for each project varied. One project is described to illustrate the model. While independent community-centered practice is not expected of the B.S.N. graduate, the model described here develops comprehension of the concepts and process of such practice.

Clinical Competence↗
PubMed1994

Building community for health: lessons from a seven-year-old neighborhood/university partnership.

This article presents two case studies highlighting the role of community conflict in the process of community empowerment. A graduate program for community health nurses (CHNs) in a large Midwestern city formed a partnership with a diverse, integrated neighborhood for the dual purposes of enhancing the community's capacity to improve its own health and teaching CHNs community organizing as a means to improve health. Central to the partnership are a broad definition of health, trust developed through long-term involvement, a commitment to reciprocity, social justice, and Freire's model of adult learning. Two initiatives that gave rise to major conflicts between community groups are analyzed. Conflicts, external and internal to the community, proved to be both powerful catalysts and potential barriers to the use of Freirian themes in community organization. Both university and community participants report needing better skills in the early recognition and management of conflict. We conclude that conflict management theory must be integrated with empowerment education theory, particularly when empowerment education is applied in a diverse community.

Adolescent↗
PubMed1987

Measures of mother-child interaction: a comparison of three methods.

Three methods of recording mother-child interaction were compared in a sample of 136 adolescent mothers with children ranging in age from 8 to 27 months. Mother-child interaction was rated during in-home observations using Barnard's Teaching Scale, Schaefer's Attachment Inventory, and Clarke-Stewart's Rating Scales. The results indicate that each measure complements the other two, and that their interrelationships support the validity of the dimensions each describes. Yet, analyses indicate that they do not share common underlying factors. The findings suggest that each measure contributes to a more complete description of mother-child interaction.

Adolescent↗
PubMedDate not supplied

Missouri rural adolescent pregnancy project (MORAPP).

The purpose of this study was to investigate the pregnancy outcomes and services available to adolescent women in Missouri, comparing rural and urban residents. A secondary analysis of a large public use data set obtained from the Missouri Department of Health was done for the 5-year period 1992 to 1996. Data were collected by county, with each of the 114 counties of the state classified as rural or urban. The SAS program was used for analysis. Results demonstrated definite patterns of similarity and dissimilarity among the teen mothers based on residence, when age and race were controlled. There were over 54,000 births to adolescent mothers in the 5-year study period. Among the outcomes of pregnancy studied were: abortion rates, inadequate weight gain, intrauterine growth retardation, and low-birthweight (LBW) infants. Among the services available to the young mothers that were studied were fertility services, WIC (women, infants, and children supplemental nutrition) program, food stamps, and Medicaid coverage for pregnancy and infant care. The outcomes are probably generalizable to Midwestern, rural/urban states similar to Missouri.

Adolescent↗
PubMedDate not supplied

Paths to adolescent parenthood: implications for prevention.

Adolescent pregnancy and parenthood are increasingly common today and pose many problems for both the individual persons involved and society as a whole. For programs to address these issues successfully, factors associated with unintended pregnancy and resulting parenthood must first be identified and understood. This paper is a review of current research on the factors associated with the four steps leading to an adolescent becoming a parent. Being an adolescent parent requires taking a particular path at four crossroads: becoming sexually active, not using or incorrectly using contraceptives, carrying rather than aborting a pregnancy, and parenting rather than placing a child for adoption. Much research in the last 15 years has explored adolescent childbearing, but many studies only compared adolescent parents to nonparents to reach conclusions about differences in these groups. This review focuses on recent studies that explore the four processes, or crossroads, separately and it excludes studies that generalize and overlap these processes. Factors that influence adolescent behavior at multiple points on the path to parenthood indicate areas particularly relevant for preventive intervention. For instance, boyfriends exert influence at all four crossroads. Sexual activity and contraceptive use increase with longevity of relationships, yet closer relationships are less often associated with raising a child. Better general communication skills, and particularly an increased ability to discuss sexuality, increases use of contraceptives, and low educational and occupational aspirations appear to influence each successive turn toward parenthood. This summary of current research serves to highlight those individual, family, dyadic, and social factors that exert great impact on adolescent parenthood by influencing young people at each of the four crossroads. These factors suggest potentially effective points for intervention to reduce the incidence of adolescent parenthood. However, poverty, unemployment, and racism also play central roles in early intercourse and childbearing, and any attempt at fundamental change must take these forces into account.

Abortion, Spontaneous↗