ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00426.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThis study of over 36000 7th‐12thgrade students focused on protective factors against the quietly disturbed and acting out behaviours, which together represent the major social morbidities of adolescence. Multivariate models developed separately for girls and boys repeatedly demonstrated the protective function of caring and connectedness in the lives of youth, particularly a sense of connectedness to family and to school. A sense of spirituality, as well as low family stress (referring to poverty, unemployment, substance use and domestic violence) also functioned as protective factors. Measures of caring and connectedness surpassed demographic variables such as two parentvssingle parent family structure as protective factors against high risk behaviours. Interventions for youth at‐risk must critically examine the ways in which opportunities for a sense of belonging may be fostered, particularly among youth who do not report any significant caring relationships in their lives with adu

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb02257.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00427.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractInsulin deficiency in either the mother or foetus has significant effects on fetal growth and development. In the human, maternal insulin deficiency, or diabetes mellitus, leads to macrosomia and increased adiposity of the foetus, while specific fetal hypo‐insulinaemia is associated with intra‐uterine growth retardation. When maternal diabetes is induced in experimental animals, no consistent increases in fetal bodyweight are observed although the body fat content of the foetus is increased in the majority of species studied. The magnitude of the fetal weight gain during maternal diabetes appears to be determined by the body fat content of the foetus, the severity and duration of the diabetes and by the temporal pattern of maternal hyperglycaemia observed during pregnancy. The latter factors, in particular, influence the level of insulin in the foetus which, in turn, regulates the rate of intra‐uterine growth. By contrast, fetal insulin deficiency has a more uniform effect on fetal growth and leads to impaired growth in both experimental and naturally occurring hypo‐insulinaemic conditions. Fetal insulin deficiency reduces fetal growth by decreasing nutrient uptake and utilization of the fetal tissues and by altering the circulating concentrations of the insulin‐like growth factors. Consequently, deficiencies in either fetal or maternal insulin secretion during pregnancy can alter fetal growth and have important consequences for perinatal survival and postnatal

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00428.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractTo date, evidence suggests that, across disciplines, the educational preparation of health professionals has not kept pace. Those involved in the education of clinicians, researchers, and educators in adolescent health are currently faced with the need to rethink traditional educational strategies. Concurrent with a shift in the primary causes of morbidity and mortality in adolescence, from infectious to social aetiologies, is an emerging clarity about the success of integrated comprehensive service settings in addressing adolescents' health needs. One approach for better preparing health providers to work in multiservice settings is to provide training in interdisciplinary programmes. Various models for interdisciplinary education in adolescent health exist; characteristics common to all are delineated. Whereas obstacles to the creation and implementation of interdisciplinary programmes, including institutional, financial, and educational barriers, are great, the need to overcome them is critical if we are to keep pace with the changing needs of the adolescent population.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb02253.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractMore than 14 million children under 5 years of age die annually in the Third World, mainly due to diarrhoea, pneumonia, malaria and immunizable diseases. The problems of poverty, malnutrition, poor sanitation, illiteracy and high fertility that traditionally are associated with underdevelopment are now being compounded by social disruption due to rapid changes in lifestyle, new diseases such as AIDS and Third World debt.A vital part of the solution is provision of basic medical and education services to all, with emphasis on female literacy and improving the status of women. Key elements in providing basic medical services are delegation and empowerment. Doctors must delegate the delivery of essential child health services to appropriately trained and adequately supported auxiliaries. Parents, especially mothers, need to be empowered with the knowledge and resources to recognize and manage, or assist in the management of, their children's health problems.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00429.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00430.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00431.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00432.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractDefinition of optimal glycaemic control in diabetic pregnancy may still be debated. Measures of glucose control (based on 4–6 daily glucose and frequent HbA1cvalues) were recorded in two series of diabetic pregnancies; one multicentre study (n= 92, 1979–82), and one study from our own institution (n= 113, 1983–85). The average pregnancy glucose levels were 5.9 mmol/L (third trimester only) and 6.5 mmol/L (all trimesters), respectively. Discriminant analysis (including pregnancy glucose, HbA1c, gestational age, diabetes duration and hypertension) revealed that gestational age only (first series) and gestational age and HbA1cindependently of each other (second series) were significantly associated with the occurrence of severe neonatal morbidity present among 30 and 16.8% of the infants, respectively. The overall outcome was favourable. The findings of no perinatal mortality, normal premature delivery rate (8.9%) and a very low rate of severe maternal hypoglycaemia (4.4%) in series two support the feasibility of a strict but individualized management prog

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00433.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY