Digital Commons Network^™

Policy Essay: Fostering The Acceptance And Inclusion Of Lgbtq Youth In The Child Welfare System: Considerations For Advancing Trauma Informed Responses For Lgbtq Youth In Care, Adam Mccormick, Karey Scheyd, Samuel Terrazas

Journal of Family Strengths

LGBTQ youth are vulnerable to nearly all forms of childhood maltreatment and trauma and are disproportionately overrepresented in the child welfare system. Many LGBTQ youth in the child welfare system encounter a number of obstacles related to discrimination, rejection, placement instability, and further maltreatment. Despite recent insights and advances in the field of trauma informed care the trauma experiences of LGBTQ youth have largely gone unaddressed in major works and frameworks related to trauma informed care. The following article explores the unique trauma and maltreatment experiences of LGBTQ youth and provides considerations for enhancing and improving practice with LGBTQ youth …

From Tolerance And Diversity To Inclusion And Celebration; New Horizons For Infusing Queer Theory Into Communities, Laura Jean Mcguire

Journal of Family Strengths

Tolerance and diversity are at times lauded as the essential terms for modern social justice movements. From school to community settings teachers, public figures, and political leaders throw these terms around to great applaud and acclaim. And yet who are we trying to serve by using these terms, and whose humanity is preserved through tolerance and diversity? In the following article I address the difference between the simplicity and shortcomings posed by tolerating and diversifying spaces to the more radical movements of inclusion and celebration. I unpack these frameworks through personal narratives concerning my field work and experiences as well …

Authentic Youth And Young Adult Partnerships: Broadening The Narrative Of Lgbtq Youth Homelessness, Jama Shelton, Christa Price, Phoebe Vancleefe

Journal of Family Strengths

Lived experience generates knowledge not available through formal education and training. If lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth and young adults (YYA) experiencing homelessness are to be effectively engaged, their needs met, and their successful transition out of homelessness facilitated, they must be partners in the creation of solutions meant to help them. That means that everyone working to address LGBTQ YYA homelessness – including policymakers, government officials, advocates, researchers, and service providers – need to understand how to partner authentically with YYA experiencing homelessness. This article will introduce a framework for authentic YYA partnerships, describe the philosophy …

A Moral Debate At The Invisible Rainbow: Thoughts About Best Practices In Servicing Lgbtq Students In Special Education, Bernardo E. Pohl Jr, Matthew Fugate, John Kelly

Journal of Family Strengths

Instead of occupying a marginal space within teacher preparation programs, special education courses and training should promote diversity in servicing marginalized groups such as lesbian, gay, bisexual, transgender, and questioning (LGBTQ) students. Within these programs, issues related to LGBTQ students should occupy a meaningful and formative space in the training of future teachers in special education. Often, special education teachers are at a loss about how to educate LGBTQ students with disabilities. Rethinking the role of special education and LGBTQ students with special needs within teacher education programs enables pre-service teachers to cultivate new values and attitudes that can enrich …

Genetic Epidemiology Of Neural Tube Defects, Philip J Lupo, A J Agopian, Heidi Castillo, Jonathan Castillo, Gerald H Clayton, Nienke P Dosa, Betsy Hopson, David B Joseph, Brandon G Rocque, William O Walker, John S Wiener, Laura E Mitchell

Faculty, Staff and Student Publications

It has been estimated that 60-70% of neural tube defects (NTDs) have a genetic component, but few causative genes have been identified. The lack of information on genes associated with non-syndromic NTDs in humans is especially notable as the "genomic revolution" has led to new tools (e.g., genome-wide genotyping arrays, next-generation sequencing) that are helping to elucidate the full spectrum of genetic variation (from common to rare) contributing to complex traits, including structural birth defects. However, the application of modern genomic approaches to the study of NTDs has lagged behind that of some other common structural birth defects. This may …

Using Formative Research And Audience-Centric Intelligence To Develop The #Justbe Digital Magazine: An Mhealth Strategy To Improve Adolescent Sexual Health, Kimberly Johnson-Baker, Honora I. Swain-Ogbonna, Maribel Cruz, Jorge Cruz, Sharon Edwards, Susan R. Tortolero

Journal of Applied Research on Children: Informing Policy for Children at Risk

Digital strategies may help to overcome challenges in providing contraception education to overlooked and key sub-populations (older teens, ethnic minority youth, LGBTQ youth, high school dropouts and males). However, many current digital strategies are not culturally specific and often have limited information on the most effective contraceptive methods. In this article, we describe the preliminary steps used to develop #JustBe, a user-centered digital strategy for ethnic minority older youth and young adults with a specific focus contraception, sexual health, consent, and healthy relationships. Technology-based strategies such as #JustBe offer advantages over traditional face-to-face methods by utilizing a confidential way …

Special Issue Introduction: We Can Do More: Challenges And Opportunities For Teen Pregnancy Prevention, Susan R. Tortolero, Kimberly Johnson-Baker

Journal of Applied Research on Children: Informing Policy for Children at Risk

Guest editors Susan Tortolero Emery and Kimberly Johnson Baker introduce Volume 8, Issue 1 of the Journal of Applied Research on Children.

Thematic Analysis Of Mainstream Rap Music - Considerations For Culturally Responsive Sexual Consent Education In High School, Kimberly Johnson, Christine Markham, Susan R. Tortolero

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: Much of the research literature on sexual consent and sexual consent education has been focused on college students, providing a significant gap in our understanding of high school students, especially ethnic minority youth, who are at greatest risk for unwanted sexual contact and sexual activity. Furthermore, recent research suggests that music with sexually suggestive and misogynistic themes influence sexual communication and consenting behaviors. An analysis of rap music produced after the year 2000 is necessary to identify themes that may influence sexual communication among youth. Methods: A thematic analysis was conducted to examine the lyrics of mainstream rap music …

Community Mobilization: A Community-Wide Approach To Promoting Adolescent Sexual Health, Sam E. Greenberg, Laura Davis, Cheryl Tutt Msw, Tonya Katcher Md, Mph

Journal of Applied Research on Children: Informing Policy for Children at Risk

Community mobilization is a strategy that organizes a community across sectors for long-term change, and is one way for communities to provide supports for young people to make healthy sexual choices. In the context of teen pregnancy, community mobilization can address the interconnected web of factors that influence teen sexual attitudes by bringing together parents, educators, health care practitioners, young people, and other key community stakeholders to address the issue jointly. From 2014 to 2016, Advocates for Youth, through a cooperative agreement with the US Office of Adolescent Health, provided financial support and capacity-building assistance to three communities to address …

Working With Faith-Based Communities To Develop An Education Tool Kit On Relationships, Sexuality, And Contraception, Jennifer Torres, Kimberly Johnson-Baker, Sheryl B. Bell, Jamie Freeny, Sharon Edwards, Susan R. Tortolero, Honora I. Swain-Ogbonna

Journal of Applied Research on Children: Informing Policy for Children at Risk

Communities disproportionately affected from higher rates of unplanned teen births are in need of sustainable approaches to prevention strategies. One approach is to build the capacity of faith-based communities (FBCs) to address the sexual health needs of the surrounding community. However there is a need for comprehensive, user-friendly resources designed for FBCs that provide critical decision-making information related to pregnancy prevention inclusive of contraception. Using community-based, theoretical and practice-informed strategies, we developed a user-friendly sexuality education tool kit in five phases: (1) building relationships with faith leaders; (2) piloting educational sessions within churches; (3) gaining insight from participating faith leaders; …

Sexual Health Education For Behavior Change: How Much Is Enough?, Ross Shegog, Elizabeth Baumler, Robert C. Addy, Melissa Peskin, Melanie Ann Thiel, Susan R. Tortolero, Christine Markham

Journal of Applied Research on Children: Informing Policy for Children at Risk

Purpose: Successful implementation of sexual health curricula in school settings is often compromised by competing academic priorities. This study explores the association between exposure to sexual health lessons (time-on-task in hours and lesson content topics) and delayed sexual initiation of middle school students at long term follow-up.

Methods: Post hoc data analysis was conducted from a RCT (n=15 middle schools) in the south-central U.S. in which grade 7 students demonstrated delayed sexual initiation (adjusted odds ratio [AOR]: 1.54, 95% CI: 1.20 to 1.99) by grade 9 follow-up after using It’s Your Game (IYG), a 24 lesson sexual health curriculum. Logistic …

Be Legendary – Using Intervention Mapping And Participatory Strategies To Develop A Multi-Component Teen Pregnancy Prevention Intervention For Older Teen Males Of Color, Kimberly Johnson, Christine Markham, Rianne Smith, Susan R. Tortolero

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background- Due to the lack of interventions on sexual and reproductive health for older teen males of color engagement with the target population is critical for intervention development. Be Legendary (BL) was developed using intervention mapping, design thinking strategies and participatory methods alongside African-American male high school students. BL is a culturally responsive, school-based teen pregnancy prevention intervention for older teen males that combines sex education with youth development to improve sexual and reproductive health outcomes and build socio-emotional and leadership skills areas. Methods -To develop BL, we engaged 13 male high school students ages 16-19 in weekly workshop …

Native Iyg: Improving Psychosocial Protective Factors For Hiv/Sti And Teen Pregnancy Prevention Among Youth In American Indian/Alaska Native Communities, Ross Shegog Phd., Stephanie Craig Rushing Phd, Mph, Cornelia Jessen Ma, Travis L. Lane Ba, Gwenda Gorman Bs, Amanda Gaston Mat, Taija Koogei Revels Bs, Jennifer Torres Mph, Jennifer Williamson, Elizabeth Baumler Phd., Robert C. Addy Phd., Melissa F. Peskin Phd., Susan R. Tortolero, Christine M. Markham Phd.

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: Few HIV/STI and pregnancy prevention programs for youth in American Indian and Alaska Native (AI/AN) communities have been rigorously evaluated despite sexual health disparities in this population. This study reports the evaluation of a culturally adapted Internet-based HIV/STI and pregnancy prevention program for AI/AN youth, Native It’s Your Game (Native IYG).

Methods: A randomized study was conducted with 523 youth (12 to 14 years old), recruited from 25 tribal sites in Alaska, Arizona, and the Pacific Northwest. Participants were surveyed at baseline and upon completion of treatment or comparison interventions. Multivariable linear regression models were used to assess impact …

Reducing Sexual Risk Among Racial/Ethnic-Minority Ninth Grade Students: Using Intervention Mapping To Modify An Evidenced-Based Curriculum, Christine M. Markham, Melissa Peskin, Ross Shegog, Paula Cuccaro, Efrat K. Gabay, Kimberly Johnson-Baker, Honora I. Swain-Ogbonna, Sharon Edwards, Susan R. Tortolero

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: Racial/ethnic-minority 9^th graders are at increased risk for teen pregnancy, HIV, and STIs compared to their White peers. Yet, few effective sexual health education programs exist for this population. Purpose: To apply IM Adapt—a systematic theory- and evidence-based approach to program adaptation—to modify an effective middle school sexual health education curriculum, It’s Your Game…Keep It Real! (IYG), for racial/ethnic-minority 9^th graders. Methods: Following the six steps of IM Adapt, we conducted a needs assessment to describe the health problems and risk behaviors of the new population; reviewed existing evidence-based programs; assessed the fit of …

Assessing The Need And Receptivity For An Integrated Healthy Sexual And Dating Relationships Intervention For Community College Students, Christine M. Markham, Melissa Peskin, Robert C. Addy, J. Michael Wilkerson, Kimberly Johnson Baker, Diane M. Santa Maria, Belinda Hernandez, Vanessa Schick, Ross Shegog, Susan R. Tortolero, Yok-Fong Paat, Jeff R. Temple

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: In emerging adulthood, youth often become involved in more serious romantic relationships. However, many lack the skills to avoid an unplanned pregnancy or sexually transmitted infection (STI), and to ensure a healthy dating relationship. Community college students serve nearly half of all undergraduate students in the United States; yet, community colleges typically lack resources for sexual health promotion. Purpose: To assess the need and receptivity for a web-based integrated healthy sexual and dating relationships intervention among community college students. Methods: In summer 2016, we partnered with three community colleges in South Central Texas to conduct an online survey of …

A License To Kill: Understanding Natural Killer Cell Licensing To Fight Cancer, Jolie Schafer

Dissertations and Theses (Open Access)

Natural killer (NK) cell education is an essential developmental process for NK cell effector function, that renders some NK cells “licensed” and others “unlicensed” (with heightened or lowered effector function potential, respectively) against tumor and targets lacking self-molecules. However, the underlying mechanisms responsible for the heightened effector responses of licensed cells remain unknown. Using NK cells derived from humans and expanded ex vivo we performed high-throughput protein expression analysis, and identified multiple proteins that are differentially regulated in licensed and unlicensed human NK cells before and after inhibition by killer-cell immunoglobulin-like receptors (KIRs) and activation by the NKp46 natural cytotoxicity …

Integrative Cancer Immunogenomic Analysis Of Serial Melanoma Biopsies Reveals Correlates Of Response And Resistance To Sequential Ctla-4 And Pd-1 Blockade Treatment, Whijae Roh

Dissertations and Theses (Open Access)

Melanoma is the most malignant form of skin cancer. The five-year survival rate for metastatic melanoma is 19.9%. Although targeted therapy of BRAF and MEK inhibitors were developed for melanoma, resistance to therapy is inevitable. Immune checkpoint blockade, which reverses the suppression of the immune system, on the other hand, has shown a durable response in 20-30% of patients with metastatic melanoma. However, more predictive and robust biomarkers of response to this therapy are still needed, and resistance mechanisms remain incompletely understood. To address this, we examined a cohort of metastatic melanoma patients treated with sequential checkpoint blockade against cytotoxic …

Memory Potential, Molecular Characterization, And Translational Applications Of The Novel Theo/Tceo T Cell Phenotype, Todd Bartkowiak, Todd Bartkowiak

Dissertations and Theses (Open Access)

T cells comprise a substantial arm of the immune system and are exquisitely adapted to combat pathogens and tumors. The inflammatory environment largely dictates the nature of T cell response. A hallmark of T cell-mediated immunity is formation of immunological memory; the ability to respond more potently to re-encounter with pathogens. The immune system is also capable of recognizing tumors as foreign, much like viral or bacterial pathogens. Tumors have evolved, though, to generate an immunosuppressive environment to avoid destruction. The field of immunotherapy seeks to overcome immune suppression, in part by targeting T cell co-receptors on the cell surface …

Impact Of Kras/Nras Mutational Heterogeneity On Clinical Outcomes In Colorectal Cancer, Jonathan M. Loree

Dissertations and Theses (Open Access)

Introduction: Mutations in KRAS/NRAS (RAS) predict a lack of benefit from anti-EGFR agents in metastatic colorectal cancer (mCRC). As next generation sequencing (NGS) has advanced, we are discovering atypical and low allele frequency mutations. We aimed to evaluate how NGS can optimally define RAS mutant CRC and the role of relative mutant allele frequency (rMAF) as a biomarker.

Methods: Using institutional and public cohorts of mCRC patients with NGS results, we described the prevalence and clinical impact of atypical (not in current guidelines) and low rMAF RAS mutations (RAS MAF by the MAF of the mutated gene with …

Quality Of Life: Socio-Demographic And Genetic Determinants As Well As Links With Cancer Outcomes, Jeanne Pierzynski

Dissertations and Theses (Open Access)

Quality of life (QOL) is an independent prognostic factor for cancer. Lung cancer is the leading cause of cancer death. Breast cancer is the most diagnosed. Bladder cancer is the most expensive cancer to treat because of its high recurrence rate. We set to perform comprehensive analyses of predictors of QOL in these cancer sites with the future goal of improving QOL and outcomes.

In 6,456 newly diagnosed lung cancer patients, we investigated the relationship between baseline patient characteristics and QOL to identify determinants of QOL. A QOL questionnaire (SF-12v1) measured patients’ physical component summary (PCS) and mental component summary …

Modeling Post Stroke Respiratory Dysfunction, Apneas And Cognitive Decline, Anthony Patrizz

Dissertations and Theses (Open Access)

Modeling Post Stroke Respiratory Dysfunction,

Apneas and Cognitive Decline

Anthony Patrizz, B.A.

Advisory Professor: Louise McCullough M.D., Ph.D.

Stroke is a major cause of mortality and the leading cause of long-term disability in the US. More than 60% of individuals suffering a first time stroke develop respiratory dysfunction, prolonging recovery and increasing mortality. Post-stroke cognitive decline is a major contributor to disability and nursing home placement, therefore the cognitive consequences of Stroke Induced Respiratory Dysfunction (SIRD) need to be explored if we hope to enhance functional recovery. The first step towards treatment of the negative consequences of SIRD is the …

Insights Into The Therapeutic Potential Of Salt Inducible Kinase 1: A Novel Mechanism Of Metabolic Control, Randi Fitzgibbon

Dissertations and Theses (Open Access)

Salt inducible kinase 1 (SIK1) has been considered a stress-inducible kinase since it was first cloned in 1999. Continued efforts since this time have been dedicated to characterizing the structure and function of SIK1. Such research has laid the ground work for our understanding of SIK1 action and regulation in tissue and stimuli dependent manners. The fundamental findings of this dissertation continue in this tradition and include investigations of SIK1 regulatory mechanisms in skeletal muscle cells, the cellular and physiological effects of SIK1 loss of function in vitro and in vivo, and intracellular metabolic and mitochondrial regulation by this …

Endocytic Trafficking Of The Amyloid Precursor Protein In Rat Cortical Neurons, Sahily Reyes

Dissertations and Theses (Open Access)

Amyloid-beta (Aβ) aggregation and deposition into extracellular plaques is a hallmark of the most common forms of dementia, including Alzheimer’s disease. The Aβ-containing plaques result from pathogenic cleavage of amyloid precursor protein (APP) by secretases resulting in intracellular production of Aβ peptides that are secreted and accumulate extracellularly. Despite considerable progress towards understanding APP processing and Aβ aggregation, the mechanisms underlying endosomal production of Aβ peptides and their secretion remain unclear. Using endosomes isolated from cultured primary neurons, we determined that the trafficking of APP from the endosomal membrane into internal vesicles of late endosome/multivesicular bodies (MVB) is dependent on …

Impact Of Terminology Mapping On Population Health Cohorts Impact, Barbara A. Berkovich

Dissertations and Theses (Open Access)

Background and Objectives: The population health care delivery model uses phenotype algorithms in the electronic health record (EHR) system to identify patient cohorts targeted for clinical interventions such as laboratory tests, and procedures. The standard terminology used to identify disease cohorts may contribute to significant variation in error rates for patient inclusion or exclusion. The United States requires EHR systems to support two diagnosis terminologies, the International Classification of Disease (ICD) and the Systematized Nomenclature of Medicine (SNOMED). Terminology mapping enables the retrieval of diagnosis data using either terminology. There are no standards of practice by which to evaluate and …

A Blueprint For Life And Love, Marilyn Todd

The Texas Heart Institute Journal

No abstract provided.

The Need For Culturally-Based Palliative Care Programs For African American Patients At End-Of-Life, Ronit Elk

Journal of Family Strengths

Patients facing life-threatening illness often experience unnecessary and preventable suffering including extreme and prolonged pain, psychological distress, as well as unsatisfactory communication with doctors, all of which result in enormous strain on patients and caregivers (Chochinov et al., 2009; Kamal et al., 2011; Morrison & Meier, 2011). It is common for needs in the physical, psychosocial and spiritual domains to be unmet (Zhukovsky, 2000). As a result, the last few weeks and months of life, and that of their loved ones, may be additionally burdened with physical, emotional and spiritual suffering. Palliative care programs, interdisciplinary care focused on relief of …

Col4a2 Is Associated With Lacunar Ischemic Stroke And Deep Ich: Meta-Analyses Among 21,500 Cases And 40,600 Controls, Kristiina Rannikmäe, Vhinoth Sivakumaran, Henry Millar, Rainer Malik, Christopher D Anderson, Mike Chong, Tushar Dave, Guido J Falcone, Israel Fernandez-Cadenas, Jordi Jimenez-Conde, Arne Lindgren, Joan Montaner, Martin O'Donnell, Guillaume Paré, Farid Radmanesh, Natalia S Rost, Agnieszka Slowik, Martin Söderholm, Matthew Traylor, Sara L Pulit, Sudha Seshadri, Brad B Worrall, Daniel Woo, Hugh S Markus, Braxton D Mitchell, Martin Dichgans, Jonathan Rosand, Cathie L M Sudlow

Faculty, Staff and Student Publications

OBJECTIVE: To determine whether common variants in familial cerebral small vessel disease (SVD) genes confer risk of sporadic cerebral SVD.

METHODS: We meta-analyzed genotype data from individuals of European ancestry to determine associations of common single nucleotide polymorphisms (SNPs) in 6 familial cerebral SVD genes (

RESULTS: A locus in

CONCLUSIONS: These results provide evidence of shared genetic determinants and suggest common pathophysiologic mechanisms of distinct ischemic and hemorrhagic cerebral SVD stroke phenotypes, offering new insights into the causal mechanisms of cerebral SVD.

Recognizing, Treating, And Preventing Trauma In Lgbtq Youth, Megan Mooney

Journal of Family Strengths

Extensive research has demonstrated that lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are disproportionally affected by a variety of traumatic experiences including verbal, physical, and sexual abuse. This paper will review common traumatic experiences and their negative sequelae among LGBTQ youth including victimization directly related to youths’ gender identity and expression or sexual orientation. We will also discuss research regarding factors such as parental acceptance that may mitigate negative psychological impacts of this abuse. Guidelines for assessing and treating LGBTQ youth who have experienced trauma will be reviewed. A case example of a queer-identified youth with a history of …

Genetic Moderation Of Cocaine Subjective Effects By Variation In The Tph1, Tph2, And Slc6a4 Serotonin Genes, Michelle A Patriquin, Sara C Hamon, Mark J Harding, Ellen M Nielsen, Thomas F Newton, Richard De La Garza, David A Nielsen

Staff and Researcher Publications

Objective: This study investigated variants of tryptophan hydroxylase (TPH)1, TPH2, and SLC6A4 in the moderation of the subjective effects of cocaine.

Methods: Non-treatment-seeking cocaine-dependent individuals (N=66) were intravenously administered saline and cocaine (40 mg) in a randomized order. Participants self-reported subjective effects of cocaine using a visual analog scale starting before administration of saline or cocaine (-15 min) to up to 20 min after infusion. Self-report ratings on the visual analog scale ranged from 0 (no effect) to 100 (greatest effect). Participants were genotyped for the TPH1 rs1799913, TPH2 rs4290270, and SLC6A4 5-HTTLPR variants. Repeated-measures analysis of covariance was used …

Increased Habenular Connectivity In Opioid Users Is Associated With An Α5 Subunit Nicotinic Receptor Genetic Variant, Kaylah Curtis, Humsini Viswanath, Kenia M Velasquez, David L Molfese, Mark J Harding, Eduardo Aramayo, Philip R Baldwin, Elisa Ambrosi, Alok Madan, Michelle Patriquin, B Christopher Frueh, J Christopher Fowler, Thomas R Kosten, David A Nielsen, Ramiro Salas

Staff and Researcher Publications

Background and objectives: Opioid use disorder (OUD) is a chronic disorder with relapse based on both desire for reinforcement (craving) and avoidance of withdrawal. The aversive aspect of dependence and relapse has been associated with a small brain structure called the habenula, which expresses large numbers of both opioid and nicotinic receptors. Additionally, opioid withdrawal symptoms can be induced in opioid-treated rodents by blocking not only opioid, but also nicotinic receptors. This receptor co-localization and cross-induction of withdrawal therefore might lead to genetic variation in the nicotinic receptor influencing development of human opioid dependence through its impact on the aversive …