The impact of adverse childhood experiences on an urban pediatric population

Objective

The goal of this study was to investigate the adverse childhood experiences (ACEs) in youth in a low-income, urban community.

Study design

Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. Medical chart documentation of ACEs as defined in previous studies were coded and each ACE criterion endorsed by a traumatic event received a score of 1 (range = 0-9). This study reports on the prevalence of various ACE categories in this population, as well as the association between ACE score and two pediatric problems: learning/behavior problems and body mass index (BMI) ≥ 85% (i.e., overweight or obese).

Results

The majority of subjects (67.2%, N = 471) had experienced 1 or more categories of adverse childhood experiences (ACE ≥ 1) and 12.0% (N = 84) had experienced 4 or more ACEs (ACE ≥ 4). Increased ACE scores correlated with increased risk of learning/behavior problems and obesity.

Conclusions

There was a significant prevalence of endorsed ACE categories in this urban population. Exposure to 4 or greater ACE categories was associated with increased risk for learning/behavior problems, as well as obesity.

Practice implications

Results from this study demonstrate the need both for screening of ACEs among youth in urban areas and for developing effective primary prevention and intervention models.     

Childhood trauma and psychiatric disorders as correlates of school dropout in a national sample of young adults

The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S.-born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys, a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2,532 young adults, aged 21-29. The dropout prevalence rate was 16% overall, with variation by childhood trauma, childhood psychiatric diagnosis, race/ethnicity, and nativity. Childhood substance and conduct disorders mediated the relation between trauma and school dropout. Likelihood of dropout was decreased for Asians, and increased for African Americans and Latinos, compared to non-Latino Whites as a function of psychiatric disorders and trauma. Timing of U.S. immigration during adolescence increased risk of dropout.     

Strengthening Universal Primary Education in Uganda: The potential role of an asset-based development policy

This paper is divided into three complementary parts. First, we examine the challenges to the Universal Primary Education (UPE) policy in Uganda, including insufficient instructional materials and family-level poverty. Second, guided by asset theory, and based on a systematic review of studies on asset-based development programs and interventions, we assess the potential of these programs in addressing the challenges of UPE, and improving access to UPE. Third, we conclude with a discussion of the implication of using asset-based development as one structural-level approach that may strengthen the UPE policy.     

Implementation of the Peer-Led Team-Learning Instructional Model as a Stopgap Measure Improves Student Achievement for Students Opting Out of Laboratory

In entry-level university courses in science, technology, engineering, and mathematics fields, students participating in associated laboratory sessions generally do better than those who have no related lab classes. This is a problem when, for various reasons, not enough lab sections can be offered for students and/or when students opt out of optional available lab courses. Faced with such a situation, this study evaluated the efficacy of the peer-led team-learning (PLTL) instructional model as a potential method for narrowing the achievement gap among undergraduate students electing not to enroll in an optional laboratory component of an introductory biology course. In peer-led workshops, small groups of students participated in solving problems and other activities that encouraged active learning. Students led by peer leaders attained significantly higher exam and final course grades in introductory biology than comparable students not participating in PLTL. Among the introductory biology students who opted not to enroll in the optional lab course, those who participated in PLTL averaged more than a letter grade higher than those who did not. This difference was statistically significant, and the PLTL workshops almost entirely closed the achievement gap in lecture exam and final grades for students who did not take the lab.     

‘Development in reverse’? A longitudinal analysis of armed conflict,fragility and school enrolment

This paper presents a longitudinal analysis of cross-national data on armed conflict, state fragility, and enrolment in primary and secondary schooling. The study is motivated by questions raised in the 2012 Human Security Report, which challenges the widely held assumption that conflict is necessarily detrimental to educational outcomes. We use multilevel modelling techniques to determine how conflict and fragility relate to changes in enrolment. Our findings suggest that growth in enrolment is significantly lower in conflict-affected countries but that the effect is dependent upon countries' overall enrolment level. However, when we control for fragility, the effect of conflict is not significant, which is consistent with the Human Security Report's suggestion that fragility is an underlying cause of both conflict and poor educational outcomes. We conclude by discussing the relevance of our findings and challenges for future research on fragility and education.     

Predicting and explaining students’ stress with the Demand–Control Model: does neuroticism also matter?

University students often report high stress levels, and studies even suggest a recent increase. However, there is a lack of theoretically based research on the structural conditions that influence students’ perceived stress. The current study compared the effects of Karasek’s demand–control dimensions with the influence of neuroticism to address environmental and individual characteristics related to stress. Two points of measurement were included: T1 in the middle of the term and T2 during the examination period. Participants were 146 psychology students at two German universities (M_age = 22.6 years). We applied an adapted version of Karasek’s Job Content Questionnaire, a self-developed stress scale, and the 21-item Big-Five-Inventory. At T1, both neuroticism and demands significantly predicted stress (total adjusted R² = .40), although relative weights analyses indicated that the contribution of demands was more pronounced (relative importance: 63%). Longitudinally, controlling for stress at T1, the demand–control dimensions explained additional variance in the increased stress level at T2, whereas neuroticism did not contribute additionally (R² = .52). Results indicate that self-reports on stress among university students are not only a reflection of underlying negative affectivity. We conclude that perceived stress can be explained by structural conditions rather than personality, providing opportunities to reduce stress among students.     

Thinking relationally about studying ‘up’

In this paper, the authors argue that despite a resurgence of elite studies, the majority of existing scholarship works to reify and legitimize social inequality through its language and method. In particular, the authors utilize Pierre Bourdieu’s concept of relational thinking to review and critique contemporary research on elite education and the ways in which such scholarship relies on a stratificationist approach to class analysis. Ultimately, this paper argues that future research on social class, and elite studies in particular, could benefit from using Bourdieu’s relational approach as a means to better address the challenges of social inequality.     

The Trouble with Higher Education: A critical examination of our universities

This study examined and compared the legal inputs, structural settings and implementation process of lifelong learning policy in Thailand and Japan focusing on street-level agents. The findings demonstrated that while both countries had legal frameworks that provided a legislative platform to promote lifelong learning among the elderly based on a bottom-up implementation of policies, three major differences existed that equated with different outcomes of lifelong learning among the elderly in both countries. First, the promotion of lifelong learning for the elderly in Thailand mirrored complex administrative structures of several host organizations and multiple legal frameworks; whilst Japan’s lifelong learning policy had been promoted based on the Social Education Act under a single ministry. Second, while Thailand based its policy implementation on government agents at the regional and local level in policy delivery, Japan developed a community-based multilayered platform that promoted the policy with active involvement from various local players. Finally, lifelong learning policy for the elderly in Thailand reflected the personal initiatives of policy promotion by government agents at the local level; whereas, lifelong learning policy for the elderly in Japan was pursued based on the interests of the elderly and the community in which they lived.