Cole Barton

Generalizing treatment effects of functional family therapy: Three replications

Abstract Functional Family Therapy with status delinquents has undergone careful scrutiny in well designed studies that included random assignment, realistic comparison treatment programs, formally trained therapists, and reasonable follow-up periods. The current report describes three replications in which FFT has been extended to new populations, has utilized less formally trained therapists, and has been applied in new treatment contexts. Taken together the replications provide important support for the generalizability of FFT across client and therapist populations.

Quality of life measures and gender comparisons in North Carolina Cardiac Rehabilitation Programs.

BACKGROUND Quality of life (QOL) is an important health-related outcome measure in patients with cardiovascular disease. The North Carolina Cardiopulmonary Rehabilitation Association (NCCRA) is a coalition of 72 state-certified, multidisciplinary cardiac rehabilitation (CR) programs. In 1997, the NCCRA Executive Board and Research Committee agreed to collect ongoing data to assess QOL changes following CR participation using the Ferrans & Powers QOL Index Cardiac Version III. The purpose of this study was to determine if changes were present in QOL scores after 12 weeks of CR in men and women from multiple outpatient centers. METHODS Data were analyzed from 420 patients from 19 Phase II early outpatient CR programs who completed the QOL index survey within the first week of program entry and upon discharge. The four QOL index domains measured were health/function, psychological/spiritual status, socioeconomic status, and family interaction. Overall QOL was tabulated as the aggregate score from the four domains. Each domain, as well as overall QOL, was compared pre- and post-CR participation with a repeated measures analysis of variance. RESULTS Across programs, statistically significant improvements in QOL indices were observed following 12 weeks of CR in each of the four domains and on the overall score in all patients. Men reported greater CR entry and discharge scores than women on the health/function, family interaction, and overall scores. Women showed a greater positive change in scores than men on the socioeconomic, family interaction, and overall scores. CONCLUSIONS Patients who participated in Phase II multidisciplinary North Carolina CR programs and completed the protocol improved QOL parameters. While men had higher physical function and overall QOL scores both pre- and post-CR, women showed greater improvements in overall scores, as well as in family and socioeconomic parameters. These findings suggest that North Carolina CR patients experience a positive change in QOL following short-term participation in CR. Further study with a larger number of patients benchmarked with programs from other regions with comparisons to patients who do not participate in formalized CR programs is indicated from this investigation.

FOCAL EXPRESSION OF MUTATED TAU IN ENTORHINAL CORTEX NEURONS OF RATS IMPAIRS SPATIAL WORKING MEMORY

Entorhinal cortex neuropathology begins very early in Alzheimers disease (AD), a disorder characterized by severe memory disruption. Indeed, loss of entorhinal volume is predictive of AD and two of the hallmark neuroanatomical markers of AD, amyloid plaques and neurofibrillary tangles (NFTs), are particularly prevalent in the entorhinal area of AD-afflicted brains. Gene transfer techniques were used to create a model neurofibrillary tauopathy by injecting a recombinant adeno-associated viral vector with a mutated human tau gene (P301L) into the entorhinal cortex of adult rats. The objective of the present investigation was to determine whether adult onset, spatially restricted tauopathy could be sufficient to reproduce progressive deficits in mnemonic function. Spatial memory on a Y-maze was tested for approximately 3 months post-surgery. Upon completion of behavioral testing the brains were assessed for expression of human tau and evidence of tauopathy. Rats injected with the tau vector became persistently impaired on the task after about 6 weeks of postoperative testing, whereas the control rats injected with a green fluorescent protein vector performed at criterion levels during that period. Histological analysis confirmed the presence of hyperphosphorylated tau and NFTs in the entorhinal cortex and neighboring retrohippocampal areas as well as limited synaptic degeneration of the perforant path. Thus, highly restricted vector-induced tauopathy in retrohippocampal areas is sufficient for producing progressive impairment in mnemonic ability in rats, successfully mimicking a key aspect of tauopathies such as AD.

Bilateral entorhinal cortex lesions impair acquisition of delayed spatial alternation in rats.

Entorhinal cortex lesions induce significant reorganization of several homotypic and heterotypic inputs to the hippocampus. This investigation determined whether surviving heterotypic inputs after bilateral entorhinal lesions would support the acquisition of a learned alternation task. Rats with entorhinal lesions or sham operations were trained to acquire a spatial alternation task. Although the sham-operated rats acquired the task within about 3 weeks postsurgery, rats with bilateral entorhinal lesions failed to learn the task after 12 consecutive weeks of training despite heterotypic sprouting of the cholinergic septodentate pathway and the expansion of the commissural/associational fiber plexus within the dentate gyrus. Thus, heterotypic sprouting failed to ameliorate significantly the effects of bilateral entorhinal lesions. Rather, entorhinal lesions produced a persistent impairment of spatial memory, characterized by a mixture of random error production and perseverative responding.

Coding defensive and supportive communications: discriminant validity and subcategory convergence

The Defensive and Supportive Communication (DSC) Interaction Coding System has been used frequently in the study of interactions in families with a juvenile delinquent. One limitation of the DSC system has been the lack of research examining the psychometric properties of the coding system. Discriminant analyses were used to examine the communication behaviors of members of 18 normal and 20 delinquent families and to determine the use of subcategories by different family members. Convergence among the subcategories for each of the main categories, defensiveness and supportiveness, was found.

Managing data entry of a large-scale interview project with optical scanning hardware and software

A hardware and software system for the cost-effective preparation of interview data is described. Scantron optical scanning hardware and DataBlocks software were used to prepare ASCII data files from structured interviews and questionnaires. These data were then edited for analysis with SPSS-X Data Entry software. Three different processes for preparing interview data were compared. Time, personnel, hardware, and software costs were projected for each process, as well as comparative risks to the integrity of data. A scanning procedure saves time and money, and it reduces the risk of errors.