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Item Adverse Childhood Experiences (ACEs) and Their Impact on Substance Misuse & Overall Health(The Center for Health Policy, 2018-03-01) Balio, Casey; Greene, Marion S.Adverse childhood experiences (ACEs) encompass a wide variety of distressing events, including emotional, physical, or sexual abuse; witnessing maternal domestic violence; or living with a household member who has a substance use disorder, is mentally ill or suicidal, or is currently or was ever incarcerated during the first 18 years of a child’s life. According to most recent estimates, nearly half of Indiana’s youth have experienced at least one ACE in their life. ACEs are linked to many risk behaviors, including substance use, which can adversely affect health outcomes.Item Adverse Childhood Experiences (ACEs) and their Impact on Substance Misuse & Overall Health(The Center for Health Policy, 2018-03-01) Balio, Casey; Greene, Marion S.Adverse childhood experiences (ACEs) encompass a wide variety of distressing events, including emotional, physical, or sexual abuse; witnessing maternal domestic violence; or living with a household member who has a substance use disorder, is mentally ill or suicidal, or is currently or was ever incarcerated during the first 18 years of a child’s life. According to most recent estimates, nearly half of Indiana’s youth have experienced at least one ACE in their life. ACEs are linked to many risk behaviors, including substance use, which can adversely affect health outcomes.Item Age-specific mortality rate ratios in adolescents and youth aged 10–24 years living with perinatally versus nonperinatally acquired HIV(Wolters Kluwer, 2021) Desmonde, Sophie; Ciaranello, Andrea L.; Malateste, Karen; Musick, Beverly; Patten, Gabriela; Thien Vu, An; Edmonds, Andrew; Neilan, Anne M.; Duda, Stephany N.; Wools-Kaloustian, Kara; Davies, Mary-Ann; Leroy, Valériane; Biostatistics and Health Data Science, School of MedicineObjective: To measure mortality incidence rates and incidence rate ratios (IRR) in adolescents and youth living with perinatally acquired HIV (YPHIV) compared with those living with nonperinatally acquired HIV (YNPHIV), by region, by sex, and during the ages of 10-14, 15-19, and 20-24 years in IeDEA. Design and methods: All those with a confirmed HIV diagnosis, antiretroviral therapy (ART)-naive at enrollment, and who have post-ART follow-up while aged 10-24 years between 2004 and 2016 were included. We estimated post-ART mortality incidence rates and 95% confidence intervals (95% CI) per 100 person-years for YPHIV (enrolled into care <10 years of age) and YNPHIV (enrolled ≥10 years and <25 years). We estimate mortality IRRs in a negative binomial regression model, adjusted for sex, region time-varying age, CD4+ cell count at ART initiation (<350 cells/μl, ≥350 cells/μl, unknown), and time on ART (<12 and ≥12 months). Results: Overall, 104 846 adolescents and youth were included: 21 340 (20%) YPHIV (50% women) and 83 506 YNPHIV (80% women). Overall mortality incidence ratios were higher among YNPHIV (incidence ratio: 2.3/100 person-years; 95% CI: 2.2-2.4) compared with YPHIV (incidence ratio: 0.7/100 person-years; 95% CI: 0.7-0.8). Among adolescents aged 10-19 years, mortality was lower among YPHIV compared with YNPHIV (all IRRs <1, ranging from 0.26, 95% CI: 0.13-0.49 in 10-14-year-old boys in the Asia-Pacific to 0.51, 95% CI: 0.30-0.87 in 15-19-year-old boys in West Africa). Conclusion: We report substantial amount of deaths occurring during adolescence. Mortality was significantly higher among YNPHIV compared to YPHIV. Specific interventions including HIV testing and early engagement in care are urgently needed to improve survival among YNPHIV.Item Association Between Proteomic Blood Biomarkers and DTI/NODDI Metrics in Adolescent Football Players: A Pilot Study(Frontiers Media, 2020-11-16) Kawata, Keisuke; Steinfeldt, Jesse A.; Huibregtse, Megan E.; Nowak, Madeleine K.; Macy, Jonathan T.; Kercher, Kyle; Rettke, Devin J.; Shin, Andrea; Chen, Zhongxue; Ejima, Keisuke; Newman, Sharlene D.; Cheng, Hu; Medicine, School of MedicineWhile neuroimaging and blood biomarker have been two of the most active areas of research in the neurotrauma community, these fields rarely intersect to delineate subconcussive brain injury. The aim of the study was to examine the association between diffusion MRI techniques [diffusion tensor imaging (DTI) and neurite orientation/dispersion density imaging (NODDI)] and brain-injury blood biomarker levels [tau, neurofilament-light (NfL), glial-fibrillary-acidic-protein (GFAP)] in high-school football players at their baseline, aiming to detect cumulative neuronal damage from prior seasons. Twenty-five football players were enrolled in the study. MRI measures and blood samples were obtained during preseason data collection. The whole-brain, tract-based spatial statistics was conducted for six diffusion metrics: fractional anisotropy (FA), mean diffusivity (MD), axial/radial diffusivity (AD, RD), neurite density index (NDI), and orientation dispersion index (ODI). Five players were ineligible for MRIs, and three serum samples were excluded due to hemolysis, resulting in 17 completed set of diffusion metrics and blood biomarker levels for association analysis. Our permutation-based regression model revealed that serum tau levels were significantly associated with MD and NDI in various axonal tracts; specifically, elevated serum tau levels correlated to elevated MD (p = 0.0044) and reduced NDI (p = 0.016) in the corpus callosum and surrounding white matter tracts (e.g., longitudinal fasciculus). Additionally, there was a negative association between NfL and ODI in the focal area of the longitudinal fasciculus. Our data suggest that high school football players may develop axonal microstructural abnormality in the corpus callosum and surrounding white matter tracts, such as longitudinal fasciculus. A future study is warranted to determine the longitudinal multimodal relationship in response to repetitive exposure to sports-related head impacts.Item Beyond Collective Supervision of Youth: Informal Social Control, Pro-social Investment and Delinquency in Urban Neighborhoods(Office of the Vice Chancellor for Research, 2011-04-08) Leech, Tamara G.J.The concentration of delinquency in certain neighborhoods represents a pervasive social inequality in the United States. Today, the distribution of urban delinquency is perhaps best described as “pockets of crime,” largely confined to urban blocks with unique characteristics (Jean 2007). An expansive amount of scholarship has addressed neighborhood responses to this persistent social issue, including collective neighborhood efforts to control rates of delinquency. It is generally accepted that to fully achieve social control of public space, neighborhoods must not only intervene in problem behavior, but must also socialize youth to avoid deviance (Bursick 1988). We currently have a strong body of research on neighborhood supervision and monitoring of delinquent behavior. Yet, we are left with a paucity of work on the association between delinquency rates and pro-social investment in youth at the neighborhood level. The purpose of this study is to begin to address these gaps in the literature by simultaneously investigating collective supervision of and pro-social investment in youth. The data for the analyses focus on one urban area in Indianapolis spanning 92 census block groups. The dataset combines census and county court data with 603 interviews of local residents. The results of the analysis indicate that the meaning of collective supervision and investment seems to be context - specific. Areas with high levels of supervision over youth have fewer incidents of relatively moderate forms of delinquency such as truancy, underage drinking, curfew violations, etc. However, this same connection between supervision and slightly more serious offenses (i.e. misdemeanors) is only evident in neighborhoods with strong collective pro-social investment in youth. Areas with high levels of this prosocial investment also experience fewer juvenile felony charges, but these same areas are weaker in the supervision of youth behavior. Overall, the analyses indicate that neighborhoods dealing with minor delinquency among youth may be able to deal with the problem by monitoring and intervening in adolescent behavior. However, investment in youth organizations, positive intergenerational relationships, and informal mentoring may be a more effective option for neighborhoods facing more serious forms of juvenile delinquency.Item Conduct disorder symptoms and illicit drug use in juvenile justice involved youth: The reciprocal relationship between positive illicit drug use attitudes and illicit drug use(Taylor & Francis, 2018-07-03) Kolp, Haley M.; Hershberger, Alexandra R.; Sanders, Jasmyn; Um, Miji; Aalsma, Matthew; Cyders, Melissa A.; Psychology, School of ScienceConduct disorder (CD) symptoms cooccur at high rates with illicit drug use in juvenile justice involved youth, which results in poorer outcomes; however, research has not identified where best to intervene in this relationship, limiting the identification of modifiable risk factors to reduce negative effects of CD symptoms. Two mediation models were examined to investigate the potential for CD symptoms to influence a reciprocal relationship between illicit drug use and positive drug attitudes, controlling for age, gender, and race. Data were examined for 245 juvenile justice involved youth (mean age = 15.46, SD = 1.30, range 12-18, 64.9% Black, 80.4% male) who completed court-ordered psychological assessments. Findings indicate: (1) Positive attitudes toward illicit drug use significantly mediated the relationship between CD symptoms and illicit drug use (β = 0.16, CI 0.09-0.27; test for indirect effect z = 4.17, p < .001) and (2) illicit drug use significantly mediated the relationship between CD symptoms and positive attitudes toward illicit drug use (β = 0.20, CI 0.12-0.32; test for indirect effect z = 4.87, p < .001). Overall, the present study suggests that CD symptoms impart risk for illicit drug use both indirectly, through more positive attitudes toward illicit drug use, and directly, which further strengthens positive attitudes toward illicit drug use.Item Differential loss of β-cell function in youth vs. adults following treatment withdrawal in the Restoring Insulin Secretion (RISE) study(Elsevier, 2021) Utzschneider, Kristina M.; Tripputi, Mark T.; Kozedub, Alexandra; Barengolts, Elena; Caprio, Sonia; Cree-Green, Melanie; Edelstein, Sharon L.; El Ghormli, Laure; Hannon, Tamara S.; Mather, Kieren J.; Palmer, Jerry; Nadeau, Kristen J.; RISE Consortium; Medicine, School of MedicineAims: To compare OGTT-derived estimates of β-cell function between youth and adults with impaired glucose tolerance (IGT) or recently diagnosed type 2 diabetes after treatment discontinuation in RISE. Methods: Youth (n = 89) and adults (n = 132) were randomized to 3 months glargine followed by 9 months metformin (G/M) or 12 months metformin (MET). Insulin sensitivity and β-cell responses were estimated from 3-hour OGTTs over 21 months. Linear mixed models tested for differences by time and age group within each treatment arm. Results: After treatment withdrawal, HbA1c increased in both youth and adults with a larger net increase in G/M youth vs. adults at 21 months. Among youth, β-cell function decreased starting at 12 months in G/M and 15 months in MET. Among adults, β-cell function remained relatively stable although insulin secretion rates decreased in G/M at 21 months. At 21 months vs. baseline β-cell function declined to a greater extent in youth vs. adults in both the G/M and MET treatment arms. Conclusions: After treatment withdrawal youth demonstrated progressive decline in β-cell function after stopping treatment with either G/M or MET. In contrast, β-cell function in adults remained stable despite an increase in HbA1c over time.Item Digital Media and Developing Brains: Concerns and Opportunities(Springer, 2024) Hutton, John S.; Piotrowski, Jessica Taylor; Bagot, Kara; Blumberg, Fran; Canli, Turhan; Chein, Jason; Christakis, Dimitri A.; Grafman, Jordan; Griffin, James A.; Hummer, Tom; Kuss, Daria J.; Lerner, Matthew; Marcovitch, Stuart; Paulus, Martin P.; Perlman, Greg; Romeo, Rachel; Thomason, Moriah E.; Turel, Ofir; Weinstein, Aviv; West, Gregory; Hurst‑Della Pietra, Pamela; Potenza, Marc N.; Psychiatry, School of MedicinePurpose of review: The incorporation of digital technologies and their use in youth's everyday lives has been increasing rapidly over the past several decades with possible impacts on youth development and mental health. This narrative review aimed to consider how the use of digital technologies may be influencing brain development underlying adaptive and maladaptive screen-related behaviors. Recent findings: To explore and provide direction for further scientific inquiry, an international group of experts considered what is known, important gaps in knowledge, and how a research agenda might be pursued regarding relationships between screen media activity and neurodevelopment from infancy through childhood and adolescence. While an understanding of brain-behavior relationships involving screen media activity has been emerging, significant gaps exist that have important implications for the health of developing youth. Summary: Specific considerations regarding brain-behavior relationships involving screen media activity exist for infancy, toddlerhood, and early childhood; middle childhood; and adolescence. Transdiagnostic frameworks may provide a foundation for guiding future research efforts. Translating knowledge gained into better interventions and policy to promote healthy development is important in a rapidly changing digital technology environment.Item Divergent Caregiver and Youth Perspectives Regarding Behavioral Health Needs and Psychosocial Functioning: An Exploratory Study(2019-11-05) Karikari, Isaac; Walton, Betty A.; Bishop, ChristineBackground. To promote effectiveness in behavioral health treatment, the system of care framework and wraparound model accentuate inclusion of family and youth as important stakeholders, not just as consumers. This has challenged conventional practices; and youth and caregivers' perspectives have become integral to treatment planning and service delivery. This study explored caregivers and youth's perspectives of behavioral health needs and psychosocial functioning. Methods. This exploratory study utilized data collected in a Midwestern, suburban county as part of the national Child and Family Study of youth with complex behavioral health needs enrolled in the Child Mental Health Wraparound initiative. The sample consisted of 25 caregiver-youth pairs. Assessment measures included the Pediatric Symptom Checklist (PSC) and the Columbia Impairment Scale (CIS). Independent t-tests were used to examine differences in caregiver and youth perspectives. Results. Significant differences were identified in caregivers and youth's perspectives of youth's behavioral health on the PSC, but no significant differences between caregivers and youth on the CIS measure. Responses showed that compared to youth, caregivers perceived a higher level of functional impairment in interpersonal relationships, academic, and community functioning. Further, caregivers' views of severity of functional impairment varied based on the caregiver type. Conclusion. Divergent perspectives regarding youth's behavioral health needs and functioning between caregivers and youth have implications for behavioral health treatment planning and service delivery. Additional research is needed on collaborative assessments and implications of different views for practice and outcomes.Item Doctoral Capstone Experiential at Camp Mariposa: Aaron’s Place(2021-04) Huber, Megan H.; Wilburn, Victoria G.; Department of Occupational Therapy, School of Health and Human Sciences; Wilburn, Victoria G.Dependence on alcohol, illicit substances, and opioids impact the parent-child relationship, childhood development, and child behaviors (Romanowicz et al., 2019). There is a strong association between parental substance abuse and subsequent child maltreatment (Opioids and Youth, 2018). Substance use disorder (SUD) can lead to family trauma and significantly impact the child’s life trajectory. However, given the support, knowledge, and tools necessary to intervene, it is possible to mitigate the negative effects of SUD and trauma. Camp Mariposa: Aaron’s Place is a camp for youth ages 9-12 who have been impacted by a family member’s SUD. By applying underutilized approaches to family and group therapy, such as yoga, theatre, and nature-based crafts, this camp promotes resiliency, protective factors, and post-traumatic growth.
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