Articles: adult.
-
Special aspects of pain in children are pointed out, and the range of relevant conditions and their frequency are compared with adult pain problems. Headache and especially migraine, with incidences of up to 50% and 10%, respectively, are the most common painful conditions to be treated in the pediatric age group. Many less frequent chronic painful disorders claim the need of special, mostly neuropediatric, knowledge; optimal diagnostic precision is important for good therapeutic results. ⋯ Another problem is that of pain assessment in infants and children; some new diagnostic tools, such as color scales and the Smiley analog scale, can help to solve these specific difficulties. Furthermore, the prediatrician accepts responsibility for the patients' future as adults and is therefore involved in the early prophylaxis of analgesic abuse. The actual and future work of pediatric pain clinics, the conditions in such institutions and the philosophy behind them are presented, and the necessity for research is pointed out.
-
Comparative Study
The aging of China's population: perspectives and implications.
"China's efforts to accelerate the pace of modernization emphasize the promotion of economic development and the reduction of its population growth through the adoption of a one-child per family policy. However, that policy has implications for the eventual aging of the country's population. This article reviews the changes in the status of the elderly, explores the changes in size of the elderly population, and various related social and policy implications." Topics considered include socioeconomic changes, underlying population dynamics, the current situation of the elderly, some international comparisons, implications of aging, planning for support of the elderly, health care, living arrangements and family support, retirement, and the status of the widowed, divorced, and unmarried in the elderly population.
-
In a retrospective cohort study of survivors of cancer and of controls, we estimated the risk of infertility after treatment for cancer during childhood or adolescence. We interviewed 2283 long-term survivors of childhood or adolescent cancer diagnosed in the period from 1945 through 1975, who were identified at five cancer centers in the United States. Requirements for admission to the study were diagnosis before the age of 20, survival for at least five years, and attainment of the age of 21. ⋯ Chemotherapy with alkylating agents, with or without radiation to sites below the diaphragm, was associated with a fertility deficit of about 60 percent in the men. Among the women, there was no apparent effect of alkylating-agent therapy administered alone (relative fertility, 1.02) and only a moderate fertility deficit when alkylating-agent therapy was combined with radiation below the diaphragm (relative fertility, 0.81). Relative fertility in the survivors varied considerably according to sex, site of cancer, and type of treatment; these factors should be taken into consideration in counseling survivors about the long-term consequences of disease.
-
The aforementioned social trends affecting women, including women in poverty, women in the labor force, and elderly women, are all ultimately related to problems of access to health care. In almost every age group, women use more health and medical services. Women are hospitalized more often, although their stays in hospitals tend to be shorter. ⋯ As the field of women's health expands and receives more emphasis, the data reflecting the experiences of large groups of women will have to be collected and analyzed ever more carefully. Information collected should include physiologic, psychosocial, and economic factors that together affect the health status of women. These data may then be used to guide health policy decision making, as well as provide a basis for health promotion and disease prevention interventions with individual clients.