Legislation, policy, and tobacco use among youth: implications for health care providers.

This paper addresses implications of recent tobacco legislation, policy, and tobacco use among youth in the context of health care policy and services. Tobacco use prevalence and definitions and diagnoses of nicotine addiction and dependence are described. Assessment of smoking prevalence in Texas provides a case study of the problem and potential solutions for tobacco use among youth. The case study highlights specific implications to be considered when providing health care focused on prevention and risk reduction for youth. The paper concludes with implications and critical Internet resources for health care providers engaging in youth tobacco control.

Childhood obesity: measurement and risk assessment.

Obesity is a common nutritional disturbance in children, ranging from 18% to 30% in children of various ages. It is even more problematic among ethnically diverse populations. Because childhood is a critical period for the initiation of obesity, appropriate measurement and assessment of children at risk are essential. Current approaches to the measurement of fatness and classification of obesity vary in their accuracy and reproducibility. Measurement of body fatness in children and adolescents is most accurately estimated by combinations of measures.

Assessment, etiology, and intervention in obesity in children.

Obesity is a common nutritional disturbance of children and affects 25% to 30% of children and adolescents. This paper examines obesity in childhood, the measurement of obesity in children, and the relationship of obesity to coronary heart disease risks and discusses weight reduction issues in children. Clinically useful definitions of obesity in children have not been established, although the body mass index, together with anthropometric measurements, may provide the practitioner with useful assessment parameters. Discussions of weight in children must acknowledge the nutritional requirements of the normally occurring growth process. Because growth (and subsequently weight) varies widely among children even of the same age, measurement, classification, and control of weight must take into account the growth process and growth requirements. Interventions in childhood obesity should be directed toward family involvement in the chosen strategy and nutritional prudence coupled with typical activity.

Contribution of angiography to the diagnosis, staging and assessment of radiation and chemotherapy of solid abdominal malignancies in children.

Sequential angiographic studies were done in six children to stage and assess the results of radiation and/or chemotherapy of solid abdominal malignancies: one bilateral Wilms' tumor, two neuroblastomas, two hepatoblastomas and one hepatocarcinoma. Angiography was of value in demonstrating the tumor, its location, extent and vascular characteristics, as well as its regression and recurrence. Wilms' tumor and neuroblastoma responded and well to radiation and chemotherapy with substantial decrease in tumor size and regression or disappearance of tumor neovasculature. Resceted tumors revealed this to be due to tumor necrosis, hemorrhage and/or cystic degeneration. Hepatoblastoma and hepatocarcinoma did not respond as well to chemotherapy, with only mild decrease in size and neovasculature of the tumor.