Pamela J Murray

West Virginia University, Morgantown, West Virginia, United States

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Publications (40)130.4 Total impact

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    ABSTRACT: Adolescents (N = 392) attending 2 urban adolescent health clinics in 2010 were surveyed regarding likelihood completing expedited partner therapy (EPT), by bringing a partner exposed to chlamydia a prescription. Eighty-five percent (330/387; 95% confidence interval, 81%-89%), reported acceptance of EPT. Adjusted analyses showed higher education, notification self-efficacy, and romantic partner were associated with EPT acceptance.
    Sexually transmitted diseases 11/2013; 40(11):894-897. · 2.58 Impact Factor
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    ABSTRACT: Current guidelines recommend the use of combined hormonal contraceptive pills for menstrual suppression in pediatric blood and marrow transplant (BMT) recipients but recent research reveals that provider practice varies. This study was designed to describe the current practice for managing menstrual issues, that is, menstrual suppression and uterine bleeding, in pediatric BMT patients and to better understand health care providers' practices in the use of gonadotropin-releasing hormone agonists (GnRHa). A cross sectional survey consisting of 53 questions was distributed via email to principal investigators in the Pediatric Blood and Marrow Transplant Consortium (PBMTC). Responses were collected using www.surveymonkey.com. Menstrual suppression and uterine bleeding in pediatric BMT patients are primarily managed by pediatric oncologists (97%). The most frequently reported hormonal method used for induction of therapeutic amenorrhea was GnRHa (41%). The top three reasons for choosing a method were greater likelihood of amenorrhea, concerns about side effects, and possible gonadal protection. Continuous combined hormonal contraceptive pills were the most commonly used method for the management of clinically significant uterine bleeding regardless of primary method used for menstrual suppression. Despite the 2002 PBMTC guidelines, wide variation in menstrual suppression management practices still exists. Our data show that use of GnRHa is more common than previously reported. Additional research is needed to develop evidence-based practice guidelines in pediatric BMT patients.
    Pediatric Blood & Cancer 02/2012; 59(3):553-7. · 2.35 Impact Factor
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    ABSTRACT: Describe the experience that girls with Rett syndrome have with menstruation including menstrual hygiene, dysmenorrhea, premenstrual syndrome (PMS), and attempts at treatment. Anonymous web-based survey. Convenience sample recruited from Rett syndrome LISTSERV in July of 2009. Mothers of girls with Rett syndrome between the ages of 10-25 who have had at least one menses. Prevalence, frequency, and severity of dysmenorrhea and PMS; hygiene concerns; and treatments attempts and perceived effectiveness. Dysmenorrhea and PMS are common problems among young women with Rett syndrome. Despite their frequency and severity they do not routinely limit activities. Multiple treatment attempts are common. Hormonal contraception is used mostly for menstrual cycle control with oral contraceptive pills the most commonly used method. Young women with Rett syndrome have standard symptoms of dysmenorrhea and PMS as well as autism spectrum specific PMS symptoms. Hormonal contraception is commonly used for menstrual management.
    Journal of pediatric and adolescent gynecology 12/2011; 25(2):122-6. · 0.90 Impact Factor
  • Amy Hamilton, Michael P Marshal, Pamela J Murray
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    ABSTRACT: We assessed the experience of 10-25-year old women with autism spectrum disorders with menstruation through their caregivers by investigating hygiene concerns, dysmenorrhea, premenstrual syndrome, and treatments. Frequent and severe symptoms of dysmenorrhea and premenstrual syndrome were common but had moderate morbidity rates. Hormonal contraception and other treatments were underused.
    Journal of Adolescent Health 10/2011; 49(4):443-5. · 2.97 Impact Factor
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    ABSTRACT: To examine the factors related to adolescents' decisions to use the transdermal contraceptive patch (patch) so as to develop a model for understanding how adolescents decide to use new contraceptive methods. We conducted in-depth semi-structured interviews with 18 young women aged 15-21 years who had experience using the patch. Data were analyzed using a two-stage method informed by grounded theory. We constructed a two-level model, encompassing individual, social, and environmental factors, to explain adolescents' decisions to use a new method of hormonal contraception. Social and environmental influences on the decision-making process included media, social network experiences and opinions, healthcare providers, and partner relationships. These in turn affected the following individual factors in the decision to use the patch: individual characteristics, method knowledge and beliefs, method support, and past contraceptive experience. The newness of the patch permeated all levels of the decision-making process. This model provides a framework for understanding the use of new contraceptive methods and can inform clinical strategies for contraceptive counseling with adolescents.
    Journal of Adolescent Health 10/2011; 49(4):357-62. · 2.97 Impact Factor
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    ABSTRACT: To examine disparities between sexual minority youth (SMY) and heterosexual youth in rates of suicidality and depression symptoms. Separate meta-analyses were conducted to examine suicidality and depression disparities. Studies were included if the average age of the participants was <18 years, and if suicidality or depression symptoms were compared across SMY and heterosexual youth. SMY reported significantly higher rates of suicidality (odds ratio [OR] = 2.92) and depression symptoms (standardized mean difference, d = .33) as compared with the heterosexual youth. Disparities increased with the increase in the severity of suicidality (ideation [OR = 1.96], intent/plans [OR = 2.20], suicide attempts [OR = 3.18], suicide attempts requiring medical attention [OR = 4.17]). Effects did not vary across gender, recruitment source, and sexual orientation definition. Disparities in suicidality and depression may be influenced by negative experiences including discrimination and victimization. Clinicians should assess sexual orientation, analyze psychosocial histories to identify associated risk factors, and promote prevention and intervention opportunities for SMY and their families.
    Journal of Adolescent Health 08/2011; 49(2):115-23. · 2.97 Impact Factor
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    ABSTRACT: To compare use of the weekly transdermal contraceptive patch (patch) with daily combined hormonal contraceptive pills (pills) in adolescents. Prospective longitudinal study of adolescents' self-selected (non-randomized) use of the patch or pills. Urban, university hospital-affiliated, adolescent outpatient clinic. 13-22-year-old female adolescents seeking hormonal contraception, 40 who chose the patch and 40 who chose pills. Data were collected via self-report on paper questionnaires at three-cycle intervals for a total of up to nine cycles. Method continuation, perfect use, method satisfaction, quality of life, and side effects, including menstrual changes and perceived mood changes. After nine cycles, 38% of patch users and 60% of pill users were still using the method they had chosen at enrollment. There were no significant differences between the groups in self-reported perfect use. No differences were found in quality of life or side effects. Both patch and pill users noted menses became lighter and more predictable and reported decreased depression prior to their menses; only the pill group reported improvement in premenstrual anger. Method satisfaction was similar in both groups except patch users were more likely to report that their contraceptive method improved normal daily activities. Despite apparent advantages of the patch over the pill, adolescents using both methods continue to face challenges achieving perfect and sustained contraceptive use.
    Journal of pediatric and adolescent gynecology 03/2011; 24(4):197-203. · 0.90 Impact Factor
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    ABSTRACT: The purpose of this article was to summarize scientific knowledge from an expert panel on reproductive health among adolescents with type 2 diabetes (T2D). Using a mental model approach, a panel of experts--representing perspectives on diabetes, adolescents, preconception counseling, and reproductive health--was convened to discuss reproductive health issues for female adolescents with T2D. Several critical issues emerged. Compared with adolescents with type 1 diabetes, (1) adolescents with T2D may perceive their disease as less severe and have less experience managing it, putting them at risk for complications; (2) T2D is more prevalent among African Americans, who may be less trusting of the medical establishment; (3) T2D is associated with obesity, and it is often difficult to change one's lifestyle within family environments practicing sedentary and dietary behaviors leading to obesity; (4) teens with T2D could be more fertile, because obesity is related to earlier puberty; (5) although obese teens with T2D have a higher risk of polycystic ovary syndrome, which is associated with infertility, treatment with metformin can increase fertility; and (6) women with type 2 diabetes are routinely transferred to insulin before or during pregnancy to allow more intensive management. Findings from the expert panel provide compelling reasons to provide early, developmentally appropriate, culturally sensitive preconception counseling for teens with T2D.
    The Diabetes Educator 10/2010; 36(6):911-9. · 1.94 Impact Factor
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    ABSTRACT: As the consequences of Mycoplasma genitalium in pregnant women are unknown, we examined the relationship between prenatal M. genitalium infection and SAB. The presence of M. genitalium was determined by PCR in urine from 82 women who subsequently experienced a SAB and 134 women who maintained their pregnancies past 22 weeks gestation. The relationships between M. genitalium and subsequent SAB, demographic, current pregnancy, and reproductive health history characteristics were evaluated. Compared to women without M. genitalium, women with M. genitalium were more likely to report nulliparity (41.7% versus 17.4%, P = .04), history of pelvic inflammatory disease (27.3% versus 8.8%, P = .08), prior C. trachomatis infection (63.6% versus 36.9%, P = .11,) and problems getting pregnant (18.2% versus 4.4%, P = .10). M. genitalium was not associated with SAB (AOR 0.9, 95% CI 0.2-3.8). Pregnant women who test positive for M. genitalium do not have an increased risk of SAB but report a history of reproductive morbidities.
    Infectious Diseases in Obstetrics and Gynecology 01/2010; 2010:984760.
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    ABSTRACT: Quality improvement programs for depressed youths in primary care settings have been shown to improve 6-month clinical outcomes, but longer-term outcomes are unknown. The authors examined 6-, 12-, and 18-month outcomes of a primary care quality improvement intervention. Primary care patients 13-21 years of age with current depressive symptoms were randomly assigned to a 6-month quality improvement intervention (N=211) or to treatment as usual enhanced with provider training (N=207). The quality improvement intervention featured expert leader teams to oversee implementation of the intervention; clinical care managers trained in cognitive-behavioral therapy for depression to support patient evaluation and treatment; and support for patient and provider choice of treatments. The quality improvement intervention, relative to enhanced treatment as usual, lowered the likelihood of severe depression (Center for Epidemiological Studies Depression Scale score > or =24) at 6 months; a similar trend at 18 months was not statistically significant. Path analyses revealed a significant indirect intervention effect on long-term depression due to the initial intervention improvement at 6 months. In this randomized effectiveness trial of a primary care quality improvement intervention for depressed youths, the main effect of the intervention on outcomes was to decrease the likelihood of severe depression at the 6-month outcome assessment. These early intervention-related improvements conferred additional long-term protection through a favorable shift in illness course through 12 and 18 months.
    American Journal of Psychiatry 09/2009; 166(9):1002-10. · 14.72 Impact Factor
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    ABSTRACT: Having better predictors of chlamydia infection may improve health care providers' decisions about when to provide testing for Chlamydia trachomatis (Ct). Adolescents' probability judgments of significant life events in the next year and by age 20 y have shown promising validity, being significantly correlated with subsequent self-reports of having experienced these events. Here, the authors examine whether female adolescents' probability judgments of having chlamydia were correlated with the objective outcome of a Ct polymerase chain reaction assay. Three hundred sexually active female adolescents were recruited from urban health care clinics in Pittsburgh. They assessed ''the percent chance that you have chlamydia right now,'' then answered questions about their demographic background and sexual history. Subsequently, the authors tested for Ct infection using a self-administered introital swab. Adolescents' probability judgments of having chlamydia ''right now'' were correlated with whether they tested positive for Ct infection, even after controlling for demographic variables and sexual history. This result held when probability judgments were dichotomized in terms of whether adolescents had assigned a zero or nonzero probability. Adolescents' mean probability judgment was less than their infection rate, indicating that, on average, they underestimated their actual risk. Adolescents can tell whether they are at increased risk for chlamydia but may need better information about its absolute magnitude. Eliciting adolescents' probability judgments of having chlamydia can add value to clinical decision making.
    Medical Decision Making 09/2009; 30(2):189-93. · 2.89 Impact Factor
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    ABSTRACT: Mycoplasma genitalium has been identified as a cause of pelvic inflammatory disease (PID), a clinical syndrome associated with inflammation of the female upper genital tract and serious reproductive sequelae. As the demographic, behavioural and sexual risk profile of women with M genitalium-associated PID is not well understood, the characteristics of M genitalium-infected women presenting with clinically suspected PID were investigated. Data from 586 participants in the PID Evaluation and Clinical Health Study were analysed. Demographic, sexual history and behavioural characteristics, including age, race, marital status, education level, sexual activity, number of sexual partners, history of sexually transmitted infection (STI), bacterial vaginosis and PID, contraception use, oral and anal sex, age at sexual debut, douching practices and drug, alcohol and tobacco use, were compared between 88 women testing positive and 498 women testing negative for M genitalium by PCR in the cervix and/or endometrium. Twenty-two women with M genitalium mono-infections were compared with 172 women who tested positive for Neisseria gonorrhoeae by culture and/or Chlamydia trachomatis by PCR. Age under 25 years, douching two or more times per month and smoking were independently associated with M genitalium. Women with M genitalium mono-infections were significantly less likely to be African-American (59.1% vs 86.0%, p = 0.001) than women with N gonorrhoeae and/or C trachomatis. Women infected with M genitalium had some characteristics commonly associated with PID and other STI. The demographic, sexual and behavioural characteristics of M genitalium-positive women were similar to women with chlamydial and/or gonococcal PID.
    Sexually transmitted infections 08/2009; 86(1):29-31. · 2.18 Impact Factor
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    ABSTRACT: Vaginal microbicides have the potential to reduce HIV/STD acquisition when used consistently. Our objectives were to determine product attributes associated with willingness to use a vaginal microbicide and whether product preferences varied according to participant characteristics. Women (n = 408) with bacterial vaginosis (BV) were recruited as part of a randomized trial to prevent BV. Participants completed a survey interview that assessed demographic information, sexual history, and douching behavior. To assess microbicide preferences, women rated whether specific product attributes would make them more or less likely to use a vaginal microbicide. Principal components analyses revealed two major groupings for the product attribute items. We determined the relative importance of each group of product attributes and whether the importance of the different groupings varied among subgroups of women. The participants' mean age was 24 years (range 14-45), 64% were black, and 74% were unmarried. Overall, participants reported being most likely to use a vaginal product with protection properties (2.54), whereas they were nearly neutral regarding side effects (0.56). The individual product attributes, could prevent BV, could prevent vaginal odor (2.72), and could prevent vaginal itching and burning (2.61), were rated similarly or slightly higher than could reduce the risk of getting an STD (2.58) or could reduce the risk of getting HIV (2.44). In multivariate analyses, protection attributes were rated significantly higher among older women and marginally higher in women with a greater number of lifetime sexual partners. Younger women were most likely to report that side effects would affect their likelihood of using the product. Women with BV rated potential protection features of a vaginal microbicide higher than side effects. A product's personal hygiene aspects were rated equally or more important than the product's ability to prevent HIV/STD infections. Younger women may respond to different factors that influence product acceptability and adherence.
    Journal of Women's Health 08/2009; 18(8):1163-7. · 1.90 Impact Factor
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    ABSTRACT: Two potencies of gelatin capsules containing Lactobacillus crispatus CTV-05 were evaluated for safety and vaginal colonization in 90 young women. Sexually active females aged 14-21 years were randomized to receive either 10(6)- or 10(8)-cfu CTV-05 capsules inserted intravaginally twice daily for 3 days. At enrollment and at 4 weekly follow-up visits, behavioral and demographic information and quantitative vaginal cultures were collected. Lactobacillus species were identified by DNA hybridization, and the CTV-05 strain was discerned using repetitive-sequence polymerase chain reaction DNA fingerprinting. Of the 90 participants, 87 returned for at least 2 follow-up visits. Of 40 participants who lacked L. crispatus colonization at enrollment, 36 (90%) were successfully colonized by CTV-05 at 1 or more follow-up visits, whereas only 24 (51%) of 47 participants colonized by L. crispatus at enrollment were positive for CTV-05 at follow-up (P < .001). Compared with sexually abstinent participants, females engaging in sexual intercourse with the use of condoms (odds ratio [OR], 6.3 [95% confidence interval {CI}, 1.3-29.4]; P = .02) or having unprotected sex (OR, 75.5 [95% CI, 6.9-820.6]; P < .001) during the first week were less likely to become colonized by CTV-05. These data suggest that the factors that predict failure to become colonized by probiotic lactobacilli include exposure to semen, vaginal intercourse, and the presence of lactobacilli of the same species at enrollment.
    The Journal of Infectious Diseases 04/2009; 199(10):1506-13. · 5.85 Impact Factor
  • Pamela J Murray
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    ABSTRACT: Obesity is a serious, lifelong, worldwide health problem. Once obese, few people are able to lose their excess weight. Bariatric surgery is an intervention that has produced substantial and sustained weight loss in adults. It is offered increasingly as an option for extremely obese adolescents. Selection criteria have been proposed by several expert consensus panels. Outcomes and metabolic consequences of bariatric surgery on glucose-insulin interactions, diabetes, sleep architecture, the gastrointestinal tract, asthma, cardiovascular dysfunction, renal parameters, polycystic ovarian syndrome, bone health, nutrition, gynecologic concerns, and mental health are reviewed here.
    Adolescent medicine: state of the art reviews 01/2009; 19(3):450-74, ix.
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    ABSTRACT: To compare cervical concentrations of numerous cytokines/chemokines in women with bacterial vaginosis (BV) compared with the levels detected after BV resolution and determine if hormonal contraceptive use modulates the local inflammatory response to BV. Cervical secretions from 81 women with BV at enrollment and normal flora at one-month follow-up were analysed for 10 different cytokines/chemokines using multiplexed fluorescent bead-based immunoassays. BV was associated with significantly higher concentrations of IL-1 beta, tumour necrosis factor (TNF), interferon-gamma, IL-2, IL-4, and IL-10 compared with the levels detected in the presence of normal vaginal flora. Analysis of results stratified by contraceptive practice demonstrated significantly lower levels of numerous cytokines among women with BV using hormonal contraceptives compared with those women with BV not using hormonal contraceptives. Hormonal contraceptive use was also associated with a statistically significant lesser change in TNF levels between the two study visits compared with the amount of change detected between visits among women who denied their use. Despite increases in the levels of both pro and anti-inflammatory cytokines in the lower genital tract of women with BV, the overall balance of these two types of molecules was maintained. The character of this local inflammatory response may help explain the typical absence of overt signs of inflammation among women with BV. In addition, hormonal contraceptive use was associated with significantly lower levels of the pro-inflammatory molecules TNF, interferon-gamma, and granulocyte macrophage colony-stimulating factor in women with BV, but did not significantly reduce the levels of IL-10, a key anti-inflammatory cytokine. These results suggest the possibility of an association between hormonal contraceptive use and altered genital tract immunity.
    Sexually transmitted infections 03/2008; 84(1):57-61. · 2.18 Impact Factor
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    ABSTRACT: This study aimed to determine female adolescents' knowledge about the contraceptive vaginal ring and to assess their attitudes toward and consideration of ring use. We recruited 164 participants, ages 14-21, who completed a 62-item, 15-min interview assessing tampon and vaginal product use history, reproductive health history and ring awareness. Among those who had heard of the ring, knowledge was assessed with a 15-item pretest. All participants received a 2-min description of the ring with a demonstration, after which attitudes, consideration of use and posttest knowledge were assessed. Our study population is unique in that 92% had been sexually active and 22% who had been sexually active had also been pregnant. The mean age of coitarche was 15.2 years, and 35% had ever used emergency contraception. More than half (52%) had never heard of the ring. Of those who had heard of it, only 35% had sufficient knowledge. After a brief demonstration with a vaginal model, 98.2% acquired sufficient knowledge to use the ring correctly. More than half (57.9%) liked the idea of the ring, and 45.7% said that they would consider using it. Logistic regression demonstrated that liking the idea of the ring and considering its use were associated with comfort using at least one vaginal product, with those who were comfortable using a vaginal product being 3.1 times more likely to like the idea of the ring compared to those who were not comfortable using a vaginal product. Logistic regression also showed that liking the idea of the ring was associated with having had at least one pelvic exam. Most participants had limited or no prior ring knowledge. Once briefly educated, all had sufficient knowledge and a substantial percentage would consider using it. The ring appeals to adolescents and should be routinely offered as a method of contraception. Comfort using at least one vaginal product is associated with liking the idea of the ring and considering its use.
    Contraception 01/2008; 76(6):444-50. · 3.09 Impact Factor
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    ABSTRACT: To describe the knowledge, attitudes, and practices of young adults toward body piercing. An anonymous 30-item survey was given to 103 undergraduate students at the campus health service of a large urban university. The questionnaire collected data on students' perceptions regarding the social acceptability of body piercing, their experiences with and attitudes toward this form of body art, and their knowledge of associated health risks. One hundred (97%) out of the 103 surveys distributed had sufficient data for analysis. Fifty-six percent of participants (age range, 17 to 25 years) reported having a body piercing at one time. Participants with a piercing were more likely to have a tattoo (OR, 4.13; 95% CI, 1.10-15.56; P=.04). The majority of participants (65 [78%]) reported "liking" body piercing on others, though a smaller percentage (45 [52%]) reported "liking" it on themselves (z=3.58, P<.001). Participants estimated the chance of potential health risks as a result of body piercing as follows: bleeding (60%), infection (56%), keloid scarring (43%), bruising (41%), allergic reaction (38%), cyst or tetanus (each 24%), hepatitis B (20%), and human immunodeficiency virus (16%). Nonpierced participants assessed the probability of adverse events as a result of body piercing at 43%, whereas their pierced counterparts estimated the risk at 30% (F(1,83)14.06, P<.001). Forty-three percent of all participants reported knowing someone (ie, other than themselves) who experienced a health problem as a result of body piercing, though few (10 of 52 [19%]) pierced participants reported similar personal experiences. Young adults believe that body piercing is highly acceptable among the general public. Furthermore, though they believe such body art is acceptable on others, they feel it is less acceptable on themselves. Study participants displayed a high level of awareness regarding the potential health risks of body art, and, in fact, overestimate those risks. Implications for patient education are addressed.
    The Journal of the American Osteopathic Association 10/2007; 107(10):432-8.
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    ABSTRACT: Home screening tests could eliminate several barriers to testing sexually transmitted diseases (STDs). To determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhoea in a high-risk sample of young women. In this randomised controlled trial, 403 young women (mean age 18.9 years, 70% black) with a recent STD or with STD-related risk factors were enrolled. Participants were recruited from clinics and high-prevalence neighbourhoods and then randomly assigned to receive either a home testing kit or an invitation to attend a medical clinic for testing at 6, 12 and 18 months after enrollment. Over 80% of women were followed for 2 years. The trial is registered with ClinicalTrials.gov, number NCT 00177437. Of 197 women in the intervention group, 140 (71%) returned at least one home test and 25 of 249 (10%) home tests were positive. Women who received home screening tests completed significantly more STD tests overall (1.94 vs 1.41 tests per woman-year, p<0.001) and more STD tests in the absence of symptoms (1.18 vs 0.75 tests per woman-year, p<0.001). More women in the intervention group completed at least one test when asymptomatic (162 (82.2%) vs 117 (61.3%), p<0.001). The intervention was most effective among women recruited outside medical clinics. There was no significant difference in the overall rate of STDs detected. Home screening significantly increased the utilisation of chlamydia and gonorrhoea testing in this sample of high-risk young women, and thus represents a feasible strategy to facilitate STD testing in young women.
    Sexually Transmitted Infections 08/2007; 83(4):286-91. · 2.61 Impact Factor
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    ABSTRACT: We sought to determine the practices of physicians who prescribe for adolescents extended cycles of combined hormonal contraception, in which hormones are taken for longer than 21 days and menstruation is delayed. Five hundred physicians from the membership rosters of the Society for Adolescent Medicine and the North American Society for Pediatric and Adolescent Gynecology were asked to complete an online 39-question survey. The 222 respondents (44% of those contacted) were mostly pediatricians (55%) and gynecologists (34%). Ninety percent reported having ever prescribed extended cycles of hormonal contraception to adolescents, and 33% said extended cycles make up more than 10% of their total combined hormonal contraceptive prescriptions. Respondents most commonly prescribed extended cycles to accommodate patients' requests to induce amenorrhea for specific events (82%) or for fewer menses per year (72%), and to treat menorrhagia (68%), dysmenorrhea (65%), and endometriosis (62%). The most commonly prescribed extended regimen was 84 continuous hormone days followed by 7 hormone-free days (46%), most often with an oral contraceptive containing 30 mug of ethinyl estradiol. Gynecologists were more likely than other physicians to prescribe extended cycles frequently, to prescribe hormone-free intervals shorter than 7 days, and to prescribe continuous regimens that eliminate the hormone-free interval completely. Physicians prescribe extended cycles of combined hormonal contraceptives to adolescents to accommodate patient requests and to treat common gynecologic conditions. Currently, a variety of extended cycling regimens are prescribed, suggesting that further study is needed to determine the optimal regimen for this subset of patients and their individual needs.
    Journal of Adolescent Health 03/2007; 40(2):151-7. · 2.97 Impact Factor

Publication Stats

578 Citations
130.40 Total Impact Points

Institutions

  • 2011
    • West Virginia University
      • Department of Medicine
      Morgantown, West Virginia, United States
  • 1999–2011
    • University of Pittsburgh
      • Department of Pediatrics
      Pittsburgh, PA, United States
  • 2009
    • Children's Hospital Los Angeles
      Los Angeles, California, United States
    • University of Florida
      Gainesville, Florida, United States
  • 2004–2009
    • Carnegie Mellon University
      • Department of Social and Decision Sciences
      Pittsburgh, PA, United States
  • 2007
    • California State University, Sacramento
      Sacramento, California, United States
  • 2005–2007
    • University of California, Los Angeles
      • Department of Psychiatry and Biobehavioural Sciences
      Los Angeles, CA, United States
    • Medical University of South Carolina
      • Division of Adolescent Medicine
      Charleston, SC, United States
  • 2006
    • University of Washington Seattle
      • Department of Medicine
      Seattle, WA, United States
    • Childrens Hospital of Pittsburgh
      • Department of Pediatrics
      Pittsburgh, Pennsylvania, United States
  • 2003
    • Magee-Womens Hospital
      Pittsburgh, Pennsylvania, United States