CLINICAL TRIALS ► Search of: Open Studies | "Vaccines" - List Results - ClinicalTrials.gov

open here to see each study (677 listed, first twenty below) ►Search of: Open Studies | "Vaccines" - List Results - ClinicalTrials.gov: "Found 677 studies with search of: Open Studies | 'Vaccines'

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Rank Status Study
1 Unknown † A Randomized Trial of Vaccine Adherence in Young Injection Drug Users - 1
Conditions: Adherence; Community Outreach; HIV Risk Behaviors; Hepatitis A Vaccines; Hepatitis B Vaccines; Hepatitis C; Needle-Exchange Programs; Substance Abuse, Intravenous
Intervention: Behavioral: Needle-Exchange Programs

2 Recruiting Immunogenicity and Safety of Meningococcal Vaccine GSK 134612 Co-administered With Pneumococcal and DTPa-HBV-IPV/Hib Vaccines
Conditions: Meningococcal Vaccines; Meningococcal Serogroup A, C, W-135 and Y Diseases
Interventions: Biological: Meningococcal vaccine GSK134612; Biological: MenC-CRM197; Biological: MenC-TT; Biological: DTPa-HBV-IPV/Hib; Biological: Pneumococcal conjugate vaccine

3 Recruiting Conjugate And Polysaccharide Vaccines Compared With Polysaccharide Vaccine In Hiv-Infected Adults
Conditions: Pneumococcal Vaccines; HIV; HIV Infections
Intervention: Biological: Prevenar and Pneumo23

4 Recruiting Study to Evaluate 13 Valent Pneumococcal Conjugate Vaccine (13vPnC) Vaccine Followed by 23-valent Pneumococcal Polysaccharide Vaccine (23vPS) Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Recipients
Condition: Vaccines, Pneumococcal Conjugate Vaccine
Interventions: Biological: 13vPnC; Biological: 23vPS

5 Recruiting Safety Study of GSK Biologicals' Human Papillomavirus Vaccine in 580299/008 Subjects From Canada or the US
Conditions: Human Papillomavirus (HPV) Type 16/18 Infections and Cervical Neoplasia.; Papillomavirus Vaccines
Intervention: Biological: GSK580299, GSK Biological's HPV vaccine

6 Recruiting Persistence and Booster Study of GSK Biologicals' Meningococcal Vaccine (GSK134612) in Healthy Children
Conditions: Meningococcal Vaccines; Meningococcal Disease
Intervention: Biological: GSK134612 vaccine

7 Not yet recruiting Phase 1 Study of the Safety and Immunogenicity of a Malaria Transmission-blocking Pfs25-Pfs25 Conjugate Vaccine
Conditions: Malaria; Malaria Vaccines; Plasmodium Falciparum Malaria
Intervention: Biological: Malaria Transmission-Blocking Pfs25-Pfs25 Conjugate Vaccine

8 Not yet recruiting Comparison of 4 Influenza Vaccines in Seniors
Condition: Influenza Vaccine
Interventions: Biological: Agriflu; Biological: Fluad; Biological: Intanza; Biological: Vaxigrip

9 Recruiting Pilot Study of the Rotavirus Vaccine in Infants With Intestinal Failure
Conditions: Intestinal Failure; Rotavirus Vaccines
Intervention: Biological: Rotarix

10 Recruiting Consistency & Immunogenicity Study of 3 Lots of GSK's Hib Conjugate Vaccine Versus ActHIB & Pentacel in Healthy Infants
Conditions: Meningitis; Osteomyelitis; Haemophilus Influenzae Vaccines; Epiglottis; Cellulitis; Haemophilus Influenzae Type B Related Disease; Pneumonia
Interventions: Biological: GSK Biologicals' Haemophilus influenzae type b vaccine (GSK 208108); Biological: ActHIBTM; Biological: PentacelTM; Biological: PediarixTM; Biological: Prevnar 13TM; Biological: RotarixTM; Biological: EngerixTM-B; Biological: InfanrixTM

11 Not yet recruiting Evaluation of Three Ascending Dose Levels of a 4-Antigen Staphylococcus Aureus Vaccine (SA4Ag) in Healthy Adults
Conditions: Staphylococcal Infections; Staphylococcal Vaccines; Bacterial Infections; Staphylococcal Skin Infections
Interventions: Biological: SA4Ag vaccine low dose; Procedure: Blood draw; Procedure: Colonization swab sample; Biological: SA4Ag vaccine mid dose; Procedure: Blood sample; Biological: SA4Ag vaccine high dose; Biological: Placebo

12 Recruiting Post-marketing Surveillance Study With GSK Biologicals' Pneumococcal Vaccine in Healthy Infants in Philippines
Conditions: Pneumococcal Disease; Streptococcus Pneumoniae Vaccines
Intervention: Biological: Synflorix™

13 Recruiting Vaccine Hyporesponse in Healthy Elderly Subjects (0000-131-02)
Condition: Vaccines, Geriatrics Studies
Interventions: Biological: Tetanus & Diptheria booster vaccine (Td); Biological: TwinrixTM [Hepatitis A Inactivated & Hepatitis B (Recombinant) Vaccine]; Biological: Dukoral® Traveler's Diarrhea Vaccine (WC/rBS)

14 Recruiting Randomized Trial of Alternative HPV Vaccination Schedules in Males in a University Setting
Conditions: Quadrivalent HPV Vaccine; Human Papillomavirus Vaccine
Intervention: Biological: quadrivalent human papillomavirus vaccine

15 Recruiting Immunogenicity and Safety Study of A New Chromatographically Purified Vero Cell Rabies Vaccine With ID Regimen and ERIG
Conditions: Rabies; Vaccine
Intervention: Biological: SPEEDA and TRCS SPEEDA

16 Not yet recruiting Immune Response Study of Influenza Vaccine
Conditions: Influenza Vaccine Allergy; Cell Mediated Reaction
Intervention:

17 Recruiting A Post-marketing Safety Study of GSK Bio IPV Vaccine (PoliorixTM) in Korean Children
Conditions: Poliomyelitis; Poliomyelitis Vaccines
Intervention: Biological: Poliomyelitis vaccine (inactivated) -PoliorixTM

18 Recruiting Study to Evaluate GSK Biologicals' Herpes Zoster Vaccine GSK1437173A in Human Immunodeficiency Virus (HIV)-Infected Subjects
Conditions: Herpes Zoster in HIV-infected Subjects; Herpes Zoster Vaccine
Interventions: Biological: Herpes Zoster Vaccine 1437173A; Biological: Placebo

19 Recruiting Study to Evaluate GSK Biologicals' Herpes Zoster Vaccine
GSK1437173A in Adults Aged >= 50 Years
Conditions: Herpes Zoster; Herpes Zoster Vaccine
Interventions: Biological: Herpes Zoster Vaccine GSK1437173A; Biological: Placebo

20 Recruiting Study Evaluating a 13-valent Pneumococcal Conjugate Vaccine in Preterm Compared to Term Infants.
Conditions: 13-valent Pneumococcal Vaccine; Premature Birth; Immunization; Safety
Intervention: Biological: 13-valent pneumococcal conjugate vaccine

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CLINICAL TRIALS ► | "Drug Resistance, Microbial" - List Results - ClinicalTrials.gov

open here to see each clinical trial listed below ► Search of: Open Studies | "Drug Resistance, Microbial" - List Results - ClinicalTrials.gov: "Found 3 studies with search of: Open Studies | 'Drug Resistance, Microbial'
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Rank Status Study
1 Recruiting Clinical and Microbiological Outcomes of Infections Due to Carbapenem-Resistant Gram-Negative Bacteria
Condition: Drug Resistance, Microbial
Intervention: Other: None - Observational study

2 Recruiting SATURN 04 Nosocomial Acquisition Study
Condition: Drug Resistance
Intervention:

3 Unknown † The Biology of HIV Transmission
Condition: HIV Infections
Intervention:

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Research Activities, August 2011: Chronic Disease: The likelihood of bacterial blood infections among patients with HIV has risen slightly in recent years

Research Activities, August 2011: Chronic Disease: The likelihood of bacterial blood infections among patients with HIV has risen slightly in recent years: "Chronic Disease
The likelihood of bacterial blood infections among patients with HIV has risen slightly in recent years

Bacteremia is the 10th leading cause of death among persons 45 years and older, with HIV-infected patients at greater risk than HIV-negative patients. However, the likelihood of bacteremia has risen slightly in this group in recent years. Blacks and intravenous drug users (IDUs) with HIV are more likely than other patients with HIV to develop bacterial blood infections (bacteremia), concludes a new study. The study followed 39,318 HIV-infected patients, 57 percent of whom were on highly active antiretroviral therapy (HAART) during the enrollment year, for up to 9 years.

John A. Fleishman, Ph.D., of the Agency for Healthcare Research, and colleagues found that the incidence of bacteremia was 13.8 events per 1,000 patient-years (PY) over the 9-year period. This rate was substantially lower than that seen in studies conducted at single clinical sites early in the era of HAART. However, the incidence per 1,000 PY in the new study declined from 15.1 in 2000 to a low of 10.7 in 2002, only to rebound to 15.0 in 2004, then declined slightly over the rest of the study period, but still staying at 13.4 in 2008.

Factors associated with significantly higher odds of bacteremia included black race (45 percent higher odds than white patients) and past IDU (65 percent higher odds than for men who had sex with men). Receipt of HAART did not appear to be directly protective against bacteremia. But patients with stronger immune systems (higher CD4 lymphocyte counts) had progressively reduced bacteremia risk, as did patients with progressively lower HIV-1 RNA copies per mL of blood (lower HIV load).

The researchers could not conclusively link bacteremia with Staphylococcus aureus. However, supplementary data from one of the participating sites found that 38 percent of 184 'bacteremia not otherwise specified' cases were due to S. aureus, and 42 percent of these were methicillin-resistant S. aureus (MRSA). The findings were based on analysis of data from the HIV Research Network, a consortium of sites that provide primary care and subspecialty care to HIV-infected patients in 14 cities in the United States. The study was funded in part by the Agency for Healthcare Research and Quality (Contract No. 290-01-0012).

More details are in 'Incidence of and risk factors for bacteraemia in HIV-infected adults in the era of highly active antiretroviral therapy,' by Baligh Ramzi Yehia, M.D., Dr. Fleishman, Lucy Wilson, Sc.M., and others for the HIV Research Network, in the March 2011 HIV Medicine [Epub ahead of print]. Reprints (AHRQ Publication No. 11-R041) are available from the AHRQ Publications Clearinghouse.

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Gene discovered that raises asthma risk in blacks: MedlinePlus

Gene discovered that raises asthma risk in blacks: MedlinePlus: "Gene discovered that raises asthma risk in blacks


URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_114872.html (*this news item will not be available after 10/29/2011)

Sunday, July 31, 2011 Reuters Health Information Logo

Related MedlinePlus Pages

* African-American Health
* Asthma
* Genes and Gene Therapy

By Julie Steenhuysen

CHICAGO (Reuters) - U.S. researchers have discovered a genetic mutation unique to African Americans that could help explain why blacks are so susceptible to asthma.

Prior studies looking for asthma genes have turned up several, but most of the studies have been too small to confirm these genes or to detect genetic changes unique to different races.

The new study, published on Sunday in the journal Nature Genetics, pools research from nine different research groups looking for genes associated with asthma among ethnically diverse North American populations.

It confirmed four genes that had been seen in previous studies and a fifth that shows up only in people of African descent.

'This is the first discovery of a gene where we see a signal in African Americans only,' Dan Nicolae of the University of Chicago, a study author and co-chair of a national research consortium called EVE that identified the gene, said in a telephone interview.

'The rates of asthma in different ethnic groups are different. African Americans have shown increasing asthma rates. We don't know why. It can be due to changing environmental risk factors,' Nicolae said.

But, he said, the new findings suggest genetics also play a significant role.

'Understanding these genetic links is an important first step toward our goal of relieving the increased burden of asthma in this population,' said Dr. Susan Shurin, acting director of the National Heart, Lung, and Blood Institute, one of the National Institutes of Health, which co-funded the study.

The group also received a major grant from the American Recovery and Reinvestment Act of 2009.

Asthma affects more than 300 million people globally, but effects vary widely. According to the researchers, U.S. asthma rates in 2001 to 2003 ranged from 7.7 percent among European Americans to 12.5 percent among African Americans.

Carole Ober of the University of Chicago, who co-leads the EVE consortium, said the findings confirm the significance of four genes identified in a large European asthma genetics study published last year called GABRIEL, offering strong evidence that these genes are important across ethnic groups.

But because the study was so large and ethnically diverse -- including data on European Americans, African Americans, African Caribbeans and Latinos -- it enabled the researchers to find this new gene variant that exists only in African Americans and African Caribbeans.

This new variant, located in a gene called PYHIN1, is part of a family of genes linked with the body's response to viral infections, Ober said.

'We were very excited when we realized it doesn't exist in Europe,' she said.

The team stressed that each gene variant on its own plays only a small role in increasing asthma risk, but that risk could be multiplied when combined with other risk genes and with environmental factors, such as smoking, that also increase asthma risk.

'It's been extraordinarily challenging to try to find variation in genes that are associated with risk for developing asthma that can be replicated among populations. It's a very complex disease with a lot of genes and a lot of environmental factors influencing risk,' Ober said.

The findings now give researchers new areas to explore in understanding the interplay of genetics and the environment in asthma risk, and may lead to better treatments.

'What you see here in this paper is only the beginning,' Nicolae said.

(Editing by Philip Barbara)
Reuters Health
(c) Copyright Thomson Reuters 2011. Check for restrictions at: http://about.reuters.com/fulllegal.asp

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Traumatic brain injury linked with tenfold increase in stroke risk

Traumatic brain injury linked with tenfold increase in stroke risk: "Traumatic brain injury linked with tenfold increase in stroke risk
American Heart Association Rapid Access Journal Report

Study Highlights:

* Suffering a trauma to the brain may increase the risk of stroke tenfold within three months.
* This is the first study to show a direct correlation between traumatic brain injury and stroke.
* Researchers suggest neuroimaging, intensive monitoring and stroke education for anyone incurring a traumatic brain injury.

DALLAS, July 28, 2011 – If you suffer traumatic brain injury, your risk of having a stroke within three months may increase tenfold, according to a new study reported in Stroke: Journal of the American Heart Association.

“It’s reasonable to assume that cerebrovascular damage in the head caused by a traumatic brain injury can trigger either a hemorrhagic stroke [when a blood vessel bursts inside the brain] or an ischemic stroke [when an artery in the brain is blocked],” said Herng-Ching Lin, Ph.D., senior study author and professor at the School of Health Care Administration, College of Medicine, Taipei Medical University in Taiwan. “However, until now, no research had been done showing a correlation between traumatic brain injury and stroke.”

It is the first study that pinpoints traumatic brain injury as a potential risk factor for subsequent stroke. Traumatic brain injury occurs when an external force such as a bump, blow or jolt to the head disrupts the normal function of the brain. Causes include falls, vehicle accidents, and violence.

In the United States alone, approximately 1 in 53 individuals sustain a traumatic brain injury each year, according to 2004 statistics from the Centers for Disease Control and Prevention. Worldwide, traumatic brain injuries are a major cause of physical impairment, social disruption and death.

Using records from a nationwide Taiwanese database, researchers investigated the risk of stroke in traumatic brain injury patients during a five-year period. The records included 23,199 adult traumatic brain injury patients who received ambulatory or hospital care between 2001 and 2003. The comparison group comprised 69,597 non-traumatic brain injury patients. The average age of all patients was 42 and 54 percent were male.

During the three months after injury, 2.91 percent of traumatic brain injury patients suffered a stroke compared with only 0.30 percent of those with non-traumatic brain injury — a tenfold difference.

Stroke risk in patients with traumatic brain injury decreased gradually over time, researchers said:

* After one year, the risk was about 4.6 times greater for patients who suffered a traumatic brain injury than for those who had not.
* After five years, the risk was 2.3 times greater for traumatic brain injury patients.

Stroke risk among traumatic brain injury patients with skull bone fractures was more pronounced than in traumatic brain injury patients without fractures, researchers said. During the first three months, those with skull bone fractures were 20 times more likely to have a stroke than patients without skull bone fractures. The risk decreased over time.

Furthermore, the risk of subarachnoid hemorrhage (bleeding in the area between the brain and the thin tissues that cover the brain) and intracerebral hemorrhage (bleeding in the brain caused by the rupture of a blood vessel) increased significantly in patients with traumatic brain injury versus non-traumatic brain injury patients.

After considering age and gender, patients with traumatic brain injury were more likely to have hypertension, diabetes, coronary heart disease, atrial fibrillation and heart failure than non-traumatic brain injury patients.

Early neuroimaging examinations — such as MRI — and intensive medical monitoring, support and intervention should be required following a traumatic brain injury, especially during the first few months and years, Lin said. Moreover, better health education initiatives could increase public awareness about the factors that cause strokes and the signs and symptoms of stroke in patients with traumatic brain injuries.

“Stroke is the most serious and disabling neurological disorder worldwide,” said Lin. “Our study leads the way in identifying stroke as an additional neurological problem that may arise following traumatic brain injury.”

Co-authors are: Yi-Hua-Chen, Ph.D, lead author and Jiunn-Horng Kang, M.D.

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.

NR11 – 1106 (TBI and Stroke/Lin)

Additional Resources:

* Visit the American Stroke Association website: strokeassociation.org.

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Most women carrying cancer genes take action: study: MedlinePlus

Most women carrying cancer genes take action: study: MedlinePlus: "Most women carrying cancer genes take action: study


URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_114857.html (*this news item will not be available after 10/27/2011)

Friday, July 29, 2011 Reuters Health Information Logo

Related MedlinePlus Pages

* Breast Cancer
* Genes and Gene Therapy
* Ovarian Cancer

By Amy Norton

NEW YORK (Reuters Health) - Women who screen positive for gene mutations that promote breast and ovarian cancers usually opt for surgery to cut their risk of the diseases, a new study suggests.

The research, reported in the journal Cancer, followed 465 women who were tested for mutations in the genes BRCA1 and BRCA2 that substantially boost the lifetime risks of breast and ovarian cancers.

It found that more than 80 percent of women who tested positive for the harmful mutations ultimately chose to have surgery to remove their ovaries, breasts or both.

'Almost all of the women who screened positive did take some sort of action,' said lead researcher Dr. Marc D. Schwartz, of the Lombardi Comprehensive Cancer Center in Washington, D.C.

That may not seem surprising. But Schwartz said there has been some skepticism about how many women with BRCA mutations would choose to have their ovaries or breasts removed.

'It's a difficult decision to have prophylactic (preventive) surgery,' Schwartz noted in an interview.

'There's been a perception that risk-reducing surgery, especially risk-reducing mastectomy, was not something most mutation carriers would choose,' he said.

But most studies on the issue, at least in the U.S., have been short-term -- looking at women's choices in the year or so after a BRCA test result. Women in the current study were followed for an average of just over five years.

Defects in the BRCA1 and BRCA2 genes substantially raise a woman's lifetime risks of breast and ovarian cancers -- to a roughly 60 percent chance of developing breast cancer, and a 15 to 40 percent risk of ovarian cancer.

By comparison, the average U.S. woman has a 12 percent chance of developing breast cancer during her lifetime and only a 1.4 percent chance of ovarian cancer.

Because of the high risks, experts recommend that some women with a strong family history of breast or ovarian cancers be screened for the gene mutations.

For women who test positive, it's a 'pretty firm recommendation' that they have their ovaries removed by about age 40, Schwartz said.

That's because ovarian cancer is difficult to catch early and, therefore, has a high death rate. And studies have found that when a woman has a BRCA mutation, surgery to remove the ovaries not only slashes her risk of developing the cancer by about 90 percent, but can also extend her life.

The recommendations on preventive mastectomy are less firm, Schwartz said.

The surgery does cut carriers' risk of breast cancer by roughly 90 percent. But removing just the ovaries is effective as well -- cutting a mutation carrier's breast cancer risk in half, because removing the ovaries takes away the body's main source of estrogen.

And unlike ovarian cancer, breast cancer can often be detected early: For women with BRCA mutations who choose not to have a mastectomy, experts recommend regular screening with not only mammography, but also MRI scans, which are better at spotting breast tumors in their earliest stages.

Of the 465 women tested in the current study, 31 percent were found to carry BRCA mutations.

There were 100 mutation carriers who still had their ovaries, and two-thirds ultimately opted to have their ovaries and fallopian tubes removed.

And of 108 mutation carriers who still had at least one breast, 37 percent chose to have a mastectomy.

(Most of the women in the study had already been diagnosed with breast or ovarian cancer when they decided to have BRCA testing, so some had previously had one breast or their ovaries removed.)

The U.S. Preventive Services Task Force, an expert panel supported by the federal government, recommends that women with certain family-history patterns of breast or ovarian cancers consider BRCA testing.

That includes women who've had: two first-degree relatives (mother, sister or daughter) diagnosed with breast cancer, one of whom developed the disease by age 50; three or more first- or second-degree relatives diagnosed with breast cancer at any age; two or more first- or second-degree relatives with ovarian cancer. The full task force recommendation can be viewed here: http://bit.ly/p2aiWD.

About 2 percent of U.S. women would meet the criteria for considering BRCA testing, according to the USPSTF.

According to Schwartz, the current findings 'lend credence' to the belief that BRCA testing will ultimately make a difference in carriers' risk of developing breast and ovarian cancers, and possibly extend their lives.

The primary limitation of the study, he said, is that all of the women were tested and received genetic counseling at a single medical center. 'Out in the world, the results may be different,' Schwartz said.

Individual doctors can, and increasingly are, ordering BRCA testing. And women may or may not get the genetic counseling that's recommended for helping them decide what to do with the test result.

And that result is often not straightforward. Many women get what's called an 'inconclusive' or 'uninformative' result: They do not have a known BRCA mutation, but the possibility that they have some genetic abnormality cannot be ruled out.

That's in contrast to a 'true negative' BRCA result -- where a woman tests negative for mutations that had previously been found in a family member.

For women with an inconclusive result, Schwartz said, genetic counseling can help them decide what to do.

If their family history of breast or ovarian cancers is very strong, it might be assumed that there is some sort of genetic risk. So they might still consider preventive surgery or possibly regular MRI screening for breast cancer.

SOURCE: http://bit.ly/kQfXNS Cancer, online June 29, 2011.

$INS01; Line LNY Insave:- TI line name (Map report)
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Research Activities, August 2011: Child/Adolescent Health: Impact of self-esteem and academic achievement on substance use and sexual initiation differs among boys and girls

Research Activities, August 2011: Child/Adolescent Health: Impact of self-esteem and academic achievement on substance use and sexual initiation differs among boys and girls: "Child/Adolescent Health
Impact of self-esteem and academic achievement on substance use and sexual initiation differs among boys and girls

A new study focused on adolescent risk-taking shows that high self-esteem, measured during an initial survey of 1,670 students enrolled in grades 7 through 12, was associated with lower odds of substance abuse in the following year among girls, but not among boys. Self-esteem was not significantly correlated with first sexual intercourse (sexual debut) 1 year later among girls or boys, according to Stephanie B. Wheeler, Ph.D., of the University of North Carolina. In addition, higher academic performance in school was associated with less risky activities among young girls. Female students with 'A' averages had significantly lower odds of sexual debut 1 year later compared with students with 'C' averages and below.

In addition, female students with 'A' or 'B' averages at baseline had lower odds of illegal substance abuse in the following year, but neither self-esteem nor grades had a significant effect on substance abuse after 1 year for male students. Neither self-esteem nor academic performance at baseline had significant effects on adolescent risk-taking 6 to 7 years later.

Using the National Longitudinal Study of Adolescent Health (Add Health), the study first surveyed students in 1994-1995 and subsequently in 1995-1996 and 2001-2002. The finding that early sexual intercourse was strongly associated with subsequent substance use, and vice-versa, suggests that these activities are mutually reinforcing. As such, a behavioral intervention targeting multiple types of risky behaviors youths encounter may be warranted, suggests Dr. Wheeler. She adds that since results varied sharply by gender, thoughtfully designed, gender-specific interventions to prevent early sexual debut and substance use in adolescence may be appropriate. This research was supported by the Agency for Healthcare Research and Quality (T32 HS00032).

See 'Effects of self-esteem and academic performance on adolescent decision-making: An examination of early sexual intercourse and illegal substance use,' by Dr. Wheeler, in the Journal of Adolescent Health 47, pp. 582-590, 2010.

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