Multiple Childhood Research Articles

A life course perspective on parental incarceration and other forms of childhood adversity

Prior research on childhood adversity has revealed that exposure to multiple adverse childhood experiences (ACE) is relatively common, and that failure to consider these experiences in tandem may misattribute their effects to a single adversity. Yet attempts to isolate the effects of a given ACE are quite common, particularly in the burgeoning body of research on parental incarceration. Guided by recent theorizing in the parental incarceration effects tradition, and key insights from prior work on ACEs, the current investigation situated parental incarceration within broader contexts of childhood adversity. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we drew on person-centered analyses to consider associations between different constellations of risk, well-being, and other important life course considerations. Additionally, we centered the experience of parental incarceration to explore its prevalence across the different constellations identified and to examine its independent and interactive effects on problematic behavioral outcomes and successful adult transitions. Our findings revealed that 1) ACEs tend to cluster, 2) certain constellations may pose greater developmental risks, and 3) the effect of parental incarceration may depend, in part, on the unique set of ecological risks to which children are exposed.

Prediction of overweight/obesity risk in adolescence using static and dynamic multi-exposure models

Abstract Background Studying the risk factors for obesity development and timely identification of individuals at increased risk are key for obesity prevention. We aimed to assess the associations of multiple prenatal, infancy and childhood exposures with overweight/obesity at 13 years (y) and develop static and dynamic multiple-exposure prediction models. Methods In 4232 mother-child pairs from the Generation XXI birth cohort, we assessed, during pregnancy/infancy and childhood, 55 sociodemographic factors, anthropometric measures, lifestyle behaviors, and clinical exposures related to the mother and the child and categorized body mass index z-scores as normal weight and overweight/obesity at 13y. Static models for pregnancy/infancy, 4, 7 and 10y, and a dynamic model were fitted using Elastic Net and logistic regression and were compared in terms of predictive performance. Results Mothers with lower educational level and household income, no partner, overweight/obesity before and after pregnancy, excessive gestational weight gain, pregnancy complications and who were smokers during pregnancy had children with a higher risk of overweight/obesity at 13y. Children with higher BMI during infancy, overweight/obesity during childhood, an early introduction of solid foods (before 4 months), a higher consumption of soft drinks at 4y and females had a higher risk of overweight/obesity at 13y. We observed the lowest predictive performance for the pregnancy/infancy model (prediction error of 36%) and the highest predictive performance for the 10y and dynamic models (prediction errors of 17%). Conclusions We identified the most important predictors of overweight/obesity in adolescence, most of them modifiable, and able to be targeted in prevention strategies. Predicting overweight/obesity risk in adolescence might be suboptimal if only considering pregnancy/infancy data and improves as closer to the age of the outcome, with no additional benefit in using a complex dynamic model. Key messages • Prevention of overweight/obesity should start during prenatal life. • Children at higher risk of overweight/obesity may be identified years earlier using prediction models in clinical practice.

7336 Decades In The Dark: The Long Road To Diagnosing And Treating Hypophosphatasia

Abstract Disclosure: V.A. Mendpara: None. G. Madrigal Loria: None. L.Z. Khan: None. Background: Hypophosphatasia (HPP) is a rare bone disorder that results from deficient activity of the tissue non-specific isoenzyme alkaline phosphatase (ALP).[1] This case highlights a patient whose diagnosis of this treatable genetic condition was significantly delayed for almost two decades, despite receiving care at a prominent academic institution. The patient's persistently low ALP levels in routine lab tests were overlooked by multiple clinicians, leading to a delay in her care and eventual treatment. Case presentation: A 61-year-old Caucasian woman presented at the endocrinology clinic with complaints of severe fatigue, generalized pain, multiple childhood fractures, and ongoing dental issues. The rheumatology clinic to which she was referred for polyarthralgia diagnosed her with Hypophosphatasia (HPP) after noting chronically low alkaline phosphatase (ALP) levels from her previous charts ranging from 15 to 24 U/L (normal range: 34 to 123 U/L) over two decades. Her serum calcium, parathyroid hormone (PTH), and 25-hydroxy vitamin D levels were within normal ranges. A DEXA scan revealed normal bone density, effectively ruling out osteoporosis. Further investigation showed elevated Vitamin B6 levels at 219.6 nmol/L (normal range: 20.0 to 125.0 nmol/L), raising suspicion for HPP. The patient's family history provided additional insight, with her mother having a history of short stature and fractures and her son experiencing premature tooth loss at the age of 2. A genetic evaluation identified a heterozygous pathogenic variant in the ALPL gene (c.881A>C, p.Asp294Ala), confirming the diagnosis of autosomal dominant HPP. Initiating treatment with Asfotase alfa, a medication targeting HPP, resulted in a marked improvement in the patient's symptoms. Discussion: This case shows the diagnostic complexities of HPP, stressing the significance of actively screening for this condition via ALP levels in routine laboratory testing or during osteoporosis evaluations. The diagnostic process is critical to distinguish HPP from primary osteoporosis, as treatment and potential risks differ significantly. Inadvertent use of bisphosphonates can worsen hypomineralization and lead to atypical femoral fractures in HPP patients. Asfotase alfa enzyme replacement therapy, available since 2015, offers a targeted approach by replacing the enzyme defect, thereby mitigating symptoms. Heightened awareness among healthcare providers of HPP in adults holds the potential to enhance diagnosis rates and facilitate improved treatment outcomes for this highly treatable condition.[1] Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition. ASBMR. Presentation: 6/2/2024

Prevalence and Risk Factors of Non-Suicidal Self-Injury in a Sample of Egyptian University Students in Ain Shams University

Abstract Background Non-suicidal self-injury (NSSI) is a global health concern, with a prevalence ranging from 1.5% to 54.8%. Typically starting during adolescence, it was proposed that there is a correlation between NSSI and adverse childhood experiences (ACEs), such as parental antagonism, neglect, physical abuse, and sexual abuse. Many turn to NSSI as a strategy to cope with emotional regulation difficulties, using it as a means to navigate and manage their emotions effectively. Aim of the Work Examining the prevalence of non-suicidal self-injury (NSSI) in young adult students at Ain Shams University, exploring the methods and functions of NSSI, assessing the correlation with emotional regulation difficulties and adverse childhood experiences. Patients and Methods This study is an observational cross-sectional study, A convenient sample of 400 Undergraduate students at Ain Shams university was obtained equally distributed between the Faculties of Medicine and Education. Results Among Ain Shams University students, non-suicidal self-injury (NSSI) prevalence was 18% engaging in NSSI last year, and 4.3% reporting repetitive instances. Common forms included pounding oneself (16.2%), cutting (15.4%), and biting (15.4%). NSSI functions revealed relief from negative feelings (14.2%) and self-punishment (11.7%) as major goals. Academic challenges were a top motivating factor, alongside guilt, problem confrontation difficulties, and unstable relationships. Those with multiple adverse childhood experiences (ACEs) were more likely to engage in NSSI, showing a positive correlation with NSSI frequency. Emotional regulation difficulties, were also linked to NSSI, indicating a predictive relationship between emotional regulation challenges and self-injurious behavior in young adults. Conclusion Non-suicidal self-injury (NSSI) is prevalent among young adults. The study emphasizes the considerable influence of adverse childhood experiences (ACEs) and challenges in emotional regulation on NSSI in this demographic. In conclusion, these results underscore the crucial role of addressing early life experiences and emotional regulation to comprehend and prevent NSSI among young adults.

Positive Childhood Experiences are Associated With Alcohol Use in Adolescent and Emerging Adult Females by Adverse Childhood Experiences Dimension

PurposeExperiencing multiple adverse childhood experiences (ACEs) is associated with alcohol use in female adolescents and emerging adults. Protective and compensatory experiences (PACEs) have been theorized to off-set the health and behavioral consequences from the accumulation of ACEs throughout childhood. This study examines the association between protective experiences and subsequent alcohol and binge alcohol use frequency over one month among female adolescent and emerging adults reporting high and low levels of two ACE dimensions (household dysfunction and emotional abuse/neglect). MethodsOne hundred 43 females between the ages of 15–24 who indicated at least one binge episode in the past two weeks completed the six-item ACEs scale, the PACEs scale, and demographics at baseline. Alcohol consumption was measured prospectively over the next month during weekly appointments using the timeline follow back approach. ResultsTwo PACEs factors had significant direct associations, a source of unconditional love was associated with less frequent alcohol use (β = −0.437, 95% confidence interval [CI] -0.744, −0.131, exp(β) = 0.65, p = .005) in the context of high household dysfunction; and having a trusted adult to count on for help and advice (β = −1.373, 95% CI -2.283, −0.464, exp(β) = 0.25, p = .003) predicted fewer binge occasions in the context of high emotional abuse/neglect. Regardless of ACE dimension exposure, nonsport social group membership was associated more frequent alcohol use over the month across all ACE dimensions (β = 0.11-0.74, 95% CI -0.11, 0.74, exp(β) = 1.37 – 1.62, p ≤ .002); and having a trusted adult to count on for help and advice was associated with a 5.7 times more frequent of alcohol use among those with low household dysfunction (β = 1.74, 95% CI 0.83, 2.65, exp(β) = 5.70, p < .001). DiscussionFew PACE items are associated with direct reductions in alcohol outcomes. Indeed, there is consistently heightened risk associated with nonsport group membership for alcohol use frequency, regardless of experiences of childhood adversity. Future research should identify which protective factors have the most potential to off-set alcohol use by ACE dimension.

The MACE-SCREEN – Screening for Abuse and Neglect Across Developmental Stages

ABSTRACT Few high-quality instruments are available to comprehensively screen for multiple interpersonal traumatic childhood experiences differentiated by developmental stage. One instrument assessing various forms of childhood trauma is the Maltreatment and Abuse Chronology of Exposure (MACE-X, Teicher & Parigger, 2015), which allows for the assessment of age at exposure for every item. The aim of this study is the development of a shorter version, which is suitable for screening. In- and out-patients (n = 719) of a somatic clinic were assessed with the German version of the 75-item MACE. Descriptive statistics, a nonparametric item response theory model (Mokken Scale Analysis), and factor analysis were combined to select items for a screening version. A screener (MACE-SCREEN) with 39 items allocated to five scales was developed. Scales differentiate between abuse types and neglect, direct experience vs. witnessing violence, and the age of the perpetrator (adults vs. peers). The scales showed good internal consistency (Alpha .78 to .91) and the total score a strong correlation with the total score of the long version (r = .96). This screening version is still comprehensive as it assesses exposure to various forms of interpersonal traumatic events, including peer violence and witnessing domestic abuse. As it also allows for the concurrent assessment of age at exposure, it lends itself to assessing exposure across developmental stages.

Examining the impact of spirituality religious strength on behavioral and emotional health among youth with multiple adverse childhood experiences

PurposeAlthough spiritual/religious strengths (SRS) are widely believed to be a protective factor for youth physical and mental wellness, scant evidence is available regarding how much and in what direction a person’s past adverse experiences can affect the said protection. The study aims to validate the overall protective effect of SRS on health and investigate the mutual effect modification of SRS and accumulated adverse experiences exposure. MethodsThe study is a cross-sectional design utilizing the Child and Adolescent Needs and Strengths (CANS) administered to foster care youth aged between 5 and 17 in a large, mid-western state from July to December 2020. Logistic regressions were used on a gender-balanced working sample of 4,802 youths to model the odds of physical and mental unwellness measured by 12 behavioral and emotional needs (BEN) items in CANS and the combined multi-BENs (MBE) as 4 or more BEN items, given the presence of (a) SRS identified by CANS, (b) past trauma as having 4 or more out of 10 adverse childhood experiences (ACEs) items on the CANS, denoted as multi-ACEs (MAC), and (c) co-occurring SRS and MAC. ResultsPrimarily, the study found supported the protective benefits of SRS as the presence was associated with lower levels of BEN. However, the higher levels of adverse experiences exposure were associated with an attenuation of the relationship between SRS and BEN. Secondarily, females were found to have higher SRS and lower BEN than males; adolescents between 13 and 17 had disproportionally more ACES, greater BEN and lower SRS; Black youth had disproportionally more trauma exposure and higher BEN, but had higher SRS. ConclusionThe findings imply that having spiritual/religious strength helps promote wellbeing among foster care youth. However, it appears the greater levels of traumatic experiences exposure can overwhelm this positive impact. These findings are consistent with the complex literature on the role of spiritual/religious strength in mental health and may help clarify this complex relationship. Trauma-informed intervention should be considered nuanced approaches to address SRS among children and youth who present with these strengths.

Socioeconomic Factors Determining Multidimensional Child Poverty Groups in Central America: A Measurement Proposal from the Wellbeing Approach Using a Comprehensive Set of Children’s Rights

This article aims to show that multidimensional child poverty (MCP) is determined by several socioeconomic factors that influence the formation of stratified groups of poor children under five years of age living in Central America. This study advocates for a comprehensive set of children's rights with the purpose of addressing the different facets of child poverty from the perspective of child well-being, in order to estimate the incidence of MCP, by including multiple childhood deprivations and socioeconomic determinants. Child-specific indicators and household deprivation indicators are considered in the estimation of MCP. The study also states that child poverty is a complex concept, which includes the various types of deprivations experienced by children in the Central American societies and their deprivations are considered as the denial of children’s rights. Therefore, the MCP is estimated based on a conditional latent class analysis that includes not only manifest deprivation variables, but also socioeconomic determinants that help to better predict the incidence and probabilities of children being multidimensionally poor according to different poverty strata. The socioeconomic factors that show high risks of MCP are rural areas, indigenous children, young mothers and low levels of education attained by the head of the household, among others. One of the reasons to investigate the MCP for Belize and El Salvador is because there are few studies that address this problem for these countries and this research sheds light on the characteristics of early childhood poverty. The results indicate that the incidence of MCP is 49% in Belize and 76% in El Salvador. The research work concludes that the International Rights of the Child provide the opportunity to implement comprehensive social policies in Central America to eradicate child poverty.

Kinship verification in childhood images using curvelet transformed features

Kinship verification poses a formidable challenge due to significant age disparities between parents and children, resulting in diminished facial resemblances and consequently reduced model accuracy. In response, we introduce a novel methodology focusing on childhood imagery, wherein images of both parents and children during their early stages are leveraged, leading to more pronounced feature similarities. Our approach introduces a novel feature descriptor utilizing the curvelet transform (CLT) to extract facial descriptors from sub-bands, effectively capturing unique facial features. Additionally, we employ a convolutional neural network (CNN) to extract texture information, further enhancing the discriminative power of our method. Statistical measures are subsequently applied to evaluate image similarity, with a dedicated training phase utilized to determine an optimal threshold for kinship classification during the testing phase. Extensive evaluations conducted across multiple databases, including KINFACEW-I, II, FIW, TSKINFACE, UBKinface, and childhood image dataset, showcase the superior performance of our proposed model compared to existing state-of-the-art approaches. Our methodology not only enhances kinship verification accuracy but also underscores the significance of childhood images in mitigating age-related challenges within the domain.

Clinical and personal predictors of functioning in affective disorders: Exploratory results from baseline and 6-month follow-up of a randomised controlled trial

Comprehensive knowledge of factors causing and sustaining functional impairment in patients with affective disorders is warranted. The aim is to investigate associations between clinical factors (such as affective symptoms) and personal factors (such as personality traits, coping strategies, and childhood trauma experiences) on functioning and improvement of functioning in patients with affective disorders.This exploratory study includes data from 103 patients with bipolar disorder and unipolar depressive disorder. Clinician-rated functioning was assessed at baseline using the Functioning Assessment Short Test (FAST), and performance-based functioning was assessed at baseline and 6-month follow-up using the Assessment of Motor and Process Skills (AMPS). Data on clinical and personal factors were collected at baseline. Personal factors were measured by the Eysenck Personality Inventory (EPQ), Coping Inventory for Stressful Situations (CISS) and Childhood Trauma Questionnaire (CTQ). Pearson correlations and multiple linear regression models were used to analyse the association of clinical and personal factors with baseline functioning (FAST) and to identify predictors of improvement in functioning (AMPS) from baseline to follow-up.At baseline, greater depressive symptom severity, the personality trait neuroticism, emotional coping, and childhood trauma all correlated with poorer functioning (higher FAST scores). In multiple linear regression models, depression severity, emotional coping and childhood trauma were significant predictors of poorer functioning. More childhood trauma was a predictor of less functional improvement measured by AMPS at 6-month follow-up.In conclusion, maladaptive coping styles and depressive symptoms contribute to functional impairment in patients with affective disorders, while childhood trauma has a negative impact on long-term functional outcomes.

Abstract 6618: Pleiotropic GATA3 locus is associated with multiple childhood cancers: harnessing the existing data from the St. Jude Lifetime Cohort and the Childhood Cancer Survivor Study for genetic etiology research

Abstract Background: A genetic variant (rs3824662) at GATA3 was previously associated with risk of Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) and relapse. Our recently published childhood Hodgkin lymphoma (HL) study identified a genome-wide significant association for another genetic variant (rs3781093) in high linkage disequilibrium (D’=1.0, R2=0.91) with rs3824662. We hypothesize that GATA3 is a pleiotropic locus associated with multiple childhood cancers. Methods: The study was performed by combining 3 cohorts of childhood cancer survivors: the St Jude Lifetime Cohort Study (SJLIFE), the original and expansion cohorts of the Childhood Cancer Survivor Study (CCSS). The CCSS original cohort had SNP array genotyping and imputation, and the SJLIFE and CCSS expansion cohort underwent whole-genome sequencing. Associations between the variants mapped to GATA3 and risks of different cancer types were analyzed (a specific cancer type was selected as the case group and all other unselected cancer types served as controls, then repeated for 13 cancer types). Summary statistics were subsequently analyzed with the ASSET (Association analysis for SubSETs) method which is powerful for pooling association signals across multiple cancer types when true effects may exist only in a subset and be in opposite directions across cancer types. Results: Genotype data were available for 11623 childhood cancer survivors (5325 from the CCSS original cohort, 2428 from the CCSS expansion cohort, and 3870 from the SJLIFE, all European ancestry) were initially considered. After excluding individuals with dual enrollment or as outliers in the principal components analysis (n=667), a total of 10956 individuals remained for genetic association analysis. We identified a bi-directional association for a subset of childhood cancers with rs3781093 (2-sided P value of 6.22 × 10−19): the same effect allele (C) was associated with increased risk of ALL or soft tissue sarcoma [STS] (OR=1.21; 95% CI=1.13-1.29; P=7.4 × 10−9), and was associated with decreased risk of HL (OR=0.66; 95% CI=0.59-074; P=1.80 × 10−12). The frequencies of the effect allele (C) for rs3781093 in ALL cases (17.9%), STS cases (17.8%) and HL cases (12.5%) relative to non-cancer community controls in the SJLIFE (15.6%) and non-cancer gnomAD samples (14.9%) corroborate this finding. In our combined dataset, there were 1380 Hodgkin lymphoma cases, 2961 ALL cases and 692 STS cases. Conclusion: We discovered a novel variant in the GATA3 locus exhibiting pleiotropy with both tumor-promoting and protective effects, suggesting a shared mechanistic pathway involving GATA3 may underlie the carcinogenesis for ALL, STS and HL. Conducting systematic searches for childhood cancer pleiotropy represents an important research direction. Citation Format: Cheng Chen, Xijun Zhang, Qian Dong, Heather L. Mulder, John Easton, Xiaotu Ma, Jinghui Zhang, Jun Yang, Kim E. Nichols, Gregory T. Armstong, Kirsten K. Ness, Melissa M. Hudson, Hui Wang, Nilanjan Chatterjee, Cindy Im, Zhaoming Wang. Pleiotropic GATA3 locus is associated with multiple childhood cancers: harnessing the existing data from the St. Jude Lifetime Cohort and the Childhood Cancer Survivor Study for genetic etiology research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6618.

The relational change mechanisms of child‐centered play therapy with children exposed to adverse childhood experiences

AbstractThe researchers examined the relational mechanisms and coregulatory change mechanisms of child‐centered play therapy (CCPT) with children (ages 5–8) who endured multiple adverse childhood experiences (ACEs). The researchers computed surrogate synchrony analyses to measure heart rate synchrony between counselor and child participants during CCPT treatment. Child participants received between 10 and 14 CCPT sessions in the elementary school setting. Participants and counselor wore Empatica© E4 wristbands during sessions to collect heart rate data continuously during play therapy sessions. The researchers found consistent, large child‐counselor heart rate synchrony levels across play therapy sessions. The researchers discuss the implications of this research for counselors and play therapists working with children impacted by ACEs.

Public early childhood education: a meeting place for multiple childhoods

Resumo Neste estudo de revisão sistemática de literatura, pretende-se identificar a interseccionalidade como conceito e método analítico nas pesquisas sobre as infâncias, investigando como bebês/crianças afetam e são afetados pelos marcadores sociais de classe social, gênero, raça, deficiência e geração advindos de seus contextos familiares, institucionais, sociais e culturais. São analisadas influências de marcadores interseccionais, sua relação com a pobreza, discriminação, racismo, adulcentrismo e capacitismo. Tenciona-se as lacunas nas políticas públicas para infância, destacando a importância do acesso à educação infantil pública, protagonizada por bebês/crianças, a qual é capaz de contribuir para a emancipação humana e para o enfrentamento à desigualdade social.

The Impact of Childhood Mental Health and Substance Use on Methylation Aging Into Adulthood

To test whether childhood mental health symptoms, substance use, and early adversity accelerate the rate of DNA methylation (DNAm) aging from adolescence to adulthood. DNAm was assayed from blood samples in 381 participants in both adolescence (mean [SD] age= 13.9 [1.6] years) and adulthood (mean [SD] age= 25.9 [2.7] years). Structured diagnostic interviews were completed with participants and their parents at multiple childhood observations (1,950 total) to assess symptoms of common mental health disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, anxiety, and depression) and common types of substance use (alcohol, cannabis, nicotine) and early adversities. Neither childhood mental health symptoms nor substance use variables were associated with DNAm aging cross-sectionally. In contrast, the following mental health symptoms and substance variables were associated with accelerated DNAm aging from adolescence to adulthood: depressive symptoms (b= 0.314, SE= 0.127, p= .014), internalizing symptoms (b= 0.108, SE= 0.049, p= .029), weekly cannabis use (b=1.665, SE= 0.591, p= .005), and years of weekly cannabis use (b= 0.718, SE= 0.283, p= .012). In models testing all individual variables simultaneously, the combined effect of the variables was equivalent to a potential difference of 3.17 to 3.76 years in DNAm aging. A final model tested a variable assessing cumulative exposure to mental health symptoms, substance use, and early adversities. This cumulative variable was strongly associated with accelerated aging (b= 0.126, SE= 0.044, p= .005). Mental health symptoms and substance use accelerated DNAm aging into adulthood in a manner consistent with a shared risk mechanism. Using data from 381 participants in the Great Smoky Mountains Study, the authors examined whether childhood mental health symptoms, substance use, and early adversity accelerate biological aging, as measured by DNA methylation age, from adolescence to adulthood. Depressive symptoms and cannabis use were found to significantly accelerate biological aging. Models that tested the combined effect of mental health symptoms, substance use, and early adversity demonstrated that there was a shared effect across these types of childhood problems on accelerated aging.

"Long walk to 2030": A bibliometric and systematic review of research trends on the UN sustainable development goal 3.

Since the initiation of the Sustainable Development Goals (SDGs) by the United Nations in 2015, researchers worldwide have investigated various aspects of it. One of the key areas of interest is the third SDG, which focuses on health, with its series of indicators. This study aims to analyze the contributions of academia by using bibliographic mapping to examine scholarly publications on SDG health from 2015 to 2021. We analyzed bibliographic data from The Lens database between 2015 and 2021 using Bibliometrix page and VOSviewer. Our analysis focused on scholarly productivity, bibliometric analysis, and geographic distribution of the outputs. We retrieved a total of 450 documents from The Lens database, with articles being the most dominant document typology at 99.8%. The mean age of the documents was 3.85years, with a total of 18,440 citations. The mean citation per document was 40.98, and the mean citation per document per year was 5.85. The leading article, published in The Lancet journal, studied the effect of multiple adverse childhood experiences on health and received 1809 citations in five years. Keyword co-occurrence analysis generated three clusters, with the keyword 'human' appearing in 75.11% of all the publications. The University of London and World Health Organization were the leading institutions, while the United Kingdom, the United States, and Switzerland were the most productive countries. This study provides policymakers working on SDG health with valuable insights into research gaps within the indicators and funding challenges facing developing countries.

Childhood dementia: the collective impact and opportunities for intervention

AbstractBackgroundChildhood dementia is a devastating and under‐recognised group of conditions with a high level of unmet need. Typically monogenic in origin, this collective of neurodegenerative conditions are defined by a progressive impairment of neurocognitive function, presenting in infancy, childhood or adolescence.MethodWe undertook a scoping review and burden of illness study to understand the spectrum of childhood dementia conditions and their impact. A literature review identified conditions that met the case definition and an expert clinical working group reviewed and ratified inclusion. Epidemiological data were extracted from published literature and collective incidence, prevalence and life expectancy were modelled.ResultOver 140 individual genetic conditions were identified that can be consistently defined as childhood dementia with the largest proportion of births belonging to the lysosomal disease and mitochondrial disease categories. Collectively the incidence is surprisingly high at 1 in 2,900 births and the life expectancy is low, with most affected children not surviving into adulthood. A relational database of the childhood dementia disorders has been created and will be continually updated as new disorders are identified (https://knowledgebase.childhooddementia.org/).ConclusionThis scoping review highlights the importance of grouping these conditions as a phenotypic syndrome, rather than individually rare diseases, in keeping with the approach to adult dementia. Opportunities exist to address overlapping disease mechanisms and utilise therapeutic platforms for multiple childhood dementia conditions to tap into significant economies of scale. Collaboration with adult dementia researchers on common disease attributes is also expected to be mutually beneficial.By unifying these conditions, we have highlighted the many unmet needs of this significantly disadvantaged group of children and young people and the data presented here will enable advocacy for systemic change in treatment, care, and support for them and their families.

Gene variants and the response to childhood obesity interventions: A systematic review and meta-analysis

Multiple lifestyle-based childhood obesity interventions have been conducted to address childhood obesity, but individual's response to the universal intervention approach varied greatly. Whether gene variants related to children and adolescents' varied responses to obesity interventions remained unclear. To determine the associations of gene variants with the changes in obesity- and metabolism-related indicators after obesity interventions in children and adolescents. Ten databases and registers (including grey literature) were searched. The lifestyle-based obesity interventions in children and adolescents (≤18 years) that reported the changes in obesity- (body mass index (BMI), BMI Z-score, waist circumference (WC), waist-to-hip ratio (WHR), etc) and metabolism-related (glucose, cholesterol, etc) indicators by genotype after interventions were included. Our primary outcome was the mean difference of the changes in BMI Z-score by genotype after interventions, and secondary outcomes were changes in the remaining obesity- and metabolism-related indicators after interventions. We used the random-effects model to synthesize the results. This review included 50 studies (15,354 children and adolescents with overweight/obesity) covering 102 genes and 174 single nucleotide polymorphisms (SNPs). Approximately three-quarters of SNPs showed no evidence of association with the changes in obesity- or metabolic-related indicators after interventions. One quarter of SNPs were minorly associated with the changes in the BMI Z-score (median effect size: 0.001) with little clinical significance. Only 6 (12%) studies focused on the accumulated effect of multiple gene variants. Gene variants that have been explored appear to play a minor role in lifestyle-based obesity interventions in children and adolescents. More high-quality studies based on the design of randomized controlled trials are needed to examine the accumulated effect of multiple gene variants in childhood obesity interventions. This systematic review and meta-analysis was registered at PROSPERO as CRD42022312177.

Adjudicated Adolescents Located on a State Sex Offender Registry Website as Adults: Common Denominators

ABSTRACT This is a landmark study, the first to use a listing on a state sex offender registry website as a predictive variable for tracking adult recidivism of male adolescents adjudicated for sex offenses, and the longest to follow a cohort of these youth after discharge from a secure residential treatment program. Upon admission, the sample (N = 145) were assessed by JSORRAT-II and MEGA ♪ , two contemporary standardized, validated risk assessment tools for assessing youth who have engaged in sexually abusive behavior. They were then followed once discharged for 17.08 years into adulthood (mean follow-up = 14.0 years, SD = 1.71). Recidivism rate was 6.2% (defined as a listing for the subject on the California Megan’s Law Sex Offender Registry Website). The study offers a baseline for future studies that use a state sex offender registry website as a predictive variable for recidivism. Shared common denominators of recidivists and non-recidivists were risk level (i.e. most were High Risk or Very High Risk on MEGA ♪ ); and having a history of adverse childhood experiences other than sexual abuse (i.e. child neglect/emotional abuse and exposure to domestic violence). A history of sexual abuse, experienced by twice as many non-recidivists as recidivists, differentiated the sample. Recidivists also had fewer protective factors than non-recidivists, as assessed by the MEGA ♪ upon admission to the facility. The mean age of recidivists was younger than non-recidivists, suggesting they may have been removed from their home at an early age, and/or had an early onset of persistent coarse sexual improprieties and/or sexually abusive behaviors that persisted into adulthood. The results highlight the importance of integrating trauma-informed interventions in treatment programs for those individuals who are sexually abusive that have a history of multiple adverse childhood experiences.

Validity and reliability of the 10-Item Adverse Childhood Experiences Questionnaire (ACE-10) among adolescents in the child welfare system.

Multiple evidence suggests that the vast majority of children in the Child Welfare System (CWS) are victims of early, chronic, and multiple adverse childhood experiences. However, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10) has never been tested in such a particularly vulnerable population as adolescents living in the CWS. We aimed to assess the psychometric properties of the ACE-10 in a community sample of 240 Hungarian adolescents placed in family style group care (FGC) setting. Demographic data, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10), the Strengths and Difficulties Questionnaire (SDQ), and the HBSC Bullying Measure were used. Our results showed acceptable internal consistency (α = 0.701) and item-total correlations (rpb = 0.25-0.65, p < 0.001). However, our results also reflect that item 6 ("Parental separation/divorce") is weakly correlated with both the cumulative ACE score and the rest of the questionnaire items. When item 6 is removed, the 9-item version of the ACE produces more favorable consistency results (α = 0.729). Strong and significant associations of the cumulative ACE score with emotional and behavioral symptoms and bully victimization confirm the concurrent criterion validity of both versions of the instrument. Our findings suggest that ACE-9 and ACE-10 are viable screening tools for adverse childhood experiences in the CWS contributing to the advancement of trauma-informed care. We recommend considering the use of either the 9-item or the 10- item version in the light of the characteristics of the surveyed population. The implications and limitations are discussed.

Landscape of loss: art therapy outdoors and traumatic bereavement

ABSTRACT Background: This paper describes art therapy sessions outdoors with a six-year-old child following multiple adverse childhood experiences and a recent bereavement of a relative who died by suicide. Context: Art therapy took place in a major city in Scotland. Sessions took place both at a local community centre and a nature reserve. Approach: Sessions employed an outdoor approach to art therapy that was underpinned by artistic concepts and ecopsychology. Outcomes: The child presented in this paper engaged notably differently when sessions were taken outside. He began to explore and communicate more coherently about his life experiences and the death of his relative. Conclusions: Through interacting with the natural environment during outdoor sessions, this child was able to explore and express concerns much more freely than during indoor sessions. Implications for Research: There is a need for further research focusing on outdoor art therapy due to a dearth of peer-reviewed research on this topic.