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Biomedical subjects

V I Rickert

Publications and source records attributed to V I Rickert.

51 records · Page 3Linked to original sources
PubMed1992

Is AIDS education related to condom acquisition?

The acquisition and subsequent use of condoms are two important behaviors that sexually active adolescents must adopt to reduce the transmission of human immunodeficiency virus (HIV). The aims of this study were: first, to evaluate whether combining prescriptions for free condoms with anticipatory guidance would increase the number of adolescents actually using the prescription-redemption plan; and second, to see if education about acquired immunodeficiency syndrome (AIDS) might make adolescents more willing to obtain an HIV blood test. Adolescents were randomly assigned to one of three groups, but only those who were sexually active were included in the data analyses. Each participant was given a prescription to be redeemed for free condoms at the hospital pharmacy, and each was privately offered a confidential, free HIV blood test. Education about AIDS did not increase the likelihood that adolescents would take the blood test, since only seven subjects did so. Our logistic regression model showed the most significant variables influencing a teenager to obtain condoms were gender, socioeconomic status, lifetime number of partners, and experimental condition. Anticipatory guidance concerning HIV promoted the use of the prescription-redemption plan especially among more sexually active males who come from middle-class families.

AIDS Serodiagnosis↗
PubMed1992

Human growth hormone: a new substance of abuse among adolescents?

It has been estimated that as many as 250,000 adolescents are using anabolic steroids (AS). Recently, anecdotal reports suggest that athletes may also be using human growth hormone (HGH). The purpose of the present study was to determine the following: 1) if adolescents in two suburban midwestern high schools (83% white, 14% Asian, and 3% black) were using HGH; 2) knowledge of its effects; 3) reasons for use; and 4) concurrent AS use. After we obtained informed written consent, 224 male and 208 female 10th-grade students were surveyed using a 15-item questionnaire. Of male students surveyed, 5% (n = 11) reported past or present use of HGH, and one female student reported use. Our data suggest that among male adolescents surveyed, a majority had heard of this substance, and 31% of males reported knowing someone who was using HGH. Chi-square analysis found a significant association between AS and HGH use where seven AS users reported past or present use of HGH. Most HGH users were unaware of its side effects and reported first use between 14 and 15 years of age. No differences in sports activity, ethnicity, or age were found between users and nonusers of HGH.

Adolescent↗
PubMed1991

Effects of a peer-counseled AIDS education program on knowledge, attitudes, and satisfaction of adolescents.

Education programs for adolescents regarding acquired immunodeficiency syndrome (AIDS) have been advocated by many professionals to help minimize the risk of infection in this population. This study compares a peer-led vs. an adult-led AIDS education program on the knowledge, attitudes, and satisfaction of the adolescents with their education. Eighty-two male and female adolescents, ranging in age from 12 to 18 years, were randomly assigned to a peer (n = 27), adult (n = 28), and control (n = 27) group. Intervention consisted of receiving didactic information and viewing a videotape about AIDS transmission and prevention. All subjects completed the AIDS Knowledge Questionnaire-Revised, AIDS Attitude Survey, and a measure of consumer satisfaction. Statistical analyses revealed a significant effect for knowledge and attitudes toward practicing personal preventive behaviors and the seriousness of AIDS; both peer- and adult-led groups were superior to controls (p less than 0.05). With the exception of satisfaction with providers, no other significant effects were found across the intervention groups. Satisfaction with providers showed an effect for sex (p less than 0.05). Female adolescents reported more satisfaction with presenters than male adolescents did. Although both adult and peer counselors were equally effective in promoting knowledge gains and appropriate attitude changes, more questions were asked of the peer counselors. These data suggest that when education is presented by peer counselors, adolescents may be more likely to see AIDS as a personal danger and that peer counselors should be considered when designing comprehensive AIDS education programs.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Residents' attitudes toward the legal system and court testimony in child abuse.

Resident physicians' contacts with the legal system during management of abused children may influence their attitudes, which were evaluated in a pilot survey completed by 42 pediatric and medicine/pediatric residents. Although negative attitudes toward attorneys were common, almost all of the residents considered general and hearing-specific legal training to be a legitimate part of their residency program. They reported lower levels of stress of court testimony than expected by the authors. Most who had testified in court believed their testimony had been needed and helpful, but all who believed their testimony had been a waste of time were senior-level residents. Although most residents believed the laws and courts usually work for protecting children, only 8 of the 20 residents who had previously testified in court responded affirmatively, and none of the 10 senior residents who had previously testified held this belief. The disillusionment of senior-level residents appeared to affect attitudes toward patient care less than expected, in that 90% of those who planned to enter private practice indicated they would perform physical abuse evaluations and 70% planned to perform sexual abuse evaluations. Only one resident who did not expect to perform the evaluations gave as a reason the prospect of having to testify in court.

Arkansas↗
PubMed1990

A comparison of three clinic-based AIDS education programs on female adolescents' knowledge, attitudes, and behavior.

Health providers are becoming increasingly aware that adolescents are a population at risk for acquired immune deficiency syndrome (AIDS) and have identified education as essential for prevention. This study evaluates three clinic-based programs designed to determine the effects of education on knowledge and attitudes regarding AIDS and condom acquisition. Seventy-five sexually active females attending adolescent health clinics were randomly assigned to one of three groups: 1) controls (C) receiving no education; 2) education (E) alone consisting of a brief lecture on AIDS: and 3) enhanced education (EE) where the lecture was provided as well as a videotape describing the importance of condom use. All participants completed the AIDS Knowledge Questionnaire-Revised, the AIDS Attitude Survey, a self-report measure of condom use and received a coupon that could be exchanged for free condoms from the hospital pharmacy. A significant effect was found for knowledge, where both E and EE were superior to controls (p less than .001). No statistical differences were noted across groups regarding attitudes or condom acquisition. However, all adolescents in the EE group who reported prior condom use obtained condoms from the pharmacy as compared to the other groups (p less than .05). Our results suggest that educating adolescents in medical settings can improve their knowledge about AIDS. Didactic lectures in combination with videotape presentations on condom use appeared to be the best format for reinforcing an adolescent's existing behavior.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Adolescent wellness. Facilitating compliance in social morbidities.

The establishment of a well adolescent schedule needs to be developed similar to the scheduled clinical visits in pediatric care. However, providing adolescent wellness visits without appropriate financial reimbursement for time expended and without increased provider training may make "well" adolescent visits an unrealistic expectation. However, two major trends will significantly impact on the future of adolescent health care. These include a sharp increase in numbers of adolescents beginning in 1990 and the poverty within the adolescent population. These data suggest that obstacles, whether personal, financial, or educational, need to be addressed quickly in order to resolve these problems because of increasing numbers of adolescents and related morbidities through the year 2000. The increasing trend of juvenile poverty in this population has been significantly associated with a number of the new morbidities such as substance abuse, STD, pregnancy, and the latest morbidity, AIDS. Without a wellness schedule, it is likely that adolescents will continue to represent an underserved population; as a consequence, mortalities and morbidities will increase through the year 2000. The issue of adherence to prescribed medical regimens in the adolescent population is an interesting, complex, and especially challenging one when faced with the social morbidities. Although preliminary work in this area has progressed in the last 15 years, greater attention must be paid to the needs of adolescents in order to determine effective strategies that can minimize the effects of the current morbidities. It is important for the primary care physician not to become overwhelmed with the scope of problems that adolescents have or become discouraged because anticipatory guidance seems ineffective. Repeated dosages of anticipatory guidance should not be viewed as limitations or failures but rather as necessary and standard care. One should consider such interventions as similar to immunizations, in which certain vaccines result in life-long immunity. One would not eliminate the tetanus vaccine because the patient must receive periodic boosters. Similarly, as health care professionals, we should not consider interventions designed to preclude behavior or mental health problems as failures if periodic and developmentally appropriate relevant "boosters" are necessary. Anticipatory guidance is an extremely effective tool that every primary care physician has at his or her disposal to assist in the diagnosis of problematic behavior in adolescents and to preclude problems. Future research needs to focus on documenting strategies that can be utilized by physicians on a daily basis without excessive time or financial constraints.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1990

Behavioral methods for teaching self-catheterization skills to anxious children with myelomeningocele.

A behavior-based protocol was developed which outlined all necessary behaviors for successful self-catheterization to an anxious child with myelomeningocele. The subject had been wearing diapers daily since birth, and he expressed fear of pain and lacked confidence because of previous unsuccessful attempts. The present protocol included progressive muscle relaxation, guided visual imagery, and behavioral rehearsal that was implemented by his parents. Data collected showed daily successful intermittent self-catheterization skills two weeks and 6 months posttreatment. Thus, an alternative to traditional educational methods exists that can successfully enhance the acquisition of self-catheterization skills.

Child↗
PubMed1989

Adolescents and AIDS. Female's attitudes and behaviors toward condom purchase and use.

Condom use has been advocated as a method to prevent human immunodeficiency virus (HIV) transmission. Although condoms are not uniformly popular with adolescent males, adolescent females' beliefs about condom use are unclear. To assess the specific health attitudes and behaviors as they relate to condom purchase by adolescents, we surveyed 99 adolescent females between 12 and 19 years of age (50 black, 49 white) who were attending a comprehensive adolescent health clinic. The respondents were from low to middle socioeconomic backgrounds and 85% were sexually active. A 41-item survey was developed and focused on four areas: comfort or embarrassment with menses (EM), basic knowledge of acquired immunodeficiency syndrome (AIDS) (KA); comfort in discussing contraception with partner (CC) and risk of contracting AIDS (AR). Chi-square analyses of the four factors determined that decreased EM was related to increased age (p less than 0.05), sexual activity (p less than 0.05), and CC (p less than 0.05). Older adolescents also demonstrated greater CC (p less than 0.05). Increased KA was related to contraceptive use (p less than 0.02) as well as CC (p less than 0.02). Descriptive analyses showed that 62% of the sample reported that a fear of AIDS had influenced their contraceptive behavior, but only 17% of the females reported purchasing or using a condom to prevent AIDS transmission. These findings suggest that although adolescent females have an awareness about AIDS, their behavior remains unchanged.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Anabolic steroid use by male adolescents.

Anabolic steroids have recently been used by professional and college athletes to improve athletic ability by increasing muscle size and strength. A study was done to determine the extent of steroid use and knowledge about these drugs in a population of high school male adolescents in a southern state. A self-report questionnaire, which allowed multiple answers for each question, was administered to 853 male students in six high schools. Results indicated that an average of 11% had used or were using anabolic steroids. The following were assessed: the reasons for steroid use, the sources from which the students received information about steroids, their familiarity with the physiologic effects and complications of steroid use, and the extent of their involvement in sports. The results suggest that a segment of male adolescents are using anabolic steroids without fully understanding the risks of such behavior. Health care providers need to become knowledgeable about steroids so that they may better educate adolescents about the potential deleterious effects of these agents.

Adolescent↗
PubMed1989

Reducing bedtime tantrums: comparison between positive routines and graduated extinction.

A total of 36 toddlers and preschool children exhibiting bedtime tantrum activity were randomly assigned to one of three groups: positive routines, graduated extinction, or control. Positive routines involved changing the child's bedtime to coincide with when he naturally fell asleep, as well as parent and child engaging in a series of four to seven enjoyable activities before the child being placed in bed. During the treatment period, bedtimes were systematically scheduled earlier such that the child went to bed at the time parents had originally used. Graduated extinction consisted of the parent putting the child to bed and ignoring the tantrum activity for increasingly longer amounts of time throughout the treatment. Children in these two treatment groups had tantrums less frequently and for shorter periods than control subjects during 6 weeks of treatment and during two follow-up observations 3 and 6 weeks after treatment. Although both treatments were more effective than waiting for the child to outgrow this problem, parents of the positive routine group reported significantly improved marital satisfaction, suggesting additional benefits of this treatment strategy.

Behavior Therapy↗
PubMed1988

Reducing nocturnal awakening and crying episodes in infants and young children: a comparison between scheduled awakenings and systematic ignoring.

Infants and toddlers (N = 33) exhibiting spontaneous awakening and crying episodes during the night were randomly assigned to one of three groups: scheduled awakenings, systematic ignoring or control. Scheduled awakenings consisted of a parent arousing and feeding or consoling the child 15 to 60 minutes before typical spontaneous awakenings. Once spontaneous awakenings were precluded, scheduled awakenings by parents were gradually eliminated. Systematic ignoring consisted of allowing the child to "cry it out" without parental attention except to ensure physical well-being of their child. Children in the scheduled awakening group and the systematic ignoring group awoke and cried less frequently than children in the control group during 8 weeks of treatment and during two follow-up checks, 3 and 6 weeks after treatment. Systematic ignoring was found to be more effective than the scheduled awakenings condition during 1 week of treatment; otherwise effects of the two conditions were similar. Implications of the use of these treatment procedures are discussed.

Child, Preschool↗
PubMedDate not supplied

Bibliotherapy as an adjunct to stimulant medication in the treatment of attention-deficit hyperactivity disorder.

The effectiveness of bibliotherapy as an adjunct to stimulant medication in the treatment of children with attention-deficit hyperactivity disorder was investigated. Subjects were randomly assigned to the experimental group, or the control group. Parents in the experimental group received a written protocol (bibliotherapy) outlining behavioral techniques for managing oppositional child behavior. Results indicated significant differences favoring the experimental group on standardized measures of the intensity of behavior problems in the home, parental knowledge of behavioral principles, and teacher ratings of behavior. This bibliotherapy approach appears to offer an inexpensive adjunct to stimulant medication in the treatment of attention-deficit hyperactivity disorder when individual or group behavior management training is not feasible.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Risk factors for febrile, presumed viral illness in the first ten weeks of life.

OBJECTIVE: We attempted to identify demographic and environmental factors associated with development of febrile, presumed viral illness in infants < or = 10 weeks old. STUDY DESIGN: The study was conducted in a large, urban pediatric hospital and outpatient clinics. Infants < or = 10 weeks old admitted to the hospital for a febrile illness but discharged with a presumed viral illness as the cause of the fever (n = 106) were compared with afebrile infants who came for clinic appointments (n = 87). Thirty-three infants found to have a bacterial source of illness were dropped from analysis. RESULTS: Recent exposure to an acute respiratory illness in the home (p < 0.0001), a previous visit to the doctor that was unrelated to the hospitalization (p < 0.002), having a sibling in school or day care (p < 0.007), and exposure to two or more smokers in the home (p < 0.011) were associated with development of a presumed viral illness with fever. CONCLUSION: Families with young infants should be counseled to keep their babies away from cigarette smoke or individuals with colds or presumed viral illnesses.

Family Health↗