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Biomedical subjects

V I Rickert

Publications and source records attributed to V I Rickert.

At least 37 records · Page 2Linked to original sources
PubMed1997

Rural school-based clinics: are adolescents willing to use them and what services do they want?

Using a theoretical model of access, factors associated with rural adolescents' willingness to use primary care services through a school-based health center (SBHC) were examined. Standardized measures of health status and use were administered to 633 adolescents in grades 7-12 who resided in one rural western Maryland county. Although only 6.5% (n = 41) of the sample indicated a willingness to change their regular source of care to an SBHC, greater numbers of adolescents reported a willingness to use SBHC services, with 18%, 38%, 25%, and 16%, indicating interest in routine, acute medical, miscellaneous, and reproductive health care services, respectively. Logistic regression analysis found those adolescents who reported eligibility for free-reduced lunch and no regular source of care for illness were 3.3 and 5.4 times more likely, respectively, to use an SBHC as a primary care site than those unwilling to change their source of care. Data suggest that initially many rural adolescents appear unwilling to change their primary care site to an SBHC, but do express a willingness to use offered services.

Adolescent↗
PubMed1996

The effects of peer ridicule on depression and self-image among adolescent females with Turner syndrome.

PURPOSE: This study attempted to examine the effects of body image, height dissatisfaction, and peer ridicule on depression and self-image among adolescent females with Turner syndrome. METHODS: A prospective, cross-sectional survey examined 59 subjects' responses to standardized measures of depression, self-image, body image, height perception, and teasing. RESULTS: Descriptive statistics found the mean age of subjects to be 14.8 years (range: 13-19). Approximately 30% reported cardiac defects and 17% indicated kidney anomalies. Only five experienced spontaneous menses and 61% indicated they were receiving estrogen replacement therapy. Linear regression analyses examined the effects of body image, height perceptions, and peer ridicule on depression and self-image scores. The first regression analysis found a five-step model to account for 39% of the variance, with peer ridicule of general appearance being the most important variable. The second linear regression (R2 = .3248, P < .0004) also found peer teasing of general appearance to be significantly associated with self-image scores. Discrepancy scores between ideal versus current body shape or height, as well as teasing about these issues, appeared to be unrelated to depression and self-image among our subjects. CONCLUSION: These data suggest that peer ridicule is a domain that requires ongoing assessment by health care providers, as it appears to be an important contributor to mental health problems. Social skill interventions that emphasize strategies to manage teasing, assertively respond to negative statements, and teach effective coping skills are key variables to minimize the emotional discomfort these young women may experience.

Adaptation, Psychological↗
PubMed1996

Alcohol availability and motor vehicle fatalities.

PURPOSE: To examine the association between the availability of alcohol and male (15-24-years-old) motor vehicle fatalities. METHODS: Assessed association between motor vehicle fatality rates for each of 75 counties for males with measures of alcohol availability (whether the county was wet or dry, number of licensed on-site and off-site alcohol outlets) after controlling for other variables for a 6-year period. Poisson regression models were employed. RESULTS: No significant relationships were found between county-level motor vehicle fatality rates and any of the alcohol availability measures examined. However, rural residence was associated with much higher fatality rates. CONCLUSIONS: Overall, ecologic models, employing a wide range of variables, account for little of the variance in motor vehicle fatality rates for young men. These findings support the position that further legal or regulatory restrictions on alcohol outlet licensing may not have an impact on fatalities. The higher rates associated with rural residence, while consistent with other work, cannot be explained by alcohol beverage outlets.

Accidents, Traffic↗
PubMed1996

The effects of mental health factors on ambulatory care visits by rural teens.

This study sought to determine the effects of mental health variables on rural adolescents' use of ambulatory health care services and whether these effects varied across common outpatient settings. Using a cross-sectional survey design, 2,297 adolescents who attended public schools in grades 7 through 12 in one isolated rural Mississippi River Delta county were assessed via a standardized health behavior survey. This self-report measure inquired about relevant health behaviors such as alcohol use, depressive symptoms, and health service use. The students' mean age was 15 years and 58 percent of the sample were black. Approximately 11 percent of the sample reported symptoms of depression, 16.5 percent reported problem drinking, and slightly fewer than 6 percent reported both. After controlling for predisposing, enabling, and need factors, the reporting of depressive symptoms, problem drinking, or both was related to an increased number of outpatient visits in three of four sites examined. However, differences among sites were observed. These data suggest that mental health problems are associated with increased visits to ambulatory settings, and these problems affect service use differentially. Thus, effective interventions and better linkages between ambulatory settings and mental health providers may reduce unnecessary use.

Adolescent↗
PubMed1995

Adolescents and Norplant: preliminary findings of side effects.

PURPOSE: The purpose of this study was to investigate side effects such as menstrual irregularities, weight gain, and blood pressure changes among adolescent females who had been implanted with Norplant eight or more months. METHOD: A retrospective chart review was completed on adolescents who received care through an outpatient adolescent gynecology service. Subjects (n = 110) with an average age of 17.2 years were implanted with Norplant between March 1991 and February 1992. The mean length of time since implantation was 12.7 months and 64% were African-American. Data collected included: dates of all medical visits; presence of acne, mood changes, and menstrual patterns following implantation. Measurements of blood pressure and weight were taken at implantation and at all subsequent visits. RESULTS: Weights for Caucasian females at the last visit were significantly higher than at baseline (P < .02). With regard to the African-American females' weight, significant differences were found between baseline weight and each follow-up visit. Although we could not determine the bleeding patterns in 22% of our study sample, almost 40% of the adolescent females followed reported their bleeding to be light as well as regular and cyclic. CONCLUSION: Weight gain was the most frequently observed side-effect of Norplant in adolescents in this study.

Adolescent↗
PubMed1995

Maternal influence on the decision to adopt Norplant.

PURPOSE: To examine maternal influence and related variables on adolescents' decision to adopt Norplant. METHODS: A prospective study of 121 adolescent females who received Norplant through a hospital-based outpatient adolescent gynecology service. Each patient completed self-report questionnaires about her decision process, sexual behaviors and standardized measures of depression and anxiety at their insertion appointment or first-follow-up appointment. RESULTS: Almost 40% of the sample reported that their mother significantly influenced their decision to use Norplant and 61% of all patients stated that they had informed their mother of their choice of this contraceptive method. Through logistic regression, six variables were found to be significantly associated with mother as the most important decision source. These included: obtaining information about Norplant from a parent, maintaining the same sexual partner, past pill use, and not knowing other adolescents who boast about using the Norplant system. CONCLUSION: These data suggest that when parental consent is not required, adolescent females disclose sensitive information regarding choice-making to their mothers when they decided to adopt Norplant.

Adolescent↗
PubMed1995

Health care utilization and perceptions of health among adolescents and adults with Turner syndrome.

We surveyed women aged 12 years and older who are members of the Turner Syndrome Society of the United States in regard to their health history, current health status, and health care utilization practices to identify the range of health problems and health care practices in this group. The mean age at diagnosis was 10.8 years, and an endocrinologist (41%) or pediatrician (35%) was most likely to make the initial diagnosis. Individuals over age 35 years were diagnosed with Turner syndrome and begun on estrogen replacement therapy at a significantly older age than those who were in younger age groups. Seventy-five percent of the respondents had required some type of surgical procedure, and 14% had been hospitalized within the previous year. Ninety-four percent of women rated their overall health as good to excellent, while 6% rated it fair to poor. In the 12-17-year age group, 89% of the young women were either currently taking or had previously taken growth hormone. The prevalence of major depressive symptoms was slightly higher than the general population for adolescents but similar to the general population for adults. For adult respondents, ratings of fair to poor health were significantly associated with increased outpatient visits. Growth hormone use was significantly associated with increased visits in the adolescent population. Based on these data, it appears that the clinical care of individuals with Turner syndrome has improved, but that they continue to have relatively high hospitalization rates and utilization of subspecialty services. Despite these health problems, most respondents demonstrated good adjustment as determined by standardized mental health measures.

Adolescent↗
PubMed1994

Stability of the relationships between anabolic steroid use and multiple substance use among adolescents.

BACKGROUND: In a previous study, we tested the hypothesis that because adolescent anabolic steroid users are concerned with increasing muscle size and strength they are different from other substance users and are unlikely to use other drugs. Alternatively, if the causal factors of anabolic steroid use are similar to those for use of other substances, then adolescent anabolic steroid users would be expected to report poly drug use. Study findings confirmed the second hypothesis. PURPOSE: To test the stability of the relationships between anabolic steroid use and poly drug use over a four month period among ninth grade students. METHODS: All ninth grade students (1422) enrolled in compulsory health science classes in a country school system who had previously completed a modified version of the Centers for Disease Control and Prevention's 1989 Health Risk Survey and the 1990 Youth Risk Behavior Survey in November 1990 were asked to repeat the survey in February 1991. RESULTS: A higher percentage of males (4.7 percent) than females (2.9 percent, P < or = 0.018) reported anabolic steroid use without a doctor's prescription. As was found in the initial study, frequency of anabolic steroid use was significantly (P < 0.001) associated with frequency of use in the last 30 days of cocaine, injectable drugs, alcohol, marijuana, cigarettes, and smokeless tobacco. When those variables were analyzed with multiple regression analysis, the same four variables continued to be the best predictors of the frequency of anabolic steroid use, although the order that the variables entered into the multiple regression model changed. Use of smokeless tobacco, shared needles, cocaine, and marijuana explained more variation in the frequency of anabolic steroid use in the replication study (48.5%) than initially (32.8%). CONCLUSIONS: These findings support the hypothesis that adolescent anabolic steroid users are also likely to use other drugs and are engaging in shared needle use. These relationships remained relatively stable over a four month period of time.

Adolescent↗
PubMed1994

Adolescents and colposcopy: the use of different procedures to reduce anxiety.

OBJECTIVE: Two consecutively occurring studies examined whether using a video colposcope to view this procedure or allowing the female adolescent to watch music videos would reduce anxiety and related body movements. STUDY DESIGN: Female adolescents who underwent colposcopy were randomly assigned to one of two groups, experimental and control. In study 1, 27 female adolescents were randomly assigned either to view the procedure on a television monitor or to be part of a control group (no visual distraction). In study 2, 30 female adolescents were randomly assigned either to a music video group or to a control group. Studies were completed in a consecutive manner and used the same measures, colposcopic equipment, and professional staff, including physician. Multiple measures of anxiety were used (heart rate, behavior observation, and paper and pencil) before, during, and after the procedure. During each colposcopy the subject's behavior across 10 dimensions was observed and coded. Data were analyzed by chi 2, analysis of variance, and Student t tests. RESULTS: Study 1 found no significant differences in body movements and anxiety ratings between the video colposcope group and controls. In study 2, subjects who were allowed to watch the music videos demonstrated significantly fewer body movements indicative of pain, required less physician reassurance, and received fewer procedural explanations (p < 0.05). CONCLUSION: Results suggest that allowing a female adolescent to watch music videos during a colposcopic examination appears to decrease body movements associated with discomfort.

Adolescent↗
PubMed1993

Use of multiple drugs among adolescents who use anabolic steroids.

BACKGROUND: Because adolescent users of anabolic steroids are concerned with increasing muscle size and strength, they may be unique among substance users and unlikely to use other drugs. Alternatively, if the factors that cause the use of anabolic steroids are similar to those associated with the use of other substances, adolescents who use anabolic steroids would be expected to report use of other drugs as well. METHODS: We administered a questionnaire based on the 1989 Secondary School Health Risk Survey and the 1990 Youth Risk Behavior Survey of the Centers for Disease Control and Prevention to 1881 students enrolled in compulsory health-science classes (mean [+/- SD] age, 14.9 +/- 1.0 years) in the Richmond County, Georgia, school system. RESULTS: A higher percentage of boys (6.5 percent) than girls (1.9 percent, P < or = 0.001) reported using anabolic steroids without a doctor's prescription. Among ninth-grade students only, 5.4 percent of boys and 1.5 percent of girls reported using anabolic steroids (P < or = 0.001). Among users of anabolic steroids, 25 percent reported sharing needles to inject drugs. The frequency of anabolic-steroid use was significantly (P < 0.001) associated with the frequency of use in the previous 30 days of cocaine (r = 0.44), injectable drugs, alcohol (r = 0.23), marijuana (r = 0.42), cigarettes (r = 0.25), and smokeless tobacco (r = 0.40). On the basis of multiple regression analysis, the use of marijuana, shared needles, smokeless tobacco, and cocaine accounted for 33 percent of the variation in anabolic-steroid use among the ninth-grade students. CONCLUSIONS: In our study, adolescent users of anabolic steroids were likely to use other drugs as well, and many were sharing needles.

Adolescent↗
PubMed1993

Low-birth-weight infants born to adolescent mothers. Effects of coresidency with grandmother on child development.

OBJECTIVE: To explore the impact of young maternal age, coresidency with infant's grandmother, and other familial and environmental factors on development of low-birth-weight (LBW) infants. DESIGN: Prospective cohort analyses. SETTING: Eight medical institutions in different geographical locations participating in the Infant Health and Development Program. PARTICIPANTS: Control population of 272 LBW, preterm infants enrolled in the Infant Health and Development Program born to mothers aged 15 to 24 years. MAIN OUTCOME MEASURE: Child cognitive, behavioral, and health outcomes at 36 months' gestation-corrected age. RESULTS: Maternal age was not significantly related to child development. Coresidence with infant's grandmother was associated with improved cognitive and health outcomes. Maternal ethnicity, maternal verbal ability, and other environmental factors were also associated with child outcomes. CONCLUSIONS: Findings of this study support the need for programs that include the extended family of at-risk infants, providing education and literacy skills to the mothers and encouraging participation of all care givers of the child.

Adolescent↗
PubMed1993

A comparison of methods for alcohol and marijuana anticipatory guidance with adolescents.

The purpose of this study was to compare adolescents' knowledge of alcohol after receiving either a computer-assisted instruction program or physician-delivered anticipatory guidance or no intervention. In addition, adolescents' satisfaction was compared between intervention groups. A total of 89 adolescents attending a general medical clinic were randomly assigned to one of three conditions. The participants were from low-to-middle income families, and the mean age was 15.5 years. A two-way analysis of variance found significant main effects for both group and sex. Those adolescents in both intervention groups were significantly more knowledgeable, and males demonstrated the highest knowledge scores. There was a significant interaction between group and sex, with females more satisfied with the computer-assisted instruction as compared to males who preferred anticipatory guidance. These data suggest that the use of computer technology during a well-adolescent health visit is effective and efficient in transmitting drug-related information.

Adolescent↗
PubMed1993

Use of nonverbal tests to screen for writing dysfluency in school-age children.

Writing fluency, the ability to write rapidly and easily, is critical for the timely completion of written assignments in the classroom. Children who possess basic writing skills and have an ability to communicate ideas are often penalized for slowness in completing written tasks. The present study used frequently administered nonverbal tasks to predict performance on the Writing Fluency subtest of the Woodcock-Johnson Tests of Achievement--Revised for 146 subjects from 6 to 16 years old. A stepwise-regression analysis indicated the Coding subtest of the WISC--R, Beery Developmental Test of Visual Motor Integration, the Grooved Pegboard, and gender accounted for 32% of the variance. Logistic regression suggested cut-off scores falling one standard deviation below the mean on Coding and Beery's visuomotor test would signal need for further evaluation of writing dysfluency, particularly for boys.

Adolescent↗
PubMed1993

Left-handedness as a risk factor for unintentional injury in children.

OBJECTIVE: To determine whether left-handedness is a risk factor for unintentional injury among children and adolescents. DESIGN: Case-control study. SETTING: Pediatric emergency department of Arkansas Children's Hospital. PATIENTS: 265 patients sustaining unintentional trauma aged 6 to 18 years and 494 control patients who did not have trauma were given a questionnaire to determine handedness, past unintentional injury, and parental perception of injury proneness. RESULTS: The frequency of left-handedness in the trauma group (18.1%) was significantly greater than frequency of 10.5% in the control group (P < .003, odds ratio = 1.80, 95% confidence interval 1.20 to 2.72). Multivariate analysis revealed handedness as the only significant variable between trauma and control (P < .04). The proportion of left-handers who had been hospitalized previously for injury treatment (20.0%) was larger than the proportion of right-handers, (12.0%) (P < .026, odds ratio = 1.84, 95% confidence interval 1.03 to 3.27). More parents of left-handers rated their child as "more clumsy than average" than parents of right-handers (26.0% vs 15.2%, P < .007). CONCLUSIONS: Left-handedness appears to be a risk factor for unintentional injury in children and adolescents in a pediatric emergency department population.

Accident Proneness↗
PubMed1993

Patterns of smokeless tobacco use by young adolescents.

The use of smokeless tobacco products by adolescents has reportedly increased. The purpose of this study was to examine the use of smokeless tobacco by young adolescents across geographic locations and to look at patterns of use and variables associated with continued use beyond experimentation. Participants were 2018 students in sixth through ninth grades. Forty-five percent were male and 76% were white. Use of smokeless tobacco products was reported by 12% of the total population, and 25% reported smoking. Smokeless tobacco use was associated with cigarette smoking, alcohol use, and parental substance abuse. Those reporting alcohol use were more than four times more likely to be users of smokeless tobacco than nondrinkers. We found increased age, being male, being white, smoking, drinking, perceived effects of smokeless tobacco use, and friends' smoking behavior to be significantly associated with continued use beyond experimentation. Smokeless tobacco use was reportedly greater in rural areas. Adolescents who reported initiating use between 6 and 8 years of age were using on a more frequent basis than those who had initiated use when older. This study demonstrated the need for targeting elementary schools for educational interventions aimed at reducing smokeless tobacco use.

Adolescent↗
PubMed1992

Rurality and gender. Effects on early adolescent alcohol use.

Previous studies of adolescent alcohol use have focused almost exclusively on urban and suburban youth, although alcohol is the most important drug of abuse among rural adolescents. Young adolescents, aged 11 to 14 years (N = 1601), from urban, suburban, and two different rural areas (delta and highland), were surveyed about health-compromising behaviors, such as alcohol use. Significant differences in the number of adolescents using alcohol and the patterns of alcohol use were noted across areas by gender. Youths from the delta area, especially girls, reported drinking less frequently and in less abusive patterns than did adolescents from other areas, while youths from the highland area reported rates and patterns of drinking similar to those of urban adolescents. The reasons for intrarural variation in adolescent drinking are unknown.

Adolescent↗
PubMed1992

Adolescent body image and attitudes to anabolic steroid use.

Eleventh-grade students at seven high schools in central Arkansas were surveyed regarding anabolic steroid use, risk-taking behavior, satisfaction with body image, and attitudes and beliefs regarding anabolic steroids. A total of 1492 adolescents were surveyed. Fifty-one (7.6%) of 672 males and 12 (1.5%) of 806 females admitted anabolic steroid use. Fourteen students did not specify gender. Bivariate comparisons showed significant differences between users and nonusers in risk-taking behaviors and degree of satisfaction with body image and muscles. Users were more likely than nonusers to approve of anabolic steroid use in sports and to believe that anabolic steroid use could improve one's health. Multivariate analyses found gender, knowledge of beneficial side effects, knowing other anabolic steroid users, age, and race to be significantly related to anabolic steroid use. Information about steroids' effects seldom came from physicians, but often came from peers. Anabolic steroid use was strongly motivated by social influences, some knowledge of beneficial effects, and denial of adverse effects in white adolescent males in our study population.

Adolescent↗