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Biomedical subjects

L Tiezzi

Publications and source records attributed to L Tiezzi.

10 recordsLinked to original sources
PubMed1999

Involving men in reproductive health: the Young Men's Clinic.

OBJECTIVES: This report describes the population of young men who use the Young Men's Clinic in New York City, presents a profile of their reproductive behaviors, and describes the clinic's model of service delivery. METHODS: Data were gathered through a routine clinic visit form administered by clinic staff. RESULTS: The clinic sees approximately 1200 predominately Dominican young men each year for a wide range of clinical and mental health services. Two thirds of clients had ever been sexually active, three quarters had ever used birth control, and 69% had used birth control at their last sexual encounter. CONCLUSIONS: The Young Men's Clinic may serve as a model for health care delivery to adolescent and young adult males.

Adolescent↗
PubMed1998

A new school-based program to provide eyeglasses: childsight.

OBJECTIVE: To address the unmet need for glasses encountered in an urban school setting by developing and implementing a school-based, cost-effective program that provides appropriate spectacle correction to needy children. METHODS: A total of 5851 students 9 to 15 years of age in 4 middle schools in northern Manhattan were screened for vision. Those with vision worse than 20/40 were examined, given glasses if appropriate, or referred for additional evaluation. RESULTS: Of the 5851 children screened, 1614 (28%) had a failing result, with visual acuity less than 20/40 in the worse eye. Of this group, 1082 were given glasses that were assembled at the school within 1 hour of testing. Ten percent of the group that required glasses already had them, and the remaining were referred for a complete ophthalmic examination that was completed in 58 cases. Only 14 of these had vision loss unrelated to refractive error. CONCLUSIONS: The program successfully treated 88.3% of the children within the school who needed glasses. Given that only 10% of children who needed glasses had them, it indicates a huge need to provide glasses to at least a million children in this age group in the United States.

Adolescent↗
PubMed1996

Characteristics of users and nonusers of health clinics in inner-city junior high schools.

PURPOSE: To compare the demographic, behavioral, psychosocial, and academic characteristics of users versus nonusers of inner-city junior high school-based health clinics. METHODS: Students who used (n = 1344) and did not use (n = 2394) the health clinics based in four junior high schools in an economically disadvantaged, medically underserved New York City school district were compared on their responses to a health risk survey administered at the end of the 1991/92 academic year. RESULTS: Compared to students who did not use the clinics, students who used the clinics were more likely to have had unprotected sexual intercourse, to have had suicide intentions or attempts, to be suspended from school for fighting, to be exposed to violence and the illicit drug culture, to hold beliefs favoring involvement in sexual intercourse and suicidality, and to have failed subjects in school. CONCLUSIONS: Users of these junior high school-based health clinics are engaging in behaviors and hold beliefs that place them at risk for serious adverse health outcomes. School-based clinics have the potential to provide early intervention for these high risk adolescents.

Adolescent↗
PubMed1996

The development, reliability, and validity of a risk factor screening survey for urban minority junior high school students.

PURPOSE: To develop and evaluate a risk factor screening survey as a mechanism to identify inner-city junior high school students who may benefit from medical or mental health services available in school-based clinics. METHODS: A 36-item health risk factor screening survey was developed and administered to 3,787 predominantly Hispanic students from four schools in an economically disadvantaged, medically underserved New York City school district. Students who indicated that they were experiencing one of five major risk factors (suicidality, sexual activity, parental or guardian substance use, personal substance use, or having run away) were scheduled to visit the clinic for services, and to have their survey responses validated by clinic interview. RESULTS: The development of the screening tool resulted in a short, easy to read and understand survey instrument that was feasible to administer within a classroom setting. The reliability of the instrument was excellent, and the results of the validity study indicated that it was successful in identifying students who did not need clinic services. The screening tool produced mixed results in identifying those truly in need through single item identification (e.g., produced a moderate number of "false positives"), although combining items on the screening tool produced much higher positive predictive values. CONCLUSIONS: This screening tool can be used to effectively focus limited clinical resources on those in need. Outreach surveys of this type should be considered as a valuable component of a school-based clinic service delivery strategy.

Adolescent↗
PubMed1996

Carrying and using weapons: A survey of minority junior high school students in New York City.

To explore weapon carrying among young, inner-city adolescents, a survey was administered in fall 1993 to 2005 predominately Hispanic students (mean age = 12.8 years) in three New York City junior high schools. The survey revealed that 21% of students reported personally carrying a weapon; guns and knives were the weapons most commonly carried. Most of those who carried guns reported that they bought them. Forty-two percent indicated that they had a family member or close friend who had been shot. Boys and older students were more likely to report carrying weapons. Preventive efforts may need to begin before or on entry into junior high school rather than high school.

Adolescent↗
PubMed1995

School-based health care for urban minority junior high school students.

OBJECTIVE: To describe the use of school-based health clinics by urban minority junior high school students. DESIGN: Review of demographic and utilization data collected by service providers during clinic visits. SETTINGS AND PARTICIPANTS: Health clinics in four junior high schools that enrolled predominantly Hispanic students who were residing in an economically disadvantaged, medically underserved New York (NY) school district. RESULTS: Of 5757 students who were enrolled in the schools, 5296 (92%) obtained parental consent to use the clinics, and 3723 (65%) used the clinics during the 1991-1992 academic year. Clinic users were 11 to 15 years old, 50% male and 50% female, 81% Hispanic and 14% black, and 29% sixth graders, 33% seventh graders, and 38% eighth graders. Clinic users made 16,340 clinic visits during the 1991-1992 academic year. Presenting complaints were mental health problems (32%), illness (14%), injury (12%), physical examination (5%), immunization (3%), follow-up (21%), and other (13%). Referral sources were clinic outreach (48%), self (44%), and school personnel (8%). Disposition of visits was on-site treatment (92%), referral to an affiliated hospital (5%), and referral elsewhere (3%). Compared with a nationwide group of high school-based clinics that served predominantly black adolescents, these clinics provided more mental health care (31% vs 21%), similar illness/injury care (32% vs 30%), and less preventive (10% vs 24%) and reproductive/contraceptive (7% vs 12%) care. CONCLUSIONS: Junior high school-based clinics can provide a wide range of primary and preventive health care services for large numbers of medically underserved youths. The provision of mental health services may fill a critical need among inner-city adolescents. Clinic outreach may be necessary to maximize utilization, especially among high-risk students.

Adolescent↗
PubMed1995

Depression in users of depo-medroxyprogesterone acetate.

Prevalence of depression is high among poor, young, Hispanic inner city women. Depot-medroxyprogesterone acetate (DMPA) is a popular contraceptive choice in this group. DMPA labelling suggests that depression may worsen with use. In order to identify any association of DMPA use with worsening depression, we surveyed an English-speaking subset of DMPA users in a Title-X funded family planning clinic. Eighty women completed the CES-D scale on two occasions: once about four weeks after a DMPA injection when the subject would have been exposed to the highest blood levels, and once immediately prior to an injection when recent blood levels of the drug would be somewhat lower (or absent preceding the first injection). The median CES-D score was 14. The scores were not related to timing of the test (pre- or post-injection). The depression scores were somewhat higher among those women receiving their first DMPA injection during the study period (i.e., unexposed women) and among those women who had received four or more injections. Scores were unrelated to age or parity, but were somewhat higher in women who reported fewer years of education or a recent adverse pregnancy outcome. These data provide little evidence of increasing depression with long-term use of DMPA and no evidence of a short-term effect of dose (within the contraceptive range) on mood. Women at risk of depression should not be denied DMPA as a contraceptive choice.

Adolescent↗
PubMed1995

Sexual, assaultive, and suicidal behaviors among urban minority junior high school students.

OBJECTIVE: A greater understanding of minority adolescents' involvement in sex and violence is an essential precursor to the development of effective prevention programs targeted at inner-city youths. METHOD: To estimate the prevalence of involvement in sexual, assaultive, and suicidal behaviors and to quantify the relative importance of demographic, psychosocial, and behavioral risk factors for those behaviors, a survey was administered in the spring of 1992 to a sample of 3,738 predominantly Hispanic and African-American students attending four junior high schools in an economically disadvantaged, medically underserved New York City school district. The mean age of participants was 13.5 years; 73.7% were Dominican, 6.9% were other Hispanic, and 10.4% were black. RESULTS: Thirty-one percent of males and 7% of females reported involvement in sexual intercourse, 27% of males and 8% of females reported involvement in assaultive behavior and 10% of males and 19% of females reported suicide intentions/attempts. The primary risk factor for sexual intercourse was a belief that involvement in intercourse was common and acceptable among peers. The primary risk factor for assaultive behavior was adverse social circumstances. The primary risk factor for suicide intentions/attempts was symptoms of depression. The risk for involvement in each of the three investigated risk behaviors was substantially increased by involvement in the other two behaviors. CONCLUSIONS: These findings underscore the urgent need for comprehensive sex and violence prevention programs targeted at urban minority junior high school students and suggest factors that may identify students at highest risk.

Adolescent↗
PubMedDate not supplied

Pregnancy prevention among urban adolescents younger than 15: results of the 'In Your Face' program.

Data from a pregnancy prevention program operating through school-based clinics in four New York City junior high schools suggest that an intensive risk-identification and case-management approach may be effective among very young adolescents. Among students given a referral to a family planning clinic for contraception, the proportion who visited the clinic and obtained a method rose from 11% in the year before the program began to 76% in the program's third year. Pregnancy rates among teenagers younger than 15 decreased by 34% over four years in the program schools. In the fourth year of the program, the pregnancy rate in one school that was unable to continue the program was almost three times the average rate for the other three schools (16.5 pregnancies per 1,000 female students vs. 5.8 per 1,000).

Adolescent↗