Trauma-Informed Undergraduate Medical Education: A Pathway to Flourishing with Adversity by Enhancing Psychological Safety.

We describe the Life Experiences Curriculum (LEC), which attempts to integrate medical student well-being with trauma-informed medical education. The long-term goal of LEC is to help medical students flourish with adversity and trauma, where flourishing refers to having a sense of purpose that arises from awareness of one's strengths and limitations, shaped by life experiences. The short-term goal of LEC is to develop students' relational capacities, such as acceptance and awareness of self and others, while building and maintaining students' psychological safety.

The Association of Childhood Parental Connection With Adult Flourishing and Depressive Symptoms.

Objectives: To determine whether a common measure of childhood emotional neglect, scored instead as a continuous measure of increasing parental connection, is associated with adult flourishing and depressive symptoms, and to compare the magnitude of these 2 associations.

Methods: We pooled cross-sectional survey data from the Midlife in the United States study, collected from 2 national cohorts (2004-2006 and 2011-2014) of English-speaking, US adults, aged 25 to 74 years. Using the 5-item emotional neglect subscale of the Childhood Trauma Questionnaire, a score of increasing childhood parental connection was created by not reverse-scoring responses.

The Association Between Early Childhood Education Professionals' Perception of Workplace Spirituality and Their Intention to Stay in Their Current Program.

Unlabelled: Turnover in the US early childhood education (ECE) workforce is associated with worse outcomes for children. Greater workplace spirituality, or the perception of meaningful work, sense of community, and alignment with organizational values, is associated with reduced turnover. However, this association has not been examined in ECE professionals.

Integrating Human-Centered Design Methods Into a Health Promotion Project: Supplemental Nutrition Assistance Program Education Case Study for Intervention Design.

Background: Human-centered design, or design thinking, offers an extensive toolkit of methods and strategies for user-centered engagement that lends itself well to intervention development and implementation. These methods can be applied to the fields of public health and medicine to design interventions that may be more feasible and viable in real-world contexts than those developed with different methods.

Objective: The design team aimed to develop approaches to building food skills among caregivers of children aged 0-5 years who are eligible for a federal food assistance program while they were in the grocery store.

The Association Between Work as a Calling and Turnover Among Early Childhood Education Professionals.

Turnover of early childhood education (ECE) professionals negatively impacts program costs, staff morale, and relationships with children. We determined whether the presence of work as a calling was associated with less intention to leave the ECE field. From an online survey administered to 265 ECE professionals in Pennsylvania, a calling score based on the Calling and Vocation Questionnaire was used to create sample-defined tertiles of low (< 38), medium (38-44), and high (> 44) presence of calling.

Relational Health as a Pathway from Trauma to Flourishing in School Communities.

Background: Because traumatic life experiences are common, teaching and learning can be difficult without recognizing how trauma can make people feel psychologically unsafe. Safety can be restored through healthy relationships.

Contributions To Theory: We present a framework for how relational health-the capacity to develop and maintain safe, stable, and nurturing relationships with others-may allow flourishing in school communities, even amidst past and ongoing adversity.

The interaction of adverse childhood experiences and gender as risk factors for depression and anxiety disorders in US adults: a cross-sectional study.

Background: Exposure to adverse childhood experiences (ACEs) and being female are distinct risk factors for having a major depressive episode (MDE) or an anxiety disorder (AD) in adulthood, but it is unclear whether these two risk factors are synergistic. The purpose of this study was to determine whether exposure to ACEs and being female are more than additive (synergistic) in their association with MDE and AD in US adults.

Methods: We pooled cross-sectional survey data in the Midlife in the United States study from two nationally-representative cohorts of English-speaking US adults.

Death From COVID-19 as Context for Early Childhood Education.

This survey quantifies the prevalence of socioeconomic deprivation in the lives of early childhood education professionals as well as the prevalence of COVID-19–associated deaths of their family members and close friends.

Diabetes distress and glycaemic control in young adults with type 1 diabetes: Associations by use of insulin pumps and continuous glucose monitors.

Aims: We determined whether high diabetes distress (DD) in young adults with type 1 diabetes was associated with higher glycated haemoglobin (HbA ) levels and whether this association was similar among those who were and were not using diabetes devices (insulin pumps and/or continuous glucose monitors [CGMs]).

Methods: In 2017, an online survey was completed by 423 of 743 (57%) young adults (19-31 years) with type 1 diabetes receiving care at a specialty clinic in New York City. HbA level was the primary outcome measure, and high DD (Diabetes Distress Scale score ≥3) was the primary exposure.

Childhood Family Connection and Adult Flourishing: Associations Across Levels of Childhood Adversity.

Objective: To investigate whether higher levels of childhood family connection were associated with greater adult flourishing and if this association was present across levels of adverse childhood experiences (ACEs) and childhood socioeconomic disadvantage (SED).

Methods: We pooled cross-sectional data from telephone and mailed surveys in the Midlife in the United States study that were collected from 2 nationally representative cohorts (2004-06 and 2011-14) of English-speaking, US adults, aged 25 to 74 years. Adult flourishing z score, standardized to the study population, was created from Ryff's 42-item Psychological Well-being Scale and quartiles of childhood family connection from a 7-item scale assessing parental attention, affection, and communication during childhood.

Association of Childhood Family Connection With Flourishing in Young Adulthood Among Those With Type 1 Diabetes.

Importance: Higher levels of childhood family connection have been associated with measures of adult flourishing or eudaimonic well-being, such as purpose, self-acceptance, positive relationships, and growth. However, this association has not been examined among those with childhood-onset chronic disease.

Objectives: To investigate whether higher levels of childhood family connection were associated with greater flourishing in young adulthood among those with type 1 diabetes and, secondarily, whether this association was present across levels of adverse childhood experiences and childhood social position.

The association between dispositional mindfulness and glycemic control in type 1 diabetes during early adulthood: Differences by age and adverse childhood experiences.

Background: The study objective was to determine whether higher levels of dispositional mindfulness were associated with lower HbA levels among young adults with type 1 diabetes (T1D) and whether this association differed by age or exposure to adverse childhood experiences (ACEs).

Methods: An online cross-sectional survey, called T1 Flourish, was completed in 2017 by 423 of 743 (56.9%) young adults (19-31 years) with T1D receiving outpatient care at a diabetes specialty clinic in New York City.

The association of fatigue with dispositional mindfulness: relationships by levels of depressive symptoms, sleep quality, childhood adversity, and chronic medical conditions.

Although mindfulness-based interventions may be effective in addressing the common symptom of fatigue, no population-based studies have examined the relationship between mindfulness and fatigue. We determined whether higher levels of dispositional mindfulness were associated with lower levels of fatigue. Cross-sectional data were obtained through the Pennsylvania Head Start Staff Wellness Survey, a 2012 web-based survey in which 2199 of 3375 (65%) eligible staff participated.

A quasi-experimental study of the impact of school start time changes on adolescents' mood, self-regulation, safety, and health.

Objective: To determine whether school start time changes impact adolescents' mood, self-regulation, safety, and health.

Methods: In September 2015, two school start time changes were implemented in Fairfax County (VA) Public Schools: a 50-minute delay (to 8:10 am) for high schools and secondary schools and a 30-minute advance (to 7:30 am) for middle schools. We conducted cross-sectional surveys of students' sleep, mood, self-regulation, health, and safety before (2017 students) and after (1180 students) these changes.

Effect of a Trauma-Awareness Course on Teachers' Perceptions of Conflict With Preschool-Aged Children From Low-Income Urban Households: A Cluster Randomized Clinical Trial.

Importance: Adverse childhood experiences are common and are associated with changes in early development and learning, but training early childhood educators in trauma-informed approaches to care has not been evaluated with randomized clinical trials.

Objective: To determine whether a 6-session (12-week) professional development course, "Enhancing Trauma Awareness," improved the quality of teachers' relationships with the children in their classrooms.

Design, Setting, And Participants: This cluster randomized clinical trial conducted from September 2017 to May 2018 allocated classrooms by a computer-generated random sequence to intervention (attend Enhancing Trauma Awareness course) and control (no course) groups.

Drowsy Driving, Sleep Duration, and Chronotype in Adolescents.

Objective: To determine whether self-reported drowsy driving was associated with an evening chronotype, a biologically-based difference in circadian sleep-wake timing, and shorter school-night sleep duration in a sample of high school drivers.

Study Design: Cross-sectional observational data were obtained from an online survey in spring 2015 of 431 drivers, age 15.5-18.

A quasi-experimental study of the impact of school start time changes on adolescent sleep.

Objective: To determine whether simultaneous school start time changes (delay for some schools; advance for others) impact adolescents' sleep.

Design: Quasi-experimental study using cross-sectional surveys before and after changes to school start times in September 2015.

Setting: Eight middle (grades 7-8), 3 secondary (grades 7-12), and 8 high (grades 9-12) schools in Fairfax County (Virginia) public schools.

Trends in domain-specific physical activity and sedentary behaviors among Chinese school children, 2004-2011.

Background: Dramatic increases in child overweight have occurred in China. A comprehensive look at trends in physical activity and sedentary behaviors among Chinese youth is needed. The study aimed to examine trends in domain-specific physical activity and sedentary behaviors, explore mean and distributional changes in predicted behaviors over time, and investigate how behaviors vary by residence.

Development of a Comprehensive Assessment of Food Parenting Practices: The Home Self-Administered Tool for Environmental Assessment of Activity and Diet Family Food Practices Survey.

Background: Parents' food parenting practices influence children's dietary intake and risk for obesity and chronic disease. Understanding the influence and interactions between parents' practices and children's behavior is limited by a lack of development and psychometric testing and/or limited scope of current measures. The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) was created to address this gap.

Adverse childhood experiences, dispositional mindfulness, and adult health.

Objective: To determine whether greater dispositional mindfulness is associated with better adult health across a range of exposures to adverse childhood experiences (ACEs).

Methods: In 2012, a web-based survey of 2160 Pennsylvania Head Start staff was conducted. We assessed ACE score (count of eight categories of childhood adversity), dispositional mindfulness (Cognitive and Affective Mindfulness Scale-Revised), and the prevalence of three outcomes: multiple health conditions (≥ 3 of 7 conditions), poor health behavior (≥ 2 of 5 behaviors), and poor health-related quality of life (HRQOL) (≥ 2 of 5 indicators).

Estimated and forecasted trends in domain specific time-use and energy expenditure among adults in Russia.

Background: Examination of historical trends and projections in estimated energy expenditure in Russia is important given the country's economic downturns and growth.

Methods: Nationally representative data from the Russia Longitudinal Monitoring Survey (RLMS) from 1995-2011 was used to determine the metabolic equivalents of task (MET)-hours per week from occupational, domestic, travel, and active leisure physical activity (PA) domains, as well as sedentary leisure time (hours per week) among adults 18-60 years. Additionally, we projected what these values would be like in 2020 and 2030 if observed trends continue.

Longitudinal, cross-cohort comparison of physical activity patterns in Chinese mothers and children.

Background: There is limited evidence comparing adult and child physical activity (PA) trends and examining parent-child PA associations within a newly industrialized country setting. PA research within a newly industrialized country setting is particularly important given the negative effects of rapid urbanization, socioeconomic growth, and technological advances on PA behaviors. The purpose of our study was to examine trends and associations in PA behaviors in Chinese mother-child pairs and to investigate relationships between PA behaviors and socioeconomic variables in this dyad.