Controversies and conundrums:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia
Hanley & Belfus
1997
|
| Schriftenreihe: | Adolescent medicine
8,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XI S., S. 375 - 552 |
| ISBN: | 1560532386 |
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| 650 | 4 | |a Adolescent psychotherapy | |
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Datensatz im Suchindex
| _version_ | 1804126118374014976 |
|---|---|
| adam_text | Contents
Preface xi
Susan M. Coupey, M.D., and Robert T. Brown, M.D.
Changing Health Care Environments and Adolescent Health Care:
Legal and Policy Challenges 375
Abigail English, J.D.
The changes in the health care system and shifts toward managed care affect adoles¬
cents like all other age groups. This chapter deals with the key issues that concern ado¬
lescent health care providers while creating the health care models of the future.
Questions such as adequate health insurance for adolescents, health care delivery to
uninsured and underinsured adolescents, and protection of confidentiality all need to
be addressed for adolescents to receive the health care they need.
Discrimination in Minority Health Care 385
Jonathan M. Ellen, M.D., Jill E. Gurvey, M.P.H., and
Charles E. Irwin Jr., M.D.
Racial/ethnic minority adolescents are reported to have lower general health status, in¬
cluding higher prevalence of many infectious diseases, than white, non Hispanic
youth. Factors such as lower socioeconomic position, neighborhoods they live in, dif¬
ferent cultural views on health, and different role of the family in health care providing
are all thought to contribute to this situation. This chapter comprehensively reviews the
existing data on the health status of minority adolescents, social, demographic, educa¬
tional and cultural determinants of racial/ethnic minority populations and how they
might interfere with health care delivery to the adolescents, and discusses the need for
initiatives to improve the existing conditions.
Acculturation Issues in Adolescent Immigrants:
How Are They Related to Health? 397
Karen J. Browner Elhanan, M.D.
Following immigration to a new country, adolescents must deal with many challenges
in addition to the normal intergenerational conflicts that characterize this age. The
need to learn a new language and adapt to a different educational system combined
with the struggle to make new friends can have visible consequences on the health
status of immigrant youth, many of whom suffered severe deprivations prior to immi¬
gration. This chapter reviews physical and mental health related problems, such as
posttraumatic stress disorder, depression, anxiety, and psychosomatic problems, that
concern adolescent immigrants and their families.
Sex, Drugs, Rock n Roll, and the Media—Are the Media
Responsible for Adolescent Behavior? 403
Victor C. Strasburger, M.D.
The old controversy about the role of the media in violent behaviors of adolescents can
be combined with another unsettled question—Does the media simply reflect the vio¬
lent, aggressive, and sexually oriented society, or does it actually cause some of the be¬
haviors it depicts? This chapter reviews existing studies on the exposure of adolescents
to media derived violence, sexual behaviors, and use of tobacco, alcohol, and drugs,
and the influences that such images have on this population.
v
vi Contents
The Health Care Provider s Role in Adolescent Medical
Decision Making 415
M. Max Quinn, J.D., and Nancy Neveloff Dubler, L.L.B.
In caring for adolescent patients, health care providers often face problems other than
their medical conditions. This chapter presents three case studies that illustrate a
diversity of ethical questions that arise in the context of adolescent health care. The
investigators present and define the basic ethical principles that should govern a
health care provider s approach to treating an adolescent. Even though this study was
primarily directed toward adolescents who live without proper adult supervision, the
principles and guidelines derived from this study can apply to the health care of all
adolescents.
Confidentiality in an Age of Managed Care: Can It Exist? 427
Charles J. Wibbelsman, M.D.
Adolescents in need of medical care can be greatly influenced by concerns about pri¬
vacy; therefore confidentiality remains one of the foundations of adolescent health
care. This article discusses confidentiality and quality adolescent care in different set¬
tings of managed care. With consent laws that vary from state to state and different ad¬
ministrative restrictions of managed care, confidentiality of adolescent health care
often may be compromised, causing adolescents to look outside the health care insurer
for the medical help they need. The author discusses the benefits of HMO models able
to provide easily accessible, quality confidential care to adolescents, including preven¬
tive adolescent medicine.
School based Health Centers 433
Pamela J. Murray, M.D., M.H.P.
Over the past decade there has been a rapid increase in the number of school based
health centers (SBHCs). This chapter discusses the expanding role of SBHCs in
adolescent health care, the controversies that surround the provision and utilization
of such services, and different relationships between SBHCs and managed care
organizations.
Should Adolescents Have Over the Counter Access to
Oral Contraceptive Pills and Antibiotics? 443
Geri D. Hewitt, M.D.
The rate of teenage pregnancy and abortion in the U.S. is the highest in the developed
world. Oral contraceptive pills (OCPs) are an effective method of contraception that
has very few contraindications in healthy adolescents. This article discusses the issue
of whether adolescents should be allowed access to OCPs and antibiotics for treatment
of sexually transmitted diseases without prior consultation with a health care provider.
The author argues that patient education and counseling that result from an interaction
with a clinician are necessary for sexually active adolescents and could be greatly di¬
minished if OCPs become available over the counter.
Condom Availability in High Schools 449
J. Dennis Fortenberry, M.D., M.S.
Increased incidence of sexually transmitted diseases, especially HIV/AIDS, and unin¬
tended pregnancies among adolescents call for immediate measures that should edu¬
cate adolescents and reduce risk from such outcomes. This article discusses
school based condom availability programs as one means to facilitate access to con¬
doms and provide additional counseling for prevention of undesired consequences of
adolescent sexual behaviors.
Contents vii
Emergency Contraception 455
Melanie A. Gold, D.O.
Emergency contraception uses oral contraceptives or postcoital insertion of an in
trauterine device (IUD) to prevent pregnancy after an episode of unprotected inter¬
course. This chapter reviews the available data on the efficacy of emergency
contraceptive pills (ECPs), indications and contraindications, availability, safety, and
potential side effects. It also addresses the controversial issues that arise from equat¬
ing ECPs with abortion, as well as the effects of ECPs on contraceptive practices of
adolescents.
Adolescents and HIV: Controversies Old and New 463
S. Kenneth Schonberg, M.D., andNealD. Hoffman, M.D.
Increased incidence of HIV infection among adolescents has put more emphasis on
trying to improve HIV screening of the adolescent population. This chapter presents
some of the controversies surrounding HTV testing and counseling, the options of ado¬
lescent consent to such testing, and the confidentiality of the test results. It also dis¬
cusses recent advances achieved with HIV combination therapy and availability of
new therapeutic approaches to infected adolescents.
Medical Abortions in Adolescents: Should Pediatricians
Perform Them? 473
Mitchell D. Creinin, M.D.
This chapter discusses medical abortion as an alternative to surgical abortion, as well
as its safety, efficacy, and availability to adolescent patients. Medical abortion is
viewed by many patients as a less traumatic and more private way to achieve preg¬
nancy termination, and the issues of privacy and confidentiality are even more empha¬
sized with adolescents. The author presents medical abortion methods currently
approved in the U.S., discusses the attitudes and preferences of adolescent vs. adult pa¬
tients, and argues that, assuming proper training and patient selection, this method of
abortion can be safely and effectively administered by pediatricians caring for their
adolescent patients.
One Test Too Many: Toward an Integrated Approach to
Psychosomatic Disorders 483
Walter D. Rosenfeld, M.D., and Gary A. Walco, Ph.D.
Conditions such as chronic fatigue syndrome (CFS), fibromyalgia, and several others
belong to the group of disorders in which both physiologic and psychologic factors are
substantially involved, and in some cases there may be no real distinction between the
two. However, primary patient assessment usually employs an array of clinical tools,
and only after known physiologic factors are excluded is the patient referred for psy¬
chologic or psychiatric evaluation. This chapter suggests that clinical evaluation
should initially include both physiologic and psychosocial assessment, which would
minimize the division and greatly improve the efficacy of the treatment.
Controversies in the Diagnosis and Treatment of Attention
Deficit/Hyperactivity Disorder in Adolescents 489
Esther H. Wender, M.D.
Attention deficit/hyperactivity disorder (AD/HD) is one of the most common behav¬
ioral problems in childhood, and for about 80% of diagnosed cases remains a problem
through adolescence. This article discusses general controversies that surround recog¬
nition, correct diagnosis, and treatment of AD/HD in children, and its relationship to
conduct disorder in adolescents and adults.
viii Contents
Rebellious Adolescents: Is Toughlove the Answer? 495
Carol Ford Arkin, Ph.D., and Jeffrey B. Gillman, Ph.D.
Grassroots, mutual help groups exist as an alternative or an addition to professional
help for families who are experiencing aggressive and antisocial behaviors by their re¬
bellious adolescents. The Toughlove approach is one example of a mutual help pro¬
gram created to help parents deal with serious behavioral problems of their children.
This chapter discusses the concepts, limitations, and benefits of such a family based
program and its effectiveness in children vs. adolescents.
The Medical Clinician s Roles in Preventing Adolescent
Involvement in Violence 501
Trina Menden Anglin, M.D., Ph.D.
This chapter discusses the role of health care providers in preventing adolescent expo¬
sure to violence and involvement in violent and criminal behaviors. The author reviews
the existing primary, secondary, and tertiary violence prevention programs. The chap¬
ter also offers practical suggestions for clinicians to identify adolescents exposed to
and involved in violence and provide clinical interventions to help youth suffering
from substance abuse, AD/HD, anxiety, depression, and other mental health problems
associated with exposure to violence.
How Should Pediatricians Approach the Depressed Adolescent? 517
JeffQ. Bostic, M.D., Ed.D., and Timothy E. Wilens, M.D.
Mood disorders, such as depression, dysthymia, and bipolar disorder, affect a large
number of adolescents and impair their normal development. This chapter discusses
the pediatrician s approaches to treatment of such disorders in adolescents and specifi¬
cally addresses the role of pharmacotherapy in achieving the best therapeutic results.
Growth Hormone Treatment for Children without Growth
Hormone Deficiency: Does It Work and Will It Produce
Adolescents Who Are Better Adjusted? 527
Paul Saenger, M.D.
The development of recombinant DNA technology offered a breakthrough for treat¬
ment of children with growth hormone (GH) deficiency. However, children who are
not GH deficient but have idiopathic short stature (ISS) represent another group of fre¬
quent candidates for GH treatment. This chapter reviews the results of existing studies
of GH treatment of such children and discusses the necessities, benefits, and limita¬
tions of this approach.
Cosmetic Plastic Surgery in Adolescents 537
Berish Strauch, M.D., and Bruce Greenstein, M.D.
Perceived or real physical defects may be important for an adolescent trying to estab¬
lish self image and adjust socially. Port wine stains, breasts too small or too large,
ethnic nose, prominent ears or chin, excess of adipose tissue—all these defects can
lead to loss of self esteem and have severe consequences with regard to an adolescent s
development. This chapter discusses surgical procedures that can help adolescents
change their physical appearance and consequently improve their self confidence and
social integration.
Index 547
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| title | Controversies and conundrums |
| title_auth | Controversies and conundrums |
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| title_full_unstemmed | Controversies and conundrums guest ed.: Susan M. Coupey ... |
| title_short | Controversies and conundrums |
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| topic | Adolescent medicine Adolescent psychotherapy Health behavior in adolescence Teenagers Medical care Jugendmedizin (DE-588)4249631-7 gnd |
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