Resilience is a phenomenon that refers to the ability to overcome risk factors that increase the likelihood of academic or social failure. Considerable research has been conducted to determine what may enhance or hinder the ability of individuals to overcome adversity. Unfortunately, much of the research has focused primarily on factors that place individuals at greater risk of failure. Today in the United States, a number of students experience academic failure due to multiple risk factors. However, the research is clear that there are individuals referred to as resilient who are able to achieve at high levels in spite of many of the same risk factors. This heuristic phenomenological study provides insight, based on interviews with high risk, African-American, young adults, into those factors that enabled them to exhibit behaviors consistent with resilience in spite of risk factors in the home, school or community. The study helps to illuminate their challenges and the reasons for their success. / Ed. D.

published_or_final_version / abstract / Social Work and Social Administration / Doctoral / Doctor of Philosophy

From this series of studies, we conclude that microalbuminuria may represent a novel risk factor in SLE, and lupus patients are more susceptible to endothelial dysfunction caused by hyperhomocysteinemia. The use of antimalarial agents is beneficial for lupus patients with active disease on corticosteroid, and antioxidant vitamins are useful in lowering the oxidative stress markers but do not affect the endothelial function. The results highlight the importance of targeting the known modifiable risk factors in order to prevent premature atherosclerosis in SLE patients. / My first step was to elucidate the prevalence and metabolic abnormalities in SLE patients with microalbuminuria. Twenty percent of patients were found to have microalbuminuria, which was associated with higher mean arterial pressure, total plasma antioxidant and homocysteine levels. / Next, we recruited 12 SLE patients and 15 controls and gave them oral methionine loading to achieve acute hyperhomocysteinemia. After oral methionine loading, von Willebrand factor (vWF) levels increased significantly in both groups. The increase in vWF was apparently more pronounced in SLE (20%) compared to controls (8%). Fibrinogen binding to platelets increased significantly only in SLE patients. / Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease of unknown cause which can affect any organs. Studies have reported an increased prevalence of cardiovascular disease (CVD) in these patients. We performed a series of studies to elucidate the interaction between microalbuminuria, dyslipidaemia, hyperhomocysteinemia, oxidative stress and immune dysregulation from the underlying disease in order to understand the accelerated atherosclerotic process in SLE. / We then evaluated the effects of long-term antioxidant vitamins. The plasma malondialdehyde level was significantly decreased after treatment in the vitamin group. Other oxidative stress markers and antioxidant levels and endothelial function remained unchanged in both groups. / We then proceeded to study the relative effect of antimalarial agents on fasting lipid fractions in patients with active SLE. Total cholesterol, very low-density lipoprotein cholesterol, and low density lipoprotein cholesterol levels were significantly lower in patients taking antimalarial agents, particularly for those patients taking concomitant prednisone. In the last study, we demonstrated that hydroxychloroquine had no significant effect on the serum lipid profile in these lupus patients with mild or inactive disease. / Tam Lai Shan. / Adviser: Edmund K. Li. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1550. / Thesis (M.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 178-214). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

As the prevalence of atherosclerosis has risen to an alarming level throughout the world, this thesis investigated: (1) the effects of type 2 diabetes mellitus on the risk factors for atherosclerosis and the intima-media thickness (IMT) of the common carotid arteries (a surrogate marker for atherosclerosis), (2) the contribution of various risk factors to the IMT of the common carotid arteries and (3) the interrelationship between the risk factors. / Atherosclerosis is the process by which the inner lining of a large or medium artery is deposited with lipids, cellular waste and other substances. It reduces the vessel's elasticity, lumen size and blood flow. Atherosclerosis is the primary underlying mechanism leading to cardiovascular and cerebrovascular diseases, the second and third leading causes of death in Hong Kong. / Both traditional and emerging risk factors for atherosclerosis were studied: traditional risk factors include age, blood pressure, indices of glycaemia control (fasting glucose, insulin and haemoglobin-Alc), and fasting lipids, while the emerging risk factors include, abdominal fat volume (subcutaneous and visceral), inflammatory markers (interleukin-6 (IL-6), interleukin-8 (IL-8) and high sensitivity c-reactive protein (hsCRP)), adiponectin, stress hormones (24 hr urinary noradrenaline and adrenaline, and plasma cortisol), and occupational stress (measured by a effort-reward imbalance questionnaire). / Starting with 204 subjects recruited from three different studies, data from 84 normoglycaemic subjects, 23 patients with impaired glucose tolerance (IGT) and 77 patients with diabetes mellitus (DM) were included in the analysis. When the IMT of the common carotid arteries and various risk factors were compared between normoglycaemic, IGT and DM subjects: (1) the IMT of the common carotid arteries showed an increasing trend with the worsening of glycaemia control (normal<IGT<DM), (2) increased prevalence of hypertension, dyslipidaemia, and obesity were observed among DM patients, and (3) increased levels of inflammatory markers, reduced concentration of adiponectin (a anti-inflammatory substance), and increased plasma cortisol concentration were also found among DM subjects. As the studies were limited by sample size, only a few risk factors were found significantly related to the carotid IMT. Age was the only common risk factor which was found to be correlated to the IMT of both the normoglycaemic and the DM/IGT subjects. (Abstract shortened by UMI.) / Fok Siu Pong. / "June 2005." / Adviser: Lester A. H. Critchley. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0173. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 200-228). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

While child and adolescent depressive disorders have been historically studied as a downward extension of adult depression, recent research has supported the existence of child and adolescent depression as a distinct disorder and has indicated important developmental differences in symptomatology (Birmaher, Ryan, Williamson, Brent, & Kaufman, 1996; Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993), as well as greater intensity and endurance of depressive disorders in childhood and adolescence than in adults (Jensen, Ryan, & Prien, 1992). Continued research with adolescence is particularly necessary because such symptomatology can manifest in self destructive or even life threatening behaviors. Symptoms such as depressed mood, irritability, and diminished interest in activities can lead to cognitive, familial, and social problems (Hammen & Rudolph, 1996). There is a particular need to investigate ways to identify individuals at risk for depression, and highlighting interactions between risk factors could make this possible. Childhood and adolescent investigations have under-examined the self-schema and its possible ability to moderate the effect of negative life events on depression. The current study investigated the role of life events as an element that, when combined with distorted and negative cognitions relating to the self, would increase the existence of depressive symptomatology in adolescents. Self-schemas, life events, and interactions of both variables were examined as predictors of the severity of depressive symptomatology in 9- to 14-year old girls in two public school districts in Central Texas. Participants completed a self-report measure of depression, a projective measure of the self-schema, a self-report measure of life events, and a diagnostic interview. As expected, a negative self-schema significantly predicted level of depressive symptomatology. However, the experience of adverse life events did not predict level of depressive symptomatology. Additionally, while analyses demonstrated that adverse life events and negative self-schema together predicted the severity of depressive symptoms to a statistically significant degree, the interaction of the two independent variables did not predict severity of depressive symptoms. Implications of the results, limitations, and recommendations for future research are provided. / text

Access to abstract permanently restricted to Ball State community only / Access to thesis permanently restricted to Ball State community only / School of Physical Education, Sport, and Exercise Science

An accumulating evidence-base indicates that internalizing mental health disorders in adulthood are causally associated with cardiovascular diseases (CVD) and type-2 diabetes (T2DM). It is plausible, however, that the relationship between mental and cardiometabolic ill-health becomes established long before adulthood, and that externalizing problems (the other central domain of common psychopathology) are also involved. These questions, as well as questions on the mechanisms that underlie the relationships, have been insufficiently investigated. The overarching goal of this dissertation was to expand current knowledge on how common mental health problems increase cardiometabolic risk over the life course. First, the prospective association between childhood internalizing (emotional problems) and externalizing problems (hyperactivity and conduct problems) with CVD and T2DM risk in adolescence was assessed in data from the Avon Longitudinal Study of Parents and Children (ALSPAC, N=7,730). Results showed that hyperactivity problems were associated with insulin resistance (high HOMA-IR); that hyperactivity and conduct problems were each associated with high triglyceride levels; and that emotional problems were inversely associated with high triglyceride levels. These results suggest that childhood externalizing problems are an early life risk factor for CVD and T2DM and that childhood internalizing problems are not a risk factor or, that risk in these children does not become apparent until after adolescence. Second, the mechanisms underlying the prospective association of childhood hyperactivity and conduct problems with high levels of triglycerides in adolescence were investigated using causal mediation methods. Results showed that despite being associated with hyperactivity and with conduct problems, body mass index and lifestyle health behaviors including sleep, diet, physical activity, alcohol, and smoking, together these variables, as measured, mediated only 19.6 % and 19.3% of the associations of hyperactivity and conduct problems with triglycerides, respectively. These results would suggest that mechanisms other than body adiposity and unhealthy behaviors are also involved and that those mechanisms have a larger role in mediating these relationships. Alternatively, It is possible that the observed small role of health behaviors is due to error in measurement and therefore improving measurements for health behaviors should be a central focus of future work. Third and last, a systematic review of the literature on the relationship between childhood externalizing problems with CVD and T2DM risk was conducted. Studies were graded for propensity to bias. Evidence was summarized and assessed for consistency. Results strongly supported positive associations of externalizing problems with insulin resistance, T2DM, and with increased blood lipids among children and adolescents. Evidence suggested that associations are at least partly independent of body adiposity. Evidence provided mix support for the associations with T2DM and blood lipids in adults and with other outcomes in children or adults. Studies in children tended to be cross-sectional and to use valid and reliable assessment methods, whereas studies of adults tended to be prospective and to rely on less-valid, less reliable assessment methods. These results warrant more research, specifically prospective studies that track children into young adulthood, that employ well-validated measures of externalizing behaviors, that rely on repeated assessments of T2DM and CVD risk throughout follow-up, and that investigate mechanisms other than body adiposity and health behaviors. Overall, this dissertation has found that childhood externalizing problems are prospectively associated with elevated CVD and T2DM risk, specifically with elevated risk of increased levels of blood lipids and insulin resistance. Unlike studies in adults, this dissertation does not support a role of internalizing problems as risk factors. Among children with externalizing problems, risk becomes evident before adolescence and appears to be largely driven by pathways independent of unhealthy behaviors and body adiposity. Implications of this research’s findings for health practice were proposed. This dissertation identified several gaps and methodological shortcoming in the extant literature. Recommendations were made for future research, including fundamental next questions to investigate, and study designs and methodologies that are best suited to tackle those questions.

published_or_final_version / Community Medicine / Master / Master of Philosophy

Youth sex offenders are not a homogenous population. They differ in terms of race, social class, victim preferences (both in terms of age and in terms of whether the victim is known to the offender or not), their modus operandi to gain compliance, levels of aggression and physical violence, the types (“hands on” or “hands off”) and levels (level 1, 2, or 3) of offences and lastly their motivations for committing a sex offence. The motivations are linked to the risk factors to which an individual is exposed, for example, a youth that was previously sexually victimised could sexually act out his experiences. A qualitative approach was used in this study. The researcher aimed to gain a holistic comprehension of the risk factors that youth attribute to their sex offending behaviour and thus this was the most appropriate approach to use. A semi-structured interview schedule was used as the data collection method as this allowed the researcher the freedom to change the sequence and forms of the questions in order to follow up on responses. The function of this interview schedule was to direct the researcher to ensure that she covered all the themes needed to obtain the necessary data. The interview schedule was made up of nine categories, namely: biographic characteristics, academic performance, extramural activities, substance use, family substance use problems, family and community violence, emotional status, caring and attachment to family and peers, sexual abuse and knowledge about sex. After the interviews were conducted, the data was transcribed, analysed and interpreted. The researcher made use of interpretative phenomenological analysis (IPA) to determine the emergent themes. The researcher eliminated the emergent themes that were impossible to label, or those deemed to be irrelevant to the study. Thereafter, the researcher clustered the emergent themes into sub-ordinate themes and validated these main and sub-ordinate themes. The researcher then provided a textural description to depict the experience and a structural description to depict the possible explanation of the experience of the respondents. Finally, a composite description provided the structure for the interpretation of the data. The researcher interpreted the main and sub-ordinate themes with relation to the literature review and the theories deemed useful in explaining the risk factors associated with youth sex offending, namely: Sigmund Freud’s psychoanalytic theory, Erik Erikson’s psychosocial theory of personality development, Albert Bandura’s social cognition theory, William Marshall and Howard Barbaree’s integrated theory, and Neil Malamuth’s confluence model of sexual aggression. The analysis and interpretation of the data revealed certain possible risk factors that could contribute to the phenomenon of youth sex offending in South Africa. The researcher provided possible methods of addressing these risk factors. The dearth of knowledge regarding the phenomenon of youth sex offending highlights the need for further research and the researcher made several recommendations regarding future research prospects in order to address this social problem and to give youth sex offenders the best chance of adopting pro-social behaviour. Copyright / Dissertation (MA)--University of Pretoria, 2010. / Social Work and Criminology / unrestricted

Master of Science / Department of Civil Engineering / Sunanda Dissanayake / In the United States, approximately 1,100 people die and 40,000 people are injured annually as a result of motor vehicle crashes in work zones. These numbers may be a result of interruption to regular traffic flow caused by closed traffic lanes, poor traffic management within work zones, general misunderstanding of problems associated with work zones, or improper usage of traffic control devices. In regard to safety of work zones, this study was conducted to identify characteristics and risk factors associated with work zone crashes in Iowa, Kansas, Missouri, Nebraska and Wisconsin, states currently included in the Smart Work Zone Deployment Initiative (SWZDI) region. The study was conducted in two stages. In the first stage, characteristics and contributory causes related to work zone crashes such as environmental conditions, vehicles, crashes, drivers, and roadways were analyzed for the five states for the period 2002-2006. An analysis of percentage-wise distributions was carried out for each variable based on different conditions. Results showed that most of the work zone crashes occurred under clear environmental conditions as during daylight, no adverse weather, etc. Multiple-vehicle crashes were more predominant than single-vehicle crashes in work zone crashes. Primary driver-contributing factors of work zone crashes were inattentive driving, following too close for conditions, failure to yield right of way, driving too fast for conditions, and exceeding posted speed limits within work zones. A test of independency was performed to find the relation between crash severity and other work zone variables for the combined states. In the second stage, a statistical model was developed to identify risk factors associated with work zone crashes. In order to predict injury severity of work zone crashes, an ordered probit model analysis was carried out using the Iowa work zone crash database. According to findings of the severity model, work zone crashes involving trucks, light duty vehicles, vehicles following too close, sideswipe collisions of same-direction vehicles, nondeployment of airbags, and driver age are some of the contributing factors towards more severe crashes.