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Biomedical subjects

Linda Richter

Publications and source records attributed to Linda Richter.

17 recordsLinked to original sources
PubMed2007

Developmental potential in the first 5 years for children in developing countries.

Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data--the prevalence of early childhood stunting and the number of people living in absolute poverty--to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty.

Adolescent↗
PubMed2006

Contextual barriers to successful reentry of recovering drug offenders.

Recidivism among recovering ex-offenders is usually conceptualized as an outcome of the interplay between personal traits and treatment interventions. This focus on the individual, to the exclusion of the sociolegal context in which recovery and reintegration take place, has limited extant policy initiatives. Recidivism data from 440 drug-abusing felons who had successfully completed long-term residential treatment were examined. All else being equal, recovering offenders who began their reentry during times of high unemployment, low risk of incarceration for new offenses, or both, were found to be more likely to recidivate during their first year in the community. These findings highlight the promise of blending effective drug abuse treatment with credible sanctions against drug offenses as well as the need for job training, placement, and advocacy services.

Adult↗
PubMed2006

Sexual risk behavior among South African adolescents: is orphan status a factor?

There is concern that orphans may be at particular risk of HIV infection due to earlier age of sexual onset and higher likelihood of sexual exploitation or abuse; however, there is limited empirical evidence examining this phenomenon. Utilizing data from 1,694 Black South African youth aged 14-18, of whom 31% are classified as orphaned, this analysis explores the relationship between orphan status and sexual risk. The analysis found both male and female orphans significantly more likely to have engaged in sex as compared to non-orphans (49% vs. 39%). After adjusting for socio-demographic variables, orphans were nearly one and half times more likely than non-orphans to have had sex. Among sexually active youth, orphans reported younger age of sexual intercourse with 23% of orphans having had sex by age 13 or younger compared to 15% of non-orphans. Programmatic implications of these findings for the care and protection of orphans are discussed.

Adolescent↗
PubMed2006

Personality, attitudinal and behavioral risk profiles of young female binge drinkers and smokers.

PURPOSE: Analyses were conducted to identify personality, attitudinal and behavioral correlates of binge drinking and smoking among adolescent girls and young women, a population whose substance use attitudes and behaviors have received only limited attention in the literature. METHODS: A nationally representative sample of girls and young women (n = 929) from three age cohorts completed a telephone interview assessing various personality, attitudinal, and behavioral characteristics. Respondents were categorized into four groups based on self-reported binge drinking and smoking (binge drinker/nonsmoker, smoker/non-binge drinker, binge drinker/smoker, or non-binge drinker/nonsmoker) and were assessed on a number of variables, including self-monitoring, depressive symptoms, coping style, religiosity/spirituality, popularity, dieting behavior, and smoking- and alcohol-related expectations. Univariate and multiple regression analyses were conducted to identify characteristics that best describe each of these types of substance users. RESULTS: Risk profiles varied across the groups. Girls and young women who binge drank but did not smoke were more likely to be high self-monitors, to engage in disordered dieting, and to believe drinking provided an excuse to act with less inhibition. Those who smoked but did not binge drink were more likely to report depressive symptoms. Those who binge drank and smoked were more likely to be popular and to report depressive symptoms. Certain forms of avoidant coping and low religiosity were associated with all three types of substance use. CONCLUSION: Understanding the risk profiles of girls and young women who engage in specific forms of substance use can facilitate the identification of those at risk and the development of more targeted and effective prevention programs and interventions.

Adaptation, Psychological↗
PubMed2005

Increased nocturnal interleukin-6 excretion in patients with primary insomnia: a pilot study.

The aim of the present study was to investigate whether there is a difference in evening/nocturnal interleukin-6 (IL-6) serum excretion in patients with primary insomnia compared to controls. We hypothesized that in insomniac patients, the excretion of evening/nocturnal IL-6 is enhanced, like observed in aged adults and after sleep deprivation in healthy subjects. We studied IL-6 serum concentrations in 11 patients (two males and nine females) with primary insomnia and 11 age and gender-matched healthy controls. Sleep was monitored polysomnographically for three consecutive nights. The measurement of IL-6 (from 19:00 h to 09:00 h) in 2-h intervals were performed prior to and during the last laboratory night. Polysomnographically determined sleep parameters and subjective ratings of sleep demonstrated clear-cut impairments of sleep in the insomniac group. Nocturnal IL-6 secretion was significantly increased (p<.05) in insomniac patients for the whole measurement period (mean area under the curve+/-SD: 27.94+/-14.15 pg/ml x 2h) compared to controls (16.70+/-7.64 pg/ml x 2h). Total IL-6 secretion correlated inversely with subjectively perceived sleep quality and amount of slow wave sleep in the insomniac patients. Amount of Wake Time correlated positively with IL-6 excretion in insomniacs. The results of the present study demonstrate significantly increased nocturnal IL-6 secretion in insomniacs. It might be speculated that chronic primary insomnia with polysomnographically documented sleep impairments activates the production of IL-6 analogous to sleep deprivation studies in healthy subjects. This might also implicate a higher risk for inflammatory and cardiovascular diseases in patients with chronic insomnia.

Adult↗
PubMed2005

Nonmedical use of prescription opioids among teenagers in the United States: trends and correlates.

PURPOSE: This article reports on trends and correlates of the nonmedical use of prescription opioids among youth. METHODS: Secondary analyses of data from the National Survey on Drug Use and Health were performed on youths, ages 12 to 17. RESULTS: Analyses revealed evidence of an emerging epidemic of opioid misuse among teenagers. Sub-groups of youth at particularly high risk include females, blacks, those of lower socio-economic status, and those who hold favorable attitudes toward illicit drugs, have detached parents, or have friends who use illicit drugs. Respondents' own use of other illicit drugs is the strongest predictor of their nonmedical use of prescription opioids. CONCLUSIONS: Nonmedical use of prescription opioids is a recurrent epidemic and valuable lessons from past epidemics of this nature can be learned if historical data are studied. Prevention campaigns should target groups at risk for substance abuse and focus on improving family bonds and peer-resistance skills.

Adolescent↗
PubMed2005

Telescoping of drinking-related behaviors: gender, racial/ethnic, and age comparisons.

OBJECTIVE: To examine demographic differences in alcohol telescoping-the rate of self-reported movement from regular alcohol consumption to the onset of regular heavy drinking-as well as differences in ages of initiation of regular alcohol use and alcohol use to intoxication. METHOD: The present study compared the retrospective reports of 2037 clients (1252 males, 785 females) enrolled in substance user treatment facilities around the country in 1998 and 1999. RESULTS: Overall, the findings support previous research, indicating that women generally move more rapidly than men from initiation of regular alcohol use to problem use (telescoping). The findings also indicate that African-Americans generally begin regular alcohol use later than their Anglo counterparts and move more rapidly from initiation of regular alcohol use to problem use (telescoping). Examining the sample by older vs. younger age groups demonstrates that gender and racial/ethnic differences in the age of initiation of regular alcohol use and in telescoping may be limited by age group, as these patterns appear in the older but not the younger cohort. CONCLUSIONS: These findings suggest that self-reported regular alcohol use, alcohol abuse, and telescoping differences vary dramatically by gender, race/ethnicity, and age cohort. Furthermore, the pattern of findings suggests that these differences are more likely the result of sociocultural than biological differences between the groups under study.

Adult↗
PubMed2005

Social and behavioral aspects of child and adolescent participation in HIV vaccine trials.

Recent data indicate that the worldwide rate of HIV infection in adolescents is steadily increasing. Internationally, more than 7000 youths between 15 and 24 years of age are infected with HIV daily, resulting in more than 2.5 million new infections annually. Almost two thirds (1.7 million) of these new infections occur in Africa. Estimates in 2000 showed that the number of South Africans between 15 and 49 years of age infected with HIV was 4.7 million. This number equates to a prevalence rate of 15.4% in those younger than 20 years. Adolescents form an important target group not only for preventative efforts but also for HIV vaccine trials. This article focuses on the social and psychological factors that affect adolescent decision making by considering adolescent risk-taking behaviors, problems associated with predicting adolescent behavior, peer relationships and decision making, sexual disinhibition, and the role of family relationships in adolescent decision making.

AIDS Vaccines↗
PubMed2004

Public attitudes about underage drinking policies: results from a national survey.

We conducted a national telephone survey of 900 adults in the United States to examine the attitudes of the adult public regarding underage drinking and a series of alcohol control policies aimed at reducing it. Three versions of the survey instrument were administered, each to one-third of the sample, with the versions varying in the stipulations of the policy options. Results showed high levels of public support for most of the alcohol control policies, with relatively lower support for those that would result in restrictions on adults' access to alcohol. Respondents' support of the policy options was significantly related to their sociodemographic and attitudinal characteristics, such as sex, age, drinking frequency, and level of concern about underage drinking. The findings provide important guidelines to policymakers interested in garnering support for policies aimed at curtailing underage drinking.

Adolescent↗
PubMed2003

The acceptability of an investigational vaginal microbicide, PRO 2000 Gel, among women in a phase I clinical trial.

PURPOSE: Vaginal microbicides will provide a woman-initiated prevention strategy that could substantially reduce rates of HIV infection. The acceptability of microbicides will greatly influence the use and, hence, effectiveness of such products. In this study, the acceptability of an investigational microbicide, PRO 2000 Gel (Indevus Pharmaceuticals, Inc., Lexington, MA), was assessed, and women's opinions about microbicides and their potential for real world use were gathered. METHODS: Quantitative and qualitative data were collected from 30 U.S. and 33 South African women. All sexually active HIV-uninfected women and all sexually abstinent HIV-infected women participating in this phase I clinical trial stated in a survey that they would use PRO 2000 Gel if they had reason to be concerned about HIV and the product were available. Qualitative data, however, provided insight into the nuances of acceptability ratings. Women rated product safety, ease of use, and positive effects on sexual pleasure among the most important characteristics of acceptable microbicides. RESULTS: Opinions regarding product leakage, contraceptive capability, and the ability to be used without partners noticing, as well as characteristics of the product itself, varied substantially based on the context of sex and perceptions of risk within each individual woman's life. CONCLUSIONS: As microbicide development continues and the first investigational products move into efficacy trials, the needs and preferences of those women who constitute the potential users of microbicides become paramount. Providing woman-initiated microbicides that are safe, easy to use, and pleasurable will be key to the impact these products will have on the AIDS epidemic worldwide.

Administration, Intravaginal↗
PubMed2002

The relationship between smoking, drinking, and adolescents' self-perceived health and frequency of hospitalization: analyses from the 1997 National Household Survey on Drug Abuse.

PURPOSE: To investigate the more immediate health effects of smoking and drinking among adolescents. METHODS: Secondary analyses of data from the 1997 National Household Survey on Drug Abuse were conducted to explore the relationship between subjective and objective health outcomes and the use of alcohol and tobacco among adolescents. RESULTS: The findings suggest that adolescents who smoke or drink actually report poorer health during adolescence than those who do not. In fact, adolescents who are frequent or heavy alcohol and tobacco users report poorer subjective overall health and a greater number of overnight hospital stays during the previous year than less frequent or intense users and than nonusers. In addition, the data revealed a number of significant gender and age group differences in reports of health outcome as well. CONCLUSIONS: Demonstrating to youngsters the more immediate, negative health consequences of alcohol and tobacco use might strengthen prevention messages and ultimately decrease the use of these substances among adolescents.

Adolescent↗
PubMed2002

Marijuana use among the adolescent children of high-risk drug-abusing fathers.

This study examines marijuana use among children of male drug abusers. Subjects were 83 African-American and European-American male drug abusers, of whom the majority were injection drug users, and their children. Thirty-one of the fathers were HIV-positive and 52 were HIV-negative. Using logistic regression analyses, we explored cross-sectionally the relationship between four psychosocial domains (ie, paternal attributes, adolescent problem behaviors, father-adolescent relations, and environment) and adolescent marijuana use. The father's use of illegal drugs and his failure to cope adaptively predicted adolescent marijuana use, while a close father-child bond predicted less adolescent marijuana use. Adolescent problem behaviors predicted an increased likelihood of marijuana use. Furthermore, hierarchical regression analysis demonstrated that the adolescent's problem behavior mediated the associations between both the father-adolescent relationship and environmental factors with adolescent marijuana use. Reducing the risk factors and enhancing the protective factors within each of the domains could help reduce marijuana use among the adolescent children of drug-abusing fathers. Moreover, if a father is a drug abuser, it is important to help him establish a close bond with his child in order to help attenuate the influence of his drug use on the child's marijuana use.

Adaptation, Psychological↗
PubMed2002

Coping with body image changes following a disfiguring burn injury.

The influence of emotion-focused coping on distress following disfiguring injury was examined. Two types of emotion-focused coping (i.e., venting emotions vs. mental disengagement) were assessed in 78 patients with burn injury at baseline during acute hospitalization. Body image dissatisfaction (BID) was assessed 1 week and 2 months following discharge. Use at baseline of both venting emotions and mental disengagement, compared with use of only one or neither of these coping methods, was associated at the 2-month postdischarge follow-up with significantly higher BID related to nonfacial aspects of appearance and with a greater negative social impact of disfigurement. D. M. Wegner's (1994) theoretical model of mental control and a proposed motivational analysis are used to interpret these findings.

Adaptation, Psychological↗
PubMedDate not supplied

Regulating acute posttrauma distress.

The influence of emotion-approach and emotion-avoidance methods of coping on the development (cohort 1) and persistence (cohort 2) of posttraumatic stress symptoms was examined. The two coping methods and the frequency and intensity of intrusive, avoidant, and hyperarousal symptoms were assessed in separate series of 71 and 94 hospitalized acute burn-injured patients. In both samples, subjects who frequently used both mental distancing (emotion-avoidance) and venting emotions (emotion-approach), relative to subjects who used only one or neither of the two coping methods, had higher levels of posttraumatic stress disorder symptoms even when controlling for baseline symptoms. Higgins' (1997) motivational framework, incorporating the needs for controllability and predictability, and Wegner's (1994) theory of mental control are used to interpret the findings.

Adaptation, Psychological↗
PubMedDate not supplied

Pediatric nursing in the context of the HIV/AIDS epidemic in resource-poor settings--balancing the "art and the science".

Pediatric wards in South Africa are largely occupied by children with AIDS-related illnesses. This study uses qualitative inquiry involving focus groups with nurses into the needs of children, caregivers, and healthcare providers. The findings indicate changes to the nature of nursing practice, knowledge of nursing, and ethics of nursing care.

Burnout, Professional↗