Everyone Has Their Scars: Meaning Making In a Burn Survivor Support Group.

In the Burn Care literature, there is little on the lived experiences of burn support group members, the perceived benefits of burn support groups for the members, and even less on the meaning the survivors make of the support they receive. In order to provide effective services and to meet the psychosocial needs of burn survivors, it is important to understand the influence a support group has on its members as well as the personal experiences of those individuals who attend these groups. The purpose of this study was to explore the meaning that burn survivors make in a burn survivor support group. A non-random, purposeful convenience sample of six self-identified burn survivors was interviewed using a guided in-depth interview technique to explore their experiences in the support group. Key informant interviews and group observations served to triangulate the data collected in the individual interviews. The experiences of the group's members coalesced around five main themes: acceptance of self, perspective change, value of community, reciprocity, and structural meaning making components. The findings demonstrated the overall positive impact the support group had on psychosocial recovery. Additionally, analysis suggested that the meaning making process experience included Post Traumatic Growth and highlighted the importance of community in psychosocial recovery. Burn survivors reported unique growth opportunities that allowed them to integrate their injury into their identity within an encouraging and safe environment. Certain factors, such as improving group attendance, were addressed and both survivors and support staff generated suggestions for reaching others in need of support.

Mobility and Aging in Denver, Colorado: Travel Behavior, Mobility Barriers, and Perceptions of Transit

The number of seniors in the U.S. today is growing rapidly because of longer life expectancies and the aging Baby Boomer generation. This age groups' travel behavior will have substantial impacts on transportation, economics, safety, and the environment. This research used a mixed-methods approach to address issues of mobility and aging in Denver, Colorado. A quantitative approach was used to answer broad questions about travel behavior and the effects of age, gender, work status, disability, residential location and socio-economic status on mobility. Qualitative interviews with seniors in the Denver metro area were conducted to identify barriers to mobility, decision-making processes and travel decisions, and seniors' perceptions of public transit. The results of the quantitative and qualitative analyses show that residential location is an important variable for determining seniors' travel behaviors and transportation options. Perceptions of public transit were positive, but accessibility and information barriers exist that prevent older adult from using transit. The findings of this study will help to provide transportation and service recommendations to policymakers and planners in the Denver area as well as to inform studies of other North American cities with large aging populations.

Kids Alive! Support for Children of Parents with Cancer: An Exemplar Program for Children of Parents with Cancer

Cancer in a parent or caregiver is an event that affects the whole family. The roles and responsibilities of the diagnosed parent, as well as those of each family member, are affected at the time of diagnosis and throughout the progression of the illness. According to the American Cancer Society, there will be an estimated 1,665,540 new cancer cases diagnosed and 585,720 cancer deaths in 2014. This staggering statistic means there are a number of cancer diagnoses that will directly affect thousands of parents and their children. Past research suggests this upheaval in the system is particularly stressful on children and can lead to a number of responses including anxiety, depression, distress, and other negative reactions. Despite the large number of parents and caregivers diagnosed with cancer in the United States each year, there are relatively few support groups aimed at supporting children affected by parental cancer. Support groups provide opportunities to serve this population in a number of advantageous ways by providing safety, support, and a sense of community. Additionally, support groups allow this population of young people to express their fears and worries, connect to others going through similar circumstances, and explore their parent's diagnosis in a context that is helpful and developmentally appropriate. Past research has found that children who do not receive support during this life-changing event can be negatively affected throughout the life span. On the other hand, this event can be a time to build a child's resilience and provide the structure through which they may thrive in adversity. Support groups offer the opportunity to address this difficult event and lead to positive results. Kids Alive! is one such group that has been proactive in support for children of parents diagnosed with cancer since 1995. Kids Alive!, a support group that runs out of Porter Hospital in Denver Colorado, uses Joseph Campbell's Hero's Journey to structure monthly groups. The Hero's Journey, described in Campbell's The Hero with a Thousand Faces (1949), focuses on a set pattern that all heroes must go through during their journey towards an ultimate victory and self-discovery. Kids Alive! incorporates this journey into a curriculum aimed at helping children explore their thoughts and feelings around their parent's cancer and leads to a realization that they are not alone on this journey. Over the course of eight months, children in Kids Alive! receive support and solidarity that leads to life-changing experiences and an understanding of what a diagnosis of cancer in a parent can mean. Kids Alive! consists of professionals and volunteers who take time to recognize and support this underserved population. The program has led to positive outcomes for nearly two decades and consistently increases the numbers of children and families served. The purpose of this paper is to describe the Kids Alive! program as an exemplar program that addresses these problems by utilizing protective factors research has found in this population. Further, this paper will discuss areas of future research while providing the model of an effective program aimed at serving an important population. Additionally, the model of Kids Alive! will be described through this paper in a way that allows for other oncology settings to consider this relatively simple program that provides consistently positive results.

Modified Dialectical Behavior Therapy Program Applied Within a Time-Limited Corrections Setting

Dialectical Behavioral Therapy (DBT) is an empirically supported therapy developed to treat individuals with Borderline Personality Disorder that has sustained efficacy following completion of the treatment (Linehan, 1993; Van Den Bosch et al., 2005). The core concepts of DBT include mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance, which seek to foster more functional ways of interacting with others, coping with distress, and managing difficult emotions. Using a standard DBT format in a corrections setting can be difficult due to the population's multifaceted composition. The Denver County Jail is a unique corrections setting because it contains a unit specifically developed for male inmates with mental health issues. A corrections modified, time-limited DBT curriculum was developed to fit the needs of this unique population. During the course of the group, staff appeared to be accepting of the group material and initial feedback from inmates and officers was positive.

Electroencephalogram based Causality Graph Analysis in Behavior Tasks of Parkinson’s Disease Patients

Electroencephalographic (EEG) signals of the human brains represent electrical activities for a number of channels recorded over a the scalp. The main purpose of this thesis is to investigate the interactions and causality of different parts of a brain using EEG signals recorded during a performance subjects of verbal fluency tasks. Subjects who have Parkinson's Disease (PD) have difficulties with mental tasks, such as switching between one behavior task and another. The behavior tasks include phonemic fluency, semantic fluency, category semantic fluency and reading fluency. This method uses verbal generation skills, activating different Broca's areas of the Brodmann's areas (BA44 and BA45). Advanced signal processing techniques are used in order to determine the activated frequency bands in the granger causality for verbal fluency tasks. The graph learning technique for channel strength is used to characterize the complex graph of Granger causality. Also, the support vector machine (SVM) method is used for training a classifier between two subjects with PD and two healthy controls. Neural data from the study was recorded at the Colorado Neurological Institute (CNI). The study reveals significant difference between PD subjects and healthy controls in terms of brain connectivities in the Broca's Area BA44 and BA45 corresponding to EEG electrodes. The results in this thesis also demonstrate the possibility to classify based on the flow of information and causality in the brain of verbal fluency tasks. These methods have the potential to be applied in the future to identify pathological information flow and causality of neurological diseases.

Towards Closed-loop Deep Brain Stimulation: Behavior Recognition from Human STN

Deep brain stimulation (DBS) provides significant therapeutic benefit for movement disorders such as Parkinson’s disease (PD). Current DBS devices lack real-time feedback (thus are open loop) and stimulation parameters are adjusted during scheduled visits with a clinician. A closed-loop DBS system may reduce power consumption and side effects by adjusting stimulation parameters based on patient’s behavior. Thus behavior detection is a major step in designing such systems. Various physiological signals can be used to recognize the behaviors. Subthalamic Nucleus (STN) Local field Potential (LFP) is a great candidate signal for the neural feedback, because it can be recorded from the stimulation lead and does not require additional sensors. This thesis proposes novel detection and classification techniques for behavior recognition based on deep brain LFP. Behavior detection from such signals is the vital step in developing the next generation of closed-loop DBS devices. LFP recordings from 13 subjects are utilized in this study to design and evaluate our method. Recordings were performed during the surgery and the subjects were asked to perform various behavioral tasks. Various techniques are used understand how the behaviors modulate the STN. One method studies the time-frequency patterns in the STN LFP during the tasks. Another method measures the temporal inter-hemispheric connectivity of the STN as well as the connectivity between STN and Pre-frontal Cortex (PFC). Experimental results demonstrate that different behaviors create different m odulation patterns in STN and it’s connectivity. We use these patterns as features to classify behaviors. A method for single trial recognition of the patient’s current task is proposed. This method uses wavelet coefficients as features and support vector machine (SVM) as the classifier for recognition of a selection of behaviors: speech, motor, and random. The proposed method is 82.4% accurate for the binary classification and 73.2% for classifying three tasks. As the next step, a practical behavior detection method which asynchronously detects behaviors is proposed. This method does not use any priori knowledge of behavior onsets and is capable of asynchronously detect the finger movements of PD patients. Our study indicates that there is a motor-modulated inter-hemispheric connectivity between LFP signals recorded bilaterally from STN. We utilize a non-linear regression method to measure this inter-hemispheric connectivity and to detect the finger movements. Our experimental results using STN LFP recorded from eight patients with PD demonstrate this is a promising approach for behavior detection and developing novel closed-loop DBS systems.

Brief of Amici Curiae Scholars of the Constitutional Rights of Children in Support of Petitioners in Obergefell v. Hodges

Supreme Court precedent establishes that the government may not punish children for matters beyond their control. Same-sex marriage bans and non-recognition laws (“marriage bans”) do precisely this. The states argue that marriage is good for children, yet marriage bans categorically exclude an entire class of children – children of same-sex couples – from the legal, economic and social benefits of marriage. This amicus brief recounts a powerful body of equal protection jurisprudence that prohibits punishing children to reflect moral disapproval of parental conduct or to incentivize adult behavior. We then explain that marriage bans punish children of same-sex couples because they: 1) foreclose their central legal route to family formation; 2) categorically void their existing legal parent-child relationships incident to out-of-state marriages; 3) deny them economic rights and benefits; and 4) inflict psychological and stigmatic harm. States cannot justify marriage bans as good for children and then exclude children of same-sex couples based on moral disapproval of their same-sex parents’ relationships or to incentivize opposite-sex couples to “procreate” within the bounds of marriage. To do so, severs the connection between legal burdens and individual responsibility and creates a permanent class or caste distinction.