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Biomedical subjects

R W Blum

Publications and source records attributed to R W Blum.

At least 19 recordsLinked to original sources
PubMed1992

American Indian--Alaska Native youth health.

OBJECTIVE: To assess risk behaviors, health problems, worries and concerns, and resiliency-promoting factors among American Indian-Alaska Native adolescents. DESIGN: Survey. SETTING: Nonurban schools from eight Indian Health Service areas. PARTICIPANTS: A total of 13,454 seventh- through 12th-grade American Indian-Alaska Native youths. MAIN OUTCOME MEASURES: revised version of the Adolescent Health Survey, a comprehensive, anonymous, self-report questionnaire with 162 items addressing 10 dimensions of health. RESULTS: Poor physical health was reported by 2% of the study sample and was significantly correlated with social risk factors of physical and/or sexual abuse, suicide attempts, substance abuse, poor school performance, and nutritional inadequacies. Injury risk behaviors included never wearing seatbelts (44%), drinking and driving (37.9% of driving 10th through 12th graders), and riding with a driver who had been drinking (21.8%). Physical and sexual abuse prevalence was 10% and 13%, respectively, with 23.9% of females reporting physical abuse and 21.6% of females reporting sexual abuse by the 12th grade. Almost 6% of the entire sample endorsed signs of severe emotional distress. Eleven percent of the teens surveyed knew someone who had killed himself or herself, and 17% had attempted suicide themselves. Sixty-five percent of males and 56.8% of females reported having had intercourse by the 12th grade. Weekly or more frequent alcohol use rose from 8.2% of seventh graders to 14.1% by the 12th grade; for males, the survey noted an increase in regular alcohol use of 3% to 5% a year to 27.3% by the 12th grade. For each variable measured, rates are much higher for American Indian adolescents than those for rural white Minnesota youth, except for age at first intercourse and alcohol use. CONCLUSIONS: American Indian-Alaska Native adolescents reported high rates of health-compromising behaviors and risk factors related to unintentional injury, substance use, poor self-assessed health status, emotional distress, and suicide. Interventions must be culturally sensitive, acknowledge the heterogeneity of Indian populations, be grounded in cultural traditions that promote health, and be developed with full participation of the involved communities.

Adolescent↗
PubMed1992

Physician attitudes toward confidentiality of treatment for adolescents: findings from the Upper Midwest Regional Physicians Survey.

The provision of confidential medical services to adolescents is an enduring health policy issue in the United States, and the focus of policy statements by several professional medical organizations. Physician attitudes toward confidential service provision to teenagers were examined in the Upper Midwest Regional Physician Survey, a representative sample of community-based pediatricians and family physicians. Overall, three-quarters of participants favored confidential service provision for youths. Multivariate analysis revealed that the most salient reasons for favoring confidentiality were perception of unique needs among adolescents, year of licensure, high self-assessed competency in addressing sexual concerns of adolescence, adequacy of training in interpersonal and sexual issues, frequency of addressing interpersonal issues, and lower self-assessed adequacy of training in traditional medical problems of youths. Implications for state and federal legislation are discussed.

Adolescent↗
PubMed1991

Demographic and risk factors associated with chronic dieting in adolescents.

A comprehensive, school-based survey was administered to 36,320 Minnesota public school students in grades 7 through 12 during the 1987-1988 school year. Self-reported chronic dieting was much higher in girls than in boys (12.1% of all girls vs 2.1% of boys). For girls, the percentage of chronic dieters was significantly less in grades 7 and 8 (7.8%) than in grades 9 and 10 (13.5%) or grades 11 and 12 (14.3%). There were no differences among urban, suburban, or rural youth. Black girls were less likely to diet compared with white girls. Chronic dieters were more likely than other students to report maladaptive weight-loss techniques, such as self-induced vomiting (relative risk, 9.92 for girls and 9.40 for boys), laxative use (relative risk, 7.18 for girls and 11.00 for boys), ipecac use (relative risk, 8.33 for girls and 11.00 for boys), and diuretic use (relative risk, 7.30 for girls and 13.5 for boys). It is suggested that chronic dieting may serve as a screening marker for more severe eating and weight-loss behaviors.

Adolescent↗
PubMed1991

Overview of transition issues for youth with disabilities.

In many industrialized nations of the world it is estimated that nearly 10% of young people have chronic conditions; nearly one third have limitations of functioning. The most common conditions include hay fever, chronic sinusitis, acne, and asthma. Dramatic strides in medical management of chronic conditions in industrialized nations have resulted in nearly 85% of children born today with a congenital anomaly living at least until the age of 20. Not only are children with previously fatal conditions living until adulthood, but more of them are increasingly being mainstreamed into community settings. There is a diverse set of issue of which the clinician needs to be cognizant to successfully work with youth with chronic illness and disabilities as well as their parents.

Adolescent↗
PubMed1991

Family and peer issues among adolescents with spina bifida and cerebral palsy.

Increasingly, children with disabling conditions are surviving through childhood into adolescence and beyond. This places increased importance on understanding adolescent, family, and peer relationships, which are critical to healthy development among adolescents in general and to transitions to successful adulthood among youths with physical disabilities in particular. The purpose of this study was to identify the patterns of family and peer interactions. One hundred two youths with spina bifida and 60 adolescents with cerebral palsy between the ages of 12 and 22 completed written psychological measures as well as an in-depth structured interview. Approximately 90% of youths with spina bifida and cerebral palsy resided at home, of whom 80.4% and 72% lived with both parents. Almost without exception, parental relationships were defined as positive, with no difference of attitude noted toward the mother and father. Relationships with parents for teenagers with spina bifida were marked by high levels of dependence on parents for personal care such as bowel programs and, for both groups, low levels of responsibility at home and lack of discussion with parents about sexuality or menstruation. Although friends were viewed as very important by most respondents (approximately 83%), relationships were characterized by extremely limited out-of-school contacts, negligible participation with organized social activities, and a primary orientation toward sedentary activities. Finally, regarding heterosexual relationships, whereas 44.1% of respondents with spina bifida and 54.2% of respondents with cerebral palsy said their friends dated, only 14.7% and 28.3% of study participants indicated that they had ever been on a date and, even for those teenagers, heterosexual social contacts were infrequent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Knowledge and attitudes of health professionals toward adolescent health care.

The rising concern over the competency of health care professionals in the United States to meet the health needs of adolescents was the impetus for a national survey of 3066 physicians, nurses, social workers, nutritionists, and psychologists. The survey explored perceptions of training and competency regarding 16 dimensions of adolescent health care. Major deficits were noted for each discipline. For physicians, self-perceived limitations were in the areas of eating disorders, learning disabilities, chronic illness, and delinquent behavior. The same limitations were also mentioned by nurses. Over half of the psychologists reported deficits related to the psychological sequelae of sexual concerns, sexual orientation conflict, eating disorders, and chronic illness. Many of the same concerns reflected the perceived competencies of social workers. Nearly half of all nutritionists surveyed acknowledged deficits in almost all adolescent food-related concerns. The impact of these low levels of perceived competency is discussed in terms of implications for clinical service.

Adolescent↗
PubMed1990

Characteristics of unmarried adolescent mothers: determinants of child rearing versus adoption.

The sociodemographic and biographical characteristics of a group of unmarried adolescent mothers who opted to rear their children were compared with those of a matched group who placed their children for adoption. Those choosing adoption were more likely to be of higher socioeconomic status, to have higher educational aspirations, and to be from suburban residences. Suggestions for intervention and appropriate services are offered.

Adolescent↗
PubMed1988

Adolescent nutrition: self-perceived deficiencies and needs of practitioners working with youth.

Sixty-three percent of a random sample of 866 members within three practice groups of The American Dietetic Association responded to a survey designed to assess (a) perceived competency of nutrition management in 20 major areas of adolescent health, (b) desire to increase skill level in each area, and (c) preferred approaches for continuing education activities. Of the 549 respondents, 92% were registered dietitians (R.D.s), 5% were registration-eligible, and more than half (51%) had advanced degrees. Twenty-five percent or more of all practitioners reported deficiencies in 17 of the 20 categories. The five top areas in which respondents believed that they had insufficient skills were psychosomatic problems (87%), handicapping conditions (82%), sports nutrition (81%), alcohol/drug abuse-related nutrition concerns (80%), and anorexia nervosa/bulimia nervosa (72%). The strongest desires to improve skills were in the areas of obesity, poor dietary patterns, sports nutrition, food fads, supplement misuse, alternative diets, and eating disorders. There was low interest in strengthening skills in family planning, psychosomatic problems, and handicapping conditions. The implications of the results are discussed. Continuing education methods respondents believed to be most beneficial for learning were small conferences, lectures with ample discussion, and "hands-on" workshops.

Adolescent↗
PubMed1987

Adolescent substance abuse: diagnostic and treatment issues.

For teenagers, substance use initiation peaks between 16 and 18 years of age, with the greatest use occurring over the subsequent four years, after which time there is a significant reduction in usage. Factors associated with adolescent substance abuse include rebelliousness, relative indifference to school, tolerance for social deviance, family disruption, parental tolerance of alcohol or other drug use, and early onset of drug use. One major problem for teenagers is that the diagnosis and treatment of adolescent substance abuse is based primarily on adult models of alcoholism.

Adolescent↗
PubMed1987

The impact of a parental notification law on adolescent abortion decision-making.

In 1984, we investigated the impact of a parental notification statue with judicial bypass procedures in Minnesota. Subjects were interviewed on the day of their abortion at four Minnesota and two Wisconsin clinics. Relatively few were aware of the statute in Minnesota. Parental notification rates were similar in Minnesota and Wisconsin, which has no parental notification statute.

Abortion, Legal↗
PubMed1985

Adventure, Etc.--a health-promotion program for chronically ill and disabled youth.

Adolescents with a chronic illness or physical disability have a more difficult time separating from parents, achieving a sense of mastery, developing social skills among peers, and achieving a positive body-image than do able-bodied adolescents. To promote attainment of these developmental tasks, Adventure, Etc. was created as a wilderness/urban Outward Bound experience for chronically ill, physically disabled, and able-bodied teens. Pre- and posttesting and interviewing assessed locus of control, self-image, family environment, and family dynamics. Over a two-year period, 37 teens completed the program and were tested; 23 were chronically ill or disabled. The chronically ill/disabled group showed a significant increase in internal locus of control. No change was found in the able-bodied group. Both the able-bodied and the disabled/chronically ill groups showed a significant improvement in body image. Reported family conflict declined, as did family recreational involvement, while individual recreational activities among these adolescents increased. Based on these results, new follow-up activities for the parents and adolescents were initiated to further the gains of program participants.

Adolescent↗