Re-politicizing the WHO's social determinants of health framework.

Although the World Health Organization's (WHO's) framework on social and structural determinants of health and health inequities (SSDHHI) has done much to raise awareness of these determinants, it does not go far enough in considerations of politics and power. The framework has become more de-politicized since its publication, with the definition of social determinants shifting toward downstream and individualized factors. In the meantime, new research fields on legal, commercial and political determinants of health and health inequities have emerged; however, these have not become integrated adequately into broader SSDHHI frameworks.

Is fair representation good for children? effects of electoral partisan bias in state legislatures on policies affecting children's health and well-being.

Increasing evidence suggests that state policies impact constituents' health, but political determinants of health and health inequities remain understudied. Using state and year fixed-effects models, we determined the extent to which changes in electoral partisan bias in lower chambers of U.S.

The role of adverse childhood experiences (ACEs) in predicting academic problems among college students.

Background And Objective: The complex associations between adverse childhood experiences (ACEs) and academic performance among college students are not well understood. The following aims were examined in this longitudinal study: the direct association of ACEs on academic problems after 4 years without (1) and with accounting for other academic risk factors (2a), the possible mechanisms linking ACEs and academic problems (2b).

Participants And Setting: First-semester freshmen (N = 268; 71.

Characteristics of Disclosing Childhood Victimization and Risk of Revictimization in Young Adulthood.

Experiencing victimization in childhood increases risk of adulthood revictimization, and it is important to understand what may contribute to such risk. One factor that may help to explain the increased risk of future victimization is disclosure. However, the literature is mixed as to whether disclosure of prior victimization is helpful for protecting against adverse outcomes, and much of the research on disclosure focuses solely on sexual victimization.

What do undergraduates with high levels of childhood adversity want to cope with stress?

Objectives: We aimed to determine how universities can tailor delivery of stress-related interventions and intervention-related messages for students with adverse childhood experiences (ACEs).

Method: We assessed 762 undergraduates (76% female; average age = 20.3) on an expanded ACEs measure, stress, health, and past use of interventions and what types of interventions they would like to cope with stress.

Identifying adverse childhood experiences in pediatrics to prevent chronic health conditions.

Despite evidence that over 40% of youth in the United States have one or more adverse childhood experiences (ACEs), and that ACEs have cumulative, pernicious effects on lifelong health, few primary care clinicians routinely ask about ACEs. Lack of standardized and accurate clinical assessments for ACEs, combined with no point-of-care biomarkers of the "toxic stress" caused by ACEs, hampers prevention of the health consequences of ACEs. Thus, there is no consensus regarding how to identify, screen, and track ACEs, and whether early identification of toxic stress can prevent disease.

Adverse Childhood Experiences 101: A Primer for Clinicians.

We provide an overview of adverse childhood experiences (ACEs), including a brief history and critique of ACEs as a cumulative risk factor, how ACEs are measured, prevalence of ACEs in epidemiological studies, and associations between ACEs and negative outcomes. Next, we list current hypotheses about potential mechanisms of risk between ACEs and negative outcomes and highlight the importance of examining the social determinants of ACEs. We point out the paucity of research on protective factors in studies on ACEs.

Parent- and Sibling-Directed Aggression in Children of Domestic Violence Victims.

This study examines the nature of parent- and sibling-directed aggression and involvement in other victimization among children living with female caregivers in a domestic violence shelter. Caregivers were interviewed about their children's ( = 79; = 9.0 years) parent- and sibling-directed aggression.

Expanding the Original Definition of Adverse Childhood Experiences (ACEs).

We report two studies examining psychometric properties of an expanded measure of adverse childhood experiences (ACEs) that combined the original ACEs items with items from the Juvenile Victimization Questionnaire. In Study 1, we examined its factorial structure, internal consistency, and concurrent validity in undergraduates ( = 1479). In Study 2, we also examined replicability of frequencies of ACEs, test-retest reliability, and convergent and predictive validity.

Adverse childhood experiences as a predictor of attendance at a health-promotion program.

This short-term longitudinal study examined whether adverse childhood experiences predicted attendance at a fitness program. We asked undergraduates participating in a group fitness program at a university to complete measures of mental health and adverse childhood experiences at the start of the semester. Attendance data were obtained from the recreational center at the end of the semester.

Adverse Childhood Experiences (ACEs) and Help-Seeking for Health-Related Interventions in Young Adults.

Although college students have increasingly higher health needs, they underutilize interventions. Given the association between adverse childhood experiences (ACEs) and poor health, the goal of this study was to examine the contribution of ACEs in undergraduates to seeking help for problems related to health. An online survey of students (N = 321, 76% female, 72% Caucasian) in a large public university showed that respondents with more ACEs were more likely to seek help, including both professional and informal types of help.

Mental and Physical Health Profiles of Maltreated Youth.

To examine both mental and physical health profiles of children diagnosed as maltreated in the community, we studied diagnoses in the electronic health records (EHRs) of youth assigned maltreatment-related diagnoses (N = 406) and well-matched youth without a maltreatment-related diagnosis (N = 406) during a four-year period in a large healthcare system that covers eight hospitals and over 40 clinics. Data extracted automatically from the EHRs was supplemented by manual chart review. The odds of the maltreated group being assigned a code for mental illness was 2.

Tailoring health-related messages for young adults with adverse childhood experiences (ACEs).

The goal was to identify factors that might affect likelihood of seeking health-related interventions for young adults with adverse childhood experiences (ACEs). We tested whether ACEs were associated with (1) regulatory focus (tendency toward promoting good outcomes versus preventing bad outcomes), and (2) patient activation (the intention to take active charge of one's health). We further tested whether promotion and prevention and patient activation were associated with each other and with health.

Parental reactions to parent- and sibling-directed aggression within a domestic violence context.

Parent- and sibling-directed aggression by minor children are two forms of family violence that often co-occur and have strong relations to prior exposure to domestic violence, yet are often overlooked in intervention efforts. In addition, current research does not examine these forms of family violence in tandem, and there is very limited research with samples exposed to domestic violence. To better understand how these forms of aggression operate within a domestic violence context, we interviewed 44 women residing in a domestic violence shelter with at least one child over 3.

Health-Care Utilization Patterns of Maltreated Youth.

To examine in detail the health-care utilization patterns of maltreated children, we studied electronic health records (EHRs) of children assigned maltreatment-related codes in a large medical system. We compared youth with maltreatment-related diagnoses (N = 406) with those of well-matched youth (N = 406). Data were based on EHRs during a 4-year period from the University of Minnesota's Clinical Data Repository, which covers eight hospitals and over 40 clinics across Minnesota.

Documentation of Child Maltreatment in Electronic Health Records.

International Classification of Diseases codes for child maltreatment can aid surveillance and research, but the extent to which they are used is not well established. We documented prevalence of the use of maltreatment-related codes, examined demographic characteristics of youth assigned these codes, and compared results with previous studies. Data were extracted from electronic health records of 0- to 21-year-olds assigned 1 of 15 maltreatment-related International Classification of Diseases, Ninth Revision, codes who had encounters in a large medical system over a 4-year period.

Effects of Adverse Childhood Experiences, Stress, and Social Support on the Health of College Students.

The goal of the study was to describe the nature of adverse childhood experiences (ACEs) reported by undergraduates and to examine the effect of ACEs, perceived stress, and perceived social support on their health. Although respondents ( = 321) had parents with relatively high levels of education and indicated generally high levels of social support, results nevertheless showed a relatively high level of mental health problems and rates of ACEs that were similar to those in the general population in the state. Those with higher levels of ACEs had greater levels of stress and lower levels of social support.

Gyrification differences in children and adolescents with velocardiofacial syndrome and attention-deficit/hyperactivity disorder: a pilot study.

We used magnetic resonance imaging to investigate brain gyrification patterns between 19 children with attention-deficit/hyperactivity disorder (ADHD), 9 children with velocardiofacial syndrome (VCFS), and 23 control children. We found that VCFS is associated with widespread decreases in gyrification. In ADHD, we found minor differences from control children.

Memory-guided saccades in youth-onset psychosis and attention deficit hyperactivity disorder (ADHD).

Aim: Working memory deficits have been shown to be present in children and adolescents with schizophrenia and attention deficit hyperactivity disorder. Considering the differences in clinical characteristics between these disorders, it was the goal of this study to assess differences in the specific components of working memory in children and adolescents with psychosis and attention deficit hyperactivity disorder.

Methods: Children and adolescents (age range 8-20 years) with either a non-affective psychotic disorder (n = 25), attention deficit hyperactivity disorder (n = 33) and controls (n = 58) were administered an oculomotor delayed-response task using both a recall and a control condition.

Verbal and visuospatial working memory development and deficits in children and adolescents with schizophrenia.

Aim: Deficits in working memory are considered a core feature of schizophrenia and are present early in the course of the illness. Because working memory continues to mature through childhood and into early adulthood, it was the aim of this study to assess developmental trajectories of verbal and visuospatial working memory performance in children and adolescents with schizophrenia. Differences in the developmental trajectories in patients compared with controls may reflect differential effects within specific neural networks involved in working memory performance.

Differential fractional anisotropy abnormalities in adolescents with ADHD or schizophrenia.

Schizophrenia and Attention-Deficit/Hyperactivity Disorder (ADHD) are associated with similar deficits in working memory, attention, and inhibition. Both disorders also involve abnormalities of white matter integrity, possibly reflecting neural communication disruptions. There are likely some regional white matter abnormalities that underlie the common cognitive impairment, though also some regional abnormalities unique to each disorder.

White matter 'potholes' in early-onset schizophrenia: a new approach to evaluate white matter microstructure using diffusion tensor imaging.

There is considerable evidence implicating white matter abnormalities in the pathophysiology of schizophrenia. Many of the recent studies examining white matter have utilized diffusion tensor imaging (DTI) using either region of interest (ROI) or voxel-based approaches. Both voxel-based and ROI approaches are based on the assumption that the abnormalities in white matter overlap spatially.

Shared and nonshared symptoms in youth-onset psychosis and ADHD.

Objective: We compared ratings of behavior and attention problems between youth-onset psychosis and ADHD, two disorders in which attentional impairments play a key role, and examined the effect of psychostimulant use on age of onset in psychosis.

Method: Parent and teacher ratings of behavioral problems and ADHD symptoms were collected using the Achenbach CBCL, TRF, and SNAP-IV Teacher Rating Scales on 42 participants with psychosis, 36 with ADHD and 57 controls (ages 8-19).

Results And Conclusions: Results suggested that academic, externalizing, and attention problems reflect symptoms shared between the disorders, whereas internalizing, social and thought problems reflect factors that differ between disorders.