Adolescent medicine (Philadelphia, Pa.)
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Despite efforts by groups as diverse as the federal and state governments, public health agencies, and various advocacy groups, tobacco use continued to increase among youth during the latter part of the 1990s. This article reviews the history of tobacco control in the latter part of the 20th century with special emphasis on policy development aimed at controlling use by children and adolescents. New trends in prevention and cessation are reviewed along with a discussion of tobacco control policies that will extend into this new century.
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American children and adolescents spend an average of 3-5 hours per day with a variety of media, including television, radio, videos, videogames, and the Internet. Considerable research exists to document concerns about media violence, the impact of media on teen sexual attitudes and behavior, the relationship between alcohol and cigarette advertising and adolescent drug use, and the impact of R-rated films on attitudes about sexual violence. Very little research exists concerning adolescents' use of the Internet and the potential behavioral impact, but many parents and professionals are concerned. Solutions include: better programming, stricter regulation by parents, media education at home and in schools, and greater advocacy on the part of health professionals.
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The authors provide assessment of prevalence of adolescent substance use, along with a description of risk and protective factors and process-oriented conceptual approach to prevention of substance use among teens. They present selected adolescent substance use prevention programs and results from evaluation studies. Limitations of existing prevention programs and suggestions for future prevention efforts are also discussed.
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More adolescent in the United States die from injuries than from any other cause. This chapter describes the three leading causes of death among adolescents-interpersonal violence, suicide, and motor vehicle-related injuries. The authors examine risks associated with alcohol use and access to firearms as well as injuries that occur at work and while playing sports, and end with recommendations for preventing adolescent injuries for health care providers, schools and communities.
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Because sports-related injuries to the hand and wrist are relatively frequent and lead to significant disability if misdiagnosed or improperly treated, it is important to identify the specific nature of such an injury to reach an accurate diagnosis and administer appropriate treatment. The author advocates an initial three-step process that may help the clinician to effectively diagnose and treat injuries: listen to the description of injury mechanisms; observe the site of injury; palpate the area for tenderness or instability.