Abstract:
:The United States must improve its efforts to reduce teen pregnancy. We occupy an alarming position in the developed world from the standpoint of the magnitude of the pregnancy issue. While our society promotes sexuality to sell all sorts of consumer goods, it still refuses for the most part to make contraceptives familiar and available to sexually active teens. The youngest adolescents, 10 to 14 years, are having sex and babies at an increasing rate. Their children will have limited futures. Only by stepping up our efforts to prevent early pregnancy will we make possible a life of opportunity and choice for the young people of our country. Consequences will be costly and tragic if we do not. :The distinctive aspects of adolescent pregnancy in the U.S. are reviewed under the rubric of the "new morbidity": illnesses caused by social and life-style conditions. Quantitative trends in adolescent pregnancy are reviewed with statistics such as the annual U.S. Pregnancy rate for girls under 15, 5/1000, 4 times as high as Canada, the only other Western nation with a rate over 1/1000. Other countries pinpoint teen pregnancy, not sexual activity, as the key problem. Some social factors that have increased teen pregnancy are earlier menarche, increasing poverty, more single parent households. Determinants of sexually activity can be classed as individual, family and developmental. Individual factors include economic disadvantage, lack of opportunity and hopelessness and other problem behaviors. Family factors include race and female head of family. Development factors include pre- operational thinking, which prevents future planning and may require experience with sex to learn about it, and egocentricism, which implies an imaginary audience and the personal fable that "it will never happen to me." Teen pregnancy entails the medical risks of higher maternal mortality, cephalopelvic disproportion, anemia, toxemia and hypertension, resulting in prematurity and low birth weight. Social detriments are associate with teen childbearing, such as lower educational achievement, lower lifetime work accomplishment and income, larger families, cognitive delays in child development, lower school success and emotional problems for the child and higher risk for neglect and abuse. The cost of just Aid for Families with Dependent Children, Food Stamps and Medicaid for adolescent headed families is over $16 billion per year. The current administration has approached the problem by cutting funds, teaching the immorality of abortion, reducing the contraceptive availability and recommending teenage abstinence. The most effective programs in the U.S. are comprehensive school-based clinics.
journal_name
Pediatr Clin North Amjournal_title
Pediatric clinics of North Americaauthors
Davis Sdoi
10.1016/s0031-3955(16)36690-1subject
Has Abstractpub_date
1989-06-01 00:00:00pages
665-80issue
3eissn
0031-3955issn
1557-8240pii
S0031-3955(16)36690-1journal_volume
36pub_type
杂志文章,评审abstract::Although breastfeeding is well accepted as the optimal method of infant feeding, the US failed to reach the goals set for the year 2000. Support from employers, health insurers, health providers, and society are required to reach the goals set forth in Healthy People 2010-75% of mothers initiate breastfeeding, 50% of ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(05)70298-4
更新日期:2001-02-01 00:00:00
abstract::The evaluation of syncopal children or adolescents relies heavily on a thorough, detailed history and physical examination. All syncope associated with exercise or exertion must be considered dangerous. The ECG is mandatory, but other laboratory tests are generally of limited value unless guided by pertinent positives...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70113-9
更新日期:1999-04-01 00:00:00
abstract::College-age young women frequently experience a variety of menstrual-related complaints, including dysmenorrheal, menorrhagia, irregular menses, and menstrual-related mood changes. These problems deserve careful evaluation; they may reflect normal ovulatory menstrual symptoms or be suggestive of significant pathology ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2004.10.004
更新日期:2005-02-01 00:00:00
abstract::Increasing evidence indicates that the circadian timing system is a fundamental hemostatic system that potently influences human behavior and physiology throughout development. Circadian clock function begins during fetal life, and photic regulation of circadian phase is present at birth in primates. After birth, ther...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70486-7
更新日期:1997-04-01 00:00:00
abstract::In children, laboratory evaluations can assist in the screening of patients for inflammatory disorders, confirm diagnoses, allow for monitoring of disease activity and response to therapy, and suggest prognoses and risk of morbidities associated with rheumatic diseases. This review provides an overview of the usefulne...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2012.03.008
更新日期:2012-04-01 00:00:00
abstract::Whether providing anticipatory guidance to the young adolescent patient, conducting a preparticipation examination on a young athlete, or treating a sick user of anabolic androgenic steroids (AASs), the primary care physician must be familiar with the adverse consequences of the use of these compounds. This article re...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2007.04.001
更新日期:2007-08-01 00:00:00
abstract::Despite declines in adolescent pregnancy rates in the past decade, unplanned pregnancies among adolescents remain a significant problem in the United States. Clinicians caring for adolescents can be certain to encounter pregnancy in their patients. This article addresses surveillance and diagnosis for pregnancy in the...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70145-0
更新日期:1999-08-01 00:00:00
abstract::Although the benefits of rhGH and r-HuEPO therapy in children with CRF and on dialysis are already significant, further study of these new additions to the therapeutic arsenal remains necessary. Data on the final adult height achieved in patients who receive rhGH are extremely important information that is as yet unav...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)40098-2
更新日期:1995-12-01 00:00:00
abstract::In this article the practitioner's role in newborn screening were summarized and guidelines to assist in their execution were provided. The authors summarized the tests that are currently used in North America and provided a short discussion of current and future issues in this area. Newborn screening is no longer a s...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)38291-8
更新日期:1992-04-01 00:00:00
abstract::The application of the principles underlying successful renal transplantation in children has led us to increasing success in achieving our goals, which involve more than simple renal function replacement and include effective growth in stature, skeletal and central nervous system development, as well as social develo...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)36327-1
更新日期:1987-10-01 00:00:00
abstract::There has been a tremendous amount of progress in the perioperative approach to the child since Levy wrote "Psychic trauma of operations in children and a note on combat neurosis" nearly 50 years ago. Recognition of prolonged behavioral derangements following the anesthetic-surgical-hospital experience and the promine...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)38689-8
更新日期:1994-02-01 00:00:00
abstract::Vaccines are now available for the prevention of hepatitis A and hepatitis B. In this article, biologics are reviewed with special attention to their use in the pediatric patient. Special attention is paid to issues that developed in 1999. For hepatitis A vaccine, it is the change in US recommendations regarding incre...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70213-3
更新日期:2000-04-01 00:00:00
abstract::Diuretics are used in various conditions with fluid overload. Their efficacy in the management of congestive heart failure is well documented. In contrast, the indication of diuretics in chronic lung disease and central nervous system disorders of the newborn have not been clearly established. Substantial pharmacologi...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)36766-9
更新日期:1989-10-01 00:00:00
abstract::Lack of success in achieving considerable reductions in neonatal mortality is a contributory factor in failing to achieve Millennium Development Goal 4.2.6 million neonates still die each year, with preterm birth and infections the two leading causes. Maternal infections and environmental and infant factors influence ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2017.03.008
更新日期:2017-08-01 00:00:00
abstract::This article discusses various anomalies and abnormalities of the umbilical cord and issues related to cord care. The issue of screening newborns with an isolated single umbilical artery for renal abnormalities is addressed. The clinical presentation of infants with omphalomesenteric and urachal duct remants along wit...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2004.01.010
更新日期:2004-06-01 00:00:00
abstract::In this review, the authors describe the current information on nutrition modulation of immunity, enumerate the various immunologic tests that are potentially useful in nutritional assessment, examine the reliability of tests predicting disease and complications, and discuss how immunologic evaluation may help in the ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)34800-3
更新日期:1985-04-01 00:00:00
abstract::Vascular malformations are rare but important skin disorders in children, which often require multidisciplinary care. The goal of this article is to orient pediatricians to the various types of vascular malformations. We discuss the clinical characteristics, diagnostic criteria, and management of capillary, venous, ar...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2010.08.003
更新日期:2010-10-01 00:00:00
abstract::Emergency medicine requires diagnosing unfamiliar patients with undifferentiated acute presentations. This requires hypothesis generation and questioning, examination, and testing. Balancing patient load, care across the severity spectrum, and frequent interruptions create time pressures that predispose humans to fast...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2018.07.003
更新日期:2018-12-01 00:00:00
abstract::Youth-onset type 2 diabetes is a serious public health problem for Indigenous people throughout the world. This article reviews the epidemiology, disease burden, treatment, and challenges in achieving successful clinical management of this disorder in Indigenous youth. Screening criteria and the complications and como...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2009.09.013
更新日期:2009-12-01 00:00:00
abstract::This article describes the process of clinical assessment that may lead to differential treatment of psychiatric-related learning difficulties. The authors review differences in information processing among individuals with attention, affective, and primary thought disorders. ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)34578-3
更新日期:1984-04-01 00:00:00
abstract::Significant advances have been made in the understanding of allograft rejection. There is growing awareness that allograft acceptance, or tolerance, is also an active process rather than a passive absence of rejection. Mechanistic awareness of this process has spawned many preclinical strategies for the prevention of ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(03)00120-2
更新日期:2003-12-01 00:00:00
abstract::Important first steps have been taken towards establishing how some nutrients interact with genes and affect intestinal adaptation. These mechanisms may be typical of how other nutrients influence cell function and turnover and help to maintain intestinal integrity. The dietary effects of nucleotides on intestinal cel...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70415-6
更新日期:1996-04-01 00:00:00
abstract::Spinal deformity is a relatively common disorder, particularly in teenage girls. Early detection is possible by a simple, quick visual inspection that should be a standard part of the routine examination of all preteen and teenage patients. Follow-up observation will reveal those curvatures that are progressive and pe...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章
doi:10.1016/s0031-3955(16)36155-7
更新日期:1986-12-01 00:00:00
abstract::Although primary immunodeficiencies typically present with recurrent, chronic, or severe infections, autoimmune manifestations frequently accompany these disorders and may be the initial clinical manifestations. The presence of 2 or more autoimmune disorders, unusual severe atopic disease, or a combination of these di...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2016.08.007
更新日期:2017-02-01 00:00:00
abstract::Attention-deficit/hyperactivity disorder is the most common neurobehavioral disorder of childhood, with most children maintaining symptoms of ADHD as adolescents and as adults. It is among the most common chronic conditions that primary care pediatricians see. Progress in brain imaging, genetics, neuropsychology, and ...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(03)00077-4
更新日期:2003-10-01 00:00:00
abstract::The management of chronic cough, a common complaint in children, is challenging for most health care professionals. Millions of dollars are spent every year on unnecessary testing and treatment. A rational approach based on a detailed interview and a thorough physical examination guides further intervention and manage...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2013.04.004
更新日期:2013-08-01 00:00:00
abstract::Intestinal failure (IF) is the ultimate malabsorption state, with multiple causes, requiring long-term therapy with enteral or intravenous fluids and nutrient supplements. The primary goal during management of children with potentially reversible IF is to promote intestinal autonomy while supporting normal growth, nut...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2009.07.005
更新日期:2009-10-01 00:00:00
abstract::Neonatal infections continue to cause morbidity and mortality in infants. Among approximately 400,000 infants followed nationally, the incidence rates of early-onset sepsis infection within 3 days of life are 0.98 cases per 1000 live births. Newborn infants are at increased risk for infections because they have relati...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.pcl.2014.11.010
更新日期:2015-04-01 00:00:00
abstract::CAD results from atherosclerosis, a chronic disease process that has its origin in childhood. Children and adolescents can be at higher risk for CAD by virtue of being from families with premature CAD or familial dyslipoproteinemias. The plasma lipid and lipoprotein levels result from a number of complex metabolic pro...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(16)37021-3
更新日期:1990-12-01 00:00:00
abstract::Breast lesions, including mastalgia; benign proliferative changes; and benign masses, including fibroadenomas, are common in adolescents and young adult women. Breast cancer is rare in women less than 20 years old and uncommon in women less than 30 years old. Discrete masses in women less than 30 years old that do not...
journal_title:Pediatric clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0031-3955(05)70140-1
更新日期:1999-06-01 00:00:00