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VI Rickert

Publications and source records attributed to VI Rickert.

6 recordsLinked to original sources

Prevalence and predictors of low sexual assertiveness

Background: Personal beliefs about sexual attitudes and rights likely affect reproductive health behaviors. We examined the prevalence and predictors of low sexual assertiveness (SA) among sexually active females across three age groups (14-17 yo, 18-21 yo, and 22-26 yo).Methods: 904 white, black, and Mexican-American females presenting at community-based family planning clinics in Southeast Texas between April 1997 and February 1998 completed an anonymous self-report questionnaire that assessed demographic and reproductive characteristics, dating behaviors, mental health measures and occurrence of physical and sexual assault. Subjects also completed a sexual assertiveness scale that assessed one's right to make various reproductive health decisions and sexual communications to partners. A total SA score was obtained by summing the 13 items; scores were then dichotomized so those scoring in the lowest quartile could be compared to the others. Data were analyzed using chi-square and logistic regression stratified by age group (244 aged 14-17; 392 aged 18-21; and 268 aged 22-26).Results: 27% of subjects aged 14-17, 22% aged 18-21, and 17% aged 22-26 were identified as having low SA. For 14-17 years olds, logistic regression analyses revealed that those with low SA as compared to adequate SA were significantly more likely to be Mexican American (OR = 4.8) or black (OR = 3.1) than white, to have hand </= 1 dating partner in the last 12 months (OR = 1.8), and to report inconsistent birth control in last 12 months (OR = 2.0). Among 18-21 years olds, low (SA) was related to reporting forced sexual contact in the last 12 months (OR = 5.2), moderate-to-severe depressive symptoms (OR = 3. 0), no history of physical abuse (OR = 2.5), believing that your partner is monogomous (OR = 2.6), married or living with a male partner (OR = 2.1), </= 3 lifetime sexual partners (OR = 1.8), not using alcohol before sex (OR = 1.8), and gravidity >/= 1 (OR = 1.8). Among 22-26 years olds, low SA was associated with gravidity >/= 1 (OR = 2.8), being a high school dropout (OR = 2.1), and inconsistent birth control use in the last 12 months (OR = 1.9).Conclusions: These data suggest that 1 in 4 sexually active women report low SA and for two age groups these attitudes are associated with inconsistent contraception. Among 18-21 years olds, low SA is also associated with forced sexual contact and depressive symptoms. Thus, efforts to prevent unintended pregnancy and unwanted sexual contact may be more effective if individual levels of SA are taken into account.

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The independent and combined effects of physical and sexual abuse on health. Results Of a national survey

Background: Although physical and sexual abuse have been linked to health risk behaviors as well as mental health problems, it is unclear whether those young women who have experienced both physical and sexual abuse are at greatest risk. To examine the independent associations between physical, sexual, and/or both types of abuse and health status, mental health, and health risk behaviors among a national school-aged sample of girls. We hypothesized that the magnitude of risk would be highest for those reporting both types of abuse compared to those reporting neither or one type of abuse. Methods: In 1997, 3,015 girls in grades 5 through 12 participated in the Commonwealth Fund Adolescent Health Survey and responded to both questions inquiring about physical and sexual abuse. This sample was derives from a nationally representative cross-section of 265 public, private, and parochial schools with an oversampling of 32 urban schools to obtain ethnic diversity. Data were analyzed using chi-square and binary or multinomial logistic regression stratified by type of abuse (none, physical abuse, sexual abuse, or both). Results: About 8% (n = 246) of girls reported a past history of only physical abuse, 5% (n = 140) reported only sexual abuse, and 5% (n = 160) reported experiencing both physical and sexual abuse. Logistic regression controlling for demographic characteristics (grade level, ethnicity, family structure, and socioeconomic status) found those who reported both types of abuse as compared to those who did not report any abuse were significantly more likely to experience moderate-to-severe depressive symptoms (OR = 5.1), moderate to high life stress (OR = 3.3), history of bingeing and purging behavior (OR = 4.4), regular smoking (OR = 5.9) regular drinking (3.8), illicit drug use in the past 30 days (RR = 3.5) and fair to poor health status (OR = 1.9). In contrast, lowered adjusted odds ratios (1.8-2. 5) were seen for those reporting one type of abuse as compared to no abuse across most health outcomes.Conclusions: Those experiencing any type of abuse are at risk; however, those adolescent females who report both physical and sexual victimization are at much greater risk.

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Urban girls, internet use, and accessing health information

Background: With the burgeoning growth of the Internet, many have raised concerns over whether and how underserved populations might be included in the Information Revolution. This study examines how urban adolescent girls access the Internet and whether it is a viable source for health information.Methods: During Fall 1999 in New York City, 176 girls completed an anonymous survey where half were from a private high school (N = 86) and the other half were patients at a health clinic serving ethnically diverse and disadvantaged youth (N = 90). Data were analyzed to provide information on how urban girls use the Internet.Results: Internet use was widespread; 99% of the high school and 83% of the clinic girls said they used this medium (p <.001). On frequency, 32% of high school girls compared to 13% of the clinic girls used the Internet 6-7 days/wk (p <.001). Among the high school girls, 30% indicated that they used the Internet less than 30 min/wk and another 18% reported using the Internet more than 5 hrs/wk. Among clinic girls, 51% used the Internet less than 30 min/wk while 9% reported more than 5 hrs/wk. Comfort levels differed with 20% of the high school compared to 10% of the clinic girls reporting "extreme" comfort using the Internet (p <.001).Urban girls accessed the Web from multiple locales. Almost all (98%) of the high school girls compared to 45% of the clinic girls reported that they used the Internet from home (p <.001). Most high school girls (82%) used the Internet at school compared to 63% of the clinic girls currently in school (p <.05). More clinic girls used the Internet at another family member's house (28% vs. 14%, p <.05). Similar percentages of high school and clinic girls used the Internet at a friend's house (46%), the library (31%), or a community center (3%).With similar rates among high school and clinic girls, 44% reported that they had tried to get health information from the Web. Of these (N = 74), 50% said that they got information on different diseases, 43% on diet/nutrition, 34% on fitness/exercise, 26% on sex, 24% on alcohol/drug abuse, 20% on mental health, 14% on medicines, 12% on violence among peers, 10% on parenting, 8% on violence among dating partners, 7% on tobacco and smoking, 7% on emotional or physical abuse, 3% on sexual abuse, and 1% on illness support groups. Clinic girls were more likely to have tried to get information on sex (p <. 001) and parenting (p <.001) from the Web. Many girls (59%) indicated that it was "very" or "extremely" worthwhile to have general health information on the Web, with no significant differences between high school and clinic girls. As well, 71% and 62% said it was "very" or "extremely" worthwhile to have access to contraceptive and diet/nutrition information, respectively. Conclusions. High school girls, as anticipated, were technologically savvy. Somewhat surprising, however, were the clinic girls' high levels of Internet use and access. Significant differences revealed that the high school girls were more on-line than clinic girls, but clinic girls were still using the Web frequently. A considerable number or urban girls had tried to get a range of health information from the Internet. This study offers promising statistics on how urban adolescent girls are accessing and using the Internet, especially for health information.

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Who Is the Customer?

A 14-year-old girl was diagnosed at age 6 with type 1 diabetes mellitus. Both of her parents have been actively involved in her diabetic management. She recently gained 5.8 kg. At the time of presentation she was 174.2 cm tall and weighed 73.9 kg. While she was only moderately concerned about her recent weight gain, both her parents showed much more concern about her weight than about her blood sugar and vehemently objected to their daughter being interviewed separately, so that it became important to establish who the primary requester of treatment was. A very careful and delicate approach was chosen in which the adolescent was recommended to develop a regular exercise and eating regimen with participation and support of her parents.

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How Prepared is Prepared Enough?

A 17-year-old female was in the final stage in treatment of right unilateral cleft lip and palate. She had undergone a number of previous surgeries. Hearing and speech were good on evaluation, and her social and family situation were deemed excellent. After preparatory orthodontics she underwent a Lefort I maxillary advancement. Surgery was successful and she was admitted into postoperative recovery. However, the lack of adequate preoperative preparation caused traumatic reaction from the patient and her parents: anxiety over appearance, crying, refusal of oral fluids and oral care, refusal of analgesia, and refusal to mobilize. The patience and persistence of hospital staff slowly overcame all adversities and the patient moved on to full and successful recovery, but this case prompted changes in preoperative procedures and involvement of patients and their families in postoperative meal selection, planing, and preparation.

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Psychological and Psychiatric Emergencies: Strategies for Providers.

Given the recent increase in suicide rate among adolescents, mental health concerns constitute an area in need of systematic evaluation. Common sources of psychological stress include family conflict, depression, sexual abuse and assault, and eating disorders. Any of these problems may result in visits to the emergency department. Important ingredients for successful diagnosis and referral include careful screening, basic family therapy skills, and sensitivity to treating adolescents with respect.

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