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Biomedical subjects

M J Werner

Publications and source records attributed to M J Werner.

At least 19 recordsLinked to original sources
PubMed1999

Screening, early identification, and office-based intervention with children and youth living in substance-abusing families.

All health care professionals with clinical responsibility for the care of children and adolescents must be able to recognize, as early as possible, associated health problems or concerns in children of substance-abusing parents, and to be able to assist these children and families in seeking treatment and promoting health. Health care providers can have a tremendous influence on families of substance-abusing parents because of their understanding of family dynamics and their close long-standing relationship with the family. Information about family alcohol and other drug use should be obtained as part of routine history-taking and when there are indications of family dysfunction, child behavior or emotional problems, school difficulties, and recurring episodes of apparent accidental trauma, and in the setting of recurrent or multiple vague somatic complaints by the child or adolescent. In many instances, family problems with alcohol or drug use are not blatant; rather, their identification requires a deliberate and skilled screening effort. Combining the principles of anticipatory guidance, screening, and early identification, with the acknowledgment that families should be included in the process, leads to a clear conclusion that screening for children affected by parental substance abuse must occur at all ages across infancy, childhood, and adolescence. Health care providers need to be trained in the identification and management of children and youth exposed to parental addiction. Such training must begin during undergraduate education in the health professions and be reinforced by role-modeling among health professions faculty as well as practicing providers.

Adolescent↗
PubMed1997

Hepatitis B vaccination in adolescents: knowledge, perceived risk, and compliance.

PURPOSE: The purpose of this study was to evaluate adolescents' and parents' knowledge of hepatitis B, perceived risk of hepatitis B, and compliance with a three-dose vaccine series. METHODS: Two hundred adolescents were recruited into the study. Participants completed a questionnaire that examined hepatitis knowledge, sexual activity, contraceptive use, and perceived risk of acquiring hepatitis B infection at enrollment and the final 8-month follow-up visit. They also had blood drawn for determination of hepatitis B serology at these visits. Their parents completed a questionnaire at enrollment. RESULTS: A total of 174 (87%) participants completed the study. Adolescents initially had very little knowledge about hepatitis but did have significant improvement in their knowledge scores at the 8-month follow-up. Their parents were more knowledgable. Most teens perceived their risk of acquiring the hepatitis B infection as slight or none. Their perceptions of their risk of acquiring hepatitis B were not associated with sexual activity, contraceptive choices, or number of sexual partners. In contrast, the parents' perceptions of their teens' risk of acquiring hepatitis B were associated with the teens' sexual activity, contraceptive choices, and number of sexual partners. CONCLUSIONS: The adolescents studied had little knowledge about hepatitis or their personal risk. In contrast, the adolescents' parents were more knowledgable about hepatitis. The more informed the parent, the less sexual risk-taking behaviors the adolescent reported.

Adolescent↗
PubMed1996

Concurrent and prospective screening for problem drinking among college students.

PURPOSE: Previous studies suggest that combining the CAGE questionnaire with the Perceived Benefit of Drinking Scale (PBDS), information about an adolescent's use of tobacco, and best friend's drinking pattern is a useful composite screening measure for problem drinking. The present study was undertaken to evaluate this composite screening measure prospectively as a predictor of subsequent problem drinking among late adolescents across 3 years of college. METHODS: A random sample of 452 college freshmen entered a longitudinal study of alcohol use at the beginning of their freshman year. A total of 184 (58%) completed follow-up measures of alcohol use 32 months later. Outcome measures included the quantity and frequency of alcohol use and a composite measure of specific alcohol-related problems. RESULTS: CAGE scores, PBDS scores, tobacco use, and best friend's drinking patterns as reported at college entry together explained 33% of the variance in the quantity/frequency measure and 37% of the variance in the alcohol-related problems measure from the end of the junior year. These same variables as reported at the end of the junior year explained 50% of the variance in the quantity/frequency measure and 61% of the variance in the alcohol-related problems measure. The composite screening measure as reported at college entry had a sensitivity of 73%, specificity of 70%, positive predictive value (PPV) of 63%, and negative predictive value (NPV) of 78% for students at high risk for problem drinking at the end of the junior year. A similar concurrent composite screening measure consisting of the same variables reported at the end of the junior year had a sensitivity of 88%, specificity of 56%, PPV of 60%, and NPV of 83% for high-risk drinkers. A total of 70-73% of students could be correctly categorized by each composite screening measure. These composite screening tests had significantly better test characteristics than the CAGE or PBDS alone. CONCLUSIONS: College students' responses to the CAGE, PBDS, tobacco use, and their friends' drinking remain consistent over 3 years and correlate with concurrent and future risk for problem drinking. These variables explain significant variance in drinking and alcohol-related problems and may constitute a useful screening measure for current and future problem drinking.

Adolescent↗
PubMed1995

Relation of alcohol expectancies to changes in problem drinking among college students.

OBJECTIVE: To evaluate the relation between alcohol expectancies and problem drinking during 3 years of college. DESIGN: Cohort with 3-year follow-up. SETTING: Private university campus. PARTICIPANTS: A random sample of 260 students entered a longitudinal study of alcohol use at the beginning of their freshman year. One hundred eighty-four students completed follow-up measures at the end of their junior year. Respondents were 90% white, with a mean (+/-SD) age of 17.9 +/- 0.5 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: A standardized measure of expectations and subjective evaluations of outcomes associated with drinking, quantity and frequency of alcohol use, and a composite measure of alcohol-related problems. RESULTS: Students were divided into nondrinking, low-risk, and high-risk groups for problem drinking. A repeated-measures multivariate analysis of variance indicated significant interaction effects for risk group by expectancy scale (P < .009) and for expectancy scale by time (P < .001). The three risk groups differed significantly from each other on positive outcome expectations at entry into college and positive expectations and negative outcome evaluations at the end of the junior year. Students who became problem drinkers during college had significantly higher positive outcome expectation scores at both times and developed less concern for negative outcomes by the end of their junior year. The few initial problem drinkers who moderated their drinking during college demonstrated an increased concern for negative outcomes by their junior year. CONCLUSIONS: Alcohol expectancies are associated with differing patterns of alcohol use and are longitudinally related to subsequent changes in alcohol use and problem drinking.

Adolescent↗
PubMed1995

Early identification, screening, and brief intervention for adolescent alcohol use.

The high prevalence of alcohol and other drug use by adolescents poses a significant threat to the wellness of youth. Whereas there has been a significant decrease in the reported prevalence of use for most illicit drugs, there has been relatively little change in the reported use of alcohol and tobacco, the two most common drugs of abuse. As such, alcohol remains the drug of choice for most adolescents. In 1993, 67% of eighth graders had tried alcohol in their lifetime, as had 81% of 10th graders and 87% of high school seniors. More than a quarter of eighth graders (26%) had used alcohol in the past month, as had 42% of 10th graders and 51% of high school seniors. Most disturbing is that, in all three grade levels, among those who had used alcohol in the past 30 days, half or more had had five or more drinks in a row at least once (13.5%, 23%, and 28%, respectively). Although only 1% of adolescents consider themselves to have a drinking problem, 23% have often driven after excessive drinking, 17% report problems in peer relationships because of drinking, and 10% have been criticized by a close friend for drinking.

Adolescent↗
PubMed1995

Relationship of alcohol expectancies to problem drinking among college women.

PURPOSE: To evaluate the stability of expectancies about alcohol and their ability to prospectively explain drinking patterns and the occurrence of alcohol-related problems among college freshman women. METHODS: College women (n = 120) completed a standardized measure of expectations and subjective evaluations of positive and negative outcomes associated with drinking and a questionnaire assessing drinking patterns and common alcohol-related problems at both the beginning and end of the school year. Ninety percent of the students were Caucasian with a mean age of 17.9 years (SD = 0.5). RESULTS: Students' positive and negative outcome expectations and their subjective evaluations at the beginning of the year were significantly correlated with drinking patterns at the end of the year (p's < .05). During the year, students at low risk for problem drinking developed stronger positive attitudes toward the effects of alcohol upon courage, became less concerned about potential behavioral impairment, and perceived less negative effects upon self-perception. High risk students showed a significant decline in their positive attitudes toward the effects of alcohol upon their sociability. Expectancies about alcohol at the beginning of the school year explained 33% of variance in subsequent drinking (F = 6.17; p < .0004) and 20% of the variance in alcohol-related problems occurring during the year (F = 3.26; p < .02). Outcome evaluation scales at the beginning of the year explained more variance in subsequent drinking and alcohol-related problems than did outcome expectation scales. CONCLUSIONS: Alcohol outcome expectations and their subjective evaluations were relatively stable across the freshman year for these college women. Alcohol expectancies on entry into college explained significant amounts of variability in drinking behavior and the occurrence of alcohol-related problems during the subsequent freshman year. Students' attitudes toward perceived outcomes may be more important than the perceived likelihood of the outcomes themselves.

Adolescent↗
PubMed1995

Principles of brief intervention for adolescent alcohol, tobacco, and other drug use.

Early intervention within a primary health-care setting for problems with ATOD use includes screening, assessment, and referral services, and cognitive and behavioral brief interventions. All health-care providers who care for adolescents should possess the basic skills to communicate effectively with young patients and with parents about their concerns about ATOD use problems, should be able to identify appropriate substance-abuse services in their communities, and should be able to determine the appropriate referral options for a given adolescent patients. Some difficulties will be encountered with the introduction of behavioral technologies into medical practice. As such, more research is needed to determine the most effective approach to incorporate brief interventions into the health-care setting. Health-care providers should incorporate the principles of effective patient-provider communication and the concepts of behavior-changing strategies into their daily practices.

Adolescent↗
PubMed1994

Longitudinal evaluation of a screening measure for problem drinking among female college freshmen.

OBJECTIVE: A previous study suggested that combining the CAGE (cutting down of drinking, feeling annoyed by criticisms of drinking, feeling guilty about something that happened because of drinking, having an eye-opener) questionnaire with the Perceived-Benefit-of-Drinking Scale, an adolescent's use of tobacco, the age at which an adolescent first started drinking, and an adolescent's best friend's drinking pattern is a useful composite screening measure for problem drinking among adolescents. The present study was undertaken to evaluate prospectively this composite screening measure as a predictor of subsequent problem drinking among college women during their freshman year. DESIGN: Cross-sectional. SETTING: Private university student health service. PARTICIPANTS: A random sample of 248 college freshman women entered a longitudinal study of alcohol use at the beginning of their freshman year. One hundred twenty (48%) completed follow-up measures of alcohol use at the end of the year. Respondents were 90% white, with a mean age of 17.9 years (SD = 0.5 years). MAIN OUTCOME MEASURES: An index of the quantity and frequency of alcohol use and a composite measure of specific alcohol-related problems. RESULTS: The CAGE questionnaire score, the Perceived-Benefit-of-Drinking Scale score, the student's tobacco use, the student's best friend's drinking pattern, and the age at which the student first started drinking as reported at the beginning of the year together explained 38% of the variance in subsequent drinking habits and 26% of the variance in alcohol-related problems reported during the freshman year. Use of the composite screening measure significantly increased sensitivity and specificity beyond that obtained with the CAGE questionnaire or the Perceived-Benefit-of-Drinking Scale alone for problem drinking. CONCLUSIONS: The CAGE questions, the Perceived-Benefit-of-Drinking Scale, the student's tobacco use, the student's best friend's drinking pattern, and the age at which the student first started drinking may together constitute a clinically useful screening measure for subsequent problem drinking among female college freshmen.

Adolescent↗
PubMed1994

Screening for problem drinking among college freshmen.

PURPOSE: This study identified predictors of older adolescents at risk for problem drinking. METHODS: College freshmen (n = 492) completed a questionnaire that addressed drinking patterns, risk factors for problem drinking, the CAGE questions, the Perceived-Benefit-of-Drinking Scale (PBDS), and the Children of Alcoholics Screening Test (CAST). They also responded to questions regarding alcohol-related problems including blackouts; alcohol-related injury, illness, violence, or legal problems; driving under the influence; and missing class. 50% of students were male with a mean age of 17.9 years (SD = 0.5). RESULTS: Higher scores on the CAGE and PBDS, use of tobacco, best friend's drinking pattern, and younger age at first drinking were associated with higher scores on a quantity/frequency drinking index and with reports of significantly more alcohol-related problems. Regression models using these variables explained 40% to 51% of the variance in drinking habits and alcohol-related problems. CONCLUSION: A composite screening measure had significantly better sensitivity and specificity than either the CAGE or PBDS alone in identifying older adolescents at high risk for problem drinking.

Adolescent↗
PubMed1993

Alcohol expectancies, problem drinking, and adverse health consequences.

This study evaluated a measure of positive and negative expected effects of alcohol and their subjective evaluation in the identification of college freshmen at high risk for problem drinking and associated morbidities. It was hypothesized that greater expectations of positive outcomes and fewer negative evaluations of negative outcomes would be associated with reports of heavier drinking and more alcohol-related health problems. College freshmen (n = 328) completed a standardized measure of expectations and subjective evaluations of positive and negative outcomes associated with drinking, and a questionnaire assessing drinking patterns and common alcohol-related health problems. Fifty-two percent of students were male and the mean age was 17.9 years (SD = 0.5). Students' expectations of positive outcomes and their subjective evaluations of both positive and negative outcomes from drinking were significantly correlated with drinking and alcohol-related health problems indices (p < 0.001). Gender, expectation of positive outcomes, and evaluation of negative outcomes explained 29% of the variance in drinking and 15% of the variance in alcohol-related health problems indices. Heavier-drinking students and those reporting more health problems expected more positive effects on their sociability and sexuality (p < 0.03) and were less concerned about cognitive and behavioral impairment as a result of drinking (p < 0.001). Students with more health problems were less concerned that drinking would lead to risk-taking or aggressive behavior (p < 0.003). Positive and negative outcome expectancies and their subjective evaluations accounted for a significant portion of the variability in drinking and alcohol-related health problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Hallucinogens.

Explore the source record for details and available documents.

Adolescent↗
PubMed1992

Problem drinking among college freshmen.

Entering college freshmen (n = 308) completed a questionnaire which assessed drinking behaviors and identified students at risk for problem drinking as defined by the CAGE (focuses on Cutting down on drinking, Annoyance by criticism by others about drinking, Guilty feelings about drinking, and the use of an Eye opener) questionnaire and Perceived-Benefit-of-Drinking Scale (PBDS). Students were 50% male with a mean age of 17.9 years. In the past month, 17% had drunk on 10 or more occasions, and 18% had binged on 6 or more occasions. CAGE scores of 2 or greater were obtained by 21% and PBDS scores of 3 or greater by 29%, reflecting high risk for problem drinking. High-risk CAGE and PBDS scores were associated with frequent drinking and binging. Student reports of parental problem drinking were not associated with high risk for problem drinking. Intent to join a fraternity or sorority (the Greek system) was associated with frequent drinking, binging, and high-risk CAGE and PBDS scores. Approaches to screening for problem drinking which emphasize attitudes and beliefs may be useful. The Greek system appears to be attractive to high-risk students and should be a focus of prevention programming.

Adolescent↗
PubMed1991

Medical needs of performing arts students.

A questionnaire was administered to 71 college students enrolled in dance, drama, and musical theater programs to assess health care problems, injuries, risk-taking behaviors, and sources of care. Many desired help with depression, fatigue, and chronic bone or joint pain, although 37% identified no regular physician. Thirty-nine students reported 87 injuries involving the back, foot, ankle, and knee; 12% sustained injuries at least monthly; and 72% of injuries occurred in class. The incidence of eating disorders appears to be low, as assessed by indirect measures such as body weight, oligomenorrhea, diet pill or laxative use, and scores on a body image index. The 30-day prevalence of tobacco use was 26%; marijuana, 11%; and alcohol, 71%. This survey suggests that performing arts students have important unmet health care needs.

Adolescent↗
PubMed1991

Urinary leukocyte esterase screening for asymptomatic sexually transmitted disease in adolescent males.

The objective of this study was to evaluate the effectiveness of urinary leukocyte esterase on random urine specimens as a screening test for chlamydial and gonococcal urethral infections in asymptomatic males. Random urine specimens were obtained on 106 consecutive asymptomatic adolescent males during intake physical examination at a residential vocational training program. Results of urinary leukocyte esterase were compared to those of urethral cultures for Chlamydia trachomatis and Neisseria gonorrhoeae. Five subjects had positive chlamydia cultures, three subjects had positive gonococcal cultures, and one patient had positive cultures for both organisms. Sixteen subjects had leukocyte esterase tests reported as "trace" or greater. When compare to positive culture results for either Chlamydia or gonorrhea, urinary leukocyte esterase activity had a sensitivity of 78%, specificity of 91%, and positive predictive value of 44%. A random urine specimen for urinary leukocyte esterase activity is a cost-effective screening method for chlamydial and gonococcal urethral infections in asymptomatic adolescent males.

Adolescent↗
PubMed1988

Protein synthesis by HepG2 cells infected with influenza B virus.

Reye's syndrome is an acute hepatopathy and encephalopathy affecting children during the convalescent period of a viral infection, frequently influenza B. The role of influenza B in the pathogenesis of Reye's syndrome is unknown. To investigate this relationship, an in vitro system was designed to examine the interaction of influenza B virus with a cell line of human hepatocytes (HepG2) which retains many specific hepatic synthetic characteristics. HepG2 was capable of supporting a productive infection by influenza B, although greater virus inputs were required than in fully permissive Madin-Darby canine kidney cells. Because of the recent association of Reye's syndrome with aspirin use, the kinetics of influenza B growth were studied in the presence of acetylsalicylic acid (25 and 100 micrograms/ml) and were not found to be altered. Protein synthesis by HepG2 cells was decreased by 80% in influenza B-infected cells when compared to uninfected controls. Acetylsalicylic acid, 100 micrograms/ml, did not affect the rate of 35S-methionine incorporation by infected or uninfected HepG2 cells. The rates of synthesis of specific proteins (albumin, transferrin, and apoprotein B) by HepG2 cells were determined by immunoprecipitation of 35S-methionine labeled cell lysates. After 12 h of infection, synthesis of all three plasma proteins was decreased by 40-60%. These studies describe a useful system for delineation of mechanisms by which influenza B virus interacts with host hepatocytes and the host-cell protein synthetic machinery. The studies could be pertinent to the pathogenesis of Reye's syndrome.

Aspirin↗