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Biomedical subjects

J M Ellen

Publications and source records attributed to J M Ellen.

30 records · Page 2Linked to original sources
PubMed1996

Types of adolescent sexual relationships and associated perceptions about condom use.

PURPOSE: The purpose of this study was to describe the various types of adolescent sexual relationships and to examine the association between the type of sexual relationship and adolescents' perceptions about the consistency with which other adolescents use condoms. METHODS: Adolescents attending a university-based adolescent medicine clinic completed a self-administered questionnaire. Subjects were asked to rate the importance of six qualities (caring about each other, length of time of relationship, ability to talk about anything, ability to talk about sex and condoms, doing things together, and attraction to partner's looks) for each of four different types of sexual relationships (steady, casual, friends, and "one-night stands"). Subjects were also asked to estimate the frequency with which adolescents use condoms with each type of sexual partner. RESULTS: Questionnaires were completed by 75 sexually experienced adolescents. The mean age of the sample was 16.6 years, and 41.3% were male. All qualities, except attraction to partner's looks, were rated more important for steady partners compared with the other partner types, and more important for sexual relationships with casual partners and friends than for "one-night stands" (p < .001). Sexually experienced subjects believed that condoms are used less frequently with steady partners and more frequently with "one-night stands" (p < .001). CONCLUSIONS: Interventions designed to increase the consistency with which adolescents use condoms should take into account the different types of sexual relationships, each with distinct expectancies about the consistency of condom use.

Adolescent↗
PubMed1996

Relationship of alcohol use and risky sexual behavior: a review and analysis of findings.

In this review article, three methodologic approaches that have been used to examine the association between adolescents' alcohol use and their involvement in risky sex are discussed: global correlation studies, situational covariation studies, and event analyses. The strengths and limitations of each of these research methods are discussed. An extensive review of the most rigorous studies, which used event analysis to examine the alcohol-risky sex link, reveals positive results for first-time sexual events but equivocal findings for other types of sexual relationships. It is argued that differences in the types of sexual relationships studied have been confounded, limiting our ability to evaluate the extent to which alcohol has a causal influence on adolescents' condom use. It is suggested that future investigations consider the nature of the sexual relationship, and go beyond studying the length or status of the relationship to explore how variation in relationship dimensions such as trust and intimacy affect adolescents' sexual behavior.

Adolescent↗
PubMed1996

Primary care management of adolescent sexual behavior.

Adolescents continue to engage in sexual behaviors that place them at risk for sexually transmitted diseases, including HIV, and pregnancy. Recent advances in the prevention and management of sexually transmitted diseases and pregnancy may eventually lead to fewer negative consequences associated with adolescent sexual behavior. This paper discusses scientific and technologic advances in the management of adolescent sexual behavior such as the use of DNA amplification tests to detect genital chlamydial infection and the new female-controlled contraceptives.

Adolescent↗
PubMed1995

The relationship between grandmothers' involvement in child care and emergency department utilization.

This study examines the relationship between involvement of grandmothers in child care and poor urban mothers' use of the emergency department (ED) for nonurgent care. Mothers with an index child between one and two years old were interviewed in the waiting room of a pediatric continuity clinic. They were asked about the proximity and involvement in child care of a grandmother, great-grandmother, or female family member. Frequency of ED use was abstracted from the index child's medical records. Results showed that mothers who frequently used the ED for nonemergent pediatric care were more likely to have the child's grandmother or great-grandmother living in close proximity or involved in care of the child than infrequent users (80 vs 45%, P < 0.05). This study suggests that proximity and involvement of the grandmother may influence health care decisions.

Adult↗
PubMed1995

Socioeconomic differences in sexually transmitted disease rates among black and white adolescents, San Francisco, 1990 to 1992.

This paper examines the effect of socioeconomic position on the differences in the 3-year rates (1990 to 1992) of reported cases of gonorrhea and chlamydia between Black and White adolescents, aged 12 to 20 years, residing in San Francisco. The crude relative risks for Blacks were 23.4 (95% confidence interval [CI] = 20.4, 27.8) for gonorrhea and 9.3 (95% CI = 8.3, 10.3) for chlamydia. Adjusting for poverty and occupational status, the relative risks were 28.7 (95% CI = 22.5, 36.1) for gonorrhea and 8.9 (95% CI = 7.4, 10.6) for chlamydia. This study demonstrates that factors other than poverty and occupational status account for the racial/ethnic differences in the rates of gonorrhea and chlamydia among adolescents in San Francisco.

Adolescent↗
PubMed1993

Appointment-keeping behavior in adolescents: factors associated with follow-up appointment-keeping.

STUDY OBJECTIVES: To identify the sociodemographic and Health Belief Model predictors of follow-up appointment-keeping behavior. DESIGN: Prospective observational study. SETTINGS: General adolescent medical clinic. PATIENTS AND MEASUREMENTS: Sequential sample of 166 adolescents (aged 12 to 20 years, mean = 15.9 years) enrolled in the clinic. The population was 75% female; the racial-ethnic distribution of the sample was 37.9% black, 29.8% white, 11.2% Asian, 14.3% Hispanic, and 6.8% "other" background. Subjects' social class was primarily lower-middle (60.5%) and middle class (28.6%). A subsample was randomly assigned to be interviewed about their beliefs concerning their follow-up appointment and the constructs of the Health Belief Model. RESULTS: Forty-eight percent of the total sample failed to keep their follow-up appointment. There was a significant positive correlation between social class and appointment keeping (F = 5.07; df = 5,110; P = .026). Neither race-ethnicity nor who made the appointment were found to be associated with follow-up appointment-keeping. The only construct of the Health Belief Model found to be significantly associated with appointment keeping was the number of potential negative outcomes resulting from noncompliance perceived by the subject (F = 6.85; df = 1.74; P = .011). CONCLUSIONS: Clinicians must work with adolescents to improve their understanding of the potential negative outcomes associated with noncompliance to improve appointment-keeping behavior.

Adolescent↗
PubMed1986

Killing of cultured hepatocytes by the mixed-function oxidation of ethoxycoumarin.

Ethoxycoumarin is metabolized by mixed-function oxidation to give 7-hydroxycoumarin (umbelliferone) and acetaldehyde, without formation of an intermediate electrophile. Ethoxycoumarin was found, nevertheless, to injure cultured rat hepatocytes. Male hepatocytes were more sensitive than female to ethoxycoumarin. Phenobarbital increased cell killing, and SKF 525A, an inhibitor of ethoxycoumarin metabolism, prevented it. Neither umbelliferone nor acetaldehyde were toxic. Cellular glutathione decreased and oxidized glutathione (GSSG) accumulated in the culture medium. Sulfhydryl reagents prevented the cell killing without inhibiting metabolism. Lipid peroxidation was detected prior to evidence of cell death, and the antioxidant N,N'-diphenyl-phenylenediamine prevented both the lipid peroxidation and cell killing without inhibiting metabolism. Inhibition of glutathione reductase with 1,3-bis(chloroethyl)-1-nitrosourea potentiated the cell killing without increasing metabolism. Pretreatment of the cells with the ferric iron chelator deferoxamine reduced cell killing, again without inhibiting metabolism. Ferric chloride restored the sensitivity of deferoxamine-pretreated hepatocytes to ethoxycoumarin. These data define a new experimental model in which lethal liver cell injury is dependent on the metabolism of ethoxycoumarin but unrelated to its two known metabolites. An oxidative stress accompanying the cytochrome P-450-dependent metabolism of ethoxycoumarin is proposed as the mechanism coupling metabolism to lethal cell injury.

Animals↗
PubMedDate not supplied

The link between the use of crack cocaine and the sexually transmitted diseases of a clinic population. A comparison of adolescents with adults.

BACKGROUND AND OBJECTIVES: To determine whether personal and/or a partner's use of crack cocaine is associated with the diagnosis of early syphilis or gonorrhea independent of high-risk sex behaviors, and to determine whether the relationships between crack cocaine and associated sexually transmitted diseases (STDs) are similar for adolescents and adults. STUDY DESIGN: A cross-sectional behavioral survey of hetero-sexual males and females attending public STD clinics in three cities. Logistic regression was used to identify risk behavior patterns associated with each STD compared with no STD. RESULTS: Multivariate analysis revealed that men who were high on drugs, including crack cocaine, before or during sex were more likely to be diagnosed with syphilis (Odds Ratio [OR] = 1.49; Confidence Intervals [CI] = 1.06, 2.13). Males more likely to be diagnosed with gonorrhea were younger (OR = 0.94; CI = 0.92, 0.96), had sex with a crack cocaine user (OR = 1.99; CI = 1.36, 2.91), did not use condoms last time they had sex with a nonmain partner (OR = 1.59; CI = 1.09, 2.13), and did not have sex with an intravenous drug user (OR = 0.45; CI = 0.22, 0.95). For women, there were no independent risk factor for syphilis but younger age was a risk factor for gonorrhea (OR = 0.95; CI = 0.91, 0.99). The associations between crack cocaine and syphilis and gonorrhea in men and between crack cocaine and syphilis in women were not significant among adolescents in this study. CONCLUSION: The results of this study highlight the differences in the crack cocaine-related behaviors of adults and adolescents at risk for gonorrhea and syphilis. The nature of these differences support the use of distinct intervention strategies for each STD and for adolescents and adults.

Adolescent↗