Universal vaccination against varicella.
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Adult↗
Biomedical subjects
R W Spingarn
Publications and source records attributed to R W Spingarn.
When pharmaceutical manufacturers' employees present grand rounds, what do residents remember?
PURPOSE: To evaluate the educational effect on residents of a grand rounds given by a pharmaceutical company employee. METHOD: Using a retrospective cohort study design, the authors questioned 75 housestaff at a university hospital three months after a February 1990 grand rounds on Lyme disease to determine whether the residents' beliefs about the drug of choice for this disease differed between attendees and non-attendees. Odds ratios, 95% confidence intervals, and logistic regression were used for the analysis of results. RESULTS: The 22 housestaff who had attended the grand rounds were more likely to choose appropriately the cephalosporin manufactured by the speaker's company over other drugs for patients with Lyme disease presenting with second-degree heart block (adjusted odds ratio of 8.4; 95% CI 2.1-38.9). However, they also chose it inappropriately for first-degree heart block (adjusted odds ratio of 7.8; 95% CI 1.6-45.5). None of the attendees, compared with 11 (21%) of the non-attendees, named an oral antibiotic for both of two milder presentations, even though oral therapy would be more appropriate (p = .027). CONCLUSION: The results suggest that grand rounds effectively change residents' beliefs, but a sponsoring company's drug may be favored. Information assimilated in this way may not be well supported by the scientific literature and could result in a choice of treatment that is more expensive than other acceptable treatments.
Choice Behavior↗
Male adolescents involved in pregnancy: associated health risk and problem behaviors.
OBJECTIVE: Little is known about male high school students who have been involved in a pregnancy. This study was undertaken to determine whether male involvement with a pregnancy during adolescence is associated with other risk and problem behaviors. METHODS: The 1993 Massachusetts Youth Risk Behavior Survey was conducted on a random sample of 3054 9th- through 12th-grade students. The use of tobacco, alcohol, and other drugs, early and multiple sexual experiences, fighting resulting in injury, and demographic variables were compared between sexually active young men who reported being involved in pregnancy (n = 82) and their counterparts who reported not ever causing a pregnancy (n = 537). Associations were measured using chi 2 analyses and Kruskal-Wallis analysis of variance. Stepwise logistic regression was used to further analyze those variables significantly associated with involvement with a pregnancy. RESULTS: Based on logistic regression, older age and earlier ages of onset of cocaine use, initial sexual intercourse, and regular use of cigarettes were associated with being involved with a pregnancy. An increased lifetime frequency of cocaine use, lifetime frequency of alcohol use, and an increased number of lifetime sexual partners were also associated with having caused a pregnancy. Those who reported involvement with a pregnancy reported a higher frequency of being injured in a fight during the past year, drinking while driving, and having multiple sexual partners during the previous 30 days than those who had not gotten someone pregnant. CONCLUSIONS: A history of being involved with a pregnancy clustered with other health risk and problem behaviors to form a "risk behavior syndrome." These findings suggest that when risk behaviors are encountered during the routine comprehensive screening of male adolescents, strategies for pregnancy prevention among young men should also be emphasized.
Adolescent↗
Condom availability and prevention issues for adolescents.
Sexual activity among adolescents in the United States increased during the 1970s and 1980s but appears to be leveling off in the early 1990s. Condom use among sexually active adolescents has been irregular and variable. Recent trends, however, suggest that teenagers may be using condoms more often. More than half of all high school students used a condom at last intercourse in a nationwide survey. The most recent data about adolescent sexual activity and condom use are summarized, and recent studies examining attitudes and beliefs about condoms are reviewed. Many authors suggest that knowledge alone may be insufficient to change adolescent behavior in regard to condoms. The importance of understanding cultural norms and the social meaning of condoms among groups of teenagers is discussed. Differentiating disease protection from pregnancy prevention is also examined. Suggestions are made regarding strengthening condom negotiating skills in individuals. Recently published accounts of communities that have adopted condom programs in their schools by successfully addressing political obstacles are outlined.
Adolescent↗