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Manzoni P, Mostert M, Latino MA, Pugni L, Stolfi I, Decembrino L, Vagnarelli F, Corona G, Tridapalli E, Vetrano G, Memo L, Priolo C, Galletto P, Giovannozzi C, Gallo E, Pedicino R, Barberi I, Faldella G, Mosca F, Saia OS, Bollani L, Maragliano R, Ruffinazzi G, Tzialla C, Stronati M, Rizzollo S, Farina D, Benjamin DK, Smith PB, Jacqz-Aigrain E, Kaguelidou F, Cohen-Wolkowiez M. Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT. Early Hum Dev 2012; 88 Suppl 2:S60-4. [PMID: 22633517 DOI: 10.1016/s0378-3782(12)70017-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fungal colonisation by Candida spp. affects a high proportion of VLBW neonates in NICU. However, few data are available on the clinical characteristics of colonisation in preterm infants who are colonised at baseline via vertical transmission, compared to preterms who become colonised during their stay in NICU via horizontal transmission. MATERIAL AND METHODS We reviewed the database of a multicentre, randomised trial of prophylactic fluconazole in VLBW neonates conducted in 8 Italian NICUs in the years 2004 and 2005 (Manzoni et al., NEJM 2007;356(24):2483-95). Per the protocol, all enrolled infants underwent weekly surveillance cultures from birth till discharge. We investigated the frequency of the two different modalities of Candida colonisation in this population, as well as the clinical and outcome characteristics possibly related to them. RESULTS Overall, Candida colonisation affected 54 of 336 infants (16.1%). Baseline (i.e., detected <3(rd) day of life) colonisation affected 16 (4.7%), and acquired 38 (11.4%), of the 54 colonised preterms. Infants with baseline colonisation had significantly higher birth weight (1229 ± 28 g vs. 1047 g ± 29, p = 0.01) and gestational age (30.2 wks ± 2.7 vs. 28.5 wks ± 2.6, p = 0.01), and were significantly more likely to limit progression from colonisation to invasive Candida infection when fluconazole prophylaxis was instituted (21.6% vs. 42.7%, p = 0.009). Isolation of C. parapsilosis was significantly more frequent in infants with acquired colonisation. CONCLUSIONS Infants with baseline and acquired colonisation differ for demographics characteristics and for their response to fluconazole prophylaxis. This information may be useful for targeting more accurate management strategies for these two different groups of colonised preterms in NICU.
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MESH Headings
- Antifungal Agents/therapeutic use
- Candida/drug effects
- Candida/isolation & purification
- Candida/pathogenicity
- Candidiasis, Invasive/drug therapy
- Candidiasis, Invasive/prevention & control
- Candidiasis, Invasive/transmission
- Female
- Fluconazole/therapeutic use
- Humans
- Infant
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/drug therapy
- Infant, Premature, Diseases/prevention & control
- Infant, Very Low Birth Weight
- Infectious Disease Transmission, Vertical
- Intensive Care Units, Neonatal
- Male
- Premature Birth
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Clark RH, Gordon P, Walker WM, Laughon M, Smith PB, Spitzer AR. Characteristics of patients who die of necrotizing enterocolitis. J Perinatol 2012; 32:199-204. [PMID: 21593813 PMCID: PMC3289772 DOI: 10.1038/jp.2011.65] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Necrotizing enterocolitis (NEC) is associated with high morbidity and mortality among infants admitted for intensive care. The factors associated with mortality and catastrophic presentation remain poorly understood. Our objective was to describe the factors associated with mortality in infants with NEC and to quantify the degree to which catastrophic presentation contributes to mortality in infants with NEC. Catastrophic NEC was defined before data analysis as NEC that led to death within 7 days of diagnosis. STUDY DESIGN We performed a retrospective review of the Pediatrix's Clinical Data Warehouse (1997 to 2009, n=560,227) to compare the demographic, therapeutic and outcome characteristics of infants who survived NEC vs those who died. Associations were tested by bivariate and multivariate analysis. RESULT We compared the 5594 infants diagnosed with NEC and who were discharged home with 1505 infants diagnosed with NEC who died. In multivariate analysis, the factors associated with death (P<0.01 in analysis) were lower estimated gestational age, lower birth weight, treatment with assisted ventilation on the day of diagnosis of NEC, treatment with vasopressors at the time of diagnosis, and Black race. Patients who received only ampicillin and gentamicin on the day of diagnosis were less likely to die. Two-thirds of NEC deaths occurred quickly (<7 days from diagnosis), with a median time of death of one day from time of diagnosis. Infants who died within 7 days of diagnosis had a higher birth weight, more often were on vasopressors and high frequency ventilation at the time of diagnosis compared with patients who died at 7 or more days. Although mortality decreased with increasing gestational age, the proportion of deaths that occurred within 7 days was relatively consistent (65 to 75% of the patients who died) across all gestational ages. CONCLUSION Mortality among infants who have NEC remains high and infants who die of NEC commonly (66%) die quickly. Most of the factors associated with mortality are related to immaturity, low birth weight and severity of illness.
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Schell WA, Benton JL, Smith PB, Poore M, Rouse JL, Boles DJ, Johnson MD, Alexander BD, Pamula VK, Eckhardt AE, Pollack MG, Benjamin DK, Perfect JR, Mitchell TG. Evaluation of a digital microfluidic real-time PCR platform to detect DNA of Candida albicans in blood. Eur J Clin Microbiol Infect Dis 2012; 31:2237-45. [PMID: 22327343 DOI: 10.1007/s10096-012-1561-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Accepted: 01/18/2012] [Indexed: 11/24/2022]
Abstract
Species of Candida frequently cause life-threatening infections in neonates, transplant and intensive care unit (ICU) patients, and others with compromised host defenses. The successful management of systemic candidiasis depends upon early, rapid diagnosis. Blood cultures are the standard diagnostic method, but identification requires days and less than half of the patients are positive. These limitations may be eliminated by using real-time polymerase chain reaction (PCR) to detect Candida DNA in the blood specimens of patients at risk. Here, we optimized a PCR protocol to detect 5-10 yeasts in low volumes of simulated and clinical specimens. We also used a mouse model of systemic candidiasis and determined that candidemia is optimally detectable during the first few days after infection. However, PCR tests are often costly, labor-intensive, and inconvenient for routine use. To address these obstacles, we evaluated the innovative microfluidic real-time PCR platform (Advanced Liquid Logic, Inc.), which has the potential for full automation and rapid turnaround. Eleven and nine of 16 specimens from individual patients with culture-proven candidemia tested positive for C. albicans DNA by conventional and microfluidic real-time PCR, respectively, for a combined sensitivity of 94%. The microfluidic platform offers a significant technical advance in the detection of microbial DNA in clinical specimens.
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Cohen-Wolkowiez M, Benjamin DK, Piper L, Cheifetz IM, Moran C, Liu P, Aram J, Kashuba ADM, Capparelli E, Walsh TJ, Hope WW, Smith PB. Safety and pharmacokinetics of multiple-dose anidulafungin in infants and neonates. Clin Pharmacol Ther 2011; 89:702-7. [PMID: 21412233 DOI: 10.1038/clpt.2011.26] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Candida infections are common and often fatal in infants and neonates. Anidulafungin has excellent activity against Candida species, but the pharmacokinetics (PK) and safety of the drug in infants and neonates are unknown. The object of our study was to determine the PK and safety of anidulafungin in infants and neonates at risk for invasive candidiasis. Intravenous anidulafungin (1.5 mg/kg/day maintenance dose) was administered to 15 infants and neonates over 3 to 5 days. Plasma samples were collected after the first dose and again after the third to fifth doses. The pharmacokinetic parameters of the drug were determined by noncompartmental analysis. Safety was assessed using National Cancer Institute common toxicity criteria. The study showed that drug exposure levels were similar between neonates and infants; the median areas under the concentration-time curve (range) was 75 (30-109) µg·h/ml and 98 (55-278) µg·h/ml (P = 0.12) for neonates and infants, respectively. No drug-related serious adverse events were observed. The study results indicate that neonates and infants receiving 1.5 mg/kg/day have anidulafungin exposure levels similar to those in children receiving similar weight-based dosing and in adult patients receiving 100 mg/day.
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Baker-Smith CM, Benjamin DK, Califf RM, Murphy MD, Li JS, Smith PB. Cough in pediatric patients receiving angiotensin-converting enzyme inhibitor therapy or angiotensin receptor blocker therapy in randomized controlled trials. Clin Pharmacol Ther 2010; 87:668-71. [PMID: 20130570 DOI: 10.1038/clpt.2009.231] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The incidence of cough in children receiving antihypertension therapy with angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs) is unknown. We analyzed patient-level data from eight randomized trials for the treatment of pediatric hypertension, six of them involving ACEis and two involving ARBs. The incidence of cough in children receiving ACEis (reported cough, 3.2%) was similar to that in children receiving ARBs (reported cough, 1.8%) (P = 0.34). Reports of cough were lower in children than in adults.
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Moran C, Smith PB, Cohen-Wolkowiez M, Benjamin DK. Clinical trial design in neonatal pharmacology: effect of center differences, with lessons from the Pediatric Oncology Cooperative Research experience. Clin Pharmacol Ther 2009; 86:589-91. [PMID: 19915602 DOI: 10.1038/clpt.2009.175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Survival for premature neonates has improved dramatically over the past 20 years; however, there has been minimal improvement in prematurity-associated morbidities. Morbidity rates and assessment of outcomes vary across neonatology intensive care units (NICUs). Here, we address the reasons underlying these differences, note the impact that this center variation has on trial design and interpretation, and highlight the success of the efforts in pediatric oncology to develop standards of care through the conduct of multicenter clinical trials.
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Benjamin DK, Smith PB, Arrieta A, Castro L, Sánchez PJ, Kaufman D, Arnold LJ, Kovanda LL, Sawamoto T, Buell DN, Hope WW, Walsh TJ. Safety and pharmacokinetics of repeat-dose micafungin in young infants. Clin Pharmacol Ther 2009; 87:93-9. [PMID: 19890251 DOI: 10.1038/clpt.2009.200] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Given the risk of central nervous system infection, relatively high weight-based echinocandin dosages may be required for the successful treatment of invasive candidiasis and candidemia in young infants. This open-label study assessed the safety and pharmacokinetics (PK) of micafungin in 13 young infants (>48 h and <120 days of life) with suspected candidemia or invasive candidiasis. Infants of body weight > or =1,000 and <1,000 g received 7 and 10 mg/kg/day, respectively, for a minimum of 4-5 days. In the 7-mg/kg/day group, the mean baseline weight and gestational age were 2,101 g and 30 weeks, respectively; in the 10-mg/kg/day group, they were 688 g and 25 weeks, respectively. The median pharmacokinetic values for the 7- and 10-mg/kg/day groups, respectively, were as follows: area under the concentration-time curve from 0 to 24 h (AUC(0-24)), 258.1 and 291.2 microg x h/ml; clearance at steady state adjusted for body weight, 0.45 and 0.57 ml/min/kg; maximum plasma concentration, 23.3 and 24.9 micro g/ml; and volume of distribution at steady state adjusted for body weight, 341.4 and 542.8 ml/kg. No deaths or discontinuations from treatment occurred. These data suggest that micafungin dosages of 7 and 10 mg/kg/day are well tolerated and provide exposure levels that have been shown (in animal models) to be adequate for central nervous system coverage.
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Cohen-Wolkowiez M, Smith PB, Mangum B, Steinbach WJ, Alexander BD, Cotten CM, Clark RH, Walsh TJ, Benjamin DK. Neonatal Candida meningitis: significance of cerebrospinal fluid parameters and blood cultures. J Perinatol 2007; 27:97-100. [PMID: 17080094 DOI: 10.1038/sj.jp.7211628] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the frequency of normal cerebrospinal fluid (CSF) parameters in Candida meningitis and the proportion of candidemia associated with Candida meningitis. STUDY DESIGN We evaluated the initial lumbar puncture results from infants discharged from 150 Neonatal Intensive Care Units between 1997 and 2004. Candida meningitis was diagnosed by a positive CSF culture or positive Gram stain for yeast. We calculated two-tailed P-values using non-parametric testing, Mann-Whitney, Kruskal-Wallis or Fisher's exact tests where appropriate. RESULTS Twenty infants had culture-positive Candida meningitis. Normal CSF parameters were found in 43% (3/7) of the infants with Candida meningitis and only 37% (7/19) of them had positive blood cultures for Candida. CONCLUSION Normal CSF parameters do not exclude the diagnosis of neonatal Candida meningitis. The majority of infants in this cohort with Candida meningitis did not have evidence of candidemia at the time of diagnosis.
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Smith PB, Steinbach WJ, Cotten CM, Schell WA, Perfect JR, Walsh TJ, Benjamin DK. Caspofungin for the treatment of azole resistant candidemia in a premature infant. J Perinatol 2007; 27:127-9. [PMID: 17262048 DOI: 10.1038/sj.jp.7211637] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Candidemia is common in extremely low birth weight infants and is associated with substantial mortality and morbidity. Treatment options have traditionally been limited to amphotericin B deoxycholate or fluconazole. We present a case of a premature infant with persistent candidemia despite antifungal treatment that responded to therapy with caspofungin, an echinocandin antifungal. The infant's Candida isolate developed resistance to azoles during fluconazole administration and also suffered from severe hypercalcemia during the initiation of caspofungin therapy.
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Smith PB, Cotten CM, Garges HP, Tiffany KF, Lenfestey RW, Moody MA, Li JS, Benjamin DK. A comparison of neonatal Gram-negative rod and Gram-positive cocci meningitis. J Perinatol 2006; 26:111-4. [PMID: 16435007 DOI: 10.1038/sj.jp.7211438] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Neonatal meningitis is an illness with potentially devastating consequences. Early identification of potential risk factors for Gram-negative rod (GNR) infections versus Gram-positive cocci (GPC) infection prior to obtaining final culture results is of value in order to appropriately guide expirical therapy. We sought to compare laboratory and clinical parameters of GNR and GPC meningitis in a cohort of term and premature infants. STUDY DESIGN We evaluated lumbar punctures from neonates cared for at 150 neonatal intensive care units managed by the Pediatrix Medical Group Inc. We compared cerebrospinal fluid (CSF) parameters (white blood cell count, red blood cell count, glucose, and protein), demographics, and outcomes between infants with GNR and GPC meningitis. CSF cultures positive with coagulase-negative staphylococci were excluded. RESULTS We identified 77 infants with GNR and 86 with GPC meningitis. There were no differences in gestational age, birth weight, infant sex, race, or rate of Caesarean section. GNR meningitis was more often diagnosed after the third postnatal day and was associated with higher white blood cell and red blood cell counts. GNR meningitis diagnosed in the first 3 days of life was associated with antepartum antibiotic exposure. No difference was noted in either CSF protein or glucose levels. After correcting for gestational age, there was no observed difference in mortality between infants infected with GNR or GPC. CONCLUSION Compared to GPC meningitis, GNR meningitis was associated with several aspects of the clinical history and laboratory findings including older age of presentation, antepartum exposure to antibiotics, and elevated CSF white blood cell and red blood cell counts.
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Chacko MR, Wiemann CM, Kozinetz CA, Diclemente RJ, Smith PB, Velasquez MM, von Sternberg K. New sexual partners and readiness to seek screening for chlamydia and gonorrhoea: predictors among minority young women. Sex Transm Infect 2006; 82:75-9. [PMID: 16461612 PMCID: PMC2563815 DOI: 10.1136/sti.2004.014118] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2005] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To determine (1) level of readiness and (2) demographic and behavioural predictors of readiness to seek chlamydia (CT) and gonorrhoea (NGC) screening in the absence of symptoms after sex with a "new" partner. METHODS Baseline data, obtained as part of a larger randomised controlled clinical trial in young women, were analysed. Readiness to seek screening for CT and NGC after sex with a "new" partner was assessed using the stages of change framework from the transtheoretical model of change-precontemplation, contemplation, preparation, and action. Ordinal logistic regression, using the proportional odds model, was used to determine predictors of being in action for or having already been screened for CT and NGC after sex with a "new" partner. RESULTS The sample consisted of 376 predominantly African American (67%) young women (mean age 18.5 (SD 1.4) years). The distribution of readiness to seek CT and NGC screening was 4% precontemplation, 11% contemplation, 28% preparation, and 57% action. The best fitting logistic model that predicted being in action for seeking screening after sex with a "new" partner included high perceived seriousness of acquiring a sexually transmitted infection (OR = 2.02, 95% CI 1.05 to 3.89), and having "other" (not steady) partners in the last 6 months (OR = 0.50, 95% C.I. 0.32 to 0.78) CONCLUSIONS Many young women report that they were not getting screened for CT and NGC after sex with a "new" partner and therefore may be at increased risk of an untreated STI. Enhancing level of perceived seriousness of acquiring an STI from a "new" partner may increase a young woman's readiness to seek screening after initiating a new sexual relationship.
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Smith PB, Buzi RS, Weinman ML. HIV testing and counseling among adolescents attending family planning clinics. AIDS Care 2005; 17:451-6. [PMID: 16036230 DOI: 10.1080/09540120412331291788] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined whether an assessment tool combining HIV-related risk behaviors and symptoms would increase HIV testing and return for post-test counseling among 466 adolescents attending family planning clinics. The results indicted that high-risk behaviors were common among these adolescents. The majority (78.3%) identified themselves as not using condoms consistently, almost a quarter (24.7%) reported a history of STDs and 129 (27.7%) reported they had pierced their bodies. A total of 214 (45.9%) received HIV testing. Two (0.4%) adolescents, one male and one female, tested positive for HIV. Of the 214 adolescents who underwent testing, 183 (85.5%) returned to the clinic for post-test counseling. The results of this study indicated that adolescents who reported risk behaviors and symptoms were not more likely than those who reported no risk behaviors and symptoms to request testing and return for post-test counseling. In light of these results, the authors review the protocols associated with testing and post-test counseling and propose solutions that can potentially improve these processes. The authors recommend integrating a risk assessment tool with HIV testing in family planning clinics as testing and return for post-test counseling rates were high.
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Street R, Woolley JC, Smith PB. Magnetic Viscosity under Discontinuously and Continuously Variable Field Conditions. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0370-1301/65/9/305] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Street R, Woolley JC, Smith PB. The Influence of Heat Treatment on Magnetic Viscosity in Permanent Magnet Alloys. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0370-1301/65/6/115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Smith PB, Beck JG, Davies D. Contraceptive use among high-risk adolescents. JOURNAL OF SEX EDUCATION AND THERAPY 2002; 13:52-7. [PMID: 12143704 DOI: 10.1080/01614576.1987.11074909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Smith PB, Buzi RS, Weinman ML. Mental health problems and symptoms among male adolescents attending a teen health clinic. ADOLESCENCE 2002; 36:323-32. [PMID: 11572310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The purpose of this study was to examine the frequency and nature of mental health problems and symptoms among a group of 51 inner-city male adolescents attending a teen health clinic at a large county hospital in the southwestern part of the United States. They were administered a problem area checklist and a problem symptom checklist. The problem area checklist covered a range of mental health issues, including peer/friendship, relationship, and family problems; problems with money, time, and the law; substance use; and eating disorders. The problem symptom checklist queried participants about anger, nervousness, depression, fear, loneliness, suicide, aggression, and self-esteem. The results indicated that these young males experienced significant mental health problems and symptoms, such as relationship problems, problems with time and money, and symptoms of anger, depression, and aggression. Further, scared/afraid feelings correlated with five of the eight problem areas. The authors recommend investigating ways to target young males who present at such clinics in order to address their mental health problems and symptoms, as well as studying how their environment affects their overall health.
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Smith PB. Nurse not at fault in needlestick injury case. NURSING TIMES 2001; 97:21. [PMID: 11954077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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McCrae RR, Costa PT, Ostendorf F, Angleitner A, Hrebícková M, Avia MD, Sanz J, Sánchez-Bernardos ML, Kusdil ME, Woodfield R, Saunders PR, Smith PB. Nature over nurture: temperament, personality, and life span development. J Pers Soc Psychol 2000. [PMID: 10653513 DOI: 10.1037//0022-3514.78.1.173] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Temperaments are often regarded as biologically based psychological tendencies with intrinsic paths of development. It is argued that this definition applies to the personality traits of the five-factor model. Evidence for the endogenous nature of traits is summarized from studies of behavior genetics, parent-child relations, personality structure, animal personality, and the longitudinal stability of individual differences. New evidence for intrinsic maturation is offered from analyses of NEO Five-Factor Inventory scores for men and women age 14 and over in German, British, Spanish, Czech, and Turkish samples (N = 5,085). These data support strong conceptual links to child temperament despite modest empirical associations. The intrinsic maturation of personality is complemented by the culturally conditioned development of characteristic adaptations that express personality; interventions in human development are best addressed to these.
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Chacko MR, Smith PB, Kozinetz CA. Understanding partner notification (Patient self-referral method) by young women. J Pediatr Adolesc Gynecol 2000; 13:27-32. [PMID: 10742671 DOI: 10.1016/s1083-3188(00)00002-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
STUDY OBJECTIVE To understand the communication process involved in the patient-self referral method among adolescent females with chlamydia and gonococcal infection. DESIGN A cross-sectional descriptive study using a convenience sample was conducted in 54 predominantly African-American females, 13 to 20 years-old, with gonococcal and/or chlamydia cervicitis at an urban hospital based reproductive health clinic. Subjects interviewed at their treatment visit were asked what method of notification they used to tell their partner(s). Subjects who had not notified their partner were asked about their intended communication method and what they envisioned they would say to their partner. Coding methodology was used to analyze the information. In addition to qualitative information, outcome measures were the proportion of subjects who notified their partner(s), their communication method, style, and barriers to communication. RESULTS According to the treatment visit, 57% (31/54) of subjects reported notifying their partner. Most had notified their partner by phone or face-to-face, stated basic facts about the infection, and used a "direct" and "sensitive" communication style. Of the subjects who had not notified their partner (23/54), several barriers to notification were reported, but 82% said they intend to notify their partner(s). CONCLUSIONS Strategies to promote the patient-self referral method among young women who do not notify their partner(s) need further assessment.
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McCrae RR, Costa PT, Ostendorf F, Angleitner A, Hrebícková M, Avia MD, Sanz J, Sánchez-Bernardos ML, Kusdil ME, Woodfield R, Saunders PR, Smith PB. Nature over nurture: temperament, personality, and life span development. J Pers Soc Psychol 2000; 78:173-86. [PMID: 10653513 DOI: 10.1037/0022-3514.78.1.173] [Citation(s) in RCA: 507] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Temperaments are often regarded as biologically based psychological tendencies with intrinsic paths of development. It is argued that this definition applies to the personality traits of the five-factor model. Evidence for the endogenous nature of traits is summarized from studies of behavior genetics, parent-child relations, personality structure, animal personality, and the longitudinal stability of individual differences. New evidence for intrinsic maturation is offered from analyses of NEO Five-Factor Inventory scores for men and women age 14 and over in German, British, Spanish, Czech, and Turkish samples (N = 5,085). These data support strong conceptual links to child temperament despite modest empirical associations. The intrinsic maturation of personality is complemented by the culturally conditioned development of characteristic adaptations that express personality; interventions in human development are best addressed to these.
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Smith PB, Weinman ML, Buzi RS. Young males attending a family-planning clinic: some ideas about consequences of child abuse. Psychol Rep 1999; 85:529-32. [PMID: 10611786 DOI: 10.2466/pr0.1999.85.2.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
33 young males attending a family-planning clinic were asked about the consequences of child abuse as it affects behavioral problems of teens and their interest in programs that deal specifically with these problems. Nine reported they had been victims of abuse. Most believed that drug and alcohol misuse and suicide were the major consequences of child abuse. Fifteen were interested in programs for prevention of child abuse but not for specific problems such as substance misuse and smoking cessation. This study's findings suggest that family-planning clinics with services for males must address their behavioral as well as medical needs.
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Abstract
STUDY OBJECTIVE To assess oral contraceptive pill (OCP) continuation rates and factors associated with OCP continuation in young women. DESIGN A 12-month retrospective cohort study by chart review of 226 young women seen for an initial clinic visit. SETTING Urban hospital-based family planning clinic. PARTICIPANTS Predominantly African-American, sexually active young women, 12 to 21 years of age (median age, 17.2 years). MAIN OUTCOME MEASURES Scheduled OCP-appointment-keeping rates, pregnancy rates, and associated factors were compared between OCP-compliant and -noncompliant groups. RESULTS The OCP-appointment-keeping rate declined dramatically over 1 year, from 29% at the 3-month visit to 9% at the 12-month visit. Almost half seeking a postpartum visit checkup (PPVup) did not return after the initial clinic visit. Overall, a higher OCP-appointment-keeping rate was noted in those seeking OCPs vs. PPVup at the initial visit; P < .05 for 12-month visit. There was no difference in the pregnancy rates between OCP-compliant and -noncompliant groups. School enrollment and nulliparity was significantly associated with OCP compliance until the 6-month visit (P < .05). CONCLUSION In an urban hospital based clinic, the OCP continuation rate after the initial visit was poor. Continuation of OCPs may be anticipated by type of services sought at an initial visit. Methods to improve OCP continuation in this setting should be implemented.
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Smith PB, Mumford DM, Foreman S. Legal issues associated with sexual activity between adults and minors in Texas: a review. Tex Med 1999; 95:65-9. [PMID: 10434769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Recent research on adolescent mothers and the age of their sexual partners has stimulated discussion of whether legal action should be taken against adult men who engage in sexual intercourse with minors. A nonrandom poll that started as casual questions but extended over 6 months to 52 doctors initiated this review. It became apparent that the primary care physicians (pediatrics, family medicine, and internal medicine) had little, if any, understanding of some key legal facts in Texas associated with adolescent sexuality and pregnancy, especially when adult partners are involved. This article provides a legislative overview for practitioners in an attempt to clarify the law, remediate any deficiency of knowledge, and remind physicians of their role in reporting sexual abuse of minors.
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