Charles W. Linder

Comparison of Two Violence Prevention Curricula for Middle School Adolescents

OBJECTIVE To compare the effectiveness of the Violence Prevention Curriculum for Adolescents to the Conflict Resolution: A Curriculum for Youth Providers among middle school students. METHODS A sample (N = 225) of adolescents (males = 48%) representing 20% of the student population in two middle schools were administered a pretest questionnaire. Of these students, 89% were African-American, 10% were white, and 1% were Native-American and lived in public housing (40%) or in neighborhoods adjacent to public housing (60%). Each school was randomly assigned to one of the curricula. Each curriculum was administered during 10 50-min sessions held twice a week over 5 weeks. One week later, 209 students who completed the 10 sessions were tested with the same questionnaire. The data were analyzed with a repeated-measures analysis of variance. RESULTS Students who received either curriculum reported significant decreases in their self-reported use of violence in hypothetical conflict situations, frequency of use of violence in the previous 30 days, and frequency of physical fights in the previous 30 days. The conflict resolution curriculum was more effective in reducing the frequency of fights resulting in an injury requiring medical treatment in the previous 30 days. CONCLUSIONS Both curricula were successful in reducing three indicators of violence. However, the conflict resolution approach was more successful in reducing the frequency of more severe physical fights requiring medical treatment. The latter finding is of particular importance, because that physical fighting is the form of violence behavior in which young adolescents most often engage.

The effect of physical conditioning on serum lipids and lipoproteins in white male adolescents.

This study was designed to measure the effect of physical conditioning on the serum lipid and lipoprotein levels of white male adolescents. Fifty white males, ages 11-17 yr, underwent pre-test evaluations including physical measurements, physical activity levels, nutritional intake, physical working capacity, and fasting serum lipid and lipoprotein levels. Each subject was randomly assigned to a physical conditioning group or to a control group. There were no statistically significant differences in pre-test measurements. The physical conditioning group participated in an 8-wk progressive aerobic exercise program 30 min/d for 4 d each wk. The pre-test measurements were then repeated for both groups. Based on Students t-test, the physical conditioning group had a significantly higher physical working capacity on the post-test than the control group. An analysis of covariance test showed no differences between the groups in the post-test serum lipid and lipoprotein levels. The results suggested that although the exercise program was strenuous enough to increase significantly the physical working capacity of the exercise group, it did not alter their serum lipid and lipoprotein levels during the 8-wk period.

Influence of position during examination, and sex of examiner on patient anxiety during pelvic examination

It has been reported that adult women prefer the semi-sitting position over the supine position for the pelvic examination. We determined the effect of the pelvic examination position and the examiners gender on adolescent anxiety with the pelvic examination. Adolescent girls (n = 112) aged 12 to 19 years were randomly assigned to a semi-sitting or supine position and to a male or female physician. Before and after the examination questionnaires containing the Spielberger State-Trait Anxiety Inventory and other scales were administered. There were no differences between the groups in pre-examination anxiety or concern. Patients in the semi-sitting group reported fewer negative responses during the examination when examined by a male physician (P less than or equal to 0.009); those in the supine group reported fewer negative responses when examined by a female physician. These findings persisted after controlling for previous pelvic examinations, frequency of sexual activity, and Tanner stage. Patients who had previously had a pelvic examination and were examined in the semi-sitting position by a male physician reported the lowest levels of post-examination anxiety (P less than or equal to 0.02). Patients who had never had a pelvic examination expressed less anxiety if they were examined in the semi-sitting position by a female physician. These data suggest that the patients previous history of pelvic examinations and the gender of the examiner should be considered when selecting the pelvic examination position.

Relationship between habitual physical activity and serum lipoprotein levels in white male adolescents.

It is currently thought that increased physical activity can have a positive influence on high-density lipoprotein cholesterol (HDL-C) levels in adults. However, only a limited amount of research has been directed at studying the influence of physical activity on HDL-C in adolescents. This study correlated the reported levels of physical activity, exercise capacity, physical measurements, and 48-hr dietary intake of 50 white male adolescents with their levels of HDL-C, ratio of total serum cholesterol (T.Chol) to HDL-C, and ratio of low-density lipoprotein (LDL-C) to HDL-C. Using multiple regression, age (r = -0.42) was the strongest predictor of HDL-C, followed in order by TV watched/night (r = -0.42) and height (r = -0.31) (R2 = 0.28). Age (r = 0.38) was the strongest predictor of the T.Chol/HDL-C ratio, followed by days jogged/week (r = -0.32), TV watched/night (r = 0.29), and systolic blood pressure (r = 0.30) (R2 = 0.30). The days jogged per week (r = -0.32) was the best predictor of the LDL-C/HDL-C ratio, followed in order by hours spent reading/day (r = 0.27) and systolic blood pressure (r = 0.23) (R2 = 0.23). Maximum exercise capacity was not related to these lipoprotein components. These findings suggest that the level of habitual physical activity in white male adolescents may be associated with the level of HDL-C in relation to T.Chol and LDL-C.

Exercise, Serum Lipids, and Cardiovascular Disease—Risk Factors in Children

This article addresses the questions: Does regular exercise help the heart protect against coronary disease, and if so, what level of exercise is protective? If exercise protects against cardiovascular disease, what physiologic and biochemical changes induce this protection, and can these changes be measured or monitored—and can exercise in children protect against atherosclerosis in adulthood?

Breath-Holding Spells in Children: Studies of Frequency, Severity, Management

From the Fitzsimons General Hospital, Denver, Colorado. Present address: Pediatric Service, Landstuhl Army Medical Center, APO New York 09180. ORDINARILY, mild breath-holding spells are of little consequence. More troublesome is the breath-holding in those few children who become unconscious or have seizures. Such episodes must be distinguished from more serious disorders such as epilepsy. Although the problem had been recognized previously, Xleigs 1 in 1848 presented the first good description of breath-holding. In 1918 Abt 2 further clarified the entity and in 1943

The Influence of a Family History of CHD Risk Factors on Serum Lipoprotein Levels in Black Children and Adolescents

This study evaluated the influence of a family history of coronary heart disease (CHD) and CHD risk factors on the total serum cholesterol/high density lipoprotein (TChol/HDL) and the low density lipoprotein/HDL (LDL/HDL) ratios of 84 black children (ages 7-11 years) and adolescents (ages 12-15 years). Fasting lipid determinations were measured on all subjects. A questionnaire was administered to each subjects parent to determine the frequency of myocardial infarction, heart disease, hypertension, stroke, atherosclerosis, diabetes, and obesity in first- and second-degree blood relatives. Based on three-way analysis of variance tests, significant stroke and age, diabetes and age, and obesity and age interactions in TChol/HDL and LDL/HDL were found. There was also an obesity and age and sex interaction effect on T.Chol/HDL. The results indicated that a family history of stroke, diabetes, or obesity can have an unfavorable effect on the TChol/HDL and LDL/HDL ratios in black adolescents.

Isolation of Neisseria gonorrhea from the Urethra of Asymptomatic Adolescent Males

Symptomatic infection with Neisseria gonorrhea (NG) has become a major health problem in the adolescent population. While sexually active adults, who carry Neisseria gonorrhea may serve as a reservoir of infection even when asymptomatic, there are few data documenting the frequency of the asymptomatic carrier state in adolescent males. The purpose of this study was to determine the frequency of NG isolates in a sample of asymptomatic adolescent males (ages 13-18 years). Urethral cultures and gram stains were performed on 249 males (95% black) from a lower socio-economic background presenting to an adolescent clinic for routine health care. Of the 249 males cultured, 177 were without symptoms or signs of urethritis. NG were isolated from four (2.26%) patients (Z = 2.03, p ≤ 0.043). They were also isolated from 65 (90.3%) of the remaining 72 who had either symptoms or signs of urethritis. Although 26% of the patients had documented gonococcal disease, only 8% offered a genitourinary complaint at the time of initial evaluation. Our data indicate a low but statistically significant incidence of NG colonization comparable to that found in adult males in this population of asymptomatic adolescent males.

The influence of oral contraceptives and habitual physical activity on serum lipids in black adolescents and young woman

The effects of oral contraceptive use and habitual physical activity on serum cholesterol and lipoproteins were studied in 37 black females ages 16 to 28 years over a 3-month period. By the third month of oral contraceptive use, high-density lipoprotein (HDL) levels were lower and the low-density lipoprotein (LDL) to HDL ratio and total serum cholesterol (T Chol) to HDL ratio were significantly higher in those receiving oral contraceptive with norgestrel. The level of physical activity had no significant effect on HDL levels. The active subjects had lower T Chol and HDL levels and a lower T Chol to HDL ratio at the end of 3 months. Subjects in the active-norethindrone group had lower T Chol to HDL ratios than those taking norgestrel. The nonactive norgestrel group had a continuous increase in their T Chol to HDL ratio over the 3-month period. These effects should be considered when counseling sexually active teenagers and when recommending an oral contraceptive.

CONTRACEPTIVE RISK-TAKING BEHAVIOR BY SEXUALLY ACTIVE ADOLESCENT FEMALES

Despite the availability of effective contraceptives, adolescent pregnancy remains a formidable health issue. Previous studies of adolescent contraceptive risk-taking have been atheoretical in nature and have been analyzed in univariate and bivariate modes. The purpose of this study was to test a multivariate theoretical model which predicts (1) the decision to use contraceptives and (2) the choice of a specific method. The model consists of: premarital sexual standards and experiences→frequency of coitus→perceived probability of pregnancy→cognitive assessment of pregnancy→contraceptive activity. The model was tested using a recent national (U.S.A.) representative sample of nonmarried, sexually active females ages 15 to 20 years (n=1010) and was analyzed with three multiple regression analysis models. The number of years of sexual activity and the frequency of attendance at religious services were associated with coital frequency (R=.17, p<0001). Coital frequency, followed by post menarchial age and years dating also had a direct effect on contraceptive use (R=.23, p<0001). Attitude toward pregnancy, previous professional birth control advice, compliance with first contraceptive method, coital frequency and the source of their first family planning services were highly associated with contraceptive use (r=.84, p<0.0001). These data support the model and provide insight into the decision process used by adolescents to take contraceptive risks.