Incorporating teaching dermatoethics in a busy outpatient clinic.
Adolescence; Adolescent; Aged; Ambulatory Care – Ethical Issues; Ambulatory Care – Methods; Ambulatory Care Facilities – Ethical Issues; Ambulatory Care Facilities/*ethics; Ambulatory Care/ethics/methods; Curriculum; Dermatology – Education; Dermatology – Ethical Issues; Dermatology/education/*ethics; Education; Ethics; Female; Humans; Male; Medical; Medical – Education; Medical/*education; Quality Control; Quality Control (Technology); Undergraduate; United States; Workload
Aldrich Nely; Mostow Eliot
Journal of the American Academy of Dermatology
2011
2011-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2010.06.050" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2010.06.050</a>
The natural history of halo nevi: a retrospective case series.
*Skin Pigmentation; Adolescence; Adolescent; Adult; Child; Databases; Disease Progression; Disease Remission; Factual/*statistics & numerical data; Female; Follow-Up Studies; Halo – Pathology; Halo – Surgery; Halo/*pathology/*surgery; Human; Humans; Male; Middle Age; Middle Aged; Nevus; Preschool; Prospective Studies; Questionnaires; Remission; Remission Induction; Resource Databases; Retrospective Design; Retrospective Studies; Skin Pigmentation; Spontaneous; Surveys and Questionnaires; Young Adult
BACKGROUND: The time period between onset of depigmentation around the halo nevus (HN) to complete resolution of the nevus and halo has not been well studied. OBJECTIVE: We sought to better understand the natural history of the HN. METHODS: A retrospective chart review of patients with a clinical diagnosis of HN selected from a private practice database (1994-2010) was performed. In all, 52 patients with 80 HN were identified. The current stage of the HN was determined by a follow-up questionnaire and physical examination of 36 patients with 56 HN. RESULTS: Seven HN were excised. Of the remaining 49 HN, 51% (25) demonstrated no change in the halo or nevus after an average of 4.2 years; 14.3% (7) demonstrated partial nevus regression with persistence of the halo after an average of 6.7 years; 4.1% (2) demonstrated complete involution of the nevus with persistent halo depigmentation after an average of 7.7 years; 8.2% (4) demonstrated complete nevus involution with some repigmentation of the halo after an average of 11.8 years; 22.4% (11) demonstrated complete resolution of the nevus with complete repigmentation of the halo after an average of 7.8 years. LIMITATION: Some subjects were lost to follow-up. The time of initial HN onset was dependent on patient recall. CONCLUSION: These results demonstrate that HN typically persist for a decade or longer. A subgroup may progress through stages of involution with a return to normal-appearing skin, but even these lesions persisted for an average of 7.8 years. Education about the prolonged natural history of HN may reassure patients and avoid unnecessary excision.
Aouthmany Mouhammad; Weinstein Mara; Zirwas Matthew J; Brodell Robert T
Journal of the American Academy of Dermatology
2012
2012-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2011.11.937" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2011.11.937</a>
Incidental findings in the cervical spine at CT for trauma evaluation.
Adult; Female; Humans; Male; Middle Aged; Adolescent; Aged; Retrospective Studies; Registries; Incidental Findings; Injury Severity Score; Length of Stay/statistics & numerical data; Data Collection; Tomography; Human; Middle Age; Adolescence; Retrospective Design; Diagnosis; Cervical Vertebrae/*diagnostic imaging/*injuries; Spinal Injuries/*diagnostic imaging; 80 and over; X-Ray Computed/*methods; Nonparametric; Statistics; Nonparametric Statistics; Trauma Severity Indices; 80 and Over; Length of Stay – Statistics and Numerical Data; X-Ray Computed – Methods; Cervical Vertebrae – Injuries; Cervical Vertebrae – Radiography; Spinal Injuries – Radiography
OBJECTIVE: CT is the standard of care for assessment of traumatic injuries. Because of the detail depicted with this technique, findings incidental to the injury are easily detected. We sought to determine the frequency and types of incidental findings in the cervical spines of trauma patients undergoing CT. MATERIALS AND METHODS: The trauma registry was accessed to identify the cases of patients evaluated with cervical spine CT at a level 1 trauma center from January to July 2007. Trauma registry data, including age, sex, injury severity score, mechanism of injury, length of stay, and diagnosis were recorded, and all CT scans of the cervical spine were reviewed for incidental findings. Clinically significant incidental findings were classified according to bodily location, and the association between various patient characteristics and the likelihood of an incidental finding was assessed. RESULTS: We identified incidental CT findings in 230 of 1,256 patients (18.3%) who underwent CT of the cervical spine during an initial trauma evaluation. We stratified the incidental findings as trauma-related and not trauma-related. The likelihood of non-trauma-related incidental findings was associated with age (p \textless 0.0001). The likelihood of trauma-related incidental findings was associated with injury severity score (p \textless 0.0001). CONCLUSION: Incidental findings in the cervical spine were associated with age, injury severity score, and mechanism of injury. Awareness of the prevalence of incidental findings is important to assuring that both traumatic and nontraumatic pathologic findings are detected and appropriately managed.
Barboza Richard; Fox Jason H; Shaffer Lynn E T; Opalek Judy M; Farooki Shella
AJR. American journal of roentgenology
2009
2009-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2214/AJR.08.1420" target="_blank" rel="noreferrer noopener">10.2214/AJR.08.1420</a>
Shear-wave elastography of the breast: value of a quality measure and comparison with strain elastography.
80 and over; 80 and Over; Adolescence; Adolescent; Adult; Aged; Biopsy; Breast Neoplasms – Pathology; Breast Neoplasms – Radiography; Breast Neoplasms – Ultrasonography; Breast Neoplasms/*diagnostic imaging/pathology; Elasticity Imaging Techniques/*methods; Female; Human; Humans; Mammary/*methods; Mammography; Middle Age; Middle Aged; Needle; Predictive Value of Tests; Sensitivity and Specificity; Signal-To-Noise Ratio; Ultrasonography; Ultrasonography – Methods
PURPOSE: To determine whether addition of quality measure (QM) of shear-wave (SW) velocity (Vs) estimation can increase SW elastography sensitivity for breast cancer. MATERIALS AND METHODS: With written informed consent, this institutional review board-approved, HIPAA-compliant study included 143 women (mean age, 48.5 years +/- 8.7) scheduled for breast biopsy. Mean lesion size was 16.4 mm +/- 11.8; 95 (66%) lesions were benign; 48 (34%), malignant. If more than one lesion was present, lesion with highest Breast Imaging Reporting and Data System (BI-RADS) category was chosen. If there were more than one with highest BI-RADS category, a lesion was randomly selected. Conventional ultrasonography (US), strain elastography, and SW elastography were performed with QM. QM assesses SW quality to provide accurate Vs. Lesions were evaluated for Vs and QM (high or low). Lesions with Vs of less than 4.5 m/sec were classified benign; lesions with Vs of 4.5 m/sec or greater, malignant. Results were correlated with pathologic findings. Vs data with or without incorporating QM were used to determine SW elastography diagnostic performance. Binomial proportions and exact 95% confidence intervals (CIs) were calculated. RESULTS: In 95 benign lesions, 13 (14%) had no SW elastography signal; 77 (81%), Vs of less than 4.5 m/sec; and five (5%), Vs of 4.5 m/sec or greater. In 48 malignant lesions, eight (17%) had no SW elastography signal; 20 (42%), Vs of less than 4.5 m/sec; and 20 (42%), V of 4.5 m/sec or greater. QM was low in 17 of 20 (85%) malignant lesions with Vs of less than 4.5 m/sec. Without QM, using Vs of 4.5 m/sec or greater as test positive, SW elastography had lesion-level sensitivity of 50% (95% CI: 34%, 66%); specificity, 94% (95% CI: 86%, 98%); positive predictive value (PPV), 80% (95% CI: 59%, 93%); and negative predictive value (NPV), 79% (95% CI: 70%, 87%). Using QM where additional lesions with both low Vs and low QM were treated as test positive, SW elastography had lesion-level sensitivity of 93% (95% CI: 80%, 98%); specificity, 89% (95% CI: 80%, 95%); PPV, 80% (95% CI: 66%, 91%); and NPV, 96% (95% CI: 89%, 99%). CONCLUSION: Addition of QM can improve SW elastography sensitivity, with no significant change in specificity.
Barr Richard G; Zhang Zheng
Radiology
2015
2015-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1148/radiol.14132404" target="_blank" rel="noreferrer noopener">10.1148/radiol.14132404</a>
Simple Triage Algorithm and Rapid Treatment and Sort, Assess, Lifesaving, Interventions, Treatment, and Transportation mass casualty triage methods for sensitivity, specificity, and predictive values.
*Algorithms; *Emergency Service; *Mass Casualty Incidents; *Triage; 80 and over; 80 and Over; Adolescence; Adolescent; Adult; Aged; Algorithms; Emergency Service; Female; Hospital; Humans; Male; Mass Casualty Incidents; Middle Age; Middle Aged; Pilot Projects; Pilot Studies; Predictive Value of Tests; Retrospective Design; Retrospective Studies; Scales; Triage; Wounds and Injuries – Diagnosis; Wounds and Injuries – Mortality; Wounds and Injuries – Therapy; Wounds and Injuries/*diagnosis/mortality/therapy; Young Adult
OBJECTIVE: Two common mass casualty triage algorithms are Simple Triage Algorithm and Rapid Treatment (START) and Sort, Assess, Lifesaving, Interventions, Treatment, and Transportation (SALT). We sought to determine the START and SALT efficacy in predicting clinical outcome by appropriate triage. METHODS: We performed a retrospective chart review of trauma registry of patients from our emergency department (ED). We applied the triage algorithms to 100 patient charts. The end points categories were defined by patient outcomes and the need for intervention: minor/green, discharged without intervention other than minor ED procedure; delayed/yellow, patients get an intervention more than 12 hours after arrival to the ED; immediate/red, patients get an intervention less than 12 hours after arrival; dead/expectant/black, patients die within 48 hours after arrival. RESULTS: The mean age was 47 years (range, 17-92 years), and 72% were male. The mechanism of injury was 41% motor vehicle collision, 32% fall, and 16% penetrating trauma. Hospital outcome was 60% minor/green, 5% delayed/yellow, 29% immediate/red, and 6% dead/black. The SALT method resulted in 5 patients overtriaged (95% confidence interval [CI], 1.6-11.2), 30 undertriaged (95% CI, 21.2-40), and 65 met triage level (95% CI, 54.8-74.3). The START method resulted in 12 overtriage (95% CI, 6.4-20), 33 undertriaged (95% CI, 23.9-43.1), and 55 at triage level (95% CI, 44.7-65). Within triage levels, sensitivity ranged from 0% to 92%, specificity from 55% to 100%, positive predictive values from 10% to 100%, and negative predictive value from 65% to 97%. CONCLUSION: Overall, neither SALT nor START was sensitive or specific for predicting clinical outcome.
Bhalla Mary Colleen; Frey Jennifer; Rider Cody; Nord Michael; Hegerhorst Mitch
The American journal of emergency medicine
2015
2015-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ajem.2015.08.021" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2015.08.021</a>
Predictors of epinephrine autoinjector needle length inadequacy.
*Needles; Adolescence; Adolescent; Adult; Anaphylaxis – Drug Therapy; Anaphylaxis/*drug therapy; Body Mass Index; Cross Sectional Studies; Cross-Sectional Studies; Epinephrine – Administration and Dosage; Epinephrine/*administration & dosage; Equipment Design; Equipment Failure; Female; Human; Humans; Injections; Intramuscular – Equipment and Supplies; Intramuscular/instrumentation; Male; Middle Age; Middle Aged; Needles; Prospective Studies; Quadriceps Muscle/*anatomy & histology/diagnostic imaging; Quadriceps Muscles – Anatomy and Histology; Quadriceps Muscles – Ultrasonography; Sex Factors; Sympathomimetics – Administration and Dosage; Sympathomimetics/*administration & dosage; Ultrasonography; Young Adult
BACKGROUND: Self-administered epinephrine is the primary out-of-hospital treatment of anaphylaxis. Intramuscular injection of epinephrine results in higher peak plasma concentration than subcutaneous injection. With the prevalence of obesity, autoinjectors may not have an adequate needle length for intramuscular injection. OBJECTIVES: To measure muscle depth and evaluate predictors of autoinjector needle length inadequacy. METHODS: We performed a prospective cross-sectional study of a convenience sample of low acuity emergency department patients aged 18 to 55 years. We recorded demographic data, measured thigh circumference, and calculated body mass index (BMI). Using ultrasound, we took depth-to-muscle measurements of the vastus lateralus in a standing position, with and without gentle pressure to simulate muscle compression that occurs with correct autoinjector use. We conducted univariate analyses using chi(2) and t tests with P
Bhalla Mary Colleen; Gable Brad D; Frey Jennifer A; Reichenbach Matthew R; Wilber Scott T
The American journal of emergency medicine
2013
2013-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ajem.2013.09.001" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2013.09.001</a>
Defining Success in Pediatric Palliative Care While Tackling the Quadruple Aim.
*Attitude of Health Personnel; Adolescence; American Academy of Pediatrics; Child; Health Personnel/*psychology; Hospice and Palliative Care Nursing/*organization & administration; Humans; Infant; Newborn; Organizational Objectives; Palliative Care – In Infancy and Childhood; Pediatric Nursing/*organization & administration; Preschool; Success
Bogetz Jori F; Friebert Sarah
Journal of palliative medicine
2017
2017-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1089/jpm.2016.0389" target="_blank" rel="noreferrer noopener">10.1089/jpm.2016.0389</a>
Revisiting classification of pain from bone metastases as mild, moderate, or severe based on correlation with function and quality of life.
*Quality of Life; *Severity of Illness Index; 80 and over; 80 and Over; Adolescence; Adolescent; Adult; Aged; Bone metastases; Bone Neoplasms; Bone Neoplasms – Complications; Bone Neoplasms/*complications/secondary; Brief Pain Inventory; Female; Functional interference; Funding Source; Human; Humans; Male; Middle Age; Middle Aged; Pain – Classification; Pain – Etiology; Pain Measurement – Methods; Pain Measurement/*methods; Pain severity; Pain/*classification/etiology; Quality of life; Quality of Life; Questionnaires; Re-irradiation; Severity of Illness Indices; Survival; Young Adult
PURPOSE: The objective of our study was to determine the optimal cut points for classification of pain scores as mild, moderate, and severe based on interference with function and quality of life (QOL). METHODS: We evaluated 822 patients who completed the Brief Pain Inventory (BPI) and/or the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 30 (QLQ-C30) prior to receiving repeat radiation therapy for previously irradiated painful bone metastases. Optimal cut points for mild, moderate, and severe pain were determined by the MANOVA that yielded the largest F ratio for the between category effect on the seven interference items of BPI and the six functional domains of QOL (physical, role, emotional, cognitive, social functioning, and global QOL) as indicated by Pillai's Trace, Wilk's lambda, and Hostelling's Trace F statistics. RESULTS: For BPI and for QOL domains separately, the two largest F ratios for Wilk's lambda, Pillai's Trace, and Hotelling's Trace F statistics were from the cut points 4, 8 and 6, 8. When combining both, the optimal cut points were 4, 8 with 1-4 (mild), 5-8 (moderate), and 9-10 (severe). With this classification, the mean scores of all the seven interference items in BPI and the six functional domains were all highly statistically different. Patients with severe pain survived significantly shorter than those with mild and moderate pain (p \textless 0.0001). CONCLUSION: Our analysis supports the classification of pain scores as follows: 1-4 as mild pain, 5-8 as moderate pain, and 9-10 as severe pain. This may facilitate conduct of future clinical trials.
Chow Edward; Ding Keyue; Parulekar Wendy R; Wong Rebecca K S; van der Linden Yvette M; Roos Daniel; Hartsell William F; Hoskin Peter; Wu Jackson S Y; Nabid Abdenour; Ong Francisca; van Tienhoven Geertjan; Babington Scott; Demas William F; Wilson Carolyn F; Brundage Michael; Zhu Liting; Meyer Ralph M
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
2016
2016-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s00520-015-2957-5" target="_blank" rel="noreferrer noopener">10.1007/s00520-015-2957-5</a>
Anti-tobacco socialization in homes in African-American and White parents, and smoking and nonsmoking parents.
Ohio; Child; Focus Groups; Socialization; Human; Questionnaires; Chi Square Test; Funding Source; Interviews; Adolescence; Audiorecording; Blacks; Whites; Survey Research; Parental Attitudes – Ethnology; Parenting – Ethnology; Smoking – In Adolescence; Smoking – Prevention and Control – In Adolescence
PURPOSE: To examine parental perceptions and behaviors with regard to teen smoking, comparing African-American and white parents, and those who did and did not smoke. METHODS: Focus groups consisting of African-American and white parents who smoked provided initial in-depth information. A computer-assisted telephone survey of a biracial sample of 311 parents of children ages 8 to 17 years provided more generalizable information regarding parental beliefs and behaviors. RESULTS: Nearly 50% of households either allowed teen smoking, had no ground rules, or had set restrictive rules but never communicated them to the children. Compared to white parents, African-American parents felt more empowered to affect their children's behaviors and were more likely to actively participate in anti-tobacco socialization within the home (all p values \textless 0.01). Among the African-American parents, 98% reported 18 years or older to be an appropriate age for teens to make up their own minds about using tobacco, whereas 26% of white parents thought 16 years to be an appropriate age (p \textless 0.001). Parents who smoked reported more frequent rule-making than those who did not smoke (p = 0.02), but were more likely to believe that childhood tobacco use is inevitable (p = 0.01). CONCLUSIONS: Many parents are not engaged in antitobacco socialization in the home. Differences in the degree of parental participation may contribute to the variance in smoking prevalence between African-American and white children.
Clark P I; Scarisbrick-Hauser A; Gautam S P; Wirk S J
Journal of Adolescent Health
1999
1999-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s1054-139x(98)00117-7" target="_blank" rel="noreferrer noopener">10.1016/s1054-139x(98)00117-7</a>
Evaluating spondylolysis in adolescent athletes: history and x-ray findings confirm the diagnosis.
Female; Male; Child; Adolescence; Diagnosis; Differential; Athletic Injuries – Diagnosis – In Adolescence; Fractures – In Adolescence; Low Back Pain – Diagnosis – In Adolescence; Lumbar Vertebrae – Injuries – In Adolescence; Orthoses – In Adolescence; Spondylolysis – Diagnosis – In Adolescence
Low back pain is less common in young people than in adults but more often can be traced to a specific cause. A common cause of back pain in adolescents is spondylolysis, a fatigue fracture of a lumbar vertebra that occurs most frequently in young athletes. This condition is caused by repetitive trunk hyperextension. Clinical detection of spondylolysis may involve physical examination, radiography, CT, or MRI. A careful differential diagnosis is necessary to distinguish spondylolysis from a number of other disorders that cause chronic back pain. A proper treatment protocol incorporates rest, NSAlDs, use of a brace, and physical therapy.
Congeni J
Journal of Musculoskeletal Medicine
2000
2000-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Effect of a standardized pharyngitis treatment protocol on use of antibiotics in a pediatric emergency department.
Female; Male; Ohio; Child; Infant; Human; Descriptive Statistics; Adolescence; Retrospective Design; Random Sample; Preschool; Record Review; Antibiotics – Administration and Dosage – In Infancy and Childhood; Emergency Care – Standards – In Infancy and Childhood; Penicillins – Administration and Dosage; Pharyngitis – Drug Therapy – In Infancy and Childhood; Practice Guidelines – Utilization
Diaz MCG; Symons N; Ramundo ML; Christopher NC
Archives of Pediatrics & Adolescent Medicine
2004
2004-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1001/archpedi.158.10.977" target="_blank" rel="noreferrer noopener">10.1001/archpedi.158.10.977</a>
Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011.
Adolescence; Adolescent; Adult; Aged; Ambulatory Care – Statistics and Numerical Data; Ambulatory Care/*statistics & numerical data; Anti-Bacterial Agents/*therapeutic use; Antibiotics – Therapeutic Use; Child; Female; Health Care Surveys; Human; Humans; Inappropriate Prescribing – Statistics and Numerical Data; Inappropriate Prescribing/*statistics & numerical data; Infant; Male; Middle Age; Middle Aged; Newborn; Otitis Media; Otitis Media – Drug Therapy; Pharyngitis – Drug Therapy; Pharyngitis/drug therapy; Physicians'/*statistics & numerical data; Practice Patterns; Preschool; Prevalence; Respiratory Tract Infections – Drug Therapy; Respiratory Tract Infections/drug therapy; Suppurative/*drug therapy; Surveys; United States
IMPORTANCE: The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the extent of inappropriate outpatient antibiotic use is unknown. OBJECTIVE: To estimate the rates of outpatient oral antibiotic prescribing by age and diagnosis, and the estimated portions of antibiotic use that may be inappropriate in adults and children in the United States. DESIGN, SETTING, AND PARTICIPANTS: Using the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, annual numbers and population-adjusted rates with 95% confidence intervals of ambulatory visits with oral antibiotic prescriptions by age, region, and diagnosis in the United States were estimated. EXPOSURES: Ambulatory care visits. MAIN OUTCOMES AND MEASURES: Based on national guidelines and regional variation in prescribing, diagnosis-specific prevalence and rates of total and appropriate antibiotic prescriptions were determined. These rates were combined to calculate an estimate of the appropriate annual rate of antibiotic prescriptions per 1000 population. RESULTS: Of the 184,032 sampled visits, 12.6% of visits (95% CI, 12.0%-13.3%) resulted in antibiotic prescriptions. Sinusitis was the single diagnosis associated with the most antibiotic prescriptions per 1000 population (56 antibiotic prescriptions [95% CI, 48-64]), followed by suppurative otitis media (47 antibiotic prescriptions [95% CI, 41-54]), and pharyngitis (43 antibiotic prescriptions [95% CI, 38-49]). Collectively, acute respiratory conditions per 1000 population led to 221 antibiotic prescriptions (95% CI, 198-245) annually, but only 111 antibiotic prescriptions were estimated to be appropriate for these conditions. Per 1000 population, among all conditions and ages combined in 2010-2011, an estimated 506 antibiotic prescriptions (95% CI, 458-554) were written annually, and, of these, 353 antibiotic prescriptions were estimated to be appropriate antibiotic prescriptions. CONCLUSIONS AND RELEVANCE: In the United States in 2010-2011, there was an estimated annual antibiotic prescription rate per 1000 population of 506, but only an estimated 353 antibiotic prescriptions were likely appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship.
Fleming-Dutra Katherine E; Hersh Adam L; Shapiro Daniel J; Bartoces Monina; Enns Eva A; File Thomas M Jr; Finkelstein Jonathan A; Gerber Jeffrey S; Hyun David Y; Linder Jeffrey A; Lynfield Ruth; Margolis David J; May Larissa S; Merenstein Daniel; Metlay Joshua P; Newland Jason G; Piccirillo Jay F; Roberts Rebecca M; Sanchez Guillermo V; Suda Katie J; Thomas Ann; Woo Teri Moser; Zetts Rachel M; Hicks Lauri A
JAMA
2016
2016-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1001/jama.2016.4151" target="_blank" rel="noreferrer noopener">10.1001/jama.2016.4151</a>
Fatal passenger vehicle crashes with at least 1 driver younger than 15 years: a Fatality Analysis Reporting System study.
Female; Male; Child; Multivariate Analysis; Age Factors; Midwestern United States; Licensure; Human; Descriptive Statistics; Funding Source; P-Value; Data Analysis Software; Pilot Studies; Data Analysis; Adolescence; Pearson's Correlation Coefficient; Spearman's Rank Correlation Coefficient; Southeastern United States; Regression; Statistical; Accidents; Traffic; Geographic Factors; Southwestern United States; Automobile Driving – In Adolescence; Automobile Driving – Legislation and Jurisprudence; Rural Health – In Adolescence
Frisch L; Plessinger A
Journal of Rural Health
2007
2007
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1748-0361.2007.00083.x" target="_blank" rel="noreferrer noopener">10.1111/j.1748-0361.2007.00083.x</a>
Preventive health care for adolescents.
Adolescence; Adolescent Health Services; Preventive Health Care – In Adolescence
Gilchrist V; Alexander E
Primary Care
1994
1994-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Who do you think you are? Medical student socioeconomic status and intention to work in underserved areas.
*Career Choice; *Intention; *Medically Underserved Area; Adolescence; Adolescent; Attitude of Health Personnel; Career Planning and Development; Ethnic Groups; Female; Humans; Intention; Male; Medical – Psychosocial Factors; Medical – Statistics and Numerical Data; Medical/*psychology/*statistics & numerical data; Medically Underserved Area; Medically underserviced areas; Practice location intentions; Scales; Sex Factors; Social Class; Socioeconomic status; Students; Widening participation; Young Adult
A frequently cited rationale for increasing the participation of students from low socioeconomic status (SES) backgrounds is that it will create a workforce who will choose to work in low SES and medically underserviced communities. Two theoretical arguments, one that supports and one that contradicts this assumption, are proposed to explain the practice location intentions of medical students which we examine in a longitudinal analysis. SES background and future intentions of 351 applicants to an undergraduate medical degree were assessed at Time 1, with intentions re-assessed one year later for 96% of those who were enrolled as medical students. Students from very low (and very high) SES backgrounds indicated lower intention to practice in low SES or medically underserviced areas than those from mid-range SES backgrounds. Males and students from non-English speaking backgrounds indicated less desire to work in low SES areas, perhaps explained by high aspirational motivation. SES accounted for a relatively small amount of variance in practice intentions. Alternate predictors of practice location, including individual values and training effects, and their implications for selection practice, are discussed.
Griffin Barbara; Porfeli Erik; Hu Wendy
Advances in health sciences education : theory and practice
2017
2017-05
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<a href="http://doi.org/10.1007/s10459-016-9726-1" target="_blank" rel="noreferrer noopener">10.1007/s10459-016-9726-1</a>
Direct care staff and parents'/legal guardians' perspectives on end-of-life care in a long-term care facility for medically fragile and intellectually disabled pediatric and young adult residents.
Adolescence; Adolescent; Adult; Aged; Caregivers – Psychosocial Factors; Caregivers/*psychology; Child; Clinical Assessment Tools; Disabled – Psychosocial Factors; Disabled Children/*psychology; Female; Hospital – Psychosocial Factors; Hospital/*psychology; Human; Humans; Impact of Events Scale; Infant; Long Term Care – Psychosocial Factors; Long-Term Care/*psychology; Male; Middle Age; Middle Aged; Newborn; Nursing Staff; Ohio; Parents – Psychosocial Factors; Parents/*psychology; Pediatric Nursing; Preschool; Scales; Terminal Care – Psychosocial Factors; Terminal Care/*psychology; Young Adult
OBJECTIVE: Children and young adults with severe disabilities and their families are faced with enormous challenges throughout the lifespan, including admitting the child to a long-term care facility (LTCF) and making end-of-life (EOL) care decisions. While children are residents of these specialized LTCF, the majority of their daily care, even up until death, is provided by nursing aides or habilitation aides (HAs) with limited training and educational backgrounds compared with other licensed healthcare providers. The purpose of this study was to determine the impact of a resident's EOL experience on the primary HAs and parents/guardians. METHOD: Thirty-five resident deaths occurred at Hattie Larlham Center for Children with Disabilities (HLCCD) between January 1, 2006 and February 28, 2009. The HAs and parents/legal guardians were identified for each death and invited to complete three surveys per resident (FAMCARE, Impact of Events Scale (IES)-revised, and Perspective on End-of-Life Care) to assess their experience. There were 112 surveys mailed to 62 HAs and 47 surveys mailed to 47 parents. RESULTS: Forty-two surveys were returned from 18/62 HAs (response rate 29%) and 11/47 parents/legal guardians completed the surveys (response rate 23%). The FAMCARE survey found that parents were more satisfied with the EOL care than were the HAs. The IES-revised found no difference in traumatic responses from either group. Comments from the Perspective on End-of-Life Care survey were analyzed qualitatively for common themes including pain control, respect, decision making, environmental needs, resources, and support. SIGNIFICANCE OF RESULTS: Because of a low response rate, it was difficult to draw significant conclusions; however, several interesting trends were noted regarding the number of deaths HAs experienced, satisfaction with care, and distress. The special needs of this population and their caregivers can provide crucial insights into interventions (e.g. chaplaincy support, debriefings, anticipatory counseling, environmental changes) that might be of benefit for any caregiver or parent of a child with a long-term, chronic condition, particularly involving developmental disability.
Grossberg Richard I; Blackford Martha; Friebert Sarah; Benore Ethan; Reed Michael D
Palliative & supportive care
2013
2013-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1017/S1478951512000326" target="_blank" rel="noreferrer noopener">10.1017/S1478951512000326</a>
Longitudinal assessment of bone growth and development in a facility-based population of young adults with cerebral palsy.
Absorptiometry; Adolescence; Adolescent; Adult; Bone Density – Physiology; Bone Density/*physiology; Cerebral Palsy – Physiopathology; Cerebral Palsy/*physiopathology; Child; Cross Sectional Studies; Cross-Sectional Studies; Female; Human; Humans; Long Term Care – Statistics and Numerical Data; Long-Term Care/*statistics & numerical data; Longitudinal Studies; Male; Photon; Preschool; Prospective Studies; Risk Factors; Young Adult
AIM: Osteoporosis is a significant clinical problem in persons with moderate to severe cerebral palsy (CP), causing fractures with minimal trauma. Over the past decade, most studies examining osteoporosis and CP have been cross-sectional in nature, focused exclusively on children and adolescents and only involving one evaluation of bone mineral density (BMD). The purpose of this study was to assess BMD in a group including adults with CP, and changes in each individual's BMD over a 5- to 6-year period. METHOD: The study group included 40 residents of a long-term care facility aged 6 to 26 years at the time of their initial evaluation. Twenty-one patients (52.5%) were male, 35 (88%) were white, and 38 (95%) were in Gross Motor Function Classification System level V. BMD was assessed by dual-energy X-ray absorptiometry on the right and left distal femurs for three distinct regions of interest. RESULTS: Five residents had a fracture that occurred during the study period; this represented a fracture rate of 2.1% per year in the study group. Longitudinally, annualized change in the median BMD was 0.7% to 1.0% per year in the different regions of the distal femur, but ranged widely among the study group, with both increases and decreases in BMD. Increase in BMD over time was negatively correlated with age and positively correlated with change in weight. INTERPRETATION: Changes in BMD over time in profoundly involved persons with CP can range widely, which is important to recognize when evaluating potential interventions to improve BMD. Age and changes in body weight appear the most relevant factors.
Grossberg Richard; Blackford Martha G; Kecskemethy Heidi H; Henderson Richard; Reed Michael D
Developmental medicine and child neurology
2015
2015-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/dmcn.12790" target="_blank" rel="noreferrer noopener">10.1111/dmcn.12790</a>
Using the Sauvegrain method to predict peak height velocity in boys and girls.
*Growth; Adolescence; Adolescent; Age Determination by Skeleton – Methods; Age Determination by Skeleton/*methods; Body Height – Physiology; Body Height/*physiology; Child; Elbow – Radiography; Elbow/*diagnostic imaging; Female; Follow-Up Studies; Growth; Human; Humans; Male; Observer Bias; Observer Variation; Prospective Studies; Reproducibility of Results; Reproduction; Sex Characteristics
BACKGROUND: Correlating peak height velocity (PHV) with assessments of skeletal maturity has important implications in the treatment of scoliosis and other pediatric orthopaedic disorders. This study aims to compare the appearance of the elbow to the PHV in both boys and girls. METHODS: We selected 20 children who participated in the Brush Inquiry, a comprehensive study of the development of healthy children. The PHV was identified for each subject. Three observers used the Sauvegrain method to score the elbow maturity of these subjects at 5 visits (PHV -2 years, PHV -1 year, PHV, PHV +1 year, PHV +2 years). Reliability was tested with intraclass correlation coefficients, and maturity scores were compared with the PHV timing. RESULTS: An interrater reliability score of r = 0.915 and an intrarater reliability score of r = 0.909 indicate that this method can be reliably and consistently applied to differentiate elbow x-rays of varying skeletal maturities in children. The mean total scores of boys and girls seem to be equal at the 5 visits. There were no total scores of 26 or higher for boys or girls at PHV. CONCLUSIONS: The Sauvegrain score in adolescent boys and girls is reliable, and a score of 26 or higher indicates that the child has passed PHV. There is a strong trend for the mean total score of boys to equal that of girls at each stage relative to the PHV. LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions to Authors for a complete description of levels of evidence.
Hans Sarah D; Sanders James O; Cooperman Daniel R
Journal of pediatric orthopedics
2008
2008-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/BPO.0b013e31818ee3c4" target="_blank" rel="noreferrer noopener">10.1097/BPO.0b013e31818ee3c4</a>
Precordial Catch Syndrome in Elite Swimmers With Asthma.
Adolescence; Adolescent; Asthma – Complications; Asthma/*complications; Chest Pain – Etiology; Chest Pain/*etiology; Emergency Service; Hospital; Humans; Male; Swimming; Syndrome; Thoracic Wall; Thorax
Precordial catch syndrome is a benign cause of chest pain in children and adolescents that remains underrecognized. Because of distinctive symptoms, precordial catch syndrome is not necessarily a diagnosis of exclusion. However, a detailed history eliciting diagnostic features is important, along with a physical examination excluding other pathologic disorders. We present the cases of 2 elite swimmers with asthma who had acute episodes of precordial catch syndrome, one associated with an acute asthma exacerbation and one not, while swimming during competitive swim meets that required rescue efforts for both and eventual evaluation in the emergency department.
Hayes Don Jr; Younger Bradley R; Mansour Heidi M; Strawbridge Heather
Pediatric emergency care
2016
2016-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/PEC.0000000000000715" target="_blank" rel="noreferrer noopener">10.1097/PEC.0000000000000715</a>
Early Uncomplicated Appendicitis-Who Can We Treat Nonoperatively?
Adult; Female; Male; Aged; Young Adult; Prospective Studies; Patient Selection; Drug Administration Schedule; Appendectomy; Injections; Human; Middle Age; Adolescence; Retrospective Design; Intravenous; Administration; Oral; Treatment Outcomes; Severity of Illness Indices; Antibiotics – Therapeutic Use; Ampicillin – Therapeutic Use; Appendicitis – Diagnosis; Appendicitis – Drug Therapy; Appendicitis – Surgery; Enzyme Inhibitors – Therapeutic Use; Penicillins – Therapeutic Use
This study evaluated nonoperative treatment for mild appendicitis and reviewed selection criteria to be used in introducing this option into clinical practice. A retrospective review of 73 consecutive cases of appendicitis treated by a single surgeon from 2011 to 2013 was completed. Patients who were diagnosed with mild appendicitis meeting the criteria of an APPENDICITIS scoring algorithm proposed in this manuscript were considered for nonoperative management. An additional 17 patients with mild appendicitis were offered and successfully treated nonoperatively between 2014 and 2016 and reviewed. Of these original 73 patients, 37 had moderate to severe appendicitis and directly underwent appendectomy. The remaining patients were diagnosed with mild appendicitis and considered eligible for nonoperative management. Of these, 14 patients were offered nonoperative therapy. Thirteen responded successfully; one patient responded partially, but later opted for surgery. In 2014, this scoring system and preliminary results were shared with the other surgeons in our department. Nonoperative management was then selectively adopted by a few of the surgeons from 2014 to 2016 with another 17 patients (APPENDICITIS score of 0 or 1) being offered and successfully managed nonoperatively. Patients with mild or early appendicitis can be successfully managed nonoperatively. A proposed APPENDICITIS scoring system may provide a helpful mnemonic for successfully selecting patients for this option.
Horattas Mark C; HORATTAS ILEANA K; VASILIOU ELYA M
American Surgeon
2018
2018-02
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The Impact Of A Patient Survey Or A Physician Reminder On The Provision Of Adolescent Preventive Health-care
Adolescence; General & Internal Medicine; health promotion; preventive medicine; reminder systems; trial
Background. The objective of this study was to determine if the use of a patient survey or a chart stamp could increase the implementation of adolescent preventive health care in a family practice center. Methods. Subjects were all patients 13 to 18 years old (date of birth 1972 to 1977), who visited the Aultman Family Practice Centers from October 1, 1989, through September 30, 1990 (N = 801 patient visits). Three different 1-month interventions (patient questionnaire, physician stamp, and both patient questionnaire and physician stamp) as well as a 1-month control period were implemented. The effect of the intervention on adolescent preventive health care was measured by review of documentation in the patient's chart. Results. Those charts that indicated that either the questionnaire or stamp had been used showed significantly more documented discussion of issues relating to mood, injury, sexuality, exposure to toxins, and lifestyle (all P < .01). These discussions most commonly took place during a visit for a physical examination. The percentage of visits with documented discussions did not vary significantly according to type of reminder, nor with any physician or patient characteristic. Conclusions. The use of a reminder, especially in the context of an office visit for a physical examination significantly increased the implementation of adolescent preventive health care in this family practice center.
Jolliff A S; Gilchrist V J; Bourguet C C
Journal of Family Practice
1992
1992-12
Journal Article or Conference Abstract Publication
n/a
Using a Clinical Decision Support Tool to Increase Chlamydia Screening Across a Large Primary Care Pediatric Network.
Adolescence; adolescent; chlamydia; Chlamydia Infections – Diagnosis; Clinical – Utilization; clinical decision support; Decision Support Systems; electronic health record; Electronic Health Records; Health Screening; Human; Office Visits; Pediatric Care; Primary Health Care; screening
We aim to demonstrate increased chlamydia screening across a large pediatric network using an electronic health record-based intervention. We developed a pop-up notification that alerted providers that chlamydia screening was recommended during a well adolescent visit, when appropriate. We compared chlamydia screening rates before and after the implementation of the alert. The screening rate for chlamydia improved from 2.40% in the year before intervention to 5.01% in the year after intervention ( P \textless .01). In conclusion, an electronic health record intervention was successfully able to significantly increase rates of chlamydia screening across a large pediatric network.
Karas David; Sondike Stephen; Fitzgibbon James; Redding Mark; Brown Miraides
Clinical pediatrics
2018
2018-12
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<a href="http://doi.org/10.1177/0009922818803397" target="_blank" rel="noreferrer noopener">10.1177/0009922818803397</a>
Anabolic-androgenic steroids: use and abuse in pediatric patients.
Child; Substance Abuse Detection; Sports Medicine; Adolescence; Testosterone; Substance Use Disorders – Etiology; Adolescent Behavior – Drug Effects; Androgens – Adverse Effects; Doping in Sports – Prevention and Control; Hormones – Adverse Effects
The 'win at all costs' mentality fuels athletes to seek performance-enhancing substances, such as anabolic-androgenic steroids, to gain an advantage over their opponents. Nonathletes espouse this same attitude to 'win' the battle of attractiveness. An enhanced understanding of anabolic-androgenic steroids and the motivations behind their abuse will arm pediatricians with the ability to engage their patients in a balanced discussion of the benefits and costly risks of anabolic-androgenic steroids and successfully deter further use.Copyright © 2007 by Elsevier Inc.
Kerr JM; Congeni JA
Pediatric Clinics of North America
2007
2007-08
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<a href="http://doi.org/10.1016/j.pcl.2007.04.010" target="_blank" rel="noreferrer noopener">10.1016/j.pcl.2007.04.010</a>
Automated identification of antibiotic overdoses and adverse drug events via analysis of prescribing alerts and medication administration records.
*Algorithms; *Medical Order Entry Systems; Adolescence; Adolescent; adverse drug event; Adverse Drug Event – Prevention and Control; Age Distribution; Algorithms; Anti-Bacterial Agents/*administration & dosage/adverse effects; Antibiotics – Administration and Dosage; Antibiotics – Adverse Effects; Child; clinical; Clinical; Computer Assisted; Computer-Assisted; CPOE; decision support systems; Decision Support Systems; Demography; Drug Overdose/diagnosis/*prevention & control; Drug Therapy; Drug-Related Side Effects and Adverse Reactions/*prevention & control; electronic health record; Electronic Health Records; electronic medical record; Electronic Order Entry; Female; Funding Source; Hospitals; Humans; Infant; Male; medical order entry system; Medication Errors – Prevention and Control; Medication Errors – Statistics and Numerical Data; Medication Errors/*prevention & control/statistics & numerical data; Newborn; Overdose – Diagnosis; Overdose – Prevention and Control; patient safety; Pediatric; Preschool; risk management; Young Adult
Objectives: Electronic trigger detection tools hold promise to reduce Adverse drug event (ADEs) through efficiencies of scale and real-time reporting. We hypothesized that such a tool could automatically detect medication dosing errors as well as manage and evaluate dosing rule modifications. Materials and Methods: We created an order and alert analysis system that identified antibiotic medication orders and evaluated user response to dosing alerts. Orders associated with overridden alerts were examined for evidence of administration and the delivered dose was compared to pharmacy-derived dosing rules to confirm true overdoses. True overdose cases were reviewed for association with known ADEs. Results: Of 55 546 orders reviewed, 539 were true overdose orders, which lead to 1965 known overdose administrations. Documentation of loose stools and diarrhea was significantly increased following drug administration in the overdose group. Dosing rule thresholds were altered to reflect clinically accurate dosing. These rule changes decreased overall alert burden and improved the salience of alerts. Discussion: Electronic algorithm-based detection systems can identify antibiotic overdoses that are clinically relevant and are associated with known ADEs. The system also serves as a platform for evaluating the effects of modifying electronic dosing rules. These modifications lead to decreased alert burden and improvements in response to decision support alerts. Conclusion: The success of this test case suggests that gains are possible in reducing medication errors and improving patient safety with automated algorithm-based detection systems. Follow-up studies will determine if the positive effects of the system persist and if these changes lead to improved safety outcomes.
Kirkendall Eric S; Kouril Michal; Dexheimer Judith W; Courter Joshua D; Hagedorn Philip; Szczesniak Rhonda; Li Dan; Damania Rahul; Minich Thomas; Spooner S Andrew
Journal of the American Medical Informatics Association : JAMIA
2017
2017-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/jamia/ocw086" target="_blank" rel="noreferrer noopener">10.1093/jamia/ocw086</a>
What is the draw? Assessing a risk model and conventional exploration model of e-cigarette use.
Adult; Risk Assessment; Human; Chi Square Test; Colleges and Universities; Descriptive Statistics; Scales; Data Analysis Software; Post Hoc Analysis; Surveys; Student Attitudes; Adolescence; One-Way Analysis of Variance; Logistic Regression; Sensation; Models; Theoretical; Attitude to Risk; Bivariate Statistics; Electronic Cigarettes; Pleasure; Preventive Health Care; Public Policy; Replication Studies; Risk Taking Behavior; Electronic Cigarettes – Utilization
Background/Objective: The use of electronic cigarettes (e-cigarettes) among young adults has been increasing, leading to concern due to unknown health effects. The purpose of the current study is to replicate and expand research on two contrasting models of e-cigarette use: risk model and conventional exploration model. Methods: An anonymous online survey was distributed at a midwestern university in fall 2015. There were 3,626 respondents, aged between 18 and 25, who answered the study's measures: sensation seeking, risk perception, public use attitudes, and policy views. Results: Respondents were categorized into mutually exclusive groups: nonuser (58.8%), e-cigarette only user (24.2%), cigarette only user (2.7%), and dual user (13.2%). Lending support to the risk model, higher disinhibition and endorsing e-cigarette use in public was associated with lower odds of being nonusers compared to e-cigarette only users. Support for the conventional model was found with higher perceived likelihood of getting heart disease, a risk of harm, and a risk of addiction due to e-cigarette use being associated with higher odds of being nonusers compared to e-cigarette only users. Conclusions: Results provide some support for both models. Findings can be used to inform prevention and intervention programs and services.
Laurene Kimberly R; Kodukula Geethika; Fischbein Rebecca; Kenne Deric R
Journal of Substance Use
2019
2019-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/14659891.2018.1535004" target="_blank" rel="noreferrer noopener">10.1080/14659891.2018.1535004</a>
Between- And Within-person Level Motivational Precursors Associated With Career Exploration
adaptability; Adolescence; adolescents; Career exploration; high-school-students; identity; Motivation; multidimensional measure; Personal agency beliefs; Psychology; self-efficacy; social cognitive theory; trajectories; transmission; vocational; work; Work valences
Career exploration is a critical process for child and adolescent development leading people toward suitable work and developing a vocational identity. The present study examined the role of motivational precursors, namely work valences and personal agency beliefs, in explaining in-breadth and in-depth career exploration. Given the dynamic nature of motivation, we teased apart the between-person differences and within-person variabilities in motivational precursors to examine how they are independently associated with career exploration. Two hundred one high school students comprised the sample and were surveyed three consecutive years. Results revealed that work valences and agency beliefs were associated with career exploration at both the between- and within-person level. Further, when individuals exhibited greater level of agency beliefs and positive valences, they were more likely to exhibit more in-depth exploration one year later. Implications for career guidance are discussed. (C) 2015 Elsevier Inc. All rights reserved.
Lee B; Porfeli E J; Hirschi A
Journal of Vocational Behavior
2016
2016-02
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.jvb.2015.11.009" target="_blank" rel="noreferrer noopener">10.1016/j.jvb.2015.11.009</a>
The Better Weight-Better Sleep Study: A Pilot Intervention in Primary Care.
Adult; Female; Male; Aged; Primary Health Care; Behavior Therapy; Human; Funding Source; Repeated Measures; Scales; Data Analysis Software; Middle Age; Adolescence; Regression; Treatment Outcomes; Randomized Controlled Trials; Cognitive Therapy; Sleep; Obesity – Prevention and Control; Sleep Disorders – Complications
Objective: To explore the feasibility of integrating sleep management interventions with dietary and exercise interventions for obesity in a 12-week randomized trial. Methods: We randomized 49 overweight or obese adult patients either to a better weight (BW) cognitive behavioral intervention, or to a combination of the BW intervention and a better sleep intervention, better weight-better sleep (BWBS). Results: The BWBS group lost weight faster (P=.04), and coping self-efficacy accelerated (P=.01). Conclusions: These preliminary results merit replication in a larger primary care-based trial with a longer continuous intervention and followup period.
Logue Everett E; Bourguet Claire C; Palmieri Patrick A; Scott Edward D; Matthews Beth A; Dudley Patricia; Chipman Katie J
American Journal of Health Behavior
2012
2012-06-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.5993/AJHB.36.3.4" target="_blank" rel="noreferrer noopener">10.5993/AJHB.36.3.4</a>
Adolescent premarital sexual activity, cohabitation, and attitudes toward marriage.
Female; Humans; Male; Adolescent; Prevalence; *Attitude; Interpersonal Relations; Family/psychology; Sexual Behavior/*psychology/statistics & numerical data
Societal trends indicate ambivalent attitudes about marriage. Specifically, there is greater acceptance of divorce and nontraditional living arrangements such as cohabitation, as well as acceptance and prevalence of premarital sex, than in the past. The authors examine adolescent attitudes toward marriage and their association with premarital sexual activity and cohabitation. Recommendations for helping adolescents understand the realities of marriage and family life are shared.
Martin P D; Martin D; Martin M
Adolescence
2001
1905-6
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Adolescent premarital sexual activity, cohabitation, and attitudes toward marriage.
Adolescence; Attitude to Sexuality – In Adolescence; Divorce – Trends; Marriage – Psychosocial Factors – In Adolescence; Sex Education – In Adolescence
Societal trends indicate ambivalent attitudes about marriage. Specifically, there is greater acceptance of divorce and nontraditional living arrangements such as cohabitation, as well as acceptance and prevalence of premarital sex, than in the past. The authors examine adolescent attitudes toward marriage and their association with premarital sexual activity and cohabitation. Recommendations for helping adolescents understand the realities of marriage and family life are shared.
Martin P D; Martin D; Martin M
Adolescence
2001
2001
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Expressed attitudes of adolescents toward marriage and family life.
Female; Male; Texas; Human; Descriptive Statistics; Surveys; Adolescence; Attitude Measures; Random Sample; Divorce; Sexuality; Family – Psychosocial Factors; Attitude – In Adolescence; Marriage – Psychosocial Factors
In the U.S., modifications in family structure and in attitudes concerning marriage and family life have been numerous. Areas such as sexual behavior and alternative living arrangements have become highly varied and nontraditional compared to past generations. This study examined the attitudes of adolescents toward aspects of marriage and family life. The majority of adolescents expressed negative attitudes toward divorce and viewed marriage as a lifelong commitment. While only about a third of the adolescents expressed positive attitudes toward premarital sex, a majority indicated they would engage in sexual intercourse before marriage, or already have. Interestingly, about half of the adolescents held positive attitudes toward cohabitation. Lastly, the adolescents demonstrated a growing acceptance of premarital counseling and psychoeducational interventions regarding marriage and family life.
Martin P D; Specter G; Martin D; Martin M
Adolescence
2003
2003
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Expressed attitudes of adolescents toward marriage and family life.
Humans; Adolescent; Texas; *Attitude; Sexual Behavior; Family/*psychology; Divorce; Marriage/*psychology
In the U.S., modifications in family structure and in attitudes concerning marriage and family life have been numerous. Areas such as sexual behavior and alternative living arrangements have become highly varied and nontraditional compared to past generations. This study examined the attitudes of adolescents toward aspects of marriage and family life. The majority of adolescents expressed negative attitudes toward divorce and viewed marriage as a lifelong commitment. While only about a third of the adolescents expressed positive attitudes toward premarital sex, a majority indicated they would engage in sexual intercourse before marriage, or already have. Interestingly, about half of the adolescents held positive attitudes toward cohabitation. Lastly, the adolescents demonstrated a growing acceptance of premarital counseling and psychoeducational interventions regarding marriage and family life.
Martin Paige D; Specter Gerald; Martin Don; Martin Maggie
Adolescence
2003
1905-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Technique for preservation of penile skin in genital reconstruction: free graft to the scrotum.
*Free Tissue Flaps; *Skin Transplantation; Adolescence; Adolescent; Child; Epispadias/*surgery; Humans; Hypospadias – Surgery; Hypospadias/*surgery; Infant; Male; Penis – Surgery; Penis/*surgery; Preschool; Reconstructive – Methods; Reconstructive Surgical Procedures/*methods; Reoperation; Scrotum – Surgery; Scrotum/*surgery; Skin; Skin Transplantation; Surgery; Surgical Flaps; Tissue Banks; Urogenital Abnormalities – Surgery; Young Adult
OBJECTIVE: To describe a new technique to preserve the penile epithelium with good cosmetic results when additional surgery is a significant possibility. Complex genital reconstruction can require multiple procedures. METHODS: Seven patients underwent grafting of the penile epithelium to the scrotum during genital reconstruction to bank the tissue for potential future use. The graft size was 8-40 mm in the maximal length. RESULTS: The median age at surgery was 8.1 months. The median interval to the last follow-up examination after surgery was 13.5 months. All 7 patients demonstrated excellent wound healing with good cosmetic results. CONCLUSION: In patients with complex genital anomalies, nonhair-bearing epithelium is a valuable asset. At times, the paucity of available local tissue necessitates autografting with nongenital epithelium. The need for nongenital tissue can be reduced if excess penile skin is banked for potential use at a later date. We describe a technique in which the penile skin is preserved for potential future reconstruction using free grafting to the scrotum.
Massanyi Eric Z; McMahon Daniel R
Urology
2011
2011-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.urology.2011.04.015" target="_blank" rel="noreferrer noopener">10.1016/j.urology.2011.04.015</a>
Assessing the impact on patient-physician interaction when physicians use personal digital assistants: a Northeastern Ohio Network (NEON) study.
Adult; Female; Humans; Male; Middle Aged; Ohio; Adolescent; Aged; Young Adult; Physician-Patient Relations; Health Care Surveys; *Physician-Patient Relations; Health Services Research; Computers; Human; Surveys; Middle Age; Adolescence; 80 and over; Handheld/*statistics & numerical data; 80 and Over; Hand-Held – Utilization
BACKGROUND: The effects of the use of technological devices on dimensions that affect the physician-patient relationship need to be well understood. OBJECTIVES: Determine patients' perceptions of physicians' personal digital assistant (PDA) use, comparing the results across 8 physician-patient dimensions important to clinical interactions. RESULTS: Patients completed anonymous surveys about their perceptions of physician PDA use. Data were collected during 2006 and 2007 at 12 family medicine practices. Survey items included physician sex, patient demographics, if physicians explained why they were using the PDA, and Likert ratings on 8 dimensions of how a PDA can influence physician-patient interactions (surprise, confidence, feelings, comfort, communication, relationship, intelligence, and satisfaction). The survey response rate was 78%. Physicians explained to their patients what they were doing with the PDA 64% of the time. Logistic regression analyses determined that patients of male physicians, patients attending private practices and underserved sites, patients with Medicaid insurance, and patients who observed their physician using a PDA during both the index visit and at least one prior visit were more likely to receive an explanation of PDA use. Most importantly, physician-patient communication was rated significantly more positive if an explanation of PDA use was offered. CONCLUSION: Patients rate interactions with their physicians more positively when physicians explain their PDA use.
McCord Gary; Pendleton Brian F; Schrop Susan Labuda; Weiss Lisa; Stockton LuAnne; Hamrich Lynn M
Journal of the American Board of Family Medicine : JABFM
2009
2009-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3122/jabfm.2009.04.080056" target="_blank" rel="noreferrer noopener">10.3122/jabfm.2009.04.080056</a>
Prevalence of strangulation in survivors of sexual assault and domestic violence.
80 and over; 80 and Over; Adolescence; Adolescent; Adult; Aged; Asphyxia – Epidemiology; Asphyxia/*epidemiology; Checklists; Domestic Violence; Domestic Violence/*statistics & numerical data; Female; Humans; Male; Middle Age; Middle Aged; Prevalence; Retrospective Design; Retrospective Studies; Risk Factors; Sex Offenses/*statistics & numerical data; Sexual Abuse; Young Adult
OBJECTIVES: Both sexual assault (SA) survivors and domestic violence (DV) survivors are populations at risk of strangulation injury. Our goal was to identify the prevalence of strangulation in patients who are survivors of SA and DV, identify presence of lethality risk factors in intimate partner violence, and assess differences in strangulation between SA and DV populations. METHODS: We reviewed all patient encounters from our health system's SA/DV forensic nurse examiner program from 2004 to 2008. Medical records were reviewed for documented physical signs of strangulation or documentation of strangulation. Risk factors for lethality included presence of firearm, threats of suicide/homicide by the perpetrator, significant bodily injury, loss of consciousness, loss of bladder or bowel control, voice changes, or difficulty swallowing. Data were analyzed with Pearson chi(2) and 95% confidence intervals (CIs). RESULTS: A total of 1542 encounters were reviewed. The mean patient age was 30 (range, 13-98) years and 97% were female. Six hundred forty-nine encounters were for DV assaults and 893 were SA. An intimate partner was the assailant 46% of the time; 84% DV vs 16% SA (P\textless.001). Patients reported strangulation in 23% (351/1542; 95% CI, 21%-25%) of their assaults. The prevalence of strangulation was 38% with DV and 12% with SA (P\textless.001). Most of the intimate partner encounters with strangulation had significant risk for lethality (97%, 261/269; 95% CI, 94%-99%). CONCLUSIONS: Patients presenting to our forensic nurse examiner program who were survivors of DV were more likely than SA patients to sustain strangulation. Lethality risk factors were common.
McQuown Colleen; Frey Jennifer; Steer Sheila; Fletcher Gwendolyn E; Kinkopf Brett; Fakler Michelle; Prulhiere Valorie
The American journal of emergency medicine
2016
2016-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ajem.2016.04.029" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2016.04.029</a>
Patient Preferences in Choosing a Primary Care Physician.
Adult; Female; Male; Aged; Multivariate Analysis; Odds Ratio; Prospective Studies; Decision Making; Physicians; Self Report; Family; Human; Questionnaires; Chi Square Test; Descriptive Statistics; Data Analysis Software; Middle Age; Adolescence; Logistic Regression; T-Tests; Patient Attitudes; Nonexperimental Studies; Maximum Likelihood; Patient
Mercado Francis; Mercado Margaret; Myers Nancy; Hewit Michael; Haller Nairmeen Awad
Journal of Primary Care & Community Health
2012
2012-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/2150131911421802" target="_blank" rel="noreferrer noopener">10.1177/2150131911421802</a>
The Indirect Effect of Positive Parenting on the Relationship Between Parent and Sibling Bereavement Outcomes After the Death of a Child.
*Bereavement; *Death; *Parent-Child Relations; Adolescence; Adolescent; Bereavement; Child; Death; Depression; family focused care; Female; Human; Humans; Male; parent distress; Parent-Child Relations; Parenting; Parenting/*psychology; Parents – Psychosocial Factors; Parents/*psychology; positive parenting; Post-Traumatic; Psychiatric Status Rating Scales; Psychological Tests; Siblings – Psychosocial Factors; Siblings/*psychology; Stress Disorders
CONTEXT: Families are referred to pediatric palliative care (PPC) programs when a child is diagnosed with a medical condition associated with less than a full life expectancy. When a child dies, PPC programs typically offer a range of bereavement interventions to these families, often focusing on parents. Currently, it is unclear which factors increase the likelihood that bereaved siblings will experience negative outcomes, limiting the development of empirically supported interventions that can be delivered in PPC programs. OBJECTIVES: The present study explored the relationship between parents' and surviving sibling's mental health symptoms (i.e., post-traumatic stress disorder [PTSD], prolonged grief disorder (PGD), and depression symptoms) after a child's death. Additionally, the extent to which parent functioning indirectly impacted sibling functioning through parenting behaviors (i.e., positive parenting and parent involvement) was also examined, with a specific focus on differences based on parent gender. METHODS: Sixty bereaved parents and siblings (aged 8-18) who enrolled in a PPC program from 2008 to 2013 completed measures of PTSD, PGD, and depression related to the loss of a child/sibling. Siblings also completed a measure of general parenting behaviors. RESULTS: Maternal, but not paternal, symptoms of PTSD and PGD were directly associated with sibling outcomes. Paternal symptoms were associated with sibling symptoms indirectly, through parenting behaviors (i.e., via decreasing positive parenting). CONCLUSION: These results underscore the importance of examining both maternal and paternal influences after the death of a child, demonstrate differential impact of maternal vs. paternal symptoms on siblings, and stress the importance of addressing postloss symptoms from a family systems perspective.
Morris Adam T; Gabert-Quillen Crystal; Friebert Sarah; Carst Nancy; Delahanty Douglas L
Journal of pain and symptom management
2016
2016-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jpainsymman.2015.08.011" target="_blank" rel="noreferrer noopener">10.1016/j.jpainsymman.2015.08.011</a>
Relation between leisure and career development of college students
adolescence; behavior; dimensions; exploration; identity; inventory; Psychology; salience; work
This study investigated the relation between leisure: and career development. Data were collected from college freshmen enrolled in required orientation classes (N = 239) at a midwestern stare university. Results indicated that students who perceived themselves as effective, competent and in control of their leisure possessed a clearer picture of their occupational goals, interests, and talents. Furthermore, students who were more committed to the leisure role displayed more highly developed attitudes toward exploring the world-of-work as well as greater competence for career decision making. (C) 1998 Academic Press.
Munson W W; Savickas M L
Journal of Vocational Behavior
1998
1998-10
Journal Article
<a href="http://doi.org/10.1006/jvbe.1998.1616" target="_blank" rel="noreferrer noopener">10.1006/jvbe.1998.1616</a>
Aging matters: strategies for optimal care of the elderly. Which came first? Restless leg syndrome or insomnia?
Adult; Female; Male; Aged; Middle Age; Adolescence; Insomnia; Restless Legs; Restless Legs – Epidemiology
Murphy DP; Graef B
Consultant (00107069)
2006
2006-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
The influence of family environment on dissociation in pediatric injury patients.
Female; Male; Ohio; Socioeconomic Factors; Child; Prospective Studies; Income; Self Report; Confidence Intervals; Family; Social Environment; Human; Semi-Structured Interview; Questionnaires; Chi Square Test; Descriptive Research; Descriptive Statistics; Funding Source; Scales; Correlational Studies; Data Analysis Software; Pretest-Posttest Design; Checklists; Adolescence; Pearson's Correlation Coefficient; Retrospective Design; Analysis of Covariance; Child Development; Bivariate Statistics; Severity of Illness Indices; Family Relations; Family Coping; Interview Guides; Parametric Statistics; Parenting Education; Patient-Family Relations; Dissociative Disorders – Risk Factors; Accidents – Adverse Effects; Wounds and Injuries – Complications
Nugent Nicole R; Sledjeski Eve M; Christopher Norman C; Delahanty Douglas L
Clinical Child Psychology & Psychiatry
2011
2011-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1359104511406487" target="_blank" rel="noreferrer noopener">10.1177/1359104511406487</a>
Psychometric Properties of a Career Exploratory Outcome Expectations Measure
adolescence; aspirations; career; career exploratory outcome expectations; Childhood career development; exploration; item response theory; outcome expectations; participation; perspective; Psychology; self-efficacy; social-cognitive model; students
Social cognitive career theory and research are advanced by increasing attention to career outcome expectations and by applying this theory earlier in the life span. This article offers the career exploratory outcome expectations construct as a means of applying the more general construct of career outcome expectations during the childhood period and introduces the psychometric characteristics of the Career Exploratory Outcome Expectations Scale (CEOES). Employing data from 446 fifth graders and item response theory (IRT), the CEOES presents a one-dimensional structure with a four-category Likert-type response scale. Favorable results of person- and item-separation reliability were found and the scale appears to perform equally well for both genders. The CEOES also demonstrated concurrent validity through positive associations with established self-efficacy measures. The CEOES constitutes a useful measure to study aspects of career outcome expectations in childhood, and psychometric findings affirm its use in the career assessment literature.
Oliveira I M; Taveira M D; Cadime I; Porfeli E J
Journal of Career Assessment
2016
2016-05
Journal Article
<a href="http://doi.org/10.1177/1069072715580577" target="_blank" rel="noreferrer noopener">10.1177/1069072715580577</a>