Family-based treatments for serious juvenile offenders : a multilevel meta-analysis

Dissertation supervisor: Charles M. Borduin.Includes vita.Violent criminal acts and other serious crimes committed by youths result in considerable emotional, physical, and economic effects on these youths, their families, crime victims, and the larger community. Researchers have identified several family-based treatments that hold considerable promise in reducing serious juvenile offending; however, these treatments remain underutilized by youth service systems. In the present study, I used multilevel meta-analysis to (a) characterize the nature and quality of research on family-based treatments for serious juvenile offenders, (b) summarize the findings of this research by estimating an average effect size, and (c) examine the influence of moderators (e.g., characteristics of participants, treatments, and methods) on treatment outcomes. Results from 31 studies revealed a number of methodological strengths including frequent use of random assignment and comparison to usual treatment conditions. In addition, the meta-analysis synthesized 325 effect sizes from 29 of these studies and revealed that family-based treatments produced small but meaningful treatment effects (mean d = 0.26) relative to comparison conditions. Furthermore, moderator analyses revealed that certain characteristics of participants, study methods, and measures influenced the size of treatment effects; for example, effect sizes varied by domain of outcome measure such that measures of substance use showed the largest treatment effects and measures of peer relationships showed the smallest. Overall, the results of the present study have implications for policymakers, administrators, and treatment providers who make decisions about the dissemination and implementation of family-based treatments for serious juvenile offenders. In addition, researchers who seek to develop and study these treatments may wish to consider the current findings.Includes bibliographical references (pages 76-100)

Cost-benefit analysis of multisystemic therapy for serious and violent juvenile offenders and their siblings

Title from PDF of title page (University of Missouri--Columbia, viewed on November 2, 2012).The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract, appears in the public.pdf file.Thesis advisor: Dr. Charles BorduinIncludes bibliographical references.M. A. University of Missouri--Columbia 2012."July 2012"This study investigated the economic benefits of an intensive family-based treatment (multisystemic therapy, MST) versus individual therapy (IT) using arrest data from 25-year follow-ups of referred serious and violent juvenile offenders (n = 176) and their closest-in-age siblings (n = 110). Three categories of benefits were evaluated: (1) taxpayer benefits (i.e., avoided criminal justice system costs), (2) tangible benefits to crime victims (i.e., avoided tangible losses), and (3) intangible benefits to crime victims (i.e., avoided pain and suffering). Results indicated that reductions in criminality for juvenile offenders and siblings in the MST versus IT conditions were associated with substantial benefits to both taxpayers and crime victims. Cumulative benefits of MST over IT ranged up to $34,955 per referred youth and up to$37,433 per family (i.e., when siblings were included). Overall, it was estimated that every dollar spent on MST recovered up to $4.98 in the years ahead by preventing future crimes. Sensitivity analyses also indicated that estimates of savings were robust to variations in crime victim intangible benefits, sibling juvenile arrest rates, and discount rates. The economic benefits of MST are important for administrators and policymakers to consider when allocating scarce financial resources to interventions for serious juvenile offenders

Mixed-method approaches to strengthen economic evaluations in implementation research

Abstract Background Guidance from economic evaluations on which implementation strategies represent the best return on investment will be critical to advancing the Triple Aim of health care: improving patient care and population health while minimizing per-capita cost. The results of traditional (quantitative) economic evaluations are limited by a remaining “qualitative residual” of contextual information and stakeholders perspectives, which cannot be captured by monetary values alone and is particularly prevalent in implementation science research. The emergence of qualitative methods for economic evaluation offers a promising solution. Main body To maximize the contributions of economic evaluations to implementation science, we recommend that researchers embrace a mixed-methods research agenda that merges traditional quantitative approaches with innovative, contextually grounded qualitative methods. Such studies are exceedingly rare at present. To assist implementation scientists in making use of mixed methods in this research context, we present an adapted taxonomy of mixed-method studies relevant to economic evaluation. We then illustrate the application of mixed methods in a recently completed cost-effectiveness evaluation, making use of an adapted version of reporting standards for economic evaluations. Conclusions By incorporating qualitative methods, implementation researchers can enrich their economic evaluations with detailed, context-specific information that tells the full story of the costs and impacts of implementation. We end by providing suggestions for building a research agenda in mixed-method economic evaluation, along with more resources and training to support investigators who wish to answer our call to action.https://deepblue.lib.umich.edu/bitstream/2027.42/146781/1/13012_2018_Article_850.pd

Toxicity of Volatile Methylated Species of Bismuth, Arsenic, Tin, and Mercury in Mammalian Cells In Vitro

The biochemical transformation of mercury, tin, arsenic and bismuth through formation of volatile alkylated species performs a fundamental role in determining the environmental processing of these elements. While the toxicity of inorganic forms of most of these compounds are well documented (e.g., arsenic, mercury) and some of them are of relatively low toxicity (e.g., tin, bismuth), the more lipid-soluble organometals can be highly toxic. In the present study we investigated the cyto- and genotoxicity of five volatile metal(loid) compounds: trimethylbismuth, dimethylarsenic iodide, trimethylarsine, tetramethyltin, and dimethylmercury. As far as we know, this is the first study investigating the toxicity of volatile metal(loid) compounds in vitro. Our results showed that dimethylmercury was most toxic to all three used cell lines (CHO-9 cells, CaCo, Hep-G2) followed by dimethylarsenic iodide. Tetramethyltin was the least toxic compound; however, the toxicity was also dependend upon the cell type. Human colon cells (CaCo) were most susceptible to the toxicity of the volatile compounds compared to the other cell lines. We conclude from our study that volatile metal(loid) compounds can be toxic to mammalian cells already at very low concentrations but the toxicity depends upon the metal(loid) species and the exposed cell type

Family-based treatments for serious juvenile offenders: A multilevel meta-analysis

__Objective:__ Researchers have identified several family-based treatments that hold considerable promise in reducing serious juvenile offending; however, these treatments remain underutilized by youth service systems. In the present study, we used meta-analysis to summarize the findings of research on family-based treatments for serious juvenile offenders. __Method:__ We conducted a multilevel meta-analysis that modeled dependencies between multiple effect sizes from the same study. The meta-analysis synthesized 324 effect sizes from 28 studies that met inclusion criteria. Potential moderators (e.g., characteristics of samples, treatments, methods, and measures) were entered as fixed effects in the meta-analytic model. __Results:__ Across studies, family-based treatments produced modest, yet long-lasting, treatment effects (mean d = 0.25 for antisocial behavior, 0.24 overall) relative to comparison conditions. Furthermore, certain characteristics moderated the magnitude of treatment effects; for example, measures of substance use showed the largest effects and measures of peer relationships showed the smallest effects. __Conclusions:__ Policymakers, administrators, and treatment providers may find it useful to consider the effects of family-based treatments for serious juvenile offenders in their selection of treatments for this population. In addition, investigators who seek to develop and study such treatments may wish to consider the current findings in their future research efforts

Intracellular Calcium Disturbances Induced by Arsenic and Its Methylated Derivatives in Relation to Genomic Damage and Apoptosis Induction

Arsenic and its methylated derivatives are contaminants of air, water, and food and are known as toxicants and carcinogens. Arsenic compounds are also being used as cancer chemotherapeutic agents. In humans, inorganic arsenic is metabolically methylated to mono-, di-, and trimethylated forms. Recent findings suggest that the methylation reactions represent a toxification rather than a detoxification pathway. In recent years, the correlation between arsenic exposure, cytotoxicity and genotoxicity, mutagenicity, and tumor promotion has been established, as well as the association of arsenic exposure with perturbation of physiologic processes, generation of reactive oxygen species, DNA damage, and apoptosis induction. Trivalent forms of arsenic have been found to induce apoptosis in several cellular systems with involvement of membrane-bound cell death receptors, activation of caspases, release of calcium stores, and changes of the intracellular glutathione level. It is well known that calcium ion deregulation plays a critical role in apoptotic cell death. A calcium increase in the nuclei might lead to toxic effects in the cell. In this review, we highlight the relationship between induced disturbances of calcium homeostasis, genomic damage, and apoptotic cell death caused by arsenic and its organic derivatives

Coordination of sustainable financing for evidence-based youth mental health treatments: Protocol for development and evaluation of the fiscal mapping process

BACKGROUND: Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health and economic impacts of youth mental health problems, but is complicated by the limited and fragmented funding available to youth mental health service agencies (hereafter, service agencies ). Strategic planning tools are needed that can guide these service agencies in their coordination of sustainable funding for EBTs. This protocol describes a mixed-methods research project designed to (1) develop and (2) evaluate our novel fiscal mapping process that guides strategic planning efforts to finance the sustainment of EBTs in youth mental health services. METHOD: Participants will be 48 expert stakeholder participants, including representatives from ten service agencies and their partners from funding agencies (various public and private sources) and intermediary organizations (which provide guidance and support on the delivery of specific EBTs). Aim 1 is to develop the fiscal mapping process: a multi-step, structured tool that guides service agencies in selecting the optimal combination of strategies for financing their EBT sustainment efforts. We will adapt the fiscal mapping process from an established intervention mapping process and will incorporate an existing compilation of 23 financing strategies. We will then engage participants in a modified Delphi exercise to achieve consensus on the fiscal mapping process steps and gather information that can inform the selection of strategies. Aim 2 is to evaluate preliminary impacts of the fiscal mapping process on service agencies\u27 EBT sustainment capacities (i.e., structures and processes that support sustainment) and outcomes (e.g., intentions to sustain). The ten agencies will pilot test the fiscal mapping process. We will evaluate how the fiscal mapping process impacts EBT sustainment capacities and outcomes using a comparative case study approach, incorporating data from focus groups and document review. After pilot testing, the stakeholder participants will conceptualize the process and outcomes of fiscal mapping in a participatory modeling exercise to help inform future use and evaluation of the tool. DISCUSSION: This project will generate the fiscal mapping process, which will facilitate the coordination of an array of financing strategies to sustain EBTs in community youth mental health services. This tool will promote the sustainment of youth-focused EBTs

The Fate of Chrysotile-Induced Multipolar Mitosis and Aneuploid Population in Cultured Lung Cancer Cells

Chrysotile is one of the six types of asbestos, and it is the only one that can still be commercialized in many countries. Exposure to other types of asbestos has been associated with serious diseases, such as lung carcinomas and pleural mesotheliomas. The association of chrysotile exposure with disease is controversial. However, in vitro studies show the mutagenic potential of chrysotile, which can induce DNA and cell damage. The present work aimed to analyze alterations in lung small cell carcinoma cultures after 48 h of chrysotile exposure, followed by 2, 4 and 8 days of recovery in fiber-free culture medium. Some alterations, such as aneuploid cell formation, increased number of cells in G2/M phase and cells in multipolar mitosis were observed even after 8 days of recovery. The presence of chrysotile fibers in the cell cultures was detected and cell morphology was observed by laser scanning confocal microscopy. After 4 and 8 days of recovery, only a few chrysotile fragments were present in some cells, and the cellular morphology was similar to that of control cells. Cells transfected with the GFP-tagged α-tubulin plasmid were treated with chrysotile for 24 or 48 h and cells in multipolar mitosis were observed by time-lapse microscopy. Fates of these cells were established: retention in metaphase, cell death, progression through M phase generating more than two daughter cells or cell fusion during telophase or cytokinesis. Some of them were related to the formation of aneuploid cells and cells with abnormal number of centrosomes

IgE Mediated Autoallergy against Thyroid Peroxidase – A Novel Pathomechanism of Chronic Spontaneous Urticaria?

Chronic spontaneous urticaria (csU), which is characterized by recurrent episodes of mast cell-driven wheal and flare-type skin reactions, is often associated with elevated total IgE levels and thyroid autoimmunity. We speculate that some csU patients express IgE autoantibodies against thyroid antigens such as thyroid peroxidase (TPO), which could bind to skin mast cells and induce their activation.We developed and used a site-directed human IgE capture ELISA to quantify IgE-anti-TPO. We used this assay and investigated csU patients (n = 478) and healthy control subjects (n = 127) for IgE-anti-TPO and then assessed IgE-anti-TPO-positive and -negative csU patients for clinical and serological differences. ( = 61%, IgE-anti-TPO: median 6.67, interquartile range 5.39–8.24). IgE-anti-TPO-positive and -negative csU patients had very similar distributions of age and gender as well as disease activity and duration. IgE-anti-TPO-positive csU patients exhibited significantly higher IgG-anti-TPO levels and lymphocyte counts as well as decreased C4 complement levels.Our findings show that a sizeable subgroup of csU patients expresses IgE antibodies against thyroid peroxidase. These autoantibodies could cause “autoallergic” mast cell activation, a novel pathomechanism of chronic spontaneous urticaria

Step-by-step design of proteins for small molecule interaction: a review on recent milestones

Protein design is the field of synthetic biology that aims at developing de-novo custom made proteins and peptides for specific applications. Despite exploring an ambitious goal, recent computational advances in both hardware and software technologies have paved the way to high-throughput screening and detailed design of novel folds and improved functionalities. Modern advances in the field of protein design for small molecule targeting are described in this review, organized in a step-by-step fashion: from the conception of a new or upgraded active binding site, to scaffold design, sequence optimization and experimental expression of the custom protein. In each step, contemporary examples are described, and state-of-the art software is briefly explored.publishe