Digital Commons Network^™

Resting State Default-Mode Network Connectivity In Early Depression Using A Seed Region-Of-Interest Analysis: Decreased Connectivity With Caudate Nucleus., Robyn Bluhm, Peter Williamson, Ruth Lanius, Jean Theberge, Maria Densmore, Robert Bartha, Richard Neufeld, Elizabeth Osuch

Department of Medicine Publications

AIM: Reports on resting brain activity in healthy controls have described a default-mode network (DMN) and important differences in DMN connectivity have emerged for several psychiatric conditions. No study to date, however, has investigated resting-state DMN in relatively early depression before years of medication treatment. The objective of the present study was, therefore, to investigate the DMN in patients seeking help from specialized mental health services for the first time for symptoms of depression.

METHODS: Fourteen depressed subjects and 15 matched controls were scanned using 4-T functional magnetic resonance imaging while resting with eyes closed. All but one subject was …

Changes In Self-Schema Structure In Cognitive Therapy For Major Depressive Disorder: A Randomized Clinical Trial., David J A Dozois, Peter J Bieling, Irene Patelis-Siotis, Lori Hoar, Susan Chudzik, Katie Mccabe, Henny A Westra

Psychology Publications

Negative cognitive structure (particularly for interpersonal content) has been shown in some research to persist past a current episode of depression and potentially to be a stable marker of vulnerability for depression (D. J. A. Dozois, 2007; D. J. A. Dozois & K. S. Dobson, 2001a). Given that cognitive therapy (CT) is highly effective for treating the acute phase of a depressive episode and that this treatment also reduces the risk of relapse and recurrence, it is possible that CT may alter these stable cognitive structures. In the current study, patients were randomly assigned to CT+ pharmacotherapy (n = 21) …

Factors Associated With Physical Activity Behaviors Among Rural Adolescents, Kenli A. Urruty

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

The "obesity epidemic" in the United States is a current health concern that has sparked research interest in physical activity as a means of weight management. However, little research has examined the physical activity behaviors of rural adolescents. The goal of the current study was to use a biopsychosocial framework to examine the physical activity behaviors of a sample of rural adolescents, and explore factors associated with physical activity participation.

A sample of 162 ninth- and tenth-grade students in a rural, western community were recruited for this study. Generally, the sample reported levels of physical activity for both genders that …

Influence Of Technology On Adolescent Development And Spiritual Formation, Kevin Daniel Monahan

Doctoral Dissertations and Projects

Adolescence is the time when a person develops perceptions about religious thoughts and with proper guidance, can be a stronger follower of Christ. The purpose of this project is to analyze the effects of technology on young people and to show a direct correlation between the influence of technology and spiritual growth of adolescents. I will argue that both the positive and negative influences of technology have made our students more informative yet less personally intimate. This shift of personal interaction presents a challenge to the cognitive development and spiritual formation of all students.

Hla-Dpb1 And Dpb2 Are Genetic Loci For Systemic Sclerosis: A Genome-Wide Association Study In Koreans With Replication In North Americans, Xiaodong Zhou, Jong Eun Lee, Frank C Arnett, Momiao Xiong, Min Young Park, Yeon Kyeong Yoo, Eun Soon Shin, John D Reveille, Maureen D Mayes, Jin Hyun Kim, Ran Song, Ji Yong Choi, Ji Ah Park, Yun Jong Lee, Eun Young Lee, Yeong Wook Song, Eun Bong Lee

Journal Articles

OBJECTIVE: To identify systemic sclerosis (SSc) susceptibility loci via a genome-wide association study.

METHODS: A genome-wide association study was performed in 137 patients with SSc and 564 controls from Korea using the Affymetrix Human SNP Array 5.0. After fine-mapping studies, the results were replicated in 1,107 SSc patients and 2,747 controls from a US Caucasian population.

RESULTS: The single-nucleotide polymorphisms (SNPs) (rs3128930, rs7763822, rs7764491, rs3117230, and rs3128965) of HLA-DPB1 and DPB2 on chromosome 6 formed a distinctive peak with log P values for association with SSc susceptibility (P=8.16x10(-13)). Subtyping analysis of HLA-DPB1 showed that DPB1*1301 (P=7.61x10(-8)) and DPB1*0901 (P=2.55x10(-5)) were …

Brazilian Adolescents Infected By Hiv: Epidemiologic Characteristics And Adherence To Treatment, Julia K. C. Machado, Maria J. C. Sant'anna, Veronica Coates, Flavia J. Almeida, Eitan N. Berezin, Hatim A. Omar

Pediatrics Faculty Publications

Over the last 3 decades since the first AIDS cases appeared, we have witnessed great progress in therapeutic methodologies that have transformed the evolution of the disease from debilitating and fatal, into chronic and controllable. HIV-infected children are arriving at adolescence and bringing specific challenges, not only to themselves, but also to their families and caregivers. This retrospective study sets forth epidemiological and treatment characteristics of 46 HIV-infected adolescents followed in a specialized university service relating said characteristics to therapy adherence assessed through a combination of three indirect methods. Therapy adherence did not reveal any association with either epidemiologic characteristics …

The Long-Term Neuropsychological Outcomes In Sagittal Craniosynotosis: Limited-Strip Craniectomy Vs. Whole-Vault Cranioplasty, Anup Patel

Yale Medicine Thesis Digital Library

The functional morbidity in nonsyndromic craniosynostosis is not obvious. Because of this disconnect between cranial deformity and functional disability, cranial reconstructive surgery in patients with single-suture sagittal craniosynostosis has been regarded as a cosmetic intervention. However, it has been observed in a preliminary study that children with simple craniosynostosis often have a higher proportion of learning disabilities and cognitive problems as compared to nonafflicted children. The influence of modern comprehensive surgical treatment including the optimal age to perform surgery has not been well-documented. This study examined long-term neuropsychological outcomes of children and adolescents with isolated sagittal craniosynostosis undergoing either limited-strip …

Adolescent Interest In Alcohol Responsibility Messages: The Message Matters, Kevin Kimball John

Theses and Dissertations

Adolescents are especially vulnerable to image-based messages, which place them directly in line with the lifestyle messages presented in numerous alcohol advertisements. Research has shown that teenagers encounter alcohol advertisements from a variety of sources, prompting concern over the consequences of exposure and the risks associated with teen drinking. Warning messages contained within these alcohol advertisements are often vague in their wording and targeted to promote responsible drinking among adults, making them wholly inadequate for teen deterrence. This thesis explores the problems with current alcohol responsibility messages when dealing with teens, and proposes the development of new, modified messages, that …

Exploring The Effects Of Bmi Health Report Card Letters Among 6Th Grade Students And Parents: An Application Of The Social Cognitive Theory, Jenna M. Kaczmarski

USF Tampa Graduate Theses and Dissertations

In response to the growing child and adolescent obesity epidemic, some states and local school authorities are mandating the measurement of Body Mass Index (BMI). However, there is limited research addressing whether schools are an appropriate setting and the intended as well as unintended effects of sharing this information with parents. Furthermore, there is yet to be conclusive evidence that shows that BMI screening in the school setting is an effective way to improve student BMI status. Therefore, the purpose of this research study was to explore the effects of BMI Health Report Card Letters among 6th grade students and …

An Exploratory Analysis Of The Impact Of Family Functioning On Treatment For Depression In Adolescents., Norah C. Feeny, Susan G. Silva, Mark A. Reinecke, Steven Mcnulty, Robert L. Findling, Paul Rohde, John F. Curry, Golda S. Ginsburg, Christopher J. Kratochvil, Sanjeev M. Pathak, Diane E. May, Betsy D. Kennard, Anne D. Simons, Karen C. Wells, Michele Robins, David Rosenberg, John S. March

Journal Articles: Psychiatry

This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, or placebo. Outcomes were Week 12 scores on measures of depression and global impairment. Of 20 candidate variables, one predictor emerged: Across treatments, adolescents with mothers who reported less parent-child conflict were more likely to benefit than their counterparts. When family functioning moderated outcome, adolescents who endorsed more negative environments were more likely to benefit from fluoxetine. Similarly, when moderating effects were seen on cognitive behavioral …

Dysfunctional Attitudes Scale Perfectionism: A Predictor And Partial Mediator Of Acute Treatment Outcome Among Clinically Depressed Adolescents., Rachel H. Jacobs, Susan G. Silva, Mark A. Reinecke, John F. Curry, Golda S. Ginsburg, Christopher J. Kratochvil, John S. March

Journal Articles: Psychiatry

The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures included the Children's Depression Rating Scale-Revised, the Suicidal Ideation Questionnaire-Grades 7-9, and the perfectionism subscale from the Dysfunctional Attitudes Scale (DAS). Predictor results indicate that adolescents with higher versus lower DAS perfectionism scores at baseline, regardless of treatment, continued to demonstrate elevated depression scores across the acute treatment period. …

Parent- Versus Child-Reported Functional Health Status After The Fontan Procedure., Linda M. Lambert, L Luann Minich, Jane W. Newburger, Minmin Lu, Victoria L. Pemberton, Ellen A. Mcgrath, Andrew M. Atz, Mingfen Xu, Elizabeth Radojewski, Darlene Servedio, Brian W. Mccrindle, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: We sought to compare perceptions of functional health status between children who had undergone a Fontan procedure and their parents.

METHODS: Fontan procedure survivors 10 to 18 years of age were included in the study if the child completed the Child Health Questionnaire (CHQ) and the parent completed the parent form to assess the child's functional health status. Comparisons were made between raw domain scores for the parent- and child-completed CHQs.

RESULTS: Between March 2003 and April 2004, 1078 Fontan survivors were screened. Of the 546 eligible and consented patients, 354 were 10-18 years of age and 328 parent/child …

Chromosomal Anomalies Influence Parental Treatment Decisions In Relation To Prenatally Diagnosed Congenital Heart Disease., Sinai C. Zyblewski, Elizabeth G. Hill, Girish S. Shirali, Andrew Atz, Geoffrey Forbus, Javier Gonzalez, Anthony Hlavacek

Manuscripts, Articles, Book Chapters and Other Papers

This study aimed to identify the variables that influence parental treatment decisions after a prenatal diagnosis of congenital heart disease (CHD). The authors reviewed all cases of prenatally diagnosed structural CHD from August 1998 to December 2006 at their center. The following variables were studied as potential predictors of parental intent to treat: maternal age, race, insurance status, obstetric history, fetal gender, univentricular versus biventricular cardiac physiology, and fetal chromosomal abnormality. Uni- and multivariable logistic regression analyses were performed. In the review, 252 consecutive cases of prenatally diagnosed CHD were identified. Of these, 204 women pursued full medical treatment, whereas …

Incarcerated Male Adolescent Suicide In Utah: A Case Study, Kristy Straubhaar

Theses and Dissertations

Adolescent suicide has been described as a major public health problem calling for the aid of researchers willing to better identify factors related to suicide risk. Suicide is the third-leading cause of death for 15 to 24 year olds. Despite the fact incarcerated adolescents act in self-destructive ways, minimal research has focused on suicide behavior among incarcerated adolescents. Existing data indicates that suicide among adolescent males is especially prevalent in the juvenile justice system. Several variables have been identified as risk factors for suicidal behavior, including interpersonal relationship dysfunction, substance abuse, and psychological variables such as depression and dichotomous thinking. …

Treatment Response In Depressed Adolescents With And Without Co-Morbid Attention-Deficit/Hyperactivity Disorder In The Treatment For Adolescents With Depression Study., Christopher J. Kratochvil, Diane E. May, Susan G. Silva, Vishal Madaan, Susan E. Puumala, John F. Curry, John Walkup, Hayden Kepley, Benedetto Vitiello, John S. March

Journal Articles: Psychiatry

OBJECTIVE: In the Treatment for Adolescents with Depression Study (TADS), fluoxetine (FLX) and the combination of fluoxetine with cognitive-behavioral therapy (COMB) had superior improvement trajectories compared to pill placebo (PBO), whereas cognitive-behavioral therapy (CBT) was not significantly different from PBO. Because attention-deficit/hyperactivity disorder (ADHD) and major depressive disorder (MDD) frequently co-exist, we examined whether ADHD moderated these outcomes in TADS.

METHOD: A total of 439 adolescents with MDD, 12-17 years old, were randomized to FLX, CBT, COMB, or PBO. Random coefficients regression models examined depression improvement in 377 depressed youths without ADHD and 62 with ADHD, including 20 who were …

The Impact Of Hurricane Katrina On Adolescent Psychological Adjustment And Adaptation In Southeast Louisiana, William Stephen Kelly

Doctoral Dissertations and Projects

Hurricane Katrina ripped through Louisiana and the Gulf Coast in late August 2005. This devastating storm left thousands of people homeless and forever changed the lives of those who lived in these areas. Adolescents in the storm-impacted areas continue to be affected by life events brought about by this natural catastrophe. Many adolescents moved to another parish or state and started a new school, and many students reported attending multiple schools. Adolescents lost possessions and friends, and many continue to experience grief and loss issues related to Hurricane Katrina. Family job loss and associated financial hardship added to the already …

Sexuality And Persons With Down Syndrome. A Study From Brazil, Bruna Marques Bononi, Maria José Carvalho Sant'anna, André Chao Vasconcellos De Oliveira, Tadeu Silveira Renattini, Carla Franchi Pinto, Maria Lúcia Passarelli, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

In recent years, important gains and changes have been observed in the life of teenagers with Down syndrome (DS) with increased inclusion into society. This review will discuss adolescence and sexuality in teenagers with DS from a descriptive study of 50 patients with DS between the ages of 10 and 20 years. The mean age was 13.5 years, 50% females; 86% went to school with 62.2% in school for over six years. Of the patients that attended school, 60% went to special education school and only 10% read and wrote correctly. In an evaluation of autonomy, 66% took showers, 78% …

The Medicine Wheel Nutrition Intervention: A Diabetes Education Study With The Cheyenne River Sioux Tribe, Kendra K. Kattelmann, Kibbe Conti, Cuirong Ren

Health and Nutritional Sciences Faculty Publications

OBJECTIVE: The Northern Plains Indians of the Cheyenne River Sioux Tribe have experienced significant lifestyle and dietary changes over the past seven generations that have resulted in increased rates of diabetes and obesity. The objective of this study was to determine if Northern Plains Indians with type 2 diabetes mellitus who are randomized to receive culturally adapted educational lessons based on the Medicine Wheel Model for Nutrition in addition to their usual dietary education will have better control of their type 2 diabetes than a nonintervention, usual care group who received only the usual dietary education from their personal providers. …

The Effects Of Shoe Traction And Obstacle Height On Lower Extremity Coordination Dynamics During Walking., Leslie Decker, Jeremy J. Houser, John M. Noble, Gregory M. Karst, Nicholas Stergiou

Journal Articles: Physical Therapy

This study aims to investigate the effects of shoe traction and obstacle height on lower extremity relative phase dynamics (analysis of intralimb coordination) during walking to better understand the mechanisms employed to avoid slippage following obstacle clearance. Ten participants walked at a self-selected pace during eight conditions: four obstacle heights (0%, 10%, 20%, and 40% of limb length) while wearing two pairs of shoes (low and high traction). A coordination analysis was used and phasing relationships between lower extremity segments were examined. The results demonstrated that significant behavioral changes were elicited under varied obstacle heights and frictional conditions. Both decreasing …

There Are Multiple Contributors To The Verbal Short-Term Memory Deficit In Children With Developmental Reading Disabilities., Michelle Y. Kibby

Publications

Prior research has put forth at least four possible contributors to the verbal short-term memory (VSTM) deficit in children with developmental reading disabilities (RD): poor phonological awareness that affects phonological coding into VSTM, a less effective phonological store, slow articulation rate, and fewer/poorer quality long-term memory (LTM) representations. This project is among the first to test the four suppositions in one study. Participants included 18 children with RD and 18 controls. VSTM was assessed using Baddeley's model of the phonological loop. Findings suggest all four suppositions are correct, depending upon the type of material utilized. Children with RD performed comparably …

Self-Image In Adolescent Foster Youth Who Have Had Multiple Out-Of-Home Placements, Sarah Cartier

Theses, Dissertations, and Projects

This study was undertaken to determine the feasibility of data collection from adolescents in foster care. Additionally, how do adolescent foster youth who have had multiple placements perceive their self-image and is it comparable to the self-image of an adolescent population not in foster care? Adolescent foster youth who have had multiple placements are at higher risk for negative personal, familial, environmental, communal, and societal relations. Areas of self-image identified as positive should be supported and areas identified as reflecting a lower self-image should be addressed both clinically and pragmatically. Adolescent foster youth in the custody of the Department of …

Women Among Men : The Experiences Of Female Staff In Residential Facilities For Adolescent Males, Jessica Rose Donahue

Theses, Dissertations, and Projects

This exploratory study was undertaken to examine women's experiences working in residential treatment facilities for adolescent males, and to better understand the existing gender dynamics in this particular setting. The research questions guiding this study were: How do gender stereotypes affect women's experiences working in residential treatment with adolescent males? How do women feel that they are perceived by co-workers and residents? Thirteen women participated in this qualitative study. Six women performed clinical roles, three were direct care staff, three were case managers, and one was a teacher. Through structured interviews, the participants provided narratives about their agency/job requirements or …

The Mystery Of The Body: Embodiment In The Nancy Drew Mystery Series, Katie Still

Women's, Gender, and Sexuality Studies Theses

This thesis investigates the ways in which ideas about class, gender, and race are produced and articulated through the body in the Nancy Drew Mystery series in the 1930s. Physical descriptions and bodily movements, as well as material surroundings, work together to reify and contradict dominant ideas of normalcy and deviance being located on the body.

Assessing Body Composition Of Children And Adolescents Using Dexa, Skinfolds, And Electrical Impedance, Angela Mooney

Theses and Dissertations

The purpose of this study was to determine the validity and reliability of four methods of estimating body composition in 331 participants (177 boys, 154 girls) between 12-17 years of age. Percent body fat (%BF) was assessed once on one day using DEXA and twice using the sum of two skinfold (SF) and three bio-electrical impedance analysis (BIA) devices: OMRON hand-to-hand BIA, TANITA 521 foot-to-foot BIA, and TANITA 300A foot-to-foot BIA. The same assessments were repeated on 79 of the participants on a second day. DEXA was used as the criterion method of estimating %BF. The agreement between the estimates …

Comparison Of Echocardiographic And Cardiac Magnetic Resonance Imaging Measurements Of Functional Single Ventricular Volumes, Mass, And Ejection Fraction (From The Pediatric Heart Network Fontan Cross-Sectional Study)., Renee Margossian, Marcy L. Schwartz, Ashwin Prakash, Lisa Wruck, Steven D. Colan, Andrew M. Atz, Timothy J. Bradley, Mark A. Fogel, Lynne M. Hurwitz, Edward Marcus, Andrew J. Powell, Beth F. Printz, Michael D. Puchalski, Jack Rychik, Girish S. Shirali, Richard Williams, Shi-Joon Yoo, Tal Geva, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Assessment of the size and function of a functional single ventricle (FSV) is a key element in the management of patients after the Fontan procedure. Measurement variability of ventricular mass, volume, and ejection fraction (EF) among observers by echocardiography and cardiac magnetic resonance imaging (CMR) and their reproducibility among readers in these patients have not been described. From the 546 patients enrolled in the Pediatric Heart Network Fontan Cross-Sectional Study (mean age 11.9 +/- 3.4 years), 100 echocardiograms and 50 CMR studies were assessed for measurement reproducibility; 124 subjects with paired studies were selected for comparison between modalities. Interobserver agreement …

Functional State Following The Fontan Procedure., Ismee A. Williams, Lynn A. Sleeper, Steven D. Colan, Minmin Lu, Elizabeth A. Stephenson, Jane W. Newburger, Welton M. Gersony, Meryl S. Cohen, James F. Cnota, Andrew M. Atz, Richard V. Williams, Renee Margossian, Andrew J. Powell, Mario P. Stylianou, Daphne T. Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in outcomes after completion of the Fontan circulation, long-term functional state varies. We sought to identify pre- and postoperative characteristics associated with overall function.

METHODS AND RESULTS: We analyzed data from 476 survivors with the Fontan circulation enrolled in the Pediatric Heart Network Fontan Cross-sectional Study. Mean age at creation of the Fontan circulation was 3.4 plus or minus 2.1 years, with a range from 0.7 to 17.5 years, and time since completion was 8.7 plus or minus 3.4 years, the range being from 1.1 to 17.3 years. We calculated a functional score for the survivors by …

Symptoms Of Diminished Autonomy Over Cigarettes With Non-Daily Use, Judith A. Savageau, Paul D. Mowery, Joseph R. Difranza

Judith A. Savageau

Data from a nationally representative sample of smokers (ages 12-22 years, n=2,091) was examined to investigate the prevalence of symptoms of diminished autonomy over cigarettes. Six symptoms were assessed: failed cessation, smoking despite a desire to quit, and a need or urge to smoke, irritability, restlessness, or disrupted concentration attributed to nicotine withdrawal. One or more of the six symptoms were present in 18.9% of subjects who smoked less often than once per week. Among subjects who had not smoked 20 cigarettes in their lifetime, 12.6% had symptoms of nicotine withdrawal, and 25% had made an unsuccessful quit attempt.

Lesson In A Pill Box: Teaching About The Challenges Of Medication Adherence, Darlene M. O'Connor, Judith A. Savageau, David B. Centerbar, Kimberly N. Wamback, Jennifer S. Ingle, Nicole J. Lomerson

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Medication mismanagement is a serious health issue affecting elders and people with disabilities, who often manage multiple medications. This project's goal was to educate medical and nursing students about the challenges patients face when managing complex medication regimens.

METHODS: A total of 104 first-year medical students and 40 second-year nursing students were randomly assigned to participate in a 1-week regimen of mock prescriptions or to read a description of the regimen and make predictions about what the experience would be like had they participated.

RESULTS: Quantitative results in combination with qualitative information suggest that the students taking …

Enforcement Of Underage Sales Laws As A Predictor Of Daily Smoking Among Adolescents: A National Study, Joseph R. Difranza, Judith A. Savageau, Kenneth E. Fletcher

Judith A. Savageau

BACKGROUND: With a goal to reduce youth smoking rates, the U.S. federal government mandated that states enforce laws prohibiting underage tobacco sales. Our objective was to determine if state compliance with tobacco sales laws is associated with a decreased risk of current daily smoking among adolescents.

METHODS: Data on tobacco use were obtained from a nationally representative sample of 16,244 adolescents from the 2003 Monitoring the Future survey. The association between merchant compliance with the law from 1997-2003 and current daily smoking was examined using logistic regression while controlling for cigarette prices, state restaurant smoking policies, anti-tobacco media, and demographic …

Epidemiology And Outcomes Of Candidemia In 2019 Patients: Data From The Prospective Antifungal Therapy Alliance Registry., David L Horn, Dionissios Neofytos, Elias J Anaissie, Jay A Fishman, William J Steinbach, Ali J Olyaei, Kieren A Marr, Michael A Pfaller, Chi-Hsing Chang, Karen M Webster

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Candidemia remains a major cause of morbidity and mortality in the health care setting, and the epidemiology of Candida infection is changing.

METHODS: Clinical data from patients with candidemia were extracted from the Prospective Antifungal Therapy (PATH) Alliance database, a comprehensive registry that collects information regarding invasive fungal infections. A total of 2019 patients, enrolled from 1 July 2004 through 5 March 2008, were identified. Data regarding the candidemia episode were analyzed, including the specific fungal species and patient survival at 12 weeks after diagnosis.

RESULTS: The incidence of candidemia caused by non-Candida albicans Candida species (54.4%) was higher …