Care of the poor and underserved in America. Older adolescents: a group at special risk

Article Abstract:

The lack of infant, child and adolescent services is a subject of grave concern. While many children receive some care through programs such as Medicaid, older adolescents, the 16-to 24-year-olds, are often ineligible for even this level of support. Prematurely emancipated, poorly educated, and uninsured, they fall between the cracks of the health care system. Their numbers include school dropouts; they are frequently unemployed, unprotected and particularly vulnerable. This is especially so if they are inner-city, minority persons trying to make it outside the framework of a family structure. If they are parents, their problems are magnified. Lack of education and special skills put them in a particularly difficult work situation with limited earnings and future growth potential, and inadequate health insurance for present needs. This group is further encumbered by health problems, substance abuse, sexually transmitted diseases, AIDS and caring for low-birth-weight babies. While not the usual venue of a pediatrician's concern, his or her involvement in their health problems could make a significant impact on their future. The needs, health concerns, and risks of this population are closer to the traditional areas of pediatric practice. Professionally, the pediatrician is most likely to understand the needs of these young adults, and could be a major player in developing the services that are needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Social aspects, Care and treatment, Teenagers, Youth, Stress in adolescence, Childhood stress (Psychology), Adolescent medicine

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The importance of parents' concerns about their child's development

Article Abstract:

When parents see their child's pediatrician, they often express concerns about their child's development and other psychosocial issues. The importance of these concerns is unknown. This study identified the types of concerns that parents express, compared these concerns with the child's actual development, and determined how parents came to have these concerns. Two pilot studies of 96 families showed that parental concerns represented value judgments, could be classified into developmental categories, and were related to the children's performance on screening tests. One hundred parents were surveyed and 45 percent expressed concern about development. The children were screened for developmental abnormalities, and 80 percent of those who failed the screening had parents who had expressed concern about articulation, language, fine-motor skills or general development. Of the children who passed the screening test, 94 percent had parents who expressed no developmental concerns. Parents had analyzed their children's development by comparing them with other children, and the conclusions reached by parents correlated well with the formal developmental screening results. This study suggests that pediatricians should consider parental concerns to be a helpful addition to formal developmental testing. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Evaluation, Diagnosis, Parent and child, Parent-child relations, Child development, Child development deviations, Developmental disabilities

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Diagnosis and treatment of ankle sprains: a review

Article Abstract:

Athletes of all ages are prone to occasional injuries. Ankle injuries are the most common acute musculoskeletal injuries, and occur in approximately one million persons per year. These injuries occur most often in basketball players, followed by football players and cross country runners. The usual practice has been for pediatricians to refer these cases to specialists for care and treatment, but pediatricians should acquire skills in the care and treatment of these injuries. This article describes basic diagnostic and management principles for the care of ankle sprains. Details of the physical anatomy and mechanism of the injuries are presented. Ankle sprains are of two kinds, inversion and eversion, with the latter requiring referral for orthopedic care. Other associated injuries are described in anatomic detail, with diagnostic criteria and treatment suggestions. The degree of injury varies, and procedural directions for determining the extent and nature of the trauma are provided. Immediate first aid treatment should follow the RICE mnemonic, which stands for rest, ice, compression and elevation. The earlier these procedures are implemented, the more rapid the recovery is likely to be. (Consumer Summary produced by Reliance Medical Information, Inc.)

Injuries, Medical examination, Ankle, Ankle injuries, Basketball players, Athletes

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