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PubMed1995

Evaluation status, educational setting, and behavior ratings of students with serious emotional disturbance.

60 students' files were randomly selected from a pool of 308 who were designated as seriously emotionally disturbed by their school districts. Analysis indicated that n = 30 students receiving their initial evaluations were rated more negatively by their special education and homeroom teachers than those 30 being reevaluated. Compared with the 60 special education teachers, more negative ratings were given by the 60 homeroom teachers. Elementary and secondary school placement did not significantly affect the behavior ratings.

Adolescent↗
PubMed1987

[Internal jugular vein catheter--success rate and complications with reference to educational status].

In a prospective study the success and complications of internal jugular vein catheterization in relation to the degree of experience were investigated. The internal jugular vein catheter were placed in 200 patients by experienced anaesthetists and by anaesthetists not experienced in this procedure as well. In the case of physicians trained in this procedure, the success rate was 98 percent, whereas in the case of inexperienced collegues, the success rate was 83 percent with a high number of attempted punctures. In addition to the increased rate of haematoma, during the learning period, the incidence of accidental arterial punction was 18 percent resulting in a temporary Horners-syndrome in one patient. In the group of experienced anaesthetists the accidental arterial puncture occurred only in 3 percent without any haematome. In one patient the procedure was interrupted because of temporary AV-Block (3rd degree). The complications of internal jugular vein cannulation are reviewed and the methods to avoid them are presented.

Adolescent↗
PubMed1997

Audit of screening programme for congenital hypothyroidism in Scotland 1979-93.

OBJECTIVE: To evaluate the efficiency of the screening programme for congenital hypothyroidism in Scotland and to determine the outcome in the cohort of children with positive testing for thyroid stimulating hormone (TSH). DESIGN: Establishment of comprehensive database for all Scottish infants with high TSH, detected on Guthrie screening. SUBJECTS: 344 infants born between August 1979 and December 1993 with TSH greater than 40 mU/l on initial Guthrie, or 15-40 mU/l on repeat Guthrie. MAIN OUTCOME MEASURES: Ages at time of: (a) Guthrie collection, (b) notification of positive result by laboratory, and (c) start of treatment; audit of late diagnosis/missed cases; categorisation of positive cases into definite and probable congenital hypothyroidism, transient TSH elevation, and uncertain status; educational status of children with definite and probable congenital hypothyroidism. RESULTS: 344 positive cases were categorised as having definite (224) and probable (11) congenital hypothyroidism, transient TSH elevation (88), and status uncertain (21). The overall incidence of definite/probable congenital hypothyroidism was 1 in 4400 live births. For the definite/probable groups median age of Guthrie collection was consistently between 6 and 7 days from 1983 onwards but for the whole cohort was later than 10 days in 10.5%. Median age of notification fell from 14 days in 1980 to 11 days in 1993. Median age of starting treatment ranged between 11 and 15 days from 1983 onwards. Treatment was delayed in four cases, three due to failed or late Guthrie card submission. Of 149 children with definite/ probable congenital hypothyroidism who were of school age, educational status was ascertained in 139 (93%). Only two children (1.4%) were attending special school, one of whom was known to have mild hypothyroidism. Sixteen children (11.5%) were receiving extra help in mainstream education compared with 18% of control children in the Scottish very low birth weight study. CONCLUSION: The current screening programme is working well, but efficiency could be increased by earlier and more reliable Guthrie collection. A substantial proportion of children picked up on the screening programme have a transient rise in TSH rather than true congenital hypothyroidism. The incidence of special education and learning support in Scottish children with congenital hypothyroidism appears to be no different to that of the general population.

Age Factors↗
PubMed2005

Nutritional status and birth outcomes of adolescent pregnant girls in Morogoro, Coast, and Dar es Salaam regions, Tanzania.

OBJECTIVE: Studies that link adolescence pregnancies, nutritional status, and birth outcomes in Tanzania are scarce. We examined the nutritional status and birth outcomes of pregnant adolescent girls from rural and urban areas of three regions in Tanzania. METHODS: The study was carried out in the regions of Dar es Salaam (Chamazi and Gezaulole dispensaries and Round Table Maternity Home), Coast (Tumbi Regional Hospital and Mlandizi Health Center), and Morogoro (Regional Hospital, Uhuru Clinic, and Mlali Health Center). One hundred eighty pregnant adolescent girls ages 15 to 19 y were recruited and interviewed, and their nutritional status measurements were taken at the seven health facilities. Information concerning date of birth, marital status, educational status, sex education, and income status was collected with a structured questionnaire. Height, weight, and mid-upper arm circumference were measured according to standard techniques. Hemoglobin concentration was measured with a hemoglobinometer and the HemoCue technique. Nutritional status was assessed by body mass index, and hemoglobin concentration was determined by cutoff points of the World Health Organization. Suitable statistical analysis was done with SPSS 9.0. Weekly weight gain during pregnancy was measured in 123 subjects who kept their appointments and reported back after 2 wk. Fifty-seven subjects did not keep their appointments and were lost to follow-up. Records of infants' birth weights and mode of delivery were obtained from 50 subjects who delivered at the study sites. RESULTS: The height of about 54% of the subjects was shorter than 151 cm, suggestive of short maternal height. Severe wasting was observed in 27% of subjects. Mean weekly weight gain during pregnancy was 317 +/-110 g (-500 to 500 g). No significant differences were observed between rural and urban settings. Mean infant birth weight was 2600 +/- 480 g. About 48% of infants had low birth weight (<2500 g) and only 14% of infants had birth weight greater than 3000 g. About 14% of infants were born by cesarean section. Nearly 86% of the pregnant adolescent girls were anemic. A hemoglobin concentration below 7 g/dL was observed in 5% of subjects. Most subjects (55%) had hemoglobin concentrations from 7 to lower than 10 g/dL. There was a weak correlation between infant birth weight and weekly weight gain of the girls during pregnancy (r = 0.36, P < or = 0.01). However, a strong correlation was observed between birth weight and hemoglobin level of adolescent girls during pregnancy (r = 0.67, P = 0.01). Short stature was observed to contribute toward cesarean delivery (P = 0.05) because more cesarean deliveries were performed in short girls (<151 cm tall). CONCLUSIONS: The nutritional status of pregnant adolescent girls in the study areas was poor and resulted in poor pregnancy outcome. Girls should be educated about reproductive health at the primary level of education.

Adolescent↗
PubMed2001

[Factor analysis of the health related quality of life of patients with stable chronic obstructive pulmonary disease].

OBJECTIVE: To identify factors associated with the health-related quality of life (HRQL) perceived by patients with stable chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS DESIGN: Prospective cohort study. SUBJECTS: Patients with stable COPD (n = 204, alpha = 0.05, d = 6.9%). MEASURES AND INTERVENTIONS: For every patient we recorded sociodemographic and treatment data,severity of dyspnea, and the results of gasometry and lung function and stress testing, as well as responses to the Chronic Respiratory Disease Questionnaire (CRDQ). After studying the associations between variables we carried out factor analysis of those that were significantly related to HRQL. RESULTS: Men made up 91.7% of the cohort. The mean age (standard deviation)was 71 (9), FEV1% was 45 (16) and FEV1/FVCwas 48 (10). HRQL was statically related to age, weight, body mass index (BMI), economic status, educational status, chronic treatment with oral corticosteroids, ODCA, PaO2, oxygen saturation, alveolar-arterial oxygen gradient, absolute FEV1, FEV1%, post-bronchodilatation FEV1, absolute FVC, FVC%, distance walked in six minutes, oxygen saturation before the walking test and lowest oxygen saturation during the test,difference in dyspnea before and after the test measured on a visual analog scale. Factor analysis reduced the main variables to six, which explained 74.6% of the variance, as follows: Factor1 PaO2, oxygen saturation and alveolar-arterial oxygen gradient (33.7%); Factor 2 absolute FEV1,FEV1%, FEV1 after bronchodilatation, absolute FVC and FVC% (11.9%); Factor 3 eight and BMI (8.8%); Factor 4 age, severity of dyspnea and walking test distance (8.4%);Factor 5: corticosteroid dependence and domiciliary oxygen therapy(6.3%); and Factor 6: economic and educational status (5.5%). CONCLUSION: HRQL in stable COPD patients is partially related to severity of respiratory insufficiency, airflow obstruction, nutritional status, exercise capacity, severity of disease, and socioeconomic status.

Aged↗
PubMedDate not supplied

Epidemiology of cervical cancer--a case control study on north Indian population.

The present case control study on married women with cervical cancer and controls (100 each) revealed the association of age at marriage, socioeconomic status, education status and parity with cervical cancer but young age at marriage (rr 3.79) and low socioeconomic status (rr -3.81) emerged as independent predictors of disease status.

Adolescent↗
PubMedDate not supplied

The status of alternative treatment in cancer patients in Turkey.

This study was designed to measure the frequency at which Turkish patients with cancer resort to complementary and alternative medicine (CAM). A total of 704 patients referred to the Gülhane Military Medical Academy and Ankara Numune Training Hospital between September 2002 and January 2003 were asked about the CAM therapies they used. Of these, 276 patients (39.2%) had used CAM. Gender, marital status, educational status, age, financial status, severity of pain, history of cancer in the family, and their own ideas concerning CAM therapies were found to be correlated with the frequency of resorting to CAM. Resorting to CAM may lead to delayed diagnosis and treatment, adverse drug interactions, treatment withdrawal, and disease progression. Therefore, it is very important to inform patients about these potential dangers. Further studies are needed to clarify the reasons that lead patients to resort to CAM.

Adolescent↗
PubMed1981

Primary drug abuse among women: a national study.

This study focuses on women's primary patterns of abuse for selected drugs (heroin, marijuana, barbiturates, amphetamines, sedatives, and tranquilizers) at treatment admission in relation to age at first use, marital status, education status, and race. The sample consisted of 51 390 women admitted to treatment during a recent 12 month period. The results indicated that heroin was the most abuse drug in relation to all the variables examined. Those clients who never married and those unemployed at the time of admission reported the greatest abuse of each of the primary drugs investigated. More than half of the sample had their first drug experience before age 18. This suggests the need to educate young women about drugs and to make professionals in schools and communities more aware of the nature of this problem in order that prevention and treatment programs can be developed to meet women's specific needs.

Adolescent↗
PubMed1999

How safe is motherhood in Nigeria?: the trend of maternal mortality in a tertiary health institution.

OBJECTIVE: To determine the magnitude and trend of maternal mortality in Jos University Teaching Hospital, Jos, Nigeria. DESIGN: Retrospective study. SETTING: Jos University Teaching Hospital, Jos, Nigeria. SUBJECT: All women dying in pregnancy, labour and puerperium. MAIN OUTCOME MEASURES: Maternal mortality ratio, trend of maternal mortality, age, antenatal booking status, educational status, main causes of maternal death, factors contributing to maternal deaths. RESULTS: The maternal mortality ratio was 739/100,000 total deliveries and trend rose from 450/100,000 in 1990 to 1,060/100,000 total deliveries in 1994. About 33% of all maternal deaths occurred among teenagers. The risk factors for maternal deaths included adolescence, grand multiparity, illiteracy and non-utilisation of antenatal services. The main causes of maternal mortality were haemorrhage (28.1%), sepsis (21.3%) and eclampsia (15.7%). The contributions of complicated induced abortion and anaesthetic deaths in this study are worthy of mention. CONCLUSION: The maternal mortality ratio is unacceptably high in Jos University Teaching Hospital more particularly because of the rising trend. Socio-cultural and economic factors contributed immensely to the high maternal mortality in Jos. The objective of the World Health Organisation (WHO) to reduce maternal mortality by 50% by the year 2000 will not be achieved in this part of Nigeria. Nonetheless, improvement of the nation's economy coupled with a stable policy and provision of intrastructural facilities will assist to significantly reduce maternal mortality.

Adolescent↗
PubMed1999

Social mobility and health related behaviours in young people.

STUDY OBJECTIVE: To assess the influences related to social mobility, particularly health related behaviours, as one potential explanation for the social class variation in health among adults. DESIGN: The study is based on questionnaire data from the Adolescent Health and Lifestyle Surveys of 1985, 1987, and 1989. SETTING: The whole of Finland. PARTICIPANTS: A representative sample of 8355 adolescents. The response rate was 79%. MEASUREMENT AND MAIN RESULTS: The relation between social mobility and health related behaviours among 16 and 18 year old young people was studied. The measure of social mobility was based on a combination of the social class of origin and achieved social position measured by the present educational status, educational attainment, and labour market position. Three mobility groups were constructed: the downwardly mobile, the upwardly mobile and the stable. Health related behaviours in an upwardly or downwardly mobile group were compared with a stable group from the same social class of origin by calculating relative risks (RR). RRs were assessed by calculating age and sex adjusted rate ratios approximating a Mantel-Haenszel estimate. In logistic regression analyses the independent effects of the social class of origin and the achieved social position were investigated. Most of the nine behaviours studied (smoking, alcohol use, heavy intoxication, coffee drinking, tooth brushing, consumption of sweets, lack of physical exercise, choice of bread spread, and consumption of milk) were related to the direction of mobility so that health compromising behaviours were more frequent among downwardly mobile and less frequent among upwardly mobile young people than their stable peers. Achieved social position proved to determine health related behaviours more strongly than class of origin, thus emphasising the way education facilitates both health values and behaviours as well as the future social position. CONCLUSIONS: The close relation between social mobility and health related behaviours is concluded to be a part of an explanation of social class differences in health observed among adults.

Adolescent↗
PubMed2006

Knowledge, attitude and practice of complementary and alternative medicines for diabetes.

OBJECTIVES: To investigate the current status of knowledge, attitude and practice of patients with diabetes relating to complementary and alternative medicine (CAM) in an Indian community, and to determine perceptions about the use of CAM and factors influencing knowledge and usage. SETTING: Endocrine clinic of Swaroop Rani, Nehru Hospital, Allahabad, India. STUDY DESIGN: Hospital-based cross-sectional study. PARTICIPANTS: Patients with diabetes attending the clinic for the first time. SAMPLE SIZE: A sample of 493 study participants selected by systematic sampling from a population of 6094 patients with diabetes. STUDY VARIABLES: Age, socio-economic status, educational status, religion, family history of disease, knowledge and practice of CAM, reasons for using CAM, method of use and perceived relief. STATISTICAL ANALYSIS: Normal test of proportions, chi(2) test, Kolomogorov-Smirnov test. RESULTS: Awareness of CAM among patients was high (71%). High prevalence of CAM use was found (67.7%) among all participants, and 95% among participants aware of CAM, mostly using 'naturopathy' (97.3% among users). No significant gap (P>0.10) between knowledge and practice in different categories was observed. Desire for quick and additional relief was the most common perceived reason for using CAM (86.8%). Higher levels of education and socio-economic status were significant positive correlates of CAM use. Knowledge of CAM was gained mainly from friends and neighbours. About 30% of users adopted CAM without allopathic treatment earlier. Only 42.2% of users perceived some relief by using CAM. Lowering of blood sugar was the most common perceived relief. CAM, along with diet control and exercise, resulted in maximum degree of satisfaction (61.9%) experienced by users. No relief was experienced by 53.6% of users of 'naturopathy'. CONCLUSIONS AND SUGGESTIONS: Use of CAM in diabetes is highly prevalent despite high levels of disappointment after its use. In this study, we suggest the need for health education relating to CAM and self-care in diabetes. Use of CAM should be explored with patients before clinical decisions are made.

Adult↗
PubMed1988

A survey of common misconceptions about head injury and recovery.

A survey questionnaire composed of 25 statements about head injury and recovery was administered to 221 individuals at a large regional shopping mall. Survey items were categorized into domains pertaining to the use of seatbelts, the nature of unconsciousness, the nature of amnesia, characteristics associated with brain injury, and recovery from brain injury. An additional 8 survey items inquired about the sources from which people obtained their knowledge, extent of personal experience with brain injury, occupational status, educational status, residential status, and their use of seatbelts. Results indicate substantial levels of misconception about the nature of unconsciousness, amnesia, and recovery, but surprisingly few misconceptions about seatbelts and the effects of brain damage. These findings corroborate clinical observations of gross misconceptions reported in the literature. Specific misconceptions appeared with comparable frequencies across the age groups studied, which indicates that family education for patients in rehabilitation needs to target all members of a family, rather than a designated primary caregiver.

Journal Article↗
PubMed2001

Reliability of the Problem Oriented Screening Instrument for Teenagers (POSIT) in adolescent medical practice.

PURPOSE: To determine the internal consistency and 1-week test-retest reliability of the Problem Oriented Screening Instrument for Teenagers (POSIT) among adolescent medical patients. METHODS: A research assistant administered the POSIT to a consecutive sample of 15- to 18-year-old patients arriving for routine medical care at a hospital-based adolescent medical practice. Each subject returned for a retest 1 week later. Internal consistency for each scale on test and retest was calculated using Cronbach alpha, and 1-week test-retest reliability by the intraclass correlation coefficient (r) and the kappa coefficient (kappa). RESULTS: The Substance Use/Abuse, Mental Health Status, Educational Status, and Aggressive Behavior/Delinquency scales had favorable alpha scores (>.70). Others, including Physical Health Status, had lower alpha scores. High intraclass correlation coefficients were found for all 10 POSIT scales (r =.72 to.88), although (r) was lower for males on two of the scales. Kappa coefficients for all scales indicated good reproducibility beyond chance (kappa =.42 to.73). CONCLUSIONS: This study provided supportive evidence for the reliability of the POSIT in primary care medical settings, although some POSIT scales could likely be improved. The 20- to 30-min administration time is most practical in settings that are dedicated to adolescent medicine, and computerized administration and scoring are needed.

Adolescent↗