S. Jean Emans

Harvard Medical School, Boston, Massachusetts, United States

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Publications (169)554.48 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To examine the association between self-reported sense of mission and sexual health behaviors in a geographically diverse cohort of U.S. young adult females in the Growing Up Today Study (GUTS).
    No preview · Article · Mar 2015 · Journal of Pediatric and Adolescent Gynecology
  • Ellen W Seely · Kathy E Kram · S Jean Emans

    No preview · Article · Dec 2014 · Translational Research
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    ABSTRACT: Leadership development is a core value of Maternal Child Health Bureau training programs. Mentorship, an MCH Leadership Competency, has been shown to positively affect career advancement and research productivity. Improving mentorship opportunities for junior faculty and trainees may increase pursuit of careers in areas such as adolescent health research and facilitate the development of new leaders in the field. Using a framework of Developmental Networks, a group of MCH Leadership Education in Adolescent Health training program faculty developed a pilot mentoring program offered at the Society for Adolescent Health and Medicine Annual Meeting (2011-2013). The program matched ten interdisciplinary adolescent health fellows and junior faculty with senior mentors at other institutions with expertise in the mentee's content area of study in 2011. Participants were surveyed over 2 years. Respondents indicated they were "very satisfied" with their mentor match, and all agreed or strongly agreed that the mentoring process in the session was helpful, and that the mentoring relationships resulted in several ongoing collaborations and expanded their Developmental Networks. These results demonstrate that MCH programs can apply innovative strategies to disseminate the MCH Leadership Competencies to groups beyond MCH-funded training programs through programs at scientific meetings. Such innovations may enhance the structure of mentoring, further the development of new leaders in the field, and expand developmental networks to provide support for MCH professionals transitioning to leadership roles.
    No preview · Article · Nov 2014 · Maternal and Child Health Journal
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    ABSTRACT: Objective To determine the utility of transabdominal pelvic ultrasound in the diagnosis of polycystic ovary syndrome (PCOS) during adolescence. Design Retrospective case-control study. Setting Academic tertiary care pediatric hospital. Patient(s) A case group of 54 patients (mean age, 15.2 years) with PCOS based on the National Institutes of Health criteria and a comparison group of 98 patients (mean age, 14.6 years) with acute appendicitis. Intervention(s) Transabdominal ultrasound (TAUS) images were evaluated in the two groups of adolescents, with data collected on quality of the images, ovarian volume, ovarian follicle count, and endometrial thickness. Main Outcome Measure(s) Sonographic modified Rotterdam criteria (volume >10 mL and/or follicle number per section ≥10) for polycystic ovaries (PCO). Result(s) Among the 54 patients with PCOS and 98 comparison subjects with usable images, the sonographic modified Rotterdam criteria for PCO morphology (PCOM) were met more frequently in the PCOS group than in the comparison group (65% vs. 11%). The vast majority of images were of adequate quality for diagnosis (PCOS = 94% and comparison = 91%), even in the presence of obesity. Conclusion(s) The prevalence of ovarian morphology meeting the sonographic modified Rotterdam criteria by TAUS in girls with PCOS was markedly higher than in the adolescents serving as a comparison group. PCOM findings by the sonographic modified Rotterdam criteria were uncommon in the nongynecologic comparison group, in contrast to previous reports. TAUS may provide useful information in the evaluation of PCOS during adolescence, even in obese adolescents.
    No preview · Article · Nov 2014 · Fertility and Sterility

  • No preview · Article · Apr 2014 · Journal of Pediatric and Adolescent Gynecology
  • Sarah Pitts · S Jean Emans

    No preview · Article · Apr 2014 · Journal of Adolescent Health

  • No preview · Conference Paper · Apr 2013
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    ABSTRACT: The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration's Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with less attention paid to adolescents as either the "maternal" or "child" elements of MCH discourse. Adolescence is a distinct developmental period with unique opportunities for the development of health, competence and capacity and not merely a transitional phase between childhood and adulthood. Adequately addressing adolescents' emergent and ongoing health needs requires well-trained and specialized professionals who recognize the unique role of this developmental period in the LCP.
    No preview · Article · Feb 2013 · Maternal and Child Health Journal
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    ABSTRACT: Background: Although women comprise an increasing proportion of US medical school faculty, they are underrepresented at higher ranks. Lack of effective mentoring may contribute to this disparity. We examined the role of academic rank, research focus, parenting, and part-time work on mentoring importance, needs, and gaps. Methods: In 2009, women faculty members of Harvard Medical School and Harvard School of Dental Medicine were invited by e-mail to participate in a 28-item structured questionnaire. Descriptive statistics and adjusted logistic regressions were used to identify relevant themes. Results: Of the 1179 women faculty who responded, 54% had a mentor, and 72% without a mentor desired mentoring. The most important mentor characteristic identified was availability. Respondents endorsed most mentoring areas as important (range 51%-99%); 52% of respondents identified mentoring gaps (area important and unmet) in developing and achieving career goals and negotiation skills. Interest in mentorship for skills needed for advancement (research and lecturing skills and getting national recognition) was significantly associated with lower rank. Assistant professors were most likely to identify mentoring related to writing and publishing articles, whereas associate professors identified program development/strategic planning as important. Faculty who are parents identified gaps in finding collaborators and balancing work and family life. Conclusions: This survey identified a desire for both comprehensive and targeted mentoring to address gaps that varied by faculty rank, research focus, parenting, and work time status. Strategies to enhance mentoring should address career stages and include a structured framework for assessing mentoring gaps.
    Full-text · Article · Aug 2012 · Journal of Women's Health
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    ABSTRACT: To assess equity in compensation and academic advancement in an academic pediatrics department in which a large proportion of the physician faculty hold part-time appointments. The authors analyzed anonymized data from Vanderbilt University School of Medicine Department of Pediatrics databases for physician faculty (faculty with MD or MD/PhD degrees) employed during July 1, 2007 to June 30, 2008. The primary outcomes were total compensation and years at assistant professor rank. They compared compensation and years at junior rank by part-time versus full-time status, controlling for gender, rank, track, years since first appointment as an assistant professor, and clinical productivity. Of the 119 physician faculty in the department, 112 met inclusion criteria. Among those 112 faculty, 23 (21%) were part-time and 89 (79%) were full-time faculty. Part-time faculty were more likely than full-time faculty to be women (74% versus 28%, P < .001) and married (100% versus 84%, P = .042). Analyses accounting for gender, years since first appointment, rank, clinical productivity, and track did not demonstrate significant differences in compensation by part-time versus full-time status. In other adjusted analyses, faculty with part-time appointments spent an average of 2.48 more years as an assistant professor than did faculty with full-time appointments. Overall group differences in total compensation were not apparent in this department, but physician faculty with part-time appointments spent more time at the rank of assistant professor. This study provides a model for determining and analyzing compensation and effort to ensure equity and transparency across faculty.
    No preview · Article · Jun 2011 · Academic medicine: journal of the Association of American Medical Colleges
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    ABSTRACT: Heightened publicity about hormonal contraception and thrombosis risk and the publication of new guidelines by the World Health Organization in 2009 and the Centers for Disease Control and Prevention in 2010 addressing this complex issue have led to multidisciplinary discussions on the special issues of adolescents cared for at our pediatric hospital. In this review of the literature and new guidelines, we have outlined our approach to the complex patients referred to our center. The relative risk of thrombosis on combined oral contraception is three- to fivefold, whereas the absolute risk for a healthy adolescent on this therapy is only 0.05% per year. This thrombotic risk is affected by estrogen dose, type of progestin, mechanism of delivery, and length of therapy. Oral progestin-only contraceptives and transdermal estradiol used for hormone replacement carry minimal or no thrombotic risk. Transdermal, vaginal, or intrauterine contraceptives and injectable progestins need further study. A personal history of thrombosis, persistent or inherited thrombophilia, and numerous lifestyle choices also influence thrombotic risk. In this summary of one hospital's approach to hormone therapies and thrombosis risk, we review relative-risk data and discuss the application of absolute risk to individual patient counseling. We outline our approach to challenging patients with a history of thrombosis, known thrombophilia, current anticoagulation, or family history of thrombosis or thrombophilia. Our multidisciplinary group has found that knowledge of the guidelines and individualized management plans have been particularly useful for informing discussions about hormonal and nonhormonal options across varied indications.
    Full-text · Article · Feb 2011 · PEDIATRICS
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    ABSTRACT: The academic successes of AM during the past 2 decades are marked by board certification, fellowship program accreditation, residency curricula creation, and the evolution of a remarkably respected scientific journal, the Journal of Adolescent Health. These same accomplishments have increased professional and public recognition of unmet population needs and the specialists who can help address them. The adolescent population is large, diverse, underserved, and characterized by increasingly complex medical and behavioral issues. Meeting their health care needs is a national priority. Primary care professionals who treat adolescents want and need adolescent-specific training in anticipatory guidance, screening, counseling, and management of common adolescent problems. A larger workforce of AM physicians is needed to provide this training, consult on complex medical and psychosocial issues when requested, and lead research efforts that will advance knowledge in the field. Developing this workforce will require improved recruitment into fellowship training; mentorship, policies, and resources that support trainee and faculty diversity; and articulation of the skills that define an AM physician.
    No preview · Article · Dec 2010 · JAMA Pediatrics
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    ABSTRACT: Our objective was to determine the frequency of ovulatory salivary progesterone levels before menarche in healthy girls. We recruited a prospective cohort of midpubertal, premenarcheal girls. Participants collected weekly saliva samples until first menses or for 12 months. Menstrual cycles were considered to have ovulatory salivary progesterone levels if values were greater than 0.100 ng/ml (0.318 nmol/liter) 0-14 d before menarche. Participants collected saliva samples weekly at home and attended monthly clinic visits. Patients included 63 premenarcheal females, age 9-15 yr, with body mass index higher than the fifth percentile for age and Tanner stage III or greater for both pubic hair and breast development. Frequency of ovulatory levels of salivary progesterone before menarche was assessed. Fifty-five girls completed the study, and 43 experienced menarche. Of the 42 girls who reached menarche and provided a sample within 14 d of menarche, five (12%) had ovulatory progesterone levels. The mean anovulatory salivary progesterone level was 0.041 ng/ml (0.130 nmol/liter; range, 0.012-0.078 ng/ml, 0.038-0.248 nmol/liter), and the mean ovulatory level was 0.194 ng/ml (0.617 nmol/liter; range, 0.125-0.343 ng/ml, 0.398-1.09 nmol/liter). The levels of estrogen, testosterone, and 17-hydroxyprogesterone were higher and the mean BMI was lower in those with ovulatory progesterone levels vs. those with anovulatory levels. A significant proportion of girls displayed ovulatory levels of progesterone before menarche. More research is needed to clarify the hormonal events that occur in the perimenarcheal time period.
    Full-text · Article · Jul 2010 · The Journal of Clinical Endocrinology and Metabolism
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    ABSTRACT: To address the critical shortage of physician scientists in the field of adolescent medicine, a conference of academic leaders and representatives from foundations, National Institutes of Health, Maternal and Child Health Bureau, and the American Board of Pediatrics was convened to discuss training in transdisciplinary research, facilitators and barriers of successful career trajectories, models of training, and mentorship. The following eight recommendations were made to improve training and career development: incorporate more teaching and mentoring on adolescent health research in medical schools; explore opportunities and electives to enhance clinical and research training of residents in adolescent health; broaden educational goals for Adolescent Medicine fellowship research training and develop an intensive transdisciplinary research track; redesign the career pathway for the development of faculty physician scientists transitioning from fellowship to faculty positions; expand formal collaborations between Leadership Education in Adolescent Health/other Adolescent Medicine Fellowship Programs and federal, foundation, and institutional programs; develop research forums at national meetings and opportunities for critical feedback and mentoring across programs; educate Institutional Review Boards about special requirements for high quality adolescent health research; and address the trainee and faculty career development issues specific to women and minorities to enhance opportunities for academic success.
    No preview · Article · Feb 2010 · Journal of Adolescent Health
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    ABSTRACT: Upper-extremity ovarian autologous transplantation was first used for girls undergoing abdominal/pelvic radiation therapy; long-term follow-up is provided. A case series. Tertiary pediatric medical center. Girls with Wilms tumor with planned abdominal/pelvic radiation therapy. Subjects 1, 2, and 3 (ages 5, 2, and 1 year) presented with a Wilms tumor and underwent surgical resection. Each patient underwent ovarian autotransplantation to move ovarian tissue out of the radiation field. Subjects 1 and 2 had thin slices from 1 ovary placed in the arm. Subject 3 had a free transfer of the entire ovary into an axilla. Follow-up was obtained for the subsequent 20-25 years for all 3 subjects. Pubertal, menarcheal, and menstrual history, and hormonal serum levels. All subjects survived and experienced spontaneous pubertal development and menarche. Data were available for follow-up for 20-25 years. Subjects 1 and 2 showed spontaneous follicular development of the autotransplanted ovarian tissue. They had fluctuating gonadotropin and estradiol levels until age 29 and 26, respectively; spontaneous menses until age 29 and 26; and cessation of spontaneous menses with elevated gonadotropins and low estradiol levels at age 30 and 26. Subject 3 had severe monthly axillary pain, and the ovary was transferred back to the pelvis. She then had ovarian dysfunction with intermittent spontaneous ovarian activity until age 25. Ovarian autotransplantation to the upper extremity resulted in long-term sex steroid production for spontaneous puberty, menarche, follicular development, and menses with fluctuating gonadotropin and ovarian sex steroid levels and follicular activity that lasted for 13-15 years.
    No preview · Article · Nov 2009 · Journal of pediatric and adolescent gynecology
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    ABSTRACT: Recent studies have reported gender differences in research grant applications and funding outcomes for medical school faculty. Our goal was to determine whether similar patterns exist at the resident level and, if so, to explore possible explanations. We conducted a retrospective review of all applications to an internal, mentored research grant fund at a large academic pediatric residency program from 2003 to 2008. We determined whether gender differences existed for application characteristics and outcomes and defined significant predictors of success. During the 5-year period, the fund supported 42 (66%) of 64 applications. Among all applicants, men were more likely than women to hold an advanced research degree. Men requested more money than women and obtained more favorable application scores. Funding success rates were not statistically different between male and female applicants. Among funded applicants, men received higher awards than women, although the percentage of requests funded was the same. In a multiple regression analysis, advanced degree was the significant independent predictor of successful funding outcome. Controlling for advanced degree attenuated the association between gender and timing of application, type of project, dollars requested, and dollars awarded; however, even after controlling for advanced degree, women had inferior grant scores compared with men. Gender differences existed in research grant applications and funding among pediatric residents that mirrored faculty patterns. Among residents, these differences were explained in part by the correlation of male gender with holding an advanced research degree.
    No preview · Article · Sep 2009 · PEDIATRICS
  • Elise DeVore Berlan · S Jean Emans

    No preview · Article · May 2009 · Journal of pediatric and adolescent gynecology
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    ABSTRACT: Personally controlled health records (PCHRs) enable patients to store, manage, and share their own health data, and promise unprecedented consumer access to medical information. To deploy a PCHR in the pediatric population requires crafting of access and security policies, tailored to a record that is not only under patient control, but one that may also be accessed by parents, guardians, and third-party entities. Such hybrid control of health information requires careful consideration of both the PCHR vendor's access policies, as well as institutional policies regulating data feeds to the PCHR, to ensure that the privacy and confidentiality of each user is preserved. Such policies must ensure compliance with legal mandates to prevent unintended disclosures and must preserve the complex interactions of the patient-provider relationship. Informed by our own operational involvement in the implementation of the Indivo PCHR, we provide a framework for understanding and addressing the challenges posed by child, adolescent, and family access to PCHRs.
    Full-text · Article · Sep 2008 · Journal of the American Medical Informatics Association
  • Frank M Biro · S Jean Emans

    No preview · Article · Aug 2008 · Journal of Adolescent Health
  • R.F. O'Brien · S.J. Emans
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    ABSTRACT: Polycystic ovary syndrome is a common disorder among adolescent women and its association with risk of long-term metabolic and cardiovascular sequelae is increasingly recognized over and above the cosmetic and fertility concerns. PCOS may be overlooked in early adolescence because during puberty adolescent menstrual cycles are frequently anovulatory, acne and mild hirsutism are common, and the prevalence of obesity and its consequences of insulin resistance and metabolic syndrome are increasing. Research over the past two decades has documented a spectrum of abnormalities within the hypothalamic-pituitary-ovarian axis, excess androgen production within the ovary or adrenal gland, and insulin-resistant hyperinsulinemia seen as an important contributing factor to the dysregulation of steroidogenesis seen in PCOS. No single etiologic factor appears to explain the full spectrum of PCOS. Therapies are increasingly combined to target the variety of symptoms and our increasing understanding of the pathophysiology of PCOS. Lifestyle modification with weight reduction through diet and exercise is the first and best therapy for women with PCOS. Depending on the patient's symptoms, this approach can be combined with oral contraceptive agents, metformin, and/or antiandrogens to maximize clinical response and improve quality of life. Long term, prospective studies to assess the effects of these interventions on the adverse metabolic and cardiovascular outcomes are needed. Resource materials for patients may be found at Children's Hospital Boston's Center for Young Women's Health website http://www.youngwomenshealth.org/pcosinfo.html and the Androgen Excess Society website: http://www.ae-society.org. © 2008 North American Society for Pediatric and Adolescent Gynecology.
    No preview · Article · Jul 2008 · Journal of pediatric and adolescent gynecology

Publication Stats

4k Citations
554.48 Total Impact Points


  • 1980-2015
    • Harvard Medical School
      • • Department of Medicine
      • • Department of Pediatrics
      Boston, Massachusetts, United States
    • Boston Medical Center
      Boston, Massachusetts, United States
    • University of Massachusetts Boston
      Boston, Massachusetts, United States
  • 1987-2014
    • Harvard University
      Cambridge, Massachusetts, United States
  • 1981-2014
    • Boston Children's Hospital
      • • Division of Gynecology
      • • Division of Adolescent Medicine
      • • Department of Pediatrics
      • • Division of Endocrinology
      • • Division of General Pediatrics
      • • Department of Adolescents
      Boston, Massachusetts, United States
  • 2002
    • Yale-New Haven Hospital
      New Haven, Connecticut, United States
  • 2001
    • Children's Hospital of Richmond
      Ричмонд, Virginia, United States
  • 1998
    • Boston University
      Boston, Massachusetts, United States
  • 1996
    • Beverly Hospital, Boston MA
      BVY, Massachusetts, United States
    • Simmons College
      Boston, Massachusetts, United States
  • 1995
    • Cleveland Clinic
      Cleveland, Ohio, United States
  • 1989
    • Wolfson Childrens Hospital
      Jacksonville, Florida, United States
  • 1982-1984
    • Children's Hospital & Medical Center
      Omaha, Nebraska, United States