Children's Exposure Research Articles

Addressing Maternal Perceived Fears in Supervising Children's Mobility

Children's independent mobility positively impacts their physical and mental well-being. However, parents' concerns regarding neighbourhood safety often restrict the capability of children to explore their surroundings independently. Our study of various parenting methods for supporting children's everyday use of public space is based on maternal perception of fears and the subsequent impact of those fears on children's limited exposure to spatial mobility. The study employs a qualitative retrospective approach to interview mothers in the Jakarta Metropolitan Area. We selected mothers with an argument that the impact of maternal figures on children's mobility is more significant than that of fathers. The research suggests that mobility experienced by mothers increases their perceived fears resulting in parenting practices that tend to discourage children from independently navigating public spaces. This study demonstrates that a significant reduction in women's ability to have independent mobility throughout their life course may affect their parenting methods in introducing spatial knowledge to children.

Decreased mononuclear cell NR3C1 SKA2 and FKPB5 expression levels among adult survivors of suicide bombing terror attacks in childhood are associated with the development of PTSD.

Life threatening trauma and the development of PTSD during childhood, may each associate with transcriptional perturbation of immune cell glucocorticoid reactivity, yet their separable longer term contributions are less clear. The current study compared resting mononuclear cell gene expression levels of the nuclear receptor, subfamily 3, member 1 (NR3C1) coding the glucocorticoid receptor, its trans-activator spindle and kinetochore-associated protein 2 (SKA2), and its co-chaperon FKBP prolyl isomerase 5 (FKBP5), between a cohort of young adults first seen at the Hadassah Emergency Department (ED) after surviving a suicide bombing terror attack during childhood, and followed longitudinally over the years, and matched healthy controls not exposed to life threatening trauma. While significant reductions in mononuclear cell gene expression levels were observed among young adults for all three transcripts following early trauma exposure, the development of subsequent PTSD beyond trauma exposure, accounted for a small but significant portion of the variance in each of the three transcripts. Long-term perturbation in the expression of immune cell glucocorticoid response transcripts persists among young adults who develop PTSD following life threatening trauma exposure in childhood, denoting chronic dysregulation of immune stress reactivity.

Health Impact of School Built Environment on Children

School-built environment impacts mental health, physical health, obesity, bullying, learning disorder, and respiratory disorders in children. The built environments of schools have a direct implication on the health of children. Indoor air quality in school buildings will play a role in children's exposure to pollution. One of the most consistently reported factors associated with children's active travel rates to school is the distance to school, with children more likely to walk or cycle to school the closer they live to the school. An evidence base regarding the built environment factors that shape decision-making and behavior related to active modes of travel in adults is emerging for policymakers. Functional aspects of the built environment include the distance between places; street design and geometry; street connectivity; path infrastructure, aesthetic qualities; safety; the mix of land uses; and the proximity and quality of destinations. Regarding architecture, the primary goal should be to create a space that maximizes natural light, airflow, and captivating aesthetics. Students spend their most important and developing years on school campuses; it is essential to consider their mental and physical health to create an environment where they can learn and develop their personalities in comfort. This paper discusses the health impacts that school-built environments have on children from a public health professional's perspective as well as an architect's viewpoint, as both institutions are crucial for children and adolescents to grow up in environments that encourage more active, safe, and sustainable lifestyles.

Parents' emotion suppression exacerbates the effect of COVID-19 stress on youth internalizing symptomatology.

The COVID-19 pandemic has resulted in heightened stress for families in the United States, and exposure to pandemic-related stress has been found to confer risk for mental health problems among both children and parents. To isolate risk and protective factors for children living through the ongoing pandemic, several studies have begun to examine family-level factors that may exacerbate or buffer the impact of exposure to COVID-19-related stress on children's symptomatology. Building upon the extant literature documenting associations between parents' emotion regulation and children's mental health, especially during times of stress, the present study aimed to examine parents' regulation of their own emotions as a potential moderator of the association between children's exposure to family-level COVID-19-related stress and internalizing and externalizing problems. Results suggest that parents' regulation of their own emotions using expressive suppression, specifically, may exacerbate the effect of exposure to pandemic-related stress on children's internalizing problems, but not externalizing problems. Results highlight the importance of prioritizing parents' mental health and self-regulation in prevention and intervention efforts aimed at improving family-wide mental health outcomes during public health crises that place family systems under significant stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

See no evil, hear no evil, speak no evil: assessing complex trauma in young children

AbstractComplex trauma generally refers to a child's exposure to multiple traumatic events often within the context of an interpersonal relationship. Childhood traumatic events are commonplace and can have significant implications for physical and mental health. However, traumatic events are often not assessed by clinicians involved in their care. This paper outlines an approach to assessing complex trauma in young children in clinical settings. This approach involves an initial interview, an assessment of traumatic events and trauma symptoms in the child, an assessment of the parent–child interaction, an understanding of the child's functioning in multiple settings, and an assessment of parental trauma where relevant. Complex trauma takes time to assess and is dependent on the parent's ability to recognise and acknowledge the effect trauma has had. The paper concludes with some of the challenges when assessing complex trauma in young children in clinical settings.

Self-efficacy, test anxiety and mathematics performance in Uruguayan adolescents exposed to community violence

Introduction. Community violence exposure (CVE) during adolescence relates negatively with academic performance, yet little is known about the mechanisms that underlie this association. Research on self-regulated learning identifies self-efficacy and test anxiety as key for explaining academic performance, while the stress process model of children's exposure to violence provides a framework for understanding how these aspects of the learning process may be debilitated by CVE. Method. This study aims to explore the mediating role of self-efficacy and test anxiety in the relation between CVE and academic performance. In a sample of 110 adolescents from low-income neighborhoods in Montevideo, Uruguay, structural equation modeling was used to test the hypothesis that adolescents with higher CVE have lower self-efficacy and higher test anxiety, which in turn compromises their mathematics achievement. We also hypothesize an indirect negative effect of CVE on self-efficacy through test anxiety. Results. Our data confirm that CVE is associated with test anxiety and mathematics score, yet not self-efficacy. While both self-efficacy and test anxiety relate to mathematics score, our sample does not support an indirect effect of CVE on mathematics performance through these variables. Furthermore, analysis reveal a surprising positive – yet small – indirect effect of CVE on self-efficacy through test-anxiety. Discussion and Conclusion. As self-efficacy – a malleable tool for promoting academic outcomes – appears not directly related to CVE in our sample, it holds important potential for enhancing academic achievement in youth exposed to community violence. Implications for psycho-educational interventions are set forth.

Consequences of vicarious traumatization among mental health service providers with a history of child maltreatment: A narrative review.

This narrative review synthesizes existing literature evaluating the psychological and physiological impacts of vicarious trauma (VT), secondary traumatic stress (STS), and compassion fatigue (CF) in mental health providers (MHPs) with a personal history of childhood maltreatment. It also evaluates the impact of MHP childhood maltreatment history on the risk for developing VT, STS, and CF. We conducted electronic database searches and forward and backward citation chaining to identify relevant articles. We extracted and synthesized data via iterative readings of each article, and then grouped articles into key thematic areas. We synthesized 10 studies. The studies identified a variety of psychological consequences of STS, CF, and VT, including increased risk of burnout, disruptions in cognitions, and altered worldviews. No studies examined the physiological consequences of STS, CF, or VT, highlighting a significant research gap. Nine of the 10 studies evaluated child maltreatment as a risk factor for STS, CF, or VT, with only five of these nine finding an association. Prevalence of maltreatment, especially emotional abuse and neglect, is high in the MHP population and may contribute to ongoing vulnerability to STS, CF, and VT. Childhood exposure to sexual abuse could have implications for MHPs' own intimate relationships. Studies with sample sizes capable of explicating the role of each type of child maltreatment for STS, CF, or VT among MHPs are needed. In addition, it would be prudent to regularly collect data on STS, CF, and VT experiences alongside physiological and psychological outcomes among the MHP workforce. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Vitamin D Status in Turkish Children During the Covid-19 Pandemic; A Single Center Experience

Objective: COVID-19-related lockdown decreased the children's exposure to sunlight, and they were susceptible to 25-hydroxyvitamin D [25(OH)D] deficiency. The present study aimed to examine the 25(OH)D levels 2 years before and during the first year of the pandemic. Materials and Methods: This study included children who underwent health checks between the equivalent period during 2018 October–2020 March, and they were categorized according to the date vitamin D was checked; 2018 October -2019 March (Group 1), 2019 October and 2020 March (Group 2), 2020 October, and 2021 March (Group 3). We compared the children’s 25(OH)D levels and vitamin D deficiency rates between Groups 1, 2, and 3. Results: We found that the mean of the children's 25(OH)D levels was lower during COVID-19 than in the last two years before the pandemic (p=0.039). The present study showed that the rates of 25(OH)D deficiencies among ages 0-1, and 4-7 were higher during the pandemic than before (p= 0.013, p=0.011). Conclusion: Reduced sunbathing time during confinement is associated with lower 25(OH)D levels among children aged 4–7. Although increased rates of 25(OH)D deficiency in infants are worrying.

Childhood exposure to science through museums

Andrea Ingram is an experienced lawyer, public policy advocate, social service agency executive, and a cultural institution thought leader. She currently serves as the President and CEO at DuPage Children’s Museum (DCM). Ingram’s work has focused on building networks to connect underserved and underrepresented communities and families to exceptional learning experiences. As the Vice President of Education and Guest Services at the Chicago Museum of Science and Industry (MSI) for 13 years, she developed the nationally recognized "Welcome to Science Initiative;” as the Chief of Strategic Partnerships and Information for the Illinois Department of Children and Family Services (DCFS), Ingram designed systems to connect resources to youth while leading the application of research to policy; as the Director of Budget and Tax Policy for Voices of Illinois Children, Ingram became a leading expert and advocate on the fiscal policy that impacts children and families. Two childhood educators founded DuPage Children’s Museum in 1987 with the vision of providing access for all children to playful learning experiences that support the development of their creativity, critical thinking, and problem solving skills. Building on the foundation of DCM’s 35 years of impact, Ingram is now leading DCM in a transformation that supports children and youth across Illinois in becoming innovators, scientists, and solution builders of global challenges through a local lens. MIT SPR spoke to Ingram about removing the barriers and developing policies to promote children’s engagement in science through museums.

Childhood Parental Incarceration and Adult-Onset Hypertension and Cardiovascular Risk

Parental incarceration is an adverse childhood experience that disproportionately affects racially minoritized individuals and has been associated with long-term health risks. Although cardiovascular disease remains the primary cause of mortality differences between Black and White individuals in the US, the association between parental incarceration and cardiovascular risk remains poorly understood. To examine the association between parental incarceration during childhood and incident cardiovascular risk in adulthood. This population-based cohort study included data from waves IV (2008-2009) and V (2016-2018) of the US National Longitudinal Study of Adolescent to Adult Health. Participants represented US adults transitioning from young adulthood to adulthood. Data were analyzed from October 28, 2021, to May 1, 2023. Parental incarceration was defined as a parent or parent-like figure going to jail or prison when participants were aged younger than 18 years. Outcome measures included self-reported diagnoses of obesity, hyperlipidemia, hypertension, diabetes, or heart disease as well as serum elevations in non-high-density lipoprotein cholesterol (≥160 mg/dL) and high-sensitivity C-reactive protein (hsCRP >3 mg/L), a marker of inflammation used to estimate risk of future coronary events. Using sampling weights, incident development of each outcome was modeled as a function of parental incarceration, adjusting for participant- and neighborhood-level characteristics. This study included 9629 participants representing 16 077 108 US adults. Approximately half of participants were women (5498 [weighted 50.3%]) and the majority (5895 [weighted 71.4%]) were White. The mean participant age was 37.8 years (95% CI, 37.5 to 38.0 years) in wave V compared with 28.9 years (95% CI, 28.6 to 29.1 years) in wave IV. In wave V, those with childhood exposure to parental incarceration had lower educational attainment (91 [weighted 8.2%] vs 245 [weighted 4.2%] completing less than high school), had higher rates of public insurance (257 [weighted 20.6%] vs 806 [weighted 11.0%]), and were disproportionately Black (374 [weighted 22.5%] vs 1488 [weighted 13.6%]). Parental incarceration was associated with 33% higher adjusted odds (95% CI, 1.05 to 1.68) of developing hypertension and 60% higher adjusted odds (95% CI, 1.03 to 2.48) of developing elevated hsCRP. Associations between childhood parental incarceration and other diagnoses (ie, obesity, hyperlipidemia, diabetes, or heart disease) and serum lipid levels were not observed. In this cohort study of US adults transitioning from young adulthood to adulthood, an increased incidence of hypertension and high-risk hsCRP, but not other cardiovascular risk factors, was observed among those exposed to parental incarceration during childhood. These findings suggest possible transgenerational health consequences of mass incarceration.

Metabolomics insights into the effects of pre-pregnancy lead exposure on bone metabolism in pregnant rats

Today's women of childbearing age with a history of high lead (Pb) exposure in childhood have large Pb body burdens, which increases Pb release during pregnancy by promoting bone Pb mobilisation. The purpose of this study was to investigate the metabolic mechanisms underlying bone Pb mobilisation and explore the bone metabolism-related pathways during pregnancy. Drinking water containing 0.05% sodium acetate or Pb acetate was provided to weaned female rats for 4 weeks followed by a 4-week washout period, and then rats were co-caged with healthy males of the same age until pregnancy. Blood and bone tissues of the female rats were collected at gestational day (GD) 3 (early pregnancy), GD 10 (middle pregnancy), and GD 17 (late pregnancy), respectively. Pb and calcium concentrations, biomarkers for bone turnover, bone microstructure, serum metabolomics, and metabolic indicators were intensively analyzed. The results demonstrated that pre-pregnancy Pb exposure elevated blood lead levels (BLLs) at GD17, accompanied by a negative correlation between BLLs and trabecular bone Pb levels. Meanwhile, Pb-exposed rats had low bone mass and aberrant bone architecture with a larger number of mature osteoclasts (OCs) compared to the control group. Moreover, the metabolomics uncovered that Pb exposure caused mitochondrial dysfunction, such as enhanced oxidative stress and inflammatory response, and suppressed energy metabolism. Additionally, the levels of ROS, MDA, IL-1β, and IL-18 involved in redox and inflammatory pathways of bone tissues were significantly increased in the Pb-exposed group, while antioxidant SOD and energy metabolism-related indicators including ATP levels, Na+-K+-ATPase, and Ca2+-Mg2+-ATPase activities were significantly decreased. In conclusion, pre-pregnancy Pb exposure promotes bone Pb mobilisation and affects bone microstructure in the third trimester of pregnancy, which may be attributed to OC activation and mitochondrial dysfunction.

The Intersection of Demographic Factors, Parental Awareness, and Attitudes: Implications for Children's Health Risks from Secondhand Tobacco Smoke

Objective: This study aims to investigate the association between demographic factors, such as age, ethnicity, income, education, and occupation, with parents' perspectives and awareness of the health risks associated with secondhand smoke (SHS), considering the significance of these factors for effective health education and prevention initiatives. Methods: Data were collected from 378 employees working in four higher education institutions in the Klang Valley region of Malaysia. A standardized questionnaire was administered to collect data on demographic characteristics, knowledge, and attitudes towards SHS. Path analysis was employed to examine the relationships between demographic characteristics and parents' knowledge of and attitudes towards the risks of SHS. Results: The study explored how demographic factors, namely age, education, occupation, income level, and ethnicity, influenced parents' knowledge and attitudes towards the health risks of SHS. The results indicated that none of these demographic characteristics had a significant impact on parents' attitudes and knowledge. However, it was observed that parents' financial status significantly and negatively affected their understanding of the health hazards associated with children's exposure to smoking. Conclusions: Protecting children's health and reducing the prevalence of smoking-related illnesses requires parents to enhance their knowledge and foster negative attitudes towards SHS. Developing targeted interventions that address the specific challenges parents face, particularly in relation to their financial circumstances, is crucial to promote a smoke-free environment for children. Research Implications: The study's findings provide insights into the complex relationship between demographic factors and parents' knowledge and attitudes towards SHS. These insights can inform the design of tailored interventions that consider various demographic characteristics to communicate SHS risks and promote healthier behaviours effectively. Originality/Value: This study contributes to the existing literature by examining the influence of demographic factors on parents' perspectives on SHS health risks. The findings underscore the importance of considering demographic characteristics when designing interventions to address SHS exposure and encourage healthier behaviours among parents and caregivers.

Prenatal to preschool exposure of nonylphenol and bisphenol A exposure and neurodevelopment in young children

Nonylphenol (NP) and bisphenol A (BPA) are produced in large quantities worldwide as multipurpose agents. However, studies on relations between NP and BPA exposure and childhood neurodevelopment are few, and the results are inconsistent. This study aimed to investigate associations between prenatal and early childhood NP and BPA exposure and neurodevelopment in mother-child pairs. Pregnant women at 27-38 weeks' gestation were recruited, as were children 2-3 years of age (n=94) and 4-6 years of age (n=56) years. Urine was collected to assess NP and BPA exposure. Bayley Scales of Infant and Toddler Development (3rd edition; Bayley-III), Wechsler Preschool and Primary Scale of Intelligence (4th edition), and the Full Scale Intelligence Quotient (WPPSI-IV-FSIQ) were used to assess the neurodevelopment of the children. The detection rate and concentration of NP and BPA in the urine of children 4-6 years old were higher than in those 2-3 years old. Children were divided into a high concentration group (3rd tertile) and a reference group (1st and 2nd tertiles) based on natural log-transformed urine concentration of NP and BPA. Girls' Bayley-III motor scores in the high concentration group were higher than those of the BPA reference group of urine of mothers (β=6.85, 95% confidence interval [CI]: 1.58-12.13). Boys' FSIQ in the higher concentration group were significantly lower than those in children 2-3 years old in the NP reference group (β=-11.29, 95% CI: -18.62 to -3.96) (all, p<0.05). Prenatal and childhood exposure to NP and BPA may have different effects on the neurodevelopment of young children, and there are no consistent effects between boys and girls.

Radiation exposure and leukaemia risk among cohorts of persons exposed to low and moderate doses of external ionising radiation in childhood.

Many high-dose groups demonstrate increased leukaemia risks, with risk greatest following childhood exposure; risks at low/moderate doses are less clear. We conducted a pooled analysis of the major radiation-associated leukaemias (acute myeloid leukaemia (AML) with/without the inclusion of myelodysplastic syndrome (MDS), chronic myeloid leukaemia (CML), acute lymphoblastic leukaemia (ALL)) in ten childhood-exposed groups, including Japanese atomic bomb survivors, four therapeutically irradiated and five diagnostically exposed cohorts, a mixture of incidence and mortality data. Relative/absolute risk Poisson regression models were fitted. Of 365 cases/deaths of leukaemias excluding chronic lymphocytic leukaemia, there were 272 AML/CML/ALL among 310,905 persons (7,641,362 person-years), with mean active bone marrow (ABM) dose of 0.11 Gy (range 0-5.95). We estimated significant (P < 0.005) linear excess relative risks/Gy (ERR/Gy) for: AML (n = 140) = 1.48 (95% CI 0.59-2.85), CML (n = 61) = 1.77 (95% CI 0.38-4.50), and ALL (n = 71) = 6.65 (95% CI 2.79-14.83). There is upward curvature in the dose response for ALL and AML over the full dose range, although at lower doses (<0.5 Gy) curvature for ALL is downwards. We found increased ERR/Gy for all major types of radiation-associated leukaemia after childhood exposure to ABM doses that were predominantly (for 99%) <1 Gy, and consistent with our prior analysis focusing on <100 mGy.

Exposure to the 1959-1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective.

Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To add to the literature and overcome some of these limitations, we adopted a life course perspective and used more robust methods. We investigated the association between exposure to the 1959-1961 Chinese famine and later-life NCDs and if this association depends on: life stage at exposure, famine severity, and sex. We conducted a secondary data analysis of a large-scale, nationally representative, longitudinal study-the China Health and Retirement Longitudinal Study (2011-2018, 11,094 participants). We measured famine exposure/severity using self-reported experience, life stage using age at exposure, and health using the number of NCDs. We performed Poisson growth curve models. We obtained three findings. First, compared with unexposed participants, those exposed before age 18 had a higher risk of later-life NCDs, particularly if exposed in-utero (IRR = 1.90, 95% CI [1.70, 2.12], p < .001) and in the "first 1,000 days" of life (IRR = 1.86, 95% CI [1.73, 2.00], p < .001; for 0-6 months group, IRR = 1.95, 95% CI [1.67, 2.29], p < .001). Second, the famine effects among participants moderately and severely exposed were similar (IRR = 1.18, 95% CI [1.09, 1.28], p < .001 and IRR = 1.24, 95% CI [1.17, 1.32], p < .001). Third, the famine effects did not differ between females and males (IRR = 0.98, 95% CI [0.90, 1.07], p = .703). In an individual's life course, in-utero and the "first 1,000 days" are a particularly sensitive time period with marked long-term implications for NCDs if undernutrition/famine is experienced in this period. However, this window remains open until young adulthood. This highlights the need to invest more in preventing and treating child/adolescent undernutrition to tackle later-life NCDs.

Addressing Intergenerational Inequity in Tobacco-Harm: What Helps Children of Smokers to Remain Nonsmokers?

Children of people who smoke are more likely to take up smoking themselves. In Aotearoa New Zealand (NZ), adolescent smoking declined dramatically between 2000 and 2016 despite limited change in parental smoking, demonstrating that the cycle can be broken. This study aimed to identify modifiable factors associated with never smoking in Year 10 students (14-15 years) who had at least one caregiver who smoked. We used data from the Youth Insights Survey (2016 and 2018, pooled, N = 5,422) and identified students with at least one caregiver (mother, father, grandparent, other caregiver) who smoked (N = 2,205). To investigate modifiable factors potentially associated with nonsmoking we used logistic regression with marginally adjusted prevalence estimates. Overall, 41% of students had at least one caregiver who smoked. In this group, the majority (65%) had never smoked themselves. After adjustment, never-smoking was more prevalent among students attending low-deprivation (more affluent) schools (73% had never smoked) compared to high-deprivation schools (44%); students not exposed to others' smoking inside the home (72%) or in cars (70%) in the past week compared to those exposed (59% and 51%, respectively); and students whose parents would be upset if they were caught smoking (68% vs 49% for those whose parents would not be upset), or who had high self-esteem (69% vs 55% for those with low self-esteem). Modifiable factors independently associated with non-smoking in adolescents with caregiver(s) who smoked were: nonexposure to smoking inside the home and in cars, parental expectations of nonsmoking, and high self-esteem. Even in countries like NZ with relatively low adult smoking rates, children's exposure to caregiver smoking may be prevalent, particularly in structurally disadvantaged populations. This study suggests that action to promote smokefree homes and cars, build high self-esteem in young people, and communicate expectations of non-smoking are likely to help children of people who smoke to remain nonsmokers. A comprehensive approach that also addresses "upstream" factors (eg, socioeconomic deprivation) and underlying causes of structural inequity (eg, institutional racism) is needed. Such policy and community action may help to break intergenerational cycles of tobacco use and health inequity.

Social Vulnerability to Pesticide Exposure in Children from an Agricultural Community in Mexico

Social Vulnerability to Pesticide Exposure in Children from an Agricultural Community in Mexico

The Relationship Between Antisocial Personality Disorder and Criminology: Acquired Factors and Genetic Influences

This study looks at the interaction of internal and external factors in the process of antisocial personality disorder (ASPD) and criminal conduct. It reveals the major contributions of both genetic and acquired factors using data from longitudinal twin studies, neuroimaging research, and gene-environment interaction studies. Environmental variables, such as bad childhood experiences, community hardship, and exposure to violence, also play important roles in antisocial behavior variance. The complicated interaction between genetic predispositions and environmental conditions emphasizes the need of understanding these components' dynamic character throughout an individual's development. With further knowledge, it will be feasible to build complete, individualized therapies that target both genetic and environmental aspects in the emergence and maintenance of antisocial behavior. Furthermore, this review emphasizes the importance of early intervention and prevention strategies that take an individual's unique genetic and environmental risk factors into account, ultimately contributing to a more effective approach in reducing the prevalence of ASPD and criminal behavior in society.

Male intimate partner violence (IPV) victims in Japan: Associations of types of harm, sociodemographic characteristics, and depression trait.

The purpose of this study was to examine factors affecting depression trait among male intimate partner violence (IPV) victims in Japan utilizing a multiple linear regression analysis. A web-based questionnaire survey was conducted. Male IPV victims living in Japan were recruited to answer the questionnaire on the website on February 25-26, 2021. A total of 16,414 subjects were enrolled, of whom 1466 respondents were included in the study. Other than IPV exposure, information about sociodemographic characteristics, past traumatic experiences and psychiatric history was collected. The Domestic Violence Screening Inventory (DVSI), a 20-item questionnaire regarding IPV exposure, and the Patient Health Questionnaire-9 (PHQ-9) were used to determine the intensity and the type of IPV harm and to screen for depression, respectively. The victims were more frequently subject to psychological abuse than to physical violence. Based on PHQ-9 scores, 10.7% of respondents exhibited moderate to severe depression. In the DVSI score, 79.2% of respondents required "observation and support." The lowest level of academic attainment (junior high school), positive psychiatric history, foregoing divorce to avoid adverse childhood experiences of their offspring, childhood exposure to domestic violence, younger age, having no children, and experience of school bullying were shown to be significantly associated with depression trait. Male IPV harm has a multilayered complexity. The sociodemographic characteristics and experiences of victims' own have a greater impact on depression trait than direct violent harm, suggesting that the violence-focused support might be inadequate for male victims. Comprehensive supports are urgently needed.

Real-World Evidence of Factors Affecting Cannabidiol Exposure in Children with Drug-Resistant Developmental and Epileptic Encephalopathies.

The identification of factors that affect cannabidiol (CBD) systemic exposure may aid in optimizing treatment efficacy and safety in clinical practice. In this study, we aimed to correlate CBD plasma concentrations at a steady state to demographic, clinical, and pharmacological characteristics as well as seizure frequency after the administration of a purified CBD oil solution in a real-world setting of children with drug-resistant developmental and epileptic encephalopathies (DEEs). Patients receiving oral CBD pharmaceutical products at maintenance were enrolled. Venous blood samples were drawn before the CBD morning dose, 12 h apart from the last evening dose (C0 or CBD trough concentration). A linear mixed-effect analysis was implemented to assess the correlation between C0 and clinical, laboratory, pharmacological, and lifestyle factors. Fifteen females and seven males with a median age of 12.8 years (ranging between 4.7 and 17.2) were included. The median CBD dose was 8.8 mg/kg/day (ranging between 2.6 and 22.5), and the CBD C0 median (range) was 48.2 ng/mL (3.5-366.3). The multivariate model showed a 109.6% increase in CBD C0 in patients with concomitant levothyroxine (β = 0.74 ± 0.1649, p < 0.001), 56.8% with food (β = 0.45 ± 0.1550, p < 0.01), and 116.0% after intake of a ketogenic diet (β = 0.77 ± 0.3141, p < 0.05). All patients included were responders without evidence of an association between C0 and response status. In children with DEEs, systemic concentrations of CBD may be significantly increased when co-administered with levothyroxine, food, or a ketogenic diet.