Browsing by Subject "Family"
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Item "Churches in the Vanguard:" Margaret Sanger and the Morality of Birth Control in the 1920s(2015-03-30) Maurer, Anna C.; Robertson, Nancy Marie; Cramer, Kevin; Lantzer, Jason S.Many religious leaders in the early 1900s were afraid of the immoral associations and repercussions of birth control. The Catholic Church and some Protestants never accepted contraception, or accepted it much later, but many mainline Protestants leaders did change their tune dramatically between the years of 1920 and 1931. This investigation seeks to understand how Margaret Sanger was able to use her rhetoric to move her reform from the leftist outskirts and decadent, sexual connotations into the mainstream of family-friendly, morally virtuous, and even conservative religious approval. Securing the approval of religious leaders subsequently provided the impetus for legal and medical acceptance by the late-1930s. Margaret Sanger used conferences, speeches, articles, her magazine (Birth Control Review), and several books to reinforce her message as she pragmatically shifted from the radical left closer to the center and conservatives. She knew the power of the churches to influence their members, and since the United States population had undeniably a Judeo-Christian base, this power could be harnessed in order to achieve success for the birth control movement, among the conservative medical and political communities and the public at large. Despite the clear consensus against birth control by all mainline Christian churches in 1920, including Roman Catholics and Protestants alike, the decade that followed would bring about a great divide that would continue to widen in successive decades. Sanger put forward many arguments in her works, but the ones which ultimately brought along the relatively conservative religious leaders were those that presented birth control not as a gender equity issue, but rather as a morally constructive reform that had the power to save and strengthen marriages; lessen prostitution and promiscuity; protect the health of women; reduce abortions, infanticide, and infant mortality; and improve the quality of life for children and families. Initially, many conservatives and religious leaders associated the birth control movement with radicals, feminists, prostitutes, and promiscuous youth, and feared contraception would lead to immorality and the deterioration of the family. Without the threat of pregnancy, conservatives feared that youth and even married adults would seize the opportunity to have sex outside of marriage. Others worried the decreasing size of families was a sign of growing selfishness and materialism. In response, Sanger promoted the movement as a way for conservatives to stop the rising divorce rates by strengthening and increasing marriages, and to improve the lives of families by humanely increasing the health and standard of living, for women and children especially. In short, she argued that birth control would not lead to deleterious consequences, but would actually improve family moral values and become an effective humanitarian reform. She recognized that both liberals and conservatives were united in hoping to strengthen the family, and so she emphasized those virtues and actively courted those same conservative religious leaders that had previously shunned birth control and the movement. Throughout the 1920s, she emphasized the ways in which birth control could strengthen marriages and improve the quality of life of women and children, and she effectively won over the relatively conservative religious leaders that she needed to bring about the movement’s public, medical, and political progress.Item Current State of Pediatric Reference Intervals and the Importance of Correctly Describing the Biochemistry of Child Development: A Review(American Medical Association, 2022) Lyle, Alicia N.; Pokuah, Fidelia; Dietzen, Dennis J.; Wong, Edward C. C.; Pyle-Eilola, Amy L.; Fuqua, John S.; Woodworth, Alison; Jones, Patricia M.; Akinbami, Lara J.; Garibaldi, Luigi R.; Vesper, Hubert W.; Pediatrics, School of MedicineImportance: Appropriately established pediatric reference intervals are critical to the clinical decision-making process and should reflect the physiologic changes that occur during healthy child development. Reference intervals used in pediatric care today remain highly inconsistent across a broad range of common clinical biomarkers. Observations: This narrative review assesses biomarker-specific pediatric reference intervals and their clinical utility with respect to the underlying biological changes occurring during development. Pediatric reference intervals from PubMed-indexed articles published from January 2015 to April 2021, commercial laboratory websites, study cohorts, and pediatric reference interval books were all examined. Although large numbers of pediatric reference intervals are published for some biomarkers, very few are used by clinical and commercial laboratories. The patterns, extent, and timing of biomarker changes are highly variable, particularly during developmental stages with rapid physiologic changes. However, many pediatric reference intervals do not capture these changes and thus do not accurately reflect the underlying biochemistry of development, resulting in significant inconsistencies between reference intervals. Conclusions and relevance: There is a need to correctly describe the biochemistry of child development as well as to identify strategies to develop accurate and consistent pediatric reference intervals for improved pediatric care.Item Development of Written Materials for Participants in an Alzheimer's Disease and Related Dementias Screening Trial(Sage, 2022-04-12) Head, Katharine J.; Hartsock, Jane A.; Bakas, Tamilyn; Boustani, Malaz A.; Schroeder, Matthew; Fowler, Nicole R.; Communication Studies, School of Liberal ArtsGiven that participants' experiences in clinical trials include a variety of communication touchpoints with clinical trial staff, these communications should be designed in a way that enhances the participant experience by paying attention to the self-determination theoretical concepts of competence, autonomy, and relatedness. In this feature, we argue that clinical trial teams need to consider the importance of how they design their written participant communication materials, and we explain in detail the process our multidisciplinary team took to design written materials for the patient and family caregiver participants in our Alzheimer's disease and related dementias (ADRD) screening trial. This article concludes with suggested guidance and steps for other clinical trial teams.Item The Effect of Physician Endorsement on Patients’ Perceived Importance and Necessity in Disclosing Genetic Disease to Family(Office of the Vice Chancellor for Research, 2016-04-08) Harsin, Amanda; Head, KatyWhen a physician diagnoses a patient with a genetic disease, disclosure to family is an important communication action for both the patient and family. Timely disclosure by the patient to family may help to “activate” [1] family into providing needed support to the patient [2,3], as well as activate individuals in that family to be tested for the disease [4,5,6]. This study examines whether physician endorsement of disclosing a genetic disease diagnosis to family influences patients’ perceptions of importance and necessity to disclose to family their diagnosis. We conducted online surveys with patients (N = 237, Mean age: 54 years; 85.0% Caucasian) diagnosed with a genetic disease called polycystic kidney disease (PKD). The patients in this study are the first person in their family diagnosed with PKD, called the proband. Four variables were examined in this study. IVs included participant recall of physician explaining family members’ risk for the disease and recall of whether the physician suggested sharing the diagnosis with family. DVs were participant’s perceived importance and perceived necessity to disclose diagnosis to family, with each measured on a three-point scale. Analyses revealed that participants were significantly more likely to think it was important to disclose when the physician explained that family members were at risk and to think it was important to disclose when the physician recommended disclosing the diagnosis to family. Based on these results, physicians should be made aware their endorsement of disclosing to family can significantly increase probands’ perceived importance and necessity of talking to their family and that emphasizing the genetic risk for family can increase a patient’s perception that it is important and necessary to tell their family.Item An emerging field of research: challenges in pediatric decision making(SAGE Publications, 2015-04) Lipstein, Ellen A.; Brinkman, William B.; Fiks, Alexander G.; Hendrix, Kristin S.; Kryworuchko, Jennifer; Miller, Victoria A.; Prosser, Lisa A.; Ungar, Wendy J.; Fox, David; Department of Pediatrics, IU School of MedicineThere is growing interest in pediatric decision science, spurred by policies advocating for children's involvement in medical decision making. Challenges specific to pediatric decision research include the dynamic nature of child participation in decisions due to the growth and development of children, the family context of all pediatric decisions, and the measurement of preferences and outcomes that may inform decision making in the pediatric setting. The objectives of this article are to describe each of these challenges, to provide decision researchers with insight into pediatric decision making, and to establish a blueprint for future research that will contribute to high-quality pediatric medical decision making. Much work has been done to address gaps in pediatric decision science, but substantial work remains. Understanding and addressing the challenges that exist in pediatric decision making may foster medical decision-making science across the age spectrum.Item Examining the benefits and harms of Alzheimer's disease screening for family members of older adults: study protocol for a randomized controlled trial(BMC, 2020-02-19) Fowler, Nicole R.; Head, Katharine J.; Perkins, Anthony J.; Gao, Sujuan; Callahan, Christopher M.; Bakas, Tamilyn; Suarez, Shelley D.; Boustani, Malaz A.; Medicine, School of MedicineBACKGROUND: Multiple national expert panels have identified early detection of Alzheimer's disease and related dementias (ADRD) as a national priority. However, the United States Preventive Services Task Force (USPSTF) does not currently support screening for ADRD in primary care given that the risks and benefits are unknown. The USPSTF stresses the need for research examining the impact of ADRD screening on family caregiver outcomes. METHODS: The Caregiver Outcomes of Alzheimer's Disease Screening (COADS) is a randomized controlled trial that will examine the potential benefits or harms of ADRD screening on family caregivers. It will also compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening. COADS will enroll 1800 dyads who will be randomized into three groups (n = 600/group): the 'Screening Only' group will receive ADRD screening at baseline and disclosure of the screening results, with positive-screen participants receiving a list of local resources for diagnostic follow-up; the 'Screening Plus' group will receive ADRD screening at baseline coupled with disclosure of the screening results, with positive-screen participants referred to a dementia collaborative care program for diagnostic evaluation and potential care; and the control group will receive no screening. The COADS trial will measure the quality of life of the family member (the primary outcome) and family member mood, anxiety, preparedness and self-efficacy (the secondary outcomes) at baseline and at 6, 12, 18 and 24 months. Additionally, the trial will examine the congruence of depressive and anxiety symptoms between older adults and family members at 6, 12, 18 and 24 months and compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening between the two groups randomized to screening (Screening Only versus Screening Plus). DISCUSSION: We hypothesize that caregivers in the screening arms will express higher levels of health-related quality of life, lower depressive and anxiety symptoms, and better preparation for caregiving with higher self-efficacy at 24 months. Results from this study will directly inform the National Plan to Address Alzheimer's Disease, the USPSTF and other organizations regarding ADRD screening and early detection policies.Item The experiences of family members in the nursing home to hospital transfer decision(Springer (Biomed Central Ltd.), 2016-11-15) Abrahamson, Kathleen; Bernard, Brittany; Magnabosco, Lara; Nazir, Arif; Unroe, Kathleen T.; Department of Medicine, School of MedicineBACKGROUND: The objective of this study was to better understand the experiences of family members in the nursing home to hospital transfer decision making process. Semi-structured interviews were conducted with 20 family members who had recently been involved in a nursing home to hospital transfer decision. RESULTS: Family members perceived themselves to play an advocacy role in their resident's care and interview themes clustered within three over-arching categories: Family perception of the nursing home's capacity to provide medical care: Resident and family choices; and issues at 'hand-off' and the hospital. Multiple sub-themes were also identified. CONCLUSIONS: Findings from this study contribute to knowledge surrounding the nursing home transfer decision by illuminating the experiences of family members in the transfer decision process.Item Family and Peer Influences on Substance Attitudes and Use among Juvenile Justice-Involved Youth(Springer, 2019-02) Zapolski, Tamika C. B.; Clifton, Richelle L.; Banks, Devin E.; Hershberger, Alexandra; Aalsma, Matthew; Psychology, School of ScienceJuvenile justice-involved youth experience high rates of substance use, which is concerning given associated negative consequences, including health and functional deficits. Family and peer factors are associated with a high risk of substance use among justice-involved youth. It is hypothesized that this risk process operates through pro-drug attitudes. However, limited research has been conducted on the mechanisms through which family and peer factors increase risk for substance use among juvenile justice involved youth. The current study examined both the direct and indirect effects of family and peer substance use on youth's substance use (alcohol and illicit drug use). We also examined whether this relationship differs by race. 226 detained youth (81.9% male; 74.3% Black) were recruited from an urban county in the Midwest and completed a clinical interview and substance use assessment battery. A direct effect of family/peer risk on illicit drug use was found for all youth, though the effect was stronger among White youth. Results also supported the indirect effect pathway from family/peer risk to both illicit drug use and alcohol use through pro-drug attitudes. This pathway did not vary by race. These findings suggest that interventions should focus on targeting both family/peer risk and pro-drug attitudes to reduce substance use. Given the racial difference in the direct effect of family/peer risk on illicit drug use, there may be other factors that influence risk more strongly for White youth, which warrants further investigation.Item Family Art Therapy with Adolescents who Present Self-Harming Behavior(2014-05-30) Timmerman, Hillary; King, JulietSelf-harming among adolescents is a rapidly growing clinical issue. The behavior is also one of the most difficult clinical issues for many professionals (Brown and Kimball, 2013; Favazza, 1998; Muehlenkamp & Gutierrez, 2004; Selekman and King, 2001). Therefore, it is essential to integrate and evaluate past treatment approaches and underlying theories to determine goals that address all aspects of self-harming behavior among adolescents. An array of literature exists relating the inability to regulate emotions in a healthy manner with adolescents who present self-harming behavior. This thesis addresses a psychodynamic framework that identifies the importance of early parent-child relationships. Although past literature addressing effective treatment for self-harming individuals is limited, it was found that adolescents tend to respond effectively to creativity and art-making when used as tools to regulate emotions (Huss et al., 2010; Malchiodi; 2003; Riley, 1999). This thesis provides a review of literature that discusses the phenomenon of self-harming behavior, past treatment suggestions, and theoretical information that supports family art therapy as an effective approach for most adolescents who self-harm for emotional regulation. The literature also provides information suggesting that the family may be counterproductive or even dangerous for an adolescent who self-harms. Therefore it has been concluded that one treatment plan cannot be generalizable to fit all families. However, some treatment goals were suggested that integrated psychodynamic theory, family art therapy, and self-harming behavior.Item Family-based association analysis of alcohol dependence criteria and severity(Wiley Blackwell (Blackwell Publishing), 2014-02) Wetherill, Leah; Kapoor, Manav; Agrawal, Arpana; Bucholz, Kathleen; Koller, Daniel; Bertelsen, Sarah E.; Le, Nhung; Wang, Jen-Chyong; Almasy, Laura; Hesselbrock, Victor; Kramer, John; Nurnberger, John I.; Schuckit, Marc; Tischfield, Jay A.; Xuei, Xiaoling; Porjesz, Bernice; Edenberg, Howard J.; Goate, Alison M.; Foroud, Tatiana; Department of Medical and Molecular Genetics, IU School of MedicineBackground Despite the high heritability of alcohol dependence (AD), the genes found to be associated with it account for only a small proportion of its total variability. The goal of this study was to identify and analyze phenotypes based on homogeneous classes of individuals to increase the power to detect genetic risk factors contributing to the risk of AD. Methods The 7 individual DSM-IV criteria for AD were analyzed using latent class analysis (LCA) to identify classes defined by the pattern of endorsement of the criteria. A genome-wide association study was performed in 118 extended European American families (n = 2,322 individuals) densely affected with AD to identify genes associated with AD, with each of the seven DSM-IV criteria, and with the probability of belonging to two of three latent classes. Results Heritability for DSM-IV AD was 61%, and ranged from 17-60% for the other phenotypes. A SNP in the olfactory receptor OR51L1 was significantly associated (7.3 × 10−8) with the DSM-IV criterion of persistent desire to, or inability to, cut down on drinking. LCA revealed a three-class model: the “low risk” class (50%) rarely endorsed any criteria, and none met criteria for AD; the “moderate risk” class (33) endorsed primarily 4 DSM-IV criteria, and 48% met criteria for AD; the “high risk” class (17%) manifested high endorsement probabilities for most criteria and nearly all (99%) met criteria for AD One single nucleotide polymorphism (SNP) in a sodium leak channel NALCN demonstrated genome-wide significance with the high risk class (p=4.1 × 10−8). Analyses in an independent sample did not replicate these associations. Conclusion We explored the genetic contribution to several phenotypes derived from the DSM-IV alcohol dependence criteria. The strongest evidence of association was with SNPs in NALCN and OR51L1.