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المؤلفون: Sian, Cotton, Beverly L, Connelly, Sheila S, Cohen, Robert M, Siegel, Lawrence R, Stanberry, Susan L, Rosenthal
المصدر: Herpes : the journal of the IHMF. 9(3)
مصطلحات موضوعية: Adult, Male, Parents, Physician-Patient Relations, Physicians, Infant, Newborn, Humans, Simplexvirus, Female, Herpes Simplex, Middle Aged
الوصف: Screening for possible herpes simplex virus infection in neonates may raise feelings of anxiety and distress among parents and physicians. To elicit physicians' experiences of communicating with families when screening for neonatal herpes, we conducted a series of semi-structured interviews with 15 physicians from one paediatric institution, and coded the resulting audiotapes for common themes. These included how physicians prepared families for screening and treatment, how physicians managed stigma, and perceived parental reactions. Techniques for fostering good communication included being direct and honest and ensuring the time and place for discussion were appropriate; strategies for managing stigma included placing the diagnosis in epidemiological context, and discussing the potential severity of the disease. Physicians described many parental emotional reactions, some of which were herpes-specific, and suggested strategies to manage potential discomfort when discussing neonatal herpes with families. Future research can determine which strategies are most effective, which are associated with negative psychological outcomes, and how medical students and residents can be better trained to screen for this diagnosis.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=pmid________::bf15452f0b4d858ed3544df272f72a93
https://pubmed.ncbi.nlm.nih.gov/12470602 -
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المؤلفون: Sian Cotton, Frank M. Biro, Lisa Mills, Kristin M. von Ranson, Susan L. Rosenthal, Paul Succop
المصدر: Sexually transmitted diseases. 28(9)
مصطلحات موضوعية: Microbiology (medical), medicine.medical_specialty, Longitudinal study, Adolescent, media_common.quotation_subject, Sexual Behavior, Population, Dermatology, Risk Assessment, Developmental psychology, Adolescent medicine, Risk Factors, medicine, Humans, Longitudinal Studies, Parent-Child Relations, education, media_common, Ohio, education.field_of_study, business.industry, Public Health, Environmental and Occupational Health, Age Factors, Coitus, Romance, Sexual intercourse, Infectious Diseases, Logistic Models, Feeling, Psychosexual Development, Psychosexual development, Adolescent Behavior, Menarche, Female, Family Relations, business
الوصف: Early initiation of sexual intercourse is associated with increased risk for acquiring sexually transmitted diseases. The aim was to examine variables related to sexual initiation and developmental changes in the reasons why adolescent girls have sexual intercourse. A longitudinal study of girls recruited from an adolescent medicine clinic was performed. Logistic regression showed that girls who described their families as being expressive having moral-religious emphasis providing supervision and having greater maternal education and who experienced menarche at an older age were older at sexual initiation. On the basis of contingency analyses younger girls were less likely to report attraction or love and more likely to report peers having sex as a reason for sexual intercourse at initiation. A generalized estimating equation analysis indicated that girls at younger ages are more likely to report curiosity a grown-up feeling partner pressure and friends having sexual intercourse as reasons for intercourse. Girls at older ages are more likely to report a feeling of being in love physical attraction too excited to stop drunk or high partner and feeling romantic as reasons for having sexual intercourse. Prevention programs should include a focus on familial characteristics and susceptibility to peer norms. They should be conducted with sensitivity to the developmental changes in intimate relationships that occur during adolescence. (authors)
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::88072db8c0e2a8386f286991c39e453a
https://pubmed.ncbi.nlm.nih.gov/11518871 -
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المؤلفون: Michael Yi, Joel Tsevat, Sian Cotton
المصدر: Journal of Adolescent Health. 40:S43-S44
مصطلحات موضوعية: Health related quality of life, Psychiatry and Mental health, business.industry, Pediatrics, Perinatology and Child Health, Well-being, Public Health, Environmental and Occupational Health, Medicine, business, Depressive symptoms, Existentialism, Clinical psychology
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المؤلفون: Sian Cotton, Susan L. Rosenthal
المصدر: Journal of Adolescent Health. 39:617-618
مصطلحات موضوعية: Psychiatry and Mental health, Pediatrics, Perinatology and Child Health, Public Health, Environmental and Occupational Health
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المؤلفون: Stefanie Stevenson, Sian Cotton, Christina M. Luberto
المصدر: Global Advances in Health and Medicine
مصطلحات موضوعية: medicine.medical_specialty, business.industry, Nutrition Education, Primary care physician, Psychological intervention, General Medicine, Social support, Nursing, Diabetes management, Family medicine, Health care, Medicine, Scientific Abstracts, Integrative medicine, business, Socioeconomic status
الوصف: Focus Areas: Integrative Approaches to Care, Supporting Behavioral Change Diabetes affects approximately 26 million adults and is a leading cause of death and disability in the United States (CDC, 2011). Diabetes disproportionately affects individuals from lower socioeconomic status groups, the same individuals with limited access to healthcare resources (CDC, 2011). Thus, there is a critical need to provide affordable and effective care to these at-risk individuals. In order to meet this need, we developed and implemented a unique integrative medicine (IM) “Shared Medical Visit” approach to diabetes management at a Free Health Clinic. This initiative uses IM techniques and tenants to improve the health and well-being of low-income men and women with Type II diabetes mellitus. The Shared Medical Visit model allows patients to provide and receive social support and learn from others' experiences while receiving high-quality medical care. Visits occur monthly and include 8 to 15 patients, 1 IM physician, and 1 Clinic Primary Care Physician (PCP). The IM physician leads the 90-minute group while the PCP provides individual, private visits as needed. The IM physician's goals are to promote healthy group dynamics, respect, and healthy behavior change. The visits provide several interventions, including nutrition education (eg, whole foods), healthy cooking demonstrations, and food tastings; mind-body stress reduction exercises (eg, mindfulness, breath-work); and physical activity (eg, walking groups). While we did not formally assess outcomes, group members subjectively reported an increased sense of community, appreciation of food tastings, and overall health improvement. One participant reported improved hemoglobin A1C, less medication use, and understanding how stress and sleep contribute to glucose control. The nurse manager reported that participants who attend these visits keep their clinic appointments more often than those who do not. Groups are consistently filled and have been running continuously for 21 months. Plans are underway to formally assess the impact of the group visits on health outcomes.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::35865395bcf9c6478de0195fb3422890
https://doi.org/10.7453/gahmj.2013.097cp.s10c -
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المؤلفون: Christina M. Luberto, Stefanie Stevenson, Sian Cotton
المصدر: Global Advances in Health and Medicine
مصطلحات موضوعية: Horizontal integration, business.industry, media_common.quotation_subject, Financial independence, Cost centre, General Medicine, Public relations, Business model, Management, Excellence, Sustainability, Medicine, Scientific Abstracts, Center (algebra and category theory), Integrative medicine, business, media_common
الوصف: Focus Area: Sustainable Business Models In 2012, with solely institutional support, the University of Cincinnati officially launched its Center for Integrative Health and Wellness, focused on developing integrative medicine clinical, research, and education initiatives horizontally across the academic health center. Given that Integrative Medicine (IM) is intrinsically interdisciplinary, the UC Center purposively functions according to a horizontal integration business and clinical model, rather than as a siloed vertical structure within one specific clinical or academic area. As opposed to building a separate freestanding physical clinical site, the clinical services are co-located within existing Centers for Excellence and established clinical programs including, for example, a new 25 000–squarefoot Women's Health Center, our Cancer Center, and a Neuroscience Center in development. With its own cost center, IM maintains financial independence while capitalizing on cross-programmatic marketing, development, and infrastructure. Faculty members across the academic health center were engaged early on in the development and planning of the Center in order to inform clinical services tailored to their specific patient populations. The Director of the IM program systematically delivered Grand Rounds across Departments in the College of Medicine in order to market, promote, and plan the IM expansion across the medical school. With an embedded horizontal model of clinical integration, both the financial risks and the successes of the IM program are collaborative and intrinsically shared for optimal sustainability. The Center's future plan for sustainability involves: (1) revenue-generating IM consults and shared medical visits billable through insurance; (2) trainings and wellness educational events; (3) philanthropic support and endowments; (4) federally funded research and education grants; (5) close partnering with the established Integrative Care Department at Cincinnati Children's Hospital Medical Center; and (6) continuing to build strategic horizontal partnerships.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7d00d9d2b2ecbf3e2835988672080eef
https://doi.org/10.7453/gahmj.2013.097cp.s21b -
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المؤلفون: Christina M. Puchalski, Anthony C. Leonard, Joseph M. Mrus, Amy H. Peterman, Sian Cotton, Judith Feinberg, Amy C. Justice, Susan N. Sherman, Joel Tsevat, Kenneth I. Pargament
المصدر: Journal of General Internal Medicine. 24:994-994
مصطلحات موضوعية: Adult, Male, Religion and Psychology, medicine.medical_specialty, Multivariate analysis, Alcohol Drinking, media_common.quotation_subject, education, Ethnic group, Self-concept, HIV Infections, Personal Satisfaction, Social support, Acquired immunodeficiency syndrome (AIDS), Residence Characteristics, Adaptation, Psychological, Spirituality, Ethnicity, medicine, Internal Medicine, Humans, Psychiatry, media_common, business.industry, Self-esteem, Social Support, Original Articles, social sciences, medicine.disease, Self Concept, United States, humanities, Logistic Models, Multivariate Analysis, Female, Erratum, business, Psychosocial, Follow-Up Studies
الوصف: Spirituality and religion are often central issues for patients dealing with chronic illness. The purpose of this study is to characterize spirituality/religion in a large and diverse sample of patients with HIV/AIDS by using several measures of spirituality/religion, to examine associations between spirituality/religion and a number of demographic, clinical, and psychosocial variables, and to assess changes in levels of spirituality over 12 to 18 months.We interviewed 450 patients from 4 clinical sites. Spirituality/religion was assessed by using 8 measures: the Functional Assessment of Chronic Illness Therapy-Spirituality-Expanded scale (meaning/peace, faith, and overall spirituality); the Duke Religion Index (organized and nonorganized religious activities, and intrinsic religiosity); and the Brief RCOPE scale (positive and negative religious coping). Covariates included demographics and clinical characteristics, HIV symptoms, health status, social support, self-esteem, optimism, and depressive symptoms.The patients' mean (SD) age was 43.3 (8.4) years; 387 (86%) were male; 246 (55%) were minorities; and 358 (80%) indicated a specific religious preference. Ninety-five (23%) participants attended religious services weekly, and 143 (32%) engaged in prayer or meditation at least daily. Three hundred thirty-nine (75%) patients said that their illness had strengthened their faith at least a little, and patients used positive religious coping strategies (e.g., sought God's love and care) more often than negative ones (e.g., wondered whether God has abandoned me; P.0001). In 8 multivariable models, factors associated with most facets of spirituality/religion included ethnic and racial minority status, greater optimism, less alcohol use, having a religion, greater self-esteem, greater life satisfaction, and lower overall functioning (R2=.16 to .74). Mean levels of spirituality did not change significantly over 12 to 18 months.Most patients with HIV/AIDS belonged to an organized religion and use their religion to cope with their illness. Patients with greater optimism, greater self-esteem, greater life satisfaction, minorities, and patients who drink less alcohol tend to be both more spiritual and religious. Spirituality levels remain stable over 12 to 18 months.
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المصدر: Journal of Adolescent Health. 36:529
مصطلحات موضوعية: Male, education.field_of_study, Adolescent, Depression, Population, Public Health, Environmental and Occupational Health, Attendance, Youth Risk Behavior Survey, Mental health, Religiosity, Higher Power, Psychiatry and Mental health, Risk-Taking, Surveys and Questionnaires, Pediatrics, Perinatology and Child Health, Spirituality, Belief in God, Linear Models, Humans, Female, Psychology, education, Clinical psychology
الوصف: Purpose The purpose of this study was to examine spirituality as a meaningful construct in adolescents' lives, and to examine the contribution of spirituality above and beyond that of religiosity to depressive symptoms and health-risk behaviors. Methods A total of 134 adolescents from a suburban high school completed a questionnaire assessing spirituality, religiosity, depressive symptoms, and health-risk behaviors. Spirituality was measured with 2 subscales: (1) religious well-being ("I believe that God loves/cares about me") and (2) existential well-being ("Life doesn't have much meaning"). Religiosity was assessed via belief in God/Higher Power and importance of religion. The Children's Depression Inventory-Short Form and the Youth Risk Behavior Survey (YRBS) were used to assess depressive symptoms and health-risk behaviors. Results The majority of the sample was Caucasian, with a mean age of 16.2 years. Eighty-nine percent reported a belief in God/Higher Power and 77% stated that religion was important in their lives. After controlling for demographics and religiosity, existential well-being and religious well-being accounted for an additional 29% of the variability in depressive symptoms and 17% of the variability in risk behaviors. Existential well-being was the only predictor significant in both final models ( p Conclusions Most of these adolescents reported some connection with religious and spiritual concepts, and those with higher levels of spiritual well-being, in particular, existential well-being, had fewer depressive symptoms and fewer risk-taking behaviors. This supports the inclusion of these concepts in our efforts to help promote resilience and healthy adolescent development, and in expanding our investigations beyond religious identification or attendance at religious services to broader concepts of spirituality.
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المؤلفون: Dennis Drotar, Kathy Zebracki, Sian Cotton, Susan L. Rosenthal, Joel Tsevat
المصدر: Journal of Adolescent Health. 36:119
مصطلحات موضوعية: Psychiatry and Mental health, Psychotherapist, business.industry, Pediatrics, Perinatology and Child Health, Spirituality, Public Health, Environmental and Occupational Health, Medicine, business, Adolescent health, Clinical psychology
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المؤلفون: Frank M. Biro, L Mills, Paul A. Succop, Sian Cotton, Susan L. Rosenthal
المصدر: Journal of Pediatric and Adolescent Gynecology. 14:145
مصطلحات موضوعية: Longitudinal study, medicine.medical_specialty, Intelligence quotient, Obstetrics and Gynecology, Social environment, General Medicine, Logistic regression, Developmental psychology, Test (assessment), Adolescent medicine, Intervention (counseling), Pediatrics, Perinatology and Child Health, medicine, Family Environment Scale, Psychology, Demography
الوصف: OBJECTIVE: To examine the association between biologic, demographic, and family context variables and the age of initiation of intercourse among adolescent girls. METHODS: Data were analyzed from a longitudinal study of girls recruited from an urban adolescent medicine clinic. At intake, all subjects received the Kaufman Brief Intelligence Test, to establish a screening IQ score. Mothers' highest level of education and age when she had her first child were recorded. Parental monitoring (direct, with peers, and indirect) and the Family Environment Scale were utilized to assess the social environment. Subjects were asked the age of first consensual intercourse, and categorized as early (14 or less), average (15-16) and later (17 or older). The relationship of age of debut with demographic and family context variables was analyzed using a logistic regression. RESULTS: At intake the 174 subjects had a mean age of 14.5 years. 127 were known to be sexually experienced by the end of the study; 22% initiated younger than 15, 62% between ages 15-16, and 16% ages 17 or older. An additional 22 were seen at age 17 or older and reported they were not sexually active. This latter group was included in the “later” initiators. The final logistic model revealed that girls who reported their families were more expressive, had a greater moral religious emphasis, had more direct monitoring, and whose mothers had greater education, were older when they initiated intercourse. CONCLUSIONS: Developmental and contextual factors made important contributions to age of initiation of intercourse in this longitudinal study. Factors that are modifiable, such as parental monitoring and communication, should prove to be an effective target for intervention in protecting the adolescent from early engagement in high risk behaviors.
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