Adverse childhood experiences (ACEs) have been associated with a range of physical and mental health problems, and it is now understood that the developmental timing of ACEs may be critically ...important. Despite this, there is a distinct lack of methods for the efficient assessment of such timing in research and clinical settings. We report on the development and validation of a new measure, the Adverse Life Experiences Scale (ALES), that indexes such developmental timing within a format incorporating caregivers' reports of ACEs in their own lives and those of their children. Participants were a nationally representative sample of Australian families (n = 515; Study 1), and a sample of clinic-referred families (n = 168; Study 2). Results supported the internal consistency and test-retest reliability of the ALES and indicated high levels of acceptability for the measure. In terms of validity, ALES scores were significantly associated with interview-based measures of child maltreatment and quality of the family environment, as well as measures of psychopathology across multiple informants (parents, teachers, clinician-rated). Furthermore, indices of ACEs occurring within specific age-based periods of childhood were found to explain unique variance in current symptoms of child and caregiver psychopathology, independent of the overall chronicity of those ACEs and current adversity.
Public Significance Statement
The collection of valid and reliable data on adverse childhood experiences (ACEs) is important to research and clinical practice in a range of settings. The Adverse Life Experiences Scale is a new measure of ACEs that is designed to index the occurrence and developmental timing of such experiences, both in the lives of parents and their children. This is important because existing measures have typically neglected such timing, while focusing on parents and children in isolation.
Risdiplam in Type 1 Spinal Muscular Atrophy Baranello, Giovanni; Darras, Basil T; Day, John W ...
The New England journal of medicine,
03/2021, Letnik:
384, Številka:
10
Journal Article
Recenzirano
Odprti dostop
Type 1 spinal muscular atrophy is a rare, progressive neuromuscular disease that is caused by low levels of functional survival of motor neuron (SMN) protein. Risdiplam is an orally administered, ...small molecule that modifies
pre-messenger RNA splicing and increases levels of functional SMN protein.
We report the results of part 1 of a two-part, phase 2-3, open-label study of risdiplam in infants 1 to 7 months of age who had type 1 spinal muscular atrophy, which is characterized by the infant not attaining the ability to sit without support. Primary outcomes were safety, pharmacokinetics, pharmacodynamics (including the blood SMN protein concentration), and the selection of the risdiplam dose for part 2 of the study. Exploratory outcomes included the ability to sit without support for at least 5 seconds.
A total of 21 infants were enrolled. Four infants were in a low-dose cohort and were treated with a final dose at month 12 of 0.08 mg of risdiplam per kilogram of body weight per day, and 17 were in a high-dose cohort and were treated with a final dose at month 12 of 0.2 mg per kilogram per day. The baseline median SMN protein concentrations in blood were 1.31 ng per milliliter in the low-dose cohort and 2.54 ng per milliliter in the high-dose cohort; at 12 months, the median values increased to 3.05 ng per milliliter and 5.66 ng per milliliter, respectively, which represented a median of 3.0 times and 1.9 times the baseline values in the low-dose and high-dose cohorts, respectively. Serious adverse events included pneumonia, respiratory tract infection, and acute respiratory failure. At the time of this publication, 4 infants had died of respiratory complications. Seven infants in the high-dose cohort and no infants in the low-dose cohort were able to sit without support for at least 5 seconds. The higher dose of risdiplam (0.2 mg per kilogram per day) was selected for part 2 of the study.
In infants with type 1 spinal muscular atrophy, treatment with oral risdiplam led to an increased expression of functional SMN protein in the blood. (Funded by F. Hoffmann-La Roche; ClinicalTrials.gov number, NCT02913482.).
Adverse childhood experiences (ACEs) are linked with negatively impacting child and adult health outcomes. Clinicians are integral in identifying childhood adversities and offering supportive ...measures to minimize negative effects. This systematic literature review included 13 ACE studies that examined the acceptability, feasibility, and implementation of ACE screenings from the perspectives of clinicians and patients. The findings of this review can assist clinicians in considering the appropriateness of ACE screenings for their patients and the ethical and practical issues that must be addressed for effective screening implementation.
•Patients find adverse childhood experience (ACE) questionnaires an acceptable part of care and are willing to review with their clinician.•Patients and clinicians report discussing ACE screens improves the patient-clinician relationship.•ACE screenings are feasible to incorporate into a variety of health care settings, including outpatient visits and home visits.•The successful implementation of ACE screenings includes education and training for clinicians and support staff.•The availability of local resources should be assessed and a referral system in place before implementing ACE screenings.
Many researchers have examined the cumulative effects of adverse childhood experiences (ACEs) and found that higher levels of ACEs increase the risk for worsening health conditions. Recent research ...has moved beyond the simple counting of ACEs, to develop a more nuanced understanding of the ways in which ACEs are experienced. Despite evidence that ACEs are experienced differentially by race, limited attention has been paid to these differences. The objective of the current study is to understand whether groupings of ACEs are experienced similarly across racial groups. A subsample of Latinx, Black, and White children were drawn from the National Survey of Children's Health 2016 data release was used as the sample (N = 43,711). The primary measure included in the study were 9 ACE indicators available in the survey. We use descriptive and latent class analysis to examine whether similar clusters of ACEs appear across racial groups. We found that White children had lower exposure to specific ACEs as well as total number of ACEs compared to non-Latinx Black and Latinx Children. In addition, there was not configural similarity between race/ethnic groups and the latent class structure of ACE exposure varies by child race/ethnicity, suggesting important differences by child race. Understanding the disparities in children's experiences can inform screening and intervention development.
Public Policy Relevance Statement
Prior research has focused almost exclusively on the count of adverse childhood experiences (ACEs) and has failed to recognize important racial differences in these experiences. It is critical that we consider how race may influence ACE exposure and move toward meaningful interpretation of screening as the field simultaneously considers how to better match interventions to meet children's needs.
•The prevalence of childhood maltreatment ranged 0.31-0.38 depending on subtype.•Substance use disorder samples reported almost one third of people with single types of maltreatments.•Childhood ...maltreatment rates vary between different continents and are more commonly in North America.
Substance use disorder is known to be associated with childhood trauma, yet prevalence estimates have varied markedly due to methodological differences. The meta-analysis presented here aimed to estimate prevalence rates of childhood trauma for people with substance use disorder using the short form of the Childhood Trauma Questionnaire (CTQ-SF).
Four major public databases (PubMed, Embase, The Cochrane Library and PsycINFO) were searched for eligible studies until April 2nd, 2018.
Ten studies were included with a total sample size of 1,310 across six countries. The prevalence estimates of each subtype of childhood trauma across all substance use disorder samples were: emotional abuse (38%, 95% CI: 28%-48%); physical abuse (36%, 95% CI: 27%-45%); sexual abuse (31%, 95% CI: 23%-41%); emotional neglect (31%, 95% CI: 18%-45%) and physical neglect (32%, 95% CI: 25%-40%). Subgroup analysis by continent demonstrated that the highest prevalence rates of emotional abuse were found in North America and South America (45%). Compared with other continents, the prevalence rates of North America were the highest for physical abuse, sexual abuse, emotional neglect and physical neglect (39%-44%).
Childhood trauma is prevalent among substance use disorder samples compared to the general population. Different continents have different levels of prevalence of childhood trauma, which may be due in part to socioeconomic, cultural and definitional variations.
Adopting an interdisciplinary approach, Rachel M. Heydon and Luigi Iannacci shed light on the ways in which joint notions of normality and abnormality are used to pathologize childhood.
Adult survivors of childhood sexual abuse (CSA) may experience emotional, social, and psychological difficulties, heightened due to the interpersonal nature of harm. Despite the demonstrated ...effectiveness of trauma-focused treatments in the West, a culturally specific understanding of the needs of and treatments for survivors in South Asia is still in its infancy. The study aimed to systematically review research findings on the mental health impacts of CSA on adult survivors and current treatment approaches and their efficacy and acceptability in South Asia. Seven databases (Scopus, Ovid, CINAHL, ProQuest, EThOS, Google Scholar, and Dogpile) and five peer-reviewed South Asian journals were searched from inception until March 30, 2023. Searches included participants who were adult survivors of CSA of South Asian origin residing in South Asia. Studies on their mental health, different treatments, and the efficacy and acceptability of these treatments were included. Quality assessment tools were used to appraise the quality of included studies. The results were synthesized narratively. A total of 3,362 records were retrieved, and 24 articles were included in the final review. Twenty studies reported mental health impacts of CSA on adult survivors, four studies reported current treatments offered, and two studies were on recovery. However, no study focused on the efficacy or acceptability of the treatments being delivered. Even though the needs of adult CSA survivors in South Asia have been partly identified, there is very little research into the treatments for them.
A "must read" for practitioners, policy makers and researchers interested in the detail and the theory underpinning this important family literacy initiative′ - Neil McClelland OBE, Director, ...National Literacy Trust `The REAL Project is one of the best conceptualized, most intensively documented and successful British family literacy initiatives and the book provides a comprehensive overview of all aspects of this powerful project. It is essential reading for anyone working alongside families to promote children′s early development′ - Professor Nigel Hall, Institute of Education, Manchester Metropolitan University Anyone involved in the field of early-childhood literacy should be familiar with the work of the REAL (Raising Early Achievement in Literacy) Project. Here, leading members of the project team Cathy Nutbrown, Peter Hannon and Anne Morgan, discuss the research. An essential guide to the subject, this book will be of great practical use to all in the field of early childhood literacy: students, practitioners and course leaders on literacy and early childhood courses. The authors discuss the policy contexts of early-childhood and literacy today and use their experience of the REAL project to discuss and illustrate practical research and evaluation strategies for family literacy workers. They examine the issues from all perspectives: teachers, parents and young children. The book concludes with examples of how the theoretical framework of the REAL Project (ORIM) has been used by other practitioners and an examination of the implications of such work for the future of early-childhood and literacy policy development.
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